(3.15) The Sapien Lifestyle and Its Effects on the Markers of Metabolic Disease

There are limited studies on nutrition and its effects on disease, specifically investigating long-term sustainability of a low-carbohydrate, high fat lifestyle within our healthcare system. The Sapien diet created by Dr. Gary Shlifer and Brian Sanders consists of minimally processed, nutrient dense whole foods, focusing on protein, embracing fat, and minimizing carbohydrates, in addition to having a condensed eating window. Hence, we aimed to investigate how the Sapien diet can produce an improvement in a patient’s metabolic markers, weight, and ultimately chronic disease management.

Methods:

A retrospective observational study was conducted using data from 2017 to 2022 at Evolve Healthcare. Evolve Healthcare is a primary care office that educates and instills the Sapien Lifestyle to patients. Records were screened for BMI > 25, ages 18-75, and those that had been counseled on Sapien Lifestyle with a minimum of three office visits. A minimum of three visits was used as a marker of compliance. Patients with Type 1 DM or those taking insulin were excluded from this study.  Values analyzed included: BMI, HgbA1C%, total cholesterol, HDL, triglycerides, LDL, triglycerides/HDL ratio, fasting insulin and CRP. Baseline lab values (before Sapien Lifestyle intervention) were compared to values at various follow up visits up to 18 months. A repeated measures analysis was used to calculate the average value of each marker at baseline and 18 months with standard error also noted. Statistical significance was determined if the p-value was less than 0.05, indicating a difference existed among the average values of each metabolic marker.

Results:

Data analysis revealed a significant reduction in average triglycerides 155 to 113 (p < 0.03), average BMI 32.2 to 30.8 (p < 0.01), average fasting insulin 9.8 to 9.5 (p < 0.01), and the TGL/HDL ratio 3.4 to 2.4 (p < 0.01) when lab values were compared at baseline and 18 months. No significant reduction was found in total cholesterol levels, HgbA1c, CRP or HDL.

Discussion/Conclusion:

There are limited studies on nutrition and its effects on metabolic disease. Our goal was to investigate how the Sapien Diet and Lifestyle affects markers of metabolic disease. Early detection of elevated TGL/HDL ratios can serve as an early marker for detection of atherosclerotic complications providing primary care providers with objective data to help intervene earlier. Early detection of an elevated fasting insulin can also help detect if a patient is progressing towards diabetes mellitus. This study showcases how diet and lifestyle can help with weight loss/maintenance, disease prevention, and potentially metabolic disease reversal. There is no research comparing lifestyle modifications versus pharmaceutical intervention for the management of metabolic disease. Furthermore, most research on metabolic health is driven by the pharmaceutical industry with the goal of showing the benefits of a particular pharmaceutical drug. Lifestyle modifications need to be assessed against pharmaceutical interventions and this research has not yet been completed. Our research indicates that the Sapien Diet and Lifestyle improves overall biomarkers and improves BMI.