A Recent Read: Metabolical

I stopped reading for a long time. And in the last few months I have returned to reading. Instead of picking up one book I have been trying to keep up with three magazines, and keeping 4 – 5 books open at a time, and bounce between them. And even though this does not sound like a great way to read, in June I wasn’t reading, and today I am.

And I have slowly been finishing books. One of them was Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine, by Jack Lustig.

Lustig

Jack Lustig is a doctor. He specialized in pediatric obesity. And he hit the big time outside of medicine when he wrote Fat Chance.

Five parts

The book has 28 chapters, divided into five big parts:

• Debunking Modern Medicine
• Debunking Chronic Disease
• Notes from the Nutritional Battlefield
• (Processed) Food Fight
• Where are the Food Police When You Need Them?

Major points

Medicine treats symptoms, not disease. Big pharma funds and supports doctors. Big food (agribusiness) supports and funds dieticians (and controls the research). Doctors, Dieticians, and Dentists all look at things that are druggable, or that won’t interfere with profits. The respective industries control much of the research, and are interwoven with the government agencies that nominally oversee them.

Lustig spends time teaching (science-y part here) about cell health and metabolism, and about things that go wrong with cell functioning (glycation, oxidative stress, mitochondrial dysfunction, insulin resistance, membrane integrity, inflammation, epigenetics, and autophagy)

He connects these functions (dysfunctions) to chronic noncommunicable diseases: diabetes, hypertension, heart disease, cancer, dementia, autoimmune diseases, fatty liver disease. And he focuses on what is called “metabolic syndrome.” and on insulin resistance.

These illnesses are products, per Lustig, of what we eat. And he pivots to a discussion of food. Calories, he asserts, are the wrong thing to look at. He points at the food industry as he lambastes trans-fats. He talks about the contents of processed foods. And he zeroes in on sugar.

Sugar has calories, and is classified as a food. But Lustig argues that we need nutrients, not calories, to live. And that sugar is addictive. Sugar, he concludes, should be listed as a food additive, not a nutrient.

The book disintegrates as he makes policy recommendations – but the healthy diet recs are interesting:

no to transfats, processed grains, and especially sugars (shout out to big sugary drinks, especially fruit juice)

yes to “Real Food” (although I had trouble figuring out what he specifically meant. He kept promising, but I don’t think he completely delivered). Yes to unprocessed foods. Yes to Omega-3s. No problem with fats (but no trans fats). Whole grains.

When pushed, he analyzes a few diets, but not very deeply. He seems okay with Mediterranean and Keto.

The motto “protect the liver; feed the gut” is repeated throughout the book.

Metabolical matters to me

So I have had to go to a specialist recently. What Lustig is writing about concerns me, directly (although I’m not on the verge of anything terrible – at least I don’t know that I am, and I hope not). But I’ve been to a specialist – which is how I learned about the new copays. My union – the UFT – still won’t tell its members about the new copays.

So I had a feeling my issues were related to weight, probably diet, and having just finished Metabolical, I was ready to lean heavily on diet. And in fact, after some tests (more copays and fees) the doctor brought me back (another copay) to discuss treatment – which involved mostly diet.

• Changes should be small, and sustainable.
• Animal protein from fish, chicken (I assume other poultry would fly), and pork loin (but not other pork)
• Whole grains, with a major vote of confidence for barley and farro and a strong affirmative in response to my question about buckwheat (kasha).
• Bread, pasta, cut out or reduce.
• Portion size, reduce.
• Olive oil, yes.
• Eat in more. Restaurants sneak salt, sugar, and frying into much more than we realize.
• She did not prescribe the Mediterranean Diet, but did suggest that I could get ideas from it.

There’s also this thing about how many pounds – which I am not specifying – I need to lose before I return. Needless to say, my wallet will be lighter from yet another copay – but that’s not enough.

So not exactly the same as Lustig, but they are in the same neighborhood.

So is Lustig special?

I went to check other on-line experts and websites. It turns out that when Lustig started speaking out, his stuff was pretty revolutionary. But now there are a lot of doctors saying similar things. It is no longer shocking to say, as the nurse practitioner did, that a big slice of cake is not as bad as a big sugary drink.

But he’s famous, and needs to keep it up. He’s called as an expert witness. He needs to keep his name out there, prominent. I think that drives some of the more radical-sounding parts of the book. I don’t care if sugar is classified as a food additive, as long as doctors tell us the truth. But I think Lustig needs the sensational claim, for attention. On the other hand, he’s not wrong in any obvious way, just occasionally over the top.

It’s not necessarily the be all and end all – but Metabolical is a pretty good way to begin wrapping your head around thinking about food, nutrition, medicine and health differently.

Everyone should read something about nutrition. What we learned in school – nope, not good enough. Is there a better first read? I don’t know. If there is, I would recommend it. But for now I am recommending Metabolical.