Robert H. Lustig - Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine

I retired clinically from UCSF in 2017 after forty years practicing medicine, with the notion that I could spend more time doing what I wanted to do. But as usual, Man plans and God laughs. Its been a rough five years for many reasons, including personal, professional, and health concernsIve had my share. But my family is with me, and for pulling me through, this book is dedicated to them. Daughters Miriam and Meredith, wife Julie, sister Carole Berez, thank youindeed, this book is the product of your love and patience, especially this past year. And to my extended family, neighbors Marcia and Mark Elias, my cookbook coauthor Cindy Gershen, my UCSF friends Elissa Epel and Jack Glaser, Walt Miller and Sindy Mellon, Ivy and Fred Aslan, and my editor Amy Dietz, for buoying me up when I needed it most. This book is your handiwork as much as mine.

I ts been a rough day, youre finally home after a long commute, and youre starving. You sit down at the kitchen table, turn on the TV, and inadvertently consume a plate of poison. It looks like food, it tastes like food, maybe it tastes even better than food. But what if something had been done to poison it?

Nothis isnt an episode of Game of Thrones; its whats happening to most of us every day, every meal, every snack. In bygone times, kings employed food tasters and cupbearers to sample their food and drink first to determine if it had been poisoned. Those poor peons knew that each bite might be their last. But our food today is safe, right? Your cart at the grocery store is full of vacuum-wrapped, refrigerated or frozen, hermetically sealed, spoilage-resistant, irradiated, pathogen-tested, screened-at-the-border products that meet all USDA and FDA standards. But what if that food has been altered or adulterated in some fashion by some neer-do-wells before its even been harvested, while its being cooked, or even after its been packaged, in order to kill you? And by design? Not because they want your lifejust your wallet?

We occasionally hear about E. coli in hamburger meat, Salmonella in eggs, Listeria in spinach, or even melamine in infant formula; a recall is announced, and the matter is forgotten. So our foods safe, right? But what if it acts more like a slow poison, like cigarettesone wont kill you, but ten thousand consumed over ten years might? Unlike Salmonella, you wont be feeling the effects immediately. But eventually, youll feel it... everywhere. In your heart, muscles, bladder, brain, and especially your wallet. What if this consumable poison is laced with additives that toy with your brains reward center, leading to addiction and needing ever more of it? Kind of like the pusher in the schoolyard who offers you your first toke for freeand then hes got you. And the bigger and the more chronic the dosethe quicker you die.

Lets take it a step further: what if this poison doesnt just kill you chronically, but sets you up to be susceptible to acute illnesssay, a viral pandemicthat could kill you even quicker? What if the USDA and FDA are aware that this slow consumable poison is sold in grocery stores nationwide, and they allow it to be promoted heavily? What if the entire world is exposed to the same toxic and addictive consumable poison, and has now started to get sick, too?

And finallywhat if this slow consumable poison looks like everything else in the store? How do you protect yourself?

This is not a Stephen King novel. Its real life and its happening now. This consumable poison is called processed food.

Food writer Mark Bittman has said that since food is defined as a substance that provides nutrition and promotes growth and poison is a substance that promotes illness, then much of what is produced by industrial agriculture is, quite literally, not food but poison. He was talking primarily about pesticide use versus sustainable farming, arguing that we have laced our food with poison. Yes, pesticides are one aspect of food toxicitybut only the tip of the iceberg, maybe about 10 percent of what ails us. The other 90 percent is due to the procedures of the processing, which has morphed what was food into this new slow-acting poison. Your box of cereal may tout that its organic and all naturalbut it still may be poison. Whats important is the alchemy of how the food itself has become poison. Until you understand that, you cant understand what has happened to our foodand to us. This book will explain its not whats in the foodits whats been done to the food that counts. And you cant learn that from your doctor, dietitian, advertisement, internet blog, or even a Nutrition Facts label. Nope, youre going to have to learn that yourself.

Nutrition is not the same as food science. Nutrition is what happens to food between the mouth and the cell. Food science is what happens to food between the ground and the mouth. Each is dependent on the other, yet both are opaque to the public. Thats on purposebecause the food industry and the government dont want you to know that its the food processing thats rendered the current concepts of nutrition moot.

Food processing isnt listed on the Nutrition Facts food label. The label tells you whats in the food. This is mostly irrelevantwhat you really need to know is whats been done to the food, and no label tells you that. In this book, I will make both nutrition and food science transparent. Essentially, all you need to know are two precepts, six words total: 1) protect the liver, 2) feed the gut. Those foods that satisfy both precepts are healthy; those that do neither are poison, and those that do one or the other are bad (but less bad)no matter what the USDA and FDA allow to be stated on the package. Only items that meet both of these criteria qualify as Real Food, i.e., that hasnt been stripped of its beneficial properties and sprinkled with toxins that will hasten our demise.

So buckle upIm going to take you on a ride. Now that youre strapped in, we are going on a journey from the ultra-micro to the ultra-macrofrom molecule to planet, and everything in between. Were going to get both the subcellular and the thirty-thousand-foot view. And were going to travel through time, over the last fifty years. The reason for this bottom-to-top and backward-to-forward excursion is to answer these questions: why has our health status declined, our healthcare system devolved, and our climate immolated?

Some might argue that these alterations are unrelated to each other. But it all starts with the changes in our food supply chain that shifted five decades ago in order to support the production and consumption of processed food. To make and bolster this case, Ive connected several dots for you: the food to the biochemistry; the biochemistry to the disease; the disease to the medicine; the medicine to the demographics; the demographics to the economy; the economy to the agriculture; the agriculture to the climate; the climate to the planet; and the planet back to the food yet again.

I know this sounds like a nightmare ride on an academic Tilt-A-Whirl, but Im asking you to hold on to your seat. When you see how these factors are all interlinked with one another, two incontrovertible truths emerge. First, the change in food processing, starting about fifty years ago, has fueled a slow but unrelenting medical, economic, and climate vortex downward. Its picked up speed with time and overwhelmed our medical resources, now evidenced and accentuated by the social disparities of the coronavirus pandemic. It threatens to overwhelm our planetary resources to boot. Second, in todays society, food is the only possible lever that we can apply immediately to effect change. If you do not fix