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« How Structuralist Is Your Fantasy Life? | Main | Elsewhere »

January 11, 2004

High-carb/Low-carb

Dear Friedrich --

Have you found it as startling as I have how quickly the health-tip establishment has changed its advice about carbs and fats? It seems like only five minutes ago that we were being told that fats are bad and carbs are good. Now we're being told the reverse.

Not that I pay much attention -- does anyone besides the managers of school cafeterias take the FDA's "Food Pyramid" seriously? But I'm still feeling a little disconcerted. Does the shift date back to that NYTimes Magazine section cover story "What If It's All a Big, Fat Lie?," where Robert Atkins, who'd always been portrayed by responsible types as a crackpot, was taken seriously? These days, the same dignified authorities who five minutes ago were calling Atkins a nutcase are lining up, eager to to deliver their diginified, well-considered opinion that maybe he was half-right after all.

I'm also feeling a little disconcerted by the way that no one else seems to be talking about feeling disconcerted. Where's the outrage? Perhaps we're meant not to have noticed that the ocean liner we're all passengers on is now pointed in a different direction? Oopsie, says a crewmember when you bring it up. So sorry! Just a wee mistake!

So why aren't more people throwing spitballs at the health establishment?

Anyway, a few questions:


  • Given how quickly the doctors have flip-flopped, how can there be any real science behind any of this?
  • Where are the apologies? I haven't heard a lot of mea culpas yet, whether from the institutions, the scientists and the docs who were evidently mistaken, or from the health editors and journalists who propagandized their mistakes. Given that lots of people put on weight -- and that some probably developed serious problems -- because they were eating a high-carb/low-fat diet, shouldn't some apologies be forthcoming?
  • Shouldn't the health establishment be subjecting itself to some serious soul-searching about now? How could they have gone so wrong? Aren't they worried about losing the public's trust? When the NYTimes discovered that Jayson Blair was a problem, it wasn't as if they managed to shrug it off. Why is the health-tip industry not being made to endure agonies at least as severe?
  • Why are we supposed to take their current, low-carb advice seriously?
  • And why would the health-advice industry ever expect us to pay them any attention, ever again?

Eastcoast Blowhard prediction: someday soon, someone with diabetes will file a lawsuit against the FDA, claiming that its advice made him fat and unhealthy.

Best,

Michael

posted by Michael at January 11, 2004




Comments

The real secret behind this all is:
a] it doesn't matter what you eat, so you'd better choose the food that tastes best;
b] as long as you don't eat too much of it, and do enough during the day to burn all the energy it gives. Adopting an active lifestyle is far more efficient for this, than exercising.

I recently came accross the euphemism "nutritionally challenged" for Americans that were almost to fat to stand on their own two feet. Apart from silly it is also wrong. Obesity isn't about food, it's about behaviour. Namely: eating for the wrong reasons.

That diets get so much attention probably is because people like easy solutions better than more complicated ones. And apart from that, there's a billion dollar industry behind dieting, food supplements, and even exercising.

Posted by: ijsbrand on January 11, 2004 05:28 PM



Apologies? Since when have you ever seen anyone in the health or health tip industry, the financial advice industry, the mental health industry, the "how to raise your child" industry, the feminism industry, the diet pill industry, the radical-politician-who-becomes-a-centrist industry, the hey-get-breast-implants industry, the Jane Roe who fought for an abortion and now is opposed to it industry, or the famous-person-who-wants-to-give-advice-about-how-you-can-be-just-like-them-except-then-they-change-their-mind-about-who-they-are (read: Madonna, Jane Fonda) industry....ever APOLOGIZE for changing their mind?

That's NOT the agenda, see? For any of them. It's put-the-spotlight-on-me while I can pretend (to myself as much as anyone) that I deserve the spotlight, and then don't make me notice I screwed anyone over coz that conflicts with my carefully protected self image when I shrug and change my mind. YOU would not last long in their milieu by POINTING OUT to them that they might have actually been playing with dynamite.

The "fair and balanced" media in this country also does a woefully poor job of pointing this out on anyone's behalf, too.

My GOODNESS, Michael!

Posted by: annette on January 11, 2004 06:33 PM



Whoa! Whoa! WHOA!

STOP!

You are all correct in noticing that popular opinion in the media is now much more supportive of the Atkins diet. This includes some health professionals.

It is also true to say that there are some good points made by Atkins (all carbs and fats are not the same).

But PLEASE it is not true that the mainstream of nutritionists endorses the Atkins program. My friend Dr. Pedro Teixeira with a PhD in Nutrition, tells me that the long term effects of such diet are much much less positive than some of the short term weight gain.

He said that the best overall work explaining what is the current state of our knowledge of nutrition is "Eat Drink and Be Healthy".

Cheers,

Robert

Posted by: Robert Holzbach on January 11, 2004 07:12 PM



Actually, as someone who's been on the Atkins diet myself, my doubts about the nutrition advice industry go way beyond whether fat or carbs makes you less fat. I'm beginning to wonder if the medical establishment knows, er, squat about anything concerning weight gain or loss.

Perhaps you've heard the catch-phrase, it's all about calories consumed vs. calories burned off. Talking to medical professionals, you will hear this phrase within one minute of beginning a discussion of weight loss. I was quite surprised a year or two ago to read that the calorie model of weight loss comes to us via a 1930s experiment at the University of Michigan that continued for six whole weeks. (Incidently, the guy who did the experiment spent decades pointing out that it was a small, limited experiment and that conclusions had been drawn from it that were in no way experimentally supportable from the data.)

I am now on the Optifast diet and consuming 800 calories per day. If I don't exercise, I am losing around 3 pounds per week; if I do about 1000 calories of exercise a day I lose around 5 pounds a week. Both figures are in line with the calorie-in/calorie-out model. HOWEVER, I had virtually identical amounts of weight loss on the Atkins diet a couple years ago (at similar exercise levels), and let me tell you I was consuming FAR MORE than 800 calories per day. I would estimate conservatively that I was eating 2-3 times that much. And my "excessive" (relative to a pure calorie model) weight loss continued on the Atkins diet for months at a time, so it couldn't all have been the result of the notorious Atkins diuretic effect.

I have asked a number of people who have been long time dieters (i.e., people who have a very accurate idea of calorie counts, serving sizes, etc.) who have also been on the Atkins diet if they felt they were losing more weight on Atkins than made sense from a purely caloric point of view. To a person they agreed that they thought they were.

(I don't claim to understand the full processes involved in digestion, fat storage et al, but even my limited understanding points out that there appears to be no simple mechanism in the body that closely approximates the calorie-in, calorie-out, fat-burning/fat-storage model. Fat storage seems to have a much more complex mechanism, connected to insulin levels and other hormones, etc. I only bring this up because it makes me wonder if a calorie-in, calorie-out model makes sense on a 'balanced' diet, but perhaps this mechanism can be tricked on a high protien low-carb diet.)

In any event, it would hardly be the first time that the medical establishment was laying down the law on the basis of very, very limited experimental data.

Posted by: Friedrich von Blowhard on January 11, 2004 08:06 PM



P.S. I'm not trying to endorse the Atkins diet here, BTW. I find it a very difficult diet to stay on for any length of time in excess of say, 3-4 months, so no matter how efficient it is regarding weight loss, it's a bit iffy. However, regarded as a science experiment it is certainly enough to make me wonder how superficial most medical opinion on the topic of weight loss may be.

Posted by: Friedrich von Blowhard on January 11, 2004 08:10 PM



Well, I'm disconcerted too Michael. I don't think it's for the same reasons as you. For me I think it's just that I do NOT like to monkey with how I eat. I find it stressful. (I'm finally realizing this.) And it's disconcerting because even though I look and feel healthy, I often consider myself as a failure when it comes to eating right. And really, how can anyone measure up when the bar is constantly changing?

Oddly, I keep thinking that it'll be so easy to make a dietary change in my life. Okay, so big deal, no more bread, pasta, potatoes etc. I'll eat more meat, fish, and cheese. But today, (yes today) after my latest attempt to make this "easy" switch to Atkins took a nosedive, I decided that the MOST I can change in my diet is just a little tweak here and there. I'll always rebel against any major paradigm shift when it comes to food.

Still, I'm usually curious about the latest opinions on diet. Heck, I even made a serious attempt at the "calorie restriction" diet. You're supposed to live sooooo much longer. I couldn't do it.

So, my latest tweak ... I cooked and ate Kale for the first time. It's a "top 100" food in the "Zone" cookbook. Changes like that are about all I can incorporate. Of course, I had to tell about 5 people about it. "Hey, guess what? I ate Kale last night. I actually ate Kale." My friends ... poor things.

Posted by: laurel on January 11, 2004 08:41 PM



MichaelMichael,

Many thanks for an interesting article. The reasons people gain or loose weight are very poorly understood. Unfortunately those advising us about our health are not always guided by the science, but sometimes by greed or political pressure, as evidenced by the drug industry's pressures on our doctors and via lobbyists on our government.

The internet has opened a way for those who have access to it to take responsibility for their own health. We should always keep in mind that everyone is a little different, and thus what works for one person may not work for others. Thus statistics that accompany well designed studies should be used only as a guide - recall how long it took to be able to say definitely that for most people, smoking can be lethal to the smoker and those getting his second-hand smoke. This is for the vast majority. Using the bell-curve of probabilities, there are those at each end of it who seem to be the exceptions: Those who never smoked getting many of the same diseases as smokers, and vica-versa.

Posted by: Shafik Iskander on January 11, 2004 08:55 PM



I have to say, I was never exicted about the low-fat diets in the 80's. Not that I should have even been on them, I was in high school and thin. But because I love food soooooo much, I try and make sure I balance out my intake with some kind of health management.

I eat more than I excersise, for sure. But I know in the core of my being - I must exercise as a living, breathing person. It's part of our make up to burn calories and move our asses. The more we sit in offices, eat processed crap, stress out and watch the idiot box - the more we grow wider. Natural selection takes over and there ya go, people start dying from heart attacks and disease.

Too much fat on our muscle and bones is not good. If any of us want to live longer more active lives, we need to keep the fat to a minimum. Simple logic.

Diet fads have been the rage since Kellogg's, right? Sure there is going to be different opinions from the medical and media world. No one is going to apologize for getting it
"wrong" - ideas will be constantly evolving. People have got to make an effort to buy fresh food, good food - eat 3 meals a day and excersise. No matter what diet fad is happening for the moment.

Quite frankly I don't care if you're eating ham, potatoes, string beans and a salad... if the food is fresh and the cook is not using processed ingredients - IT'S NOT BAD. Then, 3 times a week, go shake your butt in an aerobics class, take a swim, ride your bike, play tennis, do high energy yoga - whatever is the least painful and there ya go. Life in moderation.

For those who are over weight and are in programs, it takes a lot of work and discipline. It would be very hard for me, because I do love food like a crazy person. But either doing a low-calorie diet (including pasta and carbs) or trying Atkins (low-fat and no carbs) will reduce most people's weight with a lot of excercise.

My dad lost 30 pounds on Atkins and has less strain on his heart than ever. There was about 2 years there when I was convinced my dad was going to die really soon (he's 72 now with one heart attack behind him at 57), this was about 3 years ago. He changed his entire plan - lost weight and now his angina is less and less. Whew. I don't think Atkins is for everyone but it certainly worked for him. He needed to make a change fast and it worked. Discipline is the hardest part.

So go figure. Specific diets come and go... health management should be the bigger picture, don't you think?


Posted by: TurboKitty on January 11, 2004 10:07 PM



Fun trading diet and eating tips and tales. I've only got a few to pass along. A doctor friend once told me: "Don't smoke, don't get too fat, take a walk every day, and eat semi-sanely. Beyond that, it's all genes and luck." Another doctor friend, a cancer surgeon, told me that the cancer patients of his who dealt with it worst were the ones who'd been vegetarians. They'd thought that by being vegetarians they'd inoculated themselves against the possibility of getting cancer. As someone who spent years as a vegetarian (not too doctrinaire, I hope) and who was operated on for cancer before turning 50, I know what he's talking about.

Independently, on my own, I know nothing at all.

FWIW, here's a book by a Harvard Med School guy who actually does give Atkins a tip of the hat for opening up the discussion about too many carbs.

Superficial, media-centric soul that I am, what I'm mostly marveling about is how the health-tip establishment has, in just a couple of years, reversed direction entirely -- and seems to be getting away with it.

I suspect Annette's answer is the right one. Still, the NYTimes got raked over the coals for Jayson Blair. The New Republic took it on the chin for Stephen Glass. But no one's making the health-tip people grovel and beg our forgiveness. Why, do you suppose? These are people who wear serious expressions, get paid big bucks, who are quoted and looked to, whose opinions and advice really affect people's lives ... And they can get away with this kind of switcheroo?

In my ideal world, heads would roll and everyone in the health-tips biz would be forced to eat a lot of humble pie. Low-carb, of course.

Posted by: Michael Blowhard on January 11, 2004 10:25 PM



The whole switcheroo really does show how much power the old grey lady still carries, even in this internet age. I was doing the low-carb thing for years, and whenever I would try to tell somebody about it I would get poo-pooed. The Times runs one cover story in the magazine, and it's like someone turned a lightswitch.

Have you read Micheal Crichton's speech about the dangers of "consensus science"? (available here.)

"Let's be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus.

There is no such thing as consensus science. If it's consensus, it isn't science. If it's science, it isn't consensus. Period. "

Posted by: jimbo on January 11, 2004 10:49 PM



Yeah - sadly my boyfriend's super veggie aunt just died of cancer last year. Isn't that interesting? Perhaps humans were meant to have a little meat in take, here and there. I have quite a few veggie friends turned meat eaters again. Maybe it's your body's way of saying "I need animal protein!" after years of not having it. Would be impossible to convince my hard core vegetarian LALA friend of this, she'd rip my head off. She's right up there with vegans, ick!

Posted by: TurboKitty on January 11, 2004 11:41 PM



Once apon a time I lost all of my weight. I kept the weight off for about two years. I also had a very busy schedule. I did it by planning my meals, (and making all of my own meals) and spending about a half hour exercising (usually on an exercise bike) just about every day first thing in the morning. It was a slow process. I dropped about seventy pounds in about six months. I took vitamins. I eat a lot of simple prepared meals like sandwiches with lots of lettuce, onions and tomatoe thrown in. I also eat a lot of Potatoes with a little bacon and cheese thrown on top. The bigest change I made was stopping eating when I started to feel full. Full, not "stuffed" and I drank a lot of water.

I don't trust the diet industry because they are always trying to sell something. The fastest and healthiest food is usually a piece of fruit. You need protein to replace the protein your body goes through. Unless you are a world class athlete that amount of protein is about the size of the palm of your hand. I calculated that at my weight I burn about 400 calories an hour by walking at a 3 mile an hour pace. So I will have to walk over 2000 miles before I will burn up about 100 pounds of fat 3500 calories is equal to one pound of fat. If you use a ski machine or if you swim free style at a fast pace you will burn about 1000 calories an hour. You have to balance your activity with who you are and your life. To me it is now a priority and I am spending time at the gym. Real time. I am also watching my diet too. It takes about the same time to make a salad from a dominicks or jewel salad bar as it does to go to a fast food restaurant. Eat what you love, but in moderation. Pizza is not an every day food. Niether are french fries, hamburgers, hotwings, or fried chicken. It's ok to cheat and have these foods, just don't do it more than once a week.

Stay away from coffee. If you must endulge try tea instead. But ideally water would be better still.

Sometimes I think it is not the diet that is the problem. It is the instant gratification we want. Is the atkins diet a pandora's box? Just like the allowed introduction of genetically engineered foods, what are the long range health affects?

Also, these vegatarians that are developing cancer. What pesticides are being used?

Just a thought.

Shipshape

Posted by: shipshape on January 12, 2004 03:55 AM



As a physician who graduated from med school in 1993, I can state that there were no formal courses taught on nutrition as a prerequisite to graduation at that time. The only dietary teaching we received (low fat is good, lower fat is better) was through osmosis. I stressed this approach to my patients, giving them 25 fat gm/day dietary plans, and seeing them 6 - 12 weeks later having gained weight and being very upset. I started questioning the conventional wisdom about 5 years ago, and found that our assumptions about diet and its effect on health were pretty simplistic: cholesterol in the bloodstream and fat around the waistline were associated with higher mortality, so let's cut out fat and cholesterol from our diets. We now know it's more complicated than that, and a newer food pyramid was proposed by nutritional scientists at Harvard a couple years ago which puts non-fiber starches and sugars at the top (i.e. the stuff we should eat the least of). You are correct - the medical establishment, including the American Heart Association and the American Diabetic Association, should be ashamed of the > 30 years of poor nutritional advice they've given us, which I believe is the most important factor (along with an increasingly sedentary lifestyle) in causing the obesity and diabetic epidemics that we face. Here is where I think the conventional wisdom will be in 5 - 10 years:


proteins: based on lean body mass and level of activity, between 70 and 120 grams/day, avoiding preservatives such as sulfites and nitrites found in bacon, some lunchmeats, etc.

fats: high in monousaturated fats (olives, nut, legumes and their oils), low in saturated and trans-fats.

carbohydrates: high in fiber, including the colorful vegetables and berries, very low in starches such as white rice and potatoes, and very low in fruit juices except lime and lemon juices.

It ends up being what we ate before we became farmers.

Regarding the theory that if calories eaten equals calories expended, then you should maintain your weight, this would be pretty valid if fat was the clean-burning fuel that protein and carbs are. It appears that fat has about 30% exhaust fumes (ketone bodies), and, although some organs can use ketones as fuel (analagous to an afterburner in a jet turbine engine), a diet with eqivalent calories but 75 gms/day more fat (low-carb vs low-fat) will produce more weight loss.

Posted by: Jim Pierce, MD on January 12, 2004 08:01 AM



My sister was diagnosed with diabetes a year ago and the diet they put her on to control her disease is very similiar to Atkins in the later stages. She has more difficulty with weight because she had polio the last summer before Salk vaccine became available in "54 and cant do any strenuous exercise to keep her physically active but, even so, she's lost weight and has kept it off. And her diabetes is under control at this point.

My husband has hypoglycemia and went on Atkins last spring and lost 35 lbs on it over the course of 6 months and has kept them off with very little extra effort, after the induction phase. He has to vigorously walk at least 30 minutes every day or so to control his sciatica anyway and the Atkins blended in quite well. The best part is that he hasnt had a "sugar drop" in months and feels much better than before.

I personally tried Atkins and couldnt stay on it more than 6 weeks tho I lost almost 15 lbs in those weeks I was on it and they havent come back. I found the side effects of running that much protein and fat thru my gut hard to live with and had sugar withdrawal something fierce. I fell off the diet with a kerplunk.

My problem with cutting meat as a protein source altogether is that I have 3 or 4 vegetarian friends who had problems with bone density and protein levels after menopause and had to slowly reintroduce some meats back into their diet after they started having problems. It may be intellectually more comfortable to cut meat out but totally ignores that we have systems that are omnivorous.

Posted by: Deb on January 12, 2004 09:54 AM



Logology: scrolldown for comparigraphics at Lileks.

Posted by: nnyhav on January 12, 2004 10:43 AM



I've found that protein makes me gain weight so I wouldn't want to try Atkins, but I think different things work for different people. I'm trying eating a light evening meal, and not eating snacks. It's working for me so far. All things in moderation.

Posted by: Duckling on January 12, 2004 11:36 AM



Three or four years ago, when the Atkins diet was catching on with a number of my friends and colleagues, I invented a protest diet. I ate ONLY carbs -- well, at least only food the Atkins diet frowned upon, primarily bread, rice, pasta, potatos, and fruit. As with the Atkins diet, I ate as much as I wanted to and didn't alter my exercise pattern. And guess what? I lost weight -- about 10 pounds in a month, and I didn't have a bunch of excess weight to start with.

But while I've never consumed meat in huge quantities, I did find that after four weeks, I really craved beef and chicken. I craved meat so much that it became far too distracting for a simple diet. I resumed living as an omnivore.

I've heard similar stories from Atkins dieters who finally gave in and ate that bagel they'd had their eyes on. In the end, without a compelling reason to lose a great amount of weight fast, any kind of diet that leads to cravings is probably deficient, don't you think?

Posted by: Kari on January 12, 2004 12:34 PM



Duckling: Very important point there. Show me a diet anywhere this side of trying to live by photosynthesis or drinking battery acid, and I'll bet it works great for some people, doesn't matter for some, and is awful for some.

Karl: No, actually. People with allergies often crave things that are bad for them. So do addicts. Craving may be a sign of a genuine need going unaddressed, but I don't think that assuming it is is the best approach.

Posted by: Bruce Baugh on January 12, 2004 12:43 PM



That's Kari.

Point taken re: addiction, but don't addicts crave what they're addicted to regardless of diet? (Non-food related example: One of my officemates craves cigarettes, and he's not deprived of them.) In any case, with my historically limited meat intake, I doubt I am physically or psychologically addicted to meat. Still, I was missing something that created a craving I hadn't had before. The diet created the craving.

Posted by: Kari on January 12, 2004 01:43 PM



Kari: I had a similar situation. I was doing about 1600 calories a day of the normal low fat high veggie/fruit recommended diet with some moderate exercise. For a few months I lost some modest weight. It was only when I added to the normal weekly diet one big high protein breakfast (bacon, eggs, cheese etc.) that I got noticeable results. Invariably (and anecdotally of course :-), the day after the big breakfast I would weigh up to three pounds less than I would have before!

Posted by: Shemshaun on January 12, 2004 02:07 PM



Oddly, when I was on Atkins and feeling sugar withdrawal and food cravings, I wasnt fixating on candy or sweets or even straight carbs like pasta or bread. It was apples and oranges and bananas. I think it was just the idea that they were forbidden that caused the cravings. I got so tired of sitting at a meal and counting my carbs up for the day to see if I could have more carrots that it really didnt work for me. If a handful of trail mix made with raisens and dried fruit is going to do me in, then at least I will die with a smile on my face.

Posted by: Deb on January 12, 2004 04:50 PM



Read Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating, by Walter Willett. It gives an excellent summary of the state of current research and spells out the available evidence supporting various dietary recommendations. Willett makes the point that nutrition scientists have been shouting for years about the stupidity of the traditional FDA food pyramid, specifically about the need to distinguish between salubrious and insalubrious fats, and also between salubrious and insalubrious carbs, but their voices seem not to have been heard. One problem with substantially revising the FDA pyramid is that the dairy and meat lobbies strenuously object to having their products' healthfulness downgraded. Willett agrees with some parts of the Atkins diet and takes serious exception to others. If you're interested in the science behind the recommendations, Willett's a good source to start with.

Posted by: Michaela Cooper on January 12, 2004 05:12 PM



My impression is that the low-fat, hi-carb diet that was so heavily pushed in the early 1990s was driven in large part by doctors seeing that lots of East Asians ate lots of carbs and were skinny.

It never occurred to them that the ancestors of East Asians might have gone through evolutionary adaptation over thousands of years to adjust to a high carb diet. In contrast, the ancestors of Western Europeans were typically eating a higher protein, higher fat diet ("the roast beef of merrie olde England" and all that).

My experience has been that a lot of white Americans are well-suited to a high carb diet, but others are better suited to a low carb, high protein, moderate fat diet.

In the future, we'll be able to get our individual genomes tested and find out what diets are best suited to our individual makeups.

Posted by: Steve Sailer on January 12, 2004 09:04 PM



Actually there hasn't been a sea change in what nutritionists think. I still see the same old nutritionists quoted saying the same old things. low fat blah blah blah. you've got to burn more calories than you consume blah blah blah.

What's happened is that dieters have realized the conventional wisdom is WRONG based on the observable inductive evidence.

Willett is the most prominent of the nutritionists to acknowledge the CW is wrong but it's not clear that he changed his views, just that he found the scientific evidence to support his minority opinion.

I actually find it interesting to see what a hard time the CW-expousing nutritionists are having accepting that they were wrong. It's really interesting.

Posted by: ann on January 13, 2004 08:45 AM



I don't think the low-fat high-carb diet is in itself to blame. I lost a lot of weight, about a hundred pounds, eating low-calorie, very low-fat, mostly carbs. I maintained the loss for a year or two eating higher calorie, still very low-fat and mostly carbs (Vegetarian carbs at that).

What did ME in was sugar. As long as I was eating whole grains and low-fat tofu and cooked beans, I was golden. Then there was the occasional No Pudge brownie as a treat, or a handful of Jelly Bellies -- fat-free, you know -- and then it all went down the ol' pot. And (anecdotally) I'd say that's the case for most of those who found the low-fat diet "failed" -- they're the ones I see round my office eating a whole pack of Snackwells for lunch because they "only" have 20% or whatever fat...

I predict -- I have no psychic qualifications, but I predict -- that EXACTLY THE SAME BACKLASH will be heard against low-carb in about ten years' time. Atkins pancake mixes. "Low carb" chocolate bars. "Low carb" cheesecakes. Faux carb-free mashed potatoes created by some mysterious chemical process from pork rinds, for all I know -- as all these things multiply on shelves like parasites fed by consumer desperation, and are eaten instead of REAL low-carb foods -- whether that be lean fish and salad, or even bacon, eggs and heavy cream -- lo and behold, low-carbing will "stop working" in the majority of people.

Losing weight & keeping it off IS a lifestyle change. THERE IS NO WAY, in my opinion, to eat as much as one wants of standard American marketed junk food or facsimiles of same, and still lose weight, or maintain a weight loss in the long term. If that is your goal, then you MUST become "that weirdo" who doesn't live like the herd. Sorry.

However, "suck it up and work" is not really a saleable concept, is it?

Posted by: CompassRose on January 13, 2004 11:52 AM



My own experience is that I've always been a semi-Atkins eater: fair amounts of meat, metric tons of cheese (not so much as I get older), gallons of olive oil and not a hell of a lot of carbs. I eat pasta now and again, and potatoes rather more frequently than that. I think this has to do with me having a really fast metabolism. In fact, when I'm hungry, just looking at carbs makes me feel a little sick; it's as if I know that it'll burn off in a twinkling and leave me hungry again.

I think the most important thing is that I try not to eat shite, and by shite I mean pasteurized processed preservatived boxed or bagged nonsense. Cheetos to fish sticks and anything in between.

Here's my magic: I cook my own food, from reasonably fresh ingredients, and when I don't have time (like now, when I'm working 40 hours, going to grad school and planning a wedding) I tend to eat frozen food from Trader Joe's or Whole Foods—stuff that doesn't have a list of ingredients as long as your arm.

Posted by: Luis on January 13, 2004 12:30 PM



Oh, and I don't eat a lot of refined sugar, either. I used to have one hell of a sweet tooth as a kid, but it's mostly gone now, and I only ever put sugar in my coffee, really, and I'm trying to wean myself off of that.

Speaking of refined sugar, several people I know swear by the blonde turbinado sugar (commonly sold under the brand name "Sugar in the Raw") over bleached white sugar, saying that after a stretch on the blonde stuff, the white stuff will make them feel slightly ill / give them a migraine / what have you. Me, I use turbinado sugar because I like the taste better, but I wonder if anyone else has noticed similar effects.

Posted by: Luis on January 13, 2004 12:34 PM



I came up with a revolutionary diet which takes Atkin's to a whole new level.

Assuming the cave man diet is the way to go I encouraged my patients to quit going to the grocery store and start actively hunting/gathering their food. Now I can't promise your neighbours won't be a tad upset about the silent disappearance of their garden produce and family pets but I can honestly say that I don't know anyone on this diet who hasn't lost a LOT of weight.

Posted by: Dr. Niceguy on January 13, 2004 05:29 PM



My experience was much like that of Luis'. Due to a wheat allergy (not celiac/sprue; it merely makes me depressed), I was already more than halfway towards Atkins when I started, and promptly lost about 20 pounds. These days I eat more carbs, but mostly on the weekend. The cycling (the Metabolic Diet, if anyone cares) seems to give me the best of both worlds: low carb weight loss, satisfaction of cravings (like pasta) as long as I wait for the weekend, and a recharge of my glycogen reserves every 5-7 days.

The worst part of Atkins is the lack of fiber if you're not careful.

Posted by: Dave Trowbridge on January 14, 2004 01:47 AM



What I find interesting is that we live in a time and place at which we actually complain about how efficient our food is. Inexpensive food that easily converts to energy is a good thing. Our problem, if we have one, is excess consumption.

Posted by: Glowworm on January 14, 2004 05:11 PM



Michael: Have you found it as startling as I have how quickly the health-tip establishment has changed its advice about carbs and fats? It seems like only five minutes ago that we were being told that fats are bad and carbs are good. Now we're being told the reverse.

Where are the links to the supposed flip-floppers? Like some other commenters, I haven't noticed anything like the wholesale "establishment" reversal you describe. Rather, there now are a few heterodox voices where there used to be perfect ideological conformity.

Michael: Given how quickly the doctors have flip-flopped, how can there be any real science behind any of this?

Here's some science:

(From a CNN story about a recently-concluded study by Harvard's Penelope Greene showing that high-fat, low-carb dieters could consume more calories and still lose more weight than other dieters)

The study, directed by Penelope Greene of the Harvard School of Public Health and presented at a meeting here this week of the American Association for the Study of Obesity, found that people eating an extra 300 calories a day on a very low-carb regimen lost just as much during a 12-week study as those on a standard lowfat diet.

Over the course of the study, they consumed an extra 25,000 calories. That should have added up to about seven pounds. But for some reason, it did not.

"There does indeed seem to be something about a low-carb diet that says you can eat more calories and lose a similar amount of weight," Greene said.

....

Everyone's food looked similar but was cooked to different recipes. The low-carb meals were 5 percent carbohydrate, 15 percent protein and 65 percent fat. The rest got 55 percent carbohydrate, 15 percent protein and 30 percent fat.

In the end, everyone lost weight. Those on the lower-cal, low-carb regimen took off 23 pounds, while people who got the same calories on the lowfat approach lost 17 pounds. The big surprise, though, was that volunteers getting the extra 300 calories a day of low-carb food lost 20 pounds.

link Posted by: MDP on January 17, 2004 10:03 AM



MDP -- Thanks for the links and info. Interesting stuff: there's clearly much, much work yet to be done on diet and health.

As for whether there's been a diet-tip-establishment flipflop: Three years ago, the low-carb approach was present but barely visible -- you had to really look for it, and Atkins was considered a crank. These days, in the bookstores and magazine stores in the part of the country where I live, there are dozens of books on the topic, health magazines (the same ones that were pushing the high-carb/low-fat routine a few years ago) are featuring low-carb recipes, and the mainstream food companies are (lurchingly) beginning to fill grocery-store shelves with products catering to low-carb dieters. Restaurants (high end and low end) feature Atkins and low-carb dishes. And these days, at least where I live, almost everyone seems to be low-carb dieting. (Note: I'm not endorsing, just noticing). I dunno: strikes me as a remarkably quick change in direction.

I'd love it if some irreverent journalist did some research on the topic. I'm sure he'd turn up doctors, gurus, editors and writers who are writing the exact opposite today of what they were writing five years ago.

Posted by: Michael Blowhard on January 17, 2004 12:00 PM



Michael Fumento is one of the best "irreverant science journalists" I know of, and he's written a lot (mostly negative) about Atkins. It's disappointing, though, that he hasn't even mentioned last year's Harvard study in his latest articles on the subject.

Posted by: MDP on January 17, 2004 07:17 PM






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