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I recently heard an interview with Robert Lustig, author of the book _Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease_. After hearing the interview, I went ahead and bought the book.

I am now about 3/4 of the way through it. He's clear in his politics: Sugar is poison and politics conspired to create our environment of sugar-in-everything. If you disagree, you may want to read the book or watch his video.(1) He does a really good job of being convincing.

Dr. Lustig is a pediatric endogrinologist by training, and his explanations of the endocrin system signals that influence how much and what we eat are excellent. Much of the rest of the book is things that I have read elsewhere and with better explanations, which is why I am neutral.

His first interesting point is that "a calorie is a calorie" is true, but not the whole story. (He might have said irrelevant.) I believe he ended up restating it something like this: "Any calorie that you are going to burn or store, you much first eat." His point being that metabolism is very complex, and changes depending on many factors. Just "eat less and you will lose weight" is, in his way of thinking, required, but too simple.

In addition to the question of eating less, then, is the hormonal environment your food finds, and creates, in your body. First item is that insulin is the "switch" that determines whether your body will store (high insulin) or burn (low insulin) the energy that you consume. So in addition to controlling the number of calories that come in, you must also control the "switch" that determines where those calories will go -- by lowering your insulin levels to a point where your body is more likely to burn your energy than store it.

From here, we start looking at the endocrine pathways affecting hunger.

In (VERY) brief summary, there are three major hormonal/endocrine system pathways that affect eating. The first is true hunger, which is a sensation your body creates with the hormone ghrelin. Its levels are affected by the levels of fat in the body via the hormone leptin, and also by your insulin levels. High leptin levels tell your body that you're not hungry, unless your body has been driven into leptin insensitivity by having that pathway blocked for too long. High insulin short-circuits the leptin levels and tells your body to eat even if you're not hungry. Insulin levels are affected by what we eat, how quickly it is absorbed into the body, and how hard your body is having to "push" to get your organs to do what they're supposed to do. So if your insulin levels are too high, you will feel hungry even if you've got way too much fat in reserve already.

The second is the palatibility/satiety pathway. This is via the "reward" center of the brain and is primarily driven by dopamine. With this one, your body gets more out of eating than just "I'm not hungry anymore." This is where you get pleasure from the crunch of a juicy apple or the salty, hot, juicy sizzle of a wonderfully cooked piece of meat. Those sensations start a dopamine cascade, and the dopamine "unlocks" the part of the brain that says, "Oh. My. God. That was FANTASTIC." The pleasure center doesn't stay on very long, though, which is why the first two bites taste utterly fantastic and the next few are good and eventually you set your fork down and say, "What a nice meal that was. Let's go for a walk" rather than continuing to eat.

Here, too, insulin levels can mess with the dopamine pathway, leading to the body not turning your pleasure center on and off correctly. In other words, it take way too much chocolate cake to get that same "zing" you once got with a single bite. And once it's going, it takes way too long to stop it, too.

The third is the stress pathway. In this one, cortisol produced by the adrenal glands affects the desire to eat via interaction with insulin and various other things. I didn't understand this pathway as well as the others, but basically, it's the biochemical pathway from "my boss yelled at me today and all three kids are whining" to "I love my ice cream. I really really love my ice cream. My ice cream is my best friend!"

In addition to it being interesting to know that these pathways exist and have them explained, Dr. Lustig also goes out of his way to say that it is nearly impossible to fight them. These are biological drives -- things that are called drives because our conscious thought processes are forced by all our biochemical responses to follow these trails eventually. They are, as it were, "hard wired" into us.

So far, this is very thoughtfully put together.

He also goes through some truly horrifying information that I didn't know. For example, did you know that there is an epidemic of obese six-month old babies? He uses this and similar information to infer that this is not a problem of, as he puts it, "gluttony and sloth." Babies that age pretty much do nothing but eat, poop, sleep, shriek, and occasionally do something so freaking adorable that their parents turn to much. We can't tell them to eat less and exercise more. So where, he asks, does their problem come from?

They eat more. But -- why do they eat more? For several million years, babies ate what they needed (if they could get it) to end up at a healthy weight. Today, they eat more than they need. A lot more.

Apparently it comes from the formula they're drinking, and how that interacts with the hormonal pathways in their bodies. Specifically, the addition of sweet stuff (sugar and high-fructose corn syrup, which are essentially chemically identical, as well as basically doing the same things in your mouth and your body).

His claim is that sugar, as an addictive substance, is poisoning us. He further claims that our incredible and overwhelming increase in consumption is causing an incredibly number of illnesses and deaths.

After his quite convincing and horrifying exposition of the problem from his viewpoint, though, I really was disappointed. He really doesn't have anything but the very standard recommendations -- eliminate all beverages that have more than 5 calories, except milk, from your diet. Including soda, juice, chocolate milk, vitamin water, smoothies, etc. Increase your fiber intake by increasing the unprocessed foods you eat. Exercise. Not to lose weight, but to increase your health no matter how much you weigh.

All these are things that I have heard many times before, and agree with. I had hoped, once he pulled together such an excellent argument on what the problem is, that he would then have better recommendations on how to deal with it. So far, though I hope my sense improves, my feeling after reading this book is "this is hopeless. I am doomed."

However, I suspect that I, and everyone else who reads this board, am an "early adopter" when it comes to nutritional changes. It may be that I am only 20 pounds overweight because I've managed to fight through many of the choices that others who are 50 or 100 pounds overweight have not been able to manage. Even so. It's tough to be told that your entire food environment is being poisoned, and then be told that the things you're already doing are the best solutions he's got to offer.

That said, I did think of a way to reduce DD's consumption of chocolate milk (she gets it at lunch at school and says, just like I did when I was her age, that the white milk at school tastes awful), so perhaps that alone is a benefit worth all the reading.

ThyPeace, thought y'all might like a short summary. And realizes this is a really long post. It's still very short in terms of what's in the book!

(1) Dr. Lustig is the presenter in a University of California San Francisco video called "Sugar: The Bitter Truth," which is available on Youtube at
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