What a fantastic opportunity to catch up with perhaps the world’s leading anti-sugar crusader, Dr. Robert Lustig.
A pediatric endocrinologist and professor emeritus at UC San Francisco, Dr. Lustig is also the bestselling author of groundbreaking books like Fat Chance, The Hacking Of The American Mind, and the 2021 release titled, Metabolical.
This man is fighting a valiant and high stakes battle against the mighty opponents of industrialized food, tainted science, and poor government regulation. What’s refreshing about Dr. Lustig is that he does not have an angle in the game—he is simply reporting the facts and phenomenons that have led us down the disastrous path to becoming the fattest, sickest developed nation in the history of the planet.
Dr. Lustig also offers compelling solutions, and it starts with taking responsibility for your own health, voting with your pocketbook (because there is always going to be more money than votes, so the money always wins). It also may be important to consider this processed food problem with the seriousness and urgency as climate change, for example. We also talk about how to choose foods that will protect your liver and nourish your gut, as Dr. Lustig has a gift for simplifying the often frustrating challenge of eating food that helps protect against disease while also maintaining a healthy body weight. There’s also some fascinating scientific info featured in this episode, as we talk about the importance of optimizing our leptin signaling and how leptin dysregulation affects our appetite and weight.
Enjoy this episode with the great Dr. Lustig and don’t forget to check out the B.rad Breather episode about his book, The Hacking Of The American Mind.
Dr. Lustig’s bottom line is that processed food is killing us. [01:27]
Leptin is the preeminent satiety, fat storage and reproductive hormone. [03:40]
When Dr. Lustig went to medical school, what we now know about nutrition, was not taught. [06:02]
Some of Dr. Lustig first research was with normal weight kids who got obese after treatment for a tumor. [09:32]
Leptin was discovered in 1994 and found to be very involved in how our brain acknowledges hunger. [11:39]
The kids in the study became more active and lost weight when they lowered their insulin. [13:43]
Can we blame the profit seeking enterprises instead of the victim? The cause is high insulin. [17:31]
How do we get high insulin? The modern Western diet introduced high fructose corn syrup in the 70s. [19:06]
Obesity is biochemical rather than behavioral. [22:16]
Healthy as a definition consists of six words: protect the liver. Feed the gut. [28:06]
When you take in a lot of sugar, you are flooding the liver with fructose. [31:30]
The gut needs fiber. [34:16]
It takes about 20 minutes for the message to get from your intestine to the brain to say, “I’m satiated.” That’s why we say wait 20 minutes before your second helping. [37:43]
Transcending the diet wars, the basic premise is to eat real food. [40:38]
There is a bit of a problem with keto. Only the truly committed can manage a ketogenic diet for any length of time. There is also a problem with veganism. A vegan diet should be unprocessed vegan. [42:44]
Depending on your biochemistry, you can find the right diet. Unify the force against processed foods is the starting point. [45:28]
The industrial seed oils have Omega 6 and are pro-inflammatory and that drives insulin resistance. We also need Omega 3. [48:11]
Is sugar food? What is the definition of food? Sugar inhibits normal growth. [51:41]
There are eight sub-cellular pathologies that drive all chronic disease. [59:00]
If we figure out the diet thing, we can potentially be playing tennis at age 110. How can we escape the clutches of the addiction to the wrong food? [01:02:26]
- Brad Kearns.com
- Brad’s Shopping page
- Fat Chance
- The Hacking of the American Mind
- Breather show on The Hacking of the American Mind
- Dr. Robert Lustig
- Dr. Robert Lustig’s website
- Dr. Lustig’s Interview with The Guardian
- Junk food may harm skeletal development
“Gluttony and sloth are not causes of obesity. They are the symptoms of obesity.” (Taubes)
“Protect the liver, and feed the gut.” (Lustig)
“It’s not what’s in the food but rather what is done to the food.” (Lustig)
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Brad (1m 28s): Hey listeners, what an incredible honor it is to share with you my interview with the one and only Dr. Robert Lustig. He is a multi-time best selling author, arguably or not arguably the world’s preeminent, anti sugar crusader. His great books, Fat Chance, The Hacking of the American Mind and the most recent one that we focus on is called Metabolical. And this guy swings for the fences, man. He is fighting a royal and fantastic battle against the mighty forces of industrialized food and flawed government policy. And trying to take down these big beasts. Brad (2m 9s): And for us simplify this incredibly frustrating challenge of learning, how to eat healthy, protect against disease, reach and maintain an ideal body weight. And he really does simplify it with some incredible one-liners and especially the insight. So this is kind of the gateway that I envision everyone must enter before they then go choose a diet or choose a side. And we’ve been so distracted by the wars between the whole food plant-based and over on the other side is the paleo and the carnivore message. And one’s better than the other, but he’s trying to transcend and supersede all of these by saying, look, the real enemy here is processed food, and it’s the process food that’s killing us. Brad (2m 52s): That’s setting us up for a lifetime of pain and suffering and disease. And all we have to do is unwind a little bit of the confusion and choose wholesome real foods that meet his wonderful billboard criteria. And that is foods that protect the liver and feed the gut. And you’re going to learn all about that. I wish you will focus intently on this guy’s message and pay close attention. There’s going to be some scientific stuff that we have to wade into. Hopefully you can fall along with the discussion. And I do want to tee you up here because early on, he mentioned several times about leptin and not hearing the leptin when he was talking about obese patients that he experimented with and had some amazing insights. Brad (3m 41s): And so leptin is the preeminent satiety, fat storage and reproductive hormones. One of the most important hormones in the body, it responds very closely to insulin signaling. And so when insulin is high as with our adverse modern diet, it hampers the signaling of leptin to the brain. And so what that means is you’re locked into a pattern of overeating and fat storage rather than energy balance. And so we want to optimize our leptin signaling. Very important. We write about it a lot in the various books, but that’s coming right out of the gate with this insight about how the dysregulation of the hormone leptin, the preeminent satiety, fat storage and reproductive function hormone. Brad (4m 27s): When that’s dysregulated, guess what a switch turns on and you become a glutton and a sloth. And the great quote from Gary Taubs, which I mentioned in the show that gluttony and sloth are not the causes of obesity. They are the symptoms of obesity. So hopefully that’ll help you groove in here with the first part of the show and many more incredibly brilliant insights from Dr. Robert Lustig, author of Metabolical. And go listen to my breather show where I discussed insights from his previous book called The Hacking of the American Mind. He talking about sugar addiction and then expanding the conversation in Hacking the American Mind to many other dopamine triggering pathways that corporate forces are hitting us with, including social media, digital communication, and all kinds of other things. Brad (5m 19s): So good, good times with Dr. Robert Lustig. Here we go, Dr. Robert Lustig, what an honor. I can’t wait to dive into this magnificent work, especially your most recent book Metabolical, but how are you? And how’s the book release going? Robert (5m 34s): Well, how am I, I have one word. COVID. Not because I have it right, because you know, I’m just stuck, you know, here in my four walls. Brad (5m 48s): Well, I think a lot of your life’s work has been pointing towards this eventuality of people with poor metabolic health succumbing to these previously imaginary global pandemics. But yeah, it’s, it’s a tough time. Robert (6m 3s): It is. And it’s hard to watch, you know, I am a great believer in public health. I’m a great believer in people doing right, not just by themselves, but by others. That we have a responsibility to each other. And so, you know, what’s going on today is just maddening and, you know, really, really makes me very, very sad. Brad (6m 28s): Well, yeah, it’s w when you’re, when you’re in the trenches, like you are, you know, a lot of the book Metabolical has these shocking statistics that are so incredibly disturbing and, you know, I think we can kind of breeze past these if we’re not making this our life’s work, but, oh boy, I think it’s time to awaken to this. I think you did a wonderful and very comprehensive job, especially fighting this massive battle against the great giants of industrialized food and also the government’s contribution. So I want to talk about how this, how this, how you came to, to bear the arms and go into this battle from your, your lovely, probably previous life as a pediatrician, seeing patients and going to medical school and, and dreaming of helping people. Robert (7m 15s): Right. Well, so, you know, people ask me all the time, Brad, you know, you know, like, how’d you get into this, or, you know, did you have an agenda? You know, what was, what was your, you know, modus operandi? What was your plan? I had no plan. Okay. I had absolutely no plan. And I will tell you, I didn’t come with an agenda. This problem found me all right. Sometimes, you know, problems find people rather than people finding problems. I majored in nutritional biochemistry in college. And so I guess I was set up in a way to be responsive, you know, to this debacle, no one said it occurred back in 1975. Robert (7m 58s): When I learned nutritional biochemistry, you know, I learned that different foodstuffs were metabolized differently by the body. So I was very prepared to hear that. And then I went to medical school the next year in 1976, and they basically beat it out of me and said, you know, none of that matters, you know, all of that’s theoretical or it’s an animals or whatever, and we don’t take care of patients that way, you know, it’s just calories. And, you know, I was paying them a tuition bill, you know, and these are the doctors. And so, you know, like I listened, you know, for better or worse, I listened. And so really for the first 20 years as a practicing physician, you know, in an academic institution, you know, so I had plenty of backup in terms of, you know, the medical and the dietary staffs. Robert (8m 50s): You know, basically it was eat less, exercise more. You know, this is the way you treat obesity and chronic disease. And none of my patients got better. Now, the standard thought when your patients don’t get better is, well, they’re non-compliant. You know, but I was having a real problem with children being perpetrators instead of victims. Cause I’m, I’m a pediatrician and no child chooses to be obese. And then the data started coming out about the fact that babies were being born with extra fat. Okay. We had a six month old obesity epidemic. Robert (9m 32s): Okay. And these, you know, babies don’t choose what they eat. So this was, you know, sort of the cognitive dissonance that I was dealing with between, you know, what I learned then what I went to medical school to learn, and then what I was experiencing. And, you know, none of it was making any sense. Now in 1995, I moved from Madison, Wisconsin to Memphis, Tennessee to become a faculty member at St. Jude Children’s Research Hospital. We had a cadre of thirty massively obese patients who actually started out normal weight. Robert (10m 20s): But then they got a brain tumor. A tumor in the hypothalamus, right in the middle of that energy balance pathway. And because of the surgery, you know, because of the tumor, because of the surgery, because of the radiation, didn’t matter. These kids basically turned into beach balls. And, you know, the parents would basically, you know, cry, you know, at the, at the visits, you know, this is double jeopardy. My kid survived the tumor only to succumb to a therapy. And it was up to me to do something about it. Robert (10m 59s): So what do you tell them? Eat less exercise more. I mean, you know, these kids were normal weight before the tumor, so, you know, it wasn’t genetic and it wasn’t what their, you know, what the parents were feeding them before. And, you know, I mean, clearly there was some organic lesion going on here. Well, in 1994, just the year before I went to St. Jude, we discovered this hormone called leptin. Okay. It was discovered at Rockefeller University where I was a postdoc. So I knew about the hunt for it because you know, all the MDs, all the doctors at Rockefeller University all knew each other. Robert (11m 40s): Cause we all had to take call in the hospital. So Jeff Friedman and Rudy Leibel were the people who, you know, discovered leptin, plumbed leptin from the, from the leptin-deficient mouse, the OB mouse. And so I knew both of them very well. And so I was hearing about all of this, you know, at research seminars for years. And then in 1994, they actually discovered it, published it in Nature. And then I was at St. Jude. And so I postulated that these kids, these 30 kids, they couldn’t see their leptin. Clearly they had leptin before they have leptin now, but because of the tumor now they couldn’t see it because those neurons were dead. Robert (12m 23s): And so if you can’t see your leptin, what does your brain see? Your brain sees starvation. It acts like there’s no leptin, which means that you have no fat cells, which means you don’t have any adiposity on board, which means you’re starving. And so what happens when you’re starving? Well, we knew that eat more and you exercise less. And so I postulated way back when in 1995 that these kids’ obesity was because they couldn’t see their leptin. Well, that’s all well and good, but then what are you going to do about it? So I went to the literature and I knew about this model, you know, from my own work as a neuroendocrinologist. Robert (13m 3s): I knew that if you lesion the hypothalamus in a rat, they become massively obese. And one of the things that goes along with that is enormously high insulin levels. Insulin being the diabetes hormone, the energy storage hormone. So the assumption was that because these animals were releasing so much insulin, that’s what was driving all, everything. They ate into fat and causing them to gain and gain and gain and gain. And that these kids were basically the same thing. So I postulated, I guess, one of my first major contributions, I, I believe I have two major contributions to the, to the literature. Robert (13m 43s): This is one. I assumed that the insulin was the driver of their weight gain. And if we could block their insulin release, we could potentially stop the weight gain. So there was a drug at my disposal that was used for other reasons called Octreotide, which can inhibit insulin release at the level of the pancreas. So we put together a clinical research study, you know, IRB approval, you know, like, like you do. And we took eight of these kids and basically did an open label trial. And lo and behold, they all did better. You know, of the eight, you know, I mean they stopped gaining weight and actually started losing weight. Robert (14m 30s): But something even more remarkable happened, these kids started exercising spontaneously. Okay. These were kids who sat on the couch, ate Doritos and slept because their brains thought they were starving. And now because we got their insulin down, they were actually being active. One kid became a competitive swimmer. Two kids started lifting weights at home. One kid became the manager of his high school basketball team. Yeah. These were kids who were lumps on a log. These, this was, this was what the parents were most upset about was, you know, they, after the, we started treating them with the medicine. They say, I got my kid back and the kid would say, this is the first time my head hasn’t been in the cloud since the tumor. Robert (15m 13s): So this was a really big deal. So this notion that they would start exercising because their insulin was low was huge. So we did a double blind placebo controlled trial. And we put in a quality of life questionnaire to assess this and sure enough, the lower we got their insulin, the more active they were and the better their quality of life. So what this proved to me and what this, you know, sort of, you know, I wrote a paper about it in 2006. Basically what this said was that we’ve got the first law of thermodynamics completely opposite. Robert (15m 58s): So the standard mantra amongst all the establishment is if you eat it, you better burn it, or are you going to store it. That’s how the first law of thermodynamics is interpreted. I mean, the law itself says the total energy inside a closed system remains constant. That’s what the law says. But the interpretation on the law is if you eat it, you better burn it or you’re going to store it. What I said was that’s wrong. What it should be is if you’re going to store it, that is an obligate weight gain set up by forces out of your control, such as high insulin. Robert (16m 39s): And you’re expected to burn it. That is normal energy expenditure for normal quality of life. Then you’re going to have to eat it. And now the two behaviors that we associate with obesity, gluttony and sloth are actually secondary to a primary biochemical problem. That this is biochemistry, that the behavior is secondary to the biochemistry. Now I have now looked at this question throughout my career in so many different ways from Sunday and every single time, it’s the biochemistry. Robert (17m 19s): Now, sometimes we’re smart enough to figure it out. Sometimes we’re not. But to blame the victim, which is what we have been doing does not explain obese newborns. Brad (17m 32s): They’re they’re, they they’re spared the, the scrutiny, but I love how in the book, you redirect the focus to the profit seeking enterprises that, that get to blame the victim so that they don’t get regulated by the government, continue to dispense this, this processed food. And boy is that a slippery slope? Because once we start integrating this stuff into the diet, we become the, the slovenly glutton. But I love how you characterize that backwards. I hope the listeners can, can stay with us here because like Gary Taubs said, those are symptoms of obesity not causes. Robert (18m 10s): Exactly. Right. So ultimately the only way to treat a problem is to treat us cause. Brad (18m 17s): Well, there’s other ways they just don’t work, but they make a lot of money for the drug companies. Okay. So let’s talk about treating the cause. Robert (18m 25s): Right? Well, the cause is the high insulin. Okay. So what we’ve been doing at my obesity clinic at UCSF since its inception, since we started it in 2003, is get the insulin down. Not lose weight. Okay. Because weight loss doesn’t work. And you know, everybody’s got the data to show that that approach does not work. All right. What we did was said, get the insulin down any way you can and how do you do that? Well, don’t let it go up. Robert (19m 7s): So what’s the what’s what, what makes insulin go up? Two things, only two things refined carbohydrate and sugar. So what does a high refined carbohydrate, high sugar diet look like? Brad (19m 23s): USA, baby, Starbucks. Robert (19m 28s): McDonald’s the Western diet. Yeah. Okay. So what we realized, what we realized, you know, in terms of all of the work that has come since 25 years of work, is that basically what happened was we transitioned from an ancestral diet, which was low sugar, high fiber, and that ancestral diet could be a carnivore diet. It was still low sugar, high fiber, or it could be a hunter gatherer diet. It was still low sugar, high fiber. Either way you want to look at it. It was still low sugar, high fiber. We transitioned from this ancestral diet to our modern diet. Robert (20m 8s): And when did we do it? We did it well, it started in the 1920s, but really picked up speed in 1970 or so. And then in 1975 was the introduction of high fructose corn syrup, which made sugar cheap. And then in 1977, we had the first dietary guidelines for Americans, which said, eat less fat. Eat less fat. That means you have to eat more of something else, more carbohydrate. So it was these things that basically transitioned us into the modern diet. And now our epidemic of chronic metabolic disease Brad (20m 51s): And amazingly you’re quoting timelines in the seventies and eighties and whatnot. But here we are in 2021. And I’m wondering, I know we have big machines here in place, but for example, putting the spotlight on your peers who are in a great place to dispense dietary advice. But they still seem to be stuck in pre 1970 dogma that came from manipulative forces, I suppose. Robert (21m 22s): Well, so, you know, in, in the book I take doctors to task. I take dieticians to task. I take dentists to that task. Okay. Nobody escapes, unscathed. All right. You, Brad (21m 38s): I think about you, man. You’re free swinging and, you know, I am someone needs to do it. Robert (21m 43s): I’m an equal opportunity offender. Brad (21m 45s): You’re going to lose all potential sponsors for your, your, your, your brand and your billboard. Oh my goodness. Robert (21m 52s): But obviously, you know, the message is getting out. The message is getting, and I’m very, very happy that the message is getting out. In fact, just this coming Monday, there will be a paper in the American Journal of Clinical Nutrition that will support all of this. Brad (22m 12s): And that’s a big milestone, I suppose, from what they’ve published to date. Robert (22m 16s): Well, you know, it, it’s a, it’s a conglomeration of a lot of scientists who were on the other side, but now are, you know, embracing this notion that obesity is biochemical rather than behavioral. So, very excited about that fact. So, you know, bottom line is, you know, we’re educating the public, but it’s a very slow process. As you can imagine, it was slow educating the public about tobacco. You know, it was slow educating the public about opioids. You know, so educating the public about alcohol. And the reason why it was slow for all of these is number one, we’re talking about hedonic substances. Robert (23m 5s): And number two, we’re talking about industries who were making money, who didn’t want things to change. So we had the dark forces and we also had our own reward center working against us. Well for sugar. It’s the same thing. We have our own reward system working against us because sugar is addictive and we have the dark forces of big food. So should we expect anything different? No. The only thing that we’ve got going for us is number one, we have an alternative it’s called real food. Problem is that’s not what the food industry is producing. Okay. Robert (23m 45s): But you can find that and you can buy it. That’s number one. And number two is that we are about seven or eight years into this. And so the information is starting to accrue and people have seen, you know, the last 50 years, you know, this pandemic of chronic disease, type two diabetes, hypertension, dyslipidemia, cardiovascular disease, cancer, dementia, polycystic, ovarian disease, fatty liver disease. No matter what we throw at any of them, the prevalence and the severity just keeps going up. And Einstein’s theory of insanity is doing the same thing over and over again, and expecting a different result. Robert (24m 27s): Well, we’ve been doing the same thing over and over again and expecting a different result. So that means we’re insane. And the dieticians are the worst because they’re the ones promulgating this notion of calories. And they’ve been watching for the last 50 years as calories hasn’t fixed anything, but yet they’re still dispensing the same calorie advice. And when the patient doesn’t do well, their response is, well, they’re noncompliant, Brad (24m 53s): Which I suppose they are because they’re too tired and they’re too hungry Robert (24m 58s): Because, because they can’t see their leptin, right? So when you can’t see your leptin just like those kids, what do you expect? You become a glutton on a sloth, and the question is what’s causing them not to see their leptin. The answer is insulin. Insulin blocks leptin. That’s why, when we get the insulin down, the leptin can work. And when the leptin works, then people of their own volition start eating less and exercising more. That’s what we’ve shown. So the fact that the dieticians blame the victim is, you know why they are insane. Brad (25m 40s): So you had that incredible drug intervention with the third 30, more, or the eight morbidly obese kids in Tennessee, if that works so well. Robert (25m 49s): So yeah, about 18% of the adult population responded the same way. Brad (25m 55s): So is this, there’s no potential for this to be distributed in mass, to people who refuse to cut back on their Oreos or something? Robert (26m 4s): Right. So, so that is a very good question, Brad. And I’m going to tell you that that is one of the dark stains on this story. So the drug was made by a pharmaceutical company called Novartis. You’ve probably heard of, and Novartis sponsored a double blind placebo controlled trial to assess whether or not Octreotide would work in adult obesity. Now I knew from our previous work that the higher, the insulin release, the better the drug worked because after all the drugs inhibiting release. They didn’t want to do the testing to figure out who was who. Robert (26m 51s): They told me. We would figure it out after the fact. They wanted to get as many patients into the study as quickly as possible. And so we didn’t run those analyses. And then when we saw the results of how well they did over the six months of the trial, it was very clear that about 10%, maybe 15% of the patients did remarkably well, but there are a whole bunch of people that didn’t, Brad (27m 19s): They just didn’t respond ? Robert (27m 21s): Well, because they didn’t have insulin secretion was the problem. They had insulin secretion as the problem. And Octreotide would only treat the insulin secretion problem, right? It was, it was targeted at a specific pathology and about 15% of the obese adults have this pathology. But some, you know, brilliant, you know, a guy at Novartis decided, well, we don’t want to have to screen people, therefore, you know, because that’s just too hard. So therefore this isn’t a good way to do business. And so they basically deep sixed it. Robert (28m 1s): And we never even got to run the insulin levels on the trial. Brad (28m 7s): Well, fortunately, there’s a super easy way to reduce insulin for free that you can start on tomorrow for those interested. That would be going to your, I love your one liner here to solve all the diet wars in, in one swath of the pen, where you say, protect the liver and feed the gut. And that’s the, the benchmark for sourcing real food and deciding whether or not to eat it. But yeah, let’s, let’s, let’s go there and, and talk about how, how easy and simple it would be for most people to get this disease pathology turned in a, in a U-turn quickly, right? Robert (28m 46s): So in the book, I basically, you know, ask the question “what’s healthy?” You know, so the FDA has its own definition of healthy, which is low in calories, low in saturated fat high in vitamin D high in potassium. Now you think that’s healthy, really? Brad (29m 5s): Is that the spray bottle, vitamin D and potassium put on the cereal? Robert (29m 9s): I don’t even know USDA doesn’t even have a definition of healthy. Because if they did, then basically none of the foods could say that they were healthy on them. Brad (29m 20s): That’s the thing. They’re keeping that one on the back burner, Robert (29m 23s): Right? So I offer, you know, a, an empiric definition of healthy based on the science. And it is six words to causes, protect the liver, feed the gut. If you protect the liver, the liver stays insulin sensitive. If the liver stays insulin sensitive, then the pancreas can make less insulin to make the liver do its job. If the pancreas makes it less insulin, that means insulin levels all over the body fall. And if insulin levels all over the body fall, then there’s no pressure on the fat cell to take up more energy. And you actually have a chance to lose weight. Robert (30m 7s): So protect the liver. So the protect the liver from what? Answer: refined carbohydrate and sugar. Because those are the things that end up driving liver fat production in the liver. So the thing that is sort of, you know, front and center in this whole thing is what the liver does to extra energy. Now, the liver can do two things with extra energy. One is it can make glycogen. Glycogen is liver starch. Liver starch is what powers marathon runners, and why marathoners carb load before a race. Robert (30m 51s): And glycogen for lack of a better word is safe. So your liver can store as much glycogen as it needs to or wants. And it won’t get into trouble. Now glucose will go to glycogen. So starch will go to glycogen. Now, if you overload, you know, a little bit of it will turn into liver fat, and that can be a problem. But, you know, in general starch is not a big deal. However, this other molecule fructose, the sweet molecule is sugar that does not go to glycogen. Robert (31m 31s): It’s also not insulin regulated. And the liver picks up. All of it must go to the liver. First can not be first because only the liver has the transporter for it. So when you consume a 20 ounce Coke, you are flooding your liver with fructose. And the fructose basically has no place to go, but the liver. And so the liver gets overwhelmed and the mitochondria can’t process it and turn it into energy. And so the mitochondria basically stopped taking it in and the rest of the cell then turns that fructose, that sugar into fat. Robert (32m 15s): And then that fat has one of two fates. It can either be exported out of the liver as triglyceride. And you know, that’s a setup for heart disease and obesity. Or it can precipitate in the liver as a lipid droplet. Now you have fatty liver disease. And now you have insulin resistance. And now you have your risk factors for type two diabetes, cancer, and dementia. So basically once that liver decides to take that sugar and turn it into fat, you are screwed. So stop that process. Well, are there any drugs that can stop that process? Robert (32m 59s): Not yet. So the only way to stop that process right now is limit the amount of sugar your liver sees, protect the liver. So that’s you remember one, Brad (33m 11s): even You have your soda, your 7/11 Slurpee, oops. We just lost another sponsor. And then a handful of healthy blueberries from the farmer’s market. We’re getting fructose stacked on top of a, a high processed foods diet. And that’s where the problem is? Or is there a distinction between process fructose from the fructose and the blueberry? Robert (33m 33s): Well, so the first of all, the blueberry doesn’t have much fructose in it. Okay. I mean, blueberries are sweet, but they’re not, they’re not a soda. You know, there’s a certain amount of fructose in them, but it’s not very high. Fructose is so sweet. It comes through anyway. Now the blueberry has something else though. It has fiber. And so that’s number two in the, you know, cavalcade of, of things you need to understand about this, the healthy, okay. Feed the gut. Well, what does the gut eat if you’re going to feed it? And the answer is fiber. Now, fiber is the stuff you throw in the garbage when you juice the fruit. Robert (34m 17s): Right? All right. So fiber has no calories. So everyone assumed, well, fiber is useless. Fiber is just what comes along with the fruit. No, that’s the mistake. It turns out the fiber is not for you. The fiber is for your microbiome. The fiber is there food. So when you eat food, you’re eating the food for you. And you’re eating the food for them. Cause they got to live. Okay. You got 10 trillion cells in your body. You got a hundred trillion bacteria in your intestine. Okay. They outnumber, you ten to one. Each of us is just a big bag of bacteria with legs. Robert (34m 59s): Now they got to eat something. Well, what do they eat? Well, eat what you eat. The question is, how much did you get versus how much did they get? And fiber makes sure they get what they need because fiber is their food. So fiber does six, count them, six separate things in your gut that are all related to your body’s metabolism and your metabolic health. Six here they are: the fiber. And there are two kinds of fiber, soluble. And insoluble. Soluble is like pectin or inulin. Robert (35m 39s): Like we’re holding jelly together. Insoluble like cellulose, like the stringy stuff in salary. Okay. Together, they form a gel on the inside of the intestine. You can actually see it on an electron microscopy, right? Imagine a fish net. The water goes through the fishnet. But now imagine a fish net that has a whole lot of kelp. Okay. Now the water doesn’t go through the fish net because the kelp is blocking up the holes. Well, that’s what’s happening in your intestine. Okay. The insoluble fiber, the cellulose sets up the lattice work of the fish net, the soluble fiber or globular. Robert (36m 19s): They plugged the holes in the fish net and together they form this impenetrable barrier that reduces the rate of glucose, fructose, sucrose, simple starch absorption from the gut into the bloodstream so that you protect the liver. Okay. Now, if you only put soluble fiber in like what the food industry does like FiberOne bars or Metamucil, you’re actually not setting up that gel because you need the inside double fiber and that’s not what’s there. Okay. So that’s the first thing. And what that does is that protects the liver. Robert (37m 1s): The second thing is because of that gel, because of the reduction in the rate of absorption, you keep your blood glucose from spiking too high, okay. This is the concept of glycemic load. And that means your insulin response will stay down. And if your insulin response stays down, then you’re not going to shunt sugar to fat. So that’s number two. Number three, the food moves through the intestine and the microbiome will chew up what you didn’t absorb early. So you’re feeding your microbiome. Number four, the food moves through the intestine faster because the fiber gives it bulk. Robert (37m 43s): It kind of greases the skids as it were. And so you end up getting to the end of the intestine faster. And there’s a hormone that the end of the intestine releases called peptide YY, which then goes to the brain and tells your brain, Hey, meals over, I’m done. I’m satiated. That is your satiety signal. And it takes about 20 minutes to get from the stomach to the end of the intestine, which is why we always tell everybody, wait, 20 minutes before second portions, give the food a chance to get there. But the more fiber in the food, the quicker it gets there. All right. Robert (38m 24s): I mean, think about it. The BRAT diet, the bananas, rice, applesauce, toast diet that we give to kids when they have diarrhea. Okay. The reason is because it’s constipated because it’s not moving the food through the intestine faster because there’s no fiber in it. Okay. We’ve just, you know, that’s, that’s why it works to treat diarrhea is because it’s constipating cause there’s no fiber, right? So that’s number four. Number five is the soluble fiber. The, the, the hydro, the, the, the, the inulin, the, the, the pectins, et cetera. Robert (39m 6s): They get turned into short chain fatty acids. For short chain fatty acids, like butyrate, propionate, acetate. These are actually immune modulating. They actually suppress your cytokine response, which it turns out to be extraordinarily important in COVID. One of the reasons why ultra processed food consumption actually contributes to increased COVID mortality is because of the accelerated cytokine response. You want to keep that cytokine response down, right? And the soluble fiber does that. And then number six, the insoluble fiber will act as a little scrubbies on the inside of your colon getting rid of the cancer cells. Robert (39m 49s): Now six separate things that the two fibers from real food do together. If you add soluble fiber, you only get two of them. No one can add back insoluble fiber cause insoluble fiber is not miserable, but if you could, it would also only do two of them. You need all six, the only way to get it today is real food. So that’s why you have to feed the gut, protect the liver, feed the gut. You do that, and that’s called real food. And your metabolic health will improve. Your insulin will go down. And if your insulin goes down, guess what? Robert (40m 32s): You lose weight. So that’s the key to this whole obesity debacle. Brad (40m 39s): Simple as can be. Transcending the diet wars on either side that the vegans against the paleos and the carnivores. But if we just transition over to real food now, is there some concern about you hear about getting excess fiber in the processed food diet? I suppose that’s just that one kind that you’re, you’re, you’re cranking the Metamucil and the process products. Robert (41m 2s): That’s all they’re doing is they’re just adding Metamucil. They’re adding, you know, psyllium husk or, you know, pectin or something, and that, and that won’t do it. That just won’t do it. And, you know, Metamucil has tried, you know, 50 ways from Sunday to try to get the FDA to approve health claims for Metamucil about, you know, lowering blood glucose and, you know, being a weight loss. And the bottom line is the data just aren’t there. Brad (41m 38s): The other side we hear from, let’s say, carnivore advocate of testing out your sensitivity to plants and going with the emphasis on the nutritious animal foods where comparatively we’re not getting much fiber, but do we have to go looking for mountains of high fibers food, or where’s that sweet spot? Where if we just choose natural processed unprocessed foods, we’ll be okay? Robert (42m 5s): You know, basically look at all the diets that work. Okay. There are a whole bunch of diets that work. Okay. And they stretch across the gamut. All right. We have, you know, keto, carnivore, you know, paleo, and traditional Japanese and Mediterranean and, you know, Sugar Busters for that matter and, and, and Zone and Ornish. And I forgot Atkins. Throw Atkins in it. And, you know, finally all the way to, you know, Unprocessed Vegan. All right. Robert (42m 45s): So we have things that are high fat, low carb, and we have things that are low fat, high carb. Okay. Every diet that I just mentioned works. So it’s not the carb or the fat. They all work. So what do those diets have in common? They all are real food. Now, as it turns out, you can do keto wrong. Okay. Keto is a good diet. I’m not against keto. I’m for it. We used it in our own patients at UCSF when we needed to in the right patient. Robert (43m 28s): So I’m not against it. I don’t think everyone needs to be on it. You know, I don’t think everybody has to go to that extreme. But here’s the problem with keto, even a little bit of carbohydrate will suppress insulin, sorry, sorry, will stimulate insulin. My mistake, even a small amount of carbohydrate in the diet will stimulate insulin. And if you stimulate insulin, you then stop the ketosis. If you stop the ketosis. Now, instead of being on a ketogenic diet, what you’re on is a high fat, medium carbohydrate diet, which is the single worst diet. It can be. So unless you are absolutely fastidious and measuring your ketones either with urine or breath consistently, okay. Robert (44m 12s): I can pretty much guarantee you that within two months, you’re not even on the keto diet anymore. Okay. Only the truly committed can manage a ketogenic diet for any length of time. Now that doesn’t mean that people can’t do it. They can, God knows they can, but you know, the, shall we say weekend warrior type, you know, who are just going to do this ‘c.ause it sounds like a good idea. They’re going to be falling off the wagon, you know, imminently, Brad (44m 44s): Inadvertently to sometimes Robert (44m 44s): They won’t even know and they won’t even. So this is, so this is the problem with keto. The problem with vegan is much easier to explain Coke, Doritos and Oreos are vegan. Okay. So vegan, if it’s going to work means unprocessed vegan. Processed vegan is the Western diet without meat. So that’s that that’s, that’s the bottom line. So, you know, you want to do it one way? Fine. I don’t care. You want to do it the other way. That’s fine too. You know, individual people will end up gravitating toward one or the other and presumably one will work better based on your own biochemistry than the other. Robert (45m 29s): And there are ways to figure out who you are. And I actually have that in chapter nine of the book is to figure out who you are. But I’m agnostic as to which diet is better for any individual person, right? And I’m not here to, you know, fan or flame the diet wars, you know, th th th the problem is the vegans and the ketos actually have more in common with each other than they can possibly imagine. And really their enemy, you know, the enemy of my enemy is my friend, okay, is the process, you know, the CPG companies that’s who they should be fighting with, not with each other, Brad (46m 9s): Taken our eye off the ball and getting confusion into the listener’s mind, rather than this unified force against the processed foods is a great, a great starting point for all diets, the Lustig gates of entry. And then you can come in and drift around and go experiment with what works for you. But it, it seems as simple as eliminating those, those processed foods. Robert (46m 33s): So simple, that’s the problem. It, because basically what it means is you’re going to get rid of, you know, more than 75% of what’s in the store. Brad (46m 41s): It’s not so simple, it’d be wandering around Robert (46m 46s): Indeed. So, you know, now there are ways to do it. And I’m actually working with a company I’m the chief medical officer of a company that will help people do this routinely. And without having to even read a label. Because it’ll already have read the label for you, it’s called Perfact P E R F A C T. You can find it online. And basically we’re working, we’re actually helping an international food conglomerate completely re-engineer their entire portfolio to be metabolically healthy stem to stern, start to finish. Everything will basically be metabolically healthy when we are done with it. Robert (47m 29s): By adhering to these principles. Brad (47m 33s): Seems like a good opportunity, especially for a big player to come out strong and saying, look, now you can actually trust us, sorry. About the last hundred years of cereals and Pop Tarts and whatnot. Robert (47m 45s): That’s why I’m helping them, by the way, in that not taking any money for it, you know, that would be a conflict of interest. So I don’t take money for it. I’m doing it, you know, out of the goodness of my heart. But the bottom line is if one international food conglomerate can do it, then maybe a second one, or maybe a third one, you know, and then if there’s pressure on them to do so, you know, that’s how you ultimately affect global societal change. Brad (48m 12s): So back to that association with consuming refined carbohydrates and spiking insulin, there’s also some talk about the role of refined industrial seed oils in contributing to insulin resistance, because they hamper your fat burning ability. Where does that fall in? Robert (48m 28s): Pretty much all of those seed oils are omega sixes. And omega sixes are pro-inflammatory and inflammation drives insulin resistance. So it’s, you know, omega sixes are necessary. It’s not that they’re not necessary. They are necessary. They are pro-inflammatory and you need inflammation. Okay. You know, you need inflammation to, you know, basically take care of viruses or, you know, I mean, if we didn’t have inflammation, we’d all be eaten by the maggots. You know, you have to have an inflammatory response, but the question is what kind, how often, and, you know, is it going on at baseline? Robert (49m 9s): And it turns out that the more omega six as you consume the higher, the baseline inflammatory response. And the reason is because omega six are the precursor of arachidonic acid. And arachidonic acid is the precursor of prostaglandins and leukotrienes. And, you know, you know, pro-inflammatory molecules. And so we’re supposed to consume omega sixes, but we also have to consume the opposite. We have to consume the compounds that actually suppress inflammation called omega threes. Omega threes are absolutely essential for normal brain functioning. They are part of the neuronal membrane and they keep neurons from dying. Robert (49m 52s): And so they’re very important in both depression and dementia. But omega threes, where do you get those from? Wild fish and flax, but not very much. And to be honest with you, there’s not a lot of omega threes in most vegetarian or vegan items. And, you know, people talk about eggs, being a source of omega threes. Well, you know what? Processed eggs are not, you know, it, you know. Farm, I mean, pasture raised eggs. Yes. And the reason is because then the eat the grass and the chickens, you know, I mean, they don’t make the omega threes. Robert (50m 33s): They eat the omega threes. The fish don’t make the omega-threes. They eat the omega-threes who makes the omega threes? Well, the algae, the plants make the omega threes. The fish eat the algae, we eat the fish. So we get our omega-threes third hand. Right. And the eggs, you know? Yes, the true, if the chickens eat the grass, then they have the omega threes. In the book I actually have a picture it’s unfortunately, black and white of two eggs, sunny side up, you know, frying in a skillet. One is a pasture raised egg, and the other one is a factory egg. Robert (51m 15s): And the pasture-raised egg is orange and the factory egg is yellow. So yellow eggs are actually omega-3 light. Okay. You want to go, omega-3 heavy, any pasteurized eggs, but you know, like where do you get those? Brad (51m 33s): Yeah. They’re more prevalent now, but it certainly is a big difference when you start to be selective. Same with your choices in the fish category, the meat category. Robert (51m 42s): Right? Absolutely. So, you know, this is why, you know, our current food system, our food business model has to be turned on its head because we are rewarding the food industry for poisoning us. That’s what it comes down to. And sugar is the biggest poison of all. So here’s my question to you, Brad, and to your listeners, your audience: Is sugar food? Brad (52m 19s): Well, I guess I’d have to say no if you’re talking about the, the individual molecule, but it certainly is a component of real food. Robert (52m 32s): Nope. It’s calories and calories constitute food. Brad (52m 39s): Well, I guess that’s debatable too. Robert (52m 41s): Well, it is debatable actually. You’re right. The dieticians will tell you, well, you know, I mean, sugar is energy and you know, that’s what food is. You know, I mean, that’s what food is, blah, blah, blah, garbage, garbage, garbage, garbage. All right. What is the definition of food? We’ve already talked about? The definition of healthy, what is the definition of food? Answer, go to Webster’s and is memorized it a substrate that contributes to the growth or burning of an organism. Hmm. Okay. And I accept that. Robert (53m 20s): That’s, that’s a fine definition. So a substrate that can, that contributes to the growth or burning of an organism. Let’s take burning first. What if a substrate actually inhibits burning? Brad (53m 39s): Like the seed oils? Robert (53m 40s): Well, no, no. I mean, seed oils can still be burned. They’ll still be burned. But what it, what if a specific component of food actually inhibits mitochondrial function? Mitochondria where the where the burning takes place. What if you actually inhibit mitochondrial enzymes? It turns out sugar, fructose molecule inhibits three, count them, three separate mitochondrial enzymes, inhibits ampkinase, which is what turns mitochondria on and causes them to divide and make more of them. Robert (54m 22s): It inhibits hydrogenation long chain, which is the start of the fatty acid oxidation, the burning of fats. And finally it inhibits CPT one carnitine palmitoyltransferase one, which is the shuttle mechanism by which fatty acids get into the mitochondria in the first place to burn. So three separate enzymes being inhibited by one molecule. So if fructose is inhibiting burning, then we have to look at growth. Robert (55m 3s): Does sugar contribute to growth? Then the answer is growth of cancer cells, Brad (55m 10s): Growth of the waistline. Robert (55m 12s): Well, yeah, but it does not contribute to growth. It actually inhibits growth. So my colleague, Dr. [inaudible] who is the head of nutrition at Hebrew university of Jerusalem just published a 27 page article in bone research, demonstrating the mechanisms by which ultra processed food and specifically, sugar, inhibit bone formation, bone growth. And we know that basically, once you raise insulin, what you’re doing is you’re raising cancer potential. So you’re actually increasing cancers. Robert (55m 53s): So sugar inhibits normal growth. It inhibits normal burning. So is sugar a food? Brad (56m 3s): I guess it’s losing its status very quickly here. Robert (56m 9s): In fact, sugar is a poison because anything that would inhibit the growth or burning of an organism would be a poison. Brad (56m 17s): Now where’s the cutoff point, Rob, from the natural sugars contained in the apple off the tree versus apple juice? Robert (56m 28s): It’s very simple. The apple has fiber, the juice doesn’t. Brad (56m 34s): So that’s the litmus test? Robert (56m 36s): So the fructose molecule the same in both, but the difference is that when you consumed the fructose molecule as part of an apple, the fiber made sure your liver didn’t see it. Make sure it went further down the intestine, where instead it became the food for your microbiome instead of the poison for you. Brad (57m 2s): So there comes up your other mantra, which is, it’s not, what’s in the food it’s, what’s done to the food. Correct. And that’s going to have to have us unwind a lot of the marketing content and then the food label, the food label, and all the, the touting on the box of the great things that are in this box. However, how badly processed it’s been. Robert (57m 22s): That’s right. It’s not, what’s in the food. It’s, what’s been done to the food and you can’t learn that from the label. In fact, the only way to approach this is when you see a label on any given food, it’s a warning label. Brad (57m 41s): It says nutrition facts. So we can just interpret that to me in nutrition warning. Robert (57m 47s): Yeah. Right, Exactly right. So this is what I try to convey in the book is, you know, basically how to conduct yourself in the store, how to figure out what it is you should be eating. Okay. And why it is that every single thing you do to try to make yourself healthier backfires. Brad (58m 12s): So if we want to unwind things a little bit, you mentioned glucose being the, the symptom, not the cause. I’m having fun with my continuous glucose monitor and enjoying the, Robert (58m 26s): Those health to what it looks like levels health, Brad (58m 29s): Oh, this is a Neutral Scent, but a level south people too. And it’s a really good behavior modification device because you can see in real time, what happens when you walk after your meal and all that great things. And I like how you, you mentioned exercise hitting five of the eight sub salient or pathways to disease, which is better than zero. It’s better than two, but altering the diet and the idea that you can’t outrun or out exercise a bad diet, I think, needs to come to the forefront these days. Robert (59m 1s): Indeed. So in the book I talk about the eight sub cellular pathologies that drive all chronic disease. Okay. Now these eight, I call them the hateful or the grateful eight working for you, you’ll be 110 playing tennis when they’re not working for you, you’ll be 40 in a wheelchair with two stumps on dialysis, waiting for your next stroke. Okay. And everything, of course, in between now those eight pathologies belie all the chronic diseases that I mentioned earlier on in the program, but they don’t have ICD 11 codes. Robert (59m 43s): So doctors don’t know them because they’re not getting paid for them. And doctors don’t explain them to their patients. And there’s virtually no way to figure them out, you know, from any lab tests. And there’s no medicine for any of them anyway, because none of them are druggable. But they’re all foodable. And that’s what I explained in the book. So here are the eight I’m going to name them real quick. As we’re getting ready to close here, glycation, oxidative stress, mitochondrial dysfunction, insulin resistance, membrane instability, inflammation, methylation, and finally autophagy. Robert (1h 0m 29s): Now, when these eight are working for you, you’ll be as healthy as anybody. When these eight are working against you. You’re going to be sick as hell. Right? And there’s one thing that makes all eight better, real food. And there’s one thing that makes all eight go south all at once, processed food. Brad (1h 0m 56s): I like how you say that all this fascination with fasting and kick-starting autophagy is wonderful, but if you’re have a baseline diet of real food, you don’t even need to fast to enjoy the benefits. And that kind of makes sense from an ancestral perspective to where we’re, we’re bragging about our ancestors going all winter with no food, but the ones by the ocean that figured out how to make a fish net. They were probably eating as much as they wanted all day long for years and centuries. So it’s a nice big picture. Look at everything. Instead of getting fixated with the details of how long your fasting period is today versus tomorrow and all that Robert (1h 1m 35s): Exactly right? Bottom line. Why does intermittent fasting work? Well, it probably works too. So this one, it gives your liver a chance to burn off the fat that accumulated from the hours before thereby keeping your liver insulin sensitive, i.e. Protecting your liver. And also because it promotes this phenomenon called autophagy, which is basically garbage night for the cell. It clears out all the dead wood, all the debris that’s built up from the cell, doing its job over the course of the last 24 hours. This is why we sleep by the way. That’s garbage night for the brain. It’s the time when the brain can get rid of junk, that’s accumulated protein, aggregates, lipid peroxidation products, defective mitochondria, et cetera. Robert (1h 2m 25s): It happens while you’re sleeping. Brad (1h 2m 26s): So that, that, that quip you made about playing tennis at 110. Is that just for fun? Or do you feel like we have that potential to become the norm? If we figure out this diet thing? Robert (1h 2m 38s): If we figured out the diet thing with everything else that’s going on in the longevity field? No doubt we can do that, but not if we eat like we do. And what’s the personal Brad (1h 2m 56s): Yeah. Right. And boy, there seems to be a lot of hope. You’ve mentioned the timeline of the last seven or eight years where the message is really getting out, but we’re also worse than ever in a lot of those stats that you cite in the book. We just had the medal count on the Olympics and the USA’s here and there. And then we’re 37th and a really important category in the OACD. So we gotta, we gotta sober up a little bit here, huh? Right, Robert (1h 3m 23s): Exactly. Right. You know, Olympians, I love them. They’re terrific. Okay. We should all be Olympians. But we’re not. And it’s not because we’re not just, we don’t have just God given talent. That’s because we eat crap Brad (1h 3m 42s): Now to, to extricate from this trap by a really well-meaning person, who’s writing the goals on the whiteboard and hoping they can pass by that Starbucks. But in your other book, The Hacking of the American Mind, you talked about the addictive properties and the addictive nature of all this stuff. Right? What do you, what do you recommend as some baby steps here to escape the clutches? Robert (1h 4m 4s): Right? This is the cognitive dissonance. I, you know, in the food industry uses it like crazy. I mean, you know, sugar’s their hook, you know, they put cocaine in the food if they could, but they can’t. So they put sugar in and also caffeine, you know, that’s what, because that’s, what’s legal. So what do you do? Well, the first thing you need to know is that 62% of the sugar in your diet is in the ultra processed food category. And 67% of kids’ diets. That’s where the sugar is 67%. So, you know, that’s the category we have to deal with. Robert (1h 4m 47s): Now, there’s food processing. And then there’s ultra food processing. That the difference between them, I can sum up in four simple paradigms. You have an apple, you have apple slices, apple sauce, you have an apple pie, which one is bad for you? Brad (1h 5m 14s): I’m going to say the latter to no brainer. Robert (1h 5m 17s): Well, it turns out the apple pie is worse than the apple sauce. The apple sauce is worse than the apple slices and the apple slices, believe it or not is worse than the apple. Hmm. Okay. So every degree of processing takes you down that road, but it’s really only that class for that apple pie that really pretends significant cardio-metabolic danger. All right. But that unfortunately is 90% of the food. Brad (1h 5m 48s): Right? A lot of it in disguise, we know the apple pie is a sugary treat, but when you go to Jamba Juice and look at the marketing messaging and same thing, health bomber. Yeah. Super green health bomb, right. You’re looking at grams is processed sugar, Robert (1h 6m 3s): That’s it? So this is what people have to understand. This is what people have to embrace. And if we do, then, you know, we can get somewhereJ but ultimately the food industry has to change. And you know, they’re going to basically drive this bus till the wheels fall off. Brad (1h 6m 19s): Yeah. I like your comment that there’s always going to be more money than votes. So we kind of have to vote with our pocketbook and push Robert (1h 6m 32s): With your fork 21 times a week Brad (1h 6m 34s): Or less if, if inclined what’s your personal routine. Like before we close, I’m curious. Robert (1h 6m 39s): I never discuss it. You know, that only gets me into trouble. Brad (1h 6m 41s): Yeah. I mean, you may, you made a joke that you’re, you’re not standing here as an extreme fitness guy. You wish you were, you were not overweight or something of that in an interview, but it’s a, Robert (1h 6m 55s): I I’m just a scientist. I am not, I am not a role model. I am just aside. I, you know, I understand that that doesn’t mean, you know, I do everything right. You know, and, and, and I’m clear on that. I was a stress eater throughout childhood and college and med school and really, probably for the first 45 to 50 years of my life until I started figuring out what was going on. Brad (1h 7m 19s): Right. And I suppose if we bring in a different level of mindfulness to our indulgences, and I talk about this a lot, I’m a, I’m an athletic guy and I am promoting health and all this great stuff. But when my popcorn habit gets out of hand, because it becomes more habitual than celebratory. I think there’s a clear distinction there where even, even, even Dr. Lustig is allowing us to enjoy our life a little bit. And who knows, we might see you eating a slice of cheesecake at the cafe when, when things open up in the bay area. But it’s it’s a different storage Robert (1h 7m 51s): Only at Juniors in New York city. You got us the academy cheesecake. Brad (1h 7m 58s): You got to shoot for the top great point. Oh man. Everyone. I hope you go read Metabolical. Thank you so much for spending the time explaining things that the battle that you’re fighting is tremendous and keep up the great work. Don’t don’t give up. Don’t back down now. You’ve gone this far. Robert (1h 8m 19s): No, never, never. Brad (1h 8m 20s): That’s Dr. Robert Lustig. Everybody. Thanks for listening. Thank you for listening to the show. I love sharing the experience with you and greatly appreciate your support please. Email email@example.com with feedback, suggestions, and questions for the Q and A shows. Subscribe to our email list of Brad kearns.com for a weekly blast about the published episodes and a wonderful bimonthly newsletter edition with informative articles and practical tips for all aspects of healthy living. You can also download several awesome free eBooks when you subscribe to the email list. And if you could go to the trouble to leave a five or five star review with apple podcasts or wherever else, you listen to the shows that would be super, incredibly awesome. Brad (1h 9m 7s): It helps raise the profile of the be podcast and attract new listeners. 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