The Plagues of Prosperity | Benjamin Bikman | 2018

[Music] we are sick worldwide we are dying from diseases that were once unheard of each year roughly 10 million people die from cancer and 20 million from heart disease Alzheimer's disease affects almost 50 million people and half a billion of us have diabetes less lethal though highly relevant 40 percent of men over 45 have low testosterone and 10 percent of women experience menstrual irregularities and infertility all of these disorders and more have one thing in common each of them to varying degrees is caused or exacerbated by a change in the actions and levels of the hormone insulin a condition known as insulin resistance and you might have it odds are you do it is the most common disorder worldwide affecting roughly half of all adults in the USA Mexico China and India insulin resistance is even more common across the Pacific Islands northern Africa and the Middle East unfortunately the problem will get worse before it gets better in fact answer these questions to yourself do you have more fat around your belly than you think is healthy do you have high blood pressure do you have high levels of blood triglycerides do you have patches of darker skin or small bumps of skin around your neck armpits or elsewhere do you have a family member with type-2 diabetes for women have you had gestational diabetes or PCOS for men do you have low testosterone if you answered yes to two or more of these questions you're likely insulin resistant one reason insulin resistance is so common is a result of an incorrect perspective which has an interesting historical origin in the first century AD the Greek physician yridians described a disease typifies by an excessive amount of urine in the centuries following numerous other physician scientists added descriptive aspects of this same disease but the symptoms overwhelmingly continued to focus on the extreme urine production indeed this sign was so prominent and unique that the earliest name for the disease stemmed from the Greek word meaning passing through which is diabetes a noteworthy addition to this description of the disease was made in the following centuries by Indian and Chinese physicians who added that the urine had an almost sweet taste as if it were derived from honey which further added the term mellitus as a result of these historical accounts conventional practice considers diabetes mellitus both type 1 and type 2 to be diseases of glucose or what's commonly called blood sugar this perspective historically is understandable given that the elevated glucose levels in the blood account for the two main obvious symptoms the excessive production and unique taste of the urine however this perspective is also why type 2 diabetes which is overwhelmingly most common worldwide has become epidemic because it's wrong diabetes mellitus is not a glucose disease what if these early physicians and scientists had not been so bold as to notice the taste of the urine how would their perspective of the disease have changed if rather than the taste they noted the scent of the patient's urine and even breath in such a scenario the focus would likely be less on glucose and more on fat after all the unique scent is derived from acetone which is a product and sign of excessive oxidation or burning of fat in the body something that occurs when insulin is sufficiently low or as with type 1 diabetes altogether absent in such a scenario perhaps these early efforts to understand the disease would have focused on other features of the disease unrelated to glucose but as we would later learn all relevant to insulin such a perspective would be valid and much more accurate diabetes mellitus is an insulin disease in all aspects of life a proper perspective is crucial to comprehension if we view diabetes as a disorder of insulin rather than glucose we come to a new paradigm on the two types of diabetes where they both share similarly elevated blood glucose which is how they are both clinically identified by convention they differ completely with regards to insulin levels whereas type 1 diabetes is caused by too little type 2 diabetes is caused by too much due to statistical relevance and prevalence let's discuss type 2 diabetes in more detail when we consider type 2 diabetes to be a problem of excess insulin rather than simply excess glucose two essential changes occur we identify the disease earlier and we treat it better first insulin levels can be elevated decades before blood glucose levels begin to rise this is a result of the body needing to make progressively more insulin in order to control blood glucose in these early stages insulin is elevated but blood glucose is still normal a state we know as insulin resistance however eventually the body becomes so resistant to its own insulin that blood glucose begins to rise and it's only then with the rise of glucose but not insulin that conventional clinical Diagnostics detect the disorder and classify it as diabetes again the tragedy is that this glucose centric perspective delays the detection of the disorder by several years second a type-2 diabetic enjoys better health outcomes if we focus on lowering insulin rather than just lowering glucose this is an essential aspect of truly understanding to diabetes the disease is simply a prolonged state of elevated insulin and a progressive loss of insulins actions or in other words insulin resistance if we merely try to control glucose then a direct strategy is to simply increase insulin even higher of course the most effective method to increase insulin is to inject insulin increasing the already elevated insulin levels injecting insulin in a type-2 diabetic will indeed lower blood glucose tragically it also makes everything worse at this point you know that type 2 diabetes is commonly a state of excess insulin and a loss of sensitivity to insulin but how the insulin resistance relates to the excess insulin is worth noting to induce insulin resistance we only need to increase insulin if this is surprising it shouldn't be similar to other aspects of our being our bodies become increasingly resistant to an incessant stimulus this was made clear in 1994 when scientists at UT San Antonio infused a steady subtle stream of insulin into healthy men and detected insulin resistance within just two days thus in a way treating type 2 diabetes with insulin is comparable to treating alcoholism with another glass of wine we are adding more of the very substance that caused the problem with this view in mind we can begin to understand how insulin resistance has become the most common disorder in the world unfortunately our modern dietary habits ensure almost constantly elevated insulin every waking moment we break our brief nighttime fast in the morning with insulin spiking cereal toast or bagels the nibble on insulin spiking snacks every 2 to 3 hours throughout the day before ending the day with an insulin spiking treat in the evening the relevance of living a life where our every waking moment is filled with elevated insulin stens far beyond insulin resistance and diabetes indeed as I mentioned earlier almost every chronic disease including lethal disorders such as heart disease and Alzheimer's disease and less lethal though relevant disorders like obesity and infertility is either caused or made worse by too much insulin and an ever-growing selective resistance to the insulin in fact some of these disorders are particularly relevant when treating type 2 diabetes with insulin therapy including a three-fold risk of death from heart disease and a doubling in the risk of cancer mortality and Alzheimer's also and perhaps most obviously an insulin treated type 2 diabetic can look forward to substantial fat gain because most of us are concerned with one or more of these disorders let's briefly explore how insulin resistance is so central to three parts of our bodies heart brain and body fed heart disease is the leading cause of death it encompasses numerous cardiovascular disorders including hypertension cardiomyopathy and atherosclerosis there is more than coincidence that insulin resistance is the most common disorder worldwide and heart disease is the most common cause of death if someone is moderately overweight and has hypertension the person is almost assuredly insulin resistant through five known distinct mechanisms insulin resistance causes pathological changes in the way the heart and blood vessels function creating a series of unfortunate events that culminate in an elevated blood pressure and increased effort with each heart contraction related to hypertension cardiomyopathy is a disorder typify by the heart muscle itself failing as insulin levels progressively rise with insulin resistance the elevated levels of insulin drive the growth of heart cells causing the myocardium or heart muscle to excessively thicken eventually the myocardium becomes efficiently thick that it hinders the amount of blood the heart chambers can hold and pump tragically this event can even readily occur in the developing fetus of a mother with pronounced insulin resistance fortunately in the case of the infant this is reversible because little has been published that provides a molecular mechanism explaining how insulin resistance so powerfully alters heart muscle function my lab students and I explored this question directly by increasing insulin in two situations heart cells and rodent hearts we observed that the higher the insulin the more the heart muscle cells were compromised specifically we found that the mitochondria were fundamentally and pathologically altered you may recall that mitochondria are the so-called powerhouse of the cell using nutrients to produce chemical energy for the cells to work the insulin resistance that we induced by exposing the heart cells to excess insulin disrupted the metabolic processes that are so essential to cellular survival because of heart disease prevalence intense efforts have attempted to reveal a blood marker to identify those at higher risk with extraordinary focus over the decades on LDL cholesterol unfortunately even a most thorough studies suggest that LDL cholesterol is at best a weak predictor of heart disease on its own people presenting to the emergency room for example with a heart attack are just as likely to have low LDL cholesterol levels as high insulin in contrast is powerfully predictive compared with having normal insulin levels elevated insulin increases the risk of heart disease by roughly 40 times but what of the brain Alzheimer's disease is the most common form of dementia worldwide and more ubiquitous every day once again we may be tempted to see only coincidence between the most common form of dementia and the most common health disorder in fact the connection between between Alzheimer's disease and insulin resistance is so strong that many people consider Alzheimer's disease to be an extension of type 2 diabetes occasionally called type 3 diabetes this of course means at least to some degree it's one more manifestation of insulin resistance to highlight this relationship a group in Finland performed a study on risk factors of Alzheimer's disease unsurprisingly having a genetic predisposition was the most highly significant variable in Alzheimer's disease risk a p-value of 0.0001 the next most significant variable wasn't hypertension it wasn't a stroke it wasn't smoking status or alcohol consumption it wasn't even age which had a p-value of 0.005 the next most significant variable was fasting insulin levels with a p-value of 0.05 an order of magnitude more significant than age but it doesn't end there remarkably of the five clinical tests used to determine insulin resistance in this study every single one was statistically significant with an elevated Alzheimer's disease risk fundamental to at least some instances of Alzheimer's disease is a compromised ability of the brain to use glucose a situation known as glucose hypometabolism in fact the greater the degree of brain glucose hypometabolism the more rapid the onset of Alzheimer's disease something detectable as early as the fourth decade of life we've only recently learned that the brain contains insulin responsive glucose transporters meaning insulin facilitates moving glucose from the blood to the brain this breakthrough is highly relevant in revealing a mechanism whereby insulin resistance and dementia are so tightly connected as the brain becomes insulin resistant its ability to utilize glucose for fuel is diminished as a brief aside other neurological conditions appear to share a similarly compromised ability to use glucose as a fuel for the brain including to differing degrees migraines epilepsy depression and even some instances of autism a final disorder connected with insulin is of broad interest body fat the history of the relevance of insulin in prompting the body to create and store fat is worth highlighting in 1923 Austrian physician scientist Wilhelm falta noted a functionally intact pancreas is necessary for fattening he further documented that the most efficient way to fat in a human calorie for calorie was to include abundant amounts of foods that increase insulin which is created in the pancreas in fact insulin was so effective at promoting body fat he used insulin injections to fatten people who suffered from anorexia or were considered to underweight around the same time another physician referred to insulin as an excellent fattening substance but this is an understatement falta had it right insulin is more than excellent at fattening it is necessary indeed I know of no circumstance in any organism that stores fat from worms to humans and every animal in between where fat mass can increase without elevated insulin driving the fat growth up to the present day many scientific reports indicate that insulin therapy in type 1 and type 2 diabetes remarkably increases fat mass type 2 diabetics who usually already struggle with weight can readily gain 20 pounds within six months and the higher the insulin dose the higher the degree of fat gain in type 1 diabetes where insulin is absent at the outset of therapy the changes in body fat are equally dramatic and weight can change so rapidly that clothes no longer fit within just one week tragically weight gain with insulin therapy is such an inconvenient consequence that some type 1 diabetics take drastic measures to stay thin by deliberately underdosing insulin while body fat does indeed stay in check in such a situation clinically called daya bulimia the long-term ramifications on health are disastrous many scientific reports reveal that insulin therapy significantly reduces metabolic rate accounting for as much as 30 percent of the fat gain insulin induced changes in metabolic rate became a matter of thought for my lab students and me before I mention our study I need to inform you that we all have two types of fat on our bodies distinguished from one another by metabolic activity one fat type is used to store energy which we call white fed this fat has a very slow metabolic rate the other type of fat which we call brown fat has a very high metabolic rate ten times higher than white fat in fact its metabolic rate when active is comparable to muscle all of us have varying levels of white and brown fat though the majority of our fat is the white storage fat not surprisingly those with the higher amount or a more active brown fat have a greater resistance to weight gain and insulin related disorders our study sought to tease out the effect of insulin on these two distinct fat types corroborating previous studies we found that increasing insulin increases the amount of white fat however our novel finding was that insulin pushes brown fat to act like white fat in other words insulin shifts metabolically active fat to behave like metabolically lethargic fat thereby reducing metabolic rate and potentiating fat gain collectively these findings help explain not only how metabolic rate is diminished with insulin therapy in diabetics but also how metabolic rate is increased in non-diabetic humans when a lifestyle is effectively maintaining in at lower levels up till now you may feel like I've been telling you a horror story these plagues of prosperity tell a terrifying tale nevertheless if it's been a horror story it at least has a happy ending just as our lifestyle is a cause of so many of our chronic diseases it can also be the cure at this point you're expecting me to give you a clear simple solution and here it is we must control insulin to control metabolic health there are myriad more and less effective methods to control insulin but all of them revolve around the food we eat these methods vary in proportion of fat carbohydrate and protein the key macronutrients of everything we eat as well as the frequency of eating unfortunately while the myriad methods differ in efficacy the voices promoting each of them all insist they know what's best in fact I think I know what's best to control insulin and metabolic health as well and despite my reluctance I am compelled to add my voice to the confusing chorus a scientifically sound strategy to control insulin is based on adjusting macronutrients to favour sources of energy that have the smallest effect on insulin when carbohydrate is consumed in the form of pure glucose very similar to eating a refined starch or sugar insulin dramatically increases to well above ten times over normal and depending on the person can remain elevated for several hours though this can vary when a person eats pure protein insulin will usually increase slightly over normal levels for a time remarkably fat consumption in contrast has no effect on insulin based on these data and dozens of related clinical studies three conclusions have become pillars for me one we need to control carbohydrates I'm not advocating the avoidance of an entire group of macronutrients after all carbohydrates include a remarkable range of foods rather be smart about your selection of starches and take a little time to learn how they affect insulin lest that seem onerous much of this is intuitive most fruits and vegetables as you might guess have a fairly small effect on insulin while college student staples such as bread cereal and potato chips have a pronounced effect if the carbohydrate comes in a bag or a box with a barcode it's likely one to be careful with of course sugar in its many forms and clever names is uniquely terrible this includes fruit juice and smoothies if you want to control insulin and enjoy fruit eat it don't drink it too we should prioritize protein a case has recently been made in scientific literature that recommendations of dietary protein are insufficient for most people to maintain and promote muscle and bone mass which is critical for maintaining good health and insulin sensitivity throughout life depending on age and activity an optimal level of dietary protein is around 1 to 1.5 grams of protein per kilogram body weight importantly this need for dietary protein increases with age as we get older we need more protein if you avoid protein because of something you saw in a book or documentary I hope you'll take the time to read their scientific references 3 we need to stop fearing fat we have a strong cultural aversion to dietary fat in fact by many estimates we eat a smaller portion of our diets from fat now than ever before the history behind the reasons for our issuing fat is as fascinating as it is unfortunate regardless dietary fat is a remarkable energy source because it has no effect on insulin on its own in a way it has the ability to feed our bodies but not our fat providing a new version of an old adage we aren't what we eat I'd like to think this was part of the reason for Isaiah's wise counsel to let your soul delight itself in fatness I understand that some of my conclusions may be hard to hear to this end I want to encourage you to follow the process I used to come to these conclusions with conviction first I recommend you find out for yourself if we believe such a process is sufficient even necessary to establish our own personal faith I submit it should be part of the process of finding truth within the realm of lifestyle and health as a missionary preaching the gospel in Russia 20 years ago I never told anyone to just believe me yet this is standard practice for many when it comes to lifestyle and health just as one seeking a testimony of the Book of Mormon should read the scriptures a person that is seeking to learn the truth of the most effective lifestyle changes to control insulin and health should search the scientific scriptures that is published research articles access to these resources is incredible and by learning how to effectively search and navigate websites like Google Scholar and PubMed anyone can quickly find peer-reviewed human clinical studies and learn if only by reading the abstract as you do this be mindful of the experimental model used in the studies you find and whether the results indicate causation or correlation with this distinction you'll be better prepared to make informed conclusions throughout this exploratory stage I hope you'll have an open mind to allow data not dogma to dictate your decisions for the second part of this process I recommend you test what you learn when you think you've found sufficient evidence to support an ideal lifestyle plan to fight insulin resistance and its related complications try it from keep in mind that the changes you make will ideally be sufficiently practical to follow indefinitely at this point I feel compelled to address a common attempt at improving health let's imagine I've invited each of you to join me for a dinner where the world's greatest chefs have prepared the most magnificent meals naturally you're excited to come indulge and determined to come hungry what would you do to ensure you came to my dinner as hungry as possible I suspect you would settle on two strategies you would likely eat less for some period of time prior skipping meals and generally eating very little and you would likely increase your physical activity deliberately exercising more or harder for some time in the days leading up to the dinner this would work you would come very hungry but do these two strategies seem familiar eat less exercise more this has been our best medic metabolic advice for half of a century while this advice may have some utility especially if you know you're eating too much has it really helped are we better can you see why it might not work in the long run by basing a lifestyle plan on eating less and exercising more we are ensuring an almost constant battle against hunger and hunger usually wins the third and final part of the process you can undertake to identify a lifestyle change to better control insulin is to be patient and endure the initial discomfort that comes with any change members of the Church of Jesus Christ of latter-day saints are not spared from the plagues of prosperity these chronic diseases that stem from insulin resistance in fact evidence suggests we may suffer from them more than members of other religions this should surprise us as a faith we have a unique conviction of the importance of our bodies indeed we believe that the body and spirit constitute the soul of a person this soul not just the spirit is priceless in the sight of God our struggle with poor metabolic health is even more surprising when we appreciate that we have specific revelation about health the word of wisdom given to the Prophet Joseph Smith but could our cultural interpretation of the word of wisdom partly explain why we are so prone to a prominent insulin related disorders I believe so I suspect that our application of the word of wisdom has led to a dietary pattern that skews too heavily towards foods that increase insulin particularly refined starches and sugar and thus drive insulin resistance and the associated plagues of prosperity after all how often do we gather surrounding a table filled with ice cream and brownies then offer a prayer of gratitude including a supplication that the food bless us with health and strength while I firmly believe Heavenly Father has a sense of humor this may be pushing it a little too far we should be wary of well-intentioned voices that claim to promote a word of wisdom diet there is no such thing moreover there is nothing to be gained by attempting to literally interpret the word of wisdom and most efforts involve a selective interpretation that fits a preconceived conclusion prophets and apostles have divinely interpreted the application of the word of wisdom to include avoiding a short list of habit-forming substances but they've not gone further nor should we as president Packer stated the word of wisdom has not been spelled out in more detail this then leaves tremendous room for personal interpretation and application the word of wisdom is not a checklist and as President Joseph F Smith suggested one should use his or her wisdom which can come from one's education and experience for various health and personal reasons where one member of the church chooses to eat a diet as shoeing grains and focusing on vegetables and meat another may choose to avoid meat and focus on grains and fruits insofar as both are shunning the few habit-forming substances that modern revelation has encouraged us to avoid there should be no judgment among members of the church on how each differs in the application of the word of wisdom with regards to anything else in other words by following the very few precepts provided by divine direction we need look no further into one's dietary habits and we can be confident each abides by the word of wisdom though it may be different for each of us I have known members of the church to be the recipients of hostility from fellow members and some have had a crisis of faith when they experienced substantial health benefits after changing to a diet they initially felt conflicted with their interpretation of the word of wisdom similarly it is naive to point a finger at a person waiting in line to buy a coffee or tea as we wait in line to buy a large soda we should never claim moral superiority with the word of wisdom while I don't believe there is any utility in attempting to apply a literal or singular interpretation of the word of wisdom I certainly believe it contains valuable and timely information for example when I read those verses as opposed to specific dietary advice among other things I hear a warning we should be wary of what others tell us is best a good example of this can be seen in the dietary recommendations by a prominent Diabetes Association within the United States in 1987 dr. Gerald reven perhaps the most famous diabetes scientist if such a thing as possible conducted a clinical trial among type 2 diabetics to test the efficacy of the association's recommended diet in his words this diet focused on low-fat high-carbohydrate foods containing moderate amounts of sugar within just two weeks the type 2 diabetics placed on the recommended diet got demonstrably worse glucose and insulin climbed while blood triglycerides and cholesterol spiked dr. reven accurately concluded that the recommended diet caused bility rias metabolic effects as a life scientist at BYU I enjoy being able to discuss the body's role as a temporal tool that helps us build an eternity after all there are eternal lessons best learned in a physical even mortal body our bodies give us a certain degree of power which while enabling us to exert an influence on the world are very often a focus of temptation we are tempted to misuse the power these bodies provide us I submit that a portion of our eventual judgment will be based on how we use the limited power these bodies give us and when found responsible with such power we will show our capability to receive greater power additionally some eternal lessons may have pedestrian origins but be nevertheless relevant for example the discipline required to deny oneself a late-night sugary snack may foster a similar resolve to resist the temptation to anger or various forms of spiritual self abuse of course none of this is to say there will be a measuring tape at the pearly gates we will certainly not be judged by our body size but perhaps partly by how we treated our bodies without doubt some inherently struggle more than others with metabolic health for numerous genetic and environmental reasons and thus we should never judge nevertheless there remains an inner zone in which we are sovereign unless we abdicate as effective as our bodies can be at teaching us eternal lessons we must never assume the temporal can replace the spiritual some eternal lessons are taught in quieter classrooms consider Alma the younger recall that as a young man he had a divine visitation that was so physically overwhelming that the earth shook and he fell to the ground he saw and felt the presence of a heavenly messenger however you years later when sharing his testimony he didn't cite this exceptional experience as the source of his belief remarkably he declared the source of his conviction to be the Holy Ghost through fasting and prayer a similar experience was seen among the Nephites immediately preceding Christ's birth despite seeing and hearing miraculous signs these physical experiences what they saw and heard were quickly forgotten and in the end amounted to little without an accompanying spiritual confirmation these examples serve as a reminder that knowledge comes in different ways in that a spiritual event though more subtle than its physical equivalent leaves a more lasting impression I am confident that as we direct our desires towards better health we can discover scientifically sound strategies to guide us in modifying our habits to improve health and enable us like King Benjamin to labor with all the might of our bodies and Faculty of our souls may we appreciate that our bodies can be a tool to help us develop divine attributes that prepare us for eternal progression in the name of Jesus Christ amen you

Channel: BYU Speeches

Views: 208,521

Keywords: BYU Speeches, BYU Devotionals, Benjamin Bikman

Id: xefdEXfG9j0

Length: 36min 57sec (2217 seconds)

Published: Thu Jul 19 2018

Reddit Comments

[u/therealdrewder]

I think we need to adjust our understanding of the word of wisdom in view of the modern food supply.

[u/joedzado]

Wow. I'm going to get insulin tested.

[u/TheOneTrueNolano]

Dude is an amazing professor at BYU. Very passionate, smart, and cares. Memorized every students name before the first day of class. Freaked me out when he called on me by name day 1. He has a few odder/fringe beliefs but they all come from a good place.

He is part of the reason I became a doctor.