Dhru Purohit Show - The Bitter Truth About Sugar & How It's Destroying Your Health with Dr. Robert Lustig

Episode Date: March 3, 2022

This episode is brought to you by BiOptimizers and InsideTracker. Seventy-four percent of products in the grocery store are spiked with some kind of sugar. The food industry has done this on purpose to keep you coming back for more.  Here’s the thing: The liver can innately process a small amount of sugar packaged in a real food, like a piece of whole fruit. But when it comes to large amounts in our food supply—and regularly eating lots of concentrated fructose in particular—we are poisoning our liver and mitochondria, and severely disrupting our microbiome.  Today on The Dhru Purohit Podcast, Dhru talks to Dr. Robert Lustig about the real dangers of eating too much sugar and how to take better care of our metabolic health. Dr. Lustig is a neuroendocrinologist with expertise in metabolism, obesity, and nutrition. He’s the Emeritus Professor of Pediatrics in the Division of Endocrinology and a member of the Institute for Health Policy Studies at UCSF. He is also one of the leaders of the current “anti-sugar” movement that is changing the food industry, in part through his game-changing books. His latest work is Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine. In this episode, we dive into:  -Understanding the difference between cells growing and burning, and what this has to do with disease (7:51)  -The eight chronic metabolic diseases (16:04) -The eight subcellular pathologies that underlie metabolic diseases (19:24) -How to fix the eight subcellular pathologies (22:47)  -The calorie myth (31:10) -The biggest sources of fructose in our diet (45:40) -The four substrates in our food supply that damage mitochondria (53:11) -How fructose can cause leaky gut (58:24)  -Alcohol, sugar addiction, and how to safely enjoy dessert (1:19:24) -What you can do to create change in our food system (1:33:49)   For more on Dr. Robert Lustig, follow him on Facebook @drrobertlustig, Twitter @robertlustigmd, YouTube @robertlustig, and through his website https://robertlustig.com/. Get his book, Metabolical here. This episode is brought to you by BiOptimizers and InsideTracker. Magnesium Breakthrough from BiOptimizers really stands out from the other magnesium supplements out there. It contains seven different forms of magnesium, which all have different functions in the body. There isn't anything else like it on the market. BiOptimizers is offering my community 10% off. Just head over to magbreakthrough.com/dhru and use code DHRU10. InsideTracker provides detailed nutrition and lifestyle guidance based on your individual needs. Right now, they’re offering my podcast community 25% off. Just go to insidetracker.com/DHRU to get your discount and try it out for yourself. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

One sugar-laden meal. It's a delight. It's a feast. 10,000 sugar-laden meals is death. Every meal is now a sugar-laden meal because there's sugar-laden meal. Welcome to the Drew Proet podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Robert Lustig, and he's on the podcast to walk us through the

six cellular pathways that can be utilized to create longevity and health or hijacked, primarily by sugar and refined carbohydrates, to create chronic metabolic disease. A little bit about Dr. Lustig. Dr. Lustig is a neuroendocrinologist with expertise in metabolism, obesity, and nutrition. He's the emeritus professor of pediatrics in the division of endocrinology and a member of the Institute for Health Policy Studies at UCSF. He's one of the leaders of the current anti-sugar movement that is changing the food industry, and he's doing that with his game-changing books, including his last one, which was called Metabolical, the lore and the lies of processed food,

nutrition, and modern medicine. If you're curious how big food hijacks our health with processed foods and tons of sugar, and what you can do about it, and more importantly, how you can can actually get these six cellular pathways back in your control, this episode is for you. Stay tuned. Dr. Robert Lustig, thank you for coming on the podcast. I'm a huge fan. And I'd love to jump right into our interview by reading one of your own quotes and using that to jump off into our first question.

So you're going to use what I said against me already? Hopefully for you. You said that you can't fix health care until you fix health. You can't fix health until you fix diet. And you can't fix diet until you know what the hell is wrong. So I've invited you on this podcast to help us figure out what the hell is wrong. Give us a few things, the top maybe three that you want to cover, that help us to understand what the hell is going on and why is it so wrong.

Well, first of all, Drew, thanks so much for having me. It is my pleasure. I listened to you, and you know, you've done an amazing job of curating, you know, this really complex topic of metabolic health and especially brain health. So thank you. So I'm going to just lay it out there. I'm going to go out on a limb and I'm just going to, you know, tell you the two words, the two dirtiest words in the English language. Process food. Okay, and then I'm going to tell you the one dirtiest four-letter word in the English language, Iowa. And that's all you need to know. In fact, processed food is not food. That's what it comes down to. And I say that very specifically based on the definition. So, what is the definition of food? If you go to the dictionary, which I did, here's the definition.

Substrate that contributes to either the growth or burning of an organism. I have no problem with that definition. That's a fine definition. The growth or burning of an organism. All right. Now, processed food is high sugar, low fiber. Real food is low sugar, high fiber. So let's talk about what food is, what processed food is,

and whether or not processed food actually meets this definitional criteria. So let's talk about burning first. turns out sugar, this molecule that we all love, we all seek, which actually is addictive in 20% of the population, just the same as alcohol. Turns out fructose, when you burn it in a bomb calorimeter, gives you four calories per gram, same as protein, same as other carbohydrates. but we're not bomb calorimeters. In fact, fructose, when you consume it, actually inhibits burning. It inhibits mitochondrial function, the little energy burning factories inside all ourselves. It inhibits our ability to take substrate and turn it into chemical energy called ATP. Now, the mitochondria's job is to generate ATP.

That's what powers all of our cells. If you're not making ATP, that means you're dead. It's just that simple. On off. Either you make ATP or you don't. The point is that when you're metabolically healthy, you make ATP well. When you're metabolically ill, you make ATP poorly because of mitochondrial dysfunction. Because your mitochondria aren't working well.

Turns out fructose inhibits mitochondrial function. Now, the other carbohydrate, the other simple sugar, the one that we measure in our bloodstream, the one that everyone talks about is glucose. Now, glucose is the energy of life. No argument. Every cell on the planet burns glucose for energy. Glucose is so goddamn important that if you don't consume it, your body makes it. a process called gluconeogenesis. So fat will turn into glucose in your liver. Amino acids will turn

into glucose in your liver. People who eat no carbohydrate at all. People on the ultimate ketogenic diet, if you will, still have a serum glucose level. And the reason is because their liver will take the fat and the protein and turn it into glucose. That's how important glucose is. All right? Glucose, for lack of a better word, is essential, but it's not essential to consume it. It's essential to have it, but it's not essential to consume it because your body will make it. Now, fructose, on the other hand, is a whole other ballgame because there is no biochemical reaction in any version. cell, any animal cell on the planet that requires dietary fructose for functioning. And it turns out that fructose is a mitochondrial toxin.

And the reason is because it inhibits three, count them, three separate enzymes in mitochondria. And here they are for the, you know, science crowd. Number one, it inhibits AMP kinase. AMP kinase is the fuel gauge on the liver cell. It's the enzyme that tells your cell you need more energy, and it's also the enzyme that generates more mitochondria, mitochondrial biogenesis. So if you inhibit AMP kinase, basically you're telling your cells,

you don't need to make energy. Number two, it inhibits an enzyme called ACADL, ACADL, ACA-D-Hydrogynease long chain. This is an enzyme that starts the process of cutting fatty acids into two carbon fragments for beta oxidation, which is basically what ketogenic is, all right? Is being able to use ketones for beta oxidation? Well, you have to make those two carbon fragments to make the ketogen. And so ACADL is essential for that. So if you inhibit that, that means you're inhibiting beta oxidation. And finally, number three, it inhibits the enzyme through uric acid. And we will talk about uric acid,

no doubt, because it's hot topic with Rick Johnson's book, you know, nature wanted us to be fat. And David Perlmutter's drop acid all coming out within a week of each other. So, you know, on the tip of everyone's metabolic tongue right now. Because fructose increases uric acid, uric acid inhibits the third enzyme in the mitochondria called CPT1, carnitine, palmitable transferase 1. This is the enzyme that regenerates the shuttle mechanism called carnitine that allows fatty acids to be imported into the mitochondria so that they can be beta oxidized. So if you're slowing down mitochondrial function, you're inhibiting the ability to generate ketones for beta oxidation and you're inhibiting the ability to even import those ketones in fatty acids into the mitochondria for beta oxidation.

Guess what? You end up with less ATP. So fructose inhibits burning. Glucose stimulates it. Fructose inhibits it. Okay. So that's burning. Now let's do growth. Turns out my colleague Dr. Efraud Monsignigo Ornan, who is the head of the Department of Nutrition at Hebrew University of Jerusalem, just published three papers showing that processed food and specifically fructose inhibits skeletal growth.

It inhibits long bone growth. It inhibits cortical bone growth. And we also have data to show that fructose actually hijacks the growth mechanism to generate cancer. So, bottom line, fructose does not lead to growth. It basically hijacks growth to autonomous growth rather than regulated growth. So if you're not burning and you're not growing, are you a food? So sugar and thereby proxy, process food, is not food. So if you're consuming not food, what do you think is going to happen to you?

And that's how diet went off the rails 50 years ago. and that's what's wrong. Well, I know it's obvious, but sometimes the things that are obvious don't fully connect in people's minds until they hear it. What is happening? What are you seeing out there when it comes to the most common diseases that this whole interplay that you just covered connects to? Well, there are eight diseases, eight chronic metabolic diseases.

They existed before 50 years ago, but they have jumped in prevalence so severely, so severely, that these eight, when you group them and conglomerate them, now account for 75% of all health care costs in the United States. And I'll name them. Here they are. Type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, cancer, cancer, dementia, fatty liver disease, polycystic ovarian disease. These are mitochondrial diseases. The point is that there is not one of, not one of those diseases was a child's disease. And now they're all child diseases. We never saw type 2 diabetes in a child before. and now one out of every three new diabetes diagnoses in children is type two. Fatty liver disease was the disease of alcohol.

And now five-year-olds have fatty liver disease. Children are the canaries in the coal mine. Children are getting the diseases of alcohol. Children are getting the diseases of aging. Children are getting the diseases of mitochondrial dysfunction. when they never did before. How come? Because they're eating processed food.

Processed food is a relatively recent invention. Started after World War II because we started subsidizing commodities during the first farm bill, you know, 1933 with the Depression in the Dust Bowl. And World War II basically figured out how to process food and deliver it en masse to, you know, the army. And then we, you know, realize we could make money doing this. And it was good for waste because, you know, it increased shelf life. And so we went into mass production mode of processed food. And that's when the chronic metabolic diseases started, you know, rearing their ugly head and started being seen in children. So there was no such thing as fatty liver disease until 1980 in

anyone. Today, 45% of American adults have fatty liver disease and 25% of children when this wasn't even a disease before. So you got to look to say, all right, what happened? And the bottom line is processed food happened. To take that analogy a little bit further, you also write in your book that you're calling these diseases, but in a way, these top eight that you just listed, they're not actually diseases. Now, tell us why. Take it to the next level and help us understand that. That's right.

So these are the diseases that have ICD-11 codes. These are the diseases that doctors learn about in medical school. I know because I'm a doctor and I learned about them in medical school. but in fact these diseases are actually symptoms of disease the high LDL is not the disease it's the symptom of the disease the high blood pressure is not the disease it's the symptom of the disease the high blood glucose is not the disease it's the symptom of the disease. The hyuric acid is not the disease. It's the symptom of the disease. All of these are manifestations of dysfunction of cells in our bodies. And those, that's the disease. These abnormal pathologies that have basically sprung up and are being, you know, have overtaken our general metabolism.

In my book, back here, Metabolical, I list the eight subcellular pathologies that actually belie all of these chronic diseases. So, number one, glycation. Number two, oxidative stress. Number three, mitochondrial dysfunction, which we've been talking about. Number four, insulin resistance. Number five, membrane instability. Number six, inflammation. Number seven, methylation.

Number eight, autophagy. Now, there is no ICD-11 code for any of those. Doctors don't get reimbursed for any of those. Doctors don't know what they are because they're not taught in medical school. Doctors don't know how to teach patients what they are because why would you bring something up in a doctor-patient conversation when you don't have any answers for them. So, like, why would you bother?

So the doctors don't know, the patients don't know. And it turns out those eight that I just mentioned are beli all of those other chronic metabolic diseases. They are the ultimate manifestations of these eight subcellular dysfunctions. In the book, I call them the hateful or grateful eight. When these eight processes are working right, you'll be 110 playing tennis. When they're working wrong, you'll be 40 years old in a wheelchair with two stumps on dialysis, waiting for your next stroke. And, of course, everything in between.

So fixing those eight subcellular pathologies is what metabolic health is all about. The question is, how do you do it? How do you fix those eight? The answer is, you got to look at the pathways. You got to look at the pathogenesis of each of those eight. My colleague at Turo University and I, Dr. Alejandro Gugliucci and I, put together a poster that you can get online. It's from biotechney. Basically, it's the entire of metabolic syndrome on one poster. with all the different organs and all the different intermediary pathways that are involved. And when you actually look at all of these inherent pathways that are going on inside cells, you come to a stark realization. There are no drugs for this. These eight processes are not drugable. They are foodable.

There's food to fix them. So food can either cause them or food can fix them. So this is where I actually get mad about the food is medicine movement. Real food is medicine. Process food is poison. When you just say food is medicine, you're missing the point. It's the food that made the disease in the first place. So you have to understand that processed food,

is not food. Once you get that into your head, once you understand that Cheetos is not food, then all things are possible. But that's a heavy lift for a lot of people. It's a heavy lift, but it's one of the most important lifts because the law of responsibility says

if something created it or if you had a hand in creating it. It doesn't mean that it's your fault. Doesn't mean that you're to blame. But if you had a hand in creating it, then you can have a hand in uncreating it. And so that's the most empowering thing, truly, as burdensome as it is and people sometimes feel the weight of,

so you're telling me this chronic disease that I've been suffering with is something that I've done. It's not just in my genetics or it's not just because we didn't have some miracle drug that's there. But that could be the best news ever because that means, that means that we can do something about it. Right. So that actually brings us to two separate tangents

and we'll have to explore both at the same time. Yes, that's true. And I agree with that, that yes, you have a hand in being able to fix it. That you are a victim, not a perpetrator. All right. And that, you know, but you still have to be in partnership with your doctor,

in order to be able to mitigate the risk. I agree with that. You can't expect somehow, you know, to snap your fingers and have it all go away. All right. You got into this boat. You got to get out of the boat. And you have to know, if you drive into a ditch, you have to know how you drove into the ditch in order to be able to drive back out. If you try to drive through the ditch, all you do is spin your wheels and end up further in the ditch. All right. So understanding the pathogenesis, and understanding how you got there is absolutely essential to fixing the problem. So that's why I wrote Metabolical is to explain how we got there and why and what's going on. So, yes, we all need to play our role.

And the only way to do that is with education, understanding what our contribution is. Agreed. Having said that, the immediate correlate to that is, well, if I can fix the problem, then I must have free will to do so. And the question is, is that true? Do you have free will? And this is obviously a very big philosophical question that many philosophers, you know, over many years have, you know, tried to glom on to, you know, anything all the way from Calvin to Einstein and many people in between. There's a biologist, head of the Department of Biology at the University of Pennsylvania

named Anthony Cashmore, who wrote a paper in PNAS several years ago that I just think is the best paper ever written. And it's called the Lucretion Swerve. And it basically talks about free will as a method for being able to punish perpetrators, that we had to invent free will to justify being able to have a criminal justice system. And that's the reason why there's free will, not because it's innate or inherent, but because it gives us the license to be able to punish perpetrators. And what he does is he says that ultimately free will is a combination of your DNA, which you can't fix, and your environment, which you can't fix, and some random stochastic processes thrown on top, which are random and stochastic and basically uninterpretable and

you can't prepare for them. So they're sort of out in limbo too. So that means, means that the only thing you can fix is your environment. So the question is, yes, you have free will to fix your environment. Sure, but it's your environment that's the problem. And you didn't contribute to that. Your environment happened to you. So today we're talking about the environment of our food supply, our processed food supply, industrialized profit-making processed food supply. And like, how the hell did that happen? And who let

them get away with all of this? So while, yes, we have some agency, we have some ability to fix our environment. Not everybody does. Lower socioeconomic status people can't fix their environment. If there's no grocery store within 10 miles of their home, if all they have are convenience stores, you know, and they live in food deserts, how are they supposed to fix it? All right. Children, they only get to eat what's brought into the house. Is it their fault? You know, how are they supposed to fix it? So, you know, in order to be able to understand these vulnerable populations, prisoners. Another example, they don't get to choose their food, right? And they are metabolically ill, like, all get out. So in order to be able to understand these vulnerable populations, babies, newborns,

we have an epidemic of obese newborns because we have an epidemic of obese fetuses. Okay, they don't diet and exercise. So we have to understand the role the environment plays. And that's, what I focus on is how did the environment shift our metabolism and what can we do to shift our environment back so that we can actually be healthy? It's a powerful question and as you've so diligently showed with your work the right question sets us up for where to look but if we're asking the wrong question we're looking in the wrong direction and we know the looking in the wrong direction for 50 years. And that's what I was going to get to, is give us some of the questions.

You know, the subtitle of the book is The Law and the Lies of Processed Food, Nutrition, and Modern Medicine. Give us a few examples of the questions that either the processed food industry or that modern medicine was asking that led them down to different but parallel paths. So let's start with myth number one. Okay. And this is the myth that has to be debunked. Until this one is debunked, nothing good will ever come.

All right. This is the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, We've got to start here. It's with this notion that a calorie is a calorie. Food industry says it's about calories. It's about energy balance. It's about calories in calories out. Therefore, it's about two behaviors, Lutney and Sloth. Therefore, because it's about two behaviors, if you're fat, it's your fault. Therefore, diet and exercise. Therefore, any calorie can be part of a balanced diet. Therefore, don't pick on our calories.

Go pick on somebody else's calories. All right? All of that comes from this notion that calories are fungible. That it doesn't matter what you eat. It matters how much you eat. That's basically what they say. And they say that that's personal responsibility. So what they've done in one fell swoop with one concept is put the onus on the victim and dissuage their own culpability.

Works for them. The question is, is it true? Is a calorie a calorie? And the answer is, we have so much data to show that this is the biggest lie in the history of, of medicine. In my, you know, I'm from New York. I'm from Brooklyn. So I use a lot of, shall we say, colorful language. And this is the single piece of BS. You can curse on our podcast. That's fine. It's a family podcast. I got to be careful. I can't tell you how big a piece of, you know, this is, this is bigger, okay, than Randy Marsh's poop.

in South Park. That's how big it is. It is so wrong. It was wrong from the day it was conceived, and it will be wrong till the day we finally trash it. And the problem is the food industry won't give it up. And the reason they won't give it up is it because it's their protection. It's their gravy train. They have convinced us all, that it is true and it is not true. It is the biggest lie there ever was. So we got to start there. So how can I prove it's a lie? All right. I'll prove it's a lie four ways. Four different food stuffs. Let's start with almonds. Drew, you like almonds? Love them. Love them. Ammons are great. Okay. But almonds are relatively high density, you know, in terms of calories, aren't they?

They are. So, so you eat 160 calories in almonds, okay? Handful of almonds. 160 calories in almonds. How many of those calories do absorb? Good question. Turns out the answer is 130. You ate 160, you absorbed 130. Where'd the other 30 go? the metabolic processes of rock? No, no.

The fiber in the almonds, and there are two kinds of fiber. And this becomes very important because remember I've talked high sugar, low fiber, low sugar, high fiber, right? The fiber and the almonds, and there's two kinds, soluble and insoluble. So soluble fiber is like pectins and inulin, like what holds jelly together, hydrogels. insoluble fiber is the stringy is like cellulose, the stringy stuff in celery. Okay. Almonds have both. The stringy stuff sets up a lattice work on the inside of the duodenum like a fishnet.

And the soluble fiber are globular. They plug the holes in the fish net. And together they form an impenetrable barrier. You can actually see it on electron microscopy, a whitish, secondary barrier that inhibits the absorption of simple sugars, glucose fructose, sucrose, simple starches in the duodenum so that they do not go via the portal vein to reach the liver and then get over and then overwhelm the liver so that the liver stays healthy. You are protecting the liver with the fiber in the almonds. So the liver doesn't get the oh, the,

the excess in which case then it would turn the excess into fat through this process called de novo lipogenesis new fat making which is what fructose does in particular and you don't generate an insulin response because you didn't generate a serum glucose response okay this all has to do with the concept of glycemic load to keep the insulin down okay and that keeps you metabolically healthy because insulin is the bad guy in the story. Insulin drives chronic metabolic disease because insulin drives growth, abnormal growth. It drives vascular smooth muscle growth. That's why you get coronary artery disease. It drives prostate and breast growth. That's why you get breast and prostate cancer because of the insulin. Well, okay, so you didn't generate as big an insulin response because you

didn't absorb those calories. So where'd those 30 calories go? They went further down the intestine to the next part called the jujunum. Okay, and the dejunum, that's where the bacteria are. That's where the microbiome is. So those bacteria, they want those 30 calories. And so they chew it up for their own purposes. So you have 10 trillion cells in your body. You have 100 trillion bacteria in your intestine. They outnumber you 10 to 1. You are just a big bag of bacteria with legs. Okay, those bacteria have to eat something to stay alive. Well, what do they eat?

Well, they eat what you eat? The question is, how much did you get versus how much did they get? And when you consume those almonds, you consumed it with fiber, and that fiber meant that those 30 calories weren't for you. They were for your microbiome. So even though you ate them, even though they passed your lips, even though they registered as a calorie eaten, they were not a calorie absorbed. So who cares how many calories you ate?

You care about how many calories you absorb. Well, is that measured in a calories a calorie? No. So a calorie is not a calorie because if it came with fiber, that calorie wasn't for you. Number two, protein. Okay. So protein is made.

made up of amino acids. There are 20 amino acids, right? Some of them are essential amino acids. You have to consume them. Some of them your body can make from those essential amino acids. But there are 20 amino acids. Now, if you are building muscle, you need those amino acids, because muscle is primarily protein, actin, myacin, et cetera. All right? So bodybuilders who are building muscle, they take scoops of protein powder and put it in their Vitamix to make their smoothies, right? Okay, and they're building muscle, and so they need those amino acids because they're essential. They have to consume it. But what if you're not a bodybuilder?

What if you're a mere mortal like me? And what if you consume excess protein, excess amino acids? What if you ended up going to, you know, the steakhouse and you're or, ordered that porterhouse for two and you ate the whole thing yourself. Okay. Now what? Where is the protein gone and go? Is there a storehouse for protein? And the answer is, yeah, your muscle. But if you're not building muscle, then that's not your storehouse. So what happens to the access? What happened to the other half of the porterhouse? Well, it went to the liver. The amino acids went to the liver. The liver has to turn it into energy.

So the liver has to take the amino group off the amino acid, a deamination. Now, once that happens, that amino acid now becomes an organic acid. That organic acid can now enter the Krebs cycle, which is the cycle that makes the ATP. And so you can generate energy from that amino acid once it's deamidated. Turns out that process of deamination taking that amino group off costs energy. It costs energy. And it costs twice as much energy as what your liver has to do to prepare a carbohydrate for burning. So there's a net deficit for protein,

versus carbohydrate when you are turning it into ATP. So even though protein and carbohydrate are both four calories per gram, when you're burning protein, you actually generate fewer ATPs than when you're burning carbohydrate. Therefore, calories not a calorie. Because you started with the same number of calories in bomb calorimeter, but you ended up with different level numbers of ATPs. Number three, fats. So over here on this side, we have omega-3 fatty acids, heart-healthy,

anti-inflammatory, anti-alzheimer's, save your life, anti-depression. Okay, single best thing you can put in your body, without question, omega-3s. Over here we have trans fats, the devil incarnate, okay, consumable poison, made in the lab. The reason that we put the trans fats in the food was because of the Bacteria couldn't break the trans double bond because it didn't have the enzyme that desaturates to do it. So the bacteria couldn't grow on it. That's why we had the 10-year-old Twinkie. All right. Point is, our mitochondria in our cells are refurbished bacteria.

They even have their own bacterial DNA. Well, guess what? Our mitochondria can't break that bond either. So when you consume trans fats, you are basically laying down poison in your liver and in your arteries because you can't break it all the way down to carbon dioxide and ATP because of that trans double bond. So you do not want those trans double bonds in your diet.

But the food industry put them there. Again, another reason why processed food is poison. The point is over here we got omega-3s. Over here we got trans fats. They're both nine calories per gram. One will save your life. One will kill you. Because a calorie is not a calorie. Because different foodstuffs have different functions. And then lastly, my favorite one we started with fructose and glucose. Glucose is the energy of life and fructose is poison. It's a chronic dose-dependent mitochondrial toxin. They're both four calories per gram. So it's not how much you eat. It's specifically what your

body does with what you eat. That matters. And that just blows the whole concept of calories right out of the water. So we got to start with that. That's where the food industry got on. And that's where we have to get off. Problem is, food industry is still hitting it as hard as they possibly can. Because this is the concept that keeps them out of court. Because as soon as a calorie is not a calorie, guess what? They are going to get their asses sued off. And it's already started.

Going back to where we started off, as a perfect example of this, you were chatting about fructose. Now, I think it's worthwhile. We've done a couple episodes where we've touched on this a little bit, but just in case if folks haven't heard that episode, bring those two things in connection. What you just covered, calories, not a calorie is not a calorie, and how fructose, what are, I'll set up the question, what are the biggest contributors to fructose, which we know does all sorts of damage to the body, which you just covered.

What are the biggest sources, the top ones that people are consuming in their diet today that have a direct tie-in to these eight, quote-unquote, diseases that we covered earlier? First thing you have to understand is that fructose consumption has gone up 25-fold, not 25 percent, 25-fold in the last 200 years. Our ancestors getting fruits and vegetables and occasional honey, you know, out of the ground or out of trees, you know, consumed about four to five pounds of sugar per year. We now consume 94 pounds of sugar per year. So that's almost 25fold.

And a few years ago, before the obesity epidemic, you know, hit, you know, the grand stage, you know, around 2010 to 2012, we were consuming up to 120 pounds of sugar per year. We've actually cut back to some extent, you know, with diet sweeteners and, you know, recognizing the problem and as soda consumption has, you know, started to fall. All right. So it's still a 25-fold increase. And the question is, can your liver handle that? Only your liver can metabolize fructose because only your liver has the glyphor.

Lute 5 transporter, which is the fructose-specific transporter. So when you consume glucose, it goes to every cell in your body. When you consume fructose, it only goes to your liver. And the question is, what does your liver do with it? And the answer is, well, if you're consuming only a little bit, like an apple, you have the capacity. You have the capability of being able to metabolize that fructose load. into ATP and not get yourself into trouble because you won't have consumed so much that you're

generating that liver fat okay so an apple's okay but now take that apple and turn it into a glass of apple juice first of all it's not one apple that makes a glass of apple juice it's four so you're getting the juice of four apples in that glass so all of a sudden you went from one apple to four apples Okay, you're not getting any of the fiber in order to reduce the rate of absorption and also to increase satiety because the fiber moves the food through the intestine faster to get the satiety signals sooner. So now you are, now you've got four apples in an eight ounce glass of juice and you are flooding your liver and your liver is going to take all that fructose and it's going to turn it into fat. and now that fat is going to either be packaged as triglycerides, which are potentially, you know, drivers of obesity or cardiovascular disease, or the fat droplet won't make it out of the liver. It will precipitate in the liver, and now you've got fatty liver disease, which generates the

insulin resistance, which then puts you at risk for type 2 diabetes and Alzheimer's. All right? So basically, heart disease and obesity on this side, fatty liver disease and Alzheimer's over here, all depending on what your liver will do with the fat it made from the sugar. So a little sugar is okay because you have the innate capacity to metabolize a small amount. And that's the liver's job. The liver has enzymes in it that detain. toxify all sorts of things that you're exposed to. That's why Paracelsus famously said in 1537, the dose determines the poison and nothing is without poison. It all depends on how much.

Well, so we have, you know, shall we say, you know, toxins that will make you keel over and die at parts per billion, like cyanide, ricin, sarin, vx gas, right? And then we have chronic toxins that are, you know, where we have a higher capacity like arsenic, benzene, carbon tetrachloride, tobacco smoke, where, you know, one, you know, dose won't necessarily kill you. But, you know, 10,000 might all right well fructose fits that same model one sugar-laden meal is you know a treat it's a delight it's a feast 10,000 sugar-laden meals is death but that's what we're eating because every meal is now a sugar-laden meal because there's sugar-laden meal in everything. Seventy-four percent of all the items in the American grocery store have been spiked

with added sugar. Buy the food industry on purpose because they know when they add it, you buy more. Because fructose, for lack of a better word, is addictive. This is their gravy train. This is their hook. You know, Coca-Cola used to have cocaine in the process. used to have alcohol in the recipe. And of course, it always had sugar and caffeine. So the FDA said, well, if you're going to sell it interstate, you got to get rid of the cocaine and you got to get rid of the alcohol. Well, it turned out the sugar and the caffeine was good enough to maintain the addiction. Well, that's what the rest of the food industry figured out too. So there we are. And that's why our food has been contaminated. Our entire food supply has been contaminated by the food industry

specifically for profit. You know, this all fits in this larger phrase that you have, which is protect the liver and feed the gut, right? Just to connect the dots for the folks who are listening, I'll expand you to deepen on the topic of gut because you started in that direction earlier in the podcast, but I'd love to hear more about it, is here you're talking about really protecting our liver for that onslaught of sugar, that fructose in particular. In particular, that fructose that is causing in concentrated and frequent dosages is causing all sorts of downstream effects that are happening. That's right.

So let me make it very clear to your audience, Drew. Okay. I am not fructocentric. Okay. some people think that's all I worry about. In fact, what I'm worried, what I am is mitochondrialcentric. That's my concern. Anything that causes mitochondrial dysfunction will lead to chronic metabolic disease. And it turns out there are four substrates in our food supply, all of which damage the mitochondria, all of which generate chronic metabolic disease. So there's fructative.

which is the cheap one and the one we give babies and fetuses for that matter. But there are the other three also. Branch chain amino acids, lucine, isolucine, and valine, which are essential amino acids. They're 20% of muscle, but again, if you overwhelm your liver, your liver turns those into fat and generate fatty liver and insulin resistance in mitochondrial dysfunction too. trans fats, which we already talked about, and they cause mitochondrial dysfunction. And finally, alcohol.

So what do these four substrates have in common? One, there's no insulin rise. They don't generate an insulin response. Number two, they all are metabolized by the liver. and not anywhere else, and therefore they overwhelm the liver. And number three, they poison mitochondria. So, of those four, sugar is the cheap one. Sugar is the addictive one, although alcohol is too. But sugar is the one we give to children and call it love. So I'm most worried about that one. but that doesn't mean that that's the only problem.

As you can see, processed food is a problem all by itself because it is a mitochondrial toxin. Thanks for covering that. I think that is a perfect fit with, tell us about the interplay between we've been talking about mitochondria in general and then we talked about fructose more specifically on the liver. Let's expand on the side. second portion of that idea that you've shared in multiple interviews and inside of your book,

protect the liver and feed the gut. Let's talk about the feed the gut site. What do you want our audience to know about that? We hinted out it a little bit with some of our discussions around fiber and its protective benefits and the two types of fiber. Take us a little bit deeper on some of the things that you want people to know about fiber. Absolutely. So first of all, the gut is outside your body. You need to understand that. Okay. It's a inside your body, but it's outside your body. It is the skin of your abdomen, if you will. It is supposed to present a barrier. Now, you can rub topical steroids on your skin and it will reach your bloodstream. You can ingest certain foods or medicines and they will reach your bloodstream.

okay but in general your gut is designed to keep stuff out all right it's outside your body your intestinal lumen where all the junk is where all the poop is okay where all the bacteria are okay they're not supposed to get into your bloodstream and if they do you get sepsis and you can die so your Intestinal integrity, the barrier integrity is essential for quality of life and for mortality, you know, to prevent mortality. When that intestinal barrier is weakened, bad stuff can happen. Stuff that shouldn't get into your bloodstream will. Now, the way it works is that the intestinal epithelium, the cells grab on to each other.

and these appendages of these cells are called tight junctions, tight junctions. And they're made up of proteins, one of which is called zonulins. Zonulins are famous because they're what go wrong in celiac disease. So when the zonulins are dysfunctional, it turns out you get a process called leaky gut. And that's why kids and adults with celiac disease gets so sick is because stuff in their gut gets into their bloodstream and sets up an inflammatory reaction. Well, guess what? Those onylands are in the blood-brain barrier too. So if those things, so if your tight junctions in your intestine fail, there's a reasonably good chance that tight junctions in your brain might fail too. So keeping your tight junctions tight is essential for life.

So the question is what can damage those tight junctions? What can make you get leaky gut? And there are various things like alcohol. That will do it. And there are other things like fructose. So how does fructose cause problems with tight junctions? Those zonulins, those tight junctions, the things that are holding yourselves together, they're ATP dependent. Anything that causes a fall in the ATP levels in your cells will cause them to transiently lose their integrity and their ability to hold on.

And so you will get slow, occasional, but sporadic, but nonetheless, meaningful loss of intestinal, you'll get increases in intestinal permeability. And that will lead to various lipopolysaccharides, you know, which are, you know, generate an immune response or whole bacteria or cytokines to be. able to get from the gut into the bloodstream. And if they get into the bloodstream, they go to the liver. And what happens in the liver is it sets up inflammation. And now you've got liver inflammation. Now you've got insulin resistance. Now your pancreas has to make extra insulin to make the liver do its job because the liver's dysfunctional, because the mitochondria are dysfunctional because of the inflammation. So keeping an intestinal barrier that works, a functional is essential to good metabolic health. So how do you do that? Well, don't take away their

ATP. Don't take away the cells ATP. And the various things that we've talked about, you know, do that, like for instance, fructose. Don't strip off the barrier that coats the intestinal epithelium. That's called the mucin layer, the intestinal mucin layer. And guess what? If you don't feed your bacteria in your intestine, remember the microbiome, remember those 30 calories from the almonds? If you don't feed your bacteria, your bacteria will feed on you. Those bacteria will actually strip the mucin layer off your intestinal epithelial cells, exposing them and making it much more likely that one of those cytokines or lipopolysaccharides or whole bacteria will actually make it into the bloodstream.

And you can see, I mean, we see that experimentally with animal models where we can actually measure the bacterial increase in the bloodstream after a meal, and that can be stopped by giving antibiotics. By the way, antibiotics change the microbiome as well and set you up for dysfunction as well. making the bad bacteria grow, like for instance, Clastridioides difficile, which is a much, you know, more potent and virulent bacteria. So you want the good bacteria to battle off the bad ones, which means you got to feed them, and you want your intestinal epithelial cells to have good tight junctions so they won't let junk in. So that's why intestinal permeability and inflammation are

so important to good metabolic health. And if you, if, if, if your intestinal barrier is broached, basically that starts all of the diseases of metabolic syndrome, whether you're fat or not. Are there examples of foods that many people would put into the healthier category? They typically wouldn't associate with processed foods. It's not Doritos. It's not McDonald's. But, it still nonetheless is refined or processed to a degree. Sure. That can also contribute to these things. And if so, what are some examples of those foods?

I'll give you two that people think are good. Whole grains and yogurt. So let's talk about those. We'll do one at a time. Whole grains. So whole grain bread. Is it whole grain? Says whole grain right on the label. Is it whole grain? What's the definition of whole grain? There is none. There is none. That's the key. There is no definition of whole grain because there's a whole grain's counsel, but that doesn't mean that there's a definition of whole grain.

And this is, you know, where the rubber hits the road in terms of the semantics of what the food industry is doing. to cover up its dastardly deeds. So let's talk about whole grains. Here's a grain right here, okay? The outside is the husk, the kernel, if you will. It's all fiber. Then there's the inside. The inside has two parts.

There's the starchy endosperm, where you get flour from. And there's also the germ. And that's where the nucleic acids, the polyphenols, the flavonoids, all the good stuff that you're supposed to get in whole grain is. Everybody with me? So three parts. The husk, if it stays intact, it's a whole grain. You swallow it. Okay, say in a whole grain, a true piece of whole grain bread.

And we'll talk about what that is in a minute. the enzymes in your intestine have to strip this husk off. And we don't have enzymes that work very well for that. So it takes a long time before you can actually get the what's inside to actually be liberated. So it's further down the intestine into the dejunum, into the ilium, the further parts of the intestine. And there's a good chance that the microbiome is going to want those for their own purposes so that you're feeding them. And so that's why a whole grain is good, because it's a delivery system for getting the food further down the intestine to feed your bacteria. Now, whole grain bread in the supermarket is not whole grain because the grains have been pulverized to smithereens.

all right and that liberated the flour it also liberated the nucleic acids and polyphenols and all that and they're still there okay but here's the problem those will go rancid now that they've been liberated so when they're as whole grains you can store them for months at a time you know that's what pharaoh did you know back in egypt you know they kept them whole and so you can store them. But as soon as you pulverize them, now they're on the clock. Now they're going to go rancid. And one of the reasons food goes rancid is because of the liberation of proteins and nucleic acids, which tastes terrible if they are oxidized. So the food industry will pulverize the whole grain and they will then sift off the nucleic acid.

you know, the germ. And they will leave you with this powder that still has some fiber, but not very much, and it's not surrounding the starchy endosperm. Now you consume it, and you can't set up that gel that I talked about before. And so the starches are immediately acted on by the saliva and by the stomach acid, and they, they start breaking up and now you liberate all of that glucose and it goes via the portal vein to the liver generates an insulin spike and you're off to the races in terms of chronic metabolic disease. The point was because the food industry, because the bread company started with whole grain, they're allowed to say it's whole grain, but it's not whole grain. So what is whole grain bread?

What does it look like? Can you buy it in the store? The answer is yes. not at Safeway, but you can buy it at Whole Foods, you can buy it at, you know, specialty shops that cost more. It's half the size, a loaf of one pound loaf is half the size of a regular loaf and it's dense. Okay. The way you can tell whether or not something's truly whole grain or not is if I threw it at your head, would I knock you out? Okay? If it would knock you out, then it's whole grain. If it would bounce off your head and make you say, what the hell did you do that for? Then it's not whole grain. Okay, because real German fitness bread, okay, is it, it's sliced very thin. It makes a lousy sandwich because it doesn't have a lot of gluten liberated. So it doesn't hold together as, you know, spongy. That's why, you know, We don't make, you know, kids' sandwiches for school out of whole-grained bread is because the, you know, the bread will tend to fall apart. But that's true whole-grain bread.

So you can buy it, but you can't make a sandwich out of it. So that's one thing, whole grains. Number two, yogurt. Now, yogurt has active cultures, right? Well, maybe. Maybe they do. Not necessarily. They're supposed to. And active cultures help populate the intestine with, quote, good bacteria. In particular, lactobacillus, bifidobacteria. You know, we've now found that bifidobacterium infantis seems to be a very good one is one of the things that helps babies. And it seems to be a positive one. So they're adding that now to all of

these, you know, to kombuchas and to, you know, other fermented foods and attempt to try to get them, you know, down into your intestine. The question is, if any of these foods worked, why would you have to keep eating them? If any of these probiotic supplements with these various bacteria worked, why would you have to keep taking them? If they're live cultures, they should set up shop, right? They reach the intestine. It's nice and dark and murky and, you know, all sorts of stuff in there. And certainly bacteria are growing in there. Why don't they just set up shop? Why don't they, you know, distribute themselves throughout the intestine and you only have to take them once? And the answer is because they're not living anymore. They died. And that's the reason why you needed them is because your own died.

Because you have an inhospitable intestinal environment. So you can take probiotics until the cows come home. And they're not going to make a damn bit of difference unless they can take, unless they can grow. And they're not growing. And the reason is because the environment in your intestine is inhospitable in the first place. So you have to change the environment that the bacteria find themselves in. So you don't need a probiotic.

You need something that will let the bacteria grow. You need a prebiotic. That's food for bacteria. That's what a prebiotic is. Well, what's the prebiotic that's in real food, in all real food? Fiber. Because that's the food for bacteria. That's what bacteria chew on.

That's what bacteria use. to make short chain fatty acids, which are not only beneficial for them, but beneficial for you, too, because they suppress the cytokine response, they suppress the inflammatory response. They've been shown to be anti-inflammatory, anti-cardi-vascular disease. You need those short-chain fatty acids, acetate, propionate, butyrate. The only way to get them is to let your bacteria chew on fiber. Well, the fiber is in the real food. but it's been taken out of the processed food.

So you have to protect your liver so you don't get the insulin resistance, and you have to feed your gut so you don't get the inflammation, which will also lead to the insulin resistance. You do those two things. Protect the liver, feed the gut, and now you've got metabolic health. But there's only one substrate. That does that.

That's called real food. For someone who's seeing, and this happens a lot for people as they start to clean up their diet a little bit, and they're wary of a lot of the gluten-free foods, which actually spike their blood sugar more than even just regular, you know, true whole wheat, right? In your example. Yep. So as people start to clean up their diet, sometimes they end up withering down and not having as much fiber. In some instances, there are individuals who also have very reactive gut microbiomes and intestinal

systems because of a lifelong of antibiotics and other challenges that you led to earlier. If you had to highlight a few fibers that are gentle enough that people can start to work their way up so that they don't have that heavy response of bloating or other challenges that people often write into this podcast saying like, hey, I'm trying to include more fiber and diversity, but I'm having a lot of challenges. Would you give a few an honorary mention? Okay. So the fiber in real food does work, but it doesn't work for everybody. Real food usually works. There are people who are, quote, gluten sensitive. I'm one of them, by the way.

That doesn't mean you have celiac disease. And I learned this the hard way. And I learned it from the head of pediatric gastroenterology at the University of Chicago. One of the original celiac researchers, his name is Stefano Gwandauline. Okay. Back in the early 80s, he was the one who figured out this whole tissue transglutamination business and, you know, celiac. And he ultimately, you know, came to you or Chicago and he's now had a division there. And he's the one who explained all this to me.

So a lot of people say they're gluten-sensitive, but they don't have celiac disease. They're not gluten-sensitive. They're wheat-sensitive. That's different. And here's how we know that that's true. You take their white cells, people like myself, who I don't eat regular bread anymore. I eat gluten-free bread. not because I'm trying to escape gluten.

I'm trying to escape wheat. Right? And the only way to escape wheat is to have gluten-free bread. So here's what happens. You take their white cells, you throw them in a dish, and you throw gluten on them, nothing happens. You throw rye on them, nothing happens. You throw barley on them, nothing happens. you throw wheat on them, they go bonkers.

Now, in a celiac patient, you throw wheat, barley, rye, or gluten, and they go bonkers no matter what. So clearly, these people are having a reaction to wheat, but they're not having a reaction to gluten. It turns out, wheat is a very complex organism. It is hexaploid, not diploid. there are 700 different antigens in wheat. The two that make up gluten called glutenin and gliding are the ones that, you know, celiac patients are allergic to. You can be allergic to one of the other 698.

And different people are allergic to different ones. So there's no easy test. The point is that the people who say that they are gluten-sensitive are not. They are wheat-sensitive. So instead of calling this non-celiac gluten sensitivity, we should be calling it non-celiac wheat intolerance. This is the point that Gwandelini makes, and I agree with him based on the data and based on my own experience as well. So I stay away from wheat, but I can have a beer, and it won't affect me in any way, shape, or form. It's perfectly fine. So a lot of people are consuming gluten-free cakes, gluten-free, you know, breads, et cetera.

So they're using different flowers, and a lot of those flowers are very high in sugar. For instance, sorghum flour. And so, yes, you end up with increased glucose spikes. And a lot of those flowers, of course, are devoid of their fiber. And so you're going to get even bigger spikes. And so, yes, we've learned through continuous glucose monitoring that these gluten-free products are particularly egregious in terms of metabolic health. So, yes, you do need to watch your wheat intake if you're one of these people, but you don't need

to watch your gluten intake. And what you really need to do is eat real food because you need to be. the fiber. Is there a classic way in your diet on a practical level that you have in your rhythm, your routine, and how you eat, is there a way that you have your go-to for ensuring that you hit that fiber amount every day as a part of your regimen, right? Is it that big salad at lunch? Is it, yeah, just curious about how you approach that for your own health? I try to make sure that there are two vegetables on my plate instead of a starch and a vegetable. So, like for instance, last night was Valentine's Day.

And I, you know, now it's not evergreen anywhere. People know when we did it. I made a filet mignon for my wife, my daughter, and myself. and instead of potatoes, we had Brussels and Brussels, Brussels, and broccoli. And we also did Mexican grilling onions. And that worked beautifully with a bottle of, half a bottle of Zinfandel. And we had a phenomenal Valentine's Day.

Since you mentioned it, it's always nice to clarify, because the, as you mentioned earlier, the poison is in the dose. So you mentioned wine. You guys had a nice little wine yesterday. Right. Good. When we talk about alcohol being toxic to the body and everybody has a different spectrum and there's some people, as you mentioned previously,

that have, might be more predisposed to forming an addiction or have a family history or other components, how do you think about that for yourself? Not necessarily what advice would you give to other people, but just would love to hear about how you think about alcohol in the context of your diet and everything that you've shared here today. Right. So the way to think about sugar and the way to think about alcohol is basically within the addiction model. So if you're exposed to heroin for five days, you're an addict. If you're exposed to cocaine for five days, you're an addict. If you're exposed to nicotine for five days, are you an addict? Maybe, maybe not.

About 50%. If you're exposed to alcohol for five days, are you an addict? About 20%. If you're exposed to sugar for five days, are you an addict? about 20%. So, without question, heroin and cocaine are way more addictive than nicotine or alcohol or sugar. Agreed. Not everybody's going to get addicted. There are plenty of social drinkers that can pick up a beer and put it down. I'm one of them. But 10% of America are binge drinkers and 10% of

10% are hardcore alcoholics. Now, what made them that way? I don't know. We're still trying to figure out the genetics on this. How about the nicotine? Why did 50% of those people not become addicted to five days of cigarettes? I don't know. We're still trying to figure it out. So different exposures lead to different reasons. and different levels of addiction. But if you're in that group, and it's easy to tell if you're sugar addicted, because all you have to do is to see the words coming out of your mouth,

oh, I have a horrible sweet tooth. That's sugar addiction till proven otherwise. The point that you can even say that in public is because it's socially acceptable. Now, I don't think you can really say, oh, I have a huge problem with alcohol and get away with it in public. all right there's you know a little bit of a stigma there and you certainly can't say it for

cocaine and heroin the point is sugar is you know one legal two love you know and i put that in quotes and three accept the socially acceptable at this point in time the goal is to educate the public about the dangers of sugar so that it will become less socially acceptable so You walk down the street today and you see somebody smoking cigarette. Okay. Forty years ago, they'd have been cool. Today, filthy habit, disgusting. You feel bad for them.

You feel pity for them. Right? Used to be, if you would, you know, see people drinking, even in public, you know, like a beer at a baseball game, you know. hey, they're having a good time. Now you start wondering, you know, maybe they've had too many beers. Maybe that's not so good. Today, you walk down the street, you see somebody drinking a Coca-Cola.

And you think, well, you know, they're cool. You know, my goal is for 10 years from now for you to walk down the street, see somebody drinking a Coca-Cola and feel sorry for them. Feel sorry for them. And really what you're saying, going back to what you talked about with the environment, having empathy for them, right? what were the situation of circumstances, education, what they were exposed to that led them to that place, that it felt like consuming that on a regular basis.

And the hope would be also that if they're not in that addictive zone, and if some people want to enjoy a Coca-Cola every so often, it's not my drink. I haven't had probably a Coke in a long time. Actually, the last time that I was about to have a Coke was when Levels, who I know you're an advisor for, Levels Continuous Glucose Monitor, wanted to do a test and have people do the Coke Challenge. which was a whole different thing. But this brings up a larger point, which I think is super important for you all. You've shared before on past interviews that you're not against dessert. No.

If it actually is dessert. The challenge for most people is that they don't know that they're eating dessert for breakfast, lunch, and dinner. And not just in the form of sugar, which is easier to catch, but also in the form of a lot of these refined carbohydrates or healthy foods disguised, their processed foods disguised to be healthy, but have just as much, if not more sugar than a Coca-Cola or other stuff that's there. Example.

Granola is a disaster. All right? It's got this health halo. Okay. Yogurt, health halo. Oh, I'm having a yogurt for breakfast. Okay. A six-ounce plain yogurt has seven grams of sugar, all lactose, perfectly fine.

The liver will turn the galactose into glucose. No problem. If you consume a strawberry yogurt instead, six-ounce strawberry yogurt, that's 23 grams of sugar. So that's a difference of 16 grams between the strawberry yogurt and the plain yogurt. Right? That's the problem. It's the strawberry, not the yogurt. Another example, raisin bran. So it's raisins and bran, right? Or is it? What color are raisins? Brown, purple? What color are the raisins in raisin brand? White? Why is that? Are they using white grapes in the raisin brand? No, they're dipped in sugar on purpose. So if you actually look at the amount of sugar in the raisins in a cup of raisin bran, it comes out to eight grams.

If you look at the side of the package, one cup of raisin brand is 16 grams of sugar. That means there's eight grams of added sugar that they've added to the raisins to make them sweeter so that you will eat the raisin brand. Have you ever had raisin brand where the raisins were just raisins? you wouldn't buy that. So they dress up a lot of things to make them, quote, acceptable and try to give them a, quote, health halo. The same, of course, is true for all of these juices that you have to be very wary of. So, yeah, there's a lot of subterfuge on the part of the industry to get you to consume their product and sugars the hook. Because sugar, for lack of a better word, is addictive.

When we hear all this and your book, by the way, which is fantastic, I have the Kindle version, otherwise you would see your printed copy right behind me. Your book, which is fantastic. How do you take notes? I love highlighting on my Kindle. I can get through a book so quickly on my Kindle. So I will be one of those people that will go on record and say, And I'm so thankful for Kindles and digital books because I just read way better.

And I read way more. And I recognize it's not for everyone. But sometimes technology gets a bad rap in this area. It's made my life so much more rich. Your book, the language. I'm glad it's made someone's life rich because it's only made my life miserable. Well, if it wasn't for technology, I wouldn't be able to have this conversation with you. So I'm super appreciative of that.

your book, which is in the show notes below, Metabolical, The Law and Lies of Processed Food, Nutrition, and Modern Medicine, you go even deeper into some of the things that we talked about today. Highly recommended for anybody to pick that up. And if people don't read to the end, which sometimes happens with books, or if people are listening to the first part of this interview, you start to imagine a very pessimistic world. And it's not the case.

there are actual solutions inside of their besides the practical things that we can do on an individual basis. One of the things that you opened up with, which is how do we change the environment? How do we influence the environment, especially if we're an individual who cares about making the world a better place for people who especially don't have access to it? Give us a few of the things that you found through your research, your findings, your own practice as a doctor that you think can help influence this, not just for ourselves, but for the other folks that are out there who aren't listening to podcasts or working two to three jobs a day

and are just trying to provide for their families. You ask very good questions. Ultimately, am I a pessimist? And the answer is, I'm sort of a pessimist at heart, but I'm actually optimistic about this. And I'll tell you why. In the last 30 years, we have seen four, count them, four cultural tectonic shifts in America. And here they are. Ready? Bicycle helmets and seatbelts. Smoking in public places. Drunk driving.

Condoms and bathrooms. Now, 30 years ago, if somebody stood up in a state house or, you know, Congress or, you know, Congress or Parliament or anywhere else in the world and proposed legislation for any one of those four things that had gotten left right out of town. Nanny state, liberty interest, get out of my kitchen, get out of my bathroom, get out of my car. Today, we're all facts of life. No one's belly aching about any of those things. We're belly aching about other things like vaccines, but we're not belly aching about those four. And if you pull your car out of your driveway and you haven't clicked your seatbelt, your kids will scream at you. So I like had that happen. And why to take 30 years? Answer, we taught the

children. The children grew up and they voted. And the naysayers are dead. That's how a cultural tectonic shift works. And that's why it takes 30 years. Well, we're about eight, nine, maybe even 10 years into this cultural tectonic shift. And we're already seeing the benefits of it. There's soda taxes in six cities and 28 countries. Okay. That would have been anathema. You know, even five years ago. We've, you know, we've gotten there. All right? various food industry concerns are starting to worry about this. For instance, Danone and Bunei Unilever have reduced the added sugar in their respective portfolios by 14%. Now, I'll be honest with you, 14% is like, you know, it's the drop in the bucket. I'm working with an international food

conglomerate right now to reduce their added sugar in their portfolio, 176 different skews, by 78%. It's a two-year project. We're one year in. And, you know, we're going to be able to do it. So the point is that there are people who are getting it. Mars agreed to, you know, the 10% USDA dietary guidelines. They're a frigging candy company.

M&Ms and, you know, Snickers. Guess what Coke even agreed to the 10%? because they were under pressure because of what happened to their global energy balance network disaster. You know, they're a pariah in the public health community. And they're trying to basically back their way back in. The point is, they're under a lot of pressure to do right. Because this metabolic disaster that has befallen the human race, okay, this is, you know, I mean, aside from climate change, this is it. Okay. And of course, the two are related, you know, climate change and the metabolic health crisis.

So we're seeing, you know, the benefits of, you know, this kind of advocacy in the changes that have been made in the food industry, in what's happening. You know, we're seeing it, you know, with, you know, vegan meats. I'm not telling you that they're good or bad, but we're seeing the fact that, you know, these issues are coming to the fore. So I'm actually quite optimistic about those things. The question is, what can you do? What can the individual do? And the answer is there are several things. Number one, you vote.

You vote with your fork. You vote 21 times a week. Okay, and you know who taught me that? Your colleague, Mark Hyman. He's the one who said it on the movie that we were both in fed up. you get to vote with your fork. All right? And if everyone voted with their fork, you know what?

The food industry would have to listen. Okay, because ultimately, we are the, not the 2,000 pound gorilla. We are the 200 million ton gorilla if we actually exerted our collective willpower. Number two, you can talk to your congressman and make this an important. important issue. Before, you know, like five years ago, the only person in either the House or the Senate who actually cared about food and said something, you know, about the problem was Tom Harkin, and he's gone. But now there are a whole bunch of people talking about it. Rosa DeLoro is talking about it from Connecticut, Jim McGovern from Massachusetts, Tim Ryan from Ohio, Mark DeSolone,

here from California, have all made, you know, the problem of food, you know, part of their platforms. So there's, you know, a, shall we say, an early groundswell within, you know, within, within Congress. And so you need to basically apply pressure yourselves, you know, to get these, you know, to get congressmen and congressmen on board. All right, what else can you do? First of all, you can petition and lobby your school districts to provide real food to children in school. I am the chief science officer of a nonprofit here in the Bay Area called Eat Real, where we're actually changing the food procurement paradigm for school districts so that every kid gets fresh, real food.

each day at school. Now, one of the reasons why they eat garbage now is because back in the 1970s, the Congress basically said to the school districts that, you know, to the Department of Education, to the school districts, you have to make book on your, on your cafeterias. They can't be lost leaders for your schools. They have to basically, you know, meet their budget. And so all of a sudden, they were under the gun. And so they turned to Cisco and McDonald's and, you know, everybody else. And they said, and they said, oh, sure, we'll be happy to feed your kids. And guess what? Because we'll feed your kids. You won't even need all those lunch ladies. You can fire them. And you can actually recoup the infrastructure, the real estate in the schools to turn the food prep areas in the cafeteria. into classrooms which you're going to need. And so they did. And so now the schools don't even

have any place to produce the food. And that's, of course, that was their plan all along, was to basically, you know, make you hostage to the food industry. And now all these schools are, so they can't even provide real food. So we've developed a business model that, you know, actually prepares the food off-site at a centralized facility. and then farms it out. And we've done this now in the Mount Diablo Unified School District here in the East Bay, and we're doing it in 213 districts around the country. So if you're listening to this and you're worried about school food, we've got an answer for you. Okay. All you have to do is want it. And all you have to do is talk to your school board about inquiring into it. Eat real. Okay. There's an example of something you can do.

that can change kids' metabolic health and their grades on a dime, as an example. Then there are other things we can do. Ultimately, you know, insurance companies will pay for food if they don't have to pay for medicine. And so I am the chief science officer of a for-profit called Fugel, which connects four-stakeholders. the patient, the doctor, the grocery store, and the insurance company. So that food that will be of benefit to the patient will be covered by the insurance company,

whereas food that will not be of benefit to the patient, the patient will have to pay for. In which case, they're nudged into doing the right thing because they're worried about the money. So there are ways to do this. There are technological patches. there are, you know, general cultural fixes. Okay. The point is they're out there. They're all in metabolical.

And, you know, I, you know, ask people to, you know, open your minds to the concept that food is not food. Or doesn't, or sometimes it's not food. Real food is food. And processed food is not. And if you understand that. then you can do a lot. Robert, that's a hopeful message to wind us down on. And I want to thank you for coming on the podcast.

There's a whole area, if you're open for it, I'd love to do a round two that we didn't get a chance to get into. But I think there's a great primer for setting our audience up for why this topic is so important, why they should care. And most importantly, what we can actually do about it to reclaim our health. I think about the current system that we're in. It's a de facto system. It wasn't always designed intentionally.

You have all these different actors that hijacked one piece of it to optimize it for their benefit and often their profit, right? Okay, great. That's what it was. But now it's up to us to actually intentionally design it to take it in a different direction. And with your roadmap, we're actually going to a chance to step into it. So I want to thank you for coming on the podcast. and sharing. We have the link to your book in the show notes, Metabolical, The Lour and Lies of

of Processed Food, Nutrition, Modern Medicine. Anywhere else you want to send our audience or any asks of them? Well, you can go to Robert Lustig.com and there's a whole host of information, infographics, things that you can give your doctor. My ask to all of you is that doctors don't know a damn thing about nutrition because they're not taught nutrition in medical school. Only 28% of medical schools even have a nutrition curriculum, and it's only 19.6 contact hours median when you have 6,000 contact hours as part of a normal medical education. So 75% of the diseases and 75% of the health care costs could be recouped if doctors knew what the hell they were doing. But they didn't learn it. So how are they going to apply it? So my ask for you is read metabolical. And if you think that what's in

metabolical is worthwhile, gift it to your doctor. It all starts with education. Got to start there. It levels the playing field and, you know, makes it more likely for policy measures to take hold. Well, one thing that I am very excited about is doctors are also hungry for this information. So I've never seen as many, and many of my family members, being South Asian, you know, there's a huge percentage of my family members that are doctors, friends of mine. They are so curious about this and they love listening to podcasts. All the great ones that are out there. Levels, Peter Atia, Dr. Hyman. So I'm so excited that this information is able to get out there further and that the people who need the information the most are actually getting a

chance to get their hands on it. So thank you for being a part of that and spread the word. Let me add one other thing. Please. It's not just the doctors. Give it to your dentist. There's a whole section in there about dentistry. And indeed. And there's a whole section about dietetics. And so the question to ask your dietician is, is a calorie a calorie? And if they say yes, find a new dietitian. That's a great sign. Dr. Robert Lustig, thank you again for making the time. It's a huge honor. Appreciate you for coming on the podcast. Thank you for having me, Drew. It's been my pleasure.