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Sugar: The New Fat

3/3/2012

3 Comments

 
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We've been hearing the same thing for the past 30 years: Fat is bad. It has more than twice as many calories as protein or carbs AND it shares the same name with the very characteristic so many of us have acquired during this obesity epidemic.

It has been the general consensus because it makes sense on a superficial level. If people are gaining weight by eating too many calories, then eliminating fat (the most potent calorie-contributor) from the diet should ameliorate the problem. The recommendations soon followed: "Choose lean meats; Use low fat salad dressing; Eat fat free potato chips." 

After 30 years of trying, Americans - as well as the rest of the world - have not been very successful.

Inadequate advice or poor compliance are the two obvious explanations for this failure.  The latter has been incriminated thus far: the majority of Americans just aren't listening. Yet much evidence suggests they may have been listening quite well.

Clinical Trial Evidence
The appearance and sudden popularity of the Atkins diet in the 1990s had dieters running to the meat department, leaving carbs in the dust. The apparent success of this diet, mostly ascertained from anecdotal evidence, had the overweight population excited and health experts worried. A diet characterized by high amounts of meat and fat was deemed impossible to be effective and a serious health risk.

At the time, few clinical trials had been done analyzing the efficacy and safety of such a diet, which understandably led to extreme skepticism among dietitians and doctors. Recent years have seen numerous studies comparing a calorie unlimited, low carbohydrate diet to various other low-fat, low calorie diets.In other words, a battle between two notorious opponents: Eat until you are full and limit carbs Vs. Eat until you reach a calorie limit and restrict fat. Since fat has 9 calories per gram and protein or carbs have 4 calories per gram, a high fat diets seem destined to fail.

Yet to the surprise of many, when compared to other diets, the calorie unrestricted, lowest carbohydrate diet group generally — but not always — loses more weight. With few exceptions, their HDL increases and their blood triglyceride levels decrease without having any significant effect on LDL (bad cholesterol). When subjects keep their carbohydrate intake lower than 50-75 grams per day, they seem to be most successful.

Often times the various groups fare the same, both losing approximately the same amount of weight. But NEVER, in dietary clinical trial history, has the low-fat, low-calorie diet group lost more weight (more on this idea).
The High Fat Paradox
The very idea that a diet characterized by high-fat foods and unlimited calories can do as well, or better, than a low-fat, calorie-restricted diet poses a challenge to the current weight-loss recommendations. However, conceding to this evidence, and altering the recommendations would mean the advice from the last 30 years may have been premature. 


Yet it seems that slowly, the anti-carb message is seeping in. 

Here is a recent public service announcement from the New York City Health Department:

Researchers at Harvard Seem To Agree:
"Fat is not the problem. If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases."

-Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health

"The country's big low-fat message backfired. The overemphasis on reducing fat caused the consumption of carbohydrates and sugar in our diets to soar. That shift may be linked to the biggest health problems in America today."

-Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health. 


Compliance to the high-carbohydrate recommendations

According to the center for disease control, since 1975 Americans have eaten less fat and more carbohydrates:

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Perhaps it is possible that the blame does not lie entirely on the individual, due to the fact that this change in eating behavior is EXACTLY what we were asked to do:

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3 Comments
Alexandra M
3/5/2012 01:22:52 am

Could you give a link to where Willet said that? It seems that Willet often says these sensible things (as he did when Gary Taubes interviewed him for Good Calories, Bad Calories), only to say later that his remarks were "taken out of context."

Even (link below) this article starts with an admission that there's scant evidence of a link between saturated fat in the diet and heart disease, and then goes on just a few paragraphs later to say that if you eat refined carbohydrates in lieu of saturated fat "The net effect is <b>as bad for the heart as eating too much saturated fat</b>."


http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/

Reply
Larry link
3/5/2012 02:34:59 am

Here it is: http://www.latimes.com/health/la-he-carbs-20101220,0,5464425.story

I have noticed that often about Willet as well. But if you read what he says in the PBS diet wars, it sounds eerily similar to what Gary has been saying. And this is not out of context:

This campaign to reduce fat in the diet has had some pretty disastrous consequences. ... One of the most unfortunate unintended consequences of the fat-free crusade was the idea that if it wasn't fat, it wouldn't make you fat. I even had colleagues who were telling the public that you can't get fat eating carbohydrates. Actually, farmers have known for thousands of years that you can make animals fat by feeding them grains, as long as you don't let them run around too much, and it turns out that applies to humans. We can very easily get fat from eating too many carbohydrates, and the public was really directed to only focus on fat calories, when we really have to keep an eye on calories no matter where they're coming from.

With more fat-free products than ever, Americans got fatter.


http://www.pbs.org/wgbh/pages/frontline/shows/diet/themes/lowfat.html

Reply
Alexandra M
3/6/2012 11:24:31 pm

Wow! That LA Times article was from December of 2010. So where's the "upheaval" they're talking about?

"Joanne Slavin, professor of nutrition at the University of Minnesota and a member of the advisory committee for the 2010 Dietary Guidelines for Americans, is less inclined to support the movement. The committee, she says, "looked at carbohydrates and health outcomes and did not find a relationship between carbohydrate intake and increased disease risk."

Seriously??

"Most Americans need to reduce calories and increase activity, Slavin adds."

Same old, same old.

"...but making a hit list of carbohydrate-containing foods is shortsighted and doomed to fail, similar to the low-fat rules that started in the 1980s."

Don't these people ever read anything? It is not "similar" to the low-fat rules - it's the opposite. Telling people to eat the diet they evolved to eat is NOT similar to telling them to avoid it!

*end rant* :)




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