Dhru Purohit Show - #223: How Insulin Resistance Destroys Your Brain and Promotes Alzheimer’s and Cognitive Decline with Dr. Ben Bikman

Episode Date: June 17, 2021

How Insulin Resistance Destroys Your Brain and Promotes Alzheimer’s and Cognitive Decline | This episode is brought to you by InsideTracker. Nearly six million individuals live with Alzheimer’s disease in the U.S., and the numbers continue to rise. After 30 years of encountering dead ends while addressing Alzheimer’s disease as a problem of brain plaques, researchers are looking at other contributing factors.    There is a growing body of evidence that indicates a strong correlation between Alzheimer’s disease and a disrupted metabolic state, where the brain can’t get enough energy.   On today’s episode of The Dhru Purohit Podcast, Dhru sits down with Dr. Benjamin Bikman, a renowned metabolic research scientist, and a popular speaker on human metabolism and nutrition. Backed by years of research, Dr. Bikman’s mission is to help the world appreciate the prevalence and relevance of insulin resistance. He is the author of, Why We Get Sick, which offers a thought-provoking yet real solution to insulin resistance and how to reverse pre-diabetes, improve brain function, shed fat, and prevent diabetes. Dr. Bikman has a Doctor of Philosophy in Bioenergetics from East Carolina University, a Master of Science in Exercise Physiology, and a Bachelor of Science in Exercise Science from Brigham Young University. In this episode, we dive into:    -Why Alzheimer’s disease is increasingly being referred to as insulin resistance of the brain or type 3 diabetes (11:13)  -How the brain runs on different fuel sources (14:07)  -Why insulin prevents the production of ketones (19:42)  -Early signs of potential cognitive decline (30:45)  -Common foods that drive insulin resistance (41:32)  -The role insulin resistance plays in migraine headaches and epilepsy (56:05)  -Where to get your carbohydrates from (1:06:09)  -Foods that fuel your body and brain (1:09:24)  -How seed oils wreak havoc on our health (1:17:28)  -What you can do today to reduce your risk for Alzheimer’s disease (1:28:03)  For more on Dr. Bikman you can follow him on Instagram @BenBikmanPhD, on Facebook @BenjaminBikmanPhD, on Twitter @BenBikmanPhD, and through his websites http://bikmanlab.byu.edu/ and https://www.insuliniq.com/. Get his book, Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease―and How to Fight It, at https://benbellabooks.com/shop/why-we-get-sick/. Also mentioned in this episode: -HLTH Code Meal Replacement Shake - https://gethlth.com/ -Levels Continuous Glucose Monitor - https://www.levelshealth.com/ -Episode #154: The Mind-Blowing Science of Fat-Burning and Insulin Resistance with Dr. Benjamin Bikman - https://drhyman.com/blog/2020/09/24/bb-ep15 -OmegaQuant Test - https://omegaquant.com/ -Post-mortem study of the brains of former Alzheimer’s disease patients - https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12310 -How Industrial Seed Oils Are Making Us Sick - https://chriskresser.com/how-industrial-seed-oils-are-making-us-sick/ Sign up for Dhru’s Try This Newsletter - https://dhrupurohit.com/newsletter. This episode is brought to you by InsideTracker. Right now, they’re offering my podcast community 25% off. Just go to https://www.insidetracker.com/DHRU. Learn more about your ad choices. Visit megaphone.fm/adchoices

When it comes to something as seemingly helpless as Alzheimer's disease, there are three very powerful strategies to improve your insulin sensitivity and help, one, reduce your risk of Alzheimer's, and then two, perhaps even reverse course. Hi, everyone. Our guest today is Dr. Benjamin Bickman, and we're talking all things, how to protect your brain from Alzheimer's, dementia, cognitive decline. If these topics interest you, you won't want to miss this groundbreaking interview. Have you ever gone to your doctor?

your normal annual physical and after sitting with them for 10 minutes, they quickly look at your labs and tell you, hey, everything looks normal. Keep it up and I'll see you again next year. Maybe even give you a nice little pat on the back. I can't tell you how many listeners of the podcast have told me that they've had this exact experience and how honestly how frustrating it can be. Now, we all know that normal isn't always optimal. Just because something's not wrong doesn't mean that we feel great. So traditional medicine is great at finding out when something is blatantly wrong, but they don't always do the best job when we need to highlight how we can do better. So what if you could get detailed nutritional and lifestyle guidance based on your

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With their app, you can track your progress every day, and they have an amazing support team to help you with any questions you might have. InsideTracker looks at everything from metabolic and inflammatory markers to top nutrients and hormones. It even tests your cholesterol levels to help you better manage stress, and you have the option to see how your inner age compares to your chronological age. Traditional lab tests can be hard to read on your own, but InsideTracker makes their results easy to understand and even provides tips on how to use food first for optimal nutrition. Right now, InsideTracker is offering my podcast community 25% off their system.

Just go to inside tracker.com slash Drew. That's D-H-R-U to get your discount code and try it out for yourself. That's InsideTracker, I-N-S-I-N-S-I. I-D-E tracker, T-R-A-C-K-E-R-com, backslash Drew, D-H-R-U for your 25% off. Welcome to the Drew-Peroet podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Benjamin Bickman. Dr. Ben Bickman earned his Ph.D. in bioenergetics and was a postdoctoral fellow with the Duke

National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and associate professor at Brigham Young University is to better understand the role of elevated insulin in regulating obesity and diabetes, including the revelance of ketones in mitochondrial function. Nowhere is this topic more interesting than when it comes to the brain. On today's interview, we do a deep dive into the topics of Alzheimer's, dementia, and cognitive decline in how all of those diseases and conditions are deeply linked to elevated insulin in the body. This is a deep master's class on your brain when it comes to long-term brain

health. Let's listen in. Dr. Ben Bickman, welcome back to the podcast. It's an honor to have you here again, brother. Oh, man, I'm delighted. We had such a good time in the first time that we thought, why not do it again? I'm glad to be here. Why not do it again? And we have a whole new topic. There's going to be some overlaps with the other interview that we did. And for anybody who didn't listen, check out the show notes. We'll talk about some of those topics again here. But today's conversation, we're diving deep into the topics of Alzheimer's, dementia, cognitive decline, even things like brain fog and lack of focus and how to understand how the brain works and what fuel sources run it and what fuel sources potentially harm it. So I want to just jump right in.

You know, we've spent, I don't know the exact number, but it's in the. billions of dollars of money spent on Alzheimer's and cognitive decline-based drugs. And for the most part, even very centrist and Western medicine doctors will tell you, we've gotten very little from it. And on top of that, there's millions of people around the globe that are still suffering from these chronic diseases. And the ones that aren't suffering, they're well on their way to getting it. And Alzheimer's and dementia are one of the most scary diseases, even scarier on

a lot of national surveys than even cancer. So I'd love to just start off big picture with the billions that we've spent, with the hundreds of thousands of people that are interested in this topic, paying attention to it, the thousands of researchers, what are we missing when it comes to this conversation? Yeah, yeah. There's no question we need to shift the paradigm to use a worn out cliche, perhaps, but we've been classically looking at Alzheimer's disease the same way now

for decades, which is that it's really a disease of two problems in the brain. One is the accumulation of these amyloid beta peptides, or these plaques, they're called, and then the other one is these neurofibrillary tangles, that the neurons, which ought to be, have a clear, direct structure, are getting messy. The problem with those two identifiers, well, is one, they're hard to identify. Those are only things you can identify essentially post-mortem. So it's not like you can use amyloid amyloid beta peptides and neurofibrillary tangles as an early clinical marker. You know, you can't have someone come in and take a biopsy of their brain and measure these things in the brain. So it's not a great, it's not a reliable marker. Again, it's only something you can really confirm

after they've died. But two, drugs that have been developed to directly target these and confirmation of these targets are from animal models, they don't really do much. They don't really move the needle. So there's no question we have a profound incentive to shift the paradigm and say, all right, the classic view isn't working. Now, this is something scientists, of course, don't like doing. We don't like acknowledging when our theories aren't playing out. But we need that humility. And I think it's happening to a degree where the classic paradigm isn't holding up. And this has given birth to other ideas.

One of those is, for lack of a better term, the metabolic theory or the metabolic origins of cognitive decline. And to sort of briefly put that in perspective, you can look at someone's fasting insulin in their glucose, you know, some of the most obvious markers of metabolic health, and see that that is going to be generally more tightly predictive of someone's Alzheimer's risk than even their age is going to be. So this was a study published from Finland years ago that found fasting insulin had a higher P value or a more rigorous statistically significant P value than people's age did in predicting who was going to get Alzheimer's disease. So not only do markers of insulin sensitivity and glucose handling are not only can they act

as an early indicator of the disease, but then they also actually start to go beyond just being an indicator and touch on the actual mechanism of the disease. and I'll be brief, and we can dive in as you see fit. But the hippocampus is the main site of the brain that is involved in memory and learning. So, of course, that's the part of the brain that we're most interested in when it comes to something like cognitive decline and Alzheimer's disease. And we, this part of the brain, like all parts of the brain, really relies on two fuel sources, glucose and ketones. and glucose is under the control of insulin. The hippocampus has these glucose transporters, glute four,

that were once thought to only be found primarily in muscle and fat tissue. And that's the mechanism whereby insulin controls glucose in the blood so readily. We eat a meal, glucose comes up, insulin comes up to push that glucose from the blood. Most of that's going into muscle and into fat cells. But also the hippocampus has these insulin-dependent, glucose transporters, these glute four, which normally will only open when insulin comes and knocks on the door. So we know that the hippocampus, to a degree, bases its glucose use on how well insulin is working. Now, ketone use, and this is something we can get into, is not under the control of insulin.

So that represents a different fuel altogether. But looking at Alzheimer's disease through the lens of metabolic health allows us to not only have a more accurate clinical marker, an early indicator, where you can see changes in glucose use in the body to predict Alzheimer's disease decades before the disease actually starts to settle in. But then we actually understand the mechanism where, and this is something we're actively moving into in my own lab, exploring the degree to which the hippocampus becomes insulin resistant. And it's this insulin resistance in the hippocampus as the whole body is becoming insulin resistant and moving towards type 2 diabetes, now the hippocampus is becoming compromised because essentially it has now an energy gap.

The hippocampus has a very high metabolic rate. In fact, we've compared, this is unpublished data, we've compared the metabolic rate of the hippocampus to other neighboring structures like the hypothalamus and the thalamus, and the hippocampus has a metabolic rate that's about twice or three times as high as those tissues. This is a very metabolically active tissue, this little part of the brain that's so involved in memory and learning. And if it can't get what it expects to get, here's its energy demand and it's thinking, I'm going to meet this demand mostly from glucose and maybe a little bit of ketones. And I say a little bit just because in the average person, there are no ketones in their blood. So this almost total reliance on glucose, when that glucose use is compromised, now the brain, the hippocampus, has this energy deficit or this

energy gap that it's trying desperately to make up. And to zoom out for a second, you know, for the folks, we're going to unpack all these terms that you talked about here and revisit some of the topics that we had in our first interview just in the context of Alzheimer's and dementia. But really what we're talking about here, zooming out big picture, is traditionally, especially here in the West, we saw Alzheimer's, dementia, an early cognitive decline as a sort of a blockage, primarily blamed on these amylums. plaques that were preventing our neurons in our brain from communicating the way that they needed to,

which could lead to memory gaps, forgetfulness, a sense of not being able to use your brain power. And to zoom out much bigger, as you're talking about metabolic health, you're saying, look, not only is that not true, but we've not been able to move the needle. We have to start thinking of these brain disorders and diseases as almost diabetes of the brain, right? And that's why actually there's a term that's been floating around for a while, but that's getting a lot more attention. Relate to us how Alzheimer's and cognitive decline and dementia are like diabetes and why so many researchers like yourself are starting to call this type three diabetes. Yeah. Yeah, I remember vividly the first time I ever heard that term. I was,

I think a postdoc and I was attending a conference here in the U.S. And one of my colleagues, one of my friends from my PhD time mentioned to me as I was elaborating to him, I'm with him, on how I was diving deeper into insulin resistance, which is pre-diabetes and outright type 2 diabetes research. He asked, are you going to get into the brain and study Alzheimer's? And I responded, why would I? And he said, well, haven't you heard people are calling it type 3 diabetes? And I was so intrigued. Now, I do think we do a little bit of disservice when we call it type 3 diabetes because I wouldn't

want someone to think that type 3 diabetes, this metabolic disorder of the brain, is so different from type 2 because in reality it's not. In the case of type 1 diabetes, we have an absolute lack of insulin, and so glucose levels are high. In type 2 diabetes, we have a lot of insulin, but it's not working well. We've become insulin resistant. And similarly to type 1, now we have high glucose levels. But the insulin levels are totally different. Type 3 diabetes, I would describe it, And it's essentially the exact same metabolic milieu of type 2 diabetes. That is to say, a better term may be insulin resistance of the brain. Now, I don't begrudge people using type 3 diabetes.

I've used it. And I'm glad for how catchy it is because it does relay the relevance or convey the relevance of metabolic health in this context of Alzheimer's disease, which we've never viewed as a metabolic problem or a manifestation or an extension. of poor metabolic health. But more and more, people are seeing it that way because the data keeps supporting it. This is a theory that has been posited and hasn't been knocked down yet. Let's talk about the brain and how the brain runs on different fuel sources. You talked about insulin and glucose and ketones and all these different things that play into it. We did a whole masterclass deep dive on burning belly fat and insulin resistance, but it might

be worthwhile to revisit some of these things just to get the lay of the land. So where does insulin reminder for everyone, what is insulin and where is it important to understand in the context of energy and especially in the topics of Alzheimer's dementia, cognitive decline? Yeah, yeah. So insulin has many jobs. In fact, we could almost say insulin has as many different jobs as there are distinct cells in the entire body. And that's because insulin will literally affect every cell. I know people use the term literally, very liberally these days, and I'm using it very precisely. Literally, every single cell in the body has insulin receptors, and thus will respond to insulin in some way. And it's no surprise then that insulin will do something differently at the

brain than it will at the bone and something differently at the lung than it will at the liver, because these are different cell types, and insulin will tell them to do different things. But insulin's most famous action is one I alluded to earlier, which is to control glucose. Now, again, it's far from being insulin's only action, but it is its most famous. And some may argue it's most important because if we eat a meal that is rich with carbohydrates, sugars and starches, our glucose levels will spike very rapidly. If they get too high and stay too high for too long, that is acutely lethal. We can literally die from that situation of this profound hyperglycemia because of what it's doing to our kidneys, where the kidneys simply start dumping all that glucose to get rid of

it and there's a lot of water that goes with it from our blood and then our blood volume goes too low and our blood pressure goes too low and because we are a column of water we need that pressure having pressure in the system so to speak is so essential because we have to pump it up to the brain and so the brain is the most susceptible to this drop of blood volume again which is a result of the glucose so glucose goes up that's acutely lethal insulin comes in to save the day so this is insulin acting in the role of the hero, and it pushes the glucose down, and then insulin having in its job goes back to the fortress of solitude and goes back to lower fasting levels. The tragedy in our current environment is that people are so constantly spiking their carbohydrates,

they're loading carbohydrates in the body that their blood glucose is spiking all the time. And they're doing it with the best of intentions, because after all, that's what we've been told to do. We've been told to eat a diet high in carbohydrates and to eat in some instances we're told to eat five or six small little meals per day. We have breakfast and we have a snack, then we have lunch, then a snack, dinner than a snack. And because it takes insulin in a healthy person about two to three hours to go back down to normal, the person ends up spending every waking moment in the state of elevated insulin. And so that chronic elevation in insulin is now essentially become the villain.

When insulin was working, it was the hero, it's not working, and now it's putting the body into this frank state of metabolic disarray and stimulating insulin resistance in some cells. And then in others, it's just stimulating the cells to do too much of what insulin would have been telling it to do at a modest level before. But all of this plays into the brain because the hippocampus, and this is the theory. This is my operating theory that, again, as I alluded to, we're actually actively studying now. So I'll hopefully have answers in the near future. But just like the fat cells can become insulin resistant, the muscle cells, the liver cells, the bone cells, so too to the cells of the hippocampus. And the hippocampus needs to respond to this insulin in order to pull in all the glucose that the hippocampus needs to fuel its function. And now, of course, we've mentioned both of us now that there are multiple fuels.

available. And so as we start to create that energy gap that is caused as a result of the hippocampus not being insulin sensitive and not being able to thus move the glucose in and catabolize it, that forces an increased demand for ketones. And so the brain starts in a way crying out for ketones. The hippocampus is, you know, calling out to the body almost. I know this is a silly analogy, but essentially, hey, I'm swimming in a sea of glucose, but I can't use it. Throw me. a life raft, which is going to be ketones. But because the person is living every waking moment in a state of elevated insulin, they are never making ketones. So while the brain is desperate for the ketones, the body, specifically the liver, isn't able to make any ketones because insulin

won't let it. Insulin turns off the production of ketones. And so the brain ends up starving, and this starvation is manifested as this cognitive deficit. The brain is, is, you know, the hippocampus is saying, you want me to operate this well with memory and learning. I need this much energy to operate that well. You're only giving me this much energy. So now my memory and learning is only going to work here. We're literally saying that because of our high sugar diet, our brain doesn't have the fuel that it needs.

It's crying out for help. But because of our modern lifestyle, it's not getting it. And when it doesn't get it, then a lot of bad things start to happen. Let's take a step back a little bit and talk about us living on the plains of Africa and civilization and starting and, you know, wherever we evolutionary came from. What was the reason why the liver would typically be shutting off or insulin would shut off the liver and prevent it from creating these ketones? Talk about survival and adaptation and what our lives looked like before and how this thing that was done intentionally now all of a sudden got out of whack from our modern lifestyles. Yeah, yeah, that's funny, though. It's funny for me to think of my ancestors being on the plains of Africa. I'm as a pale, freckled guy, a long way from the plains of Africa.

Yeah, but yeah, if we go back in time and sort of wonder at the evolution or the design of the body, how it is, why it is operating the way it is. And those are fun questions to answer. And so I'm answering a why question, and those are almost into the realm of philosophy because I don't know, of course, why. I know how. But knowing how the body is working, it can lend me some confidence in speculating as to why the body's working the way it is. Insulin abhors wasting energy. Insulin wants to store energy. That's one of the themes of insulin across all of the cells of the body, all of the cells that are responding to insulin, which is every one of them.

What they have in common is that insulin, despite all the other differences of the different effects that insulin is eliciting on these cells, what they all have in common is, is that insulin is attempting to tell the cell to store energy, to pull in nutrients and store them. And the production of ketones is anathema to that. It is antagonistic or an opposite phenomenon where the production of ketones is by its nature reliant on catabolism. So insulin only wants to promote anabolism and inhibit catabolism. So it wants to promote the build up and inhibit the breakdown, the production of ketones involves inherently a catabolic process. And that's because you can only make ketones from breaking down or catabolizing fats. So in the liver, when we are rapidly catabolizing fats, which happens when insulin is low,

because again, if insulin's high, it doesn't want the liver to be burning anything. It wants the liver to store fat and wants the liver to store glucose as glycogen. But when insulin comes down to fasting levels, now the liver and other cells of the body are disinhibited. And now they can start breaking down and mobilizing the energy that they've been storing. And both of these processes are good, of course. I never want anyone to think that I'm implying that insulin is a villain, and so anything insulin is trying to enabalyze or to grow is bad. Not at all. We have to have this dynamic process, and that's essential to aging well.

but when insulin has taken a backseat and gone to fasting levels, the liver starts breaking down energy. And when insulin is down at fasting levels for a sufficiently long period of time, typically this is in the order of 16 to 20 hours, it's not able to stop burning fat. Now, I don't mean to suggest that in a negative tone, essentially the liver, in the absence of an insulin signal telling it to stop, just keeps burning fat almost more than the body needs the liver to be burning. And so that excess, if you will, where the liver is burning more fat than the body needs it to burn, and the fat cells are giving this out to the liver to continue to burn, then this excess is shunted. It's like a pressure valve, and it starts turning these fats that are

burning that we're breaking down, that we're catabolizing, and we start pushing them into this route of ketones. And it is essential to do this for the brain. And this is a little bit more of the why, and people will often say ketones are muscle sparing. And there's some justification for that. We published a paper finding that actually ketones do, in fact, make muscles a little tougher against noxious stimuli. It kind of defends the muscle in a way. But their more protective effect isn't a direct effect of the ketones on the muscle. It's that if you are burning fat to make ketones, you're allowing the brain to rely on this other energy source. You're allowing the brain to be using both glucose and ketones, which it does exceptionally well.

Anyone who's fasted or done a low-carb diet, the moment ketones start going up, the brain immediately starts using them, even to the point where it's getting up to 75% of its energy from ketones. So the moment the ketones come online, which is to say in the blood, the brain starts gobbling them up very greedily. And by in so doing, by shifting its reliance to ketones and away from glucose for a time, it's allowing the muscles in the proteins in our muscles to stay in our muscles. Because if we started running out of fat tissue or alternatively, we have plenty of fat,

but our insulin spiking all the time, we are never making ketones. And so now if the brain needed this a lot of glucose, which it does, it will start breaking down the proteins in muscle to convert those broken amino acids, those remnants of the protein, to convert them into glucose to ensure the brain. brain is getting all the energy it needs, and it would be just coming from glucose. So in that sense, our ability to make ketones is an effort to allow the muscle to maintain its muscle protein. We can defend the muscle. So ketones are in a way defending the muscle, because again, in the absence of ketones, the brain's reliance on glucose is going to be so high that it would

start stripping the amino acids from muscle protein to convert those amino acids into glucose to help the brain get the energy. So ketones are kind of, they're filling that gap and allowing the muscle to keep its mass. Let's talk about, you talked about and hinted towards some of the research that you guys have done and also the research that's available out there

and again, zooming in and out, which is our audience loves to do, you have such a fantastic way of explaining the science, and we also do a great job of zooming out together and saying, okay, so what does this mean? So in the context of some of these studies and you do some great Instagram videos, please, if you're not following Dr. Ben Bickman on Instagram, you can find the link to his

Instagram page. He does some great IG TVs on the recent literature that's coming out there. So let's talk about some of the studies that show that when you fuel your brain with the right foods, in this case, supplying the brain with more ketones, which usually means having more higher quality fats and lowering the amount of really sugar and processed carbohydrates. the body starts responding. So can you highlight one of these studies you've talked about before on your Instagram? Yeah. Oh, yeah, gladly.

In fact, to lay the groundwork, which is what we've done in a very practical way with our recent manuscript. So that might be the best place to start. So we recently published a paper where we had access to a gene database from human hippocampal samples. So these are human tissue donors that when they died, they donated their body to science. and we were able to, working with a group who does this, they were able to quantify all of the genes from the hippocampus of people who had died with Alzheimer's disease and people who died without, no hint of Alzheimer's.

So a control group and an Alzheimer's group. And again, this is human data. These are human genes that we're talking about. We were able to scrutinize the expression of genes involved in glucose metabolism and genes involved in ketone metabolism. And what we found is that there was a broad reduction in essentially every gene involved in glucose metabolism in the brains of the people with Alzheimer's disease. So the hippocampus had a broad, almost every gene.

I think we looked at around 20 or so, the genes involved in glucose uptake into the hippocampus, genes involved in the breakdown or the burning of the glucose, all of them were down in the hippocampus of the people with Alzheimer's disease. In contrast, the genes involved the roughly, I know, 18 genes we looked at involved in ketone metabolism, ketone uptake and ketone burning, were almost totally normal in the hippocampus of people who had died with Alzheimer's compared with people who had died without any evidence of Alzheimer's. So this was providing a very real genetic foundation for what we already see in the literature.

And now I'm relying on the work, what I'm citing now is the work of a man named Stephen Cunane. And I invite anyone to look up his stuff. It is fascinating. He had found previously that in people with early cognitive decline, so nothing even as bad as full Alzheimer's disease, just early cognitive decline and full-blown Alzheimer's disease, that when they measured the degree to which the hippocampus was pulling in glucose and burning it was significantly down. So actually measuring glucose use was down in the people with cognitive decline.

In contrast, ketone use was totally normal. There was no deficit in the brain's ability to use ketone. tones. And he's the one who gave birth to that term an energy gap. Now, one of the most compelling studies his group was involved with was a study based on 20-year-old women who had PCOS, who have PCOS or who do not. Now, very, very briefly, I promise this is relevant. Polysistic ovary syndrome is the most common form of infertility in women, and it is at its core a disease of too much insulin. For reasons that I won't get into at the moment, But suffice it to say, if a woman has PCOS, it is exceptionally likely that she actually has high insulin levels and is to some degree insulin resistant.

What they found in these girls in their 20s, they could detect reductions in brain glucose use and mild cognitive impairment compared to another group of 20-year-old women of same body weight who didn't have any PCOS. So back to my comment earlier, how markers of insulin resistance can predict cognitive decline decades before the person's actually diagnosed with Alzheimer's disease. This is one of the very best instances. And again, Stephen's group actually quantified this deficit in glucose use in the brains of those young women. So this is relevant in the long term and it's relevant in the short term, but all of it reflective of just of how, how found foundational our understanding of metabolism is in the brain to our understanding Alzheimer's disease. I mean, it's such a profound takeaway. And I just want to make sure that everybody really gets this because let's contrast what you're saying, which is so profound with the current model that we have in Westernized medicine, which has been exporting all around the world.

So most people think when it comes to Alzheimer's dementia, in those two particular categories, Either I have it. I have the genes, right? 23 and me is popularized. Like, do I have the double alleles? Do I have the genes? Is it inside of me? Oh, Alzheimer's dementia, it runs in my family.

So I feel hopeless. And I don't know. It's a crapshoot. Am I going to get it? Am I not going to get it? And they wait for us to age. And then one day we show up at the doctor's office and they say, we're starting to see some cognitive impairment.

You know, we're starting to see that you're not functioning as well. you might have Alzheimer's and somebody walks away with the diagnosis. And they feel a sense of feeling completely lack of control and helpless. They're a random victim of this scary disease that they have no idea how it started. So that's the current model is one day you show up. And if you're lucky, you won't get it if there's a family history. And even if there's no family history, you might just end up with a diagnosis anyway. And what you're talking about here is years before,

a diagnosis would show up, there are markers. There are things that are going on in our health that are a clear predictor that we are likely to end up with this super scary and unfortunate chronic disease. So you mentioned PCOS as an example in young women, right? Polycystic ovarian syndrome, which affects a lot of people, leads to infertility. I have many friends of mine that I grew up, especially that are South Asian. We talked a little bit about this before who have high. high carbohydrate, high sugar diets, very little protein, and often they were told that fat is bad.

So they ate the standard Indian diet, right, or the standard South Asian diet. And many of those women suffered and ended up getting PCOS. What are some other examples of diseases that people, especially young people, might be diagnosed with that are not Alzheimer's or dementia, but are a clear predictor that they could end up with that one day if they do not change their course. Yeah. Oh, what a great, what a great segue. Yeah. So I do hope, before I get into that, I do hope that there is a note of hopefulness in what we're talking about. My hope is that someone listening to this will feel empowered that when they learn that their Alzheimer's disease is to a large degree in most or many

instances based on poor metabolic health, well, that's something you can fight. You can do something about that. Being told, oh, well, you probably just have these plaques in your brain, well, that's just a shoulder shrug and, oh, great, well, there's nothing I can do about that. But this is something you can do. So it is the good news, this paradigm shift of looking at the metabolic origins of Alzheimer's disease. Now, to look at the relevance of metabolic health and other seemingly non-metabolic pathologies, it's pretty compelling, where it's fun to note the what would have been viewed just as a coincidence. For example, someone would note, okay, well, insulin resistance is the most common metabolic disorder. In fact, it's the most common disorder,

full stop. But they would say insulin resistance is the most common metabolic disorder. And Alzheimer's is is the most common dementia related disorder. But they don't have anything in common. Well, of course, the truth is, as we've been elaborating, they do have very much in common. They would, another person would say, insulin resistance is the most common metabolic problem. And PC, is the most common female infertility, but they don't have anything in common. Well, in fact, they do. It's foundational. And other instances of this would be reflected in, say, male infertility. The most common form of male infertility is erectile dysfunction. And in fact, it is so consistent to see those two happening together, it's beyond coincidence, so I'll elaborate in just a second,

that some view erectile dysfunction as the earliest detectable symptom of erectile dysfunction. of insulin resistance and otherwise healthy men. So you have a guy comes in and he doesn't fit the profile of a metabolically unhealthy individual. But if he has insulin resistant, if he has erectile dysfunction, that should ignite the suspicion that the person actually has insulin resistance. And that's because of what insulin resistance, how insulin's changing at the blood vessels. Now in the case of polycystic ovary syndrome, that's a problem because of what the insulin is doing to the ovaries and its ability to create sex hormones. hormones appropriately to foster female fertility. In the case of the male, it has nothing to do with

his testes. It has everything to do with the blood vessels. And insulin must be working appropriately. In other words, the body must be insulin sensitive for blood vessels to dilate when we want them to. Or in any way, in any of these blood vessels throughout the entire body, insulin works. And when it's working, it will promote the dilation of blood vessels. And when someone is insulin resistant, those blood vessels don't dilate, they stay constricted. And of course, that has an obvious relevance to erectile dysfunction because erection is based on the ability to dilate blood vessels and to change blood flow.

Well, if you can't dilate the blood vessels because they're insulin resistant, you can't change the blood flow, and now the person has erectile dysfunction. And then just to be brief, other pathologies would be things like fatty liver disease, which is the most common liver problem in the world. that is at its core fundamentally related to high levels of insulin and insulin resistance. And then we have numerous other disorders of the skin and of the joints, et cetera, that insulin resistance plays into. So you can see why I'm such a big advocate of people seeing insulin

resistance when they might not have originally. Because our typical view now, which is a global view, and I appreciate that you stated it that way, because we might be tempted to say a Western view, but it is truly global now. Our view of disease would be to say you have hypertension, you have infertility, and you have diabetes. These are three disorders that are all distinct and have nothing to do with each other, and the person would open up their medicine cabinet and pull out those three medications relevant to each of those problems. But the truth of the matter is each of those problems and many, many others are, in fact, branches coming off the same tree. So rather than just coming and pruning the branch, knowing that it's just going to

grow back, which is all the medications doing in these instances, let's just cut the damn tree down. Let's just acknowledge that these are all branches coming from the same tree, you know, all manifestations of insulin resistance, to be precise. Let's address the insulin resistance. And thankfully, it is something we can address exquisitely well. Now we are, we are, this is the common soil kind of hypothesis of chronic disease, which is essentially that insulin resistance is going to be causing or exacerbating virtually every chronic disease. So let's make sure we're looking at it and then let's make sure we're improving it the best possible way.

This is incredibly powerful and really also too, we're giving the control back to everybody who's listening or watching right now because the biggest reminder is get excited when you find out or we can be excited when we find out that we're part of the problem because as a mentor of mine used to always say, if you're part of the problem, then you're part of the solution. If these diseases happen randomly and they're just like darts against the wall and you're unfortunate and you get hit so you get Alzheimer's, there's nothing that you can do about it.

Same thing with cancer, you know, and I've interviewed some of your friends and colleagues on this topic before. But if we realize that what we're doing today is part of the quote unquote problem that's creating these chronic diseases, then we're empowered to do something about it. And that connection is whether it's erectile dysfunction, belly fat, as you mentioned, is one of the first indicators that if there's excessive belly fat or some belly fat that's piling up around your waist, that's one of the most immediate predictors of insulin resistance. PCOS, as you mentioned, fatty liver disease.

We call these things different names as human beings that are using language, but the body essentially sees them all as one. a survival mechanism that we call disease that is trying to adapt and do its best job to control the excess level of insulin and the high state of glucose that it's constantly in. Yeah, well said. I agree. The body isn't making these divisions that we want to make, where we want to see a fertility problem versus a liver problem versus a blood vessel problem.

The body is one great whole. It's all these pieces working together. all these different tissues are like cogs in a machine. And if one cog is broken, well, other cogs are going to suffer in one way or another. So, yeah, I look, having that holistic view of disease is relevant. Now, but I don't want someone to think I'm a simpleton in this regard, where they roll their eyes and say, oh, gosh, Ben, sure. Sir has his favorite villain and it's insulin resistance. And so I see insulin resistance everywhere, and that's all I'm addressing.

not at all. I'm in no way attempting to state that insulin resistance is the only relevant variable, but it is a common one. It's a common thread. Not only is it common statistically, but it's also a common or a shared origin of virtually every, certainly all the problems we've mentioned, and many more we have it. Of course, environmental factors play a role. You know, other toxins can play a role, especially when it comes to Alzheimer's. We've had on past individuals that talk about higher levels of heavy metals in the brain. But there's this through line, especially when we look at Alzheimer's dementia cognitive decline in sort of a global population level. Take, for instance, where I'm from in India,

we had some of the lowest rates of Alzheimer's historically. And then all of a sudden, something changed. What changed? The processed Western diet, the high, why is India now, growing in Alzheimer's, but also one of the fastest growing rates of diabetes. It does seem to be both on these studies that you're doing, but on a global scale when we look at correlation, that this Western diet that's been exported all around the world is now taking a severe toll, even for countries that typically did not deal with these chronic diseases like Alzheimer's at levels that they're dealing with them now. So let's dive in a little bit. We've been talking about insulin and how that's impacted by glucose. But just to make it really practical, if we went back to

the gentleman that you were talking about earlier whose work you've been inspired and the group that you did the study with when you were looking at the genetic, you know, these genes in these two different brains of individuals that had Alzheimer's and didn't have Alzheimer's, let's talk about what the contrast in diet on a practical level for somebody who might end up with Alzheimer's, at a later stage, dementia, or start to see the early signs of cognitive decline. What do you think are the very basic things that they're eating on a daily basis that are driving this over a period of time and pushing this insulin resistance in the body? Yeah.

Yeah. So this study I had alluded to earlier from Finland, and I think it was in the late 90s by the lead author is K-U-S-I-S-T-O, anyone who wants to look it up. They found every single marker of insulin sensitivity and glucose metabolism or glucose tolerance, every single one. I think there were five markers they used. Every one of them was statistically significant. But in contrast, other habits like cigarette smoking and drinking weren't.

And so these ones that people would view as certainly going to be pathological and would be relevant to Alzheimer's, they weren't. But again, every marker of insulin function was statistically relevant. And so I'm confident in saying anything a person can do to maintain insulin sensitivity or improve insulin sensitivity is going to be an effective strategy. But there's more than just diet. You know, and I know last time we spoke very heavily about the dietary role, and we've even touched on it now, which is when you're consistently spiking your glucose, which is then resulting in a subsequent prolonged spike of insulin. When you're doing that all the time, too much insulin drives insulin resistance. And that I can state as absolute fact, because we see this in all three relevant biomedical

models. I could take cells in a petri dish or rodents in my lab or humans at a clinic and I can cause insulin resistance in every single one of those, as has been done in the published literature, and create insulin resistance. So that's a fundamental background. Too much insulin causes insulin resistance. But then there are two other inputs that I consider to be primary causes. I consider them to be primary because once again, in cells, rodents and humans, the literature

supports this idea. One of them is stress. We know, and I know that's a big vague term. And I don't like leading with that because stress is big and vague, vague to the point that it's hard for someone to control their stress. There may be variables that are out of their control. So my emphasis in mentioning stress is there are. are always variables under our control that we need to focus on. So if someone suspects, if they

hear us talking, they say, well, Ben and Drew, my diet is great, but I still have insulin resistance. Well, then it is time to look at the other two, which is stress and inflammation. And again, both of those are big, vague ideas, but each of them also contribute in their own right to causing insulin resistance. So I mean stress alone, and that's the main stress hormones, like cortisol and epinephrine, those are the two prototypical stress hormones, they directly cause insulin resistance in cells, rodents, and humans. Inflammation, if we just activate inflammatory pathways, independent of stress, like cortisol, independent of insulin itself,

we can cause insulin resistance in cells, rodents, and humans. And so now the idea of stress, we know that cortisol and epinephrine will cause insulin resistance if they're up for too long and too high. Some of the obvious culprits are sleep. We know that sleep deprivation will increase those stress hormones and a bad night of sleep will create insulin resistance the next day. Now, thankfully, you can reverse it as quickly as you caused it by getting good sleep, but even still, it touches on the relevance of stress as an input to insulin resistance. And then inflammation is very relevant. In fact, that was really the focus, the almost singular focus of my postdoctoral work with Duke University 10 to 15.

years ago, it was exploring the specific inflammatory pathways, the biochemical events within cells, and not even immune cells. I'm not talking about macrophages. I'm talking about fat cells and muscle cells and neurons. If you activate those inflammatory pathways, insulin resistance is going to be one of the results when it's turned on for too long. And so with inflammation, you see in people with autoimmune diseases where they have as the autoimmunity is active, so too is the insulin resistance. And as the autoimmunity subsides, so too does the insulin resistance and the body becomes more insulin sensitive. That those studies in humans are perhaps the most compelling to establish that connection between inflammation and insulin resistance.

So when someone's hearing us talk, and again, this is the good news of this kind of metabolic theory of Alzheimer's disease, that far from being a disease that the person, as you mentioned earlier, they get that diagnosis and they walk out with this helpless hanging of the head and shuffling their feet in discouragement, they ought to say, all right, I've long known I needed to improve my lifestyle. This was the kick in the pants. I'm all in. And I would say as the person gets all in, keep those three ideas in mind. How can you live a life that's keeping your insulin low, helping your body stay insulin sensitive?

How can you keep your stress down? That's hard because there's some things we can't control. But there's almost a psychological aspect to it. If it's something you can't control, then you have to come to terms with it and help soften that stress on your body by reconciling that in your own mind. But nevertheless, control your stress. And then three, control your inflammation. And that has more relevance than just an autoimmunity.

That's the kind of heavy hammer aspect of it. But there's a fine little chisel when it comes to inflammation, which is just, are you exposing yourself to something that's causing inflammation? It can be something you're eating. There are people with genuine food sensitivities. If you're sensitive to a food, part of the response or part of the manifestation of that sensitivity is going to be inflammation. The body will mount some form of an immune response to whatever that food is that you've

exposed yourself to that your body's just ill-equipped to deal with. So that's the good news. Again, when it comes to something as seemingly helpless as Alzheimer's disease, there are three very powerful strategies to improve your insulin. and sensitivity and help, one, reduce your risk of Alzheimer's, and then two, perhaps even reverse course to a degree. Yeah, and I want to talk about that coming up in here in a second, and I really appreciate you bringing in that holistic view because it's not just diet, these other aspects play a

role. And if I could double down on diet for a second, diet does also impact those things. You know, when your glucose is out of control, as anybody with the continuous glucose monitor, you know, me and you both rock levels, levels help, and you're an advisor to them. We'll see that when your glucose is high, when your blood sugar is high at night, your sleep gets thrown off, right? You don't sleep as well. It's hard to really kind of get in the zone.

And additionally, too, some, we had a doctor on the podcast, a naturopathic doctor who was talking about patients that get panic attacks. She said, I've never seen a patient. that has a panic attack when their blood sugar is balanced. It's always when there's a deep crash. And then before that crash came a huge spike. So this is a very well-known thing that if you're getting stressed out in your life, because your blood sugar is on a roller coaster and you can't focus well.

And then your body starts to get into panic mode and starts secreting more cortisol because it's saying, hey, listen, we're about to run out of food and we're going down fast. Like you need to start really paying attention and go out there and kill something, hunt something, find something. And you need to eat now, which is why some people get hangary when their blood sugar drops really low. So diet does, these other areas are important. And we can't get there alone and they, and diet does impact them. So it's a little bit of both, right? It's these other areas important and pay attention to how diet does impact those.

So going back to this. Can I elaborate on that for just one sec? It's so interesting. It's something I would have never realized if I hadn't been wearing a CGM and using levels to monitor myself. One of the more remarkable moments came for me about probably four months ago. I had been, we'd been driving as a family down to southern Utah, which is just beautiful. And we were going to go mountain biking with the kids, my wife and the kids. Right near the time we were. were getting about to arrive. One of the gas station stops, this is my confession. My kids had bought some little candies, and I'm all right with that.

Of course, we just don't make it. It's always an exception. But they'd had this, one of my little boy had a little pack of gummy candies. And I just love gummy candies. I have an unhealthy obsession with gummy candies. And I control it. So that's my confession. I'm addicted to gummy candies.

But we were getting there and it was so warm outside. in southern Utah, kind of the desert of southern Utah, that I thought, well, these gummies are going to get all spoiled and kind of jelly. So I'm just going to eat them. It was Mike and I, so, it was like jelly bean, little candies. And so I just ate most of this little box just very, very rapidly. My boy had only eaten a couple, and I thought, ah, I'm just going to, I'm down these really quickly. Then we get out and we start biking, I start to get, I feel horrible. I'm, I'm jitter. I'm a little shaky. My palms are sweaty. I have this profound headache. And I didn't know what was happening. It was something I'd never really felt before. And I check my blood glucose levels and I dropped

down to about 40. And I see this huge spike when I'd eaten the candies and this enormous drop. Well, what is so interesting about that unique state where someone has this, what's called a rebound hypoglycemia, where they eat a meal and they get a little brain fog or a little tired. and lethargic. What happens in that unique state is you've spiked the glucose. Insulin has rocketed up to try to prevent it from going too high. In my case, and many others, insulin overshoots it. Insulin goes too far. And for me, I think it was a combination of having eaten these and immediately getting up and moving around where my muscles were also very greedily pulling in the glucose independent of insulin. So my glucose rocketed down, went really low. So at that

moment, my brain is relatively deficient in glucose. It's not able to meet its energetic needs from glucose alone because glucose went so low so quickly. Now, a person would hear me say this and think, well, why not then just rely on ketones? But I had already wiped out my ketones by spiking up my insulin. We only ever have fairly little ketones in the blood. So this massive spike in my glucose ended up in the hour afterwards, or about, you know, about 45 minutes after, after it happened, I end up depriving my brain of its two sources because the glucose plummeted down, getting to what was a very uncomfortably low level for me at the time, and this massive insulin spike would have deprived my brain of the ketones. So I did, in fact, have, very likely,

an acute period of time, an acute moment of brain, of an energy gap. My brain was hungry, and it was essentially telling my body, hey, I need to stop things. I'm getting hungry. And if I go too hungry for too long, we're dead. So muscles, liver, I need you guys to slow things down to spare some of this energy so that I can make sure I'm fed and we can continue to survive. So people who, now my instance was quite extreme. It was very profound feeling. And I just had to sit down and let it kind of work. I told my wife and the kids just kept going. I just drank water and had some salt just to try to keep my blood pressure up and just work my way through it over the next 15 minutes or so. But to a lesser, maybe more subtle degree, I think this is a common phenomenon

where someone is, they're at work and they're trying to get the best productivity from their brain. And I understand that. That's my moneymaker. Everything I do is because of my brain. And so we're relying on our brain to be to be optimal. And yet when we are loading the system with these sugars and starches, we are creating a potential period of starvation. Sure, we're going to work great in that moment where the insulin spiked, the glucose is spiked, but the inevitable drop and the potential excess drop where we've gone below where we should have been, that results, of course, in a reduction, I would think, a reduction in productivity as the brain is kind of mildly starving. So even in these short-term moments, brain energy use is profoundly relevant, and I suspect

most people are putting themselves on that never-ending spike and drop. that results in the brain kind of suffering. What a great story because it highlights this thing that is so important for us to pay attention to now is whether you have Alzheimer's and dementia history and your family, even if, you know, you may be thinking, okay, so I'm eating this way to one day avoid those diseases in the future. But actually, it's not just that.

You may be eating this way or lowering your stress or prioritizing sleep so that you can get the maximum performance now. When you get the maximum performance now, you can show up and give love and attention to everything in life that you want to give love and attention to. And like you mentioned, yours was an extreme, but there are people that are listening today that are having their daily version of that. After lunch, whether they're in the offices or working from home right now, they get a crash and they can't focus. So they reach for that coffee. Their brain's not working in the way that they wanted to. What are some other examples besides, you know, this brainfall?

that we're talking about. What are some of the other examples that people might be dealing with when their blood sugar's out of whack, when insulin is being overproduced, they may not have a chronic disease that has a name like PCOS or they may not have erectile dysfunction. But what are the daily things that are going on when it comes to their brain that are examples that, hey, we got to pay attention here and start rebalancing stuff. Yeah. Yeah. In fact, two of the obvious ones, it was a bit of an oversight that I didn't mention them sooner. One is epilepsy, which is admittedly a bit a unique situation, of course, that doesn't afflict that many people. But a second is much more common and more common all the time, which is migraine headaches. We had been discussing

Alzheimer's disease in part, in a very real way, as this phenomenon of brain glucose hypometabolism. So essentially, that Alzheimer's disease is in part coming, or is born from the brain not being able to get enough energy from glucose. Well, and we can detect this. And we can detect this. in humans. We can measure, of course, like we mentioned, we can measure that brain glucose use is down in these states of cognitive decline. We see the exact same thing in epilepsy. And this could be why people with epilepsy respond so favorably to ketogenic diets, to the point that in many, many people, it's completely curative. If they suffer frequent seizures, they simply, they adhere to a ketogenic diet, and they may never have another seizure again. This used to be the, or,

original treatment for epilepsy until we got so clever that we made drugs. And a drug will never work as well as a lifestyle change. And epilepsy is no exception. But also, of course, most people don't suffer from epilepsy. A lot of people suffer from migraines. Once again, people with frequent migraines have detectable reductions in brain glucose use. And for over a hundred years, I think the earliest paper was in 1929, so about 100 years ago, we have reports from 1920s and 1930s of physicians taking people with migraines, frequent migraines, putting them into a ketogenic state or a ketosis, and their migraines stop entirely.

I have a colleague six doors down. He once heard me mention this just in passing. I wasn't even talking with him. And he comes to me a few months after that, and he says, Ben, I've just got to take it. tell you what's happened to me. He would get one to two debilitating migraines a week. So this would lay him out. He would miss work on occasion when it was that, when it was really bad. And now he said, Ben, I heard you say this in the past four months or so. He said, not only have I lost about 30 pounds,

but he said, I haven't had a single migraine this entire time. I mean, it is transformed the way he lives his life. And I've seen this play out in multiple other individuals, but it's just particularly fun when it happens to a cynical, skeptical scientist like I'm surrounded by, as all scientists thought to be a little skeptical. But you see this happening where Alzheimer's, similar to what we mentioned earlier, someone would look at Alzheimer's and migraines and epilepsy and say, yeah, sure, they all affect the brain, but they have nothing in common. The reality is each of them has confirmed reductions in brain glucose use. Now, whether you can turn that around or not, That's one part of it. Can you improve the brain glucose use? But even if you can't, then all the more reason to give it some ketones from time to time. Let the brain be the true hybrid engine that it wants to be. Don't keep that one fuel take empty, the ketone tank. Give the brain the ketones. So you'd mention that your question, what are the other brain disorders independent of the acute brain fog or the acute sort of lapse in clear cognition? We already have Alzheimer's disease, but then we have these others like migraine.

which appear to be kind of in that same vein. It's certainly in that same family of problem. In the lines of the story that you shared earlier, another story that I have that really came out of also wearing, you know, my continuous glucose monitor is I would always hear about how, you know, gluten-free products, which typically are made with these,

even if they're healthy, quote-unquote, healthy products, they're made with these refined starches, right? Cassava, tapioca, other stuff. It's not the whole plant with all the fiber. It's these refined starches that are being used to make or, you know, tapioca. In some cases, you know, some almond flour, things like that. But a lot of them these days increasingly, a lot more people are seeing potato starch, cassava, you know, those types of items in there, those carbohydrates.

And I always, okay, so I knew I need to minimize those in my diet. But I thought, great, you know, a company that I love and I still love them and I respect them for what they've done. So please don't see this as a criticism on the company. But Siette wraps, right? They popularize this tortilla, this gluten-free tortillas that were there. And I used to make them at lunchtime. So I'd make super healthy salad, like all balanced out, everything great, some grass-fed, you know, beef or maybe some wild-caught salmon. And then I'd make a little tortilla wrap.

And I would have like, you know, four, five, six or seven. And I can remember, you know what? let me try this on my glucose monitor because sometimes after lunch I would always tell people, I don't like eating a big lunch because I feel totally drained and I can't focus afterwards. So I wore my glucose monitor and I had these gluten-free items, these sortier wraps. And immediately I saw that having done a test the last week, which I had a pizza from a place here in L.A. that's very well known because they import their wheat from Italy, right? So it's native wheat.

It's called pizana. And I have that. You know, once a quarter, I want a little pizza, just like you wanted those gummy bears. You know, you want a little taste, have a couple of slices, and I'm good after that. Don't need to eat the whole pie. So I compared that to this pizza, which you think should skyrocket you, but it was made with native wheat. It wasn't gluten-free.

And I saw that nothing had spiked my blood sugar more and then created. this chasm on the roller coaster and on the other side, this dip, which nothing had spiked it more than these gluten-free wraps that I had had. And so this is another just reminder for folks that are out there that even still, there's a lot of my friends that think that they're eating healthy and they're doing the best they have with the knowledge that's there. But if sometimes they're not paying attention or looking into these things or actually looking at like the net carbs of items or protein powders, you know, that are out there, they may still be on this roller coaster that's leading to this brain fog, this ability not to be able to focus, they can't concentrate,

and we chalk it up to old age, or that's just me. But we were never meant to be this way. These are all new items. But, you know, to the last point that I want to make here before I have you chime in, this is good. If this is happening to you, this is good, because it means, Your body is giving you a little smoke detector alarm. Just like we know, the smoke detector is going off. There might be fire. At least we should pay attention because something's burning. This is your smoke signal.

This is your detector saying it's time to pay attention. We need to get serious about this matter and create a different way of life. Yeah. Oh, for sure. Yeah, this is one of those canaries in the coal mine where when someone feels these moments, don't overlook them and wonder whether it might be a problem. of what you're doing to your body and your insulin sensitivity function. Yeah, it is one of the great ironies that gluten-free products, the irony to me is a guy

who sees health and wellness through the lens of glucose control and insulin control, is that you've removed one of the most common offenders, which is wheat. Now, for my view, again, I don't look at wheat as a problem because of its gluten. to me, it's a problem because of what it's going to do to my glucose and insulin. But again, the irony in gluten-free products is having removed one of the great offenders, which is wheat, they've actually put in, in many instances, even worse offenders, which is tapioca starch and potato starch. Those will increase your glucose much more than wheat will.

Now, again, maybe the person is thinking, well, I don't care because it doesn't have the gluten. That's all I care about. But you should care for all the reasons we've been elaborating on. And that really is one of the true utilities of CGMs. Because when you see what's happening to your glucose levels, you can't unsee it. And my hope is as CGMs become more common and more accessible, people will start, they'll make their own lifestyle changes because they'll see exactly what you and I saw. They look at what's happened and they can't unsee it. So they don't have to have Drew and Ben saying you really got to control your carbohydrates and be smarter about them.

they end up coming to those conclusions on their own, which is, of course, far more powerful because it's not someone imposing or someone encouraging you. You provide your own encouragement because once you see what those foods are doing to your glucose levels and how you feel during those changes, you can't unsee it. And it just naturally will lead into better behavior. You know, we've talked a little bit about carbohydrates, but just so that we're clear for everybody who's listening, you know, we're talking about processed and refined carbohydrates that are often in these processed foods, even health foods, right?

Health foods that are out there, not to mention that a lot of times people will add just straight up sugar because when you remove the, when you're trying to make gluten-free products taste better, especially if they're dairy-free too and you've removed the fat, you've got to pump it with a ton of sugar just to make up for that, you know, lack of taste. Right. But, you know, vegetables or carbs too, but just give them the contrast here. Why vegetables for the most part, right, broccoli, other vegetables, that we'd be eating, we're not really talking necessarily about that.

Just help people understand, just so that's super clear. Yeah, yeah. Yeah, so I want to emphasize that my view on carbohydrates is control carbohydrates, which at its simplest definition is don't get your carbs from a bag in a box with a barcode. That's the simplest way of my view of carbohydrates. I'm not saying we can't eat them, not at all. But it's typically going to be carbohydrates that are the biggest offender when it comes to trying to control glucose and insulin.

So just be smart about it. And in general, at the simplest level, focus on fruits and vegetables. If a person's building their carbohydrate consumption around fruits and vegetables, we almost don't need to go any further. Eat, but I would say eat them, don't drink them. Don't juice them and make, you know, a smoothie maybe to a degree, but certainly not juice. But eat fruits and vegetables and just be much more careful with grains. that's generally the way it goes.

And that alone is often going to be enough. But when someone's ready to go to the next level or if they need to because they have a family history of type two diabetes or they already have type two diabetes, then my next level is while you've been focusing on fruits and vegetables, now it's time to remove the biggest offenders in that category, which is going to be like if a vegetable grows in the ground, then be careful with it. I'm not saying you can't eat it, but it's going to just naturally be much starchier. if the vegetable grows above the ground,

it's generally one you can have almost as much as you want to shove in your face. It's going to have such a modest effect on glucose and insulin. Right. The contrast between, let's say, broccoli above ground, and then even something that can be healthy and in moderate form, but out of control can spike you crazy would be like a potato or even sweet potatoes, which a lot of people eat. Sweet potatoes grows underground.

It's a lot starchier. Anybody who wears a CGM or knows anything about, How blood sugar knows that if you eat a big bowl of sweet potatoes or have some, you know, a big bowl of sweet potato fries, that can spike you almost. It's almost the equivalent in your body as a Coca-Cola, right? Or a soft drink that's there. Yep, yep. So that's that next level.

So in general, I don't mean at all to declare war on carbohydrates. Far, far from it. I think they can be a wonderful, healthy part of a smart diet. But we can't get them from bags and boxes with barcodes. focus on fruits and vegetables, eat them, don't drink them. And then if someone needs a little further push, well, then it gets to that next level of, all right, well, let's scrutinize your vegetables and, you know, some of your fruits to avoid the big, the starchiest or the most sugary of those.

But often, I don't, often we don't need to go that far. If a person is, but no, someone would hear us and say, oh, so Ben is saying at a high level, potatoes can be okay. And I am at a high level saying that. But that is not the same as eating potato chips. You know, and that's back to my point. If it comes in a bag or a box with a barcode, beware. How's that for some alliteration?

How many bees can I put in a row? Beware. So those are some of the categories of foods on the offenders. Give us some examples. You know, we talked about the importance of fat. We talked about the, we talked a little bit about protein. Give us some examples of foods that not only fuel your body, but also fuel your brain. What are some of the positive things?

I mean, vegetables are positive. but typically we've had this war on fat for years. And that's starting to change a little bit, even with big personalities like Malcolm Gladwell is starting to do, you know, having done some podcast episodes, helping people understand how we got it wrong when it came to fat. My business partner, Dr. Mark Hyman, writing a whole book on fat. You talk about it a bunch in your book, Why We Get Sick.

So let's talk about fat as a category and some of the staple fats that we can have in our diet that are beneficial when it comes to this whole topic that we're going. in. Yeah, yeah. So fats, I am a big friend of fats in the diet for two main reasons. One is that they are in fact essential. There are fats that humans must eat to survive. So we have to, we have to have, we have a genuine biological imperative to eat certain fats. And then two, of all three macronutrients, fat is quite unique because fat alone, which of course people don't eat it that way, but it's powerful in that fat does not have an effect on insulin. If someone's eating fat, again, we don't do that, and I'll get to that point in a moment,

but fat isn't an insulin spiking nutrient. But so maybe to keep it at that level for a moment longer, I am a great defender of natural fats or ancestral fats or any other terms we could use there. And that is to say the fats that we as a species have been eating since time immemorial. Obviously, animal fats fit into that. There's no, there's, this is beyond debate. It's surprising that it's ever debated. It certainly shouldn't be.

We as humans are omnivores and we've been eating animals since the beginning of our species. And in fact, one of the leading theories of evolution, which is all theoretical, of course, is that we became humans because we ate animals. That's something called the expensive tissue hypothesis, and I won't get into that. But someone could look it up. But it's possible. But I want to just chime in there because it is important. when you look it up, if you are excited to know that our brain wouldn't be what it is today

if we didn't learn how to cook and especially concentrate calories, which came in the form of animal fats. Yep, that's exactly right. Yep, you encompassed it perfectly. I couldn't have said it better myself. Yep. So eating animals might have made us human. Of course, that's all theoretical.

So the animal fats I defend, we are well adapted to eating those because we've been eating them since the very beginning of time, human time. And then two, fruit fats. Fruit fats are the fats that our ancestors would have needed nothing more than to simply step on it or press it with some simple kind of lever. But essentially, this is fat that's coming from the flesh of a fruit. And the fatty fruits are coconuts, avocados, olives. I think that's it. I think those are the main ones, and there might be in one or two more. But those fruit fats are, again, we're well adapted to them. They're saturated and they're predominantly saturated and mono-unsaturated fats. There's no problem with that. We know what to do with those. They're a healthy part of the

diet. And again, I suspect part of the reason they're healthy is that we've been eating them for so long. You know, it's thousands of years that we've been just scooping out the flesh of a coconut and pressing it to get oil. We've been stamping. on the olives to get oil from the olives. This is something we've been doing. Now, the offenders in the fat category, lest anyone think I'm giving fat just carte blanche, eat as much as you want any kind, no, far from it. And that's because the most commonly consumed fat now in the U.S., and in fact, I suspect in throughout Asia, it's a different kind, but it's in that same family. But the average American gets more of his and her calories from soybean oil than any other single source.

of fat. So that introduces this other family of fats, which is the industrial seed oils. That's the best term. People will commonly call it vegetable oil. Like when I was living in Asia, including a talk I gave in India, you see vegetable oil bottles everywhere. It's vegetable oil. And everyone thinks it's a good thing because we've had that idea so thoroughly beat into our heads. Indeed, you and I were just saying how vegetables are wonderful and can be a wonderfully healthy part of the diet. But it's such a misnomer because these are oils that are not coming from vegetables. Vegetables don't give oils. These are oils coming from seeds like cotton seed or corn seed or from the seeds of the corn or as I said soybean oil. These seed oils are enriched with a type of fat

that our body, we're eating tens of thousands of times more now than we ever have in all of human history. And there's a compelling manuscript published by a man named Christopher Ramsden, who works at the National Institutes of Health, the NIH here in the U.S. He published a paper looking at changes in fat consumption in the U.S. for the last 100 years from 1909. And at the time this was in the 2000 teens when he published this report. And it's shocking to see beef consumption, the fat that we get from beef, which is looked at as, you know, the great offender here. It's almost totally consistent. It started to go up. It went down and it kind of went back to where it was about 100 years ago. And then we look at soybean oil and it went from nothing to being the number one

by a wide margin, the number one consumed fat in the American diet. And I would say at this point, it's essentially reflected in various ways as the global diet now. And then even fat number two was shortening, which I think is a mix of cotton seed oil and some other seed oils. But the two main consumed fats in the average American and maybe even global diet are from these seed oils. And that's so relevant because we've long been saying that saturated fats are the origins of heart disease. But you look at the consumption of saturated fats like from beef and eggs. It has not moved in a hundred years as a percent of our diet. And so that directly you look at heart disease and it's spiking, well then you'd expect saturated fat consumption to be spiking and it's flat. The only

fat consumption that follows this trend in heart disease and obesity and diabetes and dementia are the seed oils. That has gone from nothing, never having been no part of our diet as humans, to now becoming the single largest source of fats in our diet. So we need to focus on fats. Certainly they're healthy, but they need to come from these ancestral fats like animals and fruits. Complete that sort of connection there and back to insulin and,

glucose, even though some of these fats, these omega-6 seed oil fats, which by the way, I'll send a link in the show notes to the actual process. You know, if you want olive oil, you're stepping on olives or you're pressing olives. And sometimes some fancy, you know, if you're processing a lot of it, you might have a centerfusion to make the process a little bit easier. But if you want to get oil out of a seed, if you want to get oil out of corn, you're talking about a 12 to 20. 24-step process, including chemical solvents and deodorizing agents and a whole host of other things that are anything but natural, as you mentioned. But earlier in the interview, you were talking about, you know, the importance of sleep. Then you were talking about diet and, let's say, like, you know, glucose. Then you were also talking about inflammation. So let's close the loop

and how do these seed oils play into the inflammatory, besides them not being natural and industrialized, but what do they actually do? How do they wreak havoc on our body and especially our brains? Yeah, yeah. So I would say there are probably two causes here, two connections between seed oils, which are enriched in omega-6 fats and then inflammation.

One is that maybe I'll start with the less obvious one, which is that seed fats are uniquely metabolized into molecules. that create an altered redox state, or in other words, to say that another more palatable way, they create a profound oxidative stress, creating reactive oxygen species that are absolutely disastrous to the body. So that, as the body's fighting oxidative stress, inflammation can go up in that same state. So there's one phenomenon where these fats are metabolized into these these very dangerous oxidative stress molecules. Then the other one is the more well known in most circles,

which is that omega-6 fats are precursors to a type of fat called arachidonic acid, which itself is a precursor to molecules that promote inflammation. And these are like leukotrienes, for example, are part of this, and prostaglandins. these very explicitly pro-inflammatory molecules are derived from arachidonic acid, which is itself often derived from omega-6 fats. So we are putting a fat into our body that is directly contributing to inflammation. And one of Christopher Ramsden's other findings, and I mentioned him earlier,

as the scientist who looked at fat consumption in the U.S., he looks at, as others do too, the omega-6 to omega-3 ratio. And noting that omega-6 and omega-3s are both considered essential fats, those are the fats that I was alluding to when I talked about how they're necessary for the diet. It's interesting to look at the habit, the dietary changes where our omega-6 is now tens of thousands of, you know, I think 56,000 percent higher now than it 100 years ago. Our omega-3s have not gone up. And so the view is that our ancestral omega-6 to omega-3 ratio was about a ratio of three to one.

And that's just reflected in nature. Eggs have omega-6s and omega-3s. Animal fats have omega-6s and omega-3s. So they're always there, and that's good because we need them. They would typically come at a ratio of three to one. Now, let me back up for just a quick sec, because omega-3s actually challenged the inflammatory actions of omega-6s. Whereas omega-6s are being metabolized into things like leukotriens and prostaglandins, omega-3s are getting metabolized into resolvins, these molecules called resolvins,

and they will start to challenge some of the inflammation that the omega-6s are trying to propagate or to promote. So we went from an ancestral ratio of three to one, and now we're at a ratio of about 20 to 1. So we have skewed this so heavily in the direction of omega-6s that it stands to reason that we have this greater inflammatory burden that the omega-3s just, it's a fight that the omega-3s are constantly losing. We haven't matched this massive increase in omega-6s by a massive increase in omega-3s. And so the ratio, what omega-3s may be trying to do to counter the inflammatory effects of omega-6s is just, it's all for not. You know, I think this is especially important for everybody to listen to, but in the context of dementia, Alzheimer's cognitive decline, we know that these conditions are, there's a lot of moving parts that are there, but we know that inflammation plays a major role. So we have to be thinking about these processed foods that we're eating that primarily have these seed-based oils in them, they are basically the oils that are setting your brain on fire.

fire. They are the oils that you consume them over the period of your life. We know that now through the study of nutritional psychology and some great physicians and researchers that are in that space, that depression, Alzheimer's, these things, they all relate to some level of inflammation. In fact, they sometimes are calling depressed. You have to think of depression as inflammation of the brain, not in every instance, but in a lot of the instances that are there. So you want to cool the brain down. We don't want our brains to be on fire because that's going to promote the likelihood that we're going to end up with these conditions that we're trying to avoid. Yeah. And one of the tragedies of this massive shift to omega-6 rich seed oils is that they always

come with carbs. So we have created this perfect storm of nutrients where we're getting foods like, say, a potato chip or virtually any kind of baked kind of carbohydrate type good. is going to be, of course, high in sugar, and almost always the source of fat is going to be soybean oil or one of its companions in that toxic family of fats. So it's not just that the person's drinking a bottle of soybean oil, it's that they're frying anon in the soybean oil, or they're eating crackers that are baked with soybean oil, or it's the twinkie, you know, whatever it is, those two almost always come together. And that's almost almost in a nutshell, what's perfectly wrong with the modern diet.

High and refined carbohydrates and high and refined oils. That is not the way we were and generally deficient in protein. But it's really those two, they always come together. So my admonition to avoid carbs that come in bags and boxes with barcodes, that what comes with it is an admonition to avoid those seed oils, because whatever that carb is, very likely it's been baked or cooked or fried in a seed oil. And I just want to say on a personal level, having been somebody who was younger and my dad was a CFO of a group of psychiatric hospitals, I grew up in sort of that world of mental

health, paying attention, everything like that. And I always felt great. And I went vegan when I graduated high school. And actually, it did wonders for me. Getting off a dairy, I was on antibiotics my entire life. I got off a dairy. My skin cleared up completely. And I found out then I had a sensitivity, as you were sharing earlier, I had a sensitivity to traditional commercial cows milk dairy that we raise here in the U.S., which is really not a health food. You know, there's a lot of better health foods that are out there. There's much better quality dairies that are there. So I took a big leap forward. My skin was clear. I thought, wow, vegan is the way to go. This is the, you know, the future. And I was such a passionate person telling everybody about my story and testimony. I was evangelizing

out there. And then after a few years of being in school and studying computer. pure science, I really, you know, started to notice that I didn't feel as good. I got the blues more often. That continued for a few years. I was eating a lot of processed vegan food, the soy meats and the, you know, industrialized seed oils and everything that I was consuming, not getting any good quality of mega-3s. I'm not eating fish. I wasn't eating it before, but at least I was having some dairy, which was making up for some of the difference that's there. And as we get older, we're less resilient. So it's the natural part of age process that's there. I am not able to cope with all this inflammation. And then one day I came out with, you know, my dad's saying,

I think you're depressed and we really have to do something about it. And looking back now, I can see that I had a version of inflammation of my brain through eating all these processed foods and lacking these good quality fats and nutrients that are there. On top of that, I really felt that being a vegan, again, nothing wrong with people wanting to be vegan or vegetables. vegetarian. I've been there before. Just it's what works best for your body. A component that I came across recently from an individual and entrepreneur in the space, he said, we have to understand that almost 12% of our entire landmass on Earth is being cleared primarily for vegetable oils that are being driven there. So for people who think that they're doing the planet of favor by

not eating meat or doing other stuff, these vegetable oils, which are a big part of people's diets, especially people who are vegetarian, are wreaking havoc on the earth and it's not sustainable. I agree. I couldn't have said it better myself. It's part of the myth of the modern view of vegetarian or vegan eating. And again, I don't mean to be derogatory here. I really don't because I know that's a very passionate subject. But if a person is eating that way because they believe it's healthier for the planet, the truth is far from it. Now, I'm not to defend large-scale ranching practices, which are also catastrophic in their own right. So not to say that we don't need changes, we do, but we need them across the board, including when it comes, including kind of

vegan favorites like soy, peas and corn, et cetera. And that's not even to mention the number of animal lives lost, which is considerable. When you go clear the land, it's more than just damaging the land. It is in fact also accounting for significant death of animals that lived on that land. So there is a, there's a tremendous, that's a, that's something someone has to reconcile because if they're, if they're eating a particular way because they feel it's better for the planet, very likely it isn't, unfortunately. Yeah. And as you mentioned, we need to look at all aspects. There's problems with, you know, factory farming and obviously we're getting a lot more attention on regenerative farming. Small farms, bringing those back in favor. We won't go too deep

down that rabbit hole, but that was just my personal background and experience. And when I changed, then and started eating more omega-3s in my diet, getting that index more optimized. And I want to just give a shout out. I have no affiliation with them, but there's a test called the Omega Quant. It's $99.9. You can get it online. Anybody can do a prick test at home. And it'll give you your omega-3 to omega-6 ratio and tell you what the optimal index is.

You don't have to go to your doctor. You can just do it. Again, I have no affiliation with them. But that was one of the early tests that I did to see that my omega-6 was out of whack. and I was just driving all this inflammation in my body. So, Dr. Bickman, I have a question for you. You know, naturally there's somebody that's watching this who's family member or a loved one or themselves,

you know, as recently got a diagnosis in these topics that we opened the conversation with. Maybe it's early dementia. Maybe they're starting, they caught it, hopefully, knock on wood, that they're starting to see some serious cognitive decline and it's being caught early or they're noticing. it. Is there still hope for them? If this is a person that's watching or listening today or has a loved one that has one of these diagnosis, is there hope for them? And what would be some of the

high-level things that you would tell them that they can immediately start doing to at least start to gain some control back in their life with these diseases? Yeah. Yeah. So I do think there's reason to be hopeful. And of course, the earlier the person intervenes, the much more hope a person can have. When someone has what would be diagnosed based on cognition, full-blown Alzheimer's disease, I, to my knowledge, that is irreversible. There is some, there's some permanent loss of cognition that you will never get back. Now, having said that, there is evidence, there are studies in humans, to show that even then, if a person starts making dietary changes in particular, cognition can improve. So while they are unlikely to be able to get back

to where they used to be, they can at least go that direction, which is better than stopping it altogether and certainly better than continuing to move and slip deeper into dementia. And these studies have been based really on two things, but they actually play into each other, and we've been discussing this. But one, it is to lower insulin by any means possible. And that's going to generally be controlling carbohydrates and focusing more on protein and fat sources, which have little to no effect on insulin, and fasting as well, of course. So that's the first strategy. It's try to lower the insulin as quickly and completely as possible. That will

improve insulin sensitivity in the brain and the rest of the body, and that will allow the brain to use glucose better, so filling some of that energy gap. But at the same time, again, this is no surprise given how we've been talking, when insulin is low, the body will be making ketones. And that's perhaps the greatest, most profound evidence from multiple scientists, I'm finding that if you can just put a person into ketosis, within hours, you can do the same cognitive tests you've done before, and cognition improves. Now, I'm not saying you've reversed and cured the Alzheimer's. No, nothing is so dramatic. But you have, in fact, improved cognition. And so the person who's noticing this mild cognitive impairment, then all the more reason to go all in.

You just, you commit now because you can see the future, a future where you won't be able to understand what's happening. And that is a sobering. That is a terrifying future. So the earlier a person is sensing these deficits, the more firmly they ought to resolve to lowering their insulin, which will again have the two benefits. improving insulin sensitivity and promoting the production of ketones, thereby helping the brain use glucose better and giving it that alternative fuel ketones so that the brain isn't so dependent on glucose metabolism. So I would say that's step number one.

Start tomorrow, change your breakfast, especially breakfast. Overnight, you've been fasting, insulin has come down, maybe you've started making some ketones. Don't stop that process so violently by eating a breast. breakfast that is so rich with sugars and starches. And tragically, that's often when we eat the most. We eat cereal or toast or bagels with orange juice. That is going to spike our insulin and immediately stop all of that metabolic benefit that started happening overnight when we were finally giving our bodies a break from the incessant glucose and insulin spikes. So control the

carbs, focus on protein and fat, and I would say start tomorrow for breakfast. The beautiful thing about that is that you nail that breakfast piece, you get some of those good quality fats in the morning, you are just less hungry throughout the day. So for anybody who's listening, if they missed our first podcast, the beauty of all this too is that you just are not so driven by the need to eat all the time. You have more control. You feel good. It's not willpower. We're not talking about relying on willpower. We're actually saying breaking that cycle. And, getting a chance to have a little bit more freedom. So great, you're a little hungry, then you can go eat.

But if you don't get anything to eat because a podcast is running longer or you're in a meeting or you're doing something else. It's not the end of the world. You're not about to bite somebody's head off. You know, one of the most saddest things that I saw is a few years ago, there's a group of my friends. We volunteer regularly at different places. And there's a famous memory care center, which primarily focuses on Alzheimer's patients.

And it's actually pretty well known because Ronald Reagan spent some of his time there after his diagnosis many years ago before, you know, he's passed away. And we went to volunteer this memory care center. And we were sitting down spending time with some of the folks there. It was an individual's birthday who was a patient that was there. And one of the nurses that was there was carrying around sort of a little baggy. And I was like, oh, like, what's inside of that, you know, baggy? and it was basically a collection of candies. And she said, you know, I keep candy on me at all times because when, first of all,

the cravings for a lot of older people in general, but these Alzheimer patients, they crave candy a lot. They crave sugar a lot. And I just find that when they're irritable a little bit, I'll give them a little bit of candy and it kind of makes everybody's lives a little bit easier. And I thought, wow, you know, I didn't have the knowledge that I have now. But even then I knew that obviously this isn't a, great way to promote health and it's definitely not doing their Alzheimer's any favor. And, you know,

we want to break free of that cycle so that not only do we not end up in a situation like that where we have to be taken care of at a memory center or a nursing home and we're susceptible to a whole bunch of other diseases, right? A lot of people who are diagnosed with Alzheimer's or cognitive decline are also vulnerable to have diabetes. They're also more likely to get COVID, which has been a big topic. So we're trying to create a better lives for ourselves and our families and break free and create more freedom that's there for us. And I really feel like anytime I get a chance to talk to you about this topic

or anything that's related there, it's so hopeful because it's that reminder that we're not a victim of our circumstances, we can actually take action today and improve our lives right now. So I just want to acknowledge you, Dr. Bickman, for being that voice of hope and also the voice of reason when it takes years to really pivot the health industrial complex. Yeah, oh, well said. Yeah, maybe one key takeaway is that when it comes to Alzheimer's disease and so many other

chronic problems, the food we eat is either the culprit or the cure. That is the simplest way of looking at it. And it will, if we allow the food to be the cure, then it will work better than any medication could ever hope to work. The best diabetes medications, the best Alzheimer's medications, the best infertility medications will pale in comparison to lifestyle changes that will then feed into improvements in metabolic health, specifically, I would say insulin sensitivity. So the food we eat is the culprit or the cure.

Yeah. And in the meantime, we have to be able to do things. that we can take action. We're pro-medicine. You know, we're pro-all-these advancements that are there. And medicine is so amazing and we're so lucky that we have all these technologies and advancements in health. But until there's something like a nanobot that can go in

and remove the bad things inside of our diet or whatever it might be or what the future looks like, we have to play that role. Food is medicine and it can influence towards the positive or the negative. Ben, this has been fantastic. I want to run through a few different things. that you have in your ecosystem and in your world that I think that our listeners would love to get a chance to get into.

Your book is so awesome. And the title is why we get sick. And that's the best title because you do a deep dive into all these topics and make the connection between this really most specifically insulin, as we talked about here, and how it relates to everything that we go through. So one, congratulations on a fantastic book. I've been seeing you in all the people's podcast. podcast, and we have the links to the show notes that are available, and you're always doing,

you know, expanding on that content on your social media. You also started a product company, I think with your brothers, right? You started a product company with your brothers. Tell us a little about that. Yeah, that's great. Thanks for mentioning it. Yeah, so my two of my older brothers, and I've got a lot. I'm the eighth boy. So seven older brothers. So two of my elder brothers, we just wanted to do, wanted to make low carb easy, where when someone goes on a low carb diet, it can be a challenge to just plan the meals and know what to eat. And it's a crowded space for sure, but we just wanted to do it better than we thought was happening elsewhere. So people can learn more about it. It's a low carb, high fat, high protein meal replacement shake and go to

get health. So the name of the company's health code and health is spelled HLTH because who has time for vowels these days. So go to get health, hLTH.com, and they can learn more about it there. That's fantastic. That's really great. And you were kind enough to send it to me last time. The taste is amazing. I do have a little bit of a sensitivity to dairy.

So I'm balancing that out. I did commit to you that I would try it. And I could say for anybody who's listening, the taste is fantastic, right? The taste is fantastic. And I was able to gift it to a friend who devoured it and then continued to order that item. So I'm just putting this out there one day. You might come up with a version that I can also enjoy. I know. I know. It doesn't have dairy inside of it. But hey, the version you have right now is fantastic. When we do, when we do, you'll be the first to know. Yeah. Yes, please. Because, you know,

a lot of meal replacements, they taste like crap and they don't have the best nutritional backing on the end of it, right? And it's so great that even a friend of mine who has a parent that they're taking care of who they were supplementing their diet with insure, which is horrendous. I said, you know, you should check out this protein powder that my friend Ben Bickman came up with. So anybody who's looking for that, we'll have the link in the show notes. You are, we've mentioned it before and we'll just give him a shout out. You're an advisor to Levels Health, the continuous glucose monitor company that's out there. So we'll have the link to that.

Anywhere else that you'd like to send our audience when it comes to your world and ecosystem? Yeah, well, thanks again. Again, what a great conversation this has been. Yeah, as you mentioned earlier, I'm fairly active on social media, and it's really just only ever me giving some scientific insight, just quick little video clips. And that's mostly on Instagram. I've just found Instagram to be an overall more friendly environment than any of the other social media platforms. And people can find me there at Ben Bickman, Ph.D. And then I also helped co-found an online dietary coaching platform.

So people that are just having a hard time knowing how to move through this, I'm not one of the coaches. I'm just one of the founders, and that's a company called Insulin IQ. So people can find that at InsulinIQ.com. That's the end of it. But I know sometimes people don't like hearing academics be involved in entrepreneurial pursuits, and not that anyone's attacking me. But my defense of it is, if it were necessary at all, when you think you have answers to important questions,

you can't help but want to turn that into solutions to important problems. And so this is just my ongoing effort to try to put what I believe to be true in the realm of science into practice where someone can, they can take these ideas that we've been talking about and just as easily as possible with my pursuits and yours and many, many others, just actually implement these changes. So I don't want to, I don't want science to stay in the laboratory, I guess, is another way of saying it. I want to have a way to, my own practical view of things, demand. that I try to find a way to put these things into practice in the real world. And that's what these efforts are. I wish we had more academics getting into entrepreneurship and starting companies. You know, for anybody who's listening, please, if you have an answer, if you have a way

to improve people's lives, if you have a solution to make it easier, healthier, that's what's needed because that's the only way we'll be able to scale up health. You know, health sometimes can be expensive in the current model, although eating whole foods is not that expensive. and they don't all have to be organic, right? Organic when you can. There's a lot of resources there, but we need more solutions. So anybody that's listening, please go and scratch that entrepreneurial itch.

And for the listeners that are here, if you want more, Ben Bickman, just a little shout out to our past interview. Your video was our number one producing, you know, viewed video on YouTube. So check that out on the show notes. And the podcast was one of the top podcast of 2020. So there's more of that. we do a deep masterclass what Dr. Bickman does on fat burning. When you understand that, it changes your understanding of fat. So plenty of links for people to go through and continue the journey on.

Dr. Bickman, a deep note of gratitude for who you are in the world and really putting yourself out there, getting out of just academia alone and extending that conversation, making the studies relatable in book form, in podcast form, in your social media clips. We need more of that, and I applaud you for it, and I'm honored to call you a friend in my world. Oh, I share that sentiment completely, Drew. Always a wonderful time visiting with you.

I think hopefully the listeners, they will really come away from this, enriched and, as we noted, a couple times empowered, that we can control metabolic health, and that means to a degree we can control chronic disease. Beautifully said. Dr. Bickman, thank you for being here. Thanks, brother.