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Speaker A: Welcome to the Huberman Lab podcast, where we discuss science and science based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Doctor Robert Lustig. Doctor Robert Lustig is an endocrinologist. That is, he's... |
Speaker B: Pleasure, truly. Just being here, being invited. High honor. Really appreciate it. And it's not doctor, it's just Rob. |
Speaker A: Okay, Rob, I've been looking forward to this conversation for a long time. I've seen your now famous, can we also say infamous but famous YouTube video about sugar. We'll put a link to it in the show. Note captions. It's been viewed many, many millions of times. |
Speaker B: Yeah, and I still can't figure out why that is. You know, I didn't think my mother would watch it, and she didn't, but 24 and a half million people did. |
Speaker A: Well, I think people are very interested in what to eat, what not to eat. And we'll start off simply talking about what most everyone believes and understands, which is that a calorie is a form of heat energy that's given off during the processing of some food bit or something. If that's mysterious to people... |
Speaker B: Everyone thinks that obesity is about energy balance. That is, calories in, calories out, therefore two gluttony and sloth. Therefore, if you're fat, it's your fault. Therefore, diet and exercise, therefore, any calorie can be part of a balanced diet. Therefore, don't pick on our calories. Go pick on somebod... |
Speaker A: I do. |
Speaker B: Me, too. Almonds are great. You eat 160 calories in almonds. How many of those do you absorb? 130. You eat 160, you absorb 130. Where'd the other 30 go in the. |
Speaker A: Processing of that food? Energy? |
Speaker B: No. Turns out the fiber in those almonds, both soluble and insoluble fiber. And by the way, fiber is sort of the key to the kingdom in this story. It forms a gel on the inside of your intestine. The insoluble fiber, the cellulose, forms a fishnet, if you will. A lattice work on the inside of your duodenum, t... |
Speaker A: Or let's say you're a kid going through puberty who's synthesizing a lot of muscle, not because they're lifting weights, because. |
Speaker B: Testosterone'S making it happen. Yeah, absolutely. But let's say you're not. Let's say you're just schlump off the street like Joe Schmo. And you eat that porterhouse. You've taken on all these amino acids. There's no place to store it other than muscle. So your liver takes the excess and deamidates that ami... |
Speaker A: Cause when you asked about almonds, why the 160 versus 130? I thought it was the processing. It turned out it was fiber. You're saying for protein. Let's make it realistic for a really nice big porterhouse steak, which I love, by the way. Let's say. Let's say 800 calories. Well, it turns out how much of that... |
Speaker B: Right. So about 10% of everything you eat goes to just maintaining body temperature. It's called the thermic effect of food. But when you're eating protein, you actually generate more. And the reason is because it takes two ATP to phosphorylate that organic acid as opposed to one ATP to phosphorylate that ca... |
Speaker A: Okay, so, but in this, let's make it actually realistic. A 1600 calorie porterhouse with a nice slab of butter, of grass fed butter on there. I do this every once in a while. Not often. |
Speaker B: Some creamed spinach and maybe some mushrooms along the side. |
Speaker A: Honestly, I see it when I'm eating a porterhouse. I don't want to adulterate the taste with anything else except maybe some butter, maybe a salad afterwards. But let's say 1600 calories, it's got some fat in there for sure. Let's say 1000 of those calories is protein. The other 600 are fat, something like th... |
Speaker B: Well, if you ingested 1600, well, that's. |
Speaker A: What went in the mouth. But what is going to go against your burn deficit? |
Speaker B: Right. So I would have to actually do the math to figure that out. But as a guess. |
Speaker A: Yeah. Back of the envelope. |
Speaker B: Back of the envelope calculation, you're going to lose about 25% of that. Wow. |
Speaker A: So we're talking 750 calories. Yeah. And to translate this a bit. So what we're saying here is if you're somebody who is trying to lose weight or maintain weight or perhaps even gain weight, you eat a 1600 calorie porterhouse with a slab of butter on it. 600 of those calories, we're saying in this is fat wit... |
Speaker B: That's right. |
Speaker A: That's a huge difference. |
Speaker B: Exactly. And another reason why a calorie is not a calorie. Now, let's take the third. Let's take fats. So here we have omega three s. Heart healthy, anti inflammatory, anti Alzheimer's, save your life. And over here we have trans fats, the devil incarnate consumable poison. Because you can't break the trans... |
Speaker A: All right? |
Speaker B: Now, glucose is the energy of life. |
Speaker A: So here we're talking carbohydrates. I think most of our audience will be familiar with the so called macronutrients. So we talked about fat, in this case, almonds. There's some fiber in there. Probably a little bit of carbohydrate. |
Speaker B: A little bit. |
Speaker A: Little bit. We talked about the porterhouse with butter. You can be hungry already. That's protein and fat. |
Speaker B: Yeah. |
Speaker A: Very little, if any, carbohydrate. Zero, essentially. Maybe 10, zero. Yeah. And then now we're talking about carbohydrates, and we're going to subdivide that into glucose and fructose. |
Speaker B: Right. Galactose basically becomes glucose in the liver. So we can dispense with that unless you have a disease called galactosemia, which is about one in 20,000 and causes neonatal meningitis. And, you know, it's a disease, as a pediatric endocrinologist, I would take care of. But we can dispense with that ... |
Speaker A: That's gluconeogenesis. |
Speaker B: Gluconeogenesis, that's right. It will take a fatty acid and turn it into glucose. And specifically, the glycerol portion of the triglyceride will turn into glucose. So the inuit, they didn't have any place to grow carbohydrate. They had ice, they had whale blubber. They still have serum glucose level. And t... |
Speaker A: Okay, we'll come back to this because I think it's really important. The idea that ingestion of carbohydrates and as you called it, the studying of carbohydrate molecules on hormones can augment the function of those hormones. And with aging, that's a less efficient process. |
Speaker B: It's a less efficient process, but it's not because of consumption. |
Speaker A: Right. People are still, I see the plenty of folks who are 65 and older eating plenty of carbohydrates. You're saying a lot of them have deficient thyroid, testosterone, estrogen, prolactin, et cetera. Because of the way those carbohydrates are not studying the hormones. |
Speaker B: Exactly. So all of those are glycoprotein hormones. |
Speaker A: Let's tee that up for later because I think that's an interesting, it's a very important avenue to go down. |
Speaker B: Okay? And there's a disease in children, in babies called congenital disorders of glycosylation. Where you can't put glucose molecules on specific proteins. And it causes severe mental retardation, all sorts of metabolic havoc. And a lot of those babies die, for that matter. So that's an important thing. All... |
Speaker A: Okay, sorry. I'm gonna just answer. So you're saying that even though we can process fructose, we have a limited. |
Speaker B: Capacity to process it in the same way we have a limited capacity to metabolize alcohol. Now, if you have one drink a day, you're okay. If you have two drinks a day, depends on how big you are. You and I can probably, I would. |
Speaker A: Argue two drinks a week is the maximum, but let's not go there. But in terms of. You're saying, when you say fructose, processing of fructose is vestigial, what you're saying is that we don't need to do it. It's like the appendix. It's an organ for which it has no function. |
Speaker B: Exactly. And fructose has no function in the human body, period. |
Speaker A: You don't need it. |
Speaker B: You don't need it. You don't need it. But our diet is replete with it. In fact, our fructose consumption's gone up 25 fold since the beginning of the last century. |
Speaker A: I have to ask this now. I love fruit. That is berries galore, especially since the price of berries seems to have come down. It used to be that you only get them at certain times of year. I'm what you call a drive by blueberry eater. So I'll just walk past and just take a fistful. You can't put them in front... |
Speaker B: No problem. |
Speaker A: Loaded with fructose. |
Speaker B: No. |
Speaker A: Plenty of fiber, low fructose, low fructose, and berries. |
Speaker B: Berries are the lowest fructose of all the food. |
Speaker A: I was so worried about asking you this today. |
Speaker B: Not a problem. |
Speaker A: Okay. |
Speaker B: And fruit is okay because of the fiber. So the molecule, the fructose molecule is the same whether it's in a berry or in a banana or for that matter, in a Coca cola. The fructose molecule is the same molecule. The difference is that in the berry, it comes with a whole lot of fiber in the banana, it comes wit... |
Speaker A: Got it. Such a relief. And I must say, recently I had a whole body MRI as a preemptive thing. |
Speaker B: What was that? |
Speaker A: It was great. I got to watch a Netflix in there. And I never had a whole body MRI. I learned a few things that were useful to me. I got a clean bill of health, so that's great. One of the pieces of feedback I got is that my gut was filled with this very high contrast stuff. And they asked, do you consume a l... |
Speaker B: Wow. |
Speaker A: And basically my entire gut was filled with blueberries. I suppose I need to cut back a little bit. But now I know that fruit is okay, especially if the fruit has a lot of fiber. But fructose itself, especially if it's not partnered with fiber, is first of all not required for survival at all. But you're tel... |
Speaker B: Yeah. And let me tell you why it's problematic. We haven't gotten to that yet. We're just talking about whether it's vestigial versus needed. Now let's talk about what fructose does. Turns out fructose inhibits three, count them, three separate enzymes necessary for normal mitochondrial function. Mild, your ... |
Speaker A: Okay, so it basically acts like a key that doesn't turn the lock, but prevents the key that you want in that lock from entering the lock. |
Speaker B: It's like gluing a lock shut. |
Speaker A: Got it. So that's one of the enzymes. |
Speaker B: That's 1 second one, acad L acyl CoA dehydrogenase lung chain. So this is necessary to cleave two carbon fragments off fatty acids to prepare them for metabolism. So it inhibits that one and then finally it inhibits carnitine. Palmidal transferase one now, CPT one now. That's the enzyme that regenerates carn... |
Speaker A: You said fructose inhibits all three of these enzymatic pathways. As a biologist, I have to ask, how potently does it inhibit them? I mean, because there are drugs that block receptors and then there are drugs that block receptors with unbelievable affinity. So, you know, I mean, mechanistically in a dish, m... |
Speaker B: All right, so look, you know, the dose determines the poison, right? Paracelsus 1537. There are toxins that are parts per billion and will kill you. Like sarin, ricin, cyanide. By the way, cyanide is a good analogy because it's working on mitochondria. It's basically causing mitochondria to be completely def... |
Speaker A: That's why I can eat an apple seed that has a little bit of arsenic in it, but I'm not going to die. |
Speaker B: And then finally there, and by the tobacco smoke goes in there, and then finally you have weak toxins where it's not one exposure that will kill you. It's 10,000 exposures that'll kill you. |
Speaker A: Like alcohol or toxic people. |
Speaker B: Yeah, well, sometimes. |
Speaker A: Sometimes it only takes one mild toxic. Couldn't resist, sorry. Sometimes it only mildly toxic people. |
Speaker B: Anyway, the point is that fructose is in that last category. So it's not what you do one day that kills you, it's what you do every day that kills you. And if you basically eat ultra processed food, high in sugar for ten years in a row, it's going to show up in terms of your comorbidities. And ultimately, ye... |
Speaker A: The previous generation, are they gone? I do remember as a kid when we had margarine in our refrigerator. This is actually a big debate in my home. One parent, I won't identify which Washington, pro margarine, the other was pro butter, anti margarine. The marriage didn't last, but there were other reasons. |
Speaker B: That's probably why I went. |
Speaker A: Butter. |
Speaker B: Butter is fine. In fact, time declared front cover butter's back. Margarine was the bad guy, without question. And we know now, but back when we thought it was a calorie, it was a calorie. We thought, oh, margarine, it's the same nine calories per gram. And we said, it lowers your triglycerides. Bad idea. Be... |
Speaker A: They're illegal. |
Speaker B: They're illegal, they're banned. You can make trans fats in your own kitchen by taking olive oil and heating it to beyond the smoking point. So they're not completely gone, they're just gone from ultra processed food. So now sugar is the big problem because of these three enzymes that you are inhibiting the ... |
Speaker A: You're reducing the intensity of the furnace. |
Speaker B: Yeah, exactly. So this whole calories a calorie just makes no sense. And it hasn't worked at any level. And there is no study that actually shows that cutting calories makes a difference. And I can show you voluminous data that shows that virtually every weight loss study that led to caloric restriction basi... |
Speaker A: Just to round out our earlier discussion. Cause I find it fascinating and I know other people will as well. We talked about that 160 calories. That's actually 130 at the business end of things, of almonds. We talked about the porterhouse steak with butter and the 25% reduction in what's actually quote unquot... |
Speaker B: Sure with that the food industry does this on purpose. |
Speaker A: Really? |
Speaker B: Oh, absolutely. So they tell you a sugar is a sugar, which is not true. They tell you a calorie is a calorie, which is not true. And they tell you a fat is a fat, which is not true. This is very specifically. So when you're talking about sugar, you're talking about dietary sugar or you're talking about blood... |
Speaker A: And I never use dietary cholesterol or circulating cholesterol or. |
Speaker B: Absolutely. Okay. So we've done this to ourselves, but the food industry has really promulgated it because we farmed out nutrition policy and information to the food industry. So they actually use this for their purposes. It's one of the problems in this field. |
Speaker A: I'd like to take a quick break and acknowledge one of our sponsors, athletic greens. Athletic greens, now called ag one, is a vitamin mineral probiotic drink that covers all of your foundational nutritional needs. I've been taking athletic greens since 2012, so I'm delighted that they're sponsoring the podca... |
Speaker B: It's pretty pitiful. |
Speaker A: Same with the pizza dough. It's like they claim it's the water. Whatever it is, it's different back there. And it's better. |
Speaker B: Indeed. |
Speaker A: Half a bagel, let's say 250 calories, mostly carbohydrate. This is an unlined, no cream cheese, no smear, as they call it back there. No, no cream cheese, no butter, none of that thing. Just half of bagels, 250 calories. So that's what I ate. You're saying that a calorie eaten is not a calorie eaten. How muc... |
Speaker B: Yeah, it is. It's polymerized glucose. |
Speaker A: Okay, polymerized glucose. How much of that is actually utilized or burned versus, you know, the original 250. |
Speaker B: So if you look at what happens to energy in the body, 65% of that which is ingested goes to resting energy expenditure just to power the body. 10% goes to the thermic effect of food, and then 25% goes to activity. That's the breakdown of where the energy goes. |
Speaker A: And that's calories from fat, protein and carbohydrates. |
Speaker B: Yeah, from everything together and glucose is a perfectly good example of how that works. The point is, though, that when you ingest glucose, you're getting a big glucose excursion in your bloodstream. So you're getting a big glucose spike, and that glucose spike has to come down. Well, what makes it come do... |
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