Welcome back ladies and gentlemen, boy and girls. Season 5 is here. I took a short break to collect some more interviews and put out a few episodes of the new SAPIEN podcast. You can check that out on youtube or any podcast app. It's a more casual and conversational show we shoot on video and audio with Dr. Gary in our medical clinic Evolve Healthcare in Los Angeles. We've started to take on more patients to our weight loss, chronic disease management, and SAPIEN lifestyle programs. You can find out more at http://Sapien.org/programs

We offer one off consultations, physician supervised weight loss through insurance, and the 3 month Sapien program with one-on-one diet and lifestyle coaching. This is offered in the clinic in Los Angeles or remotely. Again that's http://Sapien.org/programs

This episode is jam packed with information so get ready to take some notes. Dr. Ben Bikman is a legend. He is a professor of pathophysiology and a biomedical scientist whose research focuses on the molecular mediators of obesity and its co-morbidities. Employing cell-autonomous to whole-body systems, his lab's main efforts explore the intimate associations between the metabolic and immune systems.

He also is a world class presenter and has some fantastic lectures on youtube. I highly recommend watching them and links will be included in the show notes. Dr. Bikman is really one of the foremost minds on human metabolism in the world. I'm honored to be able to speak with him and share this episode.

I'll quickly give a shout out to Kristi and the super comprehensive show notes she does. You can get access to them by supporting the show on Patreon at http://patreon.com/peakhuman

Throwing a few bucks there allows me to keep doing this show and creating content of all kinds.

If you can't spare any cash, please give this podcast a review or even just tap the 1-5 star rating on the Apple Podcast app would be helpful. It bumps up the show in the results and gives it a bit more cred. Appreciate all the complimentary reviews so far. It helps keep me going!

Also if you like meat and eat it to survive as a human being, why not get top-quality grass finished meat from http://NoseToTail.org This is my company so you will be supporting me and a Texas ranch. Our signature products are ground beef, pork, and buffalo with all the organs mixed in. You can get your liver, kidney, heart, and spleen without having to get out the meat grinder and while enjoying a very delicious burger. With a little seasoning it tastes beautiful. I think it's the best way to get all those amazing nutrients.

Our pork and chicken is actually extra special. We spend quite a bit more money giving them a proprietary high omega 3 feed that translates into super high omega 3 meat. The omega 6 to omega 3 ratio is insane - it's less than 2 to 1. Compare it to conventional pork which is about 20:1 and conventional chicken about 24:1. This is much better for you than normal stuff obviously. Chicken and pork usually get a bad rap, and maybe that's well-deserved for conventionally grown versions. This is a different ballgame here folks. If you want to mix it up from the wonderful staple that is red meat, this is where it's at.

So let's get to this episode with Dr. Ben Bikman - we talk about brown fat vs. white fat, how this relates to the calorie in calorie out model of obesity, insulin, glucagon, and why protein doesn't cause problems in a low glucose context, longevity, mTOR, body composition and gaining muscle, to name a few - he covers so many interesting and valuable things, I don't want to hold it up any longer. Enjoy the show!

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SHOW NOTES

Ben Bikman is a professor of pathophysiology and biomedical science at BYU in the physiology and developmental biology department and the class he teaches is pathophysiology
His undergrad and MS was exercise physiology and he loved learning how the body adapts to exercise
He got into his current research interests by stumbling upon research on adipose tissue as an endocrine tissue that secretes anti-inflammatory and pro-inflammatory hormones
Insulin resistance is at the root of many diseases
Type-2 diabetes is at its core a disease of insulin resistance where there is too much insulin, the pancreas is working so hard to produce insulin but the body is not responding to it as well as it was before
Teaching pathophysiology exposed him to the link between insulin resistance to almost all chronic diseases and the more he covered more diseased states insulin resistance was always relevant
Clinicians typically look at fixing individual problems with separate medications when we could just target the underlying issue
Insulin resistance is a disease of too much insulin and part of the insulin resistance is caused by too much insulin it's a vicious cycle
Too much of a stimulus, system will reduce sensitivity to this stimulus
If insulin resistance is relevant to every chronic disease you have to resolve the insulin resistance if one of the main causes of insulin resistance is hyperinsulinemia then the best way to reverse course is to reduce the insulin and low-carb is the easiest strategy
His concerns about vegan diets
What he tries to focus on is the common grounds, keto or low-carb, vegan, whatever diet you choose the thing in common needs to be avoiding processed foods, at the end of the day, the goal is to lower insulin
If a person is in ketosis, then you know their insulin is low, it's a nice metric to know you are controlling insulin because you can't make ketones if insulin high
Of the three macronutrients, carbohydrates have the greatest insulin spike and carbohydrates are the only non-essential macronutrient
Anyone attempting to control insulin should consider the insulin to glucagon ratio which
Glucagon is one of the hormones that act in opposition to insulin, released in the alpha-cells of the pancreas
One of insulin's main actions is to lower blood glucose, if it is elevated to get glucose into our cells which is required to live
Glucagon's main job is to elevate blood glucose
In a fasted state you will have a low insulin to glucagon ratio, because glucagon triggers the mobilization of energy from stored energy
[around 20:20] When we are eating a low-carb high-fat diet, this insulin to glucagon ratio will remain similar to that of fasting so that we can mobilize energy not store it
On a low carb diet high fat diet, we are eating but we are mimicking the state of fasting
Eating carbohydrates frequently throughout the day almost guarantees insulin will be elevated all day long
In a fasted state the insulin to glucagon ratio will be around 1, on a standard american diet that will go up to around 10 and a low carb high fat will go up to maybe 2-3
A lot of people are scared to eat protein on a ketogenic diet and instead people eat a lot of pure but this is not found in nature
Context matters, glucose interferes with the insulin response to protein
[around 29:45] You can not afford to spike insulin from protein in a low carb state because you will shut down glucogeonesis which makes glucose in the fasted state and you will go hypoglycemic
Protein on a high carb diet amplifies the insulin response to glucose
The main substrate for gluconeogensis is lactate not amino acids
Gluconeogenesis is demand driven
Ketones spare muscle break down by providing an alternative fuel source
Transitioning into ketosis you go through a brief phase of using amino acids from muscle for glucose but you transition out of that once you get into ketosis
The difference between fasting and starvation is breaking down muscle as last resort
The glycemic load of the carbohydrate in the diet matters for the insulin response
Dangers of low-protein "longevity diets"
We know in experimental models one of the keys to longevity is to lower insulin
Promoting a high carb diet for longevity isn't logical because carbohydrates have the biggest insulin response
[around 40:20] Insulin increases mTOR much greater than amino acids do so the argument to lower protein to lower mTOR for longevity by replacing protein with carbohydrates is not achieving this
Soy is a complete protein however a normal response to exercise in both females and males is to transiently increase androgens (e.g. testosterone) and animal proteins don't change this response but when a man takes soy, it abolishes this androgen spike from exercise (studies haven't been done in women)
Pea protein is about half as absorbable to animal proteins
You do not need carbohydrates for the insulin spike to build muscle
The difference between lean gains vs bulking and cutting
In order to make ketones you need fat to enter mitochondria via carnitine
Carnitine is the essential transporter for fatty acids
If you are focusing on protein, fat, and carnitine in order to maintain a good insulin to glucagon ratio, there is nothing better than a piece of red meat
Insulin slows metabolic rate and ketones accelerate metabolic rate
Brown fat is enriched in mitochondria and is enriched with mitochondria in contrast to white fat and these mitochondria behave differently
Mitochondrial metabolism is "uncoupled" in brown fat and "coupled" in white fat
Ketosis helps "waste" energy so to speak
Ketones help turn white fat cells to brown fat cells
Insulin turns off mitochondrial uncoupling
Hormones dictate what the body does with food consumed to mobilize or store
Ideas behind personal fat threshold and carbohydrate-insulin theory of obesity
Inflammation and fat create a perfect storm for creating insulin resistance throughout the body
The personal fat threshold explains why slim people can be insulin resistant and overweight individuals can be metabolically healthy
Fat storage can differ among different ethnicities
You can eat a high carb diet and not gain weight and lose weight if you are eating whole food carb sources
Lab grown meats are not natural and require a ridiculous amount of antibiotics to grow in the lab
His lab website https://bikmanlab.byu.edu
Twitter: https://twitter.com/BenBikmanPhD

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