Fat Chance: The bitter truth about sugar. Dr. Lustig Robert

I respectfully disagree. In order to pull ourselves out of this ditch, we have to understand how we drove into it. Indeed, our current thinking is based on correlation, supposition, and conjecture. I wrote this book to persuade you, the reader, to take up this cause, for your own health and for our country’s. However, you can’t truly advocate for a cause unless you know what is going on. And you can’t disagree with me until you know all the facts. And that means the science. After you’ve read this book, if you think it’s a crock or that I’m a crank, tell me. I want to know. In fact, I’ll make a promise to you right now: there is not one statement made in this entire book that can’t be backed up by hard science. My reputation in the field is built on the science. It’s also my protection against those who would try to discredit me, including the food industry and, as you will see, the federal government. Indeed, it’s the only reason I haven’t been discredited yet. And I won’t be, because I stick to the science. Now and forever.

      However, in four places in the book, I let my imagination run wild. I will try to explain how obesity fits within the process of evolution, how our evolutionary biochemistry works to keep us alive, and finally how our food environment has altered that biochemistry to promote this global catastrophe. These fits of speculation will carry the section heading “Deconstructing Darwin.”

      This book is targeted at the patients who suffer, the doctors who suffer along with them, the U.S. electorate who pays for this debacle, the politicians who must take up arms to dig us out of the mess that has been created out of our economy and our health, and the rest of the world, so they don’t make the same mistakes (although they already have).

      In Part 1 of this book, I will challenge some of the theories you’re used to hearing in the media, and indeed from the medical profession. Parts 2 and 3 will focus on the science of obesity, and how the body deals with energy burning versus storage. No, you don’t need to be a biology or medical expert to understand the science. I’ve worked hard to reduce it down to its essence, and to keep it interesting, light, and accessible. In Part 2, I’ll also explain how your brain has developed, evolutionarily and in utero, to thwart your attempts at dieting. You truly are hormonal when it comes to the foods you crave, just not in the ways you think. Part 3 will elaborate on the science of fat tissue, and when and how it can make you sick. In Part 4, I will prove that our current environment is indeed “toxic.” I will show how the “American diet,” which is now the “industrial global diet,” is killing us…slowly. I will identify the poison and the antidotes, why those antidotes work, and why they’ve been added to or removed from our diet for the food industry’s purposes. Part 5 elaborates what you, as an individual, can do to protect yourself and your family by changing your “personal environment.” Finally, in Part 6, I argue that governments around the world have been co-opted by the food industry, and I will outline how they must instead partner with the populace and exert influence over the food industry to stop the obesity pandemic before we all reach the medical and financial Armageddon now within sight.

       PART I

       The Greatest Story Ever Sold

       Chapter 1

       A Fallacy of Biblical Proportion

      Juan, a 100-pound six-year-old Latino boy whose mother is a non-English-speaking farm worker from Salinas, California, comes to my clinic in 2003. He is wider than he is tall. I ask the mother in my broken Spanish, “I don’t care what your kid eats, tell me what he drinks.” No soda, but a gallon of orange juice per day. On calories alone, this accounts for 112 pounds per year of body fat. Of course, some of that is burned off, and it might influence total food intake. I explain to the mother, “La fruta es buena, el jugo es malo (the fruit is good, the juice is bad). Eat the fruit, don’t drink the juice.” She asks, “Then why does WIC [Women, Infants, and Children, a government entitlement program for the poor run by the U.S. Department of Agriculture] give it to us?”

      One kid, one mother, one question, my life was changed—and the need for this book was born. Why does WIC give it to them? There is real science behind our worldwide obesity catastrophe. And science should drive policy, but as you will see, the politics get in the way. This is the most complex issue facing the human race this side of the Middle East conflict. And it has become incrementally more complicated over time, with multitudes of stakeholders with set agendas, and bigger than the individual parties involved. Devoid of simple solutions, it has destroyed families and claimed the lives of countless people.

      You can’t pick up a newspaper or log on to the Internet without seeing some new statistic on the obesity pandemic. It’s all obesity, all the time. And how many of them have something good to report? You can bet that any tabloid headline is about one of two things—either the statistics are getting worse or another obesity drug was denied or withdrawn by the Food and Drug Administration. I’m sure you’re sick of it. I know I am. And weight loss has turned into a blood sport—just tune in to The Biggest Loser.

      In 2001, Newsweek reported that six million kids in America were seriously overweight. We have tripled that number in a decade, and the numbers are now surpassing twenty million. Yet for all the media attention, visibility, discussion, and weight loss programs, even Michelle Obama can’t put the genie back in the bottle.

      While we’re getting fatter, we’re also getting sicker. Our risk for illness is increasing faster than the increase in obesity. Indeed, the cluster of chronic metabolic diseases termed metabolic syndrome—which includes obesity, type 2 diabetes, hypertension (high blood pressure), lipid (blood fat) disorders, and cardiovascular (heart) disease—is snowballing by leaps and bounds. And then there are the other obesity-associated metabolic diseases, such as nonalcoholic fatty liver disease, kidney disease, and polycystic ovarian syndrome. Add to that the other comorbidities (related medical conditions) associated with obesity, such as orthopedic problems, sleep apnea, gallstones, and depression, and the medical devastation associated with the obesity pandemic is staggering. Every one of these diseases has become more prevalent over the past thirty years. What’s more, all of them are now found in children as young as five years old. We even have an epidemic of obese six-month-olds!¹

      The human damage in this scourge of metabolic syndrome is showing. In 2005 one study showed that despite the increased availability of medical care, our children will be the first generation of Americans who will die earlier than their forebears.² The study placed the blame squarely on the obesity epidemic. In the United States, quality-adjusted life years lost to obesity have more than doubled from 1993 to 2008. Emergency rooms are taking care of forty-year-old heart attack victims. Teens with type 2 diabetes used to be unheard of; now they are one third of all new diagnoses of diabetes. In the United States alone, 160,000 bariatric surgeries (to reduce the size of the stomach) are performed per year, at an average cost of $30,000 per surgery. Over 40 percent of death certificates now list diabetes as the cause of death, up from 13 percent twenty years ago.

      The loss in American productivity due to time off from work is staggering, the waste in medical expenditures ($147 billion per year) is breaking the bank, and this amount is predicted to increase to $192 billion by the end of the decade.