Read this book

It’s not often I read a book that makes me drastically rethink things.

This was one of them.

If you’d rather skip a summary of the book, just jump down to the TL;DR bit at the bottom of this post. If you’d like some insight into the sometimes deep dive biological science it covers, read on.

I recently heard a podcast interview with Benjamin Bikman, the doctor who wrote this book, which lays out a very convincing argument contending that insulin is the key to much more of our health as a whole than western medicine generally acknowledges.

He explains early in the book how the most commonly known use of insulin — to help people with type 2 diabetes contend with their affliction — is in itself totally misguided.

Way oversimplified but for the sake of a brief explainer, the reason people get type 2 diabetes is too much blood glucose requiring their bodies to make too much insulin for too long a period, to the point where their bodies can’t keep up with it. When this happens often and for long enough, type 2 diabetes may result.

So why, Bikman asks, are type 2 diabetics often prescribed insulin injections? He makes the point, obvious in retrospect, that it isn’t that a type 2 diabetic body doesn’t have enough insulin, it’s that it has too much. Injecting still more will help contend with the excessive glucose for a short time, but that solution is short-sighted: As with so many things, the more insulin that’s in a body more often, the more inured to its effects — “insulin resistant” — the body becomes. Which means gradually even more insulin will be needed than previous injections provide, which makes the body even more insulin resistant. It continues escalating back and forth in a kind of biological arms race. What type 2 diabetic bodies need, Bikman explains, is the exact opposite of this: Less insulin and less often in order for it to become insulin sensitive again. i.e. with normal amounts of insulin handling manageable amounts of blood glucose.

He moves on and in exhaustive (and at times exhausting) detail, backed up by hundreds of footnoted published studies, Bikman explains how insulin directly has an effect on far more aspects of your body than I, and probably most people, previously realized: Your heart, blood pressure, liver, brain functions, muscles, fertility, likelihood of getting cancer, how quickly aging affects you… the bulk of the book is dedicated to explaining how specific aspects of a person’s body benefits from proper response to insulin levels, and the negative impact that insulin resistance causes. 

The problem, Bikman explains, seems to largely be in the gradually shifting western diet. It gets down to sometimes the molecular level of what we’ve come to eat more and more of and, importantly, how often we eat. And not only how often we eat just unhealthy food, but eat anything at all.

Insulin spikes when we eat. When we aren’t eating, our insulin level gradually drops. So consider that, something we weren’t doing as recently as even 40 years ago, a lot of people have increasingly gotten into to the daily habit of waking up and eating breakfast (causing an insulin spike), having a morning snack at school or work (insulin spike), having lunch (insulin spike), having an afternoon snack (spike), then dinner (spike), and then maybe a dessert (spike) plus maybe a late night snack (spike). The increasing amounts of sugar in what we eat is only making matters worse, because with very rare exception, sugars and sweeteners bump up the insulin needed even more to contend with that particular kind of food.

Meaning, we’re now a society that eats less healthy food way more often, so now the only time our insulin isn’t spiking or trying to level off between times of eating is when we’re asleep.

The solution, Bikman explains in the last section of the book, is to pay more attention to what and when you’re eating. That is more important than, but works better in conjunction with, exercising more (good anyway, of course, but even modest exercise after you eat also helps move your glucose around without the need for insulin to do it for you). Eat healthy meals and only at meal times, he says. He lists a few pages of good, mediocre and bad foods to better manage insulin, all of which basically amounts to a keto diet of high protein and fats and fewer carbs and sugars. And even with eating healthier foods, don’t snack between meals.

Bikman is also a proponent of intermittent 12-to-18 hour fasting to better keep your insulin levels down other than when actually needed. He points out that this kind of fasting isn’t as daunting as it seems: Simply eating dinner and then not eating again until breakfast, for example, will often carry people 12 hours.

He mentions as an aside that as an added bonus, this proposed change outlook on food and moving around more (eating better, eating less often, and exercising) are of course fundamental parts of losing weight. And losing weight in itself is not only good advice for increasing numbers people as a whole, but also just happens to be another way, an added measure, to help balance out your insulin levels, as occurs more readily in healthier bodies.

And people generally do get healthier with this approach to eating. Not only is it better for you, but some type 2 diabetics have been verified to have their needed insulin injection volume drop dramatically, and some even verifiably had their diabetes reverse itself completely. Surely an appealing option for people looking at facing a lifetime of trying to medically manage their conditions.

I can’t say for sure how much success this approach to eating has offered me just yet, since it’s still early days. I’ve only been following it for a week, and I know these changes can take time to see results. Also, I’ve allowed myself… some indulgences at times to make the transition less “going cold turkey” and more a shift I can manage mentally as well as physically. Related to that, just in the last week alone it’s already become abundantly clear that it’s my mind that misses snacking more than my body does. Even the fasting, which seemed like one of the more daunting aspects of Bikman’s approach to eating, isn’t particularly difficult. I get up in the morning, have a glass of water and my morning tea, and filling my belly with liquid definitely keeps it content for a while. By the time I start getting genuinely hungry, really wanting food, I’m easily at the 12-hour mark since the last time I ate. (Even if I snacked a bit late the night before. Ahem.)

I’ll touch base in a while to update you on how it’s going.

TL;DR – All in all, this is a highly recommended book even if you only want to get a new perspective with perhaps surprising insight on how bodies operate, what’s gone so wrong why for so many, and given the statistics say you’re probably among those in potential danger of becoming insulin resistant, what you can do to help yourself.