Hi SELF Family,

Tomorrow evening I am going live on the channel for an hour. It is free, it is open to everyone, and it stays that way.

Once a month I go through what actually published in kidney health and metabolic health, with the journal named and the numbers on screen, so you can judge the evidence instead of taking my word for it. This month I have 6 studies, all from the last 6 weeks, and then I answer your questions.

Here is what we are covering.

The kidney trial we waited years for.

Finerenone has good trials behind it, and every one of them was done in people with diabetes. So a kidney doctor sitting with a patient who had protein in the urine and no diabetes was extrapolating. That gap is now filled: 1,584 adults, none with diabetes, and kidney function fell more slowly. I will also show you who was actually in that trial, because it is not who most people assume, and almost nobody reports it.

Who that trial was really about.

A follow-up published 6 weeks later found that 903 of those people, 57 percent, had a named disease of the kidney filters. IgA nephropathy, FSGS, membranous nephropathy. If you carry one of those diagnoses, you know how it feels to be told there is not much data. This one is about you.

Why your evening workout may not be doing what you think.

A trial had 35 adults run for 30 minutes on an empty stomach, once in the morning and once in the evening. The evening session burned measurably more fat. The same people then ate 547 more calories over the next 24 hours. Both results came out of the same people in the same trial, and most of the advice you have heard only accounts for the first one.

The cholesterol number almost nobody has measured.

Your level is set almost entirely by the genes you inherited. Diet barely moves it, and statins do not lower it. Roughly 1 in 5 people sit above the risk threshold. I will cover the new drug result, the honest track record of the drug class behind it, and the one blood test worth asking your doctor for.

A trial that failed, and what that teaches.

You will almost never see a failed trial covered anywhere. In a liver study of 698 people, the exciting new molecule did not beat placebo, and the unglamorous drug already in the pharmacy did.

The one I am saving for last.

A randomized trial took 90 minutes of sleep a night away from 95 adults who were already sleeping enough, for 6 weeks, and measured what happened to their bodies. Of everything I am covering, this is the one with the shortest distance between knowing it and doing something about it. No prescription, no lab test, no permission from anyone. I will also be careful with you about what that trial does and does not prove.

Set a reminder on YouTube so it is waiting for you tomorrow evening, and bring the question you have been meaning to ask.

One more thing

There is a second live every month just for channel members, on the fourth Thursday, which this month is Thursday, August 27, at 6 PM Pacific. It is a smaller room, and I answer members' questions directly on camera, so they get specific in a way they cannot in the public hour. Members also get every new video 2 days early. You can join here whenever you are ready.

See you tomorrow at 6.

With gratitude,

Dr. Sean

This content is for educational purposes only and is not medical advice. Always consult your healthcare provider for individual care. The views expressed are Dr. Hashmi's own and do not represent his employer.

Never start, stop, or change the dose of any prescription medication without consulting your physician.