When a UCSF Mini Medical School lecture about sugar and obesity given by pediatric endocrinologist Robert Lustig, MD, first hit YouTube and the UCTV website last July, it seemed unlikely that many people would tune in to watch the 90-minute video.
But now, nearly 500,000 views, 600 comments and countless tweets later, Lustig is excited to see his message about the dangers of sugar consumption resonating with the masses.
“I have been very gratified by both the volume of the response, and the quality of response that the video has garnered,” says Lustig, who serves as director of UCSF’s Weight Assessment for Teen and Child Health, or WATCH, Clinic. “I also have been very touched by the personal testimonials of many patients who have written to me about their own travails.”
In the YouTube video, Lustig argues that the current obesity epidemic can be blamed on a marked increase in the consumption of a type of sugar called fructose over the last 30 years. Fructose is a component of the two most popular sugars: sucrose or table sugar, and high-fructose corn syrup, which has become ubiquitous in soft drinks and many processed foods.
Lustig says that fructose is toxic in large quantities because it is metabolized in the liver in the same way as alcohol, which drives fat storage and makes the brain think it is hungry.
“People are searching for answers to this epidemic that make sense,” he says. “The science of fructose metabolism in the liver and fructose action in the brain turn the normal cycle of energy balance into a vicious cycle of consumption and disease.
“What I have proposed is quite controversial; that our food supply has been adulterated right under our very noses, with our tacit complicity. But I think the public gets it, and the tide is turning.”
The news media also has paid close attention to the growing popularity and importance of Lustig’s message. ABC News Nightline visited UCSF on March 8 to conduct an in-depth interview with Lustig that will air later this month. Nightline correspondent John Donvan became interested in Lustig’s work after Donvan’s wife, a physician, saw the video on YouTube and urged him to watch it.
Solving a Public Health Crisis
The heightened interest in Lustig’s video lecture coincides with the launch of a new national campaign against obesity spearheaded by First Lady Michelle Obama. Obama’s initiative aims to eliminate childhood obesity in a single generation through a variety of measures, including improved nutrition in schools and communities, and physical education programs.
The First Lady’s visionary goal is an important step forward, and UCSF researchers and clinicians are excited to do their part to help reach that goal, says psychology professor Nancy Adler, PhD, co-director of UCSF’s Center for Obesity Assessment, Study and Treatment or COAST.
“The problem of obesity truly is of epidemic proportion and raises the very real possibility that the current generation of children will be the first to have a shorter lifespan than that of their parents,” Adler says. “We are fortunate to have a remarkable group of experts at UCSF who conduct translational obesity research and are committed to solving this public health crisis.”
An obesity think tank of sorts, COAST was established in 2004 and is believed to be the first center in the country to focus on the impact that stress has on eating and weight gain. The work at COAST spans basic science, clinical studies, and social and behavioral research, enabling experts to address the obesity epidemic in all its complexity.
COAST also works closely with UCSF’s two major obesity clinics — the Adult Weight Management Program at UCSF Medical Center and the WATCH Clinic at UCSF Children’s Hospital — to directly apply the knowledge gained through research.
Translating Research into Treatment
It was basic research conducted by Mary Dallman, PhD, a physiology professor emeritus, that set the stage for UCSF’s current work around stress and obesity. Through a series of rat studies, Dallman showed that stress and fat metabolism are regulated by the same biological mechanisms, and animals subjected to greater chronic stress are more likely to eat sweet and fatty foods.
Today, researchers like Elissa Epel, PhD, associate professor of psychiatry and co-director of COAST, are applying Dallman’s basic findings and translating them into viable therapies. In one current project, Epel is developing a neurobiological test that she believes will provide an index of the extent to which a person is “hooked” on foods that are high in fat and sugar. The test, she explains, will help clinicians identify appropriate weight loss programs for individual patients.
Epel also is collaborating with Adler and Barbara Laraia, PhD, a COAST co-director and nutrition investigator, to examine early predictors of adult obesity. The researchers are testing novel interventions designed to help pregnant women keep their weight gain within recommended guidelines to see if this prevents future weight problems for women and their children. In addition to the valuable therapeutic applications of this work, Epel says it also can help inform public policy.
“Our research is very policy relevant,” she says. “Once legislators understand the root causes of obesity and see data demonstrating how certain foods affect the circuitry of the brain, they will feel compelled to protect people with better policy.”
Photos by Susan Merrell
UCSF Children’s Hospital
Adult Weight Management Program
UCSF Medical Center
New Center to Focus on Effects of Stress, Socioeconomic Status on Obesity
UCSF Today, August 11, 2009
Sugar is a Poison, Says UCSF Obesity Expert
Science Café, June 25, 2009
The Biology of Fat (or Why Literally Running Away from Stress Is a Good Idea)
Science Café, July 6, 2007