21 Comments

  1. Kathy
    In the article, Dr. Lustig says he is 45 lbs. overweight. So I'm curious: Have you ever tried to persuade him to try LCHF?
    Reply: #2
  2. Kjell Granelli
    Kathy, that's a very good idea! I just wrote an e-mail to Dr. Lustig, recommending him to try LCHF.
  3. bill
    Again, just look on page 69 of Lustig's book, Fat Chance.

    He says he cannot figure out how to lose the 45 pounds
    that he gained in his residency.

    If he doesn't know about LCHF, he's more dense than
    even I thought he was.

  4. tony
    Dr. Lustig's great message about the perils of sugar is lost by his refusal to adopt LCHF, which would slim him down, making him more credible.
  5. Paul the rat
    @ bill,
    I totally agree bill, Lustig, for some unexplained reason, can not make the final connection. (or the primary connection for that matter)

    Keep the levels of blood glucose down folks, keep them down.

    J Endocrinol Invest. 2014 May 24. [Epub ahead of print]

    Oscillating high glucose enhances oxidative stress and apoptosis in human coronary artery endothelial cells.

    Liu TS1, Pei YH, Peng YP, Chen J, Jiang SS, Gong JB.
    Author information

    Abstract
    PURPOSE:
    To investigate the toxic effect of oscillating high glucose (OHG) versus persistent high glucose (PHG) in inducing oxidative stress and cellular apoptosis in human coronary artery endothelial cells (HCAECs) in vitro.
    METHODS:
    HCAECs were incubated for 72 h continuously in normal glucose (5.5 mmol/L glucose), PHG (25 mmol/L glucose), OHG (5.5 mmol and 25 glucose mmol/L alternating every 6 h) and mannitol, respectively. Cellular viability, concentration of oxidative stress biomarkers (MDA and GSH) in the supernatants of cell culture, and intracellular ROS level were quantitated after exposure to different concentrations of glucose for a total 72 h. Apoptosis of HCAECs cultured with various glucose levels was evaluated by annexin V-FITC and PI staining followed by analysis with flow cytometry. The expressions of HO-1 and Nrf2 were measured by RT-qPCR and Western blotting at the end of the experiment.
    RESULTS:
    HCAECs cultured with PHG showed decreased cellular viability compared to those with normal level of glucose (p < 0.05). The decrease was more pronounced under OHG condition (p < 0.05). Cellular oxidative stress was provoked in HCAECs exposed to PHG with marked increased MDA level, reduced GSH concentration and elevated ROS production (p < 0.05). The stress was further amplified in the setting of OHG (p < 0.05). The cellular apoptosis was enhanced by culturing with PHG, and to a greater extent when incubated with OHG. Both expressions of HO-1 and Nrf2 were suppressed in HCAECs in persistent hyperglycemia condition, while the inhibition was more intense in the fluctuating hyperglycemia condition (p < 0.05).
    CONCLUSIONS:
    These findings indicate that OHG could be more detrimental to HCAECs than PHG. This is probably due to the enhancement of oxidative stress and cellular apoptosis induced by frequent glucose swings through the inhibition of Nrf2/HO-1 pathway.

  6. Paul the rat
    So called physiological range of blood glucose does similar damage - one does not have to be diabetic.

    Exp Gerontol. 2014 Aug 19. pii: S0531-5565(14)00244-7. doi: 10.1016/j.exger.2014.08.008. [Epub ahead of print]

    The mitochondrial O-linked N-acetylglucosamine transferase (mOGT) in the diabetic patient could be the initial trigger to develop Alzheimer disease.

    Lozano L1, Lara-Lemus R2, Zenteno E1, Alvarado-Vásquez N3.
    Author information

    Abstract
    Diabetes mellitus (DM) is considered a risk factor for the development of Alzheimer disease (AD); however, how DM favors evolution of AD is still insufficiently understood. Hyperglycemia in DM is associated to an increase in mitochondrial reactive oxygen species (ROS) generation, as well as damage of hippocampal cells, reflected by changes in morphological and mitochondrial functionality. Similar mitochondrial damage has been observed when amyloid beta (Aβ) accumulates in the brain of AD patients. In DM, the excess of glucose in the brain induces higher activity of the hexosamine biosynthesis pathway (HBP), it synthesizes UDP-N-acetylglucosamine (UDP-GlcNAc), which is used by O-linked N-acetylglucosamine transferase (OGT) to catalyze O-GlcNAcylation of numerous proteins. Although O-GlcNAcylation plays an important role in maintaining structure and cellular functionality, chronic activity of this pathway has been associated with insulin resistance and hyperglycemia-induced glucose toxicity. Three different forms of OGT are known: nucleocytoplasmic (ncOGT), short (sOGT), and mitochondrial (mOGT). Previous reports showed that overexpression of ncOGT is not toxic to the cell; in contrast, overexpression of mOGT is associated with cellular apoptosis. In this work, we suggest that hyperglycemia in the diabetic patient could induce greater expression and activity of mOGT, modifying the structure and functionality of mitochondria in hippocampal cells, accelerating neuronal damage, and favoring the start of AD. In consequence, mOGT activity could be a key point for AD development in patients with DM.

  7. Charlie
    Lustig is not really for low carb he is a main stream doctor just on a crusade against HCFS and added sugar that were the academia money is and were his peer are. His message is just a distraction to the real problem of the modern diet. Yes reducing added sugars and HCFS is a good think but like he can personally demonstrate by his weight problems is not the solution to the modern diet ills.
  8. Christopher Miles
    It seems that Dr. Lustig's weight is a point alot of people like to point out, but being overweight does not make one unhealthy. Also, being skinny or lean does not make one healthy.
    Reply: #12
  9. erdoke
    I bet he does understand that starch is a polymer of glucose (well, actually a blend of two different polymers). Glycemic Index and Glycemic Load were invented many years ago.
    I guess he's been trying not to end up in the low carb corner for some reason. Maybe he believes that the current establishment can only be changed one step at a time.
    Reply: #11
  10. Tyrannocaster
    Lustig's writing is GREAT...if you only consider him as a critic of sugar. His remarks on sugar are spot on, IMO. However, somehow he seems to have missed the rest of the picture and I don't really understand how he managed to do this; surely he's got to be aware of how other carbs play out in the body. The only thing I can come up with is that he knows but he simply chooses not to eat in a manner that will allow him to lose weight - perhaps he is one of those "I CAN'T GO WITHOUT TOAST" [fill in your own carb there] people. Or perhaps there is a medical reason which he doesn't discuss, in which case we are acting like idiots. Everybody has the right to eat they way they want AFAIC, even if it doesn't agree with what I happen to support.
  11. Boundless
    > I guess he's been trying not to end up in
    > the low carb corner for some reason.

    There's a cliche that goes "if you don't know where you're going, you'll probably end up somewhere else". A direction named "away from sugar" is clearly not in any clear direction.

    Another sugar antagonist (Richard J. Johnson, The Fat Switch) has a similar problem with "so what we do eat instead". I suspect their training, or rather the lack thereof, creates a how-could-diet-matter mentality, plus going low carb implies going high-something-else, and high fat is counter to the prevailing loopy lipid dogma.

    So they haven't connected the dots, and to be fair, there are a LOT of dots to connect. Those making the effort to connect them all are finding that they have to make recommendations that are subject to revision as new data arrives. Some, like Dr. Davis (Wheat Belly) seem willing to do this. Others are unwilling to be mistaken and either don't step out of their focus, or follow the party line when they do..

  12. bill
    "...Lustig's weight is a point alot of people like to point out..."

    No, no, Lustig is the one who points out his weight. That's a big
    difference from your statement. Lustig also points out that he
    has a bagel for breakfast. Understand? Lustig points these
    things out.

    He must sort of zone out when onstage with
    people in the LCHF community, such as Dr Eenfeldt. From
    seeing him in various places that LCHF is discussed, he has
    had ample opportunity to learn about it and understand it.

  13. murray
    If you'll permit me to play the role of the carb-devil advocate I'd submit the following.

    Lustig has made a tactical decision to attack added sugar and just added sugar. He has plenty of clinical experience to demonstrate orange juice, for example, in the quantities consumed has a qualitatively different effect than other calories. There is plenty of other evidence with respect to added sugar specifically to challenge the troglodytes who insist on "tier one" studies before doing anything to upset vested interests. So this is as clear a breach in the the all-calories-are-equal rampart that would could work with to initiate change.

    As my Montreal partners sometimes say, it is best not to cut whiskey with water. Go with your strongest point and do not dilute it with other points that could be more easily put in doubt.

    Lustig is no fool. The Atkins stigma still predominates. If he promotes LCHF he would be cast as an Atkins avatar and likely get nowhere.

    I even wonder if Lustig keeps his extra weight in order to keep his campaign qualitatively distinct from LCHF in order to advance the overall health cause. Now that would be genuine conviction. We should laud him for his sacrifice, having to eat those awful bagels to keep from being branded a low-carb fanatic.

    Reply: #19
  14. Randal L. Schwartz
    I still find his artificial distinctions between "natural" and "added sugar" and "fructose" vs "glucose" to be a bit amusing. For most people, it's total carb load, and doesn't matter whether it's blueberries or HFCS soft drinks… once insulin is triggered… the game is lost.
  15. greensleeves
    Lustig himself admits he is addicted to wheat & can't kick his bagel habit. He knows he's an addict, and he's failed trying to go cold-turkey. So why yell at him? Why not offer him a better plan for kicking his wheat addiction?

    As for why he fights against sugar only, he himself has stated that low-carb will get the funding doors slammed in your face, which is exactly why Taubes had to seek private funding. Lustig has a large lab at UCSF and he needs to stay in the mainstream to fund it. So he stays on topic and avoids low-carb.

    It's the reality of funding, that's all.

    Replies: #16, #17
  16. Boundless
    > It's the reality of funding, that's all.

    Thomas Seyfried (Cancer as a Metabolic Disease) also spent several minutes on this problem in his recent interview with Jimmy Moore.

    Funding sources claim to want researchers to "think outside the box", but won't fund anyone who does (and this is an entirely separate problem from funding sources with industry ties, who do not want to fund anything that might result in people not buying their "foods" or taking their meds).

  17. bill
    "So why yell at him? "

    Who's yelling?

  18. Charlie
    Is all about the money. You are either with the rest of your peers with the accepted unanimous idea that HCFS and added sugars are evil. So you get invited to conferences, to talk on mainstream media and get funded or you are marginalized for being too controversial by proposing what amount to a high fat diet.
  19. Boundless
    > I even wonder if Lustig keeps his extra weight in order
    > to keep his campaign qualitatively distinct from LCHF
    > in order to advance the overall health cause.

    Sorry, but that doesn't really add up. We could start with the cliche
    "don't take dietary advice from fat people".
    A recent visibly overweight Acting Surgeon General in the US was an example. The OSG (Office of S.G.) recommends the standard USDA MyPlateOfMetabolicSyndrome. Just what does dietary advice mean when delivered by someone who is not an example of target health?

    * The advice doesn't actually work?
    * The advice is too hard to follow (compliance)?
    * The advice doesn't work for some people, like the spokesperson?
    * The advice is only for the masses, and not the elites?

    Critical thinking is pretty rare in this world, and if someone isn't an example of what they advocate, and they don't have a convincing story explaining why, it's all too easy for ad hominem to arise. I could even see it affecting grant decisions.

    Lustig could choose to quietly go paleo, LCHF, etc.

    I suspect, as with most conventional MDs and nutritionists, the problem might be that LC implies high something else, and high fat is still anathema to consensus medicine and nutrition, high protein is viewed with suspicion, and optimized gut biome isn't even on their radar yet.

  20. Joe Obrocki
    Speaking of gut biome, new study finds artificial sweetener may cause glucose intolerance. I think it wasn't so much the reduction of fat in our diet but the increase of artificial sweeteners that caused the spike in obesity. The study below may explain why.

    Of Mice and Men's Guts

    In the new study, the team began by adding one of three FDA-approved artificial sweeteners—saccharin, sucralose, or aspartame—to the drinking water of mice. The researchers compared these groups of mice with others that drank only water. Within 11 weeks, the mice drinking sweetened water had developed glucose intolerance, most notably when saccharin was added to their diet.

    To see whether the mice's intestinal bacteria contributed to the problem, the team then used antibiotics to wipe out the mice's intestinal bugs and found they could return the mice's blood sugar levels to normal.

    Finally, they fed fecal samples from glucose-intolerant mice to normal mice, transferring the unhealthy mice's gut bugs. The normal mice that got these fecal samples then developed glucose intolerance within six days.

    Analysis of mouse gut bacteria after the experiments found a proliferation of the bugs involved in digesting carbohydrates in the glucose-intolerant mice. (Carbohydrates are found in breads, cereals, and other foods in the human diet.)

    "I think this is surprising," Elinav says. He calls it "counterintuitive" that artificial sweeteners, which are not meant to be absorbed by the digestive tract, end up apparently altering its performance.

    To see if the effect extends to humans, the team first looked at 381 people in a nutritional study headed by Segal. They found links between artificial sweetener use, symptoms of obesity and elevated blood sugar, and the kinds of altered gut bacteria seen in the mice.

    In particular, the study noted a 20-fold increase in the numbers of Bacteroides fragilis bacteria, linked to inflammation in the gut.

    Finally, as a proof of concept, the team enrolled five adult men and two adult women who didn't use artificial sweeteners in a one-week experiment. In the experiment, the volunteers ate the FDA's recommended allowance of saccharin, about 120 milligrams daily; they had their blood sugar levels checked every five minutes and underwent a daily glucose tolerance test.

    "Notably, even in this short-term seven-day exposure period, most individuals (4 out of 7) developed significantly poorer glycemic [blood sugar] responses," says the study. Normal mice fed fecal samples from the four human volunteers with glucose intolerance developed the same condition.

    Along with a historical shift toward processed foods over the past century, the move toward artificial sweeteners "coincides with the dramatic increase in the obesity and diabetes epidemic," the study concludes. "Our findings suggest that [artificial sweeteners] may have directly contributed to enhancing the exact epidemic they themselves were intended to fight."

    Microbiome Mystery

    "This study reinforces the idea that what we eat directly influences our gut microbiota, which, in turn, is intimately linked to many facets of our health," says Stanford University microbiologist Justin Sonnenburg. He called for closer examination of the results, pointing to the uncertainty over the mechanism behind the changes in the gut bacteria seen in the study. (Related: "The Quantified Microbiome Self.")

    For starters, when people eat artificially sweetened foods, only milligrams of the sweetener ends up in their gut, compared to most of the sugar eaten in normally sweetened foods, notes Stanford University's Christopher Gardner, another co-chair of the 2012 AHA/ADA artificial sweetener safety review. If the gut bacteria are eating artificial sweeteners, then very small amounts of the material seem to have a disproportionately large effect on the community of microbes, he says.

    The missing piece in the study is a mechanism for the artificial sweeteners to directly spur a population boom in some gut bacteria and a population bust in others.

    The researchers acknowledged that they don't understand how artificial sweeteners would stimulate the growth of potentially harmful intestinal bacteria. It's possible, but untested, that the sweeteners may change conditions in the gut in some way that spurs the growth of the microbes, even if the microbes are not eating the additives.

    Elinav says the results also point to the very individual nature of how people respond to changes in diet, noting the three out of seven people whose blood sugar remained unaffected in the last part of the study.

    "Eventually, we may be moving toward an era of personalized nutrition," he says, where individuals' diets are tuned to their digestive tract's tendencies. (Related: "Discovering My Microbiome.")

    Personalized nutrition, like personalized medicine, is a hot topic among health experts, says Wylie-Rosett, but there are fairness issues to consider: "We want to see we don't move toward an era of diet haves and have-nots. Obesity, unfortunately, has a larger effect on the have-nots."

  21. Kenguru
    Sugar is absolute and paramount poison in modern society. Got rid of it in my life, and never regretted a second. In five years caught flew only once.
    Cut complex sugars, aka carbs and add Vitamin D in the form of sunshine and you will start losing weight like crazy.

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