Dhru Purohit Show - How Insulin Resistance Leads to Alzheimer’s Disease & What You Can Do to Reduce Your Risk Today with Dr. Ben Bikman

Episode Date: August 8, 2022

This episode is brought to you by InsideTracker and Pendulum. Nearly six million individuals live with Alzheimer’s disease in the US, 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.  On today’s mini-episode, Dhru sits down with Dr. Ben Bikman to talk about the 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. 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 -Early signs of potential cognitive decline -Common foods that drive insulin resistance -Foods that fuel your body and brain -What you can do today to reduce your risk for Alzheimer's disease   Listen to the full episode here. For more on Dr. Ben Bikman, follow him on Instagram @BenBikmanPhD, Facebook @BenjaminBikmanPhD, Twitter @BenBikmanPhD, and through his websites, bikmanlab.byu.edu and insuliniq.com. Get his book, Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease―and How to Fight It, here.  This episode is brought to you by InsideTracker and Pendulum. InsideTracker provides detailed nutrition and lifestyle guidance based on your individual needs. Right now, they’re offering my podcast community 20% off. Just go to insidetracker.com/DHRU to get your discount and try it out for yourself. Pendulum is the first company to figure out how to harness the amazing benefits of Akkermansia in a probiotic capsule. To receive 20% off your first purchase of Pendulum’s Akkermansia probiotic supplement, go to Pendulumlife.com and use code DHRU20. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here. This mini episode is taken with one of our past interviews with Dr. Ben Bickman, bestselling author, and one of the top leading experts on insulin and insulin resistance. And some of what we cover in today's episode is why Alzheimer's disease is increasingly being referred to as insulin resistance of the brain or type 3 diabetes. We also talk with Dr. Ben Bickman about early signs of potential cognitive decline. We talk about common foods that drive insulin resistance. foods that fuel your body and brain instead of taking away from it.

And most importantly, what you can do today to reduce your risk from Alzheimer's disease in the future. It's a fascinating conversation with Dr. Ben Bickman. Stay tuned. Traditionally, especially here in the West, we saw Alzheimer's dementia and early cognitive decline as a sort of a blockage, primarily blamed on these amyloid plaques that were perversement. 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 3 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. This episode is brought to you by Inside Tracker.

In my opinion, I think technology can be a critical part in the solution to helping us figure out what foods are best suited for our own unique genetic makeup. That's why I was super excited when I heard about Inside Tracker. Inside Tracker helps take the guesswork out of living optimally and creates a nutrition, exercise, and lifestyle plan that's personalized

for you based on your blood work, DNA, and personal preferences. InsideTracker's cutting edge technology gives you the science-back recommendations for positive changes to your daily habits. With their app, you can track your progress every day, and they have an amazing support team to help you with all your questions. InsideTracker looks at everything from metabolic and inflammatory markers to nutrient and hormones. It even tests your cortisol levels to help you better manage stress and you have the option to see how your inner age compares to your chronological age. That's pretty fascinating.

InsideTracker makes their results easy to understand and provides tips on how to use food first for optimal nutrition. Right now, they're offering my podcast community 20% off. Just go to inside tracker.com slash drew. That's D-H-R-U to get your discount code and to try it out for yourself. that's inside tracker.com slash dhru for 20% off. If you've been listening to my podcast for a while, you probably know that optimal metabolic health is one of my main MOs. So when I heard that Pendulum was the first ever company to harness the blood sugar balancing properties of Accomancia into a probiotic capsule, I couldn't wait to sign up for their monthly subscription. If you're not familiar with Acrimancia, let me back up a little bit because you're going to want to know about why this is the next generation of beneficial bacteria that we want in our gut microbiome. For starters,

acrimancia stimulates the natural production of g-l-p-1, a hormone produced by the gut, which helps maintain healthy balance between insulin and glucose levels. On top of that, acrimancia helps strengthen our gut barrier by feeding on musin, a protein that makes up our intestinal mucal layer. The more acrimancia feeds on musin, the more our intestinal cells make, which strengthens our gut lining and promotes a healthy immune response. If you want to get the gut healing, immune boosting, immune supporting, metabolic health benefits of acrimancia in one easy to take probiotic supplement, listen up. Because right now, Pendulum is offering my community 20% off your first purchase of their Pendulum

Acrimancia probiotic supplement. All you have to do is go to their website, pendulumlife.com. That's pendulumlife.com. and use the code Drew 20, spelled D-H-R-U-20 for 20% off your first purchase. 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? Polyscystic 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 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 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 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. Another person would say, insulin resistance is the most common metabolic problem,

and PCOS 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 as I'll elaborate in just a second, that some view erectile dysfunction as the earliest detectable symptom 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 polysistic ovary syndrome, that's a problem because of what the insulin's doing to the ovaries and its ability to create sex 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, 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, 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, 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 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 drive. 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. 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 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. 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 are 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 sensitivity and help, one, reduce your risk of Alzheimer's, and then two, perhaps even reverse course to a degree. 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 too, but typically we've had this war on fat for years, and at that 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 have, 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. 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. But, of course, that's all theoretical.

But 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 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 that introduces this other family of fats, which is the industrial seed oils. That's, that's the best term. People will

commonly call it vegetable oil. Like when I was living in Asia, including a trip, 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 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. 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 100 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. 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 to, 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 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 and eketosis. 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's 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, 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 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, 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.