Fat Chance: The Science of Weight Loss

Why Almonds, Butter and Broccoli Constitute a “Health Plan”

For those who haven’t seen his 90 minute video, “Sugar: The Bitter Truth,” Doctor Robert Lustig is a man on a mission. Citing the “snowballing” of chronic metabolic diseases — type 2 diabetes, hypertension, lipid disorders and cardiovascular disease — Lustig, a neuro-endocrinologist, dives headfirst into what modern science knows about the complex chemical reactions inside our body. His book, “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease” goes even further. For anyone looking to lose weight, hold the line against Father Time, or otherwise seek out a healthier you, it is worth listening to what Lustig has to say. And be forewarned: It may change your relationship with the grocery store.

At times Lustig’s book begins to feel like a freshman level course in organic chemistry. However, this may be a small price to pay for anyone interested in what happens to you after you swallow, much less in maintaining one’s health well beyond peak years. Taking the reader through basic human enzymatic reactions, the author provides a fascinating look at how we respond to food, as well as the body’s adaptations in an environment of meal over-abundance.

Dr. Lustig asks we think of our body as divided into two parts: “lean body mass which burns energy; and fat, which stores energy.” He further simplifies: “every molecule of energy consumed has a choice: Is the energy burned or stored?” Exploring that question, and the follow-up, “what decides where the energy goes?” is key to understanding you health. For those who want to skip ahead, the answer is: “your insulin.”

Building upon that idea, and adding a bit of science that may strike the reader as unfair, researchers have confirmed that prolonged exposure to stress — end of period finals, financial trouble, domestic arguments, reduced sleep, etc. — leads to excessive intake of comfort foods, mostly sugar and fat. Scientists now know this is due to the body’s production and overall system response to cortisol. Insulin and cortisol, Lustig writes, are a “one-two punch to the gut.” He summarizes: “insulin makes you gain weight, while cortisol tells you where to put it.”

Fortunately there are two ready, accessible remedies.

The first is fiber. Lustig explains the inner workings of fiber, distinguishing between the soluble and insoluble variety, which “together are an unbeatable pair.” As a visual, think of insoluble fiber as a wire mesh screen, where soluble fiber fills the gaps between the strands of wire. This fiber combination slows the absorption of food, preventing the body from being overwhelmed, chemically speaking, after a meal. Our goal, the author recommends, should be to avoid extreme — and unhealthy — insulin spikes, which tend to wear out your system over the years, often through a response commonly known as insulin resistance.

This fiber regulated slowing process has the added benefit of allowing your brain to catch up to your stomach. As Lustig explains, through a discussion of certain natural enzymes and body pathways, being hungry is not the opposite of being full. This observation may be a lightly guarded secret, yet fundamental to “tricking” your body and perhaps establishing dominion over eating habits. Fun food fact: food needs to travel 22 feet of intestine before the “I’m full” signal is generated and sent to the brain. More than enough time for that second helping.

Finally, for reasons science is only beginning to understand, fiber has a positive effect on your gut bacteria. The human microbiome is thought to be responsible for a range of helpful, probiotic responses, from improved immune system functioning to sugar response and even mood and behavior. To underscore the complexity consider this: a human body contains about 10 trillion cells, yet it contains 100 trillion bacteria. As others have wittingly remarked, it may be better to think of “you” not as you, but rather “something else.”

The second, complementing remedy, is exercise. Exercise builds muscle, and the mitochondria inside each muscle cell burns energy while you are at rest, where 60% of your calories are expended (think sitting and sleeping). In addition, exercise reduces cortisol levels, again a good development for long-term health, as well as enables your muscles to “burn energy cleaner” and reduce certain unhealthy, though natural, waste byproducts, which can gum up the works.

Dr. Lustig also weighs in on the popular diets. From Atkins, to Low Fat, Mediterranean to Paleo, plus others, his recommendation boils down to this: “for almost everyone, reducing insulin is the linchpin to success…how [do you] get insulin down? Limit refined carbohydrates.” Replace fruit juices, sodas, and white foods (bread, rice, pasta, potatoes) with water, vegetables, and other items found along the grocery store perimeter. Then watch what happens.

I am hardly in a position to disagree. Blessed with good overall health, two years ago I caught a stomach bug that laid me out and required a full month to feel normal again. Thus motivated to prevent a second occurrence, I launched an experiment of removing most sugar and simple carbohydrates from my diet. Within a few days I noticed what Lustig and many others have written about, namely no post-lunch, afternoon crash and (even) better rest. Within a week I could see the difference on the scale and in the mirror.

Channeling a bit of Duhigg’s “The Power of Habit,” I ran the experiment for a month, which turned into a quarter, then a year and now, I suppose, a lifestyle. Admittedly, it took some time to re-acquire the butter habit, after years of “butter = bad” messaging. However, I also noticed that simplifying food choices removed some grocery store mental cycles — think “decision fatigue” associated with meat versus pasta (ha). Gone too were seasonal allergies.

Lustig would be the last person to call any of this easy. The media and cultural cues are on a continuous loop, pushing a mostly opposite message. And, as Marion Nestle makes clear in “Food Politics,” the stakeholders of status quo are vast and deep pocketed. However, if the history of science is any guide, we can trust that today’s conventional wisdom will be updated, and probably replaced, with newer, more accurate information. And, in an N=1 sort of way, each of us will benefit. Perhaps the best guidance, then, is to pay attention. Help is coming.

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