Excess fructose from sources like high fructose corn syrup, certain fruits, and excess carbohydrates, combined with polyol pathway conversion, creates an evolutionary mismatch.

“that this is the perfect storm this sucrose which is fructose and glucose so excess fructose and then getting fructose in excess from high fructose corn syrup or getting fructose and excess from high fruit consumption that is unseasonal or unnatural or fruit that's been hybridized to be higher in fruit plus excess carbohydrates overall excess carbohydrate load that we would not have had evolutionarily like you're discussing this polyol pathway by which excess glucose can actually get converted to fructose”