David Perlmutter MD reveals the exciting and challenging science behind a major health risk that almost no one is talking about. Find out how uric acid is contributing to some of the biggest health risks in modern life, how the standard American diet is the perfect formula for creating dangerous levels of uric acid in your body, and how you can make changes to your diet that will help you lose weight, control your blood sugar, and live a healthier life.  [1:40] As of 2022, David will be 67 years young and he’s planning on traveling from Vancouver to Alaska with his wife. The world has a lot of variability and uncertainty right now so it’s hard to make detailed plans for the following year, but in some ways, that’s good because it forces you to focus on the present. [5:00] David’s new book is called Drop Acid. It specifically deals with uric acid and how we discovered it to be a central player in regulating metabolic health. It’s not only that uric acid just becomes elevated, it actually plays a causal role in conditions like diabetes, hypertension, and obesity. [7:45] Metabolic issues are the number one cause of mortality on the planet. Countries like Japan have been aggressive in intervening with people with high levels of uric acid because of its dramatic associations with death from all causes. [8:25] Risk of death due to cardiovascular disease rises by 38%, stroke by 35%, and for every point of elevation in uric acid above 7 all cause mortality increases by 8%-13%. Having a high uric acid level is associated with a 80% risk of dementia, and a 55% risk of Alzheimer’s. [10:00] Testing uric acid levels is fairly routine, but what it indicated wasn’t meaningfully understood until recently. David began looking at uric acid because of his interest in metabolic health and its association to Alzheimer’s. The original paper linking uric acid to metabolic issues was published in 1894, and was buried until a researcher named Dr. Richard Johnson started doing studies on it. [12:15] David was listening to a podcast episode with Dr. Peter Attia doing an interview with Dr. Johnson and he was overwhelmed by the information. Every minute was a new pearl of information. David started communicating with Dr. Johnson, which became the basis of a new friendship. [14:30] The genetic mutations that cause humans to have higher uric acid than other mammals happened around 14 to 17 million years ago as an evolutionary survival mechanism. In times of food and water scarcity, uric acid allowed us to increase our blood sugar and retain water which were powerful advantages. [15:45] To this day, we have a component of our genes that want to be thrifty and pack away fat for the next period of food scarcity. Historically, the biggest threats to our survival was in finding food sources and being eaten by predators, and uric acid helped with both of those. [16:55] Certain cultures have evolved this gene and are more at risk of negative effects from it in our modern world. Fructose is the key ingredient to uric acid production in the body and the world is awash with it. The highest rates of obesity are in those genetic populations. [18:50] 50% of American adults will be obese by 2030, including children. 10% of kids between 12 and 18 are hypertensive. This is a direct manifestation of the foods we are eating, primarily fructose. Fructose is metabolized into uric acid and uric acid is doing the dirty work. [20:10] In the context of 99.9% of human habitation on this planet, this adaptation was very advantageous. It wasn’t until recently, when our diets have changed so significantly, that it has become a liability. [21:15] Clearing uric acid is where the challenge is. We have lost the function to clear uric acid and with most foods we eat increasing uric acid levels, it can be difficult to keep levels low on the standard American diet. Fructose is the main culprit and average daily consumption increased by 1000% between 1970 and 1990. {24:30] Not all alcohol is