Why We Get Sick

Episode 68

World renown metabolism and physiology researcher Dr. Benjamin Bikman joins the Strive for Great Health Podcast to discuss a widespread root cause of chronic diseases. 30% of Americans have impairments in metabolism and sugar processing. In medicine, we call this insulin resistance, and it is at the root of numerous diseases, including Alzheimer’s, cancer, diabetes, heart disease, obesity, and more. Dr. Bikman shares how he got into studying insulin resistance, the root causes of insulin resistance, and the complications, and how you can holistically begin to address and reverse insulin resistance. This is a must-listen episode for those who want to take control of their health and live a life of joy and wellness.

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Episode Transcript

Dr. Richard Harris: [00:00:00] Join me, Dr. Richard Harris, as we strive to unlock the secret to the human body. Strive for wellness strive for great health. Follow the show on iTunes, Spotify, Google, and Android.

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And now to this week’s episode. Welcome to the Strive for Great Health podcast. I’m your host, Dr. Richard Harris, and I have with me a very special guest, one of the foremost minds in insulin on the planet. I have Dr. Benjamin Bikman, Dr. Bikman.

Dr. Benjamin Bikman: [00:02:28] Call me Ben, call me Ben.

Dr. Richard Harris: [00:02:30] Okay. Ben, how are you doing today?

Dr. Benjamin Bikman: [00:02:32] Richard, thank you so much.

In fact, it’s funny. Sometimes people don’t know what to call me. Benjamin, of course, has a lot of nicknames. I’ve got seven older brothers. So I like to joke that I respond to anything, any derogatory form of the name Benjamin I will respond to perfectly, perfectly well. I’ve been called everything.

Dr. Richard Harris: [00:02:48]  I get that, you know, cause Richard, Dick is a nickname for Richard. Right. And I remember in high school, one guy said, Hey, what’s up, Dick? And I punched him in the solar plexus. After that, I was always Richard, Rich, or Rico or something like that.

Dr. Benjamin Bikman: [00:03:04] Yeah. Some cheekier version. Yeah. That’s one of those names that Dick used to be a perfectly suitable nickname. And then it just, of course, went out of Vogue.

Dr. Richard Harris: [00:03:12] Times change, but you know, we’re here to talk about something that’s both near and dear to us, both, you know, I had a grandfather pass away from diabetes and Alzheimer’s, my dad has diabetes. It runs very prominent in my family. And we know the underlying mechanism, the root cause, the physiology behind that is insulin resistance.

And this is like your baby, your area of expertise, one of the foremost experts on this, on the planet. How did you get into researching insulin? It’s not something that, you know, most people commonly know. How did you fall into this?

Dr. Benjamin Bikman: [00:03:46] You’re absolutely right. When I mentioned insulin, when I’m speaking with people, they immediately just assume, all I’m going to talk about is diabetes, because that’s the very narrow framework in which we’ve or the cage in which we’ve placed insulin, my interest in insulin and insulin resistance as a bigger picture really started as a master’s student where I was studying exercise physiology. And this is in the early two-thousands, and I stumbled on a paper. So my master’s thesis was based on this idea of looking at inflammation and finding the degree to which aerobics, cardiovascular fitness, you know, as measured by VO2 max, would improve or exacerbate inflammation or, you know, how might they be related?

And I found this manuscript that had been published in the late nineties. That detailed this process whereby fat cells when they got big, started releasing pro-inflammatory cytokines, which are just proteins, which is basically like a hormone. But in this case, of course, it’s a hormone, if you will, that’s eliciting inflammation. That manuscript was so fascinating to me because it addressed two or it brought up two completely novel ideas. One that fat cells are endocrine organs, secrete hormones. Now, this had already been known. We’d known that fat cells. We, the collective scientific community, knew that fat cell secreted leptin, but I had never seen that.

That was something I was unfamiliar with. So this was novelty for me, that fat cells are secreting hormones and are thus an endocrine organ. And then second, the fact that the fat cells were secreting pro-inflammatory cytokines started to piece together this connection between fat mass and type two diabetes.

And these two were known even in the late nineties; we were seeing this come together. I don’t think the term diabesity had been coined yet, but it was shortly after. But to me, inflammation was fascinating at the time because it was the critical link between obesity and diabetes. And then, of course, I would come to find out during the course of my Ph.D.

Looking at people, post gastric bypass and all the improvements as inflammation would come down, and diabetes would improve it as I learned is because insulin resistance improved. And so then my world really started to, the stars aligned, or I started to see things with more clarity. Which is that insulin resistance is the key mediator between fat tissue and type two diabetes, and then inflammation fits in there too.

So it was starting to create a paradigm for me. And then, I followed that up, continued to study the mechanisms of insulin resistance in my postdoctoral fellowship with Duke, which was a wonderful experience. And then, when I started my own lab 10 years ago, that was the focus. That’s the foundation of the lab, insulin resistance.

So we continue to study the mechanisms in its origins. You know, what are the, what are the causes of insulin resistance and the consequences? And it’s the consequences part that has my interest it’s because insulin resistance just continues to be relevant, in fact, more relevant every day. And if it weren’t for that ongoing relevance, I confess my enthusiasm for studying insulin resistance would not be very strong.

I would have lost interest, but. I have this conviction that insulin resistance matters and, and thus understanding its origins and understanding how it connects to all of these diseases continues to be relevant.

Dr. Richard Harris: [00:07:18] Yeah, that’s, that’s really powerful. And my story is quite similar because of diabetes running so prominently in my family. When I was in college and taking biochemistry and physiology and all those courses, I said, okay, I need to understand like, what is causing this diabetes? What’s the root cause, because I want to prevent it. I don’t want to be another statistic like my family and just chalk it up to my genes and say, well, that’s it.

I’m just going to get it. I said, no, I’m a fighter. I’m going to fight this. And my whole holistic pathway, what brought me down this path, was learning about insulin properties and then learning how I can regulate the whole system. And, you know, we see it nowadays. Insulin is unfairly demonized as being a bad guy.

Right. If only things were that simple, nothing is that simple. When it comes to health, you absolutely need insulin. It’s absolutely essential. But what we need is proper insulin signaling. That’s what we need. All right. So what causes insulin resistance, and then how does insulin resistance impact our overall health?

Dr. Benjamin Bikman: [00:08:25] Yeah. Yeah. So the causes and the consequences are certainly something I’ve given a great deal of thought to in indeed at book-length have attempted to encompass these thoughts. So the causes, I think we can lump into primary and secondary. I define it that way, maybe as only you know, a basic scientist can, who’s working with cells and rodent models where we can really tease out mechanisms.

But even in these primary mechanisms, I put them as primary because we see evidence at every level, cell, rodent, and human in the three primary causes of insulin resistance, which would be you know, each contributing in their own way is inflammation, stress, and insulin itself or hyperinsulinemia, chronically elevated insulin.

With the inflammation angle, we see this very prominently with acute infections; during a course of an infection, someone will be demonstrably more insulin resistant. We also see that during active phases of an auto-immune disease, where when someone’s auto-immunity is active, you know, those sorts of things typically ebb and flow.

We see the insulin resistance, ebb, and flow with it. And then, even to the point of cell culture, you can put inflammatory cytokines into a cell culture like muscles or fat cells, and they become insulin resistant in hours. So this is a very direct what I call a primary mechanism, and then stress is as well.

And that’s because of the prototypical stress hormones. Mostly cortisol, but even epinephrine, those are insulin antagonists. They fight what insulin’s trying to do. You know, one of insulin’s main jobs is to lower glucose; well, cortisol and epinephrine want to increase glucose. So it puts these things at odds.

And when cortisol is up, insulin now has to work harder. And even again, so you can detect this in humans, which is why, when a human is given an anti-inflammatory steroid regimen like, like prednisone, for example, say to control auto-immunity, it does lower the inflammation. But because now the body’s swimming in a sea of this kind of cortisol-like molecule, it becomes insulin resistant. And we can tease it all the way back down to the cells. Increase, activate that cortisol pathway in cells, and they become insulin resistant.

And then lastly, and this is the one I believe is most relevant because it’s the one that people can manipulate so quickly by dietary changes. And that is the chronically elevated insulin that matters. And in some people, it confuses some people that I would say elevated insulin causes insulin resistance, but it is a fundamental biological principle; too much of a stimulus will result in a resistance to that stimulus, it’s fundamental across hormones, drugs, other chemicals. It doesn’t matter what it is when an organism is incessantly stimulated, it will attempt to turn down the response to that stimulus. Insulin is no exception. And that matters. I think because we have been told to eat six meals per day.

And we’ve been told to base those meals on starchy foods. And that is a wonderful way of making sure a person is living every waking moment in a state of elevated insulin, which has many consequences, including promoting insulin resistance. And then, the secondary cause is less direct, but I think it’s still relevant.

And that’s the excessive consumption of Omega six refined seed oils. And those I call secondary because of what they do at the fat cell. And then, as the fat cell gets sick, that starts to spread the insulin resistance throughout the body. I’ll just say this less, I go down an entirely different topic that we don’t want to go down yet, which is, you know, how does insulin resistance start in the body and how has it spread or what cell does it start at?

Regardless, these seed oils will accumulate in fat cells. And make the fat cells grow through what’s called hypertrophy. So we have hypertrophic fat cell growth. And when a fat cell grows through hypertrophy, that’s when it starts to become insulin resistant. So that’s one of the sort of primary or key points of insulin resistance in the body.

And then the consequences. The second part of your question are myriad. Literally, every cell in the body has insulin receptors. If insulin signaling has been altered in the body, literally every cell is in some way getting affected. Not that it’s going to be overtly pathogenic, but as things as seemingly distinct as Alzheimer’s disease, infertility, different types in men and women, fatty liver disease, arthritis.

All of these and more, type two diabetes. Of course, they seem like they’re entirely distinct, but to varying degrees, each of them shares a common root cause, namely insulin resistance.

Dr. Richard Harris: [00:13:08] Absolutely. I mean, there’s so much to unpack there. Listeners, listen to that again. There’s a lot to take in. Yeah.

Dr. Benjamin Bikman: [00:13:15] I went too fast, too.

Dr. Richard Harris: [00:13:17] That’s okay. That’s why these platforms are great, right? Because people can rewatch this media. I have transcripts. So the episode will be transcribed into words on my website. So people can go through this again because it’s so important. This is life-saving information.

Insulin resistance is one of, or probably I should say, the two top causes of chronic disease in America right now are inflammation and insulin resistance. And they’re a chicken and egg problem. They both cause each other. So if you have inflammation, you get insulin resistance. If you have insulin resistance, you get inflammation, and they are number one and number two, you know, the order can be switched root cause of chronic disease here in America. And they’re linked to all kinds of diseases. I mean, you could just name about any chronic disease, and then you can see inflammation and insulin resistance as a root cause. And it’s really sad because we’re starting to see this younger and younger, you know, there are case reports of, of nine, seven, eight-year-olds having type two diabetes.

Dr. Benjamin Bikman: [00:14:16] In fact, there’s a case. There’s a case of a Pima Indian girl out of Arizona who was four years old and diagnosed with type two diabetes. Yeah. It’s phenomenal.

Dr. Richard Harris: [00:14:27] That’s heartbreaking because that kid has no chance for a normal life. They’re going to be on dialysis or have a heart attack or be missing a limb by the time that they’re 25 years old, 24 years old, maybe even sooner because it’s so hard to get a kid to do.

Well, the things that are necessary to reverse insulin resistance because they’re a kid, I mean, how knuckleheaded were we all, when we were kids, I was a knucklehead. I drank three sodas a day. I ate nerds, and that’s just, unfortunately, what we’re taught, and we need to wake up from that. And that’s what I wanted to talk about next is; what are three practical tips that we can use to help prevent or reverse insulin resistance?

Dr. Benjamin Bikman: [00:15:09] Yeah. Well, I love three; three is a magic number. In fact, I think there are three rules appropriately aligned with each of the three macronutrients because when we want to truly start manipulating the most powerful lever of insulin resistance, which I believe is chronically elevated insulin. Diet is the culprit or the cure.

The food we eat is the cause in many instances, or it will be the solution. And so thinking of these children that are getting diagnosed with type two diabetes, it’s. You can’t blame the kid. That’s sort of hard. That’s a hard thing to say, and it’s a hard thing to hear. And so if I imagine if there were a parent listening to this and they have a child who’s really starting to suffer with these things, I don’t mean for this to sound accusatory, but this is on the parents.

You know, a four-year-old, for example, is going to eat what a four-year-old can get. If I let my kids eat cereal at every meal of the day, they would do so in do it gladly. It’s on the parents. And so what could the parent do or what could any of us do to help fight it or and reverse it? It’s controlling the macronutrients, manage your macros.

And so the first rule, and I think it’s first in my mind, I put it first because I think it’s the most important, control carbohydrates. That doesn’t mean you don’t eat any. But it means whatever carbohydrates you have in your diet, focus on fruits and vegetables first, and then let sugars and even grains, which we many will say, grains are healthy and we ought to enjoy them.

No, no, that’s unfortunately not true. They will spike your glucose, insulin significantly, even, you know, something as seemingly benign as a piece of whole-grain bread or a bowl of oatmeal. You know, when I wear a continuous glucose monitor because I study these things, and boy, it’s shocking what it does to your glucose to eat something like that?

So control your carbohydrates, focus on fruits and vegetables, but eat them. Don’t drink them. You know, God never intended us to be drinking apple juice, but eating an apple is fine. You know, if we were supposed to drink our apples that said, they’d come from the tree, perhaps.

And then, the second rule prioritize protein, make sure you’re getting enough protein. Protein really promotes satiety. So if you’re eating protein, you will just feel fuller sooner, and it will naturally help you control your appetite, but you’ve got to make sure you’re getting it from the best sources, which are always going to be animal sources.

That’s just human physiology; eggs, dairy, and meat are superior sources of protein over any form of plant protein. And lastly, it’s my third rule is don’t fear fat. Fat is kind of a magical macronutrient in that it has no effect on insulin. And I think it’s appropriate that people get their protein in a natural way, which is to say with fat, all of the best proteins come with fat naturally.

So if you’re focusing on eggs, don’t dump those egg yolks; keep the yolks in there. That’s the way it’s supposed to be. So get that protein with fat, don’t fear fat, be liberal with cooking with it, get that coconut oil or that olive oil or that butter; those are natural ancestral fats. So when it comes to fats, my focus is animal fats and fruit fats. And the fruit fats are the coconuts, avocados, and olives.

Because our ancestors, if they wanted to get oil from a soybean impossible, they didn’t have the technology until a hundred years ago to get oils from these seeds, but from fruit where it’s just the flesh of the fruit, you know, you just scoop out that coconut or get those olives. And all you do is press it in a lever or with your own body weight.

And you’re getting oil from it. And we’ve been eating that since the beginning of, well, thousands of years. Certainly, we are well adapted to animal fats and fruit fats. So those are my three rules.

Dr. Richard Harris: [00:18:50] Yeah, it’s something that’s so simple yet. It’s something that’s so hard to do. You know, unfortunately, there’s a lot of bad science out there that have demonized fats.

We have essential proteins, meaning there are proteins that we need to get from our nutrition that we can’t make. We have essential fats, meaning there are fats that our bodies cannot make. We need to get them from nutrition, and it has to be the right fat. Again, those omega six, those processed seed oils, you know, I tell people, would you drink gasoline?

They’re like, of course not. I’m like. Okay. Would you eat canola oil? Yeah. It’s heart-healthy like, okay. Did you know canola oil in the processing, it uses gasoline to extract the oil from the seed, and people are like, what? And like, yeah, canola oil. There’s nothing about canola oil that’s heart-healthy.

Zero, Absolutely zero, it’s pro-inflammatory, promotes insulin resistance, and has been linked to chronic disease. Like you put it, the ancestral fats are what we should be eating. You know, coconut oil, olive oil, you can use extra virgin, avocado oil. That’s what I cook with. And then the animal fats.

 I use butter; I use lard; I use ghee; I love duck fat. If you’ve never cooked some potatoes. Potatoes in duck fat, then you’re missing out. It is delicious. Absolutely delicious. Yeah. We’ve got an air fryer. And so what I’ll do is I’ll get a sweet potato. I’ll cut it up, season it, put some duck fat in there, put it in the air fryer.

Dr. Benjamin Bikman: [00:20:12] Yeah. I couldn’t agree more; well said. I agree with everything you just said.

Dr. Richard Harris: [00:20:16] It’s really, really important because this is something that most Americans don’t even realize that they have, right? Just like you have your continuous glucose monitor, you can check these things. One of the things I tell my clients all the time is check.

You can go to Walmart, you can go to CVS, you can get a glucometer, and you can check to see how your body’s responding to certain foods. Are they spiking up your glucose? Are they not? And that’s a simple test that you can make. And the grains is so essential because most people think that grains are heart-healthy.

The problem is that bread will spike your sugar up faster than a candy bar. So there’s no difference between eating a piece of bread and eating a Snickers. As far as your glucose response goes, that’s really important. And not only that, the processing of the bread creates substances that actually cause insulin resistance.

So when they bleach the bread, that creates problems. I always tell people, as far as grains go, ancestral grains, you know, barley, rye, quinoa, buckwheat. I don’t do oatmeal because, again, I don’t respond very well to oatmeal. Oatmeal raises my blood sugars up quite a lot. Buckwheat keeps me normal. And then I put some almond butter and maybe a little coconut oil with some cinnamon in it. And that barely touches my blood sugar. It stays constant.

Dr. Benjamin Bikman: [00:21:36] I agree with everything you’re saying. In fact, I don’t know of anyone who really responds well to oats; frankly, even we use buckwheat as well. I was raised on buckwheat, in a way, my sort of Jewish Eastern European roots. We would eat buckwheat as a frequent dinner, actually. And so now I’ve incorporated it into our family diet as well. I think it’s one of the unappreciated grains, actually.

Dr. Richard Harris: [00:21:56] Yeah. Europeans have been using buckwheat for generations. And if you look at a lot of these Russian bodybuilders, the guys who pioneered exercise fitness, you know, modern exercise fitness, they all eat buckwheat and all of them, all of them, they love it.

And so I always tell people if you want to be on the cutting edge of health and science, follow the bodybuilders to a certain extent, because they’re always the ones who are incorporating the science into their routine because that’s their job. Their job is to be a peak performance human-machine.

Dr. Benjamin Bikman: [00:22:27] Yeah. And they are wonderful Guinea pigs because they don’t care. They are desperate to get any advantage that they’re going to give it a try. And if it works, they’ll keep doing it. Yeah. Rest assured, they won’t do it if it’s not working.

Dr. Richard Harris: [00:22:37] Exactly. Exactly. So one of the things that I’m a big fan of and something that helped me a lot, and part of my wellness plan is I make sure that I periodically get into ketosis, and I’ll do that through either fasting through exogenous or drinkable ketones. I use them as a pre-workout. I love them as a pre-workout. Are you a fan of ketosis?

Dr. Benjamin Bikman: [00:23:02] That’s a great question. In fact, I like that question because it helps us tease out the difference in why someone might be adhering to a low carbohydrate diet. And by that, I mean my main advocacy for a low carbohydrate diet is the benefits of improving insulin sensitivity and in all the benefits that come with that. And then the fact that someone would get into ketosis if their insulin is down over a long period of time. And I don’t mean that long, you know, down for about 16 to 20 hours now they’re burning fat at a higher rate because that is a precipitating or proceeding event.

And then they start to get into ketosis. Ketosis, ketones have numerous benefits. In fact, we just published a paper earlier this year, actually, that details that when someone is in ketosis, the ketones are accelerating the metabolic rate in their fat cells. So beta-hydroxybutyrate, the main ketone in the blood, is stimulating the mitochondria in fat cells to just work a little higher.

The engine is idling a bit faster. That’s a great benefit for someone who wants to control their weight. Also, we know that ketones are profoundly therapeutic for the brain, whether it is migraines, whether it is Alzheimer’s disease, even a little bit of evidence with Parkinson’s disease. Ketones appear to fill in what could be a bit of an energetic gap that in the average person who’s constantly eating starches and sugars.

Glucose is the only available fuel for the brain. And yet, the brain can’t get enough of it. There’s something compromised, and it likely it’s insulin resistance of the brain, but the brain needs this much energy. And it can only get to here with glucose, and ketones can fill that gap. And indeed, evidence suggests that the brain prefers ketones as a fuel if the brain has equal access. And this has worked from a guy named Steven Cunnane equal access to ketones or glucose; the brain starts taking in the ketones at a higher rate. So. Yes, there is a profound benefit to ketones, and like you, I like to eat a diet that will ensure that I’m getting into ketosis at least a little bit each day.

And maybe more than a bit. That’s one of the main reasons I have a very, very strict breakfast and lunch, and then I will be a little more, more liberal with dinner just because I got a family and I’m a family man, you know, first and foremost. And so I don’t want my diet to interrupt the family dynamic too much, but the family dynamic is such that we’re generally kind of low or ish carb anyway.

And so I pretty much know that the moment I wake up, even if I got out of ketosis after dinner, by the time I wake up, I’m back in, and I’m in pretty much all day, maybe until dinner, depending on what we eat.

Dr. Richard Harris: [00:25:38] Yeah. Ketosis is such a powerful regulator. It’s an appetite regulator. It’s a hormone regulator insulin. It’s a neurotransmitter regulator

Dr. Benjamin Bikman: [00:25:48] inflammation too. Like you said earlier, it inhibits inflammation.

Dr. Richard Harris: [00:25:52] It’s one of the best things that you can do for yourself. And this is why intermittent fasting has so many benefits, or you look at the benefits of intermittent fasting and the benefits of ketosis. And you’re like, huh, these are the same benefits.

I wonder why, the ketones are causing these benefits. And I’m a huge fan. I actually started doing it because of migraines. So I have a family history of migraines. My mom has migraines. My sister has migraines. I’ve had migraines ever since I was about 12 years old. And just be debilitating. Ice picks in the head; I’d have aura, I’d get unstable, nauseous, sometimes I’d vomit.

And that would happen to me sometimes at the hospital. We’re seeing patients, and I’m fighting through it to see patients, and it was miserable. And when I started reading up on the science of ketones and ketosis a couple years ago, I said, huh, this is probably going to help with migraines. And I started doing it. I haven’t had a migraine in four years.

Dr. Benjamin Bikman: [00:26:48] That’s amazing. And the funny thing is Richard; you kind of found that out on your own, but we have had actual human evidence that ketosis can, in many instances, completely resolve migraines from as far back as 1928, to my knowledge, that is the first, but it is a published medical manuscript that detailed a physician’s experience, putting patients with migraines into ketosis and noting the complete resolution of their migraines. And so you’d think if we’ve known this for almost a hundred years, that ought to be the first conversation a doctor has with a patient. You know, when you were a little boy having these migraines or, or your mom, the physician.

It’s a travesty that we’ve become such a drug-centric, pharmaceutical-centric society that we no longer at least medical practice. That conversation could have gone one of two ways. Let’s say with your mom where the physician says; these are debilitating migraines that is miserable. I feel for you; there are two options.

There’s medications, which will be more or less effective, but there will always be side effects that you don’t want because every drug has side effects, or you can adopt this diet. The downside is it’s a little strict, but the upside is the only side effect really is going to be that you’re going to lose weight.

You know, if that’s even a problem. So to me, acknowledging the role of diet ought to be one of the first conversations that is had in clinical settings. But of course, you have a clinical view that I don’t have. So I’m glad to hear you say that, you know, I’m up in my ivory, academic tower, just studying these things.

I’m not the boots on the ground where the rubber meets the road. So hearing. A clinician, like you, note this, I think this is a patient who’s going to hear the right conversation.

Dr. Richard Harris: [00:28:29] Absolutely. And that’s even in, when I was still in conventional medicine, that’s the first thing I tell migraine sufferers, is the first thing I tell people with depression, the first thing I tell people with anxiety like here’s a nutritional therapy that can help you.

And then, because I am a Pharm.D. I know how the drugs work. And I know for the large part that drugs and this is kind of a generalization. I’m not telling people to stop taking their medications immediately. That’s not what I’m advocating; drugs work on the macro level. They don’t work at the micro-level.

And what I mean by that is if you have a drug, let’s say statins, for instance, billion-dollar blockbuster drug, the absolute risk reduction in studies with, for those for primary prevention. So primary prevention of a stroke, heart attack, cardiovascular disease is between three to nine percent. There’s 91 to 97% of people who will see no benefit from those medications.

And we see it all the time. People have strokes and heart attacks while they’re on their medications. And they wonder why they’ve had a stroke or a heart attack. You’re part of the, you know, if you have a hundred million people, you’re part of the 91 or 97 million people whose this drug is not going to help,

Dr. Benjamin Bikman: [00:29:36] You still have to bear the side effects of it.

You know, there’s always this toss-up, right? You, again, with your experience in studying drugs, know better than anyone, certainly better than me. It’s all just a list of side effects. It’s just is the side effect you want worth the side effects you don’t want.

Dr. Richard Harris: [00:29:51] Right? Exactly. And then look at the therapies that we use.

Fasting. What are the side effects? Are you going to feel more energy? You’re going to lose some weight. You might live a little longer. That’s a side effect. Okay. Eat differently. What’s the side effect there. You’re going to have more energy. You’re going to feel better. That seems like a win-win there. Start meditating.

What’s the side effect there. Your mind is going to be sharper. You’re going to be more clear. You’re going to have less anxiety. These therapies that we’ll use in holistic medicine have real science behind them, real data behind them. Some of it, like you, mentioned, going back almost a hundred years, some of the anecdotal evidence going back thousands of years to meditation to fasting those benefits before people even knew really any understanding of science, they knew it was beneficial.

They didn’t know why. And so we have great technology, and we have great scientific minds like yourself, but we need to combine that with some of the basics, the essentials, the things that have been promoting human health since our ancestral times. Now, is there anything new and exciting that you’re working on in the lab that you do you want to share with us?

Anything that you found this year that kind of blew your mind?

Dr. Benjamin Bikman: [00:31:03] Yeah. Yeah. So we are just about; this is in the second round of review. My interests because of a Ph.D. student that I have; her name’s Erin, and she came in with a very high interest in the brain. And so, we discussed some potential projects we could do and then ended up settling on the degree.

So her overall or overarching question is to determine the degree to which ketones increase brain function, but through strictly through the lens of alterations and mitochondrial function and as a preliminary kind of way to break into this, what we collaborated with genomics lab or, or a biostatics, a biostatistician, I actually should say.

So these guys are kind of mining all the data from all kinds of data sets, and we were able to get our hands on a data set that quantified genes in brains from people who had Alzheimer’s when they died and people who did not have any evidence of Alzheimer’s disease. And what we did was identify a list of genes involved in brain glucose, uptake, and glucose metabolism.

And we did the same thing with ketones, ketone uptake, and ketone metabolism. And on the glucose side of this story, virtually every gene was significantly down compared to the normal brain. So this broad, compromised gene expression of these proteins that would have been involved, or that would be involved in glucose metabolism.

In contrast, the ketone genes were almost totally unaffected. There are a couple of little ones that were compromised, but the overwhelming majority of them were completely normal. And this touches back to this idea of or lends some more molecular insight into how ketones are so therapeutic for people with Alzheimer’s disease, you know, and we see these case studies coming up, being published, where you take some people with full-blown Alzheimer’s disease.

In one case, in particular, notes that the patient was so sufficiently, had such dementia, they couldn’t get themselves dressed. And when you gave him this ketone drink, you just put the person, put the patient into rapid, deep ketosis through a ketone ester, they could get themselves dressed. I mean, it’s not like they went from full-on dementia to totally normal.

Not at all. There was a meaningful increase in their function. They could talk a little better. They could recall words a little better and even perform daily actions like getting dressed. That is a very real benefit, of course. And so this project, which hopefully will be published very soon, it’s in the second round of review right now.

It just sort of perhaps outlines or explains some of the mechanisms whereby ketones may be more therapeutic and why glucose isn’t working so well. And then, independent of that project, we’ve just started a project looking at near-infrared light therapy. But interestingly, we’re looking at what it does to fat cells.

And so we will be having people come into the lab, and we have this little section, you know, in a separate little room where we have these near-infrared light panels set up. And the ones we’re using were very kindly donated by a company called Juve. What we’re studying is someone will come in at day zero.

We will pull a fat biopsy. So a little piece of fat from beside their navel. And then, they will come in every day for 30 days and do this therapy session with the red light. And then we’re going to follow it up at day 30 with another fat biopsy to see whether we can detect changes in how the mitochondria have been working, and the hypothesis is that the mitochondria will be, in fact, running at a higher rate, kind of like what we saw with the ketones.

And that’s based on some evidence that had been found in, in a rodent model previously. So we’re kind of just asking, is this something that happens in humans?

Dr. Richard Harris: [00:34:53] That’s really awesome. So actually, a near-infrared light or infrared therapy is actually on my radar. I’m going to do an entire podcast episode on that because of the benefits.

So we know that this infrared light gets absorbed by part of our energy-generating mechanisms in our mitochondria. Something called cytochrome C oxidase. And this is very important in generating energy. So there’s some data that shows we generate more energy under these infrared light therapy. And this could be something that helps with fat loss with insulin signaling, with other hormones, with brain dysregulation. I think that’s so important. And actually, one of the main reasons that keeps me still getting into ketosis on a regular basis is I’m a carrier for the APO E4 gene. So I have one gene we know is a dramatic increase in the risk of developing Alzheimer’s. And part of that is because of impaired metabolism in the brain that happens with this.

And so ketosis is one of the main mechanisms I use to help protect my brain cells to help make sure they have enough energy and absolutely love it. I love how I feel when I’m in ketosis. I love the lab results I’m getting; I get all my blood work done, non-fasting cause I like to see kind of where I am in real-world scenarios.

Right. Cause most of the time, I’m not, yes, I do fast, but I want to see what’s happening in the fed state.

Dr. Benjamin Bikman: [00:36:19] Yeah. And I, I hear you. I think that’s a good point, especially when we’re forcing a patient to fast; you said you do frequently fast, so that would be more relevant to you. But I like what you’re saying, actually, when we force a patient to fast, who never fasts, that’s all artificial; those numbers are.

Dr. Richard Harris: [00:36:35] Right, this is not real-world data. So I’ll check mine fed, and I’ll check mine fasting and kind of compare. And it’s really interesting because there’s no difference. Like my glucose fed, I ate 70 grams of glucose and two hours later got my blood work done. My glucose was 80. Two hours later.

I know I’m wonderfully insulin sensitive and that’s part of my plan is to make sure I stay that way because I know I have significant risk factors at the genetic level that would lead to some chronic diseases if I ever develop insulin resistance.

Dr. Benjamin Bikman: [00:37:09] Yeah, that’s right. In fact, it’s good for you to note that because type two, diabetes actually has a stronger genetic component than type one.

In fact, by a lot, people typically think type one is genetic, and it only is very little. Type two is very much.

Dr. Richard Harris: [00:37:23] And epigenetics, and we’ve even seen studies now that in utero exposure to hyperglycemia dramatically increases your risk of developing diabetes. So you change your gene expression as a kid based upon the environment that you were in when you were being developed in your mother’s womb.

And that’s a scary, scary, scary thought given 40% of the country, about 40% is insulin resistance. So we’re just creating further and further and more and more insulin resistance earlier and earlier and earlier. And this could, even if we don’t change, I could even see people developing early-onset Alzheimer’s in their forties because of insulin resistance.

Cause they’ve had it ever since they were born. That’s a really scary thought.

Dr. Benjamin Bikman: [00:38:09] Yeah. It starts to turn into a self-perpetuating problem. I agree. Wholeheartedly. It’s almost like each generation we’re pushing each of these disorders that used to just be disorders of the very old and frail. We make them a younger each generation, you know, it’s almost like the, whatever the disease is.

It jumps 10 years ahead, 10 years ahead. And so to your point, typically, we think Alzheimer’s is a disease of, say, a 70-year-old. I think you’re right. I could believe, well, in fact, there was a study that suggested that for every 10 years, a person has type two diabetes or insulin resistance. The brain is two years older.

And so there is this phenomenon of almost prematurely aging, the brain pushing it towards dementia when the person’s biological or actual chronological age suggests it shouldn’t be; it shouldn’t be a problem yet.

Dr. Richard Harris: [00:38:56] Another really good point that I tell people is that your biological age and your chronological age may not be the same for some people.

They are for a lot of us. If you are in the processed food environment, if you’re stressed, if you’re not exercising, you know, not doing all of these things, you’re basically sending yourselves forward in a time machine. So you may be 37, but your cells are 67. And if you’re 37 with cells of a 67-year-old, you’re going to have the problems that a 67-year-old has.

And wondering why you have them at 37. And we see this all the time. I see 30-year-olds with strokes, 30-year-olds with heart attacks, 30-year-olds with limb amputations from diabetes. And it’s so sad because 80-90% of diabetes is preventable.

Dr. Benjamin Bikman: [00:39:40] I agree wholeheartedly. Yeah. If we’re talking about type two diabetes, all the more tragic in these young instances of type two diabetes, these are lifestyle problems.

Thus, they need lifestyle solutions; you know, type two diabetes isn’t the result, their insulin resistance isn’t a result of a lack of Metformin. You know, it’s, it’s not a Metformin deficiency that caused the disease. So why would we ever look at a drug like Metformin, which is a very effective drug at improving insulin sensitivity, but why would we look at that drug to solve the problem? It’s only addressing a symptom

Dr. Richard Harris: [00:40:12] And that brings up another good point where, where people are wildly insulin resistant, and then they get put on insulin. It’s like, okay if your house is on fire, I’m not throwing napalm on my house to put out the fire.

Dr. Benjamin Bikman: [00:40:26] Yeah. If you’re an alcoholic, you’re not going to drink another cup of wine, hoping that’ll help solve your alcohol.

Dr. Richard Harris: [00:40:31] Exactly. And so we’re just making things worse, and you see in the literature, it’s there. People, when they start on insulin, they gain weight. You start to have other issues associated with it. We know exactly why we’re doing this. We’re making the underlying problem worse. And you know, that’s why I love groups like Virta health, who are doing amazing things with reversing type two diabetes through lifestyle and nutrition alone.

If you are a diabetic, I highly recommend you check them out. They have some really great programs to actually treat the root cause to reverse diabetes. And then if you do get reverse, which I see this happen all the time. People didn’t end up going back cause they go back to those old behaviors.

Dr. Benjamin Bikman: [00:41:13] Yeah.

They think I’m cured. I can go back to eating the way I did before. Yeah. That’s the myth.

Dr. Richard Harris: [00:41:19] You have to stay on the path that got you there cause otherwise, you’ve had enough time where you’ve had epigenetic changes, that where you can easily go back to being insulin resistant. You know, those fat cells that we talked about, fat cells are very hard to kill, very hard to kill, and they have very long memories.

So they’ll easily switch back into an insulin-resistant, inflammatory pathway. If you go back to the behaviors you were doing that led them to that way, to begin with.

Dr. Benjamin Bikman: [00:41:47] That’s exactly right, Richard. I couldn’t agree more. If someone expects to go back to their old habits, I tell them we’ll expect to go back to your old health.

Dr. Richard Harris: [00:41:55] Well, this has been phenomenal, Ben. I appreciate you coming on the show. Before we close out, is there anything that you want to say? No,

Dr. Benjamin Bikman: [00:42:03] Richard, thanks so much. It’s always such a treat to talk with someone who is putting these ideas in practice. So a lot of the topics we spoke about, I’ll just put in a little plug, go get my book, Why We Get Sick.

I really wrote it with a lot of this stuff in mind, which was to help people be aware of the fact that there is a common route to many of these diseases, namely insulin resistance. And then when you address that root. A lot of those problems just start to resolve themselves. And so, by all means, go check out the book.

And then I would encourage anyone who is looking for some easy solutions. Check out my website, gethlth.com/. HLTH is how we spelled health, gethlth.com.

Dr. Richard Harris: [00:42:42] Well, thank you so much for being on the show, Ben; I really appreciate your time. And I appreciate all the research that you’re doing because, without people like you, I couldn’t do my job.

So I’m a huge fan of our researchers, especially our holistic-minded researchers who are out there trying to get people the science behind why we need lifestyle medicine. And so thank you so much. To all my listeners, thank you for listening to Strive for Great Health Podcast with your host, Dr. Richard Harris. Have a blessed day.

Thank you for listening to the Strive for Great Health Podcast with your host, Dr. Richard Harris. It’s our mission and goal with the podcast to impact as many lives as possible. To empower individuals to take control of their health and live a life full of joy and purpose.

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