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The LOW-CARB FRAUD
By T. COLIN CAMPBELL, HOWARD JACOBSON
BenBella Books, Inc.Copyright © 2014 T. Colin Campbell
All rights reserved.
The Low-Carb Fraud
It's no secret that Americans struggle with weight loss. Since 1980, when the rise in obesity first caught the attention of the media, the national rate of obesity has doubled. Now, more than one-third of all U.S. adults are obese. And despite hundreds of new (or cleverly recycled) "solutions" hitting the shelves in book or prepackaged food form each year, we just can't seem to stem the tide. Our national weight problem is just the tip of the iceberg, however; being overweight is linked to some of the major causes of premature death, including heart disease, stroke, Type 2 diabetes, and some cancers.
This book is primarily about low-carb diets—one of the more financially successful, and one of the most health- threatening, solutions proposed to meet our desire to shed pounds and become healthier. We'll discuss why the low-carb diet is so appealing, how we've been tricked in thinking it's healthy, and the truth about its health impacts. But this book is also concerned with the beliefs about nutrition that underlie those things: where the belief that carbs are bad came from, and why it has persisted despite so much evidence to the contrary.
There have almost always been fad diets with varying degrees of scientific merit, some more effective than others. Several decades ago, and still to a certain extent today, the most trusted advice was, essentially: eat less and exercise more. Weight loss was a matter of arithmetic—calories in vs. calories out. But we were also told that dietary fat is the problem. Fat is what makes us, well, fat. So if we want to lose weight, all we have to do is consume less of it.
But as the national obesity rate rose, it was clear that this advice on fat just wasn't cutting it. The Standard American Diet (SAD) also wasn't cutting it. We needed to rethink the way we looked at proper nutrition. It was during the 1980s, in the wake of these rising concerns, that the low-carb movement began to take hold. It hit its stride in 1988, with the publication of Dr. Robert Atkins' New Diet Revolution, which was "new" only in that it followed Atkins' 1972 book, Dr. Atkins' Diet Revolution, which had not been especially successful in the marketplace. And this "new" book's contents represented an appealing alternate belief system about weight, nutrition, and health.
In a nutshell, the low-carb movement told adherents to severely limit their intake of carbohydrates and instead to get the lion's share of their calories from protein and fat. The problem with the SAD isn't fat, the book claims, but carbs—those found in bread, rice, and pasta, in fruit and starchy vegetables. The best way to lose weight, Atkins proclaims, is to cut back on carbs.
And it worked! By feasting on bacon and steak and butter, low-carb dieters actually did drop pounds. Which would be great, except for one important thing: the low-carb diet is not good for human health. Report after report has shown the ill effects of a high-protein, high-fat diet. It's just as bad, if not worse, than the SAD it seeks to replace.
In this book, I will explore a couple of important questions: Why do people think low-carb diets are a good idea? What's the truth behind the low-carb hype? What's the truly optimal diet for achieving an ideal weight while also obtaining health and longevity?
If there's one thing I hope you'll take away from this book, it's this: the low-carb diet's ability to bring about quick weight loss is far outweighed by the serious health problems that accompany such an animal foods–heavy diet.
The Low-Carb appeal
I've spent more than forty years in experimental nutritional research, first at Virginia Tech and then at Cornell, keeping up with the latest discoveries and doing my own work, both in the lab and in the field. And as a nutritional researcher, I was surprised at first by the popularity and commercial success of the low-carb diet, especially given its serious flaws. The research on high-protein, high-fat diets has consistently demonstrated that they have disastrous health effects and fail to secure compliance and long-term weight loss. So I think it's useful to point out some factors that have contributed to these diets' appeal.
It's easy to imagine why dieters might be swayed—both then and now—by the idea of trying something radically different. Millions of Americans are on diets. Food manufacturers and marketers flood the marketplace with foods designed to help us lose weight and keep it off. Television features a steady stream of infomercials touting new gadgets, exercise routines, pills, and powders that can help us shed those unsightly pounds. And, apparently, none of it is working.
For a shocking visual, compare these two slides, taken from a CDC presentation. The first slide shows data from 1990 and is far from ideal:
Forty-six of the fifty-two states and other U.S. jurisdictions report adult obesity rates between 10 and 20 percent, with obesity defined as a Body Mass Index (BMI) greater than 30. No state has an obesity rate above 20 percent.
Now look at the data from 2010:
Just twenty years later, the thinnest states—with obesity rates under 25 percent—are all heavier than the heaviest states in 1990. And twelve states have cracked the 30-percent-plus mark.
The 2011 data, which haven't made it into the slideshow yet, include a new category: 35 percent or greater adult obesity rate.
While it wasn't strictly necessary to add that category (Alabama came closest, with a 34.9 percent rate), the CDC were obviously planning ahead.
Given the huge diet industry and its stunning lack of effectiveness, it's only natural that alternative approaches would gain popularity. Low-carb was the alternative that gained the largest amount of public acceptance and hence the greatest market share. But why did low-carb beat out the other nontraditional approaches?
One of the main answers is marketing rhetoric. On this point, I have to take my hat off to Robert Atkins. One of the major themes of my new book on nutritional science, whole: rethinking the science of nutrition (2013), is that paradigms, or entrenched ways of seeing the world, are devilishly hard to change. But Atkins and his supporters turned a century of nutritional wisdom on its head, framing dietary fat and cholesterol as nutritional heroes and attacking anyone who pointed to research showing otherwise. They gave Americans permission to eat huge amounts of some of the unhealthiest foods on the planet, and to do so not only without guilt, but with feelings of pride and superiority. The most impressive legacy of the Atkins craze is a linguistic achievement: coining the phrase "low-carb" and thereby turning most plant foods—which were previously considered the healthiest dietary choices—into dangerous and fattening no-nos.
The appeal of this was immediate, for obvious reasons. After decades of believing that losing weight was possible only by subsisting on salads, depressing lunches of grapefruit halves and fat-free cottage cheese, and diet sodas that taste like battery acid, people were told to eat as much as they wanted of their favorite foods: steak, bacon, butter, lard, cream cheese, olive oil, mayonnaise, and eggs. Eating was fun again!
And lo and behold, people found that—in the initial stages of this diet—they did lose weight. It seemed like the very foods that doctors and public officials had been warning against all those years actually promoted weight loss more effectively than the tasteless zero-fat processed foods that took all the joy from eating.
Not only could the Atkins followers sate their fat- and protein-cravings without guilt, they could even feel superior to the poor fools who were still eating salads, going to weight-loss meetings, and counting calories.
The Atkins Diet didn't just appeal to dieters; it was a boon to the meat, dairy, and egg industries as well. Not only could these companies now fend off public criticism of their products with low-carb "science," but they also saw greater sales.
The Low-Carb Landscape
Not all low-carb diets are created equal, of course. The low-carb universe Atkins brought into being has grown to encompass many different diets and eating philosophies. But these are distinguished more by marketing than by substance—they all share the same fear and loathing of carbohydrates and recommend getting most of one's calories from protein and fat.
While Robert Atkins is the father of the modern low-carb movement, he didn't come up with the low-carb concept, something he freely admits in his books. The first person on record as having used this type of diet was William Banting, a British undertaker, in the 1860s. Banting, at the age of sixty-six, tried a low-carb diet at the recommendation of his physician, Dr. William Harvey. He lost body weight in the first few weeks and commented that he might like to continue the diet—though the longer-term results of Banting's alteration in diet, to my knowledge, were never clear. A few other medical practitioners experimented with low-carb diets with their patients over the next century, but the idea didn't enter mass public consciousness until the 1972 publication of Dr. Atkins' Diet Revolution.
Riding the wave of the low-carb diet's near-term success, Atkins authored many additional books before his passing in 2003. His professional career morphed into an empire; as of this writing in 2013, the 1988 Dr. Atkins' New Diet Revolution has sold more than 15 million copies, and Atkins Nutritionals, Inc., which produces and licenses Atkins-approved products, achieves annual sales in the millions of dollars. The Atkins Foundation funds research on the low-carb diet as it relates to obesity, Alzheimer's, prostate cancer, and other diseases. And the Atkins empire perseveres, despite its founder's death and a descent into bankruptcy following company mismanagement in 2004–2005; its present-day business still claims a big piece of the weight-loss market.
Smelling profits, many other doctors and authors put their own spin on the low-carb phenomenon and created their own books, diets, and products. Most prominent among them are Mary Dan and Michael Eades' Protein Power (1995), Barry Sears' Enter the Zone (1995), Peter D'Adamo's Eat Right 4 Your Type (1997), Loren Cordain's The Paleo Diet (2002), Arthur Agatson's South Beach Diet (2005), and Eric Westman's The New Atkins for a New You (2010). Like younger siblings struggling to stand out, these various authors and their supporters go to great lengths to distinguish their "correct" diet from the others. The South Beach Diet prefers olive oil to butter and emphasizes leaner cuts of meat. Protein Power adds lots of water and nutritional supplementation to compensate for the low-carb diet's inadequacies. Enter the Zone seemingly dismisses the low-carb idea by recommending "only" 30 percent protein but still relegates carbs to less than half your total calories. (That's still low carb!) Even The Paleo Diet, despite its positive emphasis on whole foods, is just another version of the same low-carb, high-protein, high-fat idea (see Appendix). These spinoffs all occupy the same very thin slice of the human diet continuum.
In addition to their carbophobia, these authors have two other things in common: no experience in scientific research and a vast fortune generated by the sales of their shakes, powders, extracts, oils, bars, and even chocolates, along with a second fortune amassed through licensing their trademarked seal of approval.
The net effect of all this differentiation and marketing has been the normalization of low carb on a cultural level. Restaurants routinely offer low-carb menu options. It's expected that someone watching their weight will bypass the dinner rolls. And whereas twenty years ago you would have raised an eyebrow (and a few concerns for your sanity) were you to sit down to a meal of bacon, butter, and beef for the purpose of shedding pounds, these days that's a perfectly normal approach to weight loss. When absurdities get repeated often enough, they start sounding like truth.
The Real Truth About Low-Carb Diets
As I mentioned, low-carb diets are often pretty good at bringing about short-term weight loss. But that benefit comes with huge downsides. Low-carb diets target excess weight without paying attention to the underlying cause or causes of that weight, which leads to other symptoms. Low-carb diets often make those other symptoms, as well as the cause itself, worse.
What's the difference between attending to a cause and treating a symptom?
A brown lawn, for example, is a symptom. It's an unsightly, possibly embarrassing symptom that could get your neighbors shaking their heads and talking about you behind your back. "Look how he lets his lawn go," they might mutter. "Why doesn't he do something about it?"
So along comes the lawn-care specialist with a solution to your problem: green paint.
Well, not exactly.
After painting the grass, your lawn will look green temporarily, but eventually the paint will wear or wash away, and then you have to call the lawn painter back in. The paint doesn't do anything about the poor health of the grass that led to it turning brown in the first place. And if the paint is toxic, it can even make the health of the grass worse. If you really want a lush green lawn—a healthy lawn that is naturally green—you need to improve the soil: add nutrients, remove toxins, water appropriately, and use the right grass seed for your environment. In other words, focus on the root causes, not just the visible symptoms.
If you want to lose weight, focusing solely on weight loss—as the low-carb diet does—is as unproductive as painting your lawn green.
The low-carb diet's first major flaw is that it's short term. Over the long term, low-carb diets don't fulfill their promise to dieters, which is that the diet will help them reduce their weight and sustain the change. Observation studies of populations overwhelmingly show that high-protein, high-fat diets, which reflect the long-term consumption of animal-based and highly processed food products, are associated with more health problems, many of which are associated with obesity.
Americans are getting heavier and sicker, despite all the modern advances in medical care and technology. We're making no significant inroads in reducing rates of cancer, heart disease, stroke, diabetes, and dozens of other diseases intimately connected with obesity. It's just that, unlike diabetes or high blood pressure, obesity is a more visible symbol of the problem.
In truth, the obesity epidemic and the health crisis are two sides of the same coin. You can't solve one without solving the other. That's as true on an individual basis as it is for society as a whole. Obesity is a symptom, just like hypertension, clogged arteries, angina, chronic shortness of breath, belly pain, dizziness, constipation, and hundreds of others. Yet we largely, and wrongly, treat obesity as if it's a separate thing—a separate disease.
While there's a lot of overlap between a healthy body weight and overall health, they aren't synonymous. You can lose a lot of weight by getting cancer, and you can keep it off by dying, but I don't recommend that approach! Charitably, we could say that low-carb advocates are using weight loss as a Trojan Horse to get people to improve their diets and overall health—although there's little evidence for this generous interpretation. As Atkins himself was both obese and quite ill from the known consequences of a high-protein, high-fat diet at the time of his death, it's clear that this community isn't taking seriously the damning data on long-term health outcomes.
Two original research papers reveal more about the consequences of the Atkins Diet than any others because they were published by supporters of the Atkins Diet and were funded by the Atkins organization. In one paper, users of the Atkins diet, when compared to control subjects of "low-fat" dieters (dieters who were getting "only" 30 percent of their calories from fat), suffered more constipation (68 vs. 35 percent), more headaches (60 vs. 40 percent), more halitosis (38 vs. 8 percent), more muscle cramps (35 vs. 7 percent), more diarrhea (23 vs. 7 percent), more general weakness (25 vs. 8 percent), and more rashes (13 vs. 0 percent)—even those Atkins diet users who were taking vitamin supplements. In the other paper, similar prevalences were seen for the Atkins dieters for constipation (63 percent), headaches (53 percent), and halitosis (51 percent).
These Atkins Diet side effects are consistent, and the research is quite convincing. That is, when compared with the already poor Standard American Diet (SAD), which is high in fat and protein, the Atkins Diet, even higher in fat and protein, leads to far more negative health outcomes, even in the short term.
So why do dieters still believe the low-carb hype? It has a lot to do with how convincing the low-carb movement's arguments sound—even though those arguments are consistently contradicted by the science.
Excerpted from The LOW-CARB FRAUD by T. COLIN CAMPBELL, HOWARD JACOBSON. Copyright © 2014 T. Colin Campbell. Excerpted by permission of BenBella Books, Inc..
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