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Fat Chance: The Hidden Truth About Sugar, Obesity and Disease

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Robert Lustig’s 90-minute YouTube video “Sugar: The Bitter Truth”, has been viewed more than two million times. Now, in this much anticipated book, he documents the science and the politics that has led to the pandemic of chronic disease over the last 30 years.

In the late 1970s when the government mandated we get the fat out of our food, the food industry responded by pouring more sugar in. The result has been a perfect storm, disastrously altering our biochemistry and driving our eating habits out of our control.

To help us lose weight and recover our health, Lustig presents personal strategies to readjust the key hormones that regulate hunger, reward, and stress; and societal strategies to improve the health of the next generation. Compelling, controversial, and completely based in science, Fat Chance debunks the widely held notion to prove “a calorie is NOT a calorie”, and takes that science to its logical conclusion to improve health worldwide.

320 pages, Paperback

First published January 1, 2012

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About the author

Robert H. Lustig

12 books334 followers
Robert H. Lustig, M.D., is an internationally renowned pediatric endocrinologist who has spent the past sixteen yers treating childhood obesity and studying the effects of sugar on the central nervous system, metabolism, and disease. He is the director of the Weight Assessment for Teen and Child Health Program at UCSF Benioff Children's Hospital; a member of the UCSF Center for Obesity Assessment, Study, and Treatment; as well as a member of the Obesity Task Force of the Endocrine Society.

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Displaying 1 - 30 of 706 reviews
Profile Image for  ⊱ Sonja ⊰ ❤️.
2,293 reviews409 followers
September 22, 2022
Ein sehr ausführliches und informatives Buch! Vieles kennt man schon, aber es gab auch Neues und vor allem andere Blickwinkel.
Für mich sehr interessant, da mich das Thema Ernährung grundsätzlich sehr interessiert.
Profile Image for Todd.
49 reviews10 followers
February 17, 2013
This was a great book about the hormonal chains and effects of eating, and explains it in ways that are both thorough and accessible. Some of the information I had read before in my obsessive reading about fat/weight loss, but here it was put together in a systematic way to make sense of what your body is doing with what you put into it. Because I'm a social scientist, I got a bit bogged down in the last section about social policy, because his understanding of large social policies and politics is simplistic; yet I agree with his overall critique of the food industry and governmental policies on nutrition.

For me the real eye openers were: the chapter about stress and cortisol and its connection to obesity and metabolic disorders; the explanation of the liver's role in digesting both sugar & fat; the role that sedentism plays in increasing metabolic disorder and the relative miracle that daily exercise can have in reversing it; and the complexity of fructose vs. glucose.

He also busts several nutritional/weight loss myths: a calorie is not a calorie; you cannot lose weight by exercising; and all diets that eliminate sugar are successful (most successful are complete opposites, Atkins diet and Veganism, because they both eliminate sugar completely and focus the liver on one form of digestion).

One problem for me in the book is that he talks a lot about how losing weight is actually impossible, and that we should focus on health rather than weight loss. I actually agree with him, mostly, and am pleased that the negative effects of obesity on health and well-being and longevity can be eliminated by eating healthy foods—basically you should switch to whole foods, eating sugar only in the form of fruit and real whole grains (no processed grain at all, because it's just sugar)—and exercising. But I also think that he underestimates the value of something else he emphasizes, which is to change your food environment. That is one of the things that the research shows that people who are successful at weight loss do consistently. The trick is to change your food environment in a world of food abundance. I'm not quite ready to let go of my own fantasy of losing weight, although I probably should.

I was also a bit more dubious about the anti-oxidant chapters, but if I ate how he suggests, I would get plenty of them anyway, so if it turned out that we need them and in high quantities, I'd be getting them regardless.

So yeah, if you're interested in health, nutrition, obesity, or weight loss, read this book.

The fact that the food industry hates it should be endorsement enough.
Profile Image for John Braine.
362 reviews38 followers
February 21, 2021
This is getting 5 stars not because it I loved it so much, some of it was a bit of a chore. But it's one of those books that you wish everyone would read, or that it was on the school curriculum, as the content is so important.

I don't hold much truck with news headlines that say this food or that food, is bad for you, or good for you, and then next week it's bad for you again. I prefer to get my facts from scientific books, like this based around the life work and knowledge of a whole career.

Here are some facts that I have learned from this book:

- Fruit is good for you. But only as nature intended. Peel an orange, eat it, great. But even juicing it, changes the health benefits. You're just drinking sugar water, and it's not much better than a can of coke! Even smoothies shred the fibre too much.

- (Natural) Juice has 5.8 teaspoons of sugar per cup. Soda has 5.4

- "Real food doesn't have or need a Nutrition Facts label. The more labels you read, the more garbage you're buying"

- Stepping on a scale measures 4 types of weight: 1. bone, 2.Muscle 3.Subcutaneous fat (big ass, fat thighs etc) and 4 Visceral fat. Subcutaneous fat isn't bad for your health, but Visceral fat is, this is fat around your belly and inside your organs. That's the fat you need to lose. (If your focus is on health rather then vanity)

- Obese people should not be judged. They're not lazy overeaters. Although some may be, that's a grossly incorrect generalization. There is a vast range of health issues that makes it impossible for them to lose weight. And a vast range of societal problems that could have got them there in the first place.

- The single best thing you can do to keep healthy is cardiovascular workouts. Running, cycling, swimming etc. (Note: I'm talking about health, well being, not looking good).

- Sugar is a poison. It's not the type of poison that will kill you straight away. It's worse than that. It will slowly eat away at your health, and ultimately decrease your life span.

- The only guarantee you can have of eating foods that are not sugared is anything with a label... real food. Meat, fruit, veg etc.

- A calorie is NOT a calorie. This is a highly propogated myth. Or rather an oversimplified concept. Some calories are not burned off as easily as others. The type of caloric intake varies greatly. e.g. 1000 calories of Kale is not the same as 1000 calories of suar

- "All successful diets share three precepts: low sugar, high fiber, and fat and carbohydrate together in the presence of an offsetting amount of fibre. Anything after that is window dressing"

- "First step in eliminating your sugar consumption is to start eliminating all sugared beverages. We were designed to eat our calories not drink them"

- Make dessert a once-weekly treat at the weekends. For you and your kids.

I've had a life of sugar over-consumption. And I've also mostly had a sedentary life with little sports activity. And have always been *lucky* to have a metabolism that resulted in me never really getting fat. But I'm starting to almost consider that a bad thing, because I'm pretty sure that abuse has manifested itself in many other ways. Constant stomach aches, Major fatigue issues etc etc, I've a long list of symptoms. Maybe if I got fat I would have cut down on sugar intake a lot sooner and I might be healthier now.

Having said that I've vastly cut out sugar recently and started exercising, and I'm definitely noticing health benefits. And this book really drove all that home. If I could go back in time and warn my younger self about one drug to watch out for it wouldn't be tobacco, alcohol, class A drugs or recreational drugs. It'd be sugar. It's the one addictive, and slowly damaging drug that no one seriously talks to you about. Hopefully that will start to change.
Profile Image for JA.
95 reviews5 followers
February 12, 2013
I am giving this book a high rating with mixed feelings.

On the one hand, I was really interested in the information, and his explanations of the science seem solid and at a good level of detail. Fundamentally, I found it compelling and convincing enough that I am making some changes in my eating habits based on it. So, that's pretty good.

But several things about the way this was written annoyed me.

The major problem:

In some places he is very clear and specific that being overweight is one thing, and metabolic syndrome (the cluster of diseases that are correlated with overweight) is something else. He even gives specific numbers: 20% of "morbidly obese" individuals are metabolically healthy, 40% of "normal weight" individuals have metabolic syndrome. OK, that makes sense, and fits with the information I have from other sources (such as Health at Every Size). However, having stated that and given the numbers, he then goes right back to talking about obesity as a disease ("the obesity epidemic", etc). How can you teach people about the distinction if you keep using the words interchangeably?

Minor issues:

He starts every section with an anecdote about an obese child from his practice. On the one hand, it certainly catches your attention. But it felt overly sensationalist to me.

When it comes to the section where he gives advice on diet, some of the recommendations are clearly based on the science he explained earlier -- but other bits are not really explained. For instance, I would have liked to know the science behind the recommendation not to eat after dinner. Just stating that it has something to do with one of the hormones previously referenced is not sufficiently convincing.

Overall: If you drink sugared soda or juice, this book is likely to convince you to stop (or at least cut back substantially!). Similarly, if you are a couch potato, or eat a lot of fast food, he gives some compelling reasons to change your ways. But if you happen (like myself), to be a (healthy, fat) person who already has fairly reasonable eating and exercise habits, at best this may make you rethink a few details (in my case, I'm going to try to get out of the habit of eating sugar-sweetened yogurt and cut back on some of my previously habitual breakfast cereals) but it won't necessarily be life-changing.

Nevertheless, I am glad to have read it.
Profile Image for John Wiltshire.
Author 20 books731 followers
December 14, 2014
I came to this book through a recommendation by Mike of Six Pack Shortcuts on YouTube. I haven't eaten sugar for a very long time now. I don't do carbs, so it's easier for me to avoid most of the places where sugar can be found. But it does get really, really tiresome constantly going through the spiel when people offer you something to eat that's got sugar in, so I thought a little science to back up my, "Sorry, I don't do sugar," routine might help. There's nothing that makes people shut up like throwing a little science at them, is there? And I seem to be living in a world where everyone is getting fatter around me. And yet portions are getting smaller (can you remember having a Mars Bar when you were a kid and hardly being able to get your jaw wide enough to chomp around it?) and everything is supposedly "low fat". What the heck is happening? Hopefully I'm about to find out. (Well, I actually do know the answer to this, but I'm curious to see what Robert Lustig makes of it).
I'll update when I'm done.

Hmm. I finished this one today. I think my aim of being able to throw some science to back up my (always irritating to family and friends) "I don't eat sugar" claim was a little optimistic. The book is packed with science. It's the most science-y thing I've ever read, but it's way over my head. Interesting, but not stuck in the old noodle enough to quote or use.

For the first two thirds of this book I was seething. I'll explain.

Basically, doctors writing about obesity have a bit of a problem. If they say what they probably think, no one is going to read their book, and they'd eventually be quietly sidelined from the scientific community as being a bit "toxic". ie, no doctor these days is going to say that people are fat and getting fatter because they eat too much of the wrong food and don't take enough exercise. Lustig spends a huge proportion of the book claiming that obesity is nothing to do with individuals--that we are victims of the toxicity of our food. We have no choices about what we eat, about our portion size, etc. So, hence the seething from yours truly. It seemed to me that he completely and deliberately ignored the fact that there is a significant portion of the population out there who religiously make healthy food choices and take exercise to the detriment of social norms, and thus keep their weight low and stay healthy.

He also went on at some length to show that fat does not necessarily equate to ill-health, or thinness to well being. And he backed this up by talking about pregnant women and babies who need some extra fat. This seemed totally disingenuous to me. Does he not realise that the fat lobby (health at any size, the thin privilege, fat is beautiful) take books like his and subjectively quote them to promote their dangerous agendas? They fasten on any evidence that it's not their personal responsibility that they are fat (and anyway, what's wrong with being fat?) that it's genes, lack of access to real food...whatever. Well, we all realise that in some circumstances humans lay down fat stores. Yes, we were once all hunter gathers facing times of starvation. But that is far removed from the crisis of obesity that is plaguing this planet now, and his defence of obesity in terms of "it's not your fault" really pissed me off, not to put too finer point on it.

He was definitely one of the "diets don't work" supporters. Sure, diets don't work if you take diet to be "the short term horrible thing I'm going to stick to until I've lost the weight and then I can go happily back to eating and sitting on the couch just like before". Diet means lifestyle choice and, no, it's not easy to change a lifestyle, but it can be done. By taking away anyone's motivation before they've even begun by telling them they have no hope, they're victims of international conspiracies to keep them fat, seems really wrong to me. Indefensible.

I'm going to quote from a fat-activist site post which went up the other day complaining about a re-write of the song It's The Most Wonderful Time of the Year to It's the Most Fattening Time of the Year:
In short, the song bothered me because it reinforced all the stereotypes I know about why people are fat or how they became that way. It reinforced the body-policing tendencies of our society and the idea that fatness is just a matter of poor impulse-control. And it might be just a fun jokey song for people who aren’t actually fat, but if you are, it’s another slap-in-the-face reminder that you’re expected to give up any and all enjoyment in life until you lose weight. (emphasis mine)

So, according to this poor soul, food is her only enjoyment in life? Wow. Doesn't that just about sum up the obesity crisis of our time?

The last third of the book got into the politics of obesity and set out quite succinctly how the food industry is deliberately conspiring with politicians to make us fat by pricing policies, marketing etc. Lustig advocates interventions by law to enforce public health issues such as no soda in schools, a soda tax, better access to real food for the poor. All worthy initiatives. But it seems to me (and yeah, what do I know in the face of all that science he quotes that I didn't even understand) that if you've already confirmed in people's minds that being fat isn't their fault, that if they try to do something about it they will inevitably fail, then no public health message is going to make a blind bit of difference anyway.

I had a bit of an epiphany whilst I was mulling over this review out running yesterday. The words of that sad woman I've quoted above kept playing in my mind. Her only enjoyment in life.

This was my epiphany:

I've been doing something called a core challenge for a last few months. It's very simple: you hold in a plank position every day for as long as you can, then up the time the next day and the next... To anyone watching it looks very easy. You don't move. You just hold yourself on arms and toes. Trust me, it's one of the most difficult physical things you can do and it strengthens every single part of your body. I've seen huge benefits from this challenge in my weight training, my HIIT (high intensity interval training) sessions and in my running. It's CORE strength. I can't emphasise that too highly. The core of your being. Physical being anyway.
So, it seemed to me whilst out running, couldn't that somehow be transferred over to the mental side of "dieting" (I put that in quotes because I hate that term. It's not a diet, it's a lifestyle change. For LIFE). Core strength for the mind. Wow. Find the things that make life worth living outside of food... I desperately want to take that woman who found a song offensive because it threatened her relationship with food and show her all the wonderful things life has to offer when you free yourself from the addiction to food.
Run, cycle, swim, lift weights, lie like a bloody plank, dance, make love...it doesn't really matter what, it's all movement of the human body and it's fantastic, addictive, the best drug in the world. And it's all yours and it's entirely free.
I want to devise a core challenge to build motivation daily in little steps, so that people can lose weight and keep it off because they've changed the very way they think. According to Lustig no one keeps weight off. It's impossible.
I beg to differ.
So, no, I'm not all that impressed with Dr Lustig.
I had to laugh. I was recovering from my run, sitting on the deck (don't pronounce that the Kiwi way, please) drinking a freshly juiced carrot juice (I've been reading Joe Cross) and actually read in Lustig's book as I was drinking it how dangerous juice is. It's got more sugar in than soda. So, core, weights, cardio and then a run and then some carrot juice. Shit. I'm doomed.

Profile Image for Roger.
52 reviews2 followers
December 15, 2013
I watched Dr. Lustig's now famous lecture last year, Sugar: The Bitter Truth (find it on YouTube) and just finished his book - Fat Chance: Beating the Odds Against Sugar.

Read it and you will come to understand why he says "a calorie is not a calorie" and "not all calories are equal".

Learn how we metabolize our food when we eat real food and what makes things go wrong in that process when we eat processed foods - stripped of much or their nutritional content and fiber that are replaced with sugars and other additives to make them taste so good that we buy and eat more and more. Understand what this does to our biochemistry and how it short circuits not one but two pathways to the brain that normally tell us we've had enough. Ultimately this overrules the will, driving disordered eating behaviors no matter how hard we try to resist.

Dr. Lustig shows how overdosing on sugar in any form (as nearly all Americans and much of the rest of the World now does - on a daily and ever increasing bases) is toxic, reeking havoc on the body, and is manifested in ever growing rates of metabolic diseases that are killing huge numbers of people and driving billions of dollars into healthcare costs we all bare.

This is a book for all who are concerned about the food supply, nutrition, the ever growing epidemic of metabolic diseases (diabetes, heart diseases, hypertension, etc.) and the toll these are taking on the health of too many, including the epidemic of obesity rates in 6-month old babies, and the associated costs to society.

There are solutions, but in Dr. Lustig's view they need to be pushed for, demanded by all of us in order to overcome the political and big business forces against them.

I believe Dr. Lustig underestimates, or at least understates the power of the will in effecting long term personal changes in what people choose to eat - for those who have true choices available and possess the economic means to implement them. But this clearly leaves many people out, especially those effectively addicted, whose food environments are devoid of fresh whole food choices and the economic means to afford them.

This book is important in that it informs and arms us with the knowledge of how and why our biochemistry works the way it does, and that of the continually emerging picture nutritional science is bringing into clearer and clearer focus. With understanding of the principles, long term changes can result.

The science is clear, our diets need to be overwhelmingly based on real, unprocessed, whole foods, that includes both high quality proteins and lots of insoluble fiber that comes along with the sugars in those whole foods (not added sugars) to limit the absorption of the toxin fructose into the body. This along with moderate lifestyle changes to get us more physically active are the antidote to much of metabolic disease. Economic means and real, available food choices are also necessary, and these go beyond personal choice for may - especially the children of the poor.

Dr. Lustig rightly argues that metabolic syndrome is a national and global public health epidemic that will never get turned around with out political will, leadership, and public policy changes.

If you are a skeptic as I was - read this book. I believe Dr. Lustig will convince you and you'll be glad he did. It's that important.
Profile Image for Nigeyb.
1,212 reviews265 followers
May 7, 2016
Annoyingly verbose, with far too many rhetorical questions, and it's exclusively US-centric, however it is also chock full of very helpful information. A good editor could have halved the length without compromising the message or the scientific explanations however I still recommend this book to everyone.

Fat Chance: The Hidden Truth About Sugar, Obesity and Disease contains important nutritional information that is not being given the prominence it deserves by many policy makers and health professionals, and certainly not by the food industry. My assessment is that the food industry is where the tobacco industry was around fifty years ago. Those that are selling processed foods, most of which have added sugar, know their addictive products are indirectly increasing their customer's risk of all the major life threatening diseases but, due to their high profits, will do nothing unless compelled by legislation. Consumers are on their own.

This book explains why obesity has become such an issue in most developed countries. The reasons are too wide and varied to summarise here however by far and away the biggest culprit is added sugar, particularly in the form of fructose.

Robert H. Lustig's key message is that a healthy diet is high fibre and low sugar. Low sugar means you should avoid processed foods, fast foods and soft drinks, and prioritise real, unprocessed, whole foods, including high quality proteins. Increasing physical activity will further maximise your health and well being. That's my distillation of what I took to be the key message. There is a lot more useful and interesting information in the wide ranging, interesting and important book.
Profile Image for Vivian.
536 reviews38 followers
April 17, 2013
Okay, I'm convinced: sugar is the devil incarnate! Now that I've gone off gluten (with some success), looks like I'll have to add sugar to the list of edible things to avoid. Which isn't much of a stretch: considering sugar adds no value to one's daily diet, and can provoke a host of major illnesses. Lustig makes a strong case for sugar being the culprit in the American society's march toward obesity, and the fact that sugar is extremely hard to resist, especially for children, means this is one issue which is not going away any time soon. While I've been reading about the dangers of too much sugar for years, it is sobering to realize that American supermarkets are becoming repositories for processed foods, most, if not all, containing sugar (as well as salt and fat) added to increase their addictive qualities. Eating natural foods is so much easier in Europe, since the supermarket shelves here are not stocked with majority processed foods, and the advertisements for such foods are not nearly as prevalent. An interesting book for those trying to figure out what to eat for health.
Profile Image for Clayton Morris.
126 reviews84 followers
May 12, 2013
This book is a must read for anyone concerned about his or her health. Lustig knew he'd take knife and arrow attacks that's why he walked into this battle against processed food wearing an armor of excellent research and experience. If this book doesn't change your habits then you're head isn't hooked up right.
Profile Image for Richard.
1,139 reviews1,028 followers
August 10, 2016
Okay, yeah, I finished this eons ago. Then I bought a copy (I first read it as a library loan), with the intention of re-reading and writing a Big Review. Now I'm behind by at least four (five?) Big Reviews. But this could change you life — even give you years more of health and life. Read it, even if I never get around to writing that Big Review.


• GuardianUK: Fat Chance: The Bitter Truth About Sugar by Robert Lustig – review and Sugar, not fat, exposed as deadly villain in obesity epidemic , and then The demon drink: war on sugar .

• TelegraphUK: Fat Chance by Robert Lustig and Drinking Water: A History by James Salzman: review

http://www.nytimes.com/2012/11/27/bus... (links to http://graphics8.nytimes.com/packages...)

But Paleo—

And but genetics—

More re fiber:

Yet another source, an interview with the Doc 'cause he's written a cookbook:
Oh, and: The Fat Chance Cookbook: More Than 100 Recipes Ready in Under 30 Minutes to Help YouLose the Sugar and the Weight

The Atlantic did a very informative article in June 2014 that cites lots more on sugar research.
Profile Image for Beth666ann.
192 reviews3 followers
March 19, 2013
This book is depressing to anyone who struggles with weight and believes weight loss can be achieved through dieting, but it rings true and is well backed-up with research--and the author does, at the end, pose some solutions to the dilemma he outlines. Basically, this book says, diets never work and all you can do once you've ruined yourself by getting too many fat cells is exercise your ass off and try to eat lots of fiber and stay away from processed foods. Alcohol = evil. Sugar = evil. Also, when you reduce your food intake (as in a diet), your body will after a while almost ALWAYS reduce its own energy intake to counterbalance it and keep you from losing more weight. This is because when we were cavemen, we ate as much as we could in times of plenty, then slowly used up the fat in times of famine. Our bodies are apparently still keyed to that. However, the food industry, specifically through the 1970s initiative to go "low-fat" and through the discovery of the cheap-to-produce high-fructose corn syrup, took fiber out of most foods and replaced it with sugar. In the last couple of chapters, the author examines things that individuals can do (there's a great shopping list with green, yellow, and red foods), and he also examines what we as a nation can do and looks at the social policy end of things. This is an interesting look at the obesity epidemic because it looks at public health, big food, and medical stuff all at once. What's missing is psychology--but that's kind of the point: this author doesn't believe the obese should be blamed for psychological weakness. I agree--and yet I also think there are great food habits and techniques for managing intake that psychology/cognitive behavioral therapy can provide. But again, this book is not about that. It's a great, if disheartening, read.
Profile Image for Thomas Ray.
1,009 reviews326 followers
June 19, 2019
The enemy is insulin resistance. Causes liver disease, diabetes, other metabolic disease.


Avoid sugar. Avoid processed food (anything nonperishable).

Get your plant-based foods in fresh intact form: nutrients encased in a protective sheath of fiber. Slows absorption, reduces overeating, protects liver from rush of nutrients. Fresh intact fruits, vegetables, nuts, intact whole grains. If the fiber has been polished out or juiced or frozen, it can't do its job.

Every page of the first half of the book drips with revulsion for fat people.

Author admits medical doctors are one-trick ponies: "take a pill!"--and there's no pill. Doctors can do nothing.

Author comes close to acknowledging that doctors' advice--eat less, go on a diet, starve yourself to lose weight--is actively harmful: energy expenditure falls to match reduced intake. Book doesn't say this, but what's striking about very fat people is how very still they are. They got this way by being very diligent about starvation dieting. They've trained their bodies to conserve every calorie. The body preferentially consumes its own muscle, rather than fat, when starving: muscle burns fuel 24/7: the body destroys it, to stay alive.

The book is also self-contradictory, sloppy, glib, elitist.
Profile Image for Christina Dudley.
Author 16 books123 followers
November 29, 2012
I devoured this book.

Lustig, a pediatric endocrinologist at UCSF whose "Sugar: The Bitter Truth" lecture video got lots of hits on YouTube, has been watching the rise of obesity and its attendant ills in his practice over the last umpteen years. While not every obese person is unhealthy (and many people with acceptable BMIs still suffer from metabolic syndrome), obesity frequently brings in train "the cluster of chronic metabolic diseases...which includes...type 2 diabetes, hypertension (high blood pressure), lipid (blood fat) disorders, and cardiovascular disease," along with "co-morbidities associated with obesity, such as orthopedic problems, sleep apnea, gallstones, and depression." Lustig even mentioned the increase of dementia as tied to this whole mess, as insulin resistance leads to dementia!

Consider some of his alarming statistics:

- 1/4 of U.S. children are now obese;

- Greater than 40% of death certificates now list diabetes as the cause of death, up from 13% 20 years ago;

- The percentage of obese humans GLOBALLY has doubled in the last 28 years; there are now 30% more overnourished (obese) people than undernourished, worldwide;

- Fructose (all the sugars you can think of, apart from the sugar in milk) is "inevitably metabolized to fat";

- Fructose consumption has doubled in the past 30 years and increased six-fold in the last century;

- The majority of humans, regardless of weight, release double the insulin today as we did 30 years ago for the same amount of glucose; this hyperinsulinemia leads to insulin resistance, the body thinking it's starving, and increased eating, especially for foods high in fat and sugar because our dopamine receptors aren't getting cleared--a vicious cycle;

- The processed food industry has turned to increased sugars of all kinds to improve flavor and shelf life; we eat lots of processed foods; therefore, 20-25% of all calories we consume on average come from sugars; in adolescents this number can approach 40% of daily calories.

Because I was blitzing through this, I didn't absorb the science as well as I might have, but Lustig helped me understand that how often, how much, and how unhealthily we eat can be a function not of choice but of our biochemistry. The feedback systems and processing systems which served humans so well for eons were not built to handle as much food as we eat nowadays, particularly the avalanche of empty sugar calories. Sweets and fats used to be hard for us to come by--if we hit a surplus, of course our bodies stored it up (as fat) for a rainy day! Unfortunately, there are no more rainy days, so we keep storing and storing and overloading the system.

Lustig's book is not about dieting or losing weight--in fact he says we have natural weights we gravitate toward, and there isn't a heckuva lot we can do about it, exercise or no exercise. But obesity is a new thing that is environmentally-aided, and that can be fought against.

His conclusion? You can probably guess. Lots of fruits and vegetables and fiber. The fiber in fruits requires enough work to digest that it effectively negates the fructose. Milk or water to drink (lactose is not processed like fructose). Meats (not corn-fed) and dairy (ditto) are fine, but don't skip the produce. Whole grains (all the brown in them--exactly how my son doesn't like them), but even then there's no need for tons of grain. And, if it has a nutrition label, it's a processed food. Use sparingly.

The low-hanging fruit Lustig tackles first is ridding your life of soda, smoothies, frappucinos, and fruit juice. (8 ozs of orange juice has more sugar than 8 ozs of Coke.) If you do alcohol, do just enough wine to get the resveratrol benefits and then lay off.

As Lustig points out, changing one's food environment is all but impossible for the poor. After all, corn and soy receive massive government subsidies, making the processed foods based on them cheap, cheap, cheap. Even if you had access to fresh produce, your money goes farther on the stuff in boxes, and food stamps cover soda. One of the more disheartening bits of the book was when he talked about meeting with Michelle Obama's personal chef Sam Kass, the point person for the White House Obesity Task Force. Kass admitted everyone in the White House (incl the Pres) had read Lustig's NYTimes article "Is sugar toxic?" but they would do nothing to help. "Because they don't want the fight, this Administration has enough enemies." Sigh. Not that the Republicans mentioned fared any better. Basically, changing our food landscape is up to us. For those of us with the dollars, vote with our dollars! If we don't buy it, not all the food stamps in the world will make it profitable.

Kind of a bummer to read this going into Christmas-cookie season, but one of my New Year's Resolutions will be to improve the food environment for my kids. (How I wish I had a time machine! I would never have introduced our biggest consumption area for processed foods--breakfast cereal. I can only comfort myself that we don't eat any off of his "Ten Worst Children's Breakfast Cereals" list!)

Highly recommend.

(Thank you to NetGalley and Hudson Street Press for the ARC.)
Profile Image for Marcelo.
89 reviews2 followers
January 30, 2013
"A calorie is not a calorie". This very simple statement, which is repeated across this book multiple times (and which drove Lustig's conference "Sugar: the bitter truth", which can be seen on Youtube) drives the narrative of this book and in the process upends a lot of our understanding about weight, health and our personal responsibility. Lustig walks you through the metabolism of sugar - specifically fructose, the sweeter half of sucrose and HFCS - and makes a very convincing case that sugar, because of the way that it's metabolized by the body is a toxin. And considering our current industrialized food environment, which in the last 30 years has been tilted towards including sugar in higher quantities in nearly every packaged product, this has led to the disastrous metabolic syndrome pandemic (of which obesity is just an external marker) that we are experiencing now.

What was really interesting to me on this book is how many of the common messages about dieting and exercise really don't help. Exercising alone will not burn all the extra calories, your body will compensate. Low fat foods, loaded with sugar for flavor, are attacking the wrong flank in this battle. Sweeteners are basically unstudied, so there's no telling whether the sweetness itself sends signals to your body to release insulin and drive you to eat more (there are studies that you end up craving more sugar as a result, actually) And we've seen the results - dieting that frustrates people, difficulty keeping up exercise regimens in the absence of weight loss. You think you are the problem, just you and your gluttonous ways. No mention of all the stealth sugar, nicely subsidized by our taxes, that we are fed day to day while being told to lose weight. As Lustig says - "We've been frucked".

Much has been made in media outlets of the latter portion of the book, and how we can get some societal intervention to curb sugar consumption, be it through laws or regulations or taxing to limit availability. Many will say "that's too much, anyone can diet" The thing is, as Lustig says, you don't stand a chance with dieting. Every incentive is there for you to eat more and more, and to consume more and more sugar. You are hooked on it without you even knowing. You are sold healthy smoothies which are loaded sugar and have removed all insoluble fiber. You cannot find a whole grain bread in which the grain has not been smashed to smithereens and loaded with sugar for shelf life. It's everywhere. Sure, you can control it (just buy stuff in their natural form, and be very wary of any packaged product) but in the end that is not sustainable to feed the world. Something has to change in the food supply to make it healthier.

All in all this book is illuminating. This is the rare book that talks to you like an adult and says "look, here's the science, you tell me if this doesn't make sense.". And it clicks. You will never look at sugar the same way (I know I've gone and cut as much as possible from my diet in the last two weeks, after seeing the Youtube conference - and now even more so, after reading the wider, Cinemascope version). And you'll be healthier (and maybe a bit skinnier, hopefully) for it.
Profile Image for Bex.
34 reviews13 followers
April 8, 2013
This is not a diet book. It's a book about nutrition, biology and public health and its science is spot-on.

I've done a ridiculous amount of reading on nutrition and diet books (both personally and as an editor) and this book is an excellent summation of everything out there today on what we currently know about the state of our food.

The bottom line is that our government is subsidizing foods that make us sick and have been for a long time, and it's a primary reason we have seen an explosion in diabetes and obesity.

This book gives a thorough rundown (I didn't think it was that technical but I've read quite a few of these things) on how sugared processed foods are basically toxic to human beings. Sugar and corn sugar (and fructose in particular) are the real culprits, according to Lustig and he builds a very powerful case against them in this book.

If you're looking for how to apply this information to your own lives it comes down to cutting out sugar, eating processed food only when its coupled with higher fiber (3g per serving, min.), and exercising (not for weight loss benefits because exercise has very little impact on a person's weight but because it's essential to human health).

Lustig argues we need a public health policy that addresses the problems the low-fat diet has caused because low fat has translated to highly processed carbs via subsidies for corn. To put it simply: sugar, often in the form of processed carbs, destroys your body's ability to properly regulate hormones, including the signals that tell you when you're full.

Anyway, I've read lots of middling reviews for this book--people complaining that Lustig has a strong take on public policy (he'd like to regulate sugar the way we regulate tobacco or alcohol) and not a strong enough "diet" he's selling. But I think that's the strongest selling point for this book. Lustig isn't looking to sell you anything but his ideas (yet--I'm sure the Fat Chance Diet is coming if this book sells well). And his ideas are based in solid evidence.

Profile Image for Shauni.
253 reviews4 followers
September 18, 2014
I heard Dr. Lustig on NPR a year and a half ago, and finally got around to reading his book. I'm glad I did! He is a pediatric endocrinologist, and really goes into scientific detail to explain what sugar does to our bodies. I learned so much:

1. A calorie is not a calorie.
2. Sugar, at the level that most people eat it, is toxic and is a major cause of metabolic syndrome.
3. Losing weight long-term is virtually impossible.
4. Preventing (and reversing) metabolic syndrome, on the other hand, is possible by limiting sugar intake, increasing fiber, and exercising more.
5. The one thing that all successful diets, from Atkins to vegan, have in common is the exclusion of sugar.
6. Fructose is metabolized as a fat in the liver, making it really both a fat and a carbohydrate.

Dr. Lustig calls for change both on a personal level as well as a societal level. On a personal level, he urges people to eat real food, exercise more, and eliminate especially sugared beverages from their diets. On a societal level, he calls for the FDA to remove fructose from the list of foods generally regarded as safe (GRAS), SNAP to remove sugared beverages from its portfolio, school cafeterias to stop serving chocolate milk, juice, and other junk food, and legislatures to enact stricter advertising laws.

Personally, this book prompted me to set a few goals regarding sugar:
1. Avoid soda, juice, and other sugared beverages.
2. Eat 6 tsp or less of sugar per day.
3. Eat real food as much as possible, and limit processed food.
Profile Image for Andy.
1,377 reviews467 followers
November 3, 2013
Fat Chance covers much of the same info as Gary Taubes's books but is written by a medical scientist instead of by a professional writer. Usually this would give the advantage to the scientist, but Gary Taubes is one of the few science reporters in the country who understands that science (or reporting, for that matter) means asking "How do they know that?" so I also recommend those.
Dr. Lustig deserves a lot of credit for publicly speaking out to smash some of the common myths about the obesity/metabolic syndrome epidemic. He makes a convincing case that sugar is the main culprit. Still, the whole thing is not as clear as the connection between smoking and lung cancer or alcohol and drunk driving. So he may be getting carried away a bit. The book has an activist tone. He is trying to spark a movement to fight the ubiquity of sugar. It would be nice if the science were clearer, but because it does appear to be an environmental/social problem, it will be hard to see real reversal without making changes at a population level. In the meantime Dr. Lustig's recommendations for individuals are reasonable.
This book could help many people.

Why We Get Fat And What to Do About It by Gary Taubes
Good Calories, Bad Calories by Gary Taubes
Profile Image for Casey.
Author 1 book25 followers
December 31, 2015
This is an interesting book on the health food industry. It's thesis is pretty simple: sugar is bad for you.

The book first discusses why we as mammals are drawn to sugar, as (I learned this interesting tid-bit from the book) almost nothing in nature that is sweet is also poisonous. Mix this predestination for sweets and the food industry's ability to manipulate our tastebuds with salts and other additives and bam.... you have an obesity epidemic.

He also spends a great deal of time differentiating genetic predisposition for obesity and sugar-overload-induced obesity. He is not advocating for any one diet, nor does he diagnose any real diet (other than a low sugar diet).

Another thing that he notes is the tendency for health-conscious dieters to make smoothies or blend their fruits and veggies into a pulp. He argues that this is about just as harmful for you as drinking SunnyD as it strips the fruits and vegetables of their original fiber (and another argument that he uses is that you should not be consuming sugar unless it is attached to a high fiber product). So, if he is right, all of you juciers beware.

I have found that each nutritionist has their own theory. Here is mine: eat well and often! Interesting book overall, I did learn somethings, but I never know how to feel about a zealot claiming he has solved any problem completely.
Profile Image for Max Skidmore.
118 reviews
March 25, 2013
I enjoyed reading this book but only gave it two stars because of pessimism about how much is believable. There has to be just under three trillion books written about weight loss and good health. With such a volume of work, it is difficult to know who you can believe. This author is a medical doctor and that gives him some credibility. Much of the book deals with metabolism at the cellular level and is aimed at individuals with a PhD in Micro Biology....this seems to add to his credibility. However, I just had to wonder if the author is trying to sell books with a new twist on the 3 trillion?

He blames the current obesity "pandemic" on Richard Nixon who wanted to get re-elected and was worried that expensive food would derail his campaign. (Funny how Republicans are responsible for all the world's woes?) According to the author:
* The villain is sugar and it's immediate relative, High Fructose Corn Syrup
* Fat is NOT the enemy as we have been told (Thank you, Mr. Nixon)
* The antidote to our obesity "pandemic" is exercise and fiber

If you are looking for justification to eat ALL the butter and bacon you crave, pick up this book and mark pages 201 and 203.
Profile Image for Thomas DeWolf.
Author 5 books52 followers
June 12, 2013
It's the sugar that's killing us.

This is a brilliant book that should be required reading for anyone who cares about their health and the health of their loved ones. It should also be required reading for every member of Congress, every member of the medical profession, and everyone in the health insurance and drug industries. Nah, never mind. Too many in Congress and the medical profession have enabled the unhealthy changes in the food supply over the past three decades and the actions of those in health insurance and drugs prove their focus is on profits, not health.

But for real people with real health issues at stake, read this book. It goes far beyond illustrating and proving how and why our food supply has changed so much - completely for the worse - over the past 30 years. The author, Dr. Robert H. Lustig, outlines a course of action that individuals can take to counteract the system, and the policy changes that need to be enacted to fix the system. I have zero faith that the latter will happen in my lifetime, so our best hope is to take our food supply, and our health, into our own hands.
Profile Image for Sean.
145 reviews17 followers
January 27, 2013
"This book is written only for those of you who eat food. The rest of you are off the hook."

I have read a lot of books on food/food industry, and this is one of the best. It now takes a place next to Michael Pollan's book "The Omnivore's Dilemma" on my list of must reads in the genre (I also include, perhaps seemingly oddly, Morgan Spurlock's "Don't Eat This Book"). "Fat Chance" discusses the science behind what sugar and processed food is doing to our bodies. About a decade ago, I lost about 40 lbs doing the Atkins thing (which, as this book notes, is scientifically sound, but not really maintain-able in the North American sugar/carbohydrate saturated food climate). I also have gone vegetarian for three years, in part for health, and in part for environmental reasons (the meat industry is among the worst polluters on the planet). That said, similar to the other books I have liked, it is not just about obesity/losing weight, but also about the myriad of other issues that can come about as a result of what we put in our bodies.

EVERYONE should read this book.
Profile Image for Ashley.
271 reviews2 followers
March 30, 2018
I devoured this book. Much of it is rather scientific and it took extra time and effort to understand, but now that I know what happens in my body when I consume sugar and why, I feel so empowered. Lustig is clearly passionate on the subject and for good reason. While I might not totally agree with him on what should be done from a social/political standpoint, he absolutely convinced me that excess sugar consumption is making all of us sick. And I appreciate that he used science instead of scare tactics to convince me. Granted, making necessary changes will definitely not be easy and he is frank about that, but the bottom line is that his advice rings true. Eat real food, eat more fiber, exercise, reduce sugar... And you'll feel better. Makes sense to me.
111 reviews
October 29, 2016
A really interesting book which makes you think about what you are eating and why you are eating it. I definitely knew that eating sugar made you want to eat more but I never realised sugar can actually fuel hunger and block that full feeling.

I found the use of scientific studies reassuring and it didn't feel like a diet book. It felt more like an explanation of basic nutrition explaining why certain food types are good for you. It also highlighted the way sugar is an addictive substance which changes the action of hormones like insulin and leptin.

I found this book both interesting from a scientific point of view and from a nutritional viewpoint. I also found the sections which discussed how giant food companies distort the contents of their products to get you hooked, ignore the negative science about sugar and how the government and big business are joined at the hip really frightening and enlightening. Some of the latter parts of the book are a bit less interesting but overall a good effort.
Profile Image for Eddie Clarke.
225 reviews49 followers
January 3, 2013
Very passionately and persuasively written. The first chapters explain incredibly complex biochemical reactions in the body in an easily understandable way (although don't ask me to paraphrase them now!) and Lustig slowly and methodically builds up his case against sugar and its dealers (and enablers in government). He concludes the world's obesity pandemic won't be beaten by individuals exercising free choice (do we realistically have any when 80% of the food products sold in supermarkets have added sugar?) but through government regulation and control of sugar production, marketing and consumption. This book will definitely inspire me to reduce sugar in my diet, including fresh fruit juices.
Profile Image for SheAintGotNoShoes.
1,610 reviews2 followers
January 25, 2022
Ugh, that was about as much fun as getting needles stuck into your eyeballs. Read just like a college science textbook, the last kind of book I would knowingly want to read. I took this out of the library as I am onboard with his anti-sugar stance, and have enjoyed watching his videos on YouTube. The book and his talks are two separate animals.

Book did not need to be this long and can be summarized as follows :

DO NOT go anywhere near sugar, ever.
Eat a lot of fiber
DO NOT drink juice
Exercise vigorously
DO NOT ever bother dieting as it will never work anyhow.
🍩🍪🍭🍬🍫🍰🎂🥔🥖🥨🥟🥠🥧 = the no-no list

Profile Image for Kirsty.
91 reviews19 followers
October 26, 2022
Despite knowing the evils of sugar already this book has definitely educated me to the real reasons and biological mechanisms behind the obesity pandemic. I have to admit that I’ve always thought the individual was responsible for their own weight and it was their business and lack of self control. Perhaps this is my old anorexia thinking, as I know deep down that eating nothing is way easier than dieting. After reading this book I know the problem is mostly due to our food industry, along with other big factors like stress, time, and money. The biggest thing I’ve taken away from this book is rather than being neutral to obesity, ‘it’s their problem’, I’m a lot more sympathetic and wonder at what it will take to fix this problem.

Looking at myself, I’m pretty lucky, I have fairly good genes and also developed IBS-d. If I happen to eat too much sugar or high processed food I get sick in a very physical way which disrupts any reward process. My IBS just like obesity is just another symptom of the poor quality foodstuff that has been normalised and labelled as safe by food companies just because it’s cheap and keeps us addicted therefore buying more. I wonder what other ailments our modern diets have contributed to.

In a nutshell; our modern diet makes us happy and satiated short term but very sick and unhappy long term. It’s time we make the right informed choices and protect our health and stop throwing money at the reprehensible companies that are responsible. The government should definitely get behind this to make this work, whole foods should be either tax free or at the very least be cheaper. Personally, I don’t think sugar tax will work as diet drinks which are just as bad are unaffected and the sugar tax isn’t that much more expensive if you are already addicted to soft drinks. It will be interesting to see what happens in the next ten years as weight is visibly on the rise in the U.K. and our NHS is already on its knees.
Profile Image for ~☆~Autumn♥♥☔.
893 reviews52 followers
December 13, 2017
Lots of things I didn't know from a pediatric endocrinologist who treats large numbers of very sick children who apparently had too much soda in his opinion but I firmly believe that pesticides have done these things. I don't drink soda and only drank it as a child when we went PCS which is Permanent Change of Station from one air base to another. My parents believed it was unhealthy so they didn't buy it but we could drink it on trips. Like Princess Diana soda makes me sick so its easy for me to avoid. As children my sisters and I drank milk, milk and more milk. I am allergic to milk. This guy thinks milk is the greatest thing and he never thinks about food allergy or food sensitivity.

I was very surprised to read that thousands of people have NASH which kills a person and they have no idea that they have it. I was told that I had Non-alcoholic fatty liver when we lived in NM but I had no idea it was so dangerous until I read his book. Apparently, I may have since recovered as my EI doctor there put me on mega dose antioxidants (mainly vitamin C). So take your antioxidants since you might have it too but not know it.

I liked his second book much better than this one. I am still studying it.
Profile Image for Anita.
654 reviews12 followers
December 4, 2018
The book provides a lot of information on how sugar (primarily fructose) affects health. Robert Lustig is a pediatric endocrinologist and he knows what he's talking about. He gets pretty fired up sometimes talking about this matter, probably because he deals with obese children. It must break his heart and make him angry to see the suffering caused by overuse of high fructose corn syrup in processed food. A calorie is not just a calorie and the blame placed upon obese individuals is upsetting to him. He is writing the book for folks who are obese, so this attitude is more of a comfort than an irritant.

I got more motivation to read labels and use less processed food. A surprise was that there are two types of LDL. One is larger and does not deposit in arteries. This is the one in our food. The smaller one deposits in arteries and is produced in the body as a result of carbohydrates. There was a lot of info like that.

At the end there are a few chapters about the strong resistance the food processing industry and also governments have against making changes. Using a cheap sugar to give a taste that folks like and want/need more of is lucrative. Think back about how it went down with tobacco. Same idea.

This is not a weight loss book. It is about better health. A good percentage of people who are not overweight have metabolic syndrome or are on their way to it with the sugar consumed regularly.
Profile Image for Sarthak Gupta.
42 reviews3 followers
January 3, 2020
This should be a compulsory read for everyone. An absolute eye-opener regarding the true cause of rising obesity & metabolic disease in the world. This book proves how "a calorie is NOT just a calorie". It details how our hormones react differently to different foods, why diets like Keto/Vegan are successful and what is the common denominator among them that makes them so. Book also shows a big example of corporate greed. Do read.
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