Sarcopenic Obesity with Dr. Ben Bikman
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- Опубліковано 27 чер 2024
- Professor Ben Bikman discusses sarcopenic obesity, a condition involving obesity and muscle loss. This condition results from factors like sedentary lifestyles, aging, and metabolic disturbances. While obesity is common, sarcopenia typically affects the elderly, diseased, or very sedentary individuals. The combination of excessive fat and muscle loss makes sarcopenic obesity particularly challenging.
Dr. Bikman explains the crucial role of muscle in blood glucose regulation. Muscle mass reduction impairs glucose control, leading to higher blood sugar levels and increased insulin resistance. Even a short period of bedrest can significantly reduce muscle mass and insulin sensitivity. Inflammation from enlarged fat cells also contributes to muscle loss and insulin resistance, creating a vicious cycle.
Insulin resistance and sarcopenic obesity can both cause and result from each other. Insulin resistance impairs muscle protein synthesis and promotes fat cell growth, leading to further insulin resistance. Reduced muscle mass and increased fat cell size negatively impact metabolic health. Bikman stresses the importance of diet in managing sarcopenic obesity, advocating for a low-insulin diet by controlling carbs, prioritizing protein, and not fearing fats.
To combat sarcopenic obesity, Dr. Bikman recommends proper nutrition and resistance training. Reducing insulin levels helps preserve muscle mass and promote fat loss. Resistance exercise is more effective than aerobic exercise for improving metabolic health. Consistent exercise and a controlled diet can help individuals manage or prevent sarcopenic obesity and improve metabolic health.
[01:02] Understanding Fat Cell Size
[02:07] Prevalence and Impact of Sarcopenic Obesity
[05:02] Role of Muscle in Glucose Regulation
[07:12] Effects of Bedrest on Muscle and Insulin Resistance
[10:43] Insulin's Role in Muscle Protein Synthesis
[16:04] Inflammation and Insulin Resistance
[20:43] Sarcopenic Obesity Contributing to Insulin Resistance
[24:41] Consequences of Sarcopenic Obesity
[26:32] Solutions: Diet and Exercise for Sarcopenic Obesity
www.insuliniq.com
#MetabolicHealth #Sarcopenia #SarcopenicObesity #InsulinResistance #MuscleLoss #Obesity #HealthEducation #GlucoseControl #BloodSugar #InsulinSensitivity #MetabolicDisorders #HealthyAging #Inflammation #MuscleMass #FatLoss #NutritionTips #ExerciseScience #ResistanceTraining #LowCarbDiet #HealthTips #BenBikman #Metabolism #HealthyLifestyle #PreventDiabetes #FitnessEducation #DietAndExercise
References:
Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis:
www.sciencedirect.com/science...
One Week of Bed Rest Leads to Substantial Muscle Atrophy and Induces Whole-Body Insulin Resistance in the Absence of Skeletal Muscle Lipid Accumulation:
diabetesjournals.org/diabetes...
Effects of insulin on whole-body and regional amino acid metabolism:
onlinelibrary.wiley.com/doi/a...
Effect of physiologic hyperinsulinemia on skeletal muscle protein synthesis and breakdown in man:
www.jci.org/articles/view/113033
Human Skeletal Muscle Disuse Atrophy: Effects on Muscle Protein Synthesis, Breakdown, and Insulin Resistance-A Qualitative Review:
www.frontiersin.org/journals/...
Ketones Elicit Distinct Alterations in Adipose Mitochondrial Bioenergetics:
pubmed.ncbi.nlm.nih.gov/32872...
Comparison of a Very Low-Carbohydrate and Low-Fat Diet on Fasting Lipids, LDL Subclasses, Insulin Resistance, and Postprandial Lipemic Responses in Overweight Women:
www.tandfonline.com/doi/full/...
Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study:
pubmed.ncbi.nlm.nih.gov/29417...
A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women:
pubmed.ncbi.nlm.nih.gov/12679...
Long-term effects of a very low-carbohydrate diet and a low-fat diet on mood and cognitive function:
pubmed.ncbi.nlm.nih.gov/19901... - Наука та технологія
This is probably the best video on YT that explains the relationship between fat loss, insulin and retaining muscle mass. I didn't really understand the mechanisms of why Keto/Carnivore is so powerful for fat loss, now I do!
I love your lectures. I’ve recently experienced muscle loss as I’ve been healing from major surgery. Complications kept me in a chair instead of getting up and doing small stuff. I paid for that with increasing weakness. I am getting better but boy do I need to get back to strength training and walking.
Anecdotal, I know. I will never forget a morbidly obese patient I had taken care of that literally used to deficate in bed prior to coming to the hospital. Led to sarcopenia. On one occasion he attempted to get out of bed with a walker and fell. X-rays were performed to see if he had broken any bones as he had leg pain. Although his legs were literally the size of some people's waist the amount of muscle surrounding the bone was miniscule. Don't let that happen to you.
Another very important topic rarely if ever mentioned. I know of many aging acquaintances that absolutely show signs of sarcopenia, but they used to formerly be simply overweight. So in some sort of dysfunctional dieting they drop some pounds but also lose more muscle mass. They are now a bit less fat but surely have more so become weaker.
You elaborated so well on that! See so many loved ones the same thing, come down on pounds, but much more weaker, so didn't lose the pounds the right way. Definitely sarcopenia played a part, in that process..
@@mikoc7633 It seems to be that the "more elderly" tend to not like preparing their own meals and therefore their meals are NOT protein centric. That is a health disaster for all humans no matter their age.
@@ny10980 Yes so very true, I had one of my friends at the church fell and broke her hip, that shouldn't have happened that easily...
@mikoc7633 Unless like most elderly, the hip broke & then she fell...😮
But youre right, our bones shouldn't be breaking so easily...😢
@@ny10980 I'm 66 and live by myself. I've been low carb since Oct 2021 and have ended up becoming more carnivore since the start of this year. I've become very lazy with my meals but it tends to be that I'm not eating the veggies; the other day I got out the meat and was going to cook up some broccoli and cauliflower and then thought I don't really feel like it, just have the meat! I used to prefer tuna but now I prefer salmon. I used to only be able to eat salmon made into patties with egg and onion and dill and fried in butter which I would eat with zucchini and onion or avo. Now I just put 1/3 of large tin in a bowl add a veg (today I had some brussel sprouts but I really like avo with it) and then douse it with vinegar and salt. Yesterday I even drank the liquid instead of draining it; it's just spring water and salt. I was surprised at how yummy it was. I've tried sardines a few time but haven't got a taste for them, yet ...
Thank you. When I took in my food diary (low carb) to the dietician she immediately told me I wasn't eating enough carbs and that I would lose muscle. I stuck to what I was eating and got checked by an exercise physiologist 14 months after starting low carb and she said my muscles were okay.
I used to say us fat girls don't get osteoporosis becausr we do weight beating exercise everytime we move. Now, that's said mostly in jest because we really need to maintain muscle mass as we shed fat pounds and maintain better cellular health. My insulin resistance is significantly improving after 636 days carnivore and A1c down from 6.3 to 5.2. I did have much worse sarcopenic obesity that is improving but I have a ways to go. I will be improving all my metabolic functions the rest of my lifespan. I still haul 50 pound bags of animal feed without help, but it is getting harder. I thank you for this level of undersranding the cellular intricacies at work.
Dr. Bikman produces the most amazingly insightful content. I prefer to watch his videos than anything on TV.
To contribute something in thanking you for the information
Sarcopenia (Σαρκοπενία) comes from the 2 greek words Σάρκα (flesh) + Πενία (poverty)
This is interesting. Thank you for sharing.
Best description of how important muscle is . Just started doing wall squats 💪💪. Doing my resistance bands., had cancer so I know about the wasting of muscle going in for a dexa next week.!! Thank you so much for your podcast ❤❤ have a beautiful day ☀️☀️
Yes, I'm currently stuck on dex four days per week. Screws your glucose, hence screws your insulin, makes you hungry, stuffs up your sleep. If you add the changes in sense of taste reducing palatability of lots of foods ...
I've seen many people say you can improve diabetes without exercise. After 16 months of PHD and no good results this may be my answer, Ozempic and Sarcopenia. I've done plenty of walking, two to three miles a day but nothing to build muscle. Time to join a gym.
I think they might say "you don't have to exercise" so that very fat people who might be discouraged to even start changing their way of eating while they can scarcely move about, can take heart. The fat person can lose weight until they are better able to move, when they can start to exercise.
Save your $$$. You don’t need to join a gym. You can do bodyweight calisthenics at home or the local park! Do pull-ups, chin-ups, tricep dips, pushups, squats, lunges, etc!
I lost several sizes (& 55#) doing no exercise besides some walking, in 6 mos
Keto with OMAD and EFs (extended fasts)
My strength was stable
I was 55yo n a woman
@@suzannewhitaker3507 Heal the body via diet before you begin to gradually stress it with exercise! Go easy on the connective tissues in the beginning as they take longer to heal and strengthen. By not doing so you risk injury which will set you back.
Do some squats, LUNGES, use water bottles or gallon jugs for weight lifting etc
A great talk about sarcopenic obesity, thank you Dr Bikman, something we will undoubtedly see more of in the future as people age. To reverse insulin resistance and lose weight: Control carbohydrates, prioritize proteins, don't fear fat. It took me a bit of time to fully understand the importance of this video, but it was worthwhile.
I understand Ben's point that research points to a ketone wasting phenomena. What I haven't heard is any reasonable speculation as to why the body would go to the trouble to make, then *throw away*, beneficial molecules like ketones.
This channel is the best UA-cam channel for health on UA-cam!
Very important " Ben there"
thank you for all your videos Ben! 🙏🏼
This is by far your best video. It answers so many questions and explains so many things that didn't make sense before. I will watch it several times to make certain I remember and absorb it all. Thanks.🙂👍👍👍
Thank you, Dr Bikman! I really enjoy these metabolic classroom sessions! Bought your book when it first came out, and have recommended it to everyone in my circle. 😊
Hey Ben. I just love the way that you challenge my thoughts. Confusion leads to enlightenment
I look forward to your content. Well thought out, well spoken, great tone of voice. A plus!
Thank you for this excellent explanation. This is information that I have been looking for for a long time. : )
Be sure to keep in touch with latest literature Ben. With GLP-1 RA, lean mass may go down, but this is also fat in the muscle and other liquids. A new paper by M Boon shares liraglutide treatment decreases body weight and FFM but muscle strength and resting energy expenditure stay the same.
The origin of fat in the muscle may be related to consumption of seed oil
Pretty sure Professor Bikman is in touch with the latest literature.
@@shoegal7 Agreed ...
Sir Ben.
Dr. B. another grand slam here. Thank you
Outstanding, as always. Thank you, Dr. Bikman!
Thank you Dr Bickman.
Thank you so much Dr Ben ❤
Its amazing the way you explain things. thank you so much from the Netherlands !!
Thanks!
Wonderful talk! It really opened my eyes to the process of how we lose muscle mass and gain fat mass. Thank you for explaining everything in a manner that is easy to comprehend. Who better to listen to than a scientist that studies metabolism on the cellular level. You make me want to learn more, and actually practice what you are preaching!
Thanks Doc!
Thank you.
Great episode…I have family members with diabetes and all the misery that comes with it. So far through diet I have avoided it, but I have learned so much from your videos…thanks you so much, and I will definetly encourage my friends and family to listen also. ☺️. You do great work here.
Wow! Thank you. Your best video ever.
Great video again .
“ More knowledge, better health” indeed.
I very much appreciate this information. Thank you.
Hello Ben, a really great video. I just read your book recently, 'Why We Get Sick' and have added so much to my store of knowledge. Sadly I was unable to purchase it in New Zealand, so had to order it in and wait months. Lots of my friends have asked where they can buy it... do you have any influence with NZ booksellers? we need more and better information, as even in our tiny slice of paradise we have an enormous metabolic health crisis. Love the way you can blend a little humour with what would appear to be dry material, your work is inspirational.
Yes, I learned a lot from this. I subscribed.
Wow. Thank you!
I have to say your book on insulin resistance was great (Why We Get Sick), I knew a fair share going in and I still learned quite a bit. Highly recommended.
I have weights next to my couch, it has helped remind me to my weight lifting routine.
Having just read the book "Dark Calories" by Catherine Shanahan, her theory is the effect of PUFA seed oil which tends to poison the mitochondria, forcing a tendency to favor glucose metabolism. So the effect of dieting is lowering the blood sugar, making the body (with poor metabolism) break down protein to make sugar to get the blood sugar back up, because the brain is forcing this signal by the effects of cortisol and adrenaline. The real catch 22 is the low blood sugar effect forces sarcopenia because the fat cells are all metabolically sick and cannot use fat energy, so stress hormones take precedence over insulin, and you have this battle between the brain and the pancreas, known now as insulin resistance.
PUFAs are indeed toxic.
Insulin Resistance is Physiological.
It is absolutely essential when the cell is replete with fatty acids and glucose,if the entry of substrate is unlimited the cell would die !!
Insulin docks on the insulin receptor,if the cell is replete,the cell will send a signal which blocks the activity of the insulin and thus prevents further substate from entering and killing the cell !!!!!.It is more complicated bt thats the essence of IR.
Gradually lowering CHOs and increasing fat and protein ( ideally from animal sources) so the body switches to a fat burning model,up regulating lipolysis, is the key.Then lower blood glucose and Insulin is not a problem,it becomes a big advantage for those who are obese.
Dieting is indeed dangerous and should be avoided.
Very good indeed
Dr Bikman - I love the way you explain things.
Sign of a good teacher. Being able to explain complicated things in a way that the majority of people can understand it.
So true
Ben, love the science your vocab makes Miss Crabtree’s heart sing! Few use “myriad” correctly.
If wegovy and siblings are to be avoided because they simply suppress appetite, does that imply that Allulose, touted as the cheap wegovy, have the same drawbacks?
Awesome! I’ve started to harp on my patients about the MORBIDITY/suffering from hyperinsulinemia
Why are young college men researched and not young college women? Women might have a different response. As a researcher, wouldn’t you want to know what the other half of the population are doing? For example, it was traditional for women to be on bedrest for several weeks to heal after childbirth. How do they compare to young college men? Dr Ben Bikman talked about male hormones only. What impact do female hormones have on healthy young women and what fate awaits menopausal women whose ovaries have shrivelled?
Easier to study men without the constantly changing cycles of women which affect so many aspects of metabolism
Exercise is key…childbirth used to bed rest not anymore and nursing burns big calories.
@@C2yourself I disagree, when you state cycles are you preferring to menstruation. Many women don’t have those. Women have less muscle mass than men. Therefore, there should be testing with women because our physiology and hormones are quite different than males.
@@stephaniepersin4222 Men dont menstruate,dont lactate,dont have babies so in the study mentioned there are less variables to control for.Dont think it was meant as an insult to women in general or you personally.
I am confident there are similar studies excluding men,perhaps a Pub Med search might yield the info you want.
@@stephaniepersin4222 young men v young women with menstrual cycles... yes it's easier to study young men which I believe is why the vast number of studies involving humans focus on men. Yes we need studies on women as well... maybe one of these days that'll happen
I am agape. absolutely fascinating. saving this one for future reference and repeated viewing.
I’m working with people with severe handicaps, they aren’t able to exercise at all and are lying/sitting all day. Their insuline-resistance must be high, and their sarcopenia also. One of them is following a ketogenic diet for his epilepsy, that’s also helpfull for keeping some muscle mass I guess?
I wonder this too. For people who have CP, keeping that muscle must be so much more crucial, especially if they are wheelchair bound. I wonder what studies are done on this population?
This might save my life, if I figure out how to have no/low-carb food at the ready since I'm virtually bedridden now. I'm 64, hashimotos autoimmune thyroiditis with, ironically, hyperthyroidism, myasthenia gravis, steroid dependent with severe Adrenal Insufficiency due to my MG treatment via prednisone and IVIG well over the past decade. I went for years at a time eating low-carb, even keto 3 times. Lost weight 3 times. I'm immunocompromised and went off low-carb ie added sweet potatoes, rice, some fruit, during C-19. Fast forward, way more poor diet 😔 worsening MG, I was recently hospitalized with MG with acute exacerbation. I can barely stand now, obese, and for the first time in my life... I'm diabetic. I'm so confused about having taken insulin in the hospital. I didn't require high doses at all. In the morning I didnt require any sometimes. You would NOT BELIEVE what the hospital's diabetic diet was!!!!! 😮 OMG I hadn't had pancakes in YEARS, nor rolls, etc. Yikes. Well, I'm virtually bedridden at home, refusing nursing home.
I need to know exactly what to do. I think I do know, for the most part.
Btw, the hospitalist started me on Jardience. 🤷♀️
I think i just need to eat 25 carbs or less a day, and let the chips fall where they may. I'm getting weaker each day. I pray i don't have ALS. 🙏 Finances are a huge factor, but even more is i cannot cook now, at all. Maybe I could microwave sometimes. I cannot risk falling now.
Good morning! You sound very much like me. If you get some resistance bands u can start with that in bed. It is starting to help me. When i drive i use these hand grips to build the muscles in my lower arms. But after this i am really going to concentrate on my legs. So i can go back to cooking. Cant stand long enuf to cook eat out all the time. To much money. I had a reply to a comment i made that gave me more suggestions to do stuff at home to help build muscle.. just keep going a little at a time things will get better. This video was a pure God send for me! Have a blessed day🇺🇲🙏🇺🇲
I’m going to my gynecologist 7/12 and asking for replacement hormone patches. I’m 59 and was tested for metabolic rate and it was a little more higher than average. Therefore, I’ve got to experiment with low dose hormones to see if that is the thing to get an additional 20-30 lbs. Kick in all my menopausal symptoms have never gone away. I don’t believe in all these temp weight loss injections, or gastric bypass. I do take Metaformin for pre diabetes. I have a FT laborious job. Doctors believe I eat all day and know I don’t. I was 115 lbs until 40. This isn’t all in my head.
No it's not in your head, but it can be help easily and cheaply by a diet re-set. Why take metformin, when the answer is to reduce your blood glucose yourself? Cut carbs (rice, pasta, bread and potatoes) and eat as much as you like of all the great foods that won't spike your sugar. Eggs, chicken, meat, non-starchy vegetables, fish, especially sardines salmon and tuna. Salads, with nuts and any of the above, are satiating - the biggest problem is feeling hungry, so don't allow that to happen. I love my new diet. Mushrooms in creamy sauce with a salad, fried egg and ribeye steak, cooked in ghee (clarified butter, which has a high smoke point). Yum. I lost 10kg almost by accident by eating as above. Good luck 🙂
@@judyanderson4766 heart disease runs in my family and I don’t eat meat or seafood. I take Metformin per a doctors direction. Both mom and sister have diagnosed diabetes.
Find Dr. Rachel Rubin and Dr. Louise Newson on YT regarding management of Menopause and symptoms. Mindblowing education!! There IS 95% cure!!! MDs are not trained, maybe on purpose, to keep women past the 50ies forever-patients.
Solutions to wellbeing post menopause:
First step has to be HRT & local vaginal estrogene ( try Intrarosa, just awesome!) Listen to the above mentioned wonder Drs on the big why.
2. Ketoisch/carnivorish diet w/calorie awarenes and intermittent fasting ( 14-16 hours).
3. build muscle through regular exercise
(3x/4x week), lifting your own bodyweight. Rotations of sets for legs, glutes, belly, arms and shoulders. Incorporate stretching.
4. Get sunshine on your skin, into your eyes.
5. Supplement magnesium, celtic salt, 3 brazil nuts /day for selenium.
6. Drink kefir and make your own probiotics. Start with info from Dr. William Davis/YT on gut health and the microbiome. Find out about L.Reuterei, a probiotic dairy which mimics delicious yogurt and creates positive gut chemistry. Dr. Davis calls it the yogurt of love!!
Best wishes!
@judyanderson4766 Some nuts have quite a few carbs! Not a great choice when trying to stay Keto.
@@stephaniepersin4222 So skip the meat and seafood - but eat less sugar, (carbs). Eat protein from whatever source you like including eggs, - if vegetarian, tofu, soya etc. Eat salad and veg, olives, cheese, whatever you like of veggies except root vegetables (starchy carbs). Go minimal on fruits, they are full of fructose - i.e.carbs!
Medications and hormones created in a lab or from unknown substances will never give you the good health of real unprocessed food. Over to you.
Would adding a good protein and amino acid especially branch chain amino acid. Would that effect insulin resistance.
Question for Dr Bikman: Excellent lesson as always. I am still unclear on what officially constitutes obese. Is it a body fat % if so what is that? 30% by DXA is very different from 30% by calipers.
I have a close friend who is not diagnosed as sarcopenic but qualifies as skinny fat-which seems to be the same thing to me. Shes 30% fat by dxa but almost “underweight” by bmi etc. i got her to measure her insulin at last bloodwork and it came back as 2.0 so shes not hyperinsulinemic. We were talking about our parents aging and muscle loss etc so were both pushing to build more muscle in our 50s but i wonder how much i should suggest she take the fat mass seriously.
Can anyone point me to benchmarks for obesity or sarcopenia (muscle mass per height?). There are plenty of charts from who knows who floating around, im having trouble finding a solid science-based resource to point her to … “for reference for her mother”. She’s a smart one, she’ll figure it out for herself. I just dont want to perpetuate bad info.
Going on high-protein keto would probably help maintain muscle while losing fat. But there are good drugs for that too; it's just that WADA doesn't want us to have them.
Is there a blood test to check for bcaa in blood?
I'm pretty sure I have Pizzapenic obesity.
I thought this was the norm in society today. Everyone I know, as they age, their guts get bigger and their arms and legs get smaller. I'm surprised that you say it's only 10%.
What is the normal blood glucose?
How does this effect those with hypoglycemia? I feel like after 50 I can't control anything anymore no matter how good I eat..
I know a lady who has been told she has sarcopenia.
But she walks for miles every day. She told me she had a history of dieting you.
But her Gp takes no interest in what she eats. Just walk he says.
animated example provided, re-watch the movie "Wall*e" with your kids/ grandkids.
If fat being starved of blood supply contributes to sarcopenic obesity, I bet angiogenesis promoting drugs like BPC-157 could help.
Well this explains alot about why my body got so flabby. And are can barely stand. Time to take advantage of that free Y membership. Thank you ever so much for taking the time to make this video. U gave me the missing puzzle piece called my messed up body. 😊😊
Is 'going to the gym' necessary? I found myself too weak to get out of the bath... now I do pushups and squats while waiting for the jug to boil or coffee to finish. Resistance bands looped onto door handle while watching the news....leg stretches while talking on speaker phone. There are endless ways every day to change your body composition. I'm 74, it's never too late. 🙂
@@judyanderson4766 thank you for the inspiration you will here from me again
❤❤❤
I just cannot eat the amount of protein food recommended by carnivore proponents, so then i get shouted at for 'under-eating' by the carnivore-for-president crowd
If you cannot for religious/animal welfare etc eat animal fat/protein then there are reasonable plant protein alternatives,though less bio available .The carnivore crowd are just seeking the same as you...health.
There is a big space between cannot and will not !!
Best of luck and hope you achieve your health goals.
@@tonynoonan3723 nope. The plant based proteins either have more carbs than I can tolerate, or are the industrial/ultraprocessed crap I'm trying to avoid. There are reasons I chose an animal based approach. I just struggle when protein becomes too high a proportion of my intake so, despite the evangelists, I'll stick to high fat ketovore. I just think it's important for folks who dont tolerate the Baker/Chaffee method, need to be heard too.
Try whey protein powder. Low in carbs, high in protein, easier to drink and used by body builders who cannot physically eat any more meat protein, but still want protein's benefits. They have the same issue as you.
I find body builders grotesque regardless 🤢
Without insulin it's impossible to get fat? So, if somebody just drinks .5 L of olive oil every day, no chance they'll get fat? This claim is ridiculous. I'm coming from a professor a biomedical science this claim is ridiculously offensive. Please tell me he's saying this just so that people like me who never comment leaves a comment
Carnivore FTW!
I don't believe it's natural to lose muscle as we age, eating the sad diet sure But not eating the way our ancestors ate(carnivore). Im putting on more muscle @ 55 without even trying then ever before in my life.
Your body WANTS to be healthy, good on you for putting in the effort, keep it up. Kind regards🙃
Oh my goodness, the huge bellies on "worlds strongest men" explained. It looks terrible. Great video, I love your channel Doc, you explain things so clearly.
I saw 2 elderly men talking the other day. I was wondering if they were discussing the upcoming births. They both looks 8-9 months pregnant.