Dr. Richard Johnson
Appearances
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Just to talk about Alzheimer's just for a few minutes, we talked about the focus being on amyloid plaques and tau protein. And in the very beginning, everyone said, well, maybe that's the cause of Alzheimer's, these plaques. And if we can figure out how to remove the plaques or to prevent the plaques, we can treat the disease.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And so much of the focus of the big pharma has been to try to develop ways to block that. And as you have already mentioned, you know, there's been like 40 different drugs that have gone to trial and only a few have succeeded and they only work partially at best. And so people said, you know, there must be something that starts this whole disease.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Let's, you know, let's go back to when the disease is just beginning. Can we actually identify, you know, factors that seem to be important? And some of the factors that were important, you know, it's associated with diabetes and obesity, and these are diseases that I study. So I was interested in that. And it's also associated with insulin resistance in the brain.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And they do these studies where they can show that there's an impairment of glucose being taken up in the brain. If you do special scans, you can show that there's an impairment in the ability for the brain to take up glucose. It's like the brain is becoming insulin resistant.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Okay, so the brain uses glucose as its primary fuel and it loves glucose. Glucose is the main carbohydrate that's circulating in our blood. If our glucose levels are high, we call it diabetes. If the glucose levels are low, we call it hypoglycemia. But glucose is like the primary fuel and it's a major fuel the brain uses.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But in early Alzheimer's, there seems to be an impairment in the neurons being able to utilize the glucose. So insulin is a hormone that helps drive glucose into cells. if you become insulin resistant, you have trouble getting glucose into those cells. A lot of the brain, it doesn't require much insulin at all, and glucose can go in pretty easily.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But there are certain regions of the brain that are insulin sensitive, and those parts of the brain, if you become insulin resistant, you can't deliver the fuel as well. And that's associated with the second problem that you see in Alzheimer's, which is the the mitochondria are these little factories in the cell that make energy. They make ATP.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And there seems to be some problems with these energy factories in early Alzheimer's. They're not making as much ATP as they should. There's seems to be some stress going on with the mitochondria over time. There can be a loss of mitochondria. And so you have a problem with the energy factories, you have a problem with them taking up glucose to make energy, and you have low grade inflammation.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And I thought to myself, you know, this is actually what I study, but not in the brain, but what I'm studying in the circulation, what I'm studying in the systemic systems. You know, I'm looking at what drives insulin resistance, and I have personally linked it with energy production and inability for these energy factories to make ATP. And I thought, oh my gosh, there's a connection there.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And some people call early Alzheimer's brain diabetes because of this insulin resistance. And so I knew that there had to be some kind of link between those two diseases. you know, between obesity and diabetes. And people who are obese and diabetic have an increased risk for developing it.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But there seem to, it isn't a match, you know, it isn't like if you're overweight, you're going to get dementia. But there is this association. A strong correlation. Yeah, a correlation. And so I started thinking,
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
thinking about what our work shows in the body and I started thinking about how that system might work on the brain and I had this kind of aha moment where I suddenly realized that I could explain how Alzheimer's develops.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So everybody who's looking at me, please don't, you know, it's not like I'm saying this is the cause, but I would like to present you the evidence because it's very strong.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Exactly. And so just like currently, there are different groups that are saying, okay, they've got insulin resistance in the brain. How about if we give insulin through the nose, through the nostrils, where it can actually get to the brain directly? And can we treat the disease? Can we improve things? And there are early studies saying that might help a little bit.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And there are people giving anti-inflammatories that can block the inflammation in the brain. They're seeing a little bit of protection. But the problem, Drew, with all these kinds of problems, of these approaches, is they're trying to patch They're trying to put out the fire, but they're not trying to figure out what's causing the fire.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And what's fantastic about this story that I'm going to share with you is that I'm going to try to show you how it happens and how we can prevent it. And at the end, let's talk about all the ways and the evidence that we can actually reverse or block early Alzheimer's and so forth, because it's a very exciting area.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You're absolutely right. So we have identified two mutations that have occurred in the past, both kind of interesting stories that make us more susceptible to obesity and diabetes. and at the same time may also have a role in increasing our risk for Alzheimer's. But the fundamental issue is not just those mutations, but what is this pathway that's causing obesity and diabetes?
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So what I'd love to do is to take you through that part and then we can then hit the mutations and the survival pathway in the past as well.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So I was very interested in what was causing obesity and diabetes and through a series of adventures and research adventures related to doing different studies, we came to the observation that uric acid was very important in obesity and diabetes. And uric acid is a substance that circulates in our blood and it's like a breakdown product of energy. So when energy breaks down, energy is
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
we call energy ATP. And that's what we use to do everything we want. So the mitochondria, these energy factories, produce ATP. And the ATP is what gives us the energy. There's really two types of energy. There's the active energy, which is the ATP. That's for, you know, talking, running, jumping.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And then there is stored energy and stored energy is fat and can be carbohydrates too, but most of stored energy is fat. And so when a bear is hibernating and he's not eating and not getting the energy from food, he can use the stored energy or fat to produce the ATP he needs. So
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
That's right. So I became interested because we found that uric acid had a role in causing fat and it had a role in raising blood pressure and causing things. So, you know, as I mentioned, uric acid is a substance circulating in our blood and it varies. And a lot of people have low levels and some people have very high levels of uric acid.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And if the levels get really high, they can cause a disease called gout.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yeah, they get this joint pain. It's basically an inflammation of the joints. And so you get this red hot joint, typically the big toe or the knee or the ankle, sometimes the wrist, and it's miserable. It's very, very painful. It lasts a couple of weeks. Sometimes people take medication like Advil and ibuprofen can help reduce the inflammation.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But it's, you know, although people used to think of gout as just being an arthritis, there's more and more evidence that it's not. And these uric acid crystals can also go to the kidneys and go to the blood vessels. And about, there's recent studies that suggest that people with gout that they have crystals in their aorta and their coronary arteries too.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
The majority have some crystals in their blood vessels that tends to go to the plaques in the blood vessels. And so gout is not just an arthritis and it's been known for a long time that gout is also associated with obesity and diabetes and hypertension and kidney disease.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
That's right.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So anyway, so for a long time, people linked gout with being a rich man's disease, also with being overweight, obese, hypertensive, all these conditions. It's about 70% of people with gout are overweight. I mean, it's like a very strong association. 60 or 70% are diabetic. I mean, it's a very strong link. And
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
People were saying for years, you know, hypertension and diabetes and obesity increase your risk for gout. But actually, the high uric acid usually precedes the development of obesity. It precedes the development of diabetes. It precedes the development of kidney disease. It's one of the earliest markers that predicts the development of these conditions. It's a very strong predictor.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And when we were studying it, we realized that uric acid doesn't just form crystals and cause inflammation. Uric acid is biologically active. And one of its main things that it does is it acts on mitochondria, those little energy factories, and it causes stress to them and reduces their energy production. Think about that. Okay.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So anyway, so I was studying uric acid and that took me to, you know, what, we had this evidence that it was driving blood pressure and might have a cause in hypertension. And we did this study actually in adolescents who were overweight, where we lowered uric acid in them and their blood pressure corrected it. And we published it in the JAMA. It was a big deal.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yeah. We used the drug to lower the uric acid and 90% of them or so became normotensive. It was amazing. They'd never received a blood pressure test.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Then the question was, what drives the uric acid up? Most people think of alcohol and actually things like red meats, but actually one of the major things that raises uric acid is fructose and sugar. And so actually Gary Taubes, who I'm sure you know, interviewed me related to a paper that was published in the New England Journal on gout and its relationship with, you know, with diet.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And when we were talking on the phone, he says, well, what do you think about sugar as a driver of uric acid? I said, well, it's definitely is a driver. It's the fructose component. And then, you know, and, you know, after I had my conversation with him, I went home and I thought, you know, we should give fructose to animals and see if they develop high blood pressure.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And if we lower the uric acid, can we lower the blood pressure? Because at this point I was focused on blood pressure. And so what happened was, you know, some people in my lab, Taka Nakagawa, we gave fructose to animals and they became hypertensive. And so fructose is that component of sugar. So table sugar or sucrose is half fructose and half glucose.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And there's another sweetener, high fructose corn syrup. It's also about half and half fructose and glucose, but fructose is the only sugar that raises uric acid. And so we gave fructose to animals and they became hypertensive.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Blood pressure went up just like this. And we gave the drug to lower the uric acid and the blood pressure came down. But there was a big surprise because the animals got fructose also started getting fat. And they started developing insulin resistance. And their fats went up in their blood. The fat went up in their liver.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
I mean, they were developing obesity and metabolic syndrome right in front of us. And when we lowered the uric acid, we actually could reduce all of those. And I go, oh, it can't be. It can't be just lowering the blood pressure and but also lowering all these other things. And then we started realizing this was that fructose was first off, it was a very potent driver of obesity.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But the other thing is we could lessen it by lowering uric acid. And the cool part is uric acid is not in the caloric pathway. You know, so there's calories. You know, everyone says it's calories. Calories are the big driver of obesity. But uric acid was being produced independently of the calories. And when we block that part, we actually were blocking the obesity.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So what we figured out, it's not so much the insulin resistance causes inflammation, it's that fructose is driving a series of events to help the animal survive acutely. It's stimulating inflammation to help fight off infection. It's raising blood pressure to maintain circulation in a state where it thinks that it's maybe starving.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
It increases pressure in the kidneys to facilitate excretion of the stuff through the kidneys. It causes insulin resistance, which is to help preserve some glucose in the blood for tissues that need it. It makes fat, but it blocks the breaking down of fat. And so it's stimulating all of these at once, and it's all working together.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Through the mitochondria, there's specific chemical pathways that are driving each one that we've been studying. So we can actually show how the insulin resistance develops, why you can't break down the fat. It's all driven through this this particular chemistry. And then we realized that fructose was meant to help us store energy and prepare us for times when there's no food around.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yes. whereas glucose is therefore the immediate fuel and then glucose is like trying to raise the atp in the cell fructose is trying to get us to store fat and the way it does it is it drops it stuns the mitochondria drops that atp and activates all those pathways and that was the fundamental discovery we go oh my gosh this is super important in evolution in biology glucose is really meant
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
has a different role than fructose. And then we realized, though, that if you eat too much glucose, it gets turned over into fructose. And we found out that very mild dehydration could also stimulate fructose production because fructose helps the animal store water by generating fat. And then we realized that the best way to create an animal to cause mild dehydration was to eat salt.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And then we started doing studies with salt and we realized that when you eat salt and you get thirsty, you're actually stimulating fructose production from glucose. So salt activates the chemical reaction that converts glucose to fructose. So you've got two things that are important for making fructose. One is you gotta have glucose around.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So if you're on a low carb diet, you're in good shape because you're not going to have so much glucose around because all glucose comes from, you know, the main source of glucose in our body comes from the carbs. You can make glucose from amino acids and so forth, but it's not very much. And so most of the glucose that we in our body comes from the carbs.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So if you're on a low carb diet, you're not going to make very much fructose. That's why low carb diets are so fantastic because not only are they reducing sugar intake, but they're reducing carb intake that will reduce the amount of fructose you make. But salt is a very powerful way of converting glucose to fructose.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And that's why French fries, for example, cause so much obesity and are so bad because you've got the carbs, you've got that starch, the potato, And then you got to coat it with salt, make it taste really good. And that salt activates the conversion of the carb to fructose, the glucose to fructose. And then you coat it with the fat. And now you've got the fat.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yeah, you got the trifecta.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yeah. I still eat cake on my birthday. I'll eat salt. I'll have salty food occasionally. It's not that we want to eliminate these foods in any way, but what we want to do is to be aware that they can convert to fructose. And if we're doing a lot of it, we're going to generate a lot of fructose in our body and we're going to eat a lot of fructose if we eat sugary foods.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So we want to cut it back, we want to reduce it. If you can get rid of it, soft drinks, that's a good move.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yes, right.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
That's right. And natural fruit turns out to be much healthier than we think. If you're a bear and you're eating 10,000 grapes, you're going to get fat if you eat 10,000 grapes. But when you eat a natural fruit, it's only three or four grams of fructose typically in a fruit. And my friend Josh Rabinovich showed that the intestine inactivates about three to four grams of fructose.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So you can eat a natural fruit and you won't get any fructose to your liver, you know, because it's all removed by the intestine. And it's really in the liver where it controls this metabolic syndrome. And so if you just eat occasional fruit, you're going to get all the good things in the fruit. Phytonutrients. Yeah, vitamin C. Fiber. Potassium, fiber, and all these things are good.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And actually, vitamin C and flavanols and all these things, potassium, they actually counter the effects of fructose. So we actually did studies where we put animals or people on a low fructose diet and we supplemented them with natural fruits. So they were getting back fructose, but only in the form of fruit, not in the form of refined sugars.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And they lost weight and they did well, just as well as the people who did not get the natural fruit supplements.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So fruit juice. So fruit juice is where you take multiple fruit, you juice it, you get rid of some of the pulp and the fiber, and you end up with a drink that often has like three or four fruits in it. And so instead of having three or four grams of fructose, now it can have maybe have 20, 20 grams of fructose. And now it's similar to like a fruit, like a soft drink and, you know, apple juice.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
I love apple juice, but it's not good for you because there's a lot of sugar in it, a lot of fructose, and it will trigger the switch. It will trigger this this activation.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
so um so i don't recommend fruit juice so anyway so you know the first discovery was that fructose was diff different from glucose or from other foods that it really dropped the energy in the cell and that this uh and that this activated an alarm signal that triggered metabolic syndrome the second discovery though was that there are other ways you can make fructose you can make fructose and some of them are from high glycemic carbs and salty foods
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And and then we realized that if you ate a lot of those foods, you could get into trouble, too. And so but it all related to fructose, because if we blocked fructose metabolism, animals could eat salt and they wouldn't get fat. They would. They could eat salty foods. They could eat processed foods, you know. But and so it turned out to be fructose.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And so then I, you know, we began to realize that it wasn't just activating the metabolic syndrome. It was also it had these neural effects. So like the brain effects. So when animals start eating fructose, they actually start to forage for food. And that foraging is part of the survival response. So it actually, if you give fructose to an animal, it will start moving around and looking for food.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
They're hungry, they get thirsty, and it triggers a foraging response. And that information made me start thinking more about what was going on in the brain. How is fructose affecting the brain? And we knew that if you give fructose to an animal or to a human and you label the fructose, only about 1% of it gets to the brain. So there had to be another mechanism.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And the insight was that when you take these high glycemic foods or soft drinks, they stimulate fructose production in many sites, including in other tissues. And so they stimulate fructose production in the brain. And there is a brilliant doctor named Sherwin at Yale who did these studies where he infused glucose in people and he could measure fructose production going up in the brain of people.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And it happens like after about an hour. So if you infuse glucose, it takes a little while for that conversion to occur. But you can start measuring an increase in fructose in the brain.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Well, no, he was given an intravenous thing. Okay, so it still has to go to the brain, blood-brain area. Exactly. And he brought the blood glucose up. And when the blood glucose goes up, we know it converts to fructose.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
But it will convert, tissues will start making fructose wherever that glucose hits.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Right. And it also can induce insulin resistance. So now I'm going to tell you this story of how we started putting together Alzheimer's.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So the first thing is you look at what are the risk factors for Alzheimer's disease. And dietary ones, guess what they are? Eating sugar. Sugary foods has been reported to be a risk factor for developing Alzheimer's. Eating high glycemic carbs. They make fructose, right? A risk factor. Salty foods. There are all these papers showing that high salt diets increase the risk for Alzheimer's.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
What sometimes they do is like they take these little shrimp and they'll inject them with salt water. Saline water, right? Yeah. And then what that does is it makes the shrimp big, looks big.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And then people go into the market and they see these big shrimp and they go, oh, they look good. And they bring them home and then they start grilling them. And then the water comes out and they shrink. But they keep that salt in there.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So now you're getting the salt. Yes. Processed foods.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
They contain so much salt, so much sugar, and they're associated with Alzheimer's too.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Processed foods. Bread rolls, pasta sauce.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
All these things. All these things we get in the grocery store. So first off, there's this association of foods that can make fructose or that contain fructose. Correlate, you know, and I don't mean natural fruits. I mean like soft drinks and fruit juice. You know, these things are associated with Alzheimer's.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Obesity is associated with Alzheimer's. Diabetes is. And these are conditions associated with, you know, that we think fructose is driving. Okay. So then, so that's the first thing is there's this association. Then the second thing is that if you give sugar to an animal, after a number of weeks, they actually have trouble going through a maze.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So normally you can measure how long it takes for a lab mouse to get through a maze. And each time it will get a little bit smarter and it'll shorten the amount of time to get through it. But if you feed it sugar, it doesn't show that shortening. It continues to have trouble all the time getting through the maze.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And when you give the sugar to the animal and you look in the brain, guess what you find? You find suppression of the mitochondria with less, you know, there's oxidative stress to the mitochondria, which we know happens in other tissues with fructose. And it's associated with lower ATP production, low-grade inflammation, and insulin resistance. That is the hallmark of early Alzheimer's. Right.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
I mean, these are the exact same things. You can show exactly the same things. And then over time, if you take the animals out to like 18 weeks and you then you start seeing the amyloid plaques as well as tau protein in the brains of those mice. Wow. So that's pretty strong evidence. Okay.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
They call it an Alzheimer's model, but it's, yeah, exactly. Just fructose in the drinking.
Dhru Purohit Show
Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Now, here's another bit of evidence. If you take people with early Alzheimer's, and there was an autopsy study done, In early Alzheimer's, they had like nine subjects, and all nine had fructose levels in the brain five-fold higher than the controls, than the control autopsy brains. There was five times more fructose.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Except one of the controls had high fructose, but when they went back and looked, they decided, they realized that that patient had early Alzheimer's too. So there is an association there. Okay. But here's one of the most interesting bits of data.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So if you give fructose to a human, you, you, well, so let's go back. I want to talk about this foraging response again. Yes. So when animals get, so when animals get fructose, they start searching for food and foraging is a, Actual behavioral response, it's more than just looking for food. It involves a lot of things.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
First, you have to have exploratory behavior because you're going to go out into areas we've never been. So you have to be a little exploratory. You can't deliberate on anything very long because you got to get in and get out. So you had to look around very quickly. You have to have good visual cues for food, you know, so that if you see that little piece of food up there, your eye catches it.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You can see it, you know. that latch onto that chocolate cake, you know, that light up that part of the brain. You have to have less self-control. If you have too much self-control, you're not going to go into an area that's dangerous, right? Sure. You have to be bold, impulsive, So this is a behavioral set.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
In some respects, it's sort of like a hero, you know, the scout, the guy that's going to go out and try to, you know, get through the enemy lines. And, you know, I mean, there's some aspects of it that are admirable. And I think it is an admirable response. You know, you're willing to go out there and try to try to find that. But it's a it's a real behavioral response.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So it turns out that to do that, you have to stimulate certain parts of the brain and you have to inhibit other areas of the brain. So a lot of the cerebral cortex is involved in self-control, especially the frontal cortex. So you would want to inhibit that if you're going to forage.
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Yes. You want to reduce the activity there so that you have the self-control is not so strong.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Right. And you got to quiet the recent memory because you don't really want to remember how dangerous it really is, what you're about to do. You don't want to remember that line you saw yesterday. So you want to quiet that. You want to stimulate the visual cues so that you can see things real quickly.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You want to reduce the activity to the areas that are involved in deliberation so that you want to stimulate locomotor activity. So there are some things you want to stimulate and some things you want to inhibit.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Mm hmm.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So when you give fructose to a human intravenously or orally, you can do this thing called bold MRI and you can do these different things where you can look at changes in blood flow. You can look at that and guess what? If you give fructose, you activate these foraging responses, you inhibit the cortex, you inhibit blood flow to the hippocampus, which is involved in recent memory.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You stimulate the, you know, other areas, you know, like the visual cortex, for cues, for food. And you can show that if you give glucose acutely and you just look in the first 15 minutes. Remember, it takes an hour for the glucose to start converting. So if you look the first 15 minutes, you see the opposite effects of fructose. Glucose is not aiming to make you hungry. It's to satisfy you.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
So it's more of a, it's a different... So it turns out that the foraging response requires activation of the anterior cingulate. It's a part of the brain and the occiput. And the anterior cingulate has been uniquely known to be spared in Alzheimer's. And the visual cortex is generally spared.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Whereas all the areas that tryptophan inhibits turn out to be the regions of the brain that are specifically targeted in Alzheimer's. I mean, eventually Alzheimer's will affect all the brain, but in the beginning, you can really show this difference. And so when I presented that to Dale and to David Perlmutter, they go,
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You know, this is pretty significant because not so many people have been able to explain why Alzheimer's affects one region and not another.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
Yeah. So so yes. So to summarize how we think of this or the way I think of this, and I have to again thank David Perlmutter and Dale Bredesen and Maria Nagel. And but what we think is going on or is that, you know, fructose developed as an evolutionary mechanism to help animals survive. Fructose is the nutrient that helps you store energy, and it's meant to help you.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
It was meant to be a good thing. When there's very little food coming, you want to eat fructose to store that fat. You want to stimulate foraging so you can get the food so you can survive. It's all meant to be short-term and to be beneficial. But what's happened is we developed taste for foods that could make fruit dust, right? We develop sweet taste so we can pick out that food.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
We salt taste so that we can pick out the foods that that tend to help put fat on us. And in a world of hunter gatherers and in a world where where food wasn't so easily available, these were beneficial, you know, and if you, you know, and then
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
You know, now that we have all this high fructose corn syrup and sugary foods and processed foods injected with salt and sugar and we have, you know, and now that we can go to the grocery store whenever we want and we learn to crave sugar and then we, you know, we develop a craving and some people crave salty foods and we're eating all these foods to stimulate this foraging and all this.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
And what's happening is we're reducing the ATP, the energy in these cells, you know, in our brain, in our muscle, and it's leading to muscle wasting, sarcopenia. It's leading to, you know, as we lose our energy in the brain, as the cells get less ATP, They can't function as well. And then what happens is they start dying and they get inflamed and they start creating these amyloid plaques.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
It's kind of a inflammation, inflammatory response to the low energy state. And so that's what's going on, I think. And And so the wonderful – it's not wonderful, but the wonderful aspect of this is that if we actually understand what causes it, we can design and try to figure out how to prevent it. And, you know, already groups are – I mean, Dale Bredesen has been a leader at –
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
you know, developing healthy diets and approaches to to try to block Alzheimer's. And there are other groups as well that are doing keto diets and low carb diets as a mechanism to try to reduce, you know, to improve the energy in the brain. And, you know, I think there's a lot of positive things coming.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
We've known that hunter gatherers like the Samani who live in Bolivia don't really get Alzheimer's and and they're living in a very healthy environment. We know it's not natural fruits, so please, all of you. We're not trying to create fruit phobia. I want you to continue to eat fruits. But dense sugars, high glycemic carbs, we need to reduce those. We need to drink more water.
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
We discovered that when you drink water, you can block that enzyme that converts the glucose to fructose, you can actually inhibit that enzyme by staying well hydrated. And we could stop weight gain and so forth in animals on sugar by just giving them water. And we did studies in people too. So drinking like eight glasses of water a day, eight, eight ounce glasses
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Why Excess Added Sugar is Driving Modern Diseases and How to Take Back Our Metabolic Health and Overcome a Sedentary Lifestyle
is very healthy, drinking a glass of water before you eat your meal is very beneficial. I have some water right here.
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well this morning i actually skipped breakfast and uh you know one of the things is you know it turns out that things like carb restriction and intermittent fasting and all these things that people are recommending they're they're pretty effective at losing weight and the carb restriction in particular is a very very helpful because it removes not only sugar but it reduces the amount of starch you're eating and remember the starch can be converted
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to fructose. So it turns out that that is a major mechanism of protection. So if you want to lose weight, you know, carb restriction, intermittent fasting are great ways to go. But there's also, you know, what we learned from this is there are a lot of nuances. For example, it's possible to eat cake and not eat and not activate the biologic switch. And the reason is that the way fructose works
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is it's the concentration that hits the liver. When the fructose concentration in the liver is high, that's when the switch activates. So for example, if I did not want to activate this switch, I could eat a piece of cake. If I could eat a piece of cake slowly, like over a couple of hours, then it wouldn't activate the switch. Now the trouble is, of course,
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that our desire to eat the cake outbeats our logic where we know that it's not good. It's just like a soft drink. It's hard to tell a person to just sip a soft drink over two hours or over an hour. Everyone will drink it very quickly and that's the problem. But the truth is when you understand the science, you can actually figure things out. So for example, if you drink water
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if you drink more water, you can block the effects of salty foods. So we did this. We took people, we gave them salty soup, and we could show that immediately their blood pressure went up and they activated this switch. We could prove it, that they activated the switch. But if we gave the salty soup with water,
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the salt concentration did not go up in their blood, they did not trigger that enzyme, and they did not develop an increase in blood pressure, nor did they activate the switch.
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So what we call low glycemic carbs don't activate the switch. So vegetables and all those things, they're very good, even though they contain carbs. So you don't have to carb restrict completely. It turns out that it's certain carbs. It's really only four or five. Sugar. and high fructose corn syrup, I put them together. And then the other big ones are bread, rice, potatoes, and cereal.
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And those are the main ones that tend to raise glucose in our blood and activate this switch where the glucose gets converted to fructose.
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You know, I've published on how much sugar people were eating over the decades, actually going all the way back. And, and really it started really going up dramatically in the 1970s when high fructose corn syrup was added. And, you know, we've done studies and high fructose corn syrup tends to be more fattening than table sugar causes more fatty liver, for example.
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And it's because there's a little bit more fructose in it, and also probably because of how it's absorbed. By the 80s and 90s, that's when really obesity and diabetes went crazy, and they continued to increase. Now, sugar intake has decreased since 2005, particularly in soft drinks, But there's also been the rise of sugaring from power drinks.
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And we're also eating more salt than we did back in the 60s. So there's a lot of factors.
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In general, you want to avoid liquid sugar because liquid sugar is the worst because you get a lot of sugar in a short amount of time. And I include for sugar, I include table sugar in high fructose corn syrup and things like that. So liquid, soft drinks,
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energy drinks drinks that have a lot of sugar in it anything that has fruit juice really avoid that that's number one that is your number one activator of this switch reduce your sugar intake reduce your high glycemic carbs try not to eat so much salty food and try to drink more water
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There's certain umami foods, umami is another taste, and they will also enter into this switch, particularly things like beer and alcohol, but beer in particular, which has brewer's yeast in it, actually will activate the switch as well. You know, a lot of meats are good, especially poultry, fish, unprocessed red meats. There are a lot of fats that are good.
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You know, omega-3 fats, saturated fat, you have to be a little careful with. But, you know, there's a lot of monounsaturated fats, olive oil-based diets, Mediterranean diets. These are really basically healthy ways to go.
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Well, there are some problems with sugar substitutes, but in general... The first good thing is most sugar substitutes do not activate this biologic switch. They do stimulate a pleasure response in the brain, what we call a dopamine response. So they do encourage you to eat sweet foods. So if you're trying to
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stop eating sweet foods, drinking soft drinks, diet soft drinks is still going to encourage you to like sweet foods. And so it doesn't get rid of the craving. Most of them do not activate the switch. There's a few significant exceptions. Like there's one artificial sweetener called sorbitol. It's often put in like sugar-free syrups. That one still activates the switch, unfortunately.
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So that's really not a good choice. And then there are also other issues with artificial sweeteners that are quite bothersome. For example, aspartame.
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um has been reported to you know affect memory and um you know there's some papers suggesting that if you give large doses to animals that they have trouble going through a maze so i'm not a big fan of aspartame um and you know so things like stevia which is a natural artificial sweetener uh splenda sucralose there isn't too much negative about that but you know they are
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Yes. So it turns out the switch is a dimmer switch. What it means that if you take two teaspoons of sugar, you're going to activate the switch, but only mildly. Whereas if you drink a soft drink, you're going to where it's like nine teaspoons, you're going to activate the switch big time. And when you do, you drop that energy and it only will last for a few hours, okay?
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And then it will recover and everything kind of goes back, but you've now stored that extra fat, right? So initially it's sort of a short-term effect, but we're eating sugar in almost every meal. You know, it's like in 70% of processed foods. So we're activating the switch a lot, a lot. And some of us are almost staying like in an activated state.
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No, it's still part of the equation, Michael, because the way, again, the way it works is the fructose is the fire and the high fat foods are the firewood. What I mean by that is you have to activate the switch so that you don't regulate your appetite. So if you eat the fructose, now you're gonna be hungry and you're not going to control your appetite.
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And so now when you could get fat just from carbs, But the carbs are only four calories a gram. So you would have to eat a lot of carbs to gain weight. The fat is like nine calories a gram. So it's very easy to gain weight with fat if you can't control your appetite. But if you control your appetite, you're not going to eat excessive fat.
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So if you are healthy and you have not activated the switch, you can go on a high fat diet. You won't gain weight. That's what a low carb diet is. A low carb diet tends to be a high fat, high protein diet. And it doesn't cause weight gain. Because you're on a low carb diet, it prevents you from activating that switch, which is mainly driven by carbs.
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So a high fat diet is not going to cause obesity if the switch is not on. But now let's say I give you sugar and I give you a lot of carbs and you've activated the switch. Now, if you have a diet that has a lot of fat in it, you're going to gain a lot of weight because that fat is so caloric rich. It's calorie dense and you're not controlling your appetite.
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Yeah, thank you, Michael.
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Hi, Michael. Thank you for inviting me.
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It's definitely true that, you know, a number of years ago, it used to be thought that it was just calories that drive obesity and basic and basically lack of exercise. So there was a lot of talk originally, you know, that all you had to do was just kind of reduce what you're eating, the amount you're eating and exercise more, and that would cure everything.
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But, and then that became quite apparent that that's not the case and that certain foods make a difference. And over the decades, following years, it became more and more apparent that things like sugar specifically tended to make people more obese and develop metabolic syndrome more than, for example, starch.
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There was a transition where we started realizing that it wasn't just behavior, but that there was something special about the particular foods we were eating. We were involved in that early work, but what we've done since then has actually kind of given a new insight. And that is that to gain weight, you actually have to activate a biological switch.
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And that when we studied that and identified that biological switch, it did turn out to be due to sugar. And it turns out that sugar is contains two, sugar really has two compounds. There's glucose and fructose. There's two carbohydrates in sugar. And it turns out that it's the fructose that triggers this biologic switch.
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So fructose is a carbohydrate. It's a type of sugar. And it's present in fruit and honey. So things that we think of as healthy, but it's also present in table sugar. And it's also present in this sweetener called high fructose corn syrup. In high fructose corn syrup and table sugar, it's actually both glucose and fructose mixed together. Glucose is the main sugar in our blood.
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It's really the essential nutrient, the essential carb we use as our fuel for the brain and for our tissues. It's our main carbohydrate fuel. But fructose is a different fuel and it's mainly present in these foods. What's unique about fructose is that it triggers the storage of fat as opposed to the production of energy.
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It really is there to try to shift the calories we're eating from instant energy to stored energy.
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It turns out that our bodies, we have a sort of a shield in our intestine where we inactivate the first four or five grams of fructose that we eat. So it turns out that natural fruits have only small amounts of fructose. And although it's really sweet to taste, we kind of inactivate the fructose in our gut so that we don't actually get a big load of fructose to our liver where everything happens.
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And so a natural fruit does not give you enough fructose to activate the switch. Now, if you drank fruit juice, now you're going to get a large load of fructose and you're going to activate the switch. There's another reason too, natural fruits have a lot of fiber.
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and they also have vitamin c and other things and it turns out that the fiber slows the absorption and the vitamin c actually helps neutralize the effects of the fructose
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When you give animals the exact same number of calories, the weight gain is still a little bit greater with sugar, but there's a major effect, which is that the other metabolic effects of the switch, which is to become insulin resistant and diabetic and develop fatty liver, that still occurs even with controlling, even if you put them on a diet restriction.
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So if you put animals on a caloric restriction, so they're eating less than normal, but they get a high sugar diet, they're still gonna become diabetic. They're still gonna get fatty liver. They're still gonna get hypertension. So those things are not driven by the excess calories. Only the weight gain is really driven by the excess calories. You know, that's what drives the weight gain.
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But all the other things, you can be skinny and diabetic if you put an animal on a caloric restriction with a high sugar diet.
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It isn't just the fructose we eat. What we discovered was that the body can make fructose. And when the body makes fructose, you can get fat from the fructose you make. There's only one way to make fructose and you have to make it from glucose. And guess what? The best source of that is high glycemic carbs.
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So when you eat bread and rice and potatoes and cereal and chips, even though they don't contain fructose, even though they don't contain sugar, you can still get fat from them because once you eat them, the glucose can be converted to fructose in the body and high glycemic carbs do it. Now, the other big discovery was dehydration.
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Turns out that people who are overweight are almost always dehydrated. They're not drinking enough water. In fact, one study showed that people who are overweight or obese tended to be 12 times more dehydrated than the lean people.
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So when you get dehydrated, that also stimulates the enzymes to convert glucose to fructose. And when we started studying this, we didn't really understand this, but we started saying this and it turns out that people who are overweight are almost always dehydrated. They're not drinking enough water.
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In fact, one study showed that people who are overweight or obese tended to be 12 times more dehydrated than the lean people. So dehydration is very, very common. in people who are overweight. And the main reason they do that is it turns out that when you eat sugar, that dehydrates you. You think a soft drink hydrates you, it doesn't.
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So when you eat salt, the salt concentration goes up in your blood and you get thirsty and you want to drink water. But the salt concentration in the blood activates a biologic pathway to make sugar. and it makes it from carbs. So that's why French fries are so bad because the salt in the French fry actually activates the enzyme to help convert the glucose in the French fry to fructose.
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And that's why French fries, which have no sugar in them, no high fructose corn syrup, you know, but they're still bad because the salt activates this enzyme that converts the glucose to fructose.