In this episode of The Metabolic Classroom, Dr. Bikman explores the history, science, and benefits of ketones, focusing on exogenous ketones.

Ben highlights the significant benefits of ketones for brain health. He disputes the common belief that glucose is the brain’s preferred fuel, citing research by Dr. George Cahill that indicates the brain relies heavily on ketones during fasting.

The classroom also addresses the evolution and advantages of exogenous ketones. Early forms of exogenous ketones, like ketone salts, had limitations such as mineral imbalance and poor taste. Advances led to the development of ketone esters and bioidentical BHB, which are more effective and palatable. Exogenous ketones can help control appetite, reduce inflammation, and improve exercise performance. Despite initial concerns about their potential to be converted back into fat, Professor Bikman clarifies that this is not a risk, as the liver cannot reverse ketone production into fat.

Overall, Dr. Bikman emphasizes that while ketones themselves offer numerous metabolic benefits, the primary advantage of a ketogenic state is maintaining low insulin levels, which supports fat burning and overall metabolic health. He encourages the use of exogenous ketones to enhance these benefits, particularly for managing cravings, improving physical performance, and supporting cognitive function.

00:01 - Introduction to Ketones

01:58 - Types of Ketones - Explanation of the three main types of ketones: acetoacetate, acetone, and beta-hydroxybutyrate.

02:58 - Ketones and Blood Acidity - Discussion on how ketones can affect blood acidity and the distinction between ketosis and ketoacidosis.

04:04 - Insulin's Role in Ketone Production - How insulin levels determine whether the body produces fat or ketones from acetyl-CoA.

07:23 - Benefits of Low Insulin Levels - Overview of the metabolic benefits of low insulin levels, including improved fat burning and metabolic health.

08:19 - Ketones and Brain Health - The positive effects of ketones on brain function and cognitive health, debunking the myth that glucose is the brain's preferred fuel.

13:33 - Ketones and Physical Performance - Evidence that ketones improve physical performance and energy efficiency in muscle cells.

17:31 - Anti-inflammatory Effects of Ketones - Ketones’ role in inhibiting inflammation and their benefits for inflammatory disorders.

Studies Referenced:

Alzheimer’s and Parkinson’s (Cunnane et al., 2016): https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00783-x

Ketones Elicit Distinct Alterations in Adipose Mitochondrial Bioenergetics: https://pubmed.ncbi.nlm.nih.gov/32872407/

Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice: https://pubmed.ncbi.nlm.nih.gov/28877458/

The Effects of Ketogenic Diet on Insulin Sensitivity and Weight Loss, Which Came First: The Chicken or the Egg?: https://pubmed.ncbi.nlm.nih.gov/37513538/

Learn more: https://www.insuliniq.com

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In this episode of The Metabolic Classroom, Dr. Ben Bikman challenges the traditional view that saturated fats are the primary cause of atherosclerotic plaques and heart disease. He asserts that while plaques, or atheromas, in coronary arteries are composed partly of fats and foam cells, the exact process of plaque formation remains speculative. Dr. Bikman emphasizes that anyone claiming to know the definitive cause of plaque formation is likely overstating their knowledge. Foam cells, which are fat-laden macrophages, play a critical role in plaque development and are consistently present at the sites of these plaques.

Dr. Bikman explains that inflammation is a significant factor in atherosclerosis, and C-reactive protein (CRP), a marker of inflammation, is a better predictor of heart disease than LDL cholesterol. He describes how macrophages engulf oxidized LDL cholesterol, turning into foam cells and secreting pro-inflammatory proteins like CRP. This process is driven by the presence of oxidized lipids, particularly those derived from omega-6 polyunsaturated fats such as linoleic acid, which are prevalent in modern diets due to the widespread use of vegetable oils.

Ben highlights several studies to support his argument. A notable study from 1979 by Brown and Goldstein showed that macrophages only consume LDL cholesterol when it is oxidized, not in its native form. Another study from 1998 found that oxidized LDL containing specific bioactive lipids, nine and 13 HODE, is particularly problematic. These oxidized lipids are derived from linoleic acid, not from saturated or monounsaturated fats. Moreover, historical dietary studies, such as the Minnesota Coronary Experiment and the Sydney Diet Heart Study, revealed that participants consuming more polyunsaturated fats had higher mortality rates than those consuming saturated fats.

To conclude, Dr. Bikman argues that the traditional belief that saturated fat causes heart disease is flawed. He points out that recent studies, including a correlational study published in the British Medical Journal, show that refined grains, not saturated fats, are more strongly linked to heart disease and overall mortality. He suggests that the real dietary culprit is the overconsumption of omega-6 polyunsaturated fats, particularly linoleic acid, found in processed foods. This shift in perspective underscores the importance of reevaluating dietary guidelines and focusing on the types of fats consumed.

#HeartHealth #SaturatedFat #Atherosclerosis #Inflammation #InsulinResistance #LDLCholesterol #OxidizedLDL #FoamCells #Macrophages #BenBikman #MetabolicHealth #CholesterolMyths #LinoleicAcid #PolyunsaturatedFats #DietaryFats #CardiovascularResearch

Studies referenced:

Binding Site on Macrophages that Mediates Uptake in Degradation by Brown and Goldstein (1979): https://academic.oup.com/clinchem/article/46/6/829/5641219

Oxidized LDL Regulates Macrophage Gene Expression (1998): You can find more details on this study in resources like ScienceDirect and Cell Journal (you may need specific access or subscriptions to retrieve full texts).

Strong Increase in Hydroxy Fatty Acids Derived from Linoleic Acid in Human Low-Density Lipoproteins of Atherosclerotic Patients (1998): https://www.sciencegate.app/document/10.1016/s0009-3084(97)00095-9

Learn more: https://www.insuliniq.com

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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

Learn more at: https://www.insuliniq.com

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