Non-Alcoholic Fatty Liver Disease and its Link to Chronic Illnesses, Unraveling the Hidden Epidemic. 

Dr. Lustig is a treasure!

Now when I see the cupcakes and fake juice boxes come out at my grandchildren’s soccer games, I physically twitch. Exercise and poison.

He should have an audience of thousands not just the few!!!

I have not met a single professor in my whole life, who is a Knowledgeable Orator like Dr.Lustig.

I have no medical background whatsoever, and forget about remembering basic chemistry. This lecture was gold, for someone like me who has NAFLD. First time that I found out what it means... Trying to lose weight like everybody else. But after this video, I have to make major shifts in how I eat... amazing and enlightening even to the regular person. Brilliant! Thank you!!

Always a brilliant lecture by Dr. Lustig. I have highest respect for the depth and breadth of his knowledge. If actively applied, he would save our medical system and restore health to millions. The burden of chronic care for lifestyle illness is undeniable. Consumption of oxidized industrial seed oils is a huge problem too.

This should be on all tv channels 24/7.

Non fatty liver disease ( is a silent killer like hypertension. Liver fat is adriver of diabetes even in normal weight people. Fatty liver disease is a precursor of type 2 diabetes. It was the liver fat that dictates insulin resistance . Where the liver fat came from ? From nonsystemic fatty acids came from de novo lipogenesis ( DNL) Systemic fatty acids came from diet and lipolysis of peripheral adipose tissues. 3 hits to the liver that leads fatty liver disease. 1. DNL ( de novo lipogenesis) because of mitochondrial dysfunction. Ex. Reyes Syndrome - aspirin causes mitochondrial dysfunction because of changes in hepatic lipids and TGD. Causes a defect in ACAD-L enzyme. Sugar is a mitochondrial toxin. Glucose is non- toxic, because it is converted into glycogen in the liver., and glycogen is safe. But Fructose overwhelms the mitochondria to be ale to to metabolize it to ATP, and carbon dioxide. It then throw off excess as citrate which then become malonyl-CoA, into free fatty acids , then into VLDL, and exporting it out of the liver. But some will precipitate as fatty/lipid droplets in the liver causing fatty liver , insulin resistance, pancreas has to produce more insulin, which makes you fat , and you keep eating because insulin block. .Fructose reduces liver mitochondrial function, while glucose stimulates it. Fructose inhibits 3 enzymes in the liver : AMP Kinase, ACAD-L, CTP1A , decreases beta oxidation of fatty acids /lipids. Glucose stimulates 2 enzymes that increase beta oxidation. Sugar is a mitochondrial toxin. Fructose makes liver to store more fat. Sugar is toxic unrelated to calories. Metabolic improvement results after fructose restriction without calorie change, without weight loss. Liver fat production reduced, visceral fat and liver fat reduced, increased insulin sensitivity. . 2. ROS formation and inflammation. Fructose produces more ROS , and faster than glucose. Need anti-oxidants to counteract ROS. Fructose is a cellular toxin in vulnerable cells without anti-oxidants. . Fructose causes , leaky gut and liver inflammation. 3. Malnutrition and defective packaging and transport. Fat has to exit liver as VLDL. Sucrose necessary to provide the substrate for steatosis. Methionine ( methionine provide the methyl group for glutathione) deficiency reduces glutathione . Choline is necessary for hepatic lipid export because phosphatidyl choline which is needed for ApoB100 for VLDL to exit liver. . Need methionine to make glutathione , if deficient will lead to fatty liver Sugar exposure/diet with Methionine-Choline deficiency causes fatty liver disease, because sugar as substrate for ROS formation, need Methionine to make Glutathione anti-oxidant, and Choline is needed to make the fat exit the liver.. So the " 3-hit hypothesis of fatty liver or NAFLD are: 1. Mitochondrial dysfunction and DNL 2. ROS generation and inflammation 3. Malnutrition and defective packaging and transport. Sugar causes diabetes , heart disease, fatty liver disease , tooth decay . Sugar is correlated to cancer , dementia. Fructose in diet cause the Liver to get fat first/Fatty liver , causing insulin resistance, then pancreas has to produce more insulin, Foodstuffs and metabolic syndrome : Trans fats; branched chain amino acids, ethanol, Fructose All cause fatty liver disease. Liver is the only site for energy metabolism Liver is not insulin regulated No glycogen popoff ( fat , mitochondria is overwhelmed. What to do: 1. No sugar( reduce the substrate) , 2. high fiber ( to reduce sugar To liver) , 3. Choline ( improve transport) . 4. Exercise to increase clearance. Anti-oxidants are vitamin E and glutathione. Need methionine to make glutathione, Need choline to make fat exit liver.

Isn’t it odd that most of us learned out we had fatty liver when being treated for some other disease? They don’t even use the words “ fatty liver” on your lab tests. I had to google each term to find out what each was and what it meant. I also got ZERO information on what that meant for my health.

Just found out I have fatty liver. I was actually having an. Ultrasound on something else when the lady doing the ultrasound says you have fatty liver and gall stones. I had no idea. Im trying to learn all I can to try and fix it. I read recently that a new study claims Splenda or sucralose is also a cause of fatty Liver. I was drinking it daily in sugar free Gatorade. They also say it messes up your gut biome and I have leaky gut! Also aspertame will soon be labeled that it causes or may cause cancer! This is frietening why were these ever allowed in food if they are killing us?

Every time I see a kid with a juice box I want to scream. May as well be vodka.

I cured my NAFLD with NASH and fibrosis by simply removing carbohydrates from my diet. My liver is now normal.

Glad to see Dr Lustig doing more interviews! What big food corp has done to society is criminal!

I have listened to this lecture 3 or 4 times. One of the best I have ever heard (at least since his precursor lecture on the “hateful 8”). A tour de force of intellectual analysis and explanation of one of the most serious and intractable public health problems of our age. I would be intrigued to learn about the role that toxins play in mitochondrial overwhelm, ROS, and dyslipidemia.

great presentation, this came in handy for the upcoming exam ❤

Dr. Lustig needs to be working from the White House 🤓

Type 2 Diabetes is a manifestation of fatty liver disease. Type 2 diabetes occurs in obese , lean or normal weight adults, alcoholics, and children . Although obesity is a risk factor for diabetes, but obesity is not the cause of diabetes. Metabolic health ( no liver fat, no diabetes) is not necessaily related to body weight. Lean normal weight can also be sick with diabetes and fatty liver. Intra-abdominal fat ( but not subcutaneous fat - under the skin only) correlates to fatty liver and diabetes and chronic disease. Insulin resistance ( and high fasting Insulin) and Trigycerides ( not the LDL per se) are At 16:25 " the standard model of insulin resistance" Fat makes cytokines, ( TN-alpha, IL-6 ), which circulates and enter liver and causes liver to become insulin resistant, this increases hepatic glucose output , increases blood glucose which causes pancreas to produce more Insulin, which causes hyperinsulinemia, which causes more fat formation ., so on in a cycle. This is not true, . As weight increases, insulin sensitivity reduces, but there are exceptions. It is the insulin sensitivity vs insulin resistance that determines the the fate of a person, in terms of diabetes , heart disease, morbidity and mortality. 3 fat depots in the body: 1.Subcutaneous fat does not matter. You have to gain 22 lbs or 10 kilos of subcut fat before you get sick. 2. Visceral/ belly fat - is very metabolically active. Is responsive to ( acute stress) adrenergic stimulation of epinephrine, causing lipolysis in fat cells releasing fatty acids , go to liver where it is turned into ketones. ( burn fat). Neurapeptide-Y is the break for the adrenergic stimulation by epinephrine , and leads lipid storage , therefore reverses the effect of adrenergic effect of acute stress. Chronic stress releases cortisol which increases visceral fat formation, appetite and lipogenesis . Only, have to gain 5-6 lbs of visceral fat before getting sick , because visceral fat drains into the liver, more cytokines effects. 3. Liver fat ( at 25:35) - cause is alcohol , in the past. But now, it is caused by sugar , even in children . But the liver effects of alcohol and sugar are the same. Fatty liver disease is everywhere and occurs in obese and normal weight people. If have fatty liver disease is 3.5 times more likely to develop type 2 diabetes in your lifetime, because fatty liver causes liver to develop insulin resistance and pancreas beta cells burn out. Where does the fat came from? It was the liver fat that dictated insulin resistance/. Liver fat came from non- Systemic fatty acids. Systemic fatty acids come from diet and lipolysis from peripheral tissues Non- systemic fatty acids came from de novo lipogenesis by the liver. 1. De novo lipogenesis because of mitochondrial dysfunction . Example is in Reye Syndrome( acute fatty infiltration) . Cause is aspirin. Don't give aspirin to children. Aspirin causes mitochondrial dysfunction. Aspirin causes changes in hepatic lipids and triglycerides , causing mitochondria not to work. Aspirin causes a defect in ACAD-L enzyme. 2. Sugar is a mitochondrial toxin . When glucose enters the liver almost all is converted to glycogen. Glycogen is safe. But Fructose , overwhelms the mitochondria capability to metabolize it into ATP , throw off excess as citrate , to malonylCOa , then forms free fatty acids and packaged as VLDL ( with apoB100). This is how the liver turns excess sugar into fat and export it out. . But some get precipitated as fatty lipid droplets, to get fatty liver, then get insulin resistance, then pancreas has to make more insulin and you get fat, and the insulin is block and you keep eating. " fructose reduces liver mitochondrial function, while glucose stimulates it. " Fructose inhibits 3 enzymes in the liver : AMP kinase , the fuel gaugeon the liver cell ACAD-L. CTP1A generates carnosine - enzyme necessary for beta oxidation

Very troubling to hear that the GLP-1 analogs (Ozempic, et al) cause as much muscle loss as fat loss and increased risk of pancreatitis now that off-label use for weight loss is very common.

I carry an unconditional love for Robert and I wanted to share that as he shares with us

brilliant webinar and presentation. I wish Prof. Dr. lustig would offer this presentation as a MOOC. I would sign up immediately to enhance my knowledge on nutrition science and get certified for it. thanks you, Dr. Lustig for sharing your insights across the world. miss Reimara

Great up to date research important for more people to know about. It's an absurd world where we have poverty induced obesity

There are obese people who are healthy because they are able to increase the number of fat cells so none of them are engorged with fat (still insulin sensitive and not releasing FFA and inflammatory cytokines). They may not have fatty liver either.

Fascinating lecture. Thank you. Reyes Syndrome has a connection to ASA use in the face of a virus was mentioned in this lecture. My mind couldn’t help leaping to the thought that we may be seeing a new adult version of Reyes Syndrome in individuals taking 5-ASA in the face of a virus like COVID. It might lead to the unexpected dx of fatty liver and type 2 diabetes with no risk factors except being human. (No familial hx, a ketosis diet low in sugars and fructose ). Is it possible that 5-ASA might be catalyst for fatty liver formation in the face of a virus? Has anyone ever considered this? There were questions arising about the development of type 2 diabetes after COVID and those ideas being poo poo’d as mere coincidence at the timing of dx. Could there be an actual link with taking 5-ASA? Would love to hear of someone researching this. Thanks again for the lecture which is a much broader topic but can’t help but toss this out there to the pharmaceutical and scientific community to investigate.

Yes he should be speaking all over the world with this subject. Our high refine carb diet is the cause. It is not the fat in our diet.

High fructose corn syrup isn't just in Pepsi and Coca-Cola, it's in almost everything in the American diet. It's in bacon and hot dogs and "healthy" fruit juices and in Sunny-D and in hamburger buns and you-name it. So you can't just cut out soda pop, you have to look at everything. And you can't just be like someone I know who's bordering on morbidly obese and eats a ton of fruit because "My doctor told me to, it's healthy".

Fasting can do a great deal to reverse fatty liver quickly!

Deeply studied author ; very nice and useful for millions ! Author may eligible for Noble prize about his discovery and linking so many things !

Just received a type 2 diabetes diagnosis. I'm sure that it has nothing to do with high fructose corn syrup or a parasitical infection and is completely incurable. Because I'm an idiot and don't have a functional mind, but rely on my programming. Oh wait.. That's not me. That's my physician.

Keep the amazing videos coming! :)

My cousin had liver disease for the last 5 years. His SGOT and SGPT level was high. Took medicines from everywhere but no relief was found. Then he took Ayurvedic medicine from Planet Ayurveda. Now he is feeling good. Thanks

I have insulin-like growth factor-1 deficiency which is one of the causes of my fatty liver. I am 5’8” & 128 lbs If I was fat, it would be so much easier to heal because endocrine issues are much more difficult

One study found that consuming 255 grams of fructose per day did lead to an increase in liver fat and reduced insulin sensitivity. It also showed the same result if you consumed 255 grams of straight glucose as well, suggesting it may not be just the fructose that is the issue.

I can’t believe how well detailed this is it’s amazing I got more from you then my VA doctor I’ll limit my sugars and try intermittent fasting to see if I get better results

Dr. Lustig is wrong with regard to red meat. Both heme-iron and TMAO are only problem if your insulin is high. Heme-iron because high insulin affects the absorbtion of it (similarly to what insulin does to natrium [re]absorbtion). Also, high TMAO is a direct result of insulin resistance/hyperinsulinaemia, it has nothing to do with choline availability. So: If you eat sugar and are hyperinsulinaemic, adding red meat is bad. If you don't eat sugar and are insulin sensitive, red meat is the perfect food for us humans. That's why ketogenic and carnivore diets work (both eliminate the sugar and insulin spikes) but the standard american diet does not.

Whooop whooop!!! Love Dr Lustig is the best!

People often know they have a problem but don’t do anything to correct it. I given up talking to people about nutrition.

Soft drinks and fruit juice advertisements are still promoting as good healthy way of lives.

When large quantities of fructose reach the liver, the liver uses excess fructose to create fat, a process called lipogenesis. Eventually, people who consume too much fructose can develop nonalcoholic fatty liver disease, a condition in which too much fat is stored in the liver cells.

Try to imagine how many doctors there are in United States who tell their male patients in the '50s and '60s to lose 50 lb and start exercising. I think there's about seven or eight of them. The rest of them have given up.

As an RN for 20 years I am looking outside medicine to continue being healthy as I age. Medicine is designed to prolong your life with disease so you can be a pharma customer as long as possible! Understanding how our bodies work is the key to actual healthcare.

I’m def a Lustig disciple.

So helpful, thank you! ❤ I was told by doctors for 3 decades to “not worry” about my fatty liver! They said to eat less fat. Now my liver disease has progressed. Thanks to videos and kind doctors who help the public via RU-vid, I am reversing it.

Always test the audio beforehand. The audio is really bad.

I’m revisiting this video for the second time after much research and new understanding. I have respect for Dr. Lustily, BUT… he looks to me to be obese himself and this greatly distresses me. Why is this? I have a very hard time listening to someone discussing obesity and fatty liver who is himself obese. I think you need to look at yourself and actively practice your own advice. Just my opinion and no disrespect!

TY Dr. Lustig! If all this is true, then what about Bi,g P,h,arma products? For example, Sta,tins; side effect is Dm and mitochondrial dysfunction. They are heavily pushed for elevated cholesterol, which is easy to do since guideline numbers have been lowered over the years. (Memory loss is also a by product.) Body/brain needs cholesterol. What about antidepressants and mitochondrial damage? Antibiotics, which are also linked to NAFLD? And, last but not least, what about the accumulative effect of being on multiple medications? All these meds get filtered through the liver. Just wondering.🤷‍♀️ Perhaps another lecture?

What I can’t wrap my head around is WHY doctor Lustig doesn’t have Millions of views and then there are bone heads like that Berg that do. 🤦‍♀️

Wow! This was a great presentation. Very informative. I have a PhD in organic chemistry so I can manage the chemistry, but I will go back and re-watch to get more information. Thanks for sharing this.

This should be compulsory watching once people turn 18. Pass the test to be able to drive, vote, watch youtube etc 🤭

I have tremendous respect for dr. Lustig, but it looks like he got little gut on him now. He used to be slim and trim. What happened? maybe age. Not sure.

He has visceral fat himself..why if he has knowledge?

Great hypothesis but why with all our medical science we can't solve the diabetic puzzle that's currently plaguing the world. Gout for example the current medical hypothesis is all wrong...was named "the rich man's disease" and what that tells us is the cure is diet moderation. I like to see Dr. Lustig do a hypothesis on sugars and intake percentages fructose vs glucose

This guy is amazing , the explanation is on point amazing ❤

It's a little weird that Dr. Lustig has a big belly. Let's see his liver scan.

Metabolic Syndrome Related Disease's NAFLD Over Weight..Obesity .Msrd Our Whole Food (not process food)Should be Our Medicine.

Dr. Lustig is the GOAT!!! ❤❤❤

So is eating starch safe as Dr. McDugal claims?

If dairy is protective, and dairy has more saturated fat than monounsaturated and than polyunsaturated fat...saturated fat probably is protective!

Prescription for NAFLD: High IGF-1 & high insulin level (both raised by fructose from refined carbs & animal prorein), BCAA's (leusine, isoleusine, valine, abundant in animal protein), transfats (naturally occuring in dairy fat and meats) and alcohol. No wonder WFPBD lowers HOMA-IR and inflammation more effectively than DASH.

Great lecture. But still stuck on how to linearly get from [de novo] liver lipogenesis to insulin resistance. Can anyone recapitulate? Please.

He is absolutely correct! I have a BMI off 22 and have a lot of liver fat. I’m a definite TOFI.

Dr Lustig you are loved. As a person with fatty liver i am using your 4 recommendations (fiber, exercise, choline, no sugar). Thank you immensely for being an articulate, truthful and knowledgeable doctor.

Thank you Dr Lustig. I am TOFI - 1.67 m tall 50kg, very healthy diet exercise 5 hrs per week, high LDL but very low Tri. AC1 near max bound. Ultrasound shows finely layer of fat on liver!

I’m 25 years old and I have nonalcoholic fatty liver disease

Geez, 10 people. Perhaps you could have held this talk in an auditorium and invited the community?

ZDr Robert Lustig is my gardening Angel of Health Healing Knowledge 💖 And have shared his wonderful awakening podcasts with Nate Hagens 😇

It is well documented 5% weight loss leads to reduced liver fat, 7% reduces liver inflammation and 10% reduces liver fibrosis How is weight loss then not important?

I truly admire Dr. Lustig and really appreciate all his research in this topic. Just one suggestion that if he himself can drop his belly fat, it would be even more persuasive.

Super keen to understand the mechanism of serum ferretin, stored tissue ferretin with NAFLD and at what level it becomes a problem. Maybe a lecture on that would be great.

He is amazing. People, the Third Phase is CANCER. Don't ask me how I know this.

He has thousands usually and next time check the sound Doc 😅

Looks like he stopped dying his hair. About time.

Children get type 2 diabetes I'm really shocked I thought it only applied to adults.

What else has changed, Robert? Many great points from you about insulin, fructose etc. what about electromagnetic waves, that is, light?

only thing i don't agree is demonasing red meat, there is a lot of evidence against it, great video

Dr tell us what to eat

Thank you doctor for an excellent Lecture presentation 👏🏻👏🏻👏🏻👌🏻🙏🏻

Sir, which kind of fat is stored in your belly?

Straight is the way and narrow is the gate to Health and "Few" there are who find it much less do the work. Health is work, discipline, self control and de-programming ones self from the TV programming and other programming as well. Those who are looking for better Health will find it and do the work to get Better Health....

Doctor I Love Your You From Heart Bottom; One Thing, Almost All Your Presentations Seems As You are ND Rather Than MD. May ALLH Grants You ISLAM on World Here & Jannaa on World Hereafter

Also what about foods like chicken breast, qunioa and eggs? What oils should i use? If I shouldn't then let me know. What about nuts?

Professor Robert Lustig makes sense but looks a little fat especally around the waste. Is he eating in the right way and exercising?

I’m reading one of your books 📚 now and just stopped to watch this video again.

Dr L has quite the gut. Pallor. Does not abide by what he knows, hard to value what he says.

Utube - stop w/noisy ads. Going everywhere.

Liver cell death by fructose exposure can be prevented by : a) Vitamin B1 and B6, vitamin C; b) P450 inhibitors c) hydroxyl radical and carbon scavengers. d) metal chelators

And "they" say aspirin is good for you..

Thanks for this.

SO many ads with these guys. But yes, Dr. Lustig is a treasure!

As fructose is the bad guy do i need to cut out fruits like apples and bananas?

Superb.

Dr lustig does not look slim hope he is in the healthy fat No metabolic disease Not insulin resistance

Terrible quality of sound this time.

Love me some Lustig incentive, thank you Dr!

Hello Dr. Lustig, your belly is too big. I am sorry to say that.

My understanding is that Japan actually has a very high rate of "lean diabetes" and I forecast a ton of problems with diabetes and overweight also in Asia because of the huge amount and variety of ultra processed foods and sugary, starchy, snacks - check your local Asian market and you'll see what I mean. Not many are eating the true traditional diet.

This was an absolutely fascinating presentation 👏🏼and I'm not even a scientist or doctor 🤣. Right then, no more alcohol for me, and I'm eating as much whole and unprocessed foods as possible, and eating lots of whole foods. The only thing that confused me was why this was being resented to a pharma company, whose top priority is profiting from drugs 💊🤔 🤷🏻‍♀

Fruits contain fructose as well as many vitamins , minarals & fibre. Should we avoid the consumption of fruits? What is the openion of Dr. Lustig?

So what could I eat and drink then?

This study is excellent based on children..how about adoults..i've got insuline resistance along with monopuse..i think it must be connection there too..i have never eaten processed food or soda...

Serious question. If fructose is so bad should I not be eating fruit and eat white rice and potatoes instead after working out? Or can I eat fruits as long as it's not together with fatty meal