When I was growing up in the Westwood Hills section of St. Louis Park Minnesota in the 1950s, my two best friends were Jimmy McNulty and Dale Erickson. From dawn to dusk we did virtually everything together. Riding our bikes for miles, sleepovers in tents in the back yard, building forts in the woods, playing various games and sports, and driving our parents crazy were some of our favorite activities. I still remember when we were a little over five years old and we decided that it would be a good idea to spread cheese on the walls of Jimmy’s parent’s bedroom. I can still hear the screams!

Even Back Then We Had Our Junk Food Junkets
Of course like most active growing boys, food was an important part of our lives. Our parents served us nutritional and wholesome meals made from scratch, virtually the only kind available in those years. If we wanted a soda or candy, forget about finding these things at home. Our mothers were wise enough not to stock these items in their pantries. Of course being devilish young lads, we had our own solution to this dilemma. About a mile from our neighborhood there was a small shopping center with a deli and drug store with a soda fountain and a small section of penny candy. We lived near a golf course so we would often find stray golf balls and then resell them to the golfers. Once or twice a week when we had accumulated a few dollars, we would trek off to the shopping center to have a six-ounce soda at the fountain and perhaps a handful of candy.

Although we enjoyed these occasional excursions, they were never very high on our priority list. They simply fit in with the many other activities that made up our busy days. Whether or not we had access to soda and candy, we still managed to live full adolescent lives. I also remember that very few of our friends or classmates were obese. In those days an overweight kid was an anomaly, not the norm. Yes indeed, it was truly a different era.

Pharmacy or Junkfoodacy?
Enter a drug store today and you will find a completely different world than our Westwood Hills version. In order to actually find the pharmacy section of the store you first need to run the gauntlet through row upon row of super-sized soda bottles and bags and boxes of candy, chips and other assorted junk food. When you have liter bottles of soda perpetually on sale, the soda fountain seems a little bit quaint. In the middle of a massive obesity and diabetes epidemic, I think we need to ponder how we came to such a place.

In order to understand this apparent paradox—a store selling diabetes medications and food that will almost guarantee that you will develop diabetes if you consume it, you first need to understand one basic principle. Modern pharmacy chains such as Walgreens, CVS and Rite Aid are not based on a business model of keeping you healthy. If you are healthy, there’s absolutely no need for you to visit their store. After all, all the non-pharmacy fare available in these stores is likely available at a cheaper price at discount stores like Wal-Mart. Pharmacy chains only make money when you become sick. The majority of the drugs they sell are for chronic conditions like diabetes, hyperlipidemia and hypertension. All of these conditions are what I call food related diseases (FRD). If you eat a healthy diet, you likely will never suffer from one of these common conditions. If you eat the typical American diet loaded with junk and processed foods, you likely will. Thus it makes perfect sense that they sell disease-inducing food, because when you get sick they end up selling you more drugs. They end up making money in both sections of their store. And you thought the Mexican drug cartels have an efficient business model!

Preventative Medicine: Big Hat, No Cattle
The same dynamic is at play in our healthcare system. Do you know how much money your physicians makes when they give you sound preventative advice so you don’t develop diabetes or other chronic diseases? Zippo. Insurance companies don’t compensate providers for preventing diseases, but rather they pay providers for “managing” diseases once you get them. The serious money is in sickness, not health. Because there is a chronic shortage of primary care physicians and a glut of patients with food-induced diseases, they don’t need to go out of their way to help you develop these diseases as the pharmacy chains have done. If we ever do have an oversupply of primary care physicians, you will also likely also see donuts in their waiting rooms!

But wait a minute—don’t we have the best healthcare system in the world in this country? As a matter of fact, we don’t. We certainly spend more money than everyone else, futilely trying to close the barn door after the horse is in the next county. The fact remains that it is relatively inexpensive to prevent food related diseases, but they are extremely expensive to “manage”. How did we come to this? Pharmacies and gas stations are now loaded to the brim with the worst form of junk food and fast food joints are on virtually every street corner in America, often across the street from several mega-pharmacies. Are we insane?

The Scam of the Century: Calories in / Calories out
The answer is simpler than you might expect. For years we viewed obesity and the related metabolic disorders like diabetes as choices. Sure we have a lot of junk and processed food in our environment, but we are in control of how many of these “empty calories” we consume. This perspective is based on the “calorie in/calorie out” view of weight gain. If you consume more calories than you burn through metabolism and physical activity, then you start to store too much fat. If this is true, the obvious solution to obesity is to eat less and exercise more. There’s only one problem with this perspective—it doesn’t appear to be working. Despite decades of using this theory to manage our collective weight, we continue to become fatter and fatter at an epidemic rate.

As it turns out, the “calories in/calories out” theory of weight gain belongs on the trash pile of history. Although we don’t fully understand all the complexities of excessive fat storage, recent research has clearly shown that it has little to do with calories. Fat storage appears to be controlled on two levels: at the cellular level and at the master control level—the brain. It now is clear that certain types of food are inherently fattening. As it turns out, it’s not so much about how much you eat, but rather what you eat. Pioneers like Gary Taubes in his classic book “Good Calories, Bad Calories”, was one of the first to promote this approach when he focused on carbohydrates as the villains in the fat wars. In recent years Richard Johnson has clearly shown the fattening properties of excessive fructose mainly from sugar and HFCS in his books “The Sugar Fix” and “The Fat Switch”. It is now clear that excessive fructose is converted to two problematic substances—triglycerides and uric acid. We have known for years that triglycerides promote fat storage, but Dr. Johnson was the first to show that uric acid acts as a fat switch at a cellular level. Robert Lustig is a Pediatric Endocrinologist specializing in obesity and he has also been leading the charge against the toxic nature of excessive fructose.

For decades we assumed that eating fat makes us fat because it has over twice the calories per weight as carbohydrates and protein. Again we were only partially right. Eating fat makes us fat when we combine the fat with carbohydrates, sugar and HFCS, especially when the carbohydrates are high glycemic and rapidly converted to glucose. Eating fat alone or with protein does not promote fat storage. All of this fat-promoting activity described by Taubes and Johnson takes place at a cellular level, but there’s even more to the story.

When it Comes to Fat Storage, The Brain is the Conductor
Recent research has clearly shown that the brain plays the role of conductor in the symphony of fat storage. Like all other mammals, we evolved to carry around an ideal amount of body fat and our brain plays a key role in maintaining just the right amount of body fat to ensure our survival in sometimes rapidly changing environmental conditions. Thus when your brain is working properly, you don’t need to worry about fat storage—Mother Nature has your back.

As it turns out, the same dietary elements that create havoc at a cellular level—excessive fructose and high glycemic carbohydrates, also lead to a form of food-induced brain dysfunction called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Over time these dietary elements disrupt normal brain function to the point where auto-regulation of fat storage completely breaks down. The brain continues to receive false signals that there is a shortage of food in the environment and starts to promote fat storage at virtually any caloric intake. The first symptom of CARB syndrome is craving food loaded with sugar, HFCS and high glycemic carbohydrates, especially from grains.

Now things seem a little clearer. If the majority of people living in modern societies have pathological cravings for this type of food, our pharmaceutical chains, gas stations, grocery stores and fast food restaurants are simply meeting this demand. They understand little about the complex physiology of food and fat storage, but they have been quick to realize that if they provide food with these dietary components, they sell a lot more food and make more money. Don’t you just love capitalism? If a need exists, someone will show up to meet it.

Villain, Villain, Where’s the Villain?
So who is the villain in this sorry tale? The people who buy these products because they crave them? The people who make these products in a desperate hope to make a buck? In my opinion it is neither. Instead we should focus our attention on the people who have completely missed the most common disease in modern societies—CARB syndrome. While the medical profession and scientific communities were busy blaming you if you became obese, they completely missed a chronic disease that is defined by excessive fat storage. It’s not your job to identify new diseases. That’s what we pay physicians and scientists to do and in my opinion, they simply haven’t been doing their job.

I think that our current situation with our food has many parallels to the issue of cigarette smoking. For many years people accepted cigarette smoking as a reasonable activity, even after the evidence started piling up that smoking is harmful to your health. When you strip away the science and just think about it on a purely logical level, inhaling smoke into your lungs many times a day seems like an inherently bad idea. Once science started giving us evidence that this is true, people gradually began to accept the notion that quitting smoking is a good idea. After all, smoking is optional.

You Can’t Eliminate Food
When it comes to food, things are a little more complicated. We have to eat to live so eliminating food is not an option. We first have to decide what part of our diet is toxic and then we have to convince people that this is true. People tend to resist changes in long standing behaviors unless the evidence for doing so is overwhelming. We then need to develop a workable plan for eliminating or restricting the harmful dietary elements. This step is where we will likely need to hire bodyguards. Reducing or restricting sugar, HFCS and high glycemic carbohydrates from our diet will threaten many of the largest corporations in the world. This battle will make the cigarette wars seem trivial by comparison and it is far from clear if there is any chance of victory.

When It Comes to Food, You Call the Shots
The only good news in this sad tale is that you don’t have to wait for the final step in this process. Science has already shown us what components of our diet are harmful to our health. Even though not all scientists are on board at this point, trust me on this one—they will fall into line at some point in the future because the evidence is rapidly mounting. The second and third steps in this process can occur at both a personal level and a public level. You can be convinced that these foods are detrimental to your health and make a personal plan for eliminating them long before the general public is ready to take these steps. In other words you can save your own life and health even as our collective health continues to deteriorate.

That’s why I have developed this web site. My goal is to teach you about the CARB syndrome concept and to provide you with ways to prevent it or reverse it even as those around you continue to slide down the pathway of declining health and shortened lifespans. Jimmy and Dale, I dedicate this post to you. We had some great years together and if you follow my advice, there’s a good chance we can continue to make mischief for decades to come. There’s always a little more cheese to be spread around!