Mental health care gets far more interesting when you stop treating the brain like it lives in a sealed box. We connect the sharp rise in depression, anxiety, bipolar disease, PTSD, and severe mental illness to something many people never hear about in psychiatric settings: metabolic health, brain insulin resistance, and the possibility that mood symptoms can be driven by a metabolic- energy problem as opposed to a “chemical imbalance.”

We break down what the data actually shows, including how common metabolic syndrome markers are in people with major mental health diagnoses, and why the overlap matters. Then we dig into the real-world trade-offs of treatment. Medications can be lifesaving during psychosis, suicidality, or severe depression, yet some antipsychotics and antidepressants can push weight gain, fatty liver, and insulin resistance, creating a loop that keeps people stuck. We also talk through lithium’s role, its unique risk-benefit profile, and the incentives that shape prescribing.

From there, we move into ketogenic metabolic therapy and the growing research base behind it. We discuss randomized controlled trials, meta-analyses, and why confirming nutritional ketosis with blood ketones can change outcomes. Finally, we lay out the leading mechanisms: ketones as an alternative brain fuel, improved mitochondrial function, lower inflammation and oxidative stress, and shifts in neurotransmitter balance such as higher GABA and lower glutamate activity, with the gut-brain axis likely playing a supporting role.

If this sparks ideas for you or someone you care about, subscribe, share the episode, and leave a review. What part of the metabolic psychiatry model feels most convincing, and what would you want your clinician to measure first?

Slide Deck

Keto MH and Met Syndrome RFs

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia- A Pilot Trial

Ketogenic Diets and Depression and Anxiety_ A Systematic Review and Meta-Analysis _ Lifestyle Behaviors _ JAMA Psychiatry _ JAMA Network

Ketosis as a Treatment for Severe Mental Illness- A Critical Review of Preclinical and Clinical Data

Metabolic complications of psychotropic medications in psychiatric disorders- Emerging role of de novo lipogenesis and therapeutic consideration

Metabolic dysfunction in severe mental illness- updates on prevalence, aetiology and treatment options

Metabolic Improvements with a Ketogenic Diet Correlate with Symptom Improvement in Psychosis- A Randomized Controlled Trial

Metabolic syndrome in psychiatric patients- overview, mechanisms, and implications

Metabolic-Side-Effects-of-Psychiatric-Medications_2020

Most people can list their cholesterol, but they cannot tell you their blood pressure, their waist-to-hip ratio, or what their fasting insulin is doing. That mismatch leads to expensive, noisy lab panels while the biggest drivers of cardiometabolic risk stay unmeasured. We want to simplify the whole process: pick the few numbers that reliably predict long-term outcomes, track them over time, and use them to guide practical lifestyle changes.

We start with two powerful “measures,” not fancy tests: blood pressure and waist-to-hip ratio. We talk about why hypertension is often silent, how home cuffs can make tracking cheap and routine, and why waist-to-hip ratio beats BMI for estimating visceral fat, inflammation, and insulin resistance. Then we move into heart rate variability (HRV) as an accessible marker of autonomic nervous system balance. With tools like Apple Watch, smart rings, and HeartMath, HRV becomes real-time biofeedback for stress, recovery, breathing, and meditation.

From there we get tactical with labs that deliver high value for low cost. Fasting insulin, especially when paired with fasting glucose for a HOMA-IR estimate, can reveal metabolic dysfunction years before glucose or A1C force the conversation. We also unpack how much signal is hiding in routine panels like the CBC and CMP, including RDW, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and patterns that can prompt smarter questions about inflammation, immune balance, nutrition, liver health, and kidney function. We close with uric acid as a surprisingly useful marker tied to fructose exposure, diet composition, and cardiometabolic risk, even when results fall inside “normal” lab ranges.

If you want a clear, evidence-based baseline for preventive health without getting lost in niche testing, this one gives you a practical framework. Subscribe, share this with a friend who loves lab results, and leave a review with the one metric you plan to track next.

The serum platelet-to-lymphocyte ratio as a predictor of outcomes in bladder cancer patients- an updated meta-analysis

Characteristics of platelet indices and their prognostic significance in selected medical condition – a systematic review

Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Long-Term Survival in Older Adults at a Mental Health Care Center- A Historical Cohort Analysis copy

Usefulness of Complete Blood Count (CBC) to Assess Cardiovascular and Metabolic Diseases in Clinical Settings- A Comprehensive Literature Review

Red cell distribution width:platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver diseaseThe association between red blood cell distribution width-to-albumin ratio and risk of depression_ A cross-sectional analysis of NHANES – ScienceDirect

The workout myth sounds so clean: move more, burn more, lose weight. Then the real world happens, and people who train hard still plateau, regain, or feel like their body is fighting them. We dig into why by looking at research most health conversations ignore: anthropology studies that compare daily energy expenditure and obesity across lifestyles, from hunter-gatherers and pastoralists to highly industrialised nations.

Mark shares data from a large cross-cultural paper on energy expenditure and obesity across the economic spectrum. The headline is wild: once you adjust for body size, people in modern, developed settings don’t burn dramatically fewer calories than people living ancestral lifestyles. The gap is closer to 10% than the 50/50 story many of us assume. That pushes us toward a bigger, more useful explanation for weight gain than “everyone got lazy.”

We unpack the constrained energy concept, where total daily energy expenditure is tightly regulated and the body can compensate for increased activity by lowering basal metabolic rate. That helps explain why combining intense cardio with harsh calorie restriction often leads to a stall and, later, a rebound. The strongest signal tied to higher body fat is diet quality, especially ultra-processed food intake. We break down the NOVA classifications, call out sneaky “health halo” products, and end with practical moves: prioritise minimally processed foods, build muscle with resistance training, and exercise for function, strength, and a longer healthspan.

If this reframes how you think about fat loss and metabolic health, subscribe, share this with a friend who’s stuck in the treadmill trap, and leave a review so more people can find the show. What belief about weight loss do you want to unlearn next?

Audio Recording

Slide Deck PDF

Energy Expenditure and Obesity Across the Economic Spectrum

Hunter-Gatherer Energetics and Human Obesity

Ultra-processed foods- how functional is the NOVA system?

If you feel like your metabolism is “slow,” the usual advice sounds painfully simple: eat less, exercise more, repeat forever. We take a different angle and it starts with a more honest target: body composition. When you reduce visceral fat while protecting or building lean muscle, you change the drivers of inflammation, insulin resistance, cardiometabolic risk, and long-term health span. That shift also makes the process feel less like punishment and more like training your physiology to work for you.

Mark and John walk through a practical fat loss strategy that is not obsessed with the scale. The foundation is resistance training and eating with a purpose, especially prioritizing protein and including enough dietary fat to help your body get better at fat oxidation. We also dig into the timing piece that many people miss: morning meals can set your insulin tone for the whole day, and a high-protein breakfast can support muscle protein synthesis plus the thermic effect of food. You’ll hear concrete examples of what meals can look like, why flour-based processed carbs are uniquely problematic, and when root vegetables may be a smarter carbohydrate choice than grains.

Then we zoom out to one of the most fascinating tools for metabolic health: brown adipose tissue. We explain brown fat versus white fat, how thermogenesis works, and why cold exposure, strength training-related myokines, and compounds like capsaicin, green tea, ginger, and omega-3-rich foods show up in research on metabolic flexibility. The bigger theme is simple: modern comfort removes the stressors that once kept humans resilient, and selectively bringing a few back can be empowering.

If you want a clearer, science-backed roadmap for burning fat while building strength, listen now, subscribe, share with a friend who’s stuck, and leave a quick review with your biggest takeaway.

Audio Recording

Video Recording

Brown Adipose Tissue- Activation and Metabolism in Humans

Role of Brown Adipose Tissue in Metabolic Health and Efficacy of Drug Treatment for Obesity

Sugar isn’t just a treat. It can be a signal that shapes how the body builds itself. We dig into a remarkable paper published in *Science* that used post World War II UK sugar rationing as a natural experiment, then matched it to UK Biobank outcomes to ask a blunt question: what happens when added sugar is restricted during pregnancy and the first 1,000 days of life?

We walk through what changed when rationing ended in September 1953 and sugar intake jumped almost overnight, creating clear comparison groups. The results point to meaningful differences in adult risk for type 2 diabetes and high blood pressure, plus a delay in disease onset for those who still developed problems. That “windows of exposure” story opens the door to epigenetics: how environment influences gene expression through mechanisms like DNA methylation, especially during fetal development and early childhood.

From there, we connect the dots to classic epigenetic proof like the agouti mouse model, and to human research from the Quebec ice storm that links maternal stress and disrupted food supply to lasting metabolic and mental health effects in offspring. We also raise a timely question about GLP-1 medications: if appetite drops and nutrient gaps appear, what might that mean for future pregnancy outcomes?

If you care about pregnancy nutrition, added sugar, metabolic health, and prevention, this one will change how you think about “small” daily choices. Subscribe, share this with a friend, and leave a review with your biggest takeaway.

Exposure to Sugar Rationing in the First 1000 Days of Life Protected Against Chronic Disease

Sugar Restriction in Pregnancy Slides

100% of tested samples is not a rounding error. Drs. Mark Pettus and John Bagnulo walk through new research on mycotoxins in commercially available plant-based meat, cheese, fish, and beverage alternatives and explain why mold toxins deserve a place in any serious conversation about modern nutrition. We dig into what the lab methods measured, why wheat-gluten based seitan products can be especially vulnerable, and how gaps in food safety oversight can leave “plant-based” products outside the regulatory spotlight many of us assume exists.

From there, we connect the dots to what listeners actually care about: symptoms, labs, and long-term risk. We talk about common mycotoxins like aflatoxin and ochratoxin A, the reality of daily exposure when staples like wheat, corn, soy, and oat products show up at every meal, and why quantity matters as much as concentration. We also explore how these toxins can be lipophilic, how they may interact with obesity and fatty liver biology, and what research suggests about lipid changes like higher triglycerides and lower HDL.

We then zoom out to the systems most likely to take the hit: immune function, endocrine signalling, and the gut microbiome. We cover increased gut permeability, endotoxemia, inflammation, and the unsettling synergy where mycotoxins may worsen outcomes in the presence of latent viruses like Epstein-Barr or herpes family viruses. Finally, we end with grounded, doable steps: reduce reliance on ultra-processed meat analogs and dairy substitutes, do your own homework, and support elimination pathways including bile flow and bile binding strategies such as beets and specific fibers.

Subscribe for more evidence-based self-care, share this with someone who relies on plant-based substitutes, and leave a review with your biggest takeaway or question.

Mycotoxins Slide Deck

Effects of mycotoxins in foods on human health and strategies for prevention and control- A review

The role of mycotoxins in lipid metabolism and homeostasis- a systematic review

Mycotoxin contamination in plant-based beverages and meat alternatives- A survey of the UK market

Endocrine Effect of Some Mycotoxins on Humans- A Clinical Review of the Ways to Mitigate the Action of Mycotoxins

Mycotoxin- Its Impact on Gut Health and Microbiota

Fungal mycotoxins in food commodities- present status and future concerns

Mycotoxins in Food- Cancer Risks and Strategies for Control

Daylight savings may be on the chopping block, but the bigger health disruption we can actually fix today might be hiding in plain sight: low zinc status. We walk through why zinc is an essential micronutrient you cannot store, why it often slips past routine medical testing, and why modern diets can create a quiet gap between “zinc consumed” and “zinc absorbed.” If you care about energy, immunity, fertility, and healthy aging, zinc deficiency and zinc bioavailability deserve a spot on your radar.

From there, we get into the strongest part of the evidence: a systematic review and meta-analysis of randomized controlled trials on zinc supplementation in type 1 diabetes, type 2 diabetes, gestational diabetes, and prediabetes. We unpack what improved most, including insulin resistance markers like fasting insulin and HOMA-IR, along with inflammation (C-reactive protein) and oxidative stress measures (malondialdehyde and total antioxidant capacity). We also explain why zinc’s role in antioxidant enzyme systems such as superoxide dismutase can matter when inflammation and reactive oxygen species are driving cardiometabolic risk.

We then make it practical: which groups are most likely to struggle with zinc status (older adults, people with GI issues, post-bariatric surgery, pregnancy and lactation, and long-term acid suppression users), and which foods reliably deliver bioavailable zinc. We also add a crucial nuance many people miss, the copper to zinc ratio, and how high-copper patterns can shift that balance in ways that may affect infection risk and cardiovascular disease risk.

If you found this helpful, subscribe, share the episode with a friend who is working on metabolic health, and leave a quick review so more people can find the show. What’s one change you’d make to improve zinc intake or absorption starting this week?

Audio Recording

Zinc Slide Deck

Zinc deficiency in patients with type 2 diabetes increases risk of cardiovascular diseases- Tehran Lipid and Glucose Study

Zinc and Type 2 Diabetes- A Systematic Review with a Narrative Synthesis of Their Bidirectional Relationship and Clinical Perspectives for Personalized Nutritional Support

Study on Reference Range of Zinc, Copper and Copper:Zinc Ratio in Childbearing Women of China

Serum Zinc Concentrations in the US Population Are Related to Sex, Age, and Time of Blood Draw but Not Dietary or Supplemental Zinc

Serum copper-to-zinc-ratio and risk of incident infection in men- the Kuopio Ischaemic Heart Disease Risk Factor Study

Low zinc levels at clinical admission associates with poor outcomes in COVID-19

Effects of Zinc Supplementation on Glycemic Control, Insulin Resistance, Inflammation and Oxidative Stress in Diabetes- A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Heavy water sounds like a chemistry trivia fact until you realise it may be sitting at the crossroads of energy, ageing, and chronic disease. We talk about deuterium, the heavier isotope of hydrogen, and why even one extra neutron can matter when that hydrogen becomes part of the water that surrounds your proteins and powers your mitochondria. If you care about mitochondrial health, oxidative stress, insulin sensitivity, and longevity, this is a surprisingly practical conversation hiding inside a physics story.

Mark Pettus MD and John Bagnulo PhD, MPH walk through what deuterium is, where it shows up in our environment, and why modern patterns may increase deuterium load over time. We dig into the mechanism that keeps popping up: the mitochondrial electron transport chain is a precise system, and deuterium-heavy water can slow it down, reducing efficiency and increasing stress signals downstream. We also look at why hype and devices can derail credibility, and why you do not need a machine to start applying the fundamentals.

From there, we connect lifestyle to biology. Burning fat creates metabolic water that is naturally lower in deuterium, which helps explain why ketogenic or lower-carb eating keeps showing up alongside better metabolic outcomes. We discuss food choices that tend to push deuterium higher, why local and seasonal eating may matter more than people think, and how sunlight, infrared light, and “exclusion zone” water concepts fit into a broader hydration and performance picture.

If this changes how you think about water, share it with a friend, subscribe for more evidence-based self-care, and leave a review so more people can find the show. What’s one habit you’re willing to test first: carbs down, sunlight up, or more daily movement?

Deuterium Depleted Water Slides

References Noted:

Deuterium trafficking, mitochondrial dysfunction, copper homeostasis, and neurodegenerative disease

Deuterium-depleted water stimulates GLUT4 translocation in the presence of insulin, which leads to decreased blood glucose concentration

Explaining deuterium-depleted water as a cancer therapy- a narrative review

The biological impact of deuterium and therapeutic potential of deuterium-depleted water

To lower deuterium in your body, prioritize a ketogenic-style diet…

Nutritional deuterium depletion and health- a scoping review

Chronic disease doesn’t feel “modern” when you’re living it, but the causes often are. We take on the Paleodeficit Syndrome, the idea that your body still runs on an ancestral operating system while your environment has been rewritten in a few generations. That mismatch helps explain why obesity, insulin resistance, prediabetes, type 2 diabetes, fatty liver, and cardiovascular risk keep rising even as nutrition advice gets louder and more confusing.

We dig into the biggest dietary shifts that separate ancestral eating from the modern diet: grain dependence after agriculture, acellular carbohydrates from refined flour, ultra processed foods, industrial seed oils and omega 6 excess, and the way fortification can hide a low nutrient diet inside “enriched” staples. We also explore why potassium, iron, and zinc bioavailability matter, why fermentable fiber and the gut microbiome are central to metabolic health, and why seasonality used to shape human physiology in ways we rarely consider now.

Then we bring receipts. We discuss a short clinical Paleo diet intervention where insulin resistance markers (HOMA IR) and triglycerides improved fast, and we push past the simplistic cholesterol narrative by focusing on LDL particle quality: small dense versus large buoyant LDL and how insulin levels influence both. Along the way, the agouti mouse research makes the case for nutritional epigenetics, showing how diet can change gene expression and even affect future generations.

If you want practical ancestral health takeaways without hand waving, this one will challenge you in the best way. Subscribe, share with a friend who’s tired of nutrition whiplash, and leave a review so more people can find the show. What part of the modern diet do you think is most out of sync with human biology?

Natural environments, ancestral diets, and microbial ecology- is there a modern “paleo-deficit disorder”? Part II

Paleo-Deficit Slides

Chronic disease didn’t suddenly become “normal” because our genes got worse. Our genes largely stayed the same, but our world changed fast and our bodies are still trying to keep up. Mark Pettus and Dr John Bagnulo unpack Paleo Deficit Syndrome (PDS), a powerful framework in ancestral health and evolutionary medicine that helps explain why obesity, type 2 diabetes, cardiovascular disease, autoimmune issues, and neurodegeneration keep rising even as healthcare gets more sophisticated.

We zoom out beyond the usual reductionist lens and pull in evidence from anthropology and real-world populations that still live closer to ancestral patterns. We talk about the Hadza, research from the New Guinea Highlands that challenges the “aging equals decline” storyline, and why old photos from the early 1900s can look more like hunter-gatherers than today’s sedentary norm. Then we connect the dots with epigenetics, showing how quickly the environment can reshape outcomes, sometimes within a single generation.

To make it visceral, we walk through Robert Sapolsky’s observations of “junk food monkeys” and the striking health shifts seen in the Pima people after a rapid change in food and lifestyle environment. We also get candid about why these insights stay niche, and why “lifespan” is a distraction if healthy lifespan is collapsing.

We’ll post the papers and slide deck on our website so you can follow along, and we’ll continue this as a two-part series. If this perspective helps you rethink your own health trajectory, subscribe, share this with a friend, and leave a review so more people can find the conversation.

Audio Recording

Paleo-Deficit Slides

Natural environments,Part 1 ancestral diets, and microbial ecology- is there a modern paleo-deficit disorder? Part I

Natural environments,Part 2 ancestral diets, and microbial ecology- is there a modern “paleo-deficit disorder”? Part II