Review – Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine

Review – Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine
By Andrew Luer
Category: Food

Over the last couple of years, I’ve had the opportunity to serve on several scientific advisory boards with my colleague and friend, Dr. Robert Lustig. He’s certainly well known in the metabolism community, has appeared on my podcast, and has written some really impactful and empowering books. One book that has certainly proven to be enlightening and influential is entitled: Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine

Dr. Lustig is a pediatric endocrinologist by training and is well known for his research and advocacy against sugar and processed foods. The book, published in May 2021, extends Lustig’s critique of the modern food industry and its impact on our health. Here’s my overview:

Introduction to the Problem

  • Processed Foods and Chronic Diseases: Lustig argues that the rise in processed foods has led to an increase in chronic diseases like obesity, type 2 diabetes, heart disease, and even some cancers. He explains that the current healthcare system is more focused on treating the symptoms of these diseases rather than their root causes. I will add that these views clearly resonate with our messaging as it relates to Alzheimer’s disease.

Eight Pathways to Metabolic Health

Lustig identifies eight pathways that are essential for our metabolic health, and how they are impacted by diet. These include:

  1. Glycation: The process where sugar molecules bond with proteins or fats without enzymatic control, leading to aging and chronic disease. Glycation enhances both oxidative stress as well as inflammation (see below).
  2. Oxidative Stress: Imbalance between free radicals and antioxidants in the body, often worsened by processed foods.
  3. Mitochondrial Function: The energy-producing structures in cells are impacted by diet, influencing overall health.
  4. Insulin Resistance: A key factor in metabolic syndrome and type 2 diabetes, heavily influenced by diet.
  5. Membrane Instability: Diet affects the fats in cell membranes, impacting their function and stability.
  6. Inflammation: Chronic inflammation is linked to many diseases, and diet plays a critical role in controlling it.
  7. Epigenetics: The study of how behaviors and environment can cause changes that affect the way genes work, including the impact of diet.
  8. Autophagy: The body’s way of cleaning out damaged cells, which can be impacted by nutritional factors.

The Role of Sugar and Processed Foods

  • Sugar as a Toxin: Lustig argues that sugar, particularly fructose, is a major contributor to metabolic diseases. He suggests that it should be considered a toxin due to its harmful effects on the body. As many of you may note, it is fructose that we call out in my book, Drop Acid as being so threatening to metabolic health by increasing the production of uric acid.
  • The Misleading Nature of Food Labels: The book delves into how food labels can be misleading, often hiding the true content of sugar and unhealthy ingredients in processed foods.

Critique of the Food Industry and FDA

  • The Food Industry’s Role: Lustig criticizes the food industry for prioritizing profits over public health. He discusses how processed foods are engineered to be addictive and how marketing strategies target vulnerable populations, including children.
  • FDA’s Inadequate Regulations: He also critiques the FDA for not adequately regulating the food industry, particularly in terms of labeling and allowed ingredients.

The Fallacy of the Calorie Counting Model

  • Beyond Calories: Lustig argues that the focus on calorie counting is misguided. He explains that the type of calories (e.g., from whole foods vs. processed foods) matters more than the quantity.
  • The Role of Fiber: The book discusses the importance of fiber in regulating sugar absorption and promoting gut health.

Solutions and Recommendations

  • Dietary Changes: Lustig provides recommendations for a healthier diet, emphasizing whole foods over processed ones, and reducing sugar intake.
  • Policy Changes: He suggests policy changes, like taxing sugary foods and better food labeling, to promote healthier choices.
  • Education and Awareness: The book stresses the importance of educating the public about the dangers of processed foods and the benefits of whole foods.


  • A Call for Change: Lustig concludes by calling for a shift in both individual choices and public policy to combat the effects of processed foods on health.
  • Empowerment through Knowledge: He emphasizes that understanding how food affects the body can empower individuals to make healthier choices.

Metabolical provides a comprehensive analysis of how the modern food environment, particularly the prevalence of processed foods, contributes to widespread health issues. Lustig blends scientific evidence with a critique of industry practices, aiming to enlighten readers about the connection between diet and disease and to inspire a shift towards healthier eating and policy reforms. The book is a call to action for individuals and policymakers to reconsider our approach to food and health, emphasizing the power of knowledge and the importance of dietary and systemic changes to improve our collective well-being.

Related Topics

Share This


Dr. Perlmutter is one of the leading lights in medicine today, illuminating the path for solving chronic illness

Mark Hyman, MD