The Peter Attia Drive - Qualy #69 - Advice to parents and kids for creating a sustainable environment that’s going to prevent them from running into metabolic problems

Episode Date: December 3, 2019

Today's episode of The Qualys is from podcast #14 – Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system. The Qualys is a subscriber-exclusive podcast, released Tuesday through Friday, and published exclusively on our private, subscriber-only podcast feed. Qualys is short-hand for “qualifying round,” which are typically the fastest laps driven in a race car—done before the race to determine starting position on the grid for race day. The Qualys are short (i.e., “fast”), typically less than ten minutes, and highlight the best questions, topics, and tactics discussed on The Drive. Occasionally, we will also release an episode on the main podcast feed for non-subscribers, which is what you are listening to now. Learn more: https://peterattiamd.com/podcast/qualys/   Subscribe to receive access to all episodes of The Qualys (and other exclusive subscriber-only content): https://peterattiamd.com/subscribe/  Connect with Peter on Facebook.com/PeterAttiaMD | Twitter.com/PeterAttiaMD | Instagram.com/PeterAttiaMD 

Welcome to the Qualies, a subscriber exclusive podcast. Qualies is just a shorthand slang for a qualification round, which is something you do prior to the race, just a little bit quicker. Qualies podcast features episodes that are short, and we're hoping for less than 10 minutes each, which highlight the best questions, topics, tactics, etc. discussed on previous episodes of the drive. We recognize many of you as new listeners to the podcast may not have the time to go back and listen to every episode, and those of you who have already listened may have forgotten. So the new episodes of the quality is going to be released Tuesday through Friday,

and they're going to be published exclusively on our private subscriber-only podcast feed. Now occasionally we're going to release quality episodes in the main feed, which is what you're about to hear now. If you enjoy these episodes and if you're interested in hearing more, as well as receiving all of the other subscriber exclusive content, which is growing by the month, you can visit us at pteratia-md.com-forward-slash-subscribe. So without further delay, I hope you enjoy today's quality. I want to get into some more geeky biochemistry stuff, but I also know that there's probably at least one person listening to this who's a parent who's thinking, oh man, do I have to simmer down how much sugar my kids are eating? So when you saw kids in the clinic, obviously you're seeing their parents.

That's one of the advantages of pediatrics is- So it's one of the disadvantages. That's right. That's right. You have two patients. Two patients. And I don't get paid for both. But the beauty of it is you have a patient who you need to take care of, which is this child. But then you also have another caregiver who, for the most

part, wants what's best for that child. Mostly. And how would you counsel a parent who would say, look, Dr. Lestig, there's no way my kid's going to have no sugar in their life. Can you give me a way to create a sustainable environment and set of rules that's gonna prevent my kid from having the metabolic derangement

that hoses them for the rest of their life, but allows them to still be a kid? Yes, so that's what we did in clinic every single day. Here's the problem, it's not the added sugar you know. It's the added sugar you don't know. It's almost like a runs felled tone to that, right? Well, yeah, I mean, there's the known knowns and then there's the unknown knowns. And the fact is, when you look at the amount of sugar that is in sodas, it's bad. When you look at the amount of sugar that's in candy, cake, ice cream, it's about half

as much. That adds up to 50% of the added sugar consumed by children. And what is that number by the way in grams per day approximately? Oh, it runs the gamut, but the median is 18 teaspoons. That's about 90 grams, 90 sugar per day. Yeah, it used to be 120. It's actually come down because of the obesity epidemic. 90 to 94 grams, that is sugar per day. Half of the sugar is in foods you didn't know had it.

Bread, pasta sauce. Pretzels. Why pretzels have sugar? Okay. Bread, right. Why do they put sugar in bread? Any idea? So if you buy a...

It probably helps with preserving it, doesn't it? Exactly. So if you buy a loaf of bread at the bakery, how soon before it stales? Two days, typically. Two days. If you buy a loaf of bread at the grocery store, how long before it stales?

Ten days. Three weeks, even. Okay. Why? They're both bread, right? Well, what they did in the grocery store bread was for its nails. Ten days. Three weeks. Even. Okay. Why? They're both bread, right? Well, what they did in the grocery store bread was they added sugar, very specifically, because the sugar doesn't boil off when you put it in the oven.

Water does. So it acts as a humectant. It keeps. Ah, that's why it's so much moisture when you have store-bought bread. Exactly. You mectant it that's why it's so much moisture when you have store bought bread exactly That's why if you threw a loaf of bread at my head it would just bounce off is because it's kind of spongy, right? But they're also breads like German fitness bread Which don't have that they're real bread. They use whole grains. They're lumpy bumpy and they're small

The loaves they're the size of their weapons and they're small, the loaves, they're the size of their bread. They're weapons. And they're weapons, right? You could like kill somebody if you threw a German fitness bread at their head, okay? It is dense. They're both bread, but the store-bought bread had sugar added very specifically to hold on to water because sugar's polar.

And so the water stays in and therefore the bread doesn't stay this quickly. Therefore you can put a cell on by date. Way later decreased depreciation, increased profit. So if a kid came in and a kid's got an afflady and you've surmised that this child's eaten about 100 grams of sugar a day, do you say to the parent,

our target is what? 20 grams per day? What we say is we don't worry about target numbers. What we say is process food is the problem because process food is high sugar low fiber. What you want is a low sugar high fiber diet. That's called real food. Every diet out there that works

and there are a whole bunch of diets that work, okay? Certain vegan diets work. Remember, Coke is vegan, so it's not like every vegan diet's okay. The college vegan diet doesn't necessarily work. Yes, the college vegan diet does not work. Exactly right. The traditional Japanese diet, the Atkins diet, ketogenic diet, paleo diet,

Mediterranean diet, all of these diets. I have phased diets. Sure. They all work because they're all real food. Every diet that works is real food and every diet that doesn't is because it's processed food. The problem is parents don't know the difference. They don't understand that grocery store bread is processed food. The problem is parents don't know the difference. They don't understand that grocery store bread is processed food. They think it's food. They think, you know, if it's sold in the supermarket, it's food. No, there's real food. And you know what that is, but the parents don't. And what we teach them in clinic is if there's a label on the food, that's a warning label, because that means it's been processed.

Because real food doesn't need a label. Is there a nutrition facts label on broccoli? Is there a nutrition facts label on carrots? No. Is there a nutrition facts label on the meat in the meat case? No. The reason is because it's all real food. Now, when we get to meat,

there's ways of making meat a problem too. It's called corn fed. But the bottom line is, at least they're real food. Because that means you don't necessarily fixate on targets. You say, look, we're going to make it. We don't talk about this. We're going to make a conceptual change. We don't ask them to do math.

We ask them to purchase and consume real food. Now, we have to teach them what that is. So what we do, we bring all the new patients in on the same day. We see all the new patients on one day, it's like chaos. And they all meet with a dietician. They come in fasting and we draw their blood, you know, we evaluate them. And then they all sit down at a communal table and we do an hour long teaching breakfast. And the dietician narrates why those foods are available for breakfast.

So whole grain bread, natural peanut butter, not Skippy Giff, Peter Pan, but the real stuff, plain yogurt, et cetera. And we explain why these foods were chosen and how they meet the criteria of real food as opposed to what they're currently buying. Most parents get it. Now there are some who don't, there are some who say, I'm sorry, that takes too long, I can't spend the

time preparing real food. And then is there an economic consideration also? Absolutely. Do you have a sense of what it costs all things equal? Yeah, double. So a parent's going to basically have to double their food budget if they want to start eating real food. That's right. They're going to have to double their food budget and they're also going to have to double their food budget if they want to start eating real food. That's right. They're going to have to double their food budget and they're also going to have to double their food time in terms of preparation. I hope you enjoyed today's quality. Now sit tight for that legal disclaimer.

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