Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease and How to Fight It

Benjamin Bikman, PhD is an internationally renowned scientist and pathophysiology professor at Brigham Young University in Provo, Utah. Currently, his professional focus is to better understand the origins and consequences of metabolic disorders, including obesity and diabetes, with a particular emphasis on the role of insulin. He frequently publishes his research in peer-reviewed journals and presents at international science and public meetings.

​On this podcast, Ben talks with NBT Scientific Director Megan Hall about insulin resistance: what causes it, how it develops in the body, and the downstream effects of this all-too-common condition. Ben discusses the role of insulin as a regulator of human metabolism and its relevance in the development of most chronic diseases. He also offers a simple and effective prescription for optimal metabolic health and healthy ageing. 

Here’s the outline of this interview with Benjamin Bikman:

[00:00:00] Ben’s previous (2017) appearance on the NBT Podcast: Ketones, Insulin and the Physiology of Fat Cells.

[00:00:42] Ben's background and his study of metabolism.

[00:02:27] Ben's lab at BYU.

[00:03:05] Insulin resistance, defined.

[00:05:19] Causes of insulin resistance.

[00:06:15] Problems with measuring insulin resistance.

[00:10:24] Effects of diet, inflammation and stress on creating insulin resistance.

[00:14:18] How insulin resistance develops in the body.

[00:20:31] Fat hypertrophy vs hyperplasia.

[00:22:24] The Athlete's Paradox.

[00:24:22] Insulin resistance at the level of the brain; Alzheimer's as Type 3 Diabetes.

[00:28:25] Brain fog; Stephen Cunnane, PhD., Research Center on Aging, Universite de Sherbrooke.

[00:28:53] Young women with PCOS exhibit brain hypometabolism and insulin resistance; Study: Castellano, Christian-Alexandre, et al. "Regional brain glucose hypometabolism in young women with polycystic ovary syndrome: possible link to mild insulin resistance." PLoS One 10.12 (2015): e0144116.

[00:29:41] Pathological vs physiological insulin resistance.

[00:33:14] Just 50g of carbohydrate the night before improves outcomes on oral glucose tolerance test (OGTT); Study: Klein, Klara R., et al. "Carbohydrate intake prior to oral glucose tolerance testing." Journal of the Endocrine Society 5.5 (2021): bvab049.

[00:38:20] Problems with the focus on calories in nutrition research.

[00:43:09] Video: Dr. Benjamin Bikman - 'Insulin vs. Glucagon: The relevance of dietary protein'.

[00:46:55] Book: Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease and How to Fight It.

[00:51:22] Study: Walton, Chase M., et al. "Ketones Elicit Distinct Alterations in Adipose Mitochondrial Bioenergetics." International Journal of Molecular Sciences 21.17 (2020): 6255.

[00:51:52] Untreated diabetes and metabolic rate; A Study of Metabolism in Severe Diabetes, by Francis G. Benedict and Elliott P. Joslin.

[00:52:26] Insulin significantly reduces energy expenditure; Study: Nair, K. S., D. Halliday, and J. S. Garrow. "Increased energy expenditure in poorly controlled type 1 (insulin-dependent) diabetic patients." Diabetologia 27.1 (1984): 13-16.

[00:54:42] Ketogenic diet and lifespan; Megan’s study: Roberts, Megan N., et al. "A ketogenic diet extends longevity and healthspan in adult mice." Cell metabolism 26.3 (2017): 539-546.

[00:55:56] Effects of β-Hydroxybutyrate on skeletal muscle mitochondria; Study: Parker, Brian A., et al. "β-Hydroxybutyrate elicits favorable mitochondrial changes in skeletal muscle." International journal of molecular sciences 19.8 (2018): 2247.

[00:56:42] Effects of ketones on β-cell function; Study: Gropp, Jarom, et al. "β-Hydroxybutyrate improves β-cell mitochondrial function and survival." Journal of Insulin Resistance 2.1 (2017): 1-8.

[00:58:44] Paper out of UC Davis: Zhou, Zeyu, et al. "A ketogenic diet impacts markers of mitochondrial mass in a tissue specific manner in aged mice." Aging (Albany NY) 13.6 (2021): 7914.

[01:00:04] Ketone concentrations during a 36-hour fast; Study: Deru, Landon S., et al. "The Effects of Exercise on Beta-Hydroxybutyrate Concentrations over a 36-h Fast: A Randomized Crossover Study." Medicine and Science in Sports and Exercise (2021).

[01:02:27] Prescription for optimal metabolic health and healthy ageing.

[01:03:15] 4 pillars: control carbs, prioritize protein, don't fear fat, fast.

[01:05:19] Where to find Ben: Instagram, HLTH Code meal replacement shake.