Podcast

How to Improve Insulin Sensitivity and Regain Metabolic Health (Minisode #47)

Episode introduction

In this episode, Dr. Casey Means and special guest Dr. Ben Bikman teamed up on the ‎Dhru Purohit Podcast to explain the numbers and the history behind metabolic health. Dr. Means shared the healthy ranges for fasting glucose, while Dr. Bikman explained why you should go to war with carbs and befriend good fats.

Key Takeaways

The healthy range for fasting glucose

Dr. Means explains that while a glucose level of 99 is technically healthy, 100 is considered pre-diabetic. Individuals should be counseled on where they are on the range from health to unhealthy.

When you look at fasting glucose below 100, so 100 or below of a fasting glucose meaning your glucose when you wake up and you have not had any calories for eight hours. If that’s under 100, you’re considered normal, nondiabetic not pre-diabetic. Between 100 and 125 it’s pre-diabetic fasting glucose range. And if you are 126 or above, you’re considered to have type two diabetes. So what that means is that if you have a fasting glucose of 99 when you walk into the doctor’s office, it’s very likely that the doctor’s going to say, “You’re normal, you have a normal fasting glucose”. I think a lot of people are realizing that that might not be the way we should be looking at this because is 99 really optimal if you’re one point away from being pre-diabetic? Does that mean that you’re are totally in the clear? The answer is no…if we really dig into the research, it’s probably more likely that having a fasting glucose between about 70 and 85 is going to lead to much better health outcomes than if your fasting glucose is 99.

The healthy range for glucose after a meal

Dr. Means said that fasting glucose is one number, but another number to keep an eye on is your glucose level immiediately after a meal.

So we think about fasting glucose, which is when you haven’t eaten anything for eight hours. But then we also think about what are the ranges for after you eat something, where do you want to be. So right now, if you look at the International Diabetes Federation, they would say that you want to stay generally under 140 milligrams per deciliter after a meal. So let’s say your glucose is 80 before lunch, and then goes up and stays under 140 and then comes back down. That’s considered to be fine. Again, I would argue that that’s probably higher than we want to go after every meal. If you look at the literature, they’ve done quite a few studies where they’ve put continuous glucose monitors on healthy non-diabetic populations, and the vast majority of time, well over 90% of the day, people are actually spending their time between a range of 70 and 120.

Glucose levels are not static

Dr. Means said that testing your glucose once per year at the doctor’s office can be misleading, as glucose levels change so much throughout even just one day.

These fasting glucose levels bounce around a huge amount day to day. And based on the current way we track these things, which is you go to the doctor one time per year and you get a fasting glucose check. You’d think that, oh, well that probably means that these things are very static. That I’m 85 milligrams per deciliter, that’s my fasting glucose, that’s who I am. But that’s not the way it is at all. It bounces around all the time. I could have the perfect wellness day. I’m eating, cooking, all my food at home, really low glycemic, 10 zone scores for all my meals. I do a high intensity interval training workout. I get eight and a half hours of sleep. I mediated, I took magnesium, da, da, da. And the next day my fasting glucose is 72. Then the next day I could get four hours of sleep, have a very high carb late meal, not work out and be stressed. And my fasting glucose could be 95. It could be that big of a difference. And to me, that is really empowering, because it’s like okay if I dial in just a few of these things and make sure I’m checking off the boxes of my different wellness practices that I know impact my metabolism, I can really move the needle here.

Control carbohydrates

Dr. Bikman says that carbs have a role in your diet, but they should be carbs that come without a “barcode” on them.

My view on carbohydrates is control carbohydrates, which at its simplest definition is don’t get your carbs from a bag in a box with a barcode. That’s the simplest way of my view of carbohydrates. I’m not saying we can’t eat them, not at all. But it’s typically going to be carbohydrates that are the biggest offender when it comes to trying to control glucose and insulin. So just be smart about it. And in general, at the simplest level, focus on fruits and vegetables. If a person’s building their carbohydrate consumption around fruits and vegetables, we almost don’t need to go any further.

Beware of carbs that grow in the ground

Dr. Bikman says that the best way to get your carbs is via fruits and veggies. Once you’re doing that, the next step is to prioritize fruits & veggies that grow above the ground, not under it.

When someone’s need to go to the next level or if they need to because they have a family history of type two diabetes, or they already have type two diabetes. Then my next level is while you’ve been focusing on fruits and vegetables, now it’s time to remove the biggest offenders in that category, which is going to be if a vegetable grows in the ground, then be careful with it. I’m not saying you can’t eat it, but it’s going to just naturally be much starchier. If the vegetable grows above the ground, it’s generally on you can have almost as much as you want to shove in your face. It’s going to have such a modest effect on glucose and insulin.

The right way to approach carbs

Dr. Bikman summarized his outlook on carbs into a few key points.

I don’t mean at all to declare war on carbohydrates. Far, far from it. I think they can be a wonderful, healthy part of a smart diet. But we can’t get them from bags and boxes with barcodes. Focus on fruits and vegetables. Eat them, don’t drink them. And then if someone needs a little further push, well then it gets to that next level of all right well let’s scrutinize your vegetables and some of your fruits to avoid the starchiest or the most sugary of those. But often we don’t need to go that far. But someone would hear us and say, “So Ben is saying at a high level potatoes can be okay”. And I am at a high level saying that. But that is not the same as eating potato chips. And that’s back to my point, if it comes in a bag or a box with a barcode, beware.

Make good fats your friend

Dr. Bikman says that good fats are critcal to human health.

I am a big friend of fats in the diet for two main reasons. One is that are in fact essential. There are fats that humans must eat to survive. So we have to have, we have a genuine biological imperative to eat certain fats. And then two, of all three macronutrients fat is quite unique because fat alone, which of course people don’t eat it that way, but it’s powerful in that fat does have an effect on insulin. If someone’s eating fat again, we don’t do that and I’ll get to that point in a moment, but fat isn’t an insulin spiking nutrient. But so maybe to keep it at that level for a moment longer, I am a great defender of natural fats or ancestral fats or any other terms we could use there. And that is to say, the fats that we as a species have been eating since time immemorial.

Avoid vegetable oils

Dr. Bikman says that while vegetable oil has been touted as a healthy fat, it’s actually a leading cause of heart disease.

Look at soybean oil. And it went from nothing to being the number one by a wide margin, the number one consumed fat in the American diet. And I would say at this point, it’s essentially reflected in various sways as the global diet now. And then even fat number two was shortening, which I think is a mix of cotton seed oil and some other seed oils. But the two main consumed fats in the average American, and maybe even global diet are from these seed oils. And that’s so relevant because we’ve long been saying that saturated fats are the origins of heart disease. But you look at the consumption of saturated fats, like from beef and eggs, it has not moved in a hundred years as a percent of our diet. And so you directly look at heart disease and it’s spiking, well then you’d expect saturated fat consumption to be spiking. And it’s flat. The only fat consumption that follows this trend in heart disease and obesity and diabetes and dementia are the seed oils.

Episode Transcript

Dhru Purohit: Coming up on this week’s mini episode of the ‎Dhru Purohit Podcast.

Dr. Casey Means: If you’re one point away from being pre-diabetic does that mean that you’re totally in the clear? The answer is no. And the research suggests that as you move higher in the normal range towards a pre-diabetic fasting glucose level, your risk for a whole host of diseases from stroke to heart disease to of course developing type two diabetes or obesity, all go up very significantly.

‎Dhru Purohit: Considering we spend about one third of our day sleeping, wouldn’t it make sense that we spend just a little bit of time creating the right environment for a deep night’s rest? Let’s talk bedsheets in that vein because they’re a super important part of a good night’s rest. I want to tell you what my dream wishlist for everything that I’d want in the perfect set of bedsheets. Number one, comfort. Because if they’re not comfortable, nothing else matters. Number two, temperature regulation. So much science is coming out about the importance of keeping your body in the ideal temperature range at night. Not too hot, not too cold. So it’s super important to regulate temperature to get that great night’s sleep. Number three, nontoxic. So here’s the crazy thing, sleep is supposed to support our natural detoxification process. Why the heck would we want to expose ourselves to additional toxins at night with the wrong set of bedsheets.

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‎Dhru Purohit: Hi everyone, Dhru Purohit here. Obesity type two diabetes, heart disease, polycystic ovarian syndrome, and Alzheimer’s disease all have one big thing in common. They all involve of a component of blood sugar dysregulation. Considering the rampant use of sugar and flour in our food supply, managing blood sugar is something we should all be thinking about if we want to protect or improve our health. In today’s mini episode, I speak with two folks that I super look up to in this category, Dr. Casey Means and Dr. Ben Bikman. And I talk to them about how our diet and lifestyle have fundamentally changed the way that our blood sugar is regulated and how dysregulated blood sugar is wreaking havoc on our overall metabolic health. And we all know how important that is.

‎Dhru Purohit: We also talk about optimal glucose ranges and how everyone can use a continuous glucose monitor to dramatically improve their health. Let’s listen in starting with Dr. Casey Means, Stanford-trained physician, chief medical officer and co-founder of metabolic health company Levels, and an associate editor of the International Journal of Disease Reversal and Prevention. She additionally is a lecturer at Stanford University. Her mission is to maximize human potential and reverse the epidemic of preventable chronic diseases by empowering individuals with tools that can facilitate a deep understanding of our bodies and inform personalized and sustainable dietary and lifestyle choices.

‎Dhru Purohit: For context, give us a little bit of the ranges because people know about getting their fasting glucose test from the doctors. Walk us through that and let’s talk about what levels look at as the optimal ranges. Where do we want our blood sugar to be when it comes to the optimal range when we’re wearing a continuous glucose monitor?

Dr. Casey Means: So talking first about what the standard ranges are. So these are what the governing bodies are telling us are normal. And so when you look at fasting glucose below 100, so 100 or below of a fasting glucose meaning your glucose when you wake up and you have not had any calories for eight hours. If that’s under 100, you’re considered normal, nondiabetic not pre-diabetic. Between 100 and 125 it’s pre-diabetic fasting glucose range. And if you are 126 or above, you’re considered to have type two diabetes. So what that means is that if you have a fasting glucose of 99 when you walk into the doctor’s office, it’s very likely that the doctor’s going to say, “You’re normal, you have a normal fasting glucose”. I think a lot of people are realizing that that might not be the way we should be looking at this because is 99 really optimal if you’re one point away from being pre-diabetic? Does that mean that you’re are totally in the clear? The answer is no.

Dr. Casey Means: And the research suggests that as you move higher in the normal range towards a pre-diabetic fasting glucose level, your risk for a whole host of diseases from stroke to heart disease to of course developing type two diabetes or obesity, all go up very significantly. So if we really dig into the research, it’s probably more likely that having a fasting glucose between about 70 and 85 is going to lead to much better health outcomes than if your fasting glucose is 99. Even though both are within this bucket category of normal. And so I think there’s a real opportunity in the research community to start setting some guidelines around what are optimal ranges, as opposed to just normal ranges. Because these ranges that were created, normal, pre-diabetic, diabetic, this is for risk stratification. This is for helping doctors understand when to prescribe medications, resource allocation, but it’s not actually telling us what we should be shooting for, for optimal health.

Dr. Casey Means: The same is true for post meal glucose values. So we think about fasting glucose, which is when you haven’t eaten anything for eight hours. But then we also think about what are the ranges for after you eat something, where do you want to be. So right now, if you look at the International Diabetes Federation, they would say that you want to stay generally under 140 milligrams per deciliter after a meal. So let’s say your glucose is 80 before lunch, and then goes up and stays under 140 and then comes back down. That’s considered to be fine. Again, I would argue that that’s probably higher than we want to go after every meal. If you look at the literature, they’ve done quite a few studies where they’ve put continuous glucose monitors on healthy nondiabetic populations and the vast majority of time, well over 90% of the day, people are actually spending their time between a range of 70 and 120.

Dr. Casey Means: So that’s probably closer to where we want to be even after meals is under 120. I tend to shoot for under 110 or a 100 or so after meals. So really only getting up at most 30 points elevated after eating something. So let’s say I start at 80. I don’t really want to go above 110. If I start at 90, I don’t really want to go above 120. So shooting for these narrower ranges I think is going to ultimately lead us to feel better during the day. If I go from 80 to 140 and back down that’s to me going to feel like a pretty big crash.

‎Dhru Purohit: One day a little bit here and there things get off and then you can reset, it’s not a big deal. But if this is what your day looks like day in and day out, that’s when we really start to have problems.

Dr. Casey Means: Yeah, absolutely. And I think you also bring up a really great point, which is that you woke up yesterday morning, you had a late meal the night before. You woke up early and your glucose was maybe a little bit higher than normal. These fasting glucose levels bounce around a huge amount day to day. And based on the current way we track these things, which is you go to the doctor one time per year and you get a fasting glucose check. You’d think that, oh, well that probably means that these things are very static. That I’m 85 milligrams per deciliter, that’s my fasting glucose, that’s who I am. But that’s not the way it is at all. It bounces around all the time. I could have the perfect wellness day. I’m eating, cooking, all my food at home, really low glycemic, 10 zone scores for all my meals. I do a high intensity interval training workout. I get eight and a half hours of sleep. I mediated, I took magnesium, da, da, da. And the next day my fasting glucose is 72.

Dr. Casey Means: Then the next day I could get four hours of sleep, have a very high carb late meal, not work out and be stressed. And my fasting glucose could be 95. It could be that big of a difference. And to me, that is really empowering, because it’s like okay if I dial in just a few of these things and make sure I’m checking off the boxes of my different wellness practices that I know impact my metabolism, I can really move the needle here. It’s also, when I see that higher number, I’m like it’s okay. This is just a reminder to me that things are off course. I’m not in my homeostasis right now. If I let that happen for weeks and months and years where I’m doing all those behaviors that lead me to have that higher fasting glucose number, no question, that’s going to continue going up and that’s going to be more of a longer term problem.

‎Dhru Purohit: It reminds me of if I could just add, sometimes I’ll have this conversation and people are like, “I don’t want to know all the different numbers”. I’m like, “Okay. How about we try this. When it comes to your bank account, how about I tell you once a year how much money is in your bank account and then try to make financial decisions based on that”. You would not know if you were hitting your budget. You wouldn’t know if you’re overspending, if you’re underspending. But at the same time too, if you splurge a little bit one week or you have a fancy meal with your partner, a night out and you spend a little bit more money than you wanted to spend. Hopefully, knock on wood if you are in a decent position, it’s just one night that you spend a little bit more and then you can adjust appropriately. You adjust the budget. And that’s how I see this.

‎Dhru Purohit: I don’t want to wait once a year to know how much money I have in my bank account and to see how well I’m doing financially to make sure that I’m saving for retirement and all other goals that are there. And I also don’t obsess on a daily basis of, oh my gosh, I spent so much money today. I’m just going to abandon the whole plan and just fuck it. You want to pay attention through the process and see the trends and the averages and see are you headed in the right direction? Do you have enough money, say for retirement? Can you buy this house that you want to buy? Can you help your parents pay off their mortgage? Can you give X amount to charity that you need to give? And the same thing happens when it comes to our glucose meters that we have. We’re just looking at these average ones to know. And if we are completely off course with certain things like our breakfast and other stuff, we can start making changes that are there.

‎Dhru Purohit: My next guest, Dr. Ben Bikman is a world renowned metabolic research scientist, and a popular speaker on human metabolism and nutrition. Backed by years of research, Dr. Bikmans’ mission is to help the world appreciate the prevalence and the relevance of insulin resistance. He’s the author of Why We Get Sick, which offers a thought provoking yet real solution to insulin resistance and how to reverse pre-diabetes, improve brain function, shed fat and prevent diabetes. One of the tools that Dr. Ben Bikman and myself find most helpful for proactively managing our metabolic health is a continuous blood glucose monitor. Dr. Bikman and I talk about how to get personalized insights from it, what to focus on when it comes to carbohydrates and fat and which foods to limit to improve insulin sensitivity and regain metabolic health for the whole body.

‎Dhru Purohit: Now, before we jump in, just a little clarification. I am an investor in Levels and Dr. Bickman is an advisor to Levels. I so believe that we want to democratize medicine and make these continuous glucose monitors available to everyone. And I put my money where my mouth is and I’m investing in Levels. So one, just wanted you to know transparently, because I always disclose where I’m involved with companies. It’s either marked as an ad or I’ll let you know that I’m an investor. And number two, big picture because we want these things to be accessible we have to acknowledge that right now some of these solutions are expensive.

‎Dhru Purohit: If you go and sign up for Levels or you go and sign up for another app that’s out there or even if you go to your doctor and you convince them to give you a blood glucose monitor, you’re probably going to be paying somewhere between $300 and $400 a month for the sensors. It’s expensive and that needs to change. We need to get insurance companies to cover the cost of this. And that’s why Levels and Dr. Bikman and myself and Dr. Hyman are speaking up.

‎Dhru Purohit: And we need to continue to create innovation because when more people have a technology, they end up bringing the cost of it down. Flat screen TVs used to cost an arm and a leg back in the day. Now they’re a lot cheaper and you can get one for few hundred dollars on Amazon instead of a few thousand dollars. We hope the same thing happens with glucose monitors. So just wanted to add that in before we jump into Ben Bikman’s part into today’s mini episode. If you are interested in Levels, you can sign up for it using the link below, which is an invitation into the app because it in private beta at the moment. And if it’s not in the cards for you right now, don’t worry there’s still tons of free things that you can do to improve your metabolic health. And Dr. Ben Bickman goes into them in this next clip. Let’s listen in.

‎Dhru Purohit: And we’ve talked a little bit about carbohydrates, but just so that we’re clear for everybody who’s listening, we’re talking about process and refined carbohydrates that are often in these processed foods, even health foods that are out there. Not to mention that a lot of times people will add just straight up sugar, because when you’re trying to make gluten free products taste better, especially if they’re dairy free too and you’ve removed the fat, you got to pump it with a ton of sugar just to make up for that.

Dr. Ben Bikman: To make it not be like cardboard.

‎Dhru Purohit: Right. But vegetables are carbs too, but just give them the contrast here. Why vegetables for the most part, broccoli, other vegetables that we’d be eating, we’re not really talking necessarily about that. Just help people understand just so that’s super clear.

Dr. Ben Bikman: So I want to emphasize that my view on carbohydrates is control carbohydrates, which at its simplest definition is don’t get your carbs from a bag in a box with a barcode. That’s the simplest way of my view of carbohydrates. I’m not saying we can’t eat them, not at all. But it’s typically going to be carbohydrates that are the biggest offender when it comes to trying to control glucose and insulin. So just be smart about it. And in general, at the simplest level, focus on fruits and vegetables. If a person’s building their carbohydrate consumption around fruits and vegetables, we almost don’t need to go any further. But I would say eat them, don’t drink them. Don’t juice them. A smoothie maybe to a degree, but certainly not juice. But eat fruits and vegetables and just be much more careful with grains. That’s generally the way it goes. And that alone is often going to be enough.

Dr. Ben Bikman: But when someone’s need to go to the next level or if they need to because they have a family history of type two diabetes, or they already have type two diabetes. Then my next level is while you’ve been focusing on fruits and vegetables, now it’s time to remove the biggest offenders in that category, which is going to be if a vegetable grows in the ground, then be careful with it. I’m not saying you can’t eat it, but it’s going to just naturally be much starchier. If the vegetable grows above the ground, it’s generally on you can have almost as much as you want to shove in your face. It’s going to have such a modest effect on glucose and insulin.

‎Dhru Purohit: Right. The contrast between let’s say broccoli above ground, and then even something that can be healthy and in moderate form, but out of control can spike you crazy would be a potato or even sweet potatoes, which a lot of people eat. Sweet potatoes grows underground. It’s a lot starchier. Anybody who wears a CGM or knows anything about blood sugar knows that if you eat a big bowl of sweet potatoes or a big bowl of sweet potato fries, that can spike you almost the equivalent in your body as a Coca-Cola.

Dr. Ben Bikman: Yes.

‎Dhru Purohit: Or a soft drink that’s there.

Dr. Ben Bikman: Yes. So that’s that next level. So in general, I don’t mean at all to declare war on carbohydrates. Far, far from it. I think they can be a wonderful, healthy part of a smart diet. But we can’t get them from bags and boxes with barcodes. Focus on fruits and vegetables. Eat them, don’t drink them. And then if someone needs a little further push, well then it gets to that next level of all right well let’s scrutinize your vegetables and some of your fruits to avoid the starchiest or the most sugary of those. But often we don’t need to go that far. But someone would hear us and say, “So Ben is saying at a high level potatoes can be okay”. And I am at a high level saying that. But that is not the same as eating potato chips. And that’s back to my point, if it comes in a bag or a box with a barcode, beware. How’s that for some alliteration? How many b’s can I put in a row? Beware.

‎Dhru Purohit: So those are some of the categories of foods on the offenders. Give us some examples, we talked about the importance of fat, we talked a little bit about protein. Give us some examples of foods that not only fuel your body, but also fuel your brain. What are some of the positive things? Vegetables are positive too, but typically we’ve had this war on fat for years and that’s starting to change a little bit, even with big personalities like Malcolm Gladwell having done some podcast episodes, helping people understand how we got it wrong when it came to fat. My business partner, Dr. Mark Hyman writing a whole book on fat. You talk about it a bunch in your book, Why We Get Sick. So let’s talk about fat as a category and some of the staple fats that we can have in our diet that are beneficial when it comes to this whole topic that we’re going in.

Dr. Ben Bikman: Yeah. So fats, I am a big friend of fats in the diet for two main reasons. One is that are in fact essential. There are fats that humans must eat to survive. So we have to have, we have a genuine biological imperative to eat certain fats. And then two, of all three macronutrients fat is quite unique because fat alone, which of course people don’t eat it that way, but it’s powerful in that fat does have an effect on insulin. If someone’s eating fat again, we don’t do that and I’ll get to that point in a moment, but fat isn’t an insulin spiking nutrient. But so maybe to keep it at that level for a moment longer, I am a great defender of natural fats or ancestral fats or any other terms we could use there. And that is to say, the fats that we as a species have been eating since time immemorial.

Dr. Ben Bikman: Obviously animal fats fit into that. This is beyond a debate. It’s surprising that it’s ever debated. It certainly shouldn’t be. We as humans are omnivores and we’ve been eating animals since the beginning of our species. And in fact, one of the leading theories of evolution, which is all theoretical of course, is that we became humans because we ate animals. That’s something called the expensive tissue hypothesis. And I won’t get into that, but someone could look it up, but-

‎Dhru Purohit: I just want to just chime in there because it is important. When you look it up, if you are excited to, know that our brain wouldn’t be what it is today if we didn’t learn how to cook and especially concentrate calories, which came in the form of animal fats.

Dr. Ben Bikman: Yes. That’s exactly right. You encompassed it perfectly. I couldn’t have said it better myself. So eating animals might have made us human, of course that’s all theoretical. So the animal fats I defend. We are well adapted to eating those because we’ve been eating them since the very beginning of time, human time. And then two, fruit fats. Fruit fats are the fats that our ancestors would’ve needed nothing more than to simply step on it or press it with some simple kind of lever. But eventually, this is fat that’s coming from flesh of a fruit. And the fatty fruits are coconuts, avocados, olives. I think that’s it. I think those are the main ones and there might be one or two more. But those fruit fats are again, we are well adapted to them.

Dr. Ben Bikman: They’re saturated and predominantly saturated in mono and saturated fats. There’s no problem with that. We know what to do with those. They’re a healthy part of the diet. And again, I suspect part of the reason they’re healthy is that we’ve been eating them for so long. It’s thousands of years that we’ve been just scooping out the flesh of a coconut and pressing it to get oil. We’ve been stamping on the olives to get oil from the olives. This is something we’ve been doing.

Dr. Ben Bikman: Now, the offenders in the fat category, lest anyone think I’m giving fat just carp blanche, eat as much as you want any kind. No, far from it. And that’s because thee most commonly consumed fat now in the US and in fact, I suspect throughout Asia, it’s a different kind but it’s in that same family, but the average American gets more of his or her calories from soybean oil than any other single source of fat. So that introduces this other family of fats, which is the industrial seed oils. That’s the best term. People will commonly call it vegetable oil. When I was living in Asia, including a trip, a talk I gave in India. You see vegetable oil bottles everywhere. It’s vegetable oil. And everyone thinks it’s a good thing because we’ve had that idea so thoroughly beat into our heads.

Dr. Ben Bikman: Indeed, you and I were just saying how vegetables are wonderful and can be a wonderfully healthy part of the diet. But it’s such a misnomer because these are oils that are not coming from vegetables. Vegetables don’t give oils. These are oils coming from seeds like cotton seed or corn seed or from the seeds of the corn or as I said, soybean oil. These seed oils are enriched with a type of fat that our body we’re eating tens of thousands of times more now than we ever have in all of human history.

Dr. Ben Bikman: And there’s a compelling manuscript published by a man named Christopher Ramsden who works at the National Institutes of Health, the NIH here in the US. He published a paper looking at changes in fat consumption in the US for the last hundred years. From 1909 and at the time this was in the 2000 teens when he published this report. And it’s shocking to see beef consumption. The fact that we get from beef, which is looked at as the great offender here, it’s almost totally consistent. It started to go up, it went down and it went back to where it was about a hundred years ago.

Dr. Ben Bikman: And then we look at soybean oil. And it went from nothing to being the number one by a wide margin, the number one consumed fat in the American diet. And I would say at this point, it’s essentially reflected in various sways as the global diet now. And then even fat number two was shortening, which I think is a mix of cotton seed oil and some other seed oils. But the two main consumed fats in the average American, and maybe even global diet are from these seed oils. And that’s so relevant because we’ve long been saying that saturated fats are the origins of heart disease. But you look at the consumption of saturated fats, like from beef and eggs, it has not moved in a hundred years as a percent of our diet. And so you directly look at heart disease and it’s spiking, well then you’d expect saturated fat consumption to be spiking. And it’s flat.

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

‎Dhru Purohit: Thanks to technological advances like continuous glucose monitoring we can now understand how we respond individually to high carbs in our diet and sugars like never before. For one person, a sweet potato might be easy to handle metabolically. And by the way, sweet potatoes are healthy. It’s really when we overdo it in our diet and that’s one of the only things that we’re eating, that it becomes challenging. And also for another, it could mean a giant rise and fall of blood sugar with a corresponding insulin spike. At the end of the day, if you’re eating whole foods, you’re going to be okay, but it’s nice to have insights and which foods continuously spike you. This is all about the long term game. No one food or one instance of your blood sugar spiking is really the problem. And hey, sometimes it’s nice to go out and enjoy something that spikes your blood sugar.

‎Dhru Purohit: I went to Italy this summer and I had gelato like crazy. Great. That was a trip, that was a vacation. It’s not how I’m eating every single day. When I get to see the data from my glucose monitor, it helps me make better decisions in real time when it comes to the 80% of what I do on an ongoing basis. And most importantly, it pays off because I get to see how what I eat makes me feel as well as the long term protection against chronic disease. Thanks for tuning into this week’s mini episode of the Dhru Purohit Podcast. I hope you enjoyed it. If you have a friend that wants to learn more about metabolic health, send them this episode. Could end up changing their life. I’ll see you next week.