Back to Episodes
1:16:45 · Apr 13, 2022

The Hard Science of Your Metabolism on Keto, Carnivore, and Carbs With Professor Ben Bikman of BYU

Dr. Anthony Chaffee interviews Professor Ben Bikman, a PhD researcher from BYU specializing in metabolic health and insulin resistance. Professor Bikman reveals groundbreaking insights about hyperinsulinemia as a fundamental driver of modern diseases, explaining how chronically elevated insulin levels - not just insulin resistance - directly cause conditions like type 2 diabetes, PCOS, erectile dysfunction, and Alzheimer's disease. He demonstrates how insulin resistance is actually a two-sided coin: impaired insulin sensitivity at some cells combined with dangerously high insulin levels throughout the body.

The discussion explores the revolutionary concept of ketones as signaling molecules, not just fuel sources. Professor Bikman's research shows ketones bind to cellular receptors to reduce inflammation and increase metabolic rate in fat cells by 2-3 times normal levels. He debunks common fears about protein intake on low-carb diets, explaining that protein consumed with fat (as occurs naturally) actually increases glucagon more than insulin, supporting ketone production rather than inhibiting it.

Professor Bikman addresses the metabolic flexibility myth, clarifying that carnivore dieters don't lose the ability to process glucose - they simply become so fat-adapted that their pancreas reduces stored insulin. This can be quickly reversed with a single day of carbohydrate intake if needed. He emphasizes that the brain preferentially burns ketones when available, with newborn babies achieving deeper ketosis within hours of feeding than adults reach after 24-hour fasts, suggesting ketosis is our natural metabolic state.

The conversation concludes with practical applications for brain health and Alzheimer's prevention, positioning the disease as "insulin resistance of the brain" where glucose can't enter brain cells due to insulin dysfunction, while elevated insulin simultaneously prevents ketone production - leaving the brain energy-starved despite abundant glucose in the blood.

Key Takeaways

  • Hyperinsulinemia (chronically elevated insulin) directly causes PCOS in women by preventing ovaries from converting testosterone to estrogen, while insulin resistance causes erectile dysfunction in men by impairing blood vessel dilation
  • Ketones function as powerful signaling molecules that bind to G-protein-coupled receptors, reducing inflammation through NLRP3 inflammasome inhibition and increasing fat cell metabolic rate by 200-300%
  • Protein consumed with fat (not carbohydrates) increases glucagon more than insulin, actually supporting ketone production rather than inhibiting it - eliminating fears about protein intake on carnivore diets
  • Carnivore dieters don't develop true insulin resistance but rather lose first-phase insulin response due to pancreatic efficiency - this reverses completely within one day of carbohydrate intake if needed
  • Newborn babies achieve 2 millimolar ketosis within one hour of feeding, while adults require 36+ hours of fasting to reach the same levels, indicating ketosis is the natural human metabolic state
  • The brain preferentially burns ketones when available, using twice as much energy from ketones even when ketone levels are half that of glucose in the blood
  • Alzheimer's disease represents 'insulin resistance of the brain' where glucose cannot enter brain cells while elevated insulin prevents ketone production, creating an energy-starved brain despite abundant blood glucose
  • Low insulin states increase metabolic rate by approximately 300 calories per day while allowing ketone excretion through breath and urine, creating caloric waste that bypasses the calories-in-calories-out model
  • Dr. Ben Bikman's Research on Insulin Resistance and Metabolic Health
  • Hyperinsulinemia as Disease Driver - Beyond Blood Sugar Problems
  • Insulin Resistance and Infertility - PCOS and Erectile Dysfunction
  • Carnivore Diet and Physiological Insulin Resistance Misconceptions
  • High Blood Pressure and Erectile Dysfunction from Insulin Resistance
  • Ketones as Signaling Molecules - Anti-inflammatory and Metabolic Effects
  • Protein Fears in Low-Carb Diets - Debunking Too Much Protein Myths
  • Brain's Preferred Fuel - Ketones vs Glucose and Human Evolution
  • Plant Toxins and Cancer - Professor's Warning About Natural Carcinogens
  • Calories In Calories Out Myth - Why Insulin Control Beats Calorie Counting
  • Alzheimer's as Type 3 Diabetes - Brain Insulin Resistance and Ketones
  • Cholesterol and Depression - Low LDL Links to Mental Health Issues

This is an auto-generated transcript from YouTube and may contain errors or inaccuracies.

hello everyone this is dr anthony chafee i'm here today with a very special guest professor ben bickman of byu he is a phd professor uh lecturer and scientist in metabolic health and very very knowledgeable in uh all the science behind how your body works professor bickman thank you so much for coming oh my pleasure thanks so much you're very welcome um just so just so people get an idea of who you are that haven't come across your things which i fully encourage people to find your videos online um and follow your instagram page which also has very very interesting uh you know quick videos to talking about various subjects right i find very very useful could you tell us a bit about yourself and and your research yeah yeah so i am a husband father and scientist no one ever wants my parenting advice so i'll just go right to the science um but yeah i i became an interested during my phd in in the mechanisms of insulin resistance i was looking at insulin resistance as the time at the time as this connection between these two diseases i was interested in or two states maybe to be a little more accurate obesity and type 2 diabetes and i looked at insulin resistance and still do as the great mediator between those two why is weight gain so coupled to type 2 diabetes while insulin resistance is what's connecting it um and in my my view on how insulin resistance connects a fat cell to other to other things has expanded where it's not just type 2 diabetes it's also infertility and alzheimer's and more but my interest has stayed quite firmly in insulin as a hormone and my view is just unique and in the the drum that i'm pounding that i want people to hear is that insulin isn't always our friend that while it is a hormone that is needed for life it is also pathogenic when it's too high for too long and that's that's really formed my research to this day um during my postdoctoral work and then now as a principal investigator with my own lab over this last decade or so it's continued uh the work has continued looking at insulin its effects pathogenically or harmfully on the body and also other things that insulin influences like the production of ketones and how ketones act as their own signaling molecules and not just as a nutrient source but actually telling cells to do something and just to state that another way because it is unique um where it's these are not just nutrients you know ketones have a caloric value similar to about glucose actually but they also have signaling that is very unique they almost act like a hormone now they're not but they kind of act like it uh anyway i've gone a little too into too much detail as an introductory sort of statement but yeah that's my focus is metabolism in a big sense and then in a narrower sense it's it's some of the differential effects of insulin and ketones in neurons in muscle cells and fat cells in particular yeah that that's that's very interesting um very very interesting i i think that um you were the first person that i've heard talk about hyperinsulinemia as a as a driver of disease in and of itself as opposed to you know high blood sugar obviously which can cause its own damage but it has lost to this you have hyperinsulinemia which which you have been talking about as this just just itself can drive disease um what are some of the things that you found with just you know how the effects that that uh hyperinsulinemia causes in regards to obesity and diabetes and as you say also yeah yeah so it is very important too many people don't realize that hyperinsulinemia is a fundamental aspect of insulin resistance that they'll hear me or you or anyone else talk about insulin resistance and that immediately evokes this idea of it's a state in the body where the hormone insulin isn't working well that's true but it doesn't stop there insulin resistance is a coin and one side of the coin is the fact that the hormone insulin isn't working the same way that it used to at some cells of the body in other words some of the body's cells are in fact insulin resistant like muscle cells or fat cells but other cells of the body are perfectly insulin sensitive or have some mix of insulin sensitivity like liver cells or or gonads like ovaries in particular and and that all becomes relevant when we flip the coin over this coin that i'm calling insulin resistance the other side of the coin is the hyperinsulinemia you cannot have this is such an important concept and it's misunderstood by a lot of low carb folks there is no such thing as insulin resistance without hyperinsulinemia that's very important because there are some instances called physiological insulin resistance where the body has become insulin resistant to serve a valuable purpose and overwhelmingly that's growth and that's why you only have physiological insulin resistance in two situations pregnancy and puberty because those are the two periods of rampant growth in a human in the adolescent or in the adult female of course but even still it's rampant growth in the insulin resistance and the connected hyperinsulinemia help to fuel this selective growth in the adolescent or the pregnant woman but regardless whether it's harmful insulin resistance like i study in my lab the kind that's connected to alzheimer's etc or whether it's physiological insulin resistance when the body's become insulin resistant for a period of time on purpose it still is both of these aspects it's insulin is altered in how it's working and blood insulin levels are elevated in other words hyperinsulinemia and a perfect example of this anthony when we look at these two sides of the coin it's to look at the two most common forms of infertility in males and females specifically i mean erectile dysfunction and polycystic ovary syndrome respectively and in erectile dysfunction it's a problem of the insulin resistance part of this coin side of the coin which is that insulin isn't able to promote sufficient vasodilation in the man anymore and so not only does he have probably elevated blood pressure but if you can't dilate blood vessels you don't have normal erectile function and thus it's the insulin resistance that's contributing to the male form of infertility the most common in stark contrast in the female it's not the problem of compromised insulin signaling it's more a problem of the hyperinsulinemia because at her ovaries she has cells in her ovaries that are capable of rapidly converting testosterone into estrogens and that's a little known fact all estrogens were once testosterone and the ovaries convert that over very very well at a much higher rate than the testes do in men however insulin inhibits that conversion and so as she's insulin resistant and her insulin levels are higher that has a specific effect at the ovaries where it's the elevated insulin not the insulin resistance per se that is preventing her ovaries from converting the testosterone into estrogens at a high enough amount now her testosterone's too high her estrogens are too low and then she has polycystic ovary syndrome she isn't ovulating she may have more coarse body hair and so on yeah i think that's that's that's one of the things that i i've certainly noticed in in my patients and just the populations that go on to a low carb diet or especially a carnivore diet is it really overhauls their hormonal health as well and and sometimes we think of it as just getting enough cholesterol because obviously you know cholesterol is a precursor for estrogen testosterone progesterone so forth but um that you know is is uh really a secondary point to what you're talking about is because you know if you if you have this hyperinsulinity mixed state you you can have all the cholesterol you want you still won't have enough uh estrogen in women and so that's exactly right yeah and that that is something that i've noticed as well i didn't know the mechanism but i've seen polycystic ovarian syndrome uh actually reverse uh going on these elimination diets especially a carnivore diet and uh and i i did not know the mechanism so i'm very happy to so yeah yeah but but anthony so you see this though like firsthand what i envy in the physician is that you guys are where the rubber meets the road you get to be the one who actually sees this change directly the fact that you have a patient who does this and you see the insulin levels drop you know in australia maybe it's 80 picomoles and it goes down to 20 picomoles that is absolute proof positive that the person is more insulin sensitive than they were before but you have some individuals in this space who will say that well a low carb diet or carnivore diet that's going to cause a physiological insulin resistance absolutely not what they confuse and i'm sorry to veer off but i'll promise i'll just be a second on this but i think your audience may enjoy it or appreciate it if not enjoy it what does happen is that when someone has it has adhered to a low carb or zero carb diet for an extended period of time they they they uh the pancreas is too efficient to hold on to insulin when it doesn't need it and so what could happen anthony you could have a patient come in and maybe they're adhering to a standard kind of australian diet which is like the american you know it's kind of high carbs and they would drink a glucose solution and you could measure their do an oral glucose tolerance test and you see that the glucose comes up and it comes down in a pretty nice normal maybe not maybe it's not great but it comes down and it looks okay they go on super strict let's say carnivore for six months if they were to come right in from scratch and take that same oral glucose tolerance test they're going to do worse and that's not and some people will say well it's because they have physiological insulin resistance because they're ignorant and they don't know any better so we pardon them for their ignorance but it's not a matter of compromised insulin action it's not insulin resistance it's just that when you've been avoiding carbohydrates for an extended period of time even if you fast for a full 24 hours and we know this this is well documented if you're going to do an oral glucose tolerance test the next day even fasting for too long your beta cells of your pancreas start looking at all of this insulin that they have pre-formed packaged and ready to go and they think we don't need all this stuff let's start breaking down all the insulin that we have preformed because we just don't need it it's taking up space if you will now i'm being a little silly but that's kind of the way the beta cells looking at it and so when you suddenly get this rush of glucose in a system that's not expecting it you lose what's called the first phase of insulin secretion so normally when you challenge the body with glucose you'll see one little phase of insulin and then a second bigger phase that lasts a little longer than before coming down the first phase is all of the prefabricated insulin that is on hand packaged up and ready to go the second phase is all of the insulin the beta cells start making once they get the signal so they push out all the packages that they've already made then they've turned on the machinery the factory is turned on and now they start making new insulin and start releasing it just as quickly as they make it but it's that first phase that the beta cells are thinking they don't need anymore and then when you just rush the system again this even happens after if a person has fasted too long um you know around 20 hours or so they start to lose that first phase insulin response well that means you'll have a harder time clearing that glucose and so it looks like you've gotten a well a positive result in other words a negative a negative sign a bad test because you look at this and think well gosh you've you can't clear the glucose as well well it's just because you've lost that first phase of insulin temporarily all a person would need to do if if there were a carnivore adherent who knows they have to go in to do an oral glucose tolerance test just prime the pump a little bit get those beta cells making more insulin and holding onto it you start eating a few more carbs the days before you go in then you'll go in and you'll pass it with flying colors you just have to remind the beta cells to put a lot of insulin and held to make a lot of insulin and keep it on hand for when they get challenged with this rush of glucose which is something they're not used to to say it all another way even though i've already gone too long anthony pardon me but it's just to say it another way it's almost a reverse metabolic inflexibility so people have heard of this concept of metabolic flexibility which is a body that can shift between glucose and carbs really well or glucose burning and fat burning rather i mean really well the average individual because they have chronically elevated insulin is essentially stuck in glucose burning even when they start to fast which should shift their body to fat burning they don't they stay in glucose burning well if you're a carnivore it's almost like you're stuck in fat burning and the body has a little bit of a reluctance you've lost a little bit of that flexibility now i wouldn't say that's a bad thing i think it's fine if you're going to be anywhere be in fat burning mode but it does make it a problem if you come dump the body with full of glucose well it takes a little time to shift back it's a little resistant it's a little inflexible now thankfully you can go back to perfect flexibility after like a day eat some carbs one day the next day you're right back to where if you want to be there well that's where you are now again i'm not saying that that's something healthy or or needs to be done you know that's some people might hear what i'm saying and then think oh well that's why i need to cycle in and out of carnivore or ketosis no i'm not saying that but for the sake of transparency it is almost like you have this opposite form of metabolic inflexibility whereas the average person is stuck in glucose because their insulin's chronically elevated the carnivore if you will is stuck in fat burning because their insulin is chronically low now i say stuck of course they can get that right back to you know perfect flexibility if that's what they want after just a day of just snacking on some carbs yeah i was actually going to ask you about what your thoughts on the whole idea of metabolic flexibility was i i think people say well you need if you're on a carnivore diet you need to incorporate fruit and honey because you need to you need to maintain your your metabolic flexibility which is never really tracked with me and and but you know but yeah just so you don't you don't lose that at any point so if you were if you were carnivore keto for a number of years you know would you be able to snap back into it if you needed to within a day yeah absolutely perfect yeah all really all it takes is one challenge to the beta cells and then they say ah okay we're doing this again no problem i can do that yeah and probably you know they've since they've been arrested for so long they're not going to be uh they might be even even more ready to go and uh whereas you know sometimes you can get you know a type 2 diabetic you can burn out your beta islet cells and now become insulin uh dependent uh which happens to quite a lot of people more and more um it sounds like the the insulin relationship and response sort of sounds like a bit like tolerance into like drug or alcohol tolerance where you have this this buildup and difference uh different sort of enzymes to to you're anticipating your body's anticipating this uh this toxic uh exposure and you're trying to sort of mitigate that and be ready for it it sort of sounds like your body's doing that with insulin as well it understands there's just going to be an abnormal amount of carbohydrates coming in which which can cause harm hyper glycemia causing your glycation uh it damages your body and it sounds like uh it's sort of preparing for that in a sort of a tolerance mechanism yeah i thought well said i i wouldn't have said it any better myself yeah um so you mentioned erectile dysfunction as an inability for the for the body to uh you know dilate the the vessels i i've also heard you talk about that this this could be uh implicated in high blood pressure as well is that right yeah absolutely yes so um they're very common in that regard insulin tends to have when insulin is working it has a vasodilatory effect it's one of insulin's lesser-known actions but it's just further proof that insulin literally affects every part of the body every single cell of the body has insulin receptors which really makes it really unique among hormones because not all hormones effect few hormones do that but one of insulin's effects is when it binds the cells of the blood vessel it will induce the production of a molecule called nitric oxide and nitric oxide i'm sure your audience knows it's a potent vasodilator that's basically what if someone's experiencing chest pain they go in and they give them nitroglycerin it's because the nitroglycerin will help stimulate this nitric oxide throughout the body and it will throw open the blood vessels for example of the heart and then the chest pain goes away but to another degree that's what's happening around the body but in the case of the insulin resistant man when his blood vessels have become insulin resistant well that's not working as well and so insulin is trying to promote vasodilation it can't and the blood vessels stay constricted now systemically throughout the body as the vessels are more constricted the narrower that volume is of course the higher the pressure goes those are inversely related as volumes dropping in this in the chamber of the blood vessel it's pressing in on the blood more which increases pressure but then of course when it comes to erection if you can't dilate the blood vessels and they stay constricted now you have a compromised will compromise erectile function and this in fact is so uh it's such an intimate connection if you will uh scientists have suggested and physicians that erectile dysfunction may be the first clinical sign of insulin resistance in an undie in an otherwise undiagnosed man basically if there's a guy who has erectile dysfunction it might be worth testing his metabolic health namely his insulin and insulin resistance to get an idea of whether that might be the source of the problem and if it is well that's good news because we can start to fix that pretty quickly yeah and and and that's the thing too we don't we don't commonly look at or at least you know doctors i know don't commonly look at that they often will look at that as a as a sign of low testosterone i know i know yeah and um yeah but that that makes perfect sense um you were talking about uh ketones acting as signaling molecules that's actually something that that's new to me can you go into a little more depth with that oh yeah for sure i'd be happy to so let me just cite some other people's work first and then i'll get to mine um and nothing a scientist likes talking about more than his own work right like a dad who wants to brag about his kids so so other people's um kids are cute too and so other people's research matters too and and one group found that ketones actually will bind to cells and inhibit something called the nlrp3 inflammasome and whenever you hear the term like nowadays people attach an ohm onto everything you know it's metabolomics the microbiome all this ohm ohm as a suffix just generally refers to like a sum like the entirety of whatever it is you're looking at um and so the inflammasome essentially evokes this idea of of something that is in charge of all inflammation and that's not too far from the truth where this molecule nlrp3 essentially if it's activated it will essentially turn on all of the machinery to produce all of these pro-inflammatory cytokines and initiate immune systems throughout the body now of course we need a healthy immune system so this can't be viewed as a bad thing but you want it to be turned on when it's supposed to be turned on and turned off when it should be turned off one of the problems with obesity or even even not overt obesity but just fat cells that are getting too big even if the person is just modestly overweight is that they become pro-inflammatory and this is why weight gain is associated with a uh it's sometimes called the subclinical inflammatory state where it's subclinical because it's not like the person's coming in with some raging fever but in fact the inflammatory markers are higher than you would expect in an otherwise healthy person so in these instances where you have kind of aberrant activation of the immune system and inflammation which is something i've studied extensively in in my my post-doc work and even in my current lab it's it's valuable to know how can we turn that down how can we turn down this aberrant inflammation and ketones will do that when ketones and this isn't because of their energetic or their caloric value it's because they can bind to these things called g-protein-coupled receptors in anyone i know anthony i know you've heard of these anyone who's gone through any kind of biochemistry would remember if only painfully learning about g-protein-coupled receptors because they are everywhere and they signal all kinds of things but there are so many different types um that ketones will bind a particular type and in so doing act at like a hormone binding this surface receptor just like a hormone does initiating a series of events that result in the inhibition of this key inflammatory signal and so that's one example where again i'm citing someone else's work it was a fascinating study my work has found we've specifically looked at the signaling capability in fat cells and we found that when ketones come to fat cells including fat cells in humans that it starts to activate an uncoupling process at the mitochondria now now briefly all that means is basically the ketones result in the mitochondria and fat cells being much more active it basically stimulates the metabolic rate in the fat cells by about two or three times over normal and again that's not because the ketone is being burned for energy it's because there once again is a g protein coupled receptor on the fat cell that is that is activated when ketones come knocking and then that tells the cell to do something but but i i hope i can impress upon the audience just how cool that is that yes ketones are an energy that's why you know the brain so greedily pulls in ketones because it has an energetic value it has a caloric value roughly similar to glucose you know about four calories per gram but independent of that is its signaling capabilities which which is just like the cherry on top of the low carb cake where this is it's really these are molecules that again are an energy source maybe desperate for the brain or the brain becomes desperate for it so it's a very good viable energy source but also a good and viable signaling molecule that provides an anti-inflammatory and even dare i say metabolic benefit yeah well that that's yeah that's very interesting i didn't know uh any of that about ketones that's fantastic um that's that's one of the things um as well you know people talk about you know when you're in ketosis they want to they maintain that that state of ketosis they get very concerned about their ketone levels and exactly what's going on there and a lot of people will be concerned about eating too much protein and that protein like their insulin and uh and cause a problem there i you know i haven't really seen that be a problem you know when i think of things from a carnivore perspective i just think that you know this is this is just physiological this is how your body is supposed to work you're supposed to eat this stuff and and whether or not you're technically in or out of ketosis your body's still going to be running physiologically but you know what what do you think about the whole too much protein uh blood sugar insulin spike yeah yeah i love that you're asking this uh in part of course because i have a lot to say but this is something that i have a personal history with when i first became and i'll let me just share it briefly because it's interesting when i first kind of became aware of the low-carb community when my lab had started studying the effects of ketones on fat cells and in that very first early work from my lab one of the organizers of a low carb event it was called at the time low carb breckenridge and these guys reached out and said hey we can't we're aware of what you're doing we'd love for you to come give a talk at our meeting and this was the very first non-science meeting i'd ever spoken at you know it was just a lay meeting like they do low-carb melbourne you know low-carb sydney you know whatever low-carb down under um you know you have these meetings around the world of kind of low carb enthusiasts just from the community at large and so it's a lay audience this was the very first time i'd ever given a talk to a non-academic at a non-academic venue and i loved it frankly but it was that was my first exposure to the the the community in the canakito community at large um coming in as a scientist and i was so interested by what i saw and heard which was a fear of protein to your point where people were saying uh well i saw you know they were like they were drinking oil uh and you know adding butter and i thought this is so bizarre and then i in a lot of it was born from this fear of protein which itself came from the original ketogenic diets that were used to treat epilepsy right and it was such uh it was such a necessity to keep the person into deep ketosis that you didn't want to mess with that at all you didn't want to do anything to potentially blunt those ketone production the ketogenesis lest they have an epileptic seizure so tremendous reason to want to be in strict strict deep ketosis all the time well the fact is insulin can uh insulin can increase in response to dietary protein that can happen and if insulin goes up well then ketogenesis or ketone production will drop but i nevertheless thought it was tremendously a misplaced fear and then the next time i spoke at this same meeting that was the topic i spoke on it was basically helping people understand the fact that they need not be afraid of any modest increase in insulin that comes from dietary protein because if it happens in the context of a low-carb diet then the commensurate increase in insulin's opposite is glucagon namely is at least is greater than or equal to what the change in insulin is and that matters so in other words if you eat some protein and you're eating it with carbohydrate which in nature never happens never in nature protein comes with fat it doesn't come with carbs but in our you know in our hubris nowadays we've mixed the two thinking we know better than god but nevertheless if you eat your protein with glucose then you get a big increase in insulin bigger than it would have been if it was just glucose alone so no question the protein adds to the insulinogenic effect of a carbohydrate but also they're not supposed to come together if you eat the protein with the fat and there's no carb well then there may be a modest insulin increase but there's a relatively greater glucagon increase and glucagon is insulin's opposite in many many ways including ketogenesis so whereas that little elevation and insulin is trying to inhibit the production of ketones that relatively greater increase in glucagon is overcoming that and in fact acting more as a stimulate a stimulatory effect so offsetting the modest increase in insulin so to wrap all of that up my concluding thought is for the average individual who's who's focusing on just improving their health no reason to fear protein but be smart about it don't eat your protein with carbs because you will in fact amplify that insulin effect let the let the protein come with the fat that it wants to come with in nature and if you're adding anything to it let it be that you're adding a little olive oil or a little butter or whatever not carbs rather add a little fat if you need to because that fat will not increase insulin we are going to publish our own paper soon and we have studies and i'll you know i'll let the cat out of the bag a little bit we're doing macronutrient challenges and you have to eat hundreds and hundreds of calories of pure fat before you're going to notice an insulin effect if it's in the realm of even like 300 calories which is still pretty significant that's the range we're using not a single blip the insulin and the c peptide don't budge at all um but anyway to bring this back to your original question no reason to fear protein that is how we're supposed to eat fat um you know in nature that's those two come together and let's just eat them the way god intended if you will yeah i completely agree and you know i i i find that the mechanism is extremely interesting but i also try to keep side of the of the big picture which is this is how we evolve this is what we evolved to eat and so whatever is happening it's supposed to happen and so you can you can just let it happen you know nature is natural it just happens you know things have been set into place and you can just you can just let them go when we try to micromanage our our blood sugar or micromanage our ketones or micromanage our our body's ph like you're going to run into trouble your body knows how to do this a lot better than you do and um you know i like i always like hearing um some especially some of the early proponents of or people discussing a ketogenic diet that that you weren't scientists or mainly more influencers or you know physical physical trainers personal trainers and they would they would talk about these things and they'd sort of look at the studies and maybe not quite quite get them like mispronounced big words which is always great yeah yeah and uh anyone then talk about how you know ketosis is uh it's like well you know you're tricking your body into thinking and starving to death and you get the benefits of starving to death it's like wow okay so it's like apparently there's a benefit of starving to death you know yeah it's such it's so it's so moronic yes it's so funny like i remember hearing what from for one guy and i was just like i got so upset i was like you tell me one one benefit of starving to death except you're now dead and i don't have to listen to this stupid crap anymore and uh you know but they talk so you'll talk about tricking your body into thinking and starving to death it's like i'm sorry it's just silly you know in fact anthony if you'll allow me to riff for a second the irony is that if you're producing ketones you're not starving so the difference between fasting and starvation is have you run out of fat and then the moment you run out of fat on your body now you can't make ketones to feed the brain because when you're fasting the brain is producing about is the ketones are providing about 70 percent of all of the brain's energy and so its glucose need is very very low which is good because if you're not eating anything you know you're gonna especially carbs well then it's nice that the brains glucose demand has gone down once you start running out of fat your production of ketones plummet and now the brain can't get any ketones and has now become totally dependent on glucose and guess who has to start paying that well it's muscle and so now you start stripping the amino acids from the muscle in order to make all of this glucose for the brain to eat so the irony is they say well ketones it's like you're tricking your body into starvation in fact ironically having ketones means you're not in starvation you're fasting that's the difference between a fast and starvation do you have enough fat to make ketones to fuel the brain then it's a fast even if it's a 380 day fast like that fellow did in scotland or ireland or wales i think it was wales actually a documented fast of over a year he of course was morbidly obese it was under medical supervision with water minerals vitamins etc but the fact that he kept making ketones meant he didn't lose any muscle and indeed he didn't because you don't cut muscle unless you're starving and starvation happens when you run out of fat and you can't make ketones right so that's the irony so not that guy was a double [Laughter] but yeah but that's the thing is it's like you know you're not you're not going to be that smart you're not you're not out thinking you know nature and how the the world works like you're just not that smart and if you if you were smart you look at this be like okay well this is natural process let's try to emulate it as close as closely as possible and and and achieve optimal health that way yeah well in fact anthony just to be fair if you're smart you probably wouldn't call a guy a so i i should tell you my language well you know i mean you know again like it you know would you say before you know we can forgive them in their ignorance because you know you are trying to just suss this stuff out um but it does it does sort of you know make you frustrated sometimes when you see people commenting on the these uh these systems that you know that they exist in the textbook like you can read these things and and you can understand them uh you know they if you want to do the work but you know people say oh you know like it's the old saying a little bit of information is a dangerous thing they get a small piece of this they think they understand uh the entire picture and and maybe they do but likely they don't and and it was thomas sowell who one of my favorite authors uh said oh now you're talking my language yeah um yeah he says it takes a lot of knowledge to understand just how ignorant we are and and you know i noticed that firsthand when i was in medical school i woke up about halfway through my second year in medical school and leading up to that i was i was just you know so so excited about all the things i was learning and understanding like wow i really i've got a lot of control over all these sorts of things i know about this thing and this thing and this thing this is this is so great learning about how the body works and about how to treat diseases and i got halfway through my second year medical school and and it just sort of i felt like i was i was building up to a crescendo and all of a sudden i was i got to the top of this hill and i was able to see out of this vast mountain range of things i did not understand and know and i it was very humbling and i just looked at that and went okay i need to just you know shut up and and read for a number yeah yeah yeah well i just i just don't i don't know enough yet and uh and so that's um unfortunately not everyone gets to that point that they yeah they sort of see like wow i really don't know enough about this um that sort of that sort of uh leads me to my next question talking about you know the optimal uh energy source of the brain you know when i was taking biochemistry you know 20 22 years ago we were taught it was ketones you know that your brain optimally runs on ketones it preferentially runs on ketones especially when you're in a so-called fasting state which i i argue is not a fasting state i argue that that's our primary metabolic state that's the metabolic state of most animals in the wild if you look at that that's our natural state our natural state isn't putting something in our mouth yeah yeah and um and specifically not putting carbohydrates in our mouth and and getting into a hyperinsulinic uh state um but that this is this is something people talk about that that that glucose is the brain's uh primary energy source what do you say about that yeah well yeah of course i love this in fact it's very very timely i just got back from a meeting where i presented um at a science meeting and it was it was the the meeting of the american association of biological anthropologists now the acute listeners in the audience are thinking anthropologist bickman's not an anthropologist i'm not i don't study human evolution at all and i'm so grateful that i don't have to focus my career on a theory and then i can focus on just hard cold facts but even still i was so intrigued that they would reach out and invite me and i felt compelled to remind or inform the person reaching out to me i am not an anthropologist i didn't add that i i'm glad i wasn't but but i i i just felt compelled look i'm a nutrient biochemist you know mitochondrial physiologist what what do you what do i have to say and he had said i'm a i'm familiar with your work on brain energy use i am putting together a session and and it's all about the changes in human diets over you know our ancestor diets um over these periods of evolution uh and and i want you to talk about the brain acting as a hybrid and in my preparation for this talk i found a paper that had been published in like the most dynamite anthropology journals the journal of human evolution i think it was called i don't really remember but it's their really great journal that everyone wants to publish and in that article i found two it was all about how the neanderthal diet and the development of the brain and they had two comments in there both of which reflected a profound ignorance by stating that dietary carbohydrates are essential and were essential to our ancestors in the development of their brain and i actually cited that article and then i just kind of hopefully tactfully just said this is wrong um and then shared with them a quote by the national academy of sciences in the u.s stating that the lower limit of carbohydrates in the human diet is zero in other words there is no such thing as an essential carbohydrate and the whole like the idea that the human brain evolved because our ancestors ate a lot of carbs that's utterly ridiculous and that's basically the impression i gave the audience hopefully not too offensively but i had many many people come up to me afterwards very very grateful um maybe the the haters and the detractors didn't bother coming up but no one said no one uttered a negative word it was just absolute gratitude at learning this reality of human biology and physiology which is that yes it's because they mistake dietary carbohydrates with blood glucose that it appears what does appear to be the case is that the brain has some demand for some glucose that appears to be accurate although the lower limit is unknown early work by a fasting physiologist named george cahill he was putting people's glucose down to like 20 milligrams per deciliter which most people would say you're unconscious you're in a coma and you're going to die and these people because they've been long-term fast adapted which i would say ketone adapted there appeared to be no deficit to cognition and that's a pretty bloody low level of glucose but nevertheless let's kind of grant that side of it that the brain has some requirement for some glucose well it is a minimal requirement because if you take a body that has five millimolar glucose then you start increasing the ketones to one or two or even three millimolar which is still less than the five millimolar of glucose so there's still less of the ketone in the blood than there is the glucose by then the brain has already dramatically shifted its energy use and even though the ketone may be less than half of what the glucose is in the blood it's now providing double you know twice as much of energy to the brain as the glucose is so if the brain has any preferential fuel it is absolutely for the ketone and even further it's the closest i can come to kind of human or anthropology at all and i don't want to get any closer is what we see in infants you can take a newborn baby and the baby can breastfeed or bottle feed and then within an hour the baby is in a deeper state of ketosis than an adult would be after fasting for 20 for a full day i mean it is it really that baby will be a two millimolar ketones in an hour and an adult and for me if i want to get to two milli i gotta fast for like 36 hours to get to that point you know and i mean so if there's any natural state kind of back to our conversation a moment ago it is clearly that a natural state is a state of ketosis and and i think even more and i'll flirt again in the waters of anthropology i'll dabble my toes um but it's it's reflected in humans we are such totally unique creatures where we are the only land-based mammals born obese and the only animal who has a brain that is larger than the birth canal much to mothers chagrin but that means we have these very big hungry brains and all of this chubby adorable baby fat that is just producing ketones like gangbusters to fuel the brain growth and if you have a baby that is born premature and lacks sufficient adipose tissue it is much more likely that they're going to develop neurological disorders all the more reason to chubby up that baby as quickly as you can well yeah that's a good that's a good point i mean and we do see this in and you know work in neurosurgery and we get a lot of premature babies that have quite a lot of problems and and that come around with uh being just a premature child and neurological issues and neurodevelopmental uh delays as well and that can that could certainly uh explain much of that that we're seeing um that that's another thing too you know people people i remember reading um something that an article that probably in one of these these anthropology journals a friend of mine sent me when i was first doing this i said oh well you know look at this study and i think like her cousin had actually written it it was it was all about honey and how they're arguing that honey was probably the causative factor of our brains growing so big because the most nutrient dense is the most calorically dense substance and my initial response was like do you know what the word density means i know yeah that's what i'm talking about that's what i'm talking about it's like just stay in your lane yeah you know you you anthropologists and in all in on all seriousness they were incredible scientists and i was thrilled to meet them but clearly there's just this bit of a disconnect i shouldn't say stand your lane that's part of the fun of academia it's going out of your lane for a moment but just make that kind of statement about honey look i'm not trying to declare war on honey i know that in the carnivore community there are some very outspoken advocates i think it's clear that our ancestors our hunter-gatherers it's clear that if people can get honey they're going to love it and they want to eat honey but to then say that that was the like fundamental food and brain development well the brain isn't made of honey you know the brain is made of proteins and fats especially a lot of fat i mean and you need these essential fats from meat in order to have sufficient brain growth you don't get any of those from honey and i'm not trying to declare war on honey but to say that that was an essential uh that it was a necessary part of our ancestors died that to me is just silly yeah well and also you know you know people obviously like the inuits living in uh by the north pole or our ancestors coming through the ice ages you know there was no honey and there was no fruit so you know i'm certainly in the the other side of the camp where i'm saying you know honey's actually really bad he's bad for you fruit fruit can be bad for your fructose you know dr lustig from ucsf has done yeoman's work uh showing just how harmful uh fructose is but then some people say well in the context of honey and this you know in you know and fruit you know maybe it works differently and and that may be true but they haven't actually provided any evidence that it does and so until that research comes out you know i'm still going to be uh you know erring on the side of caution and avoiding uh fructose um that was another thing too you mentioned being ketone adapted uh there's a lot of different um thoughts and and and confusion on when exactly we become ketone adapted when you want to go into a carnivore diet or even a ketogenic diet um you know at what point is your body optimally running on ketones and and providing the the requisite energy for physical activity or or especially like endurance athletes while i was asking how long do i need to uh you know do this before i'm ready to go for my my big marathon yeah yeah that's a great question unfortunately that'll probably be the one question i can't answer authoritatively um because i'm just not enough of an exercise physiologist and i've never seen a study that has looked at the temporal adaptation you know like take a per a person from day zero have them start adopting a ketogenic diet and then monitor performance you know watch it go down and then how quickly does it come back up which it would it absolutely will follow some kind of curve you will have a reduction in performance then it would go back up especially for endurance um i don't know i don't know but maybe i'll so i don't appear to be totally ignorant let me share some other thoughts briefly on it i actually think when someone's getting to elite level competition i i think that they're i can see the justification for using carbohydrates in performance like zac bitter the the that incredible runner um i believe he will train and live essentially zero carb but when he's really performing and during high intensity training he will use carbs and and you know in his words it's like it's just a rocket fuel it's like an extra fuel so i do think for those who engage in very high intensity activity i could i could be easily convinced that there is a value to dietary carbohydrates even in the low carb adapted athlete but i know many especially endurance athletes who don't flirt with that kind of stuff at all and even in the midst of their iron man they're still all in full low carb keto and they do great yeah i'm just saying i could be convinced it wouldn't take a lot of evidence for me to say yeah that makes sense um where if you're tossing in some glucose in the midst of it you're going to use that glucose and you're going to use it greedily yeah i i certainly noticed um you know because i i played uh professional rugby for 10 years before i went to medical school five years of that i was on a cornerboard diet because when i when i i sort of first came upon a carnivore diet simply because i was studying cancer biology and botany just how toxic plants were these things uh are of living organisms and they and one they want to stay living organisms and so in fact i remember i heard you say something about you saw you had a professor who basically said plants are trying to kill us yeah yeah exactly yeah that's awesome yeah yeah that was my my cancer biology professor at the university of washington in seattle and you know he just you know this is something that i actually remember learning in seventh or eighth grade biology was that you know plants and animals are in an evolutionary arms race plants becoming more and more more poisonous so that less and less animals can eat them so they can survive and thrive and then animals becoming more and more adapted to specific poisons and specific plants so they can eat that plant and that's their that's their uh you know designed plant that they can eat and and that becomes a uh you know a dedicated food source they don't have to compete for resources as well so this is this is very advantageous to them like a koala like a panda um and and so we were looking at it from yeah cancer perspective and you know he was he was showing that you know 20 years ago 22 years ago uh that that um brussels sprouts at the time had already they'd already found 136 human carcinogens in them 22 years ago and that like white mushrooms had over 100 and they were literally given a handout with just pages of just every single plant and vegetable that you've ever eaten every edible so-called edible plant yeah they not a single one had less than 60 carcinogens in them and you know professor bruce ames from berkeley in 1989 published a large paper looking at the comparison between these natural poisons and the pesticides we spray on them specifically alar that was used for apples and because they were trying to ban them they were trying to ban all the pesticides in the 1980s saying these these are toxic and he was like okay yeah they are that's literally the point you know you know what insects eating these things but we've been using these these for 80 years like why would they be causing a problem now and he showed that there were 10 000 times more naturally occurring poisons in in the plants like spinach and mushrooms by weight than the the pesticides we were spraying on them and that they were orders of magnitude more likely to cause cancer in animal models than than the alar that they were studying so that's why we still have alar and other other pesticides so they justify it yeah yeah and so that's the thing you know because when you're looking in the context of the plant that you're eating the plant itself actually contains worse components and uh and and this is the entire you know you know uh idea behind gmo foods you're taking uh you know a plant that can make a toxin that will kill all these different sorts of bugs but you know maybe corn doesn't have that so you take that out you put that in the corn now that corn is protected from many many more bug species this increases crop yields this this you can grow this in areas around the world that maybe wouldn't have been able to and this is is is quite beneficial that's the idea and it saves on pesticides but what you are doing is you're making it more poisonous and and we know from inedible plants they will just kill you or make you very very sick that that is a common theme throughout the plant kingdom and and the fungi kingdom is that they they use because they can't run away or fight back like an animal can they need to use these sort of chemical deterrents to protect themselves and yeah and so our professor was going through that and we were just blown away and even though we had learned this in seventh grade and he's telling this isn't showing us the evidence of it that that whole you know you have to eat vegetables salads good for you even though it's bitter and disgusting and you don't want to uh is coming is coming to bear and i remember thinking in my head i was like but you know but vegetables are still good for you though right and he yeah he just looked at us and just said i don't need salad i don't need vegetables i don't know this guy good for him it was great and and he just said he's like he's like i don't let my kids eat vegetables plants are trying to kill you i'm like right screw plants and i just i just stopped and you know i went to the store and i just all i bought was eggs meat and milk because everything else had plants in it and i just i ate that for five years i was you know i was playing rugby you know at quite a high level i'd been an all-american i was i was playing in the the bc premier league actually we would go up to like vancouver vancouver island uh all the time with my team in seattle we played in the the top leagues in in america in the super league and then i went played professionally um uh you know in england as well and i was doing all-star all-star uh competitions and and um as well i was doing this on a pure carnivore diet without realizing it i just knew that plants were trying to kill me and i just didn't want to touch them and my performance as as a as an athlete went to all new heights it was absolutely insane i was able to train so much harder so much longer i got so much more out of it i didn't get sore anymore i couldn't get tired i got to a point of of fitness that i literally could not get tired i could not push myself hard enough for long enough to get tired i would train i would be in university at university of washington until three o'clock i'd go straight to training at 3 30 and i'd be training with rugby uh until about nine o'clock and then i'd go to the gym i could not get tired the whole time i would play a game for the university of washington i'd play a game for seattle and then i'd i'd jump in on the seconds games as well sometimes i was playing four games a weekend because i just wanted to play play play play play and i couldn't get tired i could i could not get tired and i remember thinking that that i should just like just enter a marathon or something like that because i could literally literally just split the whole thing and i was like i was like that would be i just wanted to just to get on record just how insanely fit i was and and just like you know just blow out some you know uh some marathon some scrawny little marathon runner yeah yeah and just taking his gel pack his little goose slapping out of his hand like getting out of here and uh you know but uh it just sounded like it pretty pretty boring honestly i just didn't want to just just run for extended time without you know like what if i'm if i'm running more than 40 yards like i'm hitting somebody yeah you're done you know i'm just i'm just i just got to tackle somebody like that's just not worth it to me like i need some sort of just just physical conflict at the end of it um but so probably wouldn't be safe to put me in a marathon but um but that was it and you know and i think about you know think about it biochemically and and relaying this into uh you know some sort of you know layman's terms of um you know getting a runner's high you know getting your second wind a lot of a lot of endurance athletes and a lot of just athletes in general have certainly heard about this and and some have experienced it where you you push yourself you're exercising very very hard or you're running a great distance and and you eventually run out of energy you hit the wall and you feel awful you just you're just like that's it you're cashed out most people stop at this point if they even get to that point but then there are there are people that have have have pushed themselves and pushed themselves and pushed themselves and then eventually they break through the wall they get their second wind and then they can just go forever and they feel and they feel amazing what i think is happening there biochemically is that they're in this this you know hyperglycemic insulin driven state uh and so your insulin is is is stopping your body from from mobilizing your energy from your fat and so you're going to have blood sugar you're going to have liver glycogen and muscle glycogen that you're going to be running on and especially if you carbo load and that's why they do that um but eventually you're going to run out this is a finite resource whereas in in studies we've seen in wolves in 1981 because they said you know you need to burn eat carbs or burn carbs they said well wolves don't carbo low before they chase caribou for 10 hours you know do they have do they even have blood sugar do they even have glycogen they found out yes they do and it's rock solid it doesn't change their body is constantly replenishing it and so when you're eating carbohydrates exogenous carbohydrates that's going to curtail that and that's going to stop that process and now you're going to run out of energy and normally it takes something like 16 to 24 hours before your insulin comes down low enough that you can actually start uh producing more of your own energy and then you know and that's that's usually it for everyone but if you push yourself push yourself i would imagine what's happening here is that you're actually forcing yourself to get back into a state where you can you know mobilize ketones make your blood sugar make more liver glycogen and then you just get into this this this uh runner's high and this second steady state go forever yeah whereas i think about it if you're in a ketogenic state or or a carnivore state you're you're always in that you're living in that second when you're living in that um you know you're living you'll pass the wall and you can just go forever and so even now when i'm in my my 40s and i started this again when i was sort of 37 38 when i got back from bangladesh doing humanitarian work i found that i felt a little crummy i was you know i put on extra weight and i was trying to get back in shape to to play rugby again and uh he just wasn't feeling great then two weeks on a carnivore diet i was still you know pudgy and uh and not in shape but i felt amazing i could now i could now run i could now work out i was lifting for three four hours a day i didn't want to stop you know because the more i pushed myself the more energy i had the more energy i burned the better i felt the harder i wanted to work so this positive feedback and then when i started going back to rugby you know after a couple weeks of this i was like yeah i'm getting back in there i was able to run at a dead sprint push myself very hard with all these professional athletes in seattle with the major league rugby uh team there the siebel seattle seawolves which was my little team that i grew up playing with these guys have been training very very hard for all the months that i've been away in bangladesh and and before and i had not and but i was able to keep up with with everyone and be just a dead sprint the whole time and i again i didn't get tired i didn't run out of energy and i didn't get sore the next day and so i i think that for high performance athletes especially that this is this is very advantageous now i don't i don't know exactly when you get into that yeah keto adapted uh state but i do know from from my experience it didn't take long before i felt a thousand times better than than when i wasn't doing that yeah and and even even kind of contrary to what i'd said you and and like sean baker you know these guys who are just performing it super high intensities it's not like you need to be spiking in carbs to do it um yeah and and and and that's how i sort of feel like i i yeah i've spoken to zack zack that's a really cool guy i was actually um back in 2018 i was on with uh dr baker and zach on their original podcast a human performance outliers podcast i was one of the early guests on there um and i remember talking about that and about how he was very low carb but he would use some carbohydrates for his um for his uh competitions which is like look he's he's found a system that that works for him and that and and he's you know breaking and setting world records which is which is fantastic but you know i certainly know for myself that i've i've never felt better athletically or physically than when i was on a pure carnivore diet actually actually even much better than on a ketogenic diet i wasn't specifically doing keto this last time around i just wasn't eating cards i wasn't eating sugar wasn't drinking alcohol i was just having a lot of green a lot of greens which i think was a problem and then some meat which is also a problem not getting enough nutri nutrients and and and i'm getting a lot of of these harmful effects from the greens and when i just stopped those and actually increased my my meat intake significantly i dropped like 25 pounds in about 10 days and lost a lot of water weight and felt amazing and started you know my performance and athleticism just immediately spiked um that sort of just leads me to another question what this whole idea of calories in calories out i think is is outmoded for a lot of reasons but even just my own personal example there i essentially quintupled my caloric intake at that point because i was eating very small amount of lean muscle uh muscle meat and then a lot of greens which don't have many calories in them and i went to eating two to three pounds of fatty ribeye with butter melted on it a day as i was eating way more calories and yet i dropped weight and i felt better what are your thoughts on the whole calories and calories out idea yeah yeah so i think invoking thermodynamics in weight loss was one of the greatest tragedies of our understanding of of human metabolism and and maybe even to put say that another way uh looking at nutrients as calorie sources i think is is unfortunate because if we're looking at the calories then we immediately develop a weight loss paradigm that is based on hunger whether we know it or not and when i want to kind of show this to my students i will cite i will use this analogy and i'll say imagine in fact then i'll tell this to the to the to the listeners here imagine if i'm having i'm holding a buffet a wonderful dinner at my home it's a buffet and i'm invited i've invited the world's best chefs and they're going to produce the best foods they're going to make the best foods you could ever imagine come hungry what would you do to come as hungry as possible and always the consensus is two things my students always say this they would eat a little less than the days before and they would exercise a little more and i say you're exactly right that would help you come to this glorious buffet as hungry as possible but do you see the problem with that they just gave me this perfect two-step recipe to make hunger as strong as possible that is the exact two things we've been saying for 50 years to help people lose weight yep eat less exercise more that's a great way to be really hungry and that means if you use those two same steps in order to lose weight sure you'll lose a little bit of weight initially but hunger always wins and you're going to get off and you're going to gain it all back and then some so a hunger to take this down kind of into my neck of the woods you look at what happens at a fat cell and you say i want to shrink that fat cell you can shrink a fat cell through two different ways i promise this is relevant one is low energy if you deprive a fat cell of nutrients it will shrink now of course there's a problem at the body namely the brain and that is that it's going to start to get hung push hunger and push hunger conversely an alternative way of shrinking a fat cell is lowering insulin because if you lower insulin now even if you're eating a lot you can't stop the fat cell from breaking down its fat and leaking it out so even if you're eating a lot and there's still fat coming in it likely will not match the rate at which the fat is coming out in order to be burned and even just purely caloric um discussion when insulin is low metabolic rate is higher so you your metabolic rate does go up to the tune of about 300 calories per day that's pretty significant you know that's like going out and running i don't even know i don't run five miles maybe or so but this is some now all of a sudden you don't have to do it at all it's just doing itself and so so that's one thing if you're focusing on a low insulin approach it doesn't have to be a hunger-based approach which is very valuable because you can't beat hunger you got to be satisfied otherwise you'll never stop eating two when insulin is low your metabolic rate is higher so let's say you're eating more calories in your body needs well that's okay because you're pushing out more calories than normal and then third when you're making ketones you're also excreting ketones and as i said earlier ketones have a caloric value and so if someone's in ketosis and now they're breathing out ketones or urinating out ketones they are pushing out actual caloric loaded molecules from their body and these are calories that didn't need to be burned and didn't need to be stored you just wasted them so you introduced this kind of third avenue when it comes to the bioenergetics of the body which is just wasting energy where you're just dumping ketones out back into the atmosphere if you will and and those are actual calories that used to be stored in your fat that you didn't have to exercise harder in order to burn them in your muscle you just dumped them from your body that is how determined the body is to reconcile energy when insulin is low it's just thinking if insulin is low the body is thinking i got all this energy and i just don't need it i or i can't stop getting rid of it i can't stop spending it and i can't stop getting rid of it because but that is because that's what insulin wants to do insulin wants to store store stores so it will slow metabolic rate and it will promote tissue growth that's not a bad thing we need to grow sometimes you know we need insulin i'm not saying it's bad we just don't want it to be high and when it is high we want it to be very quick it's acute it's up and then it's back down yeah and and that's and that's the thing too is it's a very good point a lot of these people uh with different sorts of diets and weight loss uh they are hungry they're hungry all the time and it's not really sustainable and and they end up i i think this is a major driver in in uh eating disorders and disordered eating you know bulimia and anorexia and they just they just get into this state they have a very unhealthy relationship with food as well um i think when we you know if you look at after the 1980s when you know 1977 when the usda declared that cholesterol caused heart disease this changed how we ate this it changed how we approached food and we had a lot of you know large rise in in various diseases but you know chronic diseases heart disease diabetes cancer obesity autoimmune diseases but also eating disorders they all went on the rise uh to a significant degree um and that's um you know what i think of you know yeah you can you can lose you can lose weight by um you know by just starving yourself but you know like people in auschwitz lost weight too you know it wasn't really that's not doesn't mean it's healthy doesn't mean it was good for them you know and so i don't think that's a model that we we should uh we should look to um emulate um you mentioned alzheimer's but this is obviously something that's that's so prevalent so important for people as they age and their their brain health and and obviously everyone's is justifiably very concerned about developing dementia and alzheimer's this is something that again is is is very new you know about 50 years ago 60 years ago we just did we did not see uh the numbers and the prevalence of uh dementia and alzheimer's this is something that people are calling type three diabetes now which i've certainly heard but i think that that um this is this would be something that uh that you would know quite a lot about i would assume yeah oh yeah yeah um so this is an active area of uh research topic in my lab now um yeah the the classic view on alzheimer's is that it was a disease of plaques accumulating in the brain and that paradigm has started to fall out of favor insofar as we have a lot of drugs now that will reduce plaques and it doesn't help the disease and we have evidence from humans um from cadavers people who died with and without alzheimer's disease you know people with no evidence of alzheimer's disease and they'll have a brain that has lots of plaques in it and yet it didn't appear to force a compromised cognition at all and this is provided an opportunity for the metabolic view of alzheimer's to come in which and there's long been evidence for this and you'd mention this term type 3 diabetes and more people will use that term i don't love it i prefer insulin resistance of the brain because it's just more precise but that's basically what it is in insulin resistance the brain has affected the brain has become affected and it can't use insulin well enough to open up the glucose transporters to fuel the brain because glucose is a primary fuel and some of that glucose uptake is dependent on insulin opening the glucose transporters well you have a compromised glucose uptake which means the brains the brain starts to go hungry and that matters because the brain has a very high metabolic rate and if it can't get all its energy from glucose now you have an energetic gap that gap could be filled by ketones however in the same person who's insulin resistant and not able to use glucose very well they don't have any ketones because they're hyperinsulinemic they have elevated insulin and as you said and we've mentioned repeatedly insulin inhibits ketogenesis and so the brain is swimming in a sea of glucose that it can't use it's calling out for this life raft in the form of ketones that insulin simply won't let the brain get and thus we're left with the hungry brain and there's evidence in humans to show that if you start to fill that gap with ketones giving a person like a ketone ester you do improve their cognition they do start to think better not that we've cured the disease nothing nothing so grand as that but we've helped tip it back a little bit and that to me is a bit of a win in a disease where there are never any wins and so my view on ins on alzheimer's is if you've already got it if a pat a loved one already has it try to increase those ketones any way we can if we want to keep it at bay keep your brain insulin sensitive and give it some ketones from time to time you know for goodness sakes let it have some ketones which is a preferred fuel if there is any preferred fuel yeah and just and just bypassing that uh that insulin resistance is uh you know it just makes so much sense and it's just a sneaky way of getting your brain working again um that's right and um that you know that's that's another thing too you know we've been we've put everybody on a low-fat so-called heart-healthy diet but as you mentioned you know the brain is you know primarily made out of fat it's something like the solid components of about 70 percent of fat and 20 of those are just dha and you know so and and the that doesn't exist in plants it doesn't exist in your plant oil seed oils um and then you have the very long chain fatty acids 20 and 22 chain fatty acids which again don't exist in plants we're not very good at making them we do make some and not enough nah certainly not yeah and so you have to get these from your diet but we've been told since since the ninth late 1970s earlier really but officially since the late 1970s uh you know the pritikin diet came out my father was a big proponent of that growing up and we just there was just no fat in the house and uh when i was growing up which probably you know curtailed our own neural uh development and brain development but every now and then my mom would get like bacon or like some fat thing and just sort of look at this like are you supposed to eat everything in your body contraband yeah everything in your body was just like just like this is life this is everything you should be eating but you felt you were conditioned to this is gross and you sort of feel oh god oh i can't believe i ate that and but thank god i i you know i did succumb to my instincts a few times um and um you know enough to avoid irreparable damage yeah yeah well yeah poor little poor little tony yeah at least a certain extent you know because yeah yeah we look at our you know anthropologically we look at the you know the size of brains has decreased yeah you know like like i think like 11 since the agricultural revolution that's pure that's not genetic that's purely environmental and and so uh we all got robbed by a good 10 of our brains that that's ours by rights and um and that bugs me but what bugs me more is that you know now you know people are just not eating fat and and i think their brains are decaying and not able to maintain uh maintain and and uh rebuild their brain uh to an extent that it starts to atrophy and we have we have mris that just have aging brains and and they atrophy and they get you know they get they get so much more shrunken down than than you would believe you look at it get a kid's mri it's just every every corner of the skull is just just packed and just stuffed in with brains and and early adolescence and adulthood is the same way and then as you go your ventricles which are the spaces inside the brain that the cerebral spinal fluid flows around uh respond in and then flows around these are usually very slit like in uh adolescence and early adulthood and then just they do widen and widen and widen and then the the you know the sulci and the jira the soul kind of the dips in between the folds of the brain they just start widening and widening and widening and you look at this and like the actual mass of the brain has just decreased by such a degree and when you think about how many billions of cells neurons are in the brain like how many hundreds of millions or you know a billion or more neurons you basically uh have have just wasted away that that that is that is frightening to me um and then you know i so that would likely be a combination of not getting enough energy to the brain to maintain it and also not getting you know sort of the requisite fatty acids to the brain what do you well i can't i can't think i can't help but think this is also a contributor to the increased depression and anxiety we have in in adults and and kids and there are a lot that's multifactorial no doubt but we also know that in strict adherence to vegan diets suicidality goes up depression goes up neurological problems follow when the brain is deprived and now this it could be coincidence this is not my area of research i'm just struck by the coincidence that we have a culture that is depriving the brain of its essential nutrients and we wonder at this this plague of of depression and anxiety yeah well you you but you're you're exactly right you know because there actually have been studies and published in psychiatric journals looking at even even things as schizophrenia and different sorts of psychiatric issues is actually benefited by putting people on at least a ketogenic or even a you know just an elimination diet and specifically with depression uh cholesterol cholesterol has been uh implicated or at least strongly associated with depression and anxiety so lower ldl cholesterol is associated with a much with a much higher rate of depression and interestingly enough lower people with low ldl cholesterol and depression have a much higher rate of suicide so this is something that psychiatrists are now uh pushing their depressed patients to get their cholesterol up and thankfully this is this is sort of coming around but there's still so many doctors and obviously you know most most uh you know people in the public they still are in this idea and mindset that fat is bad for your cholesterol is going to kill you uh but unfortunately doctors are still thinking this and it's just like this is this has been out you know the journal american medical association published in 2015 that this was a hoax this was bought and paid for by the sugar companies that cholesterol was never even associated with with heart disease and um and uh you know and so this is this is this is out there but yet they're not they're not um looking at that uh no it's a slow moving ship and it's taking time to turn around but there are those of us that are on speed boats and we've already turned it around yeah um professor bakeman i'm i'm conscious that you uh uh have uh some time time constraints so i i'll um just thank you very much for coming on it's been an absolute uh wonderful conversation i really appreciate uh your time um where can we find you where can we find uh your work and how do we follow you and support you yeah anthony thanks this was great i really had a good time in fact part of what i enjoyed when you were kind of going on about your experience in in your awakening about the dangers of plants the theme of so much of that was the power of a good professor look what it did yeah so boy it motivates me i want to put someone on the right path yeah i hope i am so yeah i i'm um people can uh i wrote a book about insulin resistance anyone who wants to learn more about it go get that book available anywhere books are sold it's called why we get sick and then uh i also helped make a low-carb meal replacement shake anyone wants to learn more go to get health hlth.com and then lastly you'd mention social media i i'm i'm fairly active on social media especially given my general disdain for it but i appreciate it as a tool uh but me my kids will never have anything to do with it um but people can find me mostly on instagram that's where i'm mostly active and people can find me at ben bickman phd and and it's usually just little as you said at the beginning just kind of little video snippets that give insight into the the wonders of human metabolism great great and i'll i'll put in links for all of those things in in the description as well for people uh to find professor bickman thank you so much i really appreciate your time and hopefully we can we can do this again sometime it was fun i had a great time anthony thanks again thank you
Share