Nov 22, 2021
Today’s episode of The Drive is a
rebroadcast of the conversation with Rick Johnson
(originally released January 6th, 2020). This episode was one
of the most popular discussions to-date and is a prelude to an
upcoming follow-up discussion which will be coming out in February
2022 along with the release of Rick’s new book.
In this episode, Rick
Johnson, professor of nephrology at the University of Colorado,
explains how his research into the causes of blood pressure
resulted in a change of research direction to focus more on how
fructose has such profound metabolic effects. Rick begins by
talking about the relationship between salt and high blood
pressure, then provides a masterclass into uric acid, and then
expertly reveals the mechanisms and pathways by which sugar
(specifically fructose) can profoundly impact metabolic health.
From there, he explains how he applies this information to real
life patients as well as touches on some of the most promising
ideas around pharmacotherapy that are being developed in response
to the epidemics of fatty liver, insulin resistance, diabetes, and
obesity. Furthermore, Rick gives his take on artificial sweeteners
compared to real sugar, discusses cancer’s affinity for fructose,
and much more.
We
discuss:
- The connection between blood
pressure and fructose that shifted Rick’s professional focus
[3:00];
- The relationship between salt and
blood pressure (and the role of sugar) [4:45];
- Defining fructose, glucose, and
sugar [18:30];
- An ancient mutation in apes that
explains why humans turn fructose into fat so easily
[22:00];
- The problems with elevated uric
acid levels, and what it tells us about how sugar causes disease
[30:30];
- How sugar causes
obesity—explaining the difference in glucose vs. fructose
metabolism and the critical pathway induced by fructose
[39:00];
- Why drinking sugar is worse than
eating it [49:00];
- Unique ability of sugar to drive
oxidative stress to the mitochondria, insulin resistance, and
diabetes [53:00];
- Why cancer loves fructose
[59:20];
- The many areas of the body that
can use fructose [1:04:00];
- Fructokinase inhibitors—a
potential blockbuster? [1:06:15];
- Treating high uric acid
levels—Rick’s approach with patients [1:09:00];
- Salt intake—what advice does Rick
give his patients? [1:15:30];
- How excess glucose (i.e., high
carb diets) can cause problems even in the absence of fructose
[1:20:00];
- Artificial sweeteners vs. real
sugar—which is better? [1:28:15];
- Umami, MSG, alcohol, beer—do
these have a role in metabolic illness?
[1:32:45];
- Fructose consumption—Is any
amount acceptable? Is fruit okay? Where does Rick draw a hard line?
[1:37:45]
- How does Rick manage the sugar
intake of his young kids? [1:42:00]; and
- More.
Show notes page for this episode: https://peterattiamd.com/rickjohnson/
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