Bikman on the hidden epidemic, why we get sick, how we heal

Photo: Jamie Matociños, Unsplash

By Marika Sboros

Every now and then comes a book that all physicians, scientists, researchers and lesser mortals should read. Why We Get Sick is one.

Many books out there have the same title but don’t let that distract you, even for a second, from this one. Its sub-title sets it apart from the rest: The Hidden Epidemic At The Root Of Most Chronic Disease – And How To Fight It.

The author is Dr Benjamin Bikman, a biomedical scientist, an associate professor of physiology and developmental biology at Brigham Young University in the US and director of its Diabetes Research Lab. The hidden epidemic Bikman writes about is insulin resistance. He believes that insulin resistance is “the most common health disorder worldwide” in adults and children, that you’ve probably never heard of.

Actually, that’s not strictly true.

Bikman doesn’t “believe” anything in his line of work. He is a scientist, after all. Bikman makes precisely that point in the book’s introduction.

He bases nothing he writes about on insulin resistance on his opinions. He bases it all on published, peer-reviewed science spanning decades. In other words, he does what all good scientists do. He goes with all the evidence, not just the cherry-picked bits that support his viewpoint.

Join Bikman on the journey

And if you find any of his conclusions “inconvenient”, he says that you’ll just have to “take on the primary evidence”.

Armed with that evidence, he takes you on a remarkable journey of discovery. He makes pitstops into all the chronic disease of which insulin resistance is the root.

It’s true that it’s not new that insulin resistance lies at the root of most chronic diseases of our time. Many distinguished minds have been saying that for years. However, just as many experts are not on board with that thinking. Or if they are, their understanding is superficial, especially about beating it.

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Bikman takes readers to brave new heights in this book. The pitstops become illuminating mini-lectures and tutorials into biology and body biochemistry.  And pathophysiology – the convergence of pathology and physiology to reveal changes in the way the body works as a result of disease.

Dr Benjamin Bikman

He devotes chapters to all the main chronic diseases. Along with problems, he presents solutions. That does not mean more drugs, surgery, medical implants or other medical interventions. Instead, Bikman focuses on simple diet and other lifestyle interventions.

Canadian nephrologist (kidney specialist) Dr Jason Fung, another expert internationally on insulin resistance, looks at that focus in the book’s foreword.

Culprit and cure

Bikman shares evidence that supports conventional medical practice, writes Fung. More importantly, he reveals a simple, basic truth about insulin resistance: It is “largely a product of our daily choices”.

That makes lifestyle “both the culprit and, with some helpful and unconventional insight, the cure”, says Fung.

Bikman makes a vital point early on. Insulin resistance on its own won’t kill you. Rather, it is simply “a reliable vehicle” that rapidly causes a host of other life-threatening conditions. Bikman highlights those conditions with sobering statistics.

Each year around the world, roughly 10 million people die from cancer; almost 20 million die from heart disease; another 50 million globally have Alzheimer’s disease, and almost a half a billion have diabetes.

Big hand of health risk

Other “less lethal” conditions are also rising. Roughly 40% of adults worldwide are considered overweight or obese. Almost half of men over 45 have lower-than-optimal testosterone levels. Almost 10% of women experience menstrual irregularities or infertility.

“To the untrained eye, these can seem unrelated,” Bikman writes.

However, these all have one thing in common – insulin resistance. To varying degrees, it either causes or exacerbates these problems, he writes. Thus, insulin resistance has a “big hand in a startling number of very serious chronic diseases, including problems of the head, heart, blood vessels, reproductive organs, and more”.

It’s why most people with it will ultimately die from heart disease or other cardiovascular complications, says Bikman.  Others will develop Alzheimer’s (or other dementia) disease, breast or prostate cancers or any number of other lethal, preventable diseases.

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That’s a bleak outlook but Bikman brings light to it throughout.

He devotes Part 1 of this book to insulin resistance, what it is, why it matters so much. He also begins with a basic definition. “At its simplest, insulin resistance is a reduced response to the hormone insulin.”

He shows that insulin resistance was once a disease of affluence  – what he likes to call a “plague of prosperity”. It was once a condition that largely affected only “well-off older people”.

Now there are documented reports of insulin-resistant four-year-olds. Up to 10% of North American children have it. Low-income countries now pass high-income countries in terms of total number of people with the condition.

Not a life sentence

“To top it all off, the overwhelming majority of people with insulin resistance don’t know they have it and have never heard of it,” Bikman writes.

But insulin resistance is not a life sentence if you already have it – as you probably do. Bikman explains why: In the US,  research shows that up to 85% of all adults may have it. That’s along with half of all adults in Mexico, China, and India;  and more than a third in Europe and Canada. The problem is “at least as prevalent” across the Pacific Islands, North Africa and the Middle East.

Yet if insulin resistance is so prevalent, why aren’t more experts making a fuss about it?

Bikman writes movingly on why it took him so long to become expert in a disease he had “never heard of”.

He didn’t set out to study insulin resistance. It beckoned with his research into obesity. In the early 2000s, as now, obesity was receiving plenty of medical and scientific attention, writes Bikman. He admits to being embarrassed by his lack of knowledge about insulin resistance. But he was also “equally amazed”  that most other scientists and physicians were just as ignorant.

If so many biomedical professionals weren’t aware of insulin resistance as a single cause of the most common chronic diseases, Bikman rightly figured that the average person would be “almost completely in the dark”.

Processed, artificial foods

Anyone wanting to grasp the enormity would have to “comb through thousands of scientific journals and manuscripts”, understand the jargon and be able to connect the dots, he writes. More importantly, they would have to “translate that research into practice”.

Over time, he realised that insulin resistance was – and is – present in almost every chronic disease. It is especially present in chronic conditions stemming from a diet high in processed and artificial foods.

As awareness of insulin resistance has grown, Bikman has been invited to discuss his research globally. He now shares his message via public speaking engagements, podcast interviews, and YouTube discussions. That’s not enough to say all he wants to – hence this book.

Bikman is clear about his goals in writing it. He aims to “demystify the science of insulin resistance” so that anyone can appreciate what it is and why it’s dangerous. He wants to arm readers with knowledge of how to reverse insulin resistance, based on sound, published evidence. And he wants to teach steps to preventing disease through simple lifestyle changes.

“No prescriptions required,” he writes

Bikman’s heady mix

He hits all targets.

Bikman’s book is well-referenced and dense with robust science. It is a heady mix of scientific history, spot-on dot-joining and helpful tips on exercise, what to eat and what to avoid like the plague. Compared with orthodoxy, he peppers it all with unconventional insight for safe, effective lifestyle interventions to fight insulin resistance going forward.

He pulls all these ingredients together in a final chapter that is a menu for putting research into action.

Bikman’s way with words helps. His book is reader-friendly, a riveting read as accessible to the layperson as the physician, scientist and researcher.