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.

In this episode, Dr. Chad Larson and Nicole demonstrate a metabolically aligned pancake recipe filmed in their home kitchen. The conversation covers the carbohydrate math behind traditional pancakes — roughly 50 to 70 grams of net carbs per stack — and how reformulation drops that to about 1.5 grams per pancake without giving up the experience of pancakes as a meal.

Each ingredient swap carries its own clinical reasoning. Almond flour and flaxseed meal replace wheat flour, with the flaxseed contributing lignans, omega-3 fatty acids, and a soluble-insoluble fiber blend that supports the gut microbiome. Monk fruit and allulose replace sugar without measurably affecting glucose or insulin. Coconut oil supplies medium-chain triglycerides — a fat your mitochondria convert to ketones with very little metabolic friction. Cinnamon contributes to post-prandial glucose regulation.

The broader point of the episode is the distinction between restriction and control. Restriction is what diets do. Control is what food literacy gives you, and it's the basis for the kind of metabolic health that survives a stressful quarter, a holiday week, or the rest of your life.

This episode is part of the ongoing Kitchen Video series. The full video version is available on YouTube.

Dr. Chad and his wife Nicole walk through a four-ingredient
skillet meal they fall back on most weeks — rotisserie chicken,
mushrooms, onions, and arugula, cooked in a single cast-iron pan
in about twelve minutes. The conversation moves through why each
ingredient earns its place metabolically and why the most durable
patients aren't the most precise eaters — they're the most
repeatable.

Topics covered:
- Protein as the metabolic anchor — thermogenesis, glucose
steadying, and muscle protein synthesis
- Why arugula's glucosinolates support phase 2 liver detoxification
- Inulin in onions and what prebiotic fiber actually does for the
gut microbiome
- Beta-glucan in mushrooms and its role in immune and
gastrointestinal function
- Why "good, better, best" beats "perfect" when sourcing real
ingredients
- How Nicole plans meals around tomorrow's schedule instead of
prepping for the week

Dr. Chad is a naturopathic medical doctor (NMD) running
The Adapt Lab, an integrative metabolic health practice in
Solana Beach, California.

Learn more at doctorchadlarson.com.

This podcast is for educational purposes only and does not
constitute medical advice. Always consult your physician
before making changes to your health regimen.

Tags: metabolic health, naturopathic medicine, functional medicine,
real food, gut microbiome, integrative medicine