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.

Subscribe on: APPLE PODCASTS | RSS | GOOGLE | OVERCAST | STITCHER



We discuss:

The connection between blood pressure and fructose that shifted Rick’s professional focus [4:00];

The relationship between salt and blood pressure (and the role of sugar) [5:45];

Defining fructose, glucose, and sugar [19:30];

An ancient mutation in apes that explains why humans turn fructose into fat so easily [23:00];

The problems with elevated uric acid levels, and what it tells us about how sugar causes disease [31:30];

How sugar causes obesity—explaining the difference in glucose vs. fructose metabolism and the critical pathway induced by fructose [40:00];

Why drinking sugar is worse than eating it [50:00];

Unique ability of sugar to drive oxidative stress to the mitochondria, insulin resistance, and diabetes [54:00];

Why cancer loves fructose [1:00:20];

The many areas of the body that can use fructose [1:05:00];

Fructokinase inhibitors—a potential blockbuster? [1:07:15];

Treating high uric acid levels—Rick’s approach with patients [1:10:00];

Salt intake—what advice does Rick give his patients? [1:16:30];

How excess glucose (i.e., high carb diets) can cause problems even in the absence of fructose [1:21:00];

Artificial sweeteners vs. real sugar—which is better? [1:29:15];

Umami, MSG, alcohol, beer—do these have a role in metabolic illness? [1:33:45];

Fructose consumption—Is any amount acceptable? Is fruit okay? Where does Rick draw a hard line? [1:38:45]

How does Rick manage the sugar intake of his young kids? [1:43:00]; and

More.

§

Sign up to receive Peter's expertise in your inbox Sign up to receive the 5 tactics in my Longevity Toolkit, followed by non-lame, weekly emails on the latest strategies and tactics for increasing your lifespan, healthspan, and well-being (plus new podcast announcements). Email *

















The connection between blood pressure and fructose that shifted Rick’s professional focus [4:00]

It started with looking into the cause of high blood pressure

The running theory for years was that the kidney has a defect in its ability to excrete salt and so that you end up retaining salt and that leads to elevated blood pressure

Rick then figured out that when you raise uric acid in animals, they developed high blood pressure

So what made uric acid go up? ⇒ Sugar, and particularly fructose , raised uric acid

“We started studying fructose and pretty soon we were so excited about what we were finding that we just kind of changed our research direction to focus more on how fructose has all of its metabolic effects.”

The relationship between salt and blood pressure (and the role of sugar) [5:45]

Does salt raise blood pressure?

The prevailing thought is that too much salt elevates blood pressure

And the advice would be to restrict the amount of salt intake

But it isn’t really the salt amount that makes a difference, but the salt concentration

When you eat salt, your serum osmolality goes up

If you drink water in combination with eating salt, you can avoid this rise in serum osmolality and avoid the rise in blood pressure

Rick’s 2018 study showed that drinking water with a salty meal will prevent a rise in blood pressure

Why it would be better to have a lower blood pressure?

When your blood pressure is high, you have an increased risk for heart failure and stroke.

As your blood pressure increases, you get a gradual increase in risk

But when the blood pressure gets around 160 to 180…

{end of show notes preview}

Would you like access to extensive show notes and references for this podcast (and more)? Check out this post to see an example of what the substantial show notes look like. Become a member today to get access. Become a Member