The Curbsiders Internal Medicine Podcast #520: Healthspan Medicine, A Practical Approach
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Apr 6, 2026 Sandeep Palakodeti, MD, MPH — board-certified internist, entrepreneur, and founder of Velocity Health. He walks through using CGMs in non-diabetics, interpreting early cardiometabolic risk beyond A1c, and practical exercise prescriptions. Short takes on VO2 max, body composition, sleep and wearables, and a cautious framework for peptides.
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Wearables Can Cause Harmful Tradeoffs
- Data neuroses from wearables can drive harmful diet swings, like carnivore diets to avoid CGM spikes.
- Palakodeti warns this may trade glucose control for higher ApoB and atherogenic risk.
Prioritize ApoB Lp(a) Body Composition And VO2 Max
- Prioritize ApoB, Lp(a), body composition, and VO2 max to assess cardiometabolic risk beyond LDL and A1c.
- Palakodeti orders ApoB/Lp(a), DEXA for visceral fat and ALMI, and VO2max estimates to quantify risk.
Measure Body Composition For Trends Not Precision
- Use simple, consistent body composition tools rather than chasing precision; track change over time on the same device.
- Palakodeti prefers calipers or waist‑to‑height ratio and emphasizes trend rather than exact percent body fat.
