AMA #17: Body composition methods tour de force, insulin resistance, and Topo Chico

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to another Ask Me Anything episode. This is AMA number 17 I'm once again joined by Bob Kaplan, and he goes by a little alias on this episode.
In this episode, we dive pretty deep into body composition. The question actually stemmed from, hey, what's the best way to measure body composition? But it digressed into what I think is a very comprehensive discussion of all the different ways that you can measure body fat and there are more than you probably realize, along with what it means. What's the difference between subcutaneous fat, visceral fat, what's the optimal body fat? What are the strategies around improving your health? Is it better to do it through a gain in muscle mass versus a loss in body fat, et cetera? And that takes up a heck of a lot of time, and it really only leaves time for one other major topic, which is one around insulin resistance. Question basically being, hey, is insulin resistance reversible? Which of course becomes a very long discussion and an opportunity, frankly, to showcase a cool little case study, which I do.
We closed this one out with a little bit of a discussion on Topo Chico. So if my recent email on Topo Chico peaked your curiosity, including my decision making around it and what my potential, call it substitute agent is that I'm now mixing in with my Topo Chico and alternating with, we talk a little bit about that. So without further delay, I hope you enjoy AMA number 17
This is gonna be a pretty cool AMA, but I actually thought I was doing it with Bob Kaplan. Didn't realize I was gonna be doing it with Mike Lute. What's going on here?

**Bob Kaplan** (2:16)
I'm donning the Whaler's caps. I figured that would be my alias today. That's usually when I check into hotels because my popularity, my celebrity, I usually check in as Mike Lute.

**Peter Attia** (2:28)
There's bonus points to anybody listening to this who knows who Mike Lute is, but the fact that you and I both immediately know, well, you know, of course, because it's your alias, but I immediately recognize it. I don't know, is that sad or?

**Bob Kaplan** (2:40)
It's impressive. I'm wondering how many people will know who the Hartford Whalers are.
It's been a while.

**Peter Attia** (2:46)
Let alone who their goalie was circa 1984

**Bob Kaplan** (2:50)
Yes, and who they are now. They still exist, but they moved and they changed their name.

**Peter Attia** (2:55)
Yes, indeed. So what do we have on the agenda, Mike, or should I say Bob, for today?

**Bob Kaplan** (3:03)
We've got a bunch of questions and I batched them. I think that's as per usual, into a few, but we've got some stuff on body fat measurements. There's so many out there. What's the best type to use and do you have to buy your own DEXA, or can you get away with some of the handheld or the stand up scales that we'll get into that. Questions around insulin and glucose and insulin resistance and whether you can reverse it. And then we got a bunch of questions around zone two.
And then maybe more of a, well not a rapid fire, but there are a lot of questions recently about Topo Chico. I think more people will know what Topo Chico is than the Hartford-Wailers and Mike Lute.
And then a couple other questions. One of the recent weekly emails was about colorectal cancer screening. And there are a lot of questions that you could grill your GI doc or your personal care physician. A lot of people are wondering, how do I do that delicately without them getting upset? I think we should just dig in from the top, which is body fat measurements.

**Peter Attia** (4:00)
I mean, I think for context, it's worth explaining why one would even care about that.
We have a very crude measurement by which we can assess a person's health and it's called weight.
So you could stand on a scale, you can measure a person's weight. And if you juxtapose that with their height, you can calculate something called a body mass index. And certainly the body mass index is proportionate to health in some way, shape or form. So we generally know that people with a body mass index in the vicinity of 20 to 25 are healthier than people with a body mass index, say between 35 and 40 That would be a relatively easy statement to make. But it doesn't really tell us a whole heck of a lot between the difference body mass index of 22 versus 26, for example. Do you know your BMI, Bob?