The title of his book, “Metabolical,” is actually a portmanteau of the words “metabolic” and “diabolical,” which captures nicely the essence of his message.
“I wrote it because nothing else has worked,” Lustig said. “Part of the problem is, this is such a complicated issue.”
Lustig says with so many stakeholders, it is critical they all have the same set of facts so they can start working together to solve the problem. Those stakeholders include patients, doctors, food companies, the insurance industry, Wall Street, and Congress.
The Two Primary Keys
In summary, it boils down to two primary issues or key problems. The first is that the medical establishment doesn’t want you to know that drugs were never intended or designed to treat the foundational cause of chronic disease.“Modern medicine has two factions, two paradigms,” Lustig said. “One is treatment of acute disease, and for the most part, they’ve gotten it reasonably right. I was part of that system for 40 years and was comfortable within it.
“But for chronic disease, Type 2 diabetes, hypertension, lipid problems, cardiovascular disease, cancer, dementia, nonalcoholic fatty liver disease, polycystic ovarian disease—all of which are chronic metabolic diseases, all of which are mitochondrial diseases—we don’t have anything. We have symptomatic relief only.”
He gives LDL lowering agents as an example. LDL (low-density lipoproteins) is sometimes referred to as the “bad cholesterol.” But drugs that help lower LDL levels don’t treat the metabolic dysfunction that caused them to rise in the first place. He says the same is true with hyperglycemia, hypertension, osteoporosis, and autoimmune disease.
“All of these, we have symptomatic treatments. We don’t cure or reverse the disease; we just treat the symptoms. And so the disease gets worse,” he said.
“It’s like giving an aspirin to a patient with a brain tumor because they have a headache.”
The result is treatments that never cure the illness but do cost the patient a lot of money.
The other problem is that the food industry doesn’t want you to know that virtually all foods are intrinsically good for you until they’re processed—and processed foods make up a majority of the foods people eat.
The History of Medicine
In his book, Lustig does an excellent job of presenting the history of our food and medical systems, and the various pressures that led us down the path to where we are today. For example, a significant part of why medical doctors are so clueless about health today is because Big Pharma was placed in charge of their education. The drug industry, in turn, was a distinct profit-making scheme from its inception.In 1910, Abraham Flexner, an educator, wrote the Flexner Report, which turned out to be a turning point in terms of creating evidence-based modern medicine, while simultaneously ignoring and eliminating many health-related factors, including nutrition and preventive medicine. His brother, Simon Flexner, a pathologist and pharmacist, was the first president of Rockefeller University.
One of the reasons the Flexner Report eliminated certain aspects of medicine was because John D. Rockefeller, president of Standard Oil, was also in the pharmaceutical business. He was trying to sell coal tar, a byproduct of oil refining, as a treatment for a range of ailments.
So, Rockefeller was seeking new profit avenues. “He basically said we have to get drugs and especially coal tar into the hands of physicians who can prescribe it,” Lustig said. The only way to do that was by overhauling the medical system and shifting the focus to pharmaceuticals.
“So that was the start of Big Pharma. That’s not the story they want to tell, but that is in fact the case.
“Same thing with dentistry. Weston Price, perhaps the most famous of all dentists, knew this back in the 1920s and ’30s and actually said that sugar was the primary driver of chronic oral disease, whether it be periodontitis or dental caries.
Why You Shouldn’t Focus on Food Labels
By now, you’ve probably trained yourself diligently to read food labels. The problem is that the label won’t tell you what’s been done to the food.“This is one of the reasons why nobody’s getting better because there’s nothing to learn from the label that will actually help you,” Lustig said.
According to Lustig, a food is healthy if it satisfies two criteria: (1) It protects your liver; and (2) it feeds your gut. A food that does neither is poison, and any food that does only one or the other, but not both, is somewhere in the middle. Real food, because it has fiber, protects your liver and nourishes your gut. Processed food is often fiberless because fiber decreases shelf life. By removing the fiber from the food, it prevents it from going rancid, but it also makes it inherently unhealthy.
“In an attempt to try to increase availability, decrease wastage, we turned our entire food supply on its head in order to create commodities rather than make food available,” Lustig said.
Then, in the 1970s, Richard Nixon told the U.S. agriculture secretary, Earl Butts, to come up with a plan to decrease food prices, as fluctuating food prices were causing political unrest. The result was the start of monoculture and chemical-driven farming.
“Now, we have nitrogen runoff destroying our environment and antibiotics in the feed in order to keep the animals alive, but basically killing off their own bacteria and ours, and also creating chronic disease and destroying the environment as well,” Lustig said.
Refinement Ruins Food
While Lustig argues that the refinement of carbohydrates is the primary culprit that makes processed food so bad for your health, I believe processed fats may be an even bigger contributor.Lustig warns that omega-6s are proinflammatory and have enough unsaturated double bonds that if you heat them high enough, you turn them into trans fats.
“That’s the problem of all of these polyunsaturated fats. They’re not meant to be heated beyond their smoking point, and we do,” he said.
Polyunsaturated fats are also highly susceptible to oxidation, and as the fat oxidizes, it breaks down into harmful sub-components such as advanced lipid oxidation end products (ALEs) and oxidized LA metabolites (OXLAMs). These ALEs and OXLAMs present their own threats to your health.
One type of advanced lipid oxidation end product (ALE) is 4HNE, a mutagen known to cause DNA damage. Studies have shown there’s a definite correlation between elevated levels of 4HNE and heart failure. LA breaks down into 4HNE even faster when the oil is heated, which is why cardiologists recommend avoiding fried foods. LA intake and the subsequent ALEs and OXLAMs produced also play a significant role in cancer.
HNE and other ALEs are extraordinarily harmful even in exceedingly small quantities. While excess sugar is certainly bad for your health and should typically be limited to 25 grams per day or less, I believe LA is far more damaging overall.
These substances increase oxidative stress and our levels of reactive oxygen species. Lustig explained the risk.
“We have a metabolic burden of reactive oxygen species (ROS) that are doing damage if you can’t quench them. That’s why we have antioxidants in our body—glutathione, vitamin E—[they’re] basically the sink for those reactive oxygen species,” he said.
You can almost think of ROS as fire that your body can use for various important functions, including immune response. But that fire poses a problem when you can’t put it out.
“[ROS] is a normal byproduct of metabolism. The point is we’re supposed to be able to quench them. You can only quench them if you get the antioxidants into you,” he said.
Real Food Is the Answer
The key, then, is to eat whole food, which is naturally rich in fiber and low in sugar. On a side note, free radicals are not all bad. They’re also biological signaling molecules, and if you indiscriminately suppress them, which is the danger you run into when using very high amounts of antioxidant supplements, it can backfire.Solutions, Solutions
Now that you know the root problems, what solutions does Lustig suggest? For starters, education alone is not enough, he says. We need education plus implementation. And that requires a different societal response.“The way I describe it is that there’s personal intervention, which for the lack of a better word we can call rehab, and societal intervention, which for lack of a better word we can call laws. Rehab and laws for everything that is a hedonic substance—you need both,” he said.
The first step of personal intervention is figuring out if you’re sick. “And don’t ask your doctor because they don’t know how to figure it out,” Lustig said. In Chapter 9 of his book, he lists clues that can help you self-diagnose.
In terms of addressing your health problems, your primary “treatment” will be to make possibly significant changes to how you shop and eat. As a general, easy-to-follow rule, if it has a label, don’t buy it. Real food does not have ingredient labels. Lustig’s book also includes guidance on how to read food labels in cases where you might not have an option.
“We also need societal intervention. The problem is the food industry doesn’t want any societal intervention because this is their gravy train. So, the question is, how do you do this?” he said.
Normally we would do it through legislation, but the food industry has completely co-opted the entire legislative branch; 338 out of 535 congressmen take money from the American Legislative Exchange Council (ALEC), and agriculture is their fourth [largest] contributor after petroleum, tobacco, and pharma.
Barring legislative success, we’re left with litigation. Already, there are a number of lawsuits in the works, several of which Lustig is a part of. Ultimately, we must restructure the entire food system so that all stakeholders benefit.
Subsidies Are the Biggest Hindrance to Change
Can the food industry make money selling real food? Lustig believes the answer is yes, and in his book, he details how real food makes both financial and ecological sense. The key is to remove subsidies, which currently grease the wheels of the processed food industry.“The subsidies are the single biggest blockade,” Lustig said. “They’re the single biggest obstacle to being able to fix the food supply because that’s what’s making processed food cheap. The Giannini Foundation at UC Berkeley did a back of envelope calculation several years ago.
“What would the price of food look like if we got rid of all food subsidies? It turns out that the price of food would not change. People say it would go up. No, it wouldn’t. It would not change except for two items. Two items would go up: Sugar and corn [used for high-fructose corn syrup]. So, basically, that would reduce consumption of the primary toxin in our diet that’s causing the most trouble.
“The food industry ... can make more money doing the right thing provided we get rid of the subsidies or make the subsidies for real food so that they can make money selling the right thing. This requires the government. There’s no way around it. That’s why this book is complete. It’s laid out for all the stakeholders, including government, as to what has to happen and why.
“I wrote this book for everyone to understand the same principles all at once, so that we can actually have an argument and a debate and hopefully come to the table about the facts, because until we do that, there will be no solving this problem. If everyone comes to the table, honestly, and admits to what the issue is, what the problem is, we can, in fact, solve it.”
