The Diet Detective
By Charles Stuart Platkin
December 23, 2002

Can Bread Make You Fat?

In 1972, at the age of 10, I pleaded with my parents to get me the Dr. Atkins diet book so I could finally lose weight. I remember cutting out the bread, pasta, and rice, as well as the sweet things like cookies, candies, and cakes. I guess you're wondering - did I actually lose weight? Yes, of course - who doesn't lose weight if they cut out bagels, spaghetti, chocolate bars, and doughnuts?

Now ask me if I gained the weight back. Of course I did.

It's interesting that a diet that is 30 years old is now back in style - from hip New York SoHo gatherings to the L.A. Hollywood circuit low-carbohydrate, high-fat diets are gracing the covers of magazines and making news headlines nationwide.

The idea behind these diets is to drastically reduce your carbohydrate intake so the body will burn its own fat for fuel. In theory, this process changes your body from a carbohydrate-burning engine into a fat-burning engine.

I wondered - if a calorie is really just a calorie, then why would it matter if you are eating steak or bread?

Carbohydrates are not intrinsically fattening - it's the excess calories that make you gain weight. "In terms of pure energy usage, it really doesn't matter whether you eat a 500-calorie bagel or a well-balanced meal of 500 calories, when you look at weight loss or gain," says Eleftheria Maratos-Flier, M.D., senior investigator on obesity, Joslin Diabetes Center, and associate professor of medicine at Harvard Medical School.

In fact, to be precise, excess calories from carbohydrates (bread, bagels, pasta) are actually less fattening than are excess calories from fat (butter, mayonnaise, frying oils) because the body has to burn calories to convert excess carbohydrates into body fat - although the difference is negligible.

But the "calorie is just a calorie" theory doesn't tell the entire story, otherwise Dr. Atkins would not be enjoying his recent return to the spotlight. So what makes millions of dieters think that Atkins has a leg to stand on?

First of all, carbohydrates are typically metabolized quickly - which means you want to eat more, because you feel hungry again soon after you eat. On the other hand, when you eat fat (bacon, eggs, steak, etc.), it takes a much longer time to digest and, therefore, you feel fuller longer.

"A high-protein, high-fat breakfast, such as a mushroom-cheese omelet, stays with you longer than the same number of calories from a high-carb bagel with jam, thus curbing your hunger, which makes it easier to cut calories over the course of a day," says Dr. Maratos-Flier.

Another bonus of the Atkins approach is the all-important mental hurdle of dieting - rather than struggling to deprive yourself, this diet feels easy because it places no limits on the amount of meats, fats, eggs, cheese, and other tasty high-fat foods you can eat.

Finally, the Atkins diet has a tricky quirk of biochemistry on its side. As discussed above, both carbohydrates and fat provide fuel for the body's energy needs, with carbohydrates being the first fuel to be metabolized.

However, when you restrict your intake of digestible carbohydrates, at a certain point, the body converts from its primary metabolic pathway of burning carbohydrate for fuel to burning fat as its main energy source. This results in weight loss. This process is known to "Atkinites" (and the medical world) as ketosis.

"The problem with reaching a state of ketosis is that it is a very inefficient process and can cause problems such as reduced overall energy, endurance, and strength," says Robert Kushner, M.D., medical director of the Wellness Institute and the Nutrition, Fitness and Weight Management Programs at Northwestern Memorial Hospital and professor of medicine at Northwestern University Medical School.

And that's not the only downside of high-fat eating - there is hard scientific data supporting the importance of low-fat diets in reducing the possibility of heart disease and certain types of cancer. "These diets disregard years of great research about the role of low-fat diets in the prevention of disease," says Dr. Kushner.

Additionally, the high-fat approach requires that we eschew a wide variety of foods - including fruits and many vegetables - which have been shown to have extensive health benefits. "Our body is not like filling up the tank of the family car, where all that is used to make the engine run is gas. Our body needs a mix of fuel on a daily basis, including protein, carbohydrates, fat, water, vitamins, and minerals and if it doesn't get this 'blended' source of energy it can create problems for us," adds Dr. Kushner.

Beyond its dubious health effects, the Atkins plan fails to take key components of human behavior into account. To start, much of the premise for eating a high-protein, high-fat diet is that you simply eat less because you feel satiated, but this relies on an assumption that we only eat when we're hungry. However, this is not the reality for many of us.

"The idea that we eat only out of physiological necessity is a naïve way of looking at the problem," says Dr. Maratos-Flier. "We eat for many reasons, including entertainment, stress, celebration, habit (e.g. finishing all your food on your plate), or simply because it's there."

Another downfall of the Atkins plan is the long-term feasibility of sustaining this way of eating for the rest of your life.

"I think you'll be hard-pressed to find anyone who is able to give up bread, pasta, cake, and even fruits for the rest of their life. The Atkins plan gets great short-term results - but once you have a 'little taste' of bread, not only does it knock your body out of ketosis, but you may likely overindulge because you've been deprived for so long," says Dr. Maratos-Flier.

Simply put, people gain weight when they eat more calories than they burn. It does not matter if these excess calories come from carbohydrate, fat, or protein -- the trick is to find a way of eating healthfully that you can sustain for the rest of your life.

"Really moderation, combined with behavior modification, is the best, and by far the healthiest, way to lose weight - but unfortunately, that doesn't seem to satisfy the hunger of the masses looking for answers to their weight loss desires," reflects Kushner.

Charles Stuart Platkin is a syndicated health, nutrition and fitness writer, author of the best-selling book, Breaking the Pattern (Red Mill Press, 2002), and founder of Nutricise.com. Copyright 2002 by Charles Stuart Platkin

©Haddon Herald 2002

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