Saturated fats, Sugar and Metabolic Health - with Dr. Richard Johnson | The Proof Podcast EP 233
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- เผยแพร่เมื่อ 28 มิ.ย. 2024
- In Episode 233, I’m joined by Dr Richard Johnson to examine how diet affects the health and function of metabolism and the liver.
👇 Visit The Proof website for supporting studies and the full show notes 👇
theproof.com/podcast/
After Dr Johnson’s appearance on [Episode #215](theproof.com/is-fructose-driv..., listeners of The Proof had many more questions. Most of the feedback I received welcomed the opportunity for discourse with someone whose views don’t align exactly with mine, helping to disrupt the echo chamber it is easy to find ourselves in. In today’s episode, we continue to explore Dr Johnson’s position, navigating where we agree and where our stances might differ.
Dr Richard Johnson is a Professor of Medicine at the University of Colorado. He is a clinician, educator, and researcher, and has been at the forefront of obesity and diabetes research for more than 20 years. He takes special interest in the role of sugar (especially fructose) and uric acid, and has been extensively cited from his publications in top medical journals.
In Episode 233, we fill in some gaps from Dr Johnson’s past episode and explore new areas. We discuss human outcome data, animal and mechanistic data, and gaps in current studies. We also cover the role of the liver, how the diet affects its health and function, and the effect this has on metabolic health and risk of disease.
Specifically, we discuss:
0:00 Intro
3:27 Dr. Johnson’s Thesis on Fructose
11:28 Gaps in Current Studies
20:20 Saturated Fat Versus Sugar
33:09 Long-term risk of Keto Diet
36:28 Fructose Effect on Saturated Fat
40:40 Survival Mechanisms
46:37 Type of Fat
53:00 Metabolic Health & Fructose
1:02:20 Role of the Liver
1:09:15 Problem with High Blood Sugar
1:17:22 Triglycerides & Uric Acid
1:27:52 When Fatty Liver Happens
1:31:45 Ceramides
1:33:30 Outro
It is a pleasure to have Dr Richard Johnson back on the show to examine the evidence and its significance. I appreciate Richard’s time and passion for this space as we navigate where we agree and where our stances might differ. I hope this episode helped you make more educated food choices.
Connect with Dr Richard Johnson:
• Instagram: / drrichardjjohnson
• Twitter: / richardjjohns11
• Website: drrichardjohnson.com/
• His book, "Nature Wants Us To Be Fat": benbellabooks.com/shop/nature...
• Episode 215 with Richard Johnson: theproof.com/is-fructose-driv...
The best way to support the show is to use the products and services offered by our sponsors. To check them out, and enjoy great savings, visit theproof.com/friends
Enjoy, friends.
Simon
Supporting studies
• Effects of short-term overfeeding with fructose, fat and fructose plus fat on plasma and hepatic lipids in healthy men [PMID: 20483648] pubmed.ncbi.nlm.nih.gov/20483...
• Four-year follow-up after two-year dietary interventions • [PMID: 23034044] pubmed.ncbi.nlm.nih.gov/23034...
• Intrahepatic Fat and Postprandial Glycemia Increase After Consumption of a Diet Enriched in Saturated Fat Compared With Free Sugars [PMID: 32165444] pubmed.ncbi.nlm.nih.gov/32165...
• No difference between high-fructose and high-glucose diets on liver triacylglycerol or biochemistry in healthy overweight men [PMID: 23872500] pubmed.ncbi.nlm.nih.gov/23872...
• Sucrose induces fatty liver and pancreatic inflammation in male breeder rats independent of excess energy intake • [PMID: 21489572] pubmed.ncbi.nlm.nih.gov/21489...
====
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#theproof #theproofpodcast #simonhill #richardjohnson #fructose
Extraordinary episode! 👏💪🙏 Your comments, Simon, we’re as fascinating as Dr. Johnson’s to me.
What a great podcast. Informative, and interesting. And Richard has the hallmark of a real scientist when he a couple of times says: "I don't know " or "I'm not certain". You just cannot know it all, and instead of trying to explain away, he just says it as it is.
It's the meat and sugar combination. I have reversed my T2D and insulin resistance on an animal based diet. No processed foods, no sugar, no seed oils, and so on.
Best to worse: non processed sugars, processed sugars, saturated fat, sugar & saturated fat. WFPB with or without poly & mono fats is best based on scientific studies & according to this podcast and others I have listened to. Losing weight will always reduce insulin resistance, and saturated fat with no sugar is better than both together. However, it is still not better than low saturated fat diet as long as you lose any excess weight & keep it off. Mediterranean diet still seems the easiest to maintain long term. For me, I am losing weight & staying satiated with low fat & high potatoes with beans. Plan on adding more unsaturated fat once I get to the desired weight. I love meat and would love to eat carnivore but the scientific studies say it is not better than a WFPB diet. But if carnivore is something one can stick to it's way better than staying insulin resistance for sure. Each to their own choices.
@@seodreamteam Thank you for your reply. Yes to each his or her own! I am learning to listen to "both sides" when it comes to this debate (carnivore vs. vegan). I hate veggies so I stick to meat, raw dairy, fish, and eggs.
I am diet agnostic but I can say you may have cured the resistance but you are going to get 10 helpings of cholesterol. Please ensure your LDL and apoB are kept in a healthy range. Probably jump on a statin tbh
@@Maverick5588 Thanks for the reply but my Lipid panel just came back in the normal range. It works for me...not a carnivore evangelist though!
Bravo brother
Outstanding conversation. Thank you Mr Hill and Dr. Johnson!
My personal experience: I was diagnosed with fatty liver disease 5 years ago. I was shocked because I’m active and thin. I tried to research the best diet to treat this and thought that Keto diet was good for fatty liver (many TH-cam videos on this 😅). So I followed a strict low carb, high fat, moderate protein diet for 1 year (chicken, fish, nuts, coconut oil, avocados, ….). My liver went from 16 cm to 19.4cm (per ultrasound) and liver enzymes went up! But, I lost 10 pounds of body weight! Maybe uric acid contributed to this? I have since changed to plant based with low saturated fats, moderate protein, high complex carbs and, thankfully, my liver size has come back to the previous size. This is such a great informative, conversation. Thank you!!
My experience is similar but not liver related . I did high animal fats (ketovore) to tackle insulin resistance and it gave me stones in my kidneys. I had to swap to lower saturated fats, more plants and also less protein. Doing much better now. I thank this podcast chanel for helping me see the common sense
Good to know. Thanks for posting.
@KD funny, I got kidney stones from vegetarian diet. Spinach/peanut butter green smoothies daily. Still trying to dissolve a 2+cm stone.
Keto folks often get high oxalate numbers from all the nuts, nut butters, and almond flower, not to mention eating low glycemic spinach.
It's not the diet, it's the content of whole food oxalates.
I bought Sally Norton's book to figure out what I could eat on my whole food diet.
@bonniek7228. So glad you were following your progress with US. There are many genetic mutations in various genes relating to the metabolism of fats and sugars by the liver that can predispose one to NAFLD. Just shows that we need to find the diet that works for us personally, no one diet works for all. I'm another person for whom keto was a disaster and WFPB works way, way better for satiation, weight loss and metabolic health.
Do you eat fruit?
Learned some new things in this interview such as how we can make fructose in the body. Thank you for this interview.
i really like the pace of this episode. Well done.
Can we appreciate Richard's devotion & joyful attitude!
Yes, the right attitude can deliver any idea. It's like the guidance on an extremely sophisticated missile. No one can defend.
@@wizardatmath I don't see why you would establish such an analogy. It's not like his message is somehow as violent as a missile.
You should interview Dr Richard Feinman MD., saturated fats are naturally occurring in the human diet for millions of years and no fatty liver and heart disease until the advent of seed oils or industrial processed vegetable and fructose. Lipid peroxidation in omega 6 fatty acids increases in inflammatory vegetable oils which damage LDL particles and lead to particle retention in the sub endothelial space, macrophages engulfing oxLDL become foam cells classically and we have atherosclerosis.
Great you have R. Johnson on the podcast! Read his book, and found it one of the most intriguing perspectives on 'why we get fat'. Makes a lot of sense in the evolutionary context, as we have to fatten up for winter, so we don't die of starvation. Great podcast, I find myself tuning in regularly.
@@TheProofWithSimonHill That there is alot of nuance to nutrition. I like that R. Johnson looks at the big picture (evolutionary context), and at the mechanisms( ATP depletion at the mitochondria etc.). It is such a compelling theory for the obesity epidemic. Fructose triggers appetite/survival pathways. Caloric surplus does the rest. Not mentioned here, but in his book he also examines how this pathway evolved in apes. Maybe nice for a follow-up podcast? ;D
Also a good discussion on saturated fat, measurability. Good questions.
Layla
@@TheProofWithSimonHill Biggest takeaway: That you made an effort on behalf of those w/normative weight and calorie intake to understand what could trigger negative liver/lipid/insulin/glucose response.
Would much appreciate keeping normies in the picture, along with, where possible, female (pre and post meno) vs male responses - pushing for further breakdowns, as hormones control so very much (think heart disease).
Thank you Simon.
What a sweet, highly intelligent and open minded man I liked your first interview with him too, such a great interview keep them coming!
The question comes to mind is "why the liver?"
I was under the impression that subcutaneous adipose tissue was for long term storage, and the liver was for temporary storage. Since chronic fatty liver is dangerous, I don't think it would be the ideal location to store for a season or two, so why isn't this saturated stored directly in the subcutaneous adipose tissue the way PUFAs seem to be?
Secondary question is "are there gender differences?"
Sir.
Your interview, just now, is the most informative; I have ever heard. Thank you so much.
I, remain.
Sincerely.
Rick Johnson is fabulous. It all makes sense. Watch all of his videos. Nurse here.. I now know low fructose/sugar especially combined with saturated fat - and low sodium is how you live to avoid Metabolic Syndrome.
That's not right though. Fruitarians (people that eat tons of fruit that naturally contain sugar/fructose) for example have reversed their type 2 diabetes and significantly increased their insulin sensitivity.
Insulin resistance and metabolic syndrome as well as obesity primarily comes from chronic overconsumption, lack of exercise and stress.
great talk and great questions. thank you simon and rick.
Nothing short of outstanding. you've got me hooked.
Really enjoyed this chat. The one thing I kind of missed (and maybe it was covered in the previous episode with Dr. Johnson) is what the Doctor feels his findings would translate to in terms of a recommended diet. For example, he made pretty clear that he is not "anti-fruit" but does that mean he would be OK with the amount of fruit in a typical whole food/plant-based diet? Fruit obviously has fructose but maybe the fiber and vitamin C (that he talked about) mitigate the risk? How do grains fit into the picture?
100% fruit juice is not a health food.
There is a podcast with Peter Attiah where R. Johnson discusses the topic.
thank you, both!
Great interview! U ask great questions and drive to great points!
This was fantastic, really appreciate the information!
This was a good discussion.
Key takeaway: High Blood Sugar (Glucose) is bad because body converts Glucose to Fructose, and Fructose has many deleterious effects. Chiefly it tricks cells to reduce ATP production, which sets off alarm signaling emergency need to gain weight resulting in insatiable appetite and intractable obesity.
It is a great advantage to have your body work this way, in "ordinary times" when fruits come in season in the summer . . . and work in your body so you that can pile on the energy stores for the coming times of famine (winter). Our bodies still work the same way; what has changed is that now it is summer all the time . . .
You have made the mistake that many researchers make in not defining your terms. What do you call high fat? Sobrecases et al. (2010) did the same. Those diets were around 55% carbohydrates, 15 % protein and fat 30%. Then some fat or sucrose or both was added and so the ratios of macronutrients shifted a bit. In the presence of lots of carbohydrate, saturated fat and saturated fat with extra sucrose produces those results but none of these were high fat diets by the definition of a well-formulated ketogenic diet. In the presence of a low carbohydrate (
@maxharris310 excellent breakdown of the discussion. So much of this conversation is contradictory to recent research, clinical studies and the work coming out of Ben Bikman's lab.
Loved this podcast. Great guest and pertinent questions.
This was a 10 in supplementing what I read in the fructose book..
Hi Simon, great show as always. Thank you so much for all your work, passion and experience you are sharing with us 🫶🏻
May I ask you a question which just goes very well with the podcast
How can your ALT level be increased if you are on a healthy plant-based diet?
(I had to switch to a candida diet recently (higer protein, slightly higher fat intake, and low carb because of my Candida overgrowth in the gut.) Doing this since beginning of October 22)) and taken blood beginning of November which indicated an ALT level of 52 U/L. I am speechless.
Any thoughts on this? 🙏🏻 x
I enjoyed this thank you… hope for more like this!
@@TheProofWithSimonHill I appreciate the interviews that encompasses all not just one side or the other. They are hard to find these days. I’m “predominantly” plant based, but leaning Mediterranean… 🙏🏾🙏🏾
Simon is the ONLY Interviewer. I'm aware of with the skill set and background knowledge to ALWAYS get to THE KEY QUESTIONS. Key here was getting to the key factors of the Fructose/Saturated Fats question.
Still need to break down WHICH Saturated Fats are problematic. Lower molecular weight Saturated Fats ARE NOT THE SAME as Palmitic Acid. Then we must look at HOW CATTLE ARE FED.
There is a study that the way sugar substitutes stimulate hunger is the same mechanism as fructose. Does that mean this would be an explaination why we see increased obesity and diabetes in people consuming sweetened beverages with those increased obesity in diabetes and not reverse causation?
Great interview! Thank you. Really interesting hearing about the different mechanisms involved. Love the openness in exploring the topic, what has been found and also what is still to be clarified. 👍🙏
Insulin resistant people, if fructose is eaten and saturated fat at the same time what can go wrong asking for a friend, you just answered, visual fat , intermittent fasting the body will replace remove old cells mitochondria , hit training growth hormone,autophagy
You have mentioned it all.
How come we are the only animals evolved on the planet that can not decide what it should eat , food companies do. Big farmer provides the medicine, and the big cats get fat bank accounts
How much fructose to flip switch?
Fantastic. Thank you.
Dr. Johnson, looking from a Paleo Diet perspective I share your view, that generally saturated fat is not the culprit!
Doctors Johnson & Lustig are doing some interesting work. I’m happy to hear both of them say that eating reasonable amounts of fruit is ok. I’m not sure sure about some things they say, but I think their work is solid enough that I have to remain open to the possibility that fructose can be or is a problem. It is potentially unfortunate for me that many of the things I like could be problematic. Fortunately, I am quite active and don’t appear to have developed any fatty liver issue and remain thin most of the time despite eating potatoes, fruit, and the odd sweets.
Lustig was in Houston recently th-cam.com/video/odZlKkGkOVI/w-d-xo.html
Wow. Thanks. Glad this popped up 😊
What about Choline pulling fat off the liver in a rapid pace
Excellent podcast. Dr Johnson’s theory is quite credible- it explains many dys metabolic issues.
Your clear steady quest using the latest scientific literature plus your book to focus on critical nutrition based issues is outstanding. I write this simultaneously with Dr Johnson’s complement to you.
I practiced internal medicine in Portland, Oregon for 42 years emphasizing prevention, am WFPB for over 10 years and was certified in lipidology. I listen to cutting edge podcasts on the molecular basis of disease often so I appreciate your high sophisticated high level interviews, but your preparation and detailed knowledge of these subjects - sets you apart. Thanks so much. I respect you so much I’m using Essential 8.
Keep doing you outstanding work!
Leptin resistance is probably a central driver of obesity, but how does that relate to GLP1 and the effectiveness of GLP1-analogs like Liraglutide and Semaglutide? The theory of reduced numbers of L-cells in the intestine leading to a lack of endogenous GLP1 production and thereby increased appetite and insulin resistance seems to be strengthened by the efficacy of these medicines. In animal models a high intake of saturated fat is a driver of increased L-cell death. It's likely that there are other factors that can drive this phenomenon, maybe fructose and uric acid? Maybe it is a part of the "prepare for winter"-function in mammals? A reduced numbers of L-cells, leading to higher appetite and increased levels of insulin, to fatten up and then during the energy restriction of winter the L-cells might have time to recuperate. I would love to hear your thoughts on this in the future!
Would like to see a podcast with Dr.Johnson and Dr.Stephanie Seneff discussing saturated fat. Dr.Seneff says saturated fat is converted into polyunsaturated fat, and is one of the healthiest fats you can consume. Animal fat is also the lowest deuterium food to consume.
Our species evolved to put on fat for the winter by eating fruits and saturated fats. In colder climates, fruits mature in the fall. That is also the time of year when game animals put on fat for the winter. Perhaps we respond to saturated fats for the same reason we respond to fructose, as a way to survive the winter in the wild.
Our bodies need protein. The most bioavailable sources of protein, and the ones that our ancestors have been eating for millions of years, come with monounsaturated and saturated fats. For example, 100 grams of ribeye steak has 3.2 grams of monounsaturated fat and 2.6 grams of saturated fat. Hamburger has 8.4 mono and 7.3 saturated.
If saturated fats make us gain fat for the winter, but monounsaturated fats do not, perhaps olive oil, which has 66.6 grams of mono and 13.3 grams of saturated fat in 100 grams, would be a better choice than butter or tallow for weight loss. Fish and shellfish are excellent sources of protein but low in saturated fat. Perhaps that is why the Mediterranean diet, which is basically olive oil, seafood, and greens is held in such high regard. A low carb olive oil and seafood diet with plenty of salads may be the ultimate weight loss diet. The seafood will give you the protein, minerals, and omega 3 that you need, the salads and herbs will give you fiber and minerals, and the olive oil will give you polyphenols and fuel.
Modern food companies have spent millions on research to invent foods that we cannot stop eating. A famous potato chip commercial said, "I bet you can't eat just one." They have learned that foods that contain sugar and fat are irresistible. Donuts, ice cream, cookies, candy, and cakes are considered treats and rewards. Foods that contain carbohydrates and oils are equally addictive. French fries, pizza, potato chips, corn chips, crackers, and similar baked concoctions are sold everywhere, including schools. I believe that these processed foods, not meat and seafood, are the cause of the obesity epidemic and metabolic disease. Do you?
@@TheProofWithSimonHill Thanks for your reply. I enjoy your approach. You seem to be committed to finding the truth, wherever the data may lead. I'm the same way. I've spent the past two years (since retirement) doing a deep dive into optimizing my health and longevity. My research indicates that inflammation is the root cause of all of the modern chronic diseases. I did a search of your website on inflammation and now have dozens of videos to watch. Thanks, I think.
I currently wear an Oura ring to track my sleep, as I agree with Matt Walker that sleep is the foundation of health and longevity. I follow Satchin Panda's advice and go for an hour long walk in nature at dawn to set my circadian rhythm. Don Layman has convinced me to eat between 30 and 60 grams of protein at breakfast to signal mTOR. Jason Fung has convinced me that the best way to loss excess fat is to eat a low carb diet and do alternate day fasting. I am able to eat both plants and animal foods, so I basically eat a low carb version of the Mediterranean diet of whole, natural foods with plenty of omega 3 rich seafood, shellfish, olive oil, broccoli, spinach, beet leaves, cilantro, asparagus, berries, pumpkin seeds, sunflower seeds, and black sesame seeds. I also have a hunch that traditional herbs and spices, including ginger, turmeric, cilantro, basil, oregano, and many others are time tested and good for me. I find that I do well eating ground beef and eggs, which I view as nutrient dense and healthy.
My biggest frustration in researching health and longevity is the design of so much of the research. I wish that I could design the experiments. For weight loss, I really want to compare a diet that limits carbs to less than 50 grams a day to a low fat, whole food diet. I would also like to see how those two compare to a similar diet where protein is at least 30% of total calories.
Tim Spector makes a good point about personalized nutrition. That will certainly be the future as science and testing advance. We do not have to believe that one size fits all, and we certainly want to focus on discovering the truth instead of picking a side and pushing an agenda. Thanks for your commitment to the truth.
First I have to say: Great that you interviewed someone that's not seeing things the same as you do. Also great that he tries really hard to not be too hard on you. :)
What becomes clear in this conversation is that no ingredient has a single effect all on its own. The effects of Saturated fat and fructose depend a lot on eachother's presence in the diet. On top of that leptin resistance seems to make things worse. Then additionally, the delayed appetite increasing effect of fructose (it takes time for leptin resistance to develop), is another factor that plays into the total effect.
Also protein as a percentage of calories seems to be another factor. Richard focuses more on the uric acid effect, but perhaps the increased metabolic rate from a higher percentage of protein is another factor that changes outcome.
Then I wonder if there may be an elephant in the room that additionally affects the total effect of the various factors. And that is intermittent fasting. The amount of time you spend in the fed state vs the fasted state. In the fasted state, you'll burn up liver fat. The more time you spend in the fasted state, the more time you are burning up fat that was deposited in the fed state. The ratio may be another factor that affects the amount of fat in the liver.
Lots os variables that make human outcome date really difficult to interprete. Like Richard indicated, most people that are in studies are on high fructose diets to begin with. This is especially true when studying people with existing metabolic disease. It would be interesting if a study could be done on people that have been at least a couple of years on a carnivore diet.
Are your views more nuanced Simon, now that you learned all these new things and perhaps appreciate the complexity of it all a bit better?
@@TheProofWithSimonHill That would be great to have a study like that. That said, just about everyone that starts a low carb diet also eats high amounts of saturated fat if they buy in at all to the low carb community woe as well as decreasing fructose to minimal levels. My wife and I for instance started low carb 3.5 years ago, majorly increased our saturated fat consumption,majorly decreased fructose laden food (fruit and sucrose) and both reversed our NALFD and our pre-diabetes (as well as losing lots of weight - over 50 lbs. each). We came from decades of high carb/low fat, trying to follow our doctor's suggestions as best we could. This all happened in the first 6 months. Three years later we still eat high saturated fats and maintain those health gains. We are anecdotes, but there are millions of us these days with similar stories). But yes, a longer term human study would be great...but no one is going to want to fund that.
Watched both interviews with Dr. Johnson and enjoyed them both. Thank you.
@@panes840 My latest lipid panel results (June 2022):
LDLc: 4.0 mmol/L, 154.68 mg/dL
HDLc: 1.49 mmol/L, 57.62 mg/dL
trigs: .59 mmol/L, 52.26 mg/dL
Non HDL: 4.27 mmol/L, 165.12 mg/dL
Total cholesterol: 5.76 mmol/L, 222.74 mg/dL
chol/HDL risk ratio: 3.87 (ref:
@@panes840 Beef, pork, we eat a fair amount of bacon, lots of eggs, we deep fry our chicken wings in lard, coconut oil. We also use virgin olive oil and avocado oil. What we NEVER use are the highly processed seed oils (vegetable oils), at least not anymore.
As a board certified lipidologist and internist I am quite concerned about your LDL-C.
You may be 50bs lighter and have enjoyed improved insulin resistance, but atherosclerosis is raging. Consider having an advanced Apo-B or NMR panel done plus (if you are over 40 a CT calcium scan.
Fitting into a smaller coffin may be aesthetically pleasing, but probably not your original intention.
@@sallywolfe535 thank you. I have requested an NMR panel but unfortunately my family practitioner tells me there is no availability of an NMR panel here in our are of BC, Canada, which I find quite surprising. I do know from looking at many low carber's lipid panels that at least when low carb (not sure if true for everyone) if trigs are low and HDL is high, it is almost guaranteed that person will have a pattern A cholesterol result. As a lipidologist, I would love to hear what your experience with the trig/HDL ratio has shown.
Very confusing, especially in the "saturated fat versus sugar" section.
Frontiers In Nutrition: February 16, 2021 - The Impact of Macronutrient Intake on Non-alcoholic Fatty Liver Disease (NAFLD): Too Much Fat, Too Much Carbohydrate, or Just Too Many Calories?
Studies Comparing Carbohydrate and Fat Overfeeding
A small number of randomized studies have compared the impact of fat or carbohydrate overfeeding on liver fat (Table 3). Studies are heterogenous in design, but there is a general trend that overfeeding with SFAs is associated with the greatest risk of hepatic steatosis and increase in transaminases, independent of changes in body weight (47, 50). Luukkonen et al. assigned 38 individuals to receive a hypercaloric diet containing either 100% simple sugars, mainly saturated fat, or mainly unsaturated fat for 3 weeks (50). Lipolysis and DNL were measured under basal conditions and during a euglycaemic hyperinsulinaemic clamp to measure insulin sensitivity. Overfeeding saturated fat increased IHTG more (+55%) than unsaturated fat (+15%, p < 0.05), while carbohydrates increased IHTG +33%. Importantly, carbohydrates increased liver fat by stimulating DNL (+98%) while saturated fat did so by significantly increasing the rate of lipolysis (unsaturated fat did not). Additionally, saturated fat induced insulin resistance and endotoxemia and significantly increased multiple plasma ceramides. The diets had also had distinct effects on adipose tissue gene expression (64). Clearly, the metabolic pathways through which different macronutrients increase liver fat are different (50). Finally it is important to note that where overfeeding studies were followed by a hypocaloric diet, changes in weight gain, adverse lipid profiles and liver fat content were all reversed (35, 46).
also
Medscape: April 7, 2022 - Does Fat vs Carbohydrate Overfeeding Matter in the Development of Fatty Liver Disease? by Caroline M. Apovian, MD
Carbohydrates increased liver fat by stimulating de novo lipogenesis, whereas saturated fat did so by increasing the rate of lipolysis. Saturated fat also induced insulin resistance and endotoxemia and significantly increased plasma ceramides. Ceramides induce skeletal muscle insulin resistance when synthesized as a result of saturated fat activation of TLR4 receptors.
Thanks for sharing the essence of these studies. Appreciate not being sent to yet another pub med rabbit hole, as sometimes I just want to adjust dietary intake asap (like, now, turning around my more recent higher intakes of sat animal fats - I feel a bit foolish.. but had taken cues from incredible inflammation lowering ability of medical level STRICT paleo keto (HighSatFat, zero carb) anti epileptic seizure (and auto immune) diets - wherein blood (esp liver) markers are watched assiduously.
(These diets work - but preclude normal life, and effect hormone levels in the extreme. For me: interferes w/sleep.)
The problem with the seed oils and the pufa is really only due to cooking with and increasing tfa especially if the oil is heated high or many many times heating and cooled, which happens a lot at fast food places
I hope you don’t mind me asking, I’m the studies mentioned with subjects given the the high saturated fat, was there a ceiling amount for HSF you noticed when fatty liver starts to develops?
That begins to make a lot of sense with different storages of fat whether visceral or subcutaneous based on temperature and ethnicity where you see Indian and darker skin individuals tend to have less subcutaneous fat and more visceral fat based on ancestral region they are from. Since they are from different temperate regions
@1:24:00 How to lower uric acid?
Looking for more information and help with plant based eaters with health problems such as high uric acid and triglycerides - what causes this and why lentils would cause gout. A 3 month trip in Sri Lanka eating lentils daily plus sugar in ginger tea and a walk up Adam's Peak. Combo? Or was it just sugar that causes higher uric acid and unaccustomed exercise. Adams Peak is a mountain in Sri Lanka. Second attack of gout was coming home and recreating the lentil curry's. Third attack always vegan but our usual wfpb sos diet included vegan junk foods and non alcoholic beer. Could that be enough for another gout attack? Decades before beer was the biggest cause but stopped beer a very long time ago and it's 12 years non alcohol.
There's space in this area for vegan health care because we're not immune to diseases. Anyone got any advice?
The problem with some Paleo and Keto pundits is that some discourage eating fruit on the basis of it's fructose content. I had years of IBS and fatigue trying various combos of keto and paleo diets after becoming intolerant to gluten. It was the saturated fat maintaining my gut inflammation-- damn ....so much time spent feeling ill. Now I have switched out the saturates and upped the high vit fruit- particularly kiwis and citrus. Things are really looking up. 🙃
From an evolutionary point of view, fructose and glucose was not a major part of our diet until 10000 years ago, when glucose became more abundant via grains. The amount of fructose in our diet has skyrocketed only a few hundred years ago. The fructose level in wild fruits, is SIGNIFICANTLY lower, than what is in fruits you find on your local property or in your supermarket. I'm not saying, that humans did not eat berries or various fruits, but they were seasonal, and not engineered for being as delicious as possible.
Curiously enough, the vast majority of fat in our diet, was animal based. One might assume, that we are adapted to it?
If we maintain the evolutionary perspective in regards to a paleolithic diet, fruits and berries should be seasonal, and not be fruits that were bioengineered for maximum sweetness. That narrows it down quite a bit, right? No apples, oranges or strawberries.
Very impressive! After these two well prepared interviews w/Richard you can count me in as a new fan and subscriber.
Keep the open minded research analysis and open questions coming Simon.
A have been listening this podcast and the last one about fructose...a have been listening to Robert Lustig Dr. Paul Mason, Dr. Eric Berg, Dr. Anthony Chaffe, Dr. Zöe Harcombe, and others and they talk about the benefits of a high fat-high low carb diet. It seems that you all agree in reducing fructose, process food and carbohydrates intake...but about fat, protein and fiber...I see that there is a lot of confusion...some says that fiber is causing constipation, others says that feed the gut. Some says that we should not eating vegetables and legumbes because of the antinutrients. With fat mostly the same. What I also see is that you all agree in the health of the mitocondria and liver, with the ATP pathway. From what a have been listening in this year or so, in my conclusion, fat (good fat like: tallow, fatty meat, olive oil, avocado, butter, ghee, cream, chesse, yogur, ...) it's good...a lot community's, cultures, tribes, have been using them with any harm to their health. And also what's the point of a diet such the vegan were you have to take supplements to be metabolically healthy, it doesn't make any sense. Even the Mediterranean diet it's none the best one because it has a lot of carbohydrates on it (bread, pasta, rice, potatoes, desserts)
Tallow, fatty meat, butter, ghee, and cream are high in saturated fat and raise ApoB.
Thank you for this interview. I learned a lot. I have a few questions. Nuts, seeds and avocados has a small amount of saturated fat. if we can moderate the amount (keep nuts to 1 ounce for example per day, and avocado to 1/5th of the fruit) will the saturated fat be an issue in the diet? Also, should we eat nuts away from fruit so that there is not the presence of saturated fat and fructose in the diet at the same time? My second question is from what I understand, Dr. Johnson talks about juicing being bad as all the essential fibre is stripped away exposing the fructose in a more concentrated form. I think he may have mentioned smoothies too in that category, but did not really talk much about whether we should avoid smoothies. Even though all the fibre is still there it has been pulverized, exposing the fructose more perhaps, so should we avoid smoothies as well? Any thoughts on these questions? Thank you again!
Most of the research shows the negative effects of saturated fat coming in at around more than 8% of your caloric intake. I would just go off of that... And whatever that means for your particular caloric intake. I personally get about 25g of saturated fat a day @ ~3100 calories, so 7%. Most of it is from plant sources, maybe a third from whole milk.
The effects of fiber also likely play into this, as fiber can move saturated fat out of your body if eaten together. So if the studies that show that 8% figure are low fiber diets, you could perhaps expect to get away with eating more saturated fat without the harmful effects. This is speculation though, so don't take it as fact.
i eat one avocado each day. i like to live dangerously.
@@limitisillusion7 Thank you for your reply. 🙂
😊I put more stock in your personal experience than some studies Thanks for sharing
I wish everyone stopped talking about weight loss and climates change and concentrate mostly about human total health.
I may have missed it, but are you saying/agreeing that we should limit fruit in our diet? Especially if we need to lose weight?
@@TheProofWithSimonHill Thanks I didn't think so.
Don't demonize saturated fats. It has to do with the individual's health status and how the fats are processed/ metabolized along with all the nutrients the individual takes in
Have heard many of this Dr.s podcasts. He was all over imo in this one. As far as I'm aware, in nature, foods do not contain both fats and sugar? Correct me if I'm wrong. So don't eat processed foods, don't eat meat or fats with fruits.? Great job w ur info Simon, podcasts are well done.
Yes. Drives me bonkers that they use processed foods in these studies - that’s not food!!!!!!!
Show me studies using only real food. Has there ever been even one?!
Kind of surprised by half of what he is saying -- strong negative on saturated fat, red meat, and seeming to defend PUFAs and plant-based diets. Saying saturated fat causes fatty liver disease is outside of what low-carbers are saying, though they both seem to have high disdain for fructose. Didn't really enjoy this talk much, but I'm open minded to other claims.
Great interview, as usual 😊
While I understand his arguments, I feel there are flaws in some studies such as: in what world is 40% fat considered “high fat”? That’s less than the SAD
Also, how would he explain fruitatarians not being fat (most seem underweight, actually)? Or the Mastering Diabetes success rate?
Another issue: in the absence of glucose in the diet (aka “carnivore”), meat proteins can be turned into glucose and if eaten in excess, stored as fat, even more so if salt is added (as referenced in the interview)
I see some holes in his ideas, is all I’m saying
In the case of the fruitarians and Mastering Diabetes success rate, it seems to involve the fiber in the fruit being eaten. That is why it is recommended to eat fruits and not drink them. Concerning meat, meat contains glycogen where many glucose molecules are stored.
"Also, how would he explain fruitatarians not being fat"
Because they are malnourished and sort of a "starvation modus" kicks in. From my perspective, fasting is much better to the health, though.
"Or the Mastering Diabetes success rate?"
That's just another vegan scam and nonsense.
@@btudrus Your source?
@@chiyerano Quote, what you are refering to exactly if you want an answer...
Just came from Nutrition Made Simples latest video on blood sugar spikes. Perfect work of the algorithm!
I want to pose a provocative question here (as I did over at Gils channel): as a dietitian I've been taught that young kids with obesity will produce more fat cells, which will make it harder for them to loose fat as adults. First of, I do wonder if that hypothesis still stands. Second, could there acctually be an advantsge to having more fat cells subcutaneusly, in the sense that it would increase the personal fat threshold? Could there acctually be an advantage of gaining weight early in life to gain extra fat cells??? Do you know of any good research looking at this?
Also, saturated fats are only a problem when mixed with carbs.
I’m curious about glucose and fructose. Dr. Johnson spoke about the difference between fructose and glucose and their effects on the brain. What are some examples of foods containing glucose and foods containing fructose? Also, I am assuming that in his studies they didn’t feed animals or humansWhole food forms of fructose or glucose?
Thanks mate for the upload.. I have been around alot in the diet world.. from vegan, to carnivore..
@@TheProofWithSimonHill yes very much so. Listening to this specific upload makes we wonder how i survived that 200 grams of butter diet pr day i did once. Didnt eat fruit on the diet ofc so didnt get alot of fructose.. but still
Where are you at now?
@@Emanuelnx il make it as short as possible.. I do more plants.. with more fish and more white meat basicly...the lack of fiber was a huge issue for me on carnivore.. I did not go to the toilet for days (5 days). I take Psyllium daily on my oats.. I do fruits sparingly mostly berry s..
@@Emanuelnx what about you ?
@@Valientes4life Cool, i’m exclusively plant based ✌️
Thank you for your great video. I understand the risk of saturated fat from animal. Is plant saturated fat also bad for health? Eg, coconut's saturated fat is medium chain triglycerides which is different from saturated fat from animals.
@@TheProofWithSimonHill Thank you for your reply. I used to take coconut oil occasionally but now I've been eating old coconut meat which requires lots of chewing. Coconut meat is unlike coconut oil because it's unprocessed and has lots of fibers. I will be doing a blood test in a few days' time and will check my cholesterol and triglycerides. Years ago my triglycerides increased a little as a result of taking coconut oil but my cholesterol levels were still good.
The results of my blood test on 20 November 2022 are as follows:
1. HDL - 133.80
2. LDL - 96.67
3. Total Cholesterol - 240.14
4. Total Chol/HDL - 1.79
5. Triglycerides - 48.72
All the cholesterol and triglycerides numbers are within the recommended ranges except for the Total Cholesterol. However I don't think it's alarming because Total Cholesterol is the sum total of HDL, LDL and other lipid components. Given that my HDL is very high, my Total Cholesterol will definitely be high. Eg, if my HDL is lower at 2, then my Total Cholesterol will be 2+2.5+0.25=4.7 which will be within the recommended range of =
Every video of Simon Hill is an amazing conversation of epic importance. It's better than first discovering Wikipedia. What a superb job! Thank you for the content.
I disagree. Simon is horrible.
@toenaq If you don't like him, you must be here to challenge your beliefs. To make a suggestion... If you want to challenge your beliefs, you're better off watching content that challenges the margins of your beliefs, rather than the complete opposition. That will be a more successful strategy to inject nuance into your belief system. Some ideological opposition can be useful, but too much tends to radicalize.
Not all Polyunsaturated Fats are equal. Too often, those we are exposes to (e.g. in fast foods & processed foods) have already been greatly degraded and oxidized or overused/overheated (e.g. used for weeks in a French Fryer) where Trans Fats and toxic aldehydes are produced.
Cold pressed seed oils with benign methods of purification ARE NOT THE SAME as Oxidized Polyunsaturated Fats as in a Croissant baked at high temperature.
Be very useful to have a discussion about the Randle cycle and it’s challenge to the doctors view. It would be interesting to get Bart Kays reaction to this interview.
I can hear Bart’s reply already ….
Yes exactly, seems they are trying to get meaningful results during worst state Randle cycle period..
I find it very tough to sit thru a Bart Kay video, but I was thinking the same thing.
This interview left me with more questions than answers....
(And I am a Rick Johnson fan because of his straightforward honesty and great accumulation of knowledge on his subject of choice)
I remember when I was a teen like 16 years old or something like that I quited drinking sugary beverages and replaced it with water and I lost like 10kg doing this
but of course I was a teen so maybe my hormones where just a little crazy but I did no exercise what ever I just did go to work and school and played video games all day
when I started consuming sugar again I was going right back to where I was before really fast
Hi! I eat keto, very high in animal fat. My LDL is high (280), HDL high, TG low and HbA1c low, my BMI 18.5 , belly 67 cm, age almost 54, in menopause. I do not worry about my very high LDL. I think I am a lean-mass-hyper-responder. I believe high LDL and high cholesterol is healthy and good for longevity. Eating animal fat is natural for humans! Our brains and cell membranes are made of saturated fat and cholesterol.
There is little evidence that "Lean mass hyper responder" is an actual thing, let alone that it is a solid case for ignoring LDL this high.
@@TheProofWithSimonHill People with high LDL and high cholesterol live longer and in better health. meddocsonline.org/annals-of-epidemiology-and-public-health/the-LDL-paradox-higher-LDL-cholesterol-is-associated-with-greater-longevity.pdf
Not to mention Serrapeptase pulling the fibrosis of the liver also
Sounds like a good idea to remove fruit at least to see if this can kickstart fat loss regardless of diet.
I find his idea and his thesis compelling, there is not enough evidence yet to confirm that though. Let's see what future studies will show.
Do any of the other great apes show this "foraging" switch triggered by fructose? I don't think it would make sense in a species that eats a lot of fructose as part of their regular diet. I mean they would have this switch triggered all the time and it seems to have some major drawbacks. If other great apes don't have it, why would we have it?
I said it in the first episode with him and I say it again: Dr‘s mic doesn‘t work.
All this talk and they do not talk about how to reverse fatty liver, high uric acid and high triglycerides.
@@TheProofWithSimonHill so standard “food pyramid” again
Fructose is the key to undertand obesity
Alzheimer and other diseases
The concern I have here is the claim that glucose is being converted to fructose under some conditions. Did I hear that right????
It happens in diabetics when blood glucose is too high and the enzyme hexokinase becomes saturated which shuttles glucose to another pathway that produces sorbitol and ultimately fructose. en.wikipedia.org/wiki/Polyol_pathway
and in non-diabetics?
@@TheProofWithSimonHill
which saturated fats??? SCT, MCT, LCT?
So glad you pushed him to talk about saturated fat because he didn’t bring it up on Max Lugavere’s podcast or another one I saw him on and the host told him he was on a carnivore diet and he didn’t say much about it, I was really disappointed. Wish you could get Henry Blackburn on, he worked with Ancel Keys and is currently 98 and still doing good 🤗
💚
He dosen't want us to be fat , He wants us balanced, & in control of ourselves & look at all the health issues, gosh & how hard to undo it , we have to learn how to say no to stuff ! like icecream 🍦 & 🎂 ,🍪 but in excess gets us gianic health problems, i appreciate stress , it made me run & 🚴♀️ & its how you dont carry extra wt ! 💝
my guess is doug graham or mike arnstein dont have fatty liver. would interesting to find out is they had it tested.
So is fructose or myocellular lipids the root cause of insulin resistance!
maybe the conversion of sugar to sat fat in a hypercaloric setting is what is driving insulin resistance and fatty liver
I love fruit eating high raw on fruit I’m not fat ? 😢
Fructose is not harmful, fructose from fruits is healthy.
Johnny Depp? Nah. Jd wishes he had Simon's bod.
I don’t think this dude is distinguishing medium buoyant ldl from small dense when we talk ldl levels in relationship to saturated fat.
The intro where you are wearing black on a black background...floating head ....
Unfortunately most studies can be manipulated to give whatever results you choose if the sponsor of the study spends enough money. Not saying all studies, but most studies that demonize saturated fat are sponsored by either processed food industries, grain industries, the sugar industry, or a combination of all 3. Eating a diet high in saturated fat is not a new phenomenon, high levels of heart disease and metabolic disease are.
Why is it you can be healthy for 5 years as a vegetarian and it's proof the diet is good for you, but if you're healthy for 5 years on keto or carnivore, it's just luck and a heart attack will eventually kill you? Polyunsaturated fats are toxic, especially in highly oxidized cheap seed oils. That's just a fact. It's completely ignored that many of the people in so-called blue zones actually consume quite a bit of cheese and dairy high in saturated fat. And if you actually spend enough time around metabolically sick people in America, you'll realize most are poor. They don't eat high levels of saturated fat. They mostly consume chicken and pork high in monounsaturated fats fried in cheap canola or corn oil while consuming high amounts of processed foods heavy in high fructose corn syrup and preserved with seed oil. The saturated fat they do consume comes in highly processed dairy, fast food, or highly processed meats that contain, you guessed it, high fructose corn syrup and seed oil. Saturated fat is demonized because animal husbandry is expensive and the margins are small. Doesn't take much money to let grain sit in a bin waiting to be processed for 5 years to make a product that's shelf stable for 3. 3 month studies are cool, but thousands of years of real world data are kind of important too.
I got way healthier once I started a keto diet. I had fatty liver and an a1c of 6.5 at 35 years old. 300 pounds 6ft1. Lost about 50 pounds in 3 months blood markers all improved drastically. Cut the processed high sugar food and switch to real food. I do think if you restrict carbs for moderately high fat and high protein that is a great recipe for weight loss and improved overall health. I don’t see why you would eat carbs when trying to lose a lot of weight. Especially if you have been eating them for so long, good to take a break to break an addiction from them. I don’t see who would wanna do low fat high carb if they had a lot of weight to lose. Unless you hate meat of course. 🤷♂️
Because you have no clue what you’re saying lol it’s best just to not make a comment at all, so you don’t confuse the ignorant vaccinated masses even more
I eat a high fat diet. My risk ratio for CVD is in the bottom third of the lowest risk category. My family did not follow a high fat diet. They followed the recommended diet; they are all dead now. Food for thought.
Insufficient info to draw a conclusion
Before weighing anything anyone has to say about anything, the question worth asking is, Did he take the shot?
@@TheProofWithSimonHill good question
His theory about metabolic syndrome being a biological process to prepare for the hard winter was seducing but I just remembered that our species emerged from Africa, a place where fruits are available all the year long. If it was correct, white people would have this ability to develop the metabolic syndrome and black people wouldn't have it, since not needed (just like white skin is an adaptation to produce enough vitamin D in clouder climates).
However, that might be something we developed to go through ice age.
My guts tell me the metabolic syndrome is more related to modern sedentary lifestyle and fructose syrop than a normal biological process occurring during the fruity summer to prepare the scarce winter.
You have to eat fats to burn fats. Either burn carbs or fats.
I think Simon is biased towards fat and wants to promote carbs.
The crux of the matter is if you are insulin resistant both carbs & fat are bad even in isocaloric level. Why? Because insulin resistance means no lipolysis - so all fat you consume gets turned into visceral or deep subcutaneous fat.
We need studies where they compare over a period of 6 months to 1 year the metabolic health of people who aren’t INSULIN RESISTANT and are placed on fat vs. carbs diet.
Moot point - if you aren’t insulin resistant - carbs and fat are bad, aka all food is bad. If you aren’t insulin resistanct it is easier to maintain good metabolic health with fats and vegetables than with carbs and vegetables. Simple carbs are poison no matter where you are in metabolic health spectrum.
Alcohol same as sugar, fatty liver disease
For us mortals... A summary: refined sugar and saturated fat is still bad for you, particularly in combination with each other. Eat food, not too much, mostly plants.
You mentioned high carbs in another video. He is telling you what I lived. You want a plant diet, high carbs . I need a healthy body.
Not a diet that makes my insulin level rise. Bikman knows plant diets have deficits even your capsules can't compensate for.
Simon I love fruit don't do this to me lol :(
So saturated fats contribute to obesity and fatty liver when combined with sugar and a low fat diet. What? That’s what he said.
If this were true how come all fruitarians are extremely skinny