Benjamin Bikman: The Heart of the Word of Wisdom

There is perhaps no better way to set up this interview than by reading the description of Dr. Benjamin Bickman's book, why We Get Sick. We are sick. Around the world, we struggle with diseases that were once considered rare. Cancer, heart disease, Alzheimer's disease, and diabetes affect millions each year. Many people are also struggling with hypertension, weight gain, fatty liver dementia, low testosterone, menstrual irregularities, infertility, and more. We treat the symptoms, not realizing that all of these diseases and disorders have something in common. Each of them is caused or made worse by a condition known as insulin resistance. And you might have it. Odds are you do. Over half of all adults in the United States are insulin resistant, with most other countries either worse or not far behind. Dr. Benjamin Bickman earned his PhD in bioenergetics and was a postdoctoral fellow with the Duke National University of Singapore studying metabolic disorders. Currently, his professional focus as a scientist and professor at Brigham Young University is to better understand the origins and consequences of metabolic disorders, including obesity and diabetes, with a particular emphasis on the role of insulin. He frequently publishes his research in peer reviewed journals and presents at international science and public meetings. This is all in an LDS living podcast where we ask the question, what does it really mean to be all in the gospel of Jesus Christ? I'm Morgan Pearson and I am so honored to have Dr. Benjamin Bickman on the line with me today. You've told me to call you Ben, so I will follow your counsel. Welcome.

Oh, thank you. My pleasure to be here. Thank you.

Well, this is a treat for me. I told Ben before we ever started this interview that I've discovered in preparing for this interview that he has many fans. And so hopefully we can introduce you to a whole new audience and you'll have even more fans after this interview. But I wondered if you could start for us by providing listeners with a little bit of background on what insulin resistance is and how you began studying and researching it.

Right. Yeah. My interest in insulin resistance began before I knew what insulin resistance was. And so that's an odd way to start a journey, but it nevertheless put me on the path. When I was a master's student at BYU many years ago, I stumbled across a paper that had just been published that identified this phenomenon in people with weight gain. What they found was that as people gained weight, which is to say that another way, as their fat tissue got bigger, they found that they had greater number of these inflammatory markers or these inflammatory proteins in their body. So in other words, inflammation was going up as weight gain was going up, and that this inflammation was thought to be contributing to this, to type 2 diabetes. And then as I would find out later, that, to me was an absolute revelation that really singularly changed the trajectory of my career. Prior to that, I had every intention of pursuing an academic career that focused on muscle and muscle growth and exercise. But with that manuscript kind of falling into my lap, I really shifted and wanted to better understand the consequences of fat growth. So rather than studying how muscle grows, I wanted to know what happens when fat cells grow. And in between those two things, you know, I started to align a series of events out in my mind. This paradigm started to form where the fat cell grows, that starts to contribute to inflammation directly. And then before it ever gets to diabetes, There was type 2 diabetes. There was this intermediate step, which was insulin resistance, which is just that, the hormone. And to define insulin resistance is worth the 30 seconds it'll take me.

Absolutely.

Insulin resistance is really a two part phenomenon. It's like a coin, and every coin has two sides. Part of insulin resistance, this problem we call insulin resistance, is what the name suggests, which is that the hormone insulin isn't working very well. Now, emphasis on the fact that it's not working well at some cells of the body, Other cells of the body are working perfectly fine and responding to insulin as well as they ever did. And that becomes a problem if we flip the coin over and we the other aspect of insulin resistance, namely that within the body, blood insulin levels are getting ever higher. They're going up more and more and more. And that's both cause and consequence of insulin resistance. But it is inseparably connected. If you are thinking about insulin resistance, you're thinking of two things. Insulin isn't working as well as it used to, and blood insulin levels are higher than they should be. And it's the combination of these two parts that really explains how insulin resistance is so, so fundamental to virtually all of the plagues of prosperity or these diseases of civilization, Diseases that were once unheard of, things like heart disease and diabetes and Alzheimer's disease, all of these have a metabolic foundation. And that foundation that they all have in common is insulin resistance. And that really is, in a nutshell, why I've devoted my career to it. Not only because of its relevance in chronic disease, but also its prevalence, where this is the singular most common health disorder worldwide. And that's why I've been invited to give talks on the topic literally around the world many times. I've been fortunate enough to bring my family with me. But from the Middle east, through Asia, through Southeast Asia. These are. Insulin resistance is really starting to just roll over the earth.

You have referred to. Been to your efforts to share this information. You've just talked about how you've shared it all around the world. You've referred to it as a crusade. Why does this matter so much to you? And why should it matter to anyone listening?

Yeah, it should matter to people listening because I'm attempting to give them an insight into their own health that they've perhaps never had before. For example, as one learns about insulin resistance, they learn, like I've just alluded to, that insulin resistance may be contributing to several of their own disorders. So perhaps you have someone who opens their medicine cabinet every morning and takes a medication for their blood pressure. They take a medication for their infertility, whether it's a man or a woman. The most common causes of infertility are both related to disorders of insulin resistance.

And.

And maybe they take a medication for their migraine headaches. And because there's three different pill bottles for each of their three problems that they're suffering at the moment, they think that these three problems have nothing in common. In reality, as I've mentioned, they all have one common problem, which is insulin resistance. And so my hope for the individual is that as they learn about this, they are able to singularly focus their efforts that rather than looking at their health problems as totally unrelated to each other and thus, why even try to fix them all, there's really one problem you can fix, namely insulin resistance. So rather than trimming the branches of a tree that continues to provide sick fruit, you just cut the tree down. And that is really what happens when you address insulin resistance. And so that's my hope for the individual, my personal crusade, really. There's a long version to this, but when I. The short. The shorter version is that after I got tenure at byu, a school that I have loved my whole life, I realized that I had really achieved my goal that I had. You know, when you get into academia, it's such a long road, and at the end of that road is get tenure. It is the last hurdle. And once you've done that, you've arrived, if you will. And so it was at that point, about six or seven years ago for me now, where I had a kind of a very reflective moment where I thought, all right, I've realized this professional success that I've long wanted and sought after. Now what? And it really was a series of questions that I went through in my mind, which was. It started with asking myself whether my Knowledge on this topic was valuable to people because, you know, not all scientists, certainly not all academics, have the good fortune of studying something that has an interest outside the halls of academia. One of the sad realities of academia, as much as academics don't want to admit it, is that much of what they do is meaningless. And that sounds a little mean, but in our more honest moments, any academic has to admit that what they actually study and are an expert in doesn't really have a direct benefit on humans. Me studying fat cells and knowing why fat cells grow and shrink and the dangers of when they grow too much, I believed that I was fortunate enough to have a knowledge set that was valuable. And then the next question was, well, what's the best way to share it? And I had to admit that the best way to share that knowledge was neither in a classroom with a handful of students, nor was it through peer reviewed science manuscripts that we publish in science journals, because the average person would never read them. And so my crusade really became expanding my classroom and going beyond the hallways and the walls of byu, despite my affection for this place and really taking these ideas out into the world and just embracing the challenge of having not only a much bigger classroom, but also a much more diverse student body. But all to convey information on a topic that I really have a strong conviction on matters More people need to understand what this problem is, where it comes from, why it matters, and what to do about it. And that really is, in the most succinct way, my crusade.

Well, the thing I think is so compelling about what you teach is that it is a belief that making small changes to one's lifestyle has the ability to heal many things going on with the body. And as the grandchild of grandparents who, I think their generation was so dependent on medicine, and I've watched that take a toll that I, I want so badly for my lifestyle to be such that when I am a grandparent, I'm much healthier. And so I, I love the way that you talk so much about lifestyle and, and I listened to an interview, Ben, where you talked about how Joseph Smith taught that we teach correct principles and they govern themselves. It's a quote that we've all heard many times. And you then said this. The tragedy in our world at the moment is we don't teach correct principles. And all the more reason why I'm sympathetic to someone who's struggling with their weight, because I look at them and think, of course you're struggling because you've been given utter nonsense as your dietary advice. I wondered maybe if we could start with what are the false principles that we have often been taught in our society today as it relates to health?

Right. There are many, unfortunately, many just wrong ideas that are a testament to how science can be hijacked. Unfortunately, truly, just as a brief tangent before diving into that, we're seeing this. We've seen this in real time, just in the most recent years, where science has become almost a religion of the irreligious. They wouldn't want to admit it or call it as such, but it's people now expressing their faith almost like an article of faith. It's their devotion to science and scientists. We, academic scientists, become the priests and priestesses of this bizarre religion. And just as a reminder, science is the endless pursuit of truth. And so there must be this deep humility and willingness to at any moment, utterly reject your own hypothesis the moment you have data that proves your hypothesis is incorrect. And so, just so that everyone remembers, science is the pursuit of truth in the physical realm. And it's beyond the physical realm where my faith comes into play. Actually, my faith comes into play even with my own science. Religion goes beyond our view of the physical world, and science helps us understand the physical world. And I'm very grateful for that and I'm grateful for my involvement in that. So with regards to nutrition and the evidence that has been given, there are few areas within all of biomedical literature that is so contentious and so debated. It takes on, if you'll pardon me for saying it, a bit of a religious fervor, a fanaticism perhaps, just to be very precise for the sake of time, among many examples I could cite. I am a scientist who focuses very heavily and most primarily on the fat cell and the traditional view, which has led to the traditional long held advice when it comes to how to lose weight, or to say that another way, how to shrink fat cells. The advice is eat less, exercise more. This is what everyone will have heard every time they're trying to lose weight. They go to their clinician or they are listening to some guru. That's what the sentiment is going to be, eat less, exercise more. As if human obesity or any, indeed fat gain in any animal, it's just uniquely a human problem among all animals, as if it's nothing more than a problem of thermodynamics, that we just have to balance all of the energy within the body. Now, not to get too deep, but of course, thermodynamics as a principle of physics was only intended to apply to what's called a Closed system. In other words, the entire universe, the body. As much as kids, these millennials may think they are the center of the universe, they're not the entire universe. And so a human is what's called an open system. We have energy that's going in and out of us in ways that we cannot compute, that we can't calculate or include as a variable in our calculations of metabolic rate. So the idea of eat less, exercise more is a very, an overly simplistic view of human nutrition and fat physiology. And just to highlight why that's important, let's imagine if we are, let's say I'm hosting a buffet and I'm inviting all of my friends and family. Everyone listening to this podcast is invited to come over to my house and I have the world's best chefs preparing delicious spread of food. And I invite everyone to come and come hungry because you're going to want to try everything on the table. And I would then ask, what would you do to make sure you came to my home as hungry as possible? I bet most people, if they think for a moment, will come to a two part conclusion. One, they would eat a little less in the day or days before they come, and that would increase hunger significantly. And two, they would probably exercise a little harder or a little more diligently in the days or hours or some period of time before the dinner. And indeed it would work perfectly. That is a perfect formula to come to my delicious dinner, my buffet, as hungry as possible. And yet you can see the problem. That is the exact advice we've been giving people for the better part of 60 or 70 years to help them lose weight. We tell them eat less, exercise more. And all that does is put them against working against their own hunger. And everyone's familiar with that game show here, the Biggest Loser. I would invite anyone to look up what happens to these contestants once the game show is over. They gain it all back. So the idea and everyone does anyone who really attempts long term weight loss? Not everyone. There may be some exceptions, but by and large the vast majority of people who try to lose weight by restricting energy, basically making the body go hungry, they will. They're doomed to failure. And so the correct principle is to acknowledge that fat cells, that every cell within the body must be told what to do with the energy that it has. We cannot assign some level of inherent intelligence to every individual cell. The body has ways of sending signals from one cell type to another in order to convey different messages, including nutrition status. And so the fat cell needs to Know that if there's energy surrounding it, if there's energy available, it needs to know, am I okay to eat this right now and store it? Because that's my job partly is to store fats, to store energy as fat. But there may be other times when there is energy available, like during exercise. During exercise, energy goes up in the blood. The actual amount of calories we have in our blood goes up even if we're not eating. And so the fat cell would see those calories and say, ah, but right now I'm not supposed to eat you, because you're supposed to be used by the muscle for energy for the exercise. And all of this is, I'm taking too long to get to my point. It's all about the hormone insulin. Insulin is the singular signal to the fat cell, telling the fat cell that it's time to store energy. And this has an effect, a rippling effect throughout the entire body when insulin is elevated. Insulin is so determined to store fat in the fat cell, to store energy that it will actually reduce the body's metabolic rate by several hundred calories in a day. And this is a very meaningful amount. You know, up to 10 to 15% of a person's metabolic rate can be turned down if they're eating a diet that's constantly keeping their insulin elevated. And in contrast, if they're eating a diet, even if they're eating so they can eat, it's not a matter of starving themselves. If they're keeping their insulin low, their metabolic rate will be higher, and the fat cell will not be storing fat, any of the energy that's coming in through their diet. It will rather be burning fat. So the correct principle, rather than looking at obesity, a human excess fat mass, and saying we need to reduce the fat mass to reduce the insulin resistance, which is a really critical sentiment, although it's a little more nuanced than that. We cannot have someone starting their weight loss journey, their fat cell shrinking journey, by just simply restricting energy and going low calorie and exercising hard. That'll work for a couple weeks, and then it will fail, because hunger always wins. And so, rather than basing a weight loss strategy on hunger, base it on the question, how can I control my insulin? And I don't want to get ahead of the conversation here, but that really is the key. Just acknowledging that energy calories matter, but so, too, do hormones. That there is an endocrine aspect to obesity that has been totally overlooked for decades. Even though in the early 1900s, 110 years ago, this was very, very well known. And then the conversation just started to change around World War II, and then the endocrine theory of obesity was completely lost. And there are those of us that are saying we've lost it to our detriment. We are fatter and suffering from the consequences of that fat mass more than we've ever been before, all while we're surrounded by all of these low fat, low calorie foods that simply are designed to make us want to eat more and more of it. So that's the correct information. That's why I am sympathetic to people who are. They've been doing their best. They have all the intentions in the world, but the information they've been given, the principles have not been correct. And so how can I expect them to make the right choices when they aren't aware of them? So my hope is that people listening to this would look at their own experience if they deem themselves as needing to shrink some fat cells and rather than continue to count calories and obsess over every gram of fat, rather start to shift your paradigm to say, how can I lower my insulin? And that will absolutely yield a superior and a longer kind of view gain, because you won't have to worry about hunger. If you're hungry, you eat.

Well, I think a lot of people listening can probably really get on board with that idea of being able to eat when you're hungry. But, Ben, you gave a talk at byu and you kind of alluded to the topic of that talk earlier, Plagues of Prosperity. And in that talk, you emphasized a few principles, and you've shared these principles far and wide that you believe can make a dramatic difference in metabolic health. Specifically, some of these include control carbs, prioritizing protein, and not fearing fat. I wondered what is most important for our listeners to know about the application of these principles.

Yeah, thank you for bringing that up. I hope the audience can appreciate the origin of my affection for alliteration, which you cited. Multiple examples in one go. Right there. That's all born from Elder Neal A. Maxwell. Actually, just as a funny little tangent, on my mission in Russia in the mid-90s, I kind of discovered Elder Maxwell starting to really read the conference editions of the Ensign at the time for the first time in my life, and was so enamored by his writing style that I would actually use his talks to practice my translation, as I had to translate for the mission president very often, and any visitors, I would have my companions read Elder Maxwell talks. And I figured if I could translate an Elder Maxwell talk. I can translate anyone. So anyway, that's part of my affection for alliteration. So, yeah, those principles control carbs, prioritize protein, don't fear fat, and then I sometimes will refer to a fourth, although I didn't. In that talk, which was frequently fast, we have a certain.