Doctors Don't Warn You! - "Healthy" Foods Making You Sick & Obese | Robert Lustig

1. RCDr. Rangan Chatterjee0:00

   When we're talking about foods, I think we need to get clear on terminology for people who are listening and they think, "Okay, look, I get this. Pr- highly processed food is at the root cause of many of these chronic diseases." Over half of what we're consuming as a country, as a Western society, are these foods. So I guess we need to really help people understand, you know, what are these foods. There's a, there's this part in the introduction where you actually... I've, I've underlined it. You said, "What if this slow consumable poison looks like everything else in the store? How do you protect yourself?"

2. RLDr. Robert Lustig0:36

   Right.

3. RCDr. Rangan Chatterjee0:36

   And that's kind of part of the problem, isn't it? I don't- it's so normalized that-

4. RLDr. Robert Lustig0:40

   That's right

5. RCDr. Rangan Chatterjee0:40

   ... I think many people don't really understand anymore, well, what is a processed food? What is real food, you know? So can you help us-

6. RLDr. Robert Lustig0:47

   Right

7. RCDr. Rangan Chatterjee0:47

   ... try and understand that?

8. RLDr. Robert Lustig0:49

   Right. Yeah. One of the first questions we ask in, uh, uh, in, in clinic, you know, we used to ask, is, you know, "Mom," you know, the, the, the mom and the kid come in, you know, for, for, you know, uh, obesity clinic, and we ask the g- uh, you know, "Mom," you know, "what do you consider food?" You know, "Do you, do you think Cheetos is food? If you think Cheetos is food, then basically nothing's gonna help you." So that's the first thing we do, is we disavow them of this concept, of this knowledge. So what we did in our clinic to be effective, and we actually studied this, we published on it, we validated it as an instrument. What we did was we, um, took all newcomers, all new referrals to our clinic, and we did a teaching breakfast. So these kids came in fasting, you know, so we could get comorbidity and safety labs. And we, you know, they saw the doctor, they got their blood drawn, they got their physical exam, and then they went to the teaching breakfast. Six kids, six parents around a table, one dietician, English and Spanish, uh, diff- you know, different times. All right? So that everybody, you know, got a teaching breakfast. And we got $100 gift certificate from Trader Joe's every month to basically buy the food for the teaching breakfast. And of course, our dietician went out and bought the, the right stuff, not the wrong stuff. [laughs] And we would then, she would then narrate for an- or he would narrate for an hour why these foods were on the table for breakfast, and why the stuff they were buying at home was the wrong stuff. Okay? And we would explain insulin, and we would show them how much sugar was in each of the things that they were getting at home and versus, you know, what, what was on the table. And four things had to come out of that, and we actually, um, validated this. Four points, four different points that conferred success. Number one, the parent had to see the kid would eat the food. Number two, the parent had to see the parent would eat the food. Number three, the parent had to see other kids would eat the food, 'cause they got other kids at home. Number four, we showed them the bill. They had to see they could afford the food.

9. RCDr. Rangan Chatterjee3:20

   [laughs]

10. RLDr. Robert Lustig3:21

    All four. If we got all four boxes ticked, those patients did well, and then there was no going back. So this was a training moment. This was a teaching moment. This was a way we could explain to, to parents and to kids what was going on, and model for them so they can do see one, do one, teach one, where like we always-

11. RCDr. Rangan Chatterjee3:50

    Yeah

12. RLDr. Robert Lustig3:50

    ... do in medical school. If you tell people what to do, they will not do it. If you show people what to do, and they do it, then they'll do it again.

13. RCDr. Rangan Chatterjee4:00

    Yeah.

14. RLDr. Robert Lustig4:02

    And not until.

15. RCDr. Rangan Chatterjee4:07

    The term real foods, I like it, you use it, but it does get a bit of pushback from certain academics. And-

16. RLDr. Robert Lustig4:18

    Right. Yeah

17. RCDr. Rangan Chatterjee4:18

    ... you know, I saw one, I think, on Instagram just a couple of weeks ago, very prominent, uh, researcher in obesity in the UK, um, denigrating the term, saying it smacks of privilege. It's, you know-

18. RLDr. Robert Lustig4:31

    Yeah

19. RCDr. Rangan Chatterjee4:31

    ... all kinds of things about it. And here's the thing-

20. RLDr. Robert Lustig4:34

    Yeah

21. RCDr. Rangan Chatterjee4:34

    ... you know, the, you know, my view, Bob, is that I found it to be very useful with my patients. Of course, if my patients don't like it, I'd come up with something else that, that they understand. Um, but generally speaking, I think the things like, you know, would your grandparents recognize it as foods, I, I think people find it quite helpful. Or does the food packet have more than five ingredients on it or not, as a kind of general rough rule. They're not perfect, but they're all kind of guidelines to try and help people make sense of this ultra-processed food environment in which they're living. And I kind of, I wonder why there's so much criticism. It's like, these things are there to help people. If you find it helpful, great. If you don't, fine. Use something else. But I don't... Like, I find a lot of people, particularly in medicine and academia, look down on these kind of, uh, what are considered simplistic terms.

22. RLDr. Robert Lustig5:29

    Yeah. I, uh, I've, I've heard those, uh, complaints also before, and I've heard about the quote, quote, "smacks of privilege" also. Basically, what we're saying is real food is food that came out of the ground, or animals that ate the food that came out of the ground. That's real food, okay? As soon as a human touched it, now it's processed. [laughs] Just a question of the degree of processing also. And, you know, I'm sure you're familiar with Carlos Monteiro at, uh, at University of São Paulo, developed this system called the NOVA system for the degree of processing, which I h- actually think is, you know, the right way to go. It's not... 'Cause that, it's not what's in the food, it's what's been done to the food that matters. All food is inherently good.It's what we do to the food that's not, and that's the point I try to make in the book.

23. RCDr. Rangan Chatterjee6:14

    Yeah

24. RLDr. Robert Lustig6:14

    And I have an entire section on what we did to the food that actually turned it from food into poison.

25. RCDr. Rangan Chatterjee6:20

    That classification system is brilliant, and perhaps you could take a kind of readily available simple food and just explain how it can go through these four stages-

26. RLDr. Robert Lustig6:32

    Sure

27. RCDr. Rangan Chatterjee6:32

    ... to, to help people really understand this.

28. RLDr. Robert Lustig6:34

    Sure, I can do this in one minute. Let's take an apple. Class one on the NOVA system would be an apple. Class two on the NOVA system would be apple slices. Class three on the NOVA system would be apple sauce, unsweetened. Class four on the NOVA system would be an apple pie. There you go. Turns out that only the class four foods are associated with chronic disease. And that's because-

29. RCDr. Rangan Chatterjee7:13

    So we can have, we can have minimally... That's really inter- So we can have, you know, minimally processed foods that are done to make-

30. RLDr. Robert Lustig7:20

    Minimally processed

Episode duration: 20:29