I am in my sixties, was put on an extreme low sodium diet, I had obesity, kidney disease, high blood pressure, insulin resistance, major gout, inflammations, nerve damage, was put on oxygen, pneumonia multiple times. I went on a very low carb/keto type diet. After a year and a half with almost no processed foods and no juice or pop, everything has disappeared, almost entirely. My doctors are stunned, as am I. My husband is healthier than he has been in 25 years. I lost a hundred and he lost 45 pounds and we don't miss all the junk and processed foods and saved huge amounts of money by not going to restaurants. This is all thanks to all of you doctors on these types of podcasts and videos. Sensible, scientific, logical information. Thank you all!

I've heard Dr. Richard Johnson being interviewed on other shows, but this Peter guy ask such good questions! And I like how Peter adds in layman's terms so us dummies understand! Excellent job Peter!

In one year, my hs-CRP has progressively decreased from 3.48 mg/L to 0.7 mg/L, my HbA1c declined from 6.2% to 5.6%, and SBP reduced to average 130 mm Hg. The simple plan: no processed foods, mostly vegetables, avoid fructose and minimize salt. Weight decreased from 256 lbs to 220 lbs. My nighttime HRV has progressively increased, resting HR decreased and my reaction: gratitude.

Wow - I am so grateful for this session. I have avidly searched for information on dietary contributors to hypertension for upwards of a decade since discovering that my uncontrolled systolic was usually in the range 160 - 200 mm Hg. The ground you have covered today has so powerfully fleshed out a conceptual model of the key metabolic drivers that I should seek to manage. So many gaps / burning questions sorted in a single session - thank you so much - 🙏🏻🔆🌼

I'm gonna need to listen to this one a few times. So much info that's new to me, and I want to make sure I'm understanding it correctly. Great chat.

This is one of the most fascinating &,informative podcasts I have found integrating biochemical, evolutional anthropoligical nutrition & medical science research. Absolutely brilliant!

This is incredible. One thing not mentioned (or I missed) is that Fructose metabolism will yield a particular molecule called Diacylglycerol which leads to PKC activation. A few episodes later and Peter is interviewing Gerald Shulmann about DAG causing insulin resistance. Things are piecing together

I can't believe I haven't listened before today. Rigorousness for the win. This is best podcast I've ever heard.

Best talk on this subject EVER. Thank you. 👍🏼👍🏼

Doctor Attia, I just listened to Dr. Perlmutter being interviewed by Doctor William Davis. Perlmutter retells how he heard your interview with Doctor Eric Johnson which inspired Permutter’s book “Drop Acid”. All of you are remarkable. And it is remarkable how a podcast can enlighten the medical field about fructose. Keep getting the word out. Thanks

The second time I listened to this interview was I absorbed a lot more information. I’m sure the third listen will add significant incremental value.

Thank you so much Peter and Rick for this first class education opportunity. What i appreciate highly is that all these insights allow us to (dis)solve all the controverses on salt, on keto diet versus ancient asian carb regiment, contoverses that are based on a lack of knowledge of all the factors playing with. Now applying all that to adapt lifestyle will take months but so motivating. Better understand how the body does not react as previously expected.. or reacts surprisingly well to a change, an experiment, we hadn't dare before. Gaining freedom in behavior

Fantastic program, Peter. Your contribution is outstanding Rick.

🥳This is one of the most thoughtful, valuable interviews I have ever heard-and like most people here, I have long been fanatic about listening to or watching anything regarding dietary wisdom for those of us now successfully. fighting our wonky sugar metabolisms. 👍😋 AND OUR HIGH BLOOD PRESSURE! 😱

Fascinating, fascinating! I am going to replay this multiple times to connect all the dots those are spinning in my head right now :-)! Absolutely love this podcast!!!!

This is brilliant. One thing I'm fascinated to understand is the intersection of salt and ketosis in this discussion?

Thank you so much for your information! My parents and parent-in-law are having same issue with high blood pressure, high trg and fatty liver even when my father stopped drinking and smoking 15 years ago. The information in your podcast make many myth become so clear and things are piecing together in my mind.

Excelent! I listened to this episode twice. Got out extra details the second time. Thank you

I love this because it presents all the “why” behind the results we are observing in our culture. The chemistry of our bodies is such a beautifully balanced dance, but when you insert a problem into the mix, everything begins to shift and result in a myriad of multi-organ problems. One change often solves a sea of problems. Thank you Dr Johnson and Dr Attia for this great podcast!

This was Outstanding Dr Attis and Dr Johnson thank you for making me way smarter for over an hour and a half. Keep up the great work for us lay people who are trying to do our best.

Another amazing talk! Thanks again Dr Attia and Dr Johnson! Loved the talk and learnt a lot!

20 Years ago. He has been doing the legit research 2 decades ago. Very grateful to hear this! Thank Peter for having him Rick Johnson M.D. on today.

Answered a pressing question for me. Why does my blood sugar stay up and ketones down even when fasting? I consume a lot of salt when fasting, plenty of water too but lots of salt as it keeps energy up. Salt is facilitating the conversion of fats to sugars for me. Whole audio was excellent. I get extra salt taking bullion with butter in hot water, bullion is basically flavored salt. My weight and blood pressure are great so I’ll keep it up. Sugar levels are not high just higher than expected while fasting and ketones lower than expected in ketosis.

Best interview I have ever heard in my life

Word of the day.... "Umami". Learn something new everyday!! With this latest release of interviews, Peter Attia appears to have upgraded The Drive to "Plaid" - well done Sir!!!

When I eat my piece of salty beef jerky post workout and sauna I will be sure to drink plenty of water. I am low carb yeah Kiwi is back. Thanks

Riveting and fascinating discussion. Many thanks to Peter and Dr Johnson. We may as a species, never come into existence were it not for the ape group returning to Africa.

Information overload. Thank you for this.

Excellent program today, sir. The best you've ever brought to your audience.

These guys did a great job!

Great interview. Thanks

Wow …. Wow I’ll have to listen to this again! This was so much information that I need to process, and then change up what I’m doing.

I turned back my Gout by quit eating sugar and anything with yeast in it. That was over 10 years ago. (late 30, early 40's). I went on a Keto diet afraid that to amount of meat would bring it back, going on 2 years later no signs of any yet. Ty for the great explanation.

Thank you for bringing this to the forefront! Another path to learn about and just love the content..where were you during the 70’s and 80’s when I was low fat and vegan? Gee, did I pay dearly for that! Thank you

Thank you Dr. Attia. Very helpfull.

Great discussion, kudos, Thx

I have elevated uric acid levels, kidney function is shite, I don't consume fructose or glucose, or that many carbs at all.......btw over 3 years I've reversed diabetes, fasting insulin levels are awesome, HbA1c really good, fasting glucose fantastic, lost 65lbs and workout most days, but BP is higher than ever!.........so work that out experts

First-rate interview and discussion.

Excellent discussion. Thank you. Early on Professor Johnson stated there was "good epidemiological" data linking higher levels of blood pressure with certain conditions. That's bothersome as epidemiology cannot establish causality. Thank you.

Very informative. This information you cannot find elsewhere.

Why not increase your ampk to inhibit ampd? Metformin and berberine can.

Great info! Now , plain English for the dummies like me . What should we do to live a healthy and long life .

Excellent interview and teachings! Thank you!

One detail that is a little bit obscure, during the discussion of the metabolism of fructose, the term "AMP-D" is used. Peter carefully explains the differences between ATP, ADP, and AMP, but does not ever spell out that AMP-D is AMP Deaminase. Rick Johnson, earlier in the conversation, mentions AMP Deaminase but from then on assumes that the reader know that (AMP-D) is AMP Deaminase. The critical fact is that AMP Deaminase (AMP-D) is a competing or alternate metabolic pathway from AMP Kinase. Even though I have listened to this discussion several times, that detail wasn't clear to me until after I had seen the relevant diagram from Rick Johnson's book, The Fat Switch. This, of course, is a critical point, since it is clear from the discussion that it is the activity of AMP-D (and the rest of that metabolic pathway) that leads to the excess production of uric acid and so the constellation of bad outcomes collectively described as the metabolic syndrome.

One of the best interviews I have heard so far. But I have to admit, that the micro management (salt, potatoes etc.) is a bit discouraging...

Great interview. So eye opening. Thank you both very much!

Honestly Rick’s book should just be called “Fructose is the cause of Metabolic Syndrome”. We’ve been searching for the primary cause of metabolic syndrome for 50 years and now we appear to have a mechanism that explains it. If true that is Nobel Prize territory and will likely save millions of lives.

08:00 and further: BP such a useful and precious information for a lay person!! (BP: 14:00 / 90) I will finally get the ability to regulate it down by further life style adaptations... 18:00 but why must our system have a path converting glucose into fructose in the first place? How is it that the evolution has led to select for such a reaction? (Salt triggers an enzyme) 45:00 AMP at a fork between two pathways 1) AMPD (Deaminase.) => uric acid or 2) AMPK (kinase) => ADP ATP. 1) no need of burning nutrients that then may be stored. 2) burning stores to produce ATP. 1) because of depletion of intracellular P through Fructose-phosphorylation (concentration and speed of intake (overwhelmed cells) trigger this AMPD path. How cynically are studies designed to hide the harm!!

Great interview

Fantastic information. A great podcast . Thank you.

Would love to hear 'insulin resistance' given greater elucidation and its place and function in the processes of metabolic syndrome given more careful delineation for the uninitiated. I somehow miss something each time it's mentioned. Well done in any case! A bitter/sweet experience to be sure for someone struggling to overcome the early warning signals.

Thank you both. So interesting and informative!

Another good talk Peter. Thanks In my recent experiments to gain weight for lean muscle mass I did the following: Firstly, I gained weight by adding sucrose in some form and also added a beer. But not so much of fructose. I added 4 kilos, increased muscle mass, and then finally manage to reduce 3 kg's in a 20 days cycle. Second, which is this time, I gained weight by adding sucrose and fructose. I also had sucrose in high calorie foods like oats/nuts chocolate and via fruit like grapes. Both the days when I had mixed this I felt more bloated and I increased my weight in just 3/4 days. The point of contention here is I felt it this time. I took a week to add same weight last time. I felt bloated this time around and I can visualise the food getting stored than it getting consumed for energy. So yes...I can confirm one thing for sure - its different when you have sucrose or fructose empty stomach where it works genuinely as a source of energy. But the moment you add both on top of your regular meals, even when the calorie intake is same...it stores fat and adds weight faster than over eating your regular food. It could be perhaps because 'metabolic basal rate' works on the food in transition whereas with fructose it could be that it gets stored as fat straight away if we have enough glucose in our system. Another reading for me which is coming through via this is....if it adds weight so quickly then its equally easier to lose fat when you drop both. And therefore it is no sin to have little bit of fructose or sucrose in our diets...its just the management of the two that matters.

As Doctor Gundry says, “Give fruit the boot.” Only in small amounts when in season.

Here's a question I'd like answered (relative to discussion at 1:22:10): Does aldose reductase gene expression get switched off on a long term fast? And if so, how long of a fast is necessary?

Fascinating and insightful.

Thanks for covering fruit consumption!

Does anyone know if coconut water is ok? Say 250ml or less.

Fantastic Podcast!

Simply put. Love u! ❤ Fight the fight🎉

Awesome content here. Thank you.

Absolutely outstanding.

Very informative. Thank you very much.

So informative. Thank you.

This would make a great movie.

Excellent work! Many thanks!🙏

1:00:10 that's an important take away.

terrific, learned so much.

How does the "Randle cycle" play the part? Fat and sugar mixed.

Interested to hear about fructose intake during sports!

Why does UA increase after a day or more of extended fast then lowers after lessor fast?

The more I learn the more sense keto and the carnivore diet makes.

I settled in an enjoyable listen to nerdy details. Instead I got new important new info.

Sugar glucose and salt can be converted to fructose?

Nothing better than a qualified intelligent interviewer (seeking personal growth), having an inquisitive conversation with another intelligent expert. We are lucky to be flys on the wall irrespective of Peter’s big apple fetish : )

Awesome information, thank you. Please do a show on PAM enzyme and how it activates all signaling hormones via - C terminal correction/snip and add - making them functional. Never new hormones could be present and at correct levels but not at all functional due to lack of PAM activation - Richard Maines and Betty Eiper 40+ years fully funded research on PAM.

I sincerely wish that Peters channel took 5 minute snippets from these interviews and started posting them. A lot of times, I'm not interested in the entire podcast…

Wow! Just wow! Great job to both of you. Thanks. You have a new subscriber :)

Great information. What happens to the purines that do not become uric acid anymore, under allopurinol? How are they trsformed and eliminated? Thank you

Awesome info

What makes the sweet go away in soft drinks? It's the salt.

Just started getting gout in the past year. And I’ve been Keto during that time. Any suggestions on eliminating it without continually taking indomethacin when it flares up? I take Allopurinol daily but it doesn’t seem to help.

Unfortunately no words about omega6, not even when mentioned potato chips.... You MUST bring Tucker Goodrich to talk about it urgently.

I don’t even know anymore how to avoid fructose. I check every label and mostly don’t even eat things that have labels, and finding out my body can produce fructose i just don’t know what to do. I don’t eat sugar and very very few carbs, like 5 crackers if i have cheese. Usually under 30 grams of carbs.

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Please Dr.Attia do studies and research on this uric acid and fructose and gout.

I am low Carb Carnivore weight 126 lbs 5’7” almost 80. Still run 3 miles then step race six or more/ day. I do light weights machines and barbells. Afterwards when I rest, I get this wave of heating is this the shock protein in action?

When I eat surgery food my blood pressure rises.

Fascinating ! Peter, did you mention that Richard Johnson has a financial interest in the development of FRK inhibitors? He does...

Awesome chat!

How does potassium play into the salt fructose issue?

Sounded like he really wanted to say something he was very excited about about cancer and fructose 😔 but was redirected

So what happens if you go on a very low carb diet? Will you be able to decrease the uric acid?

24:50 So we were fruitarians? Then cold climate selected the ones with a genetic mutation that allowed fructose to trigger more fat storage?

I am really disappointed about the gloss over on the persistence of this liver enzyme that converts glucose to fructose. What exactly does it mean that it’s persistence am I stuck with this for the rest of my goddamn life or what?

How do we lower our uric acid without taking medicine?

Fantastic informative exchange. TY!!! What I don't fully understand is why the body manufactures fructose in the first place. I get that the body may need to hoard energy and that FR facilitates that but wouldn't glucose be a more metabolically efficient way of doing that?

Febuxostat is the generic of Uloric - and cost me $6.77; however Febuxostat has a black box warning (2018) re: Stevens Johnson Syndrome. I got SJS from both Allopurinol then Febuxostat

Wonderful podcast!! I'm wondering about Allulose. It's structurally similar to fructose. Will it trigger the same metabolic pathway as fructose? I love baking with it, but will stop if it's causing me harm. Thank you!

So thrilled with the punchline on fruit! But dates are my sweetener of choice. What say you?