Book Review: Fat Chance

Looking for a good book? This is one MUST READ book! I enjoy listening to podcasts while working sometimes. My favorite podcast is Vinnie Tortorich, America’s Angriest Trainer. I HIGHLY recommend you listen to his podcast and then go out and buy his bestselling book, Fitness Confidential. I will be doing a book review of that very shortly. Vinnie has always recommended Dr. Robert Lustig’s Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease on his podcast and after IMLP I finally had some free time to pick it up and finish it.

Source: Amazon

Source: Amazon

I’ve read a lot of books within the past month and Lustig’s is by far the best one to read. I think this book should even be a required reading book in high schools and college. That’s how much I think everyone needs to read this book. Go buy it. Now!

Who is Dr. Lustig? Well, he is an internationally renowned pediatric endocrinologist who has spent the past 16 years treating childhood obesity at some of the top hospitals in the world, such as St. Jude’s Children’s Hospital and UCSF Benioff Children’s Hospital. Sooo… I would say that he knows his shit better than those Jillian Michaels and Dr. Oz characters.

Dr. Lustig became famous for his at-the-time, very controversial you-tube video called “Sugar: The Bitter Truth.” And, yes, I think you should watch that too. Fat Chance documents the science and politics that have led to the current obesity pandemic that no longer just affects the United States, but the entire world. I went on a medial mission to Costa Rica and Nicaragua in 2011 and I was surprised beyond belief the number of overweight and obese people and the number of fast-food joints in those countries. Hell, Costa Rica has a Denny’s!

Lustig reveals and outlines all the bad research that has been conducted over the years by the government and big food. Personally, I think a lot of those scientists who were involved in many of those studies should have their PhD’s removed. It’s rather disgusting how many people will sell-out to the food industry and politicians. Ok, end rant.

The book begins by setting up a valid argument why the government’s view of “calorie in, calorie out” is bullshit. I hate that term. When discussing food with my clients I always ask them “what is a calorie?” No one has yet to answer correctly. It’s because we have been brainwashed over the years to think of food as calorie in, calorie out. That’s how you’re suppose to lose weight, right? Wrong! Believe me, I was one of those people for a long time too, but the more I read (from reputable and educated sources!!) the more I learn that I have been completely duped all my life. Lustig is an endocrinologist meaning that he is a specialist in hormones and the biochemistry of the human body.

Lustig talks a lot about hormones, ya know, since he gets hormones. Hormones have a profound effect on our metabolism and how we view food. Fat Chance outlines ways to readjust our key hormones that regulate hunger, reward, and stress. That is done mainly by eliminating sugar. Sugar is an addictive toxin to our bodies. We live in a society today that thinks dietary fat is bad. Low-fat this and low-fat that. Well, guess what happens when you remove fat from food products? The food tastes like crap and the manufactures pump it full on sugar. Read the book and find out why sugar is bad for you. I’m serious, do it.

The evolution of nutritional science is what really fascinates me. Back in the early to mid-1900’s we got the science right. And then big food and some idiots got involved. The leading cause of death today in the United States is heart disease, but in the next decade or so we will see that shift to diabetes and other metabolic-related diseases, which heart disease can be considered one. In 1957 John Yudkin, a British physiologist and nutritionist, postulated that a dietary component caused heart attacks. By 1964, through natural observation studies he theorized that the consumption of sucrose was associated with heart disease. Yudkins published numerous papers on the biochemistry of sucrose and was the first person to warn us that excessive consumption could lead to heart disease, diabetes, GI diseases among other diseases.

Now, back in the United States we have Ancel Keys, a Minnesota epidemiologist. In the early 1950s Keys spend some time in England where we witnessed a large rise in heart disease. The typical English diet consisted of high fat and high cholesterol items, such as fish and chips. He noticed that those who are well fed in both the US and UK were those who could afford meat, but also seemed to suffer the most from heart disease. In the 1960s and 1970s Keys published numerous studies indicating that heart disease patients had higher cholesterol levels than non-heart disease patients. In 1980 Keys published his “Seven Countries” study, a 500-page paper that concluded that dietary fat was the single cause of heart disease. Which, the United States government and medical community has since run with. However, there are four major problems with his thesis.

The first being that his Seven Countries study started out as a Twenty-two Countries study. The seven countries he used in his study were: Japan, Italy, England, Wales, Australia, Canada, and the US. The relationship between dietary fat and heart disease looked quite convincing when the data was plotted. However, when he plotted the other countries (Austria, Ceylon, Chile, Denmark, Finland, France, Germany, Ireland, Israel, Mexico, Netherlands, New Zealand, Norway, Portugal, Sweden, and Switzerland), the correlation was almost non-existent. He also actively chose not to include indigenous tribes, such as the Inuit, Tokelau, and Maasai and Rendille, who eat only animal fat and have the lowest prevalence of heart disease on the planet. How’s that for science? Second, the role of dietary fat in heart disease is complicated by trans fat, which has signficant scientific studies to link it to metabolic syndrome. The use of trans-fats peaked during the 1960s and most likely were not considered a variable by Keys.

Third, if you look at the correlation itself, it is a problem. Japan and Italy eat the least amount of saturated fat and have the least amount of heart disease. But, they also eat the least amount of dietary sugar out of all the countries included. How do you know if it’s the sugar or the fat causing heart disease? Fourth, Keys admits that he correlated sucrose with saturated fat, but it was not important enough to him to remove sucrose from the equation. When one completes a multivariate correlation analysis, a common statistical tool that determines whether A causes B regardless of the impact of C, D, and E, one has to do the calculation both ways. In other words, Keys would have had to hold sucrose constant and show that dietary fat still correlates with heart disease. Basically, Keys used bad science. And then the government took it and ran with the idea.

This is just one of the studies Lustig discusses in his book. He discusses many more that are just as interesting. The end of the book concludes with two sections. One is on the personal solution and the other is on the public health solution. I absolutely loved the public health section because I am a public health professional. In society today we have this notion that obesity is an individual problem. That person eats too much, doesn’t exercise and it’s their fault they are fat. Lustig will tell you that’s rarely the problem. The public health section discusses ways as a society that we can conquer the impending obesity pandemic.

Overall, you will be crazy not to read this book. Out of all the books I have read this year, this is by far one of the best ones out there. It will change your view of nutrition and the obesity epidemic. Lustig gives you the science that backs up his claims. This isn’t a diet book written by some bimbo Hollywood trainer on how to lose 10-lbs in 10 days. It’s a real book based on real science that will open your eyes and mind to the current nutritional crisis in the United States.

What are you waiting for? GO BUY THE BOOK! 🙂

~ Happy Training!

Nutrition Tuesday: What’s In Your Sports Drink? Part I

Just about any athlete (and even many non-athletes) drink sports drinks while working out. And not all sports drinks are made equally. 
I recently read an article (Ultra-Endurance Exercise: The Emerging Role of “Multiple Transporter” Carbohydrates) in the Sports Nutrition Insider and became very interested in the recent research on the subject since it’s so important to endurance athletes. I actually posted the article of my Facebook page, but I doubt anyone who read it would understand it. It’s a really great overview of the subject; however, if you don’t have a background in chemistry or physiology it’s a bit hard to understand. 
Numerous studies have found that consuming carbohydrate (CHO) during prolonged moderate- to high-intensity exercise can postpone fatigue and enhance exercise performance when the exercise duration is greater than 45 minutes (1). These effects due to CHO consumption are largely attributed to a prevention of hypoglycaemia (low blood sugar) and the maintenance of high rates of CHO oxidation in late exercise when muscle and liver glycogen levels (endogenous sources) are low (1). Athletes consume CHO as exogenous sources in hopes to “spare” the endogenous sources. 
The average 150-lb male has about 1800 calories of carbohydrate stored in the liver, muscles, and blood in approximately the following distribution (2):

Number of Calories
Muscle Glycogen
Liver Glycogen
Blood Glucose
As the carbohydrate in the muscles get used during exercise, the carbohydrate in the liver gets released into the bloodstream to maintain a normal blood glucose level and to feed the brain (very important!) and the muscles. When your glycogen stores get low, you hit the wall – or “bonk.” In one study, cyclists with depleted muscle glycogen stores were only able to exercise for 55 minutes to fatigue. However, with full muscle glycogen stores they could exercise for about 120 minutes to fatigue (2). Also, trained muscles have the ability to store more glycogen than untrained muscles (32g v. 13g) (2). 
As you deplete carbohydrate from muscle glycogen stores during exercise, your body will increasingly rely on blood sugar for energy. By consuming carbohydrates during exercise via sports drinks, gels, bars, etc., your muscles have an added source of fuel. Sports drinks also help maintain normal blood sugar levels. A normal blood sugar level is important to keep your brain fed and help you think clearly, concentrate well, and remained focus. Have you ever been out training and start to lose focus and feel light-headed? That’s a sign of bonking and that your body needs carbs to function!  
Now, when CHO is ingested, it is absorbed through the intestines into the bloodstream to be carried throughout the body and delivered to cells for energy. Studies have indicated that the peak oxidation rate for exogenous CHO is about 1 g/min (1). It has been suggested that the absorption capacity of glucose in the intestine is the limited factor for the oxidation (think metabolism of CHO) of ingested glucose. 
Numerous studies have compared the oxidation rates of various types of ingested CHO with the oxidation of exogenous glucose during exercise. The oxidation rates of ingested maltose, sucrose, glucose polymer, and maltodextrin (glucose polymers derived from starch) are all similar to the oxidation rate of ingested glucose (1). However, significantly lower exogenous CHO oxidation rates have been reported for fructose (about 20-25% lower) and galactose (about 50% lower) compared to glucose (1). One of the possible reasons that both might be lower is the fact both fructose and galactose have to be converted into glucose in the liver before they can be oxidized (1). 
Glucose and other sugars don’t just magically float through the walls of the intestine into the bloodstream. Glucose must be transported via the sodium-dependent glucose transporter (SGLT1) across the intestinal wall. Studies have indicated that it is possible that SGLT1-transporters are saturated at a glucose ingestion rate of about 1 g/min, because studies with higher glucose ingestions rates do not yield higher oxidation rates (1). Now, for all you non-science geeks out there, let’s put this in layman’s terms. Imagine that your at a football game and it’s half time. You and everyone else has consumed lots of beer. Now that it’s half time, everyone is making a beeline to the bathroom. There are two bathrooms with only 4 stalls each. There are 1000 of you trying to use those 8 toilets. Since you all are all decent people with manners, you decide not to drop your trousers and pee in the middle of the hallway, but wait in a very long line to use the toilet. This is kind of what is happening in your intestines when you consume glucose from your sports drink. There is only so many SGLT1-transporters for glucose in your intestine. Of course, glucose has to have manners too and can’t just go up to another transporter molecule and say “LET ME IN!” It has to wait patiently in line for it’s turn to use the “toilet” too.


Now, fructose is lucky because he decided to buy a sky box seat and thus has his own totally awesome bathroom. Fructose is absorbed from the intestine by GLUT-5, a sodium-independent facilitative fructose transporter (1). Several recent studies have found that a sports drink containing both glucose and fructose can enable exogenous CHO oxidation rates to reach peak values of about 1.5 g/min (3). What is also very interesting is that with an increased CHO oxidation with multiple transporter carbohydrates there is also an increased fluid delivery and improved oxidation efficiency that reduces the likelihood of gastrointestinal distress, an endurance athlete’s worst nightmare (3)! 


Let’s talk sports drinks now! There are many different sports drinks available in market today and each one is slightly different. The biggest variables between sports drinks are (4):
  1. The type of sugar or sugars used – There are many different types of sugars that are used in sports drinks. The most common are sucrose, glucose, and fructose. Each sugar has its’ own unique sweetness. 
  2. The carbohydrate concentration – Studies have shown that sports drinks with a 6-8% carbohydrate concentration is well absorbed and utilized by the body for energy. Anything above 8% concentration can delay stomach emptying and cause stomach problems.
  3. The osmolality – Osmolality refers to the number of particles in a solution. A solution with fewer particles tends to produce faster fluid absorption and solutions with high number of particles (>400) can slow fluid absorption.
  4. The sodium content – A sodium level of about 110 mg per 8 ounces of fluid enhances taste, optimizes absorption, and maintains body fluids. Higher sodium contents may stimulate voluntary drinking more than lower sodium level drinks. 
See Part II tomorrow! 🙂

~Happy Training
  1. Jentjens RLPG, Moseley L, Waring RH, Harding LK, Jeukendrup AE. Oxidation of combined ingestion of glucose and fructose during exercise. J Appl Physiol. 2003; 96: 1277-1284.
  2. Clark N. (2008) Nancy Clark’s Sports Nutrition Guidebook, 4th Ed. Champaign, IL: Human Kinetics. 
  3. Robinson S. Ultra-endurance exercise: the emerging role of “multiple transporter” carbohydrates. Sports Nutrition Insider. Available at: Accessed July 8, 2012.
  4. Seebohar B. (2004). Nutrition periodization for endurance athletes. Boulder, CO: Bull Publishing Co.