Understanding Metabolic Dysfunction: A Deep Dive with Dr. Bret Scher, Part 1

Dr. Bret Scher, medical director of the Coalition for Metabolic Health, discusses making metabolic health the foundation of medicine amid rising obesity and type 2 diabetes and reports that 93% of Americans have suboptimal metabolic health. Scher defines metabolic health using markers including glucose, insulin, triglycerides, HDL, blood pressure, and waist size, and cites evidence linking insulin resistance to heart disease, stroke, cancer, psychiatric illness, and other complications. They discuss simple self- and lab-assessments (waist-to-height ratio, fasting insulin with glucose/HOMA-IR, triglyceride-to-HDL ratio, CGMs). Scher critiques the Eat Lancet report for assuming one optimal diet, reliance on low-quality nutrition epidemiology, potential nutrient shortfalls, and environmental oversimplification, while supporting newer dietary guidelines that allow lower-carb approaches. Part two covers contradictory nutrition studies, distinctions between low-carb and ketogenic diets, emerging “metabolic psychiatry” and ketogenic therapy for mental illness and cognitive decline, limits and rebound risks of GLP-1 drugs, and Coalition efforts to improve school food and influence policy.

Dr. Hoffman continues his conversation with Dr. Bret Scher, medical director of the Coalition for Metabolic Health.

The Havana Syndrome coverup—for years, bizarre symptoms were labeled “mass hysteria”, until a covert CIA op secured a portable device capable of delivering brain-scrambling sound pulses; A report card on this year’s flu shot; Omega-3s combat “neuroticism”, dementia—they also tame depression and improve cognitive function and memory in adolescents; A caller with duodenitis wants to know if she should follow advice to take Prilosec for the rest of her life; Is the shingles vaccine worth taking? 

Robotic pets make life easier for patients with dementia; Risks, benefits of “natural” ED formulas; Sorting out those pricey new injectable osteoporosis drugs; Daily multivitamin delays biological aging; Study challenges notion that aging means inevitable decline; Breastfeeding confers weight loss benefits—to moms; Can you avoid a colonoscopy with a new colon cancer blood test? Color blindness may hide warning signs of cancer.

Leyla Muedin, a registered dietician nutritionist, shifts the discussion beyond cholesterol and statins to “hidden” cardiovascular risks from insufficient vitamin K and folate intake. Citing Cleveland Clinic and other research, she notes a high prevalence of vitamin K deficiency in the U.S. and widespread inadequate folate intake globally, including low folate levels among women of reproductive age. She explains that vitamin K2 may help inhibit arterial and soft-tissue calcification via activation of matrix GLA protein, with studies linking higher K2 (MK-7) intake to lower coronary heart disease risk and slowed coronary artery calcification. Folate supports vascular function through homocysteine metabolism, with evidence associating higher folate intake with lower cardiovascular mortality, emphasizing active 5-MTHF over folic acid due to conversion limitations in many people. She also notes statins can downregulate vitamin K metabolism and encourages discussing risks, benefits, and supplements with a doctor.

Want to reverse the declines of ageing? Check your attitude.What are good supplements to take before and after a CT angiogram or any CT with contrast?Can vitamin E increase the risk of hemorrhagic stroke?Is turmeric more bioavailable than curcumin? How much should I use?

More on vitamin E studies.How do I know which ingredients to avoid in my shampoo and soaps?I have lower back pain that came out of the blue!What's the best vitamin C to take for a 78-year-old?Which brand of PEA is the most bioavailable?

Hal Cranmer, co-owner of A Paradise for Parents assisted living homes in Arizona, details improving senior care beyond “warehousing.” Cranmer describes his path from Air Force pilot to assisted living operator and explains changes he implemented over 12 years, emphasizing meaningful exercise (walks, strength training, yoga, multitasking drills) and an “exercise with oxygen therapy” bike. He highlights excessive polypharmacy in seniors and advocates deprescribing, supplement and hormone support when medically ordered, and avoiding sedating drugs used as chemical restraints. Cranmer details a low-glycemic, low-carbohydrate, ketosis-oriented nutrition approach inspired by Dr. Dale Bredesen, reporting significant weight loss and diabetes medication reduction in residents. He discusses COVID practices that preserved family contact and outdoor time, reporting no COVID deaths in his homes, and describes cognitive training via one-on-one Zoom-based brain exercises and personalized memory games.

Dr. Hoffman continues his conversation with Hal Cranmer, co-owner of A Paradise for Parents assisted living homes in Arizona.

Dr. Jacob Teitelbaum, integrative medicine physician, researcher, and best-selling author, has cutting edge strategies for improving sleep. He emphasizes circadian rhythms, time changes, and jet lag. He details reducing stress and “FOMO” from news and social media, prioritizing sleep by cutting nonessential activities, and the health risks of short sleep, including increased heart attack risk, obesity risk, and impaired immunity, plus the role of deep sleep and the glymphatic system. Teitelbaum recommends a dark, cool room, limiting blue light (eye masks, warm/yellow lighting), bedtime routines, sustained-release melatonin, chamomile tea, herbal blends, lavender, magnesium, and addressing issues like sleep apnea (including positional strategies), restless legs (ferritin testing, iron, magnesium), nocturnal hypoglycemia (protein snacks, phosphatidylserine), reflux (bicarbonate, bed elevation), and selective low-dose medications when needed. They also cover daylight saving time adjustment and travel strategies such as shifting schedules, melatonin timing, hydration, and morning light exposure.