Artwork

Contenu fourni par Peter Attia, MD, Peter Attia, and MD. Tout le contenu du podcast, y compris les épisodes, les graphiques et les descriptions de podcast, est téléchargé et fourni directement par Peter Attia, MD, Peter Attia, and MD ou son partenaire de plateforme de podcast. Si vous pensez que quelqu'un utilise votre œuvre protégée sans votre autorisation, vous pouvez suivre le processus décrit ici https://fr.player.fm/legal.
Player FM - Application Podcast
Mettez-vous hors ligne avec l'application Player FM !

#302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

2:25:03
 
Partager
 

Manage episode 419166933 series 2352826
Contenu fourni par Peter Attia, MD, Peter Attia, and MD. Tout le contenu du podcast, y compris les épisodes, les graphiques et les descriptions de podcast, est téléchargé et fourni directement par Peter Attia, MD, Peter Attia, and MD ou son partenaire de plateforme de podcast. Si vous pensez que quelqu'un utilise votre œuvre protégée sans votre autorisation, vous pouvez suivre le processus décrit ici https://fr.player.fm/legal.

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.

We discuss:

  • Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15];
  • The complex and crucial functionality of the liver, its four most essential functions, and more [8:45];
  • Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15];
  • How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45];
  • Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30];
  • The poisonous nature of ethanol to the liver [40:30];
  • Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15];
  • Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30];
  • Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15];
  • Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45];
  • Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45];
  • Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30];
  • Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30];
  • The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45];
  • Practical strategies for managing MAFLD [1:45:30];
  • The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45];
  • The potential of GLP-1 agonists for the treatment of MASLD [1:57:45];
  • How the four stages of liver disease have evolved [2:00:30];
  • Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15];
  • Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15];
  • Peter’s major takeaways [2:18:45]; and
  • More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

  continue reading

355 episodes

Artwork
iconPartager
 
Manage episode 419166933 series 2352826
Contenu fourni par Peter Attia, MD, Peter Attia, and MD. Tout le contenu du podcast, y compris les épisodes, les graphiques et les descriptions de podcast, est téléchargé et fourni directement par Peter Attia, MD, Peter Attia, and MD ou son partenaire de plateforme de podcast. Si vous pensez que quelqu'un utilise votre œuvre protégée sans votre autorisation, vous pouvez suivre le processus décrit ici https://fr.player.fm/legal.

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.

We discuss:

  • Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15];
  • The complex and crucial functionality of the liver, its four most essential functions, and more [8:45];
  • Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15];
  • How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45];
  • Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30];
  • The poisonous nature of ethanol to the liver [40:30];
  • Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15];
  • Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30];
  • Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15];
  • Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45];
  • Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45];
  • Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30];
  • Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30];
  • The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45];
  • Practical strategies for managing MAFLD [1:45:30];
  • The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45];
  • The potential of GLP-1 agonists for the treatment of MASLD [1:57:45];
  • How the four stages of liver disease have evolved [2:00:30];
  • Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15];
  • Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15];
  • Peter’s major takeaways [2:18:45]; and
  • More.

Connect With Peter on Twitter, Instagram, Facebook and YouTube

  continue reading

355 episodes

Tous les épisodes

×
 
Loading …

Bienvenue sur Lecteur FM!

Lecteur FM recherche sur Internet des podcasts de haute qualité que vous pourrez apprécier dès maintenant. C'est la meilleure application de podcast et fonctionne sur Android, iPhone et le Web. Inscrivez-vous pour synchroniser les abonnements sur tous les appareils.

 

Guide de référence rapide