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Writer's pictureCatrin Hughes

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


I just completed reading this book and believed it would be beneficial to write a review, share key points, and provide my thoughts on their objectives.


Dr. Lustig, author of Fat Chance, has dedicated over 16 years to addressing childhood obesity and conducting thorough research on the influence of sugar on the central nervous system, metabolism, and its potential implications for disease risk. Obesity poses a significant global health challenge, and this book focuses on examining the link between high sugar intake in the diet and obesity. Dr. Lustig strongly opposes sugar consumption, a stance evident from the initial pages of the book.


A Calorie Is a Calorie - or is it?


At the beginning of the book, a central question being explored is whether all calories are equal. While it is commonly believed that maintaining a healthy body weight requires balancing calorie intake and expenditure, this book challenges the notion that all calories are identical. While a burned calorie may be the same regardless of its source, the same cannot be said for consumed calories. The focus here is on the quality of the calories consumed, which ultimately determines the quantity needed. If all calories were truly equal, then all fats would be identical due to providing 9kcal per gram. However, distinctions exist between healthy fats and unhealthy fats, or unsaturated and saturated fats. Similarly, proteins vary in quality based on their amino acid composition. Proteins are comprised of different amino acid sequences, with some being of higher quality (complete proteins like those found in meat and dairy) and others of lower quality (lacking certain essential amino acids).


Eating the right stuff: real food vs manufactured/processed food


Numerous studies have demonstrated a strong link between consuming excessive amounts of processed foods like ready-made meals, pastries, and cookies, and a higher likelihood of developing diseases, notably obesity [1]. Processed foods are typically rich in sugar, salt, and saturated fat, while being low in fiber. Therefore, the main recommendation advocated in this book for individuals aiming to shed extra pounds is to cut down on processed food consumption, including beverages, and instead opt for freshly cooked meals using unprocessed or minimally processed ingredients.


Obesity stigma: Important considerations


Obese individuals are frequently held responsible for their weight, yet there is evidence indicating that factors such as genetics, metabolic adaptation, and the food environment may also play a role in causing obesity. While the media is a major contributor to weight stigma, healthcare providers are also often biased. Despite knowing that genetic predisposition can make some individuals more prone to weight gain, this stigma persists. Dr. Lustig argues that weight loss involves more than just changing behaviour, with biological factors playing a crucial role in managing weight.


Sugar - good or bad?


Bad. As per this book, sugar is identified as the culprit behind the obesity crisis. Sugar is highly addictive and challenging to avoid. The consumption of sugar triggers the release of dopamine, leading to increased cravings. Consequently, the more sugar we consume, the more rewarding it feels. Regrettably, our current environment is saturated with sugary and sweet foods, further complicating the struggle to resist sugar.


Sugar-sweetened beverages play a significant role in the high sugar intake in the UK, leading to the implementation of the Soft Drinks Industry Levy in April 2018. Nevertheless, high-sugar snacks like sweets, cakes, and biscuits are also substantial contributors to the prevalence of high sugar diets in the UK, possibly even more so than soft drinks. Consequently, cutting down on the consumption of high-sugar snacks could potentially have a more significant effect on public health, particularly in lowering Body Mass Index (BMI) [2].


Reminder


It is crucial to bear in mind that when encountering a book, article, or documentary that strongly favours a particular viewpoint, some of the references or sources cited may have been cherry-picked to bolster the author's stance. While works such as 'The Game Changers' may reference a substantial amount of research, they frequently omit evidence from opposing perspectives.


References

  1. Monteiro, C. A., Moubarac, J. C., Levy, R. B., Canella, D. S., da Costa Louzada, M. L., & Cannon, G. (2018). Household availability of ultra-processed foods and obesity in nineteen European countries. Public health nutrition, 21(1), 18-26.

  2. Scheelbeek, P. F., Cornelsen, L., Marteau, T. M., Jebb, S. A., & Smith, R. D. (2019). Potential impact on prevalence of obesity in the UK of a 20% price increase in high sugar snacks: modelling study. bmj, 366.

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