i would like to talk to you right nowabout perhaps the most over-used and misunderstood wordin the english language: "freedom." freedom has two parts: freedom from -freedom from oppression, freedom from search and seizure;and freedom to - freedom to choose. but freedom to choose has somecaveats, has some provisos. the one we ascribeis called "personal responsibility", and that's an ideology. and there are some basic principles that we ascribeto personal responsibility,
that is, we have to have knowledge. the five-year old who accidentallyshoots his brother is not guilty, because he didn't have the knowledge. access. we have 57,000 people being thrown offvoting rolls right now in america because of redistricting;they don't have access. they can't have personalresponsibility to vote. and finally, affordability. you have to be able to afford your choice,
and society has to be ableto afford your choice. an example: in california we've justreleased 100,000 inmates who are drug addicts. we said, "drug addictshave to be locked up." you know what? we can't afford it. so, these are all caveatsto personal responsibility. and then the last one,really important, is that your actionscan't hurt anyone else,
because if they do,then that's breaking the law. well, the fact is,we've got a healthcare crisis, and it's a big one. in fact, medicare will be brokeby the year 2026. we do not have the moneyto keep doing what we've been doing. and this healthcare crisisis not due to physician reimbursements, it is not due to hospital charges, it is not due to infrastructure,or administration. this healthcare crisis is dueto chronic metabolic disease.
that's where the money's going. $245 billion dollars last yearin america for diabetes. $200 billion for dementia,another chronic disease. and obamacare promises usthat we're going to be able to put 32 million sickpeople on the rolls, and we're going to to do itby providing preventative services. well, guess what? there are no preventative servicesfor these chronic metabolic diseases. they don't exist.
the only thing that works is prevention,and we don't have a prevention. so, what does this mean? this means that we're screwed. (laughter) the fact is, that we cannot afford this. where is this coming from? it's coming from this thingcalled the obesity epidemic, right? everyone says, "if only these peoplecould just eat less and exercise more, we would solve this problem;it's their fault."
that's where this comes from. you know, we have these thingscalled the seven deadly sins. we have absolved all fiveof the other sins. we've absolved jealousy,greed, wrath, pride, and lust. in fact, we have tv showsthat exhort them. the only two that we have notbeen able to get rid of, the only two that still standare gluttony and sloth. it's your fault. well, you know what?
i'm a pediatrician,and i take care of kids. i have a hard time ascribingpersonal responsibility to their obesity. in fact, we have an epidemicof obese newborns. obese newborns. now, you want to assign thempersonal responsibility? i take care of kids with brain tumors. you can see right here this arrowpointing to a goombah sitting right in the middleof this patient's energy balance pathway. a brain tumor that is causingmassive obesity.
let me tell you abouttwo of those patients. here's a patient that i took careof many years ago. she had a brain tumor,and she gained 150 pounds. you can see her hereright now at 220 pounds. and we put her on an experimentalmedication to lower her insulin level. remember, insulin is the diabetes hormone,it's also energy storage hormone. it's the hormone that tells your fat cellsto take up extra energy. there is no weight gain without insulin. and we knew that these patientshad very high insulin levels.
so we gave her a drug to drop her insulinin an experimental fashion. a week later, the mother called me up,the kid hadn't lost any weight yet, and she says, "doctor lustig,something's going on here." i go, "how do you mean?" "well, we would go to taco bell, and she would eat five tacosand an enchirito, and she'd still be hungry. we just went to taco bell and she only ate two tacos,and she was full.
and she just vacuumed the house!" i go, "really? isn't that interesting." in fact, we did this many times,and the exact same thing happened. and here she is, one year laterhaving lost 48 pounds, and feeling much betterabout herself, as you can imagine. the next patient i'm going to show youisn't even my patient. this is a beautiful 13 year old girlwho lives in hawaii. notice the lily in her hair. and one month after this picturewas taken, she was in a car accident,
and she stroked her hypothalamus, that area of the brain wherethat tumor was for the other patient. and this is her, one year later. now, does anyone really want to tell methat this is personal responsibility? that this was this young girl's fault? well, i was giving grand roundsat kaiser, honolulu, and they said maybe we shouldput this girl on this same drug. and there i am with her. and her mother said,"yes, go ahead and try."
and here she is one and a half years laterat her high school graduation. now, does anybody reallywant to make the argument that this is this kid's fault? i have a hard time with that. in fact, what we learnedfrom these experiments is that the behavioris secondary to the biochemistry. when you fix the biochemistry,the behavior improves, and we've seen it now in adults as well. so, everyone saysthe behavior's the problem.
no, it isn't. the biochemistryunderlying is the problem. well, so now you say to me, "what about the rest of us? we don't have brain tumors." well, in fact,it's the exact same problem. nothing's different. all of us now have insulin levelsthree times higher than we used to. and the question, of course,is where did that come from?
who in the audience has diabetes? anybody? must be a few of you, because diabetes is pretty big problem here. here's the problem:seven out of eight of you, seven out of eight people with diabetes don't even know they have it. you are blind to diabetes,until you become blind from diabetes. so you don't even knowyou have a problem yet. so here's the way to look at this.
here is the american population;30% obese, 70% normal weight. the standard mantra is, "it's the obese person's fault because80% of those obese people are sick. they have type 2 diabetes;they have hyperlipidemia; they have cardiovascular disease;they have hypertension; they have cancer; they have dementia; and they are breaking the bank. those 80%, those 57 million people, if we could just get themto diet and exercise,
we could solve this problem." that's the standard mantra; this is incorrect. because 20% of those obese peopleare actually metabolically healthy. they will live a completely normal life,die at completely normal age, not cost the tax payer a dime. they're just fat. conversely, up to 40%of the normal weight population have the exact same diseases.
they get type 2 diabetes, hypertension,dyslipidemia, cardiovascular disease. and you know what? they don't know they have a problem. when you add them up,it's more than half the us population. in other words, this is a public health crisis. here is an example of how that works. here are two people of equal weight;one's healthy, one is sick. want to take a guesswhich one the sick one is? can you tell?
i can tell. the one in the bottom is sick; why? the guy on the top,he's just got big love handles. the guy in the bottom has got fatall around his organs, and that is what's making him sick. and this is called tofi; t,o, f, i. thin on the outside, fat on the inside. i venture to guess there's a fewtofis in the room right now, and you think you are just fine,and you are not.
so lets talk about the last publichealth crisis that we experienced. hiv; remember hiv? 1979; patient zero. 1981; the term "aids" got coined. 1986, everett koop said,"you know, we've got a problem." when did hiv becomea public health crisis? 1991. why? because magic johnson got hiv.
and everybody said, "holy ____,this could happen to me." this really is somethingwhere everyone is at risk. because it's not a behavior,it's an exposure. so the question is,how do we resolve this? well, here's the problem;it's on this slide, right here. this is coca cola's "beating obesity"campaign, "coming together." "beating obesity will takeaction by all of us, based on one simple common sense fact: all calories count, no matterwhere they come from,
including coca-cola,and everything else with calories." a calorie is a calorie, and you can getyour calories from carrots, or you can get your caloriesfrom cheesecake, or from coca cola, or anything elsewith a "c" for that matter. it doesn't matter wherethe calories come from, it's, "a calorie is a calorie",that's what they say. i don't believe in common sense. i believe in data.
and the data say something else entirely. what the data say is some caloriescause disease more than others, because different caloriesare metabolized differently, because a calorie is not a calorie. and when you believe that a calorieis not a calorie, a whole world opens up, and actually, how to fix this problembecomes very clear. this is because of our new diet. it is 40 years old now.it is called "the western diet", it is called "the industrial global diet",
and it is basicallythe processed food diet. and everyone of youis eating it all the time, whether you like it or not. there are eight things wrong, not one, but eight things wrongwith processed food, and here they are. three thing too little,five things too much. not enough fiber, not enoughomega-3 fatty acids, which you get from wild fish not farmed fish, not enough micro-nutrients,all the vitamins and minerals.
in addition, too much trans-fats,but we know that they're coming down, branched-chain amino acids; they're amino acids you getin corn-fed beef, chicken and fish, omega-6 fatty acids in seed oils,alcohol, and finally, the big kahuna, the one that blows all the otherseven out of the water, sugar. sugar, okay? we're going to talk about thatfor the rest of the time. does sugar cause diabetes? everyone says, "well, yeah,but it's because of the calories."
"sugars are empty calories,"that's the mantra. it is not; this is absolutely not true. sugars are "toxic calories". in fact, studies from europe showthat if you consume one soda per day, your risk for diabetes goes up 29%,irrespective of the calories, irrespective of your weight,irrespective of anything else you eat. we've shown that for every150 calories the world consumes, diabetes prevalence goes upa total of 0.1%, which is nothing. but if those 150 calories happen to bea can of soda, diabetes goes up 11 fold.
1.1%, and we're not consumingone can of soda, we're consuming two and a half. so 29% of all the diabetes in the world is due to sugar, and sugar alone. this study actually satisfiesboth the scientific and legal criteria for proximate cause. you have to be able to showthat something causes something else before you can do something about it. well, we've proven it; we've shown it.
it's shown here as well; same thing. now, the question is,why does this happen? number one: sugar causesliver fat accumulation. all that fat around the organsthat i just showed you? for sure, that's what that did. and that's not love-handle fat,that's inside you. number two: sugar's addictive. weakly so, but it's everywhere,it's like alcohol. and about 20% of peopleare addicted to alcohol,
probably about the same for sugar. so you can't stop. so this slide over here showsthe prevalence of diabetes worldwide as we speak right now. who's worst? saudi arabia, kuwait,uae, qatar, and malaysia. the worst. why them? no alcohol.
but they've got soft drinkslike they're going out of style. because it's hot, and the watersupply's a question mark, and no alcohol. this is their reward. but you know what,i'd rather have alcohol. because you can only drink yourselfunder the table once a day. but for soft drinks; all day, all night. sugar in the morning, sugarin the evening, sugar at supper time. that's what we're seeing.
so, we've been overdosed. the american heart association says we should be consumingsix to nine teaspoons of sugar per day; we are up to 22. and 80% of foods that are availablein the american grocery store today are spiked with added sugar. and that's for the food industry'spurposes, not for yours. so, no access. you don't have accessbecause it doesn't exist.
real food is hard to find. number two: how about that there are 56names for sugar, so you don't even knowwhat you're consuming. and here there are. no knowledge. and how about this? everybody knows whata "nutrition facts" label is. there's a numberover there in the purple.
it's called the "daily value". notice, there's none for sugar,and that's on purpose because they don't want you to knowhow much is too much. so, no knowledge. how about the nationalschool lunch program? six cents extra. six cents, michelle obamagot out of congress. that's not even enough for two grapes. and, if you are eating school breakfast,
you're getting fruit loopsand a glass of orange juice. that's 11 teaspoons of sugar;you're already over your limit. you want to know why we have a problem? this is why we have a problem. so everyone says, "education!" "educate the public, educatethe populace, tell them what's going on!" except for one thing: education hasn'tworked for any other substance of abuse. did nancy reagan's "just say no" work? really?
i can prove that it doesn't workbecause here is the stock prices against the s&p 500for mcdonald's, coke, and pepsi, and look at what happenedat the economic downturn in 2008. they did very well, thank you. in fact, if you want make money,invest in a food company. so, where does that leave us? it leaves us with this questionof freedom and personal responsibility. what does personalresponsibility really mean? well, if the information is kept secretand you don't have knowledge,
if your access is limitedbecause you can't even find it, and if society can't afford it, and we can't even give our kidssomething healthy to eat, is it really personal responsibility? and lastly, if your decisionto drink a soda lands you in the emergency room,and costs me dollars, and if your decision to be fat and sick costs your employer $2750 per employee, whether you're obese or not,you know what that is?
that's not called freedom,that's called anarchy. that's what we've got. so the libertarians say, "wait a second;don't tell me what to eat!" well, you know what?you've already been told what to eat. where were you for the last 40 years as your food supply was beingchanged under your nose. were you protesting then? the libertarians say,"get government out of my kitchen!" you know, i don't wantgovernment in my kitchen either,
unless there's somebodymore dangerous already there. so the real question is, who the helldo you want in your kitchen? the government, who will takeyour freedom and your wallet? or the food industry, whose already taken your freedom,your wallet, and your health? that's your only choice. now, having said all this, the food industryis composed of a lot of people, and you know what?
they really wantto do the right thing, they do. individually, they would actuallylike to do the right thing. and i have met with these people,and they are actually very nice people, but, they work for a food company. and contrary to whatthe supreme court says, corporations are not people. because corporations have a fiduciaryresponsibility to their stockholders, and people don't. corporations get three month profitcycles, and wall street earning reports.
and they have to make those reports. so i've met with the food industry,and i will tell you about one story, which will remain nameless, they told me very straight out,ten scientists, ten corporate executives, they said, "you know, we can change. we've changed before. we had to change back in the 80swhen we went low fat, with two provisos; we wont go it alone,and we can't lose money."
those are two non-starters today. so what does that mean? that means that theyhave to be told what to do, and they have to do itall at the same time so that there's nocompetitive disadvantage. what does that mean? that means government. but governments are complicitand complacent. they're getting paid off.
over half of congress takes moneyfrom the food industry. and 6% of our exports are food. what do you think what happenif all of a sudden we told the world, "you know, all that shit we put in food? it really isn't so good for you." what happened when that one downer cowwent from canada to washington state? that was at the end of meat salesto britain and south korea for two years. so, they're on the other side. but we've got a crisis,because we will not have healthcare.
here is a report that just came outfrom an investment bank, an international investmentbank, credit suisse, called sugar consumption at a crossroads,and this is a direct quote from this tome: "we believe higher taxation on sugary foodand drinks would be the best option to reduce intake and fundthe healthcare costs associated with diabetes and obesity." an investment bankis calling for taxation. that's how big and badthis problem has gotten. i believe food shouldconfer wellness, not illness,
and it used to. but you know what? this is a public health crisis, and you cannot solve public healthcrisis one person at a time. here is a list of diseases that were allpersonal responsibility issues, except for the sheer gravityof each of them, became a public health crisis. why don't we add sugar to the list? personal responsibility isn't ideology.
it's the elephant in the kitchen,and we can't afford it. what we need is a policybased in biology. and it's got a name. it's called real food. and the only way we can solve this is by kicking that elephantout of the kitchen. thank you. (applause)