The heated conversation around America's water coolers these days is often about losing weight. Aside from the water in the cooler, there is little agreement about the best foods for dropping pounds.
Reports in a recent New England Journal of Medicine seemed to give the weight-loss edge to low-carbohydrate regimens, but the scientific seesaw will continue to teeter.
Whatever the medical journals say, dieters in the Atkins faction will gobble their bacon and eggs, while Dr. Dean Ornish devotees steam their lentils. Add in "The Zone," "Sugar Busters," the Mediterranean diet and others, and you have a recipe for national dietary discord, dividing husband and wife, parent and child and co-workers alike.
Can't we all just get along while we diet?
Actually, many of these diets do agree on at least one thing: Americans are overloading on concentrated sugars and refined starches. From the sugar in soft drinks to super-size processed-flour foods like white bread and bagels, this is a food category that is contributing to the bulging of American waistlines. And it may be that these kinds of foods contribute disproportionately to obesity.
"Nobody who has legitimate nutritional credentials is saying that starch and sugar is good for you," said Dr. David Katz, director of the Yale Prevention Research Center and author of "The Way To Eat." Katz observes that the food group "carbohydrate' is impossibly huge, encompassing everything from garbanzo beans to Gummi Bears. But the garbanzo beans aren't the problem.
According to federal data, from 1970 to 1994 the consumption of high-carbohydrate snacks increased by 200 percent. The use of wheat flour increased by 35 percent, corn flour by 79 percent and grain mixtures (such as pizza base) by 115 percent. That includes a lot of chips, crackers, muffins and tacos.
Readers may doubt that dueling diet gurus can agree on the dangers of overdoing these kinds of food when their dietary schemes seem to differ most on the issue of carbohydrates. On one end, there is Ornish's very-low-fat diet that is rich in carbohydrates. On the other stand the heirs of the late Dr. Robert Atkins, who believe carbohydrates are the problem.
Ornish said he encourages people to get their carbohydrates from complex carbohydrates like beans and whole grains, not simple sugars and starches. And Colette Heimowitz, director of education and research at Atkins Health and Medical Information Service in New York, explains that if people properly follow the four phases of the Atkins diet, they will eventually (at Phase 4) begin adding back complex carbohydrates -- like whole-grain foods -- into their diets.
"The white flour, the white sugar -- the refined and overly processed carbohydrates -- are the only bad ones, even from the Atkins standpoint," she notes.
There are several problems with refined carbs. One is that Americans are eating too many of them and in portions that are too big. Marion Nestle, a professor who chairs the Department of Nutrition and Food Studies at New York University, says that foods made of processed grains and those with added sugars are key players in the super-sizing phenomenon.
"Just think about bagels, muffins, the size of potato chips packages, the size of snack food packages, the size of French fry portions in fast-food restaurants and (the size of) soft drinks in movie theaters," she says. "One bagel is a quarter of the (recommended) caloric intake for one day for most people."
The super-sizing trend alone, she said, explains where the extra calories are coming from that are causing a rise in obesity and overweight in the United States.
Another problem is that it's easy to over-indulge in these foods because of what's inside them -- or not inside them. Ornish notes that that "you can consume large amounts without getting full, since the fiber and bran (that make us feel full) were removed or were not present."
And finally, it may be that the calories from concentrated sugars and refined starches are more likely to inflate the old spare tire than calories from other foods -- a possibility that is being studied and debated intensely by nutritional scientists. The body quickly absorbs such foods, and this fast action causes glucose (sugar) levels in the blood to soar. In response, the pancreas floods the bloodstream with insulin in order to regulate blood sugar.
Carbohydrates have been rated by their ability to cause such a jump in blood sugar levels -- and a corresponding spike in insulin -- on something called the glycemic index. Dr. David Ludwig, director of the obesity program at Children's Hospital in Boston, said that high-glycemic index foods appear to promote over-eating, and they may cause metabolic shifts that could cause an individual to gain fat. Ludwig said that a low-glycemic index diet provides the same blood-sugar control promised by the Atkins diet but without the same dietary restrictions.
Controlling insulin is the name of the game, said Barry Sears, creator and proponent of "The Zone" diet. He's big on most vegetables as a source of carbohydrates but said some -- like carrots and potatoes -- provoke too large an insulin response.
Introducing the glycemic index, however, produces some cracks in the unity about simple carbohydrates, since not everyone agrees on exactly what constitutes a "bad" carb.
Yale's Katz says relying too heavily on the glycemic index for guidance can be a mistake. He noted that foods are usually eaten in combinations, and this changes the absorption rate and insulin response. A diet needs to be about healthful choices, he said, and a carrot is a much better choice than an ice cream cone -- although ice cream is lower on the glycemic index.
Diet expert Dr. Xavier Pi-Sunyer, director of the Obesity Research Center at St. Luke's-Roosevelt Hospital Center in New York City, notes that the Mediterranean diet -- as followed in such countries as Italy and Spain -- includes some white-flour breads, along with rice and potatoes. "There is not much evidence that I'm aware of indicting starches," he said.
"We're eating too much of everything," he added. "It's kind of pointless to indict (one thing) as a bad guy. ..."
Indeed, diet authorities generally agree that calories count, that (most) fruits and vegetables are good, that trans fats -- largely from processed vegetable oils -- are bad (the Atkins camp dissents over saturated fat) and that exercise is required for optimal health.
Kelly D. Brownell, professor of psychology at Yale University and director of the Yale Center for Eating and Weight Disorders, said people who want to lose weight need to figure out what nutrients they're overeating and decide what type of diet makes sense. Any diet that cuts calories can work, he said.
"There are best approaches for individuals," he said. "What might be highly effective for one person will fail utterly for their next-door neighbor."
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