The title of this blog says essentially what Dr. Robert Lustig (a pediatric endocrinologist at University of California at San Francisco who specializes in childhood obesity) conveys in Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, (Hudson Street Press: 2013). To anyone in the least familiar with foods and nutrition, that sugar is a poison should come as no surprise, but the real value of Lustig’s book lies in the biochemical science he cites. Fat Chance contains all the latest scientific information you need (and, one would think, our regulating agencies, FDA and USDA would need as well) to convince you that America’s food industry and the resultant food consumption habits in this most “advanced” of countries are idiotic, sick, and sickening to an entire population and now, because of globalization, the world.
To begin with, Lustig cites the statistics on obesity in America, and specifically, how the last 30 years have been a disaster in this regard. In 2001, for example, Newsweek reported that 6 million American children were seriously overweight. Those numbers tripled in a decade, and America now boasts more than 20 million obese children, including even an epidemic of obese 6-month olds! Over 40% of American deaths now list diabetes as the cause, up from only 13% two decades ago. And the epidemic has become a worldwide pandemic: the World Health Organization (WHO) says the percent of obese humans globally has “doubled in the past 28 years,” and the UN General Assembly in 2011 asserted that “non-communicative diseases (diabetes, cancer, and heart disease) are now a greater threat to world health than infectious diseases” (such as malaria, etc.). One would think these statistics would be enough to impel government agencies to rush to control the causes of obesity and its traveling companion, metabolic syndrome (a cluster of five diseases: obesity, diabetes, lipid problems, hypertension, and cardiovascular disease). But one would be wrong. Since the mega-corporations that produce foods worldwide depend on persuading consumers to eat their junk (processed foods that cause obesity), their power has crippled national and international organizations and prevented them from warning the public of the slow death lurking in the consumption of these products. Just one example: in 2002, the WHO and FAO (Food and Agriculture Organization of the UN) jointly produced a report (TRS 916) titled “Diet, Nutrition, and the Prevention of Chronic Diseases.” It called for “limiting added sugar to less than 10% of total calories in the diet.” The food industry went ballistic, pushed its lobbying into overdrive, and eventually got U.S. Secretary of Health and Human Services, Tommy Thompson, to threaten “to withhold the $406 million annual United States contribution to WHO” unless TRS 916 was repealed. Not only was TRS 916 scuttled, but so was, ever since, even a hint of a Daily Recommended Intake for sugar. Instead, the official line of all politicians and food industry groups is that obesity is a question of personal responsibility: if you eat too much, you get fat. Not our problem. Period.
What Robert Lustig shows us is that this is simply a ploy to take the spotlight off the real threat: the ubiquity of processed foods, laced with sugar to cover up the horrors done to the whitened calories that have come to replace REAL FOOD. The real key to “the obesity pandemic,” in other words, is “our altered biochemistry,” which is due to loading us up with sugar and salt and additives that literally change how our bodies respond to hunger. One key is insulin. “We’re all hyperinsulimic,” says Lustig, with most humans today releasing double the insulin that we did a mere 30 years ago. And what does insulin do? It’s the energy storage hormone: eating a carbohydrate causes blood glucose to rise, and this signals the pancreas to release insulin to deal with this rise in glucose;
Insulin then tops off the liver’s energy reserve by making liver starch (called glycogen), and shunts any amino acids from the blood into muscle cells. Excess fatty acids, or blood lipids, are cleared into fat cells for storage for a “rainy day,” where they get turned into greasy triglycerides (such as the fat surrounding your steak). p. 35.
In brief, insulin makes fat, the more insulin the more fat. Another hormone, only discovered in 1994, comes into play as well. It’s called leptin and its job is to “signal the hypothalamus that you’ve got enough energy stored up in your fat,” i.e. that you’re full. But sometimes the VMH (ventromedial hypothalamus in the brain) can’t see or is resistant to the leptin signal. The brain then interprets this as “starvation” and directs the body to both increase energy stores (eat more), and conserve energy by reducing activity. Simultaneously, more insulin and more leptin is called for as well. Though few people are leptin deficient (from a mutation), billions, according to Lustig, exhibit leptin resistance. They have plenty of leptin, but “their hypothalami can’t see their leptin, so their brains think they’re starving.” The command is then to eat more (gluttony) and conserve energy (sloth). This is the key to the obesity epidemic, says Lustig. And studies suggest that it is the increased insulin production (hyperinsulemia), acting in the brain, that is blocking normal leptin signaling.
In sum, insulin (which most humans now produce twice as much of) produces a double whammy: in the body it causes increased energy storage in fat cells; in the brain it causes leptin resistance and the feeling of starvation. It thus drives gluttony and sloth, weight gain, and obesity worldwide. Most important, none of this is under the individual’s control. That is to say, since the biochemical process is primary and the behaviors result from the biochemistry, then the clear conclusion is: “Obesity is a biochemical alteration in the brain promoting leptin resistance with resultant weight gain.” This means that obesity is not a question of personal responsibility as corporations and the government agencies under their control would have us believe. It is a question of what has happened to human biochemistry as a result of the environmental changes caused by the types of foods we have all been inundated with in the last half century. And the correlation with “fast foods” and “processed foods” is almost perfect. For example, Lustig points out that in the U.S. in the 1950s, only 4% of the foods consumed outside the home came from fast foods (I can testify to this personally; all foods I ate growing up were cooked from scratch). In 1997, the percentage was 34%. Put another way, every day “30% of U.S. adults eat at a fast food outlet,” with McDonald’s feeding 46 million of them every day. The highly refined carbohydrates (including sugar) from such fast and/or highly processed (white bread, white rice, sodas, soy products, instant meals) foods not only cause obesity, but will also eventually make the liver sick by building up fat in the liver and other organs. This is the kind of fat, called visceral fat, that kills you.
Sugar is a chief culprit in all of this, and much of the damage has been done in the last 30 or 40 years. That’s because in the 1970s, Ancel Keys convinced American agencies like USDA and FDA that dietary fat from red meat was responsible for our health problems, mainly heart disease. In response, food manufacturers took the fat out of most foods, but without the fat, the food tasted like cardboard. To disguise this disastrous taste, processed food manufacturers upped the carbohydrate content, especially sugar. The result is our current sugar and carbohydrate glut: compared to 100 years ago, American consumption of sugar has increased 5-fold, and doubled in the last 30 years. Of that sugar consumption, 33% comes from beverages like Coke and even orange juice (containing 1.8 grams of fructose per ounce compared to only 1.7 grams for soda). Lustig sums it up thus: “The inescapable reality is that 20-25% of all the calories we consume, a total of 22 tsp/day, comes from some variation of sugar. Some adolescents consume 40% of calories as sugar.” And how much of our food contains sugar? Nearly all of it. Barry Popkin of No. Carolina University surveyed 600,000 food items for sale in the United States, and found that “80% are laced with added sugar” (234). Moreover, fully 90% of food sold in the U.S. comes from 10 food conglomerates including Coca Cola, Con Agra, Dole, General Mills, Pepsico, Kraft and Nestle—purveyors all of fast or ‘convenience’ food. And what is the definition of fast food? “It’s fiberless food,” because fiber can’t be frozen. Freezing turns fiber to mush, so it can’t be stored forever, shipped globally, and cooked quickly. So food processors remove the fiber— precisely that which is the key to a healthy gut, and thereby to a healthy human. Foods with fiber—like whole grains, or fruits and vegetables in their whole form—not only slow digestion and increase absorption of the vital nutrients in food, but also slow “the rate of flux from the intestine crossing into the bloodstream” and into the liver. The liver then gets the time to fully metabolize what’s coming into it. But when the liver is hit quickly with heavy loads of fiberless starch or sugar, the glucose level peaks higher and faster, and that translates to a higher insulin peak demand. And more insulin means more fat, more obesity, and more of the diseases associated with it.
There is more in this vital book, complete with charts and tables that are revelatory. The point, though, is what my title suggests: sugar is slowly killing us. And its increased use is the product of the policies of government agencies that have abdicated their historic role of protecting the consumer, and shifted to the role of protecting the profits of major corporations. Sugar, for example, got the highly-sought-after GRAS (Generally Recognized as Safe) status from the FDA in 1958, based on no science whatever. The same status was bestowed on High Fructose Corn Syrup in 1983. This means, quite simply, that there is no limit on its use in any food. An FDA report commissioned in 1986 put the dogma in writing:
“fructose is a valuable, traditional source of food energy, and there is no basis for recommending increases or decreases in its use in the general food supply or in special dietary use products” (242).
End of story. The fact that when this report was written, average U.S. sugar consumption was 40 pounds per person per year, and now is 130 pounds/person/year, seems to make no difference. The FDA has reaffirmed its 1986 stance twice, most recently in 2004. The same holds true in Europe. Then in 2000, in response to lawsuits brought against McDonald’s for causing obesity and heart disease (which was true), our lobby-subservient Congress came up with the Personal Responsibility in Food Consumption Act (aka the “Cheeseburger Bill”). Following the old pattern, Congress was saying—and Rep. Jim Sensenbrenner of Wisconsin said specifically—don’t blame fast foods or food companies. Blame yourself:
This bill says ‘Don’t run off and file a lawsuit if you are fat.’ It says, ‘Look in the mirror because you’re the one to blame…If a person knows or should know that eating copious orders of super-sized McDonald’s products is unhealthy and could result in weight gain, it is not the place of the law to protect them from their own excesses’” (246).
That the bill only passed the House and is not yet law doesn’t change the real message: as a consumer, you’re on your own. The fact that we (the food industry) spend billions to persuade you to eat crap, and more billions making that crap deadly to your health, and more billions lobbying your elected representatives to abdicate their responsibility to protect your health, has no bearing on the case.
If this sounds familiar, it’s because it is: tobacco companies for years used exactly the same strategy to protect themselves from any responsibility for the illness and death of smokers. We can only hope that in time, as in the tobacco case, enough people will wake up to the dangers in their fake food to force the people’s representatives to act in their behalf. Until then, we can only watch as Americans get sicker, and the skyrocketing health bills for this pandemic of obesity and metabolic syndrome continue to ravage the world—mainly, unfortunately, in poorer communities where the choices are so reduced that people would rather drink sugar-loaded beverages than the water that in many places cannot be trusted. It’s a deadly trap whose pernicious effects differ from most of ours only in degree.