At the 2026 Unbreakable Health Retreat in Miami, Emily Kaplan hosted a discussion with general surgeon Dr. Patrick Larreategui, physician assistant educator Jen Garrett, and emergency physician Dr. Luke Palmisano about the role metabolic health can play inside—and outside—the traditional medical system. Drawing on their professional experiences in surgery, emergency medicine, and medical education, the panelists describe a health care system that can be remarkably effective at treating acute illness and injury while struggling to address the lifestyle and metabolic factors driving chronic disease.
The panel discusses how nutrition, exercise, sleep, and metabolic health can become a larger part of patient care, from teaching future clinicians to asking better questions to helping patients address the root, lifestyle causes that may contribute to repeated medical problems. The panelists also describe the obstacles they encounter within hospitals and medical training, including limited time, entrenched practices, and environments that can contradict the health advice clinicians are expected to give.
A recurring theme throughout the discussion is the potential for doctors, PAs, and coaches to work more closely together. The panel explores what each can contribute, where the current medical system leaves gaps, and how gyms and trained coaches may be able to provide the education, accountability, and day-to-day support that clinicians often do not have the time or structure to deliver.
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Metabolic health, medical education, and the case for bringing clinicians and coaches together
At the 2026 Unbreakable Health Retreat in Miami, Emily Kaplan hosted a panel with Bob Kaplan, Professor Thomas Seyfried, and Dr. Derek Lee on what it means to treat cancer as a metabolic disease. They discussed the glucose-ketone index (GKI), nutritional ketosis, and strategies aimed at restricting the fuels cancer cells depend on while considering how metabolic therapy can fit alongside standard cancer treatment.
The conversation also addressed the practical realities patients face when trying to pursue a metabolic approach within the conventional oncology system, including questions about nutrition, repurposed drugs, inherited cancer risk, and how to evaluate different treatment options. Seyfried and Lee connected these clinical questions back to mitochondrial dysfunction, fermentation, and the metabolic vulnerabilities that may offer additional targets for cancer treatment.
An abbreviated version of this discussion is available here, for free.
At the 2026 Unbreakable Health Retreat in Miami, Professor Thomas Seyfried presented the case that cancer is fundamentally a mitochondrial metabolic disease rather than primarily a genetic one. He contrasts the dominant somatic mutation theory with a metabolic model in which impaired mitochondrial respiration drives a shift toward fermentation, dysregulated cell growth, and the mutations commonly associated with cancer.
Citing the work of Otto Warburg and research from his lab at Boston College, Seyfried explains how cancer cells rely heavily on fermentable fuels—particularly glucose and glutamine—and why mitochondrial dysfunction sits upstream of many of the genetic abnormalities seen in tumors. He also discusses reactive oxygen species, altered cellular signaling, and the role of mitochondria in regulating cell growth and behavior.
The presentation then turns to the therapeutic implications of this model. Seyfried explains strategies aimed at placing tumor cells under metabolic stress by restricting the fuels they depend on, including ketogenic metabolic therapy and approaches targeting glucose and glutamine. For Seyfried, the therapeutic target follows directly from the biology: restrict the fuels cancer cells depend on, exploit their metabolic weaknesses, and treat mitochondrial dysfunction as the central feature of the disease.
An abbreviated version of this discussion is available here, for free.
MetFix and BSI Members can view the full 54-minute video.
