Changing minds about food and diets with Dr Robert Lustig

Dr Robert Lustig is Professor emeritus of Pediatrics at the University of California, San Francisco. He specialises in the field of neuroendocrinology and his research and clinical practice focuses on childhood obesity and diabetes. Dr Lustig has led a global discussion of metabolic health and nutrition, exposing some of the leading myths that underlie the current problem of diet-related disease. He is the author of several books including the books Fat Chance and Metabolical: The truth about processed food and how it poisons people and the planet.

In this episode, Dr Lustig talks to Dr Louise Newson about the influence of sugar, fats, and processed foods on our brains and health, changing minds of the public and health professionals and challenging the food industry. And – just as with changing public perception of HRT – challenging misconceptions about sugar and processed food starts with education.

Dr Lustig’s 3 tips to improve your diet:

1. Yoghurt is good but make sure it doesn’t have any added sugar
2. Juice is not healthy. Fruit is healthy and has fibre which is the good part. It’s food for your microbiome.
3. Trans fats are not good for you at all, try and avoid them at all costs including watching what oils you cook with.

Dr Lustig’s website and more about all his books can be found here.

Episode Transcript:

Dr Louise Newson [00:00:09] Hello. I’m Dr. Louise Newson. And welcome to my podcast. I’m a GP and menopause specialist and I run the Newson Health Menopause and Wellbeing Centre here in Stratford upon Avon. I’m also the founder of the menopause charity and the menopause support app called balance. On the podcast, I will be joined each week by an exciting guest to help provide evidence-based information and advice about both the perimenopause and the menopause.

Dr Louise Newson [00:00:45] So today I’m interviewing someone from across the pond in America, someone who I’ve been following without him realising for many years, actually, and so I am very excited to introduce to you, Robert Lustig from America. So thank you so much today for joining me.

Dr Robert Lustig [00:01:01] Well, thank you so much for having me, Louise.

Dr Louise Newson [00:01:03] What happened was I’ve always been interested in nutrition, and it’s something that, as a medic, I got taught very little about, actually. And I don’t think things have really changed over the last 25 years or so. And I read your book in 2013, Fat Chance. It also says on the title ‘The Bitter Truth about sugar’ and I thought sugar? What sugar? Fat? How is that connected? I didn’t really know much then. I hate to tell that, and I read your book, I remember I started reading it in the bath, actually and I had such a cold bath at the end because I couldn’t put it down, and everything you said made so much sense. And then I got really cross because I thought, ‘Why hadn’t anyone told me this before?’ And so you have been so instrumental in even the way that I eat, the way my children eat, the way I help patients, actually. And it’s incredible. And then you’ve just brought out your most recent book ‘Metabolical’, which is just a play on words that we will talk about in a bit. A phenomenal book. So can we start with just a bit about your background and why you decided to write the first book and what you’re doing now? Because it’s really very interesting.

Dr Robert Lustig [00:02:13] Well, thanks. First of all, why were you reading it in the bath? Because then you have to take a cold shower afterwards? You know, I came at this totally, completely through the back door. This was not my mission. This was not my jam, as it were. It is true that I did major in nutritional biochemistry in college. So I was set up for this and I was always interested in sort of the micronutrient story going way back to even high school days. Why is it that, you know, vitamins and minerals? You know, I went to MIT, which had a wonderful nutrition department, and I had people like Nevin Scrimshaw and Vernon Young and Hamish Monro, you know, giants in the field of the early days of nutrition and vitamins. And then I went to med school and they beat it out of me and said, ‘Oh’, you know, ‘we don’t deal with any of that’ or ‘it’s just about calories’. And I thought, ‘Well, you know, I’m paying big money for this medical degree and I should listen to the gurus’, you know, and I sort of forgot about it and I practised like I learnt in med school, you know, calories in, calories out. And balance, you know, ‘you are what you eat’, ‘if you’re fat, it’s your fault’. Blah blah blah blah. And then in 1995, the endocrine community discovered the hormone leptin. And as a neuroendocrinologist, this sort of was the holy grail at the time. And I knew leptin was coming because I worked at Rockefeller University alongside Jeff Friedman and Rudy Leibel. And, you know, the whole group that actually cloned leptin from the ob/ob mouse. So, you know, I was there when they were planning it, you know, and we all had to take call in the Rockefeller University Hospital together. So, you know, everybody knew what everybody else was doing. So I was very prepared for this. And at the time, I had moved from the University of Wisconsin to St. Jude Children’s Research Hospital in Memphis, Tennessee, where I inherited a cadre of children who had survived their brain tumours only to become enormously morbidly obese. And the parents were basically claiming, you know, this is ‘double jeopardy’. ‘My child survived the tumour only to succumb to a complication of the therapy’, which was absolutely true. This form of obesity, where you damage the hypothalamus, the energy balance area of the brain, which you know a lot about because as a menopause specialist, you know, it’s sort of, you know, going great guns for you too. This form is called hypothalamic obesity. It’s been known for 100 years, but we didn’t know what caused it. And when leptin was first discovered, I said, you know, these kids clearly must have had leptin working before the tumour. But now that the hypothalamus has been damaged and that area of the brain is dead, now they can’t see their leptin, so they must have what we would call leptin resistance. They can’t see their leptin, and because they can’t see their leptin, their brains think they’re starving. And when you’re starving, two things happen. And I knew all of this already. One is you eat like crazy, and the other is you burn like crap. You stop burning. Reduce your energy expenditure, you actually ratchet down your mitochondria in an attempt to try to conserve. So you need to eat and you need to conserve because your brain thinks you’re starved. And I said, ‘Well, I got 40 of these kids. What the hell am I going to do?’ Well, you know, I researched the literature. I knew a little bit about this anyway, and I knew that these kids put out an enormous amount of the hormone insulin. Insulin for your audience is, you know, the diabetes hormone, certainly. But actually, that’s really a bad moniker for it. What it is is it’s the energy storage hormone. Insulin takes whatever energy is in your bloodstream that you’re not burning right now, and it puts it into fat for storage. More insulin, more fat. And we knew that these kids had very high insulin levels. So I then assumed, well, something about their leptin resistance meant that since their brain thought they were starving, they were putting out more insulin in an attempt to make more fat to try to raise the leptin level, but they never can see it because you know that part of the brain’s dead. So what am I going to do? Well, let’s try to get the insulin down. I had a drug at my disposal called octreotide, which you may be familiar with. And what it does is it suppresses growth hormone for Acromegaly X, and I knew that as an endocrinologist, but it also suppresses insulin. I said, ‘All right, let’s try this drug’. We did it in IOB approved protocol and all that [unclear]. And lo and behold, the patients started losing weight, but something even more remarkable happened. They started exercising spontaneously out of the blue. One kid started lifting weights at home. One kid became manager of his high school basketball team. One became a competitive swimmer. These were kids who sat on the couch, ate Doritos and slept.

Dr Louise Newson [00:07:46] So very transformational.

Dr Robert Lustig [00:07:47] Right? Absolutely. And it happened within a week. And the parents are saying, ‘I’ve got my kid back!’ and the kids would say, ‘this is the first time my head hasn’t been in the clouds since the tumour’. Now, this was really remarkable that their behaviour changed because we got their insulin down. So then of course, we did a double blind, placebo-controlled trial and showed the exact same thing that if we got the insulin down, these patients not only lost weight, but they felt better and started moving more. And so what that showed me was that the behaviours associated with obesity, the gluttony and the sloth was actually secondary to the biochemistry, and the biochemistry comes first. And we know that this is true for all sorts of things, including, for instance, menopause. OK. We know, for instance, the irritability that comes along with menopause is due to the hormonal fluctuations. We don’t argue that. We don’t say, ‘Oh, those women are crazy, and that’s why their estrogen goes down’. No, we say ‘the women’s estrogen goes down, and that’s why they go crazy’, OK? We know what the cause and effect is. Well, this was no different. So I changed my belief system on a dime because I saw the research, because I lived the research. Now I have been for the last 20 years trying to get the medical profession to wake up and change their belief system.

Dr Louise Newson [00:09:16] Is that easy?

Dr Robert Lustig [00:09:17] And you can imagine that that is quite a heavy, heavy lift. It is tough.

Dr Louise Newson [00:09:22] It’s so interesting isn’t it because, like we said at the beginning, you know, medical school, undergraduate, even postgraduate training really doesn’t include much about nutrition, and it makes it very simplified. You know, you talk about calorie. We talk about fats. We talk about sugars. We talk about insulin in a very good way because we need insulin. You know, if you don’t have insulin, you’ve got diabetes, right? So but what we don’t see is how different levels of insulin and the spikes of insulin can really be very pro-inflammatory. And we also don’t see how this sugar conversion to fats is something that I didn’t even really think about until I read your book because you think all fats are bad. But actually, of course, we know there’s some really good, healthy fats that we should all be having.

Dr Robert Lustig [00:10:06] 60% of your brain is fat. I mean, if you don’t eat fat, guess what? You know, your brain rots. And the fact of the matter is it’s like putting blinders on. You know, if you don’t know what’s out there, you know, you don’t know to look.

Dr Louise Newson [00:10:22] Yeah. And I think it’s really important. And I think the other thing is that we all do learn at medical school is we have to listen to our patients. Our patients know the right things. Often in medicine, we’re trying to compartmentalise things. We’re trying to find a diagnosis. And I have sat there in consultations for many years listening to middle aged women telling me that they put on weight and they’re saying that their lifestyle hasn’t changed, the exercise hasn’t changed. And you sit there and the first time it happened, you think, ‘Yeah, really, I bet they’re having a sneaky McDonald’s or they’re having a packet of crisps or they’re having some biscuits with their cup of tea in the afternoon’. But you hear it time and time again and like you with these children and you think, well, maybe there is something lets just – and I always think in medicine, if I’m not sure about something, let’s go back to some basic pathophysiology. Let’s just work out first principles. What are these women? What’s the common denominator? Well, they haven’t got enough estrogen and probably haven’t got enough testosterone as well. We know that the body needs estrogen. Of course it does. And we know that adipocytes fat cells produce estrogen, not a very nice estrogen, but they still produce it. And so these poor women are having these metabolic changes going on out of their control. So there’s us as physicians not believing them and there’s them having these processes that they don’t know what’s going on and as you know – well obviously, that’s why you’ve called your book ‘Metabolical’ – have a whole metabolic syndrome is really scary, actually, and it’s far more scary than diabetes. Once you’ve got diabetes, you’ve got a diagnosis. But actually, before that, we want to stop type two diabetes or any of the other inflammatory conditions, and there are so many aren’t there, but we don’t – as doctors, we wait for the disease, but we should be looking more about how to prevent these diseases. And they’re all connected, aren’t they?

Dr Robert Lustig [00:12:14] Well, they are. You know, the fact is that at menopause, women start making lots of triglycerides. Now we still don’t know exactly why premenopausal women don’t. Everyone’s looking, but we don’t know. But what happens is that women catch up. There’s probably some role of estrogen in changing liver metabolism so that triglyceride levels stay down. But as soon as menopause hits and the estrogen levels fall, those triglyceride levels go up. And triglyceride can either be a substrate for heart disease or it can be a substrate for obesity, or it can be a substrate that never leaves the liver and it causes fatty liver disease, which then causes insulin resistance, which then causes type two diabetes, Alzheimer’s and everything else. So postmenopausal increases in triglyceride are at the heart of the metabolic syndrome in postmenopausal women. And so the fact that they say that they are feeling different, the fact that they are metabolised differently is very well borne out by the data. What causes that is anybody’s guess. But there’s no doubt that using transdermal estrogen to raise estrogen levels back up can mitigate some of that.

Dr Louise Newson [00:13:43] Yeah, absolutely. We certainly see it a lot, and even myself and I was perimenopausal and didn’t even realise, I just thought it was working too hard. I was moody, irritable, tired, back-to-back, migraines, all the rest, and I suddenly looked down and think, ‘Gosh, I’ve got this extra bit of fat that I’ve never carried at all on my waist’. And it was really quite disconcerting. And we see a lot of women in the clinic who have raised cholesterol, raised triglycerides and we know that – or we see a lot – when they have estrogen back (like you say it’s transdermal so it’s estradiol), their markers, reduce. Their cholesterol, goes down and their body shape changes as well. And testosterone seems to have an effect as well, because I think it can help shift some fat to muscle, too. So this is very interesting metabolic processes that are going on, and we don’t know enough about it because no one’s interested in menopausal women. There’s not enough research.

Dr Robert Lustig [00:14:37] You know, people are interested, including me. It’s just a question of, you know, being able to actually demonstrate mechanism. We have the empiric data. We understand the phenomenology. But until we understand mechanism, we won’t really understand whether there’s a drug target or not. And, you know, basically if there’s no drug target, then doctors don’t talk about it. Yeah, that’s wrong. But that’s the way we’re bred in medical school is, you know, there’s a drug for everything you know there’s a pill. Well, you know, unfortunately, there’s no pill for this.

Dr Louise Newson [00:15:10] No, but there’s hormones. So, you know, having the hormones back makes a huge difference. And as you know, the minority of women are taking hormone replacement because they’ve been scared away for the wrong reasons.

Dr Robert Lustig [00:15:20] You know, ultimately and I don’t want to get into a tit for tat on this. The fact of the matter is that certain estrogen preparations, especially those with progesterone, have been associated with increased risks of cancer, especially breast cancer. However, lack of those hormones is associated with an enormous increase in cardiovascular disease. Everyone has to die.

Dr Louise Newson [00:15:44] Yeah, totally.

Dr Robert Lustig [00:15:45] It’s just a question of how and when. So the idea that, you know, doctors would withhold hormone replacement therapy specifically because of this cancer issue, I think is, shall we say, misplaced.

Dr Louise Newson [00:15:59] Yes. So there’s a lot that needs to be done for education and that gets us back to obviously the work that you’re doing is educating healthcare professionals. But also you’re doing a huge amount educating the consumers, the people that buy the food, the people that eat the food. But also more importantly, I think, you’re doing a lot of awareness for the people that make the food because the other thing that I learnt very early on when reading your work and reading other works as well is about the processing of food. The, you know, the calorie is not a calorie. And in fact, just after I read your book, I was at a meeting with someone from Public Health England and it..

Dr Robert Lustig [00:16:39] Oh, I’ll bet I know who!

Dr Louise Newson [00:16:41] I’m not going to mention any names, but it was about obesity, actually, and it was about awareness. And this lady stood up and she was talking about, ‘We need to reduce calories. We need to have low fat milk. We need to have low fat spreads rather than butter’. So I put my hand up and said, ‘Well, surely if I had 100 calories of Mars bars or chocolate, or 100 calories of almonds, surely metabolically that would be quite different in my body’. And she said ‘No a calorie is a calorie’ and I said, ‘But hang on! I drive to work and I see all these children eating crisps for their breakfast. When I grew up in the 70s, we would have full fat milk, we’d all fight over the cream at the top on our cereal and we’d have butter. We’d have cream. But we would never have any processed food because it wasn’t there. We couldn’t go and buy a ready-made lasagne, you know, and there’s no way we would be allowed a bag of crisps in the morning. So surely this has an effect.’ They wouldn’t listen, and there are a few other doctors there who thought I was mad. But it makes sense, doesn’t it?

Dr Robert Lustig [00:17:49] I will tell you on your show that two years ago, before the pandemic, I had an audience along with my good friend and colleague Dr Aseem Malhotra, with Sadiq Khan your mayor to talk about just this issue. But in the room were two members of Public Health England and I will tell you that they, number one, were immovable on this subject, and number two, ignored all the evidence because for them, a calorie is a calorie. The question is why do they think this, this is their belief system or are they being paid off? And now we have some data to suggest that might be the latter. Bottom line, I know who you’re talking about. I know the person in question. I will not embarrass them on this podcast, but I am going to tell your audience that just because a governmental agency says something doesn’t make it so. That is what I will say.

Dr Louise Newson [00:18:54] I mean, there’s a big corruption out there, isn’t there with the fast – not just fast food – but the process. You know, there’s a small number of companies that really feed the majority of people, and it’s the same in the U.K., but it’s worse in the USA, isn’t it? And it’s very frightening when you see what people put in their mouths. But actually, I feel really sad for a lot of people because they don’t know what they’re doing, because the labelling of these foods looks like they’re healthy, doesn’t it?

Dr Robert Lustig [00:19:22] Well, I feel bad for them, too, which is why I write books. On the other hand, you know, you can write books and you can provide people with the information and then, you know, it’s what they do with it. And you know, unfortunately, what many people do with it is, you know, basically put it in the circular file. You know, the question is, why does that happen? And this sort of dovetails with the question you asked me at the very beginning. People ask me, ‘Who are your detractors, Dr. Lustig?’ And I can basically put them into four bins and I call them the four D’s: the Dinosaurs, the people who are so calcified that they can’t learn something new. The Deniers, OK, the like, the anti-vaxxers, you know, who have, you know, sort of a religious penchant, you know, in one direction or another. The Dilettantes, you know, the people who are actually taking money as it were. And unfortunately, there are a lot of people in medicine and science who take money. We can have a whole talk about, you know, that. They are in the UK in full force, one of them being Diabetes UK. I suggest everyone look at diabetes.co.uk, not Diabetes UK, different organisation, completely different message. And then finally, the last one of the four, the four D’s is the drug addicts who basically say, don’t take away my sugar because I’m addicted. The fact in the matter is every one of those is their own belief system. So we’re battling multiple belief systems at once, and it’s highly problematic to get information out to the public in a meaningful way. So people say, ‘Well, how do you change minds? How do you change minds?’ And here’s how I do it. Imagine you and I are on opposite sides of a brick wall. And my job is to get to you. There are three ways to try to get to you with this brick wall in the middle. One is to blow a hole in the wall. Now, if I do that, you’re going to run away. And so that’s not going to work very well. Number two, I can try to walk around the wall. And sometimes that works. But what if the wall is circular or you just keep walking around and around and the other person’s on the inside? And that’s that, you know, religious belief system or how far you walk around, there’s no getting there. So that’s a problem. And then the third way, which is the most effective way, is dismantling the wall. Brick by brick. Now, dismantling the wall is not the same as blowing a hole in the wall because you can actually reassemble the wall with you on the other side. And if you do it slowly and you do it methodically, you can actually keep people in the conversation until you finally reach the point where they can’t deny what’s been said. Now that takes a long time. It takes art. It takes some perseverance, to say the least. And that’s what I try to do. Now I will tell you that for 30 out of my 40 years in medicine, I blew holes in walls and it wasn’t all that effective and I’m sort of into that realisation. Oh, about a decade ago. And so now I do my best to dismantle the wall. And that’s one of the reasons why I write books.

Dr Louise Newson [00:22:52] I love it. I absolutely love it because I feel like I’ve blown so many holes in walls over the last five or six years, and often I’ve crumbled at the bottom, to be honest. And it’s very hard to sometimes get up and think, ‘Actually, why am I doing this? What am I doing this for?’ And then I go to my clinic, and I hear another story of another woman who’s given up her job or her partner’s left her. Or I speak to suicidal women because they haven’t got their hormones and no one will listen to them. Or people that can’t sit down because they’ve got such bad vaginal dryness and no one will give them vaginal estrogen. And so you think ‘Right I’ve got a choice? I can wallow in self-pity, or I can just carry on and just be a bit more careful with this wall’. And I think someone said to me a while ago, just be persistent and consistent with your messaging and make sure that whatever you say is evidence based. And I think that’s so important.

Dr Robert Lustig [00:23:48] That’s exactly what your science is your sword and your shield.

Dr Louise Newson [00:23:51] Yeah, absolutely. And I will say, you know, I don’t do any work with any pharmaceutical companies. I don’t endorse any products. So I think as a physician, it’s such a powerful position, but it’s so easy to get wrong if you get greedy or if you get lured into something and I need to sleep at night. And so I want to make sure that everything I do is as good as it can be. And I think that’s the only thing that’s making some people listen. And I’ve got some great supporters over here, but it takes a while, doesn’t it, for people to? And I think it’s changing something that people have never thought about before. You know, we’ve got data from the WHI showing that estrogen-only HRT is associated with a lower risk of breast cancer. Well, that’s very hard for people to understand when they’ve been told for so long, and it’s the same with you and food. You know, we’ve been told for so long that fat’s bad and sugar is probably OK. And then suddenly you’re telling us other things and how do we believe that?

Dr Robert Lustig [00:24:52] Well, here’s the way I explain this to people. In the last 30 years, there have been four – count them – four cultural tectonic shifts in America and also in the UK. No different. OK, and here they are, four: number one bicycle helmets and seatbelts, number two smoking in public places, number three drunk driving, number four condoms in bathrooms. Thirty years ago, if someone stood up in a State House or in Congress or in parliament and proposed legislation for any one of these four they’d have gotten laughed right out of town. Nanny state! Liberty interest! Get out of my kitchen. Get out of my bathroom. Get out of my car. All right? They’re all facts of life. No one’s bellyaching about any of those. Now we have new things to bellyache about like vaccine mandates and all, but no one’s bellyaching about those four. And if you pull out of your driveway today and you haven’t clicked your seatbelt, your kids will scream at you. OK, now how did that happen and why did it take 30 years? Answer? We taught the children. The children grew up. They voted and the naysayers are dead. So this is a generational shift, but it started with education. Education softens the playing field, education allows for an idea to ultimately take root and take hold, and it has to germinate and it takes a while. All right. And you have to basically till the soil and you have to allow for this to occur. It doesn’t just happen. Point is, there’s a beginning and there’s an end and then there’s everything in the middle. The issue with respect to diet, we’re about, I would say, nine years into a 30-year cycle, right? We’re not even close to being done, but there are people who now actually recognise what the problem is, and we have empiric data to show that people’s minds are being changed. IFIC, which is the International Food Information Council, – it’s the public relations arm of the food industry – in 2011 asks the question ‘what single food component causes weight gain?’ And back then only 11% said refined carbohydrate or sugar. 42% said a calorie is a calorie or they didn’t know. They asked the same question in 2018, exactly the same way. And now 33% of the population said refined carbohydrate and sugar. And the ones who changed their minds all came from ‘a calorie is a calorie’ or ‘I don’t know’.

Dr Louise Newson [00:27:42] Amazing.

Dr Robert Lustig [00:27:43] So they’ve done the work for me. All right. They’ve actually demonstrated that the messaging is getting out and that you actually can change people’s minds. OK, but it takes a long time and you have to be persistent and you have to be patient. And that’s my counsel to you Louise, is that you will have to be patient. There is a possibility that this problem will outlive you, and you have to be OK with that.

Dr Louise Newson [00:28:11] Yes, I know.

Dr Robert Lustig [00:28:11] People who are trying to influence public health have to be copacetic with the idea that this problem may survive them, and they have to be OK with that.

Dr Louise Newson [00:28:21] Yeah, no. It’s really, really good advice. Very interesting. And I think it is, you know, I spent a lot of time and energy this year helping disseminate knowledge as much as possible. We’ve got our app balance, which is available free to people, and it’s just tipped over half a million downloads and is in over 150 countries. And you know, people are now helping themselves because they’ve got knowledge and knowledge is power, isn’t it? And I think that’s the same, you know, with what you’re doing is that we’re allowing people to have choices over their diet and knowing what they’re doing is really important and knowing how to make choices, not just for them, but for their families too.

Dr Robert Lustig [00:29:00] Well, I would challenge that. The question is, if 74% of the items in the grocery store are spiked with added sugar, how many choices do you actually have to avoid?

Dr Louise Newson [00:29:11] Well, totally. But it’s changing, isn’t it? I think it’s making sure that people try and eat the way that they can, but also with the economics as well because it can be more expensive. And so certainly, I mean, I’ve always cooked for a deep freezer because I’m so busy and I’ve got three children that I don’t want them growing up on rubbish. So I cook a lot. But I’m very organised. So it’s the organisation that can be difficult, but it’s also hiding vegetables in food. If I gave my children leeks and courgettes and lentils, they would just no way eat them, but I chopped them up small and put them in mincemeat. And then the mince is cheaper. It’s easier, and then they’re getting vegetable. So it’s like, win, win. But it’s knowing these tricks rather than just going and buying something.

Dr Robert Lustig [00:29:56] I actually published a no added sugar cookbook. I don’t know if it’s available in the UK. It’s called the Fat Chance Cookbook specifically because real food actually tastes good and kids will eat it. So there are ways to do this. It’s not a done deal, and it’s not a foregone conclusion. The other thing is that some, I won’t say all, certainly not all, but some of the consumer-packaged goods industry, the CPG industry, they’re on to this. They know there’s a problem and they are doing something about it. As an example, Danone and Unilever have both reduced the sugar footprint in their portfolio by 14%. Now, 14% is poultry, but it demonstrates that they understand there’s a problem. I am actually working with an international food conglomerate in the Middle East to reduce their added sugar footprint by 78%.

Dr Louise Newson [00:30:54] Wow.

Dr Robert Lustig [00:30:55] So people understand that there’s a problem. The food industry understands there’s a problem. They’re looking for the right answer that won’t affect their bottom line. You know, that’s the challenge. But the problem is well stated, and people are starting to understand that there is a problem.

Dr Louise Newson [00:31:12] It’s amazing. I think the progress that you’ve made and the momentum has certainly started and it’s not going to shift back. So I’m very grateful for your time today and I could talk for hours, but we haven’t got hours. But at the end of every podcast, I always ask for three take-home tips. So I’m very keen actually to ask you Robert, if you could just say three things that most people could change to their diet that is going to reduce this inflammation and reduce their risk of metabolic syndrome, actually.

Dr Robert Lustig [00:31:44] Number one. Yoghurt. OK, now yoghurt supposed to be good for you, and it is, OK, it’s a fermented food. If it’s yoghurt without added sugar. So if you eat plain yoghurt and add whole fruit to it like yoghurt was originally designed to be, then you’re good. But if you’re eating the strawberry yoghurt in the refrigerator section of the supermarket, then it’s a disaster. So that’s one example. The second, of course, is juice. Everyone’s goes the juice is healthy, juice is not healthy. Fruit is healthy because fruit has fibre and juice doesn’t, and the fibre is actually the good part of the fruit. But we throw it in the garbage. The fibre is food for your bacteria, for your microbiome. And if you don’t feed your microbiome, your microbiome will feed on you. It’ll actually strip the mucin layer right off your intestinal epithelial cells. And that will actually lead you to leaky gut, irritable bowel syndrome, inflammatory bowel disease, systemic inflammation, insulin resistance and metabolic syndrome. So that’s, shall we say, a no no also. And then, of course, the third one, which sort of everybody knows now, is trans fats. Trans fats are the devil incarnate. OK. There is no trans fat that is good for you. And the reason is that they were put in the food in the first places because bacteria can’t digest the trans fats because they don’t have the desaturates to break the trans double bond. Well, our mitochondria are refurbished bacteria. We can’t break that bond either. And that means that when you consume a trans fat, it never leaves. What it does is it goes to your liver and causes insulin resistance or goes to your arteries, lines your arteries and causes cardiovascular disease, consumable poison, verifiably consumable poison. Now we know that and they’re coming out of our food. So you say, ah trans fats problem solved, right? Not exactly. A lot of the polyunsaturated oils that we cook in. When you heat them very high, the heat will flip the double bond. So a cis fat will become a trans fat so you can actually make trans fats at home. All right. From canola oil, you know, which is quote healthy unquote. Not necessarily. All right. Olive oil, you know the best oil to cook with. Guess what? It’s not the best oil to fry with. Olive oil was meant to be consumed at room temperature, not to be used for, you know, frying up a chicken cutlet. So bottom line is watch your fats. Not because fats are bad, but because the way you cook them could make them bad.

Dr Louise Newson [00:34:32] Very good advice and, you know, very easy to change, actually. So lots to think about. And certainly, we’ll put a link to your new book in the notes so that people can have a look and it’s filled with evidence as well. So it’s great to read and digest, literally.

Dr Robert Lustig [00:34:50] It’s not about digesting it. It’s about metabolising.

Dr Louise Newson [00:34:55] Excellent. So thank you so much for your time today. I really, really appreciate it. And good luck with everything that you’re doing.

Dr Robert Lustig [00:35:01] It’s been my pleasure, Louise. Thank you for having me.

Dr Louise Newson [00:35:05] For more information about the perimenopause and menopause, please visit my website balance-menopause.com or you can download the free balance app, which is available to download from the App Store or from Google Play.

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