
#194 - How fructose drives metabolic disease | Rick Johnson, M.D.
About this episode
View the Show Notes Page for This Episode
Become a Member to Receive Exclusive Content
Episode Description:
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:
- Unique features of fructose metabolism and why it matters [2:45];
- A primer on fructose metabolism and uric acid [10:30];
- Endogenous fructose production, the polyol pathway, and the effect of non-fructose sugars [22:00];
- Findings from animal studies of glucose and fructose consumption [29:00];
- What calorie-controlled studies say about the claim that a "calorie is a calorie" [42:15];
- Implications for aging and disease [51:15];
- Impact of endogenous fructose production on obesity and metabolic syndrome [1:01:30];
- Why vulnerability to the negative effects of sugar increases with age and menopause [1:04:30];
- Dietary strategies to reduce the negative impact of fructose [1:16:30];
- The role of hypertension in chronic disease and tips for lowering blood pressure [1:30:45];
- The impact of fructose and uric acid on kidney function and blood pressure [1:39:45];
- The potential role of sodium in hypertension, obesity, and metabolic syndrome [1:49:00];
- The role of vasopressin in metabolic disease [1:54:00];
- More.
Sign Up to Receive Peter's Weekly Newsletter
Connect With Peter on Twitter, Instagram, Facebook and YouTube
Get every episode summarized
Each time The Peter Attia Drive publishes, we email you a written briefing from the transcript — the topics, who appeared, and any specific claims, with the ad reads skipped.
Email me new episodesFree for 3 shows. No card needed.
No transcript yet
This episode has not been transcribed. Request it and it moves to the front of the queue.
More episodes
More from The Peter Attia Drive

#390 ‒ AMA #84: Family health history, preventing heart disease, metabolic healt...
The Peter Attia Drive

#389 - Thinking scientifically: why it's hard, why it matters, and a practical t...
The Peter Attia Drive

#388 — Prostate cancer screening: why current PSA guidelines are failing men and...
The Peter Attia Drive

#387 - AMA #83: Peptides—evaluating the science, safety, and hype in a rapidly g...
The Peter Attia Drive