FoundMyFitness Podcast Summary: Episode #104 with Dr. Ben Bikman

Title: FoundMyFitness
Host: Dr. Rhonda Patrick, Ph.D.
Guest: Dr. Ben Bikman, Ph.D.
Episode Title: How To Reverse Insulin Resistance Through Diet, Exercise, & Sleep
Release Date: July 11, 2025

Introduction

In Episode #104 of FoundMyFitness, host Dr. Rhonda Patrick engages in an insightful conversation with Dr. Ben Bikman, a renowned expert in insulin metabolism and Professor of Physiology and Developmental Biology at Brigham Young University. The discussion delves deep into the multifaceted role of insulin resistance in chronic diseases and explores actionable strategies to reverse it through dietary changes, exercise, and optimized sleep.

Understanding Insulin Resistance

Dr. Rhonda Patrick opens the discussion by highlighting the pivotal role of insulin resistance in driving chronic conditions such as obesity, diabetes, cardiovascular diseases, and cognitive decline. She emphasizes that insulin resistance often develops silently, persisting for years before glucose levels indicate a problem.

Dr. Rhonda Patrick [00:00]: "Insulin resistance is increasingly recognized as a key contributor to chronic diseases such as obesity, diabetes, cardiovascular disease and even cognitive decline..."

Dr. Bikman underscores the concept of "pre pre diabetes," where individuals have elevated insulin levels without yet showing elevated blood glucose, making early detection challenging.

The Glucose-Centric Paradigm

The conversation critiques the traditional medical focus on glucose levels for monitoring metabolic health, arguing that this approach misses early signs of insulin resistance.

Dr. Ben Bikman [05:19]: "Much of modern clinical care has what I call a glucose-centric paradigm when it comes to monitoring metabolic health..."

Bikman advocates for incorporating insulin measurements into routine health assessments to identify insulin resistance early, potentially preventing the progression to type 2 diabetes.

Detection and Early Signs of Insulin Resistance

Dr. Bikman discusses practical methods for detecting insulin resistance outside of conventional blood tests. He highlights the utility of Continuous Glucose Monitors (CGMs) for monitoring dynamic glucose changes post-meals.

Dr. Ben Bikman [08:56]: "I'm an enormous advocate of CGM use... If a person's curious about their insulin resistance, in many instances you don't even need to get a blood test."

Additionally, he mentions visible physical indicators such as acanthosis nigricans and skin tags as strong evidence of insulin resistance.

Insulin's Broader Physiological Roles

Beyond glucose regulation, insulin plays critical roles in various bodily functions, including fat storage, appetite regulation, inflammation, and hormone synthesis.

Dr. Ben Bikman [23:02]: "Insulin has a direct inhibitory role on aromatase... It also regulates nitric oxide production, regulating dilation of blood vessels and other hormones throughout the body..."

Understanding these diverse roles underscores why insulin resistance can lead to a multitude of health issues, making it a central target for intervention.

Macronutrients and Insulin Sensitivity

The duo explores how different macronutrients impact insulin signaling and metabolic health. They discuss the nuanced effects of refined carbohydrates, sugars, saturated fats, and polyunsaturated fats.

Dr. Ben Bikman [31:41]: "In cell cultures, if you treat cells with saturated fat, palmitate... you get insulin resistance very quickly."

However, Bikman notes that in low-carbohydrate contexts, saturated fats and certain polyunsaturated fats do not induce insulin resistance, highlighting the importance of dietary context.

Meal Timing and Frequency

Meal timing is pivotal in managing insulin sensitivity. Bikman advocates for time-restricted eating and intermittent fasting to keep insulin levels consistently low, thus enhancing metabolic flexibility.

Dr. Ben Bikman [57:37]: "High carb diet with abundant calories, eating multiple times a day is the worst way to do it."

He recommends having fewer meals, preferably earlier in the day, and avoiding late-night snacking to improve both metabolic health and sleep quality.

Fat Cell Dynamics: Hyperplasia vs. Hypertrophy

A key segment focuses on the differences between fat cell hyperplasia (increasing the number of fat cells) and hypertrophy (increasing the size of existing fat cells).

Dr. Ben Bikman [97:17]: "Some ethnicities like whites and blacks have the ability to make new fat cells... whereas East Asians and South Asians predominantly undergo hypertrophy."

Hypertrophic fat cells are more insulin-resistant and pro-inflammatory, leading to higher risks of metabolic diseases despite lower overall fat mass.

Environmental Factors Affecting Insulin Resistance

Beyond diet and exercise, environmental toxins such as particulate matter (PM2.5), cigarette smoke, and microplastics contribute to insulin resistance by inducing inflammation and mitochondrial dysfunction.

Dr. Ben Bikman [72:55]: "We have published reports looking at PM 2.5 diesel exhaust particles... they had much fatter fat cells... even though they were eating the exact same amount of calories."

While acknowledging the significance of these factors, Bikman emphasizes that dietary and lifestyle changes remain more actionable for the average person.

GLP1 Agonist Medications: Benefits and Pitfalls

The discussion shifts to GLP1 agonists like Ozempic and Wegovy, examining their mechanisms, benefits for weight loss, and potential long-term risks.

Dr. Ben Bikman [132:07]: "At the lower dose originally used, these GLP1 activators worked by inhibiting glucagon... At higher doses, they delay gastric emptying and activate satiety centers."

While recognizing their effectiveness in reducing appetite and promoting weight loss, Bikman expresses concerns over long-term usage, citing increased risks of depression and suicidal behavior.

Practical Strategies to Reverse Insulin Resistance

Dr. Bikman offers actionable strategies to improve insulin sensitivity:

1. Dietary Modifications:

   • Control Carbs: Focus on whole fruits and vegetables, avoiding refined carbohydrates and sugars.
   • Prioritize Protein and Fat: Incorporate ample protein and healthy fats to stabilize insulin levels.
   • Supplements: Berberine and apple cider vinegar can aid in reducing blood glucose levels.

   Dr. Ben Bikman [175:17]: "Control carbs, prioritize protein, don't fear fat."

2. Exercise Protocols:

   • Strength Training: Enhances muscle mass, increasing glucose disposal.
   • High-Intensity Interval Training (HIIT): Boosts metabolic rate and insulin sensitivity.
   • Exercise Snacks: Short bouts of physical activity post-meals can reduce glucose spikes.

   Dr. Ben Bikman [53:31]: "Get to failure... fatigue yourself."

3. Meal Timing:

   • Intermittent Fasting: Limit eating to earlier parts of the day and avoid late-night meals.
   • Avoid Evening Snacking: Reduces insulin spikes that can disrupt sleep and promote fat storage.

Key Biomarkers for Metabolic Health and Longevity

Dr. Bikman emphasizes the importance of specific biomarkers in assessing metabolic health:

1. Fasting Insulin: A critical indicator of insulin resistance. Levels below 6 µU/mL are ideal, while levels in the mid-teens to 20s signal potential issues.

   Dr. Ben Bikman [175:32]: "Fasting insulin... if it's up to about the mid teens or high teens, it's a problem."

2. Triglyceride to HDL Ratio: A better predictor of cardiovascular risk than LDL cholesterol.

   Dr. Ben Bikman [173:50]: "If that number is less than 1.5, that's a great sign..."

3. Uric Acid: Lower levels correlate with better longevity and metabolic health.

4. A1C: Reflects average blood glucose levels over three months, useful for diabetes diagnosis and management.

Conclusion: Practical Takeaways for Improved Metabolic Health

Dr. Bikman and Dr. Patrick conclude the episode by offering succinct, actionable advice:

• Change Breakfast Habits: Avoid high-carb, sugary breakfasts. Opt for low-glycemic meals rich in protein and healthy fats.

  Dr. Ben Bikman [175:32]: "Change breakfast tomorrow... eat a low glycemic load meal."

• Embrace Time-Restricted Eating: Concentrate caloric intake earlier in the day and fast during evening hours to enhance insulin sensitivity and improve sleep quality.

• Incorporate Regular Exercise: Focus on strength training and HIIT to increase muscle mass and metabolic rate.

• Utilize Supplements Wisely: Consider berberine and apple cider vinegar to support blood glucose management.

• Monitor Key Biomarkers: Regularly check fasting insulin, triglyceride to HDL ratio, and uric acid to stay informed about metabolic health.

Dr. Bikman underscores the transformative potential of these strategies, citing a clinical report where newly diagnosed type 2 diabetics reversed their condition within 90 days through lifestyle interventions alone.

Dr. Ben Bikman [81:06]: "In just 90 days, their A1C went down the average from 8.9 to 5.6... without a pill or injection."

Final Thoughts

This episode of FoundMyFitness provides a comprehensive exploration of insulin resistance, its pervasive impact on health, and strategic interventions to reverse its effects. Dr. Ben Bikman's expertise offers listeners a nuanced understanding of metabolic health, empowering them with knowledge and practical tools to enhance their longevity and quality of life.

For more insights and updates on metabolic health, visit Dr. Ben Bikman's website at BenBikman.com and follow his work on InsulinIQ.

Note: All quotes are attributed with their respective timestamps for reference and continuity.