Like everyone else in California this week, I made an emergency provisions trip to the supermarket in response to our state’s “shelter in place” order to try to flatten the coronavirus infection curve. What I saw amazed me. All the produce, all the meat, all the milk, all the nuts, all the dairy, were fully stocked. What was gone from the shelves? Pasta, breakfast cereal, and candy. Really?

Now, I understand that these consumables last a long time. I understand that people are not sure about the resilience of the food supply. I understand that people are worried that the fresh food somewhere along the food chain might have been handled by a virus carrier. And, as an obesity researcher, I understand that they are “tasty”, and right now, everyone is just a little bit stressed which drives the brain’s need for some form of “reward”. Parents are using sugar as the reward for good behavior while cooped up in the house, while the mom is guzzling Ben and Jerry’s.

But this is the exact WRONG formulation. This isn’t going away soon. We’re in this for the long haul, and what we eat matters. Who dies from coronavirus? The elderly, and those with pre-existing conditions, such as diabetes, heart disease, hypertension, and kidney disease — and these affect young people as well. The current thinking is that these people don’t have the resilience to stand up to the virus. This is partially true, they don’t. But why not? Because these groups are already in a state of chronic inflammation, which stems from their prior poor nutrition.

The elderly lose muscle and brain function as they age. Is this just from aging? Not specifically — there is a subset of octogenarians who are doing just fine, and there are centenarians who can run rings around you. Rather, most of the elderly fall prey to malnutrition, which can be due to any one of the Nine D’s: Depression, Dementia, Diarrhea, Drugs, Dentition, Dysgeusia (inability to taste), Dysfunction (specifically immune), Dysphagia (inability to swallow), and Disease (the same diseases that younger people get).

And what are these diseases that serve as risk factors for dying from COVID-19? They are the diseases of metabolic syndrome. Diabetes, heart disease, hypertension, kidney disease — these are the diseases that travel with obesity. But obesity is not a cause, because 20% of obese people don’t have them, while 40% of normal weight people do. Rather, obesity is a marker for the two underlying cellular pathologies — mitochondrial dysfunction (the inability to utilize energy properly) and insulin resistance (the inability of cells, especially the liver, to respond to the insulin signal). Because of these two problems, people with metabolic syndrome are already in a high cytokine (inflammation) state, which is what drives these chronic diseases.

Then throw COVID-19 on top, and you have the makings of a tsunami of inflammation. You’ve heard that this virus causes pneumonia. That’s true, because pneumonia just means lung inflammation. But it’s not due to the virus itself. It’s due to the ensuing cytokine response, known as Adult Respiratory Distress Syndrome (ARDS), which destroys normal lung tissue.

Your inflammatory status is the single best predictor of survival. What worsens your inflammation? Processed food, because of three inherent problems: 1) excess omega-6 fatty acids (seed oils like soybean oil) which are pro-inflammatory; 2) lack of omega-3’s (oily fish), which are anti-inflammatory; and 3) excess sugar (virtually all processed food), as the fructose (sweet) molecule in sugar poisons mitochondria and induces insulin resistance directly.  Conversely, improving your inflammatory status is the single best way to improve your chance for survival. Flavonoids, polyphenols, vitamin C, vitamin D, all of which have anti-oxidant, anti-inflammatory, and immune strengthening capacities. That’s called REAL FOOD — the stuff that’s still in the supermarket!

But what about food-borne viral transmission, you ask? While it is true that COVID-19 is very resourceful and can bind to intestinal epithelial cells, no one appears to have contracted the virus through the oral route. This is a droplet disease. My UCSF colleagues have posted a full assessment of the virus’ transmission and epidemiology, and the gut is not a route of infection. If you’re still worried, cook the hell out of it; it’s still better than eating the crap out of the box.

The big problem is that 33% of Americans today don’t know how to cook; because a whole generation has grown up on processed food. To this end, my non-profit Eat REAL <eatreal.org> is posting food guides on how to eat immune system-boosting food, and the contents of my Fat Chance Cookbook is online so that adults can make easy quick recipes using real food; and the only extra piece of cooking equipment you would need is a blender.

Processed food kills. It kills by causing chronic disease. But chronic disease puts you at risk for acute disease as well. Real Food won’t prevent you from becoming infected with COVID-19. But it certainly can help you to survive it.

– Robert H. Lustig, M.D., M.S.L.

Robert H. Lustig, M.D., M.S.L. is Emeritus Professor of Pediatric Endocrinology in the Division of Endocrinology and member of the Institute for Health Policy Studies at the University of California, San Francisco. He is also Chief Science Officer of the non-profit Eat REAL and Medical Advisor for the Hypoglycemia Support Foundation. He takes no money from the food industry.

Eat Real Food Poster by Joe Wirtheim.

All Hail to the Kail podcast featuring the fascinating story of fat vs. sugar and how it’s still misinforming what we eat today, featuring Nina Teicholz, Dr. Aseem Malhotra, and Professor Michael Yudkin, son of John Yudkin, author of Pure White and Deadly.

A future for the world’s children?

A WHO-UNICEF-Lancet Commission

Resource Page: https://www.thelancet.com/commissions/future-child
Toolkit: https://www.who.int/news-room/campaigns/a-future-fit-for-children/#resources

Executive Summary

The health and wellbeing of children now and in the future depends on overcoming new challenges that are escalating at such speed as to threaten the progress and successes of the past two decades in child health. The climate emergency is rapidly undermining the future survival of all species, and the likelihood of a world in which all children enjoy their right to health appears increasingly out of reach. A second existential threat that is more insidious has emerged: predatory commercial exploitation that is encouraging harmful and addictive activities that are extremely deleterious to young people’s health.

The WHO–UNICEF–Lancet Commission lays the foundations for a new global movement for child health that addresses these two crises and presents high-level recommendations that position children at the centre of the Sustainable Development Goals (SDGs).

Listen

A future for the world’s children? A WHO-UNICEF-Lancet Commission

Richard Horton, Sarah Dalglish, and Grace Gatera talk about the future for children alive today, alongside findings from the new Commission

Excerpts

“Currently children around the world are unprotected from commercial predatory interests…”

“Our report chose to focus in on the commercial marketing of harmful products to children and their caregivers. We saw that this has taken on a fairly sinister new aspect in the area of social media and algorithmic targeting. There is a lot of evidence that children are specifically targeted with advertisements for alcohol, tobacco, e-cigarettes, sugar-sweetened beverages, and other unhealthy products. At the same time, their parents are targeted for ads for breast milk substitutes – all of which can be very unhealthy for children. The amount of these ads is just staggering. Children and adolescents, for example, in Australia, view some 51 million ads for alcohol during sports programs in a single year, mostly during daytime hours. That’s just one example. In an era like today where non-communicable diseases kill some 41 million people globally each year, we thought this issue is not getting nearly enough attention that it requires because people’s health trajectories, in terms of their behaviors, what they eat, drink, whether they smoke, are often set during childhood and adolescence.”
– Sarah Dalglish

“Overnutrition is causing disease on a vast scale and is almost impossible to stamp out…”

Richard Horton explains why and what we can do about it:

“There’s not one country in the world that’s successfully introduced policies to address overnutrition and the driving forces of overnutrition are the commercial determinants of health. The predatory behavior of food manufacturers who use marketing and advertising techniques to deliberately target vulnerable young people, and nobody is defending the interests of those vulnerable young people. We think the public health community, the medical community, should be one of those forces in society to protect the interests of children and young people, and that’s what this commission is trying to do…to lay out the evidence, to signpost the challenge, and to begin the action necessary to do so.  I think it’s going to be very challenging to commercial determinants of child and adolescent health because we underestimate the force of these predatory food companies in our society. They are huge, the cross transnational borders, they have enormously successful political lobbying, capacities and efforts, and to take the medical and health communities and try and defeat their work is a challenge that seems of superhuman proportions, but the medical community is also transnational, it is its own network, it has enormous and evidential moral force. I think that we can persuade the public that we need to be putting our children first and their interests first. No parent, no family, no community wants to see their children in twenty or thirty or forty years time, living with, suffering from, the kinds of diseases that they are beginning to suffer from because they have become victims of this predatory corporate behavior. So, I think the challenge is great, but the prize is great too, and the prize is the health of our children and young people.”

Link to the report:

A future for the world’s children? A WHO–UNICEF–Lancet Commission