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episode #121

Interview with Dr. Ben Bikman: The Importance of Controlling Insulin for Fat Loss, How to Break a Fast, and Stop Eating Chicken!!

February 8, 2022 in Podcast


This week I interviewed metabolic and diabetes scientist, and author of Why We Get Sick - Dr. Ben Bikman! We discussed a wide array of topics including the role of insulin in the body, calories vs. insulin, how to break a fast, the importance of salt in the diet, and fermenting foods for overall health! Enjoy this insightful interview with Ben and be sure to check out his book, Why We Get Sick.

0 (1s): Coming up on the get lean, eat clean podcast. 1 (4s): The tragedy in our low salt obsession is that the more and more you cut salt in the diet, the higher the insulin gets because insulin is a water retaining hormone and assault pertaining hormone. And because salt is a molecule that is so essential for life. As you start cutting it in your diet. Well, then the body becomes all the more desperate to hold on to what it's got. And so insulin climbs in order to try to keep that in and as insulin stays high, you become insulin resistant. There are actual human clinical interventional studies that have proven this. So this isn't even correlation slash coincidence. This is causality. The more someone is cutting salt, the more likely that they are becoming more and more insulin resistant, ironically, all in an effort to try to hold on to the salt that they do have 0 (54s): Hello and welcome to the get lean eat clean podcast. I'm Brian grin, and I'm here to give you actionable tips to get your body back to what it once was five, 10, even 15 years ago each week. I'll give you an in-depth interview with a health expert from around the world to cut through the fluff and get you long-term sustainable results. This week I interviewed metabolic and diabetes scientists and the author of why we get sick. Dr. Ben Beekman. We discuss the role of insulin in the body, calories versus insulin. How to break a fast, the importance of salt in the diet and fermenting foods for help. This was a great interview with Dr. Ben. I've been wanting to get him on the podcast for a long time, and I really enjoyed it. 0 (1m 37s): I know you will too. Thanks so much for listening and enjoy the interview. All right. Welcome to the get lean eat clean podcast. My name is Brian grin, and I have a special guest, Dr. Ben. Bickman welcome to the show. 1 (1m 51s): Hey brother. Glad to be here. Thanks for the invitation. Yeah, 0 (1m 55s): Glad we could get together. I've heard you on a bunch of different podcasts. I'm like, God, he's, he's a lot smarter than me. I got to get them on. 1 (2m 1s): No, no, no, listen, Hey, let's just start this right off. What I, what I really in all, in all sincerity, there's a difference of course. And you know, this you're just being self-deprecating, but you know, just kind of intellect and smarts versus just, this is a guy who's just spent a lot of time becoming familiar with a certain topic. You know what I mean? Right. I don't think people with PhDs they're no smarter than anybody else. They just found a topic. They cared enough to devote an ungodly amount of time to understanding. That's the only difference because you asked me about your car. I don't know. You know, the dimwit, 0 (2m 36s): That's very true. I mean like anything, if you want to be really good at, you got to almost obsess about it, right? 1 (2m 41s): Yeah, yeah. That's right. Yeah. I 0 (2m 43s): Obsess about golf. So that's a whole nother thing. 1 (2m 47s): And my view on golf is I'll do it when I'm too old to do anything else. So 0 (2m 52s): You know what though? You got to start a little bit early, so you get, 1 (2m 54s): Oh, no, I know. I know. I will. I will. 0 (2m 57s): Okay, awesome. Well, we're going to, I got a bunch of different ideas of regarding topics we can talk about maybe before we get into that, just give the audience just a, maybe a short background of, of, you know, I know on your Facebook page, you say you're a diabetes and obesity scientists, which is pretty, pretty cool. Maybe give them a little background of, of, of your, yeah. You're you're your teacher and author. I also have your book here. Why we get sick. 1 (3m 25s): Yeah. Yeah. So you kind of, that's a pretty thorough introduction. I am a research scientist. So publishing scientists, conducting research in my lab all the time, even today, doing some experiments, looking at how fat cells express different levels of thyroid hormone receptor, and how that influences the metabolic rate in fat cells. Nothing to publish on that yet. But yeah, so active researcher publishing and presenting. I'm also a professor in the sense that I teach classes. I have an undergraduate assignment where I teach undergraduate students about the body when it gets sick, like diabetes, for example. And then I have a graduate course that I teach about endocrinology. 1 (4m 7s): So the study of hormones, which is perfect for me because I study hormones in my lab. And so it's fun for me to be able to teach that topic. I'm very kind of on the nose. And then of course, outside of the classroom, in the lab, I am a husband and father, and that means more than anything else. 0 (4m 25s): Yeah. And what got you interested in, you know, just, you know, I know you talked a lot about insulin resistance and hormones in general. What, what sort of got you interested in all that? 1 (4m 34s): Oh yeah. It all started with insulin and that it all started with the fat cell. I will, I will, I will not forget the moment where I was getting a master's degree in exercise science. And I knew I wanted to do pursue academia and become a scientist and a scientist and a professor. But I, you know, I was still learning what I wanted to do and what I would become in that regard, professionally speaking. And then I stumbled upon a paper that had been published just a couple of years prior. So this is early two thousands. The paper was published late nineties, which detailed how fat cells when they got big, started to secrete pro-inflammatory proteins called cytokines. 1 (5m 16s): And that starts to start to promote an inflammatory profile in the body, which then caused this condition called insulin resistance, which I wasn't familiar with, but that was thought to be the link at the time. And it still is thought to be a link connecting weight gain to type two diabetes. So that was the beginning of it all, very humble, almost accidental origins. And then I couldn't get insulin resistance and inflammation out of my mind. And then I pursued that very deliberately with my, with my PhD work, my dissertation looking at changes in inflammation and insulin sensitivity in people who were overweight, obese, who had gastric bypass surgeries. 1 (5m 57s): And then more, again, more intent, deliberate focus on this topic with inflammation and insulin resistance during my post-doctoral fellowship. And then when I started to run my own lab here at BYU, 11 years ago, the theme continued. 0 (6m 14s): Yeah. Interesting. I have, I've always been intrigued as well. Not maybe quite on the same level as you with insulin and its role in the body. Maybe tell, talk to our audience a little bit about, I mean, we could probably spend an hour about all its different roles at a place, but perhaps what it has to do with, you know, just with fat loss and things that could affect, you know, every people on an everyday basis. 1 (6m 37s): Yeah. Yeah. So insulin is a hormone of, for life of life rather than you must have it or you'll die. And the relevance of insulin is reflected in the fact that literally every single cell of the body has insulin receptors. In other words, every cell has these little pockets that just insulin will come and bind and then tell the cell to do something. Now it's no surprise because there's such a variety of cells in the body that insulin will tell different cells to do different things. The most famous thing that it tells cells to do is to take in glucose. Some cells will respond in some like muscle cells by opening doors, for glucose to come in and thereby lower blood glucose, but at fat cells, in addition to stimulating glucose uptake, which the fat cell will use to turn into fat, it will also very powerfully block the inhibition of fat breakdown. 1 (7m 33s): But that first point Brian is relevant. There are people I've seen in the, in the kind of social media space that will say fat cells don't turn glucose to fat. That is absolutely false glucose alone. Just glucose alone is capable of activating the enzymatic machinery to, to turn on the PA the, the biochemical pathway to make fat from, from just scratch carbons like from glucose, not even insulin, but just glucose alone provides that signal. And so we have to put that myth to bed. Glucose is absolutely a molecule that a fat cell will use to build fat molecules. 1 (8m 15s): So in other words, to turn it into fat, but again, at the same time, insulin is powerfully inhibiting the breakdown of that fat. And so, but it's not as much stimulating the uptake of fat. That's important that the uptake of fat is something that doesn't require insulin's involvement. Unlike the uptake of glucose, if a fat cells pulling in glucose insulin tells it to do that that's necessary. But with regards to the fat alone, insulin's blocking the breakdown of that fat. And so the net effect of this is while the fat cell continues to take in fat without insulin even telling it to what it starts to grow, because insulin is blocking the breakdown of the, not to mention inducing the synthesis of new fat in the form of turning glucose into fat. 0 (9m 4s): Now I'm a little bit off that point is, you know, there's, there's sort of two arguments. There's probably more than just two, but there's sort of two sides of it. You know, you have sort of maybe an old school approach. Maybe some new school is like, you know, it's all about calories and, and then other people are like, well, no, it has to do with, you know, insulin and, and its ability to, you know, obviously not spike as much. And as often as it should, I'm, I've always been more, I've never counted calories my whole life I've I just sort of go off intuition, try to eat till I'm full, you know, till I'm satisfied and move on. And I can sort of just, you know, until I've always been on the insulin side, but I'm just curious, what's your thoughts. 0 (9m 50s): I know which side maybe you sit on, but it probably is a combination of both. 1 (9m 54s): Yeah, absolutely. It is. It is absolutely. I have a, I have a, I think a particular particularly qualified and perhaps unique view on this because my PhD was on a topic or a degree in bioenergetics, which is the study of energy in cells in calories are the unit of energy. We call it like a calorie, but it's a way of just quantifying energy. So I have a unique appreciation for energy use and even the laws of thermodynamics. And so I am deliberate in saying this, I think in, I think giving food a caloric value is one of the greatest mistakes we ever made in the realm of human nutrition and understanding who did that? 1 (10m 42s): Yeah, I know. I know. So it was scientists in the early, I think, late 18 hundreds, I guess. I'm sure they thought they were doing them a favor, right? And there's something to be said for just knowledge, but then trying to apply that to the human organism as if we are a perfect thermodynamic machine. If we were, if our bodies represented the entirety of energy in the universe, then it would make sense because then you can perfectly capture and quantify and account for every unit of energy. We are not, we are, what's called an open system and thus the laws of thermodynamics simply cannot be applied to the organism to, to a living organism. 1 (11m 24s): I think it is a travesty of science that it was ever invoked in the first place. And that it continues to be invoked. Now having said this, I'm not saying energy doesn't matter. Energy does matter. But our obsessive focus on energy has caused us to totally overlook the relevance of hormones because hormones, especially insulin, or what, tell the body, the cells of the body, what to do with the energy that it has case in point right across the hallway is my laboratory where we literally right now have fat cells growing in a little Petri dish. Brian, I can into that little soupy mix of, for the cells to grow. 1 (12m 5s): I can have ample calories from glucose and fatty acids and the fat or triglycerides, the fat cells won't grow at all. They'll just stay these little kind of stubby, dark little cells until we spike insulin into the culture, into that little bath. At the moment we put insulin in day after day after day, we can start to detect fat droplets within and they get these big, become these big bubbly fat cells. Like you think of fat cells, it can not happen unless insulin is elevated. It's impossible. So a cell needs to be told what to do with energy. And, and there's so much I could say on this and, and maybe I'll just leave it at that for the sake of time that energy matters. 1 (12m 49s): Absolutely. But if we aren't accounting for calorie F for hormones, then we are not counting the energy appropriately. Right. 0 (12m 59s): Right. Well said, well said, and I know you talked on a recent podcast about a study that was done. I thought it was really cool. Maybe you can touch on that is where they regarding low carb and a higher carb. And they kept everything else the same. Right. And the individual, the metabolic rate actually was better on a low, on a low carb diet. Is that right? 1 (13m 22s): Oh yeah, yeah. Yeah. In fact, that's right. Yes. So this even happens in non-diabetic humans and multiple groups have shown this now that if a human is eating a diet that is very low in refined carbs, and insulin is low, their metabolic rate will be anywhere from a hundred to 300 calories a day higher without doing anything else. It's not like they're exercising. They're not on the stair-step or for an extra hour. Just metabolic rate is that much higher. The most dramatic example of this is seeing in type one diabetics we've known for over a hundred years, that when insulin is low, like in the case of type one, diabetes metabolic rate is significantly higher than it should be based on the body size. 1 (14m 4s): And then the moment you start giving the person insulin, this was studies done in the, in the eighties more recently, the moment you start giving them insulin metabolic rate slows to where you'd expect. And that happens in type one diabetes where it's quite dramatic because it goes from no insulin to abundant insulin. But even in the case of type two diabetes, which is already elevated insulin, you give them insulin therapy, metabolic rate slows. From the moment you start, the insulin therapy and insulin is so determined to store energy, that it will slow the metabolic rate to make energy storage even easier. 0 (14m 40s): Wow. And I know Dr. Jason Fung, I think that was one of the first books I read is obesity code. And he talks a lot about that and how he started treating people who are type two diabetic with fasting. What are your thoughts around implementing fasting is something that I talk quite a bit about on the podcast. And what are your thoughts around that for individuals to implement on a day-to-day basis? 1 (15m 4s): Yeah, I think it's genius. I think Jason, Jason ought to be credited and I, I appreciate that you're bringing him up because he is really the godfather of the modern interest in fasting. I think fasting needs to be used, but also used carefully because I think sometimes in some people fasting becomes a binge purge cycle where they fast, they get super hungry and then they binge and need all kinds of garbage. They, they overeat, they feel full and uncomfortable. They have shame, they regret it. They resolve to do better the next day. And they do the exact same thing. So with I'm a huge advocate of fasting, but I think that how a person breaks the fast is more important than how long they go. 1 (15m 49s): In other words, the food they eat at the end of their fast matters much more than how long the fast goes. Now. I don't know that Jason agrees with that. I wouldn't be surprised if he does, but that's kinda my own view of the, on the matter. 0 (16m 2s): Yeah. Well, on that topic, let's talk a little about breaking a fast and w what are the type of foods that you would recommend someone? You know, I think obviously if you're doing a longer, fast, it probably plays more of a role if you're doing it every day. And you're sort of used to it, obviously the foods you eat are, do play a role, but if, especially if you're doing a prolonged, fast breaking it correctly is really important. What type of, yeah. What are some of the foods that, and I know you mentioned some of them in your book, are you just looking is a main thing that you're looking at is like glycaemic load and things like that and how it affects you. 1 (16m 34s): Yeah. So I sometimes worry that I'm too boring, that I'm too one dimensional and, you know, I'm the guy with the hammer and I see insulin as the nail. Every you're starting just hitting it all the time. But my view on it is that the value of fasting well would be manifold. There would be multiple benefits, but one of them would be that, that you lower insulin. And then when insulin comes down, you are mobilizing fat and burning it. There's no question about that. And that's why you're making ketones because you're burning fat so much, but you're also activating autophagy. As much as people are obsessed with the toffee. Nowadays, I think that's appropriate. Autophagy does appear to be very beneficial and even necessary for a lot of the benefits of fasting. 1 (17m 15s): Then you've got to lower insulin. If insulin is elevated, you can not activate a top. A G insulin will stop that process because it's energy wasting and insulin. Doesn't like to waste energy. And so my view on it is when you break the fast, keep that going and, and keep that insulin down and go transition from a kind of true classic caloric fast when you're not eating or drinking calories. And then when you're breaking that, have you move your body into what I like to refer to as a nutritional fast, which is now you're eating, you're getting nutrients, but because you're scrutinizing the, and focusing more on proteins and fats, the insulin effect is much more modest, and you can continue to get some of the benefits of the fasting. 1 (17m 59s): What are your thoughts on fructose? Yeah. Yes. I'm not an advocate of, well, I certainly not an advocate of how most people are getting for dose, which is, you know, they're drinking it and juices, and they're getting it from lots of sugar. I know that there, within the community, low-carb community, a lot of prominent voices are advocating, honey. I I'm, I don't know. I'm not overtly opposed to that. Honey is a mix of glucose and fructose kind of like sugar is, but of course it's very natural. And if it's, if it's not pasteurized, I think it can have a lot of benefits like with antibodies and enhancing immunity and people. But I also don't think that people need to be trying to get honey in their diet fructose, although that's not what you asked me about too much fructose will absolutely promote fatty liver disease. 1 (18m 51s): Fructose also increases cortisol sensitivity in fat cells, which can result in more fat storage on the visceral or truncal space of the body. Not to mention that fructose metabolism increases uric acid, which can increase gout. So I'm not an advocate of, of certainly refined fruit dose. And maybe if the fruit dose were coming in the form of, you know, infrequent honey, well, then, you know, I can't really be opposed to that. An occasional, maybe fruit. Like, are you totally anti oh yeah. Oh yeah, sure, sure. I'm sorry. Yeah. So my view on fruit is my view on diet overall. The first rule for me is controlled carbohydrates. 1 (19m 32s): And generally what I mean by that is don't get your carbs from bags and boxes with barcodes, but rather fruits and vegetables. And if you're eating them, not drinking them, then essentially that's something you can enjoy ad libitum, there's really no in my mind, unless you're a type two diabetic trying to get off your drugs, then you gotta be much more thorough and strict, but for the average person, who's not type two diabetic and doesn't want to be then basically fruits and vegetables are fine by my estimation. Do you prioritize protein when you, yeah. So that's rule number two for me. So yeah, the first one is controlled carbs and then prioritize protein. But it's interesting, Brian, because when I first joined the low carb space, if you will, the social media space, there was absolutely a fear of protein, right? 1 (20m 20s): And in fact, that was so interesting to me that I devoted some time to it and gave a talk at low carb Breckenridge years ago, looking at protein and helping people understand one that has a modest effect on insulin itself. And two it's usually coupled with an equal or even greater effect of glucagon. And I was, I think, kind of the one who brought glucagon into the conversation here, which offsets would insulin's doing, but as pleased as I am, that protein is no longer vilified. I wonder at how far we've swung the other way, where, where it's protein at all costs and protein has become the single greatest component of the diet. 1 (21m 5s): I don't think even, even at the expense of fat where it's just high protein and low everything else, I don't think that is a diet that is prudent in part because the best proteins come with fat. And in our hubris, we think we know better. I would say than God, others would say than mother nature, but, but those protein sources that come with fat should come with the fat. We literally digest the protein better when we eat it with fat, the bile acids that get released with fat ingestion facilitate the proteolytic breakdown and digestion of proteins. You do not digest protein as well without fat. 1 (21m 47s): In other words, also the two are more anabolic than just protein alone. So I am not an advocate of prioritizing fat. You know, people being very liberal, adding fat to everything. I don't think that's overly prudent, but at the same time, I'm very opposed to just pushing protein at all costs and cutting back everything else, protein is it is supposed to come with fat. It does in nature, always there is no exception, zero exception of a natural protein coming just as protein. It always comes with fat. 1 (22m 26s): Well, who do we think we are to pull those two apart? So I think fat should come with protein as much as I'm an advocate of prioritizing protein. Don't fear, the fat that comes with it. And that's kinda my third rule. 0 (22m 39s): Would that be like the difference between having a lean chicken breast and maybe like a ribeye? 1 (22m 44s): Absolutely. Yes. And that's why I'm not an advocate of chicken. I think chicken, our obsession with chicken has become, it is one of the bigger shifts in the modern human diet. A hundred years ago, we ate very little chicken and that has become now the single most common source of animal protein in the diet by far nothing's even close to how much chicken we eat. And I think that's wrong. We used to keep chickens around for their eggs, which is a one-to-one mix of protein to fat, kind of like a fatty could have beef. Well, that's what we should do. That's what we should get back to in my mind. 0 (23m 18s): Yeah. And I noticed you mentioned something you talked about in the book a little bit about white adipose tissue and brown adipose tissue. I thought that would be a cool thing to talk about and its relation with cold therapy, right? 1 (23m 33s): Yeah, yeah. Yeah. So most people wouldn't even know that there are these two different, very, very different types of fat we have on the body. White fat is the majority of the fact that we have overwhelmingly, you know, on the average individual, the white adipose tissue or the white fat would be well over 90%, 95 plus percent of the fact that we have, and it is very white when you actually remove it from the VOD body. It's very white because it's just fat and fat. These, these plain triglycerides, I mean, it almost looks like a little ball of squishy coconut oil. I mean, it's very white in contrast the brown adipose tissue, which humans typically have in this thoracic space is very brown because it's enriched with mitochondria, the, the fat burning part of the cell, which has a reddish brown color. 1 (24m 23s): And there's so much of it that these fat cells are very brown when you remove them. Interestingly, particularly in humans, because so much of our fat is subcutaneous or the fat right below our skin, that fat has the potential to kind of act like brown fat. It doesn't become brown fat per se. It becomes what we call beige fat. It does get a little darker. It will have a little more mitochondria, but nothing as far as the actual brown fat cells, but indeed they have a much higher metabolic rate, which is kind of the purpose of the brown fat brown fat cells exist to burn fat and make a lot of heat. Whereas white fat cells exist to store fat and thus have a very low metabolic rate about a 10th that of the brown fat cells. 1 (25m 10s): But when insulin goes down and ketones are up, we've published two papers on this topic. Another one about to come out. Metabolic rate goes up a lot in the white fat cells by about two or three times and cold therapy when you are lowering the body temperature for a few minutes. And, and that takes some time in immersion. There's no substitute for immersion. A cold shower is fine and I think it can be helped. It is not the same. No. And so the actual immersion in cold against the skin will activate the brown fat and not only the brown fat here, but also stimulate those white fat cells to start to shift into behaving more like brown fat cells or beige as we call them. 0 (25m 54s): I wanted to ask about code there because I actually recently put a cold plunger in, in my house and I've been using it like almost every day. And it's, 1 (26m 3s): You know, I I'll tell you, Brian, I'm actually jealous. So I've been trying, I've been talking to the athletic training facility here on campus because I know a lot of these guys and there are so many hurdles to me getting in to use their ice bath, but I've just not been able to do it. Like I can only go in the athletes aren't there and they got a socially distance, you know, you gotta be masked up and I'm like, I don't want it. I don't want to do all that stuff. And I also don't want to be sitting in an ice bath with like a 300 pound lineman on the football team. You know, 0 (26m 32s): Just tell him you're the kicker. He won't know. 1 (26m 36s): Yeah. I'm the scrawny one on the team. 0 (26m 40s): Well, I will say more and more companies are coming out with, with these plungers and you can get one for not a crazy amount of money. And I will say it is like, not only just like, it's just, it's therapeutic. I really think like, if you just like, it's a game changer. If people are like, not that I'm like clinically depressed or anything, but it just makes you feel so good 1 (27m 3s): And you keep it outside. 0 (27m 5s): So I don't, I have a room it's like, sort of off the house. It's it's, it's, it's a sunroom 1 (27m 10s): Covered pet 0 (27m 11s): Like a covered patio. Yeah, exactly. It's covered, but it's 1 (27m 14s): Closed in. 0 (27m 15s): It's closed in. You could, you could, you could have, I could have this outside if I want it to, but I'm in Chicago and so, yeah. And, and filters the water. I mean, this one's really, I mean, I, I splurge on this one, but it filters the water. You don't have to keep refilling it. I mean, it's great. I mean, yeah, no kidding. But I've recommended. I mean, you, you won't, yeah. I'm not a coffee drinker, but you don't need coffee anymore. If you start, start. 1 (27m 39s): Great. Yeah. I'm not either, I'm not a coffee drinker either, but I've, I'm so interested in, in really leaning into this. I'm going to look into it. I'm enough. I'm enough of an influencer. Now I'm just going to get someone to send me one. 0 (27m 51s): No, for sure you should work that I'll try. It really is a game changer. Okay. We got off a little bit, but I just was curious about that. Why don't we touch a little bit about, well, I was thinking salt, salt and insulin resistance. I think salt has like a, a sort of a bad name to it. And these low salt diets, just like the low fat sort of trend that came a rock bound. But a lot of this stuff has started is sort of going by the wayside. What are your thoughts on salt? 1 (28m 23s): Yeah. Yeah. Well, I think it's bonkers. So the obsession on salt is partly born from old studies that looked at something called the dash diet, the dietary approach, or I think approach to stop hypertension. And in these studies, they found that, you know, you follow the dash diet, which is a low salt diet and indeed blood pressure drops pretty well. And meaningfully, however, what these clowns don't want to admit is that while the dash diet is yes, a low salt diet, it's also low in refined carbohydrates. Well, they don't want to acknowledge that. But the fact of the matter is insulin is a water retaining hormone among its many, many effects throughout the entire body. 1 (29m 7s): It's affects indirectly at the kidney are to tell the kidney to retain salt and retain water. And, and, and so people kind of mix these up. What's interesting is that you, if you can put someone on a low carb diet, like, like we've done and we published a paper a few years ago, just low carb. They can eat as much salt as they want blood pressure, just plummets and studies that have explicitly just teased out the salt alone, not the low carb or the low refined carbs, which is part of the dash diet, which is a confounding variable. When you just control the salt blood pressure drops like one or two points. It's meaningless. It's totally utterly meaningless. 1 (29m 48s): The tragedy in our low salt obsession is that the more and more you cut salt in the diet, the higher the insulin gets because insulin is a water retaining hormone and assault pertaining hormone. And because salt is a molecule that is so essential for life, as you start cutting it in your diet, well, then the body becomes all the more desperate to hold on to what it's got. And so insulin climbs in order to try to keep that in and as insulin stays high, you become insulin resistant. There are actual human clinical interventional studies that have proven this. So this isn't even correlation slash coincidence. This is causality. The more someone is cutting salt, the more likely that they are becoming more and more insulin resistant, ironically all in an effort to try to hold on to the salt that they do have. 0 (30m 38s): The body's amazing. 1 (30m 40s): It, well, it's more complicated than people want to admit, unfortunately. Yeah. 0 (30m 43s): So what would you recommend? I mean, I'm always thinking about, I think about not thinking about salt all the time, but I do put like a good quality Redmond salt on, on all my meats and fishes and things like that. But is that enough? 1 (30m 57s): Yeah, that's a, that's a good, that's a good question. I, you know, the, the guy who had asked, I encourage anyone to go see what James D Nicola Antonio has said about this. I don't know a specific amount. My view on it is salt until you're satisfied basically. And so I, I'm very liberal with salt. I added, I added of course, very liberally on any meat that I'm eating. I added, I have a little low carb meal replacement shake that I helped formulate in anyone, anyone who wants to learn, go to get health HLT H get health.com to learn more. I always, as much as we put Redmond salt in there already, I always add more. I just like things to be a little salty and my blood pressure has never been a problem. 1 (31m 40s): Yeah. 0 (31m 41s): Yeah. I, I know there's a lot of companies coming out now where, you know, like Rob Wolf's company and things like that, where you can edit the liquids and things like that. Why don't we touch a little bit on, on a hormone called leptin? I'm curious. Cause you know, you talk about hunger and weight loss. I think they sort of go hand in hand, if you can sort of control your appetite, obviously that can control your weight loss goals. So what role does leptin play? 1 (32m 9s): Yeah. Yeah. So leptin is an undeniably important when it comes to body weight regulation, but not necessarily in the way people think. So first of all, leptin is a hormone that that does promote satiety in, in the hypothalamus that kind of the hunger appetite center. And that's, that's its most famous effect, but that is not, I would say that's not why the, the, the individual or the organism starts to gain so much fat because even if you calorie clamp them, they still get fatter than their normal leptin litter mates. You know, when we're talking about rodents, which is the, you know, an ideal model, just because leptin deficiencies in humans are so uncommon. 1 (32m 50s): But what people don't appreciate is that leptin is a powerful inhibitor of insulin release that when leptin goes up, it inhibits insulin production. And so thus in the absence of leptin to quote, one of the scientists who studied this years ago, Jay, I think his name was Jeff Friedman. He said, insulin goes through the roof in these animals that they're even when you're controlling for their diet, they have chronically very high levels of insulin. And of course that's going to promote fat gain substantially leptin. Isn't going to promote fat gain or, or blocking necessarily. It will certainly have a, an appetite regulatory regulating effect. But so too does insulin insulin regulates appetite itself. 1 (33m 33s): And as you become more and more insulin resistant because of the flooding of the body with insulin, insulin is enabled to regulate appetite as well. So as important as lectin is a, and it's no surprise, I'm sure for everyone listening, it's like they can roll their eyes and say, oh man, of course, Ben took it back to insulin only because it's justified everybody. You know, that's why I'm bringing it back to insulin that you cannot really understand an obese model or an, an overweight organism with promoting fat gain, unless you understand insulin, any other signal is just kind of a, a secondary input and insulin is going to be the main signal. 0 (34m 10s): Now I know you've talked about this on a few other podcasts regarding the difference between, you know, we're all caught up in what our fasting glucose glucose is, and we're sort of shining or not measuring our fasting insulin, but it really should be the other way around. Right? 1 (34m 27s): Oh yeah, yeah, yeah, yeah, absolutely. I, I consider one of the tragedies of modern medicine is that our, we have a, such a, an obsession with glucose when our obsession should be with insulin, especially now that it is so measurable, but of course still unfortunately much harder to measure than glucose. And that's why glucose is going to be hard to, to kind of kick out of that primary position. It thinks it's the hero, but it's actually the sidekick in the story insulins that the main character here, but it's just hard to measure insulin. You know, if you, and I want to know what our insulin levels are, we got to go draw blood and that blood that's got to go to the lab and then the doctor's office will let us know what the results are. 1 (35m 8s): There is no rapid let alone, real time way to measure insulin. Like there is glucose, you know, I'm wearing a continuous glucose monitor through levels, levels, health, and I can know what my glucose levels are anytime it's just scientifically so much easier to measure glucose. And there are so many groups around the world trying to get real-time measurements of insulin. I would imagine there are some very smart people, but it's, it's, it's so complicated. It's so hard to do that, to be Frank. I don't see it happening within the next five years. I think it's five to 10 years out before we get that kind of technology. 0 (35m 46s): So what are some of the maybe measurements that people should go? They, you know, obviously now with like, you know, these lab Corp's and things, you can go walk in labs and get what are some, or maybe are the top ones that individuals can just do on their own, along with, you know, other than obviously fasting insulin. Was there anything else that people should keep an eye on? 1 (36m 5s): Yeah. Yeah, but let me just beat that drum one more time. If someone can get in and get their insulin measured, if it, if it's fasting and your insulin is less than six micro units per mil, that's really, really good. You're doing great. If it's under 10, you're probably doing fine as well. And then as it gets up into the teens, then it's kind of a warning. And if it's up into the twenties and it isn't some people red light, you got to make some changes. However, the problem with insulin is like most hormones, it has a rhythm to it. And so it's possible that someone's come in and they've measured their insulin at the peak, you know, the perfectly wrong time. There's no way to predict that. Unfortunately. Well then all the more reason to lean on a different marker, which is the triglyceride to HDL ratio, take your fasting triglycerides and divide it by your HDL cholesterol. 1 (36m 49s): And that, that is a surprisingly accurate predictor of insulin resistance. And if that triglyceride to HDL ratio is less than 1.5, then you're doing really good. 0 (36m 59s): I just did mine. Actually. 1 (37m 2s): I was pull that out. Pull that out, man. Yeah, here 0 (37m 4s): It is. I was 0.4, five 1 (37m 7s): Oh dynamite. Okay. You're doing great. That cold bath, that cold bath is working. 0 (37m 12s): Oh God. Yeah. Yeah. I, cause I keep hearing that come up and I was like, oh, I just got some blood work. It's interesting thing. My blood work is across the board. I think, solid not going to go through everything, but the one thing that it just spikes is the fasting glucose. For some reason, it's like it was 1 0 7 and I don't know if that's physiological insulin, but that's a totally different thing. Right. 1 (37m 39s): You know what? So once upon a time that would have been considered a normal number. Did you know that? So over the years, what was can see what's been considered a normal glucose level has been pushed down down further, further, further. I don't know the reason for this, the cynical reason. And I admit the older I get, the more cynical I'm becoming. I think by, by having a stricter more strict glucose cutoff, it's a great way to put people on medications earlier, right. Based. Cause cause someone might say to you Brian, you're you're pre-diabetic we've got to put you on Metformin here. It's basically I know it's cynical, but it's a really good way to sell more drugs. 1 (38m 19s): No doubt. And, and so you tell me your glucose is 1 0 7 and that your insulin's good. Your triglyceride HDL ratio is good. On-site you're fine. I don't think there's any reason to be worried, but also if you had done some cold therapy earlier that day, for example, that's a stress on the system now, a therapeutic stress, but any stress is associated with at least some acute increase in glucose. There's no way around it. Same goes with exercise. Same goes with a sauna. If it's a stress on the system, glucose will climb for a time or you had a bad night of sleep, which actually goes through the same mechanisms that the cold there in stress does with sauna and et cetera. But nevertheless, there are so many variables that can play into just manipulating your glucose levels, even for just a few hours at a time that if your all your other numbers are good, then you're, you're solid in my view. 0 (39m 9s): What about measuring ketones? Yeah. Yeah. 1 (39m 12s): Yeah. So I think ketones are helpful only well, multiple reasons, but one reason is that if you have detectable levels of ketones and your insulin level is low because insulin inhibits ketogenesis. So, so powerfully that if you're making ketones, that is an inverse indicator basically, or it's, it's proof positive that your insulin is low. 0 (39m 37s): Okay. Yeah. You know, regarding fasting glucose, there's a few people that have told me in the low carb space that, you know, and I'm not like I don't necessarily count carbs, but I know it's very low and I've been doing it for a while. They said maybe perhaps having day a day of more higher carb day, just to, I don't know, just to get the body used to using maybe different fuel sources. You know, I don't know your thought on that. I don't like set, you know, Dr. Saldino has started to implement the days of higher carbs along with his carnivore, you know, ish diet, you know? 1 (40m 15s): Yeah. Yeah. So I don't know of any published research on that. And so I always want to be careful because you know, I'm the PhD here and you know, I, I want to rely on data all the time. So I'm unaware of any data that have been published on that topic. However, however, there is certainly something to be said for, I don't want to say it that way. There's no doubt that by if you eat carbs from time to time, you do, I have to say this. Although I, I regret that people will misunderstand it perhaps a little bit. If you want to maintain the most, the highest level of metabolic flexibility, which is the ability to shift between carbs and fats very readily, then you would want to have carbs from time to time. 1 (41m 5s): Now, someone would hear me say that and say, oh, done. I'm in. I want maximum Mecca metabolic flexibility. Metabolic flexibility only matters if you are eating carbs from time to time. For example, if someone doesn't eat carbs for 48 hours, they're there, their pancreas stops making insulin. Not, not because it's sick or anything. It just is. It's almost as if the pancreas is sampling blood thinking, oh, we're not getting any glucose spikes anymore. And we got all this insulin that we've made and have, have we were holding it here, packaged, ready to go. That's something called the first phase of insulin. Like if you and I were to go and eat a bagel, if we were to measure our insulin kind of five minutes at a time, it would go like this. 1 (41m 51s): And like that there's two phases. The first phase is the release of all the insulin. The pancreas already has. The second phase is the release of all the insulin it starts making from scratch. So it's basically like this factory with a warehouse in the warehouse is holding all the pre-made insulin and the factory is ready to be flicked on at the moment. It needs to, to start making more insulin, but it takes a little bit of time for it to do so if you, if you cut your carbs, even if you just fast for 24 hours, not even low carb, you get rid of the warehouse. You, you will get rid of the, the pancreas is so determined to be efficient, that it's looking at all this insulin in just 16 or 18 hours into a fast, it basically starts to say, oh, it looks like we don't need this. 1 (42m 37s): After all, let's start just tearing down the boxes and throw all the insulin way. And it will literally break the insulin back down and do its component amino acids. Thus, if you and I were then to go eat a bagel after having fasted for 24 hours, not to mention, been on a low carb ketogenic diet for several weeks, we lose the first phase. And so we eat that bagel. Now our glucose has a little longer time to get higher because it's waiting for the factory to start making new insulin. We still bring it back down, but it took a little longer in contrast, we eat that bagel and you and I eat another bagel about six hours later, after everything has settled back down our glucose, won't go as high. 1 (43m 17s): It'll go up and it'll come down in a much more expected pattern because the beta cells, now we're thinking, oh, we're going to start doing this again. All right, let's fill the warehouse again with all the pre-formed insulin. So what happens is when you adhere to a low carb diet, or you just fast for 24 hours, you lose the first phase of insulin release and thus become a little more glucose intolerant, not insulin resistant. Brian, anyone who tells you that a low carb diet causes insulin resistance. You laugh in their face. That is demonstrably false. They do not become insulin resistant, even physiological insulin resistant. People who say that don't know the hell they're talking about. It's not true. They become glucose intolerant, which is not the same thing. 1 (44m 0s): And it's acute. It's corrected the one-time. You eat some carbs, eat carbs again, a few hours later. And everything's is right as it ever was even better than ever. So there's something to be said. If someone wants to be metabolically flexible and eat carbs from time to time and have it have minimal effect. And if you're a honey lover, then you would want to do that. Well then fine. If however you're all in and you are controlling your insulin and having ketones to help with your migraine headaches or your seizures, or you want to get off your type two diabetes medication, then there's no reason to cycle out of a low carb diet and have deliberate periods of eating carbs. 1 (44m 40s): That's just, that's a Liberty that those that are already metabolically healthy can, can afford to take. But I'm not saying there's no justification for it, Ryan. Again, if someone's singular goal is to have maximum metabolic flexibility, then you do want to put carbs in there. Most people nowadays are metabolically inflexible stuck in the sugar burning mode, the car burning or glucose burning because their insulin is chronically elevated and insulin is what dictates, which fuel you're using. In contrast people that have been adhering to a ketogenic diet for a prolonged period, they are metabolically inflexible kind of in the other way, they're stuck in fat burning. If you will. Now I say stuck, but I lose that term loosely because to get out of it, all they got to do is eat some carbs and they're right back to being metabolically flexible. 0 (45m 26s): What would you say to someone that's majority of people I would say are that are sort of stuck in this glucose burning mode, the sugar burning mode to get, to get out of that and get into more of a fat burning mode. 1 (45m 38s): Yeah. Yeah. Well, it, it is all about lowering insulin. That is literally the reason why they're stuck in sugar burning it's because if you're insulin resistant insulin resistance is and always is a state of elevated insulin. And that's why when people want to invoke physiological insulin resistance in the context of a low carb diet, I laugh in their face and I invite you to do the same, Brian. Let's not be polite about it. It's because those are low insulin states and you cannot have insulin resistance without elevated insulin. And that's the problem. The people that are metabolically inflexible stuck in sugar burning it's because their insulin is chronically elevated. Well, start fasting start adopting a low carb or controlled carb diet. 1 (46m 20s): The insulin will come down and now you're burning fat. 0 (46m 24s): What, what are some good tips I noticed in your book? And I'm curious your thoughts, and obviously if it's in the book, you obviously agree with it to some degree is apple cider vinegar. Yeah, 1 (46m 33s): Yeah, yeah. So, yeah, so I put it in there, so 0 (46m 35s): Yeah, I figured. Yeah. Yeah. 1 (46m 38s): But did not have a ghost writer and just for the record, 0 (46m 42s): Although, you know, it's interesting. Cause some people come out with books and then, you know, you change your thoughts. 1 (46m 48s): Yeah, yeah, absolutely. Yep. Yep. There are, there are indeed some things in the book that if I do a second edition, I'd like to update, but that's not one of them. So there's no question. Apple cider vinegar, like take two tablespoons a day, helps improve insulin sensitivity, let alone taking a shot of it. Right. When you're about to eat your starchy, most starchy or sugary snack or meal of the day before. Yeah. Before. Yeah. But it'll absolutely bring down the glucose and the insulin. There's just something about it. Altering glucose, digestion and absorption, improving insulin sensitivity, which it does in, in, in increasing mitochondrial biogenesis, like literally stimulating the synthesis of new mitochondria. 1 (47m 28s): I, to me, the apple cider vinegar, that's kind of like what honey is to Paul Saladino apple cider vinegar is to me, you know, he loves his honey and I, I'm a pretty big advocate of apple cider vinegar. Part of it is born from my affection for fermenting, which, which is ironic because I don't drink alcohol. And that's like one of the most popular fermented things. But, but I'm a, I'm a fan of fermenting. And I think that there's, we've lost something in that as much as there are people who kind of espouse these kind of primal eating well, what about fermenting? That was a part of, of, of an ancient diet that when our ancestors had carbohydrates and they wanted to preserve them to any degree, they would ferment these because they didn't have refrigeration. 1 (48m 14s): They didn't have ways of preserving the food. And when you ferment a food or, or dairy, the bacteria are eating the sugars from that. And so then what we end up eating has a much lower sugar starch content than it did before. At the same time when bacteria ferment they're different from our cells and we ferment, they make short chain fatty acids. Whereas we make, you know, something like lactate, they make short chain fats and short chain fats are vinegar among them among a couple others. But vinegar is a fat. It is a fat fatty acid is it is the shortest of all the fats in, in possible. 1 (48m 56s): And they're tart shortly short chain fats have a very tart flavor, which I love. I love the tartness. I'm sorry 0 (49m 2s): For you to do ferment your own foods or do by for methods. 1 (49m 5s): Yeah. So I, for a time we would ferment our own dairy. I liked making kefir for the kids, especially, and I would drink it too. And I would add some like whole strawberries into it and blend it up as smoothies for the kids. And they loved it. We just got out of the habit because I got too busy and you got these little kind of dairy, fermenting cultures. You got to treat them like little babies. You know, they need a lot of attention. So no, I'm not committed enough to do my own fermenting, but I like to buy unfiltered raw apple cider vinegar, same goes with sauerkraut, unpasteurized, unfiltered sauerkraut, and an unsweetened whole fat to fear or this kind of fermented dairy and the same yogurt is a fermented dairy too. 1 (49m 51s): Of course. 0 (49m 52s): Yeah. And I was just going to say, I know we're getting up to it here, but I could probably talk for, maybe we'll do a part two. And in the, in the part two, I want to hear about your cold plunging, 1 (50m 2s): My cold plunging. Yeah. 0 (50m 3s): You said you were going to get into it so 1 (50m 5s): Well, yeah. I want to, I, you know, I just got to, what I need you to do is send me your contact at that company. And I'm going to say, Hey, I'm a little bit of an influencer. I'll do a real fast. Right? Well, I'm going to try because I'm a professor, so I can't afford a cold bed. They don't pay me that much. 0 (50m 21s): You know, Brad Kearns, you know, bread turns. He does a, he's a buddy of mine in the podcasting world, but he does a video on, he just has his own homemade one and it's, you know, you can just go to home Depot and make your own. And you know, it's not, it's not a bad way to go or, you know, start that way. So yeah, my, my thought was, 1 (50m 39s): And you do it, you go all the way, you know, do you go over your head sometimes and hold your breath for a few seconds? Or is it just going to, up to your neck? 0 (50m 45s): Yeah, so right. I go up to my neck. Like I did it last night. I go up to my neck for about two to three minutes and then the last, maybe 10, 15 seconds I'll dunk. 1 (50m 55s): Okay. And then that's it. You're done. That's it. You get out towel off and try to, 0 (51m 2s): Yeah. You know, I don't like to jump right into until like a warm shower. I like to just settle for a little bit and then, and then I'll go into the warmth. 1 (51m 11s): Love it, man. 0 (51m 12s): Love it. It's the, it's the cheapest hack, easiest hack. 1 (51m 16s): I'm going to do it. I'm going to just go into those to hell with those 300 pound lineman. I'm going to say, Hey, move over. And they'll say, who are you? And I'll say, I'm Dr. Beckman noodle schmuck make room. 0 (51m 25s): Yeah, I know who I am. A few more questions. Then we'll finish up dairy thoughts on dairy. I've actually been, I have a farm, not that close, but 45 minutes away that I got some raw dairy from, but I guess what's your overall writing thought on dairy. And does it, does it bright raise insulin quite a bit or no. 1 (51m 47s): Absolutely. It does increase insulin. My view now I don't mean to then suggest that it's something to be strictly avoided. I am an advocate of actually raw dairy. If that's a healthy cow, that's healthy milk and I love it. So I'm, I'm, I'm, I'm a fan of that, but always whole milk. That is all we get in the Bickman home in my home. It's only whole milk. I don't drink a lot of milk only because I look at milk as a food for growth. Right. And, and it's high in all three macronutrients, which is why there's a decent insulin spike, but, but nothing like, you know, junk food, like even a piece of bread, but, but it's high in all three macronutrients, which is perfectly formulated to help social that mommy mammal can make baby mammal grow quickly while I'm done growing. 1 (52m 37s): But, but sometimes I'll drink it, but mostly it's for the kids. I'm eager for them to drink milk anytime they want. I don't drink it too much, but I do sometimes. 0 (52m 48s): Yeah, yeah. Yeah. If you can get raw milk, I've been getting it for the last few months. It's so much better than regular. Well, we're getting out of here. What's the best way for people to, I know you mentioned you have the meal replacement, which is H L T H code, right? Health code. 1 (53m 5s): That's right. Yeah. And the website is get health and, and people can see the blog there. I have blog and in video content and then, and get the shake. Anyone who's interested used by all means use the code, Ben 10, B E N one zero to get a 10% off. It's a great, I think it's the best meal replacement shake out there. Of course I made it, but I made it because I just didn't think there was a good one out there. So by all means, everyone go learn more about it. If you guys give it a try, I can practically guarantee you'll love it. And then other than that, I'm mostly active on Instagram, frankly, which is funny because when I first got involved in social media a number of years ago, which was totally because I knew I was gonna write a book and I wanted to be able to kind of market it myself. 1 (53m 50s): Right. I was mostly involved in Twitter and I've come to hate Twitter, Brian. I don't know how you feel. Every time I engage on Twitter, I regret it. Honestly, it doesn't even matter what it is. So I only mostly get on Twitter now to follow college football and basketball. Actually, it's just college sports now. And then, and then I've kind of shifted to Instagram, which is just a, it's kind of a better medium for me. And I never would have admitted this about even about a year ago, but nevertheless, that's my long-winded way of saying, find me on Instagram. I typically do about one or two videos a week, always about human nutrition. It's nothing kind of me posing, you know, with a peace sign in front of like a steak or something. It's just, it's just me kind of doing a little kind of classroom session. 1 (54m 30s): Usually about a minute. I noticed the find me there. Ben Beckman PHS. 0 (54m 34s): Yeah. Ad or Freon. Well, Instagram, Facebook, but Facebook too. It publishes on Facebook as well. And then obviously the book, why we get sick, great book just to use as a reference and in the back, I love the fact that you, you know, you give action steps and tips, you know, like apple cider vinegar and things like this and, and, and foods that aren't, aren't going to raise insulin. Yeah. 1 (54m 56s): Yeah. In fact, in fact, let's let, I'll make that plug guys go buy some shake, go buy my books so I can afford to have a cold bath. Like Brian. 0 (55m 4s): We'll see if we can get you one and then we'll do we'll. We'll do a part two. How about that? Yeah. Well, thanks for coming on. 1 (55m 12s): Oh my pleasure. This was fun. In fact, everyone. Pardon me? If I'm a little cheeky, I guess I'm a little Punchdrunk this time of day, Brian just brings out the cheekiness in me. 0 (55m 20s): No, this is great. You know, I've listened to a lot of your interviews and I'm like, how can we make this a little bit different? But I think we've touched on a ton of great information that people could just, 1 (55m 27s): Yeah. Yeah. There's some gems here. Yeah. Thanks. I really enjoyed it. Thanks again for 0 (55m 32s): No, my pleasure and have a great day. Thank you. 1 (55m 35s): Thanks brother. 0 (55m 37s): Hey, get lean equally nation. Are you a man between the ages of 40 and 60 years old looking to lose inches around your waist have significantly more energy throughout the day and gain muscle all while minimizing the risk of injuries? Well, I'm looking for three to five people to work one-on-one with in my fat burner blueprint signature program, which I've developed by utilizing my 15 years experience in the health and fitness space. This program is designed specifically for those committed, to making serious progress towards their health goals. Over the next six months, we will focus on sleep stress, nutrition, meal, timing, and building lean muscle. 0 (56m 18s): If this sounds like a fit for you, email me@brianatbriangrin.com with the subject line blueprint. That's brian@briangrin.com with the subject line blueprint. Thanks for listening to the get lean, eat clean podcasts. I understand there are millions of other podcasts out there and you've chosen to listen to mine. And I appreciate that. Check out the show notes@bryangrin.com for everything that was mentioned in this episode, feel free to subscribe to the podcast and share it with a friend or family member. That's looking to get their body back to what it once was. Thanks again, and have a great day.

Dr. Ben Bikman

This week I interviewed metabolic and diabetes scientist, and author of Why We Get Sick - Dr. Ben Bikman! We discussed a wide array of topics including the role of insulin in the body, calories vs. insulin, how to break a fast, the importance of salt in the diet, and fermenting foods for overall health! Enjoy this insightful interview with Ben and be sure to check out his book, Why We Get Sick,


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