“I don’t love being a doctor anymore….” So began a lecture titled “Healthy, Wealthy, and Wise?” that I attended on our American diet, presented as the Virginia Hospital Center’s Annual Dolan Lecture. The speaker, Dr. Robert H. Lustig, explained that he became a doctor to treat diseases of children. But now, he says, he spends most of his clinical time taking care of children suffering from adult diseases: particularly chronic metabolic diseases often related to obesity and diabetes. Although the subject matter was shocking and sad at times, the lecture was educational, entertaining, and transformative. Dr Lustig’s theme was that Americans, and especially our children, are suffering from chronic metabolic disease primarily because of the amount of added SUGAR in the foods we eat.
Following are some highlights from the lecture, but I urge you to make some time to watch Lustig’s similar talk, “Sugar, the Bitter Truth” on YouTube—it’s long (90 minutes) but so worth your time. It could indeed change—and even save—your life. Here’s a snip to give you an idea.
Who’s Healthy? Not US, Apparently!
• In 2001, 6 million kids in the U.S. were seriously overweight (obese). At present, that number is 20 million. By 2030, 42% of Americans will be obese if the current trend continues.
• Of the 30% of Americans who are obese now, about 80% have a metabolic disorder. However, so do about 40% of the non-obese population, which is an even larger number.
• Rates of type 2 diabetes are climbing faster than obesity rates. This counters the common belief that type 2 diabetes results from obesity.
• Dr. Lustig gave many persuasive arguments, using both epidemiology statistics and nutrition biochemistry, to show that the real culprit is all the added sugar in our modern American diet. Change the diet and you take a big chunk out of both epidemics: obesity and type II diabetes.
Wise Up. What Causes Obesity and Metabolic Disease?
Some Biochemistry from the Dolan Lecture
• The driver for obesity in most American kids and adults is defective leptin signaling to the brain (called leptin resistance). Leptin is a hormone that regulates metabolism and body weight. It is part of a network of regulatory hormones that control how energy (calories) is metabolized and used in the body.
• The brains of leptin-resistant people do not receive the signal that they are full, so their brains tell them to “keep eating, we’re still hungry.”
• Too much insulin production is a factor in leptin resistance. So lowering insulin production helps prevent leptin resistance and overeating.
• Americans today produce much more insulin than we did 30 years ago. So how did we change our biochemistry? It turns out that added sugars (like those in processed foods) increase insulin production, which in turn overrides the leptin signal that we’re actually full with sufficient energy to burn.
All calories are not created equal
• According to Dr. Lusting, nutritional biochemistry shows that some calories cause more problems than others. It’s not just how many calories you eat but what your body does with those calories.
• In America today, we are waaaay too much into processed foods, which includes nearly everything served at fast-food places. In fact, 80% of items in the American food supply have added sugar (e.g., sucrose, high-fructose corn syrup).
• While many things are wrong with our processed food diet, Dr. Lustig believes that SUGAR IS WHERE THE ACTION IS. The added sugars we increasingly consume are not just “empty calories”: our bodies actually metabolize them differently.
• For example, fruits and vegetables contain relatively small amounts of fructose (a simple sugar) that are bodies can handle well. The problem is added fructose, which has infiltrated our diets in the form of soft drinks, cereals, convenience foods, canned sauces, soups, etc. Half of every gram of sucrose (cane sugar) or high-fructose corn sweetener is fructose. The added fructose overwhelms our bodies’ ability to process it as a useful energy source, and instead stores it as FAT.
• When it comes to carbohydrates, complex carbs are better than refined carbs (present in processed foods) because the body takes longer to break them down to glucose (another simple sugar), even at the same number of calories. So whole grains and other complex carbs provide a slower, steadier feed of essential fuel to the body. And they contain little or no fructose.
Is diet soda a solution? A recent study showed that, like regular soda, the diet stuff is also associated with obesity, diabetes, and heart disease. The study found that drinking even one can of diet soda per day is "enough to significantly increase the risk for health problems." Here’s Huff Po’s take on the NIH-supported study. Said Dr. Lustig: the results to date are “not absolute[ly certain] but a worry.” My personal advice: avoid them. They may be fooling your brain, resulting in overeating, lowered energy metabolism, and increased fat storage.
• So guess who’s wealthy? Yep! Processed food manufacturers. According to this chart from the Bureau of Labor Statistics, we have doubled our consumption of processed foods and sweets since 1985.
Finally, what infused this lecture was Dr. Lustig’s passion for getting the word out about sugar. In addition to authoring many academic works, Dr. Lustig is the president of the nonprofit Institute for Responsible Nutrition, a think tank devoted to improving our food supply.
Start a new trend today: read labels—and ingredients—and look for added sugar. Start to shake the sugar habit, even a little at a time. Small steps can lead you to a new, healthier pattern.
Other helpful resources:
Dr. Lustig’s books Fat Chance and the Fat Chance Cookbook + Sugar Has 56 Names: A Shopper’s Guide, which emphasizes the importance of reading labels, NOT just for nutrient info (the Nutrition Facts box), but also Ingredients.*
*If a package says “made from whole grain,” and the first ingredient is “wheat flour,” that doesn’t mean much. Any time the grain has been beaten into flour, you’re right back to processed, refined food and accelerated glucose absorption.
The toxic truth about sugar (Lustig et al. Nature. Vol. 482, Feb. 2, 2012)
Is Sugar Toxic? (G. Taubes. New York Times. April 13, 2011)
Interview on NPR’s Talk of the Nation, January 2013:
The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data (Basu et al. PLOS One. Feb. 27, 2013). The study’s authors, which include Lustig, urge public health policies to reduce sugar consumption as diabetes prevention, especially for developing countries where diabetes rates are rising dramatically, “irrespective of obesity.”
Keep moving — Jen Katt