The mission of the Society of Metabolic Health Practitioners (SMHP) is reflected in the objective of the 2025 Symposium for Metabolic Health. Its central tenet is improving global metabolic health through ‘education, training, and support of evidence-based nutritional approaches, including carbohydrate reduction as a valid therapeutic option or intervention’.1 The accelerating rise of metabolic diseases in the 21st century poses a global health crisis, driving increases in disability-adjusted life years and mortality.2 Urgent, coordinated international action is needed to reverse these trends and safeguard future population health. In response to this crisis, the SMHP convenes biannual conferences for health professionals worldwide.
The SMHP unites healthcare professionals to advance care for people living with chronic diseases. Its work includes professional webinars, a research academy, journal clubs, forums, blogs and developing position statements. Through these efforts, members gain access to educational resources, patient resources and tools to improve their practice.
The research academy trains members to conduct and publish studies, Grand Rounds showcase current research and practice applications, and biannual Metabolic Health Symposia gather professionals, researchers and the public for updates on global metabolic health efforts. This year’s conference exemplified collaboration between SMHP, clinicians and researchers, to share emerging evidence. This report reviews key presentations and research findings from the 2025 Symposium, with a focus on neurodegenerative and neurological disease conditions, broader metabolic health issues and clinical applications to guide future research.
Conference overview and objectives
The 2025 Symposium for Metabolic Health, held in San Diego, California, brought together healthcare professionals, researchers and the public to examine the latest advancements in metabolic health. The 4-day event focused on therapeutic carbohydrate reduction (TCR) and its role in neurodegenerative diseases (Parkinson’s disease, Alzheimer’s disease, multiple sclerosis and amyotrophic lateral sclerosis), as well as insulin resistance, inflammation and hyperinsulinaemia. Sessions also addressed related conditions such as type 2 diabetes, obesity and cardiovascular disease.
The Symposium provided practitioners with evidence-based strategies for managing metabolic and neurological disorders, highlighted state-of-the-art approaches in chronic disease care and current policy implications. Qualified professionals received CME for licensure. Table 1a and Table 1b3 list the presenters and their topics.
Presenters and topics.
Speakers
Topic-Title
Michael Hoffman
Dementia
Denise Potter
Epilepsy
Dominic D’Agostino
Traumatic brain injury
Michael Hoffman
Migraine
Csilla Ari D’Agostino
Neuroprotection and neuroregeneration with ketone metabolic therapy
Dave Feldman
CTA: Preliminary data on the final analysis
Dr Annette Bosworth
Menopause brain: Why every man should care
Dr. Ben Bocichio
Fast track to health – ‘Slow’ resistance training building metabolic health one muscle at a time
Dr Robert Kilz
Reproductive dysfunction and the carnivore cure
Roshana Saghani
Become a better coach by listening deeper
Gary Taubes
The stickiness problem: A history of metabolic Ketogenic therapies and the challenge to acceptance and use
Dr. Tony Hampton
Obesity without overeating
Craig Emmerich
A deeper dive into insulin and ketones
Peter Ballerstedt
Food for thought: Metabolic health & ‘sustainability’
Belinda Fettke
How do you sell the blue zones ‘Longevity Pill’ To the western world?
Bret Scher
Metabolic psychiatry: Redefining mental illness through a metabolic lens
Dr. Robert Cywes
Metabolic health: Macros v hormones – Diet v lifestyle notes
Barbara Levy
Menopausal hormone therapy: Who, what, when, and why
Dr. Steve Phinney
Dietary fat and fatty acid metabolism from the keto-adapted perspective
Lilly Johnston
Plaque, proof and prevention: Rethinking cardiovascular risk
Dr. Brian Lenzkes
It takes guts to talk about this: The gut microbiome and metabolic health
Dr. Adrian Soto-Mota
Predicting high and low cardiovascular risk in people with an LMHR phenotype. New data from the Keto-CTA study
Panel: Roshani Sanghani, Barbara Levy, Lily Johnston, Dave Feldman, Csilla Ari D’Agostino,
Final panel discussion and Q&A
Note: Speaker schedule for the symposium3 was taken from the SMHP website. Please see the full reference list of the article, Tidman MM, White DR, White TA. Symposium for metabolic health 2025: Conference report and summary of highlights. J. metab. health. 2025;8(1), a130. https://doi.org/10.4102/jmh.v8i1.130, for more information. Earn 28 Prescribed Category 1 CME credits or 4 years of CEU credit for NASN practitioners.
CTA, computed tomography angiography; ADHD, attention-deficit hyperactivity disorder; LMHR, Lean mass hyper-responder; SMHP, Society of Metabolic Health Practitioners; CME, continuing medical education; CEU, continuing education units; NASN, national association of school nurses; Q&A, questions and answers.
Presenters and topics.
Professional poster presentations
Title-Topic
Peter Ballerstedt, PhD
Operation grassroots: Empowering non-medical professionals to promote metabolic health
Lori Calabrese, MD
Toxic roots: How the breakdown begins-and how to heal
Dr. Claire Cohen
The ketogenic diet as a metabolic intervention in bipolar disorder and schizophrenia: A review of current evidence and clinical potential
Jana Cupp, CNA
Children’s mental health resource center ketogenic therapy in action programme
Csilla Ari D’Agostino
Chronic supplementation with exogenous ketones induces divergent hepatic and inflammatory
Rachel Frase
Ketogenic diet or neurosurgery: When wild fear walks into a metabolic psychiatry practice
Dorian Greenow, Keto Mojo
Therapeutic Carbohydrate Reduction (TCR) in diabetes management
Ally Houston
Food in ADHD and depression (FAD) study protocol. Diet and coaching for the management of attention deficit hyperactivity disorder and related depression Symptoms: A 16-week randomised controlled intervention efficacy study
Aayush Khanna
Metabolic health is not just for adults: Let’s start early
Dr. Melanie Tidman
The SMHP research academy
Dr. Melanie Tidman
The ketogenic diet and MetSyn in Parkinson’s disease: A case study
Dr. Melanie Tidman
A synergistic approach to bone and metabolic health: Case study on the impact of a ketogenic diet, resistance training, and bioavailable calcium: A case report
Dr. Steve Riggs
Implementing TCR in primary care settings: A feasibility study
Note: Speaker schedule for the symposium3 was taken from the SMHP website. Please see the full reference list of the article, Tidman MM, White DR, White TA. Symposium for metabolic health 2025: Conference report and summary of highlights. J. metab. health. 2025;8(1), a130. https://doi.org/10.4102/jmh.v8i1.130, for more information. Earn 28 Prescribed Category 1 CME credits or 4 years of CEU credit for NASN practitioners.
CTA, computed tomography angiography; ADHD, attention-deficit hyperactivity disorder; LMHR, Lean mass hyper-responder; SMHP, Society of Metabolic Health Practitioners; CME, continuing medical education; CEU, continuing education units; NASN, national association of school nurses; PhD, Doctor of Philosphy; MD, Doctor of Medicine; CNA, Certified Nursing Assistant.
Neurological conditionsDay 1
On the first day of the Symposium, the focus was on applying TCR and ketogenic strategies to neurological and neurodegenerative conditions. Presentations opened with an overview of epilepsy and seizure disorders, affecting nearly 50 million individuals worldwide.4 Speakers emphasised the high prevalence of treatment-resistant epilepsy, affecting roughly one-third of paediatric patients, and highlighted evidence demonstrating seizure reductions of 50% – 90% in children adhering to TCR or ketogenic diets. Practical strategies for patient education and clinical application were discussed.
Sessions then addressed the neuroprotective role of ketones in traumatic brain injury (TBI), particularly in the acute post-injury phase. Evidence showed that blood ketone levels of 1.0 mmol/L – 2.0 mmol/L may mitigate neuronal damage and that combining exogenous ketone with hyperbaric oxygen therapy yields favourable outcomes. Presenters also addressed migraines, described as ‘brain angina’, affecting over one billion people, predominantly women, and linked to factors such as TBI, Vitamin D deficiency, alcohol use, insulin resistance, tumours, periodontal disease and vascular changes.
A dementia session reported a 24% rise in early-onset cases, with PET (positron emission tomography) imaging studies linking cortical impairment to metabolic syndrome, mild cognitive impairment, dementia and related risks. Experts introduced ‘The Five Brain Fitness Rules’, based on work by Medina: physical activity, low-carbohydrate nutrition, sleep hygiene, social engagement and cognitive training.5 They also urged a re-evaluation of hormone replacement therapy (HRT), citing its neurological benefits and flaws in earlier studies.
The day concluded with menopause-related brain changes, particularly the impact of oestrogen depletion on metabolism, cognition and mood. Oestrogen receptors in the hippocampus and brainstem were noted, alongside a critical re-examination of the 2003 HRT study that influenced decades of clinical practice. Speakers stressed the need to revisit HRT, given its methodological flaws and its potential role in supporting long-term neurological health.
Metabolic health applications to practice settings
The remainder of the Symposium (Days 2–4) highlighted the practical applications of metabolic health research across various settings, including clinical, reproductive, community and performance contexts.
Day 2
The second day highlighted translational research and patient-centred strategies, including slow resistance training and findings from the Lean Mass Hyper-Responder (LMHR) Keto computed tomography angiography (CTA) study. Presentations explored carnivore diets in relation to reproductive dysfunction and provided motivational interviewing techniques to support adherence to these diets. The day closed with a historical review of ketogenic therapies and their growing clinical significance.
Day 3
The third day centred on a broader public health perspective. Speakers presented metabolic strategies for addressing obesity and insulin resistance, followed by discussions on building collaborations with agricultural professionals to develop sustainable food systems. The final session critically evaluated research on regions of the world where people live significantly longer, known as ‘blue zones’, contrasting plant-based health campaigns with the sociopolitical and religious forces influencing their global promotion.
Day 4
The final day examined the intersection of metabolic and mental health, alongside advanced clinical assessment tools. Sessions covered metabolic lab work for individualised therapies, long-term challenges of carnivore diets and fat metabolism in fat-adapted athletes. Additional presentations revisited LMHR Keto CTA data, emerging evidence in women’s health and the value of carotid intima-media thickness and coronary artery calcium scans for cardiovascular risks. The Symposium concluded with an interactive panel allowing participants to engage with experts, apply insights and synthesise the learning from the 4-day programme.
The Society of Metabolic Health Practitioners: Research academy
The SMHP Research Academy presented four projects led by faculty and members, reflecting its commitment to expanding evidence-based TCR and ketogenic strategies in chronic diseases. Projects included a systematic review on ketogenic therapies in metabolic psychiatry (bipolar disorders and schizophrenia); a case study applying ketogenic nutrition to osteoporosis with metabolic syndrome; a ketogenic intervention in Parkinson’s; and a large-scale database analysis evaluating TCR in medical practice. Each emphasised patient-centred outcomes and clinical relevance. Posters further showcased diverse research and clinical applications. Strong international participation highlights SMHP’s global reach and dedication to collaboration, advancing evidence-based metabolic health and improving patient outcomes.
Networking and educational opportunities
Beyond the scientific sessions, the Symposium fostered collaborations and extended learning beyond the lecture hall. Discussions highlighted emerging trends in metabolic health, clinical applications, ongoing research and future directions. The event drew over 500 participants, with half attending in person and the other half participating virtually, and featured 22 international speakers representing diverse disciplines.
Networking enriched the 4-day programme, with sponsored dinners facilitating informal dialogue and post-session showcases of original research and clinical practice. The Expo connected attendees with new technologies, diagnostics and nutritional innovations. Notably, three of the four SMHP Research Academy projects presented as posters are now slated for journal submission, underscoring the Society’s mission to advance evidence-based metabolic research through global collaboration and education.
Conclusion
The 2025 Symposium for Metabolic Health, held in San Diego, gathered approximately 500 global practitioners for 4 days of research presentations, panel discussions and collaborative exchange. While centred on neurological and neurodegenerative conditions (including the use of TCR in dementias, migraines, TBI and menopause-related brain changes), the programme also addressed a broad range of metabolic health topics spanning clinical care, public health and patient engagement. Poster sessions, sponsored dinners and informal networking reinforced the Symposium’s role as an educational forum and catalyst for future collaboration. Attendee surveys reflected this impact, with 73% (38/52) rating the conference as excellent, 25% (13/52) as good and 0.01% (1/52) as neutral (Figure 1).6
Survey results: How would you rate the overall quality of the conference?
Looking ahead, organisers plan to expand the SMHP Research Academy’s presence, increase poster presentations and introduce disease-specific research roundtables to deepen collaboration between providers and investigators. Day 1 will continue to spotlight a focused theme, ensuring both breadth and depth in programme content. Through these efforts, future symposia aim to build on the momentum of 2025, advancing global understanding and innovation in metabolic health.
Acknowledgements
This article is based on conference papers originally presented at 2025 Symposium for Metabolic Health, held in San Diego, California, United States, on 14–18 August 2025. The conference paper, titled ‘Symposium for Metabolic Health 2025: Conference Report and Summary of Highlights’ was subsequently expanded and revised for this journal publication. This re-publication is done with permission from the conference organisers. The authors utilised OpenAI’s ChatGPT (https://chat.openai.com/) to assist in generating ideas, refining the writing process, reorganising the original content and adhering to the journal’s requirements.
Competing interests
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
CRediT authorship contribution
Melanie M. Tidman: Conceptualisation, Methodology, Investigation, Writing, Project administration, Resources, Editing, Supervision. Dawn R. White: Methods, Writing, Data, Table creation. Tim A. White: Writing, Editing. All authors reviewed the article, contributed to the discussion of results, approved the final version for submission and publication, and take responsibility for the integrity of its findings.
Data availability
The data that support the findings of this study are available on request from the corresponding author, Melanie M. Tidman.
Disclaimer
The views and opinions expressed in this article are those of the authors and are the product of professional research. The article does not necessarily reflect the official policy or position of any affiliated institution, funder, agency, or that of the publisher. The authors are responsible for this article’s results, findings and content.
ReferencesSociety of Metabolic Health Practitioners (SMHP). Mission statement [homepage on the Internet]. Society of Metabolic Health Practitioners; 2025[cited 2025 Aug 28]. Available from: https://thesmhp.org/about-us/mission/ZhangH, ZhouXD, ShapiroMD, et al. Global burden of metabolic diseases, 1990–2021. Metabolism. 2024;160:155999. https://doi.org/10.1016/j.metabol.2024.155999Society of Metabolic Health Practitioners (SMHP). Speaker schedule [homepage on the Internet]. Society of Metabolic Health Practitioners; 2025[cited n.d.]. Available from: https://thesmhp.org/WHO. Epilepsy [homepage on the Internet]. World Health Organization; 2025[cited 2025 Aug 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsyMedinaJ. Brain rules (updated and expanded): 12 principles for surviving and thriving at work, home, and school. 2nd ed. Seattle, Washington: Pear Press; 2014.Society of Metabolic Health Practitioners (SMHP). Satisfaction Survey Results [homepage on the Internet]. SMHP; 2024[cited 2025 Sep 10]. Available from: https://thesmhp.org/?gad_source=1&gad_campaignid=23206517199&gbraid=0AAAABADZ10cnaqNT47nETCnEq6Vlmi-rc&gclid=CjwKCAiAzrbIBhA3EiwAUBaUdVA6BnPJTg1Sdu8LPy_UuezqGbc_-yG6N_mWwcS6i9bBZlsMuwmgOxoC6LkQAvD_BwE
How to cite this article: Tidman MM, White DR, White TA. Symposium for metabolic health 2025: Conference report and summary of highlights. J. metab. health. 2025;8(1), a130. https://doi.org/10.4102/jmh.v8i1.130