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The Peter Attia Drive

#14 - Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 10 September 2018

⏱️ 83 minutes

🧾️ Download transcript

Summary

In this episode, Rob Lustig — a researcher, an expert in fructose metabolism, and a former pediatric endocrinologist — discusses what’s wrong with the current food environment, and what we can do to reduce our chances of becoming part of the obesity, diabetes, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) epidemics. Rob recently earned a Master of Studies in Law because he believes that educating people about sugar from a scientific standpoint is only half the equation: the other half involves changing policy, which he explains in this episode.

We discuss:

  • What’s the difference between glucose and fructose? [7:00];
  • Do we have biomarkers that can give us some indication of average exposure to fructose over a given period of time? [14:20];
  • What’s the difference between ALT and AST? [18:45];
  • Inflammation, endothelial function, and uric acid [21:30];
  • Is there something that fructose does better than glucose? [23:45];
  • For children that undergo a remarkable shift from metabolic health to metabolic derangement, is there a concern that these kids suffer an epigenetic hit that makes it harder for them later in life? [26:15];
  • How many times do you have to introduce a savory food vs a sugary food to an infant before they will accept it? [29:30];
  • How are alcohol and fructose similar in how they affect the brain? [33:51];
  • Advice for parents and kids for creating a sustainable environment that's going to prevent them from running into metabolic problems [40:30];
  • Why do some populations have a higher risk for NAFLD? [45:42];
  • What causes NAFLD? [48:45];
  • Is insulin resistance the result of NAFLD or is NAFLD the result of insulin resistance? [56:00];
  • HRV, cortisol, and norepinephrine [1:00:30];
  • What are the actual mechanisms that links metabolic syndrome, insulin resistance, fatty liver, and type 2 diabetes? [1:03:00];
  • Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance? [1:09:00];
  • What is the difference between soluble and insoluble fiber and why do you need both? [1:13:00];
  • How can we change the food system when 10 companies control almost 90 percent of the Calories we consume in the US? [1:15:00]; and
  • More.

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Transcript

Click on a timestamp to play from that location

0:00.0

Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.

0:10.0

The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,

0:15.7

along with a few other obsessions along the way. I've spent the last several years working

0:19.6

with some of the most successful top performing individuals in the world, and this podcast

0:23.8

is my attempt to synthesize what I've learned along the way to help you live a higher quality

0:28.3

more fulfilling life. If you enjoy this podcast, you can find more information on today's

0:32.4

episode and other topics at peteratiamd.com.

0:41.8

In this episode, I'll be speaking with my friend Dr. Rob Lustig, who I suspect a good number

0:46.7

of you will have already heard of and certainly have been familiar with through his pretty

0:50.5

impressive presence on YouTube and his talk called Sugar the Bitter Truth that went viral.

0:56.7

I believe in 2011. That's about the time when I met Rob.

1:01.3

Now this podcast kind of grew out of a really interesting discussion that I think I get

1:05.5

into in the podcast a little bit, but I think it was in 2016 when Rob and I were both invited

1:12.8

to Hong Kong to speak at the Credit Suisse Asian Investment Conference. We were on a panel

1:18.8

together, and it just so happened that we were in the same flight back to San Francisco,

1:23.9

which was not just a long flight, but more importantly a flight where you weren't going

1:27.2

to be sleeping much. And Rob and I ended up huddling together over a laptop, going over

1:34.2

some really interesting data on Natholdie, which we'll get into in this podcast. And I

1:40.0

remember thinking like that just kind of left an impression of my mind, which was, God,

1:43.2

this is the kind of discussion I really enjoy having with people like Rob, because it gets

1:48.1

into the nuance and away from the headlines. And obviously many years later, fast forward

1:52.9

to where we are now, I'm starting the podcast. One of the first people I wanted to reach out

...

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