Metabolic OS with Dr. Chad Larson
This episode covers oven-baked tilapia served over a Mediterranean salad — and organizes the argument around a practical fish hierarchy: good is tilapia, better is salmon, best is wild Alaskan sockeye. The framing is a more clinically useful way to think about what each fish is doing and what the rest of the plate needs to contribute. Chad Larson, NMD walks through the SMASH framework — salmon, mackerel, anchovy, sardines, herring — as the oily fish category delivering 1,500 to 2,500 mg of EPA and DHA per 100 grams, versus tilapia's roughly 100 to 200 mg. That gap is structural: farmed tilapia's omega-6 to long-chain omega-3 ratio averages around 11:1 (Chilton et al., Wake Forest, 2008), a feature of corn- and soy-based aquaculture feed that hasn't materially changed. What tilapia does contribute — 26 grams of protein per 100 grams, selenium, B12 — earns it a place as a legitimate weeknight protein source. The omega-3 case has to come from elsewhere in the week. The episode also covers sourcing: nearly all tilapia sold in US retail is farmed, with domestic producers (Regal Springs, Blue Ridge Aquaculture) operating under tighter feed standards; Trader Joe's frozen tilapia is flagged as a practical default. The cardiometabolic argument rests on the olive oil, not the fish. Tilapia has roughly 2 grams of total fat per 100 grams. The butter and high-polyphenol EVOO used in cooking, and the additional olive oil added at the end, are filling in what the fish doesn't bring. Oleuropein and hydroxytyrosol, the active phenolic compounds in early-harvest EVOO, carry the mechanism. A 2023 meta-analysis of 33 trials in the Journal of Nutrition found meaningful improvements in insulin sensitivity associated with high-polyphenol extra virgin olive oil. The Mediterranean salad — Kalamata olives, chickpeas, pepperoncinis, romaine, Pecorino Romano — is built around the same framework. This episode is part of the ongoing Kitchen Video series. The full video version is available on YouTube.
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