Insulin resistance will force the blood vessels to be very constricted all of which play together to make for a very high blood pressure so as much as we have been telling the world that we should be cutting back salt no we should have been telling them to cut back on what spikes your insulin refined starches and sugars but with regards to salt it's interesting for me to note where did that whole view come from within the united states decades ago there was a study that was published and they called it the dash diet dietary approaches to stop hypertension d-a-s-h the dash diet and in the dash diet one of the critical changes was to tell people to eat less salt and when they found that when people adopt a dash diet it's amazing their blood pressure goes down however unfortunately they also tell people to do lots of other things with the dash diet like when they tell someone to go on the dash diet they also tell them to eat less sugar and less refined starches and sugars well it's possible indeed i would say it's absolutely the case that what's actually lowering their blood pressure isn't that they cut their salt back it's that they were cutting their refined starches and sugars back and it's that that had the main effect and the cutting the salt was just some innocent bystander but to put a fine point on it in human studies if you have humans cut back their salt considerably they become insulin resistant so take a healthy group of humans say you need to eat less salt and they do so if you measure them a week later while they're adhering to this they will be significantly more insulin resistant than before they ever cut back their salt it's one of the ironies of the whole scenario where a physician may be telling a patient with high blood pressure you need to cut back your salt and they end up eating less salt and yet their their blood their blood pressure gets worse it's because the main contributor to high blood pressure is insulin resistance and by telling them to cut back on their salt you made them more insulin resistant and that whole mechanism is because one of insulin's many many effects is to want the body to hold on to salt and water and so if you start cutting your salt all of a sudden insulin says well there's little salt coming in i need to do what i can to retain whatever salt we do have and so it starts retaining salt and water more in order to try to offset the lack of salt coming in and while insulin's going higher and higher the body's becoming more and more insulin resistant so salt restriction can cause insulin resistance in humans you talk about four pillars to eating in your book while we get sick you outline these four essential pillars to develop a strategy for maintaining low insulin levels and combating insulin resistance what are the four pillars yes so when it comes to controlling insulin resistance the key is to manage macronutrients and the best way to manage macronutrients is going to be a strategy that helps lower insulin lowering insulin is the key to both slow insulin resistance and fast insulin resistance so the more the strategy lowers insulin the more effective it's going to be and there are poor there are four pillars so the first one control carbohydrates second prioritize protein third don't fear fat and then fourth after the first three have been taken care of four frequently fast so with the first one very briefly by controlled carbohydrates i mean that it is time to focus more on whole fruits and vegetables eat them don't drink them and then don't get your carbohydrates from bags and boxes with barcodes that the more you're opening up a package and getting your chips or your crackers or your cereal or your bread the more you're going to be spiking your glucose and your insulin keep that on the shelves at the grocery store focus on whole fruits and vegetables that's going to be the key for number one control carbs now while you're eating fewer carbohydrates you need to eat something and so prioritize protein i would say particularly animal source protein which is the best source of all of the amino acids that humans need and then with those proteins will come fat don't fear that fat that's number three fat is very satiating when combined with protein when fat and protein come together we digest it better sometimes people will find that if they just have a scoop of whey protein it can be very upsetting on their stomach it's because we're not supposed to eat protein alone in nature that never happens in nature protein always comes with fat that's how we should eat it we digest it better and human studies have shown that when a human eats pure protein there is some degree of muscle growth albeit microscopically minuscule but when we eat protein with fat we have significantly greater muscle growth than we do with the protein alone so that is the three pillars that encompass the macronutrients or the big parts of our diet but once a person has done that then they are well positioned to adopt a strategy a structured strategy of fasting and that can be there are as many ways to fast as there are people who want to and i do think it should come last once you've learned how to eat better food your your body has adapted to burning its own fat for fuel but it can take the it can take a intermittent fasting where it's one meal of the day you're fasting through it can do where people do alternate day fasting there are countless different ways to do it even if i'm in ketosis then you don't need to do it as much because you're already lowering your insulin so if a person's already in ketosis in fact if a person were in ketosis and frequently fasting depending on how lean they are it's going to become extremely difficult to retain muscle yeah so those are the four pillars it will be an extraordinarily effective way to address insulin resistance but the problem as i started when i that i mentioned is that while these concepts are simple that does not mean they're because humans show addiction addictive tendencies to only one macronutrient not fats not proteins all of the evidence of the neurobiology of addiction in humans points to carbohydrates and so as much as i lay out this simple plan it can be difficult and this is why this self-discipline required is difficult enough that it's why people find that they have to result in you know relying on drugs for these kinds of things physical activity exercise useful for keeping my insulin levels in check yeah yeah i'm really glad you brought up exercise i'm an enormous advocate of exercise the best exercise to improve insulin sensitivity is the one you'll do and so if someone listening to this is an 80 year old grandma and if she if her form of exercise is walking around the street down around the block with her girlfriends but then if someone else has the ability to go cross-country skiing or crossfit do it so the best exercise is the one you'll do now having said that the better exercise is the one that you'll do that keeps muscle muscle building work is going to be minute for minute a more effective way of improving insulin sensitivity than than any kind of aerobic activity and that's because muscle is the great consumer of glucose and back to the in fact not only does muscle eat the most glucose from the blood but it's also how it eats the glucose when it's exercising so earlier we talked about how insulin it kind of comes and knocks on the door of the muscle cell and then the muscle cell will open the door and allow the glucose to come in thereby lowering blood glucose unless the muscle is exercising when a muscle is exercising and i'm kind of mimicking the contraction and relaxation of a muscle when the muscle is exercising it has its own way of opening those doors so there's an insulin independent method where the muscle cell essentially tells insulin insulin i know normally i have to wait for you to come and open these doors but i'm so hungry during this exercise that i'm not going to wait and so the doors just open so the contracting muscle has its own way to rush to pull the glucose in which means of course that a person's going to have an easier time controlling their blood glucose which in turn would mean a better time controlling insulin but the more muscle a person has the easier it is and this could be one of the reasons why if you look at longevity and look at the markers of muscle strength versus the markers of cardiovascular aerobic fitness the aerobic fitness markers are terrible predictors of longevity it's muscle and strength that predicts longevity for multiple reasons including just the very act of living and moving but also because if you have more muscle you're going to control your glucose better which means you're going to control your insulin better then you're back to these variables that people use to predict or what are the most accurate indicators of it's who has the best glucose control more muscle helps that happen there's a big debate around whether we should be calorie restricting and low fat diet whether we should be calorie restricting in a moderate fat diet or calorie restricting and a low carb diet yes what's your take on that yeah i am unabashedly in favor of carbohydrate restriction um i would say for two reasons um that one reason i think that carbohydrates should be the macronutrient that is most scrutinized is because it's the one we eat the most of seventy percent of all calories consumed globally come from carbohydrates that is the one that has the biggest insulin effect for and that's a problem for all the reasons we've discussed but two carbohydrates are not essential um this is controversial people don't like to acknowledge it but there is literally no biological need that humans have for carbohydrate um the in the united states a report decades ago from the department of agriculture looking at the needs of human nutrition there's a quote there and i'm not going to get it exactly right but i'll get it pretty close it stated in this document that the lower limit of carbohydrate consumption in humans is zero in other words there is no such thing as an essential carbohydrate now i'm not well then let's not eat any of them no but i am saying why is that the one we focus the most on as 70 of all calories globally are coming from that one you're telling me that we most of what we eat comes from what we don't need why not put the focus on the things we do need there are such things as essential fatty acids let's eat fat there are such things as essential amino acids so let's eat protein and make sure we get what we need and then on any remainder of the plate we can get some other things that we want to nibble on like plants if you love the driver ceo brand and you watch this channel please do me a huge favor become part of the 15 percent of the viewers on this channel that have hit the subscribe button it helps us tremendously and the bigger the channel gets the bigger the guests胰島素抵抗會迫使血管收縮，所有這些因素都會導致血壓升高，所以我們一直在告訴世人應該減少鹽的攝入量，而不是應該告訴他們減少精製澱粉和糖的攝入量，但關於鹽，我想說的是，幾十年前，在美國，有一項研究報告發表了，他們稱之為 "Dash dietary approaches to stop hypertension d-a-s-"，在 "Dash diet "中，一個關鍵的改變就是告訴人們少吃鹽。他們發現，當人們採用 "破折號 "飲食法時，他們的血壓會驚人地下降，但不幸的是，他們也告訴人們在 "破折號 "飲食法中還
