Vitality Unleashed: The Functional Medicine Podcast

From “Normal” Labs To Peak Performance: The Executive Metabolism Reset

• Dr. Kumar from LifeWellMD.com • Season 1 • Episode 201

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Your labs say “normal,” but your body keeps tapping the brakes. We pull back the curtain on the hidden drivers that sap elite performers: visceral fat you can’t see, early insulin resistance masked by “fine” glucose, and subclinical inflammation that accelerates every metabolic problem. Drawing on precision practices used in executive medicine, we show how to replace catastrophe-avoidance care with an optimization model built for sustained energy, sharp focus, and real longevity.

We break down why BMI and basic panels are blunt tools, and why the lean mass to visceral fat ratio predicts risk far better than the scale. You’ll hear how HOMA-IR flags trouble years before A1C turns red, why HSCRP is the friction measure that links insulin signaling and vascular health, and how HRV reveals your resilience under stress. We also unpack the executive reality—chronic decisions, travel, jet lag, late meals, poor sleep, and “decompressing” with alcohol—and how this pattern drives midsection fat, brain fog, and the 2 p.m. crash that no coffee can fix.

Then we move into solutions. The executive metabolism reset blueprint combines body composition analysis, fasting insulin and lipid subfractions, advanced liver screening, and hormone panels with precise interventions: structured strength training, rigorous protein targets, low-glycemic nutrition, and time-restricted eating when it fits the data. Add deep sleep work, stress tools that raise HRV, gut repair, and targeted therapies when needed, and you get measurable drops in visceral fat, normalized HOMA-IR, lower HSCRP, faster recovery, and a return to sustained cognitive output. If “normal” has you stuck at 85 percent capacity, it’s time to reclaim the missing 15 and put it to work where it matters most.

If this resonates, follow the show, share it with a colleague who lives on redline, and leave a quick review to help more high performers find a smarter path to health and longevity.

Follow Dr. Kumar on his substack account:  doctorkumar.substack.com

Disclaimer:
The information provided in this podcast is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making changes to your supplement regimen or health routine. Individual needs and reactions vary, so it’s important to make informed decisions with the guidance of your physician.

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If you enjoyed today’s episode, be sure to subscribe, leave us a review, and share it with someone who might benefit. For more insights and updates, visit our website at Lifewellmd.com.

Stay Informed, Stay Healthy:
Remember, informed choices lead to better health. Until next time, be well and take care of yourself.

SPEAKER_01:

Welcome back to the deep dive. Today we are talking directly to you.

SPEAKER_00:

Specifically to the high responsibility executive, the entrepreneur, the person who, you know, measures success by output and effectiveness.

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You're relentless in your professional life, but lately maybe you've noticed a lag in your personal performance. You're running on pure drive, but it feels like the engine is sputtering.

SPEAKER_00:

Aaron Powell You know the routine, you do the right thing, you prioritize that annual physical.

SPEAKER_01:

Of course.

SPEAKER_00:

You get your standard blood work back. And your doctor, who is really just relying on these insurance-driven metrics, tells you everything looks normal. BMI is fine, your blood sugar is fine, cholesterol is acceptable, everything is normal.

SPEAKER_01:

But inside, you know that's just not the whole story. I mean, that exhausting brain fog that hits you mid-afternoon.

SPEAKER_00:

Yeah.

SPEAKER_01:

That's real.

SPEAKER_00:

It's very real. Or that persistent sort of low-grade inflammatory ache in your joints.

SPEAKER_01:

And the belt. Despite your best efforts, the belt notch keeps moving in the wrong direction.

SPEAKER_00:

Aaron Powell Right. And that feeling of metabolic fatigue.

unknown:

Yeah.

SPEAKER_00:

That is a critical warning sign that standard medicine is, well, it's simply missing it.

SPEAKER_01:

It just highlights this vast and I think dangerous gap between standard lab tests.

SPEAKER_00:

Trevor Burrus, Jr. Which are designed for catastrophe avoidance.

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And the metrics that you need for true metabolic optimization for longevity.

SPEAKER_00:

Exactly.

SPEAKER_01:

Okay, so let's unpack this. This deep dive is a wake-up call to show you exactly what is hiding in plain sight.

SPEAKER_00:

Aaron Powell We're going beyond the basics today. We have to look at the silent risks. Things like visceral fat, early insulin resistance, and subclinical inflammation. Trevor Burrus, Jr.

SPEAKER_01:

The things that advanced for years while your standard results are waving that all-clear flag.

SPEAKER_00:

Aaron Powell Our mission today is to show you not just the metrics you need to insist on, but also a path forward, a way to fundamentally reset your health span and your performance.

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And this is modeled after innovative practices like the executive metabolism reset that's being used by Dr. Kumar's team at Life Well MD.

SPEAKER_00:

That's right.

SPEAKER_01:

So let's start with that fundamental conflict. You have these two models of assessment operating in parallel. In that standard insurance-driven visit, what's the core mandate?

SPEAKER_00:

Aaron Powell The core mandate is intervention only at the point of overt disease.

SPEAKER_01:

Aaron Powell So wait until it's broken?

SPEAKER_00:

Pretty much. They focus on the minimum standard metrics. You know, basic height-to-weight calculation like BMI, simple fasting glucose, and standard total lipids.

SPEAKER_01:

There's no time for anything else.

SPEAKER_00:

The scope and the time simply aren't there for any kind of deeper metabolic mapping. They're waiting until you officially cross the threshold into type 2 diabetes or, you know, full-blown heart disease.

SPEAKER_01:

Aaron Powell They're reacting to a disaster that's already happened, not preventing a risk that's looming right in front of you.

SPEAKER_00:

Precisely.

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So contrast that with, say, a precision or concierge model. The Life Well MD approach, which is really built for the executive who is seeking optimization.

SPEAKER_00:

Our approach is all about reversal and preemption. And that requires advanced metabolic mapping. So what does that look like? It means we're moving beyond a simple BMI to measure crucial physical indicators, things like waist-to-hip ratio, and critically, we use technology to accurately estimate your visceral fat volume.

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And on the lab side.

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On the lab side, we prioritize highly sensitive C-reactive protein, or HSCRP, and the homeostatic model assessment for insulin resistance, HIIR.

SPEAKER_01:

We're talking about leading indicators, not lagging ones.

SPEAKER_00:

Exactly. We even integrate full body composition scans, which often include non-invasive assessments for liver fat. Why is that so important? Because the standard model fails the high achiever by ignoring the early dysfunction that's been creeping up for years. You might have 10 years of accelerating insulin resistance before your standard A1C marker ever turns diabetic.

SPEAKER_01:

Wow. 10 years.

SPEAKER_00:

Catching it early is the difference between, say, a minor course correction and a catastrophic outcome.

SPEAKER_01:

Aaron Powell That makes perfect sense. So if we're looking for those early warning signs, let's dive into why your normal labs are missing the most dangerous risk factors.

SPEAKER_00:

Let's do it.

SPEAKER_01:

And let's start with the difference between the fat you can see and maybe more importantly, the fat you can't. Trevor Burrus, Jr.

SPEAKER_00:

Right. Most people obsess over their BMI, but BMI, it only measures your total mass relative to your height. It's a very blunt instrument.

SPEAKER_01:

Aaron Powell So what's the real enemy?

SPEAKER_00:

The real enemy is visceral fat. That is the metabolically active fat that's stored deep around your internal organs, your liver, your pancreas, your intestines.

SPEAKER_01:

Aaron Powell I've heard you use a business analogy for this before, calling it the toxic overhead cost. Why is it so much worse than the fat you can pinch?

SPEAKER_00:

Because visceral fat isn't inert. It's not just sitting there, it's an active endocrine organ.

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An organ.

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An organ and it's pumping out inflammatory molecules, they're called the depicines, directly into your bloodstream and particularly into your liver.

SPEAKER_01:

Aaron Powell That sounds bad.

SPEAKER_00:

It is. And here's where it gets really interesting. We know now that individuals who have a normal BMI but high visceral fat.

SPEAKER_01:

That TOAFI acronym, right? Thin outside fat inside.

SPEAKER_00:

That's the one. They have a significantly higher cardiovascular risk compared to even heavier individuals who store their fat subcutaneously, just under the skin.

SPEAKER_01:

Aaron Powell So you can look fit, you can look lean, but internally your system is just gummed up with this toxic fat and is jacking up your heart disease risk.

SPEAKER_00:

Aaron Powell Absolutely. And that's why the measurement we find more predictive is the lean mass to visceral fat ratio.

SPEAKER_01:

Aaron Powell Okay, what does that tell you?

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Aaron Powell If that ratio starts to deteriorate, so your muscle mass is dropping while your visceral fat is increasing, you see these strong correlations with hypertension, with dyslipidemia, and with diabetes risk.

SPEAKER_01:

And the crazy part is the number on the scale might not even move.

SPEAKER_00:

Aaron Powell The scale might not move at all, but the internal dynamics are actively working against your longevity.

SPEAKER_01:

And this breakdown is happening while the standard indicator fasting glucose still looks perfectly fine. You're probably asking, why am I crashing if my glucose is normal?

SPEAKER_00:

Aaron Powell Well, that brings us to early insulin resistance and the power of a metric called OBAIR.

SPEAKER_01:

Okay.

SPEAKER_00:

See, insulin resistance means your cells are becoming deaf to the insulin signal. So to compensate, your pancreas has to pump out heroic amounts of insulin just to keep your blood glucose in that normal range.

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So your glucose looks fine only because your system is working overtime to mask the problem.

SPEAKER_00:

Aaron Powell It's working unsustainably hard, yes.

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Aaron Ross Powell If we think of your pancreas as, say, a supply chain management system, what is OMA IR telling us?

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Aaron Powell If we connect this to the bigger picture, OMA IR is the engine warning light for your pancreas.

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And it's flashing.

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It's flashing years before the engine actually seizes up. It's calculated using both fasting glucose and fasting insulin. And recent studies have confirmed that higher HOMA IR values within that so-called normal glucose range still predict a much greater metabolic risk.

SPEAKER_01:

But standard panels don't measure fasting insulin?

SPEAKER_00:

They don't. So they completely miss this powerful diagnostic opportunity.

SPEAKER_01:

Aaron Powell So what's fascinating here is a person could be told they're completely fine, but if their HOMA IR is elevated, their system is already under this tremendous strain.

SPEAKER_00:

Aaron Powell Right. And that leads directly to those afternoon energy crashes and the brain fog we talked about.

SPEAKER_01:

That midday crash isn't just needing a coffee.

SPEAKER_00:

No, it's not. It's often a symptom of poor glucose homeostasis that's being driven by that underlying insulin resistance. It's an immediate performance issue.

SPEAKER_01:

Aaron Powell And the thing that ties this all together that acts as the ultimate metabolic accelerator is subclinical inflammation, the silent killer.

SPEAKER_00:

Correct. We measure this with HSCRP, high sensitivity C reactive protein.

SPEAKER_01:

So what is that measuring?

SPEAKER_00:

It's measuring low-grade systemic friction in your body. And we know that even a low-grade elevation of HSCRP in ranges often dismissed by standard tests is strongly associated with abnormal glucose and lipid metabolism.

SPEAKER_01:

Pouring gas on the fire.

SPEAKER_00:

It's the metabolic accelerator. It damages the lining of your blood vessels and it interferes with insulin signaling. It makes everything worse.

SPEAKER_01:

It sounds like inflammation is the common denominator that really links the visceral fat deposition and that accelerating insulin resistance.

SPEAKER_00:

Precisely. The clinical studies are very clear on this. Subclinical inflammation tracks tightly with every single trait of metabolic syndrome: high triglycerides, low HDL, impaired glucose.

SPEAKER_01:

So if you want to optimize your health span and performance.

SPEAKER_00:

You have to cool that fire.

SPEAKER_01:

No. Let's pivot. If these risks are present in the general population, why does this hit the high achieving executive hardest? It's the executive reality and the acceleration factor.

SPEAKER_00:

It truly is the perfect storm. And it really comes down to lifestyle. Executives are masters of pushing limits, right? Right. But those limits accelerate metabolic dysfunction. I mean, think about the common scenario.

SPEAKER_01:

Okay.

SPEAKER_00:

Chronic high stress from sustained decision making, elevated cortisol levels, constant travel, and jet lag disrupting your circadian rhythms.

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Your regular high calorie meals on the go.

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And often poor sleep and a reliance on alcohol to decompress at the end of a long day.

SPEAKER_01:

That high cortisol is the enemy of visceral fat control, isn't it?

SPEAKER_00:

Oh, absolutely. Chronic stress means chronic cortisol. And cortisol is a major driver of visceral fat accumulation, specifically around your midsection.

SPEAKER_01:

So stress is telling your body to store fat in the worst possible place.

SPEAKER_00:

That high stress state is directly telling your body to hoard resources and store them in the most dangerous place. This isn't just theory. We see it in the scans of our high stress clients.

SPEAKER_01:

And the travel, that constant cycle of interrupted sleep that has to wreck your insulin sensitivity almost immediately.

SPEAKER_00:

It's catastrophic. Sleep deprivation acutely impairs insulin sensitivity and it elevates your hunger hormones.

SPEAKER_01:

That's a double whammy.

SPEAKER_00:

A huge one. You lose sleep negotiating a deal in London, and your body reacts by becoming more insulin resistant and craving carbohydrates the next day. The executive lifestyle is metabolically destructive if it's not managed proactively with precision tools.

SPEAKER_01:

And the big picture here, this isn't just about feeling suboptimal. This metabolic acceleration directly impacts your professional life right now.

SPEAKER_00:

Absolutely.

SPEAKER_01:

Can you really maintain focus during a marathon board meeting when your home AIR is through the roof? No.

SPEAKER_00:

And the longevity risk is massive. Metabolic syndrome and its components, when they're identified at midlife, substantially increase your risk of cardiovascular events, stroke, and type 2 diabetes over the next decade.

SPEAKER_01:

Aaron Powell And that's true even when the individual lab values look only mildly abnormal.

SPEAKER_00:

Exactly. Accepting mildly abnormal today means accepting severely compromised health later. This is a performance risk, a family risk, a legacy risk that you just can't afford to ignore?

SPEAKER_01:

So if the problem is that standard medicine only looks for catastrophe, the solution has to be proactive optimization.

SPEAKER_00:

It has to be.

SPEAKER_01:

Let's look at the LifeWell MD executive metabolism reset blueprint. If we connect this to the bigger picture, the solution starts with truly advanced diagnostics.

SPEAKER_00:

Aaron Powell We have to see the full picture, which means going far deeper than a standard physical.

SPEAKER_01:

What does that assessment look like?

SPEAKER_00:

It begins with those critical body composition measurements, a full analysis of visceral fat, that lean mass to visceral fat ratio. And we also look at detailed physiological data like resting heart rate and heart rate variability, or HRV.

SPEAKER_01:

HRV is a fascinating metric. It gives you insight into the autonomic nervous system. What does that tell you about an executive?

SPEAKER_00:

HRV tells us how well your body is managing the stress you subjected to. It's an objective metric of resilience.

SPEAKER_01:

So how well are you bouncing back?

SPEAKER_00:

Exactly. Low HRV correlates strongly with poor recovery, chronic stress, and often higher inflammation. It tells us not just what the metabolism is doing, but how the body is coping with that executive workload.

SPEAKER_01:

And the advanced labs that are required for this kind of reset.

SPEAKER_00:

They're comprehensive. We use fasting, insulin, and glucose to calculate home EIR. We run full lipid subfractions.

SPEAKER_01:

So not just basic cholesterol.

SPEAKER_00:

No, we're looking at particle size and risk. We measure HSCRP to the finest degree. And we require critical liver screening, often including imaging, to look for metabolic dysfunction associated steatotic liver disease, or MANA estate.

SPEAKER_01:

And hormones.

SPEAKER_00:

A full hormone, panel testosterone, thyroid, cortisol is absolutely non-negotiable. Hormones are inextricably linked to metabolic function.

SPEAKER_01:

So the key intervention then must be targeting that visceral and hepatic fat, which you said are the primary drivers of all this cardiometabolic disease.

SPEAKER_00:

Aaron Powell Absolutely. You have to address the root cause, which is often fat accumulating in the wrong places. We know, for example, that MAN SLD can occur even with a normal BMI.

SPEAKER_01:

The lean MASLD.

SPEAKER_00:

And it often carries worse outcomes. You can't just diet your way out of this. You need a fundamental body composition shift.

SPEAKER_01:

Aaron Powell How does the blueprint drive that kind of shift?

SPEAKER_00:

Aaron Ross Powell Our strategies are very precise. Structured strength training prescriptions to build that metabolically active muscle mass, rigorous protein optimization to support muscle and satiety, low glycemic eating patterns.

SPEAKER_01:

To stabilize blood sugar.

SPEAKER_00:

Right. And time-restricted eating, or TRE, when it's clinically appropriate. These targeted interventions are what's crucial for reducing visceral and liver fat.

SPEAKER_01:

This gives you the freedom to fix the insulin resistance before it becomes a chronic disease. That has to be the biggest advantage of this model.

SPEAKER_00:

It is the defining advantage. An elevated OMI IR is the clear signal of an early breakdown.

SPEAKER_01:

The warning light.

SPEAKER_00:

It's the warning light. And because we identify it years ahead of a standard diagnosis, we can deploy a full spectrum of preventative tools. That means intensive nutrition and exercise plans, sophisticated sleepwork, stress interventions, and when necessary, tailored medications or peptides.

SPEAKER_01:

All designed to optimize that insulin response.

SPEAKER_00:

Exactly. And restore glucose homeostasis. We don't wait for the official label of diabetic to start reversing the problem.

SPEAKER_01:

And finally, cooling that systemic fire of inflammation. How do you bring down the HSCRP?

SPEAKER_00:

Well, this requires holistic work because inflammation is driven by so many factors.

SPEAKER_01:

It's not just one thing.

SPEAKER_00:

Never just one thing. Our strategies focus intensely on anti-inflammatory nutrition. So removing those metabolic irritants, along with gut repair, deep sleep optimization, and active measurable stress interventions. The objective is to bring that HSCRP marker down to optimal, very low levels.

SPEAKER_01:

To take your foot off that metabolic accelerator.

SPEAKER_00:

That's the goal. It's about creating an internal environment that supports peak performance and longevity.

SPEAKER_01:

To bring this comprehensive blueprint to life, let's share a quick, de-identified story. This is the story of an executive who truly, truly thought he was fine.

SPEAKER_00:

Yes. We worked with a highly successful tech executive, mid-40s, a marathon runner, normal BMI. On paper, he was the picture of health.

SPEAKER_01:

That he didn't feel healthy.

SPEAKER_00:

Not at all. He came to us feeling completely depleted. He described falling asleep on the couch by 8 p.m., struggling to maintain focus past two in the afternoon, and this persistent tightness in his abdomen he couldn't shake. He said, and I quote, I'm operating at 80% capacity.

SPEAKER_01:

So what did the standard physical miss and what did your advanced assessment find?

SPEAKER_00:

The standard physical said he was perfectly healthy. Our assessment revealed a significantly high waist circumference, indicating dangerous fat distribution. His visceral fat estimate was in the high risk category.

SPEAKER_01:

And the laps.

SPEAKER_00:

His OMA IR was double the optimal limit, meaning his pancreas was running a marathon every single day just to keep his glucose normal. And his HSERP was mildly but persistently elevated.

SPEAKER_01:

So he wasn't tired because of his work. He was tired because his entire metabolic system was in crisis.

SPEAKER_00:

Exactly. So we initiated the executive metabolism reset blueprint. We focused on optimizing his protein intake, structuring his strength training, and using targeted sleep and stress interventions to bring down that cortisol-driven inflammation.

SPEAKER_01:

And what was the transformation over the next, say, six to twelve months? What were the results?

SPEAKER_00:

The transformation was well, it was profound and measurable. He lost 17 pounds, which is great.

SPEAKER_01:

But that's not the whole story.

SPEAKER_00:

Not even close. Yeah. The real win was that he shed over 70% of his estimated visceral fat.

SPEAKER_01:

Wow.

SPEAKER_00:

His Hobi IR dropped into the optimal range, and his HSCRP was reduced by 60%. But the true measure was his self-reported performance.

SPEAKER_01:

How did he feel?

SPEAKER_00:

His sustained focus dramatically improved, he recovered faster from travel, and he reported operating consistently at 95% capacity. So what does this all mean? The normal threshold set by standard medicine is merely the point where disease is officially recognized. It is not the point where true health and peak performance begin.

SPEAKER_01:

Right.

SPEAKER_00:

If you're an executive and you're committed to performing at the highest level for the next two decades, you need an assessment that's built for optimization and longevity, not just for avoiding catastrophe.

SPEAKER_01:

This raises a really important question for you to think about. If you are accepting normal and operating at 85% capacity right now, because of that silent metabolic dysfunction, that brain fog, that fatigue, what is the true cost of that lost 15% on your career momentum, on your biggest deals, your personal energy, and your overall health span over the next decade?

SPEAKER_00:

The opportunity cost of accepting average health is massive when excellence is achievable.

SPEAKER_01:

It's time to stop letting normal labs lie to you. We'd invite you to explore a more proactive path. Take control of your metabolism with an executive metabolism reset assessment.

SPEAKER_00:

An assessment focused on uncovering those specific hidden risks we discussed: visceral fat, early insulin resistance, inflammation, and liver health.

SPEAKER_01:

This assessment, designed by the innovative team at LifeWell MD, is really the ideal pivot point for performance.

SPEAKER_00:

It is. We look forward to guiding you toward metabolic excellence and a sustained health span.

SPEAKER_01:

To learn more about optimizing your health span and starting your wellness journey, you can contact Dr. Kumar's Innovative Clinic at LifewellMD.com. That's L I F E W E L L M D dot com.

SPEAKER_00:

Or just call. The number is 561 210 9999.

SPEAKER_01:

That's 561 2109999. Call today to book your executive metabolism reset assessment. It's time to take control.