The Food Reward Hypothesis: A Rule Of Thumb For All Successful Diets

Readers, I’m not an expert on anything (except for maybe shoestring travel in Europe).  But every now and then, I hit the nail on the head without thinking.

Literally, after just posting this comment on another fitness blogger’s post on Food Logging

Food diaries are the absolute best tool for facilitating weight loss. Statistical fact.
When I first woke up from my junk-food induced coma and realized I was (again) way too fat, I bought a book on diet and weight loss, written by a business man.

Key point was to treat calories like money. Create a daily deficit, and you will lose weight and go broke.

Easy. I lost 40 pounds in three months.

But I am totally OVER food logging. As long as I don’t eat over-stimulating food, my body, which has thankfully repaired its hunger/satiety gauges through clean whole foods eating, tells me when to quit.

I eat a lot. 3,000-4,000 calories a day, on average, and no—I’m not working out.  Just living. I try to eat as much variety as possible, and tracking ALL THAT FOOD is a pain.

–I began to read an article I’d left open yesterday in my browser, on the food reward hypothesis.

From the article,

The food reward hypothesis of obesity states that the reward and palatability value of food influence body fatness, and excess reward/palatability can promote body fat accumulation.

In other words, when food is yummy, we eat more of it.  Too much eating eventually leads to overweight/fat accumulation, and/or possibly brain damage (i.e. damage in the hypothalamus, where appetite is regulated) and obesity.

Now, this might sound like a no-brainer, right?

Wrong, if you’re a low-carber.  If you’re like Gary Taubes (the “journalist” to which the fabulous article was written as a response piece), or a no-cash-crop-Paleo promoter, you probably want us to think that it is the type of calorie, not how tasty it is.  In other words, carbs, by virtue of their caloric type, cause fatness, and fats and proteins do not.

The author of the paper, Stephan Guyenet, explains the backwardation of this “no brainer” as follows,

I thought it would be more productive to discuss one of the core elements of [Taubes'] position, which has arguably been one of his greatest influences on the public.  This is the “paradigm shift” he promotes, away from thinking about obesity as a problem of energy imbalance (energy in vs. out), and toward thinking about it as a “disorder of excess fat accumulation” where energy imbalance is the result rather than the cause of fat tissue expansion (36)…He uses this argument to brush aside much of the last 60 years of obesity research, and the opinions of many seasoned researchers, arguing that they are largely irrelevant because they operate under the wrong paradigm (logical framework).

And the pages of Good Calories, Bad Calories came screaming back to me!  As well as the feelings I’d had after reading it, which led me to compose my longest article to date, which is little more than my amateur attempt to piece together the words of other experts and my own knowledge–a blunder, out of focus, but there, nonetheless, and I hope not far off the mark.

All I have to say is Taubes is reaching with his new paradigm.

Back to my little blog comment, though: “As long as I don’t eat over-stimulating food.”  Over-stimulating, aka, highly palatable food.

It did not take my subsequent years of voracious consumption (pun intended) of nutritional information to learn this.  It just seemed sensible.  I knew that if I bit into a cookie, I’d Tasmanian Devil the whole box.  Most women know this.

Me, especially after a workout.

I knew that if I wanted a slice a bread, I certainly wasn’t going to eat it as-is.  It would have been a vessel for delivering fat and/or sugar into my mouth!

Fat! Sugar! Married in a sandwich! NOM NOM.

I knew that some foods (like corn chips) are “like crack,” and other foods (like carrots) have a very rapid diminishing return on pleasure–and yet, both are high carb foods.

You’d never ask your waiter to bring over another basket of carrots.

So if you don’t blow your brains out with fat, salt, and sugar, or any combination thereof, you’ll probably be on your way to weight loss until you’ve “kicked the habit.”

Yeah… the habit.  We can be addicted to food.  We can also be overly-habituated to certain food presentations (i.e., “I can’t eat Thanksgiving turkey without cranberry sauce!”).

I hate to strip food of its beauty–of its aroma, flavor, and interplay with our olfactory and visual senses.  I hate to strip away its relationship to culture: food as a gift, food as a gesture, food as religion, food as identity–but if we take a moment and identify food solely as fuel, and treat it as such, we begin to lose our psychological dependence on it, and allow it to guide our health in more appropriate directions.

Guyenet states is beautifully in this other article,

Diet trials have shown that a ‘simple’ diet, low in palatability and reward value, reduces hunger and causes fat loss in obese humans and animals, apparently by lowering the ‘defended’ level of fat mass (30313233). This may be a reason why virtually any diet in which food choices are restricted (e.g., Paleo, vegan, fruitarian), including diametrically opposed approaches like low-fat and low-carbohydrate diets, can reduce food intake and body fatness in clinical trials.

I said it on my Nutrition Page, “Whether you follow a meat-centered, vegetarian, vegan, macrobiotic, or raw food diet, there is one common denominator for success: that the foods are of high quality and unadulterated.

So here’s the rule of thumb, if you’re trying to eat less.  Eat whole foods, or process them in your own kitchen.

Denise Minger vs. T. Colin Campbell — The China Study debate and take-home lessons.

Eat food, mostly plants, not too much. – Michael Pollan

I just spent the last several days reading the critique of T. Colin Campbell’s The China Study, written by Denise Minger.

Earlier this week, I decided to revisit The China Study book for its references–in search of the “holy grail” of significant argument in science: peer-reviewed articles in scientific journals.   As I am more fond of works of journalism (due in large part to the inaccessibility of prohibitively expensive scientific journals), I have amassed many books on a variety of nutritional subjects–written by people who have aggregated available data, on all sides of the nutritional debate.  I did this in an effort to get a broad “macro” understanding of good nutrition.

But when faced with an extremely arrogant unhealthy fellow quite opposed to organic-pushing-yuppies, and refusing to read anything but peer-reviewed journals, I had no choice but to re-open The China Study and start looking through its references.

That’s when I wondered if anyone had finally criticized the book, as it had been years since I’d last wondered.

Many have suggested that I become a registered dietitian.  Every time this is suggested, I think how that might be nice, but ultimately balk at the notion of studying the effects of isolated nutrients.  Frankly, I don’t have the science background and wouldn’t want to go back to school just to go back to school.

And besides… I’m a fitness trainer–plain and simple.  And while I could devote my attention to a PhD in kinesiology or something of the sort, it wouldn’t contribute very much to the job that I love, which has only a part to do with hard science, and the rest to do with lifestyle modification, motivation, behavioral psychology, nutrition, and goal-setting.

Thus, with a complete and utter lack of any scientific qualifications, I brave the field of nutrition, which is just about the most hotly debated subject ever.  More than politics, more than religion.  Criticizing what and how people eat is bold, because it tends to put to make people very defensive.    After all, you are what you eat.  Criticize how someone eats–you criticize what they are and what works for them (or at least what they think works for them).

That being said, my safest approach is broad in scope.  First, eat.  And read.  And eat.  And read some more.  And eat.  And read and read and read and eat and eat and eat.  And after all of this, I still can’t be sure what an optimal diet will be.

Like any amateur blogger on nutrition, I’ve done it all: vegetarian, vegan, raw food, paleo, macrobiotic, Atkins, high protein, and more.  Most fitness trainers experiment with diet as obsessively as diet-zealots.  I’ll spare the back story.  Suffice it to say, I’m like the rest of them.

I’ve read a lot of books.  I’ve done a lot of research.  My leg-work pales in comparison to Denise Minger (despite my own enthusiasm for the subject, and handful of years over her) and most definitely to T. Colin Campbell.  But allow me to speak about them both.

Enter Denise Minger – A twenty-something, passionate, zealous independent researcher with no formal education in nutrition, statistics, and other relevant sciences.  But I will be the last person to disregard her on such grounds, because I do not believe that knowledge and understanding is limited to formal credentials.  She is clearly a bright and diligent person, and I know I will very much enjoy the rest of her blog’s content.

My first impressions of her were awe and curiosity, as she was making some compelling claims that I could not superficially dismiss with the knowledge I had.  As I continued to read her blog, her About page, and finally, her bashing of The China Study, I was more turned off by her tone, her arrogance, and frenetic writing style.  But that didn’t mean what she was saying was worthless.  I was compelled by her arguments, like her many readers and fans.  Like the majority of them (I can only assume), I lack the raw data of the China Study, as well as the tools to interpret it correctly.  But even so, something felt wrong with her hard-line criticism.

My favorite books in nutrition happen to be Weston A. Price’s Nutrition and Physical Degeneration, T. Colin Campbell’s The China Study, and Healing With Whole Foods: Asian Traditions and Modern Nutrition, by Paul Pritchford.  It’s an eclectic mix of kind-of science, conventional science, and non-science.  I’m a huge fan of the concept of not messing up food by hyper-processing it.  All these books are in agreement there.

The discord in recent debate around nutrition comes from animal vs. plant-sourced food, and each of my favorite books has something different to say.  Price is all for animal foods so long as they are nutrient-dense and indigenous.  Campbell is highly suspect of animal foods, especially as a large percentage of diet, and prefers to abstain, but does not tell his readers to be vegan.  And Pritchford has a strong preference towards plant-foods, with quite minimal levels of animal foods.

Having done it all, and always modifying my diet due to my very erratic lifestyle of travel and re-location and volunteering, I eat what I can get, and I’m a stickler for quality.  I don’t tell my clients to be vegan.  But I make gosh-darn sure to emphasize that animal foods should be kept at a minimum.  It feels right.  The conglomerate opinion of the material I’ve covered states the same thing.  The common denominators are pretty consistent.

And this, I think, is the crux of T. Colin Campbell’s book, and was stated with great diplomacy in his response to her China Study bashing.  He has many decades in the field and has read untold studies in nutrition, conferred with untold scientists, nutritionists, doctors, and more.  Honestly, if I had to bank on anyone’s wealth of knowledge (irrespective of academic credentials), I’d bank on him.  Frankly, if 23-year old Denise spent the next couple of years working 40 hours a week on the subject of nutrition, she still would only have scratched the surface of Campbell’s experience.  Nothing teaches better than experience, with credentials or without.

The more you learn, the more you realize you don’t know, and you can read T. Colin Campbell’s admission that The China Study is the most comprehensive in its design, but its data alone do not provide all the answers.

I argue that causality in nutrition, as it relates to disease, will be impossible to prove except in the rarest of cases, which I cannot even imagine.  Why?

Well… from a training standpoint, we don’t merely eat.  We move, we live, we inundate ourselves in chemicals, we pollute our environments, we meditate, we do things.  We do so many things–eat so many things–and do so many things to the things that we eat…

I know that some people respond to exercise differently than others.  There are hard-gainers and easy-gainers.  Stubborn fat, and elusive muscle.  In my case, muscle that comes too readily, and fat that just stays put–vegan, raw, or not.  It is amazing.

If people don’t respond uniformly to exercise, why should I expect them to respond uniformly to a diet?  Some people take more, and some people take less.

Same with diet.

So I ask, what is the point, Ms. Minger, of your relentless efforts against T. Colin Campbell, when your diet closely resembles his “plant-based” recommendation?  Campbell is a spokesperson for veganism, but neither his foundation nor his book go beyond “whole-food plant-based,” I think in order to differentiate from out-of-proportion (often poorly implemented) vegan dogma and idealism.

Ms. Minger can reference studies that demonstrate effects contrary to what Campbell is conveying.  I can show you examples of fat people who don’t get skinny with lots of energy expenditure.  That doesn’t mean cardio should be chucked out of the approach.  It merely demonstrates the complexity of the subjects at hand.

The comments one her blog speak volumes.  She’s created a community of semi-raw/paleo/Weston A. Pricers vehemently opposed to veganism, with scores of anecdotes stating how veganism made them sick, this and that and this.

Any diet can be applied poorly.

What I’ve learned in my time as a “tinfoil-hat-wearing conspiracy theorist” is that a smart enough person can draw enough arrows to make a compelling case for anything.  And Ms. Minger is a very smart chick.  It’s clear.  Campbell is also pretty smart.

If you look hard enough, you will find what you’re looking for.

Now, if you consider the sheer number of arrows pointing in favor of Campbell’s conclusions which are, namely, that even moderate consumption of animal-sourced foods and refined foods promote poor health in our time, there are a lot.  I mean, a lot of them.  He has quite a bit of science to back up his claims (although, considering the amount of data out there, much of it inevitably conflicts with itself), but more importantly, he has modern human populations and controlled clinic trials to reference as well.

Minger also has done her due diligence (again, not on the order of magnitude of Campbell and his associates–she’ll be nipping at their heels for years to come), especially with the raw data of the China Study itself.  She, too, has been able to draw some compelling arrows in favor of her own conclusion which is… umm… that’s the thing.  After spending days reading her blog and the comments and the counter arguments, and so forth, I wasn’t quite sure what she was trying to accomplish.

Was it that milk doesn’t kill people?  That refined carbohydrates are equally guilty for poor health?  That people who consume more animal-based foods also consume more refined foods, and it’s unfair to hyper-focus on animal protein?  That Campbell should have controlled for other factors in his years-long analysis of the China Study data performed by himself and his assistants?  She modifies her original post by stating that she wants to “highlight potential weaknesses” in the China Study.

She takes a list of statements made by Campbell and attempts to dissect them with the raw China Study data and supporting studies.  In doing so, she draws a bunch of new arrows that point in an opposite direction.

But did she accomplish anything beyond giving animal-food-obsessed fans some reassurance that  their foods won’t necessarily kill them?  I don’t think so.

Let’s say that Minger got it right–that Campbell’s evidence is self-contradictory.  The conclusions may not follow, but that doesn’t mean they’re wrong.  After all, Minger herself eats the diet recommended by Campbell in The China Study.

Show me the clinical evidence of group of people following his dietary recommendations and dying from diseases of affluence.  Show me.  Do that, and I’ll be impressed.

T. Colin Campbell is a scientist.  He is a lot of other things now, too.  He’s a vegan spokesperson.  He’s a marketer.  He’s a teacher.  He’s an author.  His behavior in each of these roles must be taken in stride.  But by no means should Ms. Minger smear his work to such an extent that she’s led many of her readers into thinking that he should be kicked out of the scientific community and that his recommendations are garbage.  Some of the comments left on her blog were startling, to say the least.

The release of The China Study book was business and marketing.  Authors are beholden to publishers. Publishers need to market books.  Films need spokespeople.  Messages get conveyed, re-conveyed, re-worded, and so on until the public can digest it in sound bytes.

The paleo movement so defensive of animal foods is currently what’s hot.  I remember when raw was the headlining diet.  I can’t help but feel like Ms. Minger’s aggressive criticism is more a product of her zealous defense of her own diet (inclusive of animal foods in limited amounts) than anything else.  We can interpret data over and over again, control for that, omit this, include too much.  But the bottom line is that a whole-foods plant-based (who said vegan?) diet, applied intelligently, works for a lot of people.  This does not mean that paleo doesn’t work.

I will concede that Campbell pays a great deal of attention to the effects of animal-sourced food, and too little to the effects of refined carbohydrates and oils.  Again, it does not make his recommendations wrong.  We’re not talking about cause.  We’re talking about association.  If the ingestion of animal-sourced foods leads to the displacement of plant foods–if the chemical high we get from animal foods leads to an extra-chemical high from combining them with refined foods–his recommendations still hold.

And what do I think of Ms. Minger’s “raw food, plant-based, paleo-ish, Weston-A-Price style fusion?”  I think it’s great.  I mean, I don’t think it gets much better than that, especially if you are young and healthy and don’t have contraindications.  But you cannot remove anything from its context.  Would I eat that diet if I had cancer or kidney disease?  Probably not.

T. Colin Campbell and company are addressing a nation of sick people in a polluted environment with a plant-based strategy demonstrated in risk–not causality.  I believe their recommendations are safe and effective when applied intelligently.  I believe, furthermore, that their recommendations are excellent in the context of industrial agriculture, environmental constraints, and negative externalities–as well as in the context of changing farm policy, swiftly reversing an obesity epidemic, and empowering consumers.

Don’t miss the forest for the trees, trying too hard to be right.

Diets Containing 10-20% HFCS / Sugar don’t prevent weight loss.

This was a fun read.

A study published recently (August, 2012) in Nutrition Journal called “The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters” made some conclusions about sugar consumption and weight loss.

If you don’t know what “hypocaloric” means, it means “low-calorie.”  The study took different groups of overweight-to-obese people and placed them on diets containing levels of sugar (sucrose) or HFCS (high fructose corn syrup) in levels of 10-20% of their total caloric intake, and ensured that all groups achieved a caloric deficit of about 300 calories per day.  Every group, including the control group, was also put on an exercise program.

And what happened?

Short answer: everyone lost body fat.

Yippie!

I didn’t need to read the article to know that would happen.  Come on.  That’s just Personal Training 101: calories in vs. calories out–plus the bonus of thermogenetic exercise!  Every trainer is taught to sell training on that concept.  Burn more than you eat and you lose weight.

“What are you getting at?” you ask.

Well… this isn’t new research.  It’s old.  Super old.  We didn’t need a controlled double-blind study to prove it.  Trainers see it every day.  Anyone who had ever deliberately lost weight by counting calories know this.

But if you dig deeper and look at the underlying biochemistry of sugar metabolism, it still isn’t news.  No one explains it better than Dr. Robert H. Lustig.  Sucrose and HFCS are almost identical in composition, and in how they behave in the body.

To be completely fair, HFCS got a very bad reputation for a while.  People failed to see that it was pretty much the same as regular table sugar.

The scientists, in an effort to save the reputation of added sweeteners, state:

evidence regarding a potential positive association between sugar sweetened beverage consumption and obesity is inconsistent [43]. Because of the metabolic nature of overweight and obesity and the complexity of the western diet, it is unlikely that a single food or food group is the  primary cause. Randomized, clinical feeding trials have shown inconsistent results from testing the effects of added sugar on weight gain. Differences in study instruments and methods, population studied and study design may have contributed to these inconsistent findings.

In other words, science has a very tough time pinning down cause and effect in multi-variable situations.  It can’t really.  ”Causation” is exceedingly difficult to prove.  But correlations are easy to demonstrate.  Too easy, sometimes.  This is why social context, politics, policy, money, corruption, public opinion, advertising, and everything else should always be factored into the decision-making process.  Emotional intuitive (visceral) decisions shouldn’t be overlooked, either.  Yes, these things get us into trouble, but so does science.

My favorite quote these days is “100% of all products recalled by the FDA were deemed ‘safe and effective’ by the FDA.”  Science can be bullshit.  ”Good science” is much rarer in our industry-led scientific data pool.

I have absolutely no argument with what the study concluded:

“In conclusion, similar decreases in weight and indices of adiposity are observed when overweight or obese individuals are subjected to hypocaloric diets with different prescribed levels of sucrose or high fructose corn syrup.”  < (AND EXERCISE, you jerks!  You left that out!)

At the bottom, I looked for conflicts of interest.  Here’s what it said: “JM Rippe has received research funding from the Corn Refiners Association for the present study. The other study authors reported no competing interests.”

Ok… one guy.  Big deal.  And there were how many scientists?

Here they are:

Joshua Lowndes (jlowndes@rippelifestyle.com})
Diana Kawiecki (Dkawiecki@rippelifestyle.com})
Sabrina Pardo (Spardo@rippelifestyle.com})
Von Nguyen (Vnguyen@rippelifestyle.com})
Kathleen J Melanson (kmelanson@uri.edu})
Zhiping Yu (Zyu@rippelifestyle.com})
James M Rippe (Jrippe@rippelifestyle.com})

Wow!  They all WORK FOR Mr. James M. Rippe!  No conflict of interest, you say?  That’s sweet.

The CORN REFINERS ASSOCIATION paid Mr. Rippe and his associates (or employees) to design a study that teaches us nothing new at all, to make HFCS look less hazardous than it is.  I had such a giggle over this I thought I’d point it out to my readers.

HFCS and Sugar consumption at levels of 10-20% of a low-calorie (plus exercise) diet don’t inhibit weight loss when efforts are well-structured and executed.  The introduction of HFCS didn’t make us fat, they’d like us to think.  Well let me say this: the correlations are staggering.

Correlations are neat little things that help us make general decisions.  Correlations should be taken with other correlations and perhaps a dose of intuition.  This ads up to lifestyle change.

So keep in mind that the Corn Refiner’s Association is a lobbying group whose sole purpose is to make the public and politicians feel all warm and fuzzy about corn.

Corn. King corn.  The CORNerstone of farm policy.  The crop that receives the most subsidies (i.e. ‘welfare’).  The crop around which our backward policies have enabled the competitive wipe-out of other corn producers.  The crop around which so much GMO attention and research is hinging.  The crop that is quite impossibly being directed towards “sustainable energy.”

Good old corn, you complicated SOB.  I’m so glad these scientists devoted their valuable skills to the promotion of bastardized food production and processing.

6-Pack Abs Are Expensive

…unless you’re a teenage boy, or a hard-gainer.

The guy on the cover of Men’s Health Magazine is a professional model.  His job is to look good, and he doesn’t look that good by cutting back on carbs and doing crunches.

That guy probably pays money to look that good.  A lot of money.

I work in a body building gym in San Francisco.  It also just so happens to be San Francisco’s “gay gym.”  Sure, straight people are allowed in, but the member base is predominantly male.  You’re either a body builder, gay, or both.

It seems to me that body image is as important to this particular member base as it is for women!  Everywhere you look, there are tight, hard bodies pumping iron.  There’s the core group: the members who arrive every day, without fail, and work out for 2-3 hours.  Lift-pause-lift-pause-lift-pause.

…and then some “cardio:” slow, deliberate steps on the stair mill–forever.

I don’t know enough about body building to give an in-depth analysis, but what I can tell you is that these guys have the most expensive bodies of anyone I’ve ever known in a neighborhood gym.

  • $200 a month for supplements: protein powder, meal replacement, BCAAS, and more.
  • $100 a month for extra food: shakes, smoothies, and chicken.  Lots of chicken.  Insane amounts of chicken.
  • $0-$400 a month for personal training and accountability.
  • $80-$200 a month for body work, including stretching, massage, hair removal, and tanning.
  • $$$ = Time.  Tons of time exercising and eating.  Time planning meals.  Time commuting to and from the gym.  Time waiting between sets.  Having a solid body is one of the most time-intensive exercise goals of them all.  It’s like playing a sport, only your “practice” is 2-3x longer every day, and you have to invest 2-3x more time fretting about your food, and 2-3x more time recovering (every workout aims to demolish muscles; every workout aims to leave them twitching, dying, and torn at a microscopic level, in order to repair and grow bigger and stronger).  What is an hour of your time worth?

Don’t get me wrong.  I have tremendous respect for body builders.  It is a sport that requires insane precision and dedication.

But I’m weary on their behalf.  I’m weary for the time they spend fretting about whether one shoulder looks bigger than the other, about whether their kidneys are okay, whether they are coping with their body dysmorphia constructively.

Hey!  That’s just for body builders!  I don’t want to be a big massive guy.  I just want that 6-pack!

Take a ticket.  You and everyone else who doesn’t want an ounce of fat on them.  And there are two ways to get rid of every ounce of fat:

1) Just don’t eat.  Ever.  Give up food.

2) Don’t eat carbs.  Hyper-dose yourself on protein.  Stick with natural, unprocessed fats when needed, and lean protein the rest of the time.  Oh, and when you’re ready for your photo shoot, dehydrate yourself.

The body is designed to have a healthy layer of fat on it.  Your brain is wired to seek out fat and sugar.  When it ingests fat, it thinks, “Awesome!  Let’s eat more of that!”  When it finds sugar, it says, “Whoa! Cheap, delicious energy!”  When the two are combined, “Holy shit!  The is the most amazing food stuff I’ve ever encountered!”  It’s fat and carbs that the body wants.

Fat keeps the body feeling full longer than anything else, and it keeps the body running slowly.  Carbs are the body’s preferred energy source, and they allow for fast, rapid movement; they also make you feel happy.

The body does not have the same hard-wiring for protein.  Of course, protein is an essential macro-nutrient, but after you eat a sufficient amount, the brain says, “Boy, I don’t want another bite of chicken.  I’ll throw up.  I’m warning you…  No more!”

Eating massive amounts of protein is hard work.  And it’s hard work to digest as well.  You’re net energy decreases, and your organs work over-time.  It also requires a lot of water to digest.  If you aren’t getting sufficient fiber and vegetable intake, you run the short-term risk of constipation (uncomfortable) and the long-term risk of colon cancer (life threatening) and other types of cancer (if your protein is predominantly animal-sourced).

On the plus side: you will have very healthy hair and nails, and big muscles.

If you have a good ethic of regular exercise, including a variety of exercise activities, and you are fretting about your abs, know that for most people, 6-pack abs take an extreme level of dedication that may not be lifestyle friendly.

“Sugar: The Bitter Truth,” from Robert H. Lustig, MD: A Summary

Dr. Robert H. Lustig begins with the question, “What do the Atkins diet and the Japanese diet have in common?”  It’s an odd question, as the two diets seem diametrically opposed.  The Atkins diet is all fat, no carb.  And the Japanese diet is all carb, no fat.  They both work.  So, what do they have in common?

They both eliminate the sugar fructose.

Lustig continues into a 90-minute lecture, called “Sugar: The Bitter Truth,” which can be viewed for free on Youtube.  Amazingly, this 90-minute talk on sugar and biochemistry was viewed by over 1.5 million people.  1.5 million people wanted to learn how fructose is basically the common denominator for virtually every aspect of Metabolic Syndrome.

Lustig begins with a basic law: if you eat it, you better burn it, or you’re going to store it.  This is the law of thermodynamics, pushed forward by fitness trainers and fad diets.  For many, it’s true.  Calories in vs. calories out will determine skinny or fat.

But it’s not true.  I’ve always said that if you eat 2,000 calories of protein vs. 2,000 calories of sugar, you will achieve a very different body shape.

Energy expenditure equals quality of life, Lustig continues.  The more energy you burn, the better you feel.  But we are not burning this energy, and America is suffering from an obesity epidemic.

There is a hormone in our body that tells us to stop eating.  It’s called leptin.  It’s supposed to tell us to stop eating, but Americans are eating more than ever, so clearly leptin isn’t working anymore.  There is something we are eating that is distorting our normal biochemical negative feedback system.

Is it the fat in our diet?

Nope, he says dismissively.  We’ve actually decreased our fat intake, as a country, from 40 to 30% over the past few decades.

It’s the carbs, Lustig declares.  There’s something in the carbohydrate we are eating that has shut down leptin.

Americans consume 65 lbs of high fructose corn syrup a year.  HFCS is much sweeter than most sugars.  The syrup is comprised of glucose and fructose (fructose will vary from 42-50%).  Sucrose (table sugar) is also a fructose and a glucose; table sugar is 50% glucose, 50% fructose.

Lustig declares, HFCS and sugar are the same.  They are both poison.  Sugar isn’t just about empty calories. Fructose is a poison, and it distorts your body’s chemistry.

Every single year, Americans not only eat more, but they eat more of their calories from sugar.

After summarizing how the Nixon administration would change the face of American food production and culture forever, and the tight correlation between soft drink consumption and obesity, Lustig asks his audience to hang on tight for a whirlwind tour of how glucose, fructose, and ethanol (alcohol) break down in the body.

Fructose is not glucose:

1. Fructose is 7 times more likely to form advanced glycation end products

2. Fructose does not suppress ghrelin (the hunger hormone) because it does not break down until it reaches the liver.

3. Fructose does not stimulate insulin or leptin.

4. Fructose is the only sugar metabolized by the liver.

5. It promotes metabolic syndrome.

Compare 2 slices of white bread (which is roughly 120 calories of glucose), to liquor (roughly 120 calories of ethanol), to a glass of a sugar-sweetened beverage (about 120 calories of sucrose, half of which is fructose).

The Bread (glucose) – 120 calories:

-80% of the glucose will be used by the body.

-About 20% of the glucose will hit the liver and get stored as glycogen (for future physical activity).

-A tiny fraction of the glucose will be made into ATP which, if not burned, will go through a number of biochemical processes, turning into citrate, and may be stored as fat.

-Perhaps 1/2 a calorie will end up as Pattern B Cholesterol (very low density lipoprotein), but it is negligible.  This is why you can live off white rice and not die of a heart attack.

The Alcohol (ethanol) – 120 calories:

- 24 calories will hit the kidneys, muscle, and brain.

-96 calories hit the liver.  This is four times the amount, compared to white bread (glucose).

-What hits the liver metabolizes into acetaldehyde (like formaldehyde), which is toxic.

- Like glucose, it breaks down into lots of citrate, and will be stored as fat (four times the amount!).

-The other by-product of this metabolic process is the production of Pattern B Cholesterol (VLDL), again, four times the amount.

The Sugary Beverage (sucrose) – 120 calories:

-60 calories from glucose will break down similarly to the white bread (48 calories to the body, 12 calories to the liver to be stored as glycogen).

-60 calories from fructose will all go to the liver.

-In total, 72 calories reaching the liver will need to be phosphoralated (turned into energy–ATP–adenosine tri phosphate).  That is a lot–three times the amount, when compared to white bread.

-You lose a lot of phosphate in this process, and so the body provides a rescue molecule, and the end waste product from the metabolism of these calories is uric acid (which causes gout and hypertension, among other things).

-Uric acid blocks the your body’s chemical–endothelial nitric oxide synthase–for maintaining low blood pressure.

-Citrate, again, arises from the metabolism of all these calories, which promotes fat retention, dyslipidemia, VLDL, and high blood triglycerides.

-In short, from any fructose load, 30% of it will end up as fat.

-An excess of body fat changes the way your body responds to leptin.  Leptin is a hormone produced by adipocytes (fat cells).  The more fat you have, the more leptin is produced to act on your brain’s hypothalamus.  But when there is too much, you develop leptin insensitivity; your brain can no longer recognize it and thinks you’re starving.  So you eat more.

A final comparison between soda and beer:

COKE BEER
Calories 150 150
Calories from fructose 75 (4.1 kcal/g) 0
Calories from other carbs 75 (glucose) 60 (maltose)
Calories from alcohol 0 90 (7kcal/g)
1st pass G.I. metabolism 0% 0%
Calories reaching the liver 90 92

Lustig says fructose is ethanol without the buzz.

Fructose is like drinking fat.  30% goes to fat storage.  It is metabolized like fat.

A high sugar diet is essentially a high fat diet.

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