本集节目中，科罗拉多大学肾脏病学教授Rick Johnson探讨了果糖代谢的独特之处，及其在现代饮食下的潜在危害。节目深入讲解了身体如何从葡萄糖生成果糖，以及循环的葡萄糖和盐水平如何激活这一过程。Rick还讨论了衰老相关的代谢灵活性下降、饮食和更年期激素变化对糖代谢的影响。此外，他还提出了通过饮食调整和药物治疗来对抗代谢疾病的策略，并探讨了果糖代谢和尿酸对肾功能和血压的影响。最后，节目讨论了血管加压素在促进果糖对体重增加和胰岛素抵抗的影响中的作用。

🍎果糖代谢的独特之处在于，身体可以将葡萄糖转化为果糖。循环的葡萄糖和盐水平可以激活这一转化过程，这与祖先的生存机制有关，但在现代饮食中可能带来健康风险。

⏳衰老与代谢灵活性下降密切相关。随着年龄增长，身体对糖的代谢反应可能发生改变。更年期相关的激素变化也会影响糖代谢，增加对糖的敏感性。

🥗饮食在对抗代谢疾病中起关键作用。减少果糖摄入是重要的策略。同时，节目还讨论了降血压的饮食建议，以及果糖和尿酸对肾功能和血压的影响。

💧血管加压素在代谢疾病中扮演角色。它促进果糖对体重增加和胰岛素抵抗的影响。了解其作用有助于更全面地理解代谢疾病的机制。

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Episode Description:

Rick Johnson, Professor of Nephrology at the University of Colorado and a previous guest on The Drive, returns for a follow-up about unique features of fructose metabolism, and how this system that aided the survival of human ancestors has become potentially hazardous based on our culture’s dietary norms. In this episode, Rick explains how the body can generate fructose from glucose and how circulating glucose and salt levels can activate this conversion. He discusses the decline in metabolic flexibility associated with aging, as well as how factors such as sugar intake or menopause-associated hormone changes can alter responses to sugar across a lifetime. In addition, Rick lays out strategies for combating the development of metabolic illness using dietary changes and pharmaceutical therapies, and he discusses the impact of fructose metabolism and uric acid on kidney function and blood pressure. He concludes with a discussion of vasopressin, a hormone that facilitates fructose’s effects on weight gain and insulin resistance.

We discuss:

• Unique features of fructose metabolism and why it matters [2:45];
• A primer on fructose metabolism and uric acid [10:30];
• Endogenous fructose production, the polyol pathway, and the effect of non-fructose sugars [22:00];
• Findings from animal studies of glucose and fructose consumption [29:00];
• What calorie-controlled studies say about the claim that a “calorie is a calorie” [42:15];
• Implications for aging and disease [51:15];
• Impact of endogenous fructose production on obesity and metabolic syndrome [1:01:30];
• Why vulnerability to the negative effects of sugar increases with age and menopause [1:04:30];
• Dietary strategies to reduce the negative impact of fructose [1:16:30];
• The role of hypertension in chronic disease and tips for lowering blood pressure [1:30:45];
• The impact of fructose and uric acid on kidney function and blood pressure [1:39:45];
• The potential role of sodium in hypertension, obesity, and metabolic syndrome [1:49:00];
• The role of vasopressin in metabolic disease [1:54:00];
• More.

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