Qualy #69 - Advice to parents and kids for creating a sustainable environment that's going to prevent them from running into metabolic problems

**Peter Attia** (0:05)
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I want to get into some more geeky biochemistry stuff, but I also know that there's probably at least one person listening to this who's a parent who's thinking, oh man, do I have to simmer down how much sugar my kids are eating? So when you saw kids in the clinic, obviously you're seeing their parents. That's one of the advantages of pediatrics is-

**Robert Lustig** (1:21)
It's also one of the disadvantages.

**Peter Attia** (1:23)
That's right, that's right. You have two patients.

**Robert Lustig** (1:24)
Two patients, and I don't get paid for both.

**Peter Attia** (1:27)
But the beauty of it is you have a patient who you need to take care of, which is this child, but then you also have another caregiver who for the most part wants what's best for that child.

**Robert Lustig** (1:36)
Mostly.

**Peter Attia** (1:37)
And how would you counsel a parent who would say, look, Dr. Lustig, there's no way my kid's gonna have no sugar in their life. Can you give me a way to create a sustainable environment and set of rules that's gonna prevent my kid from having the metabolic derangement that hoses them for the rest of their life, but allows them to still be a kid?

**Robert Lustig** (1:56)
Yes, so that's what we did in clinic every single day.
Here's the problem. It's not the added sugar you know. It's the added sugar you don't know.

**Peter Attia** (2:07)
It's almost like a Rumsfeld tone to that, right?

**Robert Lustig** (2:09)
Well, yeah, I mean, there's the known knowns, and then there's the unknown knowns. And the fact is, when you look at the amount of sugar that is in sodas, it's bad. When you look at the amount of sugar that's in candy, cake, ice cream, it's about half as much.
That adds up to 50% of the added sugar consumed by children.

**Peter Attia** (2:35)
And what is that number, by the way, in grams per day approximately?

**Robert Lustig** (2:38)
Oh, it runs the gamut, but the median is 18 teaspoons.

**Peter Attia** (2:42)
So that's about 90 grams of sugar per day.

**Robert Lustig** (2:45)
Yeah, it used to be 120 It's actually come down because of the obesity epidemic.
90 to 94 grams of added sugar per day.
Half of the sugar is in foods you didn't know had it.

**Peter Attia** (2:57)
Bread, pasta sauce.

**Robert Lustig** (2:58)
Pretzels. Why pretzels have sugar in them, okay? Bread, right. Why do they put sugar in bread?
Any idea? I guess.

**Peter Attia** (3:07)
It probably helps with preserving it, doesn't it?

**Robert Lustig** (3:09)
Exactly. So if you buy a loaf of bread at the bakery, how soon before it stales?

**Peter Attia** (3:14)
Two days, typically.

**Robert Lustig** (3:15)
Two days. If you buy a loaf of bread at the grocery store, how long before it stales?

**Peter Attia** (3:20)
10 days.

**Robert Lustig** (3:21)
Three weeks.
Why? They're both bread, right? Well, what they did in the grocery store bread was they added sugar, very specifically, because the sugar doesn't boil off when you put it in the oven. Water does. So it acts as a humectant. It keeps.

**Peter Attia** (3:41)
That's why it's so much moister when you have store-bought bread.

**Robert Lustig** (3:44)
Exactly. That's why if you threw a loaf of bread at my head, it would just bounce off, is because it's kind of spongy, right?
But there are also breads like German fitness bread, which don't have that. They're real bread. They use whole grains. They're lumpy, bumpy. And they're small, the loaves. They're the size of a brick.