Dr. Robert Lufkin is a radiologist who calls himself a “medical school insider.” He’s taught at the David Geffen School of Medicine at UCLA, and the Keck School of Medicine of the University of Southern California.
Lufkin believes in Western medicine, noting it has transformed the world for the better with surgery and medicines that save people's lives. But he’s horrified by the such as obesity, Type 2 diabetes and heart disease. “For most of these diseases, the pills and surgeries don’t address the root cause, and the disease continues to get worse and worse and worse.
They just sort of mask the symptoms," Lufkin, who holds a medical license in California, tells TODAY.com. Lufkin believes lifestyle is key to preventing chronic disease and writes about his advice in the new book, “ ” He doesn’t believe they’re intentional lies since medical knowledge is always evolving and doctors have to constantly re-evaluate things they thought were true.
But he’s critical of what he calls the "currently accepted dogma" in medical school, which is often presented without any alternative theories, he notes. Lufkin says these are three of the “lies” he taught in medical school. TODAY.
com also reached out to medical specialists in each field for their take on what he believes. The interviews were edited and condensed for clarity: The obesity lie is that to lose weight, just exercise more and eat less. This advice doesn’t work.
Exercise has . Unfortunately, because it’s very difficult to burn enough calories exercising to make up for the food we eat. Also, the advice to “eat less” implies that it doesn’t matter what you eat, just eat less — that a calorie is just a calorie.
But the food we eat is a signal to our bodies, and the three main macronutrients signal different things to our body. Fat and protein give our body energy, and help it grow and sustain. , and the job of insulin is to tell our bodies to store fat.
So carbohydrates are a way to tell our body to gain weight. That means a calorie of carbohydrates is not equal to a calorie of fat or protein. If I eat 100 calories of potato chips, that will signal my body to make insulin and begin storing fat.
Some of the energy will be stored as fat. I’ll be hungry again. On the other hand, if I eat 100 calories in a hardboiled egg, which is largely fat and protein, that will not trigger the fat storage mechanism.
It will all go to energy and I’ll not be that hungry. I can eat one egg and I don’t feel any urge to eat the rest of the dozen in the carton, but it’s very hard to eat one potato chip and not want to gobble down the whole package. To lose weight, just decrease the number of calories that drive weight storage — .
A calorie is a calorie when it comes to weight management. People think that because they're eating “healthy calories” they should not be gaining weight. But every food — healthy or not — has calories.
What's important is that people trying to lose weight pay attention to the total calories they're consuming each day and stay below a certain limit. For example, a large avocado has 300 calories and some doughnuts have 300 calories, too. The avocado is the healthier choice because it has nutrients and vitamins.
However, if someone is trying to lose weight and wants to consume or less — they can still lose weight if they eat the doughnut instead of the avocado, as long as they're below their calorie limit for the day. They may feel hungrier because of the food choices they are making and this makes weight loss harder. Fat, protein and carbohydrates all impact insulin and various mechanisms of fat storage.
But each has different impacts on the body’s energy, hunger and satiety, and even how you feel. We have data that many macronutrient restrictive diets work for weight loss. Some feel eating fewer carbs is best, but one can lose weight by only or less protein only, too.
Diets for weight loss are very personalized. I have some patients who eat only protein and are still struggling with weight loss. I typically recommend a low-carb diet for patients struggling with Type 2 diabetes, prediabetes, PCOS or other forms of insulin resistance to help keep their blood sugars more regulated.
. . The most commonly agreed on advice is that eating a healthy diet, reducing the number of calories consumed and regular exercise can help people maintain a healthy body weight.
The hypertension lie is that high blood pressure is best treated with drugs. When I was diagnosed with , I was prescribed medicines for it and told to . I tried avoiding salt.
It didn’t work for me, and many people find that that’s not the solution for them. I’m not recommending anyone discontinue medications their physician has prescribed for them. But pills for hypertension — while they can be lifesaving and control very high blood pressure swings — may not be as beneficial as , which we know works.
I did it myself by adopting a metabolically healthy diet that’s low in carbohydrates and sugar. I’ve also considerably. When people adopt a diet that’s metabolically healthy, one of the side effects is that their blood pressure will drop.
Also , which is one of the one of the foundations for blood pressure management, nobody disagrees on. 30 minutes a day is great. It’s also beneficial from a mental health point of view.
So it’s not that the medications don’t work or that they’re not useful. But long term, I would advise everyone to look at lifestyle and try to get off the medicines if you can. Treat the root cause rather than just treating the symptoms with the medications.
Lifestyle is critically important, but many patients need medications to lower blood pressure in addition to lifestyle alone. It's very hard sometimes to get people into a healthy body weight, engage in regular activity, and watch salt and alcohol intake — all of which may be important in blood pressure control. That may get some patients off medications; it may not.
It may get patients under better control and needing less medication. Maintaining a healthy body weight keeps blood pressure under control. It is not the sugar or the carbohydrates per se that affect blood pressure.
. . Lifestyle changes that include regular exercise, a healthy diet that limits salt and alcohol, maintaining a healthy weight and managing stress can prevent high blood pressure.
Some people may need medication to lower high blood pressure. The cardiovascular disease lie is that statins are a good choice to prevent heart disease. What really causes heart disease? It’s complex.
— a class of prescription drugs that slow down how much cholesterol the liver makes — can affect the . I’m not recommending anyone discontinue their statins without speaking with their physician. But I believe metabolic health is much more important.
I believe eating a sugar-covered doughnut poses a much higher risk for a heart attack than eating a beef hamburger. The beef has saturated fat and it may raise your LDL cholesterol, but the sugar, carbohydrates and seed oils in the donut will drive insulin resistance and inflammation. These metabolic abnormalities are much more strongly associated with heart disease than LDL cholesterol.
Cholesterol is so fundamental in our bodies. It makes up our brain, our cell membranes. Lowering LDL cholesterol with statins can have side effects.
Dietary cholesterol has very little effect on blood cholesterol. I remember growing up, we avoided egg yolks because of the cholesterol. Now, I believe are one of the healthiest things one can eat.
The best thing we could do to is change our lifestyle and address the root causes. We get to choose our lifestyle every day. When I wake up in the morning, I get to choose what food I put in my mouth, how much I exercise.
Do I take that 30-minute walk? Do I have stress? How’s the quality and quantity of my ? All these things affect cardiovascular disease. The risk factors for cardiovascular disease are multifactorial, and obesity and diabetes do put individuals at risk. But there's no doubt a diet high in saturated fat and LDL cholesterol is one of the most significant risk factors.
Reducing the saturated fat in our diet reduces risk for heart disease. You’d be doing the public a disservice to say skip the doughnut and eat the hamburger. When it comes to eggs, moderation is important.
I eat egg whites. I do not eat egg yolks. Dietary intake of cholesterol does affect our blood cholesterol levels.
We recommend lowering cholesterol in people living with, and at risk for, cardiovascular disease. There is good scientific data showing very low levels of cholesterol are safe. We can modify our risk by changing our lifestyle to some degree, but that’s not the whole answer.
We may have a genetic tendency for high cholesterol. In certain individuals with high cholesterol or who are at higher risk for cardiovascular disease, statins are a good choice. — .
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Staying at a healthy weight, eating a healthy diet, managing stress, getting enough sleep, and controlling blood pressure, and cholesterol and triglyceride levels can help prevent heart disease. Some people may need medication to reduce their cholesterol. A.
Pawlowski is a TODAY health reporter focusing on health news and features. Previously, she was a writer, producer and editor at CNN..
