Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine

by Robert H. Lustig

I will battle the cacophony of conflicting information on food and chronic disease with these two easy precepts: 1) protect the liver, 2) feed the gut. Every nutrient, every food, every food pattern, every food timing paradigm obeys these two precepts. However, implementing them is difficult and only possible with Real Food—even though that’s not what Big Food is selling.

The holy grail of Modern Medicine is you can’t fix healthcare until you fix health; and you can’t fix health until you fix the food. Everyone is talking about healthcare, few people are talking about health, and nobody is talking about the food.

Insulin resistance is the primary defect in metabolic syndrome, the cluster of NCDs. Insulin resistance manifests itself in a myriad of tissues and ways, which may vary from person to person. You may be overweight, or not. You might have high cholesterol, but maybe it’s normal. You might have high blood pressure, although it could be low. All of these are tissue-specific symptoms of metabolic dysfunction. Previously, doctors only diagnosed metabolic syndrome if you were obese. Now we know better. Even people who aren’t overweight develop metabolic syndrome. The issue is that doctors are still targeting obesity, which they think is the disease. Rather, it’s just another symptom.

Two other hormones also play a role in the hunger-satiety system. Leptin is a satiety hormone released from your adipocytes that tells your brain, “I have enough energy on board; I can stop eating.” Ghrelin is a hunger hormone released from your stomach that tells your brain, “I’m empty—feed me!” Normally, insulin does double duty—it tells your body to “store,” while it tells your brain to “stop eating.” When insulin is low and working right, both insulin and leptin counterbalance ghrelin and keep you weight-stable. But when you become insulin resistant, the leptin signal is blocked—now the ghrelin runs things, so you’re hungrier and storing like crazy. Therefore, the prime directive of metabolic therapy is “get the insulin down.” And that’s true, regardless of your weight.