Wie unser Essen uns krank macht: Die Lügen und Tricks der Lebensmittelindustrie durchschauen, chronische Krankheiten vermeiden und gesund bleiben. Die Gefahren und Risiken erkennen

by Robert H. Lustig

In der Hektik des Alltags greifen wir nur allzu gern auf verarbeitete Lebensmittel zurück. Doch genau diese sind dafür verantwortlich, dass Diabetes und viele weitere chronische Erkrankungen sich so rasant verbreiten. Dr. Robert H. Lustig verändert die Sichtweise auf unsere Nahrung radikal: Er entlarvt die Lügen und Strategien der Lebensmittelindustrie und beschreibt, wie verarbeitete Lebensmittel uns süchtig machen. Der erfahrene Mediziner zeigt aber auch auf, wie man es trotzdem schafft, sich gesund zu ernähren, und welche chronischen Beschwerden man dadurch vermeiden oder sogar rückgängig machen kann. Ein Wegweiser zu einem gesünderen und glücklicheren Leben.

Genres: Health, Nonfiction, Nutrition, Food, Science, Audiobook, Self Help

666 pages, Kindle Edition

First published May 4, 2021

About the author

Robert H. Lustig, M.D., is an internationally renowned pediatric endocrinologist who has spent the past sixteen yers treating childhood obesity and studying the effects of sugar on the central nervous system, metabolism, and disease. He is the director of the Weight Assessment for Teen and Child Health Program at UCSF Benioff Children's Hospital; a member of the UCSF Center for Obesity Assessment, Study, and Treatment; as well as a member of the Obesity Task Force of the Endocrine Society.

Reviews

[Wolfram Alderson · Rating 5 out of 5]

Dr. Lustig never ceases to expand your mind with his science and wit. Boohoo, some think he is too critical of the food and beverage industry, and he does question just about every assumption that one may have about nutrition and what is healthy. Yeah, he can sound pissed off at times, but what would you expect from a pediatrician who has experienced more and more children piling up at his exam room door with diseases that were once only associated with older adults. Only 12% of people in the US are metabolically healthy, and the rates of people dying from metabolic disease dwarf all those dying by wars and communicable disease. But, in our culture, it is perfectly legal to kill people with bad food, just as long as you do it slowly, over decades of time, starting when they are young. Over 50% of people in the US are prediabetic or diabetic. So, if Dr. Lustig's book, Metabolical, doesn't wake you the hell up, nothing will... 'Metabolical' offers a strong message to the processed food industry: stop killing us with your toxic food-like substances.

[Boy Blue · Rating 3 out of 5]

I picture an emaciated Lustig hunched in the corner of a dark cell where he has been thrown by a bad government at the behest of big food, big pharma, and big medicine.

Near the door of the cell sits an untouched tray with various plastic wrapped food items and a juice box.

A single sunbeam illuminates the space and half of his face.

He's muttering a phrase over and over to himself.

As you draw closer you begin to make it out.

"Protect the liver, feed the gut."

Why this mantra? Why does the former Dr Lustig rot in a cell if that is the simple secret he's protecting?

Such are the evils that marshal before him.



I have little doubt that Lustig is right, that processed food is the main culprit for obesity and other metabolic syndromes. I believe almost everything Lustig says in this book. My only problem is with his approach.


The Shotgun Approach


Lustig takes aim at absolutely everything. He's got decades of pent up rage that he just lets loose on anything in a health and diet adjacent space. It takes over half the book to set the scene, then the main action is over quickly and we're back to dishing dirt on every organisation that ever existed. He barely looks for examples of successful health policy (possible they don't exist). He recognises the UK's salt reduction and recent sugar tax on soft drinks but then he doesn't really examine their efficacy and application elsewhere (obviously the latter was only recent 2018).


Also if your narrative is going to jump around like a flea on acid then you can't also be factually stuffed to exploding and not have a chronology to events. I've never liked it when books keep telling you to jump to other chapters for further explanation as if you're in a choose your own adventure Goosebumps book.


I should also mention that the section on how processed food is killing the planet is a threadbare account and seems to be a vague tokenism to tap into the prevailing eco warrior mentality of modern times. Lustig could probably have also left his politics and humour at the door as they weaken his message and reduce the otherwise universal appeal of the book (although it is very American centric). I also would have been interested into more of an exploration around why the grain fed unhealthy and fat marbled steak from America tastes better than the Argentine grass fed one.


But the big problem is that what this book has to say is important and everyone needs to get the message. It's also pretty much common sense. Your mum has told you everything Lustig will tell you, she just lacks the medical training and millions of studies but she's no less right.


Don't eat processed food, eat real food, avoid sugar, eat fibre etc.


I've heard it all before, just never seen it in such a chaotic, inflamed and impassioned delivery. Metabolical indeed.

[Sharon · Rating 5 out of 5]

Dr. Robert Lustig, whose 2009 talk "Sugar: The Bitter Truth" has over 13 million views, has always been clear about his opinion of the processed food industry. Turns out he was holding back in his two previous books, "Fat Chance" and "The Hacking of the American Mind." In case we didn't get the message before, he breaks it down into two simple rules for eating Real Food: (1) protect the liver; (2) feed the gut. He then proceeds to explain what that means in practical terms, describing what the highly processed food-like substances found in our supermarkets do to our bodies. Nutrition labels only tell us about the macronutrients (protein, fats, and carbohydrates) and a few of the vitamins and minerals in processed food, but the label doesn't tell us what has been done to the food, and that's what Dr. Lustig explains in detail. Finally, he goes into some detail to persuade us that highly processed foods are not just a "personal choice," but rise to the level of a public health crisis that must be addressed, and outlines some of the ways this can be done, using as his model the public health structures in place for alcohol and tobacco.

[Carol Bakker · Rating 4 out of 5]

Lustig's telos:
1. All food is inherently good; it's what's been done to the food that's bad.
2. Protect the liver, feed the gut.

A truckload of good information from a pediatric endocrinologist, but a challenge to distill practical tips. I listened to this book first, but knew I really needed to read the print with my eyes. His solution to the metabolic mess we (practically all the world) are in is to eat Real Food.

Real Food. What exactly does he mean? On page 202 I finally found the answer: low-sugar and high-fiber. Cutting added sugar from your diet will protect your liver, which cannot process sugar-dumps. Focusing on fiber feeds the gut microbiome.

Lustig discusses eight pathologies that lead to metabolic dysfunction:
Glycation
Oxidative Stress
Mitochondrial Dysfunction
Insulin Resistance
Membrane Integrity
Inflammation
Epigenetics
Autophagy

Lustig gives his solutions in Part V which rely on government intervention (soda tax, eliminate farm subsidies, ban access to soda in institutions). I am not inclined toward his politics. But I wonder.

I know that any lasting change must start with a change in thinking. Making meals must take priority. I was recently served fettuccine Alfredo that was wretched. The noodles were normal, but the sauce was from a jar. It's not that hard to make a sauce! Amy Dacyczyn (remember her Tightwad Gazette?) proved it took as long to make microwave popcorn as cook-on-the-stove popcorn.

It's complicated. We sneer at processed food, but on some level food must be processed if you want tomato paste in April. I personally know farmers who are struggling to hold onto their farms. How would they survive without subsidies? And who wants to be the kid whose mom brings carrot sticks for his birthday, really?

The hit-me-between-the eyes sentence. If any form of sugar is one of the first three ingredients, it's a dessert. That means Trader Joe's Beef and Broccoli is dessert.

The other jolt was the cover art. It's a still life of junk food (without any brand names). I expected a burger, fries, etc. and saw what looks like a two-liter 7-Up bottle. But (Costco) muffins and (Costco) chicken raised my eyebrows. Busted!

[Dan Howard · Rating 3 out of 5]

I was a bit disappointed in Dr. Lustig's latest book. While I agree with most of the authors beliefs as described in the book, I found the writing a bit tedious. The author tries much too hard to use "cute" turns of phrase and popular culture references (e.g., "like a Facebook relationship, it's complicated.") This becomes tiresome after a few chapters.

Dr. Lustig also lets his political leanings get in the way of logical support of his positions. I have read his earlier books and clearly knew he is very pro government regulation and taxation to enforce his beliefs on the proper diet. The problem with this position to my mind is that it is a very slippery slope. Dr. Lustig believes that the government should enforce reduced consumption of sugar and processed food. But many vegetarians/vegans would want similar government intervention to prevent consumption of animal products. Whose belief should the government enforce?

It's also painfully obvious that Lustig is a pretty extreme political partisan. When disagreeing with a government action undertaken in a democratic administration, he attributes the action (or inaction) to simple incompetence. When similar actions occur under a republican administration, they are attributed to evil intent. The author doesn't get out of the first chapter without asserting relative to the decreased US life expectancy ".. Trump's response, which hoped to solve the problem by letting sick people die." Such gratuitous insults aren't cute or clever and certainly don't contribute to persuasive argument.

[Donna · Rating 4 out of 5]

This is Nonfiction Health. I have some mixed feelings about this one. I loved the way this one started and I wish that feeling was carried throughout the whole book. Sometimes this felt all over the place. The author covered many different tangents. Not a bad thing per se, but it felt wordy and a little on the choppy side. That part was just okay for me.

What I liked: I liked the author's passion and knowledge. I also liked that out of all the books I've read on this topic, this author pulls it all together and leaves plenty of room for forward momentum. He was also one of the first author's that I've read that isn't "anti" any food group except sugar and processed foods. Otherwise, meat, eggs, etc., can all be purposeful.

This was probably 3.5 stars for me. I'm rounding up to 4 stars though for the overall message. I think this is a wake-up call for everyone.

[Wick Welker · Rating 5 out of 5]

Calories In, Calories Out is Nonsense.

I made the switch about a year ago to entirely cutting out ultra processed foods from my diet. I’m a busy dad and husband but me and my wife cook everyday and I bake several times a week. I stopped focusing on calorie counting to keep a healthy weight and instead focused on the food that is going into my body. It has made all the difference. I lost weight and my relationship to food dramatically changed. Hunger and satiety are toned down and not as strongly associated with my brain’s reward system. So it took little convincing to me to pick up Metabolical. And here’s the thrust of his arguments: ultra processed foods (UPFs) are causing fatty liver disease, metabolic syndrome, leaky gut, insulin resistance, mitochondrial oxidative stress and chronic inflammation. UPFs are slowly killing everyone.

Calorie In, Calorie Out?

Let’s do a thought experiment. For one year one person eats 3,000 calories of McDonald's food and nothing but that. That same person’s identical twin spends one year on a tropical island where they can only consume 3,000 calories of coconuts and crab legs. Does anyone really in their right mind believe that these two twins will have the same weight at the end of the year? Of course they will not. Do you think someone who only consumed 3,000 calories of alcohol would also look a little different assuming they are supplemented with vitamins? You know that’s true in an intuitive way and the author explains why in a cellular metabolic way. It is soooo much more complicated than the calorie deficit. It’s not about absolute calorie consumption, it’s about the types of food, or food-like-substances, you are putting in your body.

One of the problems is high fructose corn syrup (HFCS). It’s… not really a food, it’s an additive to food to make food addictive.Let’s back it up.

Table sugar is a disaccharide called sucrose which contains: 1 molecule of glucose and 1 molecule of fructose. It is naturally found in sugar cane and fruit. It’s also naturally very scarce. Every cell of your body can metabolize the glucose no problem, via glycolysis, to create energy and it doesn’t require oxygen to do this. Fructose, on the other hand, is primarily metabolized by the liver, something like 50-70%. Sucrose is so incredibly sweet to use because we are engineered to crave it because it is such a beautifully quick source of energy. Our cellular biology was not designed for a diet abundance in sucrose.

Here’s the thing about HFCS, it’s also a mixture of glucose and fructose and doesn’t even contain that much more fructose than sucrose. BUT, the sugars in HFCS are chemically unbound as opposed to sucrose which bonds glucose and fructose together. This unbound fructose from HFCS hits the liver like a metabolic sledgehammer as opposed to sucrose which takes longer to metabolize and gets to the liver in a more balanced manner. HFCS is also found in something like 75% of all foods in the grocery store. Why? Because it’s sweet and addictive and so the food makers make sure it is there. It’s pervasive, cheap and addicting. So HFCS is both economically available and bioavailable.

Here’s the problem: all the gut punching amounts of fructose is killing your liver. Your liver is processing most of it and here’s the kicker: unlike glucose, fructose enters liver cells without the regulation of insulin. Insulin only controls glucose cellular uptake. Not fructose. Fructose just waltzes into the liver and causes a very specific problem: hypermetabolic overload. It’s just too much energy and so your liver has to package it away somewhere and what does it do? It stores it as liver fat in a process called de novo lipogenesis (DNL). DNL creates a toxic excess of palmitate, a saturated fatty acid which spills into the rest of the body (dyslipidemia). This also causes infiltration of fat into the liver (steatosis) which is fatty liver disease. This process drives hepatic high insulin as a maladaptive attempt to keep glucose under control. The fat in the liver then drives the formation of other metabolites (DAGs and cermaides) that interfere with insulin receptor signaling within the liver cells. The liver then becomes insulin resistant. Because the liver becomes insulin resistant, it starts dumping more glucose into the rest of the body which then stimulates the pancreas to create more insulin and BAM you have peripheral insulin resistance or type 2 diabetes. This right here is the epicenter of metabolic disease. And it all starts with slamming our livers with fructose.

High insulin, or hyperinsulinemia, is bad. High serum insulin has an adverse reaction in every tissue bed. High insulin can mess with satiety in the brain and increase risk for cognitive disease like Alzheimer's. High insulin messes with blood vessels and their smooth muscle which can put you at risk for things like heart attacks and strokes. High insulin stimulates more triglycerides production which can cause heart attacks and stroke. You can get diastolic dysfunction in the heart from high insulin. Fat tissue itself responds to insulin by… storing more fat. Skeletal muscle can cause intra-muscle lipid accumulation. High insulin can cause fluid retention and high blood pressure from the kidneys. The list goes on.

Do you see how it’s all related? It’s like a terrible metabolic chain reaction nightmare that all starters with ultra processed foods. This book will make it clear for you.

Western medicine is all about treating the symptoms of western lifestyle. We focus on keeping glucose low in diabetics, which is a symptom of metabolic disease, rather than keeping insulin low by addressing the underlying metabolic disease caused by processed foods. Hospital revenue is derived from procedures, most of which are treating the end of line consequences of metabolic disease. Preventative medicine is not profitable. But do you know what is profitable? Catastrophic medicine. It’s when the diseased bodies show up that the coffers are open. Now, I’m a doctor, an anesthesiologist intensivist, and I don’t think Western medicine has done this by design from the beginning. Western medicine is simply a guild of highly educated people that are working within market-based institutions that follow the money. And the money is found in treating the symptoms of metabolic diseases.

Obesity is a symptom, not a disease. Obesity is a consequence of metabolic disease. Something like 20% of obese people don’t have metabolic disease and plenty of people think they do. Let’s reiterate: you can be obese and healthy. I have been saying this for years but I don’t have the endocrinology chops to back up my claims. Now I do. Because the author is an endocrinologist. Don’t people see that by labeling obesity as a disease it opens the pharmaceutical floodgates to profit from yet another symptom of metabolic disease without addressing the underlying cause which is (all with me now): ultra processed foods?

Don’t get me wrong, I’m all about fat-positivity and I do not believe that obesity is a moral failing. Obesity is a fallout from conspiring corporate influences to keep us addicted to harmful food products. Fortunately the new popularity of GLP-1 drugs (like Ozempic) do address the underlying metabolic derangements, much like resting high glucose with insulin, it doesn’t really address the problem of intake of ultra processed foods. It’s not like GLP-1 drugs are going to stop people from magically ingesting toxic food and they keep people reliant on an expensive pharmaceutical. Are you getting the theme? → PROFIT. But it’s even worse, this arrangement with insulin and GLP-1 dependence creates a rent seeking operation of patient’s very bodies where the food industry creates the persistent metabolic disease state and Big Pharma mitigates the fallout from the metabolic disease state. It’s perverse. The real solution is cessation of ultra processed foods which would simply fix the metabolic disease. But here’s the thing, the processed food market wants you to believe it’s all about the calorie deficit so that obesity and metabolic disease will remain a moral failing of the consumer. As long as it’s your fault and not theirs, no policy change is needed from the FDA and USDA.

Let’s discuss the gut. It needs fiber. Why? Because there are billions of bacteria down there and if they directly touch the skin of your gut, you're going to get inflammatory cells coming in to keep them in check. A fiber lining protects the gut and feeds the bacteria appropriately so they don’t have unchecked growth. Well, UPF have detergents in them, also known as emulsifiers, that break down this fiber/mucus layer, exposing your gut to chronic inflammation. Stuff like soy lecithin, polysorbates, carboxymethylcellulose, propylene glycol, DATEM, xanthan gum and many more emulsify foods, bringing water and fat soluble things together, to make them mix well, have longer shelf life and to have a smoothie more tasty quality. All of these detergents can disrupt the gut mucosal barrier and cause inflammation and translocation of bacteria and their products (like lipopolysaccharides). This is concept behind the “leaky gut” theory (not a formal diagnosis). And, spoiler, but leaky gut and chronic inflammation can also drive metabolic disease via hyperinsulin and oxidative stress (which is where too many oxygen free radicals are created for too many cellular calories that have a tendency to tear stuff apart).

Are you seeing that there is no shortage of mechanisms by which ultra-processed foods destroy your body? I’ve only gone over like three of them. There are many more. I’ll stop boring you and just tell you: read the book.

Okay, so feeling trapped? What can you do? Well, I’ll tell you what I do.

One criticism of this book I’ve seen is that the author isn’t specific about what “real food” is. My response to that is: stop playing dumb. You know exactly what real food is. If you really don’t know, there is a food processing grade created in Brazil called NOVA. Here it is:


NOVA Group

1
Unprocessed or Minimally Processed Foods

Natural foods altered slightly to make them safe or edible (washing, cutting, drying, freezing, etc.)
Fresh fruits, vegetables, eggs, milk, plain meat, rice

2
Processed Culinary Ingredients

Substances extracted from Group 1 foods or nature, used in cooking
Sugar, oil, butter, salt, honey, starch

3
Processed Foods

Foods made by combining Group 1 and 2 items; generally have 2–3 ingredients
Canned vegetables, cheeses, fresh bread, jams

4
Ultra-Processed Foods

Industrial formulations with additives, flavorings, emulsifiers; little resemblance to whole foods
Soft drinks, chips, fast food, instant noodles, packaged snacks

My advice: never eat Group 4 foods. Ever. In my home, the only Group 3 processed foods in our pantry are pasta, beans, bottled tomatoes, oatmeal. In our fridge it is mostly Group 1 and 2 with some 3, so like milk, cheese, butter, fresh veggies and condiments. Everything else we cook and bake. The only other major Group 3 processed food in our home is bread and other baked goods that we bake and process ourselves. Want ice cream? Buy an ice cream maker that takes only 4 ingredients to make vanilla ice cream. Does this take time and planning? You bet. Does it take money? Yes some upfront kitchen and pantry infrastructure cost but it will be waaaay cheaper in the long run as your grocery bill plummets. Is it joyful to make your own foods and feed them to your family knowing you’re not giving them poisons? You bet. Will you lose weight and reverse your metabolic disease? You bet. Can anyone do it? You bet. Is it easy? Not at first but once you adjust, there isn’t going back.

Good luck out there.

[Zora · Rating 5 out of 5]

I was hoping for more on the evils of big pharma, but what's in here is choice, angry/frustrated, though not without hope. (He has hope. I don't. Money talks and runaway capitalism is gonna kill us, and I can only be thankful I'm old enough it will kill everyone else after I'm gone.) I've been to the website to look at the footnotes--very exhaustive.

I'm predisposed to agree with him, so there's that you should consider before swallowing my rating (though you should swallow my rating before you swallow any processed food!). My bias: I grow all my own fruits and vegetables (which takes me about 500 hours of work every year, including preserving and $300 for a return of about $5000 worth of organic veg and fruit, some of which I give away to neighbors, friends, and family. I eat wild game when I can get it and wild fish (though this is not entirely without problem; all the water where I live is full of lead and what-not from industrial contamination.) I can afford free-range eggs but not grass fed beef.

I don't trust the medical-pharm industry one little bit. I've never been healthier than when I was without insurance for 18 years and so saw no doctors, except for once I went and got a CBC and lipid panel (I'm totally healthy) and paid out of pocket. I just went to a dermatologist to make sure I didn't have skin cancer (I didn't, despite all the hours outdoors without sun block, but they froze off three little AKs and told me not to worry about it again for five years, a truth I appreciated instead of them lying and saying I needed to go back every year.)

So obviously, he's preaching to the choir, though this section of the altos simply cannot afford free-range animal meat, so that's just not going to change no matter how many rich internet doctors admonish me to be richer than I am. Thanks guys, but I'm pretty poor, so that it what it is.

Basic message here. Eat real food as mother nature grew it/bred it for you. Not processed food. It 1) protects your liver and 2) feeds the colonies of critters in your gut that keep you sane and healthy.

Other messages: most doctors don't have a clue about nutrition. Most nutritionists don't study the science enough either. And your government has not your best interests at heart but the interests of rich people who own the big food corps and big agriculture. (But you knew that already, right?) So for sure don't listen to them. "Listen to the science" isn't even perfect advice, because if Coca-Cola is funding the science on how bad sugar is for you, how reliable can those results be, hmmm? So that's the book.

I've been eating real food, most days, for six or seven years now. When I ordered this book, I'd been off sugar and flour for six months, which I've done like 6 times before. Something about six months off sugar that seems to make me swerve off course. When I got the book in hand, I'd been back on sugar for ten days, and it was escalating use because FFS, sugar is addictive! Seriously, awfully, addictive. You think you'll have a spoonful on the slightly under-ripe berries, and pretty soon, you're drinking Coke with a straw, and dreaming of going out for an ice cream cone. Stupid stuff, sugar. I can say no to booze, cocaine, speed, pot, LSD, but give me Valium or sugar, and I only want more. Thank god they don't put Valium in chips along with the sugar and soy oil. I'd be sunk.

Anyhoo, liked it, laughed several times, and am re-re-re reminded to quit sugar AGAIN. Thanks Dr. L.

[Susan · Rating 5 out of 5]

Dr. Lustig is a nutrition hero. I nominate him to be the Secretary of Agriculture with great hope for the many obese children dependent on 2-3 meals per day from the National School Meal Programs.

[Dana Goldstein · Rating 2 out of 5]

This rating is fueled by emotions. While this book is well-researched and based in science, I felt my anxiety spike with each chapter. I’m better equipped with knowledge about how the food industry manipulates what’s in our food, what drugs we end up on and how we spend our money, but I was left with this overwhelming question:

WHAT THE FUCK CAN WE EAT?

I understand real food, and we eat a lot of it in our home. But I’m now questioning the fiber in my bread, the can of tuna l eat without mayo, and the balsamic vinegar I drizzle on my salad. Is anything safe?

It would have been nice to learn about what a real food diet looks like. I guess the final message of this book is we have to measure our risk. I guess it’s better to eat a can of tuna that might have microplastics than to slather a slice of white bread with commercially-made peanut butter.

Overall, the book brought me to the conclusion that it’s nearly impossible to avoid additives, preservatives and pesticides.

Sigh.

I’m ordering a pizza for lunch.

[Emily Kestrel]

DNF at 12%.

There may be some good info in this book, but I just can’t with the writing style. Lots of fear-mongering language and hyperbole. “Processed foods are poison.” “Sugar is toxic.” “Low fat diets have killed more people than cigarettes.”

Also lots of conspiracy theory lingo. Big Pharma and Big Government are in cahoots with Modern Medicine to keep us from eating Real Food. (Yeah, he really loves his capital letters.)

Lots of other people left great reviews, but it’s not for me.

[Jan Peregrine · Rating 5 out of 5]

Obesity's not the problem, argues Dr. Robert H. Lustig MD, MSL, in his latest health book Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine. The problem is that our bodies' metabolic systems have been rendered dysfunctional by our addiction, often from our first months of life, to highly processed, not real, food. I haven't read his first book Fat Chance, but did enjoy The Hacking of the American Mind.

As a neuroendocrinologist and pediatrician for the last 45 years, Lustig was taught like other medical doctors to only treat the symptoms, not the causes, of illness. He was taught very little about nutrition and to enjoy the perks of being a prescribing, unhelpful doctor.

It disturbed him so much that finally he tried to understand why his child patients were getting so chronically sick, fat inside and out, and dying.

He realized that the one way to eat and drink for health protects the liver and feeds the gut.

You can, you see, be slender and have a fatty liver or heart. This is usually why fit-looking athletes fall dead of a heart attack. They were eating a diet of refined carbs as found in junk or highly-processed food. They were drinking lots of glucose and fructose-laden drinks, which includes juices as well as sodas and energy drinks.

Some obese people don't have the metabolic syndrome and only accumulate fat on the outside. They could be perfectly healthy and only eat too much nonprocessed food with both kinds of fiber.

Lustig sets the medical facts straight in other, important ways.

One fact is that our bodies do not need sugar. We make glucose through glycerol from triglycerides in dietary and body fat (I think it's body) and omega 3 fatty acids. Another longstanding myth he debunks is that a calorie is not a calorie like any other. What's important is how your body absorbs the calories and not how many you ingest.

All these facts do not surprise me. It seems like common sense to me to only eat real food with soluble and insoluble fiber, which is food that feeds the gut bacteria and keeps them happy so you don't wind up with a leaky gut and chronic, deadly diseases.

Lustig speaks a lot about insulin resistance being behind the metabolic syndrome.

He talks a lot about how rich countries like the US are the sickest and why and how simply trying to educate people addicted to highly-processed food has never helped change their eating habits. We need to tax sugar and all its addicting forms.28 countries already do this and save billions in health care.

I've given you a lot to think about, but I hope you can understand how crucial eating fiber-rich food is for your health and fitness. Lustig doesn't claim to advocate a certain diet, but he seems most okay with a flexitarian diet that's mostly fresh produce with a couple servings a week of “pasture-fed” meat and wild fish. These options, though, are unreliable and unsustainable as well as pricey.

I've eaten a whole foods, plant-based diet happily for nearly nineteen years and cook from scratch too. Restaurants will keep you metabolically unhealthy.

My final comment is that Lustig is absolutely right that we will never fix our health care crisis without fixing our health. Health cannot be fixed without acknowledging what's horribly wrong with our food industry and government subsidies and how we feed our children no veggies at all!

Food culture change starts with us. It starts with what we choose to eat. It took many decades to bring Big Tobacco to its knees (yet the US still subsidizes tobacco!!) and Big Pharma is getting its just desserts finally.

We can force change to Big Food and Agriculture too.

Hope you'll check out Lustig!

[Jens van der Kreet · Rating 5 out of 5]

Robert Lustig liefert eine beeindruckend detaillierte Zusammenfassung all dessen, was in den USA schiefläuft in Bezug auf unsere Ernährung. Entwarnung für Europa kann es hier nicht geben. Zwar sind bei uns die Rahmenbedingungen leicht unterschiedlich – die Lobbyorganisationen heißen anders, die Kommunikationswege zur Regierung funktionieren anders usw. – , im Großen und Ganzen sind bei uns die Wirkungsmechanismen ähnlich.

Hauptthese des Buches, die er immer wieder wiederholt:
Gesunde Ernährung muss den Darm ernähren und die Leber schützen.
Diese Aufgabe wird durch verarbeitete Lebensmittel nicht erreicht, wodurch sehr viele Menschen, insbesondere Kinder, krank werden.

Tatsächlich decken sich die Beschreibungen Lustigs mit der vorhandenen Literatur zum Thema Ernährung. Sein Wissensstand entspricht der aktuellen Forschung, es gibt keinen Aufreger mehr, den er neu präsentiert und der für Furore sorgt.

Es ist alles bekannt und wissenschaftlich nachgewiesen. Verarbeitete Lebensmittel sind für den menschlichen Körper nicht gut, weil sie zugesetzten Zucker haben, zu viel Salz, zu wenige Ballaststoffe. Man schaue sich die Nährwertangaben auf den Produkten im Supermarkt an, da weiß man Bescheid!

Wenn schon in Hummus Zucker beigemischt ist, wie will der Körper das managen, wo jeder weiß: Die Dosis macht das Gift. Wenn man sich dann überlegt, dass US-Schulkantinen der einzige Ort auf der Welt ohne Ballaststoffe sind, das zieht einen echt runter.

Das Schöne ist: Wir können etwas dafür tun, dass die Lage besser wird. Wir müssen unser Essen selbst machen. Das kostet Zeit, die sollte es einem Wert sein. Zum Glück kann man dieses Hörbuch dabei konsumieren.

[Brittin · Rating 2 out of 5]

Rating this based on my experience of reading this book (as I usually do). I did not enjoy this book.

There is a lot of great info here, and I assume sound science to back it up. Some good info debunking "it's just about calories in, calories out" and calling out industries and systems that are more focused on money than helping people be well.

BUT.

This book is so mansplain-y. Lots of generalizations (e.g. about dietitians), could be very triggering/harmful to folks who have many barriers and a lack of resources to eating real food (instead of "poison" aka processed food) and while it acknowledges social issues once or twice, it does no justice to them. It's especially tone deaf to those who may be experiencing negative body image, disordered eating or an eating disorder as it assigns moral value to food (good vs. bad) and recommends some archaic tips ("don't shop when hungry", "shop the perimeter of the store") that could further complicate the relationships people have with their body and food. It also gives SPECIFIC waist measurements that people should be "concerned" about. What?!?

Here's the points he repeats over and over (and over):
- "Protect the liver, feel the gut."
- "It's not what's in your food, it's what's done to your food."
- "Sugar is bad."

I agree with all these things in theory, but taking a cue from Lustig, "sometimes it's not what you say, it's how you say it."

Audiobook: 12h 3m

[Harish Sankar · Rating 5 out of 5]

Opened my eyes to the debacle that is SUgar and Processed Food.
Got me to re-read the science portions, but what a revelation.

If this book does not convince you to stop your sugar intake, what will?

[Jeff · Rating 3 out of 5]

Interesting Concept. Remarkable Honesty. Questionable Science. First, I gotta mention that the author intentionally left out the Bibliography, claiming it would run to 70 pages and add $5 to the cost of the book, so he instead put it on the website of the book. Which is an interesting idea, but part of his reasoning was also that this would allow users to click the links and see the sources directly... which eReader users can already do in an appropriately linked (re: fully publication-ready) bibliography. But he discusses this in the very introduction of the book, which sets the tone for how frankly he expresses his views throughout. Still, to this reader this was an attempt to obfuscate the sources at best, and was thus an automatic star reduction.

The other lost star comes from the at times questionable science. Rather than actually discussing various claims made by those with competing ideas, he simply claims massive conspiracies from Big Pharma, Big Food, Big Government, and whoever else he can try to conveniently scapegoat. And then he completely ignores the economic and social sciences in his recommendations for measures that would make Josef Stalin blanch at just how extreme this author wants to dictate to the masses.

Still, the ideas - while ultimately not truly novel and ultimately self serving as he *just happens* to run a nonprofit advocating these very positions - are interesting and explained in quite a bit of detail, from the chemical and cellular all the way up to the global. Making this a worthy text to read and consider... just don't buy the farm based on just this one book, and make sure you seek out competing narratives to fill in the author's inconsistencies. Recommended.

[Leah · Rating 2 out of 5]

I never thought I would read a book where I agreed wholeheartedly with the author while at the same time thought they were a blowhard and completely full of shit. I am a health care provider and I am getting old. I have seen the explosion of metabolic diseases, clearly due to diet, over my career. Somehow Lustig thinks he is the only person who has noticed this and that the medical system is not aware. This may be true to some extent but the bigger issue is that we have to work in the context of the world we live in and it isn't easy to get people to change their diets. Also, he frequently brags about all of the sources he cites. So many that he doesn't put them in the book but on his website. (maybe in reality because the publisher didn't want to publish them?) When you actually look up the sources most of the time they are either:
1) Not there
2) A link that leads nowhere (medical sources often require a subscription
3) Not relevant to the facts given. For example I looked up one about body fat and the article was about how to do the MRI technique that measures body fat content, nothing about the specific claims of body fat percentages)
Also, he reminds me of an old man who just has a lot to complain about, bringing up things he is obviously just angry about unrelated to the topic, disorganized and repetitive.

[Thomas · Rating 5 out of 5]

Great synthesis of undervalued health advice to eat more real food.

Thesis of the book is that processed food industry has diverted attention away from the following points, by focusing instead on less important or even irrelevant health issues 'enough sport', 'proteins vs carbohydrates', 'saturated vs unsaturated fats':

* shocking lack of Fibre in processed foods which makes glucose levels in blood spike less and protect the liver from becoming sick from fructose overdose. Fibre, both soluble and insoluble is also essential ingredient to feed the good bacteria in the gut.
* shocking overdose of fructose. At the cradle of many chronic diseases
* shocking overdose of omega 6 (VS omega 3) through seed oils overdose (the cheapest and most tractable oils for processed foods industry) leading to chronic inflammation

[l a u r ə n · Rating 1 out of 5]

DNF @ 44%

You ever read something and you just know the person writing it is some smug, older white guy, who is reviewing what he wrote with a satisfied cheshire grin? "Yes, yes. I am very smart."

Too opaque for the general layman. Too much of an aggressive hit piece from a guy expressing his victim complex for anyone within the industry. Too triggering with questionable biomarker references for anyone struggling to learn more about nutrition to help restrictive eating disorders. Who is this book even for, aside from this guy's ego?

It's capitalism. Just say it's capitalism. It's not individuals within the system that want you silenced, Mr. Lustig. Or some grand conspiracy. Capitalism and the commoditificaton of food is the problem.

If you want nutrition advice, read Pollan. If you want politics and the why, read Marion Nestle and Michael Moss. Leave this one on the shelf.

[Vilena · Rating 5 out of 5]

Great book for non-professionals. Easy explanations, engaging language, some humor and an exquisitely delivered exposeé on the Big Pharma and modern medicine.
Helped me refresh my own knowledge of MetS and insulin resistance.

[Tanja Berg · Rating 5 out of 5]

I need to start reviewing the books on nutrition before I mix them completely! This one is so far the best of the lot. Robert H. Lustig is a medical doctor and he has been working with overweight children for decades. This book is a follow up and expansion of his lecture “sugar: the bitter truth” that has been viewed more than 25 million times on YouTube.

I remember being told that sugar doesn’t cause diabetes. It’s a lie. The idea that eating fat causes heart disease because of increased LDL cholesterol is also a lie. It’s the fructose in our diet that does that, which the author explains in detail.

The food industry has avoided being lumped together with the tobacco industry, but both are equally detrimental to our health. The food industry adds sugar to everything, knowing full well that it is highly addictive. Nothing is said about fiber being an essential nutrient - because you can’t add it to ultra processed food. It doesn’t take well to being frozen.

We also drink a high number of calories now. Coca Cola
adds salt (sodium) to make us want more and be thirstier. There’s so much sugar that we don’t notice.

The author is angry. I guess I would be too, in his line of work. I love his snarky humor. Change your life, read the book!

I had several WTF moments and it felt like the fork literally stopped on its way to my mouth. I have now cut out all ultra-processed foods from my diet. Not hard, because I can afford it and there wasn’t much left. I’ve never had much of a sweet tooth, but when I started looking at what I was getting through drinks - juice and tea, for example, I was shocked. Orange juice is just as unhealthy as soft drinks. So, now I drink only water and milk and do not sweeten my caffeine. I dropped my morning fruit tea. No added sugar, but naturally sweet. Poison in the form of fructose. Chronic fructose share 8 out of the 12 metabolic problems as chronic alcohol. Yikes. I’ve suffered three days of headaches coming off my sugar addiction. I am less hungry and hangry, my weight is dropping by the day and my skin is better. It’s not yet been an entire week.

Of course I am going to have cake and dessert at some point, I don’t want to make a nuisance of myself. I will never drink Coke again though.

To repeat: you’ve been duped. The fat epidemic is caused by the sugar in our diet. The science is out there, the food industry doesn’t want us to look that way.

[Ali · Rating 4 out of 5]

In Metabolical, Dr. Lustig examines the root cause of the diabolical metabolic syndrome and identifies the enemy as us, well mostly those of us who cave in for the processed foods. His shotgun approach in the first twenty some chapters is mostly admiring the problem as he weighs in on every wrongdoing looking into what is done to our food as well as what is added and subtracted. His solution to all those issues is: eat real food :) which should protect your liver and feed your gut. Easier said than done! especially where more than 70% of food products in the market is processed food. Even if we stick to fresh produce at the local farmers market, not sure how real it would be with all the agricultural modifications and alterations. Maybe I am another lost cause hedonic actor of sugar addiction with grain brain but reading all this “real food” sounds more like deadpan. If not fed up yet, last two chapters offer some economic and cultural changes for the intended tectonic shift.

[Brendan · Rating 3 out of 5]

If you don't make it through the first half of Metabolical, which is mostly a discourse on cellular biology, biochemistry and nutritional science that gave me bad flashbacks to high school biology, the entire book can be easily summarized in three words: SUGAR IS BAD.

How bad is sugar (and the processed foods to which it is added)? It's responsible for everything from people dying to economic and environmental catastrophe. According to Lustig, sugar causes both climate change and the rise of fascism (defined by Lustig as "Donald Trump"). And this is really the problem with the book. While it contains a lot of useful information about nutrition, it is really a screed against the food industry from a leftist perspective with regular injections of hostility towards President Trump in particular. As a result, the book's utility is limited. While Lustig repeatedly extols "real food," he spends a lot more time bemoaning "non-real" foods. Everything is bad. Meat from cows that received antibiotics. Bread from a supermarket. Literally "any food with a nutrition label." It would have been nice if Lustig could have identified the various "real foods" and their benefits, and maybe other supermarket foods that weren't that bad.

But Metabolical isn't really a nutrition and diet book. It's more about the science of nutrition and national nutrition policy. Despite Lustig's manifest bias and preference for regulation and laws (which haven't worked so far to keep America healthy), his proposals are pretty reasonable and interesting. It's hard to object to his suggestion to eliminate sugar subsidies and tax sugar like alcohol and tobacco. A proposal to have health insurers pay for "real food" for insureds because they'll save on health costs in the long term is interesting, too. The problem is that too much of Metabolical is science that is far beyond my understanding (and likely beyond the understanding of anyone without a science degree) and relentless diatribes about how terrible sugar and processed food are.

[Mary Book · Rating 4 out of 5]

I had already read "The Case Against Sugar" by Gary Taubes and agreed with that analysis, so "Metabolical" was something I was already predisposed to like. This book does an excellent job of laying out all of the body's cellular metabolical processes ... but if you are not well versed in scientific language, about half the book will go over your head. I have to admit that I am not well versed in cellular chemistry and biological processes, so yes, parts of this were difficult to understand. I think the book could also do a much better job of explaining how excess insulin and other chemicals actually interfere with the body's metabolism. I also wish the author had included a list of the foods that he considers "Real Food". (Since I am addicted to popcorn, I was very curious to know if he considers SkinnyPop to be a Real Food but alas, I have to figure that out for myself. I'm going to say that SkinnyPop is a "Real Food"). Overall, though, it made me recommit to decreasing the sugar in my diet and it also changed my mind about taxing soda. (Yes, we should tax soda.) (Maybe this book will finally answer my daughters' prayers that I stop drinking diet soda!). I found this book to be very convincing as to offering an explanation for the chronic diseases that are prevalent in our society.

[pennyg · Rating 3 out of 5]

Lots of Good information about processed food, treating symptoms not the disease, big pharma, big government. He says it's not necessarily that certain foods are bad for you its what's done to them by the food industry/ farm factories that make them bad for you. He covers a lot of topics, some a little too technical for me ( diagnose your own biochemical profile ?)

He explains all the problems and I agree with most of his conclusions, however he doesn't give any solutions. The only way around chemicals, antibiotic, etc. in your veg and meat is to grow your own and I'm certain that's not practical for most. I for sure don't know how to fight big pharma, big government or the food industry. Nor am I willing to tell my Dr. he is using the wrong strategy for treating my high BP. Good info just not any practical way to put it to use. He is a retired Dr. and It almost seems like a mea culpa for all the yrs he thrived as Dr. within the system.

[Ashwin · Rating 4 out of 5]

Book in a few lines
-Protect the liver (from fructose, glucose, branched-chain amino acids, omega-6 fatty acids, iron, and other oxidative stresses)
-Feed the gut with Fibre
-It's not about the food, it's what been done to the food (processing)
-Eat 'real' food, Foods with minimal processing, some processing is essential (pasteurisation)

[Paul Nutt · Rating 5 out of 5]

Attention Food Zealots

Mind blowing how the effort of one man stands to change what we think we know. Dr. Lusting calls for us to get out of our own way and return to reality concerning our nutritional choices.
Thank you Doctor.

[Diane Scholten · Rating 4 out of 5]

I really liked this book which convincingly asserts that our deluge of metabolical illnesses and ensuing rising “health care” costs are due to processed foods and knowing malfeasance on the part of Big Food, Big Pharma and mainstream medicine. He’s polemical-but I totally agree with him!

[Ginny Yurich · Rating 5 out of 5]

Looooooooved this one!! Learned so much! Very motivating - so glad I read it.

[Erika · Rating 2 out of 5]

There was a lot of scientific verbage and a lot of laws and dates and names and big words that I can’t pronounce throughout this entire book. It was completely overwhelming.
We got to the point quickly, “Eat Real Food. Don’t Eat Processed Food” but at the same time I felt like it took forever to get to the point. The author talked us through the corruption of the government, big pharma, food industries, sugar, and medicine but by the end it was abruptly over with a short chapter of here is the solution, good luck, bye.

I was hoping for more REAL food health instead of medicine is bad and sugar will kill you. I wanted more real food tips for living in this day and age, I still don’t know if honey is good or bad. Is it?

Very informative. A lot of name dropping: people, companies, and big scientific words for bioengineered compounds made in processed food.
Honestly, just so-so. Though I do recommend this book if you have a metabolic disease that you are willing to cure by changing your diet drastically, this would be great for you.

And one thing I find very wrong about this book is that he puts all the blame on obesity, metabolic disease, and all around unhealthiness on sugar and everybody but ourselves. Honestly, we have to take some of the blame. He calls it addiction, and sure some people are, but a lot of us are just usera and abusers. There are real foods out there, we have to opt for them ourselves. Some people can’t have a single drink, some people can’t have one cookie but most people do just fine with moderation even though it’s not healthy for us.

Oh, I did actually learn one thing that I am already implementing. DON’T use olive oil (or any low smoke point cooking oil) to cook with. Pick a high temp oil. There were a lot of big words but it is something about it being a single bonded something and changing to a double bonded something that releases something and makes the food you are cooking devoid of nutrients and giving you fat in your liver.