TED Talk Tuesday – Sugar: the Elephant in the Kitchen: Robert Lustig at TEDxBermuda 2013

Today let’s talk about something that is near and dear to many of us, time to cue that classic Archies song!… “Sugar, ah honey, honey” It really is a great song, but we are not here to ruminate upon the quality of songs from the 60’s, well 1969, but I digress.

Sugar. Yes, that sicky-sweet substance that seems to be in every processed item. A rose but any other name would smell, or taste, as sweet. Much thanks to Shakespeare for pointing that one out. There are actually quite a few names for this sweet serenader, over 60, which I list out in the PDF gift I give you from signing up for my email list. Nothing like a shameless plug. Sugar puns aside, it really is everywhere. Even when going to Starbucks you must request no sugar pumps, because we are so addicted to the stuff. Yes, it is an addiction, one we need to fight against just as much as smoking. Because sugar is at the root of our metabolic problems chop down the roots, and the tree falls.

To introduce the man, Dr. Lustig is a Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, and Director of the Weight Assessment for Teen and Child Health (WATCH) Program at UCSF[1]. He is famous for his 90 minute YouTube Video, Sugar: The Bitter Truth[2], it currently has 7.79 million views on YouTube. He has written some great books which include Fat Chance and Hacking the American Mind, he is also a brilliant researcher that has authored or coauthored a lot of quality papers.

Now on to the talk! Dr. Lustig starts his talk with the idea of freedom, which may seem circuitous, but I like his point. He outlines personal responsibility into 4 basic principles: knowledge, access, affordability and your actions must not harm others. Because if your actions do harm other you are breaking the law. I appreciate where he goes with his talk after that, and that is actually where my notes start.

Here are my notes on Dr. Lustig’s sweet talk:

  • We’ve got a health care crisis, and it’s a big one.
    • Medicare will be broke by the year 2026.
  • This healthcare crisis is due to chronic metabolic disease.
    • $245 billion last year in America for diabetes.
    • $200 billion for dementia, another chronic disease.
    • Obamacare promises..to put 32 million sick people on the rolls, and we’re going to..provid[e] preventative services.
  • There are no preventative services for these chronic metabolic diseases.
  • [These numbers are] coming from this thing called the obesity epidemic, right?
  • You know, we have these things called the seven deadly sins… We’ve absolved jealousy, greed, wrath, pride, and lust. In fact, we have TV shows that exhort them. The only two that we have not been able to get rid of, the only two that still stand are gluttony and sloth. It’s your fault.
  • I’m a pediatrician, and I take care of kids. And I have a hard time ascribing personal responsibility to their obesity.
  • I take care of kids with brain tumors… [in one patient a tumor] sitting right in the middle of this patient’s energy balance pathway. A brain tumor that is causing massive obesity.
  • [Another patient] had a brain tumor, and she gained 150 pounds… we put her on an experimental medication to lower her insulin level.
    • Insulin is the diabetes hormone, it’s also energy storage hormone. It’s the hormone that tells your fat cells to take up extra energy. There is no weight gain without insulin.
    • A week later, the mother called me up, the kid hadn’t lost any weight yet, and she says, [The mother notes]“Well, we would go to Taco Bell, and she would eat five tacos and an Enchirito, and she’d still be hungry. We just went to Taco Bell and she only ate two tacos, and she was full. And she just vacuumed the house!”
    • …One year later having lost 48 pounds, and feeling much better about herself, as you can imagine.
  • The next patient…is a beautiful 13-year-old girl who lives in Hawaii… she was in a car accident, and she stroked her hypothalamus, that area of the brain where that tumor was for the other patient. And this is her, one year later. [she gained a large amount of weight]
    • Now, does anyone really want to tell me that this is personal responsibility?
    • I was giving grand rounds at Kaiser, Honolulu, and they said maybe we should put this girl on this same drug.
    • [In] one and a half years later at her high school graduation [she was of similar weight].
  • What we learned from these experiments is that the behavior is secondary to the biochemistry. When you fix the biochemistry, the behavior improves, and we’ve seen it now in adults as well.`
  • … so now you say to me, “What about the rest of us? We don’t have brain tumors.” Well, in fact, it’s the exact same problem.
  • All of us now have insulin levels three times higher than we used to.
  • Here’s the problem: seven out of eight of you, seven out of eight people with diabetes don’t even know they have it.
  • Here is the American population: 30% obese, 70% normal weight.
    • The standard mantra is, “It’s the obese person’s fault because 80% of those obese people are sick…” That’s the standard mantra; this is incorrect.
    • Because 20% of those obese people are actually metabolically healthy. They will live a completely normal life, die at a completely normal age, not cost the taxpayer a dime. They’re just that.
    • Conversely, up to 40% of the normal weight population have the exact same [obesity related] diseases. They get type 2 diabetes, they get hypertension, they get dyslipidemia, they get cardiovascular disease… [most]don’t even know they have a problem.
    • When you add them up, it’s more than half the US population. In other words, this is a public health crisis.
  • Here is an example of how that works. Here are two people of equal weight: one’s healthy, one is sick. [Shows a picture of the visceral and subcutaneous fat of two subjects]… I can tell.
    • The one in the bottom is sick; why? … The guy in the bottom has got fat all around his organs, and that is what’s making him sick.
    • Called TOFI… Thin on the outside, fat on the inside… you think you are just fine, and you are not.
  • So the question is, how do we resolve this? Well, here’s the problem; it’s on this slide, right here. This is Coca Cola’s beating obesity campaign, ‘Coming Together.’ “Beating obesity will take action by all of us, based on one simple common sense fact: All calories count, no matter where they come from, including Coca-Cola, and everything else with calories.”
  • I don’t believe in common sense. I believe in data. And the data say something else entirely… [it says] some calories cause disease more than others because different calories are metabolized differently, because a calorie is not a calorie.
  • how to fix this problem becomes very clear… It is called “the Western diet”, it is called “the industrial global diet”, and it is basically the processed food diet.
  • There are eight things wrong, not one, but eight things wrong…
    • Three things too little, five things too much.
      • Not enough fiber, not enough omega-3 fatty acids… not enough micro-nutrients…
      • In addition, too much trans-fats… branched-chain amino acids,… omega-6 fatty acids… alcohol and then finally, the big kahuna, the one that blows all the other seven out of the water, sugar. Sugar, okay?
  • Does sugar cause diabetes?
    • Everyone says, “Well, yeah, but it’s because of the calories.” Sugars are empty calories,
    • … This is absolutely not true. Sugars are ‘toxic calories’.
      • In fact, studies from Europe show that if you consume one soda per day, your risk for diabetes goes up 29%, irrespective of the calories, irrespective of your weight, irrespective of anything else you eat.
      • [Another study showed]… for every 150 calories the world consumes, diabetes prevalence goes up to a total of 0.1%…
        • if those 150 calories happen to be a can of soda, diabetes goes up 11 fold. 1.1%
        • … we’re not consuming one can of soda, we’re consuming two and a half. So 29% of all diabetes in the world is due to sugar, and sugar alone.
  • Now, the question is, why does this happen?
    • Number one: sugar causes liver fat accumulation.
    • Number two: sugar’s addictive.
      • Weakly so, but it’s everywhere, it’s like alcohol. And about 20% of people are addicted to alcohol, probably about the same for sugar.
  • This slide over here shows the prevalence of diabetes worldwide… Who’s worst?
    • Saudi Arabia, Kuwait, UAE, Qatar, and Malaysia.
    • Why them? No alcohol. But they’ve got soft drinks like they’re going out of style. Because it’s hot, and the water supply’s a question mark, and no alcohol.
    • … for soft drinks; all day, all night. Sugar in the morning, sugar in the evening, sugar at supper time.
  • The American Heart Association says we should be consuming six to nine teaspoons of sugar per day; we are up to 22.
    • … 80% of foods that are available in the American grocery store today are spiked with added sugar. And that’s for the food industry’s purposes, not for yours.
  • … here are 56 names for sugar, so you don’t even know what you’re consuming.
  • And how about this? Everybody knows what a “Nutrition Facts” label is. There’s a number over there in the purple. It’s called the dietary value. Notice, there’s none for sugar, and that’s on purpose because they don’t want you to know how much is too much.
  • How about the National School Lunch Program? … if you are eating school breakfast, you’re getting Fruit Loops and a glass of orange juice. That’s 11 teaspoons of sugar; you’re already over your limit. You want to know why we have a problem? This is why we have a problem.
  • What does personal responsibility really mean? Well, if the information is kept secret and you don’t have the knowledge if your access is limited because you can’t even find it and if society can’t afford it, and we can’t even give our kids something healthy to eat, is it really personal responsibility?
    • … That’s not called freedom, that’s called anarchy.
    • … So the libertarians say, “Wait a second; don’t tell me what to eat!” Well, you know what? You’ve already been told what to eat. Where were you for the last 40 years as your food supply was being changed under your nose. Were you protesting then?
  • So the real question is, who the hell do you want in your kitchen?
    • The government, who will take your freedom and your wallet?
    • Or the food industry, who has already taken your freedom, your wallet, and your health?
  • Now, having said all this, the food industry is composed of a lot of people… They really want to do the right thing, they do. Individually, they would actually like to do the right thing.
    • [C]ontrary to what the Supreme Court says, corporations are not people. Because corporations have a fiduciary responsibility to their stockholders, and people don’t.
    • … I’ve met with the food industry… They told me very straight out, ten scientists, ten corporate executives, they said, “You know, we can change. We’ve changed before. We had to change back in the 80s when we went low fat, with two provisos; we won’t go it alone, and we can’t lose money.” Those are two non-starters today.
      • That means that they have to be told what to do, and they have to do it all at the same time so that there’s no competitive disadvantage.
      • That means government. But governments are complicit and complacent. They’re getting paid off. Over half of Congress takes money from the food industry. And 6% of our exports are food.
      • What do you think what happens if all of a sudden we’ve told the entire world, “You know, all that shit we put in food? It really isn’t so good for you.”
  • … here is a report that just came out from an investment bank, an international investment bank, Credit Suisse, called Sugar Consumption at a Crossroads, and this is a direct quote from this tome: “We believe higher taxation on sugary food and drinks would be the best option to reduce intake and fund the healthcare costs associated with diabetes and obesity.”
  • I believe food should confer wellness, not illness, and it used to.
  • This is a public health crisis, and you cannot solve public health crisis one person at a time.
  • Personal responsibility isn’t an ideology. It’s the elephant in the kitchen, and we can’t afford it. What we need is a policy based on biology. And it’s got a name. It’s called real food.

I know this is an older TED Talk, but it is still true, sugar is at the heart of many modern chronic diseases. If we want change we need to pressure the government to change, and we need to pressure them to change at the source. There is a group pushing for governmental nutrition guidelines that are based upon actual science, this group is called, The Nutrition Coalition (TNC)[4]. They are a non-partisan organization that is making it their goal to ensure that U.S. nutrition policy is based on rigorous scientific evidence. They understand the need to adopt a scientific process for evaluating evidence-based nutrition policy.  This coalition is needed now more than ever because it is only a matter on tie until we cannot afford to pay for these chronic diseases. If we change policy, then WIC, SNAP, and all government funded organizations will follow the dietary guidelines. Remember Dr. Lustig mentioning the School Lunch Program? They feed kids pop tarts, low-fat milk and fruity cereal to start their day, I know this because I have volunteered in schools while getting my degree. Teachers were dumbfounded as to why their student wouldn’t concentrate, then crash just in time for the next sugar packed lunch.

Until we can make the government change, we need to vote with our dollars and buy actual food, not processed sugar laden garbage. Where the money is, the manufacturers will follow. Remember those two provisos: “we won’t go it alone, and we can’t lose money.” Their interest is in making money if we demand better products, they will come. These products will either come from major manufacturers, or they will come from keto healthy folk that see an opportunity in the market for their niche. When change comes, we need to allow it to happen and support it if we can.

We can have our voice be heard by voting with our ballots and our dollars. Every day I feel more hopeful for us as a whole. It is only a matter of time before we can turn the tide of obesity, metabolic disease, and all other related diseases.

Resources

[1]: https://profiles.ucsf.edu/robert.lustig

[2]: https://youtu.be/dBnniua6-oM

[3]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715098/

[4]: https://www.nutritioncoalition.us/

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