Robert Lustig, M.D.. Division of Endocrinology tvnovellas.info %20V11N3/fenrv11n3pPDF. Total Caloric Intake . The USDA, AMA, and AHA call for dietary fat reduction. • Early 's: discovery of LDL. Steven Poole learns why he cannot be blamed for eating the wrong food. light that Robert Lustig shines on it. And Fat Chance, at its best, is genu- inely illuminating. Lustig, a medical doctor and endocri- nologist, has provided obesity .
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Chance by Robert Lustig is just such a book, clearly aimed at a general, rather than a medical or scientific readership. So is. Fat Chance a diet book, a science. Robert H. Lustig, M.D. is Professor of Pediatrics, in the Division of Chance: beating the odds against sugar, processed food, obesity, and. tvnovellas.info: Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease (): Robert H. Lustig: Books.
Robert Lustig describes how increased consumption of sugar has paralleled a steep rise in obesity and metabolic disease diabetes, heart disease, cancer and dementia over the last thirty years, amid dietary recommendations to eat less fat and cholesterol and therefore more carbohydrates. He claims that the answer to the epidemics of obesity and metabolic disease lies in understanding the biochemical and physiological effects of our increased consumption of sugar, and offers his recommendations for how to address these problems. In perhaps the strongest aspect of his book, Lustig deconstructs one of the most pervasive, and possibly damaging health misconceptions of our time: a calorie is a calorie. Lustig refutes this idea by devoting a large section of the book to describing the neurophysiology of the ventromedial hypothalamus a part of our brain that controls how our body responds to hunger and feeding. He explains how our fat tissues signal to our brain that our body is well-fed via the hormone leptin.
He describes the prevalence of processed and fast food in the standard American diet, and the replacement of fat by sweeteners. He spends a chapter describing the properties of sugar that qualify it as an addictive substance.
For example, one concerns the hunger of an eight-year-old girl diagnosed with type 2 diabetes, and another an obese eight-year-old boy whose father brought home unlimited quantities of juice from his job. Eventually Lustig describes fructose metabolism, and the ways in which it promotes metabolic syndrome.
He states that sugar and high-fructose corn syrup are metabolized exactly the same in our bodies, so are effectively equivalent sources of fructose. He has written a very understandable description of the known metabolic effects of fructose including liver inflammation and insulin resistance, chronic rise in insulin levels, high blood pressure, fatty liver, cancer, and more.
These effects of fructose are significant because they challenge the widely held assumption that fat causes heart disease. This small, dense LDL-cholesterol is caused by eating carbohydrates. The other type of LDL-cholesterol is large and buoyant, and does not cause heart disease. This is the type of LDL that increases after a meal containing saturated animal fats.
So, while some evidence shows that the total LDL-cholesterol level does correlate with death rates from cardiovascular disease, it is now well understood that this is due to eating carbohydrates, not fat!
Lustig argues that fructose is much more potent than glucose at raising the levels of small dense LDL. However, his critics have pointed out that the degree to which this is true in humans has not been proven. The idea that sugar could be the cause of metabolic syndrome and heart disease represents a complete paradigm shift from our decades of assumption that eating fat causes heart disease.
One of my fundamental criticisms of the book is that although he vilifies sugar, Lustig claims that eating sugar is specifically bad because it is both carbohydrate glucose and fat fructose at the same time. His logic here is very vague, and contradicts his prior statements that fructose and its metabolic effects are distinctly different from those of fat.
To say that fructose is fat is certainly not true, and when he equates fructose with fat, it perpetuates the last thirty years of nutrition and medical advice that have led to our present state of health. It may be that eating glucose with fructose can make the effects of fructose worse by raising insulin levels, but to me this would implicate carbohydrates, not fat, as the cause of metabolic disruptions.
This example brings me to another general criticism of his book. The style and organization are confusing, and most of his claims are spoken as truth without supporting evidence.
One frustrating example was for his chapter on fructose, when he describes how fructose in the liver is metabolized to excess acetyl-CoA, which is converted into fat that can promote heart disease. His description did not clarify what type of fat is formed or how that fat promotes heart disease, but did refer to his chapter on metabolic syndrome. The bitter pill of Lustig's philosophy is sweetened by an agreeably cute humour: "Naturally occurring fructose comes from sugarcane, fruits, some vegetables, and honey.
The first three have way more fibre than fructose, and the last is protected by bees. Yet to dismiss every such tract as populist scaremongering would be just as irrational as to believe them all.
The "experts" — whom it is fashionable in some quarters always to dismiss wholesale as a compromised class — did not, after all, turn out to be wrong about the harmful effects of cigarettes. Because, or so this thinking runs, they are all low-sugar and high-fibre regimes. Fat Chance is a persuasively indignant public-policy manifesto, but it's also a self-help book; curiously, each strain flatly contradicts the other.
The crux is whether people can actually change their behaviour. Of course they can, you might retort, citing friends who have successfully slimmed; but Lustig spends most of the book denying that this is even possible, the better to justify government regulation.
He suggests agricultural subsidies for green vegetables instead of for corn and soy, and taxing foods that have added sugar. This latter would be a regressive tax, he admits, but the benefits would also accrue mostly to those on low incomes. But his insistence on the complete irrelevance of "personal responsibility" leads him to rely on some ropey metaphysics and oversimplified science.
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