English Subtitles for 2015 CHS Thurs. Keynote - Robert Lustig, MD, Author, Fat Chance



Subtitles / Closed Captions - English

good afternoon everyone how is everyone doing good

all right hope you had a good lunch and a really good morning so on my name is kinda when I'm the portfolio director for the healthy living area at the Colorado Health Foundation I have the pleasure of introducing our keynote speaker Rob plastic here today on but before I do that just a couple of things to remind you that we will hopefully have some time for questions after rod speak so again no cards on

your table please fill out your questions and put them to the center or at the end and we will pick them up center of the aisle and we will pick them up during the Q&A and and try to get to as many questions as we can so but please we would love to have some questions from you so i just want to share that I first got to know Rob's work after reading an article in the new york times magazine in 2011 so for years

ago that was titled sweet & vicious that was very thought provoking so i've been following his work for many years now and so we've been trying to get him to the symposium so very excited to have him here this year and I think you will find his remarks very thought provoking as well on it so Rob is a longtime leader in the fight against obesity and diabetes in children and adults author of The New York Times bestseller fat chance Robin the pediatric

neuroendocrinology just who is currently investigating the nutritional neural hormonal and genetic influences of obesity in 2001 Rob join the division of endocrinology at the University of California San Francisco as a professor of pediatrics previously he was on staff at st. Jude's Children's Research Hospital in Memphis Tennessee working with children whose hypothalamus had been damaged my brain

tumors or subsequent surgery radiation or chemotherapy because many of these patients became massively obese he explored the role of fructose as a mediator of both chronic disease and continued calorie caloric consumption his research led to the YouTube video sugar the bitter truth which has received more than three million hits and if you have not added

hands are also appeared in the documentary fed up that came out last year i think spring of last year that again very interesting very fascinating on this topic so i mean we just heard I think this morning that it's nominated for an Emmy so please welcome me and joining welcoming Rob left thank you can and thank you everyone for inviting me and for being here for

trying to help solve this national dilemma that we've got I'm doing my best and I'm going to try to show you why we've got this problem and hopefully during the breakout session what we can potentially do about this problem now i will start out by saying that Colorado has the lowest obesity rates in the country and it also has the lowest diabetes rates in the country

you are number 1 out of 50 in both of those so that's but not for the reason you think in fact it has to do with cold an altitude not your wonderful outdoor lifestyle and there's actually biochemistry that supports that so I just had to get that off my chest and now it can go on from there it I'm a scientist came and I don't know if any of you have ever delved into the

scientific field but you know most experiments fail nine out of ten experiments fail and some of those are you know hardcore bench or clinical science experiments and some of those are social experiments as well let me give you an example of a social experiment that failed here's one right here this was just from a month ago in Time magazine ok and it listed all the reasons why this particular social experiment had

failed so we can invest a lot of effort and angst and national pride into a social experiment and ultimately have it proved a failure you can't know whether or not an experiment failed until you see the outcomes the outcomes determine whether the experiments except was successful or failed so i'm going to post to you today that each one of you has now has been

over the past 50 years then the participant an unwitting participant in a research experiment posed by 10 principal investigators all over the world that posed the following hypothesis processed food is better than real food processed food is better than real food that's the hypothesis we have to then look at the outcomes to determine

whether or not that hypothesis has been fulfilled or whether we should refute it everybody with me so far and so the outcomes that we are going to look at our consumption health and disease environment and cash flow and cash flow has three parts companies consumers in society going to take each one of those in turn so here's the experiment if you will nineteen sixty-five the start of the

experiment everybody remember Swanson TV dinners right the beginning of the experiment and spam actually was been predated that was from World War two but you picked up in 65 and here's what the experiment looks like today and you recognize all of these and of course there's many more of examples and here are the 10 principal investigators and right here okay everybody take a quick look in the center there right craft coca-cola and

PepsiCo general mills Kellogg's Mars unilever J&J PNG and Nestle ok so they have basically altered the social environment to pose this experiment so let's talk about what processed food is so processed food has the definition has to be mass-produced so that is available to everyone has to be consistent batch to batch has to be consistent country to country so that mcdonald's hamburger in France is the same as a mcdonald's hamburger in you

know in keystone specialized ingredients from specialized companies virtually all the macro nutrients the protein the carbohydrate that has to be pre frozen which means that the fiber has to be removed because you can't freeze fiber and has to stay emulsified that is the fat in the water don't separate you have to use emulsifiers to do that and it has to have very long freezer shelf life

everybody with me that's processed food so let's talk about now what the difference between processed food and real food is there are very specific differences in here they are not enough fiber and each with with each one of these there's a book that you can access that will teach you about this not enough omega-3 fatty acids which come from wild fish not farmed fish farm

fishes processed food is farmed fish eat corn while fish eat algae and the mayor of mega threes are made by the algae not the fish micronutrients of various sorts which travel with the fiber fraction and now too much trans fats although they are coming down because now the FDA has agreed that these are not generally recognized as safe and they are now going to be banned

hooray but it's been a 50-year that battle branch chain amino acids leucine isoleucine valine these are amino acids that are found in corn-fed beef chicken and fish at high amounts and your liver turns that into liver fat which is you will see is a big problem omega-6 fatty acids which are pro-inflammatory what you find them various plant seed oils let such as corn and soybean oil at various food

additives the list is myriad it's about 7,000 long emulsifiers polysorbate a 80 carboxymethyl cellulose carrageenan carrageenan anybody hurt carrageenan that's the emulsifier used in ice cream and you know who brought carrageenan and 22 ice cream Margaret Thatcher she was an ice cream chemist before she was Prime Minister

salt ok everybody familiar with salted and every one of these we have correlative data correlative not causative so that makes these highly suspect in a public health venue because in order to talk about fixing the problem you have to have causation well there's one more that we have on this list that we do have causation for

and here it is sugar this way of causation for and so most of my comments are going to be directed toward sugar but I want to understand there's a whole litany of why processed food is different from real food we will talk about whether it's better or worse as we go so the big question we know about this right

addictive and hazardous to your health well is this true what do you think well National Geographic seems to think so how about that sugar why we can't resist its not entire story you know of from richard cohen back in august 2013 about the entire sugar trade the remember the slave trade the triangle trade and why that became the single biggest commodity on the planet until oil supplanted 1940

so now it's the second biggest commodity on the planet ok so the question is why well the answer is because we love it that's why this is from the Netherlands this is from the chief medical officer of the Netherlands paul van development sugar is addictive and the most dangerous drug of the times now this is coming from a guy who lives in the Netherlands and they know

something about addictive drugs there well in fact we know it to anybody know what this is you do what is it it's that's right this is called sweeties sweeties this is a super concentrated sucrose solution that you dip the pacifier in and then you stick it in the newborn boys mouth when you do the circumcision because it releases opioids in the brain in order

to be your natural painkiller ok and sugar is a natural painkiller until it is a natural pain inducer so of the six hundred thousand items in the American food supply seventy-four percent of them have added sugar and we're talking about all the foods ok but only fifty percent of them have greater than their the recommended

amount of added salt so that means that sugar is the marker for processed food and sugar is in virtually all processed food and the reason is because sugar makes all the other bad taste go away it makes our go away like lemonade and the sis reserve in German wine it makes better go away like milk chocolate has caffeine is bitter it makes you mommy go away like for instance sweet and sour pork and it

makes salty go away like honey roasted peanuts or chex mix ok basically can make dog poop taste good with enough sugar and they do so now let's do the outcomes consumption so everyone will say well of course we're eating more I know we're eating more indie we are so 1957 over there is the White Castle original hamburger 210 calories in the middle there's Bob's Big Boy is 618 calories and the midst of the

obesity epidemic parties had the temerity to offer us the thick burger at 14 hundred and twenty calories and of course Carl's jr. has the six dollar burger 2,000 calories that's the entire allotment for the entire day right so indeed we are all eating more adults adult men are eating a hundred eighty-seven calories more than before

337 for adult women 275 in this slide 14 boys so what is it we're eating more of reading more of everything no reading more fat no we're actually eating the same amount of that so 45 where 45 calories so if you look at the secular trends and specific food and take care of the fats so whole milk way down meat and cheese up slightly me of milk desserts up a little bit my bottom line

is a wash and that's what the day to say it's a wash now our percent of calories from fat has gone down although our absolute consumption has not so we've gone from 40 to thirty percent because the USDA back in 1977 said we needed to reduce our consumption of saturated fat everybody knows about that noun that's actually the biggest tobacco on the

planet in terms of science you want to talk about bad science that was bad science ok and in the midst of all of this the obesity epidemic has just taken off so what are we eating more of well it's carbohydrate ok 220 calories out of that - 75 and here's the carbohydrate here in red and you can see all of them up through the roof

that's what we're eating more of this carbohydrate was the bottom of the food pyramid remember all those brains right because those are the cheapest thing to produce that's why so and in particular beverages right forty-one percent increase in soft drinks thirty-five percent increase in fruit drinks fruit aids and what is this stuff well in America is this thing called high

fructose ask or answer right 63 pounds per person per year but just remember that the only users of high fructose corn syrup are the US canada japan with very very limited exposure in parts of Europe yet the entire world is suffering from the same chronic metabolic diseases everyone's got it ok australia's Got if they don't have high fructose corn syrup

korea's got it they don't have high fructose corn syrup china's got it they don't have high fructose corn syrup india's got it they don't have high fructose corn syrup because high fructose corn syrup is just a cheap form of sugar high fructose corn syrup evil because it made sugar cheap it was a competition now we prop it up with subsidies and tariffs

but the fact is it doesn't matter it's not the vehicle that matters it's the payload and you'll see why and this is the payload right here so here's high fructose corn syrup on top one glucose on the Left six-membered ring glucose is the energy of life everybody on the planet has to get burns glucose for energy every cell on the planet burns glucose for energy but this other

one over here this one on the right called fractus notice five-membered ring only the liver can metabolize fructose and the problem is with that when fructose is supplied in excess which is very easy to do because the liver has a limited capacity to be able to metabolize it when you supply an excess the liver has no choice but to take that extra and turn it into liver fat and we now know that that liver fat is the driver of all of these chronic metabolic

diseases that were talking about so that's where it comes from now sucrose down below you can see one glucose one fructose joined by this Oh glycosidic linkage big deal who cares the enzyme in your intestine Sucre squeeze this in a nanosecond you liberate the two molecules you absorb them just the same so it doesn't matter that it's high fructose corn syrup or sucrose it's

sugar any which way you look at it and of course we have a lot of it and it's been going up and up and up and up so I call this slide very specifically the coca-cola conspiracy and you'll see why in a minute in 1915 that was the original standardized bottle out of Atlanta

six and a half ounces if you drank one of those every day for a year now be worth eight pounds of fat per year in terms of calories not in terms of disease but in terms of calories in 1955 after sugar became plentiful after world war two we got to 10 ounces first ones found in vending machines then 1960 the 12-ounce can still with us

that's 16 pounds of fat per year and currently of course on the right is the single unit of measure right at 20 ounces that's the only one you can find now that's two and a half eight ounce servings anybody know anybody who gets two and a half eight ounce servings out of that that's a single serving right and then finally we got the 44 ounce big case there's buster big gulp 7-eleven whatever 44 ounces and down in Texas

they got a 16-ounce coca-cola with a bag us with a Snickers bar in a bag of doritos all four ninety-nine cents a texas-sized big goal so why do I call it the coca-cola conspiracy well number one we talked about how sugar is addictive right but what else is in Coke caffeine so what does caffeine caffeine is a diuretic makes you pee free water

what else is in coke salt is fifty five milligrams per can so what happens if you take on salt lose free water you get thirsty here so why is there so much sugar and cook to hide the salt right ok so here's what our sugar consumption has done over the past 200 years the food and she likes the last 30 years with is the 200 years four pounds per year getting fruits and vegetables out of the ground with occasional honey

all the way up to a hundred pounds per year right now at 98 and there is processed food in nineteen sixty-five and you can see what happened all right everybody with me i'm going to show you this slide again later you'll see why alright so that's consumption consumptions up now let's do health and disease so here's what's happened to our health

parameters this from the New England Journal smoking down systolic blood pressure down cholesterol down physical activity I all good we should be reaping a health benefit shouldn't we but we're not in fact we've got a health deficit why because obesity is up and diabetes is through that friggin roof

forty-four percent increase that's why and that's chewing through all the health care resources it's also bankrupting social security because when you become diabetic you go on disability and you need healthy young people to pay into Social Security so that the sick old people can take out and if the healthy young people are taken out early

then you don't have the money for the sick old people and social security is experiencing a crisis the world over because of this because of chronic metabolic disease here's the problem this is from coca-cola this was their coming together campaign of 2013 you probably saw it on football games they had a two minute video beating

obesity will take action by all of us based on one simple common-sense fact all calories count no matter where they come from including coca-cola and everything else with calories so you can get your calories from carrots we can get calories from cheesecake or you can get calories from coca-cola we get calories from kumquats the matter because the calories calories more than

you burn a game wait feat lesson where you lose weight a calorie is a calorie therefore its energy balance eat less exercise more diet and exercise if you're fat it's your fault why pick on our calories go pick on somebody else's calories this is their subterfuge this is how they deflect criticism and they say it's common sense

well I don't believe in common sense I believe in science i believe in data on the scientists because the science says something else completely with the sciences is that some calories cause disease more than others because different calories are metabolized differently because a calorie is not a calorie it's called nutritional biochemistry and I knew this back in nineteen seventy five and then I went to medical school

and they beat it out of me for the next thirty five years I practice the calorie is a calorie and I didn't make anybody healthier and then I did the research and started realizing oh my god I knew this 35 years ago and then maybe that's why I'm so passionate about it is because this information has been suppressed over the past 50 years that a calorie is not a calorie let's show you that a

calorie is not a calorie so you have to basically hold calories constant and show that specific foods still have specific effects unrelated to calories and unrelated to obesity here's an example this is heart disease death over the last two decades based on percent of calories in the diet as added sugar so percent of calories still taking into account total calories right and take into account obesity -

so here's the histogram and the histogram has a median at eighteen percent for the whole US population eighteen percent of our calories come from added sugar and that red line in the center is heart disease death hazard risk ratio and the inflection points at fifteen percent median eighteen percent inflection point fifteen percent does that mean that means that more than half the US population has an increased risk of heart disease death due to their

added sugar consumption and if you're out here on the tail end on the right side 30 32 32 percent which is where our kids are our teenagers are that's their hazardous ratio for heart disease death is for four fold greater unrelated to calories and unrelated to obesity this is a study from Europe called the epic interact study where they factored

out total energy I and factored out obesity BMI and ask the question do sugar-sweetened beverages increased risk for diabetes and the answer is over a debt two decades yes by twenty-nine percent each sugar-sweetened beverage consumed per day increases your risk for diabetes by twenty-nine percent and in America we're

not drinking one sugar beverage they were drinking two and a half so take that up to 68 sent this is our study that we published two years ago where we looked at the Food and Agriculture Organization statistics database and we looked at line items of different foods and food stuffs over a decade country by country and ask the question what predicted diabetes in increase in diabetes

prevalence and the answer only sugar not total calories total calories was irrelevant for every extra hundred fifty calories any country aight diabetes prevalence went up a total of 0.1 percent nothing nada but if those hundred fifty calories happen to be a can of soda instead diabetes prevalence went up 11-fold 11-fold for every hundred fifty calories as sugar 1 point 1 percent these data actually meet causation

they meet the Bradford Hill criteria for causal medical insurance because we show dose more sugar more diabetes we showed duration longer exposure more diabetes we showed directionality countries where sugar went up for diabetes countries with sugar went down and there were few less diabetes and most importantly for causation you have to show precedence you have to show that the cause precedes the effect

right and that's the problem with correlation studies is it's a snapshot in time you don't know about reverse causality but here we had causality because we showed three years three years we never should have changed diabetes change in the same direction three years later and when we took out oh bc we took out total calories and we

estimate that twenty-five percent of all the diabetes on the planet is due to sugar and sugar alone we have now done an interventional study that even supports this even more so and this is now under review at a major journal we should have shown it an abstract form what we did is we took forty three kids with metabolic syndrome and we cater we created their meals for 10 days

no added sugar but same number of calories same amount of carbohydrate same amount of protein same manifest we just took the chicken teriyaki output the turkey hot dogs in we took the sweetened yogurt output the baked potato chips in we took the pastries out we put the bagels in ok no change in weight no change in calories 10 days we studied them before

and after and here's what happened sub-q fat so big but fat no change because no change in weight but visceral fat the bad fat the belly fat everybody talks about down ten percent and most importantly liver fat down twenty-nine percent in 10 days and the liver fat is the cause of all those chronic metabolic diseases

pancreatic fat you're not supposed to have fat in your pancreas these kids did and three-quarters of them the pancreatic that went down to on the same number of calories if a calorie for calorie how could do this it's because the calorie is not a calorie so we have causation for sugar and diabetes sugar and heart disease sugar and fatty liver disease and also sugar and tooth decay

now I know that way Hornsby is in this room and asked me very specifically to talk about this because the dental foundation delta dental is very interested in this issue everybody thinks that fluoride fixes tooth decay garbage it's not true ok fluoride makes you think that it fixes tooth decay this is not true diet fixes tooth decay and sugar causes tooth decay and sugar

is the biggest problem in children of all it's the greatest number of anesthesia it's the greatest number of admissions to the hospital and is the greatest contributor to chronic pain worldwide bar none or anything ok we also have correlation for cancer and dementia but not causation yet we're

working on that all right let's do environment real quick so the question is does sugar harm the environment the answer is oh yeah soil erosion water generation wind generation loss of harvest you bet here's the Everglades ok there's a lake okeechobee there in the upper left

wherever you see orange yellow and light green that's sugar not Everglades they've taken over and the phosphate runoff is killing the Everglades and this is true in the Amazon as well and so we are actually losing ground in terms of our environment and this is of course contributing to global warming as well

now cash flow the big one let's start with companies so here's what's happened to our food 1982 2012 meets down ten percent because we were all told to the low-fat fruits and vegetables exactly the same now we're always told we don't eat enough fruits and vegetables and that's true we don't but we never did and we didn't have this problem in 1982 but we have it

now on the same number of fruits and vegetables why is that because that's not the problem everybody thinks to mention i'm not against for some vegetables I'm for them because I'm for fiber ok but if you think for some vegetables by offering those like this five to 10 crap is going to solve this problem

you got another thing coming grains and baked goes up a percent and that's a problem because greens and baked goods as glucose and glucose means insulin and insulin means weight gain and so that's part of the obesity equation no argument there dairy products down two and a half percent because now we're all lactose intolerant here's the big one in yellow processed foods and suites 11.6 22.9

percent a doubling in the span of 30 years this is what has happened to our food over this process food tobacco this 50-year experiment now let's talk about the company's so here's the SMP 500 and blue from 2007 - 2011 and here's the stock price from mcdonalds Coke and Pepsi there's the economic downturn

two thousand eight right over there and you can see they weather the storm very nicely thank you and here's hormel ADM general mills conagra procter & gamble and crafts against the SMP 500 want to make money invest in a food company right because they're all doing better than the SMP but not so because now we know what's going on

and over the last two years things have changed things have changed for the food companies so here's a big sugar here is taken Lyle OVO and suker against the SMP and all of a sudden not doing so hot anymore and here's dr pepper snapple Pepsi coke mcdonalds against the SMP for the last two years and you know that mcdonalds fired CEO right and you know that Coke

fired 1,800 employees to save three billion dollars and you know what they plan on doing with those three billion dollars investing in children's marketing you okay with that so now let's talk about consumers so here's what the price of food at the consumer level has done ok take a look at the right side which is better than the left side here so

there's a healthier food in green and less healthy food in red and you'll notice that less healthy food has always been cheaper than healthy food we know that but take a look at the slope of the line so over that decade healthy food in the UK has gone up by seven pence per pound less healthy food sorry whereas healthy food is gone up by 17 pence per pound in other words not only is healthy food and more expensive but it's getting more

expensive with time which of course is why everybody ops for less healthier processed food and that's true worldwide because you can see here we're looking now at the percent of gross domestic product spent this food country by country and here's the u.s. at seven percent and there's the UK at nine percent and there's australia at eleven percent and we are the three most obese countries

take a look at all the countries that are in purple they spend more than thirty six percent of their gdp on food and all of them have been in revolution in the last three years and that's on purpose because if your food is expensive you're mad ok that's what happens

so in essence you know Karl Marx said religion is the opiate of the people you have a karl marx never met mcdonalds so the question is well you'd say that processed food therefore is a good deal for consumers but you would be wrong because here now we're looking at the projections for us healthcare costs over the course of the next couple of years and there's hospital

there's physician and there's pharma and they do not add up to the total health care costs because the rest of its going to chronic metabolic disease which each person is footing the bill and they're putting it in the in their insurance premiums so when you actually look at how much money you save on food it is more more than evened out by the amount of money you spend on healthcare

insurance and when you finally do get sick which of course fifty percent of our population does at a younger age you are going to be spending a whole lot more because of food-related chronic metabolic disease so this is not a good deal now let's do society remember the slide member processed food

there it is 1965 i'm gonna overlay on this graph now the percent of GDP spent on healthcare in the United States during this same period of time everybody ready what do you see processed food entered and health care costs skyrocketed now that's temporal relation but we actually have the data that shows that this is why healthcare costs skyrocketed because it didn't skyrocket for

infectious disease it skyrocketed for chronic metabolic disease this is what is chewing through all the health care costs this is not good for the health care establishment this is not good for the Colorado Health Foundation let's do the math the food industry grosses one trillion dollars a year of which 450 billion is gross profit yet

health care costs in the United States total 2.7 trillion dollars a year and of that seventy-five percent is chronic metabolic disease and of that seventy-five percent of it is preventable so when you do the math 75-percent of seventy percent of 2.7 that's 1.4 trillion dollars going down a freakin rat hole every single year you want to know why everybody's broke you want to know why

Medicare's going broke you want to know why social security is going broke this is why this is not recruitable money unless we fix the chronic metabolic disease problem worse yet we spend triple what the food industry makes so this is not a zero-sum game this is a negative sum game there's more money going out than they're taking in this is unsustainable and this is why Medicare's going broke and we will not

be able to fix this problem until we fix chronic metabolic disease and we cannot fix chronic metabolic disease until we fix processed food and in order to fix processed food we have to fix sugar I'm not the only one assesses this is a report 46 page report from the international investment bank credit suisse ok sugar consumption at a crossroads from two years ago

and here's what they say we believe higher taxation on sugary food and drinks would be the best option to reduce sugar intake and help fund the fast growing healthcare costs associated with type 2 diabetes and OBC this is that global investment bank people and their color for taxation who ever heard of such a thing a bank calling for taxation are you kidding me and this is morgan stanley from this year so they're

looking now in green at the rate of economic productivity and growth for the OECD countries the organization of Economic Cooperation development - 37 most advanced countries in the world over the next 20 years that's that green line and the blue line is if we got rid of sugar and the yellow line is if we keep it where it is today and if we keep it where it is today

you can see that that economic productivity percentage goes to 0 so Morgan Stanley call this the bitter sweet aftertaste of sugar so if morgan stanley and Credit Suisse get it why don't you well guess who else gets it how about this Mars Mars company the candy company the Milky Way company the snickers company

the eminem is company they get it they announced on may eight and this is a direct quote from their letter to Secretary Vilsack at the USDA Mars supports the DX recommendation that consumers reduce their added sugar intake to no more than ten percent of daily energy intake furthermore supports labeling and education approaches including added sugars and off label nutrition education at Mars we believe it is time for all

stakeholders including industry to engage in a constructive discussion that focuses on effective approaches to helping consumers manage their intake of added sugars a candy company gets it but they're the only ones why did they get it and nobody else does because they are privately held they don't have to make Wall Street quarterly reports they don't have to

have stockholders they don't have to satisfy their three-month quarterly earnings they can take the long view and they get it the rest of the cup food industry is fighting this tooth and nail and in the intervention section when we're going to talk later we will tell you why so let's do the scorecard imagine the last 50 years was an experiment process

food is better than real food that the hypothesis so what do we know consumption way up you bet how about health disaster in fact if this had been an institutional review board protocol at a hospital it would have been stopped decades ago because of the increase in deaths

environment clearly negative and finally cash flow companies very good previously but not so good lately consumers good in the short term because processed food is cheaper but really bad in the long term because of the chronic metabolic disease it causes and finally to society megadeth total disaster

only one answer real food this is an experiment that failed processed food is an experiment that failed nine out of every ten experiments fail and the food in the street needs to get the message so what we're going to do well at ucsf we're gonna do what we can

we've instituted the healthy beverage initiative the hospital because remember hospitals are we're smoking stopped right hospitals led the charge in terms of cessation of smoking we don't allow smoking in hospitals well there are no more sugar sweetened beverages on the ucsf campus any Hospital can do this with the right political will

proposal number two let's rename type 2 diabetes because no one knows what the hell it is ok i swear to god no one knows what the hell it is let's call it what it is processed food disease that's what it is promise proposal number three let's roll back the subsidies for processed food grover norquist / nor question I have a lot to be upset and angry about each other about

ok but this is one thing we actually agree on a proposal number for a label stamp right on the front of the package that says real food approved that is if you buy this product ain't nothing dangerous in it this is real food so that people can actually no and lastly what I think is the big one we got trans fats off the FDA's grass list it took 25 years

sugar is not a food sugar is not nutrition it's good it's fun it's like it's it's it's pleasant but it's not nutrition can anybody named me an energy source that is not nutrition that there's no biochemical reaction in the body that requires it and that when consumed in excess it's a toxin but we love it a lot alcohol alcohol is not a food alcohol is not nutrition

right well sugar and alcohol are identical and sugar causes the same diseases alcohol without the alcohol because of the way it's metabolized in the liver because that liver fat that we talked about Sugar's the alcohol of the child and sugar should not be on the grass list for that reason because it's causing disease and that is one of the things that my nonprofit is dedicated to not to seeing through for more information you

want the science this is a website that you can access called sugar science . org at ucsf the university of california davis and Emory University have comes vetted 8,000 clinical research articles and distilled it down into five messages for the general public without politics just the science fed up which con mentioned before which tells us how we got here to where we are today

a new documentary that hasn't reached America yet the US distributor is planning an October release here called sugar-coated which tells us why we got to where we are today you put the two together fed up and sugar-coated and it's an unbeatable combination so i recommend this all to you when it comes out that chance and cookbook that basically because thirty-three percent of americans do not know how to cook and

you cannot solve this until they do because if you don't have to cook your hostage to the food industry for the rest of your life sweet revenge a public television video that is played around the country has had more than 400 viewings over the course of the last couple of months that explains all of this and it is now being translated into spanish and finally our nonprofit called the Institute for Responsible nutrition

because we're taking on big food we're going to fix this problem in the ways that we can as a non-profit the question is what can government what can society what can you do to help foster this new war if you will we've had several wars we had a war against tobacco well now we've got the war against big food and they're very similar and we will talk about the

interventions and how they work later on with that I want to close and i'll be happy to take all of your questions and I thank you all for your attention that's great thank you rob and I'm pleased i have a few questions to start but if you could go by the way before we did anybody pick up the summit daily today

I think this is from today July thirtieth page 12 simplifying sugars the good and the bad I mean it's even coming up here I mean you know this is like amazing everybody's getting into the act yes so please get your questions to the center and we'll pick him up but i'll start with a few here that I that I have so you have some great proposals up there but you know and i know you see patients but what can parents do you

know many of us work with underserved parents parents who don't have a lot of resources what can they do I think the basis so we deal with patients like this in clinic every single day this is what I do for a living you know I run the weight assessment 14 and child health clinic at ucsf if you concentrate on calories you cannot win

it's not possible to win and that's what virtually all medical establishments are teaching parents at this point we undo that we teach them otherwise we actually teach them about disease we actually teach them about what's going on we don't make it about calories we make it about the biochemistry we teach them about the biochemistry now I don't expect all of you to go out and teach people about biochemistry although that's what sweet revenge does actually

what we do is we explain the difference between process food and real food and our dietitian one's a teaching breakfast for all new patients and i'll tell you the teaching breakfast is the single most important thing we do in order to be able to educate our parents and our patients as to what's going on so they come fasting so we draw their blood and then we sit that you know what they see the doctor and then we sit them down to a communal breakfast because

they're hungry right so we have six kids and six parents sitting at a communal table and it's narrated by a dietitian for an hour and we explain why these different things are on the buffet on the table and for things have to come out of that teaching breakfast number one the parent has to see the kids will eat the food

number two the parent has to see the Paranal eat the food number three the parent has to see that other kids will eat the food because they got other kids at home and number for most importantly the parent has to see that they can afford the food because if any one of those things don't happen they will not spend money at the store to change what's in their pantry

so you have to accomplish every single one of those but we do and then people get it people understand what's going on and then they will spend their hard-earned dollars at the store to buy appropriate foodstuffs rather than processed food stuffs and that's when we start seeing changes and we start seeing metabolic disease go away but it takes that level of commitment and that's what we do

so is there a way to do that without a teaching breakfast without showing you know without you know actually you know by telling them and not showing them yeah we do that too but the point is you have to have one message you have to make it the message is very clear and people don't know what real food is not anymore they forgot or they never got exposed to it and kids never got exposed to it and

they need to be great well and I'm gonna fall by know we have some more questions here but just as a follow-up to that your your you present very compelling evidence that no sugar and processed food are are probably bad for us and I think we all get that but you there's no mention of physical activity in here and we know their health

benefits of the quality of their physical activities the single best thing you can do for yourself without question physical activity is the top thing that you can do no ifs ands or buts but physical activity does not cause weight loss this is a myth physical activity does not cause weight loss now if you believe a calorie is a calorie then physical activity should

cause weight loss right because if you're burning you ought to be losing weight except you don't why not because you're building muscle and wasn't muscle weighs more than fat so what happens is there visceral fat goes down and their muscle goes up and so if they're watching the scale

they may actually gained weight and then they say oh was me it's not working for me and then they hit the ben & jerry's the point is the outcome variable that you have given them to monitor is the wrong one physical activity is beneficial for physical activities sake because of its health benefit not because of its weight loss potential and people need to understand that in

order to get them motivated to do it so that's really really important and you people don't know why it why is it so why does why is that good these muscles have my comfortable that mitochondria burn energy instead of your liver then storing it ok so anything that up your mitochondria is good

like for instance called up to mitochondria altitude up to mitochondria this is why colorado is less obese this is why Colorado has less diabetes because you guys out here have more mitochondria than I do so I think we should all move to Colorado it will increase your tax base but short of that and by the way with global warming all the people from the coast will be here really soon so so I i

recommend you know Colorado to everybody but not because of your outdoor lifestyle that is a sham ok it's because you're cold and you're high Wow and now you're high that's way too oh my that's a whole nother session okay all right um I've been reading up a lot on reviews of your broken and other talks that

you've had and I think the scientific community has certainly I think criticize you for your approach and so the question is that is the scientific field unified in this conclusion of sugar that you come to of course not when is the scientific community ever or you know conclusive and anything but the point is that there are a lot of people who made a lot of money and made their entire careers steeped in the concept of a calorie is a calorie and I'm let me

just tell you a quick quick vignette anybody heard of marion Nestle anybody know marion Nestle she's one of the food politics people she runs a blog called food politics she has written many many books on the subject she is in our Deann mph and a PhD in molecular biology of all things and she is the head of nutrition department at NYU

so I know Marion for a long time and I ask marion if she would write a blurb for my book and Marian is sent to the galleys turn she says Rob I can't write up a blurb for your book I said well okay i mean i understand but like why not she's because i just wrote a book called why calories count and my agent tells me that I be shooting myself in the foot if I did

so you know there are a lot of people were vested in this old notion and it takes a long time to turn an aircraft carrier around and that this is not something that's going to happen simply or quietly this is going to be you know this is the this is the war the other thing you have to do though when you look at when scientists are talking about this and they're on the other side you have to see who's funding

them ok and you really need this is very important for instance let me give you an example there was a paper that came out and plus med back in 2013 where they looked at a meta-analysis of all of the studies of sugar-sweetened beverages and weight gain and there were 18 data points 18 studies of sugar-sweetened beverages and weight gain and what they did was they sort of

them based on industry funding so of the six that were industry-funded five said no effects of sugared beverages on waking of the twelve without industry funding 10 of the 12 said yes significant effect of sugar-sweetened beverages on weight gain so from now on when you read a scientific study i want you all to put raise your right hand in the air take an oath with me

okay from now on when I look at a scientific study instead of looking at the results are the conclusions first i will look at the funding source right now we've got a lot of questions here so we'll try to get through them this is I think a really appropriate question for this audience you mentioned that you know when the proposals is eat real food I think ever no one would argue with that but yeah that's the funny part is

like who would argue with that but people are well and I think for those of us who who work with and engage with underserved communities it is more expensive you know question is how does the community change the message that real food is too expensive for poor communities so the fact is it doesn't have to be more expensive there are things you can do their shopping tips and there are cooking tips that can actually make real

food cheaper if you do choose to go that route in the fat chance cookbook which is the companion book to the fat chance my colleagues integration who is a chef and an entrepreneur actually has a set of precepts that people can use in terms of what they can freeze what they can put aside what they can use for other things that ultimately make going to the store a lot easier making food a lot cheaper and you know

basically showing where the substitutions can occur that can actually bring costs down so yes you have to shop smart ok you can't just shop you have to shop smart but we could be teaching those things to people and that could be helping them do that they have to want to and they have to understand the value of doing so

right now they don't understand the value of doing so so you got to teach them that first great I think we have time for one more question so i got i have three here that I think can be lumped together so first part of this question is sugar dangerous in all forms corn syrup high fructose sucrose and then is honey agave maple syrup doesn't matter

ok if it's a caloric sweetener it's got fructose in it because that's what makes it sweet so the answer is it doesn't matter so second part is are all our sugar substitutes any better than sugar everybody wants to know me too everybody wants to the sugar substitutes everybody see the New York Times opinion article by dr. Aaron Carol

just this past Monday ok that said oh artificial sweeteners are better than sugar that doesn't mean artificial sweeteners are good and yahoo health had a piece on Tuesday countering that which I'm quoted in so look for it that basically says dr. Carol doesn't know what he's talking about here's the problem with artificial sweeteners there are three and i'll try

to do a quick there's something called pharmacokinetics there's something called pharmacodynamics they're not the same pharmacokinetics is what your body does the drug pharmacodynamics is what a drug test your body they're not the same we have all the pharmacokinetics roll the dice sweetness

because the FDA demands it but we have none of the pharmacodynamics does the FDA does not demand that pharmacodynamics tells you about chronic toxicity food industry says what the FDA is not asking for we're not going to do it and the NIH says food industries compound food industries profit we're not going to pay for it so no data number two you put something sweet on the tongue message goes tongue

to bring sugar bowl is coming get ready to release the insulin message goes from the brain to the pancreas get ready to release the insulin vesicles on my command line them up and get them ready to go but then the Sugar Bowl is never comes because it was a diet sweetener what does the pancreas do does it hold on to him or does it go find some

calories to go work on the data suggests the ladder in which case then you would overreach in response to a diet sweetener that's what the data suggest although it's not proven lastly paper came out last year in science that said that artificial sweeteners like aspartame and sucralose change the intestinal microbiome the bacteria in your intestine that are normally and important for chronic

metabolic health and you know for metabolic health and turn them to a different species that ends up causing metabolic dysfunction and causing leaky gut and causing glucose intolerance now that is only an animal's we have yet to show it in humans the other thing that was just came out as emulsifiers emulsifiers of detergents right the carotene and I mentioned the detergent because they keep that more

together so what happens if you throw a detergent into your small intestine it chews up the mucin layer on the surface of the intestinal epithelial cells so that bacteria can get to those cells because that was the barrier that protected them and so that might be the cause of various chronic GI complaints and autoimmune diseases

that's yet to be proven to but it's very enticing bottom line processed food is a problem and artificial sweeteners are processed food ok well we could keep going but we do have a hard stop and so please help me thinking at robbed last a party ok and before you go just a couple of things I'm if you want to hear more from

rob and people have a discovery session on sugar-sweetened beverage tax debating that please join us and we have a whole host of other great discovery sessions for you to choose from and then just a reminder that tonight we have our dinner reception that will have the announcement of the iglehart awards so please join us for that so again thank you very much and we're gonna start the

sessions at 1 30 sharp this removes that's great you take a look



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The 2015 Colorado Health Symposium - Captured Live on Ustream at http://www.ustream.tv/ColoradoHealthSymposium2015