Episode 189:
Show Notes 


In this podcast episode, in alignment with World Cancer Day, Dr Lucy Burns and Dr Mary Barson delve into the intricate relationship between metabolic health, insulin resistance, and the heightened risk of various cancers. The hosts use vivid analogies to provide accessible visuals, offering clarity on complex concepts related to insulin, insulin resistance, and metabolic health.

To enhance understanding, Dr Lucy and Dr Mary introduce tangible metaphors to convey intricate concepts in a more relatable manner.

Dr Lucy's Analogy - The Woodshed

Insulin Function
Describing insulin as a key, Dr Lucy illustrates its role in moving glucose into cells for fuel.

Woodshed Analogy
The body is likened to a house, and insulin unlocks the woodshed (representing stored body fat).
Insulin resistance, depicted as multiple locks, vividly illustrates the hindrance to accessing fat stores, leading to cravings and fatigue.

Insulin Resistance Impact
The metaphorical locked woodshed symbolizes high insulin levels, causing energy fluctuations and a reliance on high-carb foods.

Dr Mary's Analogy - Car Fuel

Fuel Types
Dr Mary draws parallels between efficient premium fuel and inefficient, damaging cheap fuel.

Analogy to Insulin Resistance
The analogy extends to insulin resistance, illustrating the inefficient use of glucose, leading to inflammation and health issues.
Relying on poor-quality fuel contributes to overall imbalances.

Rebalancing Fuel Choices
Dr Mary emphasises the significance of reducing sugars and starches to alleviate insulin resistance.
Opting for real, nourishing food emerges as a solution to rebalance the body's ability to burn stored fat.

The hosts challenge common misconceptions about weight loss, reframing it as a journey of personal development and discovery rather than a battle. They highlight the significance of understanding why one eats and acquiring new skills to make sustainable and enjoyable lifestyle changes.

The episode concludes with a commitment to explore insulin resistance and its implications for cancer in future discussions.

For more information about Real Life Medicine and our programs and special offers: https://www.rlmedicine.com/ 

Episode 189: 


Dr Lucy Burns (0:23)  Good morning gorgeous people. How are you this morning? I am joined by my beautiful colleague, Dr Mary gorgeous one. How are you this morning?

Dr Mary Barson  (0:31)   Oh, good. I'm not like a 100% but I'm good. I had this hideous health horribleness recently where I got struck down with a terrible virus that triggered, launched me into this migraine of just getting these terrible, terrible migraines, and I am heaps better. I'm so much better. But I am still just getting little migraines every day, but they are slowly getting better and better with my rehab exercises and with lots of self-care and good food and healthy lovely ketones for my brain. But you know what? I'm actually not fabulously amazing. Feeling a bit off today. How are you?

Dr Lucy Burns  (1:23)  Well, I certainly don't have hideous, horrible health. It’s just that it’s just moved into mildly manageable migraines. In fact, I'm actually great. I am great because, for me, it's summertime in Melbourne. And whilst Melbourne is not renowned for the world's best summers, it is actually lovely and sunny outside my window. And I love that. I love sunshine. I love that feeling of a bit of sun on my skin. I love being able to swim in the sun. So for me, I'm feeling pretty good. One of the things I think that is adding to my little dopamine repertoire is we have a new puppy. Nah. He's the cutest little thing and he reminds me a lot of your puppy shadow, your dog, now grown-up dog, because he is a Border Collie. It's actually not my personal dog. He's my daughter's dog. My daughter is now 20 and it's her dog. His name is Kai which means ocean in Hawaiian. I don't know if anyone realises that um it's a very popular boy’s name in Australia and I think America at the moment. 

Dr Mary Barson  (2:31)  My nephew's called Kai. He's fabulous. 

Dr Lucy Burns  (2:35)  Yeah. Yeah, yeah. So I think it's a good name. It suits her, she is an ocean girl, she loves the beach and she loves swimming. She's training to study Marine Science. So it all fits in with her identity, which as we know your identity, and who you identify as is an important marker of health. And we can certainly change our identities if we need to. So ya know, he is a blue merle. So he's got one blue eye, one brown eye.  Tell you what, I forgot how much puppies like to dig. So my rose garden, which is currently full of holes is it's reasonably spectacular. But the other thing he did do the other night was, it was nighttime and we had all this barking and my daughter went out and she's she stopped screaming– Oh my god, oh my god, we're thinking about what's out there. So my husband runs out. And it turns out that the dog had dug this huge hole all the way down and pulled out a yabby. For our, you know, overseas listeners a yabby is sort of like a lobster slash crayfish.

Dr Mary Barson  (3:48)  Freshwater lobster. Yeah.

Dr Lucy Burns  (3:53)  Yeah, in a dirt hole must have been sort of so it's obviously don't you know, down to the water table or something and this is blue-nicked. Anyway, luckily, we have a dam on our property, so tie, my husband, tying Kai, scoops up the yabby and scoops it down into the dam. But yes, that was a funny story.

Dr Mary Barson  (4:12)  That is funny, ah Border Collies bless them. I have to just quickly interject with a little Border Collie anecdote of my own. My now a grown-up Border Collie. It's got one brown eye and one green. She's as smart as Border Collies are and has figured out how to open doors. She can open doors we've got like the doors that had the flat doorknob and she could jump on them pull them down and push and yep, so yep, no, no room in the house is safe unless it closes the other way so she can lock herself in rooms. If she can only push them open shake up but yes, they're so smart. It's annoying.

So from troublesome Border Collies onto something quiet I'm serious now. February 4, is World Cancer Day, which has just been a time of this recording. And we would like to chat about how cancer fits into the greater metabolic health picture. Lucy and I, we are metabolic health experts, we empower people to heal their metabolism and reclaim their health. And this is so much it goes far beyond simple weight loss. Weight management is part of it, but it's just a small part of it. Having poor metabolic health causes and increases your risk of lots of cancers. And Lucy, tell us what the cancers are that we know are associated with metabolic ill health and insulin resistance.

Dr Lucy Burns  (5:53)  Yeah, absolutely. Thanks, Miss. So there is actually 13 known accounts of the known to be associated with increased weight. So in particular, with obesity, which is, you know, and again, obesity, such a fraught term, mainly because it's been used, you know, as a slur and you know, people feel very judged by it. So, in this case, we're just using it purely as a medical terminology medical word. We know that the majority of obesity is associated with high insulin. So these cancers that you know, you have an increased risk of developing these cancers, if you have significant obesity, so these are esophageal cancer, breast cancer, liver cancer, gallbladder cancer, kidney cancer, renal cancer, bowel cancer, multiple myeloma. meningioma, which is actually often a benign tumour, thyroid cancer, stomach cancer, pancreatic cancer, ovarian cancer and uterine cancer. Like it's big, it's a big mess.

Dr Mary Barson  (7:02)  And as you read that, that list, in my mind, people like patients flashed into my mind, I've known people with every one of those and beautiful people that have been in my life as patients and clients and it's a lot more than a list. It really is people's lives, that are adversely affected by insulin resistance. There are lots of mechanisms by which insulin resistance causes cancer, there are a lot of them. And it's even not entirely understood. Insulin resistance itself is a very, very complex metabolic disorder that plays out at the level of the mitochondria in our cells and it's a dysregulation of how we manage our fuel. Insulin resistance causes inflammation, it causes increased oxidation, and increased reactive oxygen species in our bodies, it affects the way that our cells function. It actually causes changes in our genetics and the way that our genes are expressed in epigenetics. It increases certain stress responses, which change the way that proteins in our cells react. It can also increase from a hormonal point of view, elevated insulin and insulin resistance create this hormonal setting within the body that literally increases the growth of cancer cells. We know that many cancer cells have got increased insulin receptors, so they become more prone to grow in response to elevated insulin. All of these things happen quite at a complex biochemical level, which can prime the body to get more cancers to be more prone to cancer. And it's horrible. I have known people with every single one of those conditions that I have known people. And it certainly gets very fired up because it is at its heart, something that we can prevent. And it's something that we can treat and reverse with the right advice. But how our food environment has just been created so that insulin resistance is so common in our society are we are processed food, high carb, high inflammatory foods have been normalised. And if you're in a situation, where you've got insulin resistance and high insulin, if you've got obesity to use that fraught term, I would argue very strongly that it is not your fault. It is definitely however your responsibility and you can do something about it when you know how. Absolutely.

Dr Lucy Burns  (10:06)  And I think, man, I mean, hopefully, people know that we are not in the business of judging people. And I know that lots of people do feel judged. And it's called choices, you know, choices, but often doesn't feel like a choice, it doesn't feel like a choice to have processed food, you know, and for lots of people, actually not a choice, you know, it's their environment, their circumstances, you know, processed foods are particularly cheap, it's convenient, it's easy. And for a lot of people, it doesn't feel like a choice. I would even say that, you know, smoking, which we know, is positively associated not just with lung cancer, but dozens of other cancers. For a lot of people, it's not their choice, they don't want to smoke. But they've arrived at a circumstance where maybe they were young, they were vulnerable, there was peer pressure, and they started smoking. It was, you know, encouraged when you're ostracised, if you didn't do it, there was always you know, things that are now regular that we don't do. And, you know, 30, 40 years later, they found that stopping is almost impossible. Now, that's not to say it isn't, but it doesn't feel like they're choosing to smoke. And so I think the same, you know, the same could be said, for our food environment. And you're right, you know, it is the “choices”, and I'm using air quotes for those people who can't see through the, through the podcast, it's not always a choice, it's sometimes a tool or a mechanism that will you will use to manage a situation. So that situation might be your thoughts and your feelings might be a time it might be money. So, you know, in particular, the insulin resistance and the obesity that often comes with that is a symptom of the root cause and until we can get down to that root cause just telling people to lose weight is unhealthy. 

Dr Mary Barson  (12:07)  No, absolutely. And it puts, puts the blame back on them. And, you know, both professionally and personally having known people that have had cancer, the stigma and the fear, and the shame that could potentially go along with then pointing the finger and saying, Well, it's your fault, is not only untrue, but could potentially be extremely harmful. It's not your fault.

Dr Lucy Burns  (12:41)  It's not, it's most definitely not your fault. We do like to say, though, that it is your responsibility, which, again, is not to judge people. But if you're waiting for the government to regulate things like I would love, I would love some regulation around the advertising and processed food to children. But in fact, even regulating that now those companies are bypassing all of those through social media platforms and whatnot. So waiting for somebody else to come and fix the problem is never gonna happen. So it's your job to fix the problem. It's your job to find a solution. And in many ways, it's our job to help you with that.

Dr Mary Barson  (13:27)  That is what we'd love to do. Because the solution, really, really can work we've got the right advice if you know how to nourish your body so that you can lower your insulin, reverse the effects of insulin resistance, if you know how to manage your mind so that you can make those changes easy and make those changes last, then you really can heal your body and still eat food within your budget and still really enjoy your life and still have all of the things that perhaps you might fear wouldn't be there, if you stopped eating so much fast food, processed foods and high-carb foods, your life could be wonderful, and much healthier, when you know how it really is. I reckon actually Lucy, it would be wonderful if we could do a bit of an insulin 101 here. And you being the analogy queen that you are lovely one, could you please give us an analogy about what actually is insulin and what actually is insulin resistance? 

Dr Lucy Burns  (14:32)  Okie dokie. So one of the things is, you know, again, back to basics, insulin is a hormone. So it's a hormone made by our pancreas. It's got a couple of jobs. One of its jobs is to move glucose from our blood into say our muscles and into the cells for fuel. So when we eat food, food is particularly carbohydrates are broken down into glucose. for carbohydrates, or sugars and starches of any sort, they're broken down into glucose. The pancreas goes, Oh, glucose coming rodio maximum insulin. So maximum insulin, which is great, until it's not bad if you don't have any insulin in your diet, it's a disaster. So we want, we want insulin. And then it moves that glucose from your blood into your cells, which is great. But what's happened over the last 40, 50 years, basically, because of their food environment, coupled with a bit of genetics, is that we're now finding that our pancreas is having to work very hard. So our cells are stuffed full of glucose, and the pancreas goes, alright, God, I better make some more well known, so it makes more insulin, more insulin buckets of insulin, so then you've got lots of insulin. And so what this actually means, and this was the bit that I either missed, maybe with having a nap in medical school, or I think probably it wasn't actually explained, is that insulin stops fat breakdown. So what that means in real terms, is if you imagine that your body is like a house, and you've got all these wood, all these wood fires all these fireplaces, heating it up. So when we make a fire in the fireplace, we usually use some kindling, which is a quick form of energy, essentially, small bits of paper. That's, that's like our glucose. And this is what we use it for. People often say I'm so tired, I need a bit of energy, and they'll have, you know, a sugary drink or whatever. So you've got glucose, and then we've also got logs. So the logs are like our fat and they burn long and slow. And in an ideal metabolically flexible person, you use some kindling, and then when you have kindling burns, your body will pop a log on the fireplace, so efficient, so sensible, such a perfect way for our body to fuel itself. But what happens with insulin resistance or high circulating insulin, instead of having those logs readily available next to your fireplaces? They're in our woodshed, which is where you would store your logs. So your body goes radio –Okay, I've had some food ready, ready for the next form of fuel and it tunnels out to the woodshed. And there's all of these logs like most of us have plenty of stored fuel all lined up there and you try to get a log out and the door is locked. And it's locked tight. And that lock might be, you might have one, you might have two you, might have 10 padlocks on your woodshed. And those padlocks are your level of insulin resistance or your level of circulating insulin. So if you've got lots of insulin, really high insulin levels, you'll have 10 locks. So you can't open it doesn't matter what you do. You just can't see come back to your dwindling fireplace, which by now is just filled with a few embers and you're starting to get a bit hungry, you're tired, you're hangry, you can't think and you get that you know people talk about they get a hypo or they feel hyper well they feel lethargic, or they can't they just can't think properly. And so they eat and they get hungry. Again, the brain is going– oh my god get some fuel into it. So if we wait super long, the brain again it's clever, it goes– right what's the fastest thing I can do? And it's looking then for a quick fix. So that'll be you know, soft drink cakes, lollies chocolate. Music does because they quit kindling. And then what does that do without the insulin adds another lock and the cycle then you just get stuck in this cycle. So, you know, this is where we always say to people, we want people to be able to open their woodshed, burn your stored fuel, burn your fat. And at the moment, if you have high insulin, unless you change what you're doing, you can't. So maybe you can help us out with telling us what can you do. How do you open the woodshed?

Dr Mary Barson  (19:19)  Yes, so you want to get into that stored fat and you want to be able to burn logs for fuel on your metabolic fire. You need to get insulin down. And how you do that is by reducing the amount of sugars that you ate, the amount of starches that you eat because our bodies will break starch like starchy foods, your bread, rice, potatoes, your pasta will break that starch immediately down to glucose even before we swallow it. Enzymes in our saliva will break it down to glucose. So if you find a way to reduce your sugars, starches and processed foods and instead eat yummy, delicious filling real food and find a way to make that work for you, then your insulin levels will come down. And as your insulin levels come down, so will your insulin resistance. And when that happens, your body is able to start burning that fat for fuel. In this woodshed analogy, it's a great one, we are talking purely about weight loss here. So the woodshed is like your stored body fat. And if you can get your insulin down, then you can burn your stored body fat and you can lose weight, which is of course, an important goal for a lot of people. But it goes waaaay beyond that. If you are mostly burning, kindling, that carbohydrates for fuel and your metabolic fires, actually, you know, your whole house is pretty much on fire, there is a lot going wrong for you. Another analogy you could use is that we've got two types of fuel for a car, can imagine you've got this awesome sports car, I know nothing about cars. So, this is going to be a pretty, pretty sparse analogy. But you've got your premium fuel that is going to make the car work well. And then maybe you've got some really cheap and dirty sort of fuel that's laced with, you know, biofuel, and canola oil and whatever else and you could put that in the car, and the car will run. But it's smoky and unhappy and the engine components start to break down and rust and corrode. But it's the only feeling you've got. So you keep using it. That's what happens when we've got insulin resistance and our bodies can only utilise what kind of they effectively utilise glucose for fuel. It causes a lot of problems at that biochemical molecular cellular level, that primes the body for illnesses, like type two diabetes, like increased inflammation, like cancer, like arthritis, like dementia, so many things go wrong when you've got high insulin, insulin resistance, and you're not able to burn your fat for fuel.

Dr Lucy Burns  (22:07)  Absolutely. And you know, like one of the things I want to point out and I know you know, weight loss is a fraught term, but like obesity, it's like, oh, you know, it's not politically correct. However, we know that adipose, which is the fancy nine-foot fat cells, adipose tissue, that is particularly in our midbrain region, so around the abdominal cavity, in our abdominal cavity is particularly inflammatory. It makes these fancy things called adipokines, which are inflammation cells that run around creating havoc. So when Dr Mary when you say, you know, your house is on fire, it is it's like, you know, and again, I've never been in a bushfire half Australia has and you constantly putting embers out on your roof. That's what insulin resistance is doing to our body is constantly trying to heal itself to put all these fires out. And yet, you know, embers are raining down on it.

Dr Mary Barson  (23:09)  It's so many different levels, like it affects our health on multiple hormonal, biochemical metabolic cellular processes. It's it sets us up for this terrible imbalance. But you can rebalance it and you can rebalance it by making what are actually doable, and sustainable changes. Although I will admit that it can seem completely overwhelming. And the amount of times that when I first talked to people who've come to see me as a doctor, and they've got they want, they want to lose weight, or it turns out we've done some tests and they've got insulin resistance or problems associated with insulin resistance, or their arthritis, whatever their health problem is to be improved by reducing their insulin resistance. And I talked to them about reducing sugars and starches the glaze over like –No, that's impossible, couldn't possibly do that. But you can. And this is what we love to do Lucy, this is what we love to do.

Dr Lucy Burns  (24:11)  Absolutely, absolutely. And, you know, I think the story is around weight loss is that weight loss is hard, that there's it's a battle. It's a struggle, like they're all the words that are used around it. And part of it is changing that story in your head knowing that it doesn't have to be a battle. Part of the reason it's been a battle is that lots of people have been given the wrong advice around particularly just calorie restriction, long-term calorie restriction, which just really revolves around willpower. Without getting back to that root cause of, yes, what you eat is super important. But knowing why you eat is actually the key. When you know why you eat, what tools food in particular is serving for you. And then learning new skills so that you're not reliant on particularly processed food or those, you know, just simple sugars and starches, then then you can actually do the work and heal. And it's, it can not only be easy, but it sounds a tiny bit weird, but it can actually be fun.

Dr Mary Barson  (25:22)  Yes, it can be. When you've got less cravings and less mental chatter in your head, when you've got a strengthened mindset, when you're still eating yummy, delicious food, yeah, it can totally be fun. You can absolutely reclaim your life you can. So it's not fun. It's being stuck in this hideous cycle of yo-yo dieting, and this is your cycle of being hungry. This hideous cycle of being unwell and trying everything under the sun, but nothing working. That's not fun. But be able to take back your power to get your hunger under control to get your cravings under control. Totally.

Dr Lucy Burns  (26:01)  Yep, I know. It is fun, because it's like, you know, we often say this weight loss is not a meal plan. It's you know, it's a journey of personal discovery. It is. It's personal development and at its heart. I love personal development. It's really fun. And it's learning and it's expansion, and it's so much more than just a bloody diet.

Dr Mary Barson  (26:23)  That's right. It's not a bloody diet. Definitely not.

Dr Lucy Burns  (26:29)  Awesome one. Well, I think we should probably conclude this chat and most definitely we will be talking further about all things insulin resistance we will be touching on cancer in future episodes. So lovely listeners. We look forward to catching up with you again next week. Bye bye. 

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