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Metabolical By Robert Lustig Summary

Metabolical weaves the interconnected strands of nutrition, health/disease, medicine, environment, and society into a completely new fabric by proving on a scientific basis a series of iconoclastic revelations, among them: 

  • Medicine for chronic disease treats symptoms, not the disease itself
  • You can diagnose your own biochemical profile 
  • Chronic diseases are not “druggable,” but they are “foodable” 
  • Processed food isn’t just toxic, it’s addictive
  • The war between vegan and keto is a false war—the combatants are on the same side
  • Big Food, Big Pharma, and Big Government are on the other side

Making the case that food is the only lever we have to effect biochemical change to improve our health, Lustig explains what to eat based on two novel criteria: protect the liver, and feed the gut. He insists that if we do not fix our food and change the way we eat, we will continue to court chronic disease, bankrupt healthcare, and threaten the planet. But there is hope: this book explains what’s needed to fix all three.

Dr. Robert Lustig, a pediatric neuroendocrinologist who has long been on the cutting edge of medicine and science, challenges our current healthcare paradigm which has gone off the rails under the influence of Big Food, Big Pharma, and Big Government.

You can’t solve a problem if you don’t know what the problem is. One of Lustig’s singular gifts as a communicator is his ability to “connect the dots” for the general reader, in order to unpack the scientific data and concepts behind his arguments, as he tells the “real story of food” and “the story of real food.” 

About the Author

Robert H. Lustig, MD, MSL, is the editor of the academic volume Obesity Before Birth and the internationally acclaimed author of the popular works Fat ChanceSugar Has 56 NamesThe Fat Chance Cookbook, and The Hacking of the American Mind. He is an Emeritus Professor of Pediatrics in the Division of Endocrinology and a member of the Institute for Health Policy Studies at UCSF. He lectures globally and consults with numerous medical societies and policy organizations to improve population health. He lives with his family in San Francisco.

Metabolical By Robert Lustig Introduction

Excerpt. © Reprinted by permission. All rights reserved.

It’s been a rough day, you’re finally home after a long commute, and you’re starving. You sit down at the kitchen table, turn on the TV, and inadvertently consume a plate of poison. It looks like food, it tastes like food, maybe it tastes even better than food. But what if something had been done to poison it?

No—this isn’t an episode of Game of Thrones; it’s what’s happening to most of us every day, every meal, every snack. In bygone times, kings employed food tasters and cupbearers to sample their food and drink first to determine if it had been poisoned. Those poor peons knew that each bite might be their last. But our food today is safe, right?

Your cart at the grocery store is full of vacuum-wrapped, refrigerated or frozen, hermetically sealed, spoilage-resistant, irradiated, pathogen-tested, screened-at-the-border products that meet all USDA and FDA standards. But what if that food has been altered or adulterated in some fashion by some ne’er-do-wells before it’s even been harvested, while it’s being cooked, or even after it’s been packaged, in order to kill you? And by design? Not because they want your life—just your wallet?

We occasionally hear about E. coli in hamburger meat, Salmonella in eggs, Listeria in spinach, or even melamine in infant formula; a recall is announced, and the matter is forgotten. So our food’s safe, right? But what if it acts more like a slow poison, like cigarettes—one won’t kill you, but ten thousand consumed over ten years might? Unlike Salmonella, you won’t be feeling the effects immediately.

But eventually, you’ll feel it . . . everywhere. In your heart, muscles, bladder, brain, and especially your wallet. What if this consumable poison is laced with additives that toy with your brain’s reward center, leading to addiction and needing ever more of it? Kind of like the pusher in the schoolyard who offers you your first toke for free—and then he’s got you. And the bigger and the more chronic the dose—the quicker you die.

Let’s take it a step further: what if this poison doesn’t just kill you chronically, but sets you up to be susceptible to acute illness—say, a viral pandemic—that could kill you even quicker? What if the USDA and FDA are aware that this slow consumable poison is sold in grocery stores nationwide, and they allow it to be promoted heavily? What if the entire world is exposed to the same toxic and addictive consumable poison, and has now started to get sick, too?

And finally—what if this slow consumable poison looks like everything else in the store? How do you protect yourself?

This is not a Stephen King novel. It’s real life and it’s happening now. This consumable poison is called processed food.

Food writer Mark Bittman has said that since food is defined as “a substance that provides nutrition and promotes growth” and poison is “a substance that promotes illness,” then “much of what is produced by industrial agriculture is, quite literally, not food but poison.” He was talking primarily about pesticide use versus sustainable farming, arguing that we have laced our food with poison. Yes, pesticides are one aspect of food toxicity—but only the tip of the iceberg, maybe about 10 percent of what ails us.

The other 90 percent is due to the procedures of the processing, which has morphed what was food into this new slow-acting poison. Your box of cereal may tout that it’s “organic” and “all-natural”—but it still may be poison. What’s important is the alchemy of how the food itself has become poison. Until you understand that, you can’t understand what has happened to our food—and to us. This book will explain it’s not what’s in the food—it’s what’s been done to the food that counts. And you can’t learn that from your doctor, dietitian, advertisement, internet blog, or even a Nutrition Facts label. Nope, you’re going to have to learn that yourself.

Nutrition is not the same as food science. Nutrition is what happens to food between the mouth and the cell. Food science is what happens to food between the ground and the mouth. Each is dependent on the other, yet both are “opaque” to the public. That’s on purpose—because the food industry and the government don’t want you to know that it’s the food processing that’s rendered the current concepts of nutrition moot.

Food processing isn’t listed on the Nutrition Facts food label. The label tells you what’s in the food. This is mostly irrelevant—what you really need to know is what’s been done to the food, and no label tells you that. In this book, I will make both nutrition and food science transparent.

Essentially, all you need to know are two precepts, six words total: 1) protect the liver, 2) feed the gut. Those foods that satisfy both precepts are healthy; those that do neither are poison, and those that do one or the other are bad (but less bad)—no matter what the USDA and FDA allow to be stated on the package. Only items that meet both of these criteria qualify as Real Food, i.e., that hasn’t been stripped of its beneficial properties and sprinkled with toxins that will hasten our demise.

So buckle up—I’m going to take you on a ride. Now that you’re strapped in, we are going on a journey from the ultra-micro to the ultra-macro—from molecule to planet, and everything in between. We’re going to get both the subcellular and the thirty-thousand-foot view. And we’re going to travel through time, over the last fifty years. The reason for this bottom-to-top and backward-to-forward excursion is to answer these questions: why has our health status declined, our healthcare system devolved, and our climate immolated?

Some might argue that these alterations are unrelated to each other. But it all starts with the changes in our food supply chain that shifted five decades ago in order to support the production and consumption of processed food. To make and bolster this case, I’ve connected several dots for you: the food to the biochemistry; the biochemistry to the disease; the disease to the medicine; the medicine to the demographics; the demographics to the economy; the economy to the agriculture; the agriculture to the climate; the climate to the planet; and the planet back to the food yet again.

I know this sounds like a nightmare ride on an academic Tilt-A-Whirl, but I’m asking you to hold on to your seat. When you see how these factors are all interlinked with one another, two incontrovertible truths emerge. First, the change in food processing, starting about fifty years ago, has fueled a slow but unrelenting medical, economic, and climate vortex downward. It’s picked up speed with time and overwhelmed our medical resources, now evidenced and accentuated by the social disparities of the coronavirus pandemic.

It threatens to overwhelm our planetary resources to boot. Second, in today’s society, food is the only possible lever that we can apply immediately to effect change. If you do not fix your food, you continue to court chronic disease and death. If we do not fix our food, we continue to court societal and planetary oblivion. This book explains what’s needed to fix both.

Most nutrition authors have a diet to sell to you, a single ax to grind, don’t take care of patients, can’t provide a diagnosis or medical advice, and think that there’s one diet that fits all. They can’t or won’t address nutritional issues based on age, sex, or race, because they only know one aspect of nutrition, and can’t meld it into context for individual readers. Frankly, we have a right to view them as co-opted.

Conversely, clinical health professionals are supposed to keep you healthy, but they can’t do that if they haven’t been taught how. For decades, the combined healthcare professions have subscribed to the inevitability of chronic disease and aging, and have been consistently dissuaded from keeping you healthy with the “lure of cure,” and more recently the “temptation of treatment”—because they don’t know otherwise.

Doctors and dietitians and dentists have been part of the problem, but we can be part of the solution—but only by changing the paradigm. By elaborating on the science and pathways of chronic disease in this book, I will demonstrate that our current processed food model is prima facie defective, and must be discarded in favor of a Real Food model.

Many people think Real Food is effete and snobbish, and that I must’ve had a privileged upbringing to eschew the Standard American Diet. Nothing could be further from the truth. My mother worked two jobs, by day a New York City school secretary, and by night the agent for my grandparents’ rental properties. I heated up and ate a whole lot of Swanson TV dinners (I hated the Salisbury steak). I also was a stress eater, and in medical school, I was the master of the three-second lunch, as I would have to inhale a sandwich while transitioning from one clinic to another. Hardly a diet to be envied.

I didn’t just stumble into this problem, but like you, originally I yielded to the siren song of mainstream nutrition dogma. I majored in nutritional biochemistry at MIT, graduating in 1976. I was fascinated by how micronutrients such as vitamins could fix certain diseases, but not others. I was also intrigued by the tabloid headlines proclaiming that some people who consumed high-protein formula shakes for weight loss were dying from kidney failure.

It was clear to me then that the science and the physiology of nutrition actually mattered. Then I went to Cornell University Medical College in New York City, where despite having one of the most distinguished nutritionists in the world on faculty (Professor Maurice Shils, 1914– 2015), there was no nutrition curriculum, and they beat my scientific interest in it out of me.

I was told that my undergraduate training was irrelevant in dealing with how to take care of patients. I succumbed to the “common wisdom” of calories, obesity, and the inevitability of aging—they taught that it was all about calories in and calories out, and I believed what I was told, even though it was the opposite of what I’d learned just one year prior. Hey, these were the doctors, the experts, and my parents were paying a big tuition bill for learning and incorporating the expertise of those doctors.

So, mea culpa—I practiced medicine for my first twenty years as a pediatric endocrinologist (glandular and hormone problems in children) without a real clue of what was truly right or wrong when it came to disease. Match the diagnosis to the disease, and then the treatment to the diagnosis. A big game of Clue: Colonel Mustard in the Conservatory with the Candlestick. And then throw some medicines at it. My colleagues eschewed seeing the obese children who were my patients because they were steeped in that same common wisdom—it’s about energy balance; the kids eat too much and exercise too little; it’s all their fault.

When I was at the University of Tennessee in the late 1990s, one divisional colleague sent a form letter to outside providers admonishing them for referring such patients, to dispel their belief that an endocrinologist could somehow cure obesity—such sacrilege!—that a doctor could somehow upend the first law of thermodynamics, which espouses a simple mantra: a calorie is a calorie. That mantra, recited with almost religious fervor, has set medicine back at least fifty years, and maybe more.

My own research showed me the inconsistencies of this mainstream nutritional dogma, and the true path forward. At UCSF we have a motto, “In God we trust, everyone else has to produce the data.” I guess everyone else trusted. But I produced the data. And it didn’t match the party line. Science said that not all calories are created equal; and it’s the food quality, not the quantity, that matters. I didn’t know it at the time, but that was my only salvation in terms of my reputation, personal integrity, and sanity. It also set up the second half of my career to be an iconoclast, relegated to the outside of both the medical establishment and the government.

You can therefore consider this book as both my act of contrition to you, the public, and my act of medical disobedience to the medical establishment. Perhaps I had to wait until I was retired from clinical practice to write this book, for no ivory tower academic bastion would want to take credit for the “medical heresy” that you’ll find sandwiched within these pages.

Doing the research myself was like taking the red pill from The Matrix (1999)—and now I know just how far down the rabbit hole goes. Iconic chef Anthony Bourdain, even in the face of his own personal demons, relished telling the full truth about his profession. My favorite Bourdain quote: “An ounce of sauce covers a multitude of sins.” That might as well be the motto of the entire food industry.

And the healthcare industry. And the medical industry. And the pharma industry. And the chemical industry. And the insurance industry. And the government, which is its own industry. But the truth will set you free. This book is my contribution to the truth—my Clinician Confidential. By educating you, the reader, this book is my attempt to eventually bring the medical profession to heel and to heal.

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Product details:

EditionInternational Edition
ISBN1538728583, 0063027712
Posted onMay 4, 2021
Page Count416 pages
AuthorRobert H. Lustig

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Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine


Author: Robert H. Lustig

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