The People's Perspective on Medicine

Show 802: Is a Calorie a Calorie? (Archive)

Nutrition experts have long insisted that a calorie is just a calorie, but evidence is mounting that the type of calories we consume makes a big difference.

The obesity epidemic in the U.S. has been increasing alarmingly. The usual explanation is that we eat too much and exercise too little. But is every calorie we eat the same as every other?

Too Much Sugar?

Some scientists think that the explanation lies in the type of food now found in our supermarkets.

Americans consume more than 150 pounds of sugar each year, on average, which comes to about 22 teaspoons of sugar daily. Much of that is hidden in processed food.

Dr. Robert Lustig, pediatric neuroendocrinologist at UCSF, believes that the processed food in our diet has contributed greatly to the epidemics of obesity and diabetes. He provides the biochemical explanation for why fructose is so damaging to children’s health. Adults suffer, too, from every excessive fructose calorie.

Is Sugar an Addiction?

Our other guest, Dr. Jacob Teitelbaum, believes that sugar should be treated as an addiction. He tells how to kick the habit.

This Week’s Guests:

Robert Lustig, MD, (pictured) is professor of clinical pediatrics in the Division of Endocrinology at the University of California, San Francisco. He also directs the Weight Assessment for Teen and Child Health (WATCH) Program there. His specialty is neuroendocrinology, with a specific emphasis on the regulation of energy balance by the central nervous system. Here is a link to his Mini Medical School presentation on YouTube:

Jacob Teitelbaum, MD, is medical director of the Fibromyalgia and Fatigue Centers and author of Beat Sugar Addiction Now and From Fatigued to Fantastic.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Not simple at all. What you call natural healthy food to most means lots of fruit, which in fact is mostly just sugar. Oversimplification is dangerous.
Many argue and recent science seems to verify, that higher in protein and fat
diets are in fact better for dieting and simply put a calorie is not just a calorie when an overabundance of carbs causes fat to be stored on the waist and makes you hungry (sugar spikes). Not simple at all!

Other than natural healthy foods, it is hard to imagine ingested agents that don’t have side effects. The questions to ask are what they are, how severe, and how frequent? I’ll take my chances with a few teaspoons of Sucralose per day vs the problems of sugar ingestion. Even daily vitamin supplements can have unpleasant consequences for some people if taken in too large quantities. Consider the effects of caffeine, not the side effects.
To lose weight, reduce calories. to maintain weight, exercise. Simple.

Be careful of sugar substitutes. I go online to look for side effects. Someone recently mentioned Stevia, but it has side effects as well.

I do believe that sugar is addictive. I decided to give up on sugar – white sugar, turbinado, honey, anything of the sort (except stevia) – and it has been quite an experience. I had terrible cravings for the first few days. I might even go as far as saying I had withdrawal symptoms (albeit they were mild). After a few weeks I felt so much better. Giving up sugar is very difficult to do because it’s in just about everything we eat, but it is worth cutting out as much as you can.

Thank you for this very informative interview. It will either inspire people to change or disturb people to change – either way we must change.

HFCS is dangerous, but is really just another (cheaper) form of sugar. Sugar=sugar. All of it is useless calories and dangerous to those of us who have trouble regulating our weight or those who worry about diabetes.
I do not eat any sugar at all – some may escape detection, but I still struggle with my weight. We have to face it; if we take in a certain number of calories, we must burn them away or store them as fat. I think the argument about obesity as a result of our eating habits is setting up a “straw man”. The problem is a lack of exercise – period! Few like it but we must do it or we will get fat by eating anything in excess of our needs.
Much of our nutritional information comes from “nutritionists” who are, in actuality, spokesmen for one advocacy or another, and they offer us little real science. The food supplement industry, for instance is an unfunny joke perpetrated on consumers who have no way to know better.

Sucrose, your plain old table sugar, beet or cane, is still chemically half-fructose. Watch Dr Lustig’s video. Even if you have never had a chemistry course, you’ll get it.
I had pre-med sciences in college, including nutrition and organic chemistry. No one taught us to look at the way fructose is special in the way it’s metabolized. Which is to say — your doctor is not likely oriented to see the problem. S/He is too busy trying to keep up with drug industry info and the wiles of insurance companies. Alas. But I think the changes patients will demonstrable by cutting out sugar will be the real heads up. The lab numbers will tell.

Yes, the Low Glycemic index is so misleading. For years, I read certain health magazines that touted the goodness of fructose. I switched to it; I sought it. What it left me with was a fatty liver. Since cutting out not just fructose, but its accomplice, sucrose, my gout (which plagued me even though I followed all the don’t-eat-uric-acid food and low-fat guidelines) is GONE. My liver tests and lipids are now good. I’m five years post kidney cancer (clear cell) and so far, all looks good.
My q:I have an intestinal disease that required the removal of my sigmoid colon. Have I lost the important PYY 3 36 source?

@ C.S. In fact there are plenty of plants that have not been selectively bred that are sweet and juicy see Denise Minger’s post Wild and Ancient Fruit: Is it Really Small, Bitter, and Low in Sugar? I agree that it’s not particularly helpful bring your God/s into the evolutionary process.

Dr. Lustig gave a good primer on the relationship between insulin, appetite, sugar and fiber. It was unfortunate that he combined his valid insights with comments that show a lack understanding of evolution. He spoke of apples as God’s way of inducing us to eat fiber through the lure of the apple’s sweetness. Apples are sweet to induce animals (including humans) to eat them, excrete their seeds elsewhere and thereby propagate their genes.
Additionally, the apples we enjoy today are largely a product of selective breeding by humans, accounting for their increased size and sweetness. It was sad to see an otherwise scientifically-based discussion interrupted by a fairy tale with no explanatory power.

As a now recovering “Juiceaholic,” I thank you!

I really enjoyed the way that the information was conveyed during this interview. I thought that if you listened closely, you could have many eureka moments. Hopefully, this will change the behavior of your listeners.
What I find so hard to believe is that mainstream doctors do not recommend taking sugar out of the diet for people who come in with symptoms like brain fog and anxiety. There are so many people out there taking anti-anxiety drugs and I’m starting to wonder if most of this is due to diet. I changed my diet over a year ago. I was having all kinds of strange symptoms.
I went to lots of specialists who kept telling me I had to go to the next specialist to cross each “system” off the list. I finally stopped this tact when I realized the tests were becoming more and more invasive and expensive. I found a local acupuncturist who specializes in nutrition. He advised that I take sugar completely out for 6 mo. I removed gluten and limited dairy as well.
My symptoms disappeared within 3 weeks. I lost weight and had a lot more energy. It’s been a year and a half and it is difficult to exist in a convenience based society. I feel like I’m the only one who cooks and I’m always fighting the constant influx of sugar from seemingly educated parents and teachers. It’s on the soccer field, it’s in the classroom, and I even found a wall of candy recently in a shoe store. Yes, it’s your child’s birthday but think of how many birthdays are being celebrated in their classroom throughout the year. Please get the message and bring in something healthy. I wish I could make every teacher in our school listen to this program. Thank you so much for airing it.

I recently read a book called “Why we gat fat”
It’s very well written and even I w/my high school education, I could understand the way sugar ruins the body.
My son at 36 has become addicted to coca-cola. W/ that he has gained 100 lb’s
over two years. I am using this info to change his habits. He is slowly drinking less Coke, and I’m happy to say, losing weight.

All that bad eating will catch up with you eventually… just like cigarette smokers.Just give it a little more time and BAM!!! Wait and see.

My son is 16 and skinny as a rail. He drinks copious amounts of soft drinks and eats at fast food places most of the time. I have tried to help him eat healthy foods but with my job and him having to stay with parents or at a buddies house, it seems impossible to do! He is not obese by any means but I am just afraid of what it is doing to him internally. Any suggestions??
People’s Pharmacy response: Providing healthy choices and setting a good example might be the best thing you can do now. It may take a few years, but young people in their 20s often return to the healthy eating styles they witnessed at home.

I can’t say that sounds like the healthiest diet, Douglas, but I do think that too much is being made of the whole fat-sugar issue.
I’ve just lost almost 30 pounds, and I eat at McDonald’s every morning! However, I’ve tracked calories in/calories out using an online food diary, so I know when enough is enough. The problem is that most people don’t. You obviously have a built-in calorimeter – or more willpower than most!

Dr. Teitelbaum’s website clearly states:
“You will not be charged for it, we will not add your email address to any sort of mailing list, and we will not give your email address to anyone else. This is 100% free with no tricks or hidden anything.”

Listened to the show 11/27 returning from Thanksgiving holiday (and food overload). What an eye opener especially when I got home and read the grams of sugar in my daily yogurt.
So two questions: 1) Is there a rule of thumb target ratio for sugar to fiber (following the logic that the fruit is good because there is fiber to offset the fructose, but the fruit juice is bad because it lacks fiber). 2) Is there a way to identify the type of sugar (fructose, glucose, lactose etc) from the food label? Now I think I will go pick some lettuce, spinach and carrots from my backyard garden (everyone should have one)!

Very well done. It brought many facts together for me.
I would like to find out more about type II hypothyroid and metabolic syndrome. Also about the connection of fluorine/chlorine intake/low iodine intake and low thyroid function leading to metabolic syndrome. Many suspect a connection between the beginning of high fructose ingestion, lack of iodine in our diet and the adding of fluorine and chlorine to our water supply/toothpaste/mouth rinse etc.
I love to listen to your program. Solving the remaining unknowns surrounding these facts may just help the Mississippi delta take a leap forward.

Thanks for having Dr. Robert Lusting on People’s Pharmacy, it really helps me how to stay healthy.

I think I understand why Dr. T. made the point that this is a societal problem and not so much about personal responsibility. I think it is the “everyone is doing it” syndrome.
For example, I have been influenced by my society for 30 years so that I have eaten too many hamburgers, drunk too much soda, eaten too much white bread, had too many fast food meals, eaten too few vegetables and too little fiber. All of that was normal and I did not realize there was truly a problem until I gained a lot of weight.
I am surrounded by not just people but an entire society that assumes that all of the above eating habits/style are normal and so I have been like a lemming following the crowd. I imagine that Dr. T. would not dispute that it is only my personal responsibility that will dig myself out of the hole that I am in regarding my weight and health. Since, in my lifetime, there will probably not be enough society changes for society to help me.
I was encouraged by this idea that it is a societal problem because it became immediately clear that the reason it is so hard to make the changes is because I am moving against “the tide” and I should not let that stop me.

The only way to be healthy is to make your own food. I had bad colitis for 10 years taking drugs and only thinking I might be eating wrong. Once I started investigating and then using an appropriate diet (Specific Carbohydrate Diet) I learned to make nutritious foods in balance and to stay away from all processed foods while becoming healthy and well beyond any past health standards. I now am writing a cookbook based on this diet and other adventures in the wonderful world of organic cooking.
You can become extremely aware of your dietary needs once you start eating well. Most people think they can live on sweets and then a quick protein fix of some meat and never think of cooking a meal. It only takes about half an hour to map out what you should eat for the week, learn about the right foods, gather your supplies and cook regularly.
Stop eating out, stop shopping for junk, make foods you are proud of and start to share with others. Then all the scientific results will make even more sense just because you, yourself, can experience the difference getting well. Awesome show! For many people, this was the only way they could get the message loud and clear. Thank you.

I’m having a little problem with no mention of meat, eggs, fish, butter, cheeses, and in general… protein. To replace simple carbs with veggies and fruit and whole grains is fine, but it is the fats in foods that keep you satiated. So may be it should be, “eat foods from the ground, and from animals”. Also, remember the book…
‘sugar blues’ written in the 70’s… might be a good read again!!

Thank you for the program. I heard it while driving through Charleston, WV the 26th of November, 2011. It described me to the point I am going to purchase the books and hope to make a change in my life that will be of benefit for my health.

Dr. Lustig’s interview was great! I have read some of the comments stating that people have tried to change their eating habits, but can’t. I do not believe it is a question of can’t, but won’t. Living healthy is a lifestyle it is not a game or a fad. If you choose to live healthy, then you have to commit to it or you are totally and completely wasting your time. You have to sacrifice things that are not necessary in order to be healthy. It’s okay to eat some “forbidden” things every now and then, but on a regular basis does not do your body any good.
People have to stop and look at the big picture. Eating all this crap that you buy from fast food places, foods with sugars and preservatives, etc., will eventually catch up with you. Would you rather eat healthy and exercise regularly, and fight disease and old age? Or would you rather just give up and cash in your chips by filling your body with this mess? I have a lot to live for including my children, therefore, I chose to live healthy so that I can enjoy the finer things of life. And the finer things of life do not include eating at Mcdonald’s, having Krispy Kreme donuts every week, etc.

If you substitute HFCS with cane sugar, you have the exact same problem. All sugars containing fructose are the problem. HFCS has the same amount of fructose as cane sugar. That’s not a defense of HFCS, its a condemnation of sane sugar as well as HFCS. Dont think drinking that “throwback” Pepsi with cane sugar instead of HFCS is helping. HFCS is bad because it’s so cheap (thank you government corn subsidies).

There’s a horrible lot of “noise” around the subject of obesity. Dr. Lustig organizes the research-to-date in a way I’ve never heard or read before. It’s utterly logical. Since UCSF is one of the leading medical facilities in the US and he’s a faculty member, I’m inclined to trust what he says.
If Dr. Lustig is correct in his conclusions – and I’m always wanting just a little more proof – I will put significant personal effort into spreading this “gospel.” I invite others to do the same.

Although I usually find your program to be one of the most beneficial I’ve ever encountered, I was very disappointed in Dr Teitelbaum’s promotion today of his short symptom test, described on your program as being on his website. This website just took me in circles for over an hour, requiring that I sign in more than once, disconnecting me, making me sign in again, and then taking me in circles again, never to Dr Teitelbaum’s short program. I am web-savvy, and this run-around does nothing to recommend Dr Teitelbaum, his supposed free test, or your fine, otherwise beyond-reproach program.

Sorry to bust the balloon of all those who think that HFCS is the only problem, but as I stated in Feb., it is all sugar (and for some of us carbs generally). The science is simple. HFCS is 55% fructose and 45% glucose. Good old fashioned refined, processed sugar is about 50% fructose and 50% glucose so the only difference with HFCS is you get a little more fructose and a little less glucose, but basically the same thing.
We just eat too much sugar, period- cake, donuts, sweetened cereal, anything with honey and on and on. We just weren’t made to handle this load which is a poison to our bodies which is why the good soldier insulin does its best to eliminate it as soon as possible, but the battle is too much for many and obesity, diabetes, and then heart problems (metabolic syndrome is the result) Stop eating all sugar and give your body a chance to feel good.

I understand avoiding the boxed foods on the inside isle of the grocery store. I recently saw that lunch meats, hot dogs and other meats in that area all have fructose corn syrup added. insane.

Most understandable discussion about sugar, ever. Lifechanging knowledge is offered here.

Well said! HFCS ~~not real sugar~~ is what’s helping make little kids not only fat but prediabetic, etc. The reasons gets into chemistry and ions, etc. but, all I kow is that it is in most everything we eat or buy; even ketchup! (WHEN I used to eat too many things ~in one day~ that had HFCS in them, I got diarhea .)
So, I am against HFCS for more than the obvious reasons!
I love this column; thank you !

I think a class action lawsuit on behalf of the public should be launched against both the FDA and the Ag Dept.
Another facet of industrialized food processing are all the ingredients used to enhance flow of material and ingredient stability (shelf life)- these additives are allowed at very low rates but what are their effects on health?
This pseudo-food is killing us and has ruined farming & the food supply

Excellent show. I meant to rate it a 5 but accidently hit the 4.

Yes, I know about HFCS. I watch labels, eat as many organic food as I can. Don’t eat sweets, only as a treat once or twice a week.

Carbohydrate Analysis of High Fructose Corn Syrup The carbohydrate contents of beverages determined after acid hydrolysis were substantially (4–5 fold) higher than the listed values of carbohydrates.

Thank you for keeping the free mp3 download available for this program longer than usual. I’ve referred SEVERAL of my friends to this after they’ve commented on my successful weight loss and exercise regimen which came about after my listening. This sugar scam (yes it is a scam!) should be more widely known and you’re to be thanked for making it happen.

It is D Ribose.

Show 802: Mickster’s comments echo my own. I think I now understand why I should eat brown rice instead of white (enriched). The nutrient information on the label did not tell me why brown was better, but it’s because of the way sugars are processed in the body because of it’s fiber. Right?

This was a fascinating. riveting show. I work with hospice patients, many of whom have very poor appetite. Excluding the patients who have clinical diabetes, I am actually wondering if fructose could be used to enhance appetite in some of these malnourished patients.
Of course the nutritional value of the fructose is… basically nothing, except calories, which in this case are needed. But, if it could be used to increase the patient’s appetite, then nutritious food could be given after the fructose “appetite stimulant”.

I certainly found Dr. Lustig interesting. But before becoming a true believer, it would be prudent for listeners to see what else is out there on the subject. I would recommend

Dr Lustig’s presentations are superb. It is like sitting at the foot of an intellectual giant. see also youtube – ‘sugar the bitter truth’.
Must get hold of John Yudkin’s Pure white and deadly which I read in 1973 and has been responsible in part my 38 yrs of lean good health. Get your hands on it every body as Dr L says every word of it has been proved correct since.
I remember visiting the US in the 80’s and ordering from a menu in S.Carolina – soft shelled crab and all kinds of marine delights. I had my Englishman visiting France hat on and was horrified when every dish arrived cooked to death coated in breadcrumbs and industrial oil. I paid up and left hungry.
I am concerned about the million sun drenched acres of land now growing corn. Are there enough people spat out by the Banking disaster who would be happy to live out there lives farming 50 acres each to supply their own slow grown food? Could be an answer. If the price of land drops to 100 bucks and acre I might be interested myself…. Respect to you all, Fred

Beta-D-ribofuranose, D-ribose, or Ribosa.

The very best explanation I’ve heard yet regarding the childhood obesity problem and insulin resistance. Would love to hear more of the same. Great show.

This show has changed my life!
It’s been two weeks since I ‘dropped fructose’ like a hot potato and I’m not looking back. My daughter is the poster child for the WIC mentality has been drilled into the head of a generation of mothers. That is the part that really shocked me – that the government bought into the baby formula ‘milkshakes’ and juice juice and more juice for kids. And the mothers of America ‘believe’ they are doing the right thing by feeding their kids these huge doses of fructose while fussing about fat that might be in milk, cheese, eggs and other ‘real’ foods.
I had my daughter listen to the show and I went online and we watched the teaching session Dr. Lustig has posted that goes further into detail on the cellular action that happens when fructose goes into the liver. This has to be the best show you’ve ever done, Terry and Joe! I think you may have sparked a revolution.
(My daughter had baked a cake for her husband the day we watched the show together. We drew her husband into the discussion. Her seven year old daughter started asking questions about sugar. We counted the bottles of juice in the fridge and started reading labels in the pantry. This is the moment our paradigm changed! The cake, by the way sat there until we threw it out!)
As an artist, I’ve been looking for a project that can be turned into a comic book slash coloring book for kids and adults that teaches them truth in nutrition. I think I’ve found what I need here.
You should see the cute liver I’m drawing!
Again, thanks for the wake up call. You’re the best – and so is Dr Lustig.

Ivan Royster on Facebook has a huge movement going to put an end to high fructose corn syrup. I signed up some time ago. As a type II diabetic, what I notice most about it is that when I eat it, it takes forever to metabolize. My understanding is that my body doesn’t recognize it and so fails to produce any insulin.
I have heard that Michelle Obama won’t allow the stuff in the White House.


Yes, in a way we have been hearing this for quite awhile. However, to hear the scientific process of what is occurring is so interesting! I love that the doctor said this is not a personal issue, this is a cultural and community wide issue. I so agree! Let’s move forward from this knowledge and begin to address it. I think the greater availability of fresh foods is a step in the right direction. I work with many people that do not have much money. They can afford junk food, but not fresh food. Downtown Detroit is becoming a farm; let’s do this in other areas too.

I totally agree with you. It’s horrifying how much stuff HFCS is in and how long it’s been in there. Not only do we use cane sugar, Costco sells cane sugar that’s organic, and that’s what we use. It took us a long time to get out of the sugar craving until we starting reading labels and absolutely not buying anything that has HFCS. Look out for HFCS that’s not labeled, too. Between HFCS and Hydrogenated Oils, the food manufacturing industry has us all in pretty bad shape. We’ve decided we have to look out for ourselves.

For Amy: It’s spelled D-Ribose. Many spell it di-ribose.

Ahh, the whole “midwest corn farmers are the cause of worldwide starvation” blame game. Well, guess what, corn is an _energy source_. It is best used in ethanol, to power our economy. It does not belong in our food supply. Keep the ethanol subsidies so we can grow a stable energy source. (Without those subsidies there would be no ethanol infrastructure in place for future non-corn sources.) But read the labels and buy food without corn, after all, it makes animals FAT.
Personally, I’m glad someone in the medical community has gotten their head out of the “diet and exercise” sand and tried to figure out why we are still getting fat. Kudos!
from a Midwest Corn Farmer, and proud of it!

It is surprising that no one has commented that this is in fact, “Atkins Light”. Lustig is smart and know that if he tries to tell people to cut carbs no one will listen. Weill has commented that if you tell people they can’t do something, they rebel. Accordingly Lustig and Weill are working to get the same result w/o scaring off those who erroneously think Atkins was wrong.
Everything Lustig says was in Taubes’ first book (Good Calories, Bad Calories) and is repeated in his second book (Why We Get Fat)
Taubes is more intellectually honest and makes clear that there is no science yet that proves fructose or high fructose corn syrup is particularly bad although they may be. The real issue is carbs period.
Taubes points out individual differences. If you can eat carbs all day and not gain weight so be it as long as your blood lipid profile is good and your sugar isn’t rising, but watch out for metabolic syndrome later in life.
For most of us carbs are the killer. Carbs cause the insulin rush that Lustig discussed and that insulin causes fat to be stored, hunger and lassitude to result as pointed out by Lustig.
Before insulin injections doctors treated diabetics by drastically cutting carbs. Dietitians tell you you must have carbs for “energy” at every meal.
This is simply untrue. You don’t need carbs for anything you can get everything you need from meat and fat.

My wife and I are both physicians. We learned a great deal of important physiology from this program that we will take to our patients, students and residents. I have been working with the local childhood obesity task force and I plan to share the MP3 version with the folks on the committee. A light went on when Dr. Lustig explained that fructose and ethanol work on the liver in similar ways. My wife and I just looked at each other with knowing nods. I always love your shows. This one had many excellent pearls. Thanks
And thank you! Getting such a ringing endorsement from such knowledgeable listeners makes the time and effort worthwhile. We truly are grateful for your kind words.

Check-out online silymarin (milk thistle) – see if it might help.

I always enjoy listening to your broadcast. But this show was great. Explained in simple terms… that we can get. No wonder we are all suffering.
I fear for my grandchildren.

I agree with your inside aisle shopping–very similar to my approach. If you follow Michael Polin’s simple rules: 1. eat real food 2. mostly plants 3. not too much – 90% of the time, and allow yourself to indulge or break the rules sensibly 5 to 10% of the time, then add in activity and exercise, you will be fine.

I thought that the interview with Dr. Lustig was very worthwhile and enlightening. I am familiar with Michael Polin’s book, and Dr. Lustig served to support his simple and effective approach to eating.
I was concerned with the information from Dr. Teitlebaum, however. I was interested with his comments on D-Ribose, so went to his website and others for more information. I learned that his research consisted of 37 test subjects with no control group. The comments I found were from fibromyalgia and chronic fatigue sufferers, but I wanted to know more about D-Ribose as an aide to sugar digestion and control.
His website looks like a marketing site in disguise, and I expect the People’s Pharmacy to provide listeners with medical authorities who have more research, and less marketing, than Dr. Tietelbaum. The website seems to provide “cure” for everything with his supplements, which I find very suspect.

This is such important information! The average person relies on the food companies, grocery stores, restaurants, etc. to provide a healthy food supply. Unfortunately, DOLLARS drive the industry NOT good health. We all have to be responsible in our food choices, and programs that educate us about how to make those choices, especially for our children are invaluable!

We immigrated to the USA 16 years ago, both my children were skinnny active kids. I watched over the past 16 years as my son especially has struggled to lose weight and myself and my daughter. My son is now over 300 pounds and he just can’t lose the weight, the ONLY difference-we ate exactly the same foods and diet as we did in Africa-I am the mom and I cook from scratch-is that beef is not corn fed in Africa and that nothing is sweetened with Corn sugar.
I have switched to organic foods but I wondered if genetic modification possibly added fructose to our diet?

Good, evidence-based information, but I find myself wondering when this info will go mainstream and when we’ll snap out of our collective stupor (and addiction) and do something about it. I wonder if the fast/convenience food that we’re eating in such high volume today will one day have the shift in demand that nicotine has experienced.

Great show; very informative. I look forward to reading your guests’ books.

Thank you for the very informative info I was wondering why I was gaining wait even though I was exercising but now I know why. thank you Dr and thank you radio IQ

How clear. How disturbing. How challenging. I am a family physician and hear the challenges that adults have as parents and individuals to make positive decisions in their lives. It is tough to change habits when so many convenient, tasty and affordable dangerous options exist.
Dr Lustig: thank you for this interview. It motivates me as a physician to continue my coaching for change, as a father to continue talking to my children about healthy choices and as an individual to lead by example. ET, D.O., Marietta OH

Absolute truth! But if you think tobacco and Oil have powerful lobbyists, watch the Tsunamai from the food industry.
I have a personal life long friend who”s family is an icon of respectability and altruism-3rd Generation Soft Drink Distribution (Won’t name for courtesy)-Sadly he “consumes” copious amounts of his products; has overt obesity, failing general health. Repeat the story across the country.
Today to address the magnitude of the problem would take the federal executive and legislative branches of our government together which is as likely to happen again as the re passage of the health bill!! Reality? Those of us “who know” will follow “the path” and lead those close to us whom we love and a few others by example.
Until the “disease” becomes a monstrous “calamity” of biblical proportions , doubtful a change will happen! Remember the “bottom line” in good ole “land of the free, home of the brave America” is : PROFIT! and Sugar equals PROFIT!

Outstanding show! I have celiac, so of course I always read the labels of the few items I purchase in the dreaded processed food aisles. Aside from the obvious precautions, steering clear of HFCS is top priority. I was amazed to found out how much sugar is in the organic yogurt that tastes so good. From now on, it’s going to be plain yogurt with a little honey and fruit.

Great advice from Dr. Lustig. Right on target.
The crazy thing is that no one I have ever talked in RTP, including doctors and PhDs, have ever expressed this unique point of view.
My father had diabetes, and I went to his doctor’s visits. In my opinion, Dr. Lustig’s analysis is correct.

Not only do I think you’re correct, but personally, I don’t think enough of your hostility was showing. It’s that VERY hostility in VERY LARGE MASS that is going to be the ONLY thing that is going to be able to stop that machine! (I’m not advocating violence here in anyway!!!) Be it to get congress to move on it, or the companies to take action on their own. Personally, I think would be a very sad statement for our society that it would take an act of congress to get a business to do something that it should have done solely on it’s on had it had any internal morals or ethics guiding it’s direction, which we all know, they DON’T have!
I unfortunately don’t think it’s quite as simple as saying that they start them young and ensure future profits though. I say that merely because I am case in point. I’m 48 y/o and I was brought up in a household where just the mere mention of the words “Kool Aid” were just about sacrilegious! We were closely watched and monitored by our mom and were rarely allowed to even have Breyers Ice Cream, which was supposedly “all natural”. Yet, I absolutely CRAVED the very things that I rarely had access to. I can’t begin to explain it. As a teenager I worked at McDonald’s and that was really the beginning of the end for me. I had no idea or real understanding of what I was eating or what I was doing to myself. I’m 5’3 1/2″ tall and weigh about 200. By the dastardly BMI (Body Mass Index) scale they use now I am considered MORBIDLY OBESE. I personally think that scale should be trashed.
I don’t know by who or how the dang thing was derived, but have gone to nursing school I still cannot to this day figure out how that scale could possibly take into account everyone’s bone structure and muscle mass. You simply cannot use that scale to determine someones severity of obesity! At least, not in my opinion! Am I over weight? Yes I am. But if I were to lose down to what the BMI says I should be down to, I would be sick and if not in the hospital, darn near to it! I wear a size 18, but I have a large bone structure and I have a tremendous amount of natural muscle mass. In my 20’s & 30’s I could go into a gym (which I did on a few occasions) with my ex husband and I could bench press and squat, using free weights and with sets and reps, more weight than the average man that DOES NOT go into the gym and work out. I was stronger than both of my younger brothers, they aren’t pipsqueaks either!
So, yes I am overweight. I have no doubt that it is because of my diet and yet I can’t seem to make the needed changes. Here’s PART of the reason why… For some reason I got sick in Feb. 2000. I went to bed one night perfectly healthy and woke up the next morning short of breath and it’s gone down hill from there. This year, Feb. 2011, makes 11 yrs. that I have been sick. I was put on 100% permanent disability and continual round the clock oxygen in June of 2004. I still don’t have a diagnosis. Go figure. It’s not for a lack of trying on the doctors part, and there have been MANY! doctors. They all say the same thing. They’ve never seen anything like it! They can’t even explain why I have to use the oxygen. And I need enormous amounts of it! I use 6L at rest and 8L – 10L on exertion. It’s absolutely ridiculous!
So here’s the problem. I can’t work. I get disability. But because I was a stay at home mom most of my adult life and worked very little at fairly low wages, I never paid much into the system. Thus, I don’t get a very big disability check. Please don’t misunderstand me. I am VERY grateful that I live in a country where I can get ANYTHING at all. I don’t know what they do in other countries. I’m almost afraid to ask.
However, though I get more than a lot of other people, I don’t get enough to be able to buy very healthy foods. After I pay my rent and utilities, my most basic of bills, which are the only bills that I have, I don’t even have cable TV, I almost have no money to buy food at all! I spend about $25/month on average for food for myself. It’s not much. I eat a lot of bologna and peanut butter & jelly. And white bread. Not because that’s what I want so much, but it’s ALL I CAN AFFORD!!!
However… ALLLLLLLL that being said… I have found out one thing that has made a HUGE difference! While having trouble sleeping my doctor sent me to have a sleep study. THAT doctor ran a BUNCH of blood tesst. Not only was my Ferritin (stored iron levels) EXTREMELY LOW (9, she it’s supposed to be over 50, but in women my age she likes it to be closer to 100) (sorry but off the top of my head I can’t remember the unit of measure they use.) But the other thing she found was that my vitamin D was also extremely low. So, I go once a month and have an IV iron infusion (my choice, I can’t tolerate iron pills) AND I take 5000 i/u’s of vitamin D3/day. THAT’s what has made such a HUGE difference.
I’ve actually lost about 20lbs with out doing ANYTHING any different. I was shocked to find out that almost immediately, with in 2 – 3 days, my cravings for sugar/junk foods drop dramatically. As in almost completely gone! It was amazing! So in as much as everything you said is VERY true, I really believe that there are probably multiple factors involved. What’s more, I would almost bet money that the variables would be vastly different for almost everyone. I mean, obviously there can only be a certain number of variables, but good grief, how many combinations could there be? I’m referring to vitamin deficiencies and the like…
Before I sign off, let me apologize for the length of this monster! I’m REALLY tired at the time I’m writing this. That usually means that I’m babbling. Adding in things that probably don’t need to be there, etc., some of it might even sound a little incoherent! (I hope not!!) I hope my point doesn’t get lost in my ramblings! Have a great weekend!!
Shelly C.
Greensboro, NC

Dr. Lustig is right-on, straight-up, correct in his analysis of insulin and fructose. My father had diabetes, and I watched the progression of his disease and the treatment by his doctors. In my opinion, Dr. Lustig has a very different opinion of insulin and fructose, BUT, he is correct.
The issue is the ratio of fructose/fiber. And fat storage.
I have a PhD degree in carbohydrate chemistry. Give his idea a chance. He is correct.

This program was very good and I would like to have a glycemic index list. I couldn’t find a complete one online. gah

Very interesting, but I wonder if all is correct.
Dr. Lustig said that fiber is not in frozen food. But I can buy frozen vegetables with fiber i.e. plain frozen peas 4 gms fiber, etc. Please explain.
He says to shop the outer aisles and not get things in boxes. What about plain unsalted and unsweetened rolled oats in boxes or bags.
Dried beans are on shelves in boxes and bags.
What about Kashi Go Lean in boxes? It has 13 grams protein and about 6 grams of fiber and very little sugar.
Is he saying to eat only meat and fresh produce – what about dried beans?
What about gouda cheese, or cottage cheese, or milk?
He said to eat only whole grain bread, but what is an example of whole grain bread vs 100% whole wheat bread?
Should we avoid wheat pasta?
He says exercise does not make a person lose weight. I disagree for a variety of reasons. One reason is that exercise often makes people feel better. Many people are emotional eaters, so if they feel poorly they will eat more and if they feel good they will eat less.
Exercise decreases my appetite, so I don’t feel like eating, so I usually eat less and lose weight.
I am of normal weight, but I avoid junk food – chips, cake, cookies, candy, pretzels, white bread. I eat supposedly healthy food from all aisles, as mentioned above. But if I did not exercise I would gain weight and have – not a huge amount but up to 5 pounds, i.e. can go from 113 to 118 in a couple of weeks, then I jump back on the exercise bandwagon.
I appreciate his out of the box scientific thinking but perhaps his thinking needs to be more out of the box in other ways as well.
Would love a response.

I wonder what he thinks about the sugars in milk and how they effect insulin, (full fat, low fat, and skim).

Long time listener, first time commenter. Love the show.
This was an excellent show that pulled several pieces together for me.
1. Sugar = glucose + fructose. Fructose is metabolized by the liver. No wonder I got the same symptoms (acne, tiredness, headaches) of excessive drinking when I ate excessive sugar!
2. The reason fruit tastes so good, it that you should be consuming the tasteless or even bitter fiber, too! My wife has long held that juice was almost as bad a soda w/r/t sugar content. Thanks for illustrating this point!
3. The insulin->adipose fat->leptin->fullness cycle was explained and helped me better understand why exercise is so freaking important!
4. I knew sugar was addicting, but with the identified specific forms now we can “name our pain” and get started recovering.
They should teach this in school.

Has anyone noticed that most Americans cannot BE without consuming? How many walk around sipping a latte, munching on a pretzel, chomping on candy or other treats, and offering children the same? I suggest that the obesity epidemic would go away if people simply stopped eating all the time.

I thoroughly enjoyed this mornings interview regarding sugar and the impact on one’s life. I have family and friends that have problems in this area. I will suggest they listen to the podcast or buy the CD – I will.

“The one exception is honey, but that’s guarded by bees.” LOL in my car!
How many experts have to tell us to stop shopping the inside aisles of the grocery store before we listen?
And fructose… where do I always see that word. Oh yeah, in High Fructose CORN Syrup. It’s clear these government subsidies need to end. Ethanol is bullsh**, the grocery store is 70% corn, and now it’s even linked to diabetes and obesity. What do we need to do? Show a link between corn and terrorism? What about corn and godlessness?

We found the information presented by Dr Teitilbaum exceptionally well developed and informative. Thank you for offering this type of insightful dialogue to your listeners.

Eat what you will.
I have not allowed by body to tell me how much to eat in 40 years. I step on the scale in the morning and eat more or less depending on my weight.
I eat a high sugar, high fat, high salt, low volume diet.
I start my morning at a donut shop and my weight varies not more than 5 pounds up and down.

Dr. Lustig enthusiastically describes the situation Americans find ourselves in. I agree with almost everything he says but think he describes a more downstream consequence of insulin resistance primarily caused by dysfunction of the p-par gamma signaling system and the nuclear receptors which start transcription for insulin receptor formation.
Industrial fats would be the prime suspects to affect the p-par gamma receptors and when the dust settles I think will be the primary cause of insulin resistance. The research to prove or disprove the fat theory has not been done but would be straight forward if the food industry is kept at arms length from the labs and the journals.
One minor quibble would be the 2 liter soda reference which only started in 1985 when polycarbonate plastics were for some strange reason approved as containers for food. Prior to this one liter bottles were about as big as were available. Even at one liter, Owens-Corning suffered many lawsuits because the larger glass containers were easier to break. I spent some time in Dr. Oscar Fryer’s lab watching breaking bottles and discussing the lawsuits in the 70’s.
Very interesting show.

How do you spell the negative glycemic index sugar mentioned on this show? It seemed to be something like “Deroybous”.

Joe and Terri–this is possibly the best, clearest and most cogent guest you have ever had on!!! Certainly he made the clearest most scientifically based explanation of the interaction of sugars (fructose), fats, the metabolic-cognitive-emotional connection to overeating and obesity.
I loved it so much that I came here to find it and listen to the entire interview, which gladly contained even more information and context. Bravo. Now, for all of us to do the hard work–put down that bag of snack food smack/crack start eating high fiber carbs, whole foods, and drinking lots of water.
One exception to all of my lavish praise…I feel that the good Doctor went astray with his wrap-up comments saying that this is a public health issue and not one of personal responsibility… it is ALWAYS about personal responsibility unless the feds have food troopers that actually spoon feed us and our families and police the food isles… much like with AIDS, teen pregnancy, drunk driving… the activity–(and consequences) will continue, regardless of enforcement/education/public policy, until those involved take personal responsibility for themselves, their bodies, and their dependents. While education and regulation are helpful, they clearly do not get it done alone.
I give him a 99% on his dissertation otherwise. Thanks for airing this–you offer such an important service to us in radio land.

Re. orange juice – what if it is ‘high pulp’ juice? Or if whole oranges (or other fruit) are crushed/blended into a juicy pulp?

During several years of teaching, I have seen school lunches go from healthy to full of processed foods. This, of course, is the cheapest way to serve food to a large group of children. I do not believe it is wise to create the need for sugar, salt and fat in our students who are experiencing at a larger percentage – childhood obesity and onset diabetes at earlier ages.
Our daily “food chain” on the lunch line is breaded meat or pizza, canned fruit (full of syrup), canned vegetables, fruit juice cups and milk (milk is a 1/2 pint containing 18g to 22g of sugar depending on the flavor.)
On the good side, students are offered raw carrots, celery, and sometimes fresh fruit (apples or bananas). We have switched from ice cream to schubert cups.
I think we should start with our most precious resource, children, in cleaning up what we are offering and teaching the next generation to eat.
The doctor is right, but bad food is always the cheapest. How sad.

Isn’t it about time for a national forum on the problems caused by additives such as High Fructose Corn Syrup added to 85% of our food supply? Much like the hearings conducted regarding smoking and cancer, a series of public investigations could lead to warning labels on foods that contain H.F.C.S. and Partially Hydrogenated Fats and are linked to heart disease and diabetes. And why not get Michelle Obama involved since she has joined the fight against diabetes, etc. ?

I enjoyed the show, both my children and I have symptoms that sounded just like what the doctors were discussing. I eagerly went to the website of Dr. Teitelbaum to learn more and take the “free” analysis that he spoke of on the show. But it is a website that looks all too much like the other websites where folks are selling dubious remedies online. And the “free” analysis that is supposedly there–you have to sign up, give them your address, etc. So, how about it, Joe and Terry, do your homework before you let people “advertise” on your show.

Can the fatty liver disease be ‘cured’ with low glycemic diet/exercise??
Is there any hope/help for the non-alcoholic fatty liver disease??
Thank You!

The combination of salt, sugar and fat is now recognized as a powerful addiction comparable to the neurological effects of cocaine -something upon which the fast food operative/dealers count. Every foreign country/culture that has allowed fast foodensteins into their countries to practice their evil corruption (my hostility is possibly showing) has seen a frightening burgeoning of obesity.
The most disturbing aspect of the marketing machines of these companies is the advertising directly aimed at children – to get them addicted while the prospective customer is young while guaranteeing future profits.

How about calling this “sugar” what it really is. High fructose corn syrup. THAT is the problem. Yes, cane sugar is not good for you either, but it less processed. We cut out anything from our diets that contain HFCS, which is in just about everything. We read labels and if it is in it, we don’t buy it, but either make it ourselves or find an alternative product. For sweets, we make our own using cane sugar or don’t eat it. Over the process of doing this, we have found we crave less sweets than in the past and have lost weight.
Now watch the president of the corn refiners association pop in here and defend HFCS. Any time I read any article that even mentions this subject, someone comes running to try and convince people how healthy is it. It’s rather humorous and does more to convince me how bad it is when I see how defensive they get.

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