I recently finished reading this book, and thought it was a good idea to review the book, and share highlights from the book, and as well as my own comments about what they are trying to achieve.
Fat Chance, written by Dr Lustig, who has spent more than 16 years treating childhood obesity and done extensive research into the effects of sugar has on the body's central nervous system, metabolism and the impact it may have on disease risk.
Obesity is a major worldwide health problem, and this book is aimed at reviewing the evidence behind high sugar consumption in the diet and obesity. In fact, Dr Lustig is firmly against consumption of sugar, and you learn this within the first couple of pages of reading the book.
A Calorie Is a Calorie - or is it?
One of the key statements that is being discussed at the start of the book is whether a calorie is a calorie. It is often said that to be able to maintain a healthy body weight, the calories in and the calories out need to be in balance. This is true. But, what this book discusses is the fact that not every calorie is the same. It can be said that a calorie burned is a calorie burned. But, a calorie eaten is not a calorie eaten. We need to be looking into the quality of what is being eaten, which then determines the quantity. If a calorie is a calorie, then all fats would be the same because fat provides 9kcal per one gram of fat. But, there is such thing as healthy fats and bad fats, or shall we say unsaturated and saturated fats. The same goes with protein. Protein is ultimately formed by long chains of amino acids, and the amino acid sequence varies from protein to protein. Depending on the amino acid structure of protein in foods, some proteins are higher in quality (or complete protein, such as meat and dairy products), and some are low quality protein (which lacks in specific amino acids in their structure).
Eating the right stuff: real food vs manufactured/processed food
Eating too much processed foods such as microwave meals, cakes and biscuits, has been shown extensively by a growing number of studies that it is associated with increased risk of diseases, in particular obesity [1]. Processed foods are high in sugar, as well as high in salt and saturated fat, and usually has a very low content of fibre. So, as promoted in this book, a key message to individuals looking to lose weight is to reduce their intake of processed food, which also includes beverages, and increase the consumption of freshly prepared dishes made from unprocessed or minimally processed foods.
Obesity stigma: Important considerations
It is often I see that obese individuals are blamed for their weight, but there is some evidence that although obesity can be cause by behavioural factors, that genetics, metabolic adaptation and the food environment could have a possible role. Evidence suggests that media is a significant source of weight stigma, but bias is also commonly found by health care providers. This stigma still remains, even though they are aware of the fact that some individuals gain weight more easily than others due to their genetic predisposition. Dr Lustig strongly believes that losing weight requires more than behaviour change, and biological factors have a key part in weight management.
Sugar - good or bad?
Bad. And according to this book, sugar is the enemy to the obesity pandemic. Sugar is addictive, and sugar is hard to resist! Sugar causes dopamine to be released, which makes us want to eat more of it. And ultimately, if we continue to eat lots of sugar, it will continue to feel rewarding. Unfortunately, our environment today is abundant with sweet and sugar rich foods, which does not help with the difficulty of resisting sugar.
Sugar sweetened drinks is a big contributor to a high sugar diet in the UK, and is the reason behind the Soft drinks Industry Levy that came into effect in the UK in April 2018. However, high sugar snacks, such as confectionary, cakes and biscuit is also a major contributor, and possibly much greater than soft drinks, toward the high sugar diets in the UK population. Therefore, reducing purchases of high sugar snacks could have a greater impact on population health, especially in reducing Body Mass Index (BMI) [2].
Reminder
It is important to remember that with any book, article, or documentary, that is very one sided about its topic, that some references or sources that have been used may have been selected to support the author's argument. Although these types of books or even documentaries like 'The Game Changers' cite o a lot of research, they often do not include the research to the contrary side of their argument.
References
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.
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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