Monday, September 13, 2010

Lustig With Moore

Dr. Lustig gained weblebrity status with his YouTube video about fructose, entitled "Sugar, The Bitter Truth" -

Here - - Jimmy interviews Dr. L.

Jimmy does a fantastic job getting the Doctor's perspective in this interview.  Lustig's experience provides a fascinating back drop.  His team was working with pediatric cancer patients.  These patients become morbidly obese and inactive after treatment.  His team discovered that their treatments resulted in these kids becoming leptin resistant.  The leptin resistance resulted in hyper-insulinemia.  Consequently, a significant portion of the food the kids ate was immediately partitioned into fat, resulting in rapid weight gain and an instantly reduced activity level in these kids; their bodies trapped energy as fat, resulting in a defacto caloric restriction, and behaved much like those on a long term calorie restricted diet.  When a medicine interrupted the insulin cycle, the kids instantly returned to 'normal' - active, energetic, themselves.  In other words, they demonstrated the concept Taubes articulated so well in "Good Calories Bad Calories":  obesity doesn't result from inactivity, obesity is the cause of inactivity - what causes obesity is hormonal disregulation.

Lustig's primary hypothesis is that fructose is a dose dependent liver toxin, which, at levels above 50 grams per day, results in leptin resistance, hyperinsulinemia, and the resulting cascade of obesity and metabolic syndrome.  He believes fructose consumption explains the difference between the healthy fat and the diabetic fat.  He articulates his case with overmuch pretense, and the sort of self-important voice one would expect from the crowd he runs with (my perception, perhaps you'll hear him differently), but he is also very precise, and very clear.  He lands on the right side of the saturated fat equation, and acknowledges that either high fructose or high carbohydrate intake results in the same outcome - hyperinsulinemia and metabolic derangement.  His avowed devotion to science over personality is always good to hear from any doctor.  In his conclusion, he asserts that he's likely to be proven wrong as the science evolves, and I agree with him.  That's what I'll discuss next.
1.  The Dr. seems to live in that gestalt that sees good government as the solution to 'our' problems.  He's in love with the idea of the political solution - his lament, "if only we could get better politicians".  That's a regrettable perspective.  Politicians being political animals is a constant.  We're as likely to see the speed of light change as to see a better class of politicians.  If we could confine them to a limited, focused role - the defense of our individual rights - we'd be making progress.  As long as we continue to empower them to 'solve our problems', we'll get the same political non-solutions and we'll pay dearly for the privilege.  Look at the USDA - first, how could the part of the government that is responsible for food production also be in charge of describing what food is or is not healthy?  This is a built in conflict of interest!  Second, no government agency of any kind should be able to make recommendations about what food is or is not good for you without supporting scientific proof.  The USDA has operated outside of the bounds of science for over 30 years.
2.  Dr. L seems to look askance at capitalism - but doesn't understand it.  He decries the fact that the food industry seeks profits by selling the unhealthy products of the industrial food chain, but seems not to realize that system exists as a result not of capitalism, but because of perverted government distortions of the food production system.  Even with the resulting system, why does the market demand low fat high sugar "energy drinks" and "sports drinks"?  Because the government spent the last 30 years telling them that FAT is the bogeyman, not sugar!!  This isn't capitalism's fault, this is the predictable result of the USDA's incompetence and irresponsible advocacy of the non-scientific "food pyramid."  Capitalism will save us - when consumers demand truly free range, grass fed farm animals, and a non-grain, non-sugar diet, we'll need the capitalists to mass produce it and bring it to market, and they will.
3.  Dr. L speaks with the arrogance of the pro-government, elitist crowd.  The sub-plot to his dialogue is heavy on the narrative describing folks who cannot run their own lives, folks who need smart folks like him to solve their problems for them via government coercion.  Yep, we sheep should just sit back and let the Dr. Ls of the world solve all our problems with their good intentions and superior knowledge.  Why not - it's worked so well so many times in the past!
4.  The doctor cites some research which concluded that ancient humans ate 300 grams of fiber per day, and he concludes that you and I should too.  This is by no means science.  It's entirely possible that pre-fire, pre-cooking man spent that much time chewing that much raw vegetation - but we've evolved well past that now and our guts are the proof.  We've as much a carnivore's gut as an herbivore's gut; and absolutely cannot get the nutrition we need any longer from eating like an herbivore.  Further, he cannot produce a single study which shows a better health outcome from a 300 grams of fiber per day intake.  He's fallen in love with fiber, which is fine with me because he can spend all day getting his fiber and leave the meat to me.  The bottom line - if you don't eat starchy, sugary laden vegetables and fruit, you don't need the fiber to slow the digestion!  It's an absurdity on its face.  Man has survived and thrived all over the planet on virtually no fiber intake.  This video pretty well spikes that narrative to my satisfaction:  If the doctor would indulge me, I'd be happy to have a contest between the two of us - he can eat his ideal diet, I'll eat mine, we'll compare notes at the end to see which if either of us makes improvement in those measures of health that matter most.  I don't think there's any risk that standing around chewing on fiber all day will create a measurable benefit in health, and while he's eating all that fiber, I'll be having a grand time doing something else - anything else!  I consider it highly undesirable to be chewing a cud like a cow all day!
Lastly, while I feel more contempt than I would like to for his political orientation and devotion to the notion - totally unsupported by science - that we need fiber to be healthy, Dr. Lustig's passionate advocacy highlighting the special perils of fructose will do much good for many people. 
While we wait for the main stream to discover the kind of work Dr. Lustig is doing, check it out for yourself - how many grams of fructose are you putting down the hatch in fruits, juices, sports drinks, sugar-sodas and "protein" bars?  Cut that back to less than 50 grams per day of fructose, and see what happens.

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