Podcast Summary: The Diary Of A CEO with Steven Bartlett
Episode Title: The Insulin & Glucose Doctor: This Will Strip Fat Faster Than Anything! The Fastest Way To Alzheimer’s! The Link Between Sugar & Cancer!
Guest: Dr. Benjamin Bikman
Release Date: February 6, 2025
Introduction to Dr. Benjamin Bikman and His Mission
In this enlightening episode, Dr. Benjamin Bikman, a leading metabolic scientist, joins Steven Bartlett to discuss the pervasive issue of insulin resistance and its far-reaching impacts on health. Dr. Bikman emphasizes his mission to reframe our understanding of chronic diseases by highlighting their common metabolic roots.
Notable Quote:
Dr. Bikman [02:24]: "My mission is to help people appreciate that much of chronic disease, we look at them as these siloed individual, distinct disorders with totally distinct origins. And yet much of them share a common core."
Understanding Insulin Resistance: Definition and Impacts
Dr. Bikman defines insulin resistance as a condition where cells in the body become less responsive to insulin, a hormone crucial for regulating blood glucose levels. This resistance is a precursor to various chronic diseases, including Alzheimer's, type 2 diabetes, heart disease, infertility, erectile dysfunction, and PCOS.
Notable Quote:
Dr. Bikman [00:00]: "Vaping is probably worse in terms of the damage to the airway and the insulin resistance that comes from it. But this gets worse because we know that insulin resistance is the core for most chronic diseases that are killing us."
Two Pathways to Insulin Resistance: Fast and Slow Lanes
Dr. Bikman outlines two distinct pathways leading to insulin resistance:
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Fast Insulin Resistance:
- Causes: Stress, inflammation, and excessive insulin levels.
- Characteristics: Develops rapidly (within hours) and can be reversed quickly by removing the causative factors.
Notable Quote:
Dr. Bikman [07:00]: "There are the fast lane, which I call fast insulin resistance, and it actually has three lanes, which I'll describe in a moment. Then there's the slow insulin resistance, which takes a little longer to get there..."
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Slow Insulin Resistance:
- Causes: Chronic dietary habits, particularly high carbohydrate intake.
- Characteristics: Develops gradually and is harder to reverse due to permanent changes in fat cell behavior and size.
Notable Quote:
Dr. Bikman [03:27]: "Insulin is a hormone that affects literally every single cell of the body. But if those cells become insulin resistant, you start to spread the disease."
Evolutionary Basis of Insulin Resistance
Dr. Bikman delves into the expensive tissue hypothesis, suggesting that human ancestors evolved to consume more nutrient-dense foods like meat, leading to a reduction in gut size and an increase in brain size fueled by ketones. This evolutionary shift underscores the brain's dependence on both glucose and ketones for optimal function.
Notable Quote:
Dr. Bikman [34:53]: "Alzheimer's disease almost always have some detectable instance of insulin resistance, if not full on diabetes, type 2 diabetes."
Insulin Resistance and Chronic Diseases: Alzheimer’s, PCOS, etc.
Insulin resistance is implicated in numerous chronic conditions:
- Alzheimer's Disease: Referred to as "type 3 diabetes," it's characterized by insulin resistance in the brain, leading to cognitive decline.
- PCOS: Insulin resistance affects ovarian function, contributing to infertility.
- Erectile Dysfunction: Insulin resistance affects blood vessel function, leading to erectile issues.
Notable Quote:
Dr. Bikman [09:16]: "Insulin isn't working quite as well as it used to. That's what gives it the name insulin resistance. But there's another part that is equally present, which is that blood insulin levels are higher."
Ethnicity and Fat Cell Storage
Fat storage varies across ethnicities, influencing susceptibility to insulin resistance and related diseases:
- Caucasians and Africans: Tend to have more fat cells that are smaller and stored subcutaneously (under the skin), which is metabolically healthier.
- East Asians and Hispanics: Have fewer fat cells that are larger and stored viscerally (around organs), increasing the risk of insulin resistance and metabolic diseases even at lower body fat levels.
Notable Quote:
Dr. Bikman [24:43]: "Women, as a result of their particular sex hormones, have more fat cells, but they're smaller. So she has more fat, but smaller fat cells. And small fat cells are healthy, insulin sensitive, anti-inflammatory fat cells."
Relationship Between Diet, Carbohydrates, and Metabolic Health
A high intake of refined carbohydrates leads to constant insulin elevation, preventing the body from burning fat efficiently. This sustained insulin level fosters fat cell enlargement, promoting insulin resistance.
Notable Quote:
Dr. Bikman [32:09]: "You'll store more as fat."
Ketosis and Its Benefits
Ketosis, a metabolic state where the body burns fat for fuel and produces ketones, offers numerous health benefits:
- Enhanced Fat Burning: Increases metabolic rate and fat oxidation.
- Cognitive Improvement: Ketones provide an efficient fuel source for the brain, potentially improving cognitive functions and reducing the risk of Alzheimer's.
- Muscle Protection: Ketones make muscle tissue more resistant to injury and reduce the propensity to break down muscle for glucose.
Notable Quote:
Dr. Bikman [84:40]: "Ketones are nothing more than a product of a lot of fat burning... ketones are the way to tell the brain, saying, brain, you think you need a lot of glucose, and if you don't get enough glucose, you would start stripping the protein from muscle to turn it into glucose. But I'm here as a ketone, so you can eat me instead and leave the muscle alone."
Potential Downsides of the Ketogenic Diet
While the ketogenic diet offers significant benefits, it also presents challenges:
- Metabolic Inflexibility: Prolonged ketosis can make the body less efficient at switching between burning fat and glucose.
- Muscle Loss: Without adequate protein intake and resistance training, muscle mass can decrease.
- Gut Microbiome Concerns: Although research is inconclusive, some argue that low carbohydrate intake may affect gut bacteria diversity.
Notable Quote:
Dr. Bikman [97:30]: "Ketosis possible to live in a... you do just stop eating. And the malnutrition, at least in part, is going to cause a loss of lean mass."
Insulin-Lowering Strategies and Lifestyle Changes
To combat insulin resistance, Dr. Bikman recommends a four-pillar approach:
- Control Carbohydrates: Focus on whole fruits and vegetables, and minimize intake of refined carbs.
- Prioritize Protein: Ensure adequate intake of essential proteins, particularly from animal sources.
- Don't Fear Fat: Incorporate healthy fats to promote satiety and support metabolic functions.
- Frequently Fast: Implement intermittent fasting to allow insulin levels to decrease and promote fat burning.
Notable Quote:
Dr. Bikman [135:35]: "When it comes to controlling insulin resistance. The key is to manage macronutrients. And the best way to manage macronutrients is going to be a strategy that helps lower insulin."
The Role of Exercise in Insulin Sensitivity
Exercise, especially resistance training, significantly enhances insulin sensitivity by increasing muscle mass, which consumes more glucose. Dr. Bikman emphasizes that the best exercise is the one you consistently perform.
Notable Quote:
Dr. Bikman [142:04]: "The best exercise is the one you'll do. And so if someone listening to this is an 80-year-old grandma, if she, if her form of exercise is walking around the street... but then if someone else has the ability to go cross-country skiing or CrossFit, do it."
Critique of Modern Diet and Medication Approaches
Dr. Bikman critiques the conventional focus on calorie restriction and medications that target glucose and cholesterol levels without addressing underlying insulin resistance. He argues that these approaches often fail to produce long-term health benefits and may even exacerbate metabolic issues.
Notable Quote:
Dr. Bikman [81:05]: "As much as we have been telling the world that we should be cutting back salt, no, we should have been telling them to cut back on what spikes your insulin."
Dangers of Liposuction
Liposuction is highlighted as a harmful procedure from a metabolic standpoint. Rather than reducing fat cell size, it removes fat cells, leading the body to store fat elsewhere, typically viscerally, thereby increasing metabolic risks.
Notable Quote:
Dr. Bikman [155:59]: "I do. From a metabolic perspective, I absolutely do. Liposuction is not dangerous to fit into the clothes you want to wear, but it's deeply problematic for metabolic health."
Insulin Resistance in Different Populations: Smoking, Pollution, and More
Environmental factors such as smoking and pollution contribute to insulin resistance by inducing inflammation and oxidative stress. Dr. Bikman discusses studies showing that exposure to pollutants like diesel exhaust can increase fat mass and insulin resistance, independent of calorie intake.
Notable Quote:
Dr. Bikman [86:30]: "We can take humans who are overweight and diabetic and hypertensive eating a standard American or global diet, and put them onto a ketogenic diet, which is going to be a much simpler diet, and yet every clinical marker gets better."
Closing Thoughts and Personal Insights
The episode concludes with personal anecdotes and reflections from both Dr. Bikman and Steven Bartlett. Dr. Bikman shares gratitude towards his wife for her unwavering support, highlighting the importance of personal relationships in achieving professional and personal goals.
Notable Quote:
Dr. Bikman [159:40]: "Most of it is just the support of my wife because at any moment, if she would have said, no, I'm done, you got to go get a job right now, I would have... she just really believed that."
Conclusion
Dr. Benjamin Bikman provides a comprehensive overview of insulin resistance, its causes, and its extensive impact on health. He advocates for a strategic approach to diet and lifestyle to manage insulin levels effectively, emphasizing the importance of carbohydrate control, adequate protein and fat intake, regular exercise, and intermittent fasting. Additionally, he raises critical points about modern medical practices and societal habits that inadvertently contribute to the insulin resistance epidemic.
For those seeking to optimize their metabolic health, this episode offers valuable insights and actionable strategies grounded in scientific research.