#368 The Key Driver of Chronic Disease That Nobody’s Talking About with David Perlmutter

Obesity, type two diabetes, fatty liver disease, high blood pressure, cardiovascular disease, strokes, and dementia are all chronic diseases underpinned by metabolic dysfunction, caused by our environment, lifestyle, and food choices. Uric acid levels, even slightly raised, can have damaging implications for our health. Food should be thought of as information, with every bite giving our body cues and signals. Fructose is a problematic food that leads to increased uric acid, driving fat storage, high blood sugar levels, high blood pressure, and insulin resistance. Better food choices can reduce uric acid levels and increase happiness, compassion, and empathy. The health of the brain and body is integrated and interdependent, and the modern lifestyle is often at odds with what serves our biology best.

Food is not just about macronutrients or micronutrients; it is also a source of information. Food is a powerful indicator to our bodies as to what we should be expecting and what is to come. While our body's hardwiring tells us to eat sweet foods as they are safe, nowadays, the toxic foods are sweet, which plays upon us. Therefore, it is essential to focus on changing our environmental part by taking out fructose from the human diet, which is now deeply in contrast to what our genome would best be served by. We need to remember that we are living with a paleolithic genome in a highly industrialized world, and this mismatch between our genome and environment can be detrimental to our whole physiology.

Our evolutionary past has cultivated behaviors in us that make us crave fat, salt and sweet as survival mechanisms. However, the overconsumption of fructose, especially in manufactured foods, threatens our health by increasing uric acid levels, leading to insulin resistance, obesity, and other metabolic issues. The loss of the uricase enzyme in our primate ancestors resulted in higher uric acid levels, which allowed for fat storage and glucose production in times of food scarcity, a helpful adaptation then. But with food abundance today, this adaptation is unhelpful and leads to chronic degenerative conditions. Understanding our evolutionary past can help us take preventive measures to avoid these health issues.

Consuming high amounts of sugar and fructose, especially from hidden sources like high fructose corn syrup, can have negative impacts on metabolic function, brain health, and heart health. It is important to focus on whole, unprocessed foods and limit sugar intake to less than 5% of daily calories. Additionally, avoiding refined carbohydrates and eating fiber-rich carbohydrates can benefit gut health and overall health. As conscious consumers, it can be challenging to navigate the sugar content of foods, as food manufacturers often use alternative names or disguise sugar with artificial sweeteners. It is crucial to become a sentinel for one's health and be mindful of the types of foods being consumed to support long-term health and wellness.

The global diet has been invaded by fructose which is tragic as sugar has been insinuated into the foods people are consuming, leading to a rise in rates of diabetes and obesity as a manifestation of an evolutionary environmental mismatch. It is important to understand the effect of foods on uric acid, as it influences blood sugar in the longer run and has a huge impact on insulin resistance. Eating whole foods is essential and it is important to know that a sweet potato or white potato in moderation is reasonable. It is crucial to have a new tool in the toolbox and understand how foods affect uric acid alongside the use of continuous glucose monitors.

The healthcare system should focus on keeping people healthy in the first place by initiating lifestyle changes instead of dealing with them once they are sick. Prevention is the ultimate principle of wisdom, and it is economically and morally right to do as a healthcare provider. Food plays a crucial role in preventing diseases and keeping inflammation at bay. Eating vegetables, fruits, and unmodified animal products is critical in maintaining a healthy lifestyle. The modern diet, high in refined carbohydrates, increases inflammation in the body, thereby making it challenging to make good decisions and exercise top-down control over impulsive and self-centered urge, requiring to focus more on nurturing health instead of fighting diseases.

Chronic inflammation affects our decision making and how we see the world. Our lifestyle choices and the foods we eat play a major role in this. Uric acid, commonly associated with gout, is also related to chronic diseases such as Alzheimer's, diabetes, and coronary artery disease. Elevated uric acid enhances inflammation in the body, threatening our brain and overall health. To counter this, we need to activate the amp kinase pathway, which tells us to avoid making more fat and raising blood sugar. This pathway is activated through exercise and drugs like metformin. Overall, our health choices not only impact our physical health but also affect our decision-making abilities, happiness, and relationships.

Elevated uric acid levels not only correlate with metabolic problems like high blood pressure and high blood sugar, but it is now understood to be causative. Even those without gout may have suboptimal uric acid levels, which can cause cardiometabolic issues. The optimal uric acid level is 5.5, which is lower than the previous normal of 7. Empowering individuals with this information can help them take control of their health by requesting a uric acid level test from their doctors. This highlights the importance of staying curious about scientific discoveries and continuously learning to better alleviate suffering and promote optimal health.

Maintaining a healthy lifestyle involves exercising, getting sufficient sleep, exposing oneself to natural surroundings, and managing stress. Type two diabetes is characterized by insulin resistance and elevated uric acid levels. Even blood sugar levels lower than the cutoff for diabetes can pose health risks. People should not wait until they become diabetic to start managing their blood sugar levels, rather they should prioritize healthier habits early on. The pharmaceutical industry has significant influence on the healthcare system, and people should not rely solely on medications to manage their health. Being aware of one's health status and taking proactive measures can prevent the onset of chronic diseases.

It's important to strive for optimal range, not just normal range, when measuring health markers like A1C and uric acid. Research shows that levels above 5.3 for A1C and 5.5 for uric acid can cause damage in the body. The biggest issue related to elevating uric acid these days is our fructose consumption, yet big name clinics are reluctant to discuss it. Excess sugar consumption should be avoided and keeping an eye on fructose and reducing stress levels can help. It's also important to not blame oneself for making poor dietary choices and instead understand the science behind our cravings and decision-making processes.

To improve our health and happiness, we need to reconnect with ourselves and make better decisions. This includes being present in the moment, limiting distractions like phone use, and allowing our prefrontal cortex (higher self) to guide decision-making. Additionally, focusing on reducing sugar (specifically fructose), alcohol, and purine intake can help control uric acid levels and reduce issues like gout. By taking these steps, we can feel better and get more out of our lives. It's important to embrace the concept of reconnection and be mindful of our actions and decisions to improve our overall well-being.