Prof. Richard Johnson - 'Nature Wants Us To Be Fat - Part 1'
摘要
TLDRDr. Rick Johnson, a professor of medicine, introduces his research on a biologic switch that he asserts underpins the current obesity epidemic. Throughout a series of talks, he plans to discuss his findings, based on his book "Nature Wants Us to Be Fat." Johnson explores how animal behaviors, historical dietary changes, and biochemical processes contribute to obesity and related diseases like diabetes and hypertension. He highlights the role of fructose—a sugar prevalent in fruit and table sugar—as a trigger for a biologic switch that tricks the body into storing fat. He illustrates this mechanism using laboratory studies and highlights a genetic mutation affecting humans' fructose metabolism, emphasizing the role of uric acid in this process. Johnson argues that understanding this switch could revolutionize obesity prevention and treatment. Future discussions will delve into specific foods that activate this switch and its impact on conditions such as cancer and dementia.
心得
- 🧬 Dr. Rick Johnson introduces a biologic switch driving obesity.
- 📚 His insights are based on his book "Nature Wants Us to Be Fat."
- 🥭 Fructose plays a critical role in activating this switch.
- 🔵 Uric acid is a key factor in this metabolic pathway.
- 🧠 Insulin resistance is part of the survival mechanism.
- ⏳ The mutation affecting uric acid dates back millions of years.
- 🍇 Animals use fructose for survival; humans consume excessively.
- 💡 Understanding this can aid in preventing and treating obesity.
- 🌍 Historical dietary shifts have influenced obesity trends.
- 🧪 Future talks will cover foods that activate this switch further.
- 🦠 Other diseases beyond obesity, like cancer, may be affected.
- 📉 Lowering uric acid could mitigate some negative effects.
时间轴
- 00:00:00 - 00:05:00
Dr. Rick Johnson introduces himself as a medicine professor sharing a discovery about a biological switch underlying obesity. The series of talks will explain the switch's discovery, its activation by foods, and its effects beyond obesity. He discloses his efforts to clinically apply his research through a small company, despite some controversies in the scientific community.
- 00:05:00 - 00:10:00
Johnson provides historical context about obesity, indicating a sharp rise since 1900. He notes the correlation between obesity, diabetes, hypertension, and other metabolic disorders, emphasizing the need to find underlying causes rather than solely relying on treatment advancements. He highlights the metabolic syndrome, a constellation of symptoms often accompanying obesity, such as systemic inflammation and high uric acid.
- 00:10:00 - 00:15:00
While past theories suggested obesity results from overconsumption and inactivity, Johnson points out that some animals purposefully gain weight for survival, indicating a controlled mechanism. This regulatory mechanism prompts animals to safely manage weight until specific conditions necessitate fat accumulation, such as survival during food shortages.
- 00:15:00 - 00:20:00
Johnson shifts focus to fructose, a sugar prevalent in fruits and significant historically and evolutionarily. He explains its connection to a biological switch in weight gain, proposing that fructose consumption disrupts energy balance, leading to increased fat storage. Historical animal studies showed metabolic changes parallel to human obesity when consuming fructose.
- 00:20:00 - 00:25:00
Beyond simple taste affinity, Johnson explores the metabolic effects of fructose, particularly in mice, observing obesity and metabolic syndrome features without taste influence. He hypothesizes fructose metabolism, rather than taste, triggers these effects, thereby suggesting that a metabolic pathway is responsible for increased fat storage and reduced energy expenditure.
- 00:25:00 - 00:30:00
Johnson delves into fructose metabolism, discussing its unique effects on the body. He details a non-caloric pathway linked to uric acid production, contributing to energy imbalance by decreasing ATP levels, driving hunger and fat storage. The uric acid produced by fructose metabolism impacts cellular energy, simulating starvation states that push weight gain.
- 00:30:00 - 00:35:00
Johnson presents a thrifty gene hypothesis, noting historical mutations affecting uric acid breakdown, increasing sensitivity to fructose. These genetic changes, beneficial for survival during past famines, now lead to heightened obesity and diabetes risk, due to elevated uric acid levels. As fructose intake has increased, these inherited traits have become detrimental.
- 00:35:00 - 00:43:18
Johnson concludes that while fructose from added sugars is a primary factor in obesity, natural fruits pose minimal risk due to their composition. He promises future discussions on endogenous fructose production mechanisms. Despite the genetic predisposition, he emphasizes that lifestyle changes could mitigate disease risks associated with fructose consumption.
思维导图
常见问题
What is the main topic of Dr. Rick Johnson's presentation?
The main topic is a biologic switch Dr. Rick Johnson believes drives obesity, its discovery, and implications for diseases beyond obesity and diabetes.
What book is Dr. Rick Johnson's talk based on?
Dr. Rick Johnson's talk is based on his book "Nature Wants Us to Be Fat."
What potential diseases beyond obesity and diabetes does the switch affect?
Beyond obesity and diabetes, the switch may affect diseases like cancer and dementia.
What historical perspective does Dr. Johnson discuss related to obesity?
He discusses how obesity began around 1900 and aligns with the increase of sugar consumption and mutations that occurred millions of years ago.
What is the role of uric acid in obesity according to Dr. Johnson?
Uric acid is associated with the biologic switch that promotes obesity by affecting energy levels in cells and driving insulin resistance.
Why are humans more sensitive to fructose?
Humans are more sensitive to fructose due to a mutation that occurred millions of years ago, which affects the breakdown of uric acid.
How does Dr. Johnson relate fructose to obesity?
Dr. Johnson relates fructose to obesity by explaining it activates a switch causing the body to gain weight through various metabolic pathways.
How do animals use fructose differently from humans?
Animals use fructose to store fat as a survival mechanism during food scarcity, whereas humans today consume it in excess, leading to obesity.
Will there be more discussions on this topic?
Yes, future talks will discuss foods that activate the switch and how it relates to other diseases.
How is insulin resistance a survival response?
Insulin resistance allows more glucose to remain in the blood for critical organs like the brain during food shortages.
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Lecture 01: Vectors in Machine Learning
- 00:00:01[Music]
- 00:00:07[Music]
- 00:00:13hello i'm dr rick johnson uh i'm a
- 00:00:16professor of medicine at the university
- 00:00:18of colorado i see patients
- 00:00:20but i've also been doing research for
- 00:00:22almost 40 years
- 00:00:24trying to figure out the cause of
- 00:00:26obesity and diabetes
- 00:00:29today i'm going to present to you a very
- 00:00:31exciting story
- 00:00:33uh about a biologic switch that i
- 00:00:35believe is the underlying mechanism
- 00:00:37driving obesity today
- 00:00:40and this talk i'm going to talk about
- 00:00:42the discovery of the switch
- 00:00:44in the next talk i'll talk about foods
- 00:00:47that activate the switch
- 00:00:48and on the third talk i will talk about
- 00:00:51how it affects diseases beyond obesity
- 00:00:54and diabetes including conditions like
- 00:00:56cancer and dementia
- 00:00:59the the talks are basically based on uh
- 00:01:02related to my book
- 00:01:03called nature wants us to be fat right
- 00:01:06here
- 00:01:07uh and um i i'm looking forward to to
- 00:01:12starting and telling you about this
- 00:01:13story
- 00:01:14so the first thing just to give a
- 00:01:16disclosure
- 00:01:18i do
- 00:01:20have a small company that i have
- 00:01:23started to try to make inhibitors to
- 00:01:25block this pathway it is not with the
- 00:01:28purpose to make money it's the purpose
- 00:01:30to take my science and the science we
- 00:01:32discovered to the clinic because i
- 00:01:35believe it can actually hopefully help
- 00:01:37save millions of people in the long run
- 00:01:40i also should say that although the
- 00:01:42research is very strong and published in
- 00:01:44the top journals uh it is not
- 00:01:46universally agreed to others
- 00:01:49and uh you know we'll have to
- 00:01:52see how science uh you know
- 00:01:55validates or not uh the work that uh
- 00:01:58that i present but it's a very strong
- 00:02:01data and i think that uh it's very well
- 00:02:03worthy of uh presenting to you
- 00:02:07so uh we call this nature wants us to be
- 00:02:10fat part one
- 00:02:12so the very first thing to be aware of
- 00:02:14is that you know everyone knows we're in
- 00:02:16an epidemic of obesity and diabetes uh
- 00:02:19but you know
- 00:02:20it really began around 1900
- 00:02:23and about that time about 1 in 30 people
- 00:02:26were overweight or obese
- 00:02:28and approximately
- 00:02:301 in 50 000 were diabetic today it's
- 00:02:34like 12 percent are diabetic like 30 are
- 00:02:37obese
- 00:02:38hypertension now affects 30 percent of
- 00:02:41our population
- 00:02:42uh chronic kidneys is very common
- 00:02:45uh heart disease is the number one cause
- 00:02:48of death i mean it was rare back in 1900
- 00:02:51for coronary artery disease
- 00:02:54so we've seen a dramatic increase in
- 00:02:57these diseases and while we've developed
- 00:03:00great ways to manage and treat these
- 00:03:02diseases and you know and
- 00:03:05surgeries and stents and thrombolytic
- 00:03:08therapies and all these different types
- 00:03:10of treatment it would be a lot better if
- 00:03:12we could figure out the cause so that we
- 00:03:15could actually prevent these diseases
- 00:03:17from happening
- 00:03:20well one of the things we do know is
- 00:03:22that people with obesity
- 00:03:24often have a constellation of findings
- 00:03:26they don't just have
- 00:03:28being overweight they'll be pre-diabetic
- 00:03:31where their blood glucose will be
- 00:03:33slightly elevated they'll have mildly
- 00:03:35elevated blood pressure they'll have
- 00:03:38increased fats not just in their tissues
- 00:03:40what we call adipose tissue but also in
- 00:03:43their blood and their liver and other
- 00:03:45sites
- 00:03:46they'll
- 00:03:47have
- 00:03:50some evidence of systemic inflammation
- 00:03:52and another particularly interesting
- 00:03:54finding is that many of them will have a
- 00:03:56high
- 00:03:57uric acid in their blood and uric acid
- 00:04:00is present in everybody it's kind of a
- 00:04:02breakdown product from
- 00:04:04uh you know nucleic acids and dna
- 00:04:07and we we make this stuff and then we
- 00:04:09excrete it but it seems to be high in
- 00:04:13patients with obesity and metabolic
- 00:04:15syndrome and it can cause a disease
- 00:04:17called gout where you get this arthritis
- 00:04:20that affects typically the big toe
- 00:04:24anyway so obesity metabolic syndrome is
- 00:04:27the
- 00:04:28name for this constellation of science
- 00:04:30and the bad part is that if you're
- 00:04:32pre-diabetic it increases your risk
- 00:04:34become diabetic if you have elevated
- 00:04:36blood pressure it increases your risk to
- 00:04:37become hypertensive if you're overweight
- 00:04:40it increases your risk to become obese
- 00:04:43you know etc etc you have mild kidney
- 00:04:45disease with
- 00:04:46early on and then you can develop kidney
- 00:04:48disease as you get older and all these
- 00:04:50add up to increase risk for stroke and
- 00:04:53heart disease and so forth so it's one
- 00:04:56kind of related problem some people
- 00:04:59present more with the fatty liver others
- 00:05:01present more with the diabetes but it's
- 00:05:04all part of one syndrome
- 00:05:06so that means that there could be
- 00:05:08a central mechanism driving it all
- 00:05:12now
- 00:05:13a lot of people think that what's
- 00:05:14driving it all is is being overweight
- 00:05:17and obese and that it's really simple
- 00:05:19that it's we're eating the wrong foods
- 00:05:21we're we're watching too much tv and
- 00:05:24activity leads to weight gain
- 00:05:26you know and so that you know one of the
- 00:05:29most classic hypotheses was was
- 00:05:33uh presented by uh elliott joslin way
- 00:05:36back in the 1930s and he said you know
- 00:05:39it's sort of obvious people are eating
- 00:05:41too much they're exercising too little
- 00:05:43this we learned about in physics it's
- 00:05:46called the law of thermodynamics too
- 00:05:47much in too little out and you have to
- 00:05:50store the extra as fat
- 00:05:53and so if we're eating too many calories
- 00:05:55and we're exercising too little that's
- 00:05:57it and you know what you should do
- 00:05:59exercise you know what you should do
- 00:06:01reduce your food intake it should be
- 00:06:03easy
- 00:06:04but it isn't easy and you and i both
- 00:06:06know it
- 00:06:07you can't yes you can lose weight by you
- 00:06:09know exercising and eating less but
- 00:06:12there's something that seems to drive us
- 00:06:14to become obese again when we were young
- 00:06:16and
- 00:06:17uh 18
- 00:06:19and 20 years old you know it seemed like
- 00:06:21for many of us that we were invincible
- 00:06:23we could eat anything we want we could
- 00:06:25do anything we wanted to do didn't
- 00:06:27matter we weren't going to gain weight
- 00:06:28but something changed we call it our
- 00:06:31metabolism has changed you know where
- 00:06:33now as we get older suddenly it's easier
- 00:06:35to gain weight but why is that what's
- 00:06:38driving it what's activating this
- 00:06:40biologic process
- 00:06:42that causes waking
- 00:06:45so we were very interested in this and
- 00:06:48uh we approached it multiple ways i i
- 00:06:51wanted to not just do classic research
- 00:06:53but i wanted i reviewed history and
- 00:06:55archaeology and i wanted to think
- 00:06:57outside the box
- 00:06:58and i began to realize that maybe one
- 00:07:00way to think about this is not to think
- 00:07:02about obesity as a disease or as a
- 00:07:04condition that's bad
- 00:07:06because some animals in the wild
- 00:07:08actually intentionally become obese
- 00:07:11it's like something good and if we could
- 00:07:13understand what it was how it was being
- 00:07:17good and what was driving it and how
- 00:07:19they were how animals turn it on to
- 00:07:21become obese then it could be a solution
- 00:07:24it could be an answer
- 00:07:26for why we're becoming
- 00:07:28obese so the first thing to know is that
- 00:07:31animals actually regulate their weight
- 00:07:33really well they eat too much one day
- 00:07:35low eat less the next they keep their
- 00:07:37weight stable if you over
- 00:07:39feed them or if you fast them your
- 00:07:42weights will change but then when you
- 00:07:43stop that they'll go right back to the
- 00:07:45weight and not just their normal weight
- 00:07:48their normal weight for that time of the
- 00:07:50year it's very really interesting so
- 00:07:52weight is normally tightly regulated
- 00:07:55normally
- 00:07:57but there are some animals that will
- 00:08:00intentionally gain weight and so they'll
- 00:08:02maintain their normal weight nine months
- 00:08:04a year and then you know a few months
- 00:08:06before winter
- 00:08:07suddenly they start preparing for for
- 00:08:11winter and they start eating a lot like
- 00:08:13the bear the hibernating ground squirrel
- 00:08:15suddenly they they go from being tightly
- 00:08:18regulated to one where they're
- 00:08:20dramatically eating more gaining fat and
- 00:08:23so forth and and the same thing's true
- 00:08:25for birds that have to fly long
- 00:08:27distances or birds that have to nest for
- 00:08:29several months they'll put on all this
- 00:08:32weight and the weight the fat actually
- 00:08:35provides a caloric source
- 00:08:38it's like a type of calorie they can use
- 00:08:40when there's no food around
- 00:08:42because when they break down the fat
- 00:08:44it's basically a type of stored energy
- 00:08:46and they will release energy that they
- 00:08:48can use and everything's about energy
- 00:08:52well it's not just the calories and the
- 00:08:54energy that's produced uh when you burn
- 00:08:57fat you also produce water and for some
- 00:09:00animals in the world that you know
- 00:09:01they're really water is kind of a
- 00:09:03critical thing and so if you like living
- 00:09:05in the desert it's it's good to have a
- 00:09:07little extra fat on board because when
- 00:09:09you burn the fat you produce water
- 00:09:11that's why the camel has a hump on its
- 00:09:13back that's why some of these
- 00:09:15fat
- 00:09:16tailed animals
- 00:09:18you know like the fat tail lemur
- 00:09:21when it when it hibernates they call it
- 00:09:23estivation in the summer but when they
- 00:09:25hibernate they're burning the fat in
- 00:09:27their tail to provide water to get
- 00:09:29through the dry season and whales they
- 00:09:32they don't drink seawater that's too
- 00:09:34salty for them so they get their water
- 00:09:36from food and some of it from the fat
- 00:09:38they have and they are fat
- 00:09:41all right
- 00:09:42so
- 00:09:43uh so in the wild
- 00:09:45fat is a good thing it fat can keep you
- 00:09:47alive fat can is a mechanism to help you
- 00:09:50survive when there's no food and no
- 00:09:52water
- 00:09:54but it isn't
- 00:09:55when these animals become fat it isn't
- 00:09:57just they become fat
- 00:09:59they actually develop all those features
- 00:10:01of metabolic syndrome that we were
- 00:10:03talking about
- 00:10:04that we get
- 00:10:05they become insulin resistant they raise
- 00:10:07their blood pressure
- 00:10:09they increase the fat in their liver
- 00:10:11they increase the fat in their blood
- 00:10:14they they do all these different things
- 00:10:16that we that we see in people with
- 00:10:18metabolic syndrome it's like uh an
- 00:10:21orchestra
- 00:10:22it's like uh it's like uh
- 00:10:25you know there's it isn't just about one
- 00:10:26guy i'm gonna increase the fat in you
- 00:10:29it's you know the guy's saying i'm going
- 00:10:31to make you insulin resistant i'm going
- 00:10:33to raise your blood pressure i'm going
- 00:10:34to give you some systemic inflammation
- 00:10:37it's a survival response it's an
- 00:10:39orchestrated response which suggests
- 00:10:42that there may be one driving cause
- 00:10:45now you may say well how is insulin
- 00:10:48resistance part of a survival response
- 00:10:50but the way it is
- 00:10:52is that normally
- 00:10:54a lot of our tissues like glucose
- 00:10:56glucose is the main carbohydrate in our
- 00:10:59blood that we use
- 00:11:01as a fuel so yeah we use fat as a fuel
- 00:11:04but in terms of carbohydrates we use
- 00:11:06glucose as our primary go-to fuel and
- 00:11:09it's used a lot by the brain it's used
- 00:11:11in tissues like the muscle but
- 00:11:13interestingly it requires a hormone of
- 00:11:16insulin to move the glucose from the
- 00:11:19blood into the muscle
- 00:11:21but there's less need for insulin in the
- 00:11:23brain the brain you know a lot of the
- 00:11:25brain can use glucose without insulin so
- 00:11:28when you become insulin resistant
- 00:11:30there's less glucose going to the muscle
- 00:11:32so there's more glucose that can go to
- 00:11:34the brain basically it allows the
- 00:11:37glucose to build up in the blood
- 00:11:39so there's more for the brain and and
- 00:11:41that is a good thing if you're if
- 00:11:42there's a food shortage you want to
- 00:11:44preserve the glucose you have
- 00:11:47for the organs that count and when it
- 00:11:50comes to survival the brain is the key
- 00:11:52okay it isn't the heart of the muscle
- 00:11:54the kidneys i'm a kidney doc but it's
- 00:11:57not none of those it's the brain you've
- 00:11:58got to be able to think if you're going
- 00:12:00to survive
- 00:12:01so what triggers this survival response
- 00:12:04well for sure we we've already known
- 00:12:06this for for some time that many animals
- 00:12:09will use fruit as a mechanism to to
- 00:12:12start increasing their fat
- 00:12:15and this was this is known that the bear
- 00:12:17for example can eat ten thousand grapes
- 00:12:19in a day in the fall and it goes from
- 00:12:21kind of tightly regulating its way to
- 00:12:23gaining eight to ten pounds a day
- 00:12:26you know birds will switch from insects
- 00:12:28more towards fruit in the fall they use
- 00:12:30the fruit to increase their fat there's
- 00:12:32even fish that eat fruit fallen from
- 00:12:36trees into the river like on the amazon
- 00:12:38when it floods and they use that fruit
- 00:12:40to build up their fat stores so that
- 00:12:43they can make it through when the river
- 00:12:44contracts and there's less food around
- 00:12:47and there's primates like the
- 00:12:49the orangutan loves fruit and will sit
- 00:12:51in a fruit in a tree and eat fruit all
- 00:12:55day long and so it's eating huge amounts
- 00:12:57of fruit getting a lot of this so what
- 00:12:59are they getting well you have to know
- 00:13:01that the main nutrient in fruit is
- 00:13:04fructose
- 00:13:05and that's a sugar it's sort of like
- 00:13:06glucose it's distinct from glucose it's
- 00:13:09much sweeter in fact if you take glucose
- 00:13:12and you give it to a person it's just
- 00:13:13very lightly sweet
- 00:13:15they people tend to like it but they
- 00:13:17don't love it and so what they what
- 00:13:20we've discovered is that when fructose
- 00:13:22and glucose are together
- 00:13:23then suddenly you have something that
- 00:13:25people love and that was the discovery
- 00:13:28of sugar
- 00:13:29table sugar sucrose which is a fructose
- 00:13:32and glucose molecule bound together and
- 00:13:34then in the 70s they discovered that
- 00:13:37they could make a sweetener from corn
- 00:13:39called high fructose corn syrup which is
- 00:13:41a mixture of fructose and glucose
- 00:13:43and then of course there's what we call
- 00:13:46hey those high carb foods like potatoes
- 00:13:48and rice and and they they don't they
- 00:13:51have starch they don't have sugar so
- 00:13:53they don't have fructose in them but uh
- 00:13:55what happens is these foods have a lot
- 00:13:58of starch and they break down to glucose
- 00:14:00and as we'll learn in lecture two
- 00:14:02unfortunately these foods can
- 00:14:05can also have a role in causing obesity
- 00:14:08and it's gonna be through the same
- 00:14:10pathway but we're gonna hold off on that
- 00:14:12for now and just move on with now that
- 00:14:16we know that the fruits that these
- 00:14:17animals eat contains fructose so the
- 00:14:20question was could fructose be
- 00:14:23a nutrient that activates the switch
- 00:14:25that makes you want to gain fat could
- 00:14:26that be the driver of the biologic
- 00:14:29switch so we took mice lab mice we put
- 00:14:32fructose in the drinking water and by
- 00:14:34god they loved the drinking water they
- 00:14:36were drinking a lot for the first couple
- 00:14:38weeks they held their weight stable
- 00:14:40because they were still regulating their
- 00:14:42weight and then something changed
- 00:14:45and they suddenly lost their control of
- 00:14:48appetite and they start eating more and
- 00:14:49more they exercise less and less they
- 00:14:52become less active especially when
- 00:14:53they're not
- 00:14:55you know what we call resting activity
- 00:14:57metabolism dropped and what happened was
- 00:15:00they became fat
- 00:15:01so the
- 00:15:03the equation was the same they're eating
- 00:15:04too much they're exercising too little
- 00:15:06but it's being driven
- 00:15:08not by
- 00:15:09a desire
- 00:15:11it's i mean it's not being driven by
- 00:15:14behaviors it's actually a special food
- 00:15:16you give them this food and suddenly
- 00:15:18they start eating more
- 00:15:22so what is it about the food is it the
- 00:15:24taste for example or is it the
- 00:15:26metabolism you know what is it that
- 00:15:28makes fructose cause this syndrome
- 00:15:32and so what we did was we took mice that
- 00:15:35couldn't taste let's just see if it's
- 00:15:37taste
- 00:15:38and so we took mice that were that had
- 00:15:40lost their taste because of a genetic
- 00:15:42manipulation and then we offer them
- 00:15:45fructose or water and you know normally
- 00:15:48uh if you if they have two bottles to
- 00:15:50choose from and they're they both
- 00:15:52contain water
- 00:15:53they'll take the water evenly they'll
- 00:15:55take about half of it from this bottle
- 00:15:57half from that bottle and you can switch
- 00:16:00the bottles and you know nothing happens
- 00:16:01but if you give them sugar water or
- 00:16:04fructose water and drinking water
- 00:16:07normally animals will take about eighty
- 00:16:09percent of their of their fluid from the
- 00:16:11sugar
- 00:16:12and twenty percent from the drinking
- 00:16:14water so they'll drink some sugar water
- 00:16:16and but they'll drink about four times
- 00:16:18more
- 00:16:19and you know if they can't taste you
- 00:16:21would think that they wouldn't care
- 00:16:23but guess what
- 00:16:25a master can't taste can still figure
- 00:16:27out where the sugar is and it will take
- 00:16:30the sugar water just like it will
- 00:16:32uh a normal mouse except that
- 00:16:35overall it takes less sugar
- 00:16:37but the preference is the same it's it
- 00:16:40still takes about four times
- 00:16:42for every for if you if they have their
- 00:16:45choice they're going to go to the sugar
- 00:16:46water four times more even if the total
- 00:16:49amount of sugar they eat will be less so
- 00:16:50the taste is there to encourage you to
- 00:16:53to find the foods that are sweet
- 00:16:56and it they probably encourage a little
- 00:16:58bit more intake but it's actually uh
- 00:17:01doesn't affect your desire for it so the
- 00:17:04desire
- 00:17:05for sugar water
- 00:17:07is independent of taste
- 00:17:09and they will still get fat
- 00:17:12if you give them sugar water
- 00:17:14they still get fat even though they
- 00:17:15can't taste it
- 00:17:17amazing
- 00:17:20now
- 00:17:20if you block their ability to metabolize
- 00:17:23fructose and we can do that by blocking
- 00:17:25the enzyme i call that enzyme khk and
- 00:17:29when you block it we call it a knockout
- 00:17:31so uh so these these mice can't
- 00:17:34metabolize fructose well when you can't
- 00:17:35metabolize fructose guess what they
- 00:17:38don't care for for the for fructose
- 00:17:40anymore and they don't get obese even
- 00:17:42when you force them to eat the same
- 00:17:44amount
- 00:17:45so there's something about fructose
- 00:17:48that's making them
- 00:17:50want to
- 00:17:51they crave it even though they can't
- 00:17:53taste it
- 00:17:54and they will get fat from it even if
- 00:17:57they can't taste it and it's something
- 00:17:58to do with the metabolism of fructose so
- 00:18:01let's figure out how that works
- 00:18:04why how does fructose work
- 00:18:06well
- 00:18:07you know and and is it from is it all
- 00:18:10from calories because i'm sure you guys
- 00:18:12have heard hey you know
- 00:18:15it isn't just calories i mean if it were
- 00:18:16just calories then why would a low-carb
- 00:18:18diet be so much better than a low-fat
- 00:18:21diet and we know that low-carb diets
- 00:18:23really are better right that's why
- 00:18:25you're watching this show
- 00:18:28because low-carb diets do work so the
- 00:18:30question is what what is it
- 00:18:32is it more it's got to be more than
- 00:18:34calories well it is more than calories
- 00:18:36but let's let's do this scientifically
- 00:18:38let's try to figure it out so one way to
- 00:18:40figure it out is you take animals
- 00:18:43and you feed them the exact same number
- 00:18:44of calories you can get sugar and you
- 00:18:47can get fat or you can you know fat in
- 00:18:50your diet or you can get um fructose and
- 00:18:53you and we're going to not give you
- 00:18:54fructose so we take this big
- 00:18:57all these rats and we say you guys are
- 00:19:00all going to eat the same amount but of
- 00:19:01course we can't really tell them
- 00:19:03you know you're going to eat only x
- 00:19:05amount so we have to serve them the same
- 00:19:08amount of food but it what happens is to
- 00:19:11do this right
- 00:19:12after you if you serve them all the same
- 00:19:14amount of food there's always one guy
- 00:19:15that eats less than the others right
- 00:19:17so if you really want to do it right you
- 00:19:19have to feed them all the same amount as
- 00:19:21the guy that gets the least so basically
- 00:19:24all the animals end up eating the same
- 00:19:26amount as the guy who eats the least now
- 00:19:28when we did this experiment we did this
- 00:19:29multiple times but one time we did the
- 00:19:31experiment where one one of the poor
- 00:19:33guys had cancer so he was eating much
- 00:19:36less so that experiment's really
- 00:19:38interesting because they're all eating
- 00:19:39less than they normally eat so guess
- 00:19:42what if you're going to put you on a
- 00:19:44diet but one one group gets
- 00:19:46high sugar or fructose and sugar
- 00:19:49and the other group doesn't get a
- 00:19:51fructose contains sugar what do you
- 00:19:52think happens
- 00:19:54well
- 00:19:56when you when you can't eat all that
- 00:19:57extra food even though you're hungry
- 00:20:00you're not going to gain as much weight
- 00:20:02because you're just not eating as much
- 00:20:03food
- 00:20:04but you'll still gain a little weight
- 00:20:06because you're you're you're reducing
- 00:20:08your your metabolism as well so when
- 00:20:11when you activate this switch
- 00:20:13you eat more but you uh have your
- 00:20:15resting energy metabolism goes down and
- 00:20:17so boom the animals got the sugar which
- 00:20:20i here's
- 00:20:22sucrose which is glucose and fructose
- 00:20:24they actually gained a little weight
- 00:20:25even though they're on the diet
- 00:20:27so they were able to conserve their
- 00:20:30energy
- 00:20:31enough so that they actually gained
- 00:20:32weight even though they were eating less
- 00:20:34than they normally eat the control
- 00:20:36animals of course lost weight
- 00:20:39but it was just very small amounts so i
- 00:20:41mean one could argue that it wasn't
- 00:20:43really significant
- 00:20:44but what was significant was even though
- 00:20:47they're eat you know the differences in
- 00:20:50weight are almost zero
- 00:20:52or very minor
- 00:20:54we're seeing huge differences in in
- 00:20:56metabolism in the body so the animals
- 00:20:59that got sugar got fatty liver they got
- 00:21:01diabetic they developed hypertensive
- 00:21:04i mean that you know it was a very
- 00:21:05significant issues and so even when
- 00:21:09calories are the same there's something
- 00:21:11special about fructose it isn't
- 00:21:14just making you eat more it is
- 00:21:17poisoning your system where you're
- 00:21:18developing diabetes and fatty liver and
- 00:21:22all those things and you can do it even
- 00:21:24when you're on a diet if you're eating a
- 00:21:27high sugar
- 00:21:28diet so what is it about
- 00:21:31how does that work
- 00:21:33how does what's the chemistry now this
- 00:21:36forgive me we're going to go two or
- 00:21:38three slides deep into chemistry but
- 00:21:40it's it's not going to be super deep but
- 00:21:42here it is when you eat fructose it's
- 00:21:45like all nutrients you use it to make
- 00:21:47energy you eat
- 00:21:49calories to make energy
- 00:21:52and we make energy that is either
- 00:21:54immediate energy
- 00:21:55which is the atp that makes me want to
- 00:21:58be able to do everything you want or we
- 00:22:00store it as energy which is what we call
- 00:22:03as fat
- 00:22:04and this is in
- 00:22:05normal calories do this
- 00:22:08but fructose is unique because what it
- 00:22:10does is it has a side path
- 00:22:14where it generates uric acid inside the
- 00:22:17cell and i call it a non-caloric pathway
- 00:22:20because it you can
- 00:22:22you can activate that pathway even
- 00:22:23without when you block the caloric
- 00:22:26pathway
- 00:22:27and yet when you do that
- 00:22:29you activate the switch so the switch
- 00:22:32turns out to be associated with this
- 00:22:34non-caloric pathway unique to fructose
- 00:22:38and what that does is it generates uric
- 00:22:40acid inside the cell uric acid goes up
- 00:22:44uh
- 00:22:44in the blood
- 00:22:46and it activates the switch and if you
- 00:22:48lower uric acid in these animals and
- 00:22:51that's all you do
- 00:22:52you can actually affect the ability to
- 00:22:55raise blood pressure to increase their
- 00:22:57weight increase their triglycerides so
- 00:22:59there's an association
- 00:23:01there's an
- 00:23:03a relationship where uric acid being
- 00:23:05produced inside the cell is triggering
- 00:23:09this switch and how does it do it well
- 00:23:11here's the complicated slide
- 00:23:14basically what it does is it helps reset
- 00:23:17the energy in the cell to a lower energy
- 00:23:20so with remember energy is atp
- 00:23:24and then there's a stored energy which
- 00:23:26is fat
- 00:23:27so if if the way fructose works is it
- 00:23:30makes the energy level or the atp level
- 00:23:34low
- 00:23:35because it tends to shunt more of the
- 00:23:37calories to fat
- 00:23:39so with when the atp levels go low it
- 00:23:42sort of
- 00:23:42activates an alarm it makes you want to
- 00:23:44eat more forage for food and activate
- 00:23:47the switch and the the actual way it
- 00:23:50works is like a series of really cool
- 00:23:52reactions so when fructose
- 00:23:55initially
- 00:23:56metabolizes it consumes
- 00:23:59some of the atp and all foods consume
- 00:24:02energy when they're being made but
- 00:24:04fructose is unique because it consumes
- 00:24:06it so rapidly that there's a fall
- 00:24:08of energy in the cell normally energy
- 00:24:11doesn't fall in the cell it's just
- 00:24:13maintained at a very high level but
- 00:24:15fructose triggers this drop in energy
- 00:24:18that then
- 00:24:19activates an enzyme that removes the amp
- 00:24:22amp is what's used to reconstitute atp
- 00:24:26so when you make amp then you can make
- 00:24:28it back to atp but this guy's like the
- 00:24:31giant sweeper and it sweeps away the amp
- 00:24:34to make uric acid and then the uric acid
- 00:24:36goes and stuns the energy factories
- 00:24:38where atp is made reducing the atp
- 00:24:42production by put blocking what we call
- 00:24:45the krebs cycle and fatty acid oxidation
- 00:24:47and all these things you don't really
- 00:24:48want to hear about and then it blocks
- 00:24:51the regeneration of atp in a low energy
- 00:24:54state
- 00:24:55by blocking this this great enzyme
- 00:24:57called ap
- 00:24:58amp kinase and the result is atp levels
- 00:25:01fall
- 00:25:02alarm signal
- 00:25:04it makes the animal feel like it doesn't
- 00:25:06have enough food because there's not the
- 00:25:08energy is down but actually it does it's
- 00:25:10just stored fat and the stored fat can't
- 00:25:14be released into regular fat because
- 00:25:16it's blocking that
- 00:25:18so the fructose blocks the
- 00:25:20ability of the fat to be
- 00:25:22uh to be broken down to generate energy
- 00:25:25so the animal feels that it's in a low
- 00:25:28energy state it feels like it's starving
- 00:25:30and guess what it wants to do eat it
- 00:25:32wants to eat it wants to increase its
- 00:25:34fat stores it's perfect it's a way to
- 00:25:37increase fat in an animal that already
- 00:25:38has fat because it tricks the system
- 00:25:42into thinking that's that you're in a
- 00:25:43low energy state and it puts you in a
- 00:25:46low energy state
- 00:25:48and what does that mean well again the
- 00:25:50uric acid goes into these energy
- 00:25:52factories called mitochondria and it
- 00:25:55blocks the production of atp
- 00:25:58and that leads to the stimulation and
- 00:26:00of fat as a stored energy and and the
- 00:26:03dropped atp leads to fatigue and being
- 00:26:06tired and now you've got it you're
- 00:26:09you're slower so you're spending less
- 00:26:12energy
- 00:26:13you're fatter you're putting weight on
- 00:26:15you're hungry
- 00:26:16it's making you fat and tired
- 00:26:19not great but it's really good if you've
- 00:26:21got to survive a period of time where
- 00:26:23there's no food around
- 00:26:26all right so so that's how the pathway
- 00:26:29works but there's a there's another side
- 00:26:31to it and the other side to it is that
- 00:26:33we humans you and me
- 00:26:36are much more sensitive to fructose than
- 00:26:39most animals and that's because of
- 00:26:41something that went wrong a long time
- 00:26:43ago so this pathway was meant to save
- 00:26:46our lives and guess what it did
- 00:26:49but the consequences
- 00:26:51of that is it made us more sensitive
- 00:26:54to sugar and here's how it worked
- 00:26:56so there's there's a famous scientist
- 00:26:58named james neal
- 00:27:00back in the 1950s he came up with this
- 00:27:02idea when he was studying
- 00:27:05natives in different environments
- 00:27:07he said you know maybe the reason
- 00:27:09obesity and diabetes are happening today
- 00:27:12is because we
- 00:27:14inherited or got mutations
- 00:27:17that
- 00:27:18affected our ability to survive in our
- 00:27:20past when things were really bad so if
- 00:27:22there was a famine
- 00:27:24maybe we had a mutation that allowed us
- 00:27:26to help survive the famine but it's
- 00:27:28increasing our risk for obesity today
- 00:27:30now that there's a lot of food and this
- 00:27:32thing got called the thrifty gene
- 00:27:34hypothesis it was really
- 00:27:37this great idea that maybe we are more
- 00:27:40the reason we're becoming obese and
- 00:27:42diabetes are diabetic is because of
- 00:27:44something that happened in our past
- 00:27:46well i told you the importance of uric
- 00:27:49acid and driving this whole process
- 00:27:52and it's interesting humans have much
- 00:27:54higher uric acids than almost all other
- 00:27:57mammals so why
- 00:27:58is it that we have these high uric acids
- 00:28:01and guess what it was from a mutation a
- 00:28:03mutation that occurred millions of years
- 00:28:05ago that affected our ability to degrade
- 00:28:08uric acid
- 00:28:09so normally uric acid is like produced
- 00:28:12when you eat foods you you can make uric
- 00:28:14acid it's also produced when energy
- 00:28:17turns around like atp
- 00:28:19well like as we talked and we always
- 00:28:21have some uric acid in our blood
- 00:28:24normally there's an enzyme most animals
- 00:28:26have an enzyme that degrades it we lost
- 00:28:28that enzyme so when it we make it it's
- 00:28:31harder to get
- 00:28:32to to lower it because we can't break it
- 00:28:35down so we have to excrete it through
- 00:28:36our kidneys our gut and as a result we
- 00:28:40can't do that as well as just breaking
- 00:28:42it down and so we end up with higher
- 00:28:44uric acid levels than most other animals
- 00:28:47now why would we want that so
- 00:28:49and and was it an advantage well when we
- 00:28:52when when we look at the history of this
- 00:28:55mutation we see that it actually
- 00:28:56occurred millions of years ago that it
- 00:28:59didn't just affect us it affected all
- 00:29:01the apes the great apes the lesser apes
- 00:29:03and humans so the this uh so it seemed
- 00:29:06to have hit an ancestor and it happened
- 00:29:10millions of years ago and the
- 00:29:11consequence of a high uric acid that the
- 00:29:13one that we best know is a disease
- 00:29:16called gout because when our uric acid
- 00:29:18gets really high it's pretty not very
- 00:29:20soluble and it crystallizes and it loves
- 00:29:23crystallizing joints causes this
- 00:29:25terrible painful joint disease called
- 00:29:28gout and it often hits the toe and these
- 00:29:31crystals deposit in the and they
- 00:29:34activate inflammation and it's hard to
- 00:29:36walk and it hurts like for several weeks
- 00:29:39until you finally get the pain under
- 00:29:40control and the inflammation under
- 00:29:42control and so why would we have a
- 00:29:44mutation that increases our risk for
- 00:29:47gout and what was happening to our
- 00:29:49ancestors millions of years ago
- 00:29:52so you had you know i i'm i love history
- 00:29:55so i went back started looking at what
- 00:29:57happened way back then and the first uh
- 00:30:00the first apes uh appeared in africa
- 00:30:02around 20 million years ago they were
- 00:30:04larger animals than the other monkeys
- 00:30:06and primates and these guys had big
- 00:30:09heads they were tailless they live in
- 00:30:10the trees and they ate mainly fruit they
- 00:30:13loved
- 00:30:15they loved fruit and so they were eating
- 00:30:17a high fructose diet so they were eating
- 00:30:20a lot of fructose and they were doing
- 00:30:22pretty well they actually
- 00:30:24were probably not eating
- 00:30:26they had this mutation they had your
- 00:30:28case way back then and so they were
- 00:30:31doing very well and then what happened
- 00:30:33was
- 00:30:35we had a change in temperature
- 00:30:38co2 levels fell and we had global
- 00:30:41cooling
- 00:30:42not global warming
- 00:30:44and as the co2 levels fell in the
- 00:30:47atmosphere
- 00:30:48the
- 00:30:49uh got cooler polar ice caps formed the
- 00:30:52sea levels fell and africa which had
- 00:30:55been pretty much uh separated from
- 00:30:57europe suddenly as the sea levels fell
- 00:31:00there were land bridges and the primates
- 00:31:03and apes and other animals entered
- 00:31:05europe
- 00:31:07now initially when the when the fruit uh
- 00:31:09when the uh
- 00:31:11apes arrived to europe there were there
- 00:31:13were plenty of fruit trees and they were
- 00:31:15able to live just the same way they did
- 00:31:17in africa but as it continued to cool
- 00:31:21the trees became a little bit more
- 00:31:23sparse and turned into woodlands instead
- 00:31:25of rainforests and and they became more
- 00:31:27deciduous and there became more uh open
- 00:31:29areas and savannas and these
- 00:31:33apes which were had been living in the
- 00:31:34trees they had to come out of the trees
- 00:31:36they had to forage more for food they
- 00:31:38couldn't find fruit
- 00:31:40all year long and especially during
- 00:31:42their cooler months there was less fruit
- 00:31:44available and so they started to starve
- 00:31:47and you can see signs of starvation by
- 00:31:49looking at the
- 00:31:50uh their teeth and and
- 00:31:53when when they're when an animal is
- 00:31:54starving they can't put the enamel down
- 00:31:56as well so they get these rings of of
- 00:31:59poor growth of enamel and we and these
- 00:32:02rings kind of look like tree rings and
- 00:32:04they're a sign of seasonal starvation
- 00:32:06these animals were starving
- 00:32:08um especially during the cooler months
- 00:32:10when there wasn't fruit available and
- 00:32:13when that happened these poor guys
- 00:32:16started to uh to to become extinct and
- 00:32:19they they retreated to little colonies
- 00:32:21and then around eight or ten million
- 00:32:23years ago there were no more apes in
- 00:32:25europe but in africa where it was wetter
- 00:32:28and uh
- 00:32:30was warmer uh the fruit trees were able
- 00:32:32to were present all year round so there
- 00:32:34wasn't really as as much of a survival
- 00:32:38uh
- 00:32:39problem there so the the the forest
- 00:32:42contracted but the apes were able to
- 00:32:44survive on their normal foods
- 00:32:48but it's interesting the fossil record
- 00:32:50suggests that our species and also the
- 00:32:53great apes and the lesser eaves were all
- 00:32:55seemed to be derided
- 00:32:57by the fossil record from the apes in
- 00:33:00europe not from the apes in africa in
- 00:33:02fact there's this thought that some of
- 00:33:04the european apes must have migrated
- 00:33:07back to africa to be the ancestors of
- 00:33:11humans and great apes and others may
- 00:33:13have migrated to southeast asia to be
- 00:33:16like the ancestor of the orangutan
- 00:33:22and so i thought this was really
- 00:33:24interesting and i flew to london to meet
- 00:33:26with dr peter andrews a famous uh
- 00:33:29anthropologist who studies these myocene
- 00:33:32apes these apes from this period 10 to
- 00:33:35you know 15 million years ago
- 00:33:38and i told them our hypothesis that you
- 00:33:41know that that this mutation had
- 00:33:43occurred that affected uric acid that
- 00:33:45uric acid is produced when you eat
- 00:33:47fructose which is what these animals
- 00:33:49were doing
- 00:33:50and how this mutation could there could
- 00:33:53potentially
- 00:33:54uh
- 00:33:55allow
- 00:33:56an animal to generate more fat
- 00:33:59from the same amount of fruit and that
- 00:34:01that might allow it to store more fat in
- 00:34:04a situation when there was less fruit
- 00:34:06available that would allow them to
- 00:34:08survive winter
- 00:34:09and then uh and and from that be able to
- 00:34:13to uh
- 00:34:15survive
- 00:34:18so uh he liked the idea we published the
- 00:34:20hypothesis but of course we needed data
- 00:34:23and one of the key experiments was done
- 00:34:25by our collaborator gabby sanchez lozada
- 00:34:28and what she did was she said okay
- 00:34:30you know laboratory rats have uricase
- 00:34:34and it's true you have to give them a
- 00:34:36large amount of fructose to get them to
- 00:34:38be fat what if i gave them a small
- 00:34:41amount of fructose but inhibited their
- 00:34:43uric ace could i still make them fat so
- 00:34:46she put them on very small amounts of
- 00:34:48soft drinks
- 00:34:49and then she inhibited uricase on top of
- 00:34:52it with or without and what she found
- 00:34:54was that when she inhibited uricase the
- 00:34:56uric acid levels were higher not
- 00:34:58surprisingly but so was the prediabetes
- 00:35:01the blood pressure the body weight the
- 00:35:04the increase in triglycerides
- 00:35:07the liver fat everything was enhanced it
- 00:35:09was exactly true
- 00:35:11we also even resurrected the extinct
- 00:35:14gene we resurrected the extinct uri-case
- 00:35:17gene
- 00:35:18and found that when we did so that we
- 00:35:20could
- 00:35:22that it could block the ability for
- 00:35:24fructose to make fat and that when we
- 00:35:25mutated it like we did that we could
- 00:35:28increase the fat response
- 00:35:30there's even some data that uric acid
- 00:35:32can be a survival factor
- 00:35:35for starving animals and
- 00:35:38way back in the 80s people found that if
- 00:35:40they gave uric acid injections to
- 00:35:43starving animals that it was similar to
- 00:35:44giving glucose and that it could help
- 00:35:46animals survive
- 00:35:48especially if they had troubles breaking
- 00:35:50down fat
- 00:35:52so what we know
- 00:35:54is that
- 00:35:56this urecase mutation
- 00:35:58uh was probably there to help uh help us
- 00:36:01survive when there wasn't a lot of
- 00:36:03fructose around and it enhanced our
- 00:36:05ability
- 00:36:06uh to make fat and to activate this for
- 00:36:09uh the survival path we then included
- 00:36:11foraging and blood pressure
- 00:36:13and brain fuel these were all
- 00:36:16uh things that uh that this mutation
- 00:36:19allowed us to do so it was a good guy
- 00:36:21but guess what
- 00:36:23today it's not a good guy and the reason
- 00:36:27is is is because of what's happened
- 00:36:29since uh
- 00:36:30that time 15 million years ago so when
- 00:36:33that mutation occurred it only raised
- 00:36:36the uric acid a little bit and the way
- 00:36:38we know that is because if we go and we
- 00:36:39study animals in the wild like the
- 00:36:41orangutan or the chimpanzee that had the
- 00:36:44mutation like us their uric acid levels
- 00:36:47are only around two or three
- 00:36:50and likewise i was able to
- 00:36:52get blood samples from the yanomami
- 00:36:54indians from actually the same
- 00:36:57expedition that james neal went on and
- 00:36:59we were able to show that the uric acid
- 00:37:01levels in the yanomami indians was
- 00:37:03around also around two or three so when
- 00:37:06the mutation occurred the uric acid
- 00:37:08levels up went up only a little bit to
- 00:37:10like the two or three range and that was
- 00:37:12enough to prevent us from starving
- 00:37:16but not enough to make us fat
- 00:37:18but then
- 00:37:20a new source of fructose cane and that
- 00:37:23new source
- 00:37:24came from sugar and the discovery of
- 00:37:26sugar cane in the ganges river valley
- 00:37:29around 500 bc
- 00:37:31led to suddenly a new sweetener that had
- 00:37:34a lot of fructose and that people liked
- 00:37:36and pretty soon diabetes and obesity
- 00:37:39were being uh reported even from that
- 00:37:41area and then the sugar got brought from
- 00:37:43india into persia and china and egypt
- 00:37:46and we start seeing reports of obesity
- 00:37:48and diabetes there around 500 bc 500 a.d
- 00:37:52for example and then it's brought in
- 00:37:54through venice during the middle ages
- 00:37:56and suddenly we start seeing obesity and
- 00:37:58diabetes among the people who could
- 00:38:00afford the sugar and it was very
- 00:38:03expensive so it was really just the
- 00:38:05royalty and the wealthy and in those
- 00:38:07days um if you were poor you were not at
- 00:38:10risk for obesity it was the wealthy who
- 00:38:13were and it was the wealthy who could
- 00:38:14afford sugar but then a sugar production
- 00:38:17increased both you know with the sugar
- 00:38:19plantations in the america
- 00:38:21with the
- 00:38:22uh advent of sugar beets
- 00:38:24you know and then in the 1970s with the
- 00:38:27with the production of high fructose
- 00:38:29corn syrup from from corn suddenly these
- 00:38:32sweeteners that have fructose in it are
- 00:38:35because are everywhere and they're being
- 00:38:37put in processed foods and they're being
- 00:38:39put in and today about 15 of our diet
- 00:38:43contains sugar and some people it's 25
- 00:38:46of our diet is sugars and added sugars
- 00:38:49that's a huge amount of sugars and 1700
- 00:38:53we're only eating four percent or four
- 00:38:55pounds of sugar
- 00:38:57uh a year and today we're eating you
- 00:38:59know 140 150 pounds of sugar a year
- 00:39:03all right and
- 00:39:05guess what now you got a lot of fructose
- 00:39:07and we're sensitive to fructose obesity
- 00:39:10and diabetes rates are soaring and they
- 00:39:12parallel the rise in sugar uric acid
- 00:39:15levels are soaring they're going up they
- 00:39:17were around only three to four
- 00:39:18milligrams
- 00:39:20remember of you know following the
- 00:39:22mutation but then with the advent of
- 00:39:24sugar and foods and beer and other
- 00:39:25things that can raise uric acid the uric
- 00:39:28acid levels continue to increase in our
- 00:39:30society and today about 20 million
- 00:39:32people in the u.s have uric acid levels
- 00:39:35of seven or higher and that's the level
- 00:39:37where you start seeing gout and so it's
- 00:39:40a real real problem
- 00:39:42and when you have gout guess what you
- 00:39:44see a lot of obesity you see a lot of
- 00:39:47diabetes you see a lot of kidney disease
- 00:39:49you see a lot of metabolic syndrome gout
- 00:39:51is the greatest risk factor
- 00:39:54for for all these these fee these
- 00:39:56diseases they they're all part of one
- 00:39:59syndrome
- 00:40:00and now if you look at uric acid levels
- 00:40:03and the frequency of obesity look
- 00:40:05you have a uric acid of 10 you have a
- 00:40:07huge chance of having obesity or
- 00:40:09diabetes
- 00:40:10it's it's amazing and you can see how it
- 00:40:13isn't just the mutation it's the
- 00:40:15mutation plus
- 00:40:17a food that's driving the obesity
- 00:40:19epidemic and it's true for kidney
- 00:40:21disease and it's true for hypertension
- 00:40:24and the higher the uric acid the greater
- 00:40:26the risk and even in people who have a
- 00:40:29high uric acid who have no other risk
- 00:40:31factors no obesity no diabetes no
- 00:40:33elevated triglycerides those people if
- 00:40:36you have a high uric acid you're at
- 00:40:38increased risk and this slide shows that
- 00:40:40you have an increased risk for obesity
- 00:40:41and hypertension and kidney disease and
- 00:40:44diabetes and fatty liver it's bad news
- 00:40:48it even predicts of course heart disease
- 00:40:50because when it's predicting all these
- 00:40:51different diseases it's going to also
- 00:40:53predict and gout in particular is
- 00:40:55associated with a higher risk for these
- 00:40:57diseases
- 00:40:59well what about fruit i mean
- 00:41:02you know i understand that fructose is
- 00:41:04is causing the obesity epidemic but
- 00:41:06we've been told fruits are good
- 00:41:08is fruit of comfort well the vast
- 00:41:11majority of fructose you're getting is
- 00:41:12from sugar it's from added sugars fruit
- 00:41:15makes up just a small amount and most
- 00:41:17fruits when we eat them we're only
- 00:41:19eating a small amount that and the fruit
- 00:41:21has
- 00:41:22only a limited amount of fructose when
- 00:41:24we're eating an individual fruit if
- 00:41:26you're a bear and you're eating 10 000
- 00:41:28berries you're gonna get fat okay if you
- 00:41:31had a bowl of grapes on the couch you're
- 00:41:33going to get fat that
- 00:41:35it adds up but if an individual fruit is
- 00:41:38not going to do it it's got fiber it's
- 00:41:39got vitamin c it's got potassium it's
- 00:41:41got a lot of things that block the
- 00:41:43effects of fructose
- 00:41:45and so you have to eat a fair amount
- 00:41:47especially ripe
- 00:41:48fruit and we tend to like tart fruit and
- 00:41:51what's more the intestine
- 00:41:53removes about the first four or five
- 00:41:55grams of fructose so that really helps
- 00:41:58out a lot too
- 00:41:59so natural fruits are good so in summary
- 00:42:02there is a biologic switch obesity is
- 00:42:05driven by a switch
- 00:42:07that switch
- 00:42:08is fructose and what the how the
- 00:42:10fructose works is it drops the energy in
- 00:42:13the cell
- 00:42:14creating a false sense of starvation
- 00:42:17and the major sources of fructose are
- 00:42:19sugar and high fructose corn syrup they
- 00:42:21make up the most and it's really liquid
- 00:42:24sugar that's the worst
- 00:42:26humans are more sensitive to fructose
- 00:42:28because they had a mutation in your case
- 00:42:3115 million years ago so we are more
- 00:42:33sensitive to sugar and we're eating a
- 00:42:35lot of it some people make it 25 of
- 00:42:38their diet and this is why we're
- 00:42:40developing obesity diabetes metabolic
- 00:42:42syndrome and all these diseases
- 00:42:44now i'm going to tell you a very bad
- 00:42:46surprise in the next lecture about how
- 00:42:48the body
- 00:42:49can also make fructose and how certain
- 00:42:52foods that don't contain sugar can still
- 00:42:54cause obesity so stay tuned thank you
- 00:42:57very much
- 00:42:58i want to do special thanks to my
- 00:43:00collaborators and and of course all this
- 00:43:03information is in my book nature wants
- 00:43:05us to be fat thank you very much
- 00:43:08[Music]
- 00:43:18you
- obesity
- fructose
- metabolism
- uric acid
- insulin resistance
- sugar
- historical diet
- disease prevention
- genetics
- energy metabolism