Metformin is the most widely used drug to fight diabetes. Let’s talk about how it works and when it doesn’t work well.
Here are the resources that Ben references during the episode: Study #1 - https://www.sciencedirect.com/science/article/abs/pii/S0891584910003874?casa_token=z96rcmkuc7YAAAAA:pxbbTkuPhL7Nop4oUECKmCq81Ev4Dc7z4XYvbaNMXLorp-F9p4nrHLo9bkUiIL0Trjv9EhNNGds Study #2 - https://www.jci.org/articles/view/13505?content_type=full Study #3 - https://europepmc.org/article/med/3817257 Study #4 - https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13039 Study #5 - https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12880
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Metformin: The Magic & Misery

Welcome to The Metabolic Classroom, a nutrition&nbsp;and lifestyle podcast focused on metabolism, which is how our bodies use energy, and the truth behind why we get sick and fat. Every week, Dr. Ben Bikman shares valuable insights that you can apply in your own life and share with friends and loved ones. The Metabolic Classroom is brought to you by InsulinIQ.com. Hosted on Acast. See acast.com/privacy for more information.

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This episode of The Metabolic Classroom is sponsored by RxSugar. Use this link to get 20% off: https://rxsugar.com/discount/BEN20
02:10 - Overview of Uric Acid: Explanation of what uric acid is and its origins from purine metabolism. 03:16 - Uric Acid and Hyperuricemia: Discussion on uric acid production, excretion, and the condition of hyperuricemia. 05:09 - Gout and Uric Acid Crystallization: How high uric acid levels lead to gout and kidney stones. 07:08 - Importance of Uric Acid in Metabolism: Why uric acid is important, its clinical relevance, and its connection to insulin resistance. 09:14 - Uric Acid and Inflammation: How uric acid causes systemic inflammation and contributes to insulin resistance. 12:27 - Sources of Uric Acid, Purines and Fructose: Detailed breakdown of purine and fructose metabolism leading to uric acid production. 16:31 - Fructose Metabolism and Uric Acid: The role of the liver in metabolizing fructose and its link to uric acid production. 22:47 - Pharmacological and Nutritional Interventions: Treatments like allopurinol and the benefits of allulose in reducing uric acid. 30:34 - Ketogenic Diet and Uric Acid: The effects of the ketogenic diet on uric acid levels and insulin sensitivity.
Summary:
In this episode of The Metabolic Classroom, Professor Bikman discusses the significance of uric acid, particularly its impact on insulin resistance. Uric acid, a byproduct of purine metabolism, is usually expelled through the kidneys. When production exceeds excretion, it leads to hyperuricemia, causing gout, kidney stones, and inflammation linked to insulin resistance.
Dr. Bikman explains that excessive uric acid activates inflammation pathways, producing ceramides that disrupt insulin signaling, leading to insulin resistance. He highlights the connection between fructose consumption and uric acid production, noting that unregulated fructose metabolism in the liver increases uric acid levels. This rise in fructose intake, rather than purine-rich foods, contributes to gout and metabolic issues.
To address this, Dr. Bikman discusses pharmacological interventions like allopurinol, which lowers uric acid levels but may have side effects. He also mentions allulose, a rare sugar that shows promise in reducing uric acid by enhancing its excretion. Despite potentially increasing uric acid, the ketogenic diet is noted for reducing inflammation and improving insulin sensitivity due to ketones.
Dr. Bikman concludes by emphasizing the importance of understanding uric acid's role in metabolic health and encourages further research and practical dietary interventions to manage uric acid levels, integrating pharmacological, nutritional, and lifestyle approaches to improve overall metabolic health.
Studies referenced in this episode:
https://pubmed.ncbi.nlm.nih.gov/24769205/
https://www.sciencedirect.com/science/article/abs/pii/S1933171115006063?via=ihub 
https://www.metabolismjournal.com/article/S0026-0495(65)80039-7/abstract 
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Uric Acid with Dr. Ben Bikman

In this episode of The Metabolic Classroom, Professor Ben Bikman, an expert in metabolic research, discusses the debate surrounding saturated fat and its impact on insulin resistance.
Dr. Bikman addresses misconceptions about saturated fat perpetuated by proponents of plant-based diets, who often blame meat-based saturated fats for insulin resistance. He refers to his own 2011 research, highlighting the role of toll-like receptor four (TLR4) activation in inducing inflammation and insulin resistance, particularly stimulated by saturated fats.
Acknowledging limitations in his earlier work, Dr. Bikman transitions to discussing fat digestion and absorption, setting the stage for studies on the impact of dietary saturated fat on metabolic outcomes. He cites a study by Volk et al. (2014) contradicting the direct link between dietary saturated fat intake and plasma saturated fat levels. Further, he discusses research challenging the low-fat emphasis of diets like DASH, including a study by Chiu et al. (2016) showing comparable blood pressure reduction with a high-fat version.
The lecture also covers a meta-analysis by Choi et al. (2020) supporting the benefits of ketogenic diets high in saturated fat for glycemic control and insulin resistance.
Dr. Bikman emphasizes the importance of considering context, suggesting that saturated fat consumption without excessive carbohydrate intake may not necessarily lead to insulin resistance. However, he acknowledges studies indicating potential concerns with high saturated fat intake in hypercaloric, high-carb diets, advocating for balanced macronutrient consumption.
00:01 - Introduction of the topic of saturated fat and insulin resistance, highlighting common misconceptions and his expertise in the field. 02:33 - Role of TLR4: Research on toll-like receptor four (TLR4) activation and its connection to inflammation and ceramide synthesis, leading to insulin resistance. 07:05 - Fat Digestion Primer: Explanation of fat digestion in the small intestine, emphasizing the formation of chylomicrons for fat transport into the bloodstream. 11:55 - Study by Volk et al. (2014): Key study that challenges the idea of dietary saturated fat directly increasing plasma saturated fat levels, despite high consumption. 16:41 - High-Fat DASH Diet Study: Research comparing a high-fat version of the DASH diet to the standard low-fat version, highlighting similar blood pressure reduction but improved lipid profiles with the high-fat diet. 19:46 - Meta-analysis by Choi et al. (2020): Demonstrating the benefits of ketogenic diets, typically high in saturated fat, in improving glycemic control and insulin resistance. 21:40 - Historical Trends: The paradox of decreasing saturated fat consumption over time while insulin resistance rates have increased, suggesting a more complex relationship. 25:58 - Overfeeding Studies: Studies showing that overconsumption of carbohydrates, particularly refined sugars and starches, can increase liver fat and saturated fat production, contributing to insulin resistance. 27:09 - Study by Luukkonen et al. (2018): Study indicating that in a hypercaloric, high-carb diet, high saturated fat intake may worsen insulin resistance compared to high unsaturated fat intake. 28:06 - Conclusion: The need for nuanced understanding, context, and critical appraisal of research findings regarding the relationship between saturated fat, carbohydrate intake, and insulin resistance.
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#InsulinResistance #SaturatedFat #MetabolicHealth #NutritionScience #HealthEducation #DietaryMyths #CellBiology #ResearchInsights #FatDigestion #KetogenicDiet #CardiometabolicHealth #DASHDiet #Inflammation #MedicalResearch #HealthDebunked  Hosted on Acast. See acast.com/privacy for more information.

Saturated Fat with Dr. Ben Bikman

This episode of the Metabolic Classroom is sponsored by Redmond Real Salt. Use code BEN15 to get 15% off of their products: https://redmond.life
Summary: In this lecture, Professor Ben Bikman explores the cardiometabolic effects of salt intake, detailing its role in electrolyte balance, fluid regulation, nerve function, muscle contractions, acid-base balance, and nutrient absorption. He explains the renin-angiotensin-aldosterone system (RAAS) and its response to low blood pressure or sodium levels, leading to sodium retention and water reabsorption in the kidneys. Dr. Bikman discusses how insulin influences salt handling by stimulating sodium reabsorption and increasing aldosterone production. He warns against the unintended consequences of salt restriction, such as elevated insulin levels and resistance, exacerbating metabolic syndrome and cardiovascular risk.
Shifting focus to fat cells, Dr. Bikman explains how aldosterone and angiotensin II affect fat cell growth and differentiation, promoting lipogenesis, inflammation, and fibrosis. He suggests salt restriction may contribute to obesity and insulin resistance. Discussing potential anti-obesity effects, he mentions angiotensin receptor blockers inhibiting angiotensin II signaling in fat cells.
Dr. Bikman stresses the complex interplay between salt, insulin, and fat cell biology, cautioning against oversimplified dietary recommendations. He encourages critical thinking about salt intake's impact on metabolic health and body composition, advocating for deeper understanding and knowledge sharing to improve health outcomes.
01:52: Importance of Salt in the Body - Overview of the essential role of salt, particularly sodium, in electrolyte balance, fluid regulation, nerve function, muscle contractions, acid-base balance, and nutrient absorption.
06:00: Biochemical Pathways of Salt Regulation - Detailed explanation of the RAAS cascade, involving renin, angiotensinogen, angiotensin-converting enzyme, angiotensin I and II, and aldosterone. Discussion of the physiological effects of angiotensin II, including vasoconstriction, thirst stimulation, and stimulation of aldosterone production.
09:48: Interaction Between Salt Regulation and Insulin - Exploration of the interaction between salt regulation pathways and insulin, including insulin's direct effect on sodium reabsorption in the kidneys and its modulation of the RAAS. Explanation of how salt restriction can lead to increased insulin levels and insulin resistance.
13:44: Consequences of Salt Restriction - Discussion of the negative health consequences of salt restriction, including increased insulin resistance and metabolic syndrome. Reference to studies showing the association between salt restriction and adverse metabolic outcomes.
17:58: Hypertension and Cardiovascular Health - Summary of the relationship between salt restriction, hypertension, and cardiovascular disease. Mention of anti-hypertensive medications targeting the RAAS, such as ACE inhibitors and angiotensin receptor blockers.
20:59: Metabolic Effects on Fat Cells - Transition to discussing the metabolic effects of salt-regulating pathways on fat cells. Explanation of how aldosterone and angiotensin II promote fat cell growth, differentiation, lipogenesis, inflammation, and fibrosis.
27:53: Conclusion and Takeaways - Recap of the lecture's key points, emphasizing the complex interplay between salt intake, insulin, and fat cell biology. Call to action for critical thinking about dietary recommendations and sharing of knowledge for informed decision-making.
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Salt and Cardiometabolic Health with Dr. Ben Bikman

Dr. Ben Bikman, a biomedical scientist and expert in cell biology, welcomes his audience to a discussion on lipedema, a topic he’s been asked about frequently. He highlights the importance of addressing insulin resistance through diet.
Ben begins by providing a primer on adipose tissue, explaining its composition and the role of fat cells and fibroblasts. He delves into the structural changes in collagen within fat tissue, particularly in lipedema, where there's an overproduction of collagen leading to increased rigidity and compression on fat cells and nerves.
The lecture explores why lipedema predominantly affects women, linking it to hormonal changes, particularly increases in estrogen levels during puberty, pregnancy, and menopause. Ben explains how estrogen influences fibroblast activity, leading to excessive collagen production and fibrosis in lipedema.
The discussion then delves into the mechanisms of pain in lipedema, attributing it to both mechanical pressure on nerves and biochemical factors such as inflammation. Finally, Ben explores various treatment approaches, including compression therapy, manual lymphatic drainage, and low-carbohydrate diets, which have shown promise in reducing pain and improving quality of life in women with lipedema.
Throughout the lecture, Dr. Bikman emphasizes a paradigm shift in understanding lipedema as a disorder of connective tissue rather than fat cells alone, offering insights into its pathophysiology and potential therapeutic interventions. He concludes by highlighting recent research supporting the efficacy of low-carbohydrate diets in managing lipedema.
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01:59 - Adipocyte Structure 04:43 - Collagen Alterations in Lipedema 06:57 - Estrogen’s Role in Lipedema 10:10 - Mechanical Factors Contributing to Pain 11:07 - Biochemical Factors Contributing to Pain 14:11 - Therapeutic Interventions for Lipedema 23:27 - Impact of Low-Carbohydrate Diet on Pain Reduction 30:14 - Insights into Fat Cell Function and Hormonal Influence 37:31 - Summary
Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial
The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema
Dr. Bikman’s website
#Lipedema #Lipadema #LipedemaAwareness #Lipoedema #LipedemaSupport #LipedemaTreatment #LipedemaSurgery #LipedemaTherapy #LipedemaDiet #LipedemaLegs #InsulinResistance #InsulinResistanceAwareness #InsulinResistanceDiet #InsulinSensitivity #MetabolicSyndrome #Type2Diabetes #BloodSugarControl #InsulinResistanceSupport #HealthyLiving #diabetesprevention Hosted on Acast. See acast.com/privacy for more information.

Lipedema with Dr. Ben Bikman

Dr. Ben Bikman discusses the intricate relationship between metabolic health and male infertility.
While metabolic health is often associated with conditions like obesity and diabetes, Dr. Bikman emphasizes its relevance to less obvious issues like male infertility. He notes that while the processes of reproduction differ between the sexes, they share a common metabolic core.
Ben highlights that infertility affects approximately 15% of couples trying to conceive, with men contributing to around 30% of cases. He explains the role of hormones like follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in male reproductive function, detailing their influence on spermatogenesis and testosterone production.
The classroom lecture delves into how poor metabolic health, particularly insulin resistance, can disrupt testosterone production and lead to issues like erectile dysfunction and reduced sperm quality. Insulin resistance affects testosterone synthesis directly in the testes and indirectly by promoting aromatization, the conversion of testosterone into estrogen, leading to a vicious cycle of reduced testosterone and increased insulin resistance.
Dr. Bikman discusses various strategies to improve metabolic health and potentially alleviate male infertility, including dietary changes, medication such as insulin-sensitizing drugs like metformin, and exercise, particularly resistance training. He stresses the importance of addressing underlying metabolic issues to improve reproductive outcomes and suggests that prioritizing metabolic health before attempting reproduction is crucial.
In conclusion, Dr. Bikman underscores the interconnectedness of metabolic health and reproductive function, advocating for a holistic approach to addressing male infertility that focuses on improving insulin sensitivity and overall metabolic well-being.
00:00 - Introduction to metabolic health's relevance in male infertility 01:18 - Infertility statistics and men's contribution to the issue 02:37 - Hormonal role in male reproductive function: FSH and LH 03:53 - FSH and LH stimulation of spermatogenesis and testosterone 05:57 - Testosterone's functions in male fertility and maturation 08:04 - Nitric oxide's role in erectile function and its insulin connection 11:28 - How insulin resistance impacts testosterone production and erectile dysfunction 14:02 - Insulin resistance's effects on testosterone synthesis and aromatization 18:55 - Strategies to improve metabolic health and alleviate male infertility 26:38 - Conclusion: The link between metabolic health and reproductive function
#MaleInfertility #FertilityHealth #Metabolism #ReproductiveHealth #InfertilityAwareness #MenHealth #SpermHealth #HormonalHealth #NutritionForFertility #HealthTalk #MaleHealth #FertilityJourney #HealthyLiving #HolisticHealth
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Metformin: The Magic & Misery

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