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NOVEMBER 2002  VOLUME 29 / NUMBER 9




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CENTER FOR SCIENCE IN THE PUBLIC INTEREST                     $2.50




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                                            H E A LT H          L E T T E R

                                               T h e Tr u t h
                                               About the
                                               Atkins Diet
                                               By Bonnie Liebman



                                               “What If It’s All Been a Big Fat Lie?”
                                               asked the cover story of the July 7th
                                               New York Times Magazine. The arti-
                                               cle, by freelance writer Gary Taubes,
                                               argues that loading our plates with
                                               fatty meats, cheeses, cream, and but-
                                               ter is the key not just to weight loss,
                                               but to a long, healthy life.
                                                “Influential researchers are begin-
                                               ning to embrace the medical heresy
                                               that maybe Dr. Atkins was right,”
                                               writes Taubes.
                                                 Taubes claims that it’s not fatty
                                               foods that make us fat and raise our
                                               risk of disease. It’s carbohydrates.
                                               And to most readers his arguments
                                               sound perfectly plausible.
                                                 Here are the facts—and the fic-
                                               tions—in Taubes’s article, which
                                               has led to a book contract with a
                                               reported $700,000 advance. And
                                               here’s what the scientists he quoted
                                               —or neglected to quote—have to
                                               say about his reporting.

                                                                  (Continued on page 3)
                                                      C O V E R          S T




P
             erhaps the most telling state-
             ment in Gary Taubes’s New
             York Times Magazine article
             comes as he explains how diffi-                    The
             cult it is to study diet and
health. “This then leads to a research lit-
erature so vast that it’s possible to find at
                                                           Tr u t h
least some published research to support
virtually any theory.”                                   About
   He got that right. It helps explain why
Taubes’s article sounds so credible.                              the
   “He knows how to spin a yarn,” says
Barbara Rolls, an obesity expert at
Pennsylvania State University. “What                     Atkins
frightens me is that he picks and chooses
his facts.”                                                     Diet
   She ought to know. Taubes inter-
viewed her for some six hours, and she
sent him “a huge bundle of papers,” but
he didn’t quote a word of it. “If the facts     CLAIM #1: The experts recom-                 s According to Taubes, Harvard
don’t fit in with his yarn, he ignores          mend an Atkins diet.                         University’s Walter Willett is one of the
them,” she says.                                                                             “small but growing minority of estab-
                                                TRUTH: They don’t.
   Instead, Taubes put together what                                                         lishment researchers [who] have come
                                                An Atkins diet is loaded with meat,          to take seriously what the low-carb-diet
sounds like convincing evidence that            butter, and other foods high in satu-        doctors have been saying all along.”
carbohydrates cause obesity.                    rated fat. Taubes implies that many of          True, Willett is concerned about the
   “He took this weird little idea and blew     the experts he quotes recommend it.          harm that may be caused by high-
it up, and people believed him,” says John      Here’s what they say:                        carbohydrate diets (see “What to Eat,”
Farquhar, a professor emeritus of                                                            page 7). But the Atkins diet? “I cer-
                                                s “The article was incredibly mislead-
medicine at Stanford University’s Center        ing,” says Gerald Reaven, the pioneer-       tainly don’t recommend it,” he says.
for Research in Disease Prevention.             ing Stanford University researcher,             His reasons: heart disease and cancer.
Taubes quoted Farquhar, but misrepre-           now emeritus, who coined the term            “There’s a clear benefit for reducing
sented his views. “What a disaster,” says       “Syndrome X.” “My quote was cor-             cardiovascular risk from replacing
Farquhar.                                       rect, but the context suggested that I       unhealthy fats—saturated and trans—
   Others agree. “It’s silly to say that car-   support eating saturated fat. I was          with healthy fats,” explains Willett,
bohydrates cause obesity,” says George          horrified.”                                  who chairs Harvard’s nutrition depart-
Blackburn of Harvard Medical School and                                                      ment. “And I told Taubes several times
                                                                                             that red meat is associated with a higher


                                                “
the Beth Israel Deaconess Medical Center
                                                                                             risk of colon and possibly prostate can-
in Boston. “We’re overweight because               Gary Taubes                               cer, but he left that out.”
we overeat calories.”
                                                   tricked us all                            s “I was greatly offended at how Gary
   It’s not clear how Taubes thought he
could ignore—or distort—what                       into coming                               Taubes tricked us all into coming across
                                                   across as                                 as supporters of the Atkins diet,” says
researchers told him. “The article was
                                                                                             Stanford’s John Farquhar.
written in bad faith,” says F. Xavier Pi-          supporters                                  Taubes’s article ends with a quote
Sunyer, director of the Obesity Research
                                                   of the                                    from Farquhar, asking: “Can we get the
Center at St. Luke’s-Roosevelt Hospital


                                                                 ”
                                                                                             low-fat proponents to apologize?” But
Center in New York. “It was irresponsi-            Atkins diet.
                                                                                             that quote was taken out of context.
ble.”                                              — John Farquhar                             “What I was referring to wasn’t that
   Here’s a point-by-point response to             Stanford University                       low-fat diets would make a person gain
Taubes’s major claims.                                                                                                         ››››
                                                                               NUTRITION ACTION HEALTHLETTER s N O V E M B E R 2 0 0 2   3
                                                        C O V E R         S T O R Y



weight and become obese,” explains                                                           CLAIM #4: We’re fat because we
Farquhar. Like Willett and Reaven, he’s                                                      ate a low-fat diet.
worried that too much carbohydrate
can raise the risk of heart disease.
  “I meant that in susceptible individu-
als, a very-low-fat [high-carb] diet can
raise triglycerides, lower HDL [‘good’]
                                                 “  My quote was
                                                    correct, but
                                                    the context
                                                                                             TRUTH: We never ate a low-fat
                                                                                             diet.
                                                                                             “At the very moment that the govern-
                                                                                             ment started telling Americans to eat
                                                    suggested                                less fat, we got fatter,” says Taubes.
cholesterol, and make harmful, small,
dense LDL,” says Farquhar.                          that I support                           “We ate more fat-free carbohydrates,
  Carbohydrates are not what has                                                             which, in turn, made us hungrier and
                                                    eating satu-
made us a nation of butterballs, how-                                                        then heavier.”
ever. “We’re overfed, over-advertised,
                                                    rated fat. I was                            It’s hard to believe this claim passed



                                                              ”
and under-exercised,” he says. “It’s the            horrified.                               the laugh test at The Times. If you
enormous portion sizes and sitting in                                                        believe Taubes, it’s not the 670-calorie
                                                    — Gerald Reaven                          Cinnabons, the 900-calorie slices of
front of the TV and computer all day”
                                                    Stanford University                      Sbarro’s sausage-and-pepperoni-stuffed
that are to blame. “It’s so gol’darn
obvious—how can anyone ignore it?”                                                           pizza, the 1,000-calorie shakes or
  “The Times editor called and tried to                                                      Double Whoppers with Cheese, the
get me to say that low-fat diets were                                                        1,600-calorie buckets of movie theater
the cause of obesity, but I wouldn’t,”          CLAIM #3: Health authorities                 popcorn, or the 3,000-calorie orders of
adds Farquhar.                                  recommended a low-fat diet as                cheese fries that have padded our back-
                                                the key to weight loss.                      sides. It’s only the low-fat Snackwells,
CLAIM #2: Saturated fat                                                                      pasta (with fat-free sauce), and bagels
                                                TRUTH: They didn’t.                          (with no cream cheese).
doesn’t promote heart disease.
                                                “We’ve been told with almost religious          “It’s preposterous,” says Samuel
TRUTH: It does.                                 certainty by everyone from the Surgeon       Klein, director of the Center for Human
If there’s any advice that experts agree        General on down, and we have come            Nutrition at the Washington University
on, it’s that people should cut back on         to believe with almost religious cer-        School of Medicine in St. Louis.
saturated fat. They’ve looked not just          tainty, that obesity is caused by the        “There’s no real evidence that low-fat
at its effect on cholesterol levels, but on     excessive consumption of fat, and that       diets have caused the obesity epi-
its tendency to promote blood clots, raise      if we eat less fat we will lose weight and   demic.”
insulin levels, and damage blood vessels.       live longer,” writes Taubes.                    Taubes argues that in the late 1970s,
They’ve issued that advice after exam-             It’s true that some diet books, notably   health authorities started telling
ining animal studies, population stud-          Dean Ornish’s Eat More, Weigh Less,          Americans to cut back on fat, and that
ies, and clinical studies.1-3 Taubes dis-       have encouraged people to eat as much        we did. Wrong.
misses them with one narrow argument.           fat-free food as they want. (Of course,         According to the U.S. Department of
   Saturated fats, he writes, “will elevate     Ornish is talking about fruits, vegeta-      Agriculture, added fats (oils, shortening,
your bad cholesterol, but they will also        bles, and whole grains, not fat-free         lard, and beef tallow) have gone up
elevate your good cholesterol. In other         cakes, cookies, and ice cream.) But          steadily since the late 1970s (see
words, it’s a virtual wash.”                    “everyone from the Surgeon General           “Hardly a Low-Fat Diet”). Total fats
   Experts disagree. “Fifty years of            on down” is baloney.                         (which include the fat in meats, cheese,
research shows that saturated fat and              “The Surgeon General’s report doesn’t     and other foods) have also gone up,
cholesterol raise LDL [‘bad’] choles-           say that fat causes obesity,” says           though not as steadily.
terol, and the higher your LDL, the             Marion Nestle, who was managing edi-            So how can Taubes write that “the
higher your risk of coronary heart dis-         tor of the report and is now chair of the    major trends in American diets, accord-
ease,” says Farquhar. Yet Taubes has no         nutrition and food studies depart-ment       ing to USDA agricultural economist
qualms about encouraging people to              at New York University. “Fat has twice       Judith Putnam, have been a decrease in
eat foods that raise their LDL.                 the calories of either protein or carbo-     the percentage of fat calories and a
   He’s willing to bet that higher HDL          hydrate. That’s why fat is fattening         ‘greatly increased consumption of car-
(“good”) cholesterol will protect them.         unless people limit calories from every-     bohydrates’”?
No experts—at the American Heart                thing else.”                                    The key is the word “percentage.”
Association; National Heart, Lung, and             And health authorities like the           The percentage of fat calories in our
Blood Institute; or elsewhere—would             American Heart Association; National         diets declined because, while we ate
take that risk.                                 Heart, Lung, and Blood Institute; and        more fat calories, we ate even more
   “The evidence that raising HDL is            U.S. Department of Agriculture never         carbohydrate calories.
protective is less solid than the evi-          urged people to cut way back on fat.            “We’re eating roughly 500 calories
dence that raising LDL is bad,” says            Their advice: “Get no more than 30           a day more than we did in 1980,”
David Gordon, a researcher at the               percent of calories from fat.” At the        Putnam told us. “More than a third of
National Heart, Lung, and Blood                 time that advice was issued, the average     the increase comes from refined grains,
Institute.                                      person was eating 35 percent fat.            a fifth comes from added sugars, and a
                                                                                             third comes from added fats.”


4   NUTRITION ACTION HEALTHLETTER s N O V E M B E R 2 0 0 2
                                                    C O V E R        S T O R Y



  Government surveys show no                The result is                               Hardly a Low-Fat Diet
change—or a slight decrease—in fat          hunger and a                              Added Fats & Oils in the Food Supply
consumption since the late 1970s. But       craving for more
they don’t look at how much fat is pro-     carbohydrates.”
duced, how much is sold, and how               It sounds con-
much is wasted. The surveys simply          vincing, but
ask consumers what they eat. And it’s       there’s a problem:
possible that once people were told to      “It’s not proven
eat less fat, they (consciously or uncon-   at all,” says Penn
sciously) started under-reporting how       State’s Barbara
much they ate.                              Rolls. “We have
  Says Putnam: “People don’t ade-           no firm data that
quately report added fats, added sugars,    glycemic index
and refined grains.”                        affects body
  The bottom line: Taubes blames the        weight or how
obesity epidemic on a low-fat diet that     full people feel
the nation never ate.                       after eating.”
                                               Harvard’s
CLAIM #5: Carbs, not fats, cause            David Ludwig has
obesity.                                    done a few stud-
TRUTH: The evidence blaming                 ies on glycemic
obesity on carbs is flimsy.                 index and weight.
                                            In the largest, he
The evidence that carbohydrates make        found that 64             According to Taubes, a low-fat diet has made us fat. Yet our con-
you fat can be called “Endocrinology        overweight ado-           sumption of all added fats combined (red line) is higher than ever
101,” says Taubes, implying that it’s       lescents who were         before. Estimates of total fat (not shown), which includes the fats
well-established fact. In a nutshell,                                 in meats, dairy, etc., also show a rise since the late 1970s. The bot-
                                            told to eat lower-        tom line: Americans never went on a low-fat diet.
Endocrinology 101 says that “we’re hun-     glycemic-index
grier than we were in the ‘70s” because     foods lost an             Source: USDA/Economic Research Service.
we’re eating more carbohydrates.            average of four
   “Sugar and starches like potatoes and    pounds, while 43
rice, or anything made from flour, like     overweight adolescents who were told               there is no good evidence that insulin
a slice of white bread,” are “known in      to make modest cuts in calories and fat            triggers weight gain. “Insulin crosses the
the jargon as high-glycemic-index car-      gained three pounds.4                              blood-brain barrier and turns off food
bohydrates, which means they are               “It’s hard to tease apart what led to           intake,” says Pi-Sunyer. “That makes
absorbed quickly into the blood,”           the weight loss in that study,” explains           sense. You’ve just eaten, so you don’t
explains Taubes.                            Rolls, “because calorie density, fiber,            need to eat for a while. If anything,
   “As a result they cause a spike of       and glycemic index all go hand in                  insulin should lower food intake.”
blood sugar and a surge of insulin          hand.”
within minutes. The resulting rush of          In other words, foods with a low                CLAIM #6: The Atkins diet is
insulin stores the blood sugar away         glycemic index—most vegetables,                    the best way to lose weight.
and a few hours later, your blood sugar     fruits, and whole grains—are also high
is lower than it was before you ate....                                                        TRUTH: We don’t know the best
                                            in fiber and low in calorie density.               way to lose weight.
                                               What’s more, Ludwig’s study didn’t
                                            randomly assign children to one diet or            “Until we have more research, no one
                                                                                               has the solution to the safest and most


“
                                            another, so the two groups weren’t
                                            comparable. “The low-glycemic-index                effective weight loss,” says Washington
  It’s preposterous.
                                            group had fewer minorities,” says                  University’s Samuel Klein.
  There’s no real                                                                                 “Preliminary data from several stud-
                                            Columbia’s Pi-Sunyer. Whites in both
  evidence that                             groups were more likely to lose weight.            ies suggest that, at least over the short-
                                               And he and others question the                  term, the Atkins diet is superior to a
  low-fat diets
                                            whole glycemic index theory. Among 5               low-fat diet in a free-living environ-
  have caused                               his criticisms: “People eat meals, where           ment,” he says. “But it’s too early to
  the obesity                               low-glycemic foods balance out high-               say that the Atkins diet is better.”



            ”                               glycemic foods.”                                      Even if ongoing studies show that
  epidemic.                                                                                    the Atkins diet promotes weight loss,
                                               For example, “people don’t eat pasta
  —Samuel Klein                             alone,” he explains. “They eat it with             we won’t know if other diets—ones
  Washington University                     olive oil, clams, tomatoes, or other               high in unsaturated fat or protein or
  School of Medicine                        foods, and that dampens the differ-                vegetables and whole grains, for exam-
                                            ences in their effects on insulin.”                ple—would work as well or better.
                                              And, contrary to Taubes’s claims,                                                    ››››
                                                                               NUTRITION ACTION HEALTHLETTER s N O V E M B E R 2 0 0 2    5
                                                        C O V E R      S T O R Y




  “We need lots more randomized                 the other if it can hurt your bones?”         referring to. In 1998, the National
controlled trials to evaluate the differ-          The problem: All the protein that          Heart, Lung, and Blood Institute issued
ent permutations,” says Walter Willett.         Atkins recommends leads to acidic             guidelines to help doctors treat obesity.7
(He and Blackburn are embarking on a            urine.6 “And there’s no dispute that an          Its conclusion: People who are told
study testing a high-unsaturated-fat            acid urine leaches calcium out of             to cut fat (but not calories) lose some
Mediterranean diet, not the high-               bones,” says Blackburn.                       weight because they inadvertently eat
saturated-fat Atkins diet, as Taubes               “You can buffer the diet by taking a       fewer calories. But people who cut fat
implies.)                                       couple of Tums a day, but now we’re           and watch calories lose more.
  “What’s important is not theories,            into medical supervision of people on            “A low-fat diet helps people eat fewer
but evidence.”                                  the diet,” he adds.                           calories,” says Rena Wing, a professor
                                                   Blackburn and others also want to          of psychiatry and human behavior at
CLAIM #7: The Atkins diet                       know whether an Atkins diet makes the         the Brown University Medical School
works because it cuts carbohy-                  blood vessels less elastic. “Studies sug-     in Providence, Rhode Island. “Maybe
drates.                                         gest that a diet high in animal fats may      people want to hear that if they eat a
TRUTH: If the Atkins diet                       cause blood vessels to constrict,” he         lower-fat diet they don’t have to eat
works, it’s not clear why.                      says. “That’s a root cause of atheroscle-     fewer calories, but that’s not true.”
                                                rosis.”                                          What about Taubes’s claim that low-
If the Atkins diet does work, it may               In preliminary studies, the LDL            fat diets are a failure “in real life”?
have nothing to do with the glycemic            (“bad”) cholesterol of people on the             Wing’s National Weight Loss
index or Atkins’s promises. “It’s               Atkins diet didn’t go up. That’s com-         Registry keeps track of people—so far,
unlikely to be related to the explana-          forting. (Of course, LDL didn’t go down       about 3,000—who report having lost at
tion in Atkins’s book,” says Klein,             either, as it usually does with weight        least 30 pounds and having kept the
“because that doesn’t make physio-              loss.)                                        weight off for at least six years.8 The
logical sense.”                                    “The harm caused by saturated fat          registry can’t “prove” which diet is best
   Other possibilities: In one study, the       could be overcome by weight loss,”            because it’s not a controlled experi-
people on a low-carb diet were told to          Klein explains. But what happens once         ment. But it does offer evidence of
follow Dr. Atkins’ New Diet Revolution,         people stop losing weight and start try-      what works in the long run.
which could have been more persua-              ing to maintain the loss? Will their             “People on low-carbohydrate diets
sive than what the people on a lower-           LDL climb? “We don’t know.”                   like Atkins’s are very rare in the reg-
fat diet got—a manual designed by                                                             istry,” says Wing.
academics.                                                                                       “The people in our registry consis-
   Or, says Klein, “it may simply be eas-                                                     tently report eating around 24 percent
ier to cut carbs.” Everyone knows what                                                        of calories from fat,” she adds. They also
they are: bread, pasta, rice, potatoes,
sweets, etc.
   Or, the monotony of a low-carb diet
could have curbed the dieters’ appetites.
“You lose a lot of foods when you cut
                                              “   It’s silly to say
                                                  that carbohy-
                                                  drates cause
                                                  obesity. We’re
                                                                                              expend roughly 2,800 calories a week—
                                                                                              that’s like walking four miles a day.
                                                                                                 Furthermore, a low-fat diet aided
                                                                                              weight loss in a six-year study of 3,200
                                                                                              people called the Diabetes Prevention
out carbs,” says Klein. And with less                                                         Program.9
variety, says Blackburn, “people eat              overweight
                                                                                                 “Patients were put on a low-fat diet
less, so they lose more weight.”                  because we                                  with about 25 percent of calories from


                                                                       ”
   “It’s also possible that a chemical is                                                     fat and they participated in 150 minutes
released by a high-fat diet that sup-             overeat calories.
                                                                                              of physical activity a week,” says Wing.
presses the appetite,” adds Klein. “We            —George Blackburn                              “They lost about seven percent of
just don’t know.”                                 Harvard University                          their body weight and kept most of it off
                                                                                              for four years. And they reduced their
CLAIM #8: The Atkins diet is safe.                                                            risk of diabetes by 58 percent.”
TRUTH: It isn’t.                                                                                 Of course, it was both diet and exer-
Taubes not only neglects to mention                                                           cise that led to their success. But if a
that the meat in an Atkins diet may                                                           low-fat diet promotes weight gain, as
promote cancer. He ignores some                 CLAIM #9: Low-fat diets don’t                 Taubes argues, the exercise—only
researchers’ concerns about other               help people lose weight.                      about 20 minutes a day—would have
adverse effects.                                TRUTH: Low-fat diets work if                  had to not only counter the fattening
   “The Atkins diet may produce more            dieters cut calories.                         effects of the low-fat diet, but actually
weight loss in the first three weeks, but                                                     lead to weight loss. Unlikely.
                                                “Low-fat weight-loss diets have proved
it’s not spectacular,” says Harvard’s           in clinical trials and real life to be dis-
George Blackburn. “Who cares if one             mal failures,” writes Taubes.
group loses a few more pounds than                It’s not clear which clinical trials he’s


6   NUTRITION ACTION HEALTHLETTER s N O V E M B E R 2 0 0 2
                                                  What to Eat
“   I told Taubes
    several times
    that red meat
                                                 Judging by The New York Times Magazine article, you’d think that experts were
                                                 in a tug-of-war over whether to endorse low-fat or low-carbohydrate diets.
                                                 Not so. Here’s what they agree on...and where they differ:
    is associated




                                                 1
    with a higher                                Cut saturated (and trans) fat. Forget Atkins. Experts agree that people
                                                 should cut back on saturated (and trans) fat. That includes burgers, french fries,
    risk of colon and
                                                 pizza, ice cream, and sweets made with butter, shortening, or stick margarine.
    possibly prostate                                “There’s a clear benefit from replacing unhealthy fats with healthy fats,” says
    cancer, but he                               Harvard’s Walter Willett. “The fat in poultry, fish, and nuts is much better than
    left that out.

                  ”
     —Walter Willett
    Harvard University
                                                 the fat in red meat and dairy.” Healthy fats also include salad dressings, mayon-
                                                 naise, cooking oils, and fish oils.
                                                     But the sky’s not the limit, as Atkins would argue. “We’re not working in the
                                                 fields and burning calories all day, so we need to pay attention to all forms of calo-
                                                 ries,” says Willett. “You can’t eat unlimited quantities of fats or you’ll gain weight.”




                                                 2
CLAIM #10: Taubes examined                       Don’t overdo carbohydrates. A high-carb diet can cause trouble for the
the evidence objectively.                        estimated 25 percent of Americans who have the Metabolic Syndrome, also called
TRUTH: He let his biases rule.                   Syndrome X or insulin resistance (see “Read My Lipids,” October 2001).
The New York Times Magazine isn’t the                “Too much carbohydrate will raise triglycerides, lower HDL cholesterol, and
National Enquirer. Readers expect The            make LDL small and dense, all of which raises the risk of heart disease,” says
Times to run articles that are honestly          Stanford University’s John Farquhar.
reported and written. Yet in August,                 That doesn’t happen to everyone. Syndrome X doesn’t show up in people
The Washington Post revealed that
                                                 who are not genetically susceptible, or in people who get too few calories or too
Taubes simply ignored research that
didn’t agree with his conclusions.               much exercise to be overweight. (In China, Japan, and other Asian nations, diets
   For example, The Post asked Taubes            are high in carbohydrates, yet heart disease rates are rock–bottom low.) But
why he made no mention of a review               many Americans are genetically susceptible, pudgy, couch potatoes.
of nearly 50 studies on weight loss in               “A high-carb diet is worse for overweight, underexercised people and for peo-
the National Heart, Lung, and Blood              ple from racial groups—Latino, Asian, Indian—in whom a higher proportion have
Institute’s 1998 Clinical Guidelines on          a genetic disposition to Type 2 diabetes,” Farquhar explains.
treating obesity. The panel of experts
                                                     But will a high-carbohydrate diet make you fat? Most researchers say no.
was chaired by Columbia University’s
Pi-Sunyer, who has served as president           Even people who get higher insulin levels on a high-carb diet don’t gain weight.
of both the American Society of                  “If anything, more studies show that insulin resistance protects against weight
Clinical Nutrition and the American              gain,” says Stanford’s Gerald Reaven.
Diabetes Association.                                Willett isn’t sure. “It may be easier to control weight if you cut back on refined
   “Anything that Pi-Sunyer is involved          starches, sugars, and potatoes,” he says. His new study is testing that theory.
with, I don’t take seriously,” said
                                                     In any case, it would be foolish to assume that the calories in fat-free carbohy-
Taubes. “He just didn’t strike me as a
scientist.”                                      drates will bounce off your body like Teflon. And it’s clear that some carbs—like
   If Taubes had written a news article          vegetables, fruits, and whole grains—are healthier than refined carbs like white
for the front page of The Times, com-            bread, soft drinks, and sweets.
ments like those would have ended his                “The type of carbohydrate matters,” says Willett, “just as the type of fat matters.”
career. But when it comes to reporting




                                                 3
about diet, the bar is set lower. Surely,        Look for a weight-loss strategy that works for you. Until more
the public deserves better.                      studies are done, it’s too early to say which diet makes it easiest to lose weight.
                                                 Some people may find it easier to cut back on bread, pasta, rice, potatoes, and
1
  Circulation 102: 2284, 2000.                   sweets, while others find it easier to cut back on fried foods, oils, salad dressings,
2
  Circulation 103: 1034, 2001.                   mayonnaise, and margarine. Just make sure that you cut calories, and that the fats
3
  www.nhlbi.nih.gov/guidelines/                  and carbs you do eat are healthy. “Most everyone agrees that we need to eat
  cholesterol/index.htm.
4
  Arch. Pediatr. Adolesc. Med. 154: 947, 2000.   more fruits and vegetables, that our grains should be whole rather than refined, that
5
  Am. J. Clin. Nutr. 76(suppl): 2908, 2002.      our protein foods should be lean, and that our oils should come from plants or
6
  Am. J. Kidney Dis. 40: 265, 2002.              fish,” says Penn State’s Barbara Rolls.
7
  www.nhlbi.nih.gov/guidelines/
                                                     “To say that experts don’t know what people should eat is deliberately mis-
  obesity/ob_gdlns.htm.
8
  Amer. J. Clin. Nutr. 66: 239, 1997.            leading.”
9
  New Eng. J. Med. 346: 393, 2002.


                                                                               NUTRITION ACTION HEALTHLETTER s N O V E M B E R 2 0 0 2      7

				
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