Fat Cell Scientist Reveals How to Lose Fat & Keep it Off Without Ever Restricting Diet | Dr. Bikman

this is an absolutely Global problem and a lot of it is because about 71% of all calories consumed globally are carbohydrates often refined and we've been told to eat five or six times a day and so you never give your body a chance to lower the insulin Dr Ben bman you are the insulin Guru you know so much about that that is your world of expertise can you tell me how does an insulin inhibit fat loss right yeah the primary mechanism is a direct inhibition of life lipolysis so lipolysis is the term we use to

refer to the breakdown of fat from the fat cell now people will often say fat burning but that's not fat burning fat burning is the end fate that's what the fat is going to go and do after it comes out of the fat cell so before we ever have fat burning or the oxidation we have the breakdown or the lipolysis insulin has this choke hold on lipolysis and if insulin levels start to climb it will inhibit lipolysis no matter what other stimulus is present so you can try to be stimulating lipolysis with catacol amines like

adrenaline for example and if insulin is elevated over even slightly over fasted levels it immediately starts to depress that signal to the point that once you've gone a couple multiples over fasted levels which is very easy to do with insulin you've shut off lipolysis entirely so largely the primary effect of insulin controlling weight loss is its effect on lipolysis and again to state that clearly as insulin goes up lipolysis drops um you shut it off but as much as people don't acknowledge this insulin absolutely influences the front end as well which is the movement of

fat but it depends on the size of the fat cell so while there's a lot of controversy and debate on insulin's ability or insulin's acting as a stimulus to pull the fat in to the fat cell um it depends on the size of the fat cell smaller fat cells insulin does stimulate fatty acid uptake into the fat fat cells so as much as it controls the back end of the fat cell by regulating lipolysis it does in fact also influence the front end particularly in smaller fat cells and as the fat cell gets larger that

effect becomes you know somewhat diminished and now insulin isn't controlling fat uptake but it's still controlling the the exit of it so the the the leaving of the fat or the lipolysis so in so with these two ideas combined if someone can appreciate pretty quickly how insulin really does control the growth and the shrinking of the fat cell so is a smaller fat cell essentially just a newer fat cell is there hyperplasia with fat cells like can you develop is a small fat cell necessarily a new fat cell or what defines a small or a

large fat cell yeah yeah so for me when I'm saying Define I actually mean like on the order of microns like how many micrometers is its diameter it doesn't necessarily mean it's a new one although it certainly could but some people genetically have the ability to make new fat cells and in fact some one of the Sexes does in particular areas but referencing some people first a paper published decades ago found that in the average obese population about 80 some perent of this mixed ethnicity population has gotten obese through hypertrophy so the number of fat

cells hasn't changed but the size of the fat cells have so that's the hypertrophy of the fat cell which is particularly pathogenic when a fat cell gets big or fat then it becomes very insulin resistant and very pro-inflammatory however a small fat cell and this is again a subset let's say about 15% of people who can become obese or do become obese they have this genetic ability to continue to make new fat cells and so to kind of come back to your question those would be younger fat cells they haven't had time to get big

but they also don't have the metabolic pressure to get big because in that individual who genetically can continue to make fat cells every time the fat cell starts to get a little bit of growth pressure on it it recruits a new fat cell and so no fat cell ever gets too big and those are the people who paradoxically can both become fantastically obese and yet still and not become type 2 diabetic and Insulin resistant and these are the people that they make TV shows about the fact is most people around the entire world could never

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a free $60 gift you and I very very likely statistically we could do everything we could TR to try to get to 600 lb and as the fat cells get bigger and bigger and bigger they become more and more insulin resistant and thus become less sensitive to insulin signal attempting to tell them to continue to get big and that's because the fat cell can reach about 20 times its normal dimensions which is unlike any cell there's no cell in the body that can grow 20 times its kind of native size but as the fat cell

begins to approach this Ma maximum Dimension it starts to become resistant to insulin all in an effort to prevent itself from literally bursting like an overfilled water balloon and so these people who genetically continue to make fat cells they are getting fatter and fatter and fatter but they still maintain their insulin sensitivity which means they can continue to get fat as it's continu continuing to get stored in small fat cells um in fact we see this even in clinical practice one of the most effective anti-diabetic drugs so a drug that would be prescribed to someone

with type two diabetes who almost always is going to be a little overweight um and there's very much an ethnic component to that but even still they may be prescribed a class of drug called a thadine diione or a tzd um these drugs will improve their insulin sensitivity very very well but paradoxically because it makes them fatter it actually stimulates their body's ability to make new fat cells and so on one hand they have this situation where they're getting fatter and fatter with every dose they're taking every month and yet at the same time their

diabetes is getting better it's because they're allowing the big hypertrophic fat cells to start sharing some of that burden with the new fat cells and so I'm such an advocate of the idea of people acknowledging this by stating it's not the mass of fat we have that matters most when it comes to insulin resistance it's how you're storing your fat are you storing your fat in hypertrophic fewer but fatter fat cells or more abundant or hyperplastic more abundant but smaller fat cells and this is very much at the heart of why across the spectrum of

ethnicities why on one hand you have say a Chinese ethnicity man who has among the lowest tolerances to store fat the Chinese typically typically on average that body type has a very limited number of fat cells and so if that person is eating a diet where insulin is stimulated and to to stimulate the growth of the fat and there's sufficient calories to fuel that growth because you need both of them you can't have fat growth without both of those then he has a very he has a very low threshold of fat gain a little bit

of fat on his body he's just mildly chubby and he already is pre-diabetic he has hypertension he has fatty liver disease on the far other end of the spectrum you have the typical Caucasian kind of northern European ethnicity which is the most abundant ethnicity in the US me and you included that is an ethnicity that's a body type that has a slightly higher potential to make new fat cells and so that's a body type where he got just as fat as the Chinese his Chinese buddy and yet he's still fine he just doesn't look as

good in his Speedo as he used to but he doesn't have any sign of fatty liver disease or any sign of pre-diabetes but he's just as fat as his old Chinese college roommate was that's the personal fat threshold idea which but again it's not because a person reaches a particular mass of fat it's that it's you would basically ask the question how full are your fat cells and the moment those fat cells are full now those fat cells become insulin resistant and they become pro-inflammatory to try to correct blood flow which is a different issue

but the combination of those variables basically leads to that being the first Domino to fall along this Cascade and then the liver becomes insulin resistant the muscle Etc is that why like for example like Glu feral f is considered more protective I I don't want to say protective but it's oh no it absolutely is that's I think it's an appropriate word to use in fact it allows me to come back to what i' alluded to where in women you have higher levels of estrogens and estrogens Signal a greater subcutaneous hyperplasia so particularly on the butt

and hips or you know with with these higher levels of estradiol in particular the sex hormones tell the body where to store fat and even how it's still insulin that tells the body how much fat to store but again sufficient calories to fuel that storage but the sex hormones tell the body where to store fat and so as estradiol levels are higher it signals more hyperplasia of that fat beneath the skin which is absolutely a healthy protective place to store fat and it is more hyperplastic so much to the woman's Chagrin she has the ability

to get fatter at her butt and hips and yet it keeps her healthier but that's what transitions with menopause as her estradi levels the estrogens start to come down I like to joke when I teach Endocrinology to my students that at that point the woman becomes a metabolic mortal that prior to that she is like it's she's bulletproof metabolically she is fatter than her male counterpart at every point in her life and yet she's healthier in every cardi metabolic marker than her male counterpart is after menopause now she's Immortal now if she has as much

fat as her male counterpart does it's going to start to cause cardi metabolic problems because she doesn't store it as much in that subcutaneous space at the butt and hips it begins to be more stored centrally just like it is on her male counterpart so how come uh today we're seeing more like apples shaped women than we were even 20 years ago like what's different in younger women now is it just like an accelerated aging effect that's kind of happening with insulin resistance what's happening there in your opinion yeah yeah yeah so I do have

to speculate um I would suspect it's in part due to a greater consumption of fructose there are some nutrients that are metabolized let's say poorly if you will that lead to altered fat storage so there was a study done in humans males and females that gave them isocaloric drinks of high glucose or high fructose both gained some degree of fat during the course of the study but where they gained the fat was totally different the high glucose drinkers gained relatively more subcutaneous fat so the pinchable jiggable fat which generally predominates on the female body where

as the fructose drinking population had more visceral atap POS so at a minimum I suspect part of it could be uh the effect of how the liver in particular is metabolizing fructose and then dumping that fructose turned into fat into that kind of portal circulation which is going to feed through visceral adipocytes first so even still that's speculative but we know for a fact in humans all calories equal well they're not but fructose consumption will Rel will selectively promote greater visceral atap POS storage and of course fructose that's um not only you know like from

fruit juice but even sugar of course any any Rich any enriched source of fructose would have the potential to contribute to that is there sort of an upper threshold of fructose or is it really genetically dependent like I mean does can some people since fructose isn't really involved in glycogen resynthesis of the muscle or anything like that like you can't necessarily exercise your way out of that in a lot of ways yet you know you've got people that are athletes that consume a fair bit of fructose yet they still have good cardiometabolic parameters and good

biomarkers and they don't have so is it is it somewhat bio-individual is there a rough number where hey like because I know like if you're eating just fruit it's kind of hard to reach a ridiculous amount of fruit yeah I agree yeah yeah that's a great question and I I don't really have my finger on the pulse of that research enough but I'll speculate because I'm a professor and I'm used to speculating um in this case I would say that it's it's interesting to me to note people who have become Advocates of consuming high fructose

sources they're always lean and healthy I I would be interested to see someone who Advocates a lot of fructose consumption who is overweight and diabetic and so I don't know that there is an inherent genetic ability to tolerate fructose a little better although there certainly could be we know that there are certain groups of people who metabolize alcohol better and why would I even invoke alcohol the one similarity between between fructose and alcohol is that they both primarily rely on the liver for their metabolism so just as we know there are people who are able

to more rapidly metabolize alcohol it wouldn't surprise me if there are people who can more rapidly um metabolize and tolerate fructose um but even still you uh I do think it's it's important to control the the the dose that whole fruit you know for me um one of the first Cardinal rules of eating a diet to improve insulin sensitivity is control carbs and when I invoke that Mantra it really is to help people understand the value of whole fruits and vegetables um not Juiced fruits and vegetables and I think that's to me that's the divider

if if this is a population or a person who's eating whole fruit then I generally would give that a thumbs up depending on where they're coming from um if this is an overweight severely type 2 diabetic there may be some fruits that would be a little more problematic than others but any would be better than drinking the fruit yeah I I want to bounce back uh just before I forget two questions on the the insulin piece with uh sort of suppressing lipolysis is it a dimmer switch more so than a light switch and if it

is a dimmer switch does it as you start to crank it up or down does it gain more momentum as you're cranking it up to 11 like so if you have an insulin release and its ability to allow fat into to a young or new fat or a small fat cell when you have a little bit of insulin is there a little bit of momentum and does it increase does it kind of gain momentum with more yeah that's a good question so to answer the first part of the question very definitively it is absolutely a

dimmer there's it is completely a function of degrees and you can titrate this beautifully in in like living breathing humans you can monitor this over time where the product of lipolysis so when we're talking about breaking down the fat from the fat cell the stored form of the fat in the fat cell is triglycerides the product of the lipolysis is free fatty acids sometimes referred to as non-esterified fatty acids but free fatty acids and you can get this measured on a blood test albeit it's not uncommonly however my point about the kind of titrating or

the changing the dose if insulin skyrockets give that body a few minutes and if you're measuring free fatty acids the free fatty acids plummet and go to almost undetected cable very very quickly in contrast the more you give the body time to allow the insulin to come down and the fastest way to do that of course is fasting so if a fast starts from this point of really high insulin and essentially no lipolysis so free fatty acids basically Baseline then the more time you're giving them you can see this beautiful crossover in Dr George Cahill

a legend in the field of fasting or what he called starvation research we would call it fasting he really has published some papers that show these kinds of figures where when insulin would start to get to around 10 Micro units per M you could immediately start to see this this reduction so the insulin's coming up you'd start to see this reduction in the free fatty acids but then back to the Paradigm I'd outlined a moment ago if you take a Fed individual and start fasting them as insulin starts coming down you can see this steady

steady decline hour after hour of the free fatty acids coming up but that's right there if you'll allow me Thomas there's an interesting test that someone can do at home so I've presented the Viewpoint that the first cell or tissue that becomes insulin resistant is the fat cell and I defend that vigorously um because of this you can actually combine the two variables that I just mentioned into what I consider to be one of the best tests for detecting insulin resistance at the earliest possible stage in other words the moment it's starting at the fat

cells so as we go back to that hypertrophic fat cell as it starts to become insulin resistant insulin levels are high there's no such thing as insulin resistance without elevated insulin you cannot pull those two apart if it's insulin resistance insulin levels are high well with what I just mentioned if insulin levels are high we would expect free fatty acids to be low unless the fat cells have become hypertrophic and now they're insulin resistant now we have this metabolic odity where both insulin is elevated and free fatty acids are elevated this is a particularly pathogenic

State because while the fat cells are full and they can't handle anymore if insulin is up you can't burn that fat normally you only have high-f free fatty acids when insulin is low and because insulin is is low you can now burn it beta oxidation or the burning of the fat is just going like Gang Busters so much so that you're burning more than you need and you start making ketones which is a different topic but if you have both High insulin and High free fatty acids now you start storing those free fatty acids in

tissues that are ill suited for long F long-term fat storage this is this idea of ectopic fat deposition where now you're storing fat in your muscles in your pancreas in your liver so you have all of these fatty deposits and tissues that are not designed to store fat but it's because when you have high insulin and High free fatty acids you can't burn that fat you have to store it just you can't store it in the fat tissue anymore does the same thing apply with high amounts of co-ingestion of fats and carbs together at the

same time or do we have a way to partition that's a great question um if you have a lot of fat and carb together um that is a particularly fattening mix because you have both of the two components um so first of all you would burn glucose as the as the primary fuel in that state because insulin dictates fuel use um in fact I just on my little YouTube channel I just finished a lecture about the Randall cycle or the glucose fatty acid cycle and described how it really is at its part um a manifestation

of insulin um if insulin is low the body is sugar burning or glucose burning if in sorry if insulin's high if insulin's high sugar burning if insulin's low fat burning if you have if you've spiked insulin because of the glucose consumption and you you've won with the high insulin you have signaled the fat cell that it's time to grow but that alone is insufficient if I took you and injected a dose of insulin in you that would yes stimulate fat cell growth by pulling glucose and inhibiting free fatty acid release and you would faint because

there wouldn't be in there would be insufficient other nutrients in your blood so I wouldn't have stimulated your fat cells to grow at all because there's no fuel for that growth so as much I'm touching on a deeper debate now oh this is great which is why do we get fat and how do we lose it um but people as much as we we want to go into separate camps um and people say no it's purely calories we know that's not true that is so easy to disprove that it's almost laughable that that idea still

has any Credence because if we took a type 1 diabetic our good friend and Dr Andrew kutnik if we took Andrew and had him eat 10,000 calories a day but deprived him of his insulin injection he would look like a prisoner of war he would be so skinny even though he's clearly eating an abundance of calories if you don't have insulin in an organism from fruit FES to humans it is utterly and completely impossible to store fat so thus in insulin is an absolutely essential component to Fat storage but so are calories because insulin alone

isn't sufficient we need insulin to tell the fat cell what to do with the energy that it has available to it um but we need the energy to actually fuel that growth so insulin's going to tell the fat cells it's time to grow but now the fat cell says to insulin okay but with what now the calories come in so neither is sufficient on its own and so this whole vicious debate and it does get unfortunately vicious I try to actually take a diplomatic route but people end up putting me into this endocrine theory of

obesity camp or the insulin Theory because of what I just said and I'll say it again with an exclamation mark you cannot store fat on a body unless insulin is elevated it is totally impossible and again if insulin is absent or really low at low fasted levels you can't keep that fat on the body but again as much as insulin is a necessary component to Signal the growth of the fat cell you have to have sufficient energy to fuel that growth and that's where the calories of course come in although I kind of changed the

topic here no no this is wild and I want to come back to another question that I had that was surrounding uh okay let's say you have a a healthy person like metabolically healthy very insulin sensitive because that person is insulin sensitive even in a healthy cohort is their potential to gain fat easier so have they kind of shot them I don't want shooting themselves in the foot in some ways like made themselves Ultra insulin sensitive that now they are more sensitive to the deposition the growth of a fat cell yeah yeah so the more

insulin sensitive a person is the more potential they have to get fat but that that's not overly surprising because it just reflects this sort of negative feedback or kind of diminishing returns idea of fat gain that the more fat a person's gaining the more the body starts to resist that fat gain assuming that they're getting fat through the hypertrophy of the fat cells which which again is how most people get fat however the the that's the kind of bad news like if someone hearing us talking says oh great I'm insulin sensitive I'm going to gain

more fat more easily than my insulin resistant overweight buddy that's true because your buddy's already kind of peaked on the curve you know it's this accelerating curve and the person who's very insulin sensitive is at the bottom and so they can accelerate weight gain more rapidly the person who's already been gaining it they're already starting to plateau and so it's that diminishing effect of of fat storage however by being insulin sensitive they have a little bit of a protection because a little insulin does the job quickly and by the job I mean it's able to

correct blood glucose very quickly so as much as the insulin in per unit time has a greater ability to promote fat storage on the insulin sensitive person it's also up for a shorter period of time so if we took an insulin sensitive individual and an insulin resistant individual and they both consumed 50 gram of glucose the insulin sensitive guy his insulin levels have gone up maybe from around three micro units per Mill up to 30 or so and they're back down to totally normal within 45 minutes the insulin resist maybe maybe an hour 90 minutes

actually I should have gone a little longer about 90 minutes the insulin resistant guy same 50 grams now his insulin has been elevated for 4 hours and so on the first guy the insulin is a little more effective at promoting fat gain but it also was elevated for a substantially shorter period of time on the insulin resistant guy he's become a little resistant to the fat promoting effects of the insulin but it was also elevated for twice or three times as long and so it's a bit of a trade-off yeah it also makes sense as

to why like when you see um you know maybe a bodybuilder that gets insanely lean and you know for a show how quickly they go back from 4% up to 10% I mean it's very fast right whereas then it takes them months to go from maybe 10% to 15% you know it's I'm no that's that's right yeah I mean it absolutely really could be just if someone can imagine this curve which is going up really quickly and then it's starting to Plateau a little bit makes a ton of sense um when you look at carbohydrate

consumption and Insulin I've often wondered this question you're the perfect person to ask for it if you have lower glycemic carbohydrates and you have like gentle bell curve and then another consumption of low gly are you basically getting gentle bell curve on top of gentle bell curve onp top of gentle bell curve where as far as where you're ultimately Landing with insulin levels ends up being higher than if you were to just say have a bolus of somewhat high glycemic have a spike and come back down yeah like is it better to have insulin do

its job come back down and what I'm getting at is like allocation of carbohydrate consumption to maybe one Bolis per day and then come back lower or frequent smaller bises yeah yeah I wish I could cite a definitive study on this question so I have to speculate because I don't know that this has been done I would I am speculating I would a lot of the reason I put the I put carbohydrates in the crosshairs is because of what it does to insulin I I I want to make sure people understand that that I'm not

declaring war on carbohydrates because of the entire macronutrient class it really is the subsequent question which is what does it do to insulin so I appreciate the question because that's how you're framing it um remember with that in mind insulin's most famous action but far from its only action and I would even say not even it's most important but insulin's most famous action is to control blood sugar now I emphasize that because a lot of what is wrong in modern clinical care when it comes to insulin resistance and type 2 diabetes therapies is that they

think it's a glucose problem it's not these are insulin problems and if we look at them as if we look at them as insulin problems we address them much more effectively than if we look at them as a glucose problem but that's a little bit of a tangent but even still if we look at if we're asking the question what happens to insulin my question is always or or my my solution is always the longer you spend in a state of low insulin the better for being lean for cognitive health for cardiometabolic health all of

these reasons longevity the more insulin is at a kind of basal State overall the better you're going to be so I would actually say it would be bet one bll is up and down would be better especially because you can manage that one dose you know if you have if you know okay lunch is my main carb meal then you're able to couple that with I'm going to eat this bigger carb meal and I'm going to go on a 15-minute walk or it's just so much easier to manage that one moment rather than okay I'm

eating some carbs now I'm getting an insulin Spike and before it ever comes down I'm eating some more now I'm eating some more but I'm spreading it out more I think that's actually part of what's gotten to the modern epidemic that we're in with regards to metabolic Health insulin resistance is the most common health disorder worldwide which is why I beat that drum so loudly I the reason I did my post-doctoral fellowship in far-flung but lovely Singapore is because even in the midst of the beautiful islands of Southeast Asia the actual rate of type 2

diabetes is higher than we have it in the US in beautiful little Singapore and as you look around the world the Middle East North Asia South Asia southeast Asia Pacific Islands Even in our own neck of the woods Mexico has higher rates of diabetes than we do in the US this is an absolutely Global problem and a lot of it is because about 71% of all calories consumed globally are carbohydrates often refined and we've been told to eat five or six times a day and so you never give your body a chance to lower the

insulin because it's going to take a couple hours to do so and the longer a person is living with elevated insulin the more that chronically elevated insulin is causing insulin resistance elevated insulin is the primary driver of insulin resistance but then of course to the astute listener they might recall that just moments ago I said that hyperinsulinemia or elevated insulin is also a chronic feature uh an Inseparable feature of insulin resistance so you end up creating this vicious cycle where the more frequently you're spiking your insulin the more you're promoting insulin resistance then the more

insulin you need to control your blood sugar now because insulin isn't working as well which is further driving insulin resistance so the solution is to just get off this hypoglycemic roller coaster but anyway to bring It full circle back to your question with some speculation um noted I would suspect it's better to just have one bolus get that get that those starches and sugars in you've done it you're done now as rapidly as you can you want to bring that insulin back down now I don't even want to sound like insulin is just this uniform

villain we must have it the absence of insulin is a death sentence it's just that we live now in a day and time where we're spiking it all the time and it's just too much of a good thing too much insulin is the primary cause of insulin resistance yeah and I I think it's safe to assume like I mean no one's getting insulin resistance from the insulin Spike you get from protein oh yeah no that's right but in fact even then when I first became familiar with the like probably right around the time you and

I first met when I was first getting familiar with this low carb Community because remember I'm not I'm I'm a professor and a scientist I was totally unaware of this whole community of at the time just kind of low carb um if not Advocates then enthusiasts or or Travelers you know along the path of learning more about it then I was invited to speak at this first lay meeting and then it was the year or so later when I think you and I met at the metabolic Health Summit but one of those early talks I

gave was to dispel the idea of protein being a problem on a ketogenic diet where it was very odd to me um to see as an outsider as just a pure scientist people saying well don't eat too much protein because you don't want to get kicked out of ketosis and I just thought what an odd concern um especially in the context of a low carb diet because a lot of the evidence has shown that the insulinogenic response to a dietary protein load really depends on the underlying glucose level so to put that very clearly if

someone eats a protein load in the absence of glucose and they have normal glucose levels there is little to no insulin release this is very nuttle nut through a series of experiments really um nailed this uh and displayed it really well so again if a person eats a pure load of protein in the absence of any glucose and they have normal glucose levels at the time there's very little insulin Spike if a person takes that protein with glucose or has underlying hypoglycemia then you will get an insulin Spike and you will examplified beyond the carbohydrate

alone and that's really in part because of what the body has to do to keep glucogenesis happening if you're fasted or on a ketogenic diet if you spike insulin you stop gluconeogenesis and you would become hypoglycemic very quickly and you would likely go unconscious and so that makes sense that the body won't elicit an insulin Spike because if it did again it would shut off the liver's ability to make new glucose and so you can't sustain it but that does present a bit of a note of caution as much as you and I both are

big Advocates of protein and I am um and I made this whole talk on YouTube the um insulin to glucagon ratio when it comes to protein consumption um where I presented some of these ideas if a person has Type 2 diabetes they actually may find that controlling protein a little bit is helpful um in that population but you know that there's a lot of nuance there but on on average I'm an enormous advocate of protein even if there is an insulin bump it is a macronutrient that I'm tremendously in favor of now having said that

lest someone misinterpret it I'm an advocate of natural protein um especially which is the protein that come it's always going to be animal natural protein is animal Source protein and natural protein always has fat there's almost no instance in nature of a protein not coming with fat and I believe that's how we should consume it we do have human evidence to show that if a human population of humans works out they eat um protein they get a certain greater degree of muscle protein synthesis if they eat protein and fat they get even more muscle protein

synthesis part of this could be because of what um the the the assistance of bile as much as we think of fat digestion and we think of bile coming from the liver than the bile duct or the the gallbladder as being only relevant to Fat consumption and it is very important for fat consumption but we also use bile to accelerate the proteolytic enzymes of digestion in the in the gut so we have these distinct class of enzymes the proteolytic enzymes that help with protein digestion we have bile and then some fat specific enzymes to help

with fat digestion but bile also facilitates the actions of the proteolytic enzymes and I don't think it's an accident again that in nature all fats come with protein in our fear of fat we have separated the two and I think that's why a lot of people think fine they just take pure protein it really upsets their intestines they probably because they're losing out on the facilitative actions of the bile which helps protein digestion but you're only going to be releasing the bile if you eat some fat so as much as I am an advocate of

protein and I am happy to admit it I also don't want that to be taken as I'm now suddenly saying it's more important than anything else protein is important but so too is the fat that's supposed to come with it wow that's wild I mean that's that's interesting to me because you know coming from like a like a fitness perspective like it was always talked about how I shouldn't say always you know some of like Charles Paquin type stuff like some like speculative and but it was like then somewhat validated where okay like hey like

you finish your workout like you're insulin sensitive like Now's the Time to have your weight protein shake just get a lean easy protein yeah so is there evidence even like post-workout that sans's carbs just having like some ground beef some some fat in it might actually get you more protein synthesis say away protein shake yeah well so this study uh I don't know I I can't remember the timing of it like did they give it I wish I could remember whether they gave it at a specific time like within a certain window following the workout

I just can't recall but this the protein and the fat they used was egg they used egg white alone which is a very good protein and then they Ed the whole egg so the magic of an egg in my mind um is that it's a one: one ratio of of fat by Mass to protein by mass and that in that study the whole egg consumption so the fat and the and the protein together was more anabolic than the protein alone I don't know of comparable studies with say wey like if you have way and then

you add dairy fat and I am an enormous advocate of dairy fat I'm an advocate of all natural fats I really am um but there's some Nuance there where people need to appreciate that if you are asking a muscle cell to undergo hypertrophy which is largely a function of the protein so that's where the proteins come into to play that's where the amino acids come into play particularly Branch chain amino acids they're helping build the structure of the interior of that muscle cell but as the muscle cell is expanding the membrane is primarily made of

fat and so if you're asking this muscle cell to get big and you're only providing it with the building blocks on the inside what a pressure on the outside so if you can be giving it some of these longchain fats that are now helping build the structure of the exterior especially phospholipids which are particularly loaded in animal fats now you're also helping with the exterior of it the membrane of it you're allowing the membrane to continue to expand as we're demanding that the interior protein um increase so is there not so much and I'm asking

honestly for my own personal you know it's it's not uncommon like actually a lot of times most of the time after a workout I just don't even bother eating like I still stay fasted for a while because I just I'm not concerned I think I don't know you've probably seen oh no no that's that's absolutely valid Dr Dr Stuart Phillips one of the leading Authorities on muscle protein synthesis and Luke vanloon at MRI also one of the absolute authorities they've referred to protein is rather than a window it's like a barn door that really as

long as you're getting some adequate amount within a pretty broad range then you're laughing I don't trip up about it at all but I'm just it's interesting because you know it's drilled into my head from even bodybuilding days in the past it's like okay have your whey protein isolate so you're not even getting the full spectrum of of you know with your water with water you know not with milk and it's like now I'm almost thinking like okay maybe a whey protein concentrate with whole milk is better in fact absolutely that's what I would say

now of course I would defer to bodybuilder you know that's not something I've ever experimented with but particularly for the average individual who just wants to be healthy and strong and not worrying about getting to a 4% body fat which from everything I understand is a miserably is a miserable way to live yeah like you talk to any of these bodybuilders during their cutting phase they are totally obsessed with one thing and one thing only and it's food yeah like at any given moment it's food that they're talking about and thinking about but that to

me is important I hate to go off on a tangent but when we invoke the same principle like people who just say no eat just all protein and cut all of their calories that is the way the bodybuilder is going to be cutting but those guys have an unnatural degree of discipline you know they these gu these are guys who are used to just punishing their bodies and gritting their teeth and getting through whatever's whatever the trial is including this constant obsession with food when we take that same strategy and then give it to an

overweight type 2 diabetic well no wonder it fails so often because now you're asking them to work against hunger if the dietary back to the same ideas where I just outlined I hope convincingly that in order for a fat cell to grow you need two components elevated insulin and sufficient calories to fuel the growth that the insulin signaling those same two variables then get turned down of course when you start to talk about how we shrink fat cells but most people and both are elevated if a person's getting fatter and fatter they have elevated insulin

to Signal the growth and sufficient calories to fuel the growth both of them need to be turned down unfortunately the overwhelming conversation only focuses on focuses on one of those variables which is the calories so if you have an individual who begins cutting their calories but they still have this underlying hyperinsulinemia Dr David Ludwig published a series of papers out of Harvard which are beautiful that look at this the the available amount of energy in the blood and I referenced this earlier in our conversation but if you are cutting calories but insulin is still high

you are pushing all the calorie nutrients into the tissues and that leaves a lower amount of calorie nutrients available in the blood and the Brain senses this the brain has a limited capacity to store energy and thus the brain says hey we're getting low on energy in the blood because it can't sense what's what's stored in the fat or the liver directly and so it starts to promote greater hunger and so if a person's weight loss or fat sh fat cell shrinking Journey starts with cutting calories they're very quickly going to return right to where

they started because if they haven't addressed the highend they're going to become very very hungry this is why when you look at these Biggest Loser game shows you never see a reunion you never see them get back together because they gain it all back so as much as calories matter my strong advice is start with the low insulin approach you just control your carbs prioritize protein Don't Fear The Fat that comes with that protein now and don't worry about the calories because if you um correct your insulin you will have a higher metabolic rate by

about two to 300 calories a day just by lowering insulin um calorie expenditure metabolic rate will just go up this is reflective of in insulin is so good at telling the body to store energy that when it's absent or when it goes down the body is spending it more readily than it would normally so metabolic rate will go up and then you will start wasting energy in the form of ketones so if insulin is down the person's burning a lot of fat because insulin controls which fuel is being used and when insulin is down for

an extended period of time about 16 hours the body is burning so much fat that the liver is actually burning more fat than it needs to meet its own energetic needs so the liver is basically saying hey I'm I don't need any more energy but also the liver is saying yeah but I can't stop burning fat because insulin's low that excess is what is turned into ketones and then now what about the ketones they have a caloric value every Ketone has a caloric value roughly similar to glucose and when a person's in ketosis you now

Direct ly eliminating those ketones from the breath and in the urine well those are calories that based on the typical view of thermodynamics we would say well they have to be burned through exercise or stored or they can just be wasted if insulin is low so that represents another mechanism whereby a low insulin approach is very helpful for weight loss because you are literally wasting energy you're breathing these ketones out or you're urinating them out and So eventually the person's going to lose a certain amount of weight by just addressing ing the insulin not even

counting calories and then if they find that they get to a plateau then I say okay now it's time to scrutinize calories but the best way in my view to do that is through structured fasting rather than through kind of constant deprivation and this underlying hunger that comes with it so anyway that was a a bit of a tangent but even still it allows me to kind of bring in a lot of other points no no that's I mean one last question on this because this is if someone were to let's say basil metabolic rate

of I let's just like just make an easy math 2,000 and they were to eat um put themselves in a deficit down to a th000 calories but they only ate carbohydrates so insulin was spiked obviously they would lose weight but would they just retain fat mass and lose muscle mass a great question so um they would lose weight but it would be relatively more lean mass than fat mass as a percent now what you've done here is actually allow me to touch on on a really important point which is a lot of people will cite

these low carb versus low fat studies and they'll say well look at the degree of fat loss it's always pretty close although mind you there has literally never been one single single Paper published finding that the lowfat diet caused more statistically significant weight loss not one but there are several that show the low carb diet having a significantly greater effect but never one in the other direction but even still they will say look at both of these studies both of them lost weight or both groups low carb versus low fat yeah but they're always low

calorie that's the thing that people don't appreciate is that you take you've taken someone eating a standard American diet high fat high carb High relatively high calorie even when you put them in the low fat group you've cut their calories down so they're eating less of everything now even less glucose and so it doesn't it's not surprising that their insulin is also reduced and so you always have this huge confounding variable so just to finish that thought and then I'll come back to your the issue you brought up up the actual only way to truly

declare a winner whether low carb is better or low fat is better is you have to see which one is more resistant to Fat gain so rather than doing these hypocaloric studies what we have to do and it's never been done ever do a hyper chloric version of both diets so you take a ketogenic low carb but matched with calories to a high to a high carb but they're both high calorie and now let's see who gets fat less yes if that makes sense now we can actually start to tease apart the the difference between

the insulin theory of obesity or the caloric theory of obesity but if we take the average person and they're only eating glucose at 1,000 grams um um 1,000 calories they're probably still eating less overall than they clearly were than when they're eating yeah so if they have a let's say let's just say they were eating 2,000 calories and they were weight stable yeah insulin would still come down um in that individual and they may have underlying a little bit of some some bits of hypoglycemia but I've not seen a study that's done this I suspect

if you compareed that person to the person eating a th000 calories of pure fat the person eating the pure fat they let's say they both lose 10 pounds but I bet as a percent of body fat the fat eater is lost more fat because fat does not increase insulin at all anyone who says otherwise is looking at type 1 diabetes studies and that's a very different metabolic M you because of the underlying hyperglucagonemia which changes the form the metrics a bit but if you take a non-diabetic and they eat pure fat there's no insulin Spike

whatsoever this has been published for decades I'm about to publish my own report looking at this exact same thing so fat alone unless it's no insulin Spike so that guy's going to have a higher metabolic rate and because the insulin is low he's going to be burning fat like Gang Busters the other guy who's eating a th000 calories of glucose he's still going to lose weight of course but I suspect that as a as a percent he's losing a little more lean mass um and preserving a little bit of fat Mass so what would your

suggestion be to the person that is still wants to have carbohydrates maybe they um want to have know 100 grams of carbohydrates to day and they're moderately active they recreationally work out we'll kind of end on this so there's a takeaway like what would you suggest periodic fasting keeping like what what would your sort of Playbook be for that person yeah yeah so just as a reminder my kind of three pillars are control carbs prioritize protein and don't fear fat and with control carbs it is first for a reason because I think I consider it

the most important you as much as possible you'd want those 100 grams of carbs to not be coming from bags and boxes with barcodes you'd want them to be whole fruits and vegetables and the difference with the whole fruit and vegetable as opposed to the processed starches and sugars is the presence of fiber so focus on fiber if you're eating a digestible carbohydrate very likely nature has a fiber that's coming with it and that's by Design and that's how we should take it but still if it's the 100 gr I would say you want to

get that not for supper um not for the LA last meal of the day because you do not want to go to bed hyperglycemic hyperglycemia stimulates the sympathetic nervous system and I'm convinced one of the main reasons most people sleep so poorly these days and I'm sympathetic to that I'm inherently a bad sleeper um a lot of it is because they Spike their glucose before they go to bed because that's when most people in indulge in starchy and sugary snacks and then they have activated their sympathetic nervous system so their body temperature climbs and their

heart rate goes up and it's beating harder and so they're lying in bed wondering why they can't fall asleep and wondering what they're anxious about they're not anxious about anything you just are hypoglycemic and that activated your sympathetic nervous system this fight ORF flight response so you want to give yourself abundant time to get back to normal glycemia before you go to bed so my advice always is load up lunch let lunch be the biggest meal especially if a person is not inclined to have breakfast even though if you are a breakfast eater and that's

when you find you're the hungriest then you could load up those carbs for breakfast then but lunch is a is a good way to do it I for me personally you know I'm I'm my late 40s I don't have a lot going for me physically and so I got to do what I can to stay fit right it's part of my marriage contract for my darling wife that I'm just going to do what I can to stay fit um but I want to be a healthy Grandpa of course Very that's very much an interest for

me me um and I'm worried about some chronic diseases and so I want to I'm unapologetically an advocate of ketones at least uh for some time of the day if a person can have some brief period of ketones that is going to be so helpful for brain health and I of all the diseases that scare me Alzheimer's is probably the one that scares me the most yeah and especially for me my my brain is my money maker like this is how I make my living and so I need it to be really sharp study after

study has shown that the brain loves ketones I want to give my brain a break from relying on glucose and allow it to consume ketones which it does incredibly readily this is as a brief tangent this is one of the things I disabuse my students of so often they've been taught that the brain um prefers glucose that is absolutely false even if if you have a a body that has say five Millar glucose and only two Millar ketones which is very achievable with a fast the brain is already getting about 70% of its energy from

those ketones so even when the GL the ketones are at half the level of the glucose the ketones are already providing two to three times more energy to the brain than the glucose is so the brain loves ketones I want to give my brain some ketones and to do that I fast through breakfast almost all the time which is not so hard it's I'm not generally very hungry and it doesn't change the dynamic in my family you know I'm married I got kids I don't want my kids to be looking across the table at Dad

wondering why dad's not eating that's weird and so I never fast through dinner that's my one kind of cardinal rule I have dinner with my family if there's a way for me to keep it kind of low carb and my wife generally sees this the way I do so it's not too hard then I do but if it's if my daughter wanted pizza for her birthday we literally just celebrated her birthday yesterday when we recorded this I'm going to eat pizza with my daughter you I'm not going to make it weird so dinner is whatever

the family's having my lunch is generally but if I can if I'm going to load up my carbs I would do it for lunch all things equal if I could I'd load it up at lunch and then breakfast I generally I'm just fasting through anyway so if you're going to take those 100 grams of carbs I'd say focus on lunch as much as you can um given the social constraints that some people may have and given the you know their their natural habits but at all costs try not to get those carbs within 3 to

four hours or so of going to bed you just do not want to go to bed hyperglycemic perfect well Ben where can everyone find you man yeah yeah thanks yeah so I try to put all my content and stuff more and more on my insulin IQ website so I got an insulin IQ YouTube channel and my insulin iq.com website beautiful thanks man you bet