The country's hungering for alternatives to fad diets

Paul Terry

Published February 12, 2004

http://www.startribune.com/stories/1519/4371953.html

I'm finishing the second week of the South Beach diet 10 pounds lighter and 10 times grumpier. I peer at my sniveling scale and wonder, "What have we done to the American people?"

I'm part of a study group subjecting ourselves to popular diets in preparation for a medical conference where we'll advise doctors on what to tell patients who've joined the low-fat revolt. Perhaps I'm too glycogen-starved for clear judgment, but I think we should start by offering a big fat apology.

It's our role, we public health practitioners and healers, to be voices of reason, sources of credibility and a counterbalance to the extremes of food companies and fitness dilettantes that turn your desire for health and comfort into profit. If we were better at our jobs, it would be excruciatingly obvious that the fat/carb conundrum is a morbidly overweight deflection from the obvious. Sixty percent of us are too fat because we're consuming 60 percent more food than 20 years ago. That's it. No fat backlash conspiracy, no salvation through sirloin. Worse, we've dragged our children into this excess. Fast-food consumption by kids has increased fivefold since 1970. On average, that means 187 more calories each day and 6 extra pounds each year.

The fervor over Dr. Robert Atkins' highly publicized revelation that you should eat less fat after all made me reply with a loud, "So what!"

Pay attention here; the USDA reported that the percentage of calories consumed from fat dropped from 45 percent in 1965 to 34 percent in 1995, yet total fat consumption has increased since 1995. Is this some confusing physiological paradox, as the carb detractors claim? No. Consuming more calories has simply overwhelmed any benefits of lower percentage-of-fat consumption. You can do the math. According to a landmark 2002 study by the University of North Carolina, soft drinks went up an average of 49 calories since 1977, french fries up 68 calories, hamburgers up 97, Mexican food up 133. And here we are dickering about proportions of carbs vs. fats.

I'm not deflecting my responsibility as a health educator. I'm persuaded by some of the logic suggesting that our low-fat advocacy of past decades backfired. What if that advice to reduce fat inadvertently led to a nation of carb-abetted, insulin-spiked, insatiably hungry calorie junkies?

But even if decades from now we find, as I suspect, that the carb craze will have its own backlash, my newfound dieter's empathy compels me to say I'm really, really sorry. While you're squinting at food labels and being yo-yo'd by Oprah, Ornish and Atkins, those of us in medicine and health education don't offer a compelling alternative. Here's what we know for sure. There are two requirements for weight loss:

• Eat less.

• Move more.

Period. If you favor a scientific explanation: Expend more kilocalories than you consume and you'll reduce your BMI (body mass index). That's a tough message to swallow, which is why we're putting ourselves through popular diets to learn how to prepare a better recipe for success.

Now I return to the rigors of the South Beach diet. Tomorrow I get fruit back. I wonder if I can supersize that.

Paul Terry is president of Park Nicollet Institute and coauthor of "Well Advised: Your Guide for Making Smart Health Decisions."

It must be nice to have an uncomprimised sugar metabolism, to be able to be thin with only a bare minimum of discipline coupled with common sense choices (i.e.: pass on that cake, it has too many calories for little nutrition). It must be nice to be in this privilaged position, so you can look condescendingly down upon the stupid, fat, obese masses as you tell them "just eat less and exercise more".

People like this guy have no idea what it feels like to feel like you are going to die if you don't eat right now. They've never experienced extreme hypoglycemia - the shakiness, iritability, confusion, weakness, intense hunger. Nor have they experienced the uncontrollable hunger that comes with hyperinsulinemia and insulin resistence.

They have no idea what it feels like to be out of control with your eating your whole life. Do they honestly believe people who became morbidly obese are so stupid, so ridiculous, that they intentionalliy eat past satiety to get fat? Don't they realize the problem ISN'T the over eating itself, but the reasons WHY you want to over eat? They have no idea what a gift it is to find low carb for people like me. Low carb, and I say this with confidence that comes with personal experience, cures most physical reasons for obesity.

No, rather than look for real solutions to the motivating factors of over-eating, they just keep saying over, and over, and over "just eat less". It's kind of like telling someone with a stab wound "you know, you won't die if you can stop bleeding". People like him would rather pretend obesity is some moral flaw that is changed exclusively through will power. I guess he feels better about himself since he doesn't struggle with weight, and is therefore morally superior.

Unfortunately, there are an awful lot of doctors and medical personnel who think exactly this way. For 20 years, doctors told me to "eat less and exercise more." They never believed me when I told them that I did exercise and they never believed me when I told them that I was physically unable to eat less because when I did so I was unable to do anything except fixate on how hungry I was and I had too many responsibilities to put that much energy into not eating. Well, low carbing has proved to me that I was right and they were wrong.

THANK YOU, ItsTheWooo. Thank you.

ItsTheWooo,

An absolutely right-on, great, fantastically wonderful post. You are my hero!

Dee