Dhru Purohit Show - A Few Crucial Things You Need to Know about Uric Acid—the Body’s Fat-Storage Switch with Dhru Purohit

Episode Date: June 6, 2022

This episode is brought to you by ButcherBox and Vivobarefoot. Uric acid is a central player in metabolic mayhem. Despite its long association with gout and kidney stones, it’s involved in so much more—especially our metabolic disease epidemic. There are three things that raise our levels of uric acid: purines, alcohol, and fructose. The latter is the biggest challenge, due to its overwhelming presence in our Standard American Diet. That doesn’t mean all fruit is bad or even that all alcohol and purine-rich foods have the same effect. Like all parts of health and nutrition, there are nuances we need to consider to create optimal health. Today on The Dhru Purohit Podcast, Dhru talks about uric acid, the role it plays in turning on, or off, our body’s fat-storage switch, and how getting it under control can significantly reduce our risk of chronic disease. In this episode, we dive into:   -The link between uric acid and metabolic dysfunction -Why our metabolic switch is always turned on -Hidden sources of fructose in our diets -How uric acid levels can tell us a lot about our cardiometabolic health  Also mentioned in this episode: -Try This: How To Turn Off Your Fat-Storage Switch -The Latest Science on How to Turn Your Body’s Fat-Storage Switch Off with Dr. Richard Johnson -​​Nature Wants Us to Be Fat: The Surprising Science Behind Why We Gain Weight and How We Can Prevent—and Reverse—It -Try This: Smoothie Recipes That Won’t Spike Your Blood Sugar -Calculate Your Fructose Intake  -Drop Acid: The Surprising New Science of Uric Acid―The Key to Losing Weight, Controlling Blood Sugar, and Achieving Extraordinary Health -UASure Uric Acid Meter  This episode is brought to you by ButcherBox and Vivobarefoot. Right now, ButcherBox is offering new members a great deal. You’ll receive two pounds of FREE salmon in your first box. Sign up at ButcherBox.com/dhru. Vivobarefoot footwear is designed to be wide, thin, and flexible—as close to barefoot as possible. They promote your foot's natural strength and movement, allowing you to feel the ground beneath your feet. Vivobarefoot is offering 20% off your first order at vivobarefoot.com/DHRU. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Everyone, Drew Brod here on today's episode, we're talking about uric acid, something that's gotten a lot of buzz this past year, especially because of the work of an individual named Dr. Richard Johnson. Why do we care about uric acid? Well, apparently, and I'm going to walk you through all this today, uric acid is deeply connected to our fat storage switch. and another level of an aha moment, nature actually wants us to get fat. So if those topics are interesting for you and you want to learn more about them, keep listening. So today we're talking about uric acid and the role that it plays in turning on or off our body's fat storage switch and how getting it under control can significantly reduce

a risk of chronic disease. In particular, today's episode is especially important for anyone who regularly drinks fruit juice as an adult. As a kid, also it's something we should be paying attention to, but primarily as adult. Anyone who regularly drinks beer, especially consumes a decent amount, you know, at least two or more beers a week. anyone who is struggling with non-alcoholic fatty liver disease or high blood pressure. And lastly, anyone who eats healthy, quote unquote, but it's still struggling to lose weight. Not that uric acid is connected to every one of those instances of somebody not being able to lose weight, but it's something to pay attention to. So let's jump in.

So you want to hear something that's kind of hard to believe. high fructose corn syrup was once intended to be an alternative sweetener for diabetics. Not only was it cheaper than cane sugar, which is what most people were using, but in the early 1970s, researchers discovered that fructose didn't spike blood sugar and insulin the same as glucose. A win-win, right? Well, not exactly. Soon after this discovery, the FDA approved the use of high-fructose corn syrup for food manufacturers, and it quickly replaced cane sugar in processed food, soft drinks, and sugar-sweetened beverages. A well-intentioned decision at the time, but we all know that it was no silver bullet for preventing type 2 diabetes, a condition that an

estimated 32 million Americans have, and that number, by the way, continues to rise not just in America, but around the globe. In fact, high fructose consumption actually induces insulin resistance, high blood pressure, and weight gain through a different mechanism, one that's linked to high levels of uric acid. Now, a couple more things about today's episode. I'm going to talk not only about all things uric acid, largely borrowing from the work of individuals like Dr. David Prowmutter and Dr. Richard Johnson, who have both been on this podcast before, but I'm also going to be talking about, why it's important to keep our levels low, how to actually do it, and what types of fructose are doing the most detrimental harm to our health? I have two big takeaways that I'm going

to give you. If you just stay with me, I'm going to get into a little bit of background knowledge. So let's get a better idea of where uric acid comes from in the body to understand why having high levels of it could be an indicator of poor metabolic health. All right, uric acid is typically associated with gout. That's how most people know about it. It's a painful condition that's most famously known for affecting the big toe but can also have effects on the wrist, elbows, fingers, and knee joints. Gout has been called the rich man's disease because it's most prevalent in men who eat a lot of red meat and shellfish, like shrimp and lobster,

and drink a considerable amount of alcohol, all of which were only affordable to the ultra-rich. These foods and alcohol contain high levels of purine, the nucleic acids that make up DNA and RNA. Now, uric acid is a product of purine breakdown. When uric acid levels are high, it crystallizes in the blood and deposits in the joints resulting in this painful inflammatory condition.

Aside from gout, By the way, researchers like Dr. Richard Johnson, who again was previously on our podcast, you can listen to the episode below after this, have discovered that high uric acid levels could be a biomarkerker for detecting early signs of metabolic dysfunction. And we know that 80 plus percent of Americans are metabolically unhealthy, but often we don't find out that they're metabolically unhealthy until much later in life. If we could start paying attention to uric acid as a leading indicator, that could help us detect and help the medical community work with patients to detect that we're headed in the wrong direction. Now, I want to give a big shout out to Dr. Richard Johnson, who have become friends with, and he wrote a book called Nature Wants Us to Be Fat. And that's a big inspiration behind our content on uric acid.

and Dr. Johnson's work is super groundbreaking. I first had heard about him on the Peter Atia podcast, and he's inspired a ton of people, including Dr. David Perlmutter, for getting people to focus on this important biomarker. All right, let's talk about the link between uric acid and metabolic dysfunction. Okay, so in addition to a purine-rich diet, foods and drinks, drinks is the key. I'm going to get to drinks in a second.

that are high in fructose can also increase uric acid levels. Some really great research that's out here, references inside of the show notes. Now, fructose, it's naturally found in things like fruits, and it has varying degrees of concentration depending on the fruit, its size, and its rightness. Now, fruit is an excellent source of prebiotic fiber, vitamins, minerals, and polyphenols, which you know we're all about on this podcast, in, again, its whole, form. This is the first hint of my recommendation today with uric acid. We start to run into problems when we consume high concentrations of fruit outside of its food matrix, specifically in the form

of fruit juice or high fructose corn syrup that's commonly found in processed foods and sugar sweetened beverages like soda. Now, before we can understand how modern day fructose consumption disrupts our metabolic health and causes us to gain weight. And where the concentrated sources of fructose hide in our diet, let's first look at the bigger picture of why fructose poses challenges for a metabolic health. All right. Little background. We are biologically programmed to see fruit and eat it and want to keep eating it because leptin, our fullness hormone, is resistant to fructose. A lot of people don't know this. reference number three inside of the show notes.

This means that our hunter-gatherer ancestors could eat as much fruit as they wanted without feeling full. Now, the question for people going down to evolutionary history, evolutionary biology history, is why would this be beneficial? This episode is brought to you by Butcher Box. Wildcaught salmon is one of my favorite go-toes to get brain-supporting anti-inflammatory fats and clean protein into my diet, but I don't just trust any old place when it comes to buying fish. Some places even intentionally mislabel their fish to make more money. So I always stock my freezer with super high quality salmon from Butcher Box. Butcher Box only uses wild caught, sustainably harvested, Alaskan Salmon,

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That's two pounds of free salmon. If you're signing up for the first time, go to Bochurcherbox. Butcher, B-U-T-C-H-E-R-B-B-O-X.com slash D-H-R-U. That's butcherbox.com backslash Drew. How crazy is it that our dieted lifestyle are such a given when it comes to our health and our focus, and yet we're still wearing the same antiquated shoes that damage our feet and our structural health and lead to lower back pain, joint pain, and sciatica problems. It's kind of nuts.

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Think about grizzly bears that spend their winter hibernating. They eat as much as they can leading up to hibernation because they're preparing to go all-scent. season long, all winter long, without food. In addition to salmon, insects, and small animals, berries are definitely on the menu and are incredibly beneficial for bears to consume during this time. I shared an anecdote that I had hiking in a national park up nearby the Canadian U.S. border, Glacier National Park. And I remember going with a tour guide out on this hike. And she was like, oh, you know, let's go around this corner over here. I know you like, you know,

eating wild fruit and things like that, I'm going to take you down this path. There's a bunch of berries. So she took us down this path and she was having a really hard time finding berries. She's like, you know what? I don't think we have any berries. It's getting closer to like the season turning. The bears have consumed this entire area of berries. And I was like just astonished by the level of berry bushes that had been just decimated by these bears.

And I was like, that is wild. Yeah, she's like, yeah, this happens every time the season starts to turn. The bears come and they gorge them. on these berries as a way to help them bulk up for winter. So background on that is like humans, bears are also leptin-resistant when it comes to fruit. They eat as much of it as they can, and whatever is left over that's not burned for energy or stored as glycogen right away is turned into fat inside of their body. When we have a lot of sugar in our system, our liver turns on our fat production.

hypogenesis and our fat storage switch. The fat stored in our muscles, liver, and adipose tissue to tap into, at a later date, when food isn't as readily available, think pre-grocery stores. And obviously for bears, no grocery stores. And in the case of bears, they are actually going through a process where they're dipping into and about to jump into hibernation. In our case, it could be famine as humans. because there may not be food around during the winter.

Now, humans don't hibernate, but we did evolve to handle harsh winters with limited amounts of food. Converting sugar into fat was a survival mechanism, but allowed our hunter-gatherer ancestors to have a source of backup energy to hunt and find food

when times were scarce. Now, fructose not only increases uric acid and allows us to store fat, but it also induces a hepatic insulin resistance when you eat a lot of it. There's a great paper in the journal Nutrition and Metabolism titled Fructose Insulin Resistance and Metabolic Dislipidemia that explains this mechanism. Why would, this is the question for us, is why would our liver want to become insulin resistant?

That's the question. One of the main reasons, according to Dr. Richard Johnson, is that blocking incoming fructose and glucose from entering the liver means more could be available and circulating in our bloodstream. The neurons in our brain have the highest energy demand and require continuous glucose delivery from the blood. Now, when our blood sugar runs low, our brain tells the pancreas to make glucagon, the hormone that releases the glycogen that's stored in our liver. Additionally, our brains produce our fight or flight hormones that metabolize phycogen. fat for energy so that any glucose that's left in the blood can be delivered to the brain.

All of this to say, sugar is our brain's preferred energy source and having more of it in our bloodstream, especially during food scarcity, gives our brain the energy it needs to find food. So we know fructose increases uric acid, but did you know uric acid increases blood pressure. Together, insulin resistance, and high blood pressure meant faster blood flow and delivery of nutrients to our tissues to have the energy they need to continue to look for food. Now, Mother Nature makes no mistakes. She created the metabolic switch in our liver to induce metabolic syndrome for a reason,

to keep us alive. However, today, our modern day industrialized diet is causing our liver's metabolic switch to backfire because we are constantly inundated, swimming in an ocean of fructose primarily that is completely throwing off our health and making us more susceptible to chronic diseases that are out there. Let's paint a picture. The typical westerner, which increasingly the Western diet is being exported around the world, rarely ever goes more than a few hours with food. And the refined carbohydrates and sugar that make up the bulk of the Western diet

makes it so that our liver's fat storage switch is almost always on. On top of that, we're getting more fructose in our diet than ever before, and not the good kind of fructose, which is from a diversity of fruits and vegetables. Due to our modern-day processed diets, most people get the majority of their fructose from concentrated liquid forms. I'm going to come back to this in a second. Unfortunately, our metabolic switch doesn't hold the same survival value as it did for our ancestors because things have changed so rapidly in such a short period of time. You know, we have to think of it as like our genetics and our body evolved over millions of years. Definitely over hundreds

of thousands of years for the uric acid switch, according to Dr. Richard Johnson. And fructose consumption, in addition to other forms of refined carbohydrates, is something new that we're dealing with. And it's much higher today than it was 100 years ago, even. This has caused many problems for a blood glucose control, insulin sensitivity, and arterial health, which explains why non-communicable, chronic diseases like obesity, type 2 diabetes, and non-alcoholic fatty liver disease, and heart disease are so common today. And by the way, all those things have a connection to poor metabolic health and poor metabolic health has a connection to uric acid. Now, a quick note about sugar. It isn't off the hook either.

Sucrose, which is table sugar, is a dysaccharide, meaning that it's made up of two sugar molecules, glucose plus fructose. You guessed it. That, like fructose, pure fructose, are also converted into fat by the liver when it can't be used up for energy or stored as glycogen. Now let's come back to high fructose corn syrup, a liquid syrup that's extracted from corn, and it's ubiquitous in soft drinks, sugar-sweetened beverages, and processed foods, which make up up to 60% of the total energy intake for Americans, according to the British Medical Journal. Before adding high-fructose corn syrup to the food supply, Americans consumed about 15 grams of fructose per day from whole fruits and vegetables. Now, the average American consumes 55

grams of fructose per day, and adolescents on average consume a whopping 73 grams of fructose per day. Fruitose accounts for about 10% of our daily energy intake. That is an astonishingly high number. And by the way, that was pulled from a paper called Dietary Fruitose Consumption amongst U.S. children and adults, the third national health and nutrition examination survey. I'll link to that inside of the show notes. And by the way, most of that comes from refined sugars and high fructose corn syrup used to make breakfast cereals, pastries, soda, fruit drinks, and other sweetened foods and beverages. Now, in addition to high fructose corn syrup, there are.

hidden sources of fruit dose in our diets disguised as healthy that might surprise you. For example, fruit juice, a popular breakfast staple for children and adults, rival soda for the amount of sugar present in a liter. For example, Minutemate's 100% apple juice contains nearly 66 grams of fruit toast per liter, which is more than Coca-Cola, which has 62.5 grams of fructose, and Dr. Pepper, which has 61 grams of fruit dose. Dr. Drinking fruit juice is another example of how taking fruit out of its food matrix can cause health problems, especially when it becomes a staple of our diet. Yes, there are vitamins, minerals, and antioxidants present in fruit juice, but that doesn't

mean it's something we want to be consuming in large quantities. Listen, some fruit juice here and there, it's no big deal. Great, it's enjoyable. Treat it like a special thing. But if you're consuming pharmacological doses of fruit juice every day with orange juice or even so-called healthier juices that are out there that have a lot of fruit inside of them, there's a lot of green juices that are out there that are totally really just fruit juices in disguise with a little bit of kale or celery mixed in, those can also be problematic if we're consuming large quantities of them on a regular basis. The same applies to high fruit smoothies. This is important topic because I often see people at the airport, you know, looking for a jamba juice or whatever. Fine. No shade. You can go to

those things on an occasional thing. But if it's something that you're getting every day before you had to work, there could be some challenges. It's one thing to add some frozen berries to your smoothie. By the way, we have a list of our favorite smoothie recipes that won't spike your blood sugar inside of the show notes, but it's a whole other beast when your smoothie consists of mostly fruit. When you blend fruit, you decimate its fiber, and the fiber is there to slow sugar absorption. This increases fructose absorption and puts more pressure on the liver to process it. I put a chart in the show notes that I've linked to, and it's very helpful for understanding the fructose impact of various fruits that you might be thinking about adding or consuming in higher quantities.

So it's a good reference that's there. Fruit juice and smoothies are rapidly ingested. And in their concentrated forms, the fructose can cause oxidative stress, insulin resistance, non-alcoholic fatty fatty liver, metabolic syndrome, and increased fatty acid accumulation in the liver and the belly. And those are all pulled from a paper titled, Fructose and Sugar, a major meat, mediator of non-alcoholic fatty liver disease. And you can find a link to that inside of the show notes. Now, coming back to uric acid,

uric acid is traditionally looked at as a biomarker for kidney function and gout. But now, especially through the work of people like David Perelmutter, Dr. Richard Johnson, we're seeing that uric acid could tell us a lot about our cardio-metabolic health as well. High uric acid levels, which primarily are elevated through fructose of being one area. There's a few others that Dr. Richard Johnson gets into in his podcast with us. High uric acid levels indicate increased levels of oxidative stress and mitochondrial damage, which is why it's so important for physicians and individuals to be aware of their levels. There are uric acid meters.

I'll talk about that in a second that you can get on Amazon. Honestly, though, the test is quite cheap. If you have a good relationship with your doctor, you can start to ask them about getting your uric acid levels measured so that you know where they are. Now, in my recommendations for today's podcast, I want to help you understand the concentrated forms of fructose in your diet so that you can keep your uric acid levels in the ideal range, even if you don't know your current level. So let's jump right into it, starting with the first recommendation.

avoid drinking sugar and beer on a frequent basis. If there's one clear takeaway that I've learned from the groundbreaking work of Dr. Richard Johnson and the follow-up work of Dr. David Perlmutter, it's this. Eat fruit in its whole food form, but avoid drinking fruit and avoid drinking sugar, specifically fruit juice and stay away or minimize beer. Now, minimizing alcohol is always a good thing, but a lot of people enjoy beer on a regular basis, and we have that term beer belly. We're going to get to that in a second.

Now, limit liquid fructose. Let's talk about that first. Soda, sweetened with high fructose corn syrup and fruit juice, are the two biggest sources of liquid fructose in our diet, making them the top recommended items to limit when it comes to keeping our uric acid levels in the ideal range. We're not talking about the occasional apple juice or coke that someone might have, every so often. We're talking about the daily or even multiple times a day consumption of these beverages. It's not about being perfect and I'm not here to fearmonger. It's about having a baseline that supports your long-term health and reduces the risk of chronic disease. Lastly, on the topic

of liquid fructose, be aware of hidden sources of fruit toast that often find their way into healthy products. Most commercial green juices that you get at like the grocery store, even at whole foods, and even smoothies are incredibly high in fructose, things that are blended with like dates. Again, nothing wrong with having those every so often. But if you're having that day in and day out in large dosages, as my business partner likes to say, Dr. Hyman, pharmacological dosages of sugar, it's going to have an impact on your body. And you can find out by getting your levels tested. Number two, limit beer.

Alcohol in general has its challenge. but beer specifically raises yuric acid levels much higher than wine or spirits because of its high concentration of purines. If beer is your go-to choice for an alcoholic beverage, you might want to reconsider. The term beer belly isn't just a stereotype. It actually has science behind it. In my interview with Dr. Richard Johnson, I talk about a documentary I watched on the topic of Japanese sumo wrestlers and how they force their bodies to gain weight very quickly when they're Sumo Camp. One of their top hacks was to drink multiple glasses of beer every night before bed. Okay, let's go to the second big recommendation. The first one was avoid drinking sugar and

beer specifically as an alcoholic beverage. Number two is clean up the base of your diet. We all know this, but we can all use a reminder here and there, simply reducing your processed food intake and switching to a more whole foods-based diet will dramatically reduce your uric acid level and improve your overall metabolic health. Now, there are uric acid meters. You can find some of them on Amazon, and I don't know, they may be helpful for some people, but next time you're at your doctor's office,

you can also ask them to throw in a uric acid test and pick up the book, Drop Acid by David Perlmutter. He goes into the ideal levels that we want to be shooting for when it comes to our baseline levels. He wants the baseline levels to give you a little bit of preview under 5.5 milligrams per deciliter, 5.5 M.G. over D.L. Honestly, I'm personally excited for the day that companies that I'm involved with,

like levels, a continuous glucose monitor company, builds a sensor that also detects uric acid because it's not easy. Unless if you have gout, your doctor isn't often looking at it. You kind of have to ask them for it. And then your levels change so regularly, kind of like your blood sugar levels, your uric acid levels changed throughout the day. And I just don't know if uric acid meter is practical for people. Now, even if you're someone that doesn't know your uric acid levels, some of the points that I've shared here on today's episode

are still things that you can do regardless of even if you know your levels or not. And more importantly, uric acid, just like you've heard a lot more people talk about metabolic health and blood sugar and glucose and insulin, and maybe you didn't know what those things were a couple years ago. I didn't know all the ins and outs of all those topics a few years ago either. But I started to hear people talk about them and I paid attention. And as the awareness grew, I started to take that education with me to make simple changes in my diet and lifestyle that helped me create an insurance policy that I could live not only longer, but as healthy as I possibly could.

And I hope today's episode is helping you do the same. Remember, we have a metabolic switch for a reason. Occasionally turning it on is what it's there for. But when we have large quantities of sugar, especially fructose in our diet, that switch stays on all the time. And that can have its detrimental challenges, but it doesn't have to be this way. I hope you enjoyed today's episode. If you did, leave a review. We would love for you to share your thoughts with the world out there on what you thought about not just this podcast episode, but the value that you're getting from the

Monday episodes we've been doing.