Paul Saladino· MD
amounts of fructose in high fructose corn syrup all these other things could definitely be an issue here now if you're pouring it down the fructose pathway fructolysis looks very different than glycolysis there's no check because phosphofructokinase isn't there but in general fructose i don't think immediately leads to gout the way that everybody says it does without metabolic dysfunction i'll show a couple of pathways here that illustrate this so alcohol intake probably does because alcohol specifically leads to increased uric acid retention in the body and alcohol is not a good thing when it comes to insulin sensitivity or when it comes to overall metabolic health purine intake leads to purine degradation uh we know this is xanthine oxidase hypoxanthine xanthine uric acid as we talked about before many will point to this side the fructose side and you know fructose does come in here there's really no check on how much goes to triglyceride accumulation which is why we shouldn't be eating massive amounts of fructose but normal evolutionary amounts don't i think cause major issues the main pathway i've seen people say is that oh this fructose is going to lead to more amp more einstein monophosphate more inosine and that leads to more uric acid this way but i as you can see in my case in kurt's case without underlying metabolic dysfunction this does not necessarily happen there's something else going on moderate amounts of fructose i do not believe are harmful in any way shape or form when it comes to gout provided that you are metabolically healthy that's what you guys get when i get super excited about this stuff i just start singing these are important to know the difference between fructolysis fructolysis and glycolysis glycolysis goes through these steps phosphofructokinase here is the rate limiting step fructose is going to bypass that and can go through these steps here and go to acetyl coa without any impediment which means you can accumulate triglycerides and dldls if you have tons of fructose but moderate amounts of fructose that we would have found seasonally in the environment i don't think are a problem for humans and we've seen that in the hadza we've seen that in tons of cultures who include fructose in their diet but don't have gout