Monday, February 13, 2006

America's Food Fad Seesaw

Did you notice the firestorm that blew across the U.S. last week? Well, actually it wasn't a real firestorm but a metaphorical one.

The results of a 10-year, $415 millon study of women between the age of 50-70 years old was published in the New England Journal of Medicine. The popular interpretation of the findings was this - eating a low fat diet had no statisically measurable deterrent effect on a woman's chance of getting heart disease or colon cancer.

Since its release last Tuesday there have been a spate of reports in the news media speculating on the implications of this study. Some health and nutritional professionals criticized the study's design, pointing out that it didn't distinguish between good and bad fats and that this older population of women needed more than 8 years of study to show the effects of changed diet on their health. Many also warned that people might jump to the wrong conclusion - i.e that you don't have to worry anymore about loading up on Big Mac's and doughnuts because this study showed it won't make any difference to whether or not you develop heart disease or cancer.

Some segments of the food industry, especially fast food joints, are probably ecstatic about these findings. But others, particularly packaged foods companies like Kraft etc. are concerned because they will now have to rethink their decade long campaign to market low-fat products as healthy. The weight-control industry finds itself in a similar dilemma because most diets are built around the principle of consuming low-fat foods.

An article in Today's Boston Globe offers the sound perspectives of professional nutritionists on this hullaballou - pointing out the limitations and flaws of this study and why it is downright dangerous to draw any general conclusions about the health effects of diet from it. There are also several sage nuggets of advice about eating offered by the nutritionists. Here are the best ones:

"Eating well never has been, is not, and never will be about deciding which of only three nutrient classes to abandon," says Katz. ''Rather . . . it always will be about making good choices within all three." He emphasizes plenty of fruit and vegetables, whole grains, lean protein, healthy oils from nuts, seeds, olives, and avocados, plus a ''modest" amount of wine and dark chocolate."

"You have to find the balance," says Brennan of the Mass. General clinic, where clients have been referred by physicians for weight loss. Diet alone doesn't determine success, she says, but ''how much you're eating." All the attention in the last decade on low-fat vs. low-carb tended to obscure one important element of weight loss, she says. Calories in, calories out is still the key."

"So for a while dieters concentrated on low fat or fat substitutes but ate just as many calories in sugar and other carbohydrates. Then they turned to high-fat, low-carb programs, which are difficult to sustain and not recommended for heart health. Now the worry is trans fats. But, Brennan cautions, just because a product has no trans fats does not make it calorie-free. She gives the example of a trans-fat-free muffin that instead has saturated fats and plenty of calories."

"Judy Phillips, senior nutritionist at the South End Community Health Center's Weight Initiative Now program, agrees that moderate changes have more long-lasting effect. But despite the constant barrage of information about various diets, the general public has a huge knowledge gap. ''People know they shouldn't be giving kids Cokes, but they don't know about calories in juice."

"Katz wonders if many people seize on the apparent confusion about diets to give them license to eat the way they want. If the experts can't seem to make up their minds, he says, the public view is sometimes, 'I'll be in Burger King when you guys sort it out.'

''I think science and anthropology converge on a dietary pattern of roughly 55 percent of calories from almost exclusively complex carbohydrates," foods that include fruit, vegetables, legumes, and whole grains. Protein (20 percent) and fat (25 percent) make up the rest."


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