Brody on diet

High-Fat Diet: Count Calories and Think Twice. Jane Brody in today’s NY Times writes intelligently about the Atkins diet and the low fat philosophy. The entire article makes good reading. I will excerpt some high points.

Does it help people lose weight? Of course it does. If you cannot eat bread, bagels, cake, cookies, ice cream, candy, crackers, muffins, sugary soft drinks, pasta, rice, most fruits and many vegetables, you will almost certainly consume fewer calories. Any diet will result in weight loss if it eliminates calories that previously were overconsumed.

This diet seems easy because it places no limits on the amounts of meats, fats, eggs, cheese and the like you can eat. These foods digest slowly, making you feel satisfied longer. Also, a diet without carbohydrates causes the body to make substances called ketones that may create a mild nausea, suppressing hunger.

We all really knew that much. Atkins is not magic. You omit so many foods that you almost have to decrease caloric intake.

What is surprising is that after three decades of simmering and soaring popularity, the Atkins diet has yet to be tested for long-term safety and effectiveness.

In an interview, Dr. Atkins said: “A long-term study would cost millions and millions of dollars. We can afford to do a six-month study.” Those shorter studies, he said, have shown “major improvements in lab tests and well-being.” He said his foundation has contributed to a study under way at Harvard comparing the short-term effectiveness and health effects of diets low in carbohydrates versus diets low in fat.

Dr. Abby Block, nutritionist at the foundation, said studies of the Atkins diet lasting six months to a year and extensive clinical experience, have shown consistent improvements in blood lipids and glucose levels, suggesting that the diet can improve health despite its high levels of saturated fats and cholesterol, long associated with heart disease risks.

Why hasn’t the government tested it? One possible reason is that it is unlikely to be approved by any review committee, given what is known about the effects of animal fats and cholesterol on the risk of heart disease, strokes and some cancers, as well as accumulating evidence that diets rich in fruits and vegetables and moderate in protein and fat can prevent diseases like high blood pressure, prostate cancer, heart disease and diabetes.

The Atkins diet is shy on several vital nutrients, including the B vitamins and vitamins A, C and D, antioxidants that slow the effects of aging, and calcium. And, a diet rich in animal protein can draw calcium from the bones, increasing the risk of osteoporosis and hip fractures.

Brody may be correct, but as I have stated on multiple occasions, one should not use theories to stop research. There are preliminary data on the Atkins diet which seem counterintuitive. Maybe our theories are wrong. Given appropriate consent (which would include disclosing the countervailing theory) one could easily get volunteers. I understand the argument; I just do not buy it!

When nutrition experts began urging Americans to cut back on fats, many filled in by eating more carbohydrates — a lot more than anyone recommended. Food producers jumped on the bandwagon to produce low-fat snacks and desserts, and Americans went hog wild, eating as much of them as they wanted.

Many fat-free foods have as many calories, or nearly as many, as their original high-fat versions, since sugars and other carbohydrates replace the fat and reduce the loss of flavor.

Third, Americans are not eating a low-fat diet. Despite a decline in the percentage of fats in the American diet, most people still eat the same amount. As caloric intake rose, the percentage of fat calories dropped but the total amount did not. Americans are eating more of everything, especially refined carbohydrates, which are made from white flour and sugars, doing neither their health nor their waistlines any good.

Too many refined carbohydrates can raise blood levels of heart-damaging triglycerides and may increase the risk of diabetes as well as obesity. Neither is it wise to cut out all fats. The body needs fat to aid in the absorption of essential nutrients, fat enhances flavor and satiety, and some fats actually promote health.

Brody points out the key problem with the low fat movement. By emphasizing low fat, we did not focus on carbohydrates. Most diet gurus agree that too much carbohydrates (especially refined carbohydrates) will cause weight gain. The question and challenge we all have is how to cut back on carbohydrates.
To which Dr. Alice H. Lichtenstein, professor of nutrition at Tufts University in Boston, added: “Reducing fat alone is no guarantee of weight loss. You must cut calories or increase physical activity.”

Dr. Denke concurred: “No matter what anyone tells you, it’s calories that count. Carefully controlled metabolic studies show that it doesn’t matter where extra calories come from. Eat more calories than you expend and you’ll gain weight.”

There you go. It really is simple. Expend more calories than you ingest (the fancy doctor’s way of saying burn more than you eat). There is no magic.