Intelligent Medicine

Nutritionist Leyla Muedin discusses a listener question about whether agave nectar can contribute to obesity like high-fructose corn syrup, arguing that regular use of sweeteners—including agave, honey, monk fruit, stevia, aspartame, sucralose, allulose, and sugar alcohols—can maintain sweet cravings, spike insulin, and contribute to weight-loss plateaus, with added concerns such as microbiome effects, GI upset, and aspartame’s neurotoxicity. She notes insulin’s role in fat storage and blood pressure via sodium retention, and suggests that needing a sweetener in coffee or tea may indicate dependence on sweetness. She then covers a newly developed, validated Food Noise Questionnaire (FNQ) published in Obesity to measure intrusive food-related rumination, highlighting its five Likert-scale items, study sample characteristics, and the need for further research, including effects of GLP-1 drugs.

More on “eat the rainbow” . . . or notMedical breakthroughs that we don't really needCan you discuss the order of eating macronutrients and its impact on blood glucose?What about the impact of apple cider vinegar on blood sugar?

If I start taking urolithin A, will it make my insomnia worse?I'm a 54-year-old postmenopausal woman with no libido—can supplements help?Can you talk more about the vegan twin study, saying plant-based diet improved fertility?What do you think of IV NAD vitamin drips?

Sugarless: Dr. Nicole Avena on Hidden Sugars, Brain Addiction, and Practical Steps to Cut Back: Neuroscientist and author Dr. Nicole Avena reveals sugar’s pervasiveness and health impacts, drawing on her book “Sugarless: The Seven-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction.” Avena explains how modern industrialized, highly processed foods—many containing added sugars—have transformed innate preferences for sweetness into harmful overconsumption linked to obesity, diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and possible dementia via insulin signaling changes. She discusses research showing sugar can stimulate dopamine reward pathways similarly to drugs and that prenatal exposure may alter offspring metabolism, preferences, and sensitivity to drugs/alcohol. For solutions, she discourages strict “cold turkey” approaches due to hidden sugars and relapse psychology, emphasizes inventorying sources and triggers, starting with eliminating sugar-sweeten

Dr. Hoffman continues his conversation with neuroscientist and author Dr. Nicole Avena.

Functional Diagnostic Nutrition: Using Saliva Testing, Food Sensitivity Labs, and Lifestyle to Find Root Causes: Reed Davis, Board Certified Holistic Health Practitioner (HHP) and Certified Nutritional Therapist (CNT), is founder of Functional Diagnostic Nutrition (FDN). He discusses using functional testing alongside conventional care to uncover “dysfunction” when standard labs appear normal. Davis describes assessing adrenal and metabolic stress via saliva testing for circadian cortisol patterns, cortisol-DHEA balance, sex hormones, secretory IgA, and melatonin, emphasizing clinical correlation and individualized “studies of one.” He outlines an approach targeting multiple “healing opportunities” (H-I-D-D-E-N: hormones, immune, digestion, detoxification, energy, nervous system) and applying D-R-E-S-S (diet, rest, exercise, stress reduction, supplementation) rather than relying on supplements alone. A case example links chronic hives, medication-related weight gain, and food triggers identified through addit

Dr. Hoffman continues his conversation with Reed Davis, Board Certified Holistic Health Practitioner (HHP), Certified Nutritional Therapist (CNT), and founder of Functional Diagnostic Nutrition (FDN). 

Press ballyhooed heart, stroke risks associated with Omega-3 supplementation, but new study dispels fears over fish oil-atrial fibrillation link; Research highlights cancer, diabetes risks from food preservatives; Do the new dietary guidelines go too far, or are they a cop-out? GLP-1 weight loss drug use could save airlines millions on fuel costs; Does a “complex tear” of the hip labrum inevitably require surgery?

Can we crack the code on aging, or are humans just “term-limited”? What are some of the most promising anti-aging interventions currently under investigation? We may be curing more cancers, and discovering them earlier, but certain cancers are increasing in incidence, especially among the young; Why extreme old age may be protective against cancer; Big meta-analysis confirms cardio benefits of low-carb diet; Patients with depression who’ve tried everything obtain surprising relief from vagus nerve stimulation; Blood sugar spikes after meals—even absent diabetes—can drive Alzheimer’s risk; New study pushes back on Tylenol-autism link, but highlights poor diet, chemical exposure , pre-natal anti-depressant use as potential culprits.

Registered dietitian nutritionist Leyla Muedin discusses a Nature Communications study of 108,723 French adults in the NutriNet-Santé cohort (2009–2023) examining long-term exposure to food preservatives and type 2 diabetes. Using detailed dietary records cross-referenced with product/additive databases, researchers identified 58 preservative-related additives and analyzed 17 consumed by at least 10% of participants; 1,131 diabetes cases occurred. Higher overall preservative intake was associated with a 47% increased diabetes risk (49% for non-antioxidant preservatives; 40% for antioxidant additives), with several specific additives linked to higher risk. Leyla questions whether the findings reflect preservatives themselves or the ultra-processed, refined-carbohydrate foods that contain them, emphasizing recommendations to favor fresh, minimally processed foods and limit refined carbs and processed foods.

A case study where a second opinion is necessaryWhat are your thoughts on the recent news implicating niacin in cardiovascular disease? 

What could it mean to get spasms in your sleep?  Is this a prediction of Parkinson's?What is the best general magnesium to use?What can my brother with diabetes take for recurrent urinary tract infections?Could my prescribed medications be causing tinnitus?Is the herpes virus a risk factor for dementia?        

Gary Taubes on Rethinking Diabetes: Diet, Insulin, and the History Behind Low-Carb Treatment: Journalist Gary Taubes is author of “Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments.” The book traces diabetes treatment history and argues that carbohydrate restriction was standard care from 1797 through the early 20th century until insulin therapy shifted practice toward drug-centered management and higher-carbohydrate diets. Taubes explains how insulin’s discovery changed dietary priorities, how later technology (radioimmunoassay) revealed that most diabetes is type 2 with insulin resistance and high insulin rather than deficiency, and why giving more insulin can worsen weight gain. They discuss major trials (including ACCORD, ADVANCE, and Look AHEAD) that failed to show benefits from intensive drug-based glucose control, the influence of low-fat guidelines, Richard Bernstein’s role in blood-glucose self-monitoring and low-carb control, controversies about obesity models,

Dr. Hoffman continues his conversation with journalist Gary Taubes, author of “Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments.”

Urolithin A (MitoPure)--Mitophagy, Muscle Recovery, Immunity, and Skin Health: Dr. Brad Currier, clinical trial manager at Timeline, a Swiss biotech company, details urolithin A (MitoPure), a postbiotic derived from pomegranate precursors that most people cannot produce due to microbiome differences. Currier explains MitoPure’s mechanism—stimulating mitophagy to recycle dysfunctional mitochondria—and reviews evidence from multiple clinical trials. He reveals a Sports Medicine study in elite male distance runners showing reduced creatine kinase and lower perceived exertion, suggesting improved recovery, plus trials in middle-aged and older adults showing improvements in strength, six-minute walk test, and VO2 max at 500 mg–1 g doses. They also cover a Nature Aging immune study reporting rejuvenation of stem-like CD8 T cells with improved mitochondrial fatty acid oxidation, ongoing research directions, supplement quality/testing for athletes, and topical urolithin A skincare trials and partnerships, including L

Dr. Hoffman continues his conversation with Dr. Brad Currier, clinical trial manager at Timeline, a Swiss biotech company.

Oprah’s new book encourages followers to “free themselves” from “shame and blame” by accessing weight loss meds; Her claim “it’s the obesity gene” is put to the test by twin studies; Study shows brain stimulation with external electronic headset produces weight loss rivaling shots, pills; Ultra-processed food ups daily calorie intake by 500; Breast-feeding moms gain less post-pregnancy weight; Solutions for  Myelodysplastic Syndrome; Scientists find hidden weight gain trigger in soybean oil.

Calculators that assess your risk for heart disease miss the boat—half of actual heart attack victims were said to be at low-risk; Why an app could erroneously tell you that you should be taking a statin; New ways to fix a calcified aortic valve; Common amino acid may bust Alzheimer’s plaque, Adequate sleep may trump healthy diet, exercise for longevity; Chinese vegetarians less likely than omnivores to surpass 100; Easily-gobbled “fast food” stokes total daily calorie intake; Common chemicals hike MS risk two-fold; Low-glutamate diet relieves migraines; Fish oil confers substantial stroke, heart attack protection to dialysis patients.

Registered dietitian nutritionist Leyla Muedin discusses how exposure to natural daylight may improve metabolic health beyond diet and exercise, highlighting a controlled crossover study of 13 adults aged 65+ with type 2 diabetes published in Cell Metabolism. Participants spent 4.5 days in living spaces lit by either natural light through large windows or artificial light, with identical meals, sleep, activity, and screen time; after a 4-week washout they switched conditions. Natural light was associated with more hours of blood glucose in the normal range, less glucose variability, higher evening melatonin, and improved fat oxidative metabolism, suggesting effects on circadian “body clocks” and coordination between central and peripheral clocks. Muedin recommends getting morning light on the face, reducing sunglasses and high SPF use, dimming lights at night, keeping consistent sleep, and spending more time outdoors; she also notes that architecture can limit sunlight exposure.

A discussion on the concepts of weight-inclusive care and healthismSome comments on medicine's biggest failures