Robert Lustig, M.D., M.S.L.: fructose, processed food, NAFLD, and changing the food system

**Peter Attia** (0:04)
Hey, everyone, welcome to The Peter Attia Drive. I'm your host, Peter Attia.
The Drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way.
I've spent the last several years working with some of the most successful top performing individuals in the world.
And this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com.
In this episode, I'll be speaking with my friend, Dr. Rob Lustig, who I suspect a good number of you will have already heard of, and certainly have been familiar with through his pretty impressive presence on YouTube, and his talk called Sugar, the Bitter Truth that went viral, I believe, in 2011 And that's about the time when I met Rob. Now, this podcast kind of grew out of a really interesting discussion that I think I get into in the podcast a little bit, but I think it was in 2016 when Rob and I were both invited to Hong Kong to speak at the Credit Suisse Asian Investment Conference. And we were on a panel together, and it just so happened that we were in the same flight back to San Francisco, which was not just a long flight, but more importantly, a flight where you weren't gonna be sleeping much. And Rob and I ended up huddling together over a laptop, going over some really interesting data on NAFLD, which we'll get into in this podcast. And I remember thinking like that just kind of left an impression on my mind, which was, God, this is the kind of discussion I really enjoy having with people like Rob, because it gets into the nuance and away from the headlines. And obviously many years later, fast forward to where we are now, I'm starting a podcast. One of the first people I wanted to reach out to was Rob to have this discussion.
Rob has very recently stepped down from his clinical responsibilities as a pediatric endocrinologist at UCSF. However, he still has a very active presence in his research department. Rob holds a bachelor's degree from MIT. He got his MD from Cornell. And he also has a Master's of Studies in Law from UC Hastings. Something that he did probably about four years ago as he began to realize that only one half of the equation in educating people about sugar was going to come from the scientific standpoint. The other half was going to have to be policy related. In this episode, we talk about a lot of things, but among them, we talk about why Rob believes the food business has really pushed towards having more and more sugar in it and why these have led to the epidemics of addiction, depression, et cetera. He talks also about how you can combat that. And I think something that people miss in Rob's headlines is that he is not just talking about avoiding sugar. He's also talking about the importance of fiber. And we actually get into a very nice discussion about the differences between soluble and insoluble fiber and how it's actually not uncommon for people to load up too much through processed foods on the soluble fibers, but they're not getting the full benefit without having the insoluble, which is really stuff that's hard to get without looking towards real foods, particularly vegetables.
This was really a fun podcast. And I think that comes across in how often we unfortunately probably talk over each other. So I apologize for that in advance. This is also one of the first podcasts I record. So I was still sort of, and I'm still sort of learning the ropes of how to do this.
Unfortunately, Rob had to go to, I believe to a deposition that morning. And so we had a really hard stop that didn't give us nearly as much time as I think we would have spent on this topic. But I do suspect that Rob and I will talk again. We also get into some of the really, I think kind of practical stuff around what is it like to be a parent when you're trying to balance the desire to let your kids be kind of normal and deal with the convenience of not making every meal something that requires a day of planning.
But how do you prevent them at the end of that extreme from sort of mainlining those nasty Capri suns and wheat thins and things like that? So I think some practical advice there is helpful. We do go really deep on fructose and there is some biochemistry in there. It does get a little nerdy. Rob can talk kind of fast and he really knows his stuff on this topic. So he does not pull back from any of that terminology. We're gonna do our best to link in the show notes to some of the definitions and some of the things in there that we get into that will give you a little bit of background. We also get into liver function testing, something that I think many people take for granted when they go to their doctor, but it becomes really important when you're trying to screen out people who might have NAFLD, non-alcoholic fatty liver disease, or NASH, it's more progressed sibling. We talk about uric acid, we talk about metabolic syndrome, we just talk about a whole bunch of things, including we talk about heart rate variability near the end. And at the time Rob asked me a question I didn't know the answer to. We have since learned the answer to that question because I was really intrigued by the discussion. And so for anybody who's interested in that little nuance on heart rate variability, we're going to link to that as well. You'll be able to find a lot more information about this, including information about Rob himself and what he's doing. And also just the stuff that we talk about at peterattiamd.com forward slash podcast. So without further delay, here is my really interesting and intense discussion with Dr. Rob Lustig.