AMA #62: Protein’s impact on appetite and weight management, and uric acid's link to disease and how to manage levels

Peter Attia

Aug 12, 2024

Episode description

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In this “Ask Me Anything” (AMA) episode, Peter dives into two important health topics: uric acid and protein, examining them from unique perspectives. For uric acid, he explores its metabolic role and connection to various diseases, focusing on the potential causal link with cardiovascular disease. He also discusses factors influencing uric acid levels, such as diet, genetics, and lifestyle, providing practical tips for effective management. Shifting to protein, Peter delves into its role in appetite and weight management, the consequences of insufficient protein, and the “protein leverage hypothesis” linking protein deficiency to obesity. He covers optimal protein intake and its impact on energy expenditure, and he compares the satiety effects of solid versus liquid protein. Finally, Peter shares his strategy for incorporating protein into a comprehensive weight management plan.

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 #62 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • Overview of episode topics (and an important discussion on fanny packs) [2:00];

  • Understanding uric acid: its role in metabolic processes, its association with gout and kidney stones, its impact on blood pressure, and more [6:00];

  • Non-modifiable factors that influence uric acid levels [11:00];

  • Modifiable factors that influence uric acid levels [14:15];

  • Association between high uric acid levels and cardiovascular disease [20:00];

  • Evidence suggesting a causal link between high uric acid levels and cardiovascular disease [24:00];

Episode description

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

In this “Ask Me Anything” (AMA) episode, Peter dives into two important health topics: uric acid and protein, examining them from unique perspectives. For uric acid, he explores its metabolic role and connection to various diseases, focusing on the potential causal link with cardiovascular disease. He also discusses factors influencing uric acid levels, such as diet, genetics, and lifestyle, providing practical tips for effective management. Shifting to protein, Peter delves into its role in appetite and weight management, the consequences of insufficient protein, and the “protein leverage hypothesis” linking protein deficiency to obesity. He covers optimal protein intake and its impact on energy expenditure, and he compares the satiety effects of solid versus liquid protein. Finally, Peter shares his strategy for incorporating protein into a comprehensive weight management plan.

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 #62 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

We discuss:

  • Overview of episode topics (and an important discussion on fanny packs) [2:00];

  • Understanding uric acid: its role in metabolic processes, its association with gout and kidney stones, its impact on blood pressure, and more [6:00];

  • Non-modifiable factors that influence uric acid levels [11:00];

  • Modifiable factors that influence uric acid levels [14:15];

  • Association between high uric acid levels and cardiovascular disease [20:00];

  • Evidence suggesting a causal link between high uric acid levels and cardiovascular disease [24:00];

Mindsip insights from this episode:

Manage uric acid spikes from intense anaerobic exercise

Heavy anaerobic exercise can cause a temporary spike in uric acid due to muscle ATP depletion, but this is not considered a pathological issue as the body seems to adapt.

Lower uric acid to reduce blood pressure

The link between high uric acid and high blood pressure is causal, as demonstrated by Mendelian randomization studies, meaning lowering uric acid can directly lower blood pressure.

Monitor uric acid levels post-menopause for health insights

Uric acid levels in women tend to be stable until menopause, after which they increase sharply, suggesting a protective role for estrogen.

Recognize obesity as a cause of high uric acid levels

Mendelian randomization studies suggest that having higher levels of body fat causally leads to high uric acid levels, rather than the other way around.

Limit beer consumption to manage uric acid levels

Beer is particularly high in the purines that create uric acid because it contains a lot of yeast, which has its own genetic material.

Beware ketosis: it can trigger gout through increased uric acid

Being in a state of ketosis from diet or fasting can dramatically increase uric acid and trigger gout because ketones compete with uric acid for excretion in the kidneys.

Use allopurinol to manage uric acid during prolonged fasts

To counteract the rise in uric acid during prolonged fasts, the host takes a medication like allopurinol.

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