Qualy #69 - Advice to parents and kids for creating a sustainable environment that's going to prevent them from running into metabolic problems
Episode Stats
Words per Minute
174.7777
Summary
In this episode of The Qualies, Dr. Peter T. Lustig, a pediatric pediatrician, talks about the dangers of sugar in the modern world, how to combat them, and what you can do about it.
Transcript
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welcome to the qualies a subscriber exclusive podcast qualies is just a shorthand slang for
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a qualification round which is something you do prior to the race just a little bit quicker
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qualies podcast features episodes that are short and we're hoping for less than 10 minutes each
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which highlight the best questions topics tactics etc discussed on previous episodes of the drive
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we recognize many of you as new listeners to the podcast may not have the time to go back and
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listen to every episode and those of you who have already listened may have forgotten so the new
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episodes of the qualies are going to be released tuesday through friday and they're going to be
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published exclusively on our private subscriber only podcast feed now occasionally we're going
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to release quali episodes in the main feed which is what you're about to hear now if you enjoy these
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episodes and if you're interested in hearing more as well as receiving all of the other subscriber
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exclusive content which is growing by the month you can visit us at peter tmd.com forward slash
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subscribe so without further delay i hope you enjoy today's quali i want to get into some more geeky
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biochemistry stuff but i also know that there's probably at least one person listening to this
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who's a parent who's thinking oh man do i have to simmer down how much sugar my kids are eating so
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when you saw kids in the clinic obviously you're seeing their parents that's one of the advantages
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of pediatrics it's also one of the disadvantages that's right that's right you have two patients
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two patients and i don't get paid for both but the beauty of it is you have you have a patient who you
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need to take care of which is this child but then you also have another caregiver who for the most part
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wants what's best for that child mostly and how would you counsel a parent who would say look
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dr lustig there's no way my kid's going to have no sugar in their life can you give me a way
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to create a sustainable environment instead of rules that's going to prevent my kid from having
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the metabolic derangement that hoses them for the rest of their life but allows them to still be a
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kid yes so that's what we did in clinic every single day here's the problem it's not the added
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sugar you know it's the added sugar you don't know it's almost there's like a rumsfeld tone to that
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right well yeah i mean there's the known knowns and then there's the unknown knowns and the fact is
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when you look at the amount of sugar that is in sodas it's bad when you look at the amount of
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sugar that's in candy cake ice cream it's about half as much that adds up to 50 percent of the
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added sugar consumed by children and what is that number by the way in grams per day approximately
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it runs the gamut but the median is 18 teaspoons so that's about 90 grams of sugar per day yeah it
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used to be 120 it's actually come down because the obesity epidemic 90 to 94 grams of added sugar per
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day half of the sugar is in foods you didn't know had it bread pasta sauce pretzels why pretzels have
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sugar okay bread right why do they put sugar in bread any idea i guess if you buy it probably helps
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with preserving it doesn't exactly so if you buy a loaf of bread at the bakery how soon before it
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stales two days typically two days if you buy a loaf of bread at the grocery store how long before it
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stales 10 days three weeks even okay why they're both bread right well what they did in the grocery
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store bread was they added sugar very specifically because the sugar doesn't boil off when you put
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it in the oven water does so it acts as a humectant it that's why it's so much moisture when you have
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store-bought bread exactly that's why if you threw a loaf of bread at my head it would just bounce off
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is because it's kind of spongy right but there are also breads like german fitness bread
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which don't have that they're real bread they use whole grains they're lumpy bumpy and they're small
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the loaves they're the size of their weapons and their weapons right you could like kill somebody
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if you threw a german fitness bread at their head okay it is dense they're both bread but the store-bought
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bread had sugar added very specifically to hold on to water because sugar's polar and so the water
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stays in and therefore the bread doesn't stale as quickly therefore you can put a sell on you know
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by date way later decreased depreciation increased profit so if a kid came in and a kid's got an
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afel d and you've surmised that this child's eaten about 100 grams of sugar a day do you say to the
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parent our target is what 20 grams per day what we say is we don't worry about target numbers what we say
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is processed food is the problem because processed food is high sugar low fiber what you want is a
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low sugar high fiber diet that's called real food every diet out there that works and there are a whole
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bunch of diets that work okay certain vegan diets work remember coke is vegan so it's not like every
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vegan diet's okay the college vegan diet doesn't necessarily yes the college vegan diet does not work
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exactly right the traditional japanese diet the atkins diet ketogenic diet paleo diet mediterranean
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diet all of these diets based diets sure they all work because they're all real food every diet that
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works is real food and every diet that doesn't is because it's processed food the problem is parents
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don't know the difference they don't understand that grocery store bread is processed food they think
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they think you know if it's sold in the supermarket it's food no there's real food and you know what
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that is but the parents don't and what we teach them in clinic is if there's a label on the food
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that's a warning label because that means it's been processed because real food doesn't need a label
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is there a you know nutrition facts label on broccoli is there a nutrition facts label on carrots no is
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there a nutrition facts label on the meat in the meat case no the reason is because it's all real food
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now when we get to meat you know there's ways of making meat a problem too it's called corn fed but
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the bottom line is at least they're real food because that means you'll you don't necessarily fixate on
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targets you say look right we're going to talk about we're going to make a conceptual change we
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don't ask them to do math we ask them to purchase and consume real food now we have to teach them what
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that is so what we do we bring all of the new patients in on the same day we see all the new
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patients on one day it's like chaos and they all meet with a dietician they come in fasting and we draw
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their blood and you know we we evaluate them and then they all sit down at a communal table and we do
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an hour-long teaching breakfast and the dietician narrates why those foods are available for breakfast
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so whole grain bread natural peanut butter you know not skippy jiff peter pan but you know the real stuff
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plain yogurt etc and we explain why these foods were chosen and how they meet the criteria of real
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food as opposed to what they're currently buying most parents get it now there are some who don't
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there are some who say i'm sorry that takes too long i can't spend the time preparing real food
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and then is there an economic consideration also what is the do you have a sense of what it costs
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all things equal yeah double go for so a parent's going to basically have to double their food budget
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if they want to start eating real food that's right they're going to have to double their food
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budget and they're also going to have to double their food time in terms of preparation i hope you
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enjoyed today's quali now sit tight for that legal disclaimer this podcast is for general informational
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purposes only and does not constitute the practice of medicine nursing or other professional
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health care services including the giving of medical advice and note no doctor patient relationship
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own risk the content of this podcast is not intended to be a substitute for professional medical advice
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diagnoses or treatment users should not disregard or delay in obtaining medical advice for any medical
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condition they have and should seek the assistance of their health care professionals for any such
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conditions lastly and perhaps most importantly i take conflicts of interest very seriously for all of my
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disclosures the companies i invest in and or advise please visit peter atia md.com forward slash about