1552 Calories: the fat-versus-carbohydrate controversy

In a bit of blinding coincidence, two articles on diet came across my screen today. First, Marc Ballon, writing in the Los Angelese Times, says Obesity blamed on bigger meals and then Gary Taubes, writing in the New York Times Sunday Magazine, asks What if It’s All Been a Big Fat Lie?

What, you might ask, has 1,552 calories? That not so tiny tidbit comes from Ballon’s article: a supersized McDonald’s Quarter Pounder (with cheese) Extra Value Meal. The Center for Science in the Public Interest has launched a campaign to require restaurants to meet labelling requirements similar to those already in place for foods sold in markets. I’m sure most of you have noticed the growing size of portions served over the last decade; even the plates most restaurants use are bigger now. Industry representatives say that consumers are not forced to overeat, that they are just responding to competition and consumer demand, and that further the blame should be placed where it really belongs: more hours spent watching television, playing video games, and surfing the Internet.

No one doubts that a quarter pounder with cheese, large fries and 42 ounces of Coca-Cola is body-abusive. McDonald’s is even producing public service TV commericals (Eating Right with Willie Munchright) featuring a charming clay spokesthing aimed at teaching kids about a balanced diet. The company goes so far as to publish a nutritionist’s guide right on the website though, amazingly, the combinations that make a meal barely feature any of their big name meals. The only one that includes french fries (small portion) is matched with a hamburger (remember, the McDonald’s hamburger is their smallest meat offering) and a small Coke still winds up with 180 calories from fat. Where are the “balanced meals” featuring the Big Mac (590 calories), the Quarter Pounder with cheese (530 calories), and Super Size French Fries (610 calories)? “But,” say McDonald’s Today (the nutrition guide), “remember, there are no ‘good’ or ‘bad’ foods. It’s your total diet that counts.” Oh, I see.

The Taubes article, a beautiful, in-depth survey of current scientific thinking on obesity, is much more useful and, I believe, an important milestone in changing public perception on a healthy diet. The focus of his article is the changing academic perception of “a diet that simply seems intuitively dangerous,” the low carbohydrate Atkins Diet. The change is being driven by the need to understand why Americans are more obese today than they were 25 years ago.

In the 1970s, weight was not the priority it is today and we had a much lower percentage of obese adults and children. Of course there were enough overweight people to fuel study. Researchers were more focused on heart disease, though, and were looking for ways to reduce it. Reduced cigarette smoking alone should have made a huge difference but it hasn’t. Beginning in the mid-70s, we began to hear the cry to lower our fat intake and agribusiness created new low-fat and fat-free products to fill supermarket shelves. Still, we got fatter. Worse, medical researchers began to see significantly increased reports of what has come to be named Syndrome X, a cluster of conditions that can lead to heart disease and Type 2 diabetes.

Atkins hasn’t stood still since publishing that first book, using the tens of thousands of patients who’ve passed through his Manhattan clinic to accumulate data beyond the reach of any other researcher. In the past few years he has particularly been harping on the need to change our diets to combat Syndrome X. But the medical establishment, beginning with a 1973 critique from the AMA, has been harshly negative to the cardiologist and dismissive of his work despite lacking any studies to support their opinion. Now, Taubes explains, researchers are finally getting grants to compare and contrast these different diets and we may finally see real answers.

What is the Atkins Diet (and other similar ones like Barry Sear’s The Zone)? While the media tends to focus on what you can’t have–pasta, potatoes, rice, and refined sugar–the truth is that you can eat quite a bit and you can eat fats? Like butter on your steak and cheese on your eggs? Is your idea of a good snack 10 strips of bacon? Go ahead and eat them every day, as much as you want. Any meat or fish is a freebie, since they are all protein and contain no carbs, as are most cheeses. The first week or so is difficult as your body goes through a sugar withdrawal but after that the difficulty is mainly psychological. I wonder, also, whether in 10 years we’ll look at high carb, low fat diets the way we look at cigarettes today.

Where does exercise come into the picture? Actually, though it doesn’t seem to matter much for weight loss, at least modest exercise is required to maintain your cardiovascular system and conditioning and is significant in maintaining good health as one ages.

My personal connection: A couple of years I went on the Atkins Diet myself after seeing the success a few friends and acquaintances had with it. Starting at 247 pounds, I dropped 38 pounds in four months and was well on my way when I ran into a vacation in Mexico and the 2000 holiday season; I kept telling myself I’d get back on it but never did. Sure enough, I gained back all the weight. I did revolt against the high cost of dietary supplements prescribed by the Atkins plan — $20-30 per month each for several different pills — and the strict prohibition against bagels.

I would encourage you to spend a little of your time to read these articles and consider your eating habits and health.

Update, next day: Dr. Atkins and a Dr. Eckles, head of the American Heart Association, both made brief appearances on CNN this afternoon. They were supposed to be the main story, discussing the NY Times article, but got cut short by the latest episode of “Where’s My Bush?, um, I mean coverage of the President’s news conference. There wasn’t time for much more than a sound bite a piece but the two questions I would have posed to Eckles are: How do you account for the 45,000 patient histories that Atkins has accumulated over the decades? How come your group has never funded a study that directly examines the claims of low carb, high fat diets?

Denbeste comments