Dr Ben Bikman: The SURPRISING Scientific Way To Burn Belly Fat FAST

Insulin is the signal that promotes the growth of fat cells. No matter how many calories that person is eating, it is totally impossible for a fat cell to grow unless insulin is elevated. Belly fat wants to be burned. Dr. Ben Bickman, a professor and metabolic.

Scientist, the best selling author of why We Get Sick. He will teach you how to burn belly fat and cure metabolic disease with diet. People, when they want to lose belly fat, what's to stopping them?

There are some signals that more selectively promote belly fat than others. One example is fructose. Alcohol consumption will promote greater visceral storage. The fat cell actually can begin to be about 10 to 20 times larger than how it was when it started. There is no other cell in the body that is capable of that much growth. Insulin is the signal, the primary signal telling the fat cell to grow. So insulin signals the growth, but then calories fuel that growth. So all of this debate, it's insulin. No, it's calories. You do need both. If you do a 24 hour fast and prick your finger or blow into a device and you see you confirm that you are in ketosis, then you have a body that has low insulin in that state, which suggests that you are likely insulin sensitive. You know you are burning fat, aggressively burning fat. If you're making ketones, you're burning fat. Epinephrine stimulates fat breakdown exceptionally well.

In the visceral adipose, there is a surprising sugar. How does that help with belly fat? It's a sugar.

Yeah. So that. This is.

Dr. Bickman.

Welcome, Rena, thank you so much. Please call me Ben. I'm delighted to join you.

When people think about losing belly fat, there are so many YouTube videos out there talking about do this exercise to burn belly fat. Do you drink this to burn belly fat? But 99% of people fail and abdominal obesity or belly fat is one of the biggest causes of heart disease, cancer and early death. And Ben, you have put 20 years of your experience into a best selling book, why we get sick. And in today's episode we're going to talk about belly fat, how to fix it using a science backed method and a surprising sugar that might help. But Ben, my first question is why is abdominal obesity or belly fat so dangerous?

Right, yeah. This is a great way to start because so much of metabolic problems starts in the fat cells. I am a firm advocate of a fat first focus when it comes to metabolic health. Belly fat is problematic because of how the body stores fat within that central region of the body, which is not like storing fat in other Areas of the body like for example, comparing belly fat storage to fat stored on the hips and the buttocks. The hips and the buttocks are out of the way, if you will, and there aren't other important tissues that are kind of battling for space. But when we start to look into the central part of the region, we have our most important organs tucked away in there. And so it makes sense that the body is going to have a fat storage method that becomes somewhat self limiting. It doesn't want, we don't, the body doesn't want to store too much fat within that central region for fear of it literally beginning to compress organs that we need to be functioning in order to survive. And of course, women who have the potential to carry another little human in that same space tend, they tend to have. A woman will tend to have less of a potential to store fat in that central region. That just is a sex based difference because men and women are not the same in many, many ways, including how we store fat. But however, that changes after a woman has left her fertile years behind. And so this is very relevant to every woman because whether she's there now, she's probably going to get there. Where her concern was of belly fat may go up as her sex hormones change with menopause specifically. So the fat that is stored centrally is a problem because of its self limiting growth. Namely, fat centrally will grow through a mechanism called hypertrophy. This is when the number of fat cells is staying static, but the size of each fat cell is growing substantially. This is very different from fat stored in the buttocks and the hip area there, where fat is out of the way. If there is a pressure for fat storage to go up because of elevated insulin and sufficient energy to fuel that growth, then the fat cells will simply proliferate or they will multiply. Where each individual fat cell is staying quite small, but the number of the fat cells is increasing substantially. But small fat cells are healthy and happy fat cells. So even though the person may have more fat than they like, the fat cells are perfectly healthy and in no way contributing to disease. They may be contributing to a larger size. You know, the woman has to wear a different size of pants than she'd like, but it's not unhealthy. However, as the fat storage is being promoted in the central region, as I mentioned, it's growing through hypertrophy and that does start to limit its own growth because of two mechanisms or two reasons. One being that the fat cell actually can begin to be about 10 to 20 times larger. Than how it was when it started. There is no other cell in the body that is capable of that much growth, but it reaches a point where it's almost like a balloon that we're filling with water. The balloon can only be filled so much until it will burst. Well, the same goes with a fat cell, that membrane, which is like the balloon itself, the membrane of the fat cell can only get to a certain size before the membrane starts to fall apart. And so as the cell is undergoing substantial hypertrophy, it begins to become insulin resistant to prevent further growth. Because insulin is the signal, the primary signal telling the fat cell to grow. And if the fat cell can start to become resistant to insulin, then it starts leaking out fat, even though fat is still coming in. Now it's leaking out fat even though insulin's trying to stop it. So now we have this state where in insulin resistance, there's high insulin and now there's high fatty acids in the blood. And those two don't normally go together. Normally you eat insulin goes up and it inhibits the breakdown of fat. So free fatty acids are down, or you're fasting, insulin is down, and thus free fatty acids will go up. But in this case, with the hypertrophic too big fat cell, now we have elevated levels of both, which starts to promote the storage of fat in other areas around the body. And then the second and final comment here is that as the fat cells get so big, they begin to push each other further and further away from capillaries, which is the smallest and functioning unit of the blood vessel, of all of our blood vessels. It's at the capillaries where we actually are exchanging oxygen and carbon dioxide, where we are feeding cells, giving them nutrients, and the cells are able to dump their metabolites or their waste products to be carried away and eliminated. So a cell needs to be very closely in close proximity to a capillary. But again, as the cells are expanding so much, they get pushed too far away. And in this case, the fat cell is trying to correct this. It's basically suffocating for lack of oxygen. And so it starts releasing this whole bunch of pro inflammatory proteins, so these proteins that are increasing inflammation throughout the body. Now, why would the fat cell do that? Because some of those proteins will stimulate the production of new capillaries, and then we can start to correct the suffocation, or what's technically called the hypoxia, or low oxygen. So here we have the big swelling fat cell that is happening more centrally, and the two things it's doing to ensure its own survival, namely becoming insulin resistant to correct growth, becoming pro inflammatory to correct the hypoxia or the suffocation happen to be two things that end up promoting greater insulin resistance throughout the rest of the body.

When we have this excess belly fat, people just look at it and think, I just want to get rid of it. I just need to like, eat less or exercise more. And we're going to get into how to fix it. So in terms of understanding a normal fat cell, because fat cells, they play a role in the body, let's first talk about the foundation so that we can understand then what causes the inflammation, the belly fat, and then how to fix it with certain solutions. So, so the fat cell, what is the role of the fat cell in the body?

Yeah, the, the easy answer is to be a storage depot for energy. That this is a way of helping the human body survive any period of calorie deprivation. It's. We begin relying, you know, you fast for just a few hours, just a few hours, and now you're already relying on your own stored energy. And the fat, of course, is a heavy, heavy contributor. And even a lean individual has hundreds of thousands of calories on their body stored as fat. In other words, enough energy to last for weeks without consuming any energy. Again, this is a lean person. Then there are instances, documented case reports of obese people who end up having true calorie fasts for over a year. They literally are just drinking vitamins, water, vitamins and minerals. So that's the easy answer to the question of why have fat? But it goes beyond that. Fat does provide insulation, it does provide physical protection from impact, even in the visceral central region. But beyond that, maybe my final comment is that it is a way of. It's a very active endocrine organ. Fat cells secrete a substantial amount of hormones. And allow me to assume that much of your audience is female. Ladies would be fascinated to learn that after she, a woman, goes through menopause, the fat tissue becomes the main producer of estrogens in her body. That prior to menopause, of course, the main producer of estrogens is the ovaries. But as the ovaries start to quiet down a little bit, having largely served their purpose in promoting this period of fertility, it ends up being the fat tissue that is the main producer of estrogens in her body at that point. So we, and this is just one example of many, and I'll maybe I'll just cite one more because it's so fascinating, which is the hormone leptin. When we think of leptin, we only ever think about its central effect in the hypothalamus to induce a sense of satiety or to reduce hunger. In other words, leptin helps a person feel full, and that is an effect, and it matters. But few people appreciate that leptin also can signal to the hypothalamus to promote fertility, that in the absence of leptin, there is no reproduction in the human, in the species. So we must have leptin that signals otherwise a person is sterile. They will not reproduce. And this is why, particularly in women who have to carry the baby and then nurse and feed the baby, energy is so much more important on her body than it is on her male counterpart. You know, if you look at the mother and the father, the mother literally must have more energy in her body to undergo the metabolically rigorous process of growing a human and then feeding that human. The male does not have that same metabolic demand expected in his role. So here it makes sense that her brain needs a signal in order to know how much energy the body has stored, essentially licking its finger and holding it up into the wind, saying, all right, which way are the metabolic winds blowing? Am I in a safe space to reproduce? Or to say that another way, Do I have enough energy before I commit to this marathon of metabolism in growing and feeding another. Another human? So all of this is some of the myriad ways that fat contributes to health. And maybe a final comment. People who have a genetic inability to store fat have profound cardiometabolic complications. This is a real disease called lipodystrophy. It can either be genetic or it can be acquired. Genetic or so born with it or acquired. And then a person will not have fat. So they will look exceptionally lean. And lest or before you foster within yourself a sense of envy, they do become very diabetic and insulin resistant, even though they look exceptionally lean. This is in their risk of heart disease skyrockets, fatty liver disease, and fibrosis skyrockets. Um, infertility, of course, is a constant struggle. This is all a reflection of how important fat tissue is.

So fat cells and having fat is important. The excess amounts of fat is not what we want. How does the fat cells over time become destroyed or stop working?

Yeah, the main. The main problem with fat cells, when they begin to contribute to disease, is when they simply get too big. Now, that is not the same, as I've emphasized now, of having too much fat, because you can have two different body types that have each gained 10 pounds of fat. And they have very, very differing effects. For example, I did my postdoctoral fellowship research in the beautiful country Singapore. One of the reasons the government of Singapore was interested in studying metabolism was because of the differential risk of cardiometabolic complications across different ethnicities. As they gain, as they gain fat, as they got fatter. And of course, Singapore is a very multicultural country, as many are these days. But in particular, if we just take the sort of two extreme ends, you could take a Caucasian sort of European man and compare him to an Asian Chinese descent ethnicity man and say they are the exact same size. They're both 510. They both weigh 80 kilos, although I'm too American, so let's say 70 kilos, maybe 80 kilos, but they gain, let's say they gain 10 kilos of pure fat, which is not hard to do. And they get together. They were college roommates, they get together 10 years later, both 10 kilos fatter. The Caucasian Northern European man is simply 10 kilos fatter, and he does not look as good in his Speedo when they go to the beach. The Chinese Asian man is also 10 pounds fatter or 10 kilos, which is not that much. So they're both just a little chubbier than they were 10 years prior. But he has fatty liver disease, he has hypertension, he probably already has type 2 diabetes. And this is all about how those two bodies are storing the fat, not the actual mass of fat. Because Caucasians will tend to produce more fat cells. There's this just simply greater genetic tendency to proliferate the fat, this process called hyperplasia, as I mentioned, whereas in the Chinese Asian ethnicity, in his body he has a limited potential, genetically ethnically determined to produce new fat cells. And thus any fat storage is generally happening through greater hypertrophy, which as we've elaborated already, is much more pathogenic when.

It comes to optimal health. What we eat is so important, especially because we need fat soluble vitamins and amino acids to feed our brain and our body. And that's why I choose a carnival lifestyle. But mental health is as important as physical health, because what we think and feel every day, and even our hormones are, can be affected by past experiences and trauma. And not many people talk about this. And even for me, there have been stages that I needed help from a licensed therapist because it could have been from my childhood trauma or my dad's recent diagnosis of a terminal brain disease called frontal temporal dementia. There are definitely times that we need to lean on extra support in our lives and that's why I have BetterHelp as a special sponsor of today's video. BetterHelp will connect you with a licensed therapist who will help and listen to you and give you unbiased advice. And I know this has been particularly beneficial for myself as there are times that we might have a problem that we can't speak to our family and our friends about, maybe because they might judge us or maybe they might not understand. So having somebody there who is qualified and licensed to help you can. To help understand what you're going through and to help to rationalize your thoughts objectively can help you in your life and your mental health. The best thing about BetterHelp is that you can do it all through phone or computer, whether that be phone call, video call, or messaging. You can choose an option that's right for you and they will match you with a licensed therapist that has years of experience with people that are going through struggles and just like yours. So if you'd like to get more support, just go to betterhelp.com 5minutebody or choose 5 Minute Body on the signup page and you can enjoy a special discount on your first month. In your opinion. People when they want to lose belly fat, what is the biggest reason why they can't lose belly fat? What's stopping them?

There are some signals that more selectively promote belly fat than others. So with the best of intentions, they may inadvertently be continuing to consume foods that that are selectively promoting belly fat. One example is fructose. So there was a very compelling human study that had humans consume drinks that were either loaded with glucose or loaded with fructose. Now, both groups of people gained fat, so they both got fat, but where they stored fat differed. Whereas the glucose drinkers stored more subcutaneous fat. So the fat beneath the skin that you pinch and jiggle, the fructose drinkers stored more visceral or central fat. So even though again, total fat mass went up the same to the same degree, but where they stored fat differed, which matters for reasons we've already elaborated. But similarly, alcohol consumption will promote greater visceral storage. And the thing that those two items or molecules have in common, fructose and alcohol, is that they're both metabolized by the liver. And when we are putting undue metabolic burden on the liver and it begins producing an abundance of fat, which it does with those two molecules, then that fat will generally get stored more in that visceral or central region, whereas glucose just generally increasing. Insulin is promoting the fat storage everywhere. You know To a more modest degree, but particularly the subcutaneous fat. So those are a couple signals that make it unique to central fat.

So when it comes to the hormonal aspect of belly fat, because there's two paradigms out there, the hormones and the calories, and we're going to talk about both. The first thing I want to talk about is the hormones, and then the calorie paradigm to see your thoughts about that pertaining to hormones. The big one is insulin. Let's first talk about the role of insulin and then insulin resistance, which is the problem that causes the belly fat. What is the role of insulin in the body in a healthy individual?

Insulin is unique among its class of hormones. And that specific class of hormones is called the peptide hormones, where it's little amino acids strung together. And there are other classes of hormones throughout the body. But insulin is unique among the peptide hormones because it affects literally every single cell of the body. And most peptide hormones don't have that potential. But every single cell of the body, I've yet to find an exception to this, so I'm being somewhat bold in my language. Has an insulin or has insulin receptors, so particular doorways that are built just for insulin to come and knock on. So then it's no surprise that insulin will do something different at a brain cell than it will at a bone cell. Even though they both respond to insulin, they're very different cell types. And so again, no surprise that insulin will have. But the thematic effect of insulin at any cell of the body is going to be telling that cell to take in and store energy and grow. As a result, insulin wants to promote growth. It is the penultimate anabolic hormone, the prototypical anabolic hormone. It wants to tell cells to grow. And in order to grow, a cell needs energy. It needs to be building up molecules within itself, new types of fats or new types of prote. Insulin wants all of this to be turned on, no matter what cell it's coming to. So that's the thematic effect. And of course, describing it that way, we can see how essential insulin is. Indeed, an absence of insulin is a death sentence. You must have insulin to survive. However, in our society, we have too much. Insulin is elevated chronically in most people, and thus there is this incessant signal to grow, grow, grow. And that is not healthy. Not only does it promote aging, with all this focus on longevity, we have a reduction in longevity, which is likely why virtually every study that has ever explored the metabolic markers of the longest lived humans, one of the most consistent findings is that they either have low fasting glucose levels or if they have measured it, they're very insulin sensitive. Because you need to have insulin down so that the body can be undergoing this rejuvenation process to take a break from growing in order to clean out, to clean house, which is a process called autophagy. And I know, of course, you're familiar with that. So that's the general overview of what insulin does and when it goes too far. And the emphasis is on the going too far. That is the singular reason why I felt compelled to write my book why we Get Sick. I just thought that there was not enough overall awareness of this chronically elevated insulin level and how it contributes to disease. And as you noted in teeing up the question, insulin resistance in particular, we've at this point, I've elaborated how fat cells contribute to insulin resistance. But even the growth of the fat cell itself must have had a preceding event, and that would. That brings us back to insulin. Insulin is the signal that promotes the growth of fat cells. Now, there are other contributing hormones, but you cannot. It is totally impossible for a fat cell to grow unless insulin is elevated. And in contrast, or to flip that around to take it one step further, if insulin is low, let alone absent, it is impossible for a fat cell to stay big. It must shrink no matter how many calories that person is eating. In fact, this effect is so obvious in someone with type 2 diabetes that it can be taken advantage of that a type 1 diabetic who has perfect control over their insulin, because every molecule of insulin is coming from what that person is injecting into their bodies, they may have learned through trial and error that they can eat whatever they want. They can eat an entire chocolate cake. And if they simply deliberately inject themselves with less insulin than they would need, they will stay as skinny as they want. Now, in fact, this is so commonly known that it has its own name. It's called diabolaemia. This combination of, of course, a couple obvious words, but there is no formal bulimia to it. The person's not vomiting. Imagine just how tempting it is. They can eat whatever they want and enjoy every bite and enjoy the satisfaction of having that food be digested. And all they need to do is poke themselves less with a needle. That is pretty tempting. I mean, I have nothing but empathy for the person who struggles with this eating disorder. Of course, there are catastrophic metabolic consequences to this and is very lethal. Let me really put an exclamation mark on that. The person is flirting with potential death, but in their minds, the ability to stay as thin as they want. That pressure is worth the risk. I mean, it isn't worth it, of course, but to them, in their minds it is. But this is just a reflection of the fact that there you cannot get around insulin when it comes to understanding the growing and the shrinking of the fat cell. Now, you somewhat mentioned this, and I hope I'm not getting too far ahead of us, but insulin is the essential signal that tells a fat cell to grow, but it cannot sustain that growth on its own. There must be sufficient fuel to provide the structure for that growth. So insulin signals the growth, but then calories fuel that growth. And so to understand why a fat cell or fat mass is going up, there must be one, the signal, which is insulin telling the fat cell to grow. And two, there must be sufficient energy available to fuel that growth. So both signals are needed. So all of this debate, it's insulin. No, it's calories. It is a bit of a splitting hairs where you do need both. You cannot have sustained fat cell growth if you only have one and not the other. If you only have insulin and an insufficiency of calories, then the person actually dies from hypoglycemia and the lack of ketones. They literally would go unconscious and die. In contrast, if you only have the calories but no insulin, then you have the untreated type 1 diabetic. So the person will now die because they're basically burning up to death. They can't stop burning energy and they run out and starve and die from ketoacidosis or just ultimate starvation. So you can't have growth of fat without both of them together. One alone is insufficient.

That's so interesting. You're the first person to be able to beautifully explain that in a way that makes sense, because there's one paradigm which is just calories, calories in, calories out, which we see in the mainstream, and the other side, which I think is more like the ketogenic carnivore space, which is a lot heavily focused on hormones. So focusing on both making sure that you're fixing your hormones and then also eating enough calories, enough energy is quite important. I wanted to circle back to insulin resistance, how that. So that leads to belly fat. But people are going to be thinking, well, I don't have insulin resistance, I'm fine because my blood glucose is okay. Could you elaborate on why your doctor focusing on glucose control is not the entire story?

Oh, yes, I'm so glad you bring that up. Yeah. Insulin resistance is Also referred to as pre diabetes. And if we include that synonym for insulin resistance, it helps put things in perspective. So insulin resistance, as you noted, is commonly, insulin resistance being the ultimate measure of metabolic health by my estimation. Commonly when a clinician is looking at metabolic health, they're only looking at glucose. They're just waiting for the glucose to start climbing. Now, unfortunately, years, even decades, before the glucose ever moves, insulin has been fighting the silent war. And so this is insulin resistance, or in its original prediabetes state, which is how it starts and lasts for years, even decades, where insulin is elevated but glucose is normal. So the insulin has to work harder and harder and harder in order to keep the glucose in a normal range. But it is working. And this is the state also that's contributing so heavily to disease. This is the state that's causing infertility and migraines and cognitive decline and fatty liver disease and heart disease, hypertension. It's insulin resistance that that is causing that. It's not the hyperglycemia that's contributing to those diseases, it's the hyperinsulinemia and the insulin resistance that always goes along with chronically elevated insulin levels. So that's why it is so important to shift the paradigm away from the current glucose centric view of metabolic health to a more encompassing insulin centric view, where we acknowledge that if we want to detect metabolic decay at its earliest stages, then we have to forget the glucose, we have to include insulin in our paradigm, and then that becomes the earliest signal warning us of a problem. But that is so important because it changes the way we view all of the diseases that I just mentioned. I imagine at the end of this, a woman who's opening her medicine cabinet every morning and she takes a blood pressure medication, she may take a blood thinner medication, she may take a medication for her pcos. And then realizing that all of those problems, elevated blood pressure, elevated clot risk, elevated menstrual dysfunction, and ovulatory challenges with pcos, while they are all very different disorders that have their own individual causes, there is one cause that is common across all of them, namely the insulin resistance. And as we'll get to that, is not treated based on any medications. It's changed by lifestyle.

Absolutely. So if someone is thinking, how do I test for the insulin or the insulin resistance, what is the let's talk about warning signs first, that they might have insulin resistance, maybe around their body or blood test, and then a test that they could order.

So in addition to some of the health consequences or disorders that I Just mentioned, like high blood pressure, which is very commonly associated with insulin resistance. If someone listening to this has consistently elevated blood pressure, then it's very likely they have insulin resistance. Now, there are other contributors to that. Even something as simple as sleep deprivation can contribute to a short term hypertension. But if it's ongoing, consistent, you should be, you are warned that it's probably your insulin resistance. But then also skin is a window to the metabolic soul where if someone. And you need to look no further than the collar, if someone. There are two distinct skin disorders that just happen to coincidentally happen around the neckline. One of them is a condition called acanthosis nigricans, which is when the skin gets a darker pigment, which is easy to see in people that are very fairly pigmented. But of course, if someone is a darker pigment of skin, it will be harder to notice the darkening of the skin, but it will feel and look differently. It will look and feel like it's crinkled tissue paper. And so that's how the skin will feel. And look around the back, particularly of the neck, but even across the front, but most especially the back, in that same area, a person can begin to develop little stalks, little columns of skin called skin tags. Now, this is not the same as a big kind of mole or mound of skin, which can be any number of things. This is a distinct thing. And people can already probably imagine it because they've seen it. It's almost like a little mushroom, just a teeny little, just little mushroom of skin just sticking straight up. And the person will start to have those around their neckline. Each of those is on its own a very strong indicator of insulin resistance. Now the good news is, and I always get asked this, whether it's the skin problems or the pcos or the blood pressure, et cetera, as you begin to correct your insulin resistance, all of those things go away.

Including your belly fat.

Including belly fat.

So I wanted to focus on, oh, and also the fasting insulin test, which is also important.

Yeah, right. So, so I just talked about the signs of it, but how to test for it. Yes, I'm very much one of the drums I beat. The loudest is to get insulin measured now in international or metric units. If you're fasting, insulin is below around 30 picomoles. That's a good sign. Or high 20s if it's lower than that, if it's lower than the mid-20s or so, that's a really good sign that your insulin is in a great range. If it's a little higher if it's getting up into the 40s, in mid-40s, that doesn't necessarily mean you're insulin resistant. It could just be that you've caught the insulin at a high point because insulin has a rhythm to it. And so it's possible that you are, in fact you do have a good insulin, you just caught it right at a very high point. And so all the more reason to just pay attention to these other markers that we described.

So you mentioned that insulin has a rhythm to it. Why are people mostly insulin resistant in the morning?

Yeah, so this is a field where I am, I'm not 100% sure because there is very conflicting data where some studies have shown and report that the body is more insulin resistant in the morning and others show that it's more insulin resistant in the afternoon, evening. And so I hate to introduce this lack of clarity, but to answer that question, if the body is more insulin resistant in the morning, it's very likely a consequence of the anti insulin hormones that are, that are involved in waking up most especially cortisol. A very normal feature, speaking of ebb and flow or circadian rhythms of hormones, is the fact that as we begin to approach waking up in the morning, cortisol levels climb and that serves a very good function. It's supposed to happen, it's natural in everyone who sleeps, everyone. So a few hours before we would wake up, about 4am or so, cortisol levels start to climb and it climbs quite a bit. And that's thought to be to be a result of the fact that as the body is starting to wake up and the brain and the nervous system is coming online, back online and metabolic demands of the body starts to rise. If cortisol goes up, it's going to be promoting the liver to start breaking down all of its stored glycogen and releasing that as glucose into the bloodstream. So commonly we'll get an elevation in glucose as we wake up as well. And so that's why in the morning some people may find that they are a little more insulin resistant. What is a very common feature and why I am inclined to say that morning is a time of insulin resistance is that in people who are insulin dependent diabetics, like a type 1 diabetic, if they eat a particular load of carbohydrate in the morning, they will have to give themselves a significantly greater insulin bolus than if they ate that same amount of carbohydrate later in the day.

Let's talk about the different types of fat so we mentioned the main way to target belly fat is to look at insulin resistance. Lower your insulin resistance if you have it. Let's talk about the different types of fat, because having fat is not bad. It's just a bad type of fat. What is the difference between white fat and brown fat?

Yeah, a lot. With white fat, that is the prototypical low metabolic rate fat, that is, that is heavily involved in fat storage or energy storage. Although as we mentioned, there are other aspects to it as well, other purposes that are very, very important. But regardless of its. Whatever we want to assign as its singular purpose, it has a very, very low metabolic rate, almost so low that you can barely detect it. And I say that with high authority because we've done those experiments in my lab across the hallway right here on campus. However, brown fat, of which we have relatively little as human adults, is the almost opposite. It has a metabolic rate that rivals muscle tissue. It is easily 10 times higher than the metabolic rate of the white fat cells. And when I mention that we have very little, we do. And it's stored somewhat oddly. It's sort of tucked and woven through this thoracic region up in the clavicle area and then woven through the rib cage. And with all of that metabolic rate, it's no surprise that it is. It looks very different. It literally looks a dark reddish brown because it has a very high metabolic rate, born from its high amount of mitochondria. So it's the mitochondria that's actually giving this fat cell much of its darker reddish color. The mitochondria are so heavily present, not unlike with muscle, but even further, the mitochondria, while being much, much higher level in brown fat than white fat, are also one step different than normal mitochondria because they, they express a protein called uncoupling protein 1 or UCP1. And to not get overly technical, I can just refer to normal fat as. Let's use the analogy of an engine. And we can have. As we look at our dashboard in our car, we see the RPMs of the engine, which is how fast is the engine turning. And then we see the speedometer, which tells us how fast the car is actually moving. And those are not the same thing. But in white fat tissue, if you, those two do move almost identically, if you begin to increase the idling of the engine, you are moving the car. So the cell would work a little more. But fat cells don't have a lot of work to do. They're not like muscle cells or neurons or kidney cells. And so they have a very low demand. This is a car that does not need to go faster than 2km an hour. And so you'd expect it with that very, very slow movement. It has a very low idle of the engine. The engine is turning very slowly. So we would say that those two things are coupled. In other words, they're working very, very tightly together, Synchronized. That's white fat. Very slow moving car with a very slow turning engine. So low speed, low RPMs. In contrast, the brown fat is moving faster. It's working more because it wants to create heat, but in the uncoupling protein allows us. So even though it has a slightly higher speed, the engine is really revving. So it's like we are coasting on a gentle slope, but the car's in neutral and we are pressing the gas pedal. Well, we're not making the car go any faster. It's still moving at a slight little clip. Maybe we're going 5km an hour. It's working a little more, going a little faster than the carve, the white fat. But the engine is really revving. You can hear it revving. We are wasting a lot of fuel, and the engine's getting really hot. That's exactly what's happening in the mitochondria of the brown fat. We are, because of the uncoupling protein, we have uncoupled the speed of the car from the revving of the engine. So the engine's generating a lot of heat, but we're not getting a lot of movement from. We're not moving the car any faster. This is the brown fat. Because of the uncoupling protein, it's burning a lot of glucose and fats just to create heat. And this becomes something we can take advantage of, because if we imagine. All right, how can I turn my brown fat on to increase its metabolic rate and help me be more insulin sensitive? Well, we can expose ourself to cold. So cold therapy is the most effective way to turn on your brown fat. Now, if I were to tell that to my wife, say, honey, you need to expose yourself. You need to have a cold immersion. She would laugh in my face. She would never do it. Cold shower to her is so hot that I can barely tolerate the temperature. So for her, she'd never engage in this. But she could still take advantage of turning on brown fat by increasing ketones. So we published multiple reports now finding that ketones are also capable of. Of activating brown fat and even making white fat. This happens with cold therapy as well, making White fat, subcutaneous fat behave more like brown fat. It's not totally becoming brown fat. We say that it becomes beige fat. Now that's something that can be turned on or turned off. Ketones do it and cold therapy does it. Cold immersion does it as well.

So white fat is the fat that you can pinch or jiggle. So the subcutaneous fat, but it's also your visceral fat. So that's what you want to try to reduce. And especially if you're thinking, I just want to get rid of my belly fat, the brown fat is high mitochondria, it's working for you and for your health. And you mentioned the Beijing, which is turning white fat more into brown fat. So you mentioned the cold therapy. Wonderful. Not so wonderful if you don't like the cold. What about the role of. You hinted to it about ketosis. What is the role in ketosis? To turn more white fat into brown fat, but also to help with insulin resistance and thereby reducing belly fat.

Mm, yes. So just as a brief primer on the metabolism of ketones, we make ketones when we are burning a lot of fat, and we can only burn a lot of fat when insulin is low. Of course, the human body is a metabolic hybrid at any moment, relying on one of two fuels. Primarily, there are actually more than just these two, but their contributions are relatively modest. At any moment, the body is sugar burning, blood sugar, glucose, or it's fat burning to varying degrees. And insulin is the primary signal that determines which one is dominant. If insulin is elevated, the body is sugar burning. If insulin is low, the body is fat burning. And if insulin stays low for upwards of 12 plus hours in the liver, the liver cells are burning so much fat that it's burning more fat than it actually needs for its own energy. So, so the liver cell is telling the mitochondria, hey, mitochondria, I need this much energy. And the mitochondria says, okay, no problem, I can fulfill that order. And because insulin is low, I'm going to give you all that energy in the form of burning fat. But because insulin is still low, I can't stop burning fat. And now you have this excess, if you will, where we are. Literally we've gone further than the liver cell needs. And so the cell says, well, I need a release valve, I need to release this energy somehow. And that shunts the. That basically opens up the doors for ketogenesis. Now we have the production of ketones from all of this fat burning, and the ketones are getting released into the bloodstream to be used, happily, by any cell that has mitochondria, which is almost every cell of the body. So ketones become a fuel. And then ketones do have direct signaling effects. So ketones as a molecule have been shown to reduce inflammation. We have shown that they have the ability to stimulate mitochondrial biogenesis. So stimulating the synthesis of new mitochondria and even in fat tissue, increase the metabolic rate of fat tissue that is a direct effect of ketones. But if we go one step further back with all of this view in mind, we see how ketones become evidence of fat burning, which is one of the reasons why a ketogenic diet is so effective at not only weight loss, but also resolving insulin resistance. Because you are lowering insulin, and the chronically elevated insulin is the main contributor to insulin resistance. And so if you're making ketones, you know your insulin is low. So let's say, for example, someone listening to this is unable to get into the clinic and get their insulin measured. Well, what happens if you just do a 24 hour fast? If you do a 24 hour fast and prick your finger or blow into a device and you see, you confirm that you are in ketosis, then you have a body that has low insulin in that state, which suggests that you are likely insulin sensitive. And if nothing else, you know you are burning fat, aggressively burning fat. If you're making ketones, you're burning fat. Now, some of that fat burning could be coming from all the fat you're eating. So that's not necessarily just the same as always losing fat, but likely you are losing fat. And also one final point, with ketones, this becomes part of the metabolic advantage and why I am such an advocate of, of someone's weight loss journey, starting with lowering insulin. If your initial priority is to lower insulin, one of the metabolic advantages of that state is that as you are making ketones, you are breathing them out or you are urinating them out. So you are excreting, you're dumping ketones from your body. And every ketone has a roughly similar caloric value to a molecule of glucose. So people don't appreciate that ketones are calories. And calorie energy matters. You know, we established that earlier, energy does matter, but so too do hormones. And hormones tell the body, particularly insulin, what to do with energy. And if insulin is low, the body wastes energy. And that's exactly what's happening here. So in a low insulin state, you're making ketones and you're dumping these calories out into the atmosphere. Whether you're breathing them out or whether you're urinating them out, those are calories that you no longer have to burn through exercise or store in your fat cells. And adding to that one step further of the metabolic advantage is the fact that when insulin is low, metabolic rate can be several hundred calories higher per day than it is if insulin is elevated.

Let's talk about foods, because that is very interesting. There is a surprising sugar sweetener that we talk about, allulose. How does that help with belly fat and so many other things? It's a sugar.

Yeah. Yeah, it is. In fact, you're describing it perfectly. It is a sugar. People want to say that it's a sweetener. It's not. It is what's called technically a rare sugar that you can get from things like figs, for example. Now, what's different or what's unique about it is that it's essentially fructose's good twin, that it's this tale of two sugars that whereas fructose has these generally negative metabolic effects, allulose is identical to sugar, with exception of one carbon has is flipped at one of the carbons within the molecules. So it is almost identical. And yet it gets absorbed differently. It competes with fructose. So if you are taking fructose in allulose, the allulose will compete against the fructose to get absorbed into the bloodstream. And then it goes further in the digestive tract as well. And so it has a substantial effect on the hormone GLP1. In fact, allulose increases GLP1 as far as we can tell, more than any other thing we can eat or drink. It increases GLP1 by up to 8 to 10 times. Now, GLP1 is important. If it doesn't sound familiar, that is the molecule that these popular weight loss drugs are taking advantage of, namely Wegovy and Ozempic. Those are drugs that stimulate the same receptors that GLP1 does. So they are what's called GLP1 agonists. But in allulose's case, you are simply just making more GLP1. And so it's no surprise that with allulose, people feel fuller, longer, and have a greater sense of satiety and their cravings are down. But also it helps resolve uric acid, which my friend Rick Johnson at the University of Colorado has really studied, and we're good buddies and we've studied this together. Allulose really rapidly lowers uric acid, which he has found helps with fat burning and insulin sensitivity. So there There, there's a lot here. But just by blocking fructose, we help prevent some belly fat. By increasing GLP1, we not only regulate appetite better, but also GLP1 has a direct effect at fat cells to stimulate fatty acid oxidation. So GLP1 stimulates fat burning, which of course ultimately helps with controlling fat mass or reducing it.

So when people think about allulose, they might be thinking, well, I might just have more stevia. That's probably the same thing. What is the difference?

Yeah. So in general, I don't want to sound like I am against sweeteners like stevia. I think, I think there is absolutely a place for these natural and artificial, even sweeteners at replacing sugar. That, to me is the priority. Replace sugar. And in that sense, all of those other sweeteners are kind of the same in my mind, for the most part, they're not all quite the same, but stevia, aspartame, monk fruit extract, they're all kind of inert replacements for sugar. But allulose takes it one step further because not only does it out compete fructose, which helps control uric acid, but it also has that GLP1 effect which the others do not have. So it is unique. Whereas the others are just an inert replacement for sugar. Allulose is in fact, I would say, a beneficial replacement for sugar because of this hormone stimulation that appears to be almost totally unique to allulose.

And how does allulose help with things like dementia?

Right. So there are studies that have looked at this, and part of the signal could be an activation. Allulose has been shown to activate ampk. An AMPK is a signal that stimulates energy burning, or glucose and fat burning, but it also stimulates mitochondrial biogenesis. So that could be one of the mechanisms whereby allulose is improving things like cognition. Because the more we learn about Alzheimer's disease, the more we really look at it as a deficit of brain energy. The brain is essentially going hungry, and anything we can do to correct that hunger, including stimulating more powerhouses like the mitochondria, are going to generally be helpful.

So is it something that you take every day, allulose with your evening meal? I actually heard that you love cereal. So instead of having the cereal, you like something sweet?

I do. Oh my.

Tell us about that.

Yes, yes. So it is. It is a just a deep character flaw. I would. I would look adonis like if it weren't for my addiction to cereal. So now, mind you, I don't indulge in it often because I am a true addiction. And I say that with a smile. But there's a true sort of sinister part of it where I will go through this cycle where if there is a yummy cereal, a cold cereal in the house, it is calling my name all evening. And it takes an absolute knuckle biting herculean effort to not eat it. And when I do, which is why it's so rarely in the home, I will go through this sort of addictive cycle where I tell myself, you know, I get to the point where I say, okay, I'm going to have some, but I'm just going to have one small bowl. And I know in the deepest part of my brain and heart that it won't stop at one bowl. But like a true addict, I just tell myself that I will. And then I end up eating three bowls and I feel sick and I can't believe I did it again and I'm ashamed of it. So I have found. So I take allulose through these Rx sugar products and there are two favorites of mine, what's called the Swealthy Stix and then the Swealthy snacks. And the snacks are little chocolate bars. It's those chocolate bars that I will eat dinner and about an hour later when the dreaded cravings beast starts to come to life, I will just take one or two of those bars and it just smashes my cravings. I've never had an easier time. Not that I'm perfect, but allulose has helped me control my evening cravings, which is when most people have cravings. You know, I know I'm not unique. It's just. What are you craving? Mine is cereal. Other people may crave toast and jam or whatever else it may be, but. But in that sense, these little chocolate bars that are 10 grams of allulose each really help put my cravings to bed A little before I'm ready for bed.

I'm very tempted to try the allulose because I mean, I tend to be more of a carnival type person. Follow the carnival diet just for. It's very easy. But then I just thought, oh, like if I have like something needed, something sweet, I could try some allulose. I wanted to also touch lastly on exercise relating to belly fat. How does exercise help with belly fat and what should we be doing?

Yeah, I'm really glad you brought this up. A point that I have wanted to make since the beginning of the discussion but didn't know how to insert it was the fact that belly fat wants to be burned. That if you take a little piece of belly fat and compare it to a piece of subcutaneous fat, the belly fat, the visceral fat, is actually breaking down its fat faster. At any given moment, it wants to be burned, but in particular, it's very, very sensitive to the sympathetic nervous system. Or to say that another way, it's very sensitive to adrenaline or epinephrine. Depending on which part of the world you're in, you'll call it one or both of those. So epinephrine. Epinephrine is one of the stress hormones of the body. Now, that doesn't mean it's bad, but if the body needs to do something physically, epinephrine is going to be there to help mobilize the energy. Epinephrine stimulates fat breakdown exceptionally well in the visceral adipose. And so anything we can do to increase epinephrine is going to selectively burn belly fat more than the other subcutaneous fat depots and ways to increase epinephrine. One is caffeine. I hate to say that a little bit for fear of it being abused, but also exercise. Exercise increases epinephrine very immediately and in a sustained way. So too does cold therapy. I hate to bring that up again, but yeah, I mean, those are some of the main stimuli, but exercise is an absolutely relevant one. So minute for minute, as epinephrine is elevated, a person will be burning a little more of their belly fat than they will fat anywhere else.

So what type of exercise would you recommend for people to start losing their belly fat?

Yeah, the best exercise. This is going to sound brilliant. Is the one you will do. Now, I hate to underwhelm everyone listening, but it really is. If there's something you will do, then do it. If you have the ability and interest, then I am an enormous advocate of resistance exercise. Anything you do to that you can do to increase the intensity, do it. So if you're walking, start walking. And then if you can add, say a 10 pound weighted vest and start climbing a hill, do it. And if you can bump that up to 30 pounds eventually, and now you're doing a ruck or this kind of weighted hike up and down the hill, do it. But if you can insert some push ups into that or some squats or some pull ups, anything you can do to fatigue the muscle is going to be, in my view, minute for minute. The best way to exercise.

Wonderful. Well, this has been an encyclopedia on how we can burn belly fat the scientific way. If people love you, Dr. Beckman, how can they find you?

Right. Thank you again so much. This was fun. Yeah. Please go to insuliniq.com that's where I have compiled everything that is Ben Bickman. All of the professional efforts that I have, whether it's my books or social media or my recent my podcast episodes, Everything is@insuliniq.com I hope you enjoyed this interview.

Now, you need to watch this video next with Professor Thomas Seyfried, all about how to reduce the risk of cancer with diet. I'll see you guys next week.