How Fructose Drives Metabolic Disease | Rick Johnson, M.D.
178,930
Published 2022-02-07
Rick Johnson, Professor of Nephrology at the University of Colorado and a previous guest on The Drive, returns for a follow-up about unique features of fructose metabolism, and how this system that aided the survival of human ancestors has become potentially hazardous based on our culture’s dietary norms. In this episode, Rick explains how the body can generate fructose from glucose and how circulating glucose and salt levels can activate this conversion. He discusses the decline in metabolic flexibility associated with aging, as well as how factors such as sugar intake or menopause-associated hormone changes can alter responses to sugar across a lifetime. In addition, Rick lays out strategies for combating the development of metabolic illness using dietary changes and pharmaceutical therapies, and he discusses the impact of fructose metabolism and uric acid on kidney function and blood pressure. He concludes with a discussion of vasopressin, a hormone that facilitates fructose’s effects on weight gain and insulin resistance.
We discuss:
00:00:00 - Intro
00:00:10 - Unique features of fructose metabolism and why it matters
00:09:00 - A primer on fructose metabolism and uric acid
00:21:04 - Endogenous fructose production, the polyol pathway, and the effect of non-fructose sugars
00:28:20 - Findings from animal studies of glucose and fructose consumption
00:45:06 - What calorie-controlled studies say about the claim that a “calorie is a calorie”
00:56:45 - Implications for aging and disease
01:08:58 - Impact of endogenous fructose production on obesity and metabolic syndrome
01:12:43 - Why vulnerability to the negative effects of sugar increases with age and menopause
01:26:43 - Dietary strategies to reduce the negative impact of fructose
01:43:56 - The role of hypertension in chronic disease and tips for lowering blood pressure
01:54:16 - The impact of fructose and uric acid on kidney function and blood pressure
02:04:50 - The potential role of sodium in hypertension, obesity, and metabolic syndrome
02:11:18 - The role of vasopressin in metabolic disease
--------
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
Learn more: bit.ly/3AU1GlM
Subscribe to receive exclusive subscriber-only content: bit.ly/3IYxadj
Sign up to receive Peter's email newsletter: bit.ly/3Ghrh9i
Connect with Peter on:
Facebook: bit.ly/PeterAttiaMDFB
Twitter: bit.ly/PeterAttiaMDTW
Instagram: bit.ly/PeterAttiaMDIG
Subscribe to The Drive:
Apple Podcast: bit.ly/TheDriveApplePodcasts
Overcast: bit.ly/TheDriveOvercast
Spotify: bit.ly/TheDriveSpotify
Google Podcasts: bit.ly/TheDriveGoogle
All Comments (21)
-
I binge-listened to this episode 3 times in a row!!! This should be required listening for all med school students and especially clinicians.
-
I think Peter’s questions are exploratory and explanatory in the best sense of those words. I am grateful that I can witness these two excellent physicians converse about topics that are vital to our health and longevity.
-
I am a 71yr old male and my average blood pressure average is 110/60 and I use at least 7 grams of salt daily. I also keep carbs low and no vegetable oils. A1c 4.9
-
What an excellent discussion. My gratitude to both professionals. These are the people who matter and who contribute a lot to this society. Congratulations Peter and Rick
-
Peter is not really a jerk, he just comes off that way sometimes. He really wants to understand things.
-
It's hard to believe that Dr. Johnson could sustain the ever more intrusive interrogations (interruptons to the rest of us) of Peter Attia into this very learned and communicative scientists attempted descriptions of his fascinating work. I had a harder time dealing, and will now go take a break (at approx 1/3 of presentation/minute 47 ish). Dr Johnson is a most gracious and amenable sort, to be sure.
-
It would be interesting to look at a flow chart of Ricks intended presentation over laid with Attia's constant wanderings.
-
Rick is a gem, love the work and love the info that you bring! Please let him finish when asking a question ;)
-
Peter. So much respect for the cogent information you are putting out there by way of your guests and your own ability to synthesize what they are saying. Thank you!
-
Another fantastic show with wealth of practical suggestions and in-depth background of underlying mechanisms.Gratitude.
-
Wow! Dr. Johnson is brilliant! Glad to be introduced to his views!
-
This is awesome. Your penetrating questions are useful, Dr.Attia. Dr.Johnson gave great answers too! Always fascinating to see scientists having soooo much info stored in their heads.
-
-
Thx Dr Rick Johnson for sharing with the world your life saving and fascinating knowledge.Your contributions are already recognized and would certainly be even more in the coming years. Thx Dr Peter attia for inviting such prestigious guest. For me the Infos in this video and the previous one were eye opening.
-
Really interesting conversation, I took a few biochem/metabolism classes in college but I forgot a lot, you broke everything down very well 👏👏👏
-
I must say I really appreciated Peter challenging Rick on his points. It really elevates the conversation.
-
Thanks for bringing Rick back to the show / Awesome episode
-
Excellent podcast. Rick has a lot of numbered dots on paper and Peter drew the lines between the dots to create an amazing picture, just like I did when I was a kid(I was pretty sure what the picture would look like but it was a fun experience). Itere was a clear and present respect between you two and I learned so much more than I anticipated. Having listened to it, my diet will now be mainly tree bark and water 😁. Cheers Alan
-
Wow what a grilling … he did really well to handle this volley of technical questions
-
Thanks for this interview - there was so much to digest that I bought the book to get the full details.
