The Insulin & Glucose Doctor: This Will Strip Your Fat Faster Than Anything!

Dr. Benjamin Bikman, a leading metabolic scientist, discusses the detrimental effects of insulin resistance, linking it to chronic diseases like Alzheimer's, infertility, and type 2 diabetes. He highlights that 88% of U.S. adults exhibit some degree of insulin resistance, exacerbated by lifestyle habits and dietary choices. Bikman advocates for controlling insulin through diet, emphasizing the reduction of carbohydrates and the importance of protein and fat intake. He also addresses the potential dangers of weight-loss drugs and liposuction, which can lead to muscle loss and metabolic issues. Bikman underscores the significance of lifestyle changes over pharmaceutical interventions for long-term health benefits.

• Vaping is potentially more damaging than smoking in terms of airway damage and insulin resistance.
• Insulin resistance is a core factor in most chronic diseases, including Alzheimer's, infertility, erectile dysfunction, and PCOS.
• 88% of adults in the US have some degree of insulin resistance, which is influenced by ethnic differences in fat storage.
• Insulin resistance can be developed quickly through lifestyle habits but can also be resolved through simple lifestyle changes.

"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."

• Insulin resistance impacts all cells, leading to widespread health issues.

"They call Alzheimer's insulin resistance of the brain, and even the most common forms of infertility, erectile dysfunction, and PCOS, insulin resistance is a heavy contributor."

• Insulin resistance is linked to various diseases, affecting different organs and functions.

• Insulin resistance is a disorder with two parts: insulin not working effectively and elevated insulin levels.
• Insulin functions as a taxi, transporting glucose to muscles and fat, but in resistance, the muscle doesn't respond properly.
• Insulin resistance leads to higher blood insulin levels as the body compensates for the reduced effectiveness.

"Insulin comes and knocks on the doors of the muscle, saying, 'Hey, muscle, I've got some sugar that wants to come in,' but the muscle's not listening."

• The analogy of insulin as a bouncer illustrates how insulin resistance prevents glucose uptake by muscles.

"We have to consider anytime we talk about insulin resistance, we think of two things happening in concert: insulin isn't working quite as well as it used to, and insulin levels are higher."

• Insulin resistance involves both decreased insulin effectiveness and increased insulin levels.

• Insulin resistance can develop rapidly (fast lane) or slowly (slow lane).
• Fast causes include stress, inflammation, and excessive insulin, which can be resolved quickly if removed.
• Slow insulin resistance involves changes in fat tissue and takes longer to develop and resolve.

"There are two Pathways to insulin resistance: the fast lane, which has three lanes, and the slow lane, which takes longer to get there but also longer to get away from it."

• Insulin resistance has multiple pathways, with fast and slow lanes representing different development speeds.

"Stress is a primary cause of fast insulin resistance, as are inflammation and too much insulin."

• Stress, inflammation, and high insulin levels are key contributors to fast insulin resistance.

• The size of fat cells, not the mass, is crucial in contributing to insulin resistance.
• Women generally have more fat cells that are smaller, making them metabolically healthier despite higher fat mass.
• Ethnic differences in fat cell number and size impact susceptibility to insulin resistance.

"It's not the mass of fat that matters most; it's the size of the fat cell that matters."

• The size of fat cells is a significant factor in metabolic health and insulin resistance.

"Women, despite universally being fatter than her male counterparts, are healthier with regards to insulin resistance and every single metabolic problem."

• Women's smaller fat cells contribute to better metabolic health compared to men.

• The expensive tissue hypothesis suggests that a meat-heavy diet led to shorter intestines and larger brains in humans.
• Insulin resistance may have evolved to help the body hold onto energy during certain life stages.
• Not all insulin resistance is harmful; physiological insulin resistance occurs during puberty and pregnancy.

"The expensive tissue hypothesis suggests that as we started eating more meat, our intestines became significantly shorter, and our brain was growing."

• A meat-heavy diet allowed human brains to grow and intestines to shrink, impacting insulin resistance evolution.

"There is insulin resistance in human development which is physiological or helpful, such as during puberty and pregnancy."

• Physiological insulin resistance is beneficial during specific life stages, unlike pathological insulin resistance.

• Insulin functions as a key regulator for energy storage and tissue growth, including muscle, bone, and fat.
• During pregnancy, insulin resistance facilitates growth, ensuring a woman can support both her and her baby's metabolic needs.
• Insulin resistance in pregnancy aids in storing fat and providing energy, crucial in times of food scarcity.

"Insulin's telling the body to store more energy to build up tissues including muscle and bone but also including fat."

• Insulin is pivotal in energy storage and tissue development, highlighting its dual role in growth and fat accumulation.

"As her body becomes insulin resistant, it actually facilitates the growth of the baby a little more rapidly."

• Pregnancy-induced insulin resistance is beneficial for fetal growth, indicating a purposeful physiological adaptation.

• Gestational diabetes mirrors type 2 diabetes but occurs during pregnancy, influenced by genetic predisposition and poor diet.
• High insulin and glucose levels during pregnancy can predispose offspring to obesity and type 2 diabetes later in life.
• Awareness and management of diet during pregnancy can mitigate risks associated with gestational diabetes.

"Gestational diabetes is essentially type 2 diabetes of pregnancy."

• Gestational diabetes functions like type 2 diabetes, emphasizing the importance of insulin regulation during pregnancy.

"The offspring of mothers who have gestational diabetes are significantly more likely to gain weight and be chubbier or fatter than their counterparts."

• Children born to mothers with gestational diabetes have a higher risk of obesity and metabolic complications.

• Increased cancer diagnosis in women could be due to heightened screening or an actual rise in incidences, particularly breast cancer.
• Factors contributing to breast cancer include obesity, delayed childbirth, and possibly metabolic conditions like insulin resistance.
• Breast cancer tissues often have more insulin receptors, linking obesity and insulin resistance to cancer growth.

"This is very, very likely almost entirely driven by breast cancer."

• The rise in cancer diagnoses among women is largely attributed to breast cancer, highlighting the need for targeted research and prevention strategies.

"The main mutations in breast cancer is a sevenfold increase in the number of insulin receptors."

• The link between insulin receptors and breast cancer underscores the importance of metabolic health in cancer prevention.

• Alzheimer's disease, often termed "type 3 diabetes," is linked to insulin resistance in the brain.
• The traditional plaque-based theory of Alzheimer's is challenged by metabolic explanations, focusing on glucose and insulin dynamics.
• Insufficient glucose metabolism in the brain due to insulin resistance leads to cognitive decline.

"Alzheimer's disease is one of the top 10 diseases now, certainly in the west, and I would argue it's because it has a metabolic origin."

• Alzheimer's is increasingly recognized as having metabolic roots, shifting the focus from plaques to insulin resistance.

"People with Alzheimer's disease almost always have some detectable instance of insulin resistance."

• Insulin resistance is a common factor in Alzheimer's, suggesting metabolic health is crucial for cognitive function.

• Different ethnicities exhibit varied fat distribution and insulin resistance, affecting metabolic health.
• East Asians tend to have less subcutaneous fat but are more prone to visceral fat accumulation, increasing metabolic risks.
• The concept of a "personal fat threshold" highlights individual differences in fat storage capacity and metabolic health.

"East Asians have fewer fat cells and they're more resistant to obesity-related metabolic issues."

• Ethnic variations in fat cell quantity and distribution influence susceptibility to metabolic diseases.

"The bigger the fat cell, the sicker the fat cell."

• Larger fat cells, often found in visceral fat, are associated with greater metabolic dysfunction.

• Longevity is linked to insulin sensitivity and effective glucose control, challenging traditional views on cholesterol.
• High cholesterol levels in long-lived individuals suggest a reevaluation of its role in health and longevity.
• Insulin plays a crucial role in cellular processes like autophagy, which are vital for longevity and metabolic health.

"The longest living humans are also the most insulin sensitive."

• Longevity correlates with insulin sensitivity, emphasizing the importance of metabolic health in lifespan extension.

"They found that the longest lived people had high cholesterol."

• High cholesterol in long-lived individuals indicates the complexity of cholesterol's role in health, questioning the current anti-cholesterol stance.

• Ketones provide an alternative energy source for the brain, especially when glucose metabolism is impaired.
• The keto diet, characterized by low carbohydrate intake, can promote insulin sensitivity and support cognitive health.
• Autophagy, stimulated by low insulin levels, is a key process in cellular maintenance and longevity.

"Ketones can swoop in to save the day."

• Ketones offer an alternative fuel for the brain, particularly beneficial in insulin-resistant conditions.

"Autophagy probably does matter for longevity, all the more reason to keep your insulin in check."

• Autophagy, facilitated by low insulin levels, is crucial for cellular health and longevity, highlighting the benefits of metabolic regulation.

• Smoking induces insulin resistance in healthy non-smokers, as demonstrated by a study in Bulgaria.
• Cigarette smoke triggers an inflammatory response that contributes to insulin resistance.
• Vaping produces similar, if not worse, effects compared to cigarette smoking in terms of inflammation and insulin resistance.

"They found that if you took healthy non-smoking people and had them start smoking, they became insulin resistant."

• Smoking can lead to insulin resistance even in healthy individuals.

"The Vaping ones are probably worse chemical for chemical in terms of their inflammatory effect, the damage to the airway, and the insulin resistance that comes from it."

• Vaping may have more severe effects on insulin resistance and inflammation compared to traditional cigarette smoking.

• Smoking does not inherently cause weight gain; it often suppresses appetite by satisfying cravings.
• Smokers may replace smoking with eating, leading to weight gain when they quit smoking.
• Addictions to food, particularly carbohydrates, can replace smoking addiction.

"It's no surprise that very commonly when a person quits smoking, they gain significant weight."

• Weight gain is common after quitting smoking due to replacement of smoking habits with eating.

• Exposure to diesel exhaust gas is linked to increased fat mass, enlarged fat cells, insulin resistance, and higher inflammation levels.
• Inhaled particulates, such as diesel exhaust and cigarette smoke, can influence fat cell growth and insulin resistance.
• Chemicals from plastics and other sources can mimic insulin's effects, promoting fat cell growth.

"Our evidence would state conclusively that yes, what you breathe does matter."

• Airborne particulates can significantly impact fat accumulation and insulin sensitivity.

"Microplastics are things that you can drink, and they will absorb through the intestine and get into the bloodstream... they will directly promote the growth of the fat cells."

• Microplastics can enter the bloodstream and promote fat cell growth.

• The ketogenic diet shifts the body to burn fat instead of glucose, with insulin determining the fuel source used.
• Ketones, produced during fat burning, are beneficial for brain function and can improve cognitive performance in conditions like Alzheimer's.
• Ketosis increases the metabolic rate of fat tissue and protects muscle from injury.

"Ketones are as we've already outlined perhaps the best fuel for the brain."

• Ketones serve as an efficient fuel source for brain function, enhancing cognitive performance.

"In ketosis, the metabolic rate of that belly fat was three times higher than when the people were not in ketosis."

• Ketosis significantly boosts the metabolic rate of fat tissue, aiding in fat loss.

• The ketogenic diet can lead to significant weight loss, particularly in reducing belly fat.
• Insulin reduction is key to effective fat loss, as high insulin levels hinder fat burning.
• The ketogenic diet can result in muscle loss if not managed properly with adequate calorie and fat intake.

"If your fat cells now have a three times higher metabolic rate, that means that the fat cells are starting to act a little bit more like your muscle cells and they're just burning more energy."

• Ketosis increases fat tissue metabolism, facilitating faster fat loss.

"Let the first step of that journey be I'm going to lower my insulin which means I'm going to control my carbohydrates."

• Controlling carbohydrate intake is crucial to lowering insulin and promoting fat loss.

• Maintaining muscle mass on a ketogenic diet requires sufficient calorie and fat intake.
• Dehydration and inadequate caloric intake can lead to decreased muscle mass during ketosis.
• Increasing fat intake can help preserve muscle mass while on a ketogenic diet.

"You probably ought to eat more fat."

• Adequate fat intake is essential to maintain muscle mass during ketosis.

• Long-term adherence to a ketogenic diet can reduce metabolic flexibility, making it harder to switch back to glucose metabolism.
• Concerns about the ketogenic diet affecting the gut microbiome are largely unfounded; changes in microbiome composition are not necessarily negative.

"If there's any negative to a ketogenic diet, it could be that you start you acutely or you temporarily become less metabolically flexible."

• Reduced metabolic flexibility is a potential downside of long-term ketogenic dieting.

"There's no evidence to support that there's any harmful change in the microbiome."

• The impact of the ketogenic diet on the gut microbiome is not conclusively negative.

• The relationship between plant-based diets and microbiome diversity is speculative, with no definitive evidence linking increased diversity to improved health.
• The ketogenic diet, despite being less diverse, can improve clinical markers such as diabetes and hypertension.

"People, dietitians will say, well, a diverse microbiome is a good microbiome. Well, prove it. How do we know that? How can you prove that to me as a basic scientist?"

• The speaker questions the assumption that a diverse microbiome is inherently beneficial without hard evidence.

• Ketosis can be beneficial for conditions like Type 2 diabetes, epilepsy, and migraines, potentially reducing or eliminating symptoms.
• Individuals without specific health conditions should manage carbohydrate intake and focus on whole foods.

"If someone has Type 2 diabetes, if they adopt a ketogenic diet, they will be off all of their diabetes medications in months."

• Ketosis can significantly improve or reverse symptoms of Type 2 diabetes.

• Different sweeteners have varying impacts on insulin levels, with some having no effect and others potentially crossing the blood-brain barrier.
• Aspartame is preferred over sucralose due to its lack of insulin effect and inability to cross the blood-brain barrier.

"Aspartame just gets divided into amino acids; we just digest it and absorb amino acids. Sucralose will go can cross the blood-brain barrier."

• Aspartame is considered safer than sucralose regarding insulin response and brain exposure.

• The relationship between salt intake and high blood pressure is minimal, with insulin resistance being a more significant factor.
• Reducing salt can inadvertently increase insulin resistance, worsening blood pressure.

"Salt has earned a terrible reputation because of a series of studies that implicated salt consumption as a cause of high blood pressure."

• Salt's negative reputation is based on studies that didn't account for other dietary factors impacting blood pressure.

• Control carbohydrates by focusing on whole fruits and vegetables.
• Prioritize protein, especially from animal sources.
• Do not fear fat; it aids in digestion and muscle growth.
• Frequently fast after adopting the first three pillars.

"Control carbohydrates, prioritize protein, don't fear fat, and frequently fast."

• These pillars are designed to manage insulin levels and combat insulin resistance effectively.

• Exercise improves insulin sensitivity, with muscle-building exercises being particularly effective.
• Muscle acts as a significant consumer of glucose, enhancing blood sugar control.

"The best exercise to improve insulin sensitivity is the one you'll do."

• Consistent exercise, particularly strength training, is crucial for maintaining insulin sensitivity.

• Carbohydrates are not essential for human nutrition, unlike fats and proteins.
• Restricting carbohydrates can aid in managing insulin levels and overall health.

"There is literally no biological need that humans have for carbohydrates."

• The emphasis should be on essential nutrients rather than carbohydrates, which are often overconsumed.

• GLP-1 receptor agonists can aid in weight loss but may lead to muscle and bone density loss.
• These drugs should be used responsibly, focusing on maintaining muscle mass through diet and exercise.

"40% of the weight they were losing on these drugs is coming from lean mass like including muscle and bone."

• Weight loss drugs can have significant side effects on lean mass, requiring careful management.

• Liposuction removes fat cells but does not improve metabolic health, as it does not address fat cell size.
• Without lifestyle changes, fat can be redistributed to less healthy areas like the abdomen.

"It's the size of our fat cells that matters most when it comes to metabolic health."

• Liposuction's impact on health is limited without addressing underlying dietary and lifestyle habits.