Tuesday, May 14, 2013

Book Review: Fat Chance

Fat Chance is next up for review. The author, Dr. Robert Lustig, is a medical doctor and the Director of the University of California San Francisco Weight Assessment For Teen And Child Health Program.  You may remember him from his Youtube video, “Sugar: The Bitter Truth”, which was viewed over 3 million times.

The basic premise of Fat Chance is that a calorie is not always a calorie.  In other words, there are hormonal consequences to the foods we eat that tend to promote fat storage or fat burning.  The book cites our increased sugar consumption as the driving force behind the obesity epidemic.  The book focuses a lot on the hormonal consequences of our food, how these hormones influence our health, ways to change our diet to improve our health, as well as a section on public health policy solutions to the obesity epidemic.  The book was extremely well written and well referenced.  I really enjoyed reading it and learned a lot.

Five Things I Really Liked About Fat Chance
1) The idea that a calorie is not necessarily a calorie.  For years, the prevailing wisdom was that if you burn more calories than you take in, you’ll lose weight, no matter what you eat.  We are now learning that this is not always true.  Certain foods start a hormonal sequence that actually promotes fat storage while other foods do not.  The book nicely explains this.

2) The section on the hormonal consequences of our food.  This was very well done.  Lustig explains what happens biochemically when we eat different types of fat, protein, and carbohydrate foods. This knowledge is absolutely essential if you want to lose weight.

3) The toxicity of sugar.  If you work with me or read any of my books, you know how I feel about sugar.  After trans fat, I believe it is the worst thing you can eat. The section on sugar nicely explains why this is so.

4) The section on visceral vs. subcutaneous fat.  This was a great explanation of the difference between these 2 types of fat.  All body fat is not created equal!  Visceral fat (found inside the abdomen and organs) is far more damaging to our health than subcutaneous.

5) His proposed policy changes to control the obesity epidemic. This section is definitely a bit controversial.  Policies such as soda taxes, placing limits on advertising for unhealthy foods, and banning sugar in schools tend to raise as many political conversations as public health conversations.  However, this section brings up some pretty interesting ways to help curb the obesity epidemic and I found it a very interesting read.

Five Things I Didn’t Agree With In Fat Chance
1) Lustig repeatedly mentions that weight loss through diet and exercise is impossible to maintain long term.  I couldn’t disagree more.  With the right combination of diet, cardiovascular exercise and resistance training, long term weight loss is absolutely possible.  I’ve seen it hundreds of times with my own clients over the past 15 years.  Just because it is not easy and most people don’t know what to do, does not mean that it is impossible.

2) Lustig goes on to mention that being a little overweight is actually good for your health. He cites studies that found those with a BMI between 25 and 30 have the longest life span.  These studies were methodologically flawed by including smokers and sick subjects.  Since most diseases cause weight loss before death, and because smokers are thinner and ultimately less healthy than non-smokers, including these subjects in statistical analyses makes it look like thin people are less healthy.  In the Harvard cohorts, when these methodological flaws were controlled for, there was strong evidence that being overweight significantly increased risk of disease and early death.

3) Lustig didn’t really go over what you should eat to lose weight and be healthy.  There were no sample meal plans, just a shopping list.  I thought there could have been a bit more guidance here.

4) That leads me to the shopping lists.  Lustig spends most of the book explaining the hormonal consequences of eating too much sugar.  He is so right, and this was my favorite part of the book. However, I was a bit confused when he presented his shopping guide.  Foods were divided into 3 categories: 1) Green light foods can be eaten anytime.  2) Yellow light foods can be eaten 3-5 times a week. 3) Red light foods can be eaten once per week.  There were a lot of high sugar yellow light foods!  For example, a bunch of high sugar breakfast cereals were in the yellow category.  Some had up to 19 grams of sugar per serving, which is almost 5 teaspoons.  These were allowed up to 5 times per week.  This amount of sugar will increase hunger and cravings for more sugar.  I’ve found 100% sugar avoidance is the only way to go.  If you have a little sugar every day, you’ll want more and never get over your cravings.

5) Very little mention of resistance training.  In my opinion, building calorie burning muscle through resistance training is an essential component of long term weight loss.  Fat chance didn’t really spend any time on this at all.

Is Fat Chance Worth Reading?
Absolutely!  This book is a must read for anyone concerned about how our diet affects our weight and our health, which should be all of us!  Dr Lustig is a smart guy who is passionate about reducing the suffering caused by the obesity epidemic.  Just about anyone who reads this book will think twice next time they are in front of a cookie or brownie.  Life without sugar is admittedly very difficult at first, but after a couple of weeks you truly won’t miss it and your health will improve in ways you won’t believe.