Physicians Are Neither Trained Nor Paid to Express the “Medical Heresy” that Good Health Depends on Good Nutrition

(p. A17) Amazingly, medical schools in the United States focus very little on nutrition. The topic, according to one study, gets less than 1% of the classroom time that aspiring physicians are required to sit through over four years—even though the foods and beverages people ingest are far and away, in America, the biggest drivers of disease.

Because of the knowledge gap, doctors routinely miss opportunities to counsel their patients on the connection between nutrition and health—thus allowing bad eating habits to keep doing major damage. This failure is one of many indictments that Robert Lustig, a physician, brings against America’s medical-nutritional establishment in “Metabolical,” a wide-ranging polemic that covers the misdeeds of food and beverage companies and the misinformation that, in his view, contributes to the undermining of health.

. . .

Dr. Lustig’s real complaint is with “ultra-processed” products, which account for 58% of Americans’ calorie intake. Such products—candy, crackers, deli meat, frozen pizzas, fruit juices—are increasingly found not just in supermarkets and restaurants but virtually everywhere: movie theaters, hardware stores, gas stations, even health clubs. They’re typically mass produced, have a long shelf life and offer low nutritional quality.

How low? Dr. Lustig characterizes these products as “poison” more than two dozen times. To validate the claim, he describes in detail how the dominant features of such foods—high in sugar but also teeming with nitrates and refined carbohydrates—lead to cancer and other chronic diseases like diabetes and heart disease. Roughly 60% of Americans are afflicted with such diseases today (up from 30% in 1980). Relatedly, unhealthy eating has contributed to the decline in U.S. life expectancy in recent years.

That doctors don’t do more to steer their patients away from such hazards is only part of Dr. Lustig’s attack on the medical profession. He believes that, on the whole, doctors are “parochial,” taking their cues mostly from other doctors and thus succumbing to herd thinking. He worries that too many elements in their professional world—research, clinical meetings, webinars—are underwritten by Big Pharma and that the little nutrition science they know is compromised by studies that are sponsored by food companies. He says that doctors “don’t listen” to their patients and prefer to reach for the “quickest and easiest form of treatment,” whether it works or not, in part because insurance companies have limited the length of patient visits. “Talking about lifestyle changes takes time that we don’t have—because that’s how we’ve been trained and how we get paid.”

. . .

Dr. Lustig says that his book is “both my act of contrition to you, the public, and my act of medical disobedience to the medical establishment.” He hints that he could write such a book only after retiring from clinical practice—at the University of California, San Francisco (where he is an emeritus professor)—because “no ivory tower academic bastion would want to take credit for the ‘medical heresy’ that you’ll find sandwiched within these pages.”

For the full review, see:

Matthew Rees. “BOOKSHELF; Is It Something I Ate?” The Wall Street Journal (Monday, May 10, 2021 [sic]): A17.

(Note: ellipses added.)

(Note: the online version of the review has the date May 9, 2021 [sic], and has the title “BOOKSHELF; ‘Metabolical’ Review: Is It Something I Ate?”)

The book under review is:

Lustig, Robert H. Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine. New York: Harper, 2021.

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