Dr. Lustig Schools A Dietitian

      110 Comments on Dr. Lustig Schools A Dietitian

A reader sent me a link to an interview with Dr. Robert Lustig, telling me that a registered dietitian called into the show to explain how it’s all about low-fat diets and calories in/calories out, which prompted Lustig to slap her down.

I listened to the entire interview, but if you only have time to enjoy hearing a dietitian put in her place, skip ahead to about 47 minutes in.ย  You can listen to the interview here.


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110 thoughts on “Dr. Lustig Schools A Dietitian

  1. Larry AJ

    WOW!! What a slap-down!

    An excellent point for point rebuttal of ALL the nonsense feed to the nutritionists in their classes that they then regurgitate as the DOGMA that is enforced by their professional society.

    Reply
  2. lenny

    47 minutes in I was not under the impression that Lustig schooled anyone. I think Lustig is a step above regular physicians but he is not in my mind as elucidated as a person who truly understands the research should be. Hate to be cliche, but we need more Kurt Harris-esque physicians, not Lustig.

    I’ve interviewed him, I’ve heard him speak several times, I’ve read papers he’s written. He’s an endocrinologist who both conducts research and treats patients. I find him very convincing.

    Reply
  3. b-nasty

    I loved (what sounded like) Dr. Lustig getting worked up over the dietician’s trite party line. She rattled off the CICO nonsense so quickly and adamantly, it’s clear she’s never really given it any thought – it is just parroted.

    Dr. Lustig isn’t even a huge fan of very low carb diets, he just makes the perfectly reasonable point that excess sugar (especially fructose) is a problem. I don’t see how any sane person could think guzzling sugar is an okay way to obtain carbohydrates, even if they don’t subscribe to the VLC approach.

    He sounded angry, and I was glad to hear it. Those people need a good slapping down.

    Lustig isn’t opposed to low-carb diets, either. He thinks sugar is the worst thing out there; Dr. Davis thinks wheat is the worst thing out there. I say we avoid both (the sugar and wheat, that is, not Lustig and Davis).

    Reply
  4. Valerie

    As the saying goes… “Oh snap!”

    I was glad he didn’t mince words. I’m so tired of hearing hogwash from misinformed dietitians.

    Reply
  5. Trina

    That was great – thanks! When I started my “journey” at the beginning of 2012 I was working with a trainer. As a few months went by and I did more and more reading – she and I had to part ways – I couldn’t hear that I just wasn’t “working hard enough” or that I wasn’t “committed”. Like I wanted to stay fat and unhealthy … sure. I tried in vein to share my new found knowledge with this person but it wasn’t meant to be. It warms my heart a little to hear someone spewing that dogma get a little smack down ๐Ÿ™‚

    Reply
  6. Wait a minute

    Um, let’s see here. Lustig has the solution, yet is still fat himself. Some solution!!!

    I didn’t hear a smackdown, I heard an arrogant researcher plying his ignorance for all to see.

    It’s not the bloody SUGAR! It’s chronic stress that is the problem, be it physiological, psychological, or nutritional. And in terms of nutrition, the only thing to really avoid is all PUFAs (yes, omega 3 included). Sugar (ie sucrose, 50/50 glucose and sucrose) is incredibly good at shutting down the stress response. Look it up.

    Yes, the problem is sugar. Kids aren’t becoming fat and diabetic because they’re more stressed. Sugar causes cavities, suppresses the immune system, produces excess uric acid, and puts fat in your liver … but it’s great for stress, eh? Yes, sugar produces a dopamine response — that’s why it’s addictive. All kinds of addictive substances reduce stress. That doesn’t mean we should be ingesting them.

    Reply
  7. JasonG

    The dietitian first states “It’s all about calories in and calories out.” Then she says that people can lose weight on anything from Atkins to the zone, but the ones that keep it off are all following a “high carb, low fat diet.”

    She blatantly contradicts herself.

    Reply
  8. Larry AJ

    WOW!! What a slap-down!

    An excellent point for point rebuttal of ALL the nonsense feed to the nutritionists in their classes that they then regurgitate as the DOGMA that is enforced by their professional society.

    Reply
  9. lenny

    47 minutes in I was not under the impression that Lustig schooled anyone. I think Lustig is a step above regular physicians but he is not in my mind as elucidated as a person who truly understands the research should be. Hate to be cliche, but we need more Kurt Harris-esque physicians, not Lustig.

    I’ve interviewed him, I’ve heard him speak several times, I’ve read papers he’s written. He’s an endocrinologist who both conducts research and treats patients. I find him very convincing.

    Reply
  10. Janknitz

    It was AWESOME! My only regret was that it came so late in the show he did not have a chance to really spell it out for the audience.

    He’s doing better at explaining his theories to a lay audience.

    Reply
  11. b-nasty

    I loved (what sounded like) Dr. Lustig getting worked up over the dietician’s trite party line. She rattled off the CICO nonsense so quickly and adamantly, it’s clear she’s never really given it any thought – it is just parroted.

    Dr. Lustig isn’t even a huge fan of very low carb diets, he just makes the perfectly reasonable point that excess sugar (especially fructose) is a problem. I don’t see how any sane person could think guzzling sugar is an okay way to obtain carbohydrates, even if they don’t subscribe to the VLC approach.

    He sounded angry, and I was glad to hear it. Those people need a good slapping down.

    Lustig isn’t opposed to low-carb diets, either. He thinks sugar is the worst thing out there; Dr. Davis thinks wheat is the worst thing out there. I say we avoid both (the sugar and wheat, that is, not Lustig and Davis).

    Reply
  12. Namu

    I sure hope the words “reality check” and “unfounded in science” were used – unfortunately I cannot listen to the cast from my fruit-brand phone. Being a registered dietitian too often is a badge of ignorance more than anything else, and it’s well beyond time the contempt the general public has been treated with for decades start flying the other way. Science never has been a matter of authority and consensus, it’s a perpetual war waged by facts against our ideas. It takes no prisoner and shows no special distinction as to whether your ideas are stamp-approved by the state – relying on public authority to shoo away the ugly results and broken predictions of low-fat make-believe is sloppy and contemptuous.

    This monday evening I gave a speech before a modest audience, relating the cold hard numbers about our (french) government’s ambitious, 200+ millions € national nutrition plan, making its total failure in every single aspect of disease prevention painfully obvious, and it seems even the listeners who knew it plainly failed,just hadn’t realized just how thorough that failure was. So the layman at least is ready to hear an alternative to the “same old”, and listening, right now, if we only stand up and fight back – which is why I’m thankful to you Tom, for being such an inspiration ๐Ÿ™‚

    Consensus isn’t science. Consensus is the enemy of good science.

    Reply
  13. Per Wikholm

    Great listening to Dr Lustig! Peculiar side effect though – for some reason my brain got stuck with that 1980’s Devo hit “Whip it” and goes on and on with lyrics like: Whip it into shape, Shape it up, It’s not too late to whip it… Whip it good.

    If I had more free time, I’d do that mix myself.

    Reply
  14. Valerie

    As the saying goes… “Oh snap!”

    I was glad he didn’t mince words. I’m so tired of hearing hogwash from misinformed dietitians.

    Reply
  15. Sean

    Too bad Lustig, along with people like Guyenet and the Diet Doctor think that the solution is more government intervention, only with the government following the proper course of action which they would prescribe. I’m underwhelmed by statist bootlickers, even when said bootlickers have good ideas about what constitutes proper nutrition.

    There’s where he and I disagree. Give the government the power to ban or regulate sugar, you’ve given them the power to do the same with anything the government deems bad for us — like saturated fat and salt.

    He knows we disagree on regulation but still agreed to sit down for an interview with me, so I give him credit for that.

    Reply
  16. Trina

    That was great – thanks! When I started my “journey” at the beginning of 2012 I was working with a trainer. As a few months went by and I did more and more reading – she and I had to part ways – I couldn’t hear that I just wasn’t “working hard enough” or that I wasn’t “committed”. Like I wanted to stay fat and unhealthy … sure. I tried in vein to share my new found knowledge with this person but it wasnโ€™t meant to be. It warms my heart a little to hear someone spewing that dogma get a little smack down ๐Ÿ™‚

    Reply
  17. Wait a minute

    Um, let’s see here. Lustig has the solution, yet is still fat himself. Some solution!!!

    I didn’t hear a smackdown, I heard an arrogant researcher plying his ignorance for all to see.

    It’s not the bloody SUGAR! It’s chronic stress that is the problem, be it physiological, psychological, or nutritional. And in terms of nutrition, the only thing to really avoid is all PUFAs (yes, omega 3 included). Sugar (ie sucrose, 50/50 glucose and sucrose) is incredibly good at shutting down the stress response. Look it up.

    Yes, the problem is sugar. Kids aren’t becoming fat and diabetic because they’re more stressed. Sugar causes cavities, suppresses the immune system, produces excess uric acid, and puts fat in your liver … but it’s great for stress, eh? Yes, sugar produces a dopamine response — that’s why it’s addictive. All kinds of addictive substances reduce stress. That doesn’t mean we should be ingesting them.

    Reply
  18. JasonG

    The dietitian first states “It’s all about calories in and calories out.” Then she says that people can lose weight on anything from Atkins to the zone, but the ones that keep it off are all following a “high carb, low fat diet.”

    She blatantly contradicts herself.

    Reply
  19. Tom Welsh

    I agree, Galina. But know-nothings usually sound more confident than true experts. The more you know, the more you know you don’t know.

    Here are two of my favourite quotations on this subject:

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt.
    – Bertrand Russell

    The best lack all conviction, while the worst
    Are full of passionate intensity.
    – William Butler Yeats

    Here’s my favorite, from Murray Rothbard talking about economics:

    “It is no crime to be ignorant of economics, which is after all a specialized discipline and one that most people consider a dismal science. But it is totally irresponsible to have a loud and vociferous opinion on economic subjects while remaining in this state of ignorance.”

    As I often said when living near and working with the Hollywood crowd, They don’t know diddly about economics, but they make up for it by being arrogant about what they think they know.

    Reply
  20. Janknitz

    It was AWESOME! My only regret was that it came so late in the show he did not have a chance to really spell it out for the audience.

    He’s doing better at explaining his theories to a lay audience.

    Reply
  21. Paul

    I would have liked to have heard a reply from the dietician after she got smacked down…but my guess is that she was either too stunned to speak or disconnected herself from the call in shame.

    I was hoping she’d have a chance to sputter a reply as well.

    Reply
  22. Namu

    I sure hope the words “reality check” and “unfounded in science” were used – unfortunately I cannot listen to the cast from my fruit-brand phone. Being a registered dietitian too often is a badge of ignorance more than anything else, and it’s well beyond time the contempt the general public has been treated with for decades start flying the other way. Science never has been a matter of authority and consensus, it’s a perpetual war waged by facts against our ideas. It takes no prisoner and shows no special distinction as to whether your ideas are stamp-approved by the state – relying on public authority to shoo away the ugly results and broken predictions of low-fat make-believe is sloppy and contemptuous.

    This monday evening I gave a speech before a modest audience, relating the cold hard numbers about our (french) government’s ambitious, 200+ millions โ‚ฌ national nutrition plan, making its total failure in every single aspect of disease prevention painfully obvious, and it seems even the listeners who knew it plainly failed,just hadn’t realized just how thorough that failure was. So the layman at least is ready to hear an alternative to the “same old”, and listening, right now, if we only stand up and fight back – which is why I’m thankful to you Tom, for being such an inspiration ๐Ÿ™‚

    Consensus isn’t science. Consensus is the enemy of good science.

    Reply
  23. Per Wikholm

    Great listening to Dr Lustig! Peculiar side effect though – for some reason my brain got stuck with that 1980’s Devo hit “Whip it” and goes on and on with lyrics like: Whip it into shape, Shape it up, It’s not too late to whip it… Whip it good.

    If I had more free time, I’d do that mix myself.

    Reply
  24. AndreaLynnette

    Ugh. Reminds me of the dietician I went to in preparation for gastric bypass (which I did not get). Food pyramid, calorie-is-a-calorie, exercise more, eat less. I remember tracking every single bite I took, and getting bawled out for not losing weight on her plan. That strident, know-it-all tone seems to be something they teach in dietician school.

    I’m glad he got mad, because I sure as heck was.

    Very common scenario: doctor or dietitian, which the patient follows faithfully. When the diet doesn’t work, doctor dietitian accuses patient of lying.

    Reply
  25. Troy Wynn

    She was a plant. “we all know we should eat a high carbohydrate, low fat diet” was intended to piss him off and get him to rant.

    If you exercise to lose body fat, but have high insulin because of a high carb diet, or high cortisol, please explain the mechanism that allows your body to burn the fat? If insulin is high, you cannot burn fat for fuel. I’d like the explanation.

    I doubt she was plant. She sounds like 99% of the dietitians out there.

    Reply
  26. Sean

    Too bad Lustig, along with people like Guyenet and the Diet Doctor think that the solution is more government intervention, only with the government following the proper course of action which they would prescribe. I’m underwhelmed by statist bootlickers, even when said bootlickers have good ideas about what constitutes proper nutrition.

    There’s where he and I disagree. Give the government the power to ban or regulate sugar, you’ve given them the power to do the same with anything the government deems bad for us — like saturated fat and salt.

    He knows we disagree on regulation but still agreed to sit down for an interview with me, so I give him credit for that.

    Reply
  27. Waldo

    I very much respect Dr. Lustig and agree his style and delivery is very convincing. I’ve not read is new book, but he still seems to be a bit behind when it comes to the ill affects of grains despite the glucose nutrition. He seems to be getting on board with healthy fats too. But even the omega-3’s he’s lauded as “heart healthy” can be a determine if oxidized. He understands Americans simply get too much omega-6. All in all I’m a fan of his and will purchase his book. I just finished Pure, White, and Deadly by John Yudkin thanks to Dr. Lustig for re-popularizing it. Amazing how Dr. Yudkin could be eschewed to curb whilst Dr. Keys was made a superstar. What a perfect storm of bad science that brewed up decades ago as you documented very well.

    He’s mentioning refined carbohydrates more these days as problem. That would include grains. Try eating them unrefined.

    Reply
  28. Pierre Robert Groulx

    She’ll basically say that it’s a dietary fad when there’s an oversimplification of what you should do to lose weight and keep it off; and yet, she’ll tell people that all you have to do to get those exact results is to focus on more physical activity and less total calorie intake. ๐Ÿ˜›

    Make up your freaking mind, lady!

    If anything is a fad diet, it’s the low-fat diet.

    Reply
  29. eddie watts

    great stuff by lustig there, i did not listen to the rest, but that one bit was worth it!

    trying to not argue with strangers/idiots from now on.
    someone told a friend on facebook that “people who try low carb diets typically die of massive organ failure”

    i’m resisting so far…

    I still argue with idiots now and then, but only for sport.

    Reply
  30. Tom Welsh

    I agree, Galina. But know-nothings usually sound more confident than true experts. The more you know, the more you know you don’t know.

    Here are two of my favourite quotations on this subject:

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt.
    – Bertrand Russell

    The best lack all conviction, while the worst
    Are full of passionate intensity.
    – William Butler Yeats

    Here’s my favorite, from Murray Rothbard talking about economics:

    “It is no crime to be ignorant of economics, which is after all a specialized discipline and one that most people consider a dismal science. But it is totally irresponsible to have a loud and vociferous opinion on economic subjects while remaining in this state of ignorance.”

    As I often said when living near and working with the Hollywood crowd, They don’t know diddly about economics, but they make up for it by being arrogant about what they think they know.

    Reply
  31. Paul

    I would have liked to have heard a reply from the dietician after she got smacked down…but my guess is that she was either too stunned to speak or disconnected herself from the call in shame.

    I was hoping she’d have a chance to sputter a reply as well.

    Reply
  32. Gayle Brown

    What the previous post from Eddie Watts said about trying not to argue with idiots reminded me of the G. K. Chesterson quote: “If you argue with a madman, it is extremely probable that you will get the worst of it; for in many ways his mind moves all the quicker for not being delayed by the things that go with good judgment.”

    Too true.

    Reply
  33. AndreaLynnette

    Ugh. Reminds me of the dietician I went to in preparation for gastric bypass (which I did not get). Food pyramid, calorie-is-a-calorie, exercise more, eat less. I remember tracking every single bite I took, and getting bawled out for not losing weight on her plan. That strident, know-it-all tone seems to be something they teach in dietician school.

    I’m glad he got mad, because I sure as heck was.

    Very common scenario: doctor or dietitian, which the patient follows faithfully. When the diet doesn’t work, doctor dietitian accuses patient of lying.

    Reply
  34. Troy Wynn

    She was a plant. “we all know we should eat a high carbohydrate, low fat diet” was intended to piss him off and get him to rant.

    If you exercise to lose body fat, but have high insulin because of a high carb diet, or high cortisol, please explain the mechanism that allows your body to burn the fat? If insulin is high, you cannot burn fat for fuel. I’d like the explanation.

    I doubt she was plant. She sounds like 99% of the dietitians out there.

    Reply
  35. Ken

    Dietitians are a class of people who have chosen a vocation based upon the assumption that dissemination of advice that is known institutionally but not generally can provide public benefit (similar to MDs in this way). This model can work, but is fatally flawed when the institution is pedalling incorrect dogma, of course.
    I think Lustig is on the right track with some ideas, but he is a zealot who wants to employ “government to coerce us”, like the “guy from CSPI”.
    Also, my very first, successively-reinforced and lasting impression from his famous Youtube video and other tip-offs is that he is obviously tightly hooked up with the AHA (and maybe also George Bray — see GCBC for relevant history) in his effort to demonize sugar — this serves those interests well by implicitly exonerating starch while scapegoating sugar. Lustig is the guy who said that “ethanol is a carbohydrate” and he is consistently wrong technically about such a bewildering variety of simple facts that he has NO credibility in his public arguments, to me. People who have hidden agendas, like Lustig, often have to resort to constant exaggeration and distortion. It is no accident, I believe, that Lustig eschews the overall low-carb concept.
    There is wisdom in crowds that is entirely lacking in the murky world of social engineering via government — I am sure you agree. Ideas should be tested, one person at a time. The truth will out eventually, and so will the untruths. What Lustig is trying to do is little different than that of CSPI, and the science is so far pretty weak, incomplete and unconvincing. I myself think that fructose is merely the strongest monosaccharide — probably an order of magnitude stronger than glucose in most of its metabolic effects (e.g. glycosylation factor). I do not buy the idea that it is otherwise fundamentally different than glucose (or galactose) — just stronger in general. But “strength” of biochemical effect makes a huge difference still, if the generalization is valid, because it is obviously much easier to overconsume fructose-containing sugars vs. starches (i.e. glucose) to get the same insidious long-term bad effect (i.e. the same number of calories yields ten times the effect). The evolutionary reason that fructose metabolism is favored in the bio-factory of the liver vs. in other end-user tissues probably relates to its potency of glycosylation and other factors.
    Still, when one examines animal-model studies of diabetes from the 1960s and earlier, one sees that mice and rats were routinely made overtly diabetic by pure glucose feeding in roughly one week back then, before the standardization of commercial lab chows containing fructose today. Of course, back then, glucose was relatively cheaper to produce (and more generally available as a monosaccharide) than fructose because massive industrial catalytic conversion of corn-glucose into fructose had not yet begun.
    Lustig may or may not have mostly the right ideas, but he is pursuing them in a dangerous way. He is completely unskeptical in all of his views, and it shows through blatantly. We (as a society) have been down this path too many times already.
    I am somewhat disappointed by the amount of enthusiastic support Lustig receives from the blog community — we should be more cautious, methinks. On the other hand, Gary Taubes’ yet-to-be-released book on sugar should be very interesting, especially because he is a SKEPTICAL thinker unlike Lustig. I suspect that one of the problems Gary may be wrestling with, though, is precisely the relatively weak amount of scientific research on sugar (even today). His standards are high, and I predict that he will not exit his current project with as strongly formed hypotheses (regarding sugar specifically) as he did with GCBC (regarding carbohydrates in general).
    By the way, I personally consume NO refined sugar in my diet whatsoever. I believe that dietary sugars (in amounts greater than thresholds which are individually unique, age-dependent and mostly unknowable) are harmful to health. But I would not impose this judgment on others, and I do not think excessive dietary sugar is anything close to the entire cause of the modern diseases of civilization — just one important contributor.

    I applaud Lustig for pointing out the problems with sugar and for pointing out what a mistake the anti-fat hyteria was. I of course disagree with him about using government’s coercive powers to prevent people from eating sugar — I think we should start by eliminating government’s coercive subsidies. I also don’t believe fructose is the only problem. In that picture I posted of myself in my low-fat days, sugar and fructose weren’t the issue. Too much starch was. That’s a potato-grain belly on me in the picture, not a sugar belly.

    Reply
  36. Ken

    P.S. In Lustig’s “Sugar: the Bitter Truth”, I was “annoyed” by too many things to count. But maybe the single motif that irritated me most consistently was his argument that glucose, as the most primitive metabolite/fuel for organisms in general, was obviously benign — the “stuff of life” or something like that.
    This is, of course, an absurd and incorrect evolution-based argument. Evolution is based solely upon ability to reproduce as a species, not on individual longevity or immortality. Lustig is probably intelligent enough to know this very well.
    Use of fatty acids as a primary fuel is associated with higher-order organisms — eukaryotic-cell based organisms maybe especially even ruminants and simple vegetarian animals metabolize fatty acids produced exogenously (in their guts, by bacteria). Fatty-acid metabolism is probably an evolutionary adaptation of more complex organisms for exactly the opposite reason that Lustig suggests: sugars are intrinsically somewhat toxic and less efficient as a fuel. Hence, the higher-order organism evolves aways from use of carbohydrates.
    As I said, Lustig has an agenda. And behind it is an effort to protect and further the reputation, power and control of the same “bad actors” (e.g. AHA since Keys, Stamler et al coopted them) that got us into this dietary mess. George Bray (old man though he is) has been on a crusade to demonize fructose and exonerate all other carb’s for the last decade, but this idea seems to have occurred to him late in his career. And suspiciously closely following after Gary Taubes’ famous articles in Science and the NYT over a decade ago. Beware!

    I heard an argument recently that instead of gluconeogensis proving we don’t need carbs, it actually proves glucose is so important, we should be eating carbs. I wonder if that applies to carnivores that only eat meat and fish that only eat other fish. They produce glucose through gluconeogensis, therefore they probably should be eating more potatoes.

    I don’t know if you heard the entire interview, but Lustig did mention that refined carbohydrates besides sugar are a problem for many people.

    Reply
  37. Waldo

    I very much respect Dr. Lustig and agree his style and delivery is very convincing. I’ve not read is new book, but he still seems to be a bit behind when it comes to the ill affects of grains despite the glucose nutrition. He seems to be getting on board with healthy fats too. But even the omega-3’s he’s lauded as “heart healthy” can be a determine if oxidized. He understands Americans simply get too much omega-6. All in all I’m a fan of his and will purchase his book. I just finished Pure, White, and Deadly by John Yudkin thanks to Dr. Lustig for re-popularizing it. Amazing how Dr. Yudkin could be eschewed to curb whilst Dr. Keys was made a superstar. What a perfect storm of bad science that brewed up decades ago as you documented very well.

    He’s mentioning refined carbohydrates more these days as problem. That would include grains. Try eating them unrefined.

    Reply

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