Episode 210: How to Beat Chronic Inflammation
Mastering Gut Health and Defeating Chronic Inflammation with Professor Ben Bikman, Ph.D. | Understanding Glucose & Insulin, Unveiling Insights for Optimal Insulin Sensitivity, and Harmonizing Stress & Sleep
Hi everyone. Welcome to the show. My guest today is Benjamin Bickman. Ben has been on the show before when his last book called “Why We Get Sick” was out. He’s also an associate professor at BYU. He got his Ph.D. in Bioenergetics, and his whole thing now is to understand the role of elevated insulin in regulating obesity and diabetes, including the relevance of ketones in mitochondrial function.
It sounds confusing, but Ben is an exceptional educator and has a remarkable ability to simplify complex concepts related to managing glucose levels and identifying triggers that can cause spikes. Understanding our glucose levels and maintaining our health is crucial, but it is equally essential to comprehend that insulin resistance and insulin sensitivity are distinct from glucose levels. Ben explains these concepts in an easy-to-understand manner and emphasizes the dangers of chronic inflammation and how it can wreak havoc on our systems, regardless of age or gender. This conversation with Ben offers several actionable takeaways that are useful for anyone looking to improve their physical performance, whether they are an athlete, weekend warrior, or someone juggling a busy work schedule while trying to stay healthy.
- Chronic Inflammation and Overall Health
- Testing Alternatives for Inflammation Levels
- Initial Steps to Manage Inflammation
- Can the Gut Actually Heal Itself?
- Are Seed Oils Really a No-Go?
- The Correlation Between Negative Thoughts and Your Gut Health
- The Gut’s Quick Turnaround
- What Actually Happens in a Body with Chronic Inflammation?
- Stressors and Chronic Inflammation Effect on Insulin Sensitivity
- Sleep, Menopause, and Weight Gain: Are They Connected?
- Does WHEN You Eat Matter?
- Carbs After a Workout Aren’t for Everyone
- Glucose Monitoring Isn’t the Only Answer
- Fruit Juice is Not Your Friend (Neither is Alcohol!)
- Supplements for Maintaining Insulin Sensitivity
Welcome to the Gabby Reece Show, where we break down the complex worlds of health, fitness, family, business, and relationships with the world’s leading experts. I’m here to simplify these topics and give you practical takeaways that you can start using today. We all know that living a healthy balanced life isn’t always easy. Let’s try working on managing life a little better and have some fun along the way. After all, life is one big experiment, and we’re all doing our best.
Anyone who has what they think is a chronic, lifelong intestinal problem; my very, very strong advice is to really scrutinize your diet. Try something for a week. The fact is, usually, it’s some plant matter that they’re responding negatively to and that the more they are careful with their plants, especially grains to varying degrees, and then maybe certain kinds of vegetables, the degree to which they’re careful with those noxious agents, that will directly improve the gut health.
BENJAMIN BIKMAN, PhD
We’ve talked before, and I have always appreciated our conversations. I am eager to delve deeper into some of the terms and concepts related to health that we often hear but may not fully understand. For instance, ketones are a term that many people may have heard but may not quite know their meaning or significance. Therefore, I would like to begin by discussing chronic inflammation, including what it is and how it affects our microbiome. Additionally, I would like to explore gut health, including what constitutes good gut health and why it is crucial for overall wellness. Of course, we cannot overlook the criticality of insulin sensitivity, which has a significant impact on our health. By addressing these key areas of health, including inflammation, gut health, and insulin sensitivity, we can potentially avoid many complications and enjoy better overall health.
Gabby, I am comfortable speaking on all the topics you mentioned except one, which is the microbiome. While I can provide some information about it, I believe that people should be cautious about accepting absolute claims regarding the microbiome as it is not well understood. However, I am knowledgeable about gut permeability, which refers to the degree to which the gut fails to filter efficiently. This issue is relevant in many ways, including how it contributes to inflammation. Inflammation, in turn, affects metabolism and insulin resistance, making it essential to address these issues together.
Chronic inflammation can be caused by various factors, including infections that persist, abnormal immune responses to normal tissues, or conditions such as obesity. There are several risk factors that can contribute to chronic inflammation levels in the body. Chronic inflammation has been associated with a range of health issues; therefore, maintaining healthy lifestyle habits and avoiding risk factors can help prevent chronic inflammation and its associated health complications. So maybe you could carve out really clearly actually what are some of the things it can do to your health and your body.
Inflammation is often viewed as a negative thing in pop culture. However, inflammation is necessary for the immune system and healing process. it, our bodies wouldn’t be able to heal from injuries or workouts. The problem arises when inflammation becomes chronic. In physiological instances, inflammation turns on and turns off once it has served its purpose. However, chronic inflammation can cause health issues such as subclinical chronic inflammation. This type of inflammation is not noticeable but can still be clinically detected. It is connected to both the immune system and metabolic system, with excess fat compromising metabolic health due to inflammation. C-reactive protein (CRP) is an excellent indicator of inflammation levels and heart disease risk. It is recommended to get CRP measured to assess inflammation levels during blood tests.
Asking for a CRP test during a routine blood test is a reasonable request for anyone concerned about inflammation levels and heart disease risk. If your doctor gives you a hard time, it’s essential to question why they would do so, as monitoring inflammation levels can help catch health problems before they escalate. However, some healthcare providers may use the “normal range” argument to dismiss concerns about inflammation levels. That’s why it’s crucial to be your advocate and push for the tests you believe are necessary for your health. While some people may feel intimidated by doctors, it’s vital to remember that healthcare providers are there to help you, and you have the right to ask questions or request additional tests if needed.
It is unfortunate but true that the more credentials a person has, the more unpleasant they tend to become. Physicians are no exception to this trend. When it comes to CRP tests, there may be some resistance due to the term “inflammation” becoming too trendy in pop culture. Some people tend to blame inflammation for every problem without really understanding it, which can lead to eye-rolling and skepticism. However, CRP tests are commonly measured during annual wellness visits because they have become an accepted way to measure heart attack risk. In fact, CRP levels can better predict heart attacks than cholesterol levels.
We won’t delve into cholesterol today, but it’s astounding how we’ve been obsessing about it for over 40 years when there are other crucial factors at play. Despite this fact, some people still prioritize cholesterol levels and opt for medication without considering other vital health markers. It’s remarkable how quickly people become indoctrinated with certain beliefs and how challenging it can be to change their minds even with new data.
When it comes to inflammation, a test can indicate whether someone has high or chronic levels of inflammation. In case the test shows high inflammation levels, it’s essential to take primary steps to address the issue. What would you say are some primary steps that can help manage inflammation levels and reduce the risk of developing health complications related to chronic inflammation?
The likely causes of high inflammation levels are environmental factors and fat tissue. The former could stem from allergies or sensitivities to substances that the person is exposed to, whether knowingly or unknowingly. For instance, someone with gluten sensitivity may experience an exaggerated immune response to gluten, leading to inflammation. Inhalation of pollutants like diesel exhaust, cigarette smoke, and vaping can also trigger inflammation in the body.
The integrity of the intestinal barrier is also critical in reducing inflammation levels. Polyunsaturated fats found in seed oils like soybean oil can increase the gap between cells in the intestinal barrier, while saturated fats can tighten the gap and reduce inflammation. Therefore, maintaining a healthy intestinal barrier and avoiding environmental toxins and allergens can help manage inflammation levels and reduce the risk of developing related health complications.
So let’s say we hear the term leaky gut. Does that mean you’re allergic to the things that you’ve been consuming, and that is the thing that really activates the reaction?
For example, let’s say somebody didn’t know about these harmful oils, and they’ve been hearing about the “Hateful 8” for the last year or so, and they really tried to eliminate these from my everyday diet over time. Will the gut heal?
And the other part of that question is, let’s say we’re working on healing the gut from these foods or these oils. If today am sitting here and my gut’s in pretty good shape, and I consume something with that oil, will that, in a one-time kind of intake, hammer my gut? Or can the body handle it a little bit? Or is it a no-go right from the beginning?
You mentioned the two things that are valuable to address regarding leaky gut: the immune system’s response to certain foods and the direct harmful effect of certain foods on gut integrity. Autoimmune problems like Crohn’s disease or ulcerative colitis can be triggered by a dietary problem, and addressing food sensitivities is essential to reduce inflammation and promote overall health.
Regarding the impact of food on gut health, there are two key aspects to consider: food allergies and autoimmune problems and the direct effect of certain foods on gut integrity. While there is no conclusive evidence on the exact degree to which the gut can heal from these issues, there is one case study published by author Nick Norwitz documenting the total resolution of ulcerative colitis in a patient within weeks of changing their diet. This is encouraging, though it’s important to note that this is just one case study.
When it comes to linoleic acid and saturated fats, linoleic acid has been shown to increase the gap junctions between epithelial cells, while saturated fats close them. While consuming unhealthy foods can open up gaps in the gut lining, I speculate that consuming healthy foods can help seal them back up within a short period of time, potentially even within hours or a day. However, there is no evidence of the timing or duration of this process. It’s essential to address food sensitivities and maintain a healthy diet for optimal gut health.
When it comes to the damage caused by food on gut health, it’s important to consider the extent of the damage and how quickly it can be resolved. In the case of autoimmune problems, evidence suggests that healing the gut can take just a few weeks. On the other hand, when it comes to the direct effect of certain foods on gut integrity, the sealing of gaps in the gut lining can happen within a matter of hours. For example, consuming unhealthy foods can open up gaps, but consuming healthy foods can help seal them back up quickly. It’s important to note that while the gut can heal relatively quickly, maintaining a healthy diet and addressing food sensitivities is essential for overall gut health.
This is an important conversation because many people feel discouraged from even starting to improve their gut health. They may feel like it’s late or that they can’t make a difference. However, it’s crucial to remember that every day is an opportunity to make positive changes and improve gut health. By seeking out information and making better choices, we can take control of our gut health and make significant improvements.
It’s essential to reject negative and discouraging thoughts and remember that the body wants to be whole and maintain homeostasis. Often, the key to healing is simply removing the harmful stimulus or substance from our diet. However, identifying the source of the problem can be challenging.
The intestines are one of the most dynamic and plastic tissues in the body, with cells that can grow quickly. While this can contribute to issues like colon cancer, it also means that the body can recover remarkably quickly from damage to the intestines. For example, in cases of ulcerative colitis, the gut can heal in just a matter of days, much like a scab forming on the skin. It’s important to recognize the body’s inherent ability to heal and take proactive steps toward improving gut health. The intestines just recover so quickly.
Many people suffer from conditions such as irritable bowel syndrome, and it can be challenging to find relief. While everyone’s body is different, making more informed choices about diet and sticking to them can lead to significant improvements in gut health. Do you think the improvement may be more drastic and quicker than people expect?
As a scientist, I try to be careful with my statements, but in this case, the evidence is clear – a person can start experiencing benefits within 24 hours of making informed dietary choices. For anyone suffering from chronic intestinal problems, my advice would be to scrutinize your diet and try eliminating certain foods for a week. Often, people respond negatively to plant matter, particularly grains and certain vegetables. By being careful with these foods and avoiding harmful molecules, gut health can be directly improved.
While it may sound controversial, it’s important to remember that not all plants are beneficial or safe to consume. In fact, many plants have defense mechanisms to discourage consumption. As a species, we have selected the plants with the lowest amount of harmful molecules and the highest amount of beneficial ones. This doesn’t mean we should declare war on all plants, but rather be mindful of which ones we consume and how they impact our gut health. In my experience, being careful with plant matter can lead to the greatest improvements in gut health.
We know that there are environmental factors that impact gut health, but since we can’t control all of them, it’s important to focus on what we can control – our diet and lifestyle choices. While we can control some environmental factors, like what we put on our skin, we live in a world where we have to contend with external pollutants.
When it comes to inflammation and its impact on gut health, it’s important to understand what inflammation actually is and how it affects the body. Chronic inflammation occurs when the immune system overreacts, leading to a range of negative health consequences. But what is actually happening in the body?
C-reactive protein is just one of many molecules in the family of cytokines, which are immune-related molecules. There are numerous cytokines, such as TNF alpha and interleukin one beta, that are even more relevant to inflammation than CRP. These molecules can either promote or turn down inflammation and work together in a healthy body.
In cases of chronic inflammation, the molecules promoting inflammation are winning over the ones that turn down inflammation. Cytokines are released by immune cells, such as lymphocytes, leukocytes, and macrophages. It’s important to understand the role of these molecules in inflammation to identify the root causes of gut health issues and take proactive steps toward improving overall well-being.
Macrophages are phagocyte cells that engulf harmful molecules and play a crucial role in the immune system. In the case of a leaky gut, bacteria can enter the bloodstream, and macrophages will sense and eat them. As it eats the harmful molecule, the macrophage recognizes that it doesn’t belong there and begins releasing cytokines as a call for help to other immune cells. Cytokines are essentially trails of breadcrumbs that lead other immune cells to the site of damage and indicate the level of inflammation in the body. Measuring cytokines like C-reactive protein or TNF alpha helps to determine the status of inflammation within the body.
Fat cells can also release cytokines, especially pro-inflammatory ones, which contribute to metabolic problems. The size of fat cells is more important than the amount of fat in determining the impact of weight gain on gut health. Understanding the role of cytokines in inflammation and metabolic health is crucial in identifying the root causes of gut health issues and taking proactive steps toward improving overall well-being.
The link between the immune and metabolic systems is becoming increasingly clear. It is thought to be the root cause of many chronic and metabolic problems, such as prediabetes and insulin resistance. It’s important to note that when it comes to fat cells, it’s not just the amount of fat but also the size of fat cells that matters.
For example, if two college roommates gain 50 pounds, the manner in which they gained the weight is more important than the amount of weight they gained. The size of their fat cells plays a crucial role. One person may gain weight by creating more fat cells, while each individual fat cell remains relatively small. However, most people tend to gain weight because each fat cell grows larger, sometimes reaching up to 10-20 times its original size. This is in contrast to other cells in the body that are not capable of such significant growth. Understanding the relationship between fat cells and weight gain is essential in identifying the root causes of gut health issues and devising strategies to improve overall well-being.
But as the cell is undergoing what’s called hypertrophy, each individual fat cell grows significantly larger, unlike hyperplasia, where fat cells multiply but remain relatively small. However, as the fat cell reaches its maximum size limit, it can no longer continue to expand. At this point, inflammation occurs, and the fat cells begin to push each other away from blood vessels and capillaries. This is problematic because for cells to exchange nutrients, oxygen, and carbon dioxide effectively, they need to be located within a few micrometers of a blood vessel or capillary. Therefore, hypertrophy can disrupt this vital process by pushing fat cells further away from blood vessels.
The issue arises when fat cells become significantly larger, reaching 20 or 30 micrometers, which is ten times the size required to be located near the capillary. As a result, swollen fat cells start pushing each other away from the blood vessel as they continue to grow, resulting in severe consequences. The fat cells become hypoxic because they are pushed too far from the blood vessel, leading to a shortage of oxygen. Consequently, the fat cells begin to suffocate and experience an oxygen deficiency. Thus, hypertrophy can cause adverse health effects by disrupting the essential process of oxygen exchange in the body.
One of the many effects of cytokines is to stimulate the synthesis of new blood vessels, which can be beneficial in aiding the healing process. For instance, if you have an injury or infection, inducing new blood vessels in the affected area stimulates immune cells’ movement, facilitating faster recovery and healing.
However, when hypertrophied fat cells release pro-inflammatory cytokines, they hope to encourage new capillary growth. Although this is a positive outcome, it increases inflammation throughout the body as these molecules flow through the bloodstream. Unfortunately, the hypertrophic fat cell is unaware that its action inflames other parts of the body, causing head-to-toe inflammation. So the hypertrophic fat cell undergoes a disorderly process called necrosis to prevent suffocation, which can have dire consequences if it dies from hypoxia. However, in attempting to save itself, the fat cell releases cytokines that cause inflammation throughout the body, affecting normal homeostasis. It’s worth noting that immune response and metabolism work together to maintain overall well-being, which is essential for any organism to survive.
But over-nourished fat cells can trigger an over-reactive immune response leading to insulin resistance – one of the most prevalent metabolic consequences of inflammation. Therefore, when fat cells become too large, they produce an overabundance of immune molecules, cytokines, which triggers an immune response as if fighting an infection. However, all these efforts are simply to ensure its survival.
In discussing the impact of hypertrophy on gut health, it’s essential to focus on the underlying principles and practice them with utmost vigilance. Maintaining insulin sensitivity is crucial in this regard – it requires constant protection and defense as the food system is not always conducive to healthy eating. Even those who are not overweight can be pre-diabetic or diabetic due to systemic issues.
Fortunately, glucose monitors can help track glucose levels, but a drop in glucose does not necessarily equate to regained insulin sensitivity. Therefore, it’s vital to prioritize insulin sensitivity and manage chronic inflammation for optimal health.
However, stress can affect individuals differently. This is something that impacts chronic inflammation, does it not? And does that also impact the capacity for insulin sensitivity?
The discussion centers on identifying the root causes of insulin resistance, which is the most common health issue globally. Inflammation is one of the primary causes of insulin resistance, independent of any other variable.
Stress is another independent factor that can cause insulin resistance. Defining stress as a state of elevated stress hormones, specifically cortisol and adrenaline, also known as epinephrine, it’s worth noting the paradoxical relationship between stress and insulin resistance. On the one hand, short-term stress can improve insulin sensitivity by inducing glucose uptake in muscles. However, chronic stress can lead to an overproduction of stress hormones, causing inflammation that ultimately contributes to insulin resistance.
Cortisol and adrenaline are two essential stress hormones that play a crucial role in normal human function. However, when there is an overabundance of these hormones, it can lead to problems, much like inflammation. Despite their significance, cortisol, and adrenaline are vastly different. They come from different cells, have different creation processes, move through blood differently, and act on cells distinctively. However, they share a common goal – to increase glucose levels significantly. When cortisol and epinephrine become elevated, they push glucose up, which puts them at odds with insulin, whose primary job is to lower glucose.
Studies have shown that the treatment of cells with cortisol leads to insulin resistance, causing the hormone to work less efficiently. Similarly, in the presence of epinephrine, cells tend to be less responsive to insulin, indicating that these stress hormones hinder insulin’s ability to function correctly.
In stressful situations, cortisol and adrenaline increase blood glucose levels, whereas insulin wants to lower them. This creates a fight over the control of glucose levels, where stress hormones make the body insulin resistant in an attempt to push glucose up, which can lead to several health issues associated with insulin resistance.
Cortisol is relatively more commonly measured, while epinephrine can also be measured without much difficulty. However, the question remains – what triggers their elevation? While environmental triggers play a significant role in inflammation, in this case, there is still a stimulus, and the most common factor is sleep deprivation.
There are many stressors in our lives, ranging from emotional stress to physical stress caused by illness or over-training. Each stressor can elevate cortisol and epinephrine levels, leading to various health problems. However, sleep deprivation is the most common factor that stimulates the increase of these hormones. Numerous human studies have shown that even a single night of sleep deprivation can cause an increase in stress hormones, leading to demonstrable insulin resistance the next day.
It’s truly measurable that after one bad night of sleep, the body becomes insulin resistant, and this is due to the elevated levels of stress hormones. Fortunately, it’s an acute stress that can be resolved with one good night of sleep. Getting adequate sleep is critical to maintaining healthy cortisol and epinephrine levels, which can help regulate glucose levels and prevent various health problems associated with insulin resistance.
Research suggests that a lack of sleep during menopause is connected to weight gain. Poor sleep quality and sleep disturbances are common during menopause and can contribute to weight gain. Your hormones are changing, but now you’re not sleeping because of these changes, and then maybe the weight starts to march on a little bit. Do you think those things are connected?
Much of the weight gain that a woman will experience is because of the loss of estrogens. It is a significant contributing factor to the weight gain experienced during menopause. Estrogens belong to a small family of female sex hormones that play a crucial role in stimulating turnover within the body. They help in burning more fat per unit per minute than their male counterparts, and women burn more fat than men do at any given moment. However, during menopause, estrogen levels decrease, resulting in a reduction in fat turnover and an increase in fat accumulation. Progesterone also contributes to this effect by causing an increase in fat deposition.
But as women lose their sex hormones, the balance between fat breakdown and fat accumulation becomes unbalanced. Before menopause, estrogen and other sex hormones help in breaking down fats through lipolysis, but as these hormones decrease, the equation tips in favor of fat accumulation. The input of fat being broken down through lipolysis is now overwhelmed by the output of fat being accumulated.
Although poor sleep quality is not the primary cause of weight gain during menopause, it can contribute to it. For instance, going to bed in a state of hyperglycemia is one of the most common causes of poor sleep during menopause. Women may find themselves craving sweet or salty foods due to hormonal changes, leading to imbalanced glucose levels that make it difficult to sleep well at night. But if, if she has had such a change in her life that she indulges in more food in the evening, especially high-carb or sugary foods, her blood sugar levels are likely to be elevated. This is particularly concerning for women going through menopause, as their fat-burning rate decreases and their fat cells become larger, leading to insulin resistance and higher glucose levels. Going to bed with high glucose levels can increase body temperature significantly and activate the sympathetic immune system. Many people assume that they can’t sleep because of anxiety, but in reality, a high glucose level is often the culprit. As a result, they may feel anxious, hot, or experience a faster heart rate, making it difficult to fall asleep. It’s the fact that you went to bed hyperglycemic that can lead to the activation of the sympathetic nervous system, which is responsible for the “fight or flight” response. This is particularly problematic when trying to rest or digest, as it’s essential to have the parasympathetic nervous system dominate during bedtime.
Diabetics are well aware of this fact, and research has shown that inducing hyperglycemia can disrupt sleep and make it difficult to achieve restful sleep. When going through menopause, changes in hormones may make it easier for women to become hyperglycemic, leading to sleep disturbances. However, it’s worth noting that hyperglycemia can impact sleep quality regardless of menopause, as it activates the sympathetic nervous system, making it difficult to achieve restful sleep. Menopause represents a significant shift in sex hormones, many of which contribute to a woman’s metabolic function and fat-burning capacity. As these hormones decrease during menopause, it becomes easier for the body to store fat, contributing to weight gain.
This change can be particularly challenging for those who consider themselves high-performance individuals, as the body’s cortisol levels are highest in the morning. In terms of diet, is it better to consume more fats and proteins in the morning when insulin sensitivity is lower? Or does that really not play a factor?
Eating the same meal at different times of day can have a different impact on insulin response. For instance, consuming a bowl of cereal in the morning could result in a higher insulin response than eating the same bowl of cereal in the evening. This phenomenon can be especially pronounced during the morning period when cortisol levels are naturally higher, and the body wants glucose levels to be correspondingly higher. As a result, the body becomes insulin resistant during this time, making it less conducive to indulging in high-carb or sugary foods.
To address this issue, it’s essential to stack the majority of your calories in the middle of the day, where possible. This can mean having a big, filling lunch and a modest dinner with the family. Fasting can also be an effective tool for dialing in insulin sensitivity and addressing chronic inflammation.
There is a lot of information available suggesting that high-performing women perform better when they are fed. However, it’s still possible to consume nutrient-dense foods during the middle of the day rather than indulging in high-carb or sugary foods during breakfast or dinner. Fasting can be an effective tool for improving insulin sensitivity and addressing chronic inflammation, particularly for high-performing individuals.
Regarding glucose intake after a hard workout, some experts suggest that consuming carbohydrates directly after exercise can be beneficial as the body’s muscle tissues are more receptive to glucose at that time. This is because physical activity depletes muscle glycogen, which can be replenished through carbohydrate intake. Do you agree with that?
If we’re talking about highly active individuals such as Gabby Reece, consuming carbohydrates after a workout can be beneficial as muscles are more receptive to glucose at that time. However, a study conducted on generally sedentary women revealed that consuming carbs after exercise can undo the insulin sensitivity benefits gained during the workout. This effect can last up to 24 hours, making it difficult for overweight, pre-diabetic, or diabetic women to improve their insulin sensitivity.
The idea of consuming sugary sports drinks or fruit smoothies after exercising is widespread, but it can be pernicious for individuals whose primary goal is to improve insulin sensitivity. In these cases, it’s better to avoid consuming carbs after exercise, particularly if the individual is insulin resistant. While high-performing athletes may have more wiggle room in their diets, overweight or diabetic women should prioritize improving their insulin sensitivity rather than indulging in carb-heavy meals or drinks after a workout.
For metabolically sound individuals like myself, consuming protein or healthy fats after a workout is more beneficial than consuming carbs. It’s a good reminder to nutrient-dense foods to support overall health and fitness goals.
Regarding glucose monitoring, it can be helpful for individuals to understand how their body reacts to different foods. However, it’s essential to note that glucose monitoring is not the end-all-be-all for maintaining insulin sensitivity and overall metabolic health. Is that fair to say?
One of my main missions is to educate clinicians, particularly doctors, and nurses, about the difference between glucose and insulin. Although these are two distinct molecules, many healthcare professionals still equate them, leading to misconceptions about insulin resistance and metabolic health. For example, some physicians may argue that measuring glucose alone is sufficient to understand insulin resistance, even though high insulin levels can be present despite normal glucose levels.
In reality, insulin resistance is a state where the body requires more insulin to keep glucose levels normal. This is because insulin becomes less efficient at controlling glucose, meaning more insulin is required to achieve the same effect. It’s crucial for both clinicians and patients to appreciate the difference between glucose and insulin and to measure insulin directly to fully understand metabolic health.
I believe that continuous glucose monitoring (CGM) can be a valuable tool for understanding how the body responds to different foods. CGM can provide dynamic insights into glucose levels and highlight how different individuals may respond differently to the same food. However, it’s important to remember that while CGM can be helpful, it doesn’t replace the need to measure insulin levels to fully understand metabolic function.
Unfortunately, measuring insulin can be challenging, and many people may wonder how to access this information. While testing for C-reactive protein (CRP) is relatively easy, measuring insulin can be more challenging due to a lack of education and awareness around its importance. Insurance may not cover it, but individuals can get their blood drawn and insulin measured at independent labs like LabCorp for about $20. Despite these challenges, it’s crucial for individuals to understand the difference between glucose and insulin and to prioritize measuring insulin to fully understand metabolic health.
What about individuals who are not high-performing athletes and are looking to improve their metabolic health? Would testing insulin levels every three months be a useful starting point? Would it help individuals understand how their lifestyle changes, such as dietary modifications or increased exercise, are impacting their insulin sensitivity and overall metabolic health?
If someone is just starting out on their journey to improve their metabolic health, it’s essential to get their insulin levels measured as soon as possible. This can provide valuable information about how their body is responding to dietary and lifestyle interventions.
However, if measuring insulin is not possible, individuals can still gain insights into their metabolic health by looking at their most recent blood tests. In particular, two lipid measurements, triglycerides and HDL cholesterol, can be useful in indicating insulin resistance. To use these measurements as a surrogate for insulin resistance, divide the triglyceride number in the numerator by the HDL cholesterol in the denominator. While these measurements may have limited value when used alone, together, they can provide valuable insights into an individual’s metabolic health.
It’s worth noting that there may be ethnic differences in how these measurements are interpreted. There are ethnic differences in metabolic state, which can affect how we interpret lipid measurements. For Caucasians and Asians, a triglyceride to HDL ratio of less than 1.5 is a good sign of insulin sensitivity. Hispanic individuals may have a slightly higher ratio, with less than around two being a good target. For black individuals, the ideal ratio is closer to one and lower.
It’s important to remember that these are general guidelines and that each individual’s metabolic health is unique. However, as a rule of thumb, a triglyceride to HDL ratio of less than around 1.5 is a good target for most individuals. If you don’t have your blood test results, you can always call your doctor’s office and request this information, as they will have measured triglyceride and HDL numbers during your last visit.
When it comes to oils, would it be accurate to say that we should stick to using olive oil, avocado oil, coconut oil, and macadamia nut oil? These oils are readily available in grocery stores and are generally considered healthier options. Are there any hidden names for oils that could be present in salad dressings or other foods that we should watch out for? Or should we simply avoid oils such as sunflower, safflower, canola, and vegetable oils, which are often considered less healthy?
And when it comes to fruit juice, it seems to be one of your favorite things. However, some people may choose to drink fruit juice as an alternative to soda or diet soda. But is this a good idea? Does it matter if the juice has pulp or not? Or should we avoid fruit juice altogether?
Before we dive into fruit juice, I would like to add some thoughts on vegetable oils. When shopping at the grocery store, it’s important to read labels carefully. The term “vegetable oil” can be misleading since these oils are actually refined seed oils. Soybean oil is the most commonly used seed oil and is often hidden under the term “vegetable oil.” It’s crucial to look at the ingredients list and avoid products that use refined seed oils as a primary ingredient.
When it comes to fats, animal fats and fruit fats are generally considered healthier options. Humans have been consuming animal fats for centuries, and there are even theories of evolution that claim our ability to eat fat played a role in the development of our species. Fruit fats, such as those found in coconuts, avocados, and olives, are also beneficial and can be enjoyed liberally.
Now, let’s talk about fruit juice. The marketing push for fruit juice is a prime example of modern advertising tactics. Many parents believe that giving their children fruit juice is a healthier alternative to soda or other sugary drinks, but this is far from the truth. Fruit juice typically contains pure fructose, which is detrimental to health and can even be worse than consuming soda.
In fact, many fruit juices contain more sugar than popular soft drinks when measured by the amount of simple carbohydrates entering the bloodstream. Despite the perceived health benefits, fruit juice should not be considered a healthy drink option.
In my family, we have deliberately created a culture where fruit juice is not a regular part of our diet. We don’t buy it, and if the kids do consume it, it’s seen as an infrequent indulgence. Instead, we primarily stick to water or milk as our beverage options. This culture has helped us avoid the negative effects of consuming large amounts of fruit juice.
However, this doesn’t mean that we view fruit in a negative light. On the contrary, we see whole fruits as a beneficial part of a healthy diet, and we actively encourage their consumption. It’s important to eat fruits instead of drinking them because consuming fruit juice can cause problems such as leaky gut syndrome.
Fructose, which is present in many fruit juices, increases the gap between cell junctions in the gut, which can lead to leaky gut syndrome. Moreover, fructose can also increase the invasion of a bacterial remnant called LPS from the gut into the bloodstream, compromising the integrity of the gut barrier.
If you’re inclined to drink fruit juice, it’s important to consider the consequences. You should think about how much sugar will enter your bloodstream and what your liver has to do to metabolize fructose. Instead, it’s better to enjoy whole fruits, which provide essential nutrients and fiber without the negative effects of concentrated fructose.
The liver processes fructose in a similar way to alcohol, leading to the development of fatty liver disease. In the past, fatty liver disease was typically associated with excessive alcohol consumption, but in recent years there has been a rise in non-alcoholic fatty liver disease caused by consuming too much fructose from sources such as fruit juice.
Like alcohol, fructose is primarily metabolized by the liver, and excessive consumption can cause the liver to turn it into fat. It’s important to recognize that alcohol and fructose are not only detrimental to insulin resistance but also negatively impact gut health.
It’s not a popular topic, but it’s important to revisit the harmful effects of alcohol consumption on insulin resistance and gut health. Although vaping and smoking are commonly known to be detrimental to our health, we often overlook the negative effects of other everyday substances such as Advil and Tylenol. These medications, which are regularly taken by many people, can be incredibly tough on the microbiome.
NSAIDs, or non-steroidal anti-inflammatory drugs such as Advil, are commonly used to inhibit inflammation by inhibiting the COX pathway. However, despite being effective, these medications are not specific and, therefore, can have negative effects on various parts of the body.
The COX pathway is involved in multiple bodily functions, including the production of mucus to protect the intestines and proper kidney function. Since NSAIDs are non-specific, they inhibit all aspects of the COX pathway, which can cause damage to the body if used carelessly.
It’s essential to use NSAIDs judiciously, and it’s recommended that those with gut problems or who notice blood in their stool avoid taking such medications. It’s important to be cautious and take steps to avoid unnecessary harm when using NSAIDs.
Do you have any preferred supplements for maintaining insulin sensitivity and overall health? I know prebiotics and probiotics can support gut health, but are there specific supplements that can aid in both areas? For example, are anti-inflammatory supplements like curcumin beneficial? I’m curious to hear your recommendations for those looking to improve their health and maintain insulin sensitivity.
To answer your question, there are several supplements that can support insulin sensitivity and overall health. However, it’s important to note that while these supplements can be beneficial, macronutrient management is crucial for optimal health. This means controlling carbohydrates, prioritizing protein from good animal sources, and not fearing fat.
One supplement that has been shown to improve insulin sensitivity and mitigate glucose spikes is apple cider vinegar. It’s inexpensive and can be easily added to water or other beverages.
Cinnamon is another supplement that has shown promising results in improving insulin sensitivity in diabetics. Additionally, inositol, which can be purchased over-the-counter, has been shown to improve insulin resistance, particularly in women with polycystic ovary syndrome (PCOS).
It’s essential to note that these supplements should be used in conjunction with a healthy diet and lifestyle changes. You can check out a meal replacement shake that was designed based on these principles by visiting gethlt.com.
There are several other molecules that can be incorporated into your diet as supplements to improve insulin sensitivity. Mate is one such supplement that can increase fat burning and improve appetite control. Unlike other caffeine sources, mate contains chlorogenic acids and theobromine, which help with fat burning and reduce hunger.
It’s important to be cautious when consuming straight caffeine sources since it can activate your body by increasing adrenaline levels and becoming a stressor on the body. Although coffee is generally considered fine, consuming too much caffeine can increase stress hormones, and it’s essential to limit caffeine intake.
Do you recommend fish oils or any other supplements for reducing inflammation? I’ve personally noticed that fish oils have been effective in reducing inflammation, but I’m curious to know your thoughts on this.
Fish oils have several benefits, particularly in reducing inflammation by selectively blocking the Cox pathway in a process that leaves other processes of cyclooxygenase intact. However, it’s crucial to be cautious when purchasing fish oil supplements and ensure they are pure and don’t contain soybean oil carriers. Fish oil supplements that are pure or combined with other oils like olive or coconut oil are highly recommended.
What would be your final message to encourage people to prioritize their insulin sensitivity and make healthier choices? I know you’re passionate about helping develop a relationship with protecting and defending their insulin sensitivity, which can significantly impact their overall health. Is there any last invitation you’d like to make to those looking to improve their health and well-being?
Promoting education and increasing familiarity with insulin resistance is a crucial professional outcome since it affects a large percentage of adults in the US and globally, increasing the risk of various chronic diseases. Insulin resistance is a concerning global issue, with statistics showing that almost every country in Asia and the Middle East has worse numbers than the US. Mexico also presents higher rates of insulin resistance than the US. The prevalence of insulin resistance is alarming, given the increased risk of chronic diseases such as Alzheimer’s, heart disease, and infertility. It directly contributes to the development of these health problems, making it critical for us to be aware of what it is and where we stand in relation to it. Measuring insulin is the best way to do that, but the triglycerides to HDL ratio is a very, very good surrogate.
A parting thought with that would be managing macros and avoiding hyperglycemia before bed is essential to maintaining good health, especially since evening snacking is often challenging to resist. Winning the evening meal and snacks can lead to better sleep, improved mood, and reinforce good habits. One approach to managing this is by drinking sparkling water with apple cider vinegar instead of indulging in tempting foods. Another useful tactic is not keeping trigger foods in the house to minimize temptation.
While moderation is a common mantra for many, it’s not always practical. Controlling your environment and managing triggers can be more effective in promoting healthy eating habits than trying to moderate consumption.
Well, Ben, I always really love talking to you and your passion. Can you remind and direct people to all the places where they can find you or even products that you are involved with that are important to you?
I share that sentiment. I previously mentioned a meal replacement shake that my brothers and I created out of frustration when I realized that merely providing ideas and principles wasn’t enough to initiate change. Putting ideas into practice can be challenging, which is why we developed the shake, available at gethealthhlt.com. Additionally, I regularly contribute educational content to the site’s blog.
My book, “Why We Get Sick,” also provides an outline of the principles we discussed and focuses on insulin resistance. I’m active on social media, particularly Instagram and Twitter, where I share one-minute lessons on human metabolism. For example, I recently shared a post about how even a few days of inactivity can take weeks to reverse with regard to insulin resistance, highlighting the importance of movement.
Those looking for more information can find me on social media at Ben Bikman, Ph.D., where I share relevant content and encourage adults to avoid consuming milk.
I want to encourage people to reconsider consuming milk, especially as adults. While dairy may still be consumed in its whole and raw form, calcium can be obtained from other sources. I invite those interested in learning more about this to follow you and gain a better understanding of why milk may not be necessary.
Milk is primarily a food for growth, making it less relevant for adults. However, fermented milk products like kefir or plain yogurt can provide benefits for gut health.
Thank you, Ben Bikman, for sharing your insights. I look forward to our next conversation and hope that we can continue to bridge the gap between information and implementation.
I’m glad to hear it. Thanks so much.
About Benjamin Bikman, Ph.D.
A fast-paced lifestyle and even faster food make it challenging to eat a healthy diet. Combined with decades of misinformation and rapidly changing opinions, it’s become nearly impossible to know what to eat (or not eat) for proper health. As a researcher and popular speaker on the topics of human metabolism and nutrition, Dr. Benjamin Bikman has seen the terrible impact a poor diet has on the health of people worldwide. His advice to the many requests he’s received has been consistent: science shows that human health and metabolism thrive when we prioritize protein and healthy dietary fats and limit our consumption of carbohydrates. To help people achieve their best health, Dr. Bikman and the co-founding team of nutrition and industry experts created HLTH Code Complete Meal. Carefully formulated to optimize health, this delicious shake is also more convenient and affordable than virtually any meal that you could make or purchase.