Why Low-fat's in the Fire

By Mike Buzalka

A blaring headline on the over of The New York Times magazine this past July 7 asked the shocking question, "What If Fat Doesn't Make You Fat?" In case you missed the point, the blaring block-type challenge was accompanied by a border to-border picture of a rather fatty t-bone steak topped with a pat of butter.

Soon, other major media outlets latched on to the story. ABC News, for example, produced its own segment on the topic for the 20/20 newsmagazine a few weeks later.

The gist of the "expose" is that the U.S. government and the nation's nutrition and diet a establishment endorsed and continue to endorse low-fat diets despite growing evidence that they not only don't work as well as advertised, but are potentially dangerous because they may raise the risk of coronary disease and cause dieters to over-eat.

As a result, say critics, millions of Americans who have followed mainstream nutrition guidelines (as epitomized by the Food Guide Pyramid), and cut the fat in their diets, may today be not only less healthy than they might have been, but more likely to be overweight and at greater risk of heart attacks, strokes, diabetes and other ills. It's not hard to see why this story has legs. Food and dieting have been national obsessions for decades, and especially so today, given the country's prevalence of obese citizens. If the low fat approach's critics are right, then not only is a mainstay of prevailing diet theory blown out of the water, but so likely is the credibility of the government and the mainstream nutrition establishment on the subject.

That would have significant consequences for, among other thing, the National School Lunch program, whose mandate that no more than 30% of school meal calories come from fat rests on the reduced dietary fat theory.

Meanwhile, FSDs and others on the front lines of the eat-away-from-home industry may face a whole new set of demands for meal options from consumers utterly at a loss as to what to believe anymore. Will the cafeteria of the future come with three grades of everything-low fat, medium-fat and high fat-to satisfy competing approaches?

Not surprisingly, mainstream dietitians are urging caution.

"For sure we need research on how to lose weight," says Julie O'Sullivan Maillet, president of the American Dietetic Association and chairperson of the department of primary care and associate dean for academic affairs and research at the University of Medicine and Dentistry of New Jersey-School of Health Related Professions.

"We Americans like to find the easy fix. We tend to like something that focuses on `less of or `more of something, such as fat, when the real issue is calories and exercise."

Maillet notes that a healthy diet can accommodate varying amounts of fat. She cites the lauded Mediterranean diet, which emphasizes high-fat olive oil, as an example.

"Total fat is too simplistic," she says. "We need to consider the different types of fat-saturate, unsaturated, trans-fatty-- in the diet and balance appropriately." She adds that the overall proportion of fat in a healthy diet is important primarily as a tool to control calorie intake to manage weight.

"Fats are more calorically dense," she notes, "so it's reasonable to limit the amount you take in. Diets should be individual." to best meet the needs of each individual."

Where's the beef.

Be that as it may, fat is ultimately not the major issue in the controversy. Even Times article author Gary Taubes admits that research supporting high fat diets is as incomplete as those supporting low-fat diets.

What is the issue, critics like Taubes note, is the unseemly-and unscientific-haste with which the government blessed the low-fat diet approach back in the late-1970s before it had any compelling clinical proof that it had any merit Since then, a series of studies costing hundreds of millions of dollars have failed to establish a definitive link between dietary fat and heart disease.

Indeed, if anything, some of those studies suggest just the opposite, that fat in the diet-even from animal sources like beef and pork-actually makes for better coronary health, by raising levels of high-density lipoprotein (HDL, or "good" cholesterol) in the body.

On the other hand, low-fat diets rich in the simple carbohydrates emphasized by nutritionists and the government's Food Guide Pyramid (rice, pasta, bread) tend not only to raise the body's levels of triglycerides-a substance increasingly linked with heart disease-but to encourage overeating by short-circuiting the body's appetite regulation mechanism.

In effect, the low-fat message may have sent millions of Americans to fill up on exactly the kind of foods that would induce them to overeat and be more prone to heart attacks.

Though the charges are incendiary, the details remain highly technical and speculative. But one fact is difficult to dismiss out of hand: obesity and its attendant evils began inching upward in the population at about the same time (the early 80s) that the low-fat message was taking hold.

Coincidence? Maybe.

After all, the last 20 years also saw the advent of the super-size combo meal, the introduction of all sorts of labor- (and exercise-) saving devices and an explosion of snack foods, fast foods and sugared beverages.

Still, other Western cultures had access to the same excess, but only the U.S., the nation where the low-fat dogma most holds sway, has super-sized both its meals and its consumers at epidemic levels.

Ironically, where this issue goes from here rests with the government. That's because, after years of belittling critics of the low-fat approach as eccentrics and cranks whose theories merited no serious examination, the National Institutes of Health recently did an about face and agreed to find comparative studies of various diet approaches.

Among those being studied are the heretofore officially ostracized high-protein (and, in effect, high-fat) diets that are the polar opposites of what NIH and other mainstream diet experts have been recommending for the past 20-plus years. If those studies track toward confirming that fat in the diet is less harmful than previously thought never mind beneficial-it could trigger a fundamental shift in mainstream dietary theory as significant as the release of the original Dietary Guidelines for Americans in the early 80s.

What could follow? Certainly, a rethinking of the Food Pyramid, which would almost literally have to be stood on its head. The school lunch program could also likely get a major revision, probably back toward the original "four food groups" approach and its emphasis on meat and dairy.

And...well, Dr. Atkins for Surgeon General anyone?

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Last modified: May 14, 2008