Why Sugar is SECRETLY Killing You Like Smoking | Dr. Robert Lustig

[00:00:00]Quality of life of an obese child is the same as a child [music] on cancer chemotherapy.

[00:00:04]>> Should sugar be regulated like alcohol?

[00:00:06]>> I think so. The idea of eat less, exercise more [music] is just what the food industry wanted you to believe.

[00:00:12]>> Do you think these food companies have blood on their hands?

[00:00:15]>> My answer is >> And when it comes to sugar, is moderation okay for an individual?

[00:00:21]>> So, depends what you mean by moderation.

[00:00:24]If you mean letting people make their own decisions, well, that's all we have. So, it's got to be okay cuz that's all we have. But really, the way to moderate people's uh consumption is by reducing the availability in the first place. That's called the iron law of public health.

[00:00:45]And it worked for tobacco and it worked for alcohol.

[00:00:47]So, the iron law of public health goes like this.

[00:00:50]Reducing the availability of a substance reduces its consumption, which reduces health harms.

[00:00:57]It's a law.

[00:00:58]Okay? You can go all the way back through history. That's the way it is.

[00:01:02]Reducing availability reduces consumption, which reduces health harms.

[00:01:07]Now, how do you reduce availability of sugar when it's everywhere? When it's in every uh ultra-processed food, when it's on every grocery store shelf, when it's in every school.

[00:01:21]And why is it in every product on every grocery shelf and in every school? And the answer is cuz it's addictive.

[00:01:30]Because there's a profit motive involved.

[00:01:34]So, could we do something about that?

[00:01:36]And the answer is yes, we can. In fact, I am the chief science officer and co-founder of a nonprofit here in the Bay Area called Eat Real, and our job is to get real food into K-12 schools around the country, and we are going national. We have already touched a million kids, and we've already gotten 30 million pounds of sugar out of their diet every year. Now, is anyone complaining about that?

[00:02:07]Only the soft drink companies.

[00:02:10]>> You said we've gotten nutrition wrong for 30 plus years.

[00:02:15]What did you see that no one else did?

[00:02:18]>> Everyone thought it was about calories.

[00:02:21]Because number one, we were told it.

[00:02:24]We learned it. I learned it.

[00:02:27]Okay? I majored in nutritional biochemistry uh in college at MIT, and I learned back then that different calories were metabolized differently.

[00:02:40]Um then I went to medical school, and they beat it out of me and told me that's not how we take care of patients.

[00:02:45]None of that matters. It's only about calories.

[00:02:49]And so, I practiced for the first 20 years of my career with that in mind, because after all, this is how the gurus do it. You know, this is how what I learned in medical school. This is what I, you know, paid big money, you know, to to learn. So, why would I argue against it?

[00:03:07]Problem was, none of my patients were getting better.

[00:03:11]And then I started doing research into the field, and started actually questioning that concept of just calories. And it turned out that sugar was not just calories. Yes, of course, it's, you know, 4 calories per gram, and glucose is 4 calories per gram, fructose is 4 calories per gram, protein is 4 calories per gram, but they are clearly None of those three things are metabolized the same way, and all three of them have different effects on the body, on the organism, that ultimately lead to metabolic mayhem, and fructose being the most egregious.

[00:03:53]Why?

[00:03:55]So, each of the following four things that I'm going to explain to you have nothing to do with calories.

[00:04:02]Number one, fructose causes fatty liver.

[00:04:08]Fructose is metabolized in the liver like alcohol, generating fat. And that fat deposits, and that's why we have this epidemic of non-alcoholic fatty liver disease, now known as metabolic associated steatotic liver disease. We went from NAFLD to MAFLD, who cares? It's the same disease.

[00:04:27]It's fatty liver, and 5-year-olds get it.

[00:04:31]Now, when I was a med student 50 years ago, the only people who had fatty liver disease were alcoholics.

[00:04:40]Now we have 5-year-olds with fatty liver disease, and they don't drink alcohol.

[00:04:46]The key is that fructose and alcohol metabolize the same way.

[00:04:51]So, it doesn't really matter.

[00:04:53]Fructose is the alcohol of the child, and that's why it's in every breakfast cereal, because fructose is the alcohol of the child.

[00:05:01]So, that's problem number one.

[00:05:03]Problem number two, fructose causes the aging reaction, the browning reaction, the caramelization reaction, known in science as the Maillard reaction.

[00:05:16]That causes proteins to brown, to become less flexible, and every time that reaction occurs, you generate a reactive oxygen species, which does damage, which has to be cleared or quenched. Fructose does it seven times faster than glucose.

[00:05:34]And fructose generates a metabolite when it's uh turned into energy that actually binds to the enzyme that controls mitochondria and cause causes mitochondrial dysfunction. Number three, fructose affects the microbiome.

[00:05:52]Glucose does not.

[00:05:54]Fructose causes the bacteria in your intestine to change and changes microbial diversity, changes the tight junctions that hold the intestinal cells together to present a barrier so that bad stuff in your intestine doesn't get into your bloodstream to cause inflammation.

[00:06:13]Well, fructose does that and glucose doesn't. And then finally, number four, fructose is addictive and glucose isn't.

[00:06:21]Fructose goes to the area of the brain that controls reward and generates reward just like nicotine, alcohol, cocaine, heroin or behaviors like shopping, gambling, internet gaming, social media, pornography, anything that causes a dopamine release is in the extreme addictive. Fructose is in the extreme addictive. The problem is we're extreme.

[00:06:47]>> Guys, we've been so passionate about finding the biggest geniuses and this is just one of the many episodes. If you want to make sure you don't miss the next one, make sure to subscribe. All right, let's get back to the episode.

[00:06:58]Why is eat less, move more not enough and what is?

[00:07:03]>> Well, eat less, move more is based on calories.

[00:07:06]Calories in, calories out.

[00:07:08]Gluttony and sloth.

[00:07:11]And there's a reason why that took hold.

[00:07:14]There's a reason why everyone believes that.

[00:07:17]Okay, if you're fat, it's your fault.

[00:07:19]Blame the victim.

[00:07:21]We're really good at it in our society.

[00:07:23]Blame the victim. We've been doing that for a while.

[00:07:26]Okay, the fact of the matter is this is not a uh victim issue.

[00:07:32]Okay, cuz everyone's exposed and everyone is susceptible.

[00:07:37]Okay, there's a reason why we've gone from 5% obesity in 1970 to 45% obesity today.

[00:07:46]Is it that everyone all of a sudden just became gluttons and sloths?

[00:07:51]The fact of the matter is the biochemistry drives the behavior. And we proved that in a study that we did many many years ago where we knocked down uh the insulin released by glucose and fructose using a medication. And when we did that, not only did the patients lose weight, but their caloric intake went down remarkably and their exercise went up remarkably. And they didn't just reduce their calorie intake, they reduced their sugar intake.

[00:08:27]They went from 47% of calories as carbohydrate to 35% of calories as carbohydrate. So, that's not an anorexia. That's not a you know, reduction in just food intake. That's a re- change in taste preference.

[00:08:43]So, when you get the insulin down, you actually change what you eat.

[00:08:48]And the food industry knows that and that's why they keep plying us with sugar.

[00:08:53]>> Is hunger something that we control or something that controls us?

[00:08:57]>> Oh, hunger controls us without question.

[00:09:01]Now, there are many reasons to eat.

[00:09:05]Three big ones.

[00:09:06]Hunger, reward, stress.

[00:09:09]Every one of those is a reason to eat.

[00:09:12]Now, hunger controls us because when we're starving, we're very hungry.

[00:09:19]Reward controls us because if reward didn't control us, these would not exist.

[00:09:29]And stress controls us because stress is a mollification for the pain.

[00:09:37]That's how we mollify the pain of our lives, of the emotional pain of living, of dealing with all of the hardships that we as human beings deal with on a day-to-day basis. Point is, stress-induced eating is a well-known driver.

[00:09:58]We actually did a study years ago where we gave an opiate antagonist to postmenopausal women.

[00:10:06]And what we showed was that the more stress they had at baseline, the more the opiate antagonist caused nausea and also the more weight loss occurred. So, in fact, their stress was driving their food intake and we could actually mitigate that by getting in the middle of their stress pathway.

[00:10:29]>> Are obese people biologically driven?

[00:10:33]>> Absolutely. Obese people are biologically driven. They can be driven at many different levels, but they are all driven.

[00:10:43]The idea that they they have choice, who would choose to be obese?

[00:10:48]Certainly not a child.

[00:10:50]Okay? The quality of life of an obese child is the same as a child on cancer chemotherapy. I mean, who would choose that?

[00:10:59]Now, you could argue that some adults choose to be obese. Like for instance, Rossini, the famous Italian composer, he chose to be a gastronome. He chose to be a gourmand and he died at age 37 of obesity-related disease.

[00:11:21]You could argue he chose. Maybe. But 5-year-olds don't choose to be obese.

[00:11:27]6-month-olds don't choose to be obese. We have an epidemic of of obese 6-month-olds.

[00:11:34]And most importantly, newborns don't choose to be obese. Four separate studies, United States, South Africa, Israel, Russia.

[00:11:45]Over the last 25 years, there's been a secular trend of an increasing body weight at birth by 200 g, half a pound.

[00:11:55]Babies born in those four countries weigh a half a pound more on average than they did 25 years ago. Now, the question is what is that half a pound? When you stick them in a DEXA scanner to find out, it's all fat. Now, newborns don't diet and exercise.

[00:12:14]How did they get obese?

[00:12:17]So, any hypothesis that you want to proffer to me about what the cause of the obesity epidemic is, you have to explain that, and you can't.

[00:12:28]And the reason is because the idea that it's about eat less, exercise more is not true.

[00:12:36]It never was. It's just what the food industry wanted you to believe.

[00:12:42]>> You said fructose is a poison.

[00:12:45]>> Indeed, a mitochondrial toxin.

[00:12:46]>> Why?

[00:12:47]>> Why?

[00:12:49]Complicated, a lot of science there. Let me try to make it easy. Fructose binds to proteins and causes them to not work well.

[00:13:02]Fructose inhibits the enzyme that controls mitochondrial function.

[00:13:09]That enzyme is called AMP kinase.

[00:13:12]So, AMP kinase is like the fuel gauge on your cell.

[00:13:16]When uh energy stores in your cell go down, that enzyme recognizes it and revs up mitochondrial biogenesis to make more in an attempt to try to keep energy levels inside the cell at a reasonable level.

[00:13:36]Fructose interferes with that.

[00:13:38]So, you run out of energy and you don't make more.

[00:13:43]So, one of the problems with sugar consumption is actually fatigue.

[00:13:49]Now, you have all of these energy drinks.

[00:13:53]The reason that the energy drinks make you feel like you have energy is because of the caffeine, not because of the sugar.

[00:14:01]The sugar is actually there to hide the bitter taste of the caffeine.

[00:14:06]The caffeine is the thing that makes you think that it's supplying you with energy. Why does caffeine do that? Well, caffeine binds to a different receptor in the cell called the adenosine receptor. The adenosine receptor is the one that basically tells you go to sleep.

[00:14:25]Okay? So, when you bind to that and inhibit that, you don't go to sleep.

[00:14:30]That's why, you know, there's a Starbucks on every corner.

[00:14:34]Okay? To not go to sleep.

[00:14:36]The fact of the matter is your cell is still winding down its energy even if you bind that receptor.

[00:14:43]So, those energy drinks are false. They tell you that they're supplying you with energy. They're actually sapping you of energy.

[00:14:54]>> Is there a safe dose of fructose?

[00:14:56]>> Sure.

[00:14:57]In the same way there's a safe dose of VX gas, there's a safe dose of ricin and sarin, there's a safe dose of arsenic, there's a safe dose of, you know, carbon tetrachloride.

[00:15:09]You know, what is it? The question is, are we over it? And the answer is, we're way over it. Okay?

[00:15:16]Um we we've looked at that question and what I I say is our livers are have a an innate capacity to metabolize fructose. In the same way, our livers have an innate capacity to metabolize alcohol.

[00:15:29]So, what is that amount?

[00:15:32]It's about 25 g per day.

[00:15:36]25 g per day.

[00:15:38]So, if you have a drink, you're okay.

[00:15:43]If you have two drinks, depends on how big you are. Maybe you're okay, maybe you're not.

[00:15:50]If you have three drinks, you're probably not okay. If you have four drinks, you really need somebody to drive you home.

[00:15:59]And if you have five drinks, you're freaking alcoholic.

[00:16:03]Okay?

[00:16:04]Ultimately, fructose is about the same.

[00:16:07]If you have a little bit, like for instance, a 4 oz glass of orange juice, that's it for the whole day.

[00:16:17]That's it for the entire day.

[00:16:20]Once you get above that, you start seeing the metabolic mayhem.

[00:16:24]So, we have a limited capacity to metabolize this mitochondrial toxin.

[00:16:30]After all, that is the liver's job is to metabolize toxins.

[00:16:34]But, no matter what the toxin, you can overwhelm your liver's ability.

[00:16:41]Different toxins, different dosages.

[00:16:45]Fructose happens to be a toxin where we have a better than average capacity to metabolize it.

[00:16:52]But, you can get above it, and we do routinely every single day.

[00:16:58]>> And what makes it different from glucose?

[00:17:01]>> So, glucose is a six-membered ring.

[00:17:03]Fructose is a five-membered ring.

[00:17:06]Glucose is transported by a set of transporters. Glu- uh fructose is not transported by those transporters. It has its own transporter.

[00:17:18]Glucose goes to glycogen. Glycogen is liver starch. That's the storage form of glucose in the liver and in muscle. So, that's what your body wants to do with excess energy is put it into glycogen because glycogen, for lack of a better word, is non-toxic.

[00:17:36]Your liver doesn't care how much glycogen it stores.

[00:17:41]We have a disorder in pediatrics that we take care of. It's called glycogen storage disease type 1A, von Gierke's disease.

[00:17:50]You can put glucose into glycogen, but you can't fish it out.

[00:17:56]So, these kids have livers down to their knees because they are just stuffed with glycogen that can't come out.

[00:18:05]Now, these kids are very sick. They have hypoglycemia like all get out.

[00:18:09]But, do they get liver failure? No.

[00:18:13]Because glycogen is non-toxic. So, glucose drives glycogen formation, which is non-toxic.

[00:18:21]Fructose does not go to glycogen.

[00:18:25]Fructose goes straight to the mitochondria, causes that mitochondrial dysfunction that I mentioned. And the only organ in the body that can metabolize fructose is the liver.

[00:18:39]So, you're getting the whole bolus, the whole load straight at your liver, and it's going straight to mitochondria, and it's causing your mitochondria to fail.

[00:18:49]So, two very different molecules.

[00:18:53]They are not the same.

[00:18:54]>> You've also said fructose is alcohol without the buzz.

[00:18:58]>> Correct.

[00:18:58]>> Is it better to consume alcohol or soda?

[00:19:02]>> You think so? [laughter] >> Um you know, let's put it this way. You can only drink yourself under the table once a day.

[00:19:08]>> Mhm.

[00:19:09]>> But, with these, how many liters can you consume?

[00:19:13]>> Should sugar be regulated like alcohol?

[00:19:15]>> I think so.

[00:19:17]Now, I've said that many times and people think I'm absolutely a freaking lunatic.

[00:19:23]It's very hard to do. It's not so much that we need to regulate it at the consumer level. It's we need to regulate it at the industry level.

[00:19:33]There is no reason why Trader Joe's beef with broccoli has 32 g of sugar in it per serving. There is no reason for that. It's beef with broccoli. Could we do something about that?

[00:19:47]Could we set upper limits for each foodstuff in order to try to reduce the total caloric burden and the total fructose burden on society. Is that possible?

[00:20:04]Could we get soda off SNAP off the Supplemental Nutrition Assistance Program? Several states have already applied for waivers and a couple of them have actually gotten it. Some others are in the process of doing it. I'm actually trying to help two states right now to do that.

[00:20:21]So, these are questions.

[00:20:24]>> In these soda brands on the table, what ingredients would you take out?

[00:20:30]>> So, the fructose is the big problem. That's the big kahuna.

[00:20:35]Could we take the fructose out? Well, obviously, if we did, it would be less sweet.

[00:20:42]Could you put something else in that could take its place?

[00:20:46]And the answer is the diet sweetener that seems to be the safest currently, and we need more research on all of these, but the one that seems to have the best biochemical profile in studies that have been done thus far, and I put that as a big caveat because I don't know and I don't want anybody coming back to me saying, "But you said."

[00:21:11]Okay? But today what we know the most appropriate diet sweetener would be a sugar. It's a naturally occurring sugar. It's called allulose. Allulose is an epimer, an isomer of fructose. It's not metabolized.

[00:21:29]It doesn't go to the liver. It goes out in the urine.

[00:21:33]It's mildly sweet.

[00:21:36]It has a sweetness index of 70.

[00:21:39]Whereas sucrose, table sugar, has a sweetness index of 100. And lab fructose, you know, isolated from glucose, has a sweetness index of 173.

[00:21:49]So, allulose is what we call a sugar extender. You could put a little bit of sugar in to get the buzz, to get the reward.

[00:22:00]And you could make up the difference with allulose.

[00:22:04]Now, the reason they haven't done that yet is because allulose is expensive.

[00:22:09]But the price is coming down because there are two new ways to make it.

[00:22:13]So, we'll see.

[00:22:14]>> And why is liquid sugar worse than solid?

[00:22:17]>> Well, liquid sugar is to some extent dissolved in a food matrix. And that food matrix can sometimes be helpful in terms of reducing the rate of absorption.

[00:22:30]Perfect example of this is fruit.

[00:22:32]Fruit has fiber. The fiber is in the matrix.

[00:22:36]So, if you look at absorption of glucose or fructose from a juice or from a sauce, like applesauce, or from a fruit, like apple.

[00:22:54]What you see is that the apple juice all of it gets absorbed.

[00:23:00]From the apple, you get only about half absorbed.

[00:23:05]From the applesauce, it's much more like the juice.

[00:23:07]So, the uh uh the potency of the um of the matrix in this case, the fiber is actually helping to mitigate some of the metabolic consequences. That's why I say fruit is good and juice is bad.

[00:23:27]So, the question is why does the industry take the fiber out? And the answer is for profit.

[00:23:35]Um because you can't freeze fiber.

[00:23:38]I'll prove it to you.

[00:23:39]Take an orange, put it in your freezer overnight, take it out the next morning, put it on your kitchen counter top, let it thaw, try to eat it, see what you get.

[00:23:49]You get mush. Why do you get mush?

[00:23:52]Cuz the ice crystals macerate the cell wall, let all the water rush in, makes it inedible.

[00:23:59]Hey, food industry knows that.

[00:24:01]So, what do they do? They squeeze it and freeze it. Now, it'll last forever.

[00:24:06]Now, they can sell it as frozen concentrated orange juice.

[00:24:11]They've turned a fruit, a food, into a commodity.

[00:24:17]Cuz the definition of commodity is storable food.

[00:24:20]So, they've reduced their depreciation, therefore they've increased their profit.

[00:24:26]Good for them, bad for you.