Levels Chief Medical Officer, Dr. Casey Means, chatted with our advisor, Dr. David Perlmutter on the discovery of how the elevation of uric acid in the body is a causative mechanism in the development of metabolic diseases, and one of the key links between obesity, diabetes, heart disease, neurologic diseases like dementia, ADHD, fatty liver disease, and more.

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They also covered:

• The several mechanisms of how uric acid causes cellular dysfunction and insulin resistance, including oxidative stress, inflammation, and even preventing insulin from getting out of the blood stream effectively.
• The evolutionary reasons why the metabolic dysfunction and weight gain caused by uric acid would have benefitted us historically in terms of low access to food and water, by letting us more easily pack on weight and raise blood pressure. And how we now live in an evolutionary-environmental mismatch where this survival mechanism is now hurting us in the face of caloric abundance.
• The different dietary and environmental factors that generate uric acid, including fructose, purine rich foods and umami foods, dehydration, alcohol, and more.
• The optimal levels for uric acid.
• How uric acid impairs our hunger signals, drives us to eat, and even promotes risk taking behavior. We talked about how to reverse high uric acid levels as a way to unlock optimal health.

Levels helps you see how food affects your health, empowering you with the tools needed to achieve health goals and improve healthspan. Levels Members gain access to the Levels app and continuous glucose monitors (CGMs), providing real-time feedback on how diet and lifestyle choices impact your metabolic health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

(04:23) - More than just gout

(06:17) - A causative role

(08:54) - The number one cause of death

(16:35) - Evolutionary environmental mismatch

(18:08) - High fructose corn syrup

(23:39) - The dangers of uric acid

(24:49) - Uric acid and dementia

(31:44) - Too much fructose

(42:43) - Erectile dysfunction and cardiovascular risk

(01:04:29) - No need to eat sugar

Transcripts & Show Notes