On The Importance of Asking the Right Question

Unless you live under a rock, you're well aware that since the July 2002 publication of Gary Taubes' well-researched and much-debated article "What If It's All Been a Big Fat Lie?" in the New York Times, 'low carb' has gotten an enormous amount of press. Unfortunately, much of it has been in the form of "Atkins vs. Ornish" debates - debates that never have enough time for the participants to finish more than a sentence or two at a time let alone go over in detail any of the research being discussed or make clear what the diets are REALLY all about. Beyond that, the "A diet vs. O diet" debate is missing the whole point, as far as I'm concerned. And you know what, I'm getting pretty darn mad about it. (If you know me at all, you know it takes an AWFUL lot to make me mad.) So, be forewarned that this is not going to be quite like anything I've written before, and it may not be very nice...

You may be wondering why I, of all people, am writing about this. Wasn't I recently an audience guest on the Donahue show during one of these "A vs O" debates? As a matter of fact, I was. I was hoping that getting my story out there (as far as it has gone so far!), along with the stories of other low carbers, could be a definite step in the right direction. And I hope it was; my wish is that that someone out there in TV land was given some hope. Even better, maybe they dusted off their old copy of Dr. Atkins New Diet Revolution (seems like a lot of folks have one of these floating around their house somewhere) and started to re-read it. That was why I agreed to show my "fat pictures" on national TV, as painful as it was. And that's what made me mad...

I'm not going to go into all the things that happened at the NBC studios that day - suffice to say that this ignorant Bronx girl saw the tip of the immense iceberg of work and sweat that goes on behind the scenes to make a television show - especially one with guests that don't exactly see eye to eye. What struck me then, and still surprises me when I think about it, is the severe TIME LIMIT under which the whole thing was running. As has already been mentioned on the various low carb websites, the hour long show seemed to have a half hour of commercials. In that short time frame, Mr. Donahue interviewed seven audience guests, three main guests, and took questions from the audience - no small feat, considering he was working mostly with folks not trained to speak to the cameras! You could see that the whole focus was (and understandably so) to create something that would grab an audience's attention and keep them from clicking away to the hundreds of other digital destinations that are always as close as their remote.

Enter the "Atkins vs. Ornish" debate...

What could be more attention-grabbing than a video clip of sausages frying in their own grease, while the voice-over says, "Can you really eat all the bacon and sausage and red meat you want and still lose weight?" (And in case you didn't know it, the answer is, NO YOU CAN'T. But we'll get to that later.) Or how about this: tell overweight, junk-food addicted Americans that they need to eat only vegetables, brown rice, fruit and seeds and meditate their cravings away! That'll get them going - or rather, keep them watching. In short, Atkins vs. Ornish APPEARS to the uninformed to be a "battle of the extremes" - something which television people seem to think (or know?) will get folks watching and keep them hooked for the hour. I can't speak to the Ornish plan - since I don't follow it. Though if you or someone you know is a vegan or vegetarian for moral or spiritual reasons, that's a whole different affair, and I take my hat off to you in respect for following your convictions. (In any event, my toxic sweat and the reduced blood flow to my brain makes it hard for me to understand all these complicated things. See Dr. Ornish's website for further details.) But I can speak to the Atkins approach - NOT as an expert - but as someone who's been following it with a little success (as in, I've lost 80lbs as of this writing and I'm not dead yet). And in that light, I have to say that the media is totally MISSING THE POINT because they're asking the WRONG QUESTION.

The Atkins vs. Ornish debate is merely a distraction from the RIGHT Question:

DOES THE ATKINS DIET (or any other low carb diet) WORK, AND DOES IT DO SO WHILE KEEPING YOU HEALTHY?

SO FAR studies are suggesting that it does. Studies at prestigious universities. Studies done by well-known researchers. Studies done by people who went into the study with the ASSUMPTION that the Atkins Diet would raise cholesterol and be too hard for people to follow - studies that had exactly the opposite result! And these are results that are being duplicated in various places - an important point. Now, officially, the jury is still out. We're all anxiously awaiting the results of the five year study being done by the National Institutes of Health. As all the researchers are so fond of saying, "We need more and longer studies..." But for now, things are looking pretty good.

This is not to say the the Ornish approach doesn't work, too. I see people it's worked for. And I think that's great. And they don't have toxic sweat, bless their hearts. Alright, sorry - it's hard not to go there. Seriously, though, I'm all for WHATEVER you can do to get yourself healthy. My personal opinion is that neither low carb NOR low fat work for "everyone". But constantly pitting the two plans against each other is NOT doing ANYONE a service. The mis-characterization of both plans ( sausage vs birdseed ) doesn't help anyone figure out which plan they should be following.

In Order to Focus on the RIGHT QUESTION, people need to understand what the WRONG questions are. I'll give you a few examples of THE WRONG QUESTIONS (which needless to say, are the ones that get asked over and over and over again...):

WRONG QUESTION #1: "How can eating all the bacon and sausage and red meat you want be healthy?"

THE ANSWER TO WRONG QUESTION #1: The Atkins Diet IS NOT a "sausage and bacon and steak" diet. Where do the people perpetuating this myth think we get all the money it would take to eat this stuff every day, may I ask? And even those who ARE rolling in dough - bad choice of words there, sorry - know that the nitrites in sausage and bacon are to be avoided because they're just plain unhealthy. So yeah, some of us choose to eat sausage and bacon occasionally, and we certainly eat more red meat than some folks would like to see. But no, that's not ALL we eat. Chicken, fish, turkey, tofu, and other sources of protein make up way way more of our diets than sausage and bacon and (for me) even beef. And you can't "eat all you want" - NO DIET can promise this (unless they want to explain it to the FTC). Low Carbing is NOT an "eat all you want diet". Never was, never will be. ANYONE WHO'S ACTUALLY TAKEN THE TIME TO READ DR. ATKINS BOOK will know that "it's not that calories don't count, it's just that you will burn more of them, with less hunger, when your body is operating on a fat-based metabolism" (DANDR, p.18) They'll also know that Dr. Atkins says "Am I advocating a high-fat diet? Not in the long run. As you increase the percentage of carbohydrates, while advancing through the different phases of Atkins, the percentage and actual amount of fat you consume will diminish." (DANDR, p. 22)

WRONG QUESTION #2: "How can eliminating whole food groups be healthy?"

THE ANSWER TO WRONG QUESTION #2: When you follow the Atkins diet, you don't ELIMINATE WHOLE FOOD GROUPS. HELLOOOOO, IS ANYONE HOME????? We need people who have been following this diet to stand up and say, (like Kim Debus did on the Donahue show) "I eat more vegetables now than I EVER did!!!". Which whole food groups are eliminated by the Atkins diet, I'd like to know? Not veggies, certainly. Not fruit or whole grains - you'll add those back in progressively after the first two weeks. (Did I mention that you add fruit and grains back in little by little after the first TWO WEEKS?) So what do we eliminate? UM, let me see...potato chips! That's it, the potato chip group! Gosh, the health risks of that are appalling, really... no, no, I know - the LOW FAT FOOD GROUP. You know - low fat cookies, low fat cheese, low fat snack bars - all that high fructose corn syrup stuff. Now that REALLY is awful, isn't it? Again, if the people saying things like this would just READ THE BOOK...but chances are they are NOT going to read "the book", so you know what? WE HAVE TO BE THE BOOK.

WRONG QUESTION #3: "If I go off the Atkins diet, will I gain all my weight back?"

THE ANSWER TO WRONG QUESTION #3: If you go off the Atkins Diet and return to your former ways of eating, you will MOST CERTAINLY gain back any weight you lost. ABSOLUTELY. But then again, if someone who had lost 100 lbs by eating brown rice, tofu and seeds went off their diet and returned to their former eating patterns THEY WOULD MOST CERTAINLY GAIN BACK ALL THE WEIGHT THEY'D LOST AS WELL. Frankly, the accusation that "when you go off Atkins you pile on the pounds" is the stupidest, most ignorant excuse for an excuse one could come up with. I wish I didn't even have to bring this up, but people keep repeating it so often that if you don't take a minute to stop and think about it, you'll find yourself going off the cliff with the rest of the lemmings. A better Question would be "which type of diet produces the best long term results?" - and I'll get to that later.

WRONG QUESTION #4: "There's no way you can lose weight on Atkins if you're eating all that fat. Fat has 9 calories per gram, while carbs have only have 4 per gram. After all, in the long run, its only calories that count, right?"

THE ANSWER TO WRONG QUESTION #4: YES YES YES. This is all true. Calories count, and fat is more energy-dense than carbohydrate, gram per gram. The question is not, does your caloric intake have to be less than your caloric expenditure. That's a given. The RIGHT QUESTIONS ARE:
1. How does one apportion those calories to be able to make the reduction in calories sustainable by the average person? AND
2. Are there any factors that change how nutrients and calories are processed by the body - are there things that would "modify the equation" so to speak?

Here are some answers:

1. Fat makes you feel full. So, eating more of it makes you tend to eat less food in total. How about that for logic? In fact, one of the frequent criticisms of the Atkins Diet that I've seen over the last few years is "its just a low calorie diet in disguise". Well, DUH! Anything that disguises from me the fact that I'm eating less is a darn good thing as far as I'm concerned.
2. There most certainly ARE factors that change how nutrients and calories are processed by the body. For instance, low fat gurus will frequently tell you to eats lots of fiber because it "takes cholesterol out of the intestines". Well, whaddya know! You mean, just because it went IN, doen't mean it went straight to your arteries??? hmmm. Or how about the frequent advice we hear to build muscle because muscle tissue uses more energy than fat tissue, so you can eat more and gain less? Isn't a calorie just a calorie just a calorie? Or, more to the point, what about Insulin Resistance? If your body has a metabolic imbalance that makes it release excessive amounts of the fat-storing hormone insulin whenever there is even a small amount of sugar in your bloodstream, won't you gain weight faster on a diet high in carbs than a diet low in carbs, even though they are composed of the same number of calories? How many of you out there have been on 1000 calorie-a-day low fat diets and not been able to lose weight, while you were able to lose on a higher calorie, lower carb plan? Count me in! So, let's skip the crap about a calorie is a calorie is a calorie. Yeah, in a beaker, on top of a bunsen burner it is. But the human body is way more complicated than that.

WRONG QUESTION #5: And now we come down to the bitter end, the question of questions (or so it would seem): "Which kind of diet produces the best long term results?"

THE ANSWER TO WRONG QUESTION #5: Well, as for a scientific answer, we don't know, because a long term independent study of the Atkins diet is just being done now. We do know that NO DIET studied so far produces long term results for the majority of people, don't we? Most dieters won't keep the weight off. Why? Simple - they go back to their old patterns of eating and inactivitiy. But let me ask you this, and please stick with me here:

If it were to be shown that more people were able to stick to a low fat diet long term, YET I FOUND IT EASIER TO STICK TO A LOW CARB DIET, which should I do?

There's a no-brainer... So, the question of 'which type of diet is easier to stick to' is really a moot point, isn't it? I don't give a fig what OTHER people find easy to stick to; I LOVE LOW CARB! If I can stick to that (more or less - I'm no diet saint, and have never claimed to be) what do I care if YOU find it easier to stick to low fat? More power to ya! We'll pass each other in the produce section with our baskets full of veggies and wave happily, you on your way to the tofu, and me on the way to the meat ailse.

No, the question is NOT which diet produces the best long term results for a study group - because what works for others may not work for me. The question is NOT which is better, Atkins or Ornish. Both may be good for different reasons for different people.

The RIGHT QUESTION IS:

Does a low carb diet like the Atkins Diet WORK, and does it do so while keeping you healthy???

And you had better believe that the ANSWER to that question is going to effect a lot of people. A lot of money and power and hype and importance are riding on the answer to that question. A lot of careers are in the balance, based on the answer to that question. A lot of folks are going to have some explaining to do, based on the answer to that question. So, lets make sure we're at least ASKING THE RIGHT QUESTION. Then maybe, at last, we can get THE RIGHT ANSWER.

LCandrea
LCE Founder

References to DANDR are from "Dr. Atkins New Diet Revolution", Avon paperback edition, 2002

I am in NO WAY associated with the Atkins Center and I am NOT an official expert about the Atkins Diet. For information about the Atkins Diet, consult www.atkinsdiet.com or READ THE BOOK.