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Michael discovers incorporating wholegrains into our diet, is a tasty swap that could really benefit our health. Wholegrains such as wholegrain pasta, bread and brown rice contain more fibre, vitamins and minerals, than refined grains. This simple swap can help reduce blood pressure, improve heart health and boost the gut microbiome. Michael talks to Dr Caleigh Sawicki, from the Brigham and Women’s hospital and Harvard Medical School, whose research suggests that the fibre consumption of wholegrains can keep us fuller for longer and this slow digestion could result in a lower increase in blood sugar.

Series Producer: Nija Dalal-Small Science Producer: Catherine Wyler Researcher: Sophie Richardson Researcher: Will Hornbrook Production Manager: Maria Simons Editor: Zoe Heron A BBC Studios production for BBC Sounds / BBC Radio 4.

You might’ve heard the terms nitrates, nitrites or nitric oxide in different contexts. There have been headlines about the “dangers” of nitrites in food, especially in processed meats like ham or bacon. But there’s also a lot of talk about the benefits of nitric oxide? It’s a very confusing topic, but hopefully after listening to todays podcast you’ll understand everything you need to know about these compounds!

In this podcast, I’ll go through:

• What nitrates actually are, as well as the terms you might have heard - nitrates, nitrites, nitric oxide and nitrosamines
• The controversy around these compounds
• How the body handles them and their impact on health
• Which foods are the highest in nitrates and why you want to eat them every day

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Gary Brecka is a human biologist and co-founder of 10X Health System.
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In this “Ask Me Anything” (AMA) episode, Peter delves into the critical subject of blood pressure, which is one of the three primary causes of atherosclerosis, along with high apoB and smoking. He begins by unraveling the nature of high blood pressure, its prevalence, and why it often goes undiagnosed. Peter describes in detail the proper way to accurately measure blood pressure and what determines a diagnosis. Next, Peter discusses the actionable steps one can take in response to high blood pressure, shedding light on the extent to which factors like weight loss, exercise, and nutrition can make an impact. He also explores the pharmacological options available and offers valuable insights on how to approach them.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #48 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

• Blood pressure and other risk factors for cardiovascular disease [2:30];
• Defining blood pressure and the purpose and meaning of a blood pressure measurement [5:45];
• The implications of high blood pressure and the importance of maintaining an optimal level [10:30];
• The importance of accurate measurements of blood pressure and how Peter approaches the care of patients at the very top range of “normal” [21:45];
• The prevalence of high blood pressure—a hidden epidemic? [24:30];
• The consequences of high blood pressure on cardiovascular health, brain health, kidneys, and more [27:45];
• Low blood pressure: symptoms and consequences [35:30];
• How to properly measure blood pressure [37:45];
• Daily variance in blood pressure and the transient changes in blood pressure during exercise [48:00];
• Primary hypertension vs. secondary hypertension: what to look for [51:45];
• Lifestyle factors impacting blood pressure: weight loss, exercise, and sodium [57:45];
• Impact of insulin resistance and type 2 diabetes on blood pressure [1:04:45];
• How sleep impacts blood pressure [1:06:45];
• Pharmacologic options for managing blood pressure [1:08:00]; and
• More.

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Today’s episode of The Drive is a rebroadcast of the conversation with Rick Johnson (originally released January 6th, 2020). This episode was one of the most popular discussions to-date and is a prelude to an upcoming follow-up discussion which will be coming out in February 2022 along with the release of Rick’s new book.

In this episode, Rick Johnson, professor of nephrology at the University of Colorado, explains how his research into the causes of blood pressure resulted in a change of research direction to focus more on how fructose has such profound metabolic effects. Rick begins by talking about the relationship between salt and high blood pressure, then provides a masterclass into uric acid, and then expertly reveals the mechanisms and pathways by which sugar (specifically fructose) can profoundly impact metabolic health. From there, he explains how he applies this information to real life patients as well as touches on some of the most promising ideas around pharmacotherapy that are being developed in response to the epidemics of fatty liver, insulin resistance, diabetes, and obesity. Furthermore, Rick gives his take on artificial sweeteners compared to real sugar, discusses cancer’s affinity for fructose, and much more.

We discuss:

• The connection between blood pressure and fructose that shifted Rick’s professional focus [3:00];
  
• The relationship between salt and blood pressure (and the role of sugar) [4:45];
  
• Defining fructose, glucose, and sugar [18:30];
  
• An ancient mutation in apes that explains why humans turn fructose into fat so easily [22:00];
  
• The problems with elevated uric acid levels, and what it tells us about how sugar causes disease [30:30];
  
• How sugar causes obesity—explaining the difference in glucose vs. fructose metabolism and the critical pathway induced by fructose [39:00];
  
• Why drinking sugar is worse than eating it [49:00];
  
• Unique ability of sugar to drive oxidative stress to the mitochondria, insulin resistance, and diabetes [53:00];
  
• Why cancer loves fructose [59:20];
  
• The many areas of the body that can use fructose [1:04:00];
  
• Fructokinase inhibitors—a potential blockbuster? [1:06:15];
  
• Treating high uric acid levels—Rick’s approach with patients [1:09:00];
  
• Salt intake—what advice does Rick give his patients? [1:15:30];
  
• How excess glucose (i.e., high carb diets) can cause problems even in the absence of fructose [1:20:00];
  
• Artificial sweeteners vs. real sugar—which is better? [1:28:15];
  
• Umami, MSG, alcohol, beer—do these have a role in metabolic illness? [1:32:45];
  
• Fructose consumption—Is any amount acceptable? Is fruit okay? Where does Rick draw a hard line? [1:37:45]
  
• How does Rick manage the sugar intake of his young kids? [1:42:00]; and
  
• More.
  

Could eating two squares of dark chocolate a day really help you reduce your risk of cardiovascular disease - and enhance blood flow to your brain? In this episode, Michael Mosley champions the wonders of chocolate. With the help of Professor Aedín Cassidy at Queen's University Belfast, he reveals the secret ingredients behind the benefits and why we should start to embrace the bitter taste of high cocoa chocolate.

In this episode, Rick Johnson, Professor of Nephrology at the University of Colorado, explains how his research into the causes of blood pressure resulted in a change of research direction to focus more on how fructose has such profound metabolic effects. Rick discusses the relationship between salt and high blood pressure, provides a masterclass into uric acid, and expertly reveals the mechanisms and pathways by which sugar (specifically fructose) can profoundly impact metabolic health. From there, he explains how he applies this information to real life patients, as well as touches on some of the most promising ideas around pharmacotherapy that are being developed in response to the epidemics of fatty liver, insulin resistance, diabetes, and obesity. Furthermore, Rick gives his take on artificial sweeteners compared to real sugar, discusses cancer’s affinity for fructose, and much more.

We discuss: 

• The connection between blood pressure and fructose that shifted Rick’s professional focus [4:00];
  
• The relationship between salt and blood pressure (and the role of sugar) [5:45];
  
• Defining fructose, glucose, and sugar [19:30];
  
• An ancient mutation in apes that explains why humans turn fructose into fat so easily [23:00];
  
• The problems with elevated uric acid levels, and what it tells us about how sugar causes disease [31:30];
  
• How sugar causes obesity—explaining the difference in glucose vs. fructose metabolism and the critical pathway induced by fructose [40:00];
  
• Why drinking sugar is worse than eating it [50:00];
  
• Unique ability of sugar to drive oxidative stress to the mitochondria, insulin resistance, and diabetes [54:00];
  
• Why cancer loves fructose [1:00:15];
  
• The many areas of the body that can use fructose [1:05:00];
  
• Fructokinase inhibitors—a potential blockbuster? [1:07:15];
  
• Treating high uric acid levels—Rick’s approach with patients [1:10:00];
  
• Salt intake—what advice does Rick give his patients? [1:16:30];
  
• How excess glucose (i.e., high carb diets) can cause problems even in the absence of fructose [1:21:00];
  
• Artificial sweeteners vs. real sugar—which is better? [1:29:15];
  
• Umami, MSG, alcohol, beer—do these have a role in metabolic illness? [1:33:45];
  
• Fructose consumption—Is any amount acceptable? Is fruit okay? Where does Rick draw a hard line? [1:38:45]
  
• How does Rick manage the sugar intake of his young kids? [1:43:00]; and
  
• More.

Learn more: https://peterattiamd.com/

Show notes page for this episode: https://peterattiamd.com/rickjohnson

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