Insulin Resistance, Fasting, Ketones and “Why We Get Sick” – Dr. Ben Bikman with Dave Asprey – #804

• Insulin resistance makes you less powerful every day until you get diabetes. – 00:41
• His new book, Why We Get Sick, the hidden epidemic at the root of most chronic disease and how to fight it.  – 1:29
• I saw this manuscript in the early 2000s. So, it’d already been out a few years. I didn’t know about it, but it started to explain the connection between fat tissue and disease. – 3:03
• The fact that the fat cell was producing these pro-inflammatory proteins, to me, really revealed two interesting details.  – 3:23
• It’s this idea I’ve convinced myself or this hope I have that my academic offspring, as they go into the clinic, they won’t think drug first, they’ll think diet. – 7:39
• If the mitochondria are dysfunctional, there’s no doubt that the production of reactive oxygen species will directly antagonize the insulin cascade. – 9:25
• The word mitochondria comes from the Greek word, mitos, which means thread. – 11:22
• The hypertrophic fat cell becomes insulin resistant to prevent itself from exploding. In the process of becoming hypoxic, it starts releasing pro-inflammatory cytokines, some of which will increase blood flow. – 15:43
• Nevertheless, the idea of inhaling insulin, it does appear to facilitate insulin action in the brain.  – 17:51
• If, however, someone has liposuction and they don’t change the habits that caused them to get that fat in the first place, the body is not going to be beat in its efforts to store energy. -20:52
• Before we go into insulin resistance, can you tell me all of the good stuff that insulin does in our bodies? Why is insulin important? – 26:20
• One of the key mutations in many cancers is to enhance their sensitivity to insulin and thus hijack that growth signal. – 30:00
• If insulin is elevated, the body is obligatory in a sugar burning mode. When insulin is down, the body must shift and go to fat burning mode. In fact, it’s fat burning so much that it starts making ketones.  – 33:45
• Insulin secretion has two phases. Very briefly. Some of that depends on pre-formed insulin, insulin that you’ve made and it’s waiting just ready for the pancreatic beta cells to release it. And then you have a second phase which is, now you’re making insulin from scratch.  – 35:23
  
• Glucose is the only molecule that will involve cytosolic enzymes. Every other nutrient that we’re breaking down must exclusively rely on the citrate cycle. – 38:38
  
• If you go on a low fat diet for a long time and then you eat a whole bunch of fat, you can’t make enough lipase. It takes the pancreas a while to switch its gears to make more lipase to break down fat. – 38:50
  
• In your book, you’re talking about why we get sick and insulin is a major star in the show. Who are the costars with insulin about why we get sick? – 40:34
  
• I say that there are three primary causes of insulin resistance. And by primary, I use the term primary to touch on the fact that in all three key biochemical or biomedical models of research, these are causes of insulin resistance.  – 43:22
  
• If cortisol is elevated in an individual with adherence to a ketogenic diet, I would definitely then suggest there’s reason to cycle with carbs. Cortisol has a fascinating effect on fat cells – 46:18
  
• Do you think it’s metabolically advisable or not advisable to take extra ceramides nutritionally? – 48:32
  
• I am utterly convinced that the sooner the average individual can use a CGM, the sooner they will begin to self-impose their own dietary changes. – 48:32
  
• The brain starts to starve or to sense this panic because it is so yoked to glucose that the drop in glucose is panic to the brain. – 53:13
  
• If thyroid is down, then the rate at which a cell is doing its work including glycolysis is compromised. That’s a universal phenomenon in the body. – 54:56
  
• What’s a maximum blood sugar level that people should have after a meal? – 55:57
  
• Can you talk about omega 6’s, particularly damaged or oxidized omega 6’s in insulin resistance? – 59:32
  
• The problem with linelaic acid and one of the key lipid peroxides that it turns into, which is called 4-HNE – 1:00:58
  
• The number two fats in the Western diet now is soybean oil and shortening. And those are both derived, or they’re both very enriched with omega 6 fats. – 1:02:46
  
• At no point in history have humans been consuming this level of omega 6 fats. – 1:04:19
  
• We’ve these refined carbohydrates and these refined oils that our ancestors would have never experienced. We’re poorly adapted to these new sources of macronutrients. – 1:05:13
  
• And guess who got much fatter than the rest? It was the soy bean oil eating animals. They got fatter and sicker, even though they were eating the exact same amount of calories. – 1:07:25
  
• A couple of my brothers, we made a low carb shake that is lower carb, higher fat, high protein. And it was a one-to-one, it’s called Health Code.  – 1:12:39
  
• I like to think of fasting as two different states, a caloric fast or a nutritional fast. I strongly strongly contend, even if you’re in a nutritional fasted state, you are getting many of the benefits of the true fast, including autophagy, improved insulin sensitivity, and heightened fat burning, which is evident in the production of ketones. – 1:19:25
  
• What’s your recommendation for breaking a fast? – 1:21:03
  
• ALA is actually the most, the single most ketogenic of all the fats. And it is a polyunsaturated fat in the brain. – 1:26:03
  
• Eggs, dairy and meat are the best proteins. They have the highest net absorption and the best amino acid profiles when it comes to dietary proteins and they always come with fat, we should eat them that way. Don’t take out the fat. – 1:30:17

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