Sugar - The Elephant in The Kitchen by Robert Lustig (Full Transcript) PDF

Sugar: The Elephant in the Kitchen by Robert Lustig
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Transcript – Robert Lustig, an American pediatric endocrinologist,

discusses Sugar: The Elephant in the Kitchen at TEDxBermuda 2013.
Full speaker bio:
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Robert Lustig – American pediatric endocrinologist
I would like to talk to you right now about perhaps the most over-used and
misunderstood word in the English language: freedom. Freedom has two
parts: freedom from — freedom from oppression, freedom from search and
seizure; and freedom to — freedom to choose.
But freedom to choose has some caveats, has some provisos. The one we
ascribe is called personal responsibility, and that’s an ideology. And there
are some basic principles that we ascribe to personal responsibility, that
is, you have to have knowledge. The five-year old who accidentally shoots
his brother is not guilty, because he didn’t have the knowledge.
Access. We have 57,000 people being thrown off voting rolls right now in
America because of redistricting; they don’t have access. They can’t have
personal responsibility to vote.
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Sugar: The Elephant in the Kitchen by Robert Lustig (Full Transcript) | 1
And finally, affordability. You have to be able to afford your choice, and
society has to be able to afford your choice. An example: In California
we’ve just released 100,000 inmates who are drug addicts. We said, “Drug
addicts have to be locked up.” You know what? We can’t afford it. So,
these are all caveats to personal responsibility.
And then the last one, really important, is that your actions can’t hurt
anyone else, because if they do, then that’s breaking the law. Well, the fact
is, we’ve got a healthcare crisis, and it’s a big one. In fact, Medicare will
be broke by the year 2026. We do not have the money to keep doing what
we’ve been doing. And this healthcare crisis is not due to physician
reimbursements, it is not due to hospital charges, it is not due to
infrastructure, or administration. This healthcare crisis is due to chronic
metabolic disease. That’s where the money’s going. $245 billion last year
in America for diabetes. $200 billion for dementia, another chronic
disease. And Obamacare promises us that we’re going to be able to put 32
million sick people on the rolls, and we’re going to be able to do it by
providing preventative services. Well, guess what? There are no
preventative services for these chronic metabolic diseases. They don’t
exist. The only thing that works is prevention, and we don’t have a
prevention.
So, what does this mean? This means that we’re screwed. The fact is, that
we cannot afford this. Where is this coming from? Well, it’s coming from
this thing called the obesity epidemic, right? Everyone says, “If only these
people could just eat less and exercise more, we would solve this problem;
it’s their fault.” That’s where this comes from.
You know, we have these things called the seven deadly sins. We have
absolved all five of the other sins. We’ve absolved jealousy, greed, wrath,
pride, and lust. In fact, we have TV shows that exhort them. The only two

that we have not been able to get rid of, the only two that still stand are
gluttony and sloth. It’s your fault.
Well, you know what? I’m a pediatrician, and I take care of kids. And I
have a hard time ascribing personal responsibility to their obesity. In fact,
we have an epidemic of obese newborns. Obese newborns. Now, you want
to assign them personal responsibility? I take care of kids with brain
tumors. You can see right here this arrow pointing to a goombah sitting
right in the middle of this patient’s energy balance pathway. A brain tumor
that is causing massive obesity. Let me tell you about two of those
patients.
Here’s a patient that I took care of many years ago. And she had a brain
tumor, and she gained 150 pounds. You can see her here right now at 220
pounds. And we put her on an experimental medication to lower her
insulin level. Remember, insulin is the diabetes hormone, it’s also energy
storage hormone. It’s the hormone that tells your fat cells to take up extra
energy. There is no weight gain without insulin. And we knew that these
patients had very high insulin levels. So we gave her a drug to drop her
insulin in an experimental fashion.
A week later, the mother called me up, the kid hadn’t lost any weight yet,
and she says, “Doctor Lustig, something’s going on here.”
I go, “How do you mean?”
“Well, we would go to Taco Bell, and she would eat five tacos and an
Enchirito, and she’d still be hungry. We just went to Taco Bell and she only
ate two tacos, and she was full. And she just vacuumed the house!””
I go, “Really? Isn’t that interesting.”
In fact, we did this many times, and the exact same thing happened. And
here she is, one year later having lost 48 pounds, and feeling much better

about herself, as you can imagine.
Now the next patient I’m going to show you isn’t even my patient. This is a
beautiful 13 year old girl who lives in Hawaii. Notice the lily in her hair.
And one month after this picture was taken, she was in a car accident, and
she stroked her hypothalamus, that area of the brain where that tumor
was for the other patient. And this is her, one year later. Now, does
anyone really want to tell me that this is personal responsibility? That this
was this young girl’s fault? Well, I was giving grand rounds at Kaiser,
Honolulu, and they said maybe we should put this girl on this same drug.
And there I am with her.
And her mother said, “Yes, go ahead and try.” And here she is one and a
half years later at her high school graduation. Now, does anybody really
want to make the argument that this is this kid’s fault? I have a hard time
with that. In fact, what we learned from these experiments is that the
behavior is secondary to the biochemistry. When you fix the biochemistry,
the behavior improves, and we’ve seen it now in adults as well.
So, everyone says the behavior’s the problem. No, it isn’t. The
biochemistry underlying is the problem. Well, so now you say to me, “What
about the rest of us? We don’t have brain tumors.” Well, in fact, it’s the
exact same problem. Nothing’s different. All of us now have insulin levels
three times higher than we used to. And the question, of course, is where
did that come from? Who here in the audience has diabetes? Anybody?
Must be a few of you, because diabetes is a pretty big problem here.
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Here’s the problem: seven out of eight of you, seven out of eight people
with diabetes don’t even know they have it. You are blind to diabetes, until
you become blind from diabetes. So you don’t even know you have a
problem yet.
So here’s the way to look at this. Here is the American population: 30%
obese, 70% normal weight. The standard mantra is, “It’s the obese
person’s fault because 80% of those obese people are sick. They have type
2 diabetes; they have hyperlipidemia; they have cardiovascular disease;
they have hypertension; they have cancer; they have dementia; and they
are breaking the bank. Those 80%, those 57 million people, if we could
just get them to diet and exercise, we could solve this problem.” That’s the
standard mantra; this is incorrect. Because 20% of those obese people are
actually metabolically healthy. They will live a completely normal life, die
at completely normal age, not cost the tax payer a dime. They’re just that.
Conversely, up to 40% of the normal weight population have the exact

same diseases. They get type 2 diabetes, they get hypertension, they get
dyslipidemia, they get cardiovascular disease. And you know what? They
don’t even know they have a problem. When you add them up, it’s more
than half the US population. In other words, this is a public health crisis.
Here is an example of how that works. Here are two people of equal
weight: one’s healthy, one is sick. Want to take a guess which one the sick
one is? Can you tell? I can tell. The one in the bottom is sick; why? The guy
on the top, he’s just got big love handles. The guy in the bottom has got fat
all around his organs, and that is what’s making him sick. And this is
called TOFI; T-O-F-I. Thin on the outside, fat on the inside. I venture to
guess there are a few TOFIs in the room right now, and you think you are
just fine, and you are not.
So let’s talk about the last public health crisis that we experienced. HIV;

remember HIV? 1979, patient Zero. 1981; the term AIDS got coined. 1986,
Everett Koop said, “You know, we’ve got a problem.” When did HIV
become a public health crisis? 1991. Why? Because Magic Johnson got
HIV. And everybody said, “Holy — this could happen to me.” This really is
something where everyone is at risk. Because it’s not a behavior, it’s an
exposure.
So the question is, how do we resolve this? Well, here’s the problem; it’s
on this slide, right here. This is Coca Cola’s beating obesity campaign,
‘Coming Together.’ “Beating 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.” A
calorie is a calorie, and you can get your calories from carrots, or you can
get your calories from cheesecake, you can get your calories from Coca
Cola, or anything else with a “C” for that matter. It doesn’t matter where
the calories come from, it’s, “a calorie is a calorie”, that’s what they say.
Well, you know what? I don’t believe in common sense. I believe in data.
And the data say something else entirely. What the data say is some
calories cause disease more than others, because different calories are
metabolized differently, because a calorie is not a calorie. And when you
believe that a calorie is not a calorie, a whole world opens up, and
actually, how to fix this problem becomes very clear.
This is because of our new diet. It is 40 years old now. It is called “the
Western diet”, it is called “the industrial global diet”, and it is basically the
processed food diet. And everyone of you is eating it all the time, whether
you like it or not.
And there are eight things wrong, not one, but eight things wrong with
processed food, and here they are. Three thing too little, five things too
much. Not enough fiber, not enough omega-3 fatty acids, which you get

from wild fish not farmed fish, not enough micro-nutrients, all the vitamins
and minerals. In addition, too much trans-fats, but we know that they’re
coming down, branched-chain amino acids; they’re amino acids you get in
corn-fed beef, chicken and fish, omega-6 fatty acids in seed oils, alcohol,
and finally, the big kahuna, the one that blows all the other seven out of
the water, sugar. Sugar, okay? We’re going to talk about that for the rest
of the time.
Does sugar cause diabetes? Everyone says, “Well, yeah, but it’s because of
the calories.” Sugars are empty calories, that’s the mantra. It is not; this is
absolutely not true. Sugars are ‘toxic calories’. In fact, studies from
Europe show that if you consume one soda per day, your risk for diabetes
goes up 29%, irrespective of the calories, irrespective of your weight,
irrespective of anything else you eat. We’ve shown that for every 150
calories the world consumes, diabetes prevalence goes up a total of 0.1%,
which is nothing. But if those 150 calories happen to be a can of soda,
diabetes goes up 11 fold. 1.1%, and we’re not consuming one can of soda,
we’re consuming two and a half. So 29% of all the diabetes in the world is
due to sugar, and sugar alone. This study actually satisfies both the
scientific and legal criteria for proximate cause. You have to be able to
show that something causes something else before you can do something
about it. Well, we’ve proven it; we’ve shown it. It’s shown here as well;
same thing.
Now, the question is, why does this happen? Number one: sugar causes
liver fat accumulation. All that fat around the organs that I just showed
you? For sure, that’s what that did. And that’s not love-handle fat, that’s
inside you.
Number two: sugar’s addictive. Weakly so, but it’s everywhere, it’s like
alcohol. And about 20% of people are addicted to alcohol, probably about
the same for sugar. So you can’t stop. So this slide over here shows the
prevalence of diabetes worldwide as we speak right now. Who’s worst?

Saudi Arabia, Kuwait, UAE, Qatar, and Malaysia. The worst. Why them?
No alcohol. But they’ve got soft drinks like they’re going out of style.
Because it’s hot, and the water supply’s a question mark, and no alcohol.
This is their reward. But you know what, I’d rather have alcohol. Because
you can only drink yourself under the table once a day. But for soft drinks;
all day, all night. Sugar in the morning, sugar in the evening, sugar at
supper time. That’s what we’re seeing.
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So, we’ve been overdosed. The American Heart Association says we should
be consuming six to nine teaspoons of sugar per day; we are up to 22. And
80% of foods that are available in the American grocery store today are
spiked with added sugar. And that’s for the food industry’s purposes, not
for yours. So, no access. You don’t have access because it doesn’t exist.
Real food is hard to find.
Number two: How about that there are 56 names for sugar, so you don’t
even know what you’re consuming. And here there are. No knowledge.
And how about this? Everybody knows what a “Nutrition Facts” label is.
There’s a number over there in the purple. It’s called the dietary value.
Notice, there’s none for sugar, and that’s on purpose because they don’t
want you to know how much is too much. So, no knowledge.
How about the National School Lunch Program? Six cents extra. Six cents,
Michelle Obama got out of Congress. That’s not even enough for two
grapes. And, if you are eating school breakfast, you’re getting Fruit Loops
and a glass of orange juice. That’s 11 teaspoons of sugar; you’re already
over your limit. You want to know why we have a problem? This is why we

have a problem.
So everyone says, “Education!” “Educate the public, educate the populace,

tell them what’s going on!” Except for one thing: education hasn’t worked
for any other substance of abuse. Did Nancy Reagan’s “Just Say No” work?
Really? And you know what? I can prove that it doesn’t work because here
is the stock prices against the S&P 500 for McDonald’s, Coke, and Pepsi,
and look at what happened at the economic downturn in 2008. They did
very well, thank you. In fact, if you want make money, invest in a food
company.
So, where does that leave us? It leaves us with this question of freedom
and personal responsibility. What does personal responsibility really
mean? Well, if the information is kept secret and you don’t have
knowledge, if your access is limited because you can’t even find it, and if
society can’t afford it, and we can’t even give our kids something healthy
to eat, is it really personal responsibility?
And lastly, if your decision to drink a soda lands you in the emergency
room, and costs me dollars, and if your decision to be fat and sick costs
your employer $2750 per employee, whether you’re obese or not, you
know what that is? That’s not called freedom, that’s called anarchy. That’s
what we’ve got.
So the libertarians say, “Wait a second; don’t tell me what to eat!” Well,
you know what? You’ve already been told what to eat. Where were you for
the last 40 years as your food supply was being changed under your nose.
Were you protesting then? The libertarians say, “Get government out of
my kitchen!” You know, I don’t want government in my kitchen either,
unless there’s somebody more dangerous already there.

So the real question is, who the hell do you want in your kitchen? The
government, who will take your freedom and your wallet? Or the food
industry, who has already taken your freedom, your wallet, and your
health? That’s your only choice.
Now, having said all this, the food industry is composed of a lot of people,
and you know what? They really want to do the right thing, they do.
Individually, they would actually like to do the right thing. And I have met
with these people, and they are actually very nice people, but, they work
for a food company.
And contrary to what the Supreme Court says, corporations are not
people. Because corporations have a fiduciary responsibility to their
stockholders, and people don’t. Corporations get three month profit
cycles, and Wall Street earning reports. And they have to make those
reports. So I’ve met with the food industry, and I will tell you about one
story, which will remain nameless. They told me very straight out, ten
scientists, ten corporate executives, they said, “You know, we can change.
We’ve changed before. We had to change back in the 80s when we went
low fat, with two provisos; we won’t go it alone, and we can’t lose money.”
Those are two non-starters today.
So what does that mean? That means that they have to be told what to do,
and they have to do it all at the same time so that there’s no competitive
disadvantage. What does that mean? That means government. But
governments are complicit and complacent. They’re getting paid off. Over
half of Congress takes money from the food industry. And 6% of our
exports are food.
What do you think what happen if all of a sudden we’ve told the entire
world, “You know, all that shit we put in food? It really isn’t so good for
you.” What happened when that one downer cow went from Canada to
Washington state? That was at the end of meat sales to Britain and South

Korea for two years. So, they’re on the other side. But we’ve got a crisis,
because we will not have healthcare.
So here is a report that just came out from an investment bank, an

international investment bank, Credit Suisse, called Sugar Consumption at
a Crossroads, and this is a direct quote from this tome: “We believe higher
taxation on sugary food and drinks would be the best option to reduce
intake and fund the healthcare costs associated with diabetes and
obesity.” An investment bank is calling for taxation. That’s how big and
bad this problem has gotten.
I believe food should confer wellness, not illness, and it used to. But you
know what? This is a public health crisis, and you cannot solve public
health crisis one person at a time. Here is a list of diseases that were all
personal responsibility issues, except for the sheer gravity of each of them,
became a public health crisis. Why don’t we add sugar to the list?
Personal responsibility isn’t ideology. It’s the elephant in the kitchen, and
we can’t afford it. What we need is a policy based in biology. And it’s got a
name. It’s called real food. And the only way you can solve this is by
kicking that elephant out of the kitchen.
Thank you.
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Sugar: The Elephant in the Kitchen by Robert Lustig

Transcript – Robert Lustig, an American pediatric endocrinologist,

Full speaker bio:

Robert Lustig – American pediatric endocrinologist

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I go, “How do you mean?”

I go, “Really? Isn’t that interesting.”

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about herself, as you can imagine.

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Conversely, up to 40% of the normal weight population have the exact

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ALSO READ: Howard Martin: Engaging The Intelligence of the Heart

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So everyone says, “Education!” “Educate the public, educate the populace,

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So here is a report that just came out from an investment bank, an

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