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

Jun 6, 2023 1h 16m 20 insights
What do obesity, insulin resistance, diabetes, fatty liver disease, hypertension, cardiovascular disease, stroke and dementia have in common? They are all chronic diseases that together are the leading cause of death in the world today. And they’re largely caused not by genes, but by our environment, lifestyle and food choices. This much many of us already know. But today’s guest brings some valuable new information to the table: the role of uric acid. Dr David Perlmutter is a board-certified neurologist and six-time New York Times bestselling author. He is on the Board of Directors of the American College of Nutrition and an Associate Professor at the University of Miami Miller School of Medicine. His latest book, Drop Acid: The Surprising New Science of Uric Acid, focuses on the pivotal role of uric acid in chronic metabolic diseases, claiming that lowering its level in the body holds the key to losing weight, controlling blood sugar, and transforming health. Many of us only think about uric acid in relation to a painful condition called gout. But, as David explains even slightly raised uric acid levels, can have damaging and widespread implications for our health. David and I discuss what he calls the ‘evolutionary environmental mismatch’ - how modern lives are at odds with what serves our biology best. And one of the key elements that is driving this mismatch is the modern food environment. Many of us simply think about food as energy or calories but David and I discuss why we need to start thinking about food as information. Every bite that we eat is giving our body cues and signals. If we give our bodies the right cues they will thrive. If we give them the wrong cues they will start to malfunction. We also talk about the relationship between our fructose intake and uric acid levels, the evolutionary benefit for slightly higher uric acid levels, how increased uric acid can drive fat storage, high blood sugar levels, high blood pressure and insulin resistance. We also discuss what changes we can make with our food choices to reduce uric acid levels in our body. David explains how certain food choices can make us more impulsive, less compassionate and less empathetic and how the right food choices can help us make better decisions and increase our happiness. David is a gifted communicator and someone who is committed to helping as many people as possible, live healthier and happier lives. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Thanks to our
Actionable Insights

1. Reduce Fructose Consumption

Actively reduce the amount of fructose consumed, as it gives problematic cues to the body, leading to increased uric acid, fat storage, high blood sugar, high blood pressure, and insulin resistance.

2. Prioritize Whole, Unprocessed Foods

Focus on consuming whole, unprocessed, and unpackaged foods to provide your body with the correct information cues for optimal health and to avoid the detrimental effects of manufactured foods.

3. Strive for Optimal Uric Acid

Aim to keep your uric acid levels at 5.5 mg/dL or below, as cardiometabolic issues related to elevated uric acid begin at this threshold, even without gout symptoms.

4. Monitor Uric Acid Levels

Get your uric acid levels checked regularly, either at home or at your doctor’s office, to understand how your diet and lifestyle choices impact this crucial metabolic marker.

5. Strive for Optimal A1c

Target an A1c level of 5.2% to 5.3% or below, as health threats to your physiology and brain health can begin at blood sugar levels far lower than what is typically considered ‘diabetic’ or ‘pre-diabetic’.

6. Reduce Dietary Inflammation

Actively reduce the consumption of pro-inflammatory foods, especially refined carbohydrates, to prevent inflammation from severing the prefrontal cortex’s control over impulsive decisions and to foster compassion and empathy.

7. View Food as Information

Shift your perspective to understand that every bite of food provides cues and signals to your body; giving the right cues helps your body thrive, while wrong cues lead to malfunction.

8. Identify Hidden Sugars

Be aware that food manufacturers use many different names for sugar and fructose on labels, so rely on your taste buds to identify sweet foods, which are likely to contain these ingredients.

9. Prioritize Dietary Fiber

Ensure your diet includes sufficient fiber from carbohydrates to nurture your gut bacteria and provide essential vitamins and minerals, avoiding the common flaw of low-carb diets that exclude fiber.

10. Avoid Refined Carbohydrates

Steer clear of refined carbohydrates, particularly if you are aiming to achieve ketosis or generally improve your metabolic health, as they contribute to inflammation and other health threats.

11. Shop Grocery Store Periphery

When grocery shopping, focus on the periphery of the store to select whole, unprocessed foods like vegetables, fruits, and unmodified animal products, which are generally healthier options.

12. Engage Prefrontal Cortex

Consciously engage your prefrontal cortex, the ‘adult in the room,’ by pausing and being present before making decisions, allowing for more measured choices that consider future implications and others.

13. Be Present, Minimize Distractions

Practice being present in the moment, especially during activities like eating, and distance yourself from distractions like cell phones to improve decision-making and foster a deeper connection with yourself.

14. Mitigate Stress & Sleep Deprivation

Actively work to mitigate stress and ensure adequate sleep, as sleep deprivation and high stress levels increase amygdala activity, making it harder to resist unhealthy cravings and leading to poor decisions.

15. Practice Self-Compassion

When making less-than-ideal dietary or lifestyle choices, especially during times of stress or sleep deprivation, practice self-compassion rather than engaging in blame or guilt, understanding that biological factors influence these moments.

16. Understand Uric Acid Triggers

Recognize that the primary factors elevating uric acid are fructose (the biggest contributor), alcohol, and purines, which provides a framework for dietary and lifestyle adjustments.

17. Consider Alcohol Reduction

If you have elevated uric acid levels and have already addressed fructose intake, consider reducing alcohol consumption as it is a significant contributor to uric acid elevation.

18. Consider Purine Reduction

If you have elevated uric acid levels after significantly reducing fructose and alcohol, then consider paying more attention to reducing high-purine foods like organ meats, sardines, anchovies, and scallops.

19. Nurture Health Mindset

Adopt a mindset focused on nurturing health and preventing disease through lifestyle interventions, rather than solely relying on ‘sickness care systems’ that intervene only after illness manifests.

20. Recognize Lifestyle Impact

Understand that lifestyle choices, particularly diet, have a profound impact not just on physical health but also on brain function, decision-making, compassion, and empathy, influencing how you perceive the world.