A Calorie is Not a Calorie: Busting Myths with Dr. Robert Lustig and the IRN


Pardon me while I gush like a total geek for a second.

I have been on the planning committee for the Wellness Conference put on by the Hospitals Association of Southern California for the last three years. For the last three years I’ve been wanting Dr. Robert Lustig to come to the conference to speak about his work with diabetic children and the research he’s done to convincingly argue that the excess sugar we consume as a society is killing us, one diabetic at a time. He finally made it to the conference this year, and I almost literally jumped for joy when I saw him walk into the room. I think I might have made him a little self-conscious when I asked him to take a picture with me, but he graciously obliged. Yesssssssssssssss!

a calorie is not a calorie Dr. Robert Lustig Institute for Responsible Nutrition

Some of you might have noticed I did a teeny tiny bit of live tweeting (a whopping 3 tweets) during his talk on Thursday of last week at HASC, but since it was just a few tweets they might have passed you by. They featured some of my favorite sound bites, which will guide you through what I consider the most important information Dr. Lustig shared.

Dr. Robert Lustig’s Work

If you’re not familiar with Dr. Lustig’s work, I suggest you start with his book Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Diabetes (affiliate link). He’s been working with children at UCSF who are presenting with the diseases of the old — metabolic syndrome, diabetes, hypertension — and in his research, he’s found that the number one problem in our modern diet today is the sheer amount of sugar we consume. He uses the old adage “the dose determines the poison” and asserts that the food industry is dosing us.

“Sugar is the alcohol of the child.”

I’ve heard Dr. Lustig speak a few times before, and each time he not only covers this problem on an individual level, but he also points out the systemic, institutionalized, tacit (but not really) agreement between “the people in charge” (USDA, FDA, lawmakers) and “the big food companies” to keep people uninformed about how much sugar we’re consuming and just how dangerous it is for our health. The most compelling evidence for this little arrangement is the fact that food labels never share the RDA percentage of sugar per serving. 

a calorie is not a calorie Dr. Robert Lustig Institute for Responsible Nutrition

The point stands that if the spot under % Daily Value were filled in with accurate percentages for Recommended Sugar Intake, people would think twice before buying sugary cereal for their kids (or any of the other boxed products in the center aisles of the grocery store). Part of Lustig’s work at the Institute for Responsible Nutrition (IRN) is to move sugar from the GRAS (Generally Recognized as Safe) list to the “Food Additive List,” citing it as an addictive substance, a cheap preservative, and not a necessary part of our diet. Doing this would put sugar in the same category as trans fat and create awareness around the health hazards of consuming too much.

“Obesity is not the problem. People Don’t Die from Obesity.”

Myth #1: If we cure obesity, we cure our health crisis. Dr. Lustig spent a long time on debunking this point, sharing obesity and diabetes rates across the globe and arguing that while there’s certainly overlap between obesity and diabetes, there are also plenty of cases where obesity is present and diabetes isn’t, and vice versa. India, Pakistan, and China, for example are not obese countries, but the rates of diabetes are skyrocketing. Mongolia and Iceland are obese but not diabetic. The position of mainstream medicine on this matter is that if you cure obesity, you cure the problem, but Dr. Lustig reveals that 40% of normal weight people (who make up 70% total population) have the exact same chronic diseases as 80% of obese people (who make up 30% of the total population). So the problem is metabolic syndrome, not obesity. Obesity is a potential symptom of the problem, but not the problem itself.

“I don’t believe in common sense. I believe in science.”

a calorie is not a calorie Dr. Robert Lustig Institute for Responsible Nutrition

Click the image to see the full infographic on the IRN website

Myth #2: A calorie is a calorie. We’ve been told our whole lives that a calorie is a calorie — that the law of thermodynamics states that if we take in more energy than we expend, we will gain weight — it’s just common sense. Well no it’s not. The laws of physics don’t trump the laws of nutritional biochemistry, and all calories are not created equal.

Our bodies react differently to different nutrients that accompany each calorie — in fact, some calories (like the ones that come from soda and other sugar-laden drinks and processed foods) are downright poisonous to us when consumed in the quantities that we’re consuming them right now. We do not digest a carrot the same way we digest a soda.

I touched on the calorie myth in my post Fatty Doesn’t Equal Fattening, where I talked about the difference between healthy fat and unhealthy fat, but Dr. Lustig drives the point home with his charts that correlate increased sugar consumption with CVD (cardiovascular disease), diabetes, and liver disease occurrences over time. You can see some of that work at the IRN website.

“Your choice to drink soda is hurting me.”

Myth #3: It’s about personal responsibility. I almost fell on the floor when I learned that the notion of “personal responsibility” was invented by the tobacco industry in 1969. It makes complete sense, and the parallels between big tobacco and big food don’t stop there. (In fact, some of the major players are/were the same!) If one can argue that quitting sugar (or smoking) is just about personal choice, an individual decision that affects no one but the person eating (or smoking), then one can keep regulation away, keep warning labels away, and keep people addicted.

If you can be convinced that your decision to eat junk (or smoke cigarettes) isn’t hurting anyone but yourself, then you can just keep right on doing what you’re doing until you’re ready to change, at which point, it’s your own personal responsibility to do so, and you should just be able to stop on your own. Forget the constant barrage of commercials advertising your substance of choice to you (no longer legal for certain media to advertise smoking). Forget the fact that it’s available at your fingertips everywhere you turn (barriers have been put into place for cigarettes, including age requirements), that nothing is labeled properly (warning labels have been legally mandated for cigarettes), and that there are so many different names for sugar that can all be buried into the ingredients label so that the average consumer is none the wiser (not the case for tobacco or nicotine products). Most importantly for our society, forget that your sugar (or smoking) addiction makes you a more expensive medical patient who’s more likely to get sick and stay sick for longer, and in the end we all bear the brunt of a sicker population. Of course big food wants to make it about personal responsibility, because it keeps them in business!

Dr. Lustig cites the three ingredients needed for the case for “personal responsibility” to be made:

  • Knowledge – of the actual contents of the food we have to eat AND of the real consequences of our current system
  • Access – to real, whole foods AND the information we need to know to make good decisions about these foods
  • Affordability – related to access, real, whole foods need to be available to all socio-economic levels, not reserved for those who can afford to shop at Whole Foods.

Click to download a PDF of this list to take with you to the grocery store!

“I’m for dessert, for dessert. I’m not for dessert for breakfast.”

This one is my favorite — I too, am for dessert! And I too have a rant on the topic of breakfast cereal! This is where the action items come in, and where I don’t leave you empty-handed thinking that the cards are stacked against you and your health. No one is asking for a ban on sugar. No one is saying that it should be considered a controlled substance. What Dr. Lustig, the folks at IRN, and I am saying is that we need to be informed, we need to recognize that we can’t do it alone, and that it IS possible to make lasting change on this issue at the personal and societal level! Here’s what you can do to make a difference:


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