Lies I Taught in Medical School

by Robert Lufkin
BenBella Books, 2024, 390 pages
reviewed by T. Nelson

This book has overflowing praise not only on the back cover but on the first seven pages, which generally means that a book really sucks. Overall, though, it's not bad, and it has some information that everyone who eats food, which is most people, should know.

But it's not really about dishonesty and corruption in medical schools as the title suggests. (For that, you'd need an encyclopedia.) It's about Robert Lufkin's theory that virtually all diseases of aging, including cancer, heart disease, Alzheimer's disease, and arthritis are metabolic disorders and the treatment is to eat “pre­agri­cult­ural whole foods.”

I tried that once. A few months ago I tried to eat one of those whole-grain cereals. It almost broke my teeth. And I'm not 100% convinced that a muffin contains 500 calories as Lufkin says. I'll have to verify that one.*

As for the “lies,” each chapter begins with one, but they're variations of three main lies:

• A calorie is just a calorie

• Fat and cholesterol cause heart disease

• Type 2 diabetes is best treated with insulin

Some of this is old news by now. Nina Teicholz's book The Hydro­gen­ated Bomb: Science and the Cholesterol Scandal is a great source for why cholesterol and dietary fat are no longer considered to cause cardio­vasc­ular disease. Jason Fung's The Obesity Code and many others have tried to pound the message in about fat and carbs. Yet grocery stores still religiously trim the fat off every­thing because customers still think eating fat makes them fat. That's why this book is still badly needed.

Perhaps the biggest culprit for obesity, says Lufkin, is high fructose corn syrup. He's right. Aside from its horrible taste, it's worse for you than cane sugar. We used it in our animal experiments to make mice obese, and it worked very well. Lufkin says non-alcoholic fatty liver disease (NAFLD) never existed before 1984, when high fructose corn syrup was introduced. You can thank the US government for that as well as for the non­alco­holic steatohepatitis (NASH) and the fatty liver that now affects one in three Americans. The “lie” is that there is no cure. His cure: eat starch. Or go on a low carb diet and your liver will heal itself as long as it hasn't turned to cirrhosis.

Another “lie” is that to lose weight, you should eat less and exercise more. Lufkin echoes Jason Fung, who says insulin causes obesity and obesity causes disease. The solution is not to eat less, but to avoid raising your insulin levels by narrowing your eating window and avoiding sugar and sugar substitutes, both of which Fung says raise insulin.

Salt is also bad for you, says Lufkin, not for its effect on blood pressure, but because it activates the polyol pathway that converts other carbohydrates (including sorbitol) into fructose.

Lufkin educates laymen in simple, easily understood terms about mTOR, which is a very complicated enzyme that Lufkin says induces insulin resistance when it's chronically activated. There's also LP(a) or lipoprotein A, and sd-LDL (small and dense lipoprotein particles), which he says is very bad, unlike ordinary LDL which everyone is terrified about but is harmless.

Unfortunately, like many health food advocates, Lufkin overstates his case. It is true that statins have many bad side effects (the “lie” being that they prevent heart disease), but he overlooks the recent findings that statins may be working by reducing inflammation, while lowering cholesterol is just an incidental side effect. Using acarbose to block digestion of carbohydrates and rapamycin as an anti-aging drug is questionable, and his attempt to resurrect the old idea that cancer is caused by the Warburg effect is unconvincing. His claim that mental illness, cancer, and Alzheimer's disease are all metabolic disorders is on thin ice, but when he says nobody dies of old age (“aging does not cause death”), while technically true, he seems to be suggesting that if the diseases of aging could be cured a person would live forever. That doesn't necessarily follow.

Then on page 249 Lufkin demolishes his whole case with a bar chart purporting to show the benefits of cutting carbs. Cutting carbs is essential for health, but the graph shows that reducing carbs from 65% to 10% reduces HbA1c (a marker for type 2 diabetes) by a whopping 1.1 ± 0.35 percent. And I'm not convinced that putting food in a blender really has as much effect on insoluble fiber as he says, though I suppose it could shorten their fiber length.

Anyone who still believes in the US government's infamous food pyramid needs to learn this stuff while you're still alive. Because afterward you'll be in a place where it's too dark to read.

Other factors he recommends are buying (but not, I assume, eating) a dog, sleeping, and getting exercise. But where we're on the same page is sugar substitutes. If you're still eating anything that contains high fructose corn syrup, stop!

june 10, 2024

* update Lufkin is correct about one thing: according to my grocery store, blueberry muffins have 460 calories, chocolate chip muffins have 480.