Insulin and ketons with Ben Bikman, PhD — Diet Doctor Podcast

[Music] welcome to the diet doctor podcast with dr. Brett sure today I'm joined by Professor Ben Bickman who's a PhD an associate professor of physiology and developmental biology at BYU now dr. Bickman got his PhD in bioenergetics and he did a postdoc fellowship at Duke University in Singapore specifically in metabolic disorders he also works for company insulin IQ and he is he is a scientist he is a true scientist at heart and I think you'll appreciate that in this in this discussion it does get fairly technical times I have to admit because he does like to talk about the science and the specifics but importantly we try and bring it back to how the science can apply to us as individuals in our everyday life and you know when Professor Bickman says something you know it's based on research you know it's based in science and interestingly he came to the low carb world through science whereas most people come to it through a personal experience a personal connection and then start to learn about the science he sort of came the other way and I think that makes him fairly unique but also fascinating so I loved talking with then I love having scientific discussions with him and for you I hope you get a lot out of this from science but I hope you can take away some practical implications of what the science means and also a sense of Ben as a human being and how he lives his life by the the tenants of keeping insulin low and how he helps to kind of educate his family about that as well but without crossing any lines without being too overbearing with it and it plays in with the students as well and we talked a little bit about that so a lot of topics a lot of science but I think you're gonna enjoy this interview if you want to get the whole transcripts please go to diet dr. calm it may be particularly useful for this one as we talk about some of the science and some of the big terms and then of course all the other wealth of information online at diet doctor calm so enjoy this interview with professor ben vintner professor ben Bickman thank you so much for joining me on the diet doctor podcast dr. Bret sure delighted to be here so formal okay we got the formality out of the way now let's just cut to the more casual discussion yeah so we are here sort of in your backyard we're at Salt Lake City your associate professor at BYU that's right and you run a lab there are really focused on metabolic diseases so tell us a little bit about your path how you got into this personally and as a career path to focus on metabolism and how that brought you to low carb yeah right so we are in my backyard BYU's about 30 miles south of here in Provo and my lab at BU I use the metabolism Research Lab and that has been a unexpected journey but one I'm so grateful for sort of stumbling into this area my undergraduate and master's degree focused on exercise science and I was interested in the way fat cells my master's thesis looked at how fat cells are linked to inflammation and that was right on the tail of work coming out of Harvard in the early 90s finding that adipocytes fat cells secrete pro-inflammatory proteins cytokines that to me was mind-blowing the idea that the adipose tissue is an endocrine organ you know it's just a fat store right actually active that was the first I'd ever heard of that sort of situation you need of course I've by that time I take in a graduate course in endocrinology so I was familiar with the the kind of stereotypical or prototypical glands the thyroid gland the gonads the the pituitary the adrenal the adrenal glands these glands that existed in large part to secrete hormones that would have some systemic effect that study I think it was a 94 mm-hmm finding that adipose itself can secrete hormones while proteins which are hormones in some instances that opened up a whole new area of interest for me and that that to me it started my interest in insulin resistance so anyway I'm being too long-winded but learning that that adipose tissue could secrete pro-inflammatory cytokines in that that in that obesity associated or induced inflammation then could cause insulin resistance that started my interest in obesity and insulin resistance looking at it in that indeed in that paradigm obesity causing insulin resistance and then so I did my my PhD work with the wonderful scientist at East Carolina University is named Linus dome and we looked at how insulin sensitivity changed so rapidly in people post gastric bypass so it's kind of this disconnection in metabolic status there are still more badly obese of course one week after post bypass surgery and yet they had become very very insulin sensitive quite quickly mind you I still think it's actually nothing not much more than just you basically starved the person for a week and look what happens but nevertheless I then follow that up with my postdoctoral work at Duke Singapore that was more lipid induced insulin resistance so my world it was and still is insulin insulin resistance and specifically making a research agenda that is focusing on the pathogenic side of insulin we we talk about insulin like it's almost like a drug you need insulin here's your syringe and yet there's a downside of course to hyperinsulinemia or when insulin is getting too high for too long that over about five years ago yeah a bite at this point sort of started kind of moving into looking at ketones as independent signaling molecules just you know molecules in their own right are not metabolic garbage so one I want to get into all the specifics oh thank you personally though so I'm curious you know so that was sort of your your academic drawing into it and then when did you start to internalize this personally and say hey there's something to this I want to start living this way right yeah that was probably about five years ago um or maybe even a little more about the time I started teaching my undergraduate assignment at BYU I teach pathophysiology and I'd wanted to devote so the sick body you know that by this time the students have looked over the physiology the organs how the organs work within the body as a system now all these nursing and the pre-med kids come to me they take pathophysiology and and looking at how things are working when they're not working and I had naturally I had a whole discussion focused on insulin resistance and that looking at that point me forcing myself to say okay what is the best way to address insulin resistance the classic I was I'm a member of the American Diabetes Association of course the rigmarole is you know whole grains low-fat high starch pretty high starch and when you actually when I thought okay I'm not gonna rely on any text book I just want this to be a course that is based on primary literature that's when things started to fall apart so I guess that's about eight years ago and then it was maybe a year or so after that um when I when I really appreciated the randomized clinical trials looking at low carb versus low fat and I thought boy this is all wrong I'd always been healthy and I'd always elicited enough self-control in in just to stay lean and healthy but once it really started losing my hair mind you awhile ago unfortunately I really thought to myself just from my egos point of view I can be bald or I can be fat I can't be both you know I knew I had to convince a girl to marry me and I thought jeez if I can just at least control how lean and fit I am you know then hair be damned you got there from it from an academic side and very much it has to be sort of disconcerning to say look this is what all the textbooks say this is what the guidelines say but as an academic I want to see the primary research and the primary research wasn't there to support it it was an uncomfortable adjustment because I now was challenging what I had been taught and told by people to this day that I gray respect and admire as academics if not necessarily scientists in certain instances and that is of course a difference you know a professor versus a scientist but but anyway yeah it was an uncomfortable growth but it was not my it was not my personal you know experience in in man affects perience incredible burst of health I was already healthy I was very active eating generally pretty well even though on the wrong kind of direction but still like I said manifesting enough self controlled to avoid junk food which already put me in some pretty comfortable territory for me my transformation was almost exclusively academic it was which again as an academic it made that transition both more uncomfortable because I I thought I knew what I knew but also gave me much more conviction because once I'd seen what I considered the reality I couldn't unsee it I could appreciate those p-values for what they were that statistical significance carried a great impact when I when I really found it do you get you get pushback from other members of your department or you know at different society meetings or whatever that since you're going against the grain although still based in science you get some conflict or some pushback from colleagues I sure do not for my department thankfully and that's partly because my department has enough respect for me that they'll know even when they if they haven't overtly agreed with me they can at least nod their head and say yeah but I don't doubt that Ben knows what he's talking about but there are others and in fact it's frustrating for me to even to remember there are others across campus in different departments who have been very upset with my perspective and and have made life a little difficult but for me it has always been here are the data show me where I'm wrong right if if you're you know one of the big points of contention was saturated fat should be no more than 10 Cal a 10% of total calories my my sincere plea here are a handful of clinical studies that put people on saturated fat a diets that were up to in one study 50% of all calories coming from saturated fat one actual randomized clinical study and here's a couple other ones please prove me wrong in all sincerity please show me the study that that number the the dietary guidelines are based on that saturated fat should be no more than ten percent of calories please show here as that step otherwise leave me alone right and there's no response to that because the study does not exist and that's where you know big part of my message is the strength of the claim has to be backed by the strength of the evidence and that's a case where it does not exist you can say it's been a human experiment without going through the IRB to tell everybody to do a ten percent saturated fat because that we don't have that study it has now I when I've been able to actually sit down with some of these people who've disagreed with me almost oh I think not almost without exception it it ends up being an amicable friendly conversation and there can at least be a sentiment of let's agree to disagree right which I'm okay with I really am but when it is someone who claims to know what I think without ever actually talking that's I I don't have any tolerance for that kind of silliness all right that makes sense but there's a lot of that out there isn't it sure is Twitter and social media and all over the place people who just want to promote their belief dig in their heels to you know defend their religion so to speak without really having an open mind to look at the other side and look at the literature and that can be frustrating I'm sure for you oh no doubt yeah yeah okay well one of the things you talk about are the plagues of prosperity right yeah I don't I think maybe you quaint in that term it's a great well if I did I stole it from Gary Taubes Oh had an article ok had an article that he called prosperities plague and so not to be my you know gary is far more eloquent to me but i thought i can say that better and so I said flags of prosperity because in fact Gary was I think talking about diabetes and insulin resistance more tangentially and to me it really was all the modern-day diseases to to varying degrees can be have a connection they have a common core if it wasn't directly causing it it was making it worse and of course that was insulin resistance yeah so tell us about insulin resistance because when we it's a term that gets thrown around a lot and I've talked about before on this podcast that they can be confusing for some people because insulin resistance the cells are resistant to the effects of insulin so insulin rises so there's hyperinsulinemia but there are also forms of insulin resistance with low insulin levels so what's a good way for the average person to think about instant resistance and how it impacts their health yeah so in fact the way you described it initially is how I overwhelmingly look at the disease it is a disease of as much a disease at least when we think about the general systemic consequences what it's doing to the body it is as much a disease as insulin isn't signaling very well so the resistance part of it vs. hyperinsulinemia you drive more insulin and in fact I'm curious you just mentioned there instances when insulin is low and and insulin resistance I actually will very collegially disagree to me there are instances of what we call I've heard it was in the low carb community and I don't want to get us off on a tangent so you pull us back if we need to people will sometimes say you adopt a low carb diet and develop physiological insulin resistance and I actually don't agree with that there are instances in human physiology of physiological insulin resistance and that's the two peas as I teach it puberty and pregnancy but sure enough hyperinsulinemia at least relative to what the person should be and that's always a qualifier right if someone if someone is normally going to be at four units Micra units and there are ten ten could be in fact pretty reasonable for someone else but nevertheless to me insulin resistance goes hand in hand with hyperinsulinemia and what we see in the instance of a low-carb adapted a fat adapted individual who takes a glucose load and now their glucose tolerance appears to be worse in fact I call that glucose intolerance which is not the same as insulin resistance and I know we're splitting hairs but I actually still think it's important because at least to me I don't know I'm not comfortable citing or invoking the term insulin resistance if insulin is low because if we were to give that person a bolus of in that's gonna work good point you see they were to infuse and do an insulin infusion why they that glucose will there's gonna be a response that insulin and that's not the same as challenging the system with glucose which I submit the system has become somewhat intolerant to at least exogenous glucose so that just the fact that the pancreas isn't responding by increasing the insulin output for that glucose load means it's did not reduce not unresponsive not that the cells are resistant to insulin but I can't say that I fully have my head wrapped around it but I just I don't like to I don't personally invoke the term physiological insulin resistance to describe the glucose intolerance that accompanies fat adaptation any they are different but I think it's important okay and that's the scientist in you yeah but admitting that I don't know at all more of the scientist in right so since we're talking about insulin there's this balance between insulin and glucagon yeah so insulin the hormone that basically says you know we want to store fat we want to take all the glucose you know and appropriate it where it needs to go and it's a marker that things are good that we're in a fed state you know perfect from it I guess a evolutionary standpoint and glucagon being short of the counterbalance the opposite of that and so one of the things I've heard you talk about before is there's a ratio of insulin to goo goo gone ratio especially how it relates to protein because protein somehow has become very controversial and you know carb world that protein can trigger gluconeogenesis the new production of glucose so if we have too much protein we can get ourselves into trouble on a low-carb diet it's sort of a simple way to think about it and the science of it is much more complicated and paints a different picture so that's a long lead up to give you a runway here to go with I'm curious how you want to explain yeah so right so that that the talk that I gave a year or so ago was the first time I'd mentioned the insulin the insulin to glucagon ratio and it was in the context of protein because as I had started it that had been I was still just a few months having stepped into the so low carb community I had I had just gotten involved in Twitter for example and and then here and then just social media in general up until that point literally three years ago or so I had no involvement whatsoever I was studying insulin and even ketones a little bit in my lab and totally oblivious to this whole world I had heard the sentiment hearing people adopting low-carb diets and their obsession with like drinking oil literally drinking oil people that were getting hundreds and hundreds if not over a thousand calories per day in in oils added to their drinks and I thought that is not healthy and in hearing this fear of protein that kind of brought me back to a concept that I had kicked around and thought about years prior the insulin of glucagon ratio you said it perfectly and George Cahill was the first this old researcher from decades ago who really looked at starvation and a lot of insulin he has a study called physiology of insulin in man or this big beautiful review paper it's so well done just to a quality of writing in etcetera that you just don't really find and I can say that as a guy who's writing and trying to copy George Cahill anyway but he mentioned insulin as the hormone the fed hormone like you said the hormone is indicative of the fed state but also the hormone that base generally directs metabolism and what I mean by that is it directs the use of energy like you mentioned a moment ago is energy going to be stored or used or as I had introduced a couple years ago or wasted in events of course ketones but nevertheless the insulin glucagon ratio does give an overall reflection of is the body in a fed or a fasted State the higher that ratios getting the more it is indicative of a fed state in other words store and inhibit so-called wasteful processes like etaf adji for example and that's just the low-hanging fruit when you talk about the opposite of the fed state which is fasted fasted state is a low insulin the glucagon ratio and the most obvious form or effect of a fasted state is a toff adji is enhanced and so when I was thinking about how to structure a conversation about protein I thought well let's look and see what happened in the insulin glucagon ratio and there was some delightful studies it was kind of an amalgamation of studies but largely based on the work of Roger Unger from UT Southwestern and he's a glucagon guy a legend in glucagon research and he has him I found an old study from him which looked at the insulin glucagon ratio and in how the low-carb insulin glucagon ratio was almost identical to the fasted state and several points lower than the conventional Western diets so it was pretty interesting to me this idea of what I like to call a nutritional fast rather than a caloric fast so someone who's still eating getting energy and yet their body is still behaving as if it's in a fasted state there's mobilization of fact there's activation of autophagy even though they're not in fact hungry they're not fasting so anyway finding ultimately that proteins someone could eat protein and if someone was in a state of glucose excess like getting the protein at the same time as glucose or underlying hyperglycemia that exaggerated this insulin and glucagon ratio in other words insulin really spiked in contrast if you're eating a protein in a fasted state or a low carb state because those two in fact are quite similar then there was essentially no effect from the protein and and so I was eager to share that message when I learned it I was enthusiastic about it as well but I have been delighted that insulin and glucagon the kind of yang to the yin have become kind of part of the the vernacular in the low carb realm because guidon is relevant I maintain that insulin is the hormone that has two hands firmly gripped in the steering wheel of directing energy but glucagon is got a hand there but it is interesting to note the difference some people will eat protein and will in fact have massive glucose spiking effect and it could be that as someone becomes a type-2 diabetic their alpha cells the glucagon producing alpha cells have become insulin resistant that is in fact more work from Roger hunker the glucagon scientist at UT Southwestern they found that part of what what I like to say flips the switch from insulin resistance which as hyperinsulinemia but normal glycaemia what flips the switch to go from hyperinsulinemia to hyperglycemia or overt or frank type 2 diabetes part of that is that the Alpha cells become resistant to insulin ability to inhibit glucagon production right so they become insulin resistant and that might be part of why that the very insulin resistant type 2 diabetic or just in other words a certain amount of the population will in fact find that as they adopt more carnivore or more protein heavy version of a low-carb ketogenic diet they might have some struggles with their glucose they might have some struggles with insulin so if they're already insulin resistant that's right yeah even to the point especially to the point of diagnosed hyperglycemia yeah so we're talking a lot about glucagon here and those probably unfamiliar for a lot of people because it's not a blood test we do or they not comas you know so it was a more of a research tool would you say and why isn't it being used clinically to you yes so you can get it measured although I'm not the physician but I know physicians who they do get it done and there are general reference ranges but it is a separate beast entirely for reasons that I confess I don't know something about the biochemistry of the molecule itself it requires a totally separate vial of blood I know when we do what's called multiplex assays we can measure or a multi analyte we could measure insulin leptin cortisol growth hormone all in one little batch of plasma from blood glucagon it's an entirely separate test it has its own set of chemicals that have to be added in order to isolate it and then in order to quantify it it's a again I don't know the reasons but it's its own beast yes I imagine it's something I mean I actually haven't looked into this after MIT so it's probably something that not many labs do it's gonna be a send out lab it's gonna be expensive insurance definitely wouldn't pay for it yeah yeah I think it would be helpful for some people to know you know what is my insulin glucagon ratio and can't will that affect the amount of protein I can handle so short of having that test what are some other markers people can used of trying to help them to Herman if they can handle a certain amount of protein without worrying about gluconeogenesis without worrying about their insulin of glucagon ratios yeah that's a G Brett I don't know there's not well I will say if we can look at the insulin glucagon ratio and maintaining it at a low state as itself part partly reflected by the insulin resistance State mm-hmm then oddly enough the triglyceride to HDL ratio is a remarkably accurate predictor of who has insulin resistance and then but again we're making some connections here then perhaps we could take that one step further to say it's probably a person who's gonna have an insulin glucagon ratio that isn't favorable now one last comment about glucagon as people are getting introduced to that perhaps for the first time there is a phenomenon I almost hate to bring this up called glucagon resistance and that could be instances of when people have had liver damage like hepatitis like an actual infection and in those instances those are the very small group of people who and I emphasize this it is a small group of people who genuinely have this but that's when someone who might start fasting and things get very bad for than Justine because in that instance of glucagon resistance the glucagon main action is to mobilize fuel it wants to mobilize fats from fat cells it wants to mobilize the glucose that's been stored as stored as glycogen in the liver and it wants to tell the liver to make ketones so it activates ketogenesis and that fasted State the inability of glucagon to break down glycogen in the liver and to promote ketogenesis in the liver because the liver is glucagon resistant makes for a brain that starts to suffer from fuel deficiencies and so there are I have heard of I learned of this foreign person who claimed they would try too fast and they were healthy sometimes people many people are so addicted to eating that they can't fast without it being very uncomfortable that is not what I'm talking about at all but this person healthy lean individual that fast and things really got bad for them profound headaches extreme discomfort they were able find a physician who did a glucagon tolerance test and this is documented in the literature where they inject the small dose of glucagon and then the expected effect is to see an increase in glucose because glucose on will mobilize the glycogen from the liver and this person didn't have it yeah so a failure to respond to the exogenous glucagon confirmed this glucagon resistance and it exists that is a real phenomenon yeah I'll be it very rare yeah well that's great the scientist in you guys excited about that I was thrilled to learn something new frankly yeah that's great so wouldn't apply to most people fasting but for some people who do have trouble fasting that could certainly be an issue it could be and again there would have to be I think some history of a liver like an overt liver problem cirrhosis and hepatitis etcetera yeah alcohol or a fatty liver or yeah now you mentioned it's hoffa G a few times in the description of insulin glucagon ratio and so a toughie G is a term we hear a lot about lately a recent Nobel Prize yeah right so give us a quick summary of what a toughie G is but more importantly what are the thresholds for triggering it because I think it's it's such a controversial topic now do we have to fast for five days to drink Adama G is a you know as an 18-6 fast good for a toughie g or it's just low carb good for a toughie G and how do we know so to give us a rundown on that yeah right yeah so as a general introduction etapa G is a process whereby the cell I'm gonna use this term and I hate to say it but kind of stays stays young and what I mean by that what's happening the the cell is able to almost check its inventory and know that the pieces within the cell but we call organelles the mitochondria the endoplasmic reticula the lysosome the peroxisome any parts of the cell inside of it this the the cell can do an inventory and recycle those and so it's a way of keeping the cell while regenerating itself in a way keeping its function optimal maybe that's the best way to say it and thus people have looked at etapa G as a key to longevity that if you can promote at AA Fujii well then your cells are going to continue to work better regenerating themselves in a way and I'm not saying that there erecting themselves but just keeping themselves functioning well optimally and then that would then logically lead with greater longevity now I am in humans of course we don't have any evidence to confirm that but that's a lot of the rationale behind the caloric restriction Studies Clerk restriction promotes longevity and that's not a sentiment I'm endorsing at all but that's the general sentiment calorie restrict that promotes longevity and the intermediate event would be it's because it's promoting a kapha G at least I'd be part of it the truth of it is insulin controls etapa G if if insulin goes up Lata fuji stops because etaf Egeus wasteful insulin wants to store a tofu G is getting energy it wants to its catabolic it's breaking down parts of the cell of course it's in the effort of keeping the cell optimal but it is still breaking stuff down it is catabolic and insulin is anti catabolic and it is anabolic and those aren't the same thing necessarily insulin is anti catabolic in certain instances like at the muscle it is anti catabolic and yet it is anabolic in other places like at the adipocyte so nevertheless insulin very much controls etaf AG and there are other variables too but l insulins the elephant in the room so once again we can come back to that insulin of glucagon ratio and essentially ask what keeps the insulin insulin to glucagon ratio in a fasted State because if you are fasted you are activating a toff ajit now like I said earlier according to Roger Unger's work from decades ago and and this has changed of course because we have higher sensitivity tests to determine insulin and glucagon now but if I remember correctly the fasted insulin glucagon ratios are on 1.5 if you eat a ketogenic diet your insulin glucagon ratio is around 2 if you eat a standard Western American diet it's about 4 so significantly higher and so I can't say exactly where that cutoff is but I would say essentially if someone's keeping their insulin at essentially fasting levels at AA fuji is running Eve whether it's a caloric fast or what I call the nutritional fast it's still going to be activating at Kaji or it won't be stopping it yeah but we can't measure a tough people can we cannot know so there is you you only have these kind of surrogates but I would strongly submit the insulin glucagon ratio is a great surrogate and and maybe to keep it simpler because as hard as it's hard to get insulin measured of course it's even harder to get glucagon measure if you're fasting insulin is going to be around 6 and below you I would strongly submit that person has active at office yeah that's really fascinating because for most people they're stressing that it has to be a fast that is not just a nutritional method of keeping insulin low so that's a great perspective and you know again we don't know one way or the other for sure but it makes a lot of sense to say if insulin is sort of the controller and then as long as you're keeping that at a low enough level you're triggering not offered yeah now one important caveat there and that says back to protein there are many people who promote longevity diets and the whole stick of the diet is restrict protis trick protein right that's because protein is known to activate mTOR an mTOR is known to inhibit etaf AG and so that's their paradigm restrict protein and so eat these bars drink this shake and it's very low protein op but it's high carb well that's fine because it's protein that inhibits the Tov G what about Nolan yeah there's a wonderful study that looked at muscle cells and it took what I think may be the most if not one of the most mTOR activating amino acids which is leucine compared leucine to insulin and leucine and insulin both increased mTOR at I think the 15-minute mark insulin did it higher so here's insulin here's leucine I don't know if this is a record but for people aren't listening I'm gonna describe it yeah I won't pantomime with my hands they both went up loosing an mTOR exposure at the muscle cells mTOR went up at 30 minutes the leucine treatment down mTOR is gone it was already back down to baseline not the insulin it stayed high and it went four times I think three or four times higher mTOR activation and it was maintained for about three times longer than the leucine and so in people the people that are pointing the finger at mTOR and implicating protein as the main mediator I say that's bonkers yeah don't restrict protein which we know is necessary in even we have these same people who are pooh-poohing protein in their own human data they find oh yes sure but when you get to 65 then actually if you eat too little protein you die more that kind of challenges the whole longevity paradigm with protein being the villain to me if you want to control mTOR because you want to promote a tofu ji well in control insulin and also acknowledge that we need we need to inhibit a tofu G at some points we can't have a tough as you constantly running and say our muscles in our bones if so they'd be always catabolic we'd waste away we'd waste away so you have to be able to have these moments of activating mTOR inhibiting a tofu g promoting anabolic processes and so even in that sense insulin is good and but protein is too we can't and I'm sure someone listening to me would be thinking yeah Ben I'm not saying proteins bad even though I'm studying it yeah but the more we try to pin the protein as the culprit the more we're missing the true villain and that is insulin or hyperinsulinemia if someone wants to activate a tofu G and inhibit mTOR scrutinizing insulin will give them a far bigger bang for their buck than scrutinizing protein that's fascinating that's a different perspective than we're hearing commonly Rachel and mostly we're hearing it from the vegan community or the the vegetarian community because they are tend to be more anti protein but in theory on the superficial level it makes sense protein and mTOR but as you're saying insulin is a much bigger much bigger player which brings in to you know the sort of cyclical nature of you know an occasional five-day fast we are limiting protein right you're also limiting insulin because it's a fast but you don't want to do that all the time obviously it's very difficult to do and reset your metabolic rate down so are you a fan of intermittent sort of longer fastings twice a year or three times year that kind of thing or do you think a steady state of keeping your insulin low is sufficient you don't really need to do more for longevity for health yeah yes so for me for me personally I don't enjoy multi-day fasts I once tried to a fast and I just did not enjoy now someone would probably say Oh Ben you just needed to give it a few more hours and you'd get into that true kind of long running state yeah but I I just enjoy eating yeah and I enjoy as a dad in the family there's only so many days you can sit at the dinner table and watch the family eat while you're talking with them hoping your kids don't really notice and that's something I'm very mindful of I don't want to eat in a way that my two daughters especially but that made me sounds bigoted but even my son would look at me and say okay daddy's not eating so I'm not gonna eat I mean I'm so worried about eating disorders partly because I'm a professor on a college campus and eating disorders are so rampant among especially young women at that age I'm terrified of somehow contributing to someone's eating disorder so but nevertheless I enjoy eating it's it's not something I enjoy going without so for me personally I'm a huge advocate of time restricted eating 18-6 in particular I will very rarely eat breakfast I simply just don't enjoy it and I do my calisthenic body weight type workouts mid-morning and if I have eaten I'm just more sluggish I can't perform as well and I just finally I don't need it I just don't need breakfast so these multi-day fasts I think they can absolutely have a place and I can deeply appreciate those in the low carb community who are the big advocates of it there's no question there's an effect there no question and I can look at that nod my head and give them a thumbs up but I'm not as much a fasting guy I'm an insulin guy and I think okay the benefit of this there may be other benefits of the fasting like just breaking an addiction for food realizing you don't have to have that when you think you do but if I'm looking at fasting as a tool to lower and improve the insulin the glucagon ratio which is in fact kind of how I look at things I think yeah there's a more comfortable way to do that that that is more sustainable and that was a great description and I love you the scientists I mean you know the science but also the practicality and you ask to fit into life and there's much more to consider every you as a role model with you as a father with you as a teacher and promoting something that could trigger problems with right eating disorders or sort of a body appreciation disorder yeah there's much more to that so that's pretty fascinating and there's this whole world of are we promoting disordered eating by promoting a low carb quote/unquote restrictive diet and there are people on both sides of the spectrum on the one hand you're eating all the vegetables all the meat all the eggs all the cheese how is that restrictive but on the other hand in today's society it's seen as very restrictive so it's frustrating yeah I had in fact just this semester not naming names so I'm not disclosing anything I had a student who approached me and said dr. Beckmann I'm it's a it's uncomfortable for me when you talk about low carb diets because it triggers my eating disorder now first of all if I can go on a tangent I hate that there's been the birth in this generation of the term trigger you know for me as a middle-aged guy no one can trigger me you know Brett you could say whatever you want to me I'm in charge of myself you see my point is he ought to stop so no one's triggering me I'll pull the trigger myself if I want it right but but my frustration with that was when the student first of all I was glad the student actually approached me um as her professor I was very gratified and proud of her for doing that but I was also very frustrated and I had to take a moment to clarify and I confirmed that was the student asking me not to show the data because that's all I ever do it is only ever here's a clinical study another one another one another one no she wasn't it was the way I was talking about it and I thought well how am I talking about and I do tend to be a very boisterous somewhat rambunctious speaker especially when I'm trying to keep my students engaged for two hours I have a two hour lecture period you're competing with Instagram and Facebook you've gotta be kind of clever and how you're talking about stuff and and so I did in fact very humbly and sincerely scrutinize the way I talk about things and thought all right maybe I can be a little more respectful but on the other hand and I and I asked the student this I said have you had similar conversations with professors who have been showing data or talking about low-fat diets because if you're telling me this mind you I was very respectful and polite but I hated the idea that it was only the professor who was talking about a low-carb diet that was triggering an eating disorder yeah and and what I liked what you'd said a moment ago when I show these students the data what is the common theme of these clinical studies is that is calorie unrestricted it's the antithesis of starvation right it is don't count your calories eat as much as you can until you're full and then you're done it's glorious it is not calorie counting and to me that is the crux of so many genuine eating disorders like anorexia or even bulimia it is I can't get that calorie into my system I need to restrict the energy so i rage against that idea and I really hope in fact the very students or anyone who's claiming that an advocate of a low carb diet in mind you when I'm in professor mode I'm not advocating anything I'm just showing the data or the science and that ends up I end up getting kind of lumped in as an advocate simply because I'm the only professor who's showing it and I do find I have to be a little more heavy-handed to make up for all the professor's who aren't right ray it's true I mean even if you are science minded at which you definitely aren't sticking to the science you still need a louder voice to overcome the hundreds of other voices that's exactly telling the opposite yeah so I kind of get branded a bit of a heretic but in reality I'm actually still trying to be quite open-minded to all of it I'm just the one who's the most open-minded that I've looked at the other side enough to really appreciate it mind you there are other I will say this in defense of my colleagues there are several other professors who feel the same way I do many of whom because they've personally experienced the incredible metabolic benefits of it these are guys who have lost phenomenal amounts of weight and they just finally can't help but talk about it because they're so enthusiastic in a way that I'm not even like there they have a conviction that I don't because they felt it I never really felt it I just had the academic conversion right yeah so you're unique in that sense that you at the academic conversion whereas most people have the personal conversion right and then look into the academics secondarily after that yeah but you can understand I think you probably had the same kind of growth yes it was more of a a genuine show me the numbers and holy smokes this isn't quite what I thought right for me it was more seeing it work my patients right and then looking into the evidence and realizing that it's not as clear-cut as it was being portrayed and then like you said once you open your eyes you can't go back I mean you can't see it you can't unsee it exactly yeah so one of the other things you've talked about is is ketones as a specific marker as a specific effect in our bodies and I guess there's a little bit of a debate which some would say don't matter and some say scientifically absolutely matters is it just lowering the carbohydrates that give a lot of the benefits of a low carb diet or is it actually the ketones themselves having an active role in our body and playing a beneficial role so great tell us about the science behind that what a great question and I feel qualified to answer it because of my growth when I as I sort of told my academic background at the beginning I really have come into this conversation academically professionally through the lens of how can someone best control their insulin and that's what got me looking into and scrutinizing low carb diets as a legitimate intervention in the what I still now consider or what I now consider to be the most effective way calorie for calorie to control insulin lower the carbohydrate and it is so rational right right and so my perspective my paradigm had been how can insulin stay as low as possible and then I was seeing while I was starting to look through the human clinical data studies that would refer to ketogenic diets and I of course knew I'd had nutritional biochemistry I knew what ketones were but because I'd had nutritional biochemistry as a student I also didn't appreciate them because they are not talked about in any in any way except negative in classic academic settings ketones are more than just quote-unquote metabolic garbage they're looked at overtly harmful molecules it should be avoided at all costs I mean they are it is overwhelmingly a negative connotation to the ketones right we're only taught about ketoacidosis exactly right that's exactly right not about anything but if nothing and in what a tragedy it truly and I mean it what a tragedy especially when we look at it in the context of diseases of Alzheimer's or overt or genuine instances of glucose hypometabolism although this is a tangent but when we know that in Alzheimer's disease the brain cannot use glucose as well we are just about to publish a paper looking at gene expressions from different sections of the brains human brains post-mortem looking at glycolysis genes in brains of normal brains versus Bank brains with dementia versus ketosis the ability of the brain to use ketones really whether the brain with dementia or not catalysis gene expression perfectly normal huh glycolysis gene expression not at all interest I'm talking about p-values of 10 to the negative nine I mean these are massively beyond any hint of coincidence yeah the brains dementia brains have a compromised ability to use glucose and we know this in human studies looking at glucose tracking to the brain radio imaging and ensure enough if the brain can't use glucose there's only one other fuel that's the ketone but anyway our fear of ketones means people don't want them at all but back to my story I would see in these low-carb studies some calling it ketogenic and I would kind of look at that with a little bit of a grimace and think I'll ketones are ketones are bad so I don't want to study that or don't want to look at that study but more and more realizing or appreciating insulins firm control over biochemistry that ketogenesis is an indicator of controlled insulin and that was my initial appreciation I thought all right if someone's in ketosis it simply means their insulin is low and that's a good thing so even then firstly I was looking at ketones as no more than an inverse indicator of what insulin was because if insulin is low ketones are elevated that was it for a while and then it was starting to see more more of these studies being published looking at how ketones improve contractility of the heart for example so more contract greater ATP production so the actual molecule that can allow the muscles to contract more ATP production per oxygen consume do you think about an ischemic hypoxic heart there's less oxygen in can maintain ATP production a so the ketones improving heart contractility ketones reducing oxidative stress and neurons and I was seeing this in thought you know what I want to I want to step into that and the greatest beauty of being a scientist is freedom if I have a question I can ask it and then if I see do I have the tools to answer that question so we started asking some of these questions and to this point we've published the one paper looking at how ketones improve or reduce the oxidative stress from muscle cells and maintain increase enhance muscle cell survivability so there are more kind of rigorous if you will a more resistant to insults yeah and so I was a paper we published last year we are finally wrapping up our paper looking at the way ketones affect mitochondrial function and at in fat cells and you know that's kind of the Browning of the fat make me fat more metabolically yeah that's it yes by several times by you know by multiples we have another study looking at how ketones affect memory and learning and brain and with some very clever brain studies we're doing so anyway your to your to your point or to your question rather I think the vast majority of the metabolic benefit that comes from a low-carb diet is that insulin is controlled III really do now it might just be that I'm the man with the hammer and in insulins the nail and I see it everywhere but even still I maintain that lowering insulin is the main metabolic benefit and then the ketones provide you know that's the 80% of the benefit of low carb is from is from insulin control the ketones provide that next 20% now mind you the more I'm learning about different molecules you're eating from high starch foods there could be other factors oxalates for example and that's stuff I don't really know enough about but that might be a sprinkling in there but to me it is mostly controlling insulin yeah and it's a it's a very pertinent question because a an issue that comes up all the time is do I need to be in ketosis when is just low carb good enough and when do I need to be in ketosis and think if the ketones have beneficial properties on their own that's more of a vote to go into ketosis but like you said it sort of the 80/20 rule right if you're going to the majority of the benefits by going low-carb for most people yes with a little bit added benefit by going into ketosis now if you're I would say that's true unless there's an overt like pathology right dementia right if you migraines or already diabetic or yep or if you need more rapid weight loss and the ketosis will probably be beneficial or faster but for a lot of the sort of average people than low-carb is good enough with a little added extra if you're in ketosis I think so that's a good way to say it yeah I think that's an interesting point all right well we've talked about a lot of different subjects a lot of science but you've already referred to sort of your role as a family man you as a father and that's sort of your primary job your primary role which is can be difficult when you talk about food as a family as a role model as you know how do you feed your kids in today's society I know a lot of our listeners have kids and probably wrestle with this so tell us some of the strategies and things you use with your kids to help them learn about health to help them learn about nutrition and to be that role model for them yeah yeah in fact Brett thanks for bringing it up without a doubt when I when I'm lying in my bed at night I'm not stewey over my decisions I made at work you know that that's a such a small part of what I'm thinking about and what I'm not worried about but just thinking about its family I think about my relationship with my wife my relationship with my children that is priority number one I'm aware enough to know that the end of my life I'm not gonna regret if I wasn't in the lab enough you know that's not gonna be my my regret yeah so for me my the low-hanging fruit in my wanting to impress upon my children the importance of what they eat it is that I talk about fat and protein as wonderful things and I don't really give them opportunities in the house to get away from that we don't have cereal they never eat cereal for breakfast ever we don't have bread that we don't have sandwiches for lunch we don't have crackers that's just not part of the snacking system it is little pepperonis it is cheese sticks it's a vegetable platter with some naan seed oil ranch dip you know where it's we make a ranch dip out of just a ranch seasoning in whole fat Greek yogurt for example or sour cream I think that's what my my wife does that anyway I tell them when they're depending on whatever kind of food they want I'll say you know let's make sure let's try to get how can we have a little more fat here how can we have a little more protein I want my kids some day to go away to college and when they're living with their roommates they'll open the fridge when they'll see skim milk and they'll see what skim or they'll see low fat free yogurt I want them to be so stumped and befuddled that there's a significant part of the people who are afraid of fat yeah I want my kids to know that is their best friend right and protein is a close second or maybe it goes hand in hand but but essentially my wife and I have been able to mind you it's still such a battle right right the kids want junk food and they're gonna get it at their friend's house they're gonna get a might get it at Grandma's house or at the uncles and that's exactly right you just can't get away from it and so they're gonna put up fights I don't want anyone to hear me and think that bickmans kids skip down the stairs in the morning ready for baking in accent no it doesn't matter I've been feeding them bacon and eggs for years they'll eat all the bacon and they'll just pick it they're scrambled eggs and I'm looking at him thinking eat your bloody eggs you know so this is that's the reality it's far closer to reality yeah it's it's not like my kids just will delightedly go grab a cheese stick no no maybe one of one of them will and another one will complain about it and I say well I want I want this we'd still have that we don't need that right right and maybe someday it'll it'll backfire maybe they'll simply get out of the house but they also know that they're healthy and they're fit kids they know that and so I'd like to think and they know that mom and dad are healthy and fit and they know that other mom and dads aren't right I think that's an important point and it's hard to bring up in a sort of politically credit way to say look at us and look at some of your friends parent and compare us and it's a hard thing to say but probably an important lesson and you know when you travel when you're in the airports and you see sort of like a slice of humanity and how heavy everybody is I'll never forget when my son I think he was maybe five at the time he's like is that person really sick because he talked about a very heavy overweight person that he just I guess doesn't experience all that much in his day-to-day life this is that person really sick why is he so big and then we should a hard conversation to have with a five-year-old but it's I was sort of pleased that they understood that that's not right and the reason behind that and so that's part of that it's a jealousy it's a delicate conversation and and for me I focus on the positive which is hey like I'll joke with my son in my daughters to my I want them to be as strong as possible I'll say you look at daddy's arm when I flex my mess I see it looks like the egg see this egg is helping daddy be strong yeah you want to be strong and they all you know they want to show off their muscles or whatever a-and I'm a terrible example of course I'm a pretty teeny guy but but I just want them to focus on the positives I don't want to scare them into eating you eat this way you're gonna look like that person but it's just rather you have a you've been blessed with a healthy strong body let's keep it that way yeah this is why I want a healthy strong body for me daddy wants a mommy wants a healthy strong body we're trying to do this by eating these kinds of things and so they do know it as much as they might fuss about it they'll want ice cream if I let them eat ice cream in it eat it all the time of course they're not they're not those kinds of kids that are gonna be offered ice cream and say no no no way they'd eat it but I want them to know that's on one side of this food balance and when we indulge in it it is it is a treat and we enjoy it and and then we know however that it can't be maintained and it can't be every day right yeah very good point very good perspective so tell us what what a day in the life of Ben Bickman looks like yeah yeah so I'll usually wake up well lately I'm working on revisions for my book which that'll be next year but it is in fact it's that whole kind of plagues of prosperity story yeah which is we have all these fears of chronic diseases and we're treating them in all these distinct ways there's another way of looking at it which address one common core and now we can start addressing pretty much everything else so I'll wake up around 5:30 maybe 5:00 and then work on the book for a bit then the kids start to wake up around 6:30 we're very strict with bedtime the six-year-old goes to bed at 6:30 the eight-year-old goes to bed at 7:30 the twelve-year-old goes to bed at 8:30 Wow it is written in stone mind you they're not in their bed and lights out but it's that's when they're in their room they potty brush teeth wash their hands I mean there's that kind of rigmarole we'll do a little prayer and then then we'll read or whatever yeah and I'll lay by them and hold their hand for a long time so it takes a while from actually fall asleep but even still they do in their out so they'll start waking up about 6:30 I make breakfast I'm I'm in I'm in charge of breakfast and we kind of rotate it's bacon and eggs it'll be some little egg muffins or it'll be low carb waffles made out of just different you know kind of way and different types of fats you've mentioned you do like in 1860 don't sorry right that's right yes so what I may sometimes do depending on what I've made for breakfast I'll bag it up and take it to my office so but it just depends I don't personally like the low carb waffles that I make my kids do so I make it for them and that that would be something I don't eat and I don't bring anything with me and so if I'm gonna plan lunch for the day I'll make all either bring lunch some cheese sticks some meat some hard-boiled eggs which are a staple for me or I'll make a shake and I love putting eggs in just raw Rocky style kind of shakes and I'll use actually a shake that I'm involved in making called best fat so I'll put that in there with some eggs and then that's my kind of that'll be lunch keep it in the fridge and then dinner is dinner whatever the family's having if I mind you my family being what it is it's never usually high carb it might be moderate but usually it's pretty low or there's an easy way to make it low carb but I'm not going to be too disruptive to the family if we're getting pizza the kids are gonna eat it and I'm fine with that I'll usually eat the toppings and and the kids know it and they'll tease daddy about it but that's an easy enough one to do that it's not too disruptive I'll usually do my workout or mid-morning depending on the time of year in the semester I'll teach in the Tuesday Thursday afternoons but then most of the time is writing and then a little bit of time in the lab now with my students I have enough graduate students that they keep the lab running independently of me and then I'm working on a grant or a paper well usually one of those two things yeah all right very interesting good good slice of life from very underwhelming yeah but you know I really appreciate that you that you're out there that you are the scientists asking the questions investigating to try and find these answers and doing it from a science standpoint that you're not gonna be the the zealot promoting things above and beyond what the science says you're always going to come back to the science and it makes you incredibly trustworthy we know when you're saying something that's based in science it's based in academics and if we find a way to apply to our lives then it should work yeah should make sense right good well said it's great perspective well thank you so much for joining us and where can people find you to learn more about you right yeah thanks Brett thanks for the invitation first of all yeah like I said about a few years ago I became active on social media I am it is I I detest self-promotion blatantly so it's not it's never pictures of me I just I'm not I don't like that for me personally it is I tried to just share research whether it's my own research for my lab or latest published research or even old research findings I'm mostly busy on Instagram and Twitter and my handle there is been Bickman PhD and then not so much on Facebook so Facebook just - a little too overwhelming yeah but that's I've consult with the supplement company unicity but and which is great and then I also have my instant IQ group great all right well we look forward to seeing more research out of your the out of your lab and now your postdocs working with you so great thanks Brett thank you [Music] [Music] you

Channel: Diet Doctor

Views: 189,941

Keywords: ben bikman, protein, insulin, ketone, dd podcast, diet doctor

Id: rkQxqodIADI

Length: 59min 54sec (3594 seconds)

Published: Tue Dec 17 2019