I love this book; I hate this book.
I love the "sugar is bad for you metabolically" story, how the conventional wisdom of a-calorie-is-a-calorie is bunk, how Ancel Keys and the lipid hypothesis is bunk, how hormones matter in understanding why we are where we are. As an expert in the field, Lustig's viewpoint gives us valid information upon how to get control over our bodies, and to shape future research. I think he's right, but I'm sure further research will illuminate how the body works. After all, Leptin wasn't even discovered until 1994, not even 20 years ago. I wish he'd look deeper in to the anti-nutrients present in all grain, but nonetheless, the fructose story is compelling.
But then Lustig the doctor becomes Lustig the amateur Economist/public policy wizard, but his lack of expertise won't stop him from how to diagnose and fix the problem through intervention. The Hippocratic oath statement of "never do harm" to anyone doesn't apply to Lustig's viewpoint of hold government guns, restrict people's choices, and rearrange all economic forces to fix a health problem. 1) Does this intervention "cause harm"? How would Lustig know? 2) Would it be effective?
Lustig is way out of his expertise realm here, but no matter; he's writing a prescription. Force the people who don't agree with me to do it my way, because sugar is addictive, and therefore, people aren't really choosing. The philosophical issue of "who owns your body" doesn't matter; Lustig needs to control your body to save the world from Obesity and Metabolic Syndrome. Because some people are addicted, and because the food industry manipulates you into making unhealthy choices. The current government regulatory scheme has been co-opted by the food industry, Lustig recounts, and so his prescription is -- more government action!
Perhaps Lustig could spend more time reading the works of experts on Regulatory Capture, in which the assertion is made that the mere existence of government regulation will always result in capture and dominance by the major players, with small players forced out. Lustig sees the food industry pulling the strings of the FDA (but he fails to talk about big pharma doing so, perhaps too close to challenging his own profession), and how politics runs our agricultural policy and shapes the food pyramid, as dominated by the biggest Agricultural interests. He talks about how the McGovern led commission on Nutrition and Human Needs manipulated us into believing Ancel Keys, and how we were completely duped. Instead of removing these harmful toxins from our lives, he asks for more. Who writes the regulations? Either current or former "experts" from the regulated industry. Lustig diagnoses the financial crisis in a one-sentence assertion, but didn't say the "prescription" to fix it, Dodd-Frank, was written by members of the industry.
Special interests are in control, so, what we need is the *right* special interests, different special interests, those influenced by Lustig, not those influenced by Keys. Does he have research to back this assertion? If he does, he doesn't show it. Oh, he cherry-picks some questionable anecdotes in order to get us to believe his model works. His choices are alcohol and tobacco, government intervention works here. It does? Here, Lustig appeals to our emotions, as politicians do. It's a way to get your cortisol working, so your Amygdala overwhelms the neocortex. It's how politics works. It's hormonal manipulation, and it's very addictive. In the economic realm, if I manipulate you, you may make choices you regret, but I have to repeat that for each and every choice. In the political realm, if I can manipulate 51% of those who vote to take away the choices of the 49%, then my guy gets to keep taking away the choices from the minority. One manipulation, many lasting effects, all enforced with government guns. Disobey, and go to jail. So more jail equals less obesity. Regulation *is* sugar; we need to lower it in our diets, but like Ancel Keys, we're off chasing the symptoms of special interests floating around the capital like small dense LDL. How they got here, says Lustig, is greed (a newly discovered substance) and Lustig prescribes a pill to drive them away.
Lustig is addicted to political power, he sees its ill effects, but he cannot help himself, he wants more. He doesn't understand the complex inter-workings of billions of people making simultaneous decisions, but no matter, if he can use the drug on you, and mobilize you to action, you and he can control the rest of people and make the world a better place. How many people have tried this? Has it worked? Did it "do no harm"? By Lustig's own examples in just the US context, it has failed. But as an economic quack, Lustig repeats the safe conventional wisdom, which is to clamp down, through force, on those who disagree. Writing more prescriptions for interventions, except we don't examine the patients, only the macro population, and then, completely misinterpret the data to suit our story.
So listen to the first half that challenges conventional wisdom with a provocative new viewpoint, and throw away the half that says conventional wisdom, bigger government, solves the problem.
For a book that suggests that empathy is a key skill necessary for emotional management, I find it ironic that Goleman goes into excruciating and painful detail of traumatic events as illustrations. Certainly, it evokes empathy (to the victims, not so much to the emotional wrecks who do evil things) . But it also became inordinately difficult to finish this very long program. I found myself avoiding it, even though I agree with many of his findings. A depressing program about how to manage one's emotions better!
Perhaps this book would hit its mark a bit better if it had more hopefulness and less dark tales.
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