This week, Alec talks with Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco, about our country’s addiction to sugar. Children today are the first American generation to have a shorter life expectancy than their parents, in large part due to obesity. According to Lustig, this obesity often comes from eating too much sugar.
Sugar is hard to avoid. A recent study reveals that 80 percent of the 600,000 food items in America are laced with added sugar. Lustig says, “There is not one biochemical reaction in your body, not one, that requires dietary fructose, not one that requires sugar. Dietary sugar is completely irrelevant to life. People say oh, you need sugar to live. Garbage.” Dr. Robert Lustig has made it his business to get the rest of the world to pay attention.
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I'm Alec Baldwin, and you're listening to Here's the thing. One of every three American adults is obese. Some reacted to Mayor Bloomberg's recent proposal to limit the sale of plus size sodas as just another example of a supersize government, but the truth is stark. Children today are the first American generation to have a shorter life expectancy than their parents, in large part due to obesity. As you probably already know, obesity is linked to diabetes, heart disease, and even cancer, and is arguably becoming the most pressing public health issue of our time. Last year, this issue became a personal one when my doctor told me I was pre diabetic. So when I read about doctor Robert Lustig and his wildly popular anti sugar lecture posted online, I paid attention. Sixty ounces of Coca cola, a Snicker's bar, in a bag of Dorito's, all for nine nine cents, and next I gave up sugar. So what do I call it the Coca Cola Conspiracy? Well, what's in coke? Caffeine? Good? Good? So it's caffeine. It's a mild stimulant, right, It's also a diuretic, right, makes you pee free water? What else is in coke? We'll get to the sugar in a minute. What else salt? Milligrams of sodium per can. It's like drinking a pizza. So what happens if you take on sodium and lose free water? You get thirstier? Right? So why is there so much sugar and coke to hide the salt? Dr Lusti is a pediatric endochronologist at you See San Francisco. Back in the eighties, he became interested in diet and obesity while working at St. Jude Children's Research Hospital in Memphis. He was treating kids recovering from brain tumor surgery. I had a stable of kids who were enormously obese, and the thing was, they were obese before the tumor, but they started gaining weight at thirty to forty pounds a year after per two year, per year, with no cessation, NonStop. These kids suffered from something called high both a lamic obesity and especially heinous form of obesity that doesn't respond to diet or exercise. When the hormone leptin was first discovered, it became very clear that these kids, because that area of the brain was dead. They couldn't see their leptin signal. Now, normally lepton would tell you you don't need to eat so much and you can burn energy properly. Literally, is the signal about appetite. And these kids were constantly hungry, and worse yet, they were the world's biggest couch potatoes. They lost interest in every single thing around them. They would sit in the couch, eat doritos, and sleep. This was their life. And the parents would come to me and say, this is double jeopardy. My child has survived the tumor only to succumb to a complication of the treatment. Why did the couch and potatoes? What was the link there? Because when your brain sees lepton, you want to burn energy. You want to exercise, you want to be physically active, you want to concentrate, you want to go do things. Leptin signals the body to exercise. Leptin signals the body that you have enough energy on board to exercise. When your brain can't see it, your brain thinks you're starting. And my job was to figure out a way to take care of these kids. So my research and obosity started back. We said, okay, these kids brains, that area of the brain is dead. I can't bring it back. I'm not a neurosurgeon. I can't transplant the hypothalamus. What can I do? So I, after doing some research, realized that we could work down stream of the brain. The brain was signaling the pancrease to make extra insulin. Insulin makes you store energy, So these kids are known to have enormously high insulin levels. So I said, all right, let's give these kids a medicine that will block the release of insulin. We did a study and low and Behold patients started losing weight, but more importantly, they started exercising. One kid started competitive swimming, two kids started lifting weights at home. One kid became the manager of his high school basketball team, running around collecting all the basketballs. I mean, you know, parents were calling me up within a week saying I've got my kid back, right. But some people also link this. You talk about the activity of the lack of activity to political things and economic things like cuts and school budgets for activities and so where, and technology. The kids are much more interested in virtual games and not getting out there and playing a game. Do you see that with the kids you worked with as well? There's no question that all those things are true. The questions are those cause or effect? There are loads of correlations and a lot of them have nothing to do with anything. The point was this was caused because we were interfering with insulin release and these kids changed their behavior. And that was the first key to what I think is the entire enchilada in terms of the obesity epidemic. And then what happened for you I wanted to do next. So then we said, maybe there are adults out there who have the same problem, they just don't have a brain tumor. Let's look for it. So we did a whole study pilot study with forty four obese adults, and we gave them the same drug to do the same thing, and loan behold, eight out of the forty four, not all of them by any means, but eight out of forty four lost a lot of weight a pound a week over twenty four weeks without doing anything. And what was even more amazing was their fat intake didn't change, their protein into didn't change. Their carbohydrate intake dropped on a dime. They went from nine hundred calories a day to calories a day, and carbohydrate they stopped snacking between meals and most important crackers bugles, you knows, absolutely. And these kids needed to get their insulin down and the medicine did it. And these adults needed to get their insulin down, and the medicine did it for them too. And most importantly, when we got there insulin down, guess what, they started exercising. So this all of a sudden became very clear. What's going on for these kids with the brain tumors. They couldn't see their leptin. Their insolence were sky high because their brain was starving. And because their brain was starving, they would eat everything under the sun and it still wouldn't be enough because they could never see their leptin. And what we realized was this is adult obesity too. They can't see their leptin either. That's where sugar came in. So sugar was a but they also triggered other It enabled other bad eating exactly. And we've learned that the higher insulin goes, the hungrier you get. Hungry you are, So the sugar is an appetite stimulant in a sense, clerant, whatever you want to call you can call it that. Absolutely we know that because David Ludwig, my opposite number. At Boston Children's he prepped a bunch of kids with a soda, a can of soda a hundred fifty calories, and then he let him loose at the fast food restaurant. So the question is did they eat more? Did they eat less? Do you think more ate more? Their insulind was high, and also there's high insulin makes you hungry. That's right, High insulind makes you hungry. And also there's a hormone in your stomach that signals hunger called grellin, And when grellan's high, you're hungry, and sugar doesn't knock it down. When I gave up sugar, it was amazing. It was like pushing a toboggan along a track to eventually get down the slope. The first couple of weeks, the first couple of months, that part in early May through June. By the time we get to July and August, we're going downhill and the weights just coming off. I cut out carbs, and I gave up pasta because that was the mega dose of carbohydrate. I mean, I would eat, you know, the fish tank sized bowl of pasta. You know, I had a lot of pasta and it's easy to do. A lot of people think that the Italian diet is the Mediterranean diet. Not at all. There is no pasta in the Mediterranean diet. We started the pasta craze because of all the immigrant Italians who couldn't afford to eat meat and vegetables here. That's what they fell back on, and it actually got exported from here back to Italy. Sam As Chop Suey did it to China. You know, these are all American inventions. So the fact is that the Italian diet is not the Mediterranean diet, never was, never will be. But I would say to people I cut back on bread. They say, okay, great. Then I'd say to them I gave up pasta. They'd say, WHOA really wow that I'd say, I gave up sugar, and they go and they're insane. Exactly. It was as if I said to them, let's go learn to play the classical piano. Now, let's begin now. It's just as undoable to them. The looks I got from people about giving up sugar. How did sugar become We're consuming a hundred and thirty pounds of sugar per person per year. Was it always that way, No, No, this is very what do you think change that? Money and marketing and you know, the food industry. So there are a couple of sort of milestones in this story. The first is the nascent candy and soft drink and sugar industry in America, which dates back to the early nineteen hundreds, but that didn't really get things started because sugar was still kind of expensive, and sugar had been expensive all throughout history. In nineteen fifty nine, we lost our sugar fix because Castro took over Cuba, and that actually started the Florida sugar industry because the sugar had come from Cuba prior to that. That's right of it, a lot of it. So that started the American sugar industry really in top notch gear. It had been in Louisiana, it had been in Hawaii. Then high fuctose cornserrup kimel, high fuctose corn syrup shows up, and all of a sudden, it's in everything. Why well, it actually it's sweeter. It is sweeter, but most important, it's cheaper. But do you find that also, this is what's happening over the last I don't know how many years. I mean, I'm not somebody who knows the history of this, but certainly in my lifetime, which is the goal is to make everything sweeter. The point is that this is actually evolutionary. This isn't her DNA, because there is no food stuff anywhere in the world that is both sweet and acutely poisonous. So it was a signal to us. It was a signal to us that it was safe to eat, even Jamaican cky fruit, which has a substance in nicolled hypoglycin, which causes Jamaican vomiting sickness and can kill you. It's only in the immature fruit. As soon as the fruit falls from the tree to the ground. Jamaican's no, it's okay to eat because it's now ripe and the toxin is gone. So we are programmed to like sweet. And what has happened is the food industry figured it out and they hijacked our taste buds for their own purposes. When you think about this epidemic, and it is an epidemic because it's a pandemic, I don't say this with any smugness or satisfaction. I say this with a lot of sadness because I had always been thin I thought I was doing the right thing health wise. I'm a vegetarian, I'm a pesketarian, if you will, And I'm beginning to really really blow up here. You know, Listen, we've got vegan type two's who are massively obese. And just because you're vegan doesn't getting that from what? What do you think they getting from? Sodas her vegan especially South Asians Indians, they can't carry as much subcutaneous fat. And once you basically fill up your subcutines, your love handle fat stores, it starts building up in your liver. And when that happens, it's all done and hell after that. But when I go out there in the world now, and I have a tremendous awareness to this obesity issue that other people are dealing with, and I have a tremendous empathy for them, I must say, everywhere I go, I see it. You want to walk up to that guy, or you want to walk with this women, you gotta go give up something, you know, the frat puccinos, or the candy or the or the bread, because you really see that people are suffering. And that's why this is so important. But other people have worked towards this prior to you. You're You're not the first person sugar is bad. Look, this has been going on since the seventies, this discussion. The chief anti sugar campaigner was a guy by the name of John Yudkin, and he was a British physiologist, nutritionist, and he wrote a book back in seventy two called Pure White and Deadly. You read this book, it's just astounding. Everything came to pass. On the other side, we had this guy, Ansel Keys, and he had done a sabbatical at the University of Cambridge in nineteen fifty two and he saw what, you know, the Brits were eating, and it was pretty horrible. And he came to the conclusion that saturated fat had to be the cause of heart disease. And he did many studies all over the world and he published a five tome called the Seven Countries Study back in nineteen seven. That was the question was that the fatter was at the sugar. We didn't know at that point what happened to sugar in the liver. We didn't know that it got turned into fat. What we knew was that saturated fat correlated with l d L levels in l d L correlated with cardiovascular disease. So the thought was, let's get rid of the saturated fat and cardiovascular disease will disappear. The whole country went low fat back in nineteen eighty. Here's the problem. When you go low fat, the food tastes like cardboard. And the food industry knew it. What were they gonna do? How are they gonna sell food? And now we had high fructose corn syrup too, When does that get introduced into the food market. The early seventies, seventy three seventy five American corporations in the second worst hurricane in American history, Hurricane Allen. It wiped out the entire Caribbean sugar cup and the food industry, especially the beverage industry, ran scared. They said, where are we going to get the sugar for all the soft drinks? And that's when reliable market exactly, And they started introducing it, and they started upping the dose, and by the transformation was complete. Is the process of getting table sugar from cane sugar more labor intensive and more expensive than the high fructose CORNCERRP process by a lot. High fructose corn syrup comes from corn and the corn market and the corn supply in this country is far more plentiful and far more liable then the cane sugar. Correct of all of the corn grown in America today ends up as high fructose corn syrup. So we have boatloads of it, and it's cheap. And because it's cheap, it started finding its way into things that never had sugar before, like hamburger buns, hamburger meat, barbecue sauce, catchup, salad dressing, I mean pretty much everything you can imagine in the store. Indeed, Barry Popkin at the University of North Carolina has just done a study that shows that eight of the food items there are six hundred thousand food items in America them are laced with sugar added sugar. Do you think that they understood back then that sweetening the bond would just about taste They knew that when they put it in, we bought more that they knew. They knew that when this was in there, people ate more of it. Palatability equals sales. It did then it does now, and we love sugar, and that's why the entire food supply of America is now sweeter than you can imagine. You walk into a drug store and there is an expanse of sugary items, candy, gum mints. And I have friends of mine who are grown people, men and women. They see a candy and you see them change behaviorally before your eyes. They'll come in and they're having a very serious conversation with you or the person you know, and all of a sudden they turn they go, oh, jelly beans. It's like kryptonite, and they just can't stop eating that stuff. Here's the problem. There's an area of your brain called the reward center. Everybody's heard of it because you know drug addiction. You know that addiction. Cocaine, morphine, heroin, nicotine, they all work in the same place. And the neurotransmitter that signals pleasure is called dopamine. You've probably heard of it. Of course, when you get a dopamine rush, you get pleasure and sugar as it the same way as all of those drugs of abuse. The problem is, when you get that pleasure, you downregulate the little proteins that catch the dopamine, called dopamine receptors, and the more you downregulate them, the more dopamine you need to get the same effect, and that's called tolerance. And then when you take the stuff away, then there's no dopamine to interact with these few proteins left, and that's called withdrawal. Tolerance and withdrawal that's called addiction. So we know how that works for all of these other drugs of abuse. Turns out sugar does the same same thing. It's the same as cocaine. The difference is that for cocaine you gotta go find it, whereas for sugar we have what we call system saturation. It's everywhere, you can't escape it. This is Alec Baldwin and you're listening to here's the thing more in a moment. Today, I'm talking with Dr Robert Lustig. We talk about regulation of like alcohol and tobacco, and I want to say that that's something that people have tried in public policy with sugar. They tried to stop food stamps being used to purchase soft drinks, and I believe they lost that that right Bloomberg petition the U s d A to take soft drinks off food stamps, and the U s d A rebuffed. Why do you think they did? Why do you think that rather than the straight up political influence of the soda ind isn't that enough? How does the U s d A do that? No one's saying that the people who are on food stamps you can't have soda. I doesn't want the government to pay for it. The U s d a's job is to sell food. That means sell whoever is going to buy it. So it's about commerce, it's about absolutely and who controls the us d A. The U s d A is basically the governmental arm of the food industry and the job of the usd You don't have a lot of faith in the us d not a whole lot. Now, the job of the USDA is to protect the food supply, and that includes protecting it from people like me. In terms of threats to public health, would you equate other products and other substances that are commonly used as being equally threatening as sugar. Du there's a caffeine epidemic in this country. There is a caffeine epidemic, and it's being stoked by all the coffee companies. But it's of less concern to you than sugar, oh way, because there's no toxic downside with sugar, type two diabetes, hypertension, dyslipidemia, gastric bypasses a hundred and forty seven billion dollars a year down a rat hole for taking care of chronic diseases which don't need to be We could balance the budget on that. We wouldn't need healthcare reform if we had obesity reform. And we can't have OBEs reform until we have some sort of sugar policy. You mentioned pretty regularly the food industry, this, the food industry that, and you know, most Americans I think who are smart realize that we have more than enough food to feed three quote unquote square meals a day to everybody in this country and those that aren't getting it. It's because of the distribution of food in our society. However, we have to cut a lot of corners to get there. In the way we produce beef, and the way we produce livestock, and the way we produced past sides, fungicides, herbicides, all of this stuff. We need a new food model. We need a new food growing model. By we're gonna need four California Central valleys in order to feed our population. We won't even have one because of the runoff in the sierra that changes in soil erosion. We won't even have one. So you know what, the obesity epidemic might even take care of itself because we'll have a famine because we are misusing our food system. Michael Pollen writes about this routinely. The bottom line is by chemically, our current food environment does not work for us, and until we fix it, will continue to pour money down a rat hole. We will continue to be sick, We will continue to die of things like diabetes and heart disease. Medicare will be broke by because there won't be any money to pay for it. You won't be able to see a doctor because they will be too busy taking care of all the other fat people in the emergency room we're having their heart attacks, and there won't be enough food anyway. As I'm listening to I'm getting really depressed and I want to go have ice cream now you really me? I want to know him enjoy bar really badly. The bottom line is there's a lot of reason to be positive. And I'll tell you why, give me an example. People are getting it. This is the tipping point. We're here now. People are starting to recognize that there's an obesity epidemic, not just obesity noncommunical disease. The epidemics diabetes exactly. That's what sucks out all the money from the entire meta establish In the sixty minutes program that you were on. Recently, they got into the cancer link. Breast cancer in particular is famous for having insulin receptors and growing in response to insulin. Prostate prost insulin receptors. Yes, they do, so there's a lot of reason to be concerned, and there's a lot of reason to keep your insulin down for all sorts of reasons. Number one, it doesn't fuel any tumors. Number two, it lets your left in work. Number three, it doesn't increase the smooth muscle of your coronary arteries so that you might end up getting a heart attack. There's a whole bunch of reasons to keep your insulin down. And the thing that makes your insulin go up most Sure, a lot of people are terrified when they sit down in a restaurant. A lot of people that are trying to stay fit and trying to stay healthy, they can go through periods. I've been through this myself where I have like a mild panic attack when I sit down at the restaurant because they say to myself, there's an enemy lurking in everything. Here. There's mercury and the fish, and there's hormones in the chicken. I don't need be even paltry. And there's too much sodium here, there's too much fat here, I don't need. It's true, it really is true. And ultimately we're all going to die of something with some very small number of exceptions. Isn't an argument being made that everything we're eating is gonna kill us? Absolutely? And I know that and you know it too. The question is how and when and with what misery that comes with down And the answer is yes, you can. The single best thing you can do for yourself quality of life wise, exercise by far and away. Nothing else comes close. The next thing that's most important is when you're eating, make sure you have some fiber. When people want to go eat fiber that you recommend they eat. Now, where do they go? Very simple? Brown food, brown and green. Okay, if it's brown and green, it's got fiber, because fiber is brown. Wheat comes out of the ground, What color is it? It's brown, You send it to the mill, you make bread out of it, and that what color is it? It's white. Where'd the brown go got milled off? God made carbohydrate with inherent fiber. So we have brown rice, whole grains, beans, we have lentils, we have other legumes, we have nuts. They're all just great. But as soon as you remove the fiber, which is called processing, now you've got a problem because now when you eat it, the sugar gets absorbed so fast that your liver gets overloaded, your mitochondria basically get sick, and now you've got insulin resistance, and now you've got all the diseases going downstream from People need to have an elevated level of consciousness and discipline about eating pasta, rice and potatoes as well at the moment they do. Um. Ultimately, I'm hoping that with sugar, it's that it's that that one to punch for sure. Absolutely, I'm hoping that the food industry will pick up on this and do the right thing. But the right well, the right thing would be to actually sell real food so that we can eat real not process if you they can do it now, you know, years ago we couldn't because we didn't have the distribution system to be able to do it. We have it now we could do it. We have the technological capability to serve and eat real food, but the food industry is making money hand over fist. If you could pick one or two things that you would change in public policy, if it was like getting the soda machines out of schools, it would be like no food stamps for soda. What would be a change in public policy? You would make one thing? What is it? The FDA currently has fructose, the sweet part of sugar, on what it's called the grass list g R A s generally regarded as safe, also has transfats on it at the moment as well. It needs to be reevaluated. It needs to be revised. The last time this was looked at, and this was before the hind fructose corn syrup blood this was before the excess sugar quarter of a century ago exactly, and they have no plans on doing so. If I could do one thing in this entire thing, it would be that what would be one more um? I would think very strongly about limiting access of sugar beverages to infants and children like zero. There's no reason for it. Something your listeners need to understand. There's not one biochemical reaction in your body, not one that requires dietary fructos, not one that requires sugar. Dietary fructos is completely irrelevant to life. People say, oh, you need sugar to live garbage. Dr Robert Lustig is writing a book about the dangers of sugar called Fat Chance, Beating the Odds against Sugar, Processed food, Obesity, and Disease. It will be out in December. Knowing what you know? What are things you don't eat? What's your diet becomes since you've been doing this work. I carry a few extra pounds and I'm not happy about it. I don't eat sugar. You don't know. I have dessert twice a year. When I'm in New York, I have a piece of Junior's cheesecake. And when I'm in New Orleans, I have bread, pudding, whiskey sauce. Those are my too, uh, twice a year other than that, No, I really don't, to be honest with you, it's not because I did this work. It's because it usually just doesn't appeal to me. What are you eating that you think you should be eating? Well, I have a half a bagel in the morning with cheese. That's sort of my standard. Breakfast and my wife gets on me for that. For lunch, Unfortunately, because I'm running between you know, patients, it often ends up being something very processed, and it's a real problem for dinner though it's a very standard dinner and I don't snack between meals, and I still can't lose it. So I understand. I'm there. I'm part of the sept probably not. I'm Alec Baldwin and you're listening to Here's the Thing who don't make the f right