Dr. Robert Lustig Links Fructose to Cellular Damage and Obesity

罗伯特·卢斯蒂格博士：果糖与细胞损伤及肥胖相关 膳食添加糖作为一种代谢毒素，无论总热量摄入多少，都会损害线粒体能量生成并诱发胰岛素抵抗。 罗伯特·卢斯蒂格博士指出，现代代谢健康问题与肥胖源于加工食品及添加糖（尤其是果糖），而非单纯的热量失衡。他阐释了果糖如何作为一种肝毒素诱发胰岛素抵抗、损害线粒体功能，并改变大脑化学机制以加剧成瘾和压力。为应对这些影响，卢斯蒂格强调必须食用富含纤维的天然全食物、减少内分泌干扰物，并解决社会层面的系统性问题，而非单纯依靠个人意志力。 肥胖与代谢疾病危机的根源在于现代食品环境，而非个人意志力或单纯的卡路里摄入失衡；每天仅喝一杯含糖饮料就会使糖尿病风险增加29%。 (0:00) 快感由多巴胺驱动且极易引发耐受与成瘾，而真正的幸福感由五羟色胺介导，过度追逐快感反而会抑制五羟色胺，导致抑郁与不快乐。 (3:34) 人体没有摄入果糖的生物学需求，过量果糖在肝脏中的代谢途径与酒精几乎完全相同，且会抑制AMPK、ACADL和CPT1等关键线粒体酶，直接破坏细胞能量生成。 (11:08) 无糖饮料并非健康替代品，其甜味会诱发头期胰岛素分泌，并破坏肠道微生物屏障引发内毒素血症；其毒性大约相当于全糖饮料的一半。 (27:12) 有效减重与逆转2型糖尿病的核心在于降低基础胰岛素水平，解除胰岛素对下丘脑瘦素信号的阻断，而非依赖限制卡路里摄入。 (40:47)

Pediatric endocrinologist Dr. Robert Lustig contends that the global obesity and chronic disease crises stem from biochemical dysregulation driven by dietary sugar and ultra-processed food, rather than a lack of personal willpower or simple caloric excess. Sugar and the Flaw of Calorie Counting (35:17) Dr. Lustig argues that calories are an inadequate metric for nutritional health because different substrates act differently at the cellular level. While glucose is an essential fuel synthesized when absent from the diet and supports mitochondrial energy via enzymes like AMPK and HAD, dietary fructose serves no biological requirement and actively damages cellular respiration. Fructose inhibits AMPK, ACADL, and CPT1, blocking fatty acid oxidation and mitochondrial biogenesis. Lustig notes that standard caloric restriction fails 90% of dieters over the long term because it ignores how specific foods alter cellular metabolism. Insulin Resistance and Liver Fat Deposition (63:31) Excess dietary fructose is metabolized in the liver similarly to alcohol, driving intrahepatic fat accumulation. Lustig notes that gaining as little as 0.25 kg of liver fat triggers systemic insulin resistance, whereas subcutaneous fat requires roughly 10 kg of accumulation before leaking inflammatory cytokines, and visceral fat requires roughly 2 kg. Liver fat drives the pancreas to overproduce insulin, which blocks brain leptin receptors in the hypothalamus, blinding the brain to satiety and creating hunger signals that mimic starvation. Pediatric Metabolic and Behavioral Trials (18:29) To demonstrate that sugar operates independently of total calories or body weight, Lustig highlights a UCSF clinical trial of 43 children with obesity and metabolic syndrome. Over a nine-to-ten-day intervention, researchers eliminated added sugars while keeping total calories, protein, fat, and body weight stable by substituting complex starches for sugary foods. Despite constant body weight, participants showed marked drops in blood pressure, fasting glucose, insulin, and serum lactate, while parents reported reduced irritability and improved focus following five initial days of acute sugar withdrawal. Commercial Processing and Fiber Removal (86:02) Lustig states that 73% of packaged grocery items contain added sugars under roughly 262 alternative names. Commercial processors deliberately strip dietary fiber from fruits and grains to prevent spoilages and enable freezing, converting perishable food into non-perishable commodities. Stripping fiber deprives the gut microbiome of substrates needed to generate short-chain fatty acids like butyrate, which maintain the intestinal mucin layer and suppress systemic inflammation. Liquid fructose further compounds the issue, with a single daily sugar-sweetened beverage increasing diabetes risk by 29%. Neurobiology of Addiction and Contentment (3:34) Lustig draws a neurochemical distinction between pleasure, driven by excitatory dopamine in the nucleus accumbens, and contentment, mediated by inhibitory serotonin. Chronic dopamine overstimulation causes postsynaptic receptor downregulation, fostering tolerance and addiction while suppressing serotonin. Chronic stress burdens the amygdala, driving fatigue and afternoon sugar cravings. To counter this, Lustig proposes 'The Four C's'—Connect (in-person interaction activating mirror neurons), Contribute (philanthropic giving), Cope (sleep, mindfulness, exercise to reduce cortisol), and Cook (consuming real food rich in tryptophan and omega-3s while minimizing fructose). Lustig concludes that addressing chronic physical, mental, and societal crises requires moving beyond individual blame to structural reform, advocating that food formulations must protect the liver, feed the gut, and support the brain. Acknowledging scientific uncertainty, he emphasizes that medical models progress non-linearly by questioning historical dogma.

儿科内分泌学专家 Robert Lustig 博士指出，全球肥胖与代谢疾病泛滥的根源并非热量过剩，而是食品工业添加的果糖与超加工食品破坏了线粒体能量转换、诱发高胰岛素血症并劫持了大脑奖励中枢。 卡路里假说的破产与果糖的线粒体毒性 (35:17) Lustig 博士主张摒弃以卡路里为核心的营养学范式。在物理测热计中释放等量热量的物质，在人体细胞内具有截然不同的生物化学命运。葡萄糖作为生命必需能量分子，能激活 AMP 活化蛋白激酶（AMPK）以促进线粒体新生，并协同羟酰辅酶 A 脱氢酶（HAD）氧化脂肪酸；而人体对果糖并无生理需求，过量果糖会直接抑制 AMPK、长链酰基辅酶 A 脱氢酶（ACADL）及肉碱棕榈酰转移酶 1（CPT1），阻断脂肪酸进入线粒体燃烧，从而削弱细胞生成三磷酸腺苷（ATP）的能力。 毒理学奠基人 Paracelsus 曾提出“剂量决定毒性”，Lustig 指出果糖在肝脏中的代谢途径与酒精高度一致。成年人肝脏每日安全处理果糖的代谢阈值约为 12 克（约 6 至 9 茶匙添加糖），儿童仅为 4 至 6 克；然而现代人平均每日摄入 50 克果糖（相当于 100 克总糖），这一超载剂量在生化层面等同于每日摄入四至五份酒精，直接诱发非酒精性脂肪肝与全身线粒体功能受损。 胰岛素阻断瘦素与三大脂肪库的代谢分水岭 (63:31) 调节体重的生物学总开关是胰岛素而非摄入的卡路里。当肝脏因转化过量糖分而积聚脂肪时，机体会产生胰岛素抵抗，促使胰腺代偿性分泌更多胰岛素；血液中高浓度的胰岛素会物理性阻断下丘脑对饱腹感信号瘦素（Leptin）的感知。即便体内脂肪细胞已释放大量瘦素，大脑仍误判身体处于极度饥饿的饥荒状态，从而被动引发进食冲动并抑制自发体力消耗。因此，单纯注射外源性瘦素对普通肥胖无效，唯有通过断绝精制碳水和添加糖来压低基线胰岛素，下丘脑才能重新识别能量储备。 人体三大脂肪库的病理阈值存在巨大差异。皮下脂肪属于能量缓冲的安全蓄水池，通常需积累约 10 公斤且脂肪泡破裂后才会释放炎性细胞因子；内脏脂肪受长期压力与皮质醇驱动，累积 2 公斤即引发代谢疾病；而危害最大的肝内脂肪仅需增加 0.25 公斤（半磅），便足以诱导不可逆的代谢综合征与全身胰岛素抵抗。这一机制解释了“外瘦内胖”（TOFI）现象，也解释了为何加州大学旧金山分校（UCSF）在对 43 名代谢综合征患儿进行的试验中，仅在热量与体重完全恒定的前提下去除添加糖 10 天，受试者的血压、血糖、胰岛素及线粒体功能紊乱指标便全线逆转。 多巴胺快感替代幸福诱发神经回路劫持 (3:34) 现代商业社会利用神经递质的混淆操纵了人类心智。快感由兴奋性神经递质多巴胺介导，刺激伏隔核产生短暂、以获取为核心的躯体刺激；真正的幸福则由抑制性神经递质血清素驱动，带来平静、利他与持久的心灵满足。多巴胺神经元极易因过度兴奋而损伤凋亡，为实现自我保护，突触后膜会下调多巴胺受体数量，迫使个体需要更强烈的刺激才能获得同等兴奋，演变为耐受与严重成瘾；更为关键的是，高水平多巴胺会反向抑制血清素通路，形成“越追求快感就越深陷抑郁”的恶性循环。 现代超市中高达 73% 的加工食品被蓄意添加糖分，精准利用了果糖刺激伏隔核的成瘾潜能。当个体面对生活慢性压力时，杏仁核与海马体的代谢需求激增，驱动大脑在午后或疲倦期向身体下达紧急补充 ATP 的生理指令，使人本能渴望甜食。这种暴食并非道德滑坡或意志力软弱，而是神经奖励系统在生物化学层面遭遇商业化劫持后的下游病理反应。 超加工食品的剥离骗局与系统性干预必要 (82:20) 从生物学定义审视，真正的食物必须同时满足“支持机体生长”与“促进能量燃烧”两项指标，而超加工食品两者皆违背，其实质并非食物而是慢性格局的代谢毒物。现代食品工业为了便于长途物流运输、延长保质期并将农产品转化为可交易的大宗期货商品，普遍采用“榨汁并冷冻”等工艺彻底剥离天然膳食纤维。这种改变使现代人日均纤维摄入量骤降至约 12 克，远低于祖先的 50 至 100 克水平，直接剥夺了 100 万亿肠道微生物的养分来源。 当肠道菌群缺乏可溶性纤维制造丁酸盐等短链脂肪酸时，细菌便会侵蚀肠壁黏蛋白层，破坏紧密连接与免疫屏障，造成肠漏现象并导致内毒素入血引发慢性系统性炎症。Lustig 强调，个人责任论在应对烟草、过量饮酒等成瘾且有毒的物质危机时历史上均告失败，超加工食品同样需要立法干预。正如英国政府在 2003 年与零售巨头达成的三年不公开隐形减盐计划最终使中风与高血压发生率骤降 40%，重塑公共健康必须依赖“保护肝脏、滋养肠道、支持大脑”的新代谢矩阵对工业生产端进行强制性重组。 Lustig 博士认为解决公共慢性疾病危机的核心在于修复现代人过度激活且失控的杏仁核，个体可通过面部互动的“连接”、利他的“奉献”、调控压力的“应对”以及富含色氨酸与欧米伽-3的真实“烹饪”（4C原则）重建神经内分泌平衡。作者同时承认科学进步是在推翻既往教条中螺旋演进的，当代医学与公共政策亟需摆脱以往孤立计算卡热量的教条，将重心彻底转移至线粒体生物化学机制及全链条食品环境的系统治理。

## Background 本期节目于2024年5月16日发布在YouTube频道《The Diary Of A CEO》，由主持人斯蒂芬·巴特利特（Steven Bartlett）主持。视频围绕儿科内分泌学专家、畅销书作者罗伯特·卢斯蒂格（Robert Lustig）博士的研究展开，深入探讨了糖分对人体健康的破坏性影响、食品工业对大众神经与消费心理的操纵，以及为何传统的“计算卡路里”理论是当代医学与营养学中最大的误区。 ## TL;DR 卢斯蒂格博士在对话中彻底颠覆了“卡路里即卡路里”的传统观念，指出驱动肥胖、2型糖尿病及慢性病大流行的核心根源是添加糖（特别是果糖）与超加工食品。他通过生物化学机制详细拆解了果糖与酒精完全一致的肝脏毒性通路，并揭示了高胰岛素血症如何在大脑下丘脑中强行屏蔽瘦素的饱腹感信号，导致机体陷入不可控的饥饿与暴食。节目进一步曝光了食品工业数十年来收买学界掩盖真相的内幕，剖析了无糖代糖饮料的胰岛素陷阱、环境致胖因子的受体劫持以及剥离膳食纤维对肠道屏障的毁灭性打击。最终，卢斯蒂格倡导回归“保护肝脏、滋养肠道、支持大脑”的真食物饮食原则，并提出了通过联结、奉献、应对与烹饪（4C法则）来平抑多巴胺、激发血清素并重获内在满足感的系统解法。 ## Atmosphere & style 整场对谈兼具实验室级别的精密生化剖析与法庭辩论般的凌厉控诉，充盈着揭露时代谎言的紧迫感与正义张力。卢斯蒂格博士言辞犀利、直率激昂，频频用充满画面感的尖锐比喻拆穿工业营销的遮羞布，而主持人巴特利特则以极其真实的困惑与求知欲步步追问，使硬核医学知识与普通人的生活困境紧密咬合。节目随着话题从线粒体酶系统延伸至全人类的杏仁核失调与文明危机，情绪层层递进，既有震撼人心的认知颠覆，又洋溢着关怀弱势群体的医者仁心与理性自救的温和力量。 ## Bulletin - [00:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=0s) 儿科内分泌学家罗伯特·卢斯蒂格指出，超市中高达 73% 的加工食品均被人为添加了额外的糖，每天仅喝一罐含糖饮料便会使 2 型糖尿病风险增加 29%。 - [36:29](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2189s) 传统“卡路里就是卡路里”的理论在生物学上完全失效；果糖在线粒体中会抑制 AMPK 等关键酶并阻碍 ATP 生成，其代谢负担及毒性与酒精如出一辙。 - [29:16](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1756s) 代糖虽然零热量，但会通过“头期胰岛素释放”反射性推高胰岛素分泌，并破坏肠道黏蛋白屏障诱发全身慢性炎症，“危害减半”绝不等于健康。 - [01:11:47](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4307s) 环境致胖物（如 PFAS、BPA、增塑剂等）作为内分泌干扰物，无需摄入热量就能直接诱导脂肪细胞增殖，迫使全人类面临前所未有的代谢紊乱。 - [01:42:09](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6129s) 基于神经生化机制，卢斯蒂格提出重建身心满足感的“4C”法则（联结、奉献、应对、做饭），以降低多巴胺与皮质醇、提升血清素并修复失控的杏仁核。 ## Key takeaways - [01:58](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=118s) 商业社会系统性地将多巴胺驱动的瞬时“快感”偷换成了血清素驱动的持久“幸福”，而多巴胺的过度刺激会直接下调受体并抑制血清素，导致全球性抑郁与成瘾。 - [12:08](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=728s) 人体生理运转虽然离不开葡萄糖，但肝脏能自行糖异生合成，而日常白糖中绑定的果糖在生理上完全非必需，其代谢全压在肝脏上，过量即产生类似酒精的毒性。 - [18:51](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1131s) UCSF 临床试验显示，仅剔除饮食中的添加糖 10 天（用等热量精制淀粉替代且体重未减轻），患病儿童的血压、胰岛素水平和乳酸酸中毒便全线显著逆转。 - [22:18](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1338s) 历史解密文件显示制糖工业早在 1960 年代就重金收买哈佛学者，在顶级期刊上将所有心血管病罪责推卸给饱和脂肪，从而掩盖糖的致命危害长达数十年。 - [36:29](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2189s) 炸弹热量计测出的卡路里只代表物理燃烧热量，而人体细胞需要的是 ATP；葡萄糖激活线粒体产能酶，果糖则抑制 AMPK、ACADL 与 CPT1 导致产能衰竭。 - [40:08](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2408s) 节食减肥复胖率高达 90% 的根源是高胰岛素血症阻断了大脑对瘦素（饱腹感及能量储备信号）的感知，使大脑误判为饥荒而被迫暴饮暴食并降低活力。 - [50:14](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3014s) 新生儿过去 25 年间平均增重 200 克且 100% 均为脂肪，这一客观医学事实彻底摧毁了将肥胖归咎于“个人贪食与懒惰道德缺陷”的伪善论调。 - [56:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3360s) 2 型糖尿病绝非不可逆的终生退行性绝症，其根源是肝脏积聚脂肪引发的胰岛素抵抗，通过切断精制糖让肝脏排脂可实现临床逆转。 - [01:03:31](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3811s) 人体三大脂肪库中，皮下脂肪是安全的能量缓冲池（需堆积 10kg 才会溢出破损），而腹部内脏脂肪受皮质醇压力驱动（2kg 即可致病），肝脏脂肪仅需 0.25kg 就足以摧毁代谢引发 TOFI（外瘦内胖）。 - [01:17:46](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4666s) 真正食物的标准是必须“促进机体生长”且“促进能量燃烧”，而超加工食品既抑制骨骼生长又抑制线粒体燃烧，在本质上属于慢性毒物。 - [01:22:53](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4973s) 膳食纤维并非给人体提供热量，而是给 100 万亿肠道细菌生存所必需的食物；食品工业为了使产品成为“耐储存、可冷冻的期货大宗商品”而蓄意剔除了不可溶性纤维。 - [01:23:53](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5033s) 肠道菌群分解可溶性膳食纤维产生的短链脂肪酸（特别是丁酸）是稳定免疫系统、抑制过度炎症风暴的核心屏障。 - [01:34:11](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5651s) 任何同时兼具“毒性”与“成瘾性”的物质都不能单纯诉诸“个人责任论”，必须像监管烟酒一样引入政府立法与强制配方改造（如英国成功推行的减盐 30% 秘密行动）。 - [01:36:50](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5810s) 评估健康食品的“代谢矩阵”由三大支柱构成：保护肝脏（低果糖）、滋养肠道（高纤维）与支持大脑（高色氨酸、高深海 Omega-3）。 - [01:47:09](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6429s) 当今人类代谢退行、精神心理障碍及社会生态戾气的共同深层生物学根源，在于高糖饮食、慢性压力与环境毒素联手摧毁了大脑恐惧中枢——杏仁核的全部制动刹车机制。 ## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=0s) 卡路里是个谎言：糖分危机与食品工业的遮羞布 对话在一开篇就直击减肥与代谢健康中最顽固的误区——“卡路里根本不是关键问题”。儿科内分泌学家罗伯特·卢斯蒂格（Robert Lustig）博士指出，他的临床与一线科研成果表明，真正推动全球最致命慢性病的元凶是“糖”。如今超市中多达 73% 的货架食品都被食品工业偷偷添加了额外的糖分，因为食品巨头心知肚明：只要加了糖，消费者就会买得更多。 卢斯蒂格博士透露，自己目前正参与多起针对食品工业巨头的诉讼。这些企业早在几十年前就心知肚明糖对人体健康的巨大破坏，却斥巨资收买科学家撰写报告掩盖真相，宣称糖分无害。这种操纵让大众深陷健康陷阱。普通人没有精力和专业知识像科学家那样拿放大镜去排查每一口吃进去的食物，而食物既能成为良药，也能沦为毒药。 - 每天仅饮用 1 罐含糖饮料，患 2 型糖尿病的风险就会飙升 29%。 - 高糖饮食不仅诱发早逝和认知功能下降，还是心理健康恶化以及注意力缺陷障碍（ADD）的核心推手。 - 超市中高达 73% 的加工食品均被食品工业人为添加了糖分。 --- ### [01:58](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=118s) 谁黑掉了我们的大脑？“快感”与“幸福”的偷梁换柱 针对著作《被黑客入侵的美国大脑》（*The Hacking of the American Mind*），主持人询问到底谁的大脑被黑了、幕后黑手又是谁。卢斯蒂格博士直言：“是你、是我，是每一个人的大脑都被黑了。”那些向公众兜售扭曲价值观与消费主义的商业势力，成功让全社会买了一张“伪造的提货单”。人类与生俱来的权利本该是获得真正的幸福，但现代社会却剥夺了这项权利，换来的是全球范围内空前绝后的抑郁与痛苦。世界卫生组织（WHO）数据显示全球已有 5% 的人陷入临床抑郁，而美国的这一比例更是高达 22%。 造成这种普遍痛苦的根源，在于过去一百年间，商业社会蓄意将“快感”（Pleasure）偷换成了“幸福”（Happiness）。卢斯蒂格博士系统梳理了两者的七大本质区别： | 维度 | 快感（Pleasure） | 幸福（Happiness） | |:--- |:--- |:--- | | **持续时间** | 短暂即逝 | 历久弥新、源远流长 | | **感知维度** | 躯体肉欲的（内脏感受） | 精神超然的（脖子以上的大脑体验） | | **行为性质** | 索取型（如在赌场赢钱） | 给予型（如做慈善、仁人家园公益） | | **体验方式** | 通常独自经历 | 往往在社交群体中共享 | | **物质依赖** | 可通过外在物质诱发 | 无法通过任何物质直接实现 | | **成瘾倾向** | 极端状态下必然导致成瘾 | 根本不存在“过于幸福而成瘾”的现象 | | **神经递质** | **多巴胺（Dopamine）** | **血清素（Serotonin）** | 任何极端的快感来源，无论是物质（如可卡因、安非他命、尼古丁、酒精、糖）还是行为（如购物狂、赌博、刷社交媒体、网络游戏、色情成瘾），其英语词尾全都可以加上“-aholic”变成成瘾症。然而，医学上从未有过对“幸福成瘾”的说法。 --- ### [05:03](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=303s) 多巴胺与血清素的神经博弈：越追求快感，为何越痛苦？ 从神经生物学机制来看，多巴胺与血清素受体完全不同，作用机制和代谢通路也天差地别。多巴胺是一种“兴奋性神经递质”，当它在脑部奖励中心——伏隔核（Nucleus Accumbens）释放并与受体结合时，人会产生强烈的奖赏感。奖赏本身至关重要，它是促使人早晨起床、维持物种繁衍生存的必要生理驱动力（例如性高潮就是一种多巴胺奖赏）。 但神经元的基本法则是“喜欢被轻抚，讨厌被重击”。多巴胺过度刺激会导致突触后神经元持续超频放电，最终走向细胞坏死。为了避免被彻底“杀死”，神经元启动了应急降阻机制——下调受体数量（Downregulation）。受体数量变少后，分子结合的机会锐减，带来相同快感所需的刺激强度不断递增，产生所谓的“耐受性”（Tolerance）和边际效益递减，这正是成瘾的生理开端。 ```mermaid flowchart TD accTitle: Dopamine vs Serotonin Neural Pathways accDescr: Diagram contrasting how dopamine downregulation leads to addiction and depression while serotonin produces contentment. subgraph PleasurePathway ["快感途径（多巴胺 / 兴奋性）"] A["高糖 / 物质 / 极端行为刺激"] --> B["伏隔核释放大量多巴胺"] B --> C["神经元过度持续放电"] C --> D["神经元启动防御：下调多巴胺受体"] D --> E["耐受性增加：需要更大剂量维持快感"] E --> F["神经元受损坏死：陷入成瘾状态"] end subgraph SerotoninImpact ["神经相互作用与抑郁"] D -. "持续高多巴胺抑制血清素".-> G["血清素系统活性被下调"] G --> H["幸福感被剥夺 / 陷入深度抑郁"] end subgraph HappinessPathway ["幸福途径（血清素 / 抑制性）"] I["连接、给予与社交体验"] --> J["大脑释放血清素"] J --> K["抑制性信号让神经元恢复安宁"] K --> L["受体不下调，体验持久满足感"] end ``` 相比之下，血清素是一种“抑制性神经递质”，它的作用是让下游神经元平复、安宁，因此人体根本不需要下调血清素受体。然而，神经系统中存在一个残酷的单向制约机制：“唯独多巴胺能够直接下调血清素的传递”。这意味着，一个人越是疯狂沉溺于寻找多巴胺驱动的瞬时快感，其大脑感受血清素幸福感的能力就越被彻底摧毁。 --- ### [07:53](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=473s) 从反式脂肪到糖：食品工业的杀人历史 人类的大脑就是这样通过饮食被精准黑客入侵的。主持人提到卢斯蒂格博士的畅销书《胖死的真相》（*Fat Chance*），并质问糖是否真的如同传闻中那样已经绑架了全人类。卢斯蒂格肯定地回答，糖不仅是社会问题，而且是当今最大的公共健康危机。 为了说明这种危害的系统性，卢斯蒂格博士以反式脂肪（Trans Fat）的历史进行了对比。反式脂肪是通过化学键在催化或高温下翻转形成的非天然脂肪。植物油（如橄榄油、菜籽油、芝麻油、花生油）通常具有顺式双键，若加热过度双键可能反转，但食品工业早在 1920 年代起就为了延长保质期和稳定烘焙品质，大规模工业氢化制造反式脂肪。科学家弗雷德·库梅罗（Fred Kummerow）早在 1957 年就拿出铁证指出反式脂肪能夺人性命，却遭到了长达几十年的忽视与打压。直到 1988 年学界才真正正视这项研究，而美国 FDA 拖延到 2013 年——整整 60 多年后——才全面禁止食品中使用反式脂肪。卢斯蒂格直言反式脂肪就是“不折不扣的人造毒药”。 - 科学家弗雷德·库梅罗于 1957 年首次发现反式脂肪的致命毒性。 - 直至 1988 年该研究才被科学界广泛重视，而 FDA 直到 2013 年才彻底全面禁用。 --- ### [10:28](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=628s) 糖是毒药吗？果糖与酒精的孪生代谢机制 那么，日常吃到的糖究竟是不是毒药？卢斯蒂格博士引用了现代毒理学之父帕拉塞尔苏斯（Paracelsus）在 1537 年提出的名言：“剂量决定毒性”（The dose determines the poison）。糖就像酒精一样：人体具备一定限度的自身代谢代偿能力，一旦摄入剂量在代谢阈值之内，造成的损伤较小；可一旦剂量超标，它就会引发严重的病理毒性。 根本原因在于：**果糖（Fructose）与酒精在人体的肝脏代谢途径几乎完全一致**。 针对日常饮食中的糖，许多人将“糖”与“果糖”混为一谈。日常使用的白砂糖（蔗糖，Sucrose）是由一分子葡萄糖（Glucose）和一分子果糖（Fructose）化学结合而成的双糖。食品巨头常年向公众灌输一种欺骗性说辞：“糖就是糖，卡路里就是卡路里，葡萄糖和果糖每克都同样提供 4 大卡能量，两者毫无差别”。卢斯蒂格驳斥道，食品工业之所以制造这种谎言，完全是为了推卸自身向食品中滥加添加糖的罪责。 从生物代谢角度来看，两者有着云泥之别： - **葡萄糖（Glucose）**：是地球生命的底层能量货币。地球上几乎每一个细胞都可以利用葡萄糖代谢供能；葡萄糖极其重要，即便完全不从饮食中摄入，人体肝脏也能通过糖异生自行合成。 - **果糖（Fructose）**：截然相反，人体根本没有任何维持生理生存必须摄入果糖的生物学需求，它在人体内几乎全部涌入肝脏处理，其代谢负担和毒性效应与酒精如出一辙。 ### [12:08](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=728s) 必需的葡萄糖与非必需的“邪恶孪生子”果糖 人体确实离不开葡萄糖，但关键在于人类根本不需要通过饮食去摄入它。罗伯特·卢斯蒂格（Robert Lustig）以生活在北极地区的因纽特人（Inuit，曾被称为爱斯基摩人）为例：他们的传统饮食中几乎没有任何碳水化合物，日常全靠冰雪环境中的鲸脂和肉类为生，然而测定他们的血液指标，却依然维持着正常的血清葡萄糖水平。这是因为人类大脑的运转主要依赖葡萄糖（虽然也能利用酮体），而且体内许多关键激素与蛋白质必须经过“糖基化”（glycosylation）修饰才能发挥生理活性——比如促黄体生成素（LH）和促卵泡激素（FSH），如果缺乏糖基化，这两类指挥睾丸与卵巢工作的激素就会失灵，直接导致不孕不育。从物种繁衍与生存的角度来看，葡萄糖不可或缺；但即便你完全不吃糖，肝脏也能通过“糖异生”（gluconeogenesis）途径，利用氨基酸和甘油脂肪酸自行制造所需的一切葡萄糖。 相比之下，日常白糖颗粒中与葡萄糖紧密绑定的另一半——果糖（fructose），则是代谢上的“邪恶孪生子”（evil twin）。普通食糖由一分子葡萄糖和一分子果糖构成。面对主持人的提问，卢斯蒂格斩钉截铁地指出：人类不仅生理上完全不需要果糖，而且一旦摄入过量，果糖就具有明确的毒性。 ```mermaid flowchart TD accTitle: 糖分代谢路径对比 accDescr: 对比葡萄糖与果糖在人体内的必需性与代谢路径 subgraph SugarMolecule ["膳食白糖分子"] G["葡萄糖 (Glucose)"] F["果糖 (Fructose)"] end subgraph BodyMetabolism ["人体代谢归宿"] G -->|"生存必需"| G_Use["大脑供能 / 蛋白质糖基化"] G_Use -.->|"饮食零摄入时"| G_Neo["肝脏通过糖异生合成 (氨基酸/脂肪)"] F -->|"非生理必需"| F_Tox["全由肝脏超负荷代谢"] F_Tox -->|"超过阈值"| F_Fat["类似酒精毒性 / 脂肪肝 / 代谢紊乱"] end ``` --- ### [13:56](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=836s) 剂量决定毒性：果糖代谢与酒精的惊人相似性 人类的肝脏并非完全无法处理果糖，它具备代谢极少量果糖的天然生理代偿能力。成年人肝脏每天大概能承受6到9茶匙的添加糖，折算下来大约是12克果糖。卢斯蒂格特别强调，这一生理负荷能力与酒精惊人地一致——肝脏每天代谢约12克纯酒精时，通常不会出现明显的代谢紊乱迹象。然而，“剂量决定毒性”（the dose determines the poison）。卢斯蒂格用饮酒打了个生动的比方：如果一天喝一杯酒，身体尚在安全阈值内；喝两杯，取决于体质与运动量，肝脏开始吃力；喝三杯就会头晕微醺，绝不该开车；喝四杯可能就需要酒吧服务员“用锅铲把你从地板上刮起来”；如果每天喝五杯，那你毫无疑问已经是个彻头彻尾的酗酒者。 现代人的果糖摄入现状正是如此失控。官方建议的每日摄入上限约为25克添加糖（约6茶匙），但现代人平均每天吞下整整100克糖（包含50克果糖），整整超标了四倍。很多人辩解称自己喝咖啡从不加糖，以为自己的糖摄入量为零，但卢斯蒂格指出这是巨大的认知误区，因为糖被食品工业“众目睽睽地隐藏”在普通加工食品中。在美国和英国的超市货架上，高达73%的在售食品都被食品工业人为注入了添加糖。商家添加糖的目的绝非为了消费者的健康，而是纯粹出于商业利益——因为食物一旦变甜，消费者的多巴胺机制被劫持，就会买得更多。 - **肝脏成人代谢上限**：每日约 12 克果糖（相当于约 6 茶匙白糖，与 1 标准杯酒精的肝负荷相当）。 - **现代人日常平均摄入**：每日约 100 克糖（含 50 克果糖），达到安全极限的 4 倍。 - **超市食品污染率**：美英超市中 73% 的加工食品均含有食品工业隐性添加的糖。 --- ### [17:09](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1029s) 校园早餐的糖过量与儿童神经精神隐患 成人的肝脏尚且无法抵御这种四倍超标的糖分轰炸，儿童的处境则更加危急。儿童肝脏每天的果糖安全代谢阈值仅为成人的三分之一，大约只有4到6克。然而，在美国有29%的学童依赖“国家学校早餐计划”（National School Breakfast Program）提供的校园餐。这份看似营养合规的典型早餐，往往只是一碗色彩鲜艳的果圈麦片（Froot Loops）配上一杯橙汁——仅仅这一顿早餐，就含有高达41克的糖分。对于代谢极限仅为12克糖的孩子来说，一日之计的清晨就直接摄入了近4倍于全天极限的糖量。 卢斯蒂格驳斥了“卡路里就是卡路里”的传统观念。果糖的毒性与热量多寡毫无关系，其生化机制更像酒精，如此庞大的过量摄入必然引发从代谢、全身健康到神经精神系统的全面并发症。他肯定地指出，糖是现代儿童注意力缺陷障碍（ADD/ADHD）以及抑郁症的核心诱因之一。功能性磁共振成像（fMRI）以及大量认知行为测试数据均证实：只要把饮食中的多余糖分抽离，孩子们的认知评分和行为表现就会迅速改善。 --- ### [18:51](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1131s) UCSF临床试验：仅用十天切断添加糖的代谢逆转奇迹 为了彻底证实糖本身的独立毒性，卢斯蒂格及其团队在加利福尼亚大学旧金山分校（UCSF）主导了一项严格的临床干预研究。他们招募了43名患有肥胖和代谢综合征的非裔与拉美裔低收入家庭儿童，这些孩子全都是高糖饮食者。研究人员先记录他们原本在家中的日常饮食，随后在接下来的9天内由实验组统一配送一日三餐。干预的核心只有一个：**彻底剥离添加糖**，将孩子们每天摄入的添加糖从28茶匙骤降至10茶匙，餐食中唯一的糖分仅来自新鲜完整水果。 为了杜绝批判者抛出“健康改善只是因为孩子减肥变瘦了”的借口，研究团队精心设计了等热量替代方案。砍掉添加糖后，孩子们每天会少摄入350到400大卡的热量，卢斯蒂格团队没有给他们吃蔬菜或高档有机食物，而是补足了精制淀粉与普通包装食品（CPG）——把糕点换成百吉饼，把加糖酸奶换成果味脱水土豆片，把照烧鸡肉换成火鸡热狗肠。他们每天给孩子称重并通电话监控，一旦体重下降就命令孩子“多吃点淀粉”，确保整个10天干预期间体重毫无变化。 实验结果震撼了研究人员。第10天复测时，在体重完全没有减轻的前提下，孩子们的代谢指标全线好转：血压下降、空腹血糖降低、空腹胰岛素骤降，胰腺重新恢复正常调节功能；体内原本标志着线粒体严重功能障碍的高乳酸血症（lactic acidosis）彻底消失。更为戏剧化的是神经行为上的剧变：在控糖的前5天，孩子们出现了典型的**戒断反应**（withdrawal），情绪极度暴躁、乖戾，家长们纷纷崩溃投诉“我的孩子彻底成了灾难”；然而一迈过第5天的门槛，戒断期结束，宛如“摩西开海，天空豁然开朗”，孩子们的注意力显著集中，在校成绩大幅提升，父母和老师惊奇地发现他们不再是课堂上的捣乱分子，甚至孩子们自己都由衷感慨：“这是我有生以来第一次感觉自己的脑袋不再昏昏沉沉、如同置身云雾之中。” | 实验指标 | 干预前状态 | 仅剔除添加糖 10 天后（体重未变） | |:--- |:--- |:--- | | **添加糖摄入量** | 每天约 28 茶匙 | 骤降至每天 10 茶匙（仅保留天然水果） | | **等热量置换方案** | 高糖垃圾食品（糕点、甜酸奶、照烧鸡） | 等热量精制淀粉（百吉饼、薯片、热狗肠，无蔬菜） | | **心血管与代谢** | 高血压、高胰岛素、胰岛功能失代偿 | 血压显著下降、空腹胰岛素与血糖恢复平稳 | | **线粒体功能** | 血液异常蓄积乳酸（线粒体受损毒性表征） | 血清乳酸完全清除，线粒体代谢恢复 | | **神经认知行为** | 难以集中、ADD表现、头脑昏沉、多动烦躁 | 前5天经历急性戒断暴躁期后，注意力与情绪显著好转 | --- ### [22:18](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1338s) 隐瞒半个世纪的学术丑闻：食品工业对科学界的操纵 当主持人感叹这简直是一场“无人过问的公共卫生丑闻”时，卢斯蒂格直言，食品工业凭借其盘根错节的权势，在长达四五十年的时间里成功将真相掩盖在厚厚的地毯之下。早在1960年代，制糖工业就已经洞悉了糖对人体健康的致命破坏，但他们选择用重金收买科学家，筑起谎言的高墙。卢斯蒂格表示，UCSF专门设立了“食品工业文件图书馆”（Food Industry Documents Library），用于系统研究企业干预公共健康的黑幕档案。 解密的历史文献揭开了一桩触目惊心的科学丑闻：1965年，美国糖业协会（Sugar Association）找上了哈佛大学公共卫生学院（Harvard School of Public Health）营养系主任弗雷德·斯塔尔（Fred Stare）及其副手马克·赫格斯特德（Mark Hegsted，此人5年后高升为美国农业部主管膳食指南的核心官员）。糖业协会向前述两位顶级学者支付了相当于今天5万美元的报酬，指使他们在全球顶级医学期刊《新英格兰医学杂志》（NEJM）上联名发表了两篇极具误导性的综述文章。这两篇文章移花接木，将心血管疾病和代谢疾病的所有罪责通通推给“饱和脂肪”，从而为糖彻底洗脱了罪名。这种系统性操纵甚至蔓延到了政府机构，食品工业巨头还深度渗透了美国国家牙科研究所（NIDR）的评审委员会和执行决策层，暗中掐断一切可能对糖产生不利定论的科研资助。 ### [24:19](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1459s) 食品工业的操控与肥胖危机的因果真相 罗伯特·卢斯蒂格（Robert Lustig）揭露了食品工业几十年前就深知其产品危害的铁证。当年制糖业为了转移公众视线，竟将本应用于牙齿健康的营养研究经费，恶意诱导去研发一种荒谬的“龋齿疫苗”（Cavities Vaccine）。卢斯蒂格带着讽刺与愤怒反问：“那款龋齿疫苗现在起作用了吗？”他强调，加州大学旧金山分校（UCSF）已经建立了专门研究“健康的商业决定因素”（Corporate Determinants of Health）的中心，所有行业操纵与自我招供的文档均已公之于众，这绝非阴谋论，而是确凿无疑的铁证。 受这种企业干预的影响，全球公共健康正面临灾难性溃败。在卢斯蒂格的著作《退糖生活》（*Fat Chance*）中列出的惊人数据表明，到 2050 年，肥胖将不再是个案而是社会常态；世界卫生组织的数据显示，过去 28 年间全球肥胖人口比例翻了一倍；而在英国，28% 的成年人患有肥胖症，另有 36% 超重，被戏称为“欧洲胖子”。更可怕的是，罹患代谢综合征相当于寿命直接缩短 15 到 20 年，而全球糖消费量在短短 50 年内激增了三倍。 面对“相关性不等于因果关系”的传统质疑，卢斯蒂格坚决反驳，指出医学界不仅掌握了细胞机制和干预试验，还拥有强大的“计量经济学分析”（Econometric Analysis）。正如我们无需将健康人强行置于烟草环境（这在伦理上违法且应被判刑）就能确认吸烟导致肺癌、无需对照组就能证实气候变化或橄榄球撞击引发慢性创伤性脑病（CTE）一样，长期自然历史数据的计量经济学模型已经无可辩驳地坐实了糖与糖尿病、心脏病、非酒精性脂肪肝以及龋齿之间的直接因果联系，目前团队也正在进一步推进糖与癌症及阿尔茨海默病的关联研究。 - **寿命减损**：患有代谢综合征直接对应 15 至 20 年的寿命损失。 - **全球趋势**：全球糖消费在过去 50 年间增长至原先的 3 倍；肥胖率在 28 年间翻番。 - **英国现状**：英国成人中有 28% 达到肥胖标准，36% 处于超重状态。 - **证据工具**：通过计量经济学分析确立直接因果，突破了随机对照试验（RCT）在长期慢性病研究中的伦理与操作局限。 --- ### [27:12](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1632s) 含糖饮料：通往糖尿病的高速公路 在诸多糖分来源中，含糖软饮料堪称首恶。数据显示，全社会高达 33% 的糖摄入量直接来自于含糖饮料，而这些产品最具毁灭性的侵蚀对象往往是贫困和缺乏医疗保障的弱势群体。 卢斯蒂格直截了当地给出了含糖苏打水的毒性剂量：每天仅仅饮用一罐含糖饮料，患糖尿病的风险就会激增 29%；若是每天喝两罐，患病风险直接飙升 58%。如今，在多达 40% 的死亡证明上，糖尿病已被列为主要的致死推手。这种中等剂量的糖分摄入就足以表现出显著的生物毒性。 ```mermaid flowchart TD accTitle: 糖摄入量与糖尿病风险及发病潜伏期的动态关系 accDescr: 展示糖摄入剂量对糖尿病患病率的影响，以及基于马尔可夫模型预测的3年时间滞后窗口。 subgraph DoseResponse["摄入剂量与风险"] A["每天饮用 1 罐含糖饮料"] --> B["糖尿病发病风险增加 29%"] C["每天饮用 2 罐含糖饮料"] --> D["糖尿病发病风险激增 58%"] end subgraph TimeWindow["时间滞后窗口（马尔可夫建模）"] E["国家整体糖供应量上升"] -->|"延迟 3 年"| F["全国糖尿病患病率显著上升"] G["国家整体糖消费量下降"] -->|"延迟 3 年"| H["全国糖尿病患病率显著下降"] end ``` 通过跨国计量经济学分析与高级马尔可夫模型（Advanced Markov Modeling），卢斯蒂格的团队测定出糖与代谢健康之间存在着极其规律的时间滞后： - 无论是在哪一个国家，当市场上糖的供应与摄入量发生变化时，糖尿病患病率的变化总是在整整 3 年后随之显现。 - 这一“3 年滞后窗口”在摄入量上升与下降时均严格对称生效，“其确定性高到你可以直接拿去银行兑现”（Take it to the bank）。 --- ### [29:16](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1756s) 无糖饮料的伪善：代糖如何欺骗身体并摧毁微生态 当主持人斯蒂芬·巴特利特（Steven Bartlett）拿出一罐遮住商标的无糖饮料（Zero/Diet Soda）并询问它是否安全时，卢斯蒂格给出了冷峻的科学判断：**“喝一罐含糖苏打水的毒性，相当于喝两罐代糖无糖苏打水。”** 他严肃提醒公众切勿落入商家的文字陷阱，“危害减半绝不等于它是健康的，危害减半依然意味着它有害”（"Half as bad does not mean good. Half as bad means half as bad."）。虽然代糖饮料零果糖、零热量，但它通过完全不同的生理机制对机体造成深重打击。 ```mermaid flowchart LR accTitle: 代糖摄入对胰岛素反应与肠道微生态的双重破坏机制 accDescr: 描摹舌头感知甜味后触发胰岛素分泌的神经反射，以及代糖损伤肠道屏障并引发全身性慢性炎症的全过程。 subgraph Pathway1["迷走神经与胰岛素轴"] A["代糖刺激舌头甜味感受器"] --> B["大脑接收信号：糖来了"] B --> C["迷走神经刺激胰腺释放胰岛素"] C --> D["高胰岛素血症<br/>（驱动动脉硬化、促发癌症）"] end subgraph Pathway2["肠道屏障与微生态破坏"] E["非营养性甜味剂进入肠道"] --> F["肠道微生态菌群失调"] F --> G["饥饿细菌吞噬肠道黏蛋白层"] G --> H["肠上皮紧密连接破坏（肠漏）"] H --> I["内毒素与LPS渗入血液"] I --> J["全身系统性慢性炎症与认知衰退"] end ``` 代糖引发人体内部灾难的第一大元凶是“头期胰岛素释放”（Cephalic Phase Insulin Release）。圣路易斯华盛顿大学雅尼娜·佩皮诺（Yanina Pepino）教授在 2013 年的研究及后续多次重复试验证实：当甜味分子接触舌头，味蕾立刻向大脑发送“糖要来了”的警报，大脑随即命令胰腺倾泻胰岛素。如果你在饮用代糖饮料的同时进食，胰岛素的分泌反应会变得异常剧烈。 高胰岛素血症的危害绝不亚于高血糖： - **高血糖导致微血管病变（Microvascular Disease）**：损伤血管内皮细胞，阻碍一氧化氮（NO）合成，迫使微小血管痉挛收缩，从而诱发高血压，并造成糖尿病典型的视网膜病变（失明）、肾病（尿毒症）和神经坏死。 - **高胰岛素导致大血管病变（Macrovascular Disease）**：胰岛素本质上是一种强大的促生长因子（Growth Factor），它会强力刺激血管平滑肌细胞增生，催生冠状动脉硬化、心肌梗死；同时刺激腺体细胞生长，成为癌症的顶级温床。 - **临床骗局**：许多 2 型糖尿病患者依靠外源胰岛素、降糖药甚至 GLP-1 受体激动剂把糖化血红蛋白（HbA1c）压到了正常范围，却依然逃不过死亡，因为他们最终被高胰岛素引发的心脏病、癌症或阿尔茨海默病夺走了性命。代糖控制了葡萄糖，却完全放纵了胰岛素。 第二大杀手锏是破坏肠道微生物群（Microbiome）。宿主如果不提供优质纤维去滋养肠道益生菌，处于饥饿和失衡状态的细菌就会反噬宿主，直接啃食肠上皮表面的保护性黏蛋白层（Mucin layer）。黏蛋白屏障脱落后，有害致病菌乘虚而入，诱发肠易激综合征（IBS）与炎症性肠病（IBD）。更糟的是，肠黏膜细胞之间的紧密连接受损瓦解，导致肠壁通透性剧增（即“肠漏”），使得肠腔内的各种废弃毒素、完整细菌以及脂多糖（LPS/内毒素）径直漏入血液循环，掀起不可逆的全身系统性慢性炎症，一路诱发代谢紊乱、心理疾患、认知功能衰退与早逝。 当主持人好奇地追问卢斯蒂格自己是否喝无糖饮料时，这位内分泌学家干脆利落地答道：“我当然不喝这玩意儿。” --- ### [34:38](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2078s) 摧毁“卡路里”神话：糖在肝脏中的代谢毒性 谈及糖对肝脏和激素的深远负面影响，卢斯蒂格指出，长期过量的糖不仅会恶化肝脏层面的胰岛素抵抗、诱发非酒精性脂肪性肝病，还会波及肾脏调节机制并导致慢性血压升高。 面对食品工业“糖只是提供能量”的经典托词，卢斯蒂格毫不留情地予以拆穿。食品加工巨头们长年推行一套看似无懈可击的话术：“葡萄糖是每克 4 大卡，果糖也是每克 4 大卡，因此二者对人体的意义是均等的。” > “如果卡路里真的是问题的核心，那他们确实是对的。但问题恰恰在于：卡路里根本就不是关键！从我的角度来看，整套卡路里理论都该被扔进下水道。我站在这里，就是要发起一场消灭卡路里度量衡的战役（#KillTheCalorie）。它在我们的社会对话中毫无立足之地，在医学界更不应有立足之地——卡路里理论糟透了（Calories suck）。” 为了证明卡路里概念的荒谬，卢斯蒂格从物理测量与生物代谢的本质鸿沟展开说明：如果你把 1 摩尔葡萄糖放到封闭的弹式热量计（Bomb Calorimeter）里点燃，测出来的热量确实是每克 4 大卡；但活生生的人体生物化学系统，绝不是一台冰冷盲目的焚烧炉，葡萄糖与果糖在肝脏内部的处理通路、酶系统的负荷以及生化后果，存在着天壤之别。 ### [36:29](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2189s) 炸弹热量计的骗局：卡路里是热量，但身体需要的是 ATP 将果糖放入炸弹热量计（bomb calorimeter）中引爆测量，确实能得出每克提供 4 卡路里的数据，但这根本无法反映人体内部的真实代谢情况。Robert Lustig 严厉指出，人体并不是炸弹热量计。炸弹热量计是一种测量装置，它通过引爆样品，测量样品释放的热量来计算卡路里——卡路里在物理定义上，仅仅是将 1 克水升高 1 摄氏度所需的热量。然而人体细胞内的“燃烧”并非物理爆炸，而是发生在线粒体（mitochondria）这种微小的细胞器中。当线粒体高效运转时，它能够彻底代谢能源底物，并将能量转化为细胞能使用的化学能量货币——ATP（三磷酸腺苷）。ATP 是驱动细胞内部所有分子马达运转、合成物质、清理垃圾以及循环废弃物不可或缺的能量来源。 葡萄糖与果糖在线粒体中的代谢途径截然相反。葡萄糖对线粒体运转极为有利，它能刺激两大关键酶：一个是 AMPK（AMP 激活蛋白激酶，线粒体合成的核心调控酶及肝脏细胞的“燃料计”，会通知肝细胞制造更多线粒体），另一个是 HADHA（羟酰辅酶 A 脱氢酶，负责裂解并氧化二碳片段以释放能量）。相反，蔗糖中的果糖分子则会同时抑制线粒体内的三处关键酶：它抑制 AMPK，抑制负责长链脂肪酸代谢的 ACADL（长链酰基辅酶 A 脱氢酶），还抑制 CPT1（肉碱棕榈酰转移酶 1，负责再生肉碱穿梭载体以把脂肪酸送入线粒体氧化）。因此，果糖的最终净效应是严重削弱线粒体功能。 ```mermaid flowchart TD accTitle: 葡萄糖与果糖对线粒体酶活性的相反影响 accDescr: 对比葡萄糖促进 ATP 生成与果糖抑制关键酶导致线粒体功能障碍的路径 subgraph GlucosePath["葡萄糖代谢路径"] G["葡萄糖 (Glucose)"] -->|激活| AMPK["AMPK (促进线粒体合成)"] G -->|激活| HADHA["HADHA (氧化二碳片段)"] AMPK --> ATP_Up["促进 ATP 生成，维持细胞机能"] HADHA --> ATP_Up end subgraph FructosePath["果糖代谢路径"] F["果糖 (Fructose)"] -->|抑制| AMPK_Inhib["抑制 AMPK"] F -->|抑制| ACADL["抑制 ACADL (阻断长链脂肪酸代谢)"] F -->|抑制| CPT1["抑制 CPT1 (阻断脂肪酸穿梭)"] AMPK_Inhib --> ATP_Down["阻碍 ATP 生成与线粒体损伤"] ACADL --> ATP_Down CPT1 --> ATP_Down end ``` 这种生化机制引发了对“能量”定义的深刻质疑：如果一种分子阻止了细胞生成化学能量 ATP，它还能被称为能量吗？在物理产热的意义上，果糖确实是能量；但在生物代谢中，果糖会抑制 ATP 合成，进而引发全身系统性健康崩溃。Lustig 情绪激动地表示，在医学和营养学界，“任何还在提‘卡路里’的人，都应该直接被解雇”，因为他们根本没有理解代谢的本质，这些人是健康问题的推手，而不是解决问题的人。 - **炸弹热量计的物理定义**：将 1 克水升高 1 摄氏度所需的热能，不能直接等同于人体内的生化反应。 - **线粒体关键酶**：葡萄糖刺激 AMPK 与 HADHA；果糖抑制 AMPK、ACADL 和 CPT-1。 - **核心逻辑冲突**：传统热量理论将果糖标记为每克 4 大卡，但它在细胞内部实际是在阻碍化学能（ATP）的有效生成。 --- ### [40:08](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2408s) 节食溜溜球效应与降胰岛素法则 针对“许多人靠计算卡路里成功减重”的普遍观点，Lustig 直言不讳地指出，几乎所有计算卡路里的人在减掉一点体重后都会陷入停滞期（plateau），随后便因难以坚持而放弃，导致体重疯狂反弹。统计显示，高达 90% 依赖限制热量摄入来减肥的人最终都会复胖，甚至反弹到比之前更高的体重，陷入典型的“溜溜球式节食”（yo-yo dieting）。这种失败的根源并非意志力崩溃，而是胰岛素抵抗（insulin resistance）以及反弹体重主要积聚在肝脏所致。一旦血液中游离的胰岛素居高不下，胰岛素就会在脑部阻断瘦素（leptin，负责控制体内脂肪设定点的关键激素）的信号传导，导致大脑无法“看见”身体已经拥有的能量储备，从而迫使机体陷入更强烈的饥饿感，将体重推向更高点。 没有胰岛素，人体根本无法储存能量和增加体重。早在 20 年前，Lustig 针对下丘脑肿瘤导致胰岛素超常分泌的患儿展开研究。当团队使用药物抑制这些患儿的胰岛素释放后，患儿不仅体重自然下降，甚至在无人督促的情况下自发开始运动。临床实验反复证明，胰岛素降得越低，患者减重越明显，精神状态也越好。胰岛素是驱动肥胖、2 型糖尿病和代谢综合征的终极祸首，因此控制体重的核心原则只有一个：“把胰岛素降下来”。 要降低体内的胰岛素水平，最有效的方法就是从源头阻止它飙升——彻底砍掉精制碳水化合物与添加糖。录音现场的一角摆满了各类高糖加工食品，包括货架上常见的花生酱杯（Reese's Peanut Butter Cups）、苹果汁、各类零食以及看似是水实则加入大量糖的调味水。Lustig 强调，这些食品正是刺激胰岛素分泌的罪魁祸首。他将自己在旧金山加利福尼亚大学（UCSF）的肥胖专科诊所转型为“胰岛素降低诊所”，临床经验证实，戒绝精制碳水与添加糖是逆转胰岛素抵抗和减重最行之有效的方案。 --- ### [43:47](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2627s) 压力、疲劳与下午 4 点的糖瘾发作 尽管许多人在前额叶皮层（理性认知层面）明白吃糖有害，但依然难以抵制诱惑，原因在于糖具有神经生物学意义上的成瘾性——果糖会直接刺激大脑伏隔核（nucleus accumbens）的多巴胺奖赏回路。当现代人面临日常压力与疲惫时，对高糖零食的渴望会进一步激化。这是因为压力会极大地加重杏仁核（amygdala，大脑的情绪和恐惧中枢）以及海马体的代谢负荷，促使杏仁核索取更多能量来安抚警报。为了获得应急的能量补给，大脑会本能地下达指令摄入能迅速吸收的糖分；即使果糖在长期会破坏线粒体 ATP 的生成，大脑在急性期仍会迫不及待地想要摄取它。 在疲劳状态下，由于杏仁核功能失调，机体的自我控制机制全面瘫痪，产生一种“管它呢，先吃再说”的冲动。主持人提到自己在早晨通常毫无对糖的渴望，可是一到傍晚工作一整天之后，强烈的渴望就会准时出现。Lustig 认同并分享了自己的亲身经历：他在 UCSF 担任教职期间体重曾大幅飙升，原因就是每天下午 4 点他总会感到精疲力竭、电量耗尽，于是便冲过马路去买一块巨大的巧克​​力曲奇吃。直到他开始深入研究患儿去除糖分后精力显著改善的数据，才猛然顿悟。戒掉下午的甜食后，他的全天能量水平恢复平稳，不再有下午骤然崩溃的断电感。 --- ### [46:03](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2763s) 超市雷区与食品包装上的营销谎言 面对生活节奏飞快、朝九晚五且需要照顾孩子的普通公众（例如普通上班族 Jennifer 或 Dave），要求他们拿放大镜审查每一件食物成分是不切实际的。现代食品工业已经将超级市场变成了一片危机四伏的“雷区”，普通人一踏进去就会轻易踩雷。针对这一困局，Lustig 给出的最简明实用的原则是：“吃真正的食物（Eat real food）”。所谓真正的食物，就是从土里长出来的植物，或者以这些天然植物为食的动物。然而现实问题是，现代人高度依赖省时省力的便利食品，甚至有 33% 的美国人根本不会下厨做饭。 当加工食品中被注入添加糖时，它在代谢层面上就变成了有害物质。食品工业常以添加了维生素、矿物质或营养强化成分为掩护来标榜健康，但 Lustig 尖锐反驳道：“毒药 A 加上解药 B，结果依然是死亡（toxin A plus antidote B still equals death）”。如果某种加工食品无法改善线粒体功能障碍，那么无论额外添加多少微量营养素或膳食补充剂都毫无意义。消费者不能轻信食品包装上的任何营销承诺：在食品工业的商业利益驱使下，包装盒上越是宣称“健康”的食品，往往越不健康；消费者最理性的应对方式，就是“反向理解包装上的宣传语”。 ### [48:13](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2893s) 食品工业的虚假标签与“提子麦片”诉讼案 食品工业界长期面临多起涉及虚假广告、品牌误导和标签造假的诉讼。美国杂货店里高达 70% 的商品都存在标注不当或误导消费者的现象。制造商在包装上大肆宣称并不属实的信息，最典型的就是滥用“健康”（healthy）一词，或者标榜“未添加糖”（no added sugar），但其配料表中却赫然列着苹果浓缩泥、覆盆子浓缩泥或蒸发甘蔗汁。实际上，工业界用于指代糖的名称多达 262 种，食品巨头熟练地运用这些障眼法，让消费者误以为产品没有添加额外的糖分。 这种欺骗行径引发了一连串严厉的法律诉讼。家乐氏（Kellogg's）就曾因其经典产品提子麦片（Raisin Bran）遭到起诉。在大众认知中，该产品无非是葡萄干和麦麸的组合；常理下葡萄干应当是深紫或棕褐色的，但提子麦片里的葡萄干表面却泛着一层不自然的白色。如果按天然葡萄干计算，一份麦片中的糖分本应是 11 克，但包装盒侧面的营养成分表却标注每份含 18 克糖。多出来的 7 克糖正是来源于那些白色的霜层——每一颗葡萄干都在浓缩糖液中浸泡过，纯粹为了让口味变得更甜。除了家乐氏，宝氏（Post）、亿滋（Mondelēz）等多家食品跨国巨头也深陷类似的法律审查，整个行业正被迫面临整改压力。 - 美国超市中约 70% 的预包装食品存在误导性宣传或虚假标签。 - 食品工业界拥有 262 种隐藏糖的别名（如各类浓缩果泥、蒸发甘蔗汁等）。 - 家乐氏提子麦片中的葡萄干因在糖液中浸泡包裹而呈现白色，每份凭空多出 7 克外裹添加糖（由 11 克暴增至 18 克）。 --- ### [50:14](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3014s) 新生儿肥胖危机：儿科医生的使命与残酷现实 面对如此积极参与诉讼与公共抗争的追问，背后的驱动力源于儿科医生的职业天职。儿童与少数族裔、服刑人员一样，属于社会中缺乏自我保护能力的弱势群体，他们没有独立的政治发声渠道，医生的责任就是为他们争取公平的生存起点。令人震惊的医学现状是，当代社会已经出现了“新生儿肥胖”（neonatal obesity）的极端病态现象。 来自以色列、南非、俄罗斯和美国四个国家的独立医学研究一致显示，在过去 25 年间，新生儿的平均出生体重上升了 200 克（约合半磅）。通过双能 X 射线吸收测定法（DEXA）对这些新生儿进行身体成分分析后发现，增加的这 200 克全部是纯脂肪。这些婴儿尚在襁褓之中，绝不可能因为暴饮暴食（gluttony）或懒惰不运动（sloth）而变胖，他们从离开母体的那一刻起，就已经陷入了代谢失调的严重劣势（"behind the eight ball"）。 - 过去 25 年间，美国、以色列、俄罗斯和南非四国新生儿平均出生体重增加了 200 克。 - DEXA 身体成分扫描证实，新生儿激增的体重 100% 均为脂肪组织。 - 新生儿肥胖现象直接摧毁了“肥胖全因个人贪吃懒惰”的道德指责论调。 --- ### [51:43](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3103s) 颠覆认知的临床发现：胰岛素如何劫持瘦素与运动欲望 在职业生涯的前 20 年里，常规的学院派医学教育让人坚信“卡路里就是卡路里”的教条，认为医生的工作无非是按部就班地开处方和做手术。这一认知在圣裘德儿童研究医院（St. Jude Children's Research Hospital）被彻底打破。当时负责收治一批因罹患脑瘤接受手术或放疗后出现严重下丘脑损伤的极端肥胖患儿。由于下丘脑受损，他们的大脑无法接收到脂肪组织释放的瘦素（leptin）信号——这是一种代表能量储备充足的饱和信号。 临床团队尝试使用抑制胰岛素分泌的药物进行干预，结果奇迹出现了：患儿不仅体重显著下降，而且自发性地开始剧烈运动。随后将该方案推广至成人肥胖患者，观察到了完全相同的结果。更颠覆传统生理学规律的是，通常体重下降会导致基础能量消耗降低，而这些受试者的能量消耗不降反升。这项研究揭示了一条关键生物学机制：过高的胰岛素会直接阻断大脑识别瘦素信号。当瘦素信号被切断，机体便会误以为处于饥饿陷阱中，导致患者陷入极度萎靡、浑身乏力且食欲暴增的状态；而一旦胰岛素水平回落，大脑看清了瘦素，饱腹感与行动活力便瞬间恢复。世人眼中肥胖者的“贪食与懒惰”，本质上只是高胰岛素血症阻断瘦素后的次级生化表现，绝非原发的人格缺陷。 ```mermaid flowchart TD accTitle: 胰岛素阻断瘦素机制流程图 accDescr: 展示高胰岛素如何阻碍下丘脑感知瘦素，从而导致机体误判为饥饿并引发暴食与能量封锁。 subgraph 正常代谢通路 A["脂肪组织分泌瘦素"] --> B["下丘脑接收饱腹信号"] B --> C["机体感知能量充沛"] C --> D["自发运动与正常代谢消耗"] end subgraph 病理阻断通路 E["精制糖与精炼碳水摄入"] --> F["胰岛素过度分泌 / 高胰岛素血症"] F -- "生化阻断" --> B F --> G["能量被强制锁入脂肪细胞"] B -. "大脑误判为饥荒".-> H["极度饥饿、暴饮暴食与嗜睡不动"] end ``` --- ### [54:04](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3244s) 脂肪肝与胰岛素抵抗：从急性脉冲到系统性衰竭 胰岛素在体内的运作可分为两个截然不同的维度：急性的胰岛素释放脉冲与长期的慢性胰岛素抵抗。摄入普通食物会引发急性的胰岛素脉冲，随后平稳回落；但如果肝脏堆积了大量脂肪，机体就会滑向恶性循环。当前全美已有 45% 的成年人和 25% 的儿童患有脂肪肝。在 1980 年以前，除酗酒外几乎不可能在临床上看到脂肪肝病例，而从未沾酒的儿童大规模出现脂肪肝，其唯一的幕后黑手就是果糖与精制糖，因为糖在肝脏中的代谢途径与酒精极为相似，会直接转化为脂肪。 脂肪肝直接导致肝脏产生胰岛素抵抗。由于肝细胞代谢功能受阻，胰腺必须像在生产线上给磨洋工的工人增派人手一样，代偿性地分泌数倍的胰岛素来强推肝脏运转。这导致全身长期浸泡在高浓度胰岛素环境中，迫使血液中的能量不断转存为皮下及内脏脂肪。要打破这一死局，关键在于降低胰岛素：通过剔除饮食中的精制碳水化合物来消除早期的急性分泌脉冲，同时通过清除肝脏脂肪逆转根本性的胰岛素抵抗。当胰腺长年累月超负荷运转、最终彻底崩溃再也无法维持足额分泌时，临床上的 2 型糖尿病便宣告形成。 - 美国成年人脂肪肝患病率已攀升至 45%，儿童群体亦达 25%。 - 1980 年前脂肪肝几乎全由酒精引起；当今非酒精性儿童脂肪肝完全由糖代谢转化驱动。 - 胰岛素抵抗迫使胰腺过度代偿，最终导致胰岛 β 细胞衰竭（"I'm done"），诱发临床糖尿病。 --- ### [56:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3360s) 2型糖尿病并非绝症：打破医学神话与逆转机制 现代主流医学院向医生灌输的糖尿病观念存在严重的认知谬误。几代医生被告知糖尿病是一种“慢性、渐进性、不可逆转的终身疾病”，患者注定需要终生依赖胰岛素注射或口服降糖药维持生命。这种说辞完全是“一文不值的彻底垃圾”（"garbage, total complete trash"）。 包括维塔健康（Virta Health）在内的多项大规模严格临床研究已确凿证明，2 型糖尿病完全可以被临床逆转。逆转的核心逻辑并非压制血糖，而是让胰腺恢复正常的激素分泌节律，而这完全取决于能否改善肝脏对胰岛素的敏感度。最直接有效的手段就是让疲惫不堪的肝脏得到喘息，切断需要其艰难代谢的精制碳水和外源糖分。极端的生酮饮食（ketogenic diet）、原始人饮食（paleo diet）以及间歇性禁食（intermittent fasting）都是践行这一原则的有效工具。例如 16 小时的禁食期能给肝脏留出充足时间去消耗代谢前一天累积的脂肪残余。相反，单纯依赖卡路里计算（calorie counting）几乎从不奏效；长期的极低热量节食虽然在理论上可行，但多项研究表明，这种限制需要持续长达五年之久才能艰难重置体内的瘦素抵抗调节点。 - 传统医学院所谓“糖尿病是不可逆的终身疾病”的教条被临床事实彻底否定。 - 逆转 2 型糖尿病的关键在于解除肝脏代谢负担，而非单纯注射药物抑制血糖指标。 - 16 小时轻断食能有效消耗过去半天在肝脏内积攒的脂肪。 - 单纯卡路里限制需要长达 5 年的残酷坚持才可能逐步修复人体的瘦素抵抗阈值。 --- ### [58:34](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3514s) 瘦素的恒温器原理：为什么注射瘦素毫无用处 为了讲透能量调控的本质，必须深入理解瘦素的运作机制。瘦素由脂肪细胞合成，当能量被驱动进入脂肪细胞储存时，脂肪便会分泌瘦素进入血液，穿过血脑屏障向位于下丘脑的中枢发出明确信号，表明机体已具备充足储备去支付青春期发育、妊娠等高代谢成本的昂贵生理开销。 可以将瘦素机制比作一个带有最低阈值却没有温度上限的房间恒温器（a floor but no ceiling）： - **临界触发**：当室内温度骤降跌破设定的最低保护线时，供暖系统会立即强行启动；但在缺乏空调制冷的前提下，温度可以无上限地向上飙升。 - **饥荒错觉**：人体内部亦是如此，一旦循环中的有效瘦素信号跌破某一阈值，大脑就会拉响遭遇饥荒的最高警报。 - **行为固化**：出于节约能量的生存本能，大脑会发出两条不可抗拒的生化指令：“疯狂进食”与“彻底瘫在沙发上不许动”。这种生物化学失衡才是导致严重肥胖患者表现出所谓贪食、懒惰行为的根本病因。 针对为何不能直接注射外源瘦素来减肥的疑问，答案在于绝大多数肥胖症患者根本不缺瘦素，他们体内充斥着过量的瘦素，面临的核心障碍是严重的“瘦素抵抗”（leptin resistance）。盲目注射外源性瘦素无异于“向烈火中倾倒煤油”，毫无疗效。其根本原因在于下丘脑的瘦素受体位点已因长期高胰岛素的干扰而被严重下调，或被彻底从生化层面上阻断屏蔽。 - 瘦素是机体能量储备充足的指标信号，其神经调节机制呈现“有底线、无上限”的单向恒温器模式。 - 当瘦素信号受阻时，大脑自动切换至严苛的节能生存程序：强制诱发摄食欲望并强力抑制肢体运动意愿。 - 肥胖患者并非缺乏瘦素，而是存在受体下调或高胰岛素引起的严重瘦素抵抗，因此外源性瘦素注射治疗完全无效。 ### [01:00:24](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3624s) 极少数的基因缺陷与普遍的环境肥胖 罗伯特·卢斯蒂格（Robert Lustig）解释了瘦素（Leptin）信号通路受阻的机制：要么是高胰岛素阻断了瘦素向大脑传递饱腹信号，要么是受体本身发生下调，甚至两者兼有。但他特别指出，医学界确实存在真正的“先天性瘦素缺乏症”（Leptin deficiency）。目前全球确诊的患者仅有14例左右，其中不少病例分布在英国；剑桥大学阿登布鲁克医院（Addenbrooke's Hospital）的萨达夫·法鲁奇（Sadaf Farooqi）和史蒂夫·奥拉希利（Steve O'Rahilly）教授在该领域进行了最为开创性的研究。 这类先天基因突变患儿的表现极为触目惊心：他们从出生起体重就疯狂飙升，到6个月大时已严重肥胖；长到3岁左右，甚至“连房门都快挤不过去”。他们体内完全没有饱腹感，清醒时见什么吃什么，并且极度缺乏运动欲望。然而，只要为他们每天注射一次外源性瘦素，补齐缺失的激素，这些孩子就会以惊人的速度迅速瘦下来。 面对主持人关于“肥胖是否由基因决定”的疑问，卢斯蒂格给出了极其明确的界定： - 基因突变导致的肥胖确实存在，除了瘦素缺乏症，还包括瘦素受体缺乏症、PC1缺乏症、黑皮质素4受体（MC4R）缺乏症、SIM1缺乏症等。 - 但这类单基因突变在全球仅有屈指可数的极少数患者携带，"世界上几乎没有人集齐这些突变"。 - 当今社会上普通大众所经历的肥胖大流行，根本不是基因缺陷导致的，而是一个彻底的**环境问题**（Environmental problem）。 --- ### [01:02:23](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3743s) 什么是致胖因子？脂肪细胞的增殖真相 话题转向卢斯蒂格在书中提出的“环境致胖因子”（Environmental Obesogens）。卢斯蒂格定义，致胖因子是指存在于生活环境中的各类化学物质，它们能直接促进脂肪细胞分化、刺激脂肪细胞生长，从而强行驱动机体增重。 主持人在此打断并指出一个极为普遍的认知误区：大多数人以为日常吃多长胖是在不断“增加脂肪细胞的数量”，甚至误以为抽脂手术（Liposuction）是把吃出来的多余细胞抽走。卢斯蒂格纠正道： - 成年人的脂肪细胞数量基本恒定；日常发胖或变瘦，主要是已有脂肪细胞**体积的膨胀与收缩**。 - 人体确实存在一个增加脂肪细胞数量的窗口期——**2岁之前的婴幼儿关键发育期**。在这个阶段过度喂养会激增脂肪细胞的总数。 - 最棘手的是，一旦新的脂肪细胞形成，它就会产生强烈的生物学倾向，时刻“渴望被油脂填满”。 --- ### [01:03:31](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=3811s) 人体三大脂肪库：皮下、内脏与肝脏脂肪 谈到抽脂的局限性，卢斯蒂格深入剖析了人体的三大脂肪储存库（Fat Depots）。在体重秤上，所有脂肪都只是重量数字，但在代谢层面上，它们的健康影响有着天壤之别。 ```mermaid flowchart TD accTitle: 人体三大脂肪库及其代谢危害对比 accDescr: 展现皮下脂肪、内脏脂肪和肝脏脂肪在致病阈值与机制上的鲜明差异 subgraph Depot1["1. 皮下脂肪 (Subcutaneous Fat)"] A["部位: 臀部/大腿/皮下\n容纳上限: 约 10 kg\n性质: 相对安全、代谢保护性"] end subgraph Depot2["2. 内脏脂肪 (Visceral Fat)"] B["部位: 腹部/大网膜\n诱因: 长期压力与皮质醇升高\n致病阈值: 仅需 2 kg"] end subgraph Depot3["3. 肝脏脂肪 (Liver Fat)"] C["部位: 肝实质细胞内\n诱因: 果糖与酒精代谢产物\n致病阈值: 仅需 0.25 kg\n形成外瘦内胖 (Skinny Fat / TOFI)"] end Depot1 -.->|超载破裂导致炎症| D["代谢综合征 & 慢性疾病"] Depot2 -->|迅速释放游离脂肪酸| D Depot3 -->|直接诱发肝脏胰岛素抵抗| D ``` 1. **皮下脂肪（Subcutaneous Fat / "大屁股脂肪"）** - **角色与机制**：这是日常穿泳衣显胖的浅层脂肪。卢斯蒂格语出惊人地指出，从代谢角度来看，这种脂肪**实际上是好的、具有保护性的**。它是人体储存多余能量的首选安全缓冲带，皮下脂肪储备越多，反而越不易患上早期代谢疾病。 - **超载阈值**：人体必须堆积大约 **10公斤（22磅）** 的多余皮下脂肪，其细胞内的脂质液泡（Fat vacuole）才会膨胀到极限破裂。破裂后油脂溢入细胞间隙导致细胞坏死，招引巨噬细胞等免疫细胞前来清理，进而分泌大量促炎细胞因子（Cytokines），引发全身代谢功能障碍。 2. **内脏脂肪（Visceral Fat / 腹部脂肪）** - **诱因与演化逻辑**：腹部深层的内脏脂肪危害极大，但它主要**不是热量过剩造成的，而是压力与皮质醇（Cortisol）直接驱动的**。卢斯蒂格列举了重度抑郁症患者的临床证据：这类患者处于无快感症（Anhedonia）状态，严重厌食、体重持续下降，甚至需要入院防止自残；但对他们进行CT扫描却发现，其皮下脂肪随消瘦锐减，内脏脂肪却因极度压力导致的高皮质醇而在腹部疯狂堆积。演化上，当人类面临猛兽追捕等生死危机时，皮质醇促使身体在腹腔快速存取高活性脂肪以供救命之需。 - **致病阈值**：仅需增加约 **2公斤（约两袋白糖的重量）**，即可触发严重的代谢病变。 3. **肝脏脂肪（Liver Fat）** - **极低阈值与外瘦内胖**：只需在肝脏中累积仅仅 **0.25公斤（半磅）** 的微量脂肪，就足以彻底摧毁代谢系统，诱发全身胰岛素抵抗。 - **隐藏的杀手**：体重秤根本称不出这250克的剧毒脂肪。这也正是伦敦大学学院（UCL）神经影像专家吉米·贝尔博士（Dr. Jimmy Bell）提出“瘦胖子”（Skinny fat）或“TOFI”（Thin on the Outside, Fat on the Inside，外瘦内胖）的原因——外观苗条不代表健康，体重大也不一定生病。 --- ### [01:09:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4140s) 果汁伪装与环境农药的致胖阴谋 面对“瘦胖子”体内的肝脏脂肪究竟从何而来的追问，卢斯蒂格斩钉截铁地回答：“糖和酒精”。这两者在人体内完全经由肝脏以近乎相同的方式代谢，这就是为什么现代极少饮酒的儿童也会罹患非酒精性脂肪肝。 主持人现场拿起一瓶苹果汁展示：包装正面显眼地印着“比纯苹果汁减少40%糖分”，并标榜“添加了维生素A、C、E”，看似极为健康。卢斯蒂格立刻拆穿了食品工业的话术花招： - 仔细看标签细则，它标注的是“苹果汁**饮料**”（Apple juice beverage），而不是“苹果汁”（Apple juice）。因为一旦经过工业深度加工或勾兑，受制于美国食品药品监督管理局（FDA）的法规和潜在诉讼风险，厂商依法不得直接自称果汁。 - 主持人从口袋里掏出一个完整的新鲜苹果与果汁做对比。卢斯蒂格解释，完整的水果是健康的，而一旦将水果打碎压榨成汁，**最具保护价值的核心成分——膳食纤维（Fiber）便荡然无存**。 不仅如此，普通水果还暗藏环境致胖风险： - 除非是有机种植，普通商业苹果表皮常残留化学农药，食用前必须彻底清洗，因为这些化学物质正是环境致胖因子。 - 卢斯蒂格提到了蕾切尔·卡森（Rachel Carson）在《寂静的春天》（*Silent Spring*）中揭露的著名杀虫剂 **DDT**。尽管美国早在1972年就已全面禁用DDT，但半个世纪后的今天，科学家依然能在当今孕妇的尿液中检测出DDT的代谢副产物 **DDE**；研究证实，孕妇体内的DDE暴露水平，能够精准预测其子女在11岁时的肥胖风险。 ### [01:11:47](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4307s) 环境致胖物：不依赖热量让你发胖的化学毒素 主持人 Stephen Bartlett 将话题从苹果引申到环境中的潜在毒素，询问究竟什么是“环境致胖物”（Environmental Obesogens），它们究竟潜伏在何处。Robert Lustig 教授给出了颠覆传统热量认知的定义：致胖物是一种能够引起体重增加的化学物质，但其作用机制“完全与卡路里无关”。人们通常无法理解“没有热量的东西怎么让人长胖”，而答案在于细胞生物学——只要某种化学物质能够诱导脂肪细胞的分化或促进其体积膨胀，它就会在不增加任何额外热量摄入的前提下导致体重攀升。 更令人震惊的是，这些化学物质在现代环境中几乎无处不在、无可规避： - **PFAS（全氟和多氟烷基物质，含 PFOA）**：俗称“永久化学品”，也是制造特氟龙（Teflon）不粘锅涂层的原料。研究表明，仅凭这种物质本身就能诱导脂肪细胞分化与增殖，直接促发肥胖。 - **三丁基锡（TBT, Tributyltin）**：常被涂刷在船底用于防止藤壶等生物附着。如今它已渗透到全球的水体和食物供应链中。哪怕在人出生之前，子宫内的 TBT 暴露就已经在刺激胎儿体内脂肪细胞的异常生长。 - **双酚 A（BPA, Bisphenol A）**：日常生活中极难避开，例如在超市或百货店随手拿取的机打热敏纸收据中就含有大量 BPA。 - **邻苯二甲酸酯（Phthalates / 增塑剂）**：为了让塑料变软而添加的化学制剂。给婴儿含在嘴里的安抚奶嘴往往就含有这类增塑剂，直接引发儿童肥胖风险。 - **对羟基苯甲酸酯（Parabens）**：广泛存在于各类化妆品中，同样具备促肥胖效应。 - **其他隐形源头**：乙烯基地板（Vinyl flooring）、儿童衣物和床垫中添加的阻燃剂等。这些外源化学分子侵入人体后，会刺激不同的受体，作为“内分泌干扰物”（Endocrine Disruptors）彻底扰乱人体原本的脂肪分化与代谢控制。 --- ### [01:14:16](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4456s) 内分泌干扰物的受体劫持与环境渗透 Lustig 教授详细解析了内分泌干扰物在体内的运作逻辑：人体内部不同组织器官之间的交流依赖于精密的信息传递系统，正常情况下是内源性激素与细胞表面的受体结合；但有时某些外源化学物质会错误激活这些受体，诱发组织异常分化——正如先天性心脏病等出生缺陷往往源于受体通路的异常变异。环境中的这些合成毒素擅长“伪装”，它们模拟体内的内源性信号，向不同组织发布错误的生化指令，迫使细胞做出反常行为，肥胖便是这种调控紊乱的直接后果之一。 Stephen 用了一个极为形象的比喻来理解这个机制：“这就像小孩子玩的几何嵌板玩具，上面有三角形、圆形和正方形孔洞。环境中的这些化学物质假扮成对应的几何积木，强行插进受体孔洞，引发了整套身体机能的运转失常。” Lustig 教授对此表示高度赞同，并指出内分泌干扰物的危害在科学界早已证据确凿：它不仅是全球人类生育力断崖式暴跌和生殖系统病变的关键推手，甚至导致美国大沼泽地（Everglades）的短吻鳄种群濒临灭绝；同时，它还对大脑发育与神经认知产生深远危害，并可能在自闭症的发生中扮演某种角色。 ```mermaid flowchart LR accTitle: 内分泌干扰物的作用机制 accDescr: 展示环境化学分子如何模拟体内激素劫持细胞受体并引发脂肪分化和代谢失常 subgraph Source["环境污染暴露源"] A["日常接触: 不粘锅 / 收据 / 奶嘴 / 罐头内衬"] end subgraph Hijack["受体信号劫持"] B["伪装激素信号<br/>(如模拟雌激素)"] C["结合细胞表面受体<br/>(分子几何形状契合)"] end subgraph Impact["病理生理后果"] D["促进脂肪细胞分化与增生<br/>(无热量致胖)"] E["生殖能力下降 / 神经发育受损"] end A --> B B --> C C --> D C --> E ``` 面对 Stephen“既然空气、地板和床垫都有毒，我们究竟该如何自处”的焦虑，Lustig 坦言，空气污染、水体中的特氟龙或 TBT 很难仅凭个人力量解决，需要依靠国家立法监管。但在微观生活习惯上，人们仍能避开明显的风险： - **饮用水隐患**：自来水确实问题重重，但不少塑料瓶装水本身也析出致胖物，毒素恰恰就来源于塑料瓶自身。 - **罐装食品（Canned Foods）的内衬陷阱**：打开食品罐头时，观察内壁颜色至关重要——如果内壁呈现白色而非金属银色，那层白色涂层就是富含 BPA 的环氧树脂。BPA 属于外源性雌激素（结构上只要具备 22 埃的间距和两个羟基就能行使雌激素活性）。雌激素的一大核心功能就是在体内堆积脂肪（如同女性展现的脂肪曲线形态），而 BPA 同样会在不知不觉中诱导身体大量囤积脂肪。 --- ### [01:17:46](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4666s) 重新定义“食物”：超加工食品与果糖本质是毒药 Lustig 将批判的矛头指向更普遍的食品供应链，直言很多我们自以为是食物的东西根本不能称之为食物，果糖（Fructose）就是典型代表。尽管果糖含有卡路里，但它对线粒体的毁灭性打击与卡路里完全无关，这种毒理学特性与酒精如出一辙——“酒精虽然有热量，但酒精的毒性与其所含热量毫无关联。具有热量并不代表它就是食物。” Lustig 抛出了对“食物”的科学定义：**所谓食物，必须是能够促进有机体“生长”（Growth）或促进体内能量“燃烧”（Burning）的底物。** 1. **是否促进生长？** 耶路撒冷希伯来大学营养学系主任 Efrat Monsonego-Ornan 博士的研究证实，超加工食品（Ultra-processed food）不仅不促进生长，反而显著“抑制生长”。长期重度摄入超加工食品的儿童群体，其最终成年身高明显低于食用天然食物的人群。 2. **是否促进燃烧？** 果糖充斥于美国杂货店 73% 的在售商品中，正如前文所阐述，它通过抑制三种线粒体核心酶的活性，直接锁死了体内的能量燃烧机制。 结论显而易见：一种既不促进生长、又阻碍能量燃烧的物质，根本不配被称为食物，它的实质就是“毒药”（Poison）。现代杂货店表面看起来琳琅满目，实际上却是一片遍布慢性毒素的“雷区”。 为了帮助大众走出选购迷局，Lustig 透露他们开发了一款名为“Perfact”的数字化过滤系统（已在电脑上线，并即将登陆手机）。该工具能根据每个人的代谢健康状况个性化剔除有害商品： - 若设置“无麸质”，自动隐去所有含麸质产品； - 若患有“代谢综合征”，系统会彻底过滤掉所有精制碳水化合物与添加糖； - 若选择“排除超加工食品”，杂货店里足足 80% 的货架商品会直接在视野中消失，让消费者精准锁定仅存的健康真食物。 --- ### [01:21:00](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4860s) 告别 30 岁后的健康转折与个性化营养（赞助商插播） Stephen 插播了一段关于自身健康反思的赞助内容。他提到，30 岁是一个让人猝不及防的生理警钟：迈过 30 岁门槛后，他明显察觉到自身新陈代谢的放缓与日常精力的下滑，促使他开始严肃关注长期健康。作为节目赞助商以及他本人投资的企业，科学营养品牌 ZOE 扮演了他的“全天候私人营养教练”。 通过 ZOE 顶尖的科学检测与个体化算法，Stephen 改变了饮食行为：在点外卖时，他学会了更聪明的搭配策略，例如主动额外加一份蔬菜并将其作为开餐的第一道菜先吃，或者在菜单中筛选膳食纤维含量最高的餐品。他为听众提供了输入专属优惠码 "CEO10" 获取 10% 折扣的福利，呼吁大家重视基于自身生物学数据的饮食改良。 --- ### [01:21:59](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4919s) 纤维的终极真相：它不是给你的，是给肠道细菌的食物 广告结束后，Stephen 将话题引回被超加工工业剥离的核心要素——膳食纤维（Fiber）。他拿起手中的新鲜苹果与一瓶苹果汁进行对比：现代食品工业将完整的苹果加工成清亮的苹果汁，在这个过程中无情地剔除并丢弃了全部纤维。为什么把纤维当作残渣扔掉会带来如此灾难性的健康后果？ Lustig 一针见血地指出，整个食品行业和公众长期陷入了一个巨大的认知误区：人们以为把水果榨成汁后，残留在榨汁机滤网上的纤维只是毫无价值的废弃残渣；过去几十年来，健康宣传一直宣称鲜榨果汁保留了所有核心营养，比如维生素 C 或是番茄中的番茄红素。不可否认，果汁确实含有这些维生素，但被扔掉的膳食纤维才是真正不可替代的关键。“纤维确实是至关重要的必需成分——只是，它根本不是为你（人体）准备的必需品，它是为你体内的数万亿‘肠道细菌’准备的生命之源。”丢弃了纤维，等于让人体肠道菌群陷入饥饿，同时让高浓度的游离果糖直接冲击人体的肝脏与线粒体。 ### [01:22:53](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4973s) 肠道菌群与膳食纤维：维持健康的第一要务 罗伯特·卢斯蒂格（Robert Lustig）指出，膳食纤维对人体微生物群落（Microbiome）来说是绝对不可或缺的，因为这正是肠道细菌所赖以生存的食物。人们常说孕妇是“一个人吃，两个人补”，但实际上，每个人无时无刻不在为体内“100 万亿”个肠道微生物进食。用什么去喂养这些微生物至关重要：如果摄入充足的纤维，肠道内就能维持高度的“细菌多样性（Bacterial Diversity）”，不会出现某一种菌群独大并压制其他菌种的失衡局面，进而促进人体的代谢健康。 更关键的是，健康的菌群多样性能够维持肠道黏膜的多重物理与免疫屏障——包括黏蛋白层（Mucin layer）、细胞间的紧密连接（Tight junctions），以及由 Th17 细胞构成的免疫屏障。如果肠道屏障运转正常，肠道内的有害物质和毒素就无法穿透肠壁渗漏进血液，从而避免引发全身性的慢性炎症。因此，喂饱肠道微生物是保障健康的“头等大事”。人类自身缺乏分解纤维的酶，这些酶只有细菌才具备；当我们把食物中的纤维剥离掉时，本质上是在活活饿死体内的微生物群。 在纤维摄入量上，现代社会存在巨大的赤字： - **远古祖先**：每日摄入约 50 至 100 克纤维。 - **美国农业部（USDA）推荐标准**：每日应摄入 25 克纤维。 - **美英两国的实际平均摄入量**：仅有 12 克左右——仅为推荐标准的一半，甚至只有祖先摄入量的四分之一至八分之一。 ```mermaid flowchart TD accTitle: 膳食纤维对肠道与全身健康的作用机制 accDescr: 展示摄入充足膳食纤维如何通过肠道菌群发酵产生短链脂肪酸并维护全身免疫 subgraph INTAKE ["食物摄入"] FIBER["可溶性膳食纤维"] end subgraph GUT ["肠道微生态与屏障"] BACTERIA["100 万亿肠道微生物"] SCFA["短链脂肪酸<br/>(乙酸/丙酸/丁酸/戊酸)"] BARRIER["加固肠道屏障<br/>(黏蛋白层 / 紧密连接 / Th17细胞)"] end subgraph SYSTEMIC ["全身效应"] IMMUNE["丁酸调节并抑制免疫过度反应"] PROTECT["阻断有害物质入血<br/>避免全身性慢性炎症"] end FIBER --> BACTERIA BACTERIA --> SCFA BACTERIA --> BARRIER SCFA --> IMMUNE BARRIER --> PROTECT ``` 卢斯蒂格强调，当细菌发酵分解可溶性纤维时，会产生短链脂肪酸（Short-chain fatty acids，SCFA），包括乙酸（Acetate）、丙酸（Propionate）、丁酸（Butyrate）和戊酸（Valerate）。其中，丁酸尤为关键，它具有免疫调节与免疫抑制作用，能够防止免疫系统过度亢进。这也解释了为何在新冠疫情期间，肥胖、患有代谢综合征等基础疾病的人群以及少数族裔的重症和死亡率明显更高——因为他们长期摄入极度缺乏纤维的超加工食品，体内短链脂肪酸极度匮乏，导致免疫系统无法得到有效调控，最终在遭遇外部病原体入侵时引发失控的免疫风暴。 --- ### [01:26:08](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5168s) 纤维去哪了？食品工业如何将“食物”变成“大宗商品” 现代食品中的纤维究竟去了哪里？答案是：食品工业主动将其去除了，其根本原因在于**“纤维无法被冷冻”**。卢斯蒂格现场给主持人留了一道“今晚的家庭作业”：拿一个新鲜苹果放进冰箱冷冻室冻上一整夜，第二天早晨拿出来放在厨房台面上解冻，然后再试着吃它。主持人好奇地问会得到什么，卢斯蒂格直言：“你会得到一滩烂泥（Mush）。”因为在冷冻过程中形成的冰晶会刺破植物细胞壁，解冻时水分全涌出来，果肉随之彻底软烂。 食品工业深谙这一物理特性。为了实现长期储存与全球运输，他们把水果“压榨并冷冻”，去除了所有不可溶性纤维，做成果汁或冷冻浓缩橙汁。这种工艺把保质期原本极短、容易腐烂的新鲜水果，变成了可以永久储存的**大宗商品（Commodity）**。一旦成为大宗商品，它就可以被存放在仓库中，并在商品期货交易所挂牌交易，投资者可以利用其价格波动进行金融投机押注；而真正的新鲜水果在运到目的地之前就会腐坏，根本无法用于金融投机。 面对这一庞大的商业操纵链条，主持人提出疑问：食品巨头坐拥数万亿美元的资本，肆意操纵、篡改我们的食物，用广告侵入并劫持我们的大脑，如果消费者被如此全方位地算计，我们很容易觉得自己成了纯粹的受害者，那么我们在个人层面上究竟还背负着什么责任？卢斯蒂格赞同主持人的感受，明确表示消费者确实被“黑客入侵（Hacked）”了。公众被灌输了一个弥天大谎，以为“加工食品（Processed food）也是食物”；实际上，它或许该被称为“加工营养素（Processed nutrients）”，因为它虽然含有营养成分，却根本无法完成真正食物的核心功能——促进健康生长与正常的能量代谢燃烧。 --- ### [01:28:44](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5324s) “个人责任论”的伪善与自由意志的生物学假象 谈到“个人责任（Personal Responsibility）”，卢斯蒂格直言，讨论个人责任的前提是必须拥有**自由意志（Free Will）**。主持人提到自己近期恰好在研究这个课题，神经科学的诸多早期研究表明，早在人类大脑做出主观决定之前，无意识的神经活动就已经发生，这意味着我们所拥有的自由意志可能远比想象的要少。卢斯蒂格对此表示强烈赞同，并引用德国著名哲学家阿瑟·叔本华（Arthur Schopenhauer）的名言： > “人可以做他想做的，但不能要他想拥有的。”（You are allowed to do what you want, but you are not allowed to want what you want.） 卢斯蒂格解释道，面对一块糖果或一盒冰淇淋，你或许有选择吃哪一个的表层选择权；但你根本无法控制自己大脑中的伏隔核（Nucleus Accumbens）正在疯狂咆哮、极度渴望糖分。那种底层的生化驱动力完全脱离了自由意志的掌控。既然底层的生化反应是你完全无法操纵的，而所谓的个人责任要求个体“承担风险并承受后果”，那么在既无法控制生化风险也无法遏制驱动力的情况下，强求个人责任无异于空中楼阁。 所谓肥胖人群表现出的“暴饮暴食（Gluttony）”和“懒惰懈怠（Sloth）”，在生物学上只是生化失调后的**继发表现**，而非道德缺陷或意志力不足。这正是为什么单纯依靠“少吃多动（Diet and exercise）”的说教几十年来根本无法遏制肥胖流行的蔓延。卢斯蒂格严肃地指出，将系统性问题归咎于“个人责任”和“谴责受害者（Blaming the victim）”在历史上从未奏效过： - 艾滋病（HIV）危机无法通过谴责受害者解决； - 烟草成瘾流行也未能通过宣扬个人责任解决； - **每一个被推诿给个人责任的议题，最终无一例外都演变成了严重的公共卫生危机（Public health crisis）。**“个人责任论”在机制上站不住脚，在实际解决效果上也彻底是个败笔。 --- ### [01:32:11](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5531s) 偏见、成瘾与必须展开的社会干预 主持人补充了一个关于心理偏见的洞察：许多人在自己擅长自我约束的领域，往往带有一种认知偏差，武断地认为那些做不到的人纯粹是“缺乏自律”。因此，很多没有糖瘾困扰、能够轻松拒绝汽水的人，在听到这些讨论时往往会轻蔑地想：“不喝不就行了吗？我每次都能管住自己。”卢斯蒂格指出，那是因为这些人的伏隔核没有像被点亮的“圣诞树”一样疯狂发出渴望信号；而为什么不同个体的神经受体反应存在如此巨大的差异，科学界至今尚未完全查明。 卢斯蒂格列举了酒精成瘾的分布数据来类比成瘾异质性： - **40% 的美国人**是滴酒不沾者（Teetotalers）； - **40% 的人**是社交饮酒者，能够随时拿起杯子、随时放下，完全不会失控（卢斯蒂格表示自己就属于此类）； - **10% 的人**是狂饮型饮酒者（Binge drinkers）； - **10% 的人**是慢性酒精成瘾者（Chronic alcoholics）。 究竟是什么生物学机制将那 20% 陷入成瘾泥潭的人与另外 80% 正常人群区分开来，目前仍是未解之谜；但可以确定的是，成瘾对这 20% 的人来说是极其致命的现实，**“糖成瘾（Sugar Addiction）”**亦是同理。卢斯蒂格透露，他即将在伦敦举办的国际食物成瘾大会（International Conference on Food Addiction）上发表主题演讲，深入探讨食物成瘾究竟需要社会层面的救济干预，还是仅能作为个人责任看待。 卢斯蒂格最后总结了一条判定社会介入标准的铁律：**任何同时具备“毒性（Toxic）”和“成瘾性（Addictive）”的物质，都必须依赖某种形式的社会法律与政策干预。** - 仅仅具有毒性而没有成瘾性的物质（如过量的氧气、极量水中毒），不需要政府立法管控； - 仅仅具有成瘾性但没有严重系统毒性的物质（如咖啡因），也不需要严厉的社会规制； - 但当一种物质——比如超加工食品中的糖分——既能造成代谢毒性，又能劫持多巴胺奖励回路导致成瘾时，放任市场与强调个人责任便等同于纵容灾难蔓延。 ### [01:34:11](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5651s) 成瘾性物质的监管逻辑与超加工食品的监管真空 Robert Lustig 探讨了物质毒性与成瘾性如何决定社会的干预策略。当一种物质既有毒又令人成瘾时——例如可卡因、酒精、尼古丁或海洛因——社会层面总会建立起双重应对机制：对个人提供戒断康复支持（Rehab），对社会制定严密的法律法规。即使是咖啡因，单独存在时可能无需特别管控，但一旦被混合进酒精（例如曾经引发广泛心律失常事件的 Four Loko 预调酒），政府就必须介入监管。 然而，面对同样兼具毒性与高度成瘾性的糖和超加工食品（Ultra-processed Food），现行体制却处于“完全真空”状态，没有任何社会干预或法律法规加以限制。Lustig 直言，食品行业从来不会主动调整，必须由政府明确下达指令规定他们该做什么。 ```mermaid flowchart TD accTitle: 物质属性与社会干预机制对比 accDescr: 对比高毒性成瘾物质与超加工食品在社会干预和法规约束上的巨大反差。 subgraph Controlled["传统成瘾与毒性物质 (酒精、尼古丁、毒品)"] A1["个人层面：戒断康复支持 (Rehab)"] A2["社会层面：强制法律与行业监管规范"] end subgraph Uncontrolled["糖与超加工食品"] B1["个人层面：缺乏系统性戒断支持"] B2["政策层面：零法规、零强制配方限制"] end ``` ### [01:35:03](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5703s) 英国减盐秘密行动：政府干预的成功先例 对于“政府干预食品工业是否真正有效”的质疑，Lustig 拿出了英国历史上的经典案例。2003年，托尼·布莱尔（Tony Blair）领导的英国政府将全英所有大型食品制造商与连锁超市（包括 Waitrose、Tesco、M&S 及各大包装消费品企业）秘密召集到谈判桌前。当时，高血压和中风发病率急剧飙升，沉重的医疗负担几乎拖垮英国国家医疗服务体系（NHS），其根源正是超加工食品中居高不下的钠含量。 为了避免任何一家企业因单独减盐而陷入竞争劣势，布莱尔政府要求全行业遵守统一规则：所有包装食品中的钠含量每年削减10%，连续推行3年，累计降幅达到30%。整个行动在完全不向公众公开的情况下推进。2011年发表在《英国医学杂志》（BMJ）上的一项著名研究证实，由于这项未对公众宣扬的公共卫生干预，英国的高血压和中风发病率骤降了40%。这个案例雄辩地证明：只要政府制定统一的强制标准，食品配方重组不仅切实可行，而且能在宏观健康层面取得惊人成效。 - **2003年秘密协议**：召集 Tesco、Waitrose、M&S 等巨头，要求3年内每年降钠10%（累计减钠30%）。 - **统一规则消除壁垒**：所有竞争对手在同一时间节点按同等比例减盐，彻底消除了单家品牌的市场流失风险。 - **临床成果**：BMJ 于2011年刊发的追踪评估显示，英国人群的高血压与中风发生率下降了 40%。 ### [01:36:50](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5810s) 重塑食品供应链：代谢矩阵的三大核心原则 这种减盐监管模式能否直接复制到糖的治理上？Lustig 分享了自己近年来与中东乳品巨头科威特丹麦乳业（Kuwaiti Danish Dairy, 简称 KDD）的合作实践。KDD 被称为“中东的雀巢”，旗下生产大量调味乳、冰淇淋、冷冻酸奶、饼干、糖果和番茄酱等典型垃圾食品。2020年，该企业管理层主动找到 Lustig，坦陈科威特本土糖尿病发病率高达18%、肥胖率达80%，他们不愿继续充当健康危机的推手，希望借助科学指导将整个产品线重新改造成有益代谢健康的食品。 Lustig 在不收取任何个人报酬的前提下组建了科学顾问团队，历时三年制定出一套指导原则，即“代谢矩阵”（The Metabolic Matrix）。该矩阵确立了评估任何食物健康与否的三大基石： 1. **保护肝脏（Protect the Liver）** 2. **滋养肠道（Feed the Gut）** 3. **支持大脑（Support the Brain）** 根据这一准则，任何能够同时满足这三点的食物就是健康食物，无论它是否经过工业加工；而三点皆不符合的食物本质上就是毒药。文献数据表明，肝脏、肠道与大脑是健康级联反应的核心驱动源，只要修复了这三大器官，下游所有器官的病变都会随之改善；反之，若避开这三大器官去医治其他外周器官，则根本无法扭转病情。 ### [01:39:21](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5961s) 科学的本质与“悲观元归纳”假说 主持人提出尖锐疑问：食品工业固然长期向公众灌输“超加工食品即是正常食物”的观念，但历史上的科学家与政府同样给出过许多后来被证伪的膳食建议；若20年后另一批科学家推翻 Lustig 的观点，证明果糖无害而蔬菜致病该怎么办？正如伍迪·艾伦1973年的科幻喜剧电影《傻瓜大闹科学城》（*Sleeper*）中，主角冷冻沉睡200年醒来后，惊讶地发现未来的医学界竟然认定热软糖和高温油炸脂肪才是长寿秘诀。 面对“10年前的知识如今已被证明是错的，现在的知识10年后也必然出错”的虚无主义态度，Lustig 解释道，这种思维在科学哲学中被称为“悲观元归纳理论”（Pessimistic Meta-induction Theory），它极易让人陷入什么都不必做的虚无主义，而这正是人类历史上中世纪黑暗时代诞生的思想温床。 Lustig 强调，科学中唯一的教条就是“不存在任何教条”（There is no dogma）。“教条”的本质是诉诸盲从与盲信，而科学的根本使命恰恰是推翻上一代人树立的教条——正如人类推翻了水蛭放血疗法、推翻了癫痫是恶魔附身的荒谬认知。科学从来不是笔直前行的坦途，而是一条不断自我修正的折线（Zigzag）。即使几十年后当下的某些细节被进一步修正，只要它推动了认知车辆向前滚动，其作为历史进程中一枚齿轮的价值就无可抹杀。科学不是某种宗教信仰或一成不变的标准答案，而是一套不断检验证据真伪的动态认知流程。 ### [01:42:09](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6129s) 践行满足感的“4C”法则：抵御多巴胺劫持 在充斥着虚假信息与感官刺激的现代环境中，为了建立内在的满足感（Contentment）并打破多巴胺带来的成瘾循环，Lustig 在其著作《The Hacking of the American Mind》中提出了简单却强大的“4C”法则。这套法则完全免费、对全球所有人开放，其神经生化机制在于：**降低多巴胺（Dopamine）、平抑皮质醇（Cortisol）、提升血清素（Serotonin）**。 #### 1. 深度连接（Connect） 真正的连接绝非通过 Facebook、Instagram 或 Zoom 等数字化屏幕实现，而必须是面对面、眼神交汇的人际互动。人类枕叶皮层中存在一套“镜像神经元”（Mirror Neurons），它们在面对面交流时，不仅读取说话者的唇语，更会细腻捕捉面部微表情与肌肉抽动，从而实时转导共情与情绪共鸣。屏幕显示会彻底“扁平化”这些生物电信号，无法激活镜像神经元。只有面对面的深度社交，才能有效激发血清素信号，带来真正的满足感。 #### 2. 践行奉献（Contribute） 奉献不是向个人的养老金账户注资，而是怀揣利他目标向他人倾注价值（例如参与“仁人家园”无偿建房）。为他人奉献会直接促使大脑释放血清素。统计数据显示，彩票大奖得主往往并不幸福，而将财富与精力慷慨赠予他人的慈善家却能体会到持久的安宁。这种表面上看似无私的利他之举，在神经生理层面实际上带来了深刻的自我滋养。 #### 3. 积极应对（Cope） 有效应对生活压力包含三大基石： - **充足睡眠（Sleep）**：长期睡眠剥夺会导致压力激素皮质醇飙升。 - **正念专注（Mindfulness）**：注意力分散与多任务并行（Multitasking）会让皮质醇居高不下。 - **适度运动（Exercise）**：久坐不动不仅诱发暴饮暴食，还会使皮质醇水平失控。 三者协同发力，能够迅速拉低皮质醇，阻断压力导致的代谢恶化。 #### 4. 亲手烹饪（Cook） 现代加工食品严重破坏了体内的神经递质平衡。以**色氨酸（Tryptophan）**为例，它是合成神经递质血清素不可或缺的化学前体，但在自然界中本身就是最稀缺的氨基酸之一，在高度精炼的超加工食品中更是几乎被剥离殆尽。通过亲手烹饪天然食材，人们才能为大脑重新补充合成血清素所必需的原始养分。 ### [01:45:57](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6357s) 滋养血清素的天然饮食与“4C原则” 罗伯特·卢斯蒂格博士（Dr. Robert Lustig）深入剖析了如何通过饮食调节大脑的神经递质平衡。要让大脑产生足够的血清素以获得内在的宁静与满足，身体必须依赖色氨酸（Tryptophan），这种必需氨基酸天然富含于鸡蛋、鸡肉和鱼类之中，在超加工食品（Ultra-processed food）中几乎难以寻觅。与此同时，超加工食品中泛滥的果糖（Fructose）会直接降低大脑中的血清素水平。另一个关键拼图是 Omega-3 脂肪酸，它同样大量存在于鸡蛋和海洋生物（海鲜、深海鱼）中。卢斯蒂格指出，虽然植物中也含有 Omega-3（即 ALA，α-亚麻酸），但它在大脑中的转化利用率极低，无法穿透血脑屏障有效滋养大脑。因此，打造健康大脑的饮食逻辑异常纯粹：高色氨酸、低果糖、高 Omega-3 脂肪酸——而这正是“真正食物”（Real Food）的定义。 总结通往幸福感的神经调节机制，卢斯蒂格重申了“4C原则”：联结（Connect）、奉献（Contribute）、应对（Cope）与亲自下厨做饭（Cook）。这一套行为与营养组合能够有效平抑多巴胺（Dopamine）带来的过度亢奋与戒断焦虑，降低皮质醇（Cortisol）压力激素，大幅提升血清素（Serotonin），从而全面改善个人的心理健康与代谢机能。卢斯蒂格直言，这套方案能解决个人层面的困境，但无法直接逆转整个社会的沉沦；要化解社会维度的危机，必须先让整个世界看清问题的本质。 ```mermaid flowchart TD accTitle: 4C原则与神经代谢调控机制 accDescr: 展现4C原则如何通过生化调节恢复心理与代谢健康 subgraph Actions["核心行为 (4C原则)"] C1["联结 (Connect)"] C2["奉献 (Contribute)"] C3["应对 (Cope)"] C4["做饭 (Cook: 高色氨酸/低果糖/高Omega-3)"] end subgraph Biochem["生化调控机制"] D1["平抑多巴胺峰值<br/>(Tamp down Dopamine)"] D2["降低皮质醇压力<br/>(Reduce Cortisol)"] D3["提升血清素水平<br/>(Raise Serotonin)"] end subgraph Outcome["身心与代谢结果"] R1["改善心理健康与内在满足"] R2["逆转代谢异常与慢性病根源"] end Actions --> Biochem Biochem --> Outcome ``` ### [01:47:09](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6429s) 危机总根源：饱受攻击的大脑杏仁核 当主持人斯蒂芬·巴特利特（Steven Bartlett）问及本场对话中尚未提及、却最为关键的核心议题时，卢斯蒂格给出了一个极具震撼力的宏观视角。他指出，人类当前正同时面临三场全面爆发的危机：首先是系统性代谢健康危机（糖尿病、代谢综合征、痴呆症、癌症）；其次是心理健康危机（抑郁症、自杀、精神分裂症、自闭症、ADHD多动症）；最后是全球与行星级危机（网络霸凌、社会不平等、战争以及正在剧烈恶化的气候变化）。他反问，这一切在同一历史节点集中爆发，难道真的只是巧合吗？如果我们将它们孤立看待并分别试图修补，就永远触碰不到本质。 卢斯蒂格揭示，所有这些危机的共同生物学根源，在于我们大脑的恐惧与情绪中心——杏仁核（Amygdala）。杏仁核正在遭受现代生活方式的全方位围攻与持续过度激活。正常情况下，大脑有四道生理“刹车”机制来抑制杏仁核的狂暴反应，但如今这四道刹车全部陷入功能失调。摧毁刹车系统的罪魁祸首正是前文探讨的一切：飙升的皮质醇、持续的心理压力、超加工食品带来的代谢毒性、长期的睡眠剥夺、空气污染以及环境毒素。这些因素彻底瓦解了神经系统传递与处理信息的正常机能，使人类深陷慢性应激、敌意与认知扭曲之中。"直到我们认清问题究竟出在哪里之前，我们都只是在原地打转；我们完全有能力倒车走出泥潭，就像当初开进去一样，但前提是你必须先看清悬崖与陷阱。" - **三重系统性危机的交汇**：代谢退行性疾病、心理精神疾病与地缘/生态危机并非彼此独立，而是同一种深层生物学紊乱的投射。 - **杏仁核功能失调（Dysfunctional Amygdala）**：恐惧与应激中枢失控，是慢性病泛滥、社会戾气加剧以及环境掠夺行为背后的核心驱动力。 - **四道制动机制全部失效**：被应激压力（皮质醇）、高糖加工饮食、睡眠缺失和环境污染联合瓦解。 ### [01:49:44](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6584s) 最后一问：写给二十岁自己的忠告与致谢 节目迎来了最后一问的传统环节：上一位匿名嘉宾为卢斯蒂格留下了一个问题——“如果有机会对20岁的自己说一句话，你希望自己早点知道什么？这会如何改善你的人生并帮你避免痛苦？” 卢斯蒂格沉思片刻后给出了充满人生沉淀的回答："我真希望我当年就知道：我根本没有必要去讨好每一个人。"他特别提到了《被讨厌的勇气》（*The Courage to Be Disliked*）这本书，强调敢于被他人讨厌本身就是一种巨大的勇气。年轻时的他极度害怕被人讨厌、不被认可，而荒谬的现实却是，越是战战兢兢地试图迎合所有人，反而越容易招致反感与不被尊重。他感叹，如果能在职业生涯早期就参透这粒真理的种子，便能卸下无数不必要的精神枷锁。 对谈尾声，斯蒂芬·巴特利特向卢斯蒂格致以崇高的敬意，高度赞誉其学术专著对全球公共健康认知的重塑。巴特利特逐一回顾了桌上的三部代表作：《被黑客入侵的美国大脑》（*The Hacking of the American Mind*），揭示了现代商业社会如何利用神经递质劫持大众意志；《机会渺茫》（*Fat Chance*），详尽拆解了糖分、超加工食品与肥胖疾病的严谨科学实证；以及奠定代谢科学基石的巨著《代谢力》（*Metabolical*），深刻揭露了食品工业与现代医学对大众的系统性误导。巴特利特动情地表示，卢斯蒂格毕生的研究不仅在挽救无数人的生命，更以极具感染力的方式推动着全人类健康对话的浪潮。两位对谈者在真挚的道谢与祝福中为这场长达近两小时的思想交锋画上了句号。 ## Notable quotes > [01:58](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=118s) 是你、是我，是每一个人的大脑都被黑了。 — 罗伯特·卢斯蒂格 > [10:28](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=628s) 剂量决定毒性。 — 帕拉塞尔苏斯 > [29:16](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1756s) 喝一罐含糖苏打水的毒性，相当于喝两罐代糖无糖苏打水。 — 罗伯特·卢斯蒂格 > [29:16](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=1756s) 危害减半绝不等于它是健康的，危害减半依然意味着它有害。 — 罗伯特·卢斯蒂格 > [34:38](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2078s) 从我的角度来看，整套卡路里理论都该被扔进下水道。我站在这里，就是要发起一场消灭卡路里度量衡的战役。它在我们的社会对话中毫无立足之地，在医学界更不应有立足之地——卡路里理论糟透了。 — 罗伯特·卢斯蒂格 > [36:29](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2189s) 任何还在提‘卡路里’的人，都应该直接被解雇。 — 罗伯特·卢斯蒂格 > [46:03](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=2763s) 毒药 A 加上解药 B，结果依然是死亡。 — 罗伯特·卢斯蒂格 > [01:17:46](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4666s) 酒精虽然有热量，但酒精的毒性与其所含热量毫无关联。具有热量并不代表它就是食物。 — 罗伯特·卢斯蒂格 > [01:21:59](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=4919s) 纤维确实是至关重要的必需成分——只是，它根本不是为你准备的必需品，它是为你体内的数万亿‘肠道细菌’准备的生命之源。 — 罗伯特·卢斯蒂格 > [01:28:44](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5324s) 人可以做他想做的，但不能要他想拥有的。 — 阿瑟·叔本华 > [01:32:11](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5531s) 任何同时具备‘毒性’和‘成瘾性’的物质，都必须依赖某种形式的社会法律与政策干预。 — 罗伯特·卢斯蒂格 > [01:39:21](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=5961s) 科学中唯一的教条就是不存在任何教条。 — 罗伯特·卢斯蒂格 > [01:49:44](https://www.youtube.com/watch?v=4DWKf5RqU-s&t=6584s) 我真希望我当年就知道：我根本没有必要去讨好每一个人。 — 罗伯特·卢斯蒂格 ## Mentioned 罗伯特·卢斯蒂格 (Robert Lustig), 斯蒂芬·巴特利特 (Steven Bartlett), The Diary Of A CEO, 《被黑客入侵的美国大脑》（The Hacking of the American Mind）, 《胖死的真相》（Fat Chance）, 《代谢力》（Metabolical）, 《寂静的春天》（Silent Spring）, 《被讨厌的勇气》, 《傻瓜大闹科学城》（Sleeper）, 加利福尼亚大学旧金山分校 (UCSF), 哈佛大学公共卫生学院, 世界卫生组织 (WHO), 美国食品药品监督管理局 (FDA), 美国国家牙科研究所 (NIDR), 美国糖业协会 (Sugar Association), 美国农业部 (USDA), 英国国家医疗服务体系 (NHS), 圣裘德儿童研究医院 (St. Jude Children's Research Hospital), 剑桥大学阿登布鲁克医院 (Addenbrooke's Hospital), 耶路撒冷希伯来大学, 伦敦大学学院 (UCL), 维塔健康 (Virta Health), ZOE, 科威特丹麦乳业 (KDD), 家乐氏 (Kellogg's), 宝氏 (Post), 亿滋 (Mondelēz), 特氟龙 (Teflon), Perfact, 帕拉塞尔苏斯 (Paracelsus), 弗雷德·库梅罗 (Fred Kummerow), 弗雷德·斯塔尔 (Fred Stare), 马克·赫格斯特德 (Mark Hegsted), 雅尼娜·佩皮诺 (Yanina Pepino), 萨达夫·法鲁奇 (Sadaf Farooqi), 史蒂夫·奥拉希利 (Steve O'Rahilly), 吉米·贝尔 (Jimmy Bell), 蕾切尔·卡森 (Rachel Carson), 埃夫拉特·蒙索内戈-奥南 (Efrat Monsonego-Ornan), 托尼·布莱尔 (Tony Blair), 阿瑟·叔本华 (Arthur Schopenhauer), 伍迪·艾伦 (Woody Allen) ## Video description Robert Lustig is a Professor of Paediatric Endocrinology and a public health expert on the impact of sugar on our health. He is the author of bestselling books such as, ‘Fat Chance’, ‘Metabolical’, and ‘The Hacking of the American Mind’. 00:00 Intro 01:58 Our Minds Have Been Hacked! 05:03 What Dopamine Does to Your Brain 07:53 Sugar Is A Big Problem In Today’s Society 10:28 Why Sugar Is Poison To Our Bodies 11:08 The Difference Between Sugar and Fructose 14:53 This Is How Sugar Is Damaging Your Body 18:29 Damaging Effects on the Brain from Sugar Consumption 22:20 How the Food Industry Is Making You Eat Crazy Amounts of Sugar 25:05 Health Side Effects 27:12 Diet Coke, Saviour or Villain? 35:17 Sugar and the Impact on Our Organs 40:08 How Important Are Calories as a Way to Lose Weight? 43:47 Sugar Addiction, Stress, and Other Triggers 46:03 The Only Foods That Don't Contain Sugar 48:31 Food Labels Are Sending Wrong and Inaccurate Messages 50:16 Babies Are Born Fatter Than Before 51:30 Research on Children's Obesity 54:20 Insulin Resistance 56:00 Can We Reverse Diabetes? 58:34 What Is Leptin & How It’s Involved In Weight Loss 01:02:23 What Are Obesogens & How They Impact Our Health 01:03:31 The 3 Different Types of Fat You Should Be Worried About 01:09:34 Fruit Consumption… Good or Bad? 01:11:45 Environmental Chemicals That Make Us Fat 01:14:16 What Is an Endocrine Disruptor & How Can We Deal with Them? 01:17:11 How To Identify Real Food 01:22:20 The Importance of Fibre in Food 01:27:02 Personal Responsibility 01:34:50 Should the Government Get Involved? 01:39:40 Are We Being Lied To? 01:42:09 The Four C's for Contentment 01:47:19 What Is the Cause of All Our Health Problems? 01:49:46 Last Question You can purchase Robert’s book, ‘Metabolical’ here: https://amzn.to/4b8pcg3 Follow Robert: Twitter - https://bit.ly/4brlsG9 Follow me: https://beacons.ai/diaryofaceo Sponsors: ZOE: http://joinzoe.com with an exclusive code CEO2024 for 10% off [Source](https://www.youtube.com/watch?v=4DWKf5RqU-s)

[1:58] 罗伯特·卢斯蒂格: 是你、是我，是每一个人的大脑都被黑了。 [10:28] 帕拉塞尔苏斯: 剂量决定毒性。 [29:16] 罗伯特·卢斯蒂格: 喝一罐含糖苏打水的毒性，相当于喝两罐代糖无糖苏打水。 [29:16] 罗伯特·卢斯蒂格: 危害减半绝不等于它是健康的，危害减半依然意味着它有害。 [34:38] 罗伯特·卢斯蒂格: 从我的角度来看，整套卡路里理论都该被扔进下水道。我站在这里，就是要发起一场消灭卡路里度量衡的战役。它在我们的社会对话中毫无立足之地，在医学界更不应有立足之地——卡路里理论糟透了。 [36:29] 罗伯特·卢斯蒂格: 任何还在提‘卡路里’的人，都应该直接被解雇。 [46:03] 罗伯特·卢斯蒂格: 毒药 A 加上解药 B，结果依然是死亡。 [77:46] 罗伯特·卢斯蒂格: 酒精虽然有热量，但酒精的毒性与其所含热量毫无关联。具有热量并不代表它就是食物。 [81:59] 罗伯特·卢斯蒂格: 纤维确实是至关重要的必需成分——只是，它根本不是为你准备的必需品，它是为你体内的数万亿‘肠道细菌’准备的生命之源。 [88:44] 阿瑟·叔本华: 人可以做他想做的，但不能要他想拥有的。 [92:11] 罗伯特·卢斯蒂格: 任何同时具备‘毒性’和‘成瘾性’的物质，都必须依赖某种形式的社会法律与政策干预。 [99:21] 罗伯特·卢斯蒂格: 科学中唯一的教条就是不存在任何教条。 [109:44] 罗伯特·卢斯蒂格: 我真希望我当年就知道：我根本没有必要去讨好每一个人。

[0:00] Robert Lustig: calories are not the issue [0:00] Robert Lustig: it's usually the opposite. [10:28] Paracelsus: The dose determines the poison. [27:12] Robert Lustig: The toxicity of one sugared soda equals the toxicity of two diet sodas. Half as bad does not mean good. Half as bad means half as bad. [86:02] Robert Lustig: You have taken a fruit, which is food, and you have turned it into a commodity... because it won't go bad. [87:02] Arthur Schopenhauer: You are allowed to do what you want, but you are not allowed to want what you want. [98:34] Robert Lustig: There's only one dogma, Stephen, and the dogma is that there is no dogma, because everything has to be refined. [102:09] Robert Lustig: High tryptophan, low fructose, high omega-3s... sounds like real food to me. [109:46] Robert Lustig: I wish I had known that I didn't have to please everyone... I was afraid of being disliked, and because I was afraid of being disliked, I was disliked.

[0:00] let's be clear and honest about this [0:02] calories are not the issue this is all [0:04] about that's the problem that's how you [0:06] lose weight do Robert lustig is an [0:09] endocrinologist whose firsthand research [0:11] has explored the role sugar has on [0:12] fueling the world's most destructive [0:14] human conditions and answerers how we [0:16] can regain control of our health if you [0:18] consume one sugared beverage per day [0:21] your risk for diabetes goes up by 29% so [0:24] this is a big problem we also know that [0:26] if you have high sugar consumption it's [0:28] got multiple detriments effects such as [0:31] mental health problems cognitive decline [0:33] early death we also know it's the [0:35] primary driver of ADD but the problem is [0:37] Sugar's addictive and 73% of all of the [0:41] items in the grocery store are spiked [0:43] with added sugar by the food industry [0:46] cuz they know when they add it you buy [0:48] more you can't believe what they're [0:50] telling you if they say something is [0:52] healthy it's usually the opposite and [0:54] I'm part of numerous lawsuits suing the [0:56] food industry because they knew that [0:59] sugar was a problem [1:00] but they paid off scientists to say it [1:03] wasn't you've been hacked but a lot of [1:05] people don't have time to be doing a [1:06] fine tooth comb over every single thing [1:09] that they're putting into their body [1:10] they're not a scientist agreed so what [1:12] advice do we give that is simple and [1:13] actionable food can be medicine food can [1:17] also be poison and the question is how [1:19] do you figure out which is which so [1:20] here's the [1:24] secret congratulations daro gang we've [1:27] made some progress 63% of you that [1:29] listen to to this podcast regularly [1:31] don't subscribe which is down from [1:34] 69% our goal is 50% so if you've ever [1:39] liked any of the videos we've posted if [1:40] you like this channel can you do me a [1:42] quick favor and hit the Subscribe button [1:43] it helps this channel more than you know [1:45] and the bigger the channel gets as [1:46] you've seen the bigger the guests get [1:49] thank you and enjoy this [1:53] episode Dr Robert [1:55] lustic on the front of your book it says [1:58] the hacking of the Mind very strong [2:02] words to use indeed whose mind has been [2:05] hacked and who is doing the hacking [2:07] yours mine everyone's who's been doing [2:11] it [2:12] well pretty [2:14] much anyone with a A belief system [2:19] that's not [2:20] yours and that's pretty much everybody [2:23] the bottom line is uh we have been sold [2:27] a bill of goods we as a society [2:30] we as individuals have been sold to bill [2:32] of goods and the idea of the book The [2:36] reason I put the book together is [2:38] because it actually makes us miserable [2:42] it has [2:43] stolen our Birthright and our birth [2:45] right is to be happy and we are not if [2:49] anything we're the opposite of happy [2:51] we're extraordinarily unhappy just look [2:53] at the incidence of depression around [2:56] the world not just in America not just [2:58] in the UK but [3:00] everywhere the World Health Organization [3:02] now says that 5% of all of the people on [3:06] the planet are clinically depressed and [3:09] here in America it's at [3:12] 22% so we're really [3:14] unhappy the question is why is this if [3:18] you know our goal is to be happy it's in [3:20] the Declaration of Independence life [3:22] liberty in the pursuit of happiness well [3:24] we're [3:25] not so why the reason is is because we [3:30] have [3:31] substituted pleasure for [3:34] happiness what's the difference between [3:36] pleasure and [3:38] happiness well pleasure is shortlived [3:41] happiness is [3:42] longlived pleasure is visceral you feel [3:46] it in your body happiness is ethereal [3:48] you feel it above the neck pleasure is [3:52] taking like from a casino happiness is [3:54] giving like habitats for Humanity [3:58] pleasure is experience [4:00] alone happiness is usually experienced [4:02] in social [4:04] groups pleasure can be achieved with [4:07] substances happiness cannot be achieved [4:09] with [4:10] substances the extremes of pleasure [4:12] whether they be substances or behaviors [4:15] so substances Like Cocaine amphetamine [4:17] nicotine alcohol sugar or behaviors uh [4:21] shopping gambling social media internet [4:23] gaming pornography in the extreme all [4:27] lead to addiction there's an a holic [4:29] after every one of those shopaholic [4:31] sexaholic chocoholic alcoholic Etc but [4:35] there's no such thing as being addicted [4:36] to too much happiness and lastly number [4:39] seven the one that is the reason for the [4:41] book Pleasures dopamine happiness is [4:44] serotonin and they are not the [4:47] same so two different neurotransmitters [4:50] two different sets of receptors two [4:52] different areas of the brain two [4:54] different mechanisms of action two [4:56] different clearance mechanisms don't [4:59] dopamine is an excitatory [5:02] neurotransmitter what does that mean [5:04] means when dopamine is released in the [5:07] area of the reward center the nucleus [5:10] accumbent it's an actual anatomic [5:13] structure in the brain which you can see [5:15] on Imaging when dopamine is released [5:18] there and it binds to its receptor like [5:20] so you get the you transduce the [5:24] feelings of reward okay and reward is [5:26] good reward is what gets you out of bed [5:28] in the morning if you don't have reward [5:30] you know basically you shrivel up and [5:33] die okay reward is essential to the [5:37] survival of the species orgasm is reward [5:41] okay you know you need it it's it's part [5:45] of daily life but okay too much reward [5:49] is a different story and the reason is [5:51] because dopamine because it's an [5:52] excitatory [5:53] neurotransmitter it causes the next cell [5:56] to fire well if it causes the next cell [5:58] to Fire and Fire and [6:00] Fire that cell [6:03] dies neurons want to be tickled not [6:06] bludgeoned chronic overstimulation of [6:08] any neuron leads to neuronal cell death [6:12] so that postoptic neuron with the [6:14] dopamine receptor it's got a plan B it's [6:17] got a way of mitigating that negative [6:20] response it [6:21] downregulates the receptor so now more [6:25] dopamine less receptors less chance that [6:28] a molecule will find a receptor to bind [6:30] to well that means your the gain the [6:35] amplitude on the reward is going down [6:38] more and more for less and less the more [6:41] law of diminishing returns like an [6:43] addiction like a tolerance yeah [6:45] tolerance is one half of addiction and [6:47] then when the neurons do start to die [6:48] that is addiction exactly right so [6:51] dopamine drives addiction and it doesn't [6:54] matter what the cause of the dopamine [6:56] release is in the extreme it will be [7:01] addictive now [7:03] serotonin does not uh does not [7:06] downregulate its own receptor because [7:07] it's not an excitatory neurotransmitter [7:09] it's an inhibitory one so do you need to [7:12] downregulate an in inhibitory response [7:15] no an inhibitory means what well it [7:17] means puts the next neuron to rest okay [7:20] instead of stimulating instead of firing [7:22] it's actually calming okay right so [7:26] there's no such thing as being addicted [7:28] to too much happiness because the [7:30] receptors are still there but there's [7:32] one thing that downregulates [7:35] serotonin and that's dopamine so the [7:37] more pleasure you seek the more unhappy [7:41] you get and we've been told for the last [7:44] 100 years that pleasure is [7:48] happiness neurologically the pathways [7:50] are entirely different as you say and [7:53] between pleasure and happiness one of [7:55] the ways that we have been h h [8:00] act [8:01] neurologically and Via our dopamine [8:03] receptors is through what we eat and [8:06] your book Fat Chance covers this really [8:08] profoundly in New York Times bestell the [8:10] first word in the subtitle there is the [8:13] word sugar MH I've heard a lot about [8:16] sugar um I see it in adverts I I I turn [8:19] over the back of anything I eat and it [8:21] says this word added sugar is sugar [8:24] really a problem in society has it [8:27] really hijacked us yes the answer is not [8:30] only is it a problem I personally think [8:34] it's the biggest problem it's not the [8:37] only problem but I think it is the [8:39] biggest one now why do I say that from a [8:43] systemic health issue the biggest [8:46] problem was trans fats what's a trans [8:50] fat trans fat is a fat that is has a [8:54] double bond in it that is flipped so [8:59] Norm normal unsaturated fats like olive [9:02] oil like canola oil like rap seed oil [9:06] like cesame oil like peanut oil okay Etc [9:11] they all have a double bond in them but [9:14] the double bond is in One Direction a [9:17] trans fat has the double bond in the [9:19] opposite direction one way to make a [9:22] trans fat is to heat it you put enough [9:24] heat across the double bond and it will [9:26] flip by itself so if you heat olive oil [9:29] too high you can actually make trans [9:31] fats at home but the food industry used [9:34] trans fats for food [9:36] stabilization for to increase shelf life [9:39] they've been using it in baked goods [9:41] since the [9:42] 1920s the scientist who first figured [9:45] out that trans fats were [9:47] dangerous Fred Kumo figured this out in [9:51] 1957 but it wasn't until 1988 that [9:55] anybody took him seriously and then we [9:57] started doing research on it and ized oh [9:59] my God this stuff is killing animals and [10:02] killing people and finally in [10:05] 2013 so over 60 years after the initial [10:10] uh [10:11] science the FDA finally banned trans [10:14] fats in our [10:15] food without question trans fats are the [10:18] devil incarnate seriously you know [10:22] consumable poison no if Sor buts is [10:24] sugar poison [10:27] sugar is like alcohol so is alcohol [10:33] poison depends on the [10:36] dose right the dose determines the [10:38] poison paracelsus [10:41] 1537 we have an innate capacity to [10:45] metabolize alcohol and if we stay below [10:48] that doesn't do too much damage if we go [10:52] above it different story same thing with [10:55] sugar same thing with this molecule the [10:57] sweet molecule fructose and the reason [10:59] is because fructose and alcohol are [11:01] metabolized virtually identically what's [11:04] the difference between sugar and [11:05] fructose so sugar dietary sugar the [11:09] sweet stuff the crystals the uh stuff [11:12] you put in your coffee the stuff I've [11:13] got over here yeah like that [11:15] stuff yeah that stuff the 10 the 5B bag [11:20] right there that's called sucros okay [11:24] this is sucrose this is sucrose now [11:26] sucrose is two molecules bound together [11:29] one molecule called glucose one molecule [11:32] called fructose they are not the same [11:35] now the food industry will tell you they [11:36] are the same they are not the same the [11:39] reason they tell you they are the same [11:41] is because that's the way they assuage [11:43] their own culpability for what they've [11:45] done to the food but they are not the [11:48] same they will say a sugar is a sugar a [11:51] calorie is a calorie a glucose and [11:53] fructose both have four calories per [11:55] gram why should you care oh you care a [11:58] lot you care a whole lot now glucose is [12:02] the energy of life every cell on the [12:04] planet Burns glucose for energy glucose [12:07] is so important that if you don't [12:08] consume it your body makes it okay the [12:11] Inuit had no carbohydrate they had ice [12:15] they had whale blubber they still had a [12:17] serum glucose level Inu so the people [12:20] that live in the uh North Poles and [12:21] stuff that's right yeah the forly known [12:23] as Eskimos right but they they didn't [12:27] have any carbohydrate they off fat but [12:31] they still had a serum glucose level [12:32] because your brain runs on glucose they [12:36] can also run on ketones too but you know [12:39] your brain runs on glucose my brain runs [12:41] on [12:42] glucose and you need glucose because [12:45] certain um hormones and certain proteins [12:49] in the body require [12:51] glycosilation in order to be effective [12:54] an example LH and FSH when you don't [12:58] have gly illation of LH and FSH the [13:01] hormones that tell your testicle and [13:03] your ovary to [13:04] work you are [13:06] infertile it's that simple so survival [13:09] of the species says you need some [13:10] glucose but if you're not consuming it [13:13] you'll still get it because your body [13:15] will make it it will make it out of [13:17] amino acids it will make it out of fat [13:20] gluconeogenesis it's called so glucose [13:24] is essential it's just not essential to [13:26] eat fructose on the other hand the a [13:29] sweet molecule in that bag which is sort [13:31] of one of the two parts of the the the [13:34] grain of sugar that I see one one part [13:35] of it is fructose that's right it's the [13:38] other half it's the the evil twin if you [13:40] will what are the two halves again [13:42] glucose yeah fructose found together I [13:45] need glucose to live my body will figure [13:46] that out [13:47] fructose do I need this you not only do [13:50] you not need [13:51] it but in high dose it's [13:56] toxic now your liver has has the innate [14:00] ability to [14:01] metabolize a small amount on the order [14:05] of about 6 to 9 teaspoons per day of [14:09] dietary sugar so half of that being [14:11] fructose so about 12 grams your liver [14:14] can manage about 12 gram of fructose a [14:17] day in the same way it can ma manage [14:20] about 12 grams of alcohol per day [14:22] without showing any signs of any U [14:25] metabolic derangement but if you go [14:28] above that that now you get problems are [14:31] we above that oh we are so above that we [14:37] are at 50 gram of fructose per day 100 [14:40] gram of sugar per day we're supposed to [14:44] be at 25 we are at 100 we are quadruple [14:47] our limit and and also just because [14:50] grams are quite hard to wrap the head [14:52] around right okay so if I was to get a [14:54] tablespoon well do teaspoons a teaspoon [14:57] teaspoons how many teaspoons of sugar [14:59] what I have to consume to get to that [15:00] level of fructose CU I say this in part [15:02] because most of us don't realize that [15:04] we're consuming sugar that's right [15:06] because it's hidden in all of the food [15:09] that's exactly right we don't even know [15:12] we say oh I never even add sugar to my [15:14] coffee therefore my sugar consumption is [15:17] zero [15:18] wrong that is not true okay because it [15:22] is hidden in plain sight in virtually [15:25] every processed food in the entire [15:28] grocery store [15:29] 73% of all of the items in the American [15:32] grocery store and in the British grocery [15:35] store are spiked with added sugar by the [15:37] food industry for its purposes not for [15:39] yours because they know when they add it [15:42] you buy more and how much does that look [15:44] like in teaspoons then the upper limit [15:47] is about six teaspoons of added sugar [15:50] per day the allowance the re all the re [15:53] the the upper limit okay the recommended [15:55] allowance is lower than that yeah okay [15:57] but the upper limit is about six [15:59] teaspoons of added sugar per day so in [16:02] alcohol terms that' be like one drink so [16:06] if you have a drink a day you're staying [16:09] below your threshold and all is fine [16:12] what if you have two drinks per [16:14] day now it depends on how well your [16:16] liver Works maybe how much exercise you [16:18] have how much total body mass you have [16:21] Etc what about if you have three drinks [16:23] a day you're going to get pretty tipsy [16:26] maybe you shouldn't be driving a car [16:28] right what if you have four drinks per [16:30] day you know they might have to you know [16:33] uh scrape you off the floor of the bar [16:35] with a spatula and what if you have five [16:37] drinks per day you're a fraking [16:38] alcoholic is what you are all right the [16:41] point is the dose determines the poison [16:44] well the same is true with sugar so we [16:47] have an innate capacity to [16:50] metabolize about 12 Gams of fructose per [16:53] day by the way that's for adults for [16:56] children it's onethird of that four gram [17:00] of fructose per [17:02] day okay four to six so we're talking [17:07] very little talking very little but when [17:09] you think about for instance kid in [17:13] America what you know 29% of kids in [17:16] America consume the National School [17:19] breakfast program breakfast in school [17:23] okay 29% so what is the National School [17:26] breakfast program breakfast it's a bowl [17:29] of Froot Loops and a glass of orange [17:31] juice that is 41 g of sugar the upper [17:36] limit for children in terms of their [17:39] metabolism is 12 gram per day they got [17:44] 41 gam and it's just [17:49] breakfast what do you think that's going [17:51] to [17:52] do now if a calorie were a calorie and [17:55] if glucose and fructose were the same [17:58] then you say say well you get got to get [17:59] your calories [18:01] somewhere but because fructose is not [18:03] glucose because fructose is more like [18:06] alcohol because fructose toxicity has [18:09] nothing to do with its [18:11] calories that is a huge overdose and it [18:15] has metabolic complications has systemic [18:18] Health complications it has mental [18:21] health complications and ultimately it [18:23] has societal complications do you think [18:25] it has neurological consequences without [18:28] question it's the it's a primary driver [18:30] of add it's not the only driver but it's [18:33] one of them it's a primary driver [18:35] depression because we have the data as [18:37] it relates to ADD and ADHD and all those [18:39] kinds of things how do we know we have [18:41] functional MRI we have performance uh [18:45] data showing that when you take the [18:47] sugar out PE kids scores get better okay [18:51] we did this ourselves at UCSF we did a [18:54] study where we took 43 children with [18:57] obesity and metabol syndrome all high [19:00] sugar consumers all low socioeconomic [19:03] status children a Latino and [19:06] African-American all high sugar [19:08] consumers and what we did was we figured [19:10] out what they were eating on their home [19:12] diet we studied them on their home diet [19:15] and then for the next nine days we [19:17] catered their meals no added sugar we [19:21] took the added sugar from 28 Tas 28 uh [19:26] uh teaspoons of added sugar per day down [19:28] to [19:29] 10 okay so huge reduction we gave them [19:33] fruit that was the only place they had [19:36] sugar in their diet otherwise we cut the [19:40] sugar out now if you do that you're [19:41] going to lose 350 to 400 calories per [19:43] day out of your diet all right so the [19:46] goal was to keep their weight stable [19:49] because if they lost weight the critics [19:51] would say well of course they got better [19:52] they lost weight so we needed to [19:54] maintain their weight so we had to put [19:56] something back in that was we caloric we [20:00] gave them extra starch so in the [20:03] vernacular we took the pastries out we [20:05] put the bagels in we took the sweeten [20:07] yogurt out we put the baked potato chips [20:08] in we took the chicken teriyaki out we [20:10] put the turkey hot dogs in so we didn't [20:12] give them good food we gave them crappy [20:14] food we gave them Safeway food you know [20:17] just cpg you know uh uh consumer [20:21] packaged Goods food you know okay so you [20:23] didn't give them vegetables just no we [20:25] didn't give them any vegetables okay but [20:27] it was no added sugar food okay it [20:29] wasn't funky food it was just food we [20:31] bought at Safeway but it was chosen to [20:34] not be um sugar containing okay and we [20:39] gave them a scale and every day we'd [20:41] call them up on the phone what your way [20:43] and if they were losing weight eat more [20:45] in order to maintain their weight for [20:46] the whole 10 days of the study and then [20:49] we studied them on day 10 every aspect [20:52] of their metabolic Health improved blood [20:55] pressure went down blood glucose went [20:57] down insulin went down their pancreas [20:59] has started working right again they had [21:01] a serum lactate level you're not [21:02] supposed to have a lactate level that [21:04] means your mitochondria are [21:05] dysfunctional if you have a lactate [21:07] level okay their lactate cleared [21:09] everything got better most importantly [21:13] for the first 5 days of that 10day [21:17] window the kids were obnoxious the [21:21] parents would complain to us my kid is a [21:26] disaster and the reason was because of [21:31] withdrawal they were withdrawing off [21:33] sugar withdrawing off [21:36] fructose and then like you know Moses [21:41] the sky [21:42] cleared and the [21:45] kids started concentrating better they [21:48] started doing better in school the [21:50] parents noticed they were less irritable [21:52] the teachers noticed they weren't [21:55] nuisances or trouble in the school [21:57] anymore the kids noticed they said this [21:59] the first time my head hasn't been in [22:00] the [22:03] clouds 5 days 5 days and in 10 days we [22:07] could see all of the metabolic [22:11] benefits even though they maintained [22:13] their weight even though they maintain [22:15] their calories sounds like a bit of a [22:18] scandal when I hear that these kids are [22:20] getting 30 almost 30% of kids are [22:22] getting you know almost you know three [22:25] to four times their recommended daily [22:29] allowance of sugar from school and that [22:33] it's having these sort of really adverse [22:35] consequences on us and the studies are [22:36] there to prove that the consequences are [22:38] very real MH it sounds like a scandal in [22:41] the sense that nobody's doing something [22:43] about it ah well yes that way it is the [22:46] point is that the food industry is very [22:48] powerful and they have you know um swept [22:52] virtually every aspect of this under the [22:55] rug for 40 to 50 years [22:59] they knew back in the [23:01] 1960s that sugar was a problem but they [23:04] paid off scientists to say it wasn't and [23:08] we actually have the documents from the [23:11] food industry they live at the UCSF food [23:14] industry documents library and we are [23:17] doing research on corporate interference [23:21] in health what do those documents show [23:24] they show that in [23:26] 1965 the sugar industry came to two [23:30] Harvard School of Public Health [23:31] scientists the head of the Department of [23:34] nutrition Fred stair and his associate [23:37] Mark hegstad who became the head of the [23:39] USDA uh five years later and paid them [23:43] $50,000 in today's money to produce two [23:48] articles for the New England Journal [23:50] saying saturated fat was the bad guy and [23:52] that sugar was [23:57] exonerated and they did and they did [24:00] it that's just one thing they did they [24:04] also infiltrated the National Institute [24:07] of dental research n IDR their study [24:11] sections and their uh executive uh [24:14] committee to take money away from [24:19] nutrition research for dental health and [24:22] put it toward a carries [24:25] vaccine a what a dental carries a Cav [24:29] vaccine okay how's that cavities vaccine [24:32] working for you okay we have all of the [24:36] data in their own words to demonstrate [24:39] that they knew exactly what they were [24:42] doing this is not hallucination this is [24:46] this is Hardcore fact and we've [24:49] published this and we now have a um a [24:52] center at UCSF devoted to understanding [24:57] the uh uh corporate determinance of [25:00] health and when we look across Society [25:03] at the consequences of this sort of [25:04] corporate interference some of the crazy [25:06] stats in your book fat chance that I [25:08] really sort of highlighted were that by [25:10] 2050 obesity will become the norm not [25:13] the exception correct what the World [25:15] Health Organization said that the [25:16] percentage of obese people globally has [25:18] doubled in the last 28 years and in the [25:21] UK 28% of adults are obese and 36% of [25:25] them are overweight that's not from your [25:27] book but that's from some research we [25:28] did on the UK numbers as well well you [25:31] know the UK is the fat man of Europe yes [25:33] that's true having metabolic syndrome is [25:36] equal to losing 15 to 20 years of life [25:38] that was in your book that's correct um [25:40] which is startling um and worldwide [25:43] sugar consumption has tripled in just [25:45] the last 50 years correct all true now [25:50] you could say that's correlation not [25:51] causation but we actually have the [25:53] causation we have the data we have it in [25:57] mechanistic terms terms we have it in um [26:00] uh clinical Interventional uh uh efforts [26:04] we have it in societal efforts um [26:06] there's a method for determining proof [26:10] that doesn't need randomized control [26:12] trials it's called econometric analysis [26:14] this is what we have for for instance [26:17] climate change there's no control group [26:19] for climate change but we still know [26:20] it's true this is what we have for [26:23] tobacco and lung cancer you know you [26:25] don't have naive people start smoking [26:28] that would be illegal immoral get you [26:29] thrown in jail but we still know that [26:31] tobacco causes lung cancer we know that [26:33] football trauma causes chronic traumatic [26:36] Andy opathy okay none of these have [26:38] control groups but we know it's true [26:41] through econometric analysis this is a [26:44] method of using natural history data [26:46] over time to be able to determine [26:50] proximate cause and we have that for [26:53] sugar and diabetes and we have it for [26:56] sugar and heart disease and we have have [26:58] it for sugar and fatty liver disease and [27:00] of course we have it for sugar and tooth [27:02] decay we're working on sugar and cancer [27:05] and sugar and dementia we're not there [27:08] yet in your book fat fat chance um on a [27:12] on page [27:13] 120 there was something particularly [27:15] curious because I think this is [27:17] a um yeah here we go it says the bottom [27:21] line is sugar consumption is a problem [27:23] 33% of sugar consumption comes from [27:26] beverages yes [27:28] and the biggest abusers are the poor and [27:30] underserved indeed so let's talk about [27:33] beverages to start with then [27:36] MH diet beverages are they fine and how [27:40] bad are the sort of fizzy pot beverages [27:42] that most of us consume every day [27:47] so let's do the um sugar soft drinks [27:51] first okay okay they are really bad if [27:55] you consume one sugared beverage per day [27:59] your risk for diabetes goes up by [28:04] 29% wow okay that's and diabetes and [28:07] that and that's if you have one if you [28:09] have two [28:11] 58% and diabetes is now the main cause [28:14] of death in 40% of death certificates [28:16] exactly [28:17] right so this is a big problem so you [28:20] know that's demonstrating its toxicity [28:22] at you know shall we say medium dose you [28:25] know at low dose you can handle it [28:28] but you know as soon as you go above [28:30] that dose it's a problem and we have the [28:32] data for it okay and all of these are [28:34] factored in these are all econometric [28:36] analysis we've shown that sugar is a [28:38] proximate cause of diabetes whenever [28:41] sugar availability changes in any [28:43] country diabetes prevalence changes 3 [28:46] years later and we've also done what's [28:49] known as advanced Markoff modeling where [28:51] we go into the future and show that when [28:54] sugar consumption goes down in any [28:55] country diabetes levels change in NE you [28:59] know reduce three years later so it's a [29:02] threeyear window between the change in [29:05] the diet and the change in the metabolic [29:06] Health consequences we have those data [29:10] and the fact that they work both on the [29:12] way up and on the way down is like you [29:14] know take it to the [29:16] bank now that's for the sugar beverages [29:20] you asked me about diet beverages I've [29:22] got one here let's let's uh look at it [29:29] all right I've covered up the logos cuz [29:30] I I've never seen this before I wonder [29:33] what that [29:35] is um the the data now show I mean for [29:40] it it took a while for these data to [29:42] come in but the data now show that the [29:44] toxicity of one sugared soda equals the [29:49] toxicity of two diet sodas half as bad [29:54] half as bad does not mean good half as [29:57] bad means half is bad well it says zero [29:59] sugar here so how can it be bad well so [30:02] because it's bad for a different reason [30:05] so the yes zero fructose zero calories I [30:09] agree but that doesn't make it good [30:13] makes it better than the sugared [30:15] alternative but it doesn't make it [30:17] good why number one you put something [30:21] sweet on the tongue message goes tongue [30:23] to brain Sugar's coming message goes [30:25] brain to pancreas Sugar's coming [30:28] release the [30:30] insulin so I still get an insulin [30:32] release you still get an insulin [30:33] response and the more other food you ate [30:35] the bigger the insulin response so you [30:38] will have an accentuated insulin [30:40] response because you were exposed to the [30:43] diet sweetener this is work from Yanina [30:45] Pino um uh 2013 at Wu St Louis and it's [30:50] been corroborated multiple times since [30:52] and why does that harm me having an [30:54] insulin response because insulin is a [30:56] bad guy so we always talk about glucose [30:58] being a bad guy in terms of diabetes and [31:00] it is of course but insulin's a bad guy [31:04] too glucose causes small vessels to be [31:08] dysfunctional causes endothelial cell [31:11] dysfunction it causes high blood [31:14] pressure because it causes those small [31:16] vessels to constrict it interferes with [31:19] nitric oxide uh which is one of the [31:22] things that relaxes the blood vessel and [31:25] it will you know basically reduce uh [31:28] blood flow to specific organs so high [31:31] glucose is not good for you and it's bad [31:33] for small vessel disease and that's why [31:35] diabetics get retinopathy nephropathy [31:38] neuropathy um uh kidney disease nerve [31:41] nerve nerve damage and um eye [31:45] disease but insulin is also a problem [31:48] because what insulin does is it causes [31:50] cell growth insulin is a growth factor [31:53] and it causes vascular smooth muscle [31:56] growth like in your coronary arteries [31:58] it causes glandular growth so it is one [32:01] of the primary drivers of heart disease [32:04] and [32:05] cancer so you can be a diabetic a type 2 [32:09] diabetic and have your hemoglobin A1c [32:13] measure of your glucose uh uh uh control [32:17] down near normal near normal range [32:21] because you're on insulin or oral [32:24] hypoglycemics or even glp1 analoges for [32:27] that matter okay and you will die just [32:30] the same because you will die of a heart [32:33] attack or of a of a cancer because [32:36] diabetics uh have a much higher [32:38] incidence of cancer they also have a [32:41] higher incidence of dementia as well and [32:43] the reason is because of insulin because [32:45] insulin is a bad guy in this story [32:48] glucose causes microvascular disease the [32:52] insulin causes macrovascular [32:55] disease they're both bad you need to [32:57] control both of them and this controls [33:01] the glucose it doesn't control the [33:05] insulin do you drink that stuff of [33:07] course not just checking is there any [33:11] other physiological consequences to diet [33:14] sodas outside of the insulin response [33:16] indeed so the other thing that we've [33:18] learned about uh uh uh non-nutritive [33:21] sweeteners across the board is that they [33:22] alter the [33:23] microbiome now the microbiome is the [33:26] bacteria that live in your gut [33:28] now you have to feed your microbiome you [33:30] have to feed your bacteria because if [33:33] you don't feed your bacteria your [33:34] bacteria will feed on you it will strip [33:36] the mucin layer a protective physical [33:39] barrier right off the surface of your [33:42] intestinal epithelial cells and when it [33:44] does that it denudes them and allows for [33:48] other bacteria toxic bacteria to take up [33:51] residence and cause irritable bowel [33:53] syndrome inflammatory bowel disease and [33:56] the Junctions between the cells become [33:59] dysfunctional as well and so they cells [34:02] become permeable and so stuff you know [34:05] in your intestine the junk in your [34:07] intestine the you know sh you know what [34:11] can actually make it through into the [34:12] bloodstream you can measure the [34:14] endotoxins and the whole bacteria the [34:17] lipopolysaccharides in the bloodstream [34:20] when the intestine is damaged even from [34:23] diet soda and what that does is that [34:26] ultimately leads to SU systemic [34:28] inflammation and that systemic [34:30] inflammation also leads to metabolic [34:33] disease mental health problems cognitive [34:36] decline early death is there a [34:38] relationship between sugar and our [34:41] hormone levels of course I mean the main [34:44] one of course is diabetes I mean you [34:46] know insulin but um high sugar uh you [34:50] know I mean if you if you have U uh high [34:53] sugar consumption it's going to cause [34:56] changes in insin response at the level [34:58] of the liver it's going to cause fatty [35:00] liver disease okay it can change your [35:03] kidneys uh uh function uh you know which [35:06] can ultimately increase blood pressure [35:09] so it's yeah it's got multiple uh uh [35:11] potential detrimental effects what [35:13] impact does sugar have on our liver [35:15] what's going on there so as I mentioned [35:19] we have an innate capacity to metabolize [35:21] a limited amount [35:24] yeah everyone says oh Sugar's [35:28] energy [35:29] well yeah but not really not really so [35:34] let let's disect [35:36] that the food industry says glucose is [35:39] four calories per gram the food industry [35:42] says fructose is four calories per gram [35:45] therefore they're equal because they're [35:46] four calories per gram and if calories [35:49] were the issue then they would be right [35:52] but calories are not the [35:53] issue okay the whole issue of calories [35:57] has has to go down the tubes okay as far [36:00] as I'm concerned that's the problem and [36:03] I am here to # kill the calorie as a [36:06] unit of measure it has no place in our [36:11] uh in in our dialogue it has no place in [36:14] medicine calories [36:16] suck now why do I say [36:19] that if you [36:21] take a mole of glucose and you throw it [36:24] into a bomb calorimeter you will get [36:26] four calories per that's true if you [36:29] take fructose and you throw it in a bomb [36:30] calorimeter you will get four calories [36:32] per gram that's true we are not bomb [36:36] calorimeters [36:38] okay what's a bom calorimeter it's a [36:41] contraption that [36:43] explodes the whatever you put in it and [36:46] measures the heat that's uh given off [36:48] from it so it measures the amount of [36:50] calories in something effectively using [36:52] some that's what calories are is the [36:54] amount of heat required to raise one gr [36:56] of water degre Centigrade okay so it's a [36:59] measure of heat yeah is what it is [37:01] that's what calories are now we do our [37:05] burning in these little organel inside [37:08] each of ourselves called [37:10] mitochondria this is all about [37:11] mitochondria and when your mitochondri [37:13] will work efficiently and well you can [37:16] burn [37:18] energy uh uh you know to completion and [37:21] you can capture that energy in the form [37:24] of chemical energy in your cell called [37:26] ATP denzine triphosphate and that's what [37:29] your cell uses to power all of the [37:31] functions that the cell needs the little [37:34] molecular Motors and making stuff and [37:37] you know basically you know and and also [37:39] cleaning house you know and recycling [37:42] junk okay in order to keep your cells [37:44] Thrive thriving and Alive okay so [37:48] mitochondria are essential now [37:52] glucose stimulates mitochondria to work [37:56] better glucose is actually [37:59] good it it stimulates two enzymes [38:03] necessary for mitochondria to work it [38:05] stimulates an enzyme called [38:07] amyas which is a the enzyme that [38:10] actually makes more [38:12] mitochondria and it's the fuel gauge on [38:15] the liver cell so it tells the liver [38:17] make [38:18] more and it also stimulates an enzyme [38:21] called HH hydroxy asil COA dehydrogenase [38:24] which is necessary to cleave two carbon [38:26] fragments and uh burn them oxidize them [38:28] for energy too so glucose we can call [38:31] good because it helps [38:34] mitochondria fructose on the other hand [38:37] this sweet molecule in sugar in [38:40] sucrose it inhibits three [38:44] enzymes in mitochondria it inhibits that [38:46] amp kinase it inhibits an enzyme called [38:49] aadl asilo dehydrogenase long chain it [38:51] inhibits cpt1 carnitine pidol [38:54] transferase one that's the enzyme that [38:58] uh regenerates carnitine which is the [38:59] shuttle by which fatty acids can get [39:01] into the mitochondria to be burned so [39:04] the net effect of fructose is to inhibit [39:07] mitochondrial [39:09] function [39:11] so does [39:13] fructose constitute energy if fructose [39:17] is actually keeping you from making [39:20] chemical energy in your [39:25] cell this is the conundrum [39:28] what do you mean by energy if we're [39:31] talking heat then fructose is energy if [39:35] you're talking ATP fructose inhibits [39:39] ATP and that's what we're talking about [39:42] because that's what leads to systemic [39:43] health problems not the [39:45] heat so all of these people as far as [39:49] I'm concerned anyone who ever uses the [39:51] word calorie fire [39:54] them because they don't get it [39:59] they are part of the problem not part of [40:02] the [40:04] solution many people will say that sort [40:06] of counting calories has helped them [40:08] with their weight loss goals you tell me [40:12] virtually everybody who counts calories [40:15] loses a little bit of weight and then [40:17] they [40:18] plateau and then they get um you know [40:21] tired of their diet and the weight comes [40:24] rushing back okay 90% of people who try [40:28] to diet through caloric restriction [40:31] regain and sometimes yoyo back even [40:33] higher so are there I don't accept that [40:36] are there studies that support this idea [40:38] that sort of the the yo-yo dieting is a [40:41] BYOD of calic restriction not because of [40:45] caloric restriction it's a problem of [40:47] insulin resistance it's a problem of [40:50] when you gain the weight back did you [40:52] gain it in the liver as liver fat [40:56] because now you've got high insulin and [40:58] Insulin blocks this hormone that goes to [41:00] the brain called leptin that is in [41:03] charge of that set point so the higher [41:06] your insulin goes the less well your [41:08] brain can see leptin and so the less [41:10] well you can regulate and so that's what [41:13] drives your weight up even higher so you [41:17] don't regain the weight by eating you [41:21] know fish and vegetables you regain the [41:23] weight because you you know went for the [41:26] bread and the rice and the pasta and the [41:28] potatoes and the sugar what's a better [41:29] plan then if I'm trying to cut a couple [41:31] of pounds what's a better approach to [41:33] take versus sort of calorie counting or [41:37] these kind of things get the insulin [41:40] down there is no weight gain without [41:42] insulin insulin is the energy storage [41:46] hormone 20 years ago from doing the [41:50] research on kids with hypothalamic [41:52] tumors who released enormous amounts of [41:54] insulin we gave them a drug that [41:56] suppressed insulin release they lost [41:58] weight and they started exercising [41:59] spontaneously because we got their [42:02] insulin down we showed that the lower we [42:05] got the insulin the more weight they [42:07] lost and the better they felt insulin is [42:10] the bad guy in The Story So numerous [42:14] investigators you know the world over [42:16] have now demonstrated that insulin is a [42:19] primary driver of both obesity and [42:22] diabetes and metabolic syndrome you got [42:25] to get the insulin down okay how do you [42:29] get insulin down best way don't let it [42:32] go up what makes it go up refine [42:35] carbohydrate and sugar all the stuff you [42:37] have over there in that corner just to [42:40] be [42:41] clear he's not pointing at my lunch we [42:44] have a pile of different sugar products [42:45] that we brought for the interview over [42:46] in the cor Corner including various [42:48] things that you find on a shelf [42:49] everything from apple juice to some [42:52] popular snacks to um some like some some [42:55] other things just don't forget the [42:56] peanut butter [42:57] The Peanut Butter Cups yeah and even [42:59] this this is just sort of um it looks [43:01] like water but it's flavored water where [43:03] they've added sugar to it right um so [43:07] yeah all of that stuff over there all [43:08] that stuff so so get the insulin down [43:11] all right so cut the refined [43:14] carbohydrate cut the sugar the dietary [43:16] sugar that is the single best way to [43:21] mitigate this process by improving [43:25] insulin resistance by getting the [43:27] insulin down and we have done this time [43:29] and time again basically I turned my [43:31] obesity Clinic into an insulin reduction [43:34] clinic for this reason a lot of people [43:36] at a sort of a prefrontal cortex logical [43:39] level understand this they understand [43:41] that they shouldn't be having sugar but [43:43] it's well they think it's about calories [43:45] they do some people do think it's about [43:46] calories for sure but even the ones that [43:48] know that sugar is not something they [43:51] should be having still struggle they do [43:54] it's EAS because Sugar's addictive right [43:57] they struggle because sugar is addictive [43:59] we know because fructose stimulates that [44:01] nucleus cumb [44:03] yeah when we get stress which is a facet [44:06] of daily life now that's right we're [44:08] much more likely to to grab a sugary [44:09] snack indeed and there's a reason for [44:12] that too because when you're stressed [44:13] that actually puts a greater uh uh [44:16] burden on your amydala and your amydala [44:18] requires more energy hippocampus too by [44:21] the way amigdala is the emotional center [44:23] of the brain the fear center of the [44:24] brain okay and so you're trying to calm [44:26] it [44:27] and so you have to increase the energy [44:31] available so because you need more ATP [44:35] and even though fructose inhibits ATP [44:39] generation you still reach for that [44:41] because you're trying to mitigate the [44:43] metabolic consequences acutely when I'm [44:46] tied I think I have a high propensity to [44:49] grabbing sugar as well indeed why is [44:51] that because you're tired you're [44:53] stressed and your amydala is [44:56] dysfunctional and so it basically tells [44:59] you hell with it I I don't have any [45:01] sugar Cravings in the morning I've come [45:03] to come to learn I don't feel the need [45:05] for sugar in the morning it's sometimes [45:06] when we get later into the evening right [45:08] after a long day exactly it's when my my [45:11] Cravings you and everyone else and me [45:13] too by the way it's not like I'm uh [45:15] immune to this I I you know am on record [45:20] I gained a lot of weight while I was a [45:23] faculty member at UCSF and every [45:27] day at 400 p.m. I just ran out of gas [45:31] and so I ran across the street to get a [45:34] you know large chocolate chip cookie [45:36] okay and that was without question the [45:39] primary driver of my wak ging okay it [45:42] wasn't until I actually started doing [45:44] the research on this and seeing that the [45:47] kids felt better when we took the sugar [45:50] out of their diet that I actually put [45:52] two and two together for myself so now I [45:55] don't do that and my energy level stays [45:58] constant throughout the day what so what [46:00] advice do we give that is simple and [46:02] actionable for Jennifer or Judith or [46:06] Dave who's listening to this now they [46:08] are you know 40 years old potentially [46:10] they have a nine-to-five job they're [46:12] very busy maybe they have some kids to [46:14] feed at the same time they they don't [46:16] have time to be like you know looking at [46:19] doing a fine sort of tooth comb over [46:21] every single thing that they're putting [46:23] into their body they're not a scientist [46:25] agreed it's a it's a problem because the [46:28] food industry has made the grocery store [46:31] a Minefield and it's really easy to set [46:34] off an explosion if you walk in you're [46:38] basically lost that's how bad it [46:41] is understood so the the simple rule is [46:46] eat real food so what's Real Food [46:50] well food that came out of the ground or [46:53] animals that ate food that came out of [46:54] the ground the problem is we all lead [46:56] busy lives and we're looking for labor [46:58] saving devices cuz people don't even [47:00] have time to cook most people 33% of [47:04] Americans don't even know how to cook [47:06] anymore so like what are they going to [47:08] do so we understand this I mean it's a [47:10] problem [47:12] agreed we need [47:14] food that is metabolically healthy for [47:18] us not metabolically detrimental and the [47:21] problem is that as soon as you put the [47:24] added sugar in the food you have made it [47:27] metabolically detrimental now the food [47:29] industry will say well there are all [47:30] these other good things in there like [47:32] vitamins and minerals we fortify it Etc [47:34] so I'm here to tell you toxin a plus [47:37] antidote B still equals [47:40] Death okay just because they put some [47:43] vitamins in there or you take a dietary [47:46] supplement if it's not solving your [47:48] mitochondrial [47:50] dysfunction what's the [47:52] point so you can't believe what the food [47:55] industry is telling you okay if they say [47:59] something is healthy it's usually the [48:01] opposite whatever it says on the package [48:04] believe the opposite because they have [48:06] an incentive to put wrong stuff on the [48:10] package and I'll be honest with you I'm [48:13] part of you know uh numerous lawsuits [48:16] suing the food industry for deceptive [48:18] advertising misbranding mislabeling 70% [48:22] of all of the items in the American [48:24] Grocery Store are misbranded or [48:26] mislabeled in what way they say things [48:29] that are not true give me some examples [48:31] well first of all any time they use the [48:33] word [48:34] healthy okay um they say no added [48:39] sugar okay but in fact they put in apple [48:42] puree or raspberry puree or evaporated [48:45] cane juice you know they they there are [48:48] 262 names for sugar and the food [48:51] industry uses all of [48:53] them and so they will say that [48:55] something's no added suar but that in [48:57] fact is actually not the case okay [49:00] there's there's a whole you know whole [49:02] host of this Kelloggs has been sued for [49:05] raisin brand okay everyone thinks raisin [49:08] brand well it's just raisins and brand [49:10] what color are the raisins in raisin [49:15] brand I've never seen it well I mean [49:19] raisins are purple yeah you purple brown [49:22] yeah yeah yeah yeah normally well the [49:24] the raisins in raisin brand are white [49:32] why if you take the raisins and raisin [49:35] brand that's supposed to be 11 gram of [49:38] sugar but on the side of the package it [49:41] says that one serving is 18 grams of [49:43] sugar where' the other seven come [49:46] from it's the white because they've all [49:50] been dipped in a sugar solution to make [49:52] them [49:55] sweeter as an example [49:58] okay so post has been sued General Mills [50:02] their's theirs was uh dismissed um uh [50:05] mandes a whole host of uh uh of [50:08] companies are actually under the gun now [50:10] to change their practices why do you [50:12] care so [50:14] much I am a [50:17] pediatrician my job is to take care of [50:20] children children are [50:23] vulnerable in the same way minorities [50:26] are vulnerable same way prisoners are [50:28] vulnerable okay they need a voice my job [50:32] is to give every kid a shot well we now [50:35] have neonatal [50:39] obesity we have babies being [50:42] born Israel South Africa Russia United [50:47] States four separate studies showing [50:49] that over the past 25 years birth weight [50:52] has gone up 200 grams half a pound in [50:57] all four countries and when you do dexa [50:59] scanning to look at body composition on [51:02] those newborns those 200 grams are all [51:04] fat we have neonatal obesity these kids [51:09] did not get obese by dieting and [51:11] exercising by gluttony and sloth they [51:15] came out of the [51:17] womb behind the [51:19] eightball it's my job as a pediatrician [51:23] to fix the problem that's what I care [51:26] okay can you just give me a little bit [51:27] of brief overview of everything you're [51:29] talking about the um studies you've [51:32] referenced all of that what is the [51:36] academic experience background research [51:39] that you've done that's built all of the [51:41] foundations of your knowledge I spent [51:43] the first 20 years of my medical [51:46] practice you know in Academia [51:50] basically you know doing what they told [51:52] me to do you know the way I learned it [51:55] and I thought calories were the same and [51:58] I thought that you know it didn't matter [52:00] and this is not what you do and this is [52:01] not how you take care of patients you [52:03] you know do prescriptions and you do [52:05] procedures and that's how you do it and [52:08] then I started doing research because I [52:10] was at St Jude Children's Research [52:11] Hospital taking care of these massively [52:13] obese kids who had brain [52:17] tumors that were treated by surgery or [52:21] radiation and they became massively [52:23] obese because of it because their [52:25] hypothalamus was damaged [52:27] because they couldn't see that leptin [52:28] signal that we talked about earlier [52:30] which is the hunger which it is part of [52:32] hunger it's not the only hunger related [52:35] it's more of an energy sufficiency [52:36] signal okay right it's the energy [52:38] sufficiency signal anyway when we [52:42] suppressed their insulin release with [52:44] that drug I mentioned before they lost [52:46] weight and they started exercising [52:48] spontaneously so we did that with adults [52:50] and guess what same thing happened and [52:53] we measured their energy expenditure and [52:55] instead of it going down as you'd expect [52:57] when you lose weight normally your [52:59] energy expenditure goes down their [53:00] expend energy expenditure went [53:03] up so what this told me was that insulin [53:07] is blocking leptin and as long as your [53:10] leptin's being [53:12] blocked you feel like crap and you're [53:16] hungry and you don't want to get off the [53:18] couch and as soon as your insulin goes [53:20] down now your brain can see the leptin [53:22] and you're not hungry and you can start [53:25] exercising what this showed me was that [53:27] the behaviors that we associate with [53:29] obesity the gluttony and the sloth are [53:32] actually secondary to this biochemical [53:35] phenomenon of insulin blocking [53:38] leptin and so this put me on the path of [53:41] understanding insulin as the problem [53:45] rather than insulin as the [53:48] result fix the insulin fix the [53:52] problem and so I've been doing that for [53:55] the last 25 years and that's what [53:59] brought you to the subject of sugar [54:01] because sugar increases insulin levels [54:04] well sugar causes insulin resistance [54:06] okay so there are two phenomena in with [54:08] insulin insulin release yeah which is an [54:11] acute phenomenon so that's when I eat [54:13] something there'll be some insulin [54:14] released which means my I have an [54:16] insulin Spike right and then it comes [54:18] back down nicely if I not or not or not [54:21] depending on how much and how [54:22] consistently I've been eating sugar [54:24] exactly right so if your liver has fat [54:28] in it and 45% of American adults now [54:31] have fat in their liver and 25% of kids [54:34] now have fat in their liver and they [54:35] never did before I mean before 19 uh 80 [54:40] if you saw fat in the liver that was [54:41] alcohol but if 25% of kids who don't [54:44] drink alcohol have fat in their liver [54:47] how'd the fat get there sugar cuz sugar [54:50] gets turned into fat in the [54:53] liver that's the that's the driver of [54:57] this what that does is that causes a [55:00] phenomenon called insulin resistance [55:03] your liver doesn't work right so your [55:06] pancreas has to make more insulin to [55:07] make your liver work right you know like [55:10] you having to put more people on the [55:11] assembly line when you know people are [55:14] you know goofing off or you know not not [55:17] getting their job done right same idea [55:21] so you have to basically Goose the liver [55:24] to do its job well that raises insulin [55:26] levels all over the body and once that [55:29] happens now you're taking energy from [55:31] your bloodstream and putting it in fat [55:33] cells for storage so by getting the [55:36] insulin down so if it's insulin [55:38] resistance fixing the insulin resistance [55:40] by getting rid of the fat in the liver [55:42] or if it's the insulin release at the [55:44] beginning by lowering your refined [55:46] carbohydrate because that's the primary [55:48] stimulus of that first [55:51] Spike either way it's refined [55:53] carbohydrate in your sugar get the [55:55] insulin down and diabetes is when your [55:59] pancreas can't keep up okay so it's [56:01] really so much insulin it goes forget [56:03] this I'm done right it's the end result [56:06] of both of these um phenomena which [56:09] we've now realized is reversible I think [56:11] there was a school of thought once upon [56:12] a time that diabetes couldn't be [56:13] reversed but that's right but it is [56:15] reversible it is very reversible for a [56:17] while so let's be let's be clear and [56:20] honest about this there is absolutely no [56:23] doubt that what doctors learn in medical [56:26] school is wrong we are told and I know [56:30] cuz I was told that diabetes is a [56:34] chronic [56:36] progressive [56:38] unrelenting [56:40] disease that never gets better and that [56:44] you will need medication whether it be [56:46] insulin or oral hypoglycemics or [56:48] whatever for the rest of your [56:50] life [56:52] garbage total complete [56:54] trash now [56:57] Vera Health numerous other uh studies of [57:03] various diets show that you can [57:06] absolutely reverse type 2 [57:10] diabetes in order to do so you have to [57:13] get the [57:15] pancreas to make insulin properly and [57:19] the only way to do that is to get the [57:21] liver to respond to insulin [57:25] properly one way is to not challenge the [57:28] liver give the liver a rest well it's [57:32] metabolizing all that refined [57:33] carbohydrate and sugar drop the refined [57:36] carbohydrate and sugar and make your [57:39] liver work better little kit so a [57:42] ketogenic diets the extreme version of [57:44] this it's not the only way but it is a [57:47] way paleo diet is another version [57:49] fasting intermittent fasting will give [57:52] your liver a chance to burn off the fat [57:54] that's accumulated over the last 16 [57:56] hours there are many ways to skin this [57:59] cat calorie counting almost never [58:04] calorie [58:05] restriction yes calorie restriction but [58:08] it's got to be consistent and longterm [58:11] and we've shown numerous Studies have [58:13] shown that as you restrict calories that [58:18] leptin resistance does not get better [58:20] quickly it takes years for that leptin [58:23] resistance to finally go away like five [58:26] years before you change the set point [58:30] let's take a step back so what does [58:31] leptin do again it's about energy so [58:34] leptin is made in your fat cells yeah in [58:37] response to driving energy into fat the [58:40] cell will make leptin the leptin will [58:41] circulate in the bloodstream will go to [58:43] your brain go to your hypothalamus and [58:45] say hey I've got enough energy on board [58:49] okay to engage in expensive metabolic [58:53] processes so we don't need anym I don't [58:55] need to eat eat more I can engage in [58:58] puberty I can engage in pregnancy okay [59:01] okay both of which are high [59:04] metabolic uh uh processes okay okay so [59:08] it is like the servo mechanism like the [59:11] thermostat on your house okay you have a [59:14] a floor but no ceiling so when you're [59:18] when it's cold in your house the heat [59:20] kicks in but if you don't have air [59:23] conditioning it can go higher right same [59:26] idea with leptin floor no ceiling so [59:29] when your leptin goes below a certain [59:32] threshold your brain will see that as [59:35] starvation you get really hungry and so [59:37] you will get both hungry and you will [59:38] also sit on the couch okay okay [59:42] H so that's the way the activity [59:44] component comes in because your brain's [59:45] saying listen don't waste this energy [59:47] exactly conserve okay because we're in [59:50] trouble here we're we're in trouble down [59:52] here okay so eat more and don't [59:58] move that's the biochemistry that drives [60:01] the behavior why don't they have leptin [60:04] injections well they do oh really but it [60:06] turns out it doesn't work in leptin [60:08] resistance because the problem is not [60:11] that you're missing leptin the problem [60:13] is you have too much leptin it's just [60:15] not working so adding more leptin is [60:17] like throwing kerosene on the fire the [60:19] recepto sites have stopped receptor [60:21] sites are not there either they've been [60:23] downregulated or they're being blocked [60:24] one or the other if insulin blocks it [60:28] okay or they can be downregulated too [60:30] both now if you're leptin [60:32] deficient and there are 14 patients with [60:35] leptin deficiency and quite a few of [60:37] them by the way are in the UK of the 14 [60:40] and sadf faruki and Steve O'Reilly at [60:43] Aden Brook's hos Aden Brook's Hospital [60:45] in Cambridge are the people who've done [60:47] the most work on leptin deficiency if [60:50] you take a patient who's LEP and [60:52] deficient they basically start gaining [60:55] weight as soon as they're born by age 6 [60:58] months they're already massively obese [61:02] by the age of you know three they they [61:05] you you can't they can't even fit [61:07] through the [61:08] door okay they eat everything in sight [61:12] and they don't move you give them a shot [61:15] of leptin because they're deficient [61:16] you're replacing what's [61:18] missing and they slim down like that [61:22] they're genetically leptin deficient [61:24] they're genetically leptin deficient [61:25] they have a mutation in their leptin [61:28] Gene so obesity could be genetic in some [61:31] very very small cases very small number [61:34] of patients it is genetic but that's not [61:37] what's going on in the rest of the [61:39] population so yes is obesity genetic for [61:44] a small fraction sure we have leptin [61:49] deficiency we have letin receptor [61:51] deficiency we have pc1 deficiency we [61:53] have melanocortin 4 receptor deficiency [61:55] we have sim1 deficiency we there a whole [61:58] host of different genes and nobody has [62:01] them nobody has them all right like 14 [62:05] people have them it's very rare for the [62:09] reason for General Garden variety [62:13] obesity out in the world to be due to a [62:16] genetic problem this is an environmental [62:19] problem in your book you talk about [62:20] environmental obesogens I've never heard [62:23] that term before what does it mean so [62:26] obesogens are chemicals in the [62:29] environment that actually drive weight [62:32] gain they cause the differentiation of [62:35] fat cells or they cause the growth of [62:38] fat cells now fat cells are [62:42] complex okay you have a certain number [62:45] but you can increase that number [62:48] especially early on in life there's a [62:49] critical period before Age 2 where you [62:52] can actually increase fat cell number [62:54] and once a fat cell is developed it [62:58] wants to stay filled I mean we got to [63:00] pause here just for a second because I [63:02] think most people think that when we eat [63:04] food we increase the number of fat cells [63:06] we have no we increase the size of the [63:08] fat cells we have this was a really I [63:10] learned this a couple of a couple of [63:11] years ago and it kind of changed the way [63:14] I think about a lot of things including [63:15] liposuction yeah because with [63:17] liposuction you kind of think that [63:19] you're taking away fat cells that you've [63:21] added to your body through diet but [63:23] actually the fat cells stay the same [63:25] they grow and Shrink well there's also a [63:28] problem with liposuction as well um [63:31] there are three fat [63:33] Depot okay and they're not the same on [63:37] the scale they're the same because you [63:39] weigh a certain amount but from a [63:42] metabolic standpoint they are not the [63:44] same so let's take each of the fat Depot [63:46] separately so that your audience will [63:49] understand what it is that they're [63:50] actually concerned about so the first [63:53] fat Depot is the obvious what we call [63:56] subcutaneous or big butt fat belly fat [64:00] as well no that comes later oh that's [64:01] the second one okay subcutaneous [64:03] cutanous big butt fat or does this [64:05] bathing suit make me look fat fat so are [64:08] you saying that's good or bad it's [64:10] actually good I agree it's [64:14] protective the more of it the less [64:17] likely that you will have metabolic [64:21] disease it is the place where your body [64:23] wants to put excess energy because it's [64:27] safe now most of us have a certain [64:31] ability to grow that fat to a certain [64:34] level before it starts becoming a [64:37] problem eventually you can overload that [64:39] subcutaneous fat where you will actually [64:43] make the fat vacu the little pocket of [64:46] of fat within the fat [64:49] cell grow so much that it will actually [64:52] cause the uh border of the V Ule to [64:56] decompensate and now you've spilled the [64:59] grease into the cell that will kill the [65:01] cell and that will cause um uh [65:04] inflammatory cells to congregate to try [65:06] to clean up the grease and then they [65:08] secrete um proteins called cyto coses [65:11] which end up causing the metabolic [65:13] dysfunction in any [65:15] case you can overload your subcutaneous [65:18] fat but you have to work at it so about [65:22] how much fat does your sub cutaneous fat [65:26] have to grow before you become [65:28] metabolically ill on average about 10 [65:32] kilos 22 pounds some more some less okay [65:38] now let's take the second fat Depot [65:40] belly fat viseral fat this fat here [65:44] everyone's worst type of fat well yes [65:48] but not because of [65:50] Cosmetics because of [65:53] metabolism in any case the the visceral [65:56] fat the belly fat is that due to [65:59] calories is that due to weight gain that [66:01] is actually due to cortisol that's due [66:04] to [66:05] stress and the reason we know that is [66:08] because you can take patients who are [66:11] have endogenous clinical depression okay [66:15] they are [66:16] anhedonic they don't eat because they [66:19] generate no reward from Life they [66:22] generate no reward from eating [66:26] they are losing weight they have to be [66:28] admitted to the hospital to keep them [66:31] from killing themselves so these are [66:33] with people with suicidal ideation who [66:35] have to be admitted to psychiatric [66:37] hospitals you put them in a scanner and [66:40] it turns out they're losing subcutaneous [66:42] fat because they're not eating they're [66:45] gaining visceral fat because the [66:48] cortisol from the stress that goes along [66:50] with the depression is actually laying [66:53] down more fat in their [66:56] belly [66:57] why it's what cortisol does because when [67:00] you're stressed you need an a readily [67:04] available and metabolically active [67:07] source of energy in case you're being [67:09] chased by the lion so that metabolic fat [67:13] that visceral fat is eminently [67:16] retrievable rapidly oh okay interesting [67:20] okay [67:22] now how many pounds or kilos of visceral [67:26] fat you have to gain before you become [67:28] metabolically [67:30] ill I'm going to guess it's it's not a [67:33] lot based that's right not a lot so [67:35] subcutaneous was 10 kilograms that's [67:37] right now we're talking about two [67:39] kilograms okay so two kind of bags of [67:41] sugar yeah pretty [67:44] much okay now finally the third fat [67:48] Depot liver [67:50] fat now how many kilos of liver fat can [67:56] you acrw before you become metabolically [67:59] ill live is really small I no idea okay [68:03] one qu of a [68:05] kilo half a [68:07] pound and when you become metabolically [68:10] ill then all of the dysfunction we [68:12] talked about previously happens that's [68:14] right so you can become metabolically [68:16] ill and be thin because your [68:19] subcutaneous Fat's okay even your [68:21] visceral Fat's okay but if you've got [68:23] liver fat can you measure a quarter of a [68:26] kilo on the scale [68:29] no have you had the phrase skinny fat [68:31] that's this is skinny [68:33] fat so tofi TFI thin on the outside fat [68:37] on the inside skinny fat was actually [68:40] coined by Dr Jimmy Bell at University [68:42] College London okay neuro imager that's [68:45] exactly right so just because you're [68:47] overweight doesn't mean you're sick and [68:49] just because you're thin doesn't mean [68:51] you're healthy because of these three [68:54] fat Depot this is exactly what we're [68:58] talking about so are skinny fat people [69:00] typically more stressed if we kind of [69:02] they often are often are you they often [69:03] are the question is how did that liver [69:06] fat get formed the answer is sugar and [69:09] alcohol because that's where sugar and [69:11] alcohol go in order to be processed okay [69:15] and so that's why so many people now [69:17] have fatty liver disease that never had [69:19] it before that's why children have fatty [69:21] liver disease even though they don't [69:23] drink alcohol because they drink [69:25] something that is metabolized just like [69:28] alcohol like apple juice like apple [69:30] juice I've got a bottle of apple juice [69:32] here in front of me and on it it says 40 [69:34] in big letters 40% less sugar than 100% [69:38] apple juice it says with added vitamins [69:42] a c and e they've added all three [69:46] vitamins in there that must be so that's [69:48] not apple juice that's an apple [69:50] drink to be to be clear it says apple [69:53] juice beverage here on the front ah they [69:55] called it a juice beverage not juice [69:58] there's a that that's technically [70:00] correct but there's a you know reason [70:02] they have to declare that from the FDA [70:05] why because they can't call it juice if [70:08] it's not juice if they've done something [70:09] to it I mean how would I know it says [70:11] apple juice beverage I well that that's [70:14] part of the [70:17] subugu [70:18] lawsuits they have to call it a juice [70:20] beverage because they've done something [70:23] to it okay so I've got this Apple in my [70:26] pocket mhm this apple here right this is [70:30] healthy that is healthy but if I blend [70:32] this down it looks like this no well the [70:35] question is what was lost in the process [70:38] of blending it [70:39] down you took away the good [70:43] part the fiber the fiber by the way you [70:47] don't know if that apple is as healthy [70:48] as it could be and the reason is cuz you [70:50] don't know if it was sprayed with [70:52] pesticides was it an organic apple or [70:54] was it just a standard commercial Apple [70:56] was a standard commercial Apple you [70:58] might have to wash it first why because [71:01] the pesticides can be environmental [71:03] obesogens many pesticides such as I mean [71:07] the the famous one was DDT now it's been [71:09] gone since [71:11] 1972 Rachel Carson you know Silent [71:14] Spring you know was all about how DDT [71:17] was you know environmentally affecting [71:19] you know the entire world okay we banned [71:23] DDT in 1972 but you can measure the [71:25] metabolite of DDT called DDE in pregnant [71:29] women's urine today 50 years later and [71:33] that level of DDE in that pregnant woman [71:36] is predicting obesity in her [71:39] Offspring 11 years later so let's go [71:42] over these two subjects then we've got [71:43] environmental obesogens right I think [71:45] I've pronounced that correctly um let's [71:47] finish off on that and then I want to go [71:49] into fiber so environmental obesogens [71:51] which might be on this apple what what [71:53] are they and where where are they so uh [71:57] an obesogen is a chemical that causes [72:00] weight gain not because of its [72:04] calories okay now you say how can [72:07] something cause weight gain if it [72:09] doesn't have calories the answer is if [72:11] it causes the differentiation or growth [72:13] of fat cells it will cause weight gain [72:16] unrelated to calories so we have [72:20] chemicals in our environment that are [72:23] unescapable [72:25] you can't escape air pollution you can't [72:29] escape forever chemicals like for [72:31] instance pasas what's that polyfloral [72:35] alal substances [72:37] Teflon remember Teflon yeah yeah the [72:40] material the material that non-stick [72:43] pans were coated with yeah that's pasas [72:46] that was per floro octanoic acid turns [72:50] out that causes obesity by [72:53] itself it causes the differentiation and [72:56] growth of fat cells tributal tin this is [73:00] what you paint on the bottoms of boats [73:03] to keep Barnacles from attaching to the [73:06] hull it's in all of our food supply all [73:09] of our water supply all over the world [73:12] that causes fat cells to grow before [73:15] you're [73:16] born exposures to all sorts of things um [73:20] BPA bisphenol a okay when you get your [73:24] receipt your paper receipt from Target [73:26] that's bisphenol [73:28] a phalates or plasticizers you stick a [73:31] binky in a baby's mouth a pacifier [73:35] that's a plasticizer that's got phalates [73:38] in it that causes [73:40] obesity parabens in [73:43] cosmetics will cause [73:46] obesity vinyl [73:50] flooring um flame retardance in [73:52] children's clothing and in mattresses [73:55] all of these things will drive different [73:58] receptors in the body and act as what we [74:00] call endocrine [74:02] disruptors and those endocrine [74:04] disruptors will change the um uh [74:07] differentiation and the growth of fat [74:09] cells to increase [74:11] osity so what's an endocrine disruptor [74:15] so our cells have receptors that way [74:20] communication from one area of the body [74:23] to another can occur like hormones [74:25] binding to receptors well sometimes [74:28] they're not hormones sometimes they're [74:29] other chemicals that cause [74:31] differentiation of different uh uh areas [74:33] of the body to form different organs for [74:37] instance this is one of the things that [74:38] goes wrong in congenital uh defects like [74:41] congenital heart disease okay receptor [74:44] alterations so we have receptors on all [74:47] of our cells for different processes for [74:50] different [74:51] chemicals there are things in our [74:53] environment that basically [74:56] mimic endogenous signals to our body and [75:00] basically tell different tissues to do [75:04] different things than they ought to be [75:06] doing because those things are present [75:09] and one of them is obesity in my head I [75:11] think of it like a remember those toys [75:14] you used to play with when you were a [75:15] kid and it shows like a triangle shape [75:17] and a circle shape and a square shape [75:19] and you've got to pick up the [75:20] corresponding piece and Slot it in the [75:22] hole right I I see it as things in our [75:24] environment are pretending to be those [75:27] shapes so they're sort of impacting with [75:30] our recepto site right which is the [75:31] whole and causing us to do things that [75:34] are dysfunctional that's right and this [75:37] is well known has been known for years [75:39] we um you know it's one of the reasons [75:41] for the decrease in fertility the [75:44] changes in reproductive capacity it's [75:46] one of the reasons the alligator [75:48] population in the Everglades is [75:50] disappearing as endocrine disruptors [75:53] well it also has effect on [75:55] neurocognition and brain development and [75:59] potentially I don't want to you know get [76:01] too far a field but potentially might [76:03] play a role in autism we haven't proven [76:06] that yet I want to make that clear but [76:08] without question some of these chemicals [76:12] can cause fat cells to differentiate and [76:14] grow so if they're everywhere what do I [76:16] do about it because it's I feels like I [76:17] can't touch the floor I can't I can't go [76:19] to a I can't lay in a bed I'm like well [76:21] you can't do much about air pollution I [76:23] mean except as a society we can do [76:25] something we can't do much about uh the [76:28] Teflon in the in the water or the TBT in [76:32] the water except to try to pass [76:34] regulations to control those things but [76:37] you know get get Congress or Parliament [76:39] to do that you know that's a that's a [76:41] real trick is that better water that I [76:43] can drink sorry just on that point uh [76:45] well you can try uh certainly uh tap [76:49] water is going to be a problem but the [76:51] fact is some of the bottled waters still [76:53] have obesogens and to be honest with you [76:55] if there if it's bottled the obesogen [76:58] might be in the [76:59] bottle canned [77:02] foods if you look at the inside of the [77:04] can what color is it is it silver isn't [77:08] it silver or is it [77:10] White H if it's white that's [77:13] BPA so canned foods have high BPA levels [77:18] BPA is an estrogen okay and it doesn't [77:22] take much to be an estrogen 22 angst two [77:25] hydroxy groups you're an estrogen okay [77:27] there are a lot of chemicals in our [77:29] environment that masquerade as estrogens [77:32] and BPA is one of them and estrogen [77:34] causes fat deposition just look at the [77:37] curves of a woman that's estrogen [77:40] causing fat deposition well BPA can do [77:42] that [77:43] too so as an example but there are also [77:48] things in our food that we think are [77:51] food and one example is fructose now [77:56] fructose has calories true but fructose [78:00] has all these effects on mitochondria [78:02] that have nothing to do with its [78:04] calories in the same way that alcohol [78:06] has calories but alcohol has toxic [78:09] effects that have nothing to do with its [78:12] calories so just because something has [78:14] calories doesn't make it a food what's [78:17] the definition of food Stephen I will [78:21] tell you you was going to say don't ask [78:23] me substrate that contributes to either [78:24] growth or burning of an organism so [78:27] here's the question does ultra processed [78:30] food contribute to growth my colleague [78:33] Dr arrat manigo Oran who is the chairman [78:36] of nutrition at Hebrew University of [78:38] Jerusalem has looked at this question in [78:42] fact Ultra processed food inhibits [78:45] growth populations that are exposed to [78:47] high ultrapress food consumption have [78:50] lower final Heights than populations [78:53] that are not [78:55] so if it's inhibiting growth not a food [78:59] okay now let's take burning I've already [79:01] told you that there are three enzymes [79:03] that fructose which is in 73% of the [79:06] items in the American Grocery Store it [79:08] inhibits burning because it inhibits [79:10] mitochondrial function so if you don't [79:13] stimulate growth and you don't stimulate [79:16] burning is that a food no so if it's not [79:20] a food what is it poison so food can be [79:26] medicine food can also be poison and the [79:29] question is how do you figure out which [79:30] is [79:31] which when you walk into the grocery [79:33] store it all looks the same but in fact [79:37] there are things in there that will [79:40] contribute to growth and burning and [79:42] there are things that will inhibit it [79:44] and we need some method for being able [79:48] to [79:49] distinguish those we have it we made it [79:55] it exists on your computer it will [79:57] ultimately soon exist on your phone and [80:00] you will actually be able to order your [80:03] food to be metabolically healthy without [80:06] ever having to walk into that mine field [80:08] of a grocery store ever again how would [80:12] that be and just buy the stuff that's [80:15] good for you instead of chancing the [80:18] stuff that's bad for you it's called [80:20] perfect and what it does is it will [80:23] filter out all of the stuff in the [80:26] grocery store that's metabolically [80:28] unhealthy for you not for the next guy [80:32] for you you can apply specific filters [80:36] that will if you're glutenfree it will [80:37] take out all the things that have gluten [80:39] so you don't have to look at the label [80:41] if you are if you have metabolic [80:42] syndrome it will take all the refined [80:44] carbohydrate and all the sugar things [80:46] out so you don't even have to look at [80:48] them if you specifically want to avoid [80:50] the ultr processed food it will take [80:53] those out by the way that will cut [80:55] the items that you can see in the [80:56] grocery store by [80:58] 80% how many of you started thinking [81:00] about your long-term Health when you hit [81:02] 30 for me this was a wakeup moment of me [81:05] thinking to myself okay I probably need [81:07] to start paying a little bit more [81:08] attention now I already felt a change in [81:10] myself when I hit 30 with things like my [81:12] metabolism my energy levels so this year [81:16] is no different Zoe which is a company [81:18] I've invested in but also a company that [81:20] are a sponsor of this podcast helps me [81:22] to make smarter food choices all based [81:24] on their world leading science and my [81:26] own test results if I'm ordering food I [81:29] know how to make my takeaway so much [81:31] smarter by adding things like a side of [81:33] vegetables to eat first or choosing the [81:35] option with the most fiber Zoe helps me [81:37] to make that choice it guides me and [81:40] coaches me it's my personalized [81:41] nutrition coach that I have on me 24/7 [81:44] and to help you start your Zoe journey [81:46] and start making smarter food choices [81:48] I'm giving you guys 10% off when you [81:50] join Zoe now all you've got to do is use [81:52] code ce10 at the check out when you sign [81:55] up enjoy and let me know how you get on [81:59] let's talk then about fiber we we talked [82:02] about it briefly but I want to just [82:03] really close off on the point of f [82:05] because you said that when we take an [82:07] apple here like the Apple in my hand and [82:09] we turn it into this thing in my hand [82:10] this apple juice right the harm is that [82:13] they're removing the fiber why does that [82:15] matter so everyone thinks that fiber is [82:18] the stuff you throw in the garbage after [82:20] you've Juiced the fruit we were told [82:23] forever [82:25] that the uh uh the juice had the [82:29] essential vitamins and minerals like the [82:33] vitamin [82:34] C or the lopine if you're a [82:38] tomato and that's true they do but turns [82:42] out the [82:44] fiber is essential it's just not [82:47] essential for [82:49] you it's essential for your bacteria [82:53] it's essential for your microbiome [82:55] that's what your bacteria want to eat [83:00] you have to feed your microbiome you [83:03] know always we always say when women are [83:05] pregnant you're eating for two well [83:07] we're always eating for 100 [83:10] trillion okay the 100 trillion are in [83:12] our intestine and what you feed them [83:17] matters because if you feed them well [83:19] you will have what we call bacterial [83:22] diversity and you will not have one any [83:25] one species uh overwhelming any other [83:28] species and that will actually [83:30] contribute to metabolic Health it will [83:33] allow for the barriers in the intestine [83:35] to work properly the mucin layer the [83:38] tight junctions the uh immunologic [83:40] barrier called the th17 cells your [83:43] intestine will present the appropriate [83:46] barrier so that bad stuff in your [83:49] intestine won't get into your [83:51] bloodstream to cause systemic [83:53] inflammation [83:55] so feeding your gut is job one and what [83:59] does your gut like to eat it likes to [84:02] eat fiber now we humans don't have the [84:05] enzymes to digest fiber you need [84:08] specialized enzymes the bacteria have [84:10] them so the fiber is the food for the [84:14] bacteria when you take the fiber out of [84:16] the food you're starving the bacteria [84:20] now how many grams of fiber are we [84:22] supposed to eat every day [84:25] our ancestors ate between 50 and 100 [84:28] grams of fiber a day the USDA says we're [84:32] supposed to consume 25 grams of fiber [84:34] per day how many grams do we actually [84:38] consume here in America and by the way [84:40] uke the same mean 12 so we're getting [84:44] half the amount the USDA says and one qu [84:47] the amount our ancestors did and the [84:50] question is does it matter the answer is [84:52] oh yeah it matters big [84:55] because what happens is when you [84:58] feed fiber to the bacteria you get [85:02] multiple species instead of one that [85:05] basically crowd out all the others okay [85:08] and you get this metabolic biodiversity [85:12] and it basically improves your metabolic [85:15] Health in addition the uh bacteria will [85:19] chew that soluble fiber up into a [85:22] compound called short chain fatty [85:24] acids acetate propionate butyrate [85:28] valorate berate is particularly helpful [85:32] it is an immune suppressant it keeps [85:35] your immune system in check it's one of [85:38] the reasons that covid was worse for [85:43] people who were obese and who had [85:45] pre-existing conditions like metabolic [85:47] syndrome and also of course minority [85:50] populations because of ultr processed [85:54] food consumption and lack of fiber lack [85:57] of short chain fatty acids therefore [86:00] lack of ability to fend off Foreign [86:04] Invaders because their immune systems [86:06] were not tamped [86:08] down where did the fiber go they took it [86:12] out why the because you can't freeze [86:14] fiber so that Apple okay yeah okay your [86:20] homework assignment for tonight y take [86:23] that apple and put it in your freezer [86:27] overnight take it out in the morning put [86:29] it on the kitchen [86:31] countertop let it thaw try to eat it see [86:35] what you get what am I going to get mush [86:38] oh really now why does that turn it into [86:42] mush the ice crystals that form will [86:45] mate the cell wall and let all the water [86:47] rush in okay okay turn it into mush food [86:50] industry knows that so what do they do [86:52] squeeze it and freeze it now it lasts [86:53] forever now you've you got apple juice [86:55] or frozen concentrated orange juice you [86:57] have taken a fruit which is food and you [87:02] have turned it into a [87:05] commodity storable food which you can [87:08] sell on the Commodities exchange because [87:11] it won't go bad so it has a price and [87:15] that price will fluctuate and you can [87:17] then bet on the Commodities exchange but [87:20] you can't sell fruit like that because [87:22] it'll go rancid by the time you've sold [87:25] it anywhere so all these people are [87:27] doing this to us um what responsibility [87:30] do I have on a personal [87:31] level because you know if these comp the [87:34] big companies with all this money [87:35] trillions of dollars they're all [87:36] manipulating me bastardizing my food [87:39] they you know hacking my brain giving me [87:41] these adverts y I am it's easy to fall [87:44] into the Trap of thinking listen I'm a [87:46] victim here well you are because you've [87:49] been hacked as we started this you know [87:52] the the podcast okay you you've been [87:54] told one thing and the real world is [87:57] actually something else okay you've been [88:00] hacked you specifically been hacked with [88:03] the notion that processed food is [88:06] food everyone thinks that because they [88:09] called it processed food maybe they [88:11] shouldn't call it processed food maybe [88:12] they should call it processed [88:16] nutrients because the stuff that's in it [88:18] are nutrients but it's not [88:21] food because it doesn't do what food [88:24] does which is contribute to growth or [88:26] burning [88:28] so the question is what's your [88:32] responsibility and what's society's [88:35] responsibility so this is a very [88:37] important question and it's a question [88:39] you know that comes up all the [88:42] time personal [88:44] responsibility does it exist well in [88:47] order to exercise personal [88:48] responsibility first you have to [88:50] exercise Free Will that's a [88:52] prerequisite so we can get into this and [88:55] we probably would need about 6 [88:57] hours okay and we don't have it but do [89:01] we have free will yes or [89:05] no complicated question it's a [89:07] complicated question and it's one I've [89:08] actually been researching this week [89:10] funly enough for a different project [89:11] that I'm working on okay and I was [89:13] trying to find get to a point um where I [89:16] had a solid answer now there's a couple [89:18] of schools of thoughts here one school [89:20] of thought when we look at the [89:22] neurological um [89:24] processes might suggest and there's some [89:27] early studies that suggest that we have [89:29] much less Free Will than we assume [89:31] because things happen in our brain [89:33] before we make a decision there's some [89:34] studies there um [89:39] but do we have free will to make our own [89:42] decisions I think we have a lot less [89:45] Free Will than we think we have very [89:48] little free will yeah if at all here's [89:51] the best way to think of it Arthur [89:53] shopau famous German philosopher [89:56] famously said you are allowed to do what [90:00] you want but you are not allowed to want [90:03] what you [90:04] want those things are actually [90:07] predetermined so you have choice in [90:10] whether you want the candy bar or the [90:13] ice [90:14] cream but you don't have choice about [90:17] the fact that your nucleus succumbent is [90:19] Raging saying give me [90:22] sugar that's the choice the choice is [90:26] how you satisfy the biochemical drive [90:30] but the biochemical drive has you know [90:33] is is Way Beyond Free Will so the [90:37] question is if you don't have free will [90:40] how can you exercise personal [90:42] responsibility because that's a [90:43] prerequisite in order to be able to do [90:45] that because personal responsibility [90:48] says take the risks suffer the [90:50] consequences but if you can't control [90:54] the risks or the consequences how can [90:56] you exercise personal [90:58] responsibility I have just shown you [91:00] that the behaviors associated with [91:03] obesity the gluttony and the sloth are [91:05] actually secondary to the biochemistry [91:07] which you have absolutely no control [91:09] over in fact we have [91:12] no ability to be able to mitigate that [91:15] and that's why we have this obesity [91:19] pandemic and you know diet and exercise [91:21] hasn't solved it for just that reason [91:26] so who do we need to point the finger at [91:27] who needs to resolve the issue well it [91:29] has to be resolved at several uh levels [91:32] it has to be resolved for the public [91:33] that's why you and I are doing this [91:34] podcast now because they have to [91:37] understand what's really at issue okay [91:40] blaming the victim has never worked when [91:44] did it work did it work for [91:46] HIV did it work for tobacco it never [91:50] worked okay every personal [91:52] responsibility issue becomes a Public [91:55] Health [91:57] crisis because personal responsibility [91:59] hasn't solved any of them it's a loser [92:03] it's a loser in terms of its mechanism [92:06] and it's a loser in terms of its uh [92:08] efficacy doesn't work can I throw a [92:11] thought into there as well because in [92:14] some areas of Our Lives where we do have [92:16] discipline we tend to have a bias [92:17] towards assuming everyone else doesn't [92:19] have discipline and that's what they're [92:21] missing if that makes sense so great way [92:24] to blame people were listening to this [92:26] that don't struggle with diet and sugar [92:29] and all of those things and ex whatever [92:31] all those [92:32] subjects their brain will probably be [92:35] thinking God you can just choose not to [92:37] I choose not to all the time I choose [92:39] not to have the can of you know fizzy [92:41] drink all the time because their nuclear [92:44] succumbent is not going off like a [92:46] Christmas tree why is it not going off [92:47] like a Christmas tree we don't know yet [92:50] why do some people smoke and some people [92:52] don't why do some people drink and some [92:54] people don't look 40% of Americans are [92:56] tea tolers never touch the stuff 40% of [93:00] social drinkers can pick it up put it [93:02] down you know no problem I'm in that [93:04] category 20% are binge drinkers I sorry [93:07] 10% are binge Drinkers and 10% are [93:09] chronic [93:10] alcoholics what distinguishes the 20% [93:12] who have a problem from the 80% who [93:15] don't we don't know yet to this day we [93:18] still don't know but we know that for [93:21] that 20% it is a problem we also know [93:23] there this thing called sugar addiction [93:25] and there's going to be on May 17th in [93:27] London the International Conference on [93:30] food addiction I will be the keynote [93:33] speaker um to discuss exactly this issue [93:37] is there such a thing as food addiction [93:39] and if there is such a thing as food [93:40] addiction does it portend uh need for [93:45] societal [93:47] remediation ra or is this really just a [93:50] personal responsibility issue well [93:53] everything that is both toxic and [93:55] addictive has required some sort of [93:57] societal intervention okay so you have [94:01] things that are toxic but not addictive [94:03] Like Oxygen and water you don't have to [94:05] regulate those you have things that are [94:07] addictive but not toxic like caffeine no [94:09] you don't have to really regulate that [94:11] either unless you add it to alcohol [94:12] which case then you have four Loco and [94:14] then you get arhythmia and then you do [94:16] have to regulate it but what if you're [94:18] both toxic and addictive like cocaine or [94:21] alcohol or nicotine or heroin [94:24] for those we all have uh uh societal [94:28] intervention you know rehab for the [94:30] personal and laws for the [94:34] societal for sugar for ultra-processed [94:38] food we have [94:40] nothing it's the same issue nothing [94:45] different so you want regulation from [94:48] the government on sugar I think that the [94:53] industory has to be told what to [94:57] do they haven't yet now the question is [95:01] would it work the answer is yeah it [95:03] would and actually who found out that it [95:06] would work the UK you did it it did it [95:10] back in the 2000s so in 2003 the Blair [95:16] government brought all of the uh UK uh [95:20] food manufacturers to the table in [95:24] secret so wait Rose and Tesco and M&S [95:28] and you know every other cpg uh purveyor [95:32] in in uh the UK and had a secret meeting [95:36] and were told and told them look [95:39] hypertension is running rampant and [95:42] stroke is breaking the NHS [95:46] bank and it's because of the sodium we [95:49] have to get the sodium levels in ultr [95:53] proc ESS Foods down so every one of you [95:57] is going to play by the same rules so [95:59] that there's no competitive disadvantage [96:01] and you're all going to reduce the [96:03] amount of sodium in each of your items [96:07] by 10% per year over a three-year period [96:11] so that there will be 30% less [96:14] sodium 3 years from now in 20 six it was [96:19] 2007 I think at the time and they all [96:22] did and they didn't tell the public and [96:25] in 2011 famous paper in British medical [96:27] journal showed a 40% reduction in [96:30] hypertension and stroke due to this [96:33] public health intervention that the [96:36] Blair government did without telling the [96:39] public it works should have told the [96:41] public no don't tell the public so would [96:48] this work for [96:50] sugar so I am working with a company in [96:54] the Middle East right now okay I don't [96:56] take money okay it's a um you know I do [96:59] this because it's the right thing to do [97:02] uh it's called Kuwaiti Danish Dairy kdd [97:05] it's like the Nestle of the Middle East [97:07] and they make all sorts of junk they [97:09] make flavored milks they make ice cream [97:12] they make frozen yogurt they make [97:14] biscuits they make confectionary they [97:16] make tomato sauce okay like all bad [97:18] stuff right they came to me in 2020 and [97:22] said we want to be a metabolic healthy [97:24] company we want to do the right thing [97:28] because right now Kuwait has an 18% [97:31] diabetes rate and an 80% obesity rate [97:34] and we don't want to be the cause of [97:36] it can you help us re-engineer our [97:39] product [97:40] portfolio to be metabolically [97:44] healthy and so we com comen the [97:46] scientific advisory team and we've [97:49] worked for the past 3 years to develop a [97:52] set of guidelines a set of [97:54] principles and we have developed what we [97:56] call the metabolic [97:58] Matrix three principles three precepts [98:02] to turn food metabolically healthy and [98:05] here they are protect the liver feed the [98:08] gut support the brain any food that does [98:12] all three of those is healthy whether [98:15] it's ultr processed or not any food that [98:18] does none of the three is poison whether [98:21] it's Ultra processed or not [98:24] now why those three organs because if [98:27] you the data show in the literature if [98:30] you fix those three organs all the [98:31] downstream organs also get fixed whereas [98:34] if you fix other organs those three [98:36] organs don't get fixed so those three [98:38] organs are primary and all the data [98:41] shows that if you fix those three you [98:43] can actually improve both U morbidity [98:47] and [98:48] mortality so that's the the goal that's [98:52] the rubric [98:54] protect the liver feed the gut support [98:56] the brain so could we apply that [99:01] principle to the food supply can any [99:04] individual apply it to their own grocery [99:08] purchases use perfect you'll get it can [99:12] the government do it yeah they did it in [99:15] the UK they can do it again it's not [99:19] crazy it can be done the fact is we're [99:21] all carrying a belief system [99:24] around okay and now where did that [99:26] belief system come from the belief [99:28] system is that ultr processed food is [99:30] food yeah where did it come from came [99:33] from the food industry they told us so [99:36] the scientists and governments told us [99:38] so as well though if you look back [99:39] through history so how do we know the [99:40] scientists and governments are telling [99:42] us the truth [99:43] now that's a very good question that's a [99:46] super [99:47] question how do you know what's true [99:52] where we're in this problem right now [99:55] I'm worried that in 20 years time I'm [99:56] going to be sat on this podcast if [99:57] people are still listening and I'm going [99:58] to be sat with another scientist and [100:00] he's going to be saying do you know that [100:01] the uh Dr Robert lusting who you had on [100:04] 20 years ago everything he said has been [100:06] disproved and he's going to say fructose [100:09] is the key apple juice is really [100:10] important we found out that uh [100:12] vegetables are causing autism did you [100:14] ever see the movie sleeper no Woody [100:16] Allen 1973 honestly I've seen no movies [100:20] he wakes up after 200 years and [100:22] suspended animation and he finds out [100:25] that hot fudge and deep fat are good for [100:28] you said oh we you know debunked all the [100:31] you know stuff from before so I get this [100:34] question all the [100:36] time everything we knew 10 years ago is [100:39] already wrong and everything we know [100:42] today will be wrong 10 years from [100:45] now so if everything we know today will [100:48] be wrong 10 years from now why do [100:50] anything about it cuz no matter what it [100:53] is is it's likely to be wrong this is [100:55] known as the pessimistic meta induction [100:58] Theory this is how the Dark Ages [101:01] started the idea of Dogma there's only [101:06] one Dogma Stephen and the Dogma is that [101:08] there is no [101:10] Dogma because everything has to be [101:13] refined Dogma how do you define the word [101:16] dogma Dogma means you take it on faith [101:20] okay you take it on faith okay that's [101:22] what science is for is to debunk the [101:25] previous generation's Dogma if we didn't [101:28] do that okay we'd still be using [101:31] leeches okay we've debunked that Dogma [101:35] we would still think that seizures were [101:37] demonic possession we've debunked that [101:39] Dogma okay ultimately science is not a [101:42] straight line it's a [101:45] zigzag okay but it still moves forward [101:48] so if I end up being discredited 10 [101:52] years from now 20 years from now 30 [101:55] years from now hey I was a cog in the [101:57] wheel at least I drove the the the [102:01] vehicle [102:02] forward that's [102:04] okay and science is really a process [102:06] isn't it it's exactly process it's not a [102:09] religious belief it's not a set of [102:10] answers it's just a process to [102:13] uncovering um information I guess but [102:15] you have to then evaluate each piece of [102:18] information for its veracity yeah [102:20] because the problem with information is [102:23] we are now peppered with disinformation [102:26] and how do you determine what's real and [102:28] what's not you say that to achieve [102:31] contentment you recommend following the [102:34] four CES for contentment indeed what are [102:37] the four CES by the way if you follow [102:39] the four seas you will be a whole lot [102:42] better off in terms of your [102:43] understanding information versus [102:46] disinformation so in my book hacking of [102:50] the American or contemporary mind I talk [102:54] about ways to lower your [102:57] dopamine reduce your cortisol and raise [103:00] your [103:01] serotonin and they're all four things [103:04] your mother told you and they're all [103:06] free and they're all available to [103:08] everyone on the [103:12] planet number [103:14] one connect now connect does not mean [103:18] through [103:19] Facebook connect does not mean digital [103:21] connection it means means social [103:23] connection it means what we're doing [103:25] right now face to face eye to eye now [103:28] why does Facebook not work why does Zoom [103:32] not work you're looking at somebody eye [103:35] to [103:35] eye they've they've now done the Imaging [103:39] studies okay there are a set of neurons [103:41] in the back of your head in the [103:42] occipital cortex called mirror neurons [103:45] and they are not just reading the lips [103:48] of the person you're talking to they are [103:50] reading the facial uh structure [103:53] and the muscle movements and they are [103:55] actually transducing the [103:58] emotion from the person you're talking [104:00] to when you're watching on a screen it [104:03] flattens out you can't tell so you don't [104:05] get the same [104:07] information that information ultimately [104:10] generates a serotonin signal so you get [104:13] contentment so social connection [104:16] actually drives contentment so that's [104:19] number one number two contribute and [104:23] does not mean to your retirement account [104:25] it means contribute to others okay [104:29] contribute with purpose like Habitat for [104:32] Humanity B basically giving to others [104:36] because when they when you give to [104:38] others you feel better yourself okay [104:41] that generates the serotonin the signal [104:44] okay so you know lottery winners you [104:48] know are not [104:49] happy but people who actually give their [104:52] money away are that's one of the reasons [104:55] why we have philanthropy makes people [104:56] feel better it's quite selfish in that [104:59] regard then isn't it in well yes indeed [105:01] it it seems selfless but it's actually [105:03] selfish which is fine it works just [105:07] great number three cope and cope is [105:11] three things it's sleep mindfulness [105:13] exercise all of which are necessary to [105:15] Tamp down [105:16] cortisol because you if you're sleep [105:19] deprived your cortisol goes through the [105:20] roof if you are um uh distracted [105:24] multitasking your cortisol goes through [105:26] the roof okay and if you're sedentary [105:29] okay you number one you're eating like [105:30] crazy and you're also and your cortisol [105:32] also goes through the roof sleep [105:33] mindfulness exercise all things to get [105:36] your cortisol down and finally number [105:38] four the last C [105:41] cook why because there are three things [105:45] that contribute to this dopamine [105:47] serotonin imbalance the first [105:50] tryptophane tryptophane is the precursor [105:52] to serotonin tryptophane is not an ultra [105:55] processed food it is the rarest amino [105:57] acid you find it in eggs chicken fish [105:58] not exactly Ultra processed food number [106:01] two fructose fructose reduces serotonin [106:05] okay and there's lots of fructose in in [106:07] the ultrapress food and finally lastly [106:11] omega-3 fatty acids and omega-3 fatty [106:14] acids are in again eggs and in um in uh [106:18] marine life okay there there's a little [106:20] bit of Omega-3s and vegetables you know [106:22] ala which is doesn't reach the brain so [106:25] that's not a that's not a big winner for [106:27] uh fixing this problem so you need high [106:31] tryptophane low fructose High Omega-3s [106:35] sounds like real food to [106:36] me [106:38] so uh connect contribute cope cook it [106:44] will Tamp down your dopamine reduce your [106:46] cortisol raise your serotonin improve [106:50] your mental health improve your [106:52] metabolic public health and will solve [106:55] your [106:57] problem it won't solve societies we have [107:00] to work on getting the whole world to [107:03] understand what the problem is before we [107:05] can fix it Dr Robert leting what is the [107:09] thing we haven't talked about the most [107:11] important topic we haven't talked about [107:13] that we should have wow [107:18] well we [107:20] have a systemic Health crisis [107:25] diabetes metabolic [107:27] syndrome um dementia cancer we have a [107:31] mental health [107:33] crisis [107:34] depression [107:36] suicide [107:38] schizophrenia uh autism [107:42] add we have a global Health crisis we [107:47] have cyber bullying we have social [107:50] inequality we have [107:53] War we have um climate change planet is [107:59] ulating all at the same [108:02] time [108:06] coincidence or are these [108:09] somehow inextricably [108:12] related are these the same thing or are [108:15] these different things if we believe [108:18] they are separate we're going to solve [108:20] try to solve each one individual [108:23] and never get to the root [108:25] cause the root [108:28] cause is our amydala the fearce center [108:32] of our [108:33] brain it's under [108:36] attack from all of the things we've [108:38] talked about [108:40] today that dysfunctional amydala is the [108:44] driver of chronic disease it is the [108:46] driver of the Mental Health crisis it is [108:48] the driver of the global health and [108:50] planetary crisis [108:53] there are four breaks on the amydala and [108:55] they're all dysfunctional today and [108:58] they're all dysfunctional because of the [108:59] things we've talked about today because [109:01] of cortisol because of stress because of [109:03] ultra-processed food because of sleep [109:07] deprivation because of the um uh change [109:10] in the environment because of air [109:12] pollution because of um all the things [109:15] that ultimately impact our brain's [109:20] ability to transduce information [109:24] until we recognize where the problem is [109:28] we're going to be spinning our [109:30] Wheels we can do this we can back out [109:33] the same way we drove into the Stitch [109:36] but you can't solve a problem until you [109:39] know what the problem [109:41] is Dr Robert leting thank you so much we [109:44] have a closing tradition on this podcast [109:45] where the last guest leaves a question [109:46] for the next guest not knowing who [109:47] they're leaving it for and the question [109:49] that's been left for you is here we go [109:52] let's have a look [109:55] okay nice question um what would you [109:58] tell your 20-year-old self that you wish [110:02] you knew and that would have positively [110:04] impacted your life and avoided [110:12] pain I wish I had [110:15] known [110:18] that I didn't have to please everyone [110:25] there's a book called the courage of [110:26] being [110:28] disliked it's courageous to be disliked [110:34] I was afraid of being disliked and [110:38] because I was afraid of being disliked I [110:39] was [110:43] disliked it's such a wish I had [110:46] known that nugget of Truth early on in [110:50] my career [110:54] thank you so much Dr pleasure thank you [110:57] I have to say your work is exceptional [110:59] um your books are incredible I've [111:01] got three of them here but I know there [111:03] there's many more um I'd recommend them [111:06] all incredibly highly the hacking of the [111:07] American mind is a fantastic book that [111:09] doesn't just apply to Americans it [111:10] applies to um all Industries around the [111:13] world um all Western economies around [111:14] the world which are set up in in very [111:16] similar ways fat chance and another book [111:18] that I've been through um in detail is [111:20] about beating the odds against sugar [111:21] processed food obesity and disease which [111:23] covers much of your work in the studies [111:24] that you referenced today an incredible [111:26] incredible book and I also have this [111:28] book called metabolical did I pronounce [111:31] that correctly you did metabolical the L [111:33] and the lies of processed food nutrition [111:35] and modern medicine which is a little [111:36] bit of a bigger book but it's um it [111:38] gives more of the foundations around [111:40] metabolism which I think a lot of people [111:41] don't understand so thank you thank you [111:44] for um your your Brilliance in so many [111:46] ways and but thank you for your life's [111:48] work because your life's work is Saving [111:50] Lives it's propelling us forward it's [111:52] it's driving a conversation forward and [111:54] you do it in a way that's so [111:55] unbelievably engaging that it's hard not [111:57] to pay attention so thank you Robert [111:59] well thank you and thank you for you [112:01] doing what you do [112:05] [Music] [112:23] a