Fat Tissue Scientist Reveals How to Lose Drastically More Fat by Manipulating Insulin - Dr. Bikman

Intro (0s)

• Cortisol can break down the body to increase blood glucose levels, destroying collagen in skin and proteins from bone, and stripping away amino acids to use for gluconeogenesis, prioritizing glucose increase over body preservation (4s).
• Insulin plays a minimal role during exercise, as it is antithetical to the process, taking a back seat to allow for energy mobilization (42s).
• Insulin's primary action is to store nutrients, including amino acids, fats, and glucose, which is opposite to the energy mobilization required during exercise (50s).
• When insulin is elevated, it locks in energy and does not want to mobilize it, which is counterproductive to the catabolic state needed during exercise (1m35s).
• During exercise, insulin levels decrease due to various mechanisms, including a direct nervous system effect that tells the beta cells of the pancreas to reduce insulin production (2m6s).
• The decrease in insulin allows for the increase of other hormones, such as epinephrine, cortisol, glucagon, and growth hormone, which are more catabolic and help mobilize energy (2m34s).
• Growth hormone, despite being associated with tissue growth, is actually catabolic and helps mobilize energy by inducing lipolysis and glycogenolysis, providing fuel for subsequent tissue growth (2m49s).
• Exercise is an effective way to keep insulin levels low, which is essential for being lean and living long, as insulin dominance is not compatible with the catabolic state required during exercise (3m57s).

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Exercise & Insulin | Carb Consumption During Exercise (6m18s)

• Insulin is only necessary for glucose uptake into a few cells, primarily muscle and fat cells, which have a glucose transporter that only opens when insulin is present (6m50s).
• Other cells, such as those in the liver, kidneys, and red blood cells, have glucose transporters that are always open, allowing glucose to enter the cell without the need for insulin (7m7s).
• Insulin still affects these cells in other ways, including telling them what to do with the glucose, but it does not control the entrance of glucose (7m16s).
• Muscle cells are unique in that they have a "back door" for glucose uptake that is insulin-independent, which is activated during exercise when insulin levels are low (7m38s).
• During muscle contraction, calcium activates an enzyme that moves the glucose transporter GLUT4 to the surface of the muscle cell, allowing glucose to enter without the need for insulin (8m7s).
• This insulin-independent glucose uptake is beneficial for people who are doing low-carb diets, as it allows them to consume some carbs during exercise without relying on insulin (8m51s).
• However, it's not a free pass to consume excessive carbs, and the amount of carbs that can be consumed without relying on insulin is still limited (9m4s).
• The decision to consume carbs during exercise depends on individual outcomes, such as improving insulin sensitivity, and may not be prudent for everyone (9m31s).
• A study in women found that exercising and fasting improved insulin sensitivity, suggesting that consuming carbs during exercise may not be necessary for this outcome (9m46s).
• The degree of insulin sensitivity can be influenced by exercise and glucose consumption, and the outcome depends on the specific goal of the individual, such as a lean marathon runner, bodybuilder, or someone seeking to maintain insulin sensitivity (9m50s).
• Consuming carbs during exercise may undo the insulin-sensitizing effect of exercise, as seen in a study of women, and therefore may not be beneficial for those seeking to improve insulin sensitivity (9m59s).
• For individuals exercising to improve insulin sensitivity, such as overweight type 2 diabetics, it may not be prudent to consume carbs during exercise (11m11s).
• However, for leaner individuals or those with different outcomes specific to a sport, consuming carbs during exercise may be necessary to perform at their best (11m24s).
• Research by Dr. Andrew Cnockaert suggests that the only requirement for carbohydrates during intense endurance activity is to prevent exercise-induced hypoglycemia, which can be achieved with as little as 3.4 grams of carbs every 20 minutes (11m42s).
• This amount is sufficient to keep blood glucose levels stable, and it highlights how little carbohydrates are required to achieve this goal (12m12s).
• Athletes who have adapted to a ketogenic state through training can break the classic paradigm of relying on glucose as the primary fuel source at higher intensities, and instead continue to burn fat at higher intensities (13m10s).
• Research in exercise physiology has shown that the amount of fat that can be oxidized to sustain exercise is much higher than previously thought, with one study finding a 9-fold increase in fat oxidation, breaking the rules of fuel utilization during exercise (13m19s).
• To achieve this, the body must have a higher abundance of mitochondria, the site of fat burning, and enzymes involved in moving fat into the mitochondria, which can be achieved through training that pressures the body to rely on fat as fuel (13m51s).
• When the body is forced to rely on fat at higher intensities, it adapts by increasing the abundance of mitochondria and enzymes, allowing for higher levels of fat oxidation (14m28s).
• This adaptation can be beneficial in long endurance events, where the main reason people fail is due to running out of glucose, as the body can rely on fat and ketones as alternative fuels (14m42s).
• Carbohydrate loading may not be necessary for the average person, and consuming carbs during exercise may not be necessary either, as the body can rely on fat and ketones for fuel (15m19s).
• Oxidizing fat at higher intensities can also lead to glycogen sparing throughout the workout, leaving more energy in reserve for high-intensity efforts (15m30s).
• Even in ketogenic athletes, muscle glycogen levels can be normal, indicating that the muscle is able to maintain its glycogen stores even when relying on fat and ketones for fuel (16m21s).
• This can be a potential difference maker in high-intensity efforts, where having untapped muscle glycogen can provide an energy boost (16m42s).

Fasted Training (16m50s)

• Fasted training can be thought of as creating an adaptation pressure, similar to wearing a nutritional weight vest, which induces more fat adaptation during a workout (16m51s).
• Training in a fasted state can burn more fat during the workout itself, as the body prioritizes the use of available energy sources, with ketones being the priority (17m42s).
• The body's metabolic system can be compared to a bus with different boarding zones for various nutrients, with ketones having priority boarding and being burned first (17m56s).
• Eating nutrients during or after a workout can slow down the use of stored fat, replacing those nutrients in fat cells shortly after consumption (18m35s).
• The most important part of a fast is how it is ended, with the focus being on what is eaten when breaking the fast, rather than the duration of the fast (19m0s).
• A poorly planned fast can lead to a cycle of bingeing and purging, resulting in feelings of shame and guilt, which can be harmful (19m23s).
• The way a fast is ended matters more than the duration, and this principle can also be applied to exercise, with the focus being on the quality of the workout and nutrition rather than just the duration (20m0s).
• Exercising in a fasted state, as opposed to consuming glucose, can have different effects on the body's energy use and fat adaptation (20m13s).
• When exercising on an empty stomach, the body will burn more fat because there is no incoming fuel competing with stored body fat for energy, allowing the body to utilize its own fat more efficiently (20m24s).
• Although fasting during exercise may lead to increased fat burning, it's essential to consider what happens in the following 24 hours, as some individuals may overcompensate by eating uncontrollably after fasting (20m47s).
• If an individual can control their food intake after fasting and exercising, they may end up in a more advantageous fat-burning position (21m20s).
• Hunger is a crucial factor in fat loss, and breaking a fast with proteins and fats can help reduce hunger throughout the day (21m25s).
• A human study found that when the first meal of the day was low in carbs and high in fat, participants were much less hungry throughout the day, even when calorie intake was matched (21m40s).
• Having a plan for what to eat after exercising and fasting can help with accountability and prevent overeating, especially in the evening when cravings are typically the strongest (22m6s).
• It's essential to have a plan in place for managing hunger and food intake, especially in the evening, to avoid overeating and making unhealthy choices (22m37s).

Constrained Energy Model & Fat Burning (23m4s)

• The concept of the "constrain energy model" is discussed in relation to fat burning, where the body may experience a rebound effect after fasting or exercise, leading to overeating and making up for lost calories over time (23m5s).
• Research has shown that people who exercise may inadvertently become less active throughout the day, which can offset the benefits of exercise, a phenomenon known as the "permissive effect of exercise" (23m50s).
• This permissive effect is not limited to exercise, as people who deliberately restrict certain foods or drinks may also make up for it in other ways, feeling like they've "earned it" (24m5s).
• The body has a natural desire to resist changes to its basal state, whether it's an increase or decrease in energy expenditure, and will adapt to maintain homeostasis (24m34s).
• Exercise alone is not sufficient for weight loss, as people may compensate by eating more, and controlling diet is necessary to achieve weight loss (24m52s).
• To overcome a weight loss plateau, it's essential to have a strategy that mobilizes the body's energy stores, rather than working against hunger, which will ultimately lead to failure (25m23s).
• Lowering insulin levels is a crucial first step in a weight loss journey, as it allows the body to mobilize its energy stores, and reducing insulin levels can be achieved through dietary changes (25m44s).
• When ketone levels are elevated, satiety is improved, and people with eating disorders have reported a better relationship with food when their brain is fueled by ketones (25m56s).
• When individuals start training their bodies to rely on their own fat for fuel by changing their diet to lower insulin levels, they undergo a slow and steady adaptation, allowing them to access stored fat energy (26m25s).
• Overweight or relatively lean people often consume energy bars and drinks while hiking, despite having hundreds of thousands of calories stored as fat, which cannot be accessed until insulin levels come down (27m14s).
• The body has two fuel sources: a small amount of glucose (around 2,000 calories) and hundreds of thousands of calories stored as fat, even in lean individuals (28m30s).
• The average person only taps into the modest glucose fuel source, constantly filling it up, which is analogous to a semi-truck hauling a tanker of gasoline but only using a small fuel tank (28m41s).
• When people wake up and eat a starchy, sugary breakfast, their glucose and insulin levels spike, causing hunger and continuing the cycle of refueling and experiencing highs and lows in energy and mood (28m49s).
• If individuals can lower their insulin levels, they can access their stored fat fuel, which is a rock-steady energy source that separates them from the highs and lows of glucose levels and associated hunger, lethargy, and mood swings (29m16s).
• The more the metabolic engine is coupled to glucose, the more frequent hunger and energy level fluctuations will be experienced as glucose levels go up and down (29m40s).
• When the body gets coupled to using fat as the fuel, it has a steady energy source, leading to more stability in energy and overall well-being, while also improving metabolic health (29m54s).
• Once the body adapts to using fat as fuel, it takes time for the body to figure out how to efficiently use this new energy source (30m18s).
• In the athletic community, especially in the endurance world, people are starting to realize that it takes time for the body to adapt to using fat as fuel (30m30s).
• Carbohydrates have an anti-catabolic effect, which means they help prevent muscle breakdown, but this can also make muscles dependent on carbs and lead to muscle loss when carbs are not available (30m40s).
• Being more fat-adapted and conditioned to training fasted can help protect muscle tissue and prevent muscle loss (30m55s).
• When muscles are used to relying on carbs, they can become spoiled and hit the panic button when carbs are not available, leading to muscle loss and catabolism (31m16s).
• Developing metabolic flexibility and fat adaptation can help spare muscle mass and prevent muscle loss (31m29s).
• A recent meta-analysis found that there is no difference in building and retaining muscle mass between high-carb diets and ketogenic diets in weightlifters, as long as the stimulus and calories are sufficient (31m45s).
• Ketones can help defend muscle mass by providing an alternative energy source and reducing the need for muscle breakdown (32m19s).

Fasting vs Starvation (32m30s)

• Fasting and starvation are two distinct concepts, with the primary difference being the presence of body fat, as the moment a person's body runs out of fat, the fast has ended, and starvation has begun (32m35s).
• When a person has fat to burn, they produce ketones, which signal the brain to leave muscle alone, but when fat is depleted, ketones disappear, and the body starts burning muscle for fuel, leading to starvation (32m58s).
• Ketones play a crucial role in defending muscle, as they prevent the body from burning muscle for fuel, and as long as ketones are being produced from fat burning, the body won't touch its muscle (33m19s).
• A case report of a morbidly obese man in the UK who fasted for 382 days under medical supervision, with only vitamins, minerals, water, coffee, and tea, but no calories, is cited as an example of the difference between fasting and starvation (33m30s).
• The man in the case report was able to fast for an extended period without starving because he had a significant amount of fat to burn, which produced ketones and prevented his body from burning muscle (33m53s).
• In contrast, people with less body fat would not be able to sustain a fast for as long, as they would quickly deplete their fat stores and enter starvation mode, leading to muscle loss and other negative consequences (34m11s).
• Research has shown that ketones have a protective effect on muscle, making it more robust and resilient to insults, and that ketones are essential for preserving muscle mass during fasting or other forms of caloric restriction (34m29s).
• The presence of ketones in the body has been found to help muscle cells survive better and be more resistant to damage, highlighting the importance of ketones in maintaining muscle health (34m47s).
• Ketones are considered the muscle's "best friend" due to their protective effects, and their presence is crucial for maintaining muscle mass and overall health during periods of fasting or caloric restriction (34m55s).

Caffeine & Fat Loss (34m59s)

• Caffeine is a beneficial molecule for exercise, stimulating lipolysis, the breakdown of fat from fat cells, and beta oxidation, the burning of those fats, making it a powerful ergogenic aid (35m39s).
• Caffeine is also ketogenic, accelerating ketogenesis by burning more fat and producing more ketones, which have various metabolic benefits, including signaling satiety, controlling inflammation, and defending muscle (35m57s).
• Caffeine can be considered a "free ride" for fat loss, as it helps burn more fat without requiring additional effort, but this effect can be offset if the body compensates for the increased fat burning (35m26s).
• Caffeine increases epinephrine, a stress hormone that can cause insulin resistance if elevated too much for too long, which is a cardinal cause of insulin resistance (36m51s).
• Consuming caffeine from plant sources, such as coffee or yerba, may be beneficial as they contain other molecules that increase dopamine, which can negate the insulin resistance effect of epinephrine and have a beneficial effect on fat burning (37m33s).
• In contrast, consuming pure caffeine sources, such as caffeinated soda, may not have the same benefits as they lack the other compounds that can balance out the effects of epinephrine (37m25s).

Benefits of Insulin (38m19s)

• Insulin has recovery properties, particularly in restoring glycogen in muscles and the liver, which prepares the body for the next exercise bout by providing high-octane fuel in the form of glucose (38m19s).
• Insulin facilitates the recovery of spent fuel, especially glucose fuel and glycogen, and is necessary to restore glycogen in muscles and the liver (38m40s).
• There is a misunderstanding about insulin's effects on muscle, as it is often viewed as an anabolic hormone in bodybuilding, but its primary role is to protect muscle protein rather than promote its growth (39m6s).
• Research by Dr. Sh at the University of Minnesota in the early 1990s found that insulin promotes muscle growth by inhibiting proteolysis, or the breakdown of proteins into amino acids, rather than promoting the uptake of amino acids and their conversion into muscle protein (40m3s).
• Insulin is not necessary for the uptake of amino acids and their conversion into protein, but rather helps to protect existing muscle protein from being broken down (40m26s).
• Chronically elevated levels of amino acids, particularly branched-chain amino acids, are a common feature of type 2 diabetes, but this is not caused by the amino acids themselves, but rather by the muscle becoming insulin resistant (41m25s).
• As the muscle becomes insulin resistant, it breaks down protein into amino acids, leading to elevated levels of amino acids in the blood (41m52s).
• Insulin resistance can lead to increased proteolysis in muscles, causing them to break down more easily, and resulting in the release of branched-chain amino acids into the plasma (42m2s).
• Consuming carbohydrates post-workout can trigger an anti-catabolic effect due to the insulin response, but this effect can also be achieved through protein consumption, which increases insulin levels (42m30s).
• A recent meta-analysis found that individuals on a ketogenic diet with minimal carbohydrate intake can achieve the same muscle growth and strength as high-carb athletes, suggesting that an insulin spike is not necessary for muscle growth (42m43s).
• Insulin has a natural rhythm throughout the day, even during fasting, which can help maintain normal muscle metabolism (42m56s).
• Other signals, such as insulin-like growth factors (IGFs), can promote muscle growth and retention, even in the absence of high insulin levels (43m12s).
• IGFs are stimulated by growth hormone, which increases during fasting, and can help promote muscle growth and retention (43m15s).
• Dr. Mike Israel, a high-carb proponent, suggests that carbohydrates are beneficial for muscle building because they trigger appetite and increase food intake (44m21s).
• Dr. Israel also suggests that consuming carbohydrates after a workout can help reduce cortisol levels and promote recovery, although this idea is not supported by literature (44m54s).
• Reducing cortisol levels and promoting recovery after a workout may have a positive impact on actual recovery, although more research is needed to confirm this (45m8s).
• Cortisol is not a uniform villain and is a necessary hormone, even if it's often referred to as a stress hormone, as it plays a crucial role in recovery and improvement, and some level of stress is beneficial for growth and development (45m29s).
• Chronically elevated cortisol levels can be catabolic to muscle, causing the body to break down muscle tissue to increase blood glucose, but this typically occurs at pathological levels, such as in Cushing's Disease or Cushing syndrome (46m6s).
• Normal physiological shifts in cortisol, such as those experienced during exercise or fasting, are unlikely to be pathogenic and do not typically result in muscle stripping (46m54s).
• Some health influencers may recommend high-carb diets for overweight individuals with type 2 diabetes, but there is limited evidence to support this approach, and low-carb diets may be more effective for this population (47m37s).
• Insulin resistance is a major health concern, potentially affecting up to 88% of adults in the US, and is the primary focus of research in this area (48m9s).
• The health needs and recommendations for lean, athletic individuals may differ significantly from those for overweight individuals with type 2 diabetes, and it's essential to consider the specific population being studied or advised (47m52s).
• The global problem of obesity and diabetes is highlighted, with the US not being in the top 10 for obesity or top 20 for diabetes rates, indicating a widespread issue (48m39s).
• Insulin resistance is a significant concern, and it is wished that more people with influential voices would consider this group when discussing food addictions and provide more cautious advice (48m47s).
• Giving individuals with food addictions blanket advice, such as drinking as much fruit juice as they want, can lead to overconsumption and is not suitable for everyone (48m59s).
• Mike is mentioned as someone who can handle more aggressive approaches to diet, but this may not be the case for others who struggle with food addictions (49m14s).
• The importance of considering individual differences in dietary needs and restrictions is emphasized, particularly for those who are insulin resistant or struggling with food addictions (49m21s).

Where to Find More of Dr. Bikman (49m25s)

• Dr. Bikman's content can be primarily found on insulinIQ.com, which includes upcoming modules and lessons that people can join to learn from him (49m28s).
• Dr. Bikman also has an Insulin IQ YouTube channel where he hosts a weekly Metabolic Classroom, and people can subscribe to it (49m37s).