Robert Lustig, M.D., M.S.L. — "Processed Food: An Experiment That Failed"

[Music] [Applause] Thank You Allison and thank all of George Brown College for this wonderful opportunity to address everyone I said last night at the speakers dinner food is medicine which means that chefs or doctors and if you look at it that way hopefully everyone will come on board however I do want to take one opportunity to correct one thing that Loraine said which i think is very important and relevant to the rest of this talk you are not what you eat you are what you do with what you eat and what you do with what you eat ultimately determines whether or not you get sick or not and that's what we're going to focus on today so the title of this talk is processed food and experiment that failed now how many in the room have ever done science of any sort okay quite a few quite a few so you probably then know that 9 out of every 10 experiments or failures now when you have a failure what do you do you have to determine was it the hypothesis that was wrong or was it the procedure that was wrong or was it the interpretation that was wrong and you have to go back and rethink it some of those experiments are actually grand social experiments like this one I forgot that and that's my discipline nice might just overside my disclosure slide I wrote a book ok I take no money from the industry some of those experiments are social experiments like this one we have in the United States I don't believe you have this in Canada I think the question is is this a success or a failure well Time magazine determines based on the outcome variables that this was a grand social experiment that was deemed a failure now I don't care what you think about the death penalty or not but I do care what you think about processed food and that's what we're going to talk about today so imagine that everyone in this room all of us have actually been unwitting research subjects in a grand experiment of fifty years duration posed by ten principal investigators situated around the world who all posed the following hypothesis processed food is better than real food now how would you determine if that experiment was a success or a failure well you have to look at the outcome variables and for this experiment those outcome variables are the following consumption health and disease the environment and finally cash flow and cash flow has three parts to companies to consumers and to society and we will deal with each of these in turn everybody understand the format of the talk so here's how the experiments started and I will tell you I ate a lot of those once and TV dinners okay Salisbury steak was my favorite yeah you remember that one do you well unfortunately this is what it looks like today and all you have to do is walk through you know the aisle at any supermarket and all of this is very well known - and here are your ten principal investigators they're in the center and you have heard of every single one of these in fact if you've heard of a food it is one of these ten companies which control 90% of the food around the world so first we have to define what do we mean by processed food and Joanna bleiben of a nutrition critic from a food critic from UK published this book called swallow this and this is the definition of processed food it has to be mass produced has to be consistent batch to batch it has to be consistent country to country so that the experience is the same wherever you go it is specialized ingredients from specialized companies virtually all the macronutrients have to be pre frozen in order to be able to withstand long flights and shipping that means the fiber has to be removed and that's an extraordinarily important point because you can't freeze fiber prove it to you go home tonight take an orange put it in your freezer take it out in the morning put it on the counter let it fall try to eat it see what you get you get mush right why do you get mush because the ice crystals macerate the cell wall allow all the water to rush in hey food industry knows that so squeeze it and freeze it lasts forever you can sell it forever it becomes a commodity that's the definition of commodity is storable food and when we went from food to commodity that's where things changed for just that reason it has to stay emulsified so that when you put the lasagna in the microwave the fat and the water don't separate out under the heat and it has to have a long shelf life or freezer life otherwise depreciations too high costs go up and then you've got a problem everybody with me so far so that's the food engineering definition of processed food but there's a nutritional definition of processed food as well three things too little eight things too much we're going to take them in turn not enough fiber now fiber is what you throw in the garbage after you juice the drink right no fiber is actually the reason to eat the fruit in the first place and the reason is because what fiber does it forms a gel on the inside of your intestine the soluble and insoluble fiber and you need both and of course fruit has both forms a gel and that becomes a secondary barrier that prevents early absorption in the duodenum so that all of the calories don't reach your liver and we're going to talk a lot about the liver today and if you don't absorb them early what happens number one your blood glucose doesn't spike is high therefore your blood insulin doesn't spike is high which is important metabolically to keep yourself in yin yang energy balance and so means that you're not going to absorb them early which means they're going to go further down the intestine to the next part called the jejunum and what's in the jejunum the bacteria now the bacteria not in the duodenum because the pH just changed but they are in the jejunum that's called the microbiome you've all heard that term I'm sure now it's a hot term in medicine so when you consume food with fiber in other words real food you're feeding your bacteria you're not feeding you you're feeding your bacteria and that's a good thing so not enough fiber not enough omega-3 fatty acids so these are heart-healthy anti-inflammatory antioxidant okay but what kind of salmon wild salmon or farm stem turns out wild salmon because wild salmon do not make omega-3s wild salmon eat Omega threes well what made the Omega threes the algae the salmon eat the algae we eat the salmon that's how we get them we get them third hand but if you're eating farmed salmon you might as well eat a stick micronutrients so vitamins minerals various other cofactors for in for metabolism like diets and etc you know these are usually found in the fibre fraction for instance vitamin b1 thiamine the first disease that was known to be a nutritional deficiency disease beriberi occurred in the Chinese when they started polishing rice because the thiamine was in the fiber fraction we learned that and that's how we discovered the existence of vitamins so when you remove the fiber you remove a lot of the micronutrients and then finally eight things too much too many trans fats now trans fats are the devil incarnate trans fats are the single most dangerous consumable you can put in your body cyanide is a little more dangerous but trans-fats are next why all right the reason trans-fats were put into the food is because bacteria can't digest them because they don't have the enzyme to cleave the double bond the trans double bond because normal fatty acids are cysts not trans so the bacteria would try to chew them up into two carbon fragments and then they'd reach the trans double bond and they'd stop so they couldn't grow on it so that things that were made with trans fats could not go rancid witness the ten-year-old Twinkie well guess what our mitochondria in ourselves are refurbished bacteria we don't have that enzyme either so when we consume trans fats same thing happens you reach the trans double bond that's it and then they line your arteries and livers and cause heart disease liver disease and many other of the chronic metabolic diseases we know today now in 2013 our FDA finally after 25 years of basically screaming and jumping up and down and practically sitting on them finally agreed that trans fats were not generally recognized as safe and they are now being removed from the diet hooray finally a nutritional win took a long time branched chain amino acids leucine isoleucine and valine these are three essential amino acids you have to eat them you can't make them they are the primary components of muscle so bodybuilders consume protein powder which is virtually all branched chain amino acids and if you're building muscle that's a good thing to do but what if you're not building muscle what if you're a mere mortal like me and you take in too many branched chain amino acids there's no place else to store them except muscle so what happens to them they go to the liver the liver takes the amino group off they become alpha keto acids enter the Krebs cycle overwhelm the krebs cycle and the mitochondria have no choice but to take the excess throw them off and get they get turned into liver fat and we're going to talk again about liver fat at great length in just a few minutes so that's one of the ways that meat could cause disease because of the excess branched-chain amino acids and so we're which kind of meat has that corn-fed beef chicken and fish breast that not so much that's important to changes the composition of what you're eating omega-6 fatty acids so these are pro-inflammatory you need them or you will be eaten by the maggots but you don't need so many of them if you have a lot of them you tend to induce a pro-inflammatory state because omega sixes are the precursors to a compound called arachidonic acid which then leads to prostaglandins which are primary inflammatory media food additives of all sorts red food dye number this yellow food dye number that etc etc I don't have to go with into all those for you emulsifiers is one of my favorite so like I said you need the emulsifiers to keep the microwave lasagna from separating out well what are most of Fire's they're detergents they keep fat and water together that's why you add the tide to your laundry well what happens if you add the tide to your intestine think about it there is a mucin layer that coats all the intestinal epithelial cells that gets eaten away and there electron microscopy studies that show the bacterial opposition on to the intestinal epithelial cells and that has been associated with various autoimmune phenomena in the gut and possibly even food allergy the fact that that mucin layer gets destroyed so what are some emulsifiers polysorbate 80 carboxymethyl cellulose and my favorite perhaps yours too carrageenan everybody heard of carrageenan okay so where do you find carrageenan in ice cream ice cream okay that's what keeps the fat in the water together in the ice cream and who introduced carrageenan to ice cream Margaret Thatcher she was an ice-cream chemist before she was an MP she truly was the Iron Lady salt now salt is complicated because 15 to 20 percent of the American I assume Canadian population as well are exquisitely salt sensitive and currently we are consuming triple our appropriate allotted consumption of salt we should be consuming 2.3 grams of sodium we are getting 6.9 grams of sodium now 80 percent of us can excrete the extra sodium without significant upset because our kidneys are working fine but that 15 to 20 percent they need their salt to come down and the problem is it ain't coming down okay Campbell Soup try to remove some of the salt from their special requests oops float landed flat on their face ain't doing that again so the question is should Saul come down if it's only 15 to 20 percent that's a Public Health versus clinical medicine question which we're going to leave for another day nitrates so that's what's in cured beef sausage bacon setter okay nitrates form nitro so ureas in the intestine which have been shown to be directly causative to colon cancer and finally the number 11 the Big Kahuna the one that blows all the other 10 out of the water sugar and between Gary and me we're going to tell you a lot about sugar today so you all know this is true when did you learn this did you learn it recently in fact we've been saying this since 1950 but when did somebody do something about it 1994 44 years of knowing something and not doing anything about it so my question to you today is is this true and if so what shall we do about it National Geographic seems to think so why we can't resist it and they mean it this is from Paul van developin who is the chair the head of Amsterdam's Health Service okay and he says that sugar is addictive and the most dangerous drug of the times and coming from the Netherlands he should know something about addictive substances in fact we all know this and here's why we know this anybody know what this is maybe everybody ever work in a newborn nursery this is called sweeties sweeties it is a super concentrated sucrose solution that you dip the pacifier in and stick in the normal newborn boy's mouth before the circumcision the Jews have wine the rest of the world has sweeties because they do the same thing they activate your own endogenous opioids because they are addictive and of the 600,000 food items that are currently available in the american food supply 74 percent of them are spiked with added sugar for the food industry's purposes not for yours conversely of a study that where 400 packaged items were looked at for salt only 50% of them had greater than the recommendation for added salt that means that sugar is the marker for processed food okay because if there's sugar in a food god put it there but if there's added sugar in a food a company put it there everybody got it so that's the marker so now let's do our 4 outcome variables consumption so over here on the Left we have the original White Castle hamburgers retain calories in the middle we have Bob's Big Boy at 618 calories and in America in the midst of the obesity epidemic Hardee's had the temerity to offer us the thick burger at 1420 calories and in California we are so lucky that we have the Carl's jr. $6 burger 2000 calories that's the entire caloric allotment for the day right okay and they're proud of it okay may do commercials about that fact okay basically like stick it to the man you know if you know what I mean okay so our calories up absolutely we are all eating more no question one hundred eighty seven calories per day for adult men 335 calories per day extra for adult women 275 calories more per day for teen boys yes we are all eating more the question is what are we eating more of is it fat nope not fat only 5 grams 45 calories basically the fats awash here's the secular trends and specific food intake over time and you can see whole milk way down meat and dairy that's out the same cheeses up slightly milk desserts up slightly bottom is awash and that's what the data say it's a wash we are not eating more fat in fact as our percent of calories from fat have gone down because of the USDA the a hav AMA and every other medical organization who told us to reduce our consumption of fat to try to prevent heart disease we did we went from 40 to 30% and as we did it our obesity and metabolic syndrome prevalence have gone through the roof because it ain't the fat never was it's the carbohydrate 228 calories in this in the team boys and here are the carbohydrates here in red all through the roof why because carbohydrates are commodities you can sell them and in particular one we know of well beverages right 45 1% increase in soft drinks 35% increase in fruit drinks fruit days etc what is this stuff well here in North America it is this stuff high fructose corn syrup you have it here in Canada 2k 63 pounds per person but you know what the rest of the world doesn't have so much of this very limited exposure in your Japan has because was invented there but the rest of the Pacific Rim no high fructose corn syrup none in Australia none in Korea none in China and you know what they got more diabetes and we do how is that possible because it's not the high fructose corn syrup per se high fructose corn syrup is evil no question but it's no more no more evil than sucrose but it is cheaper because we grow it at home and we don't have to import and there's no tariffs on it so what are we talking about well here's the composition high fructose corn syrup on top sucrose on the bottom notice high fructose corn syrup one glucose on the Left six membered ring one fructose five membered ring on the right you'll notice they are not the same six membered ring five membered ring so food industry says all sugars are the same patently not true because the picture says so now look down below it's sucrose one six membered ring one five membered ring o glycosidic linkage linking the two the enzyme sucrase and your intestine Cleaves us in about a nanosecond you absorb the two molecules equally bottom line it's a wash they have a same high fructose corn syrup sucrose they're the same but because high fructose corn syrup entered in 1975 it provided competition for sugar it made sugar cheaper and then everyone could afford to put more in especially as we went low-fat everybody got that okay so I call this slide very specifically the Coca Cola conspiracy and I mean it you'll see why over there 19:15 the original bottle out of Atlanta first one being sold nationally six and a half ounces who wet drank one of those every day for a year I'll be worth eight pounds of fat per year then 1955 the next size up after sugar became plentiful after World War 2 rationing 10 ounces first ones found in vending machines okay that would be worth 13 pounds of fat then came the ever ubiquitous 12 ounce can in 1960 that's worth 16 pounds of fat and over there is the single unit of measure in America today the twenty ounce okay now anybody know how many servings are supposed to be in that bottle two and a half eight ounce servings anybody know anybody who gets two and a half eight ounce servings out of that that's a single serving okay that's worth twenty six pounds of fat and then in the middle we have the 7-eleven big case there's Buster big gulp whatever you want to call it forty four ounces that's worth fifty seven pounds of fat per year so you say well QED we're done here you go right here that's the problem not so fast there's more way more so if you look at what's happened to our sugar consumption our ancestors getting fruits and vegetables out of the ground in like the 1800s and the occasional honey got about four pounds of sugar per day we peaked at around 110 hundred twenty pounds of sugar per day we have gone down slightly because of the obesity epidemic reduced by about 10% but you can see what's gone on you can see where processed food entered the sphere okay everybody with me so far so consumption way up no argument alright time for the next variable out health and disease so this is from the New England Journal of Medicine a couple years ago and what we're looking at are things that are preventable that contribute to health and disease and what you'll notice is smoking down blood pressure down cholesterol down activity we should be reaping a health benefit but we are not if anything we have a health deficit and why is that because obesity is up and diabetes is through the roof its quadrupled since the 1970s diabetes used to be a disease of over 65 people and now it is a disease of eight year olds and in America we're going to knock all those diabetics off the rolls this is the head of management and budget nick Mulvaney saying specifically that we're taking diabetics off the rolls because we can't afford them so here's the problem in America at least I don't know if you had it here in Canada probably during a Blue Jays game you probably saw this commercial for coca-cola in 2013 called coming together okay it's a two-minute video and this is a direct quote from that video meeting 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 so according to them you can get your calories from carrots or you can get your calories from cheesecake you get your calories from coca-cola bring its calories from kumquats doesn't matter if you eat more than you burn you will gain weight if you eat less than your burn you will lose weight therefore it's about energy balance therefore it is about calories in calories out therefore it is about diet and exercise therefore it is about two behaviors therefore if you're fat it's your fault therefore any calorie can be part of a balanced diet therefore don't pick on our calories go pick on somebody else's calories all of those mantras which you have heard from everyone including your government are based on this premise that a calorie is a calorie and after all it's common sense well I don't believe in common sense I believe in science I believe in data and what the data say is something completely different what the data say is that some calories cause disease more than others because kids different calories are metabolized differently in the body because a calorie is not a calorie you are not what you eat you are what you do with what you eat and in order to understand that you have to understand some science it's called nutritional biochemistry so how many of you in here are dietitians you learned about counting calories day one I am here to tell you that you can throw that away now because if you count calories you are part of the problem not part of the solution and I mean that very specifically and I will hunt you down and here's why back in the 1970s we had a little war going on in nutrition not like we don't have one now but we had one then there were these two guys at the top of the two camps if you will this guy over here on the right named John you'd give British physiologist nutritionist biochemist was the first one to say you know what sugar is a problem sugars the bad guy in this story I need a lot of correlative data and he wrote this book in 1972 called pure white and Dez lee where he basically figured it but it was all correlative data because that's all he had on the other side on the Left we have this other guy named Ancel keys everybody heard him the K ration during World War two so you know he had a name already any of course he was from Minnesota so he had to be telling the truth my wife tells me that all the time she's from Minnesota okay and he's the one who said saturated fat was the bad guy and they too had a war okay and you know Gary actually researched that war very specifically and will tell you a little bit more about it I'm sure in the next lecture but let's look at Keyes's data since it's all about the data so here is seven countries u.s. Canada there you are Australia England and Wales Italy Japan coronary heart disease on the y-axis calories from fat on the x-axis looks pretty good correlation right except for one thing it wasn't the seven country study it was the 22 country study those seven were cherry picked because here are all 22 now there's still some sort of relation but it's not nearly as tight is it and he left out the outliers the Messiah the Inuit urban Deeley the Tokelau tribes they eat bread and meat and milk this is not a carbohydrate to be found in their diet they have the lowest incidence of heart disease on the planet well how do you explain that if it's about saturated fat in fact others not just doctors have come to this conclusion that there's a problem that we've made a mistake in fact this report from Credit Suisse came out last year September 2016 called fat the new health paradigm and this is their decision I had no input to this whatsoever a high intake of omega-6 fats vegetable oils has not been proven as beneficial for our health and trans fats have been shown to have negative health effects the higher intake of vegetable oils and the increase in carbohydrate consumption in the last 30 or 40 years are the two leading factors behind the high rates of obesity and metabolic syndrome in the United States saturated and monounsaturated fats are not okay they looked at the science themselves not influenced by any corporation and came up with this determination a bank did this and now we have the smoking gun I'll show you it to you in a minute so let's look at this question of sugar and metabolic disease that Credit Suisse has so aptly pointed out over here we have a histogram of the n hannahs database in America you know what that is right Nutrition Examination Survey and this histogram depicts the media that the the percent of calories in the diet as added sugar so it's controlled for calories fiza's percent and the median of this histogram is at 18% and this goes over 20 years 1988 to 2006 the red line going through the center is the hazard risk ratio for heart disease death dying of a heart attack for that same population over the same period of time and the inflection point of that graph is 15% so what does that mean that means that more than half the u.s. population has an increased risk of dying of a heart attack because of their added sugar consumption exclusive of calories and if you happen to be out on the right end of that you'll notice that the hazard risk ratio is 4 so if you're consuming 30 to 32 percent of your calories of sugar which our teenagers are doing you're going to fourth fold more chance of dying of a heart attack so if you think we have a health crisis now wait till all the Gurney's okay at Toronto General are filled with heart attack victims in their 40s okay let's see if you can get medical care we've already basically said we're throwing those people out you're gonna have to throw them out too soon this is from the epic interacts aids is the Europe version of the in Haynes asking the question do sugar sweetened beverages SSBs predict diabetes rates and you'll notice the red box so adjusted model plus e eye energy intake so that's calories plus BM i thats obesity so adjusted for calories and obesity each sugar beverage consumed per day increases risk for death by 29% and america we're not consuming one sugar beverage per day we're consuming two and a half on average so take that number up to 68 percent increased risk of diabetes here are two meta-analyses the top one for sugar beverages like soda the bottom one for fruit juice and you'll notice that when you adjust for adiposity they do not cross one they do not cross identity which means that they're statistically significant fruit juice statistically significantly correlates overtime with diabetes rates but fruit juice is healthy it's got a vitamin C take a friggin pill the reason fruit is healthy is because it has fiber fruit juice doesn't everybody got that so throw your smoothie machines away people this is a study that we did my grad student is my dietitian Luis Rodriguez we took the N Haines adolescent database and determined what percent of their cowls calories adjusted for adiposity came from sugar in all their foods and we divided them up into quintiles the reference quintile is the first quintile at 30 grams per day of added sugar and you can see as the quintiles go up the risk for metabolic syndrome goes up tenfold in adolescents we also looked at the Food and Agriculture Organization statistics database so for the whole world over a decade 2000 and 2010 we looked at line items we looked at total calories we looked at fruits excluding wine meats oils fiber containing foods dairy and sugar sugar crops and sweeteners as separate line items calories per person per day per country per year for a decade we then melded that with the International Diabetes Federation statistics database for diabetes prevalence country by country year by year for the same decade and then we melded that with the World Bank gross national income database to control for the five confounders poverty urbanization aging physical activity and obesity to ask the question what about the world's diet predicts diabetes answer only sugar nothing else not total hours total calories were nothing if any country had an extra hundred fifty calories per person per day in their country diabetes prevalence went up a total of 0.1% nothing but if those hundred 50 calories happen to be can a soda instead diabetes prevalence went up 11 fold 1.1 percent and again in America we're two and a half times that much so take this up to 2.4 percent since we have a total diabetes prevalence of nine point three percent that means that 29 percent of all the diabetes in America today this minute are due to sugar and sugar alum you want something to do there's a good place to start and now we have causation true causation because what we did in this study this was the first paper now we have three what we did in this study was we took 43 children out of our clinic at UCSF our obesity clinic with metabolic syndrome let's you know an african-american so poor kids eating a crappy diet and what we do is we figured out what they were eating at home we studied them on their home diet and then for the next nine days we catered their meals no added sugar we still gave him fruit but no added sugar and we didn't give them funky food we gave them food right out of Safeway okay we gave him processed food we gave him crappy food okay we took the pastries out we put the bagels in we took the sweetened yogurt out we put the chicken baked potato chips in we took the chicken teriyaki out we put the turkey hotdogs in okay crappy food not even fiber containing food just no added sugar food now if you're going to do that you're going to reduce their calories by 350 to 400 calories per day which case they're going to lose weight in which case then they'll get better in which case then all your critics will say well of course I got better they lost weight so what we did was we gave them those calories back as starch got it calorie for calorie the same no change in weight a fructose for glucose exchange to get the fructose out of the diet but we increased the glucose got it no increase in fiber no increase in weight no change in calories nine days right that's the paradigm here's what we found every one of their fasting labs got better you can see day zero day 10 and if it's in red it means it was significant blood pressure went down insulin sensitivity improved lactate they had a lactate level you now supposed to have a lactate level at baseline if you have a lactate level either you ran a marathon or you have cancer or you have a mitochondrial disease they had a lactate level in because indeed they did have a mitochondrial disease it was called mitochondrial overload which is what metabolic syndrome really is and that got better everything got that including their lipids so if you look over here a and B can see the tail the red that's the small dense LDL that's the atherogenic particle that causes the heart disease you'll notice on day zero you can see it and on day ten it's gone just disappeared and the changes in lipoprotein subfractions all improved triglycerides went down 46% and a possi 3 one of the markers for heart attack went down 49% with no change in calories and no change in weight here's their glucose tolerance tests notice their glucose went down by 8 percent glucose area in the curve and on the right there insulin went down by 25% and their beta cells started to rest so that their base cells weren't exhausted because that's what happens in type 2 diabetes you get beta cell exhaustion we then wanted to see what was going on in the liver so we wanted to measure how fast the liver was turning sugar into fat so we gave them c-13 labeled fructose oh sorry c-13 labelled acetate we're doing fructose now c-13 labelled acetate as you can see in the middle there and it gets incorporated into palmitate fatty acid which you can then measure coming out in the blood and here's what happened to their fat making capability they got cut in half over the course of the ten days with no change in calories no change in white and here's what happened to their liver fat depose noticing green the sub-q fat didn't change because they didn't lose weight so there's up Q thighs stay the same their visceral fat big belly fat went down 7% and their liver fat went down 22% in 10 days with no change in calories and no change in weight and the reason is because fructose is the primary driver of that liver fat and we now have the data to show that that is true and here's what happens basically when you're adding fructose you're basically making lots of triglycerides some of it gets exported out as plasma serum triglyceride which we measured which went down and some of it gets stuck in the liver when you take the fructose out deliver fact those down the Denova lipogenesis new fat making goes down the the LDL goes down the visceral fat went down the liver fat went down and their metabolic status improved we made them better on the same number of calories that's causation intervention causation so we have the data for for diseases sugar positive positive for for diseases diabetes heart disease fatty liver disease and tooth decay we have associative indirect data for sugar and cancer and sugar and dementia but we don't have direct data yet we don't have positive data we know that sugar causes insulin resistance we know insulin resistance causes cancer and dementia we just don't know that sugar causes those things directly or is it just mediated through insulin we don't know that yet we're working on and we now know as I mentioned before that this is the whole thing the whole fat thing was a big lie and the reason we know it is because my colleagues at UCSF Kristin Karns who used to work with Gary wrote with Mother Jones article huh knife on that study was yeah tamasam absolutely gary funded this study by sending kristin to boston to get the data and laura schmidt and stan glands publish this paper in JAMA internal medicine and I'm just going to read you the one line here which New England Journal of Medicine 1965 which singled out fat and cholesterol as the dietary causes of coronary heart disease and downplayed the evidence that soup course consumption was also a risk factor the sugar Research Foundation set the reviews objective contributed articles from inclusion and receive dress the sugar research foundations funding was not disclosed the sugar foundation put their thumb on the scale to tell us that fat was the bad guy and sugar was exonerated back 40 years ago and Harvard School of Public Health transmitted this in the New England Journal of Medicine and there are still people today who still believe this it is my job and as Gary's job to disavow that belief amongst all of you because we have the data and we have the smoking gun now the environment sugar go to the environment what do you think so World Wildlife Federation published this report saying that soil erosion because of sugar cane planting is a huge problem in fact America is going to need four central valleys by the year 2050 and we will not even have one because of soil erosion and sugar is a primary driver of soil erosion not necessarily in Central Valley but in other places here is Lake Okeechobee in the Everglades and wherever you see orange light green or dark yellow that's sugar plantation in fact last two years ago okay when not the last hurricane Matt yeah when Matthew Matthew came through okay they had to open the locks of Lake Okeechobee and all of the contaminated water spilled out into the west coast of Florida and it basically killed off all the wildlife on the west coast of Florida Fort Myers all the way down to Naples because of this this is Minnesota okay this is what happened from 1929 the depression through till today and you'll know respect in 1929 they used to grow a lot of things in Minnesota and now they only grow corn and soy why commodities that's why okay because coin gets turned into high-fructose corn syrup that's why so here's corn planting in the United States in the upper right is atrazine use in order to keep that corn from being eaten by the locusts in the bottom right is the nitrate contamination you can see it all through the Missouri Valley in the Mississippi and finally my favorite bottom left the ratio of government payments to Farm gross income and what do you say you see a big black hole so what is the dirtiest four-letter word in the English language Iowa because Iowa is the first presidential caucus okay and until Donald Trump you couldn't win the presidency without winning Iowa he's pretty unusual all right in addition when you do this you get resistance you get super weeds and you can see how the super weeds have gone up now if you think this is good for the environment I got a bridge to sell you okay this is a really big problem and finally last one cash flow start with companies this is Gary's picture from the Mother Jones article of how our food dollars have been reallocated over the 30 years of this disaster 82 to 2012 meats down 10% because we're all told to go low-fat fruits and vegetables notice exactly the same no change no difference now we're always told we don't eat enough fruits and vegetables and that is true we don't what we never did a new but we didn't have this problem then but we sure as hell have it now because it ain't about the fruits and vegetables so promoting the fruits and vegetables I mean okay but don't think somehow that that's somehow miraculously going to fix this problem cuz it ain't and it hasn't Anna won't brains and baked goods up a percent and that's important because that's glucose and glucose means insulin and insulin means weight gain so that's part of the obesity equation dairy products down two and a half percent because now we're all lactose intolerant and oh I am and lastly the big kahuna processed foods and sweets eleven point six up to twenty-two point nine percent of doubling in the span of 30 years that's what changed and that's where the action is and that's where the data say the problem is so we have the epidemiology we have the mechanism we have the results we have the intervention we have the smoking gun what the hell more do you need but the food industry is doing quite well so here's the sp500 in blue and here's the stock price for McDonald's Coke and Pepsi I notice there's the economic downturn of 2008 over there and they weathered that very nicely but don't quite well thank you right and here is Hormel ConAgra ADM proctor & gamble a craft and ConAgra all doing better than the S&P want to make money invest in a food company but guess what now the word is out so here's more recently the SP against Tate & Lyle olavo and Sid Zucker three sugar companies all of a sudden not doing so well in fact many sugar factories have closed although you still have one here in Toronto that is open here's the stock price of Dr Pepper Snapple Pepsi Coke and McDonald's all of a sudden not doing as well as the S&P and Coke fired 1,800 employees to save three billion dollars to reinvest in children's marketing McDonald's fired their CEO Don Thompson for poor performance and what did they do to try to resurrect their brand breakfast all day fantastic get the picture everybody got it okay and finally a second to consumers so on the left is individual foodstuffs but just look at the right healthy versus less healthy food real versus processed food notice in 2002 real food cost twice as much as processed food indeed and the trajectory of increase of price is much higher for the real food went up seventeen pence per pounds as opposed to the processed food where went up seven pence per pound so you would say well process was a good deal it's cheaper it's better because you can spend your money on iPads instead of cornflakes right so here's the percent of GDP spent country by country there we are us seven percent GDP lowest percent GDP spent on food and of course we are the most obese nation there's the UK at nine percent and there's Australia at 11 percent okay notice the ones in purple they spend 36 percent of their GDP on food or greater they've all been in revolution for the land in some time in the last five years that's not by accident and you get the picture well here's the problem here are medical costs going up over time and when you look at hospital physician and pharmaco they do not add up the total costs because the rest of it is going to care for type 2 diabetes in fact we spend more than they make let's talk about that so remember the slide I showed you before now I'm going to overlay on this slide the percent of GDP in America spent on healthcare for the same period of time notice when we started with processed food that's when the percent of GDP spent on healthcare started to rise so let's do the math the food industry in America grosses one point four six trillion dollars a year of which 657 billion is gross total profit health care however cost three point two trillion of which 75% is chronic metabolic disease the diseases in metabolic syndrome and seventy five percent that would be preventable if we could go back to 1970 levels that means 75 percent of 75 percent of three point two trillion that's one point eight trillion dollars a year wasted we spend triple what the food industry makes cleaning up their mess that is unsustainable and that is why Medicare is going broke so also why Social Security is going broke so Social Security as you know is a Ponzi scheme okay the only difference between Social Security and Bernie Madoff is that with Bernie Madoff okay you had a chance of making some money before he went belly-up that's the difference okay the healthy young people have to pay in so that the sick infirm people at the top can take out but what happens when the young people are not healthy what if they're sick what if they can't contribute because they're on disability in fact what if Social Security has to pay them the entire foundation of the pyramid collapses that's why Social Security will be broke by the year 2026 as well this is from morgan stanley another international investment bank okay and what did they say this is the percent of economic growth on the y axis against modeling the next 20 years with a low sugar case in blue and a high sugar case in gold which is where we are now and you will notice that the gold case at by the year 2035 takes us to zero point zero percent economic growth now who is that good for anybody is that even good for the food industry think about so credit suisse an international investment bank who determined that fat was not the problem also published this report called sugar consumption at a crossroads and this is what they said we believe higher taxation on sugary food and drinks would be the best option to reduce sugar intake and help fund the fast growing health care costs associated with type 2 diabetes and obesity an international investment bank is calling for taxation now how effed up is that that's how big and bad this problem has gotten and they get it a bank gets it but the doctors in fact we have modeled how much money and how many lives we could save if we could reduce the sugar consumption by either 20% which could be achievable with taxes or by 50% which would be achievable if we actually adhered to USDA guidelines and you can see fatty liver disease heart disease type 2 diabetes obesity all better and here's the amount of money we would save during that same period of time in fact the doctors now the International Diabetes Federation went to the g20 in 2015 and told the g20 that they had to tax sugar to save lives and money Mexico did it and you know what it worked and it's still working now it didn't work as well as they had predicted of course the food industry said C it didn't work because they predicted a 10% decline they got a 6% decline but it still worked and it was durable because it lasted for two years and going on now number year number four Berkeley did it and here's the data on Berkeley those sugar sweetened beverages down water way up and the UK has announced sugar tax going into effect next year unless brexit ruins that and the thing is that the food industry actually knows this they know and who was the one who first knew it of all people Mars the candy maker M&Ms Milky Way Snickers sugar is their stock and trade and they came out with a statement that said that Dave supported the USDA's approach to no more than 10% of daily intake and they also believed that it was time for all stakeholders including industry to engage in a constructive discussion that focuses on effective approaches to help consumers manage their intake of added sugars candy company gets it and guess who gets it now Coca Cola they themselves have now admitted a calorie is not a calorie so all you dieticians who are still doing math I'm hunting you down this is about science this is not about math it never was about the math and if you're doing math you're part of the problem not part of the solution fix it so imagine the past 50 years have been this grand experiment the hypothesis processed food is better than real food let's look at the scorecard consumption way up no argument health and disease a complete and utter disaster in fact if this had been a research protocol it would have been stopped decades ago by the IRB because of the deaths environment huge problem superweeds Iowa and cash flow to companies good previously not so good now for consumers short-term gain for long term pain because diabetes costs more than soda and for society 0.0% economic growth processed food is an experiment that failed you are chefs food is medicine that means that chefs are doctors and you need to think of it that way and you need to practice it that way what are you feeding your clients because they'll keel over because of what you fed them unless you're careful there's only one answer real food real food works real food has worked for millennia it's only in this little experiment that things went awry Adam you see SF we put our money where our mouth is and we have taken sugar beverages off campus called the UCSF healthy beverage initiative we have a tool box that can help any institution do the same to get rid of sugary beverages remember where did smoking disappear first hospitals because we have to model good behavior for the patients so we've gotten rid of sugar beverages I advise you to do the same and you can and we can help you number two proposal number two let's call type type two diabetes what it is processed food disease now that would be an educational moment wouldn't it you have processed food disease I think maybe somebody might actually change what they did if you told them that yeah because diabetes is an Egyptian word means siphon nobody knows that okay we here in the bathroom peeing your brains out siphon you know but like people say I got the sugar they don't even understand what that means because there are two definitions of sugar right blood sugar and dietary sugar and they are confused on purpose by the industry for their own purposes because the food industry says you need sugar to live no you don't you need a blood sugar to live you don't need dietary sugar to live they say that on purpose to confabulation fuse to obfuscate the truth you have to understand the science to be able to call them on it proposal number three let's get rid of subsidies there's no economist on the planet who believes in subsidies anyways because they distort the market let the market work so let's roll back the subsidies for corn wheat soy and sugar Hank you say they say well food prices would go up well you know what the genie any foundation at UC Berkeley actually modeled what would happen to food prices if we got rid of all subsidies and it turns out the only two things that would go up on sugar in corn perfect just what we want let's get rid of food subsidies proposal number four a trust mark we've developed a non-profit to take this on called real re al responsible epicurean and agricultural leadership you see this on a package see this in a restaurant you know that this restaurant can't kill you we have this now as a we've rolled this out state of Tennessee assigned on we're getting state of Virginia could do it here in Canada and finally let's get sugar off the grass less generally recognized as safe list because sugar is not food sugar is a food additive like alcohol and it does the same diseases as alcohol causes the same problems alcohol because alcohol is metabolized to fat in the liver and sugars metabolize to fatten the liver sugar is the alcohol of the child and that is why children today get the diseases of alcohol without alcohol because they are indistinguishable at the level of the mitochondria you would never give you kid it can of Budweiser but you don't give think twice about giving them a can of coke and they're the same you know what I would pass on all of this because it's too much so for more information we have a website that is curated by UCSF called sugar science org 8,000 clinical research articles vetted by twelve independent scientists who do not take money and distilled into five messages for the general public that they can use fed up a movie that told how we got to where we are today with our food supply sugar-coated made here in Toronto by the cutting factory a movie that tells why we got to where we are today the corporate malfeasance the fraud the PR campaign which Gary and I both appear in sweet revenge a public television special that we produced to help people reverse their type 2 diabetes with food that chance being sold outside I didn't bring him here that's blame George Brown for this Gary's book the case against sugar also here and a new book coming out September 12 called the hacking of the American mind and I'll be happy to talk to that with you on the break if you like I've taken enough of your time I want to thank all of my colleagues at UCSF at eat real org our nonprofit - that's doing this work to advocate for changes in the global food supply to support and promote real food to ameliorate childhood obesity and type 2 diabetes thank you so much [Applause] [Music] [Applause] [Music]

Channel: The Centre for Hospitality and Culinary Arts at George Brown College

Views: 450,181

Keywords: gbcans, nutrition, ambition-nutrition, robert lustig, Rob lustig, health, wellness, George Brown College, GBC, Centre for Hospitality and Culinary Arts at George Brown College, CHCA, ambition nutrition, science, research, health eating, diet, healthy diet

Id: pvgxNDuQ5DI

Length: 61min 48sec (3708 seconds)

Published: Mon Sep 11 2017

Reddit Comments

[u/vincentninja68]

@35:46

Dr.Lustig conducted a small experiment on obese children's diets (43 total), and for 9 days swapped out added sugar food items with conventional processed carbohydrate foods ("crappy food" with no added sugar). The total calorie intake was the same Essentially a swap of fructose for glucose.

Results:

Fasting lab results improved, Blood pressure down, insulin sensitivity up, Lactate improved, Lipid profiles improved, Glucose Tolorance Improves, Insulin dropped. While subcutaneous fat did not decrease, viceral fat and liver fat did decrease.

The result of this small experiment are remarkable because it shows that even with a poor choice of carbohydrate replacement of fructose, this much improvement can occur in the span of a week of removing added sugar from a diet.

[u/unibball]

Good video except for his belief that we all need fiber.