#14 – Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system
Peter Attia MD Peter Attia MD
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 Published On Dec 22, 2019

Original release date: 9/10/2018

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 of 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.

Show notes page: https://peterattiamd.com/roblustig/

About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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