Fat Chance: Fructose 2.0 by Dr. Robert Lustig (Transcript)

Dr. Robert Lustig

Fat Chance: Fructose 2.0 by Dr. Robert Lustig is his latest update and a sequel to his popular YouTube video Sugar: The Bitter Truth. We decided to produce the whole transcript of the video just as we did with his former one. Below is the full transcript…


Robert Baron – UCSF Professor of Medicine

Good evening everyone. Welcome again to our penultimate class in this semester’s course on nutrition. A reminder that next week we will be talking about vitamins and minerals and vitamin and mineral supplements, so please join us for that last class. Dr. Jeffrey Tice will be the professor joining us that evening.

Tonight we have what I guess for some of you has been the lecture you’ve been waiting for since the beginning. Dr. Lustig gave a similar lecture in 2009. Little did we know at the time that it would have 3.5 million downloads since then but also in this room at a course very similar to this that I also chaired, and it’s really, I think, changed his life more than anything else but I think the hope is that it’s also changed the field and the topic and the policies and the politics that we are going to talk about tonight.

Many of you know Dr. Lustig is an internationally known neuroendocrinologist in pediatrics. He trained for part of his time at UCSF, then went back east to do a clinical neuroendrocrinology and came back to UCSF in 2001 where he’s continued to do his clinical science on factors that control appetite, particularly the interaction between the hormones of insulin, leptin, ghrelin, and appetite control and metabolic syndrome and obesity.

More recently, in part around the time of the video and certainly in the four years since Rob has become an international leader in the efforts to improve our nutrition not only in the United States but around the world. He’s focused a larger part by putting a real microscope on the issues of fructose and sugar in general and refined foods in general, the relationship of the dietary fiber and the many of the other topics that we’ve been talking about over the course of the course.

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Rob just returned from Europe this morning, in fact arrived here at 5 o’clock this evening. We think he had dinner. We know he hasn’t had sleep, it’s 4 o’clock Europe time for him. So this was really a heroic effort. Our fingers were crossed that all the flights would be on time, and I’m very pleased more than you can imagine that he’s here tonight, because I didn’t want to give this lecture as well.

But in addition to his work, Rob recently took a sabbatical in order to further this work and spend a large part of that time at Hastings [ph] School of Law getting a Master of studies in Law, and part of his aspiration I think is really to add his legal training now to his science and medical training to continue to advocate for good nutrition around the world.

So we’re very anxious to hear about his newest thoughts on this topic. We’ve entitled the talk the same title as his best-selling book “Fat Chance” and added the subtitle “Fructose 2.0”. Rob?

Robert Lustig – Professor of Pediatrics, Endocrinology Division, UCSF 

Thank you, Bobby and thank all of you for coming, you know, to some extent this is sort of like déjà vu all over again, having done this 4 years ago and it really did change my life and hopefully changed a few peoples’ lives in the audience and certainly around the world. I still get emails from that video today, people who’ve seen it for the first time.

That video, we’re going to refer back to it in some — to some extent tonight because I am not going to redo the biochemistry, there’s no point in doing it twice.

What we’re going to talk tonight about is primarily the physiology. So in essence, the two videos will end up being complementary on YouTube and hopefully people who watch it will end up watching both, so keep that in mind so, in essence, the two videos will end up being complementary on YouTube and hopefully people who watch it will end up watching both, so keep that in mind.

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All right. Well, a lot’s happened in four years, and the data just keeps rolling in, and unfortunately for us all the data is pretty awful. So you’ll see why as we go and I will try to delineate that as we go.

So first of all I have no disclosures, no food industry is putting me up to this, be sure of that. So here’s the past, this is 2001. 6 million kids are seriously overweight. Well, with all of the media attention, with all of the NIH money, with all of the clinical programs and with Michelle Obama’s vegetable gardens we are now up to 20 million.

What’s now at the present?

Here’s the present. Currently there are 30% more obese people on the planet than undernourished people. And this has happened only within 15 years because 15 years ago it was exactly the opposite. And it’s occurring in countries that still have under nutrition.

So how do you explain that, other than to say that can’t be behavior, that’s got to be an exposure. This looks like any standard pandemic influenza, typhoid, etc. This looks like a microbial phenomenon rather than a behavioral phenomenon, we’re going to go there.

366 million diabetics walking the earth, that’s 5% of the worlds’ population. And they are chewing through all the health-care resources.


This was just three months ago, diabetes costs the US $24 billion. Now if we could recoup even a fraction of that, we wouldn’t even need health-care reform. In fact, it’s been suggested that we wouldn’t even need financial reform. Okay, 41% rise in 5 years, this is going up so fast it makes your head spin.

What’s the future going to be like

And here’s the future if we do nothing. Experts predict 165 million Americans, 42% would be obese by the year 2030. 100 million Americans, that’ll be 33%, will have diabetes by 2050, but fear not, because it won’t really matter because Medicare will be broke by 2026.

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So, as the Soup Nazi once said: “No health-care for you”. Well, the fact of the matter is, I’m going to be 69 in 2026 and I want my freaking Medicare. And so should you all. The point is we have to do something different, and you know the old adage, right? Of the definition of insanity is doing the same thing over and over again and expecting a different result.

Well I’m here to tell you for the last 30 years we’ve done the same thing over and over and over again and there has been no change in the result. So we have to rethink this, we have to reframe the argument and that’s what we are going to try to do tonight. And I’m going to do it right now.

So here’s the way people view this issue. This is a Venn diagram of all the adults in America: 30% obese over here, and 70% normal weight over here. And everybody assumes that the problem is this group over here because 80% of the obese population is sick in some fashion with type-2 diabetes, lipid problems, hypertension, cardiovascular disease, cancer, dementia, non-alcoholic fatty liver disease, polycystic ovarian disease, etc, etc.

So if you do the math on this, that’s 80% of 30% of 240 million, that’s 57 million sick, and it’s those 57 million that are bankrupting the country. And so it’s the obese person’s fault only. And that’s the way everyone views this.

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