Low-Fat Lies and High-Fat Frauds













Americans have been convinced that "low-fat" is synonymous with "healthy." They treat fat like poison, and they are obsessed with banishing it from their lives. They will eat a cupboard full of rice cakes for lunch and pasta by the pound for dinner and wonder why they don't lose weight. Even if they do lose weight on the very-low-fat diets recommended by low-fat gurus, they have a hard time sticking to the diet and keeping off the weight. Worse yet, and unknown to them, if they do fail to lose weight, as many do, their low-fat diets may be causing dangerous biochemical side effects that may increase the health risks low-fat diets are intended to reduce--a danger they will seldom hear about from the people who promote low-fat diets.

Millions of Americans are eating low-fat, high-carbohydrate food and failing to lose weight. In fact, they're gaining weight. As they do, their triglyercide levels climb, their HDL levels fall, and many will develop smaller, more aggressive LDL that is highly prone to oxidize and cause heart disease. One of the best-kept secrets about carotenes---cancer-fighting phytochemicals---is that you need a little fat to absorb them. Eat no fat and the carotene passes through your system and, quite literally, goes down the drain.

We are not saying low-fat diets cause cancer and heart disease. Disease causality is very hard to establish in matters of nutrition. We are saying, however, that there are potentially deleterious effects of low-fat diets that are consistently overlooked because of the national obsession with eliminating all forms of fat. These deleterious effects are especially problematic in many of the low-fat products that are so aggressively marketed.

Furthermore, there are positive benefits to certain fats that are likewise ignored. In fact, this national phobia has prevented policy makers from enthusiastically embracing the Mediterranean diet which is clearly effective in reducing heart disease and cancer risk. At best, they damn it with feint praise. Even the American Heart Association web page alludes to its benefits, but then urges caution in adopting it.

Clearly, low-fat diets have the potential to lower HDL and raise triglycerides. In some people, small LDL will form. These are very unfavorable changes. This is most often seen in people who fail to lose weight on low fat diets, which includes most people. It is not unreasonable to propose that these changes could contribute to increased rates of heart disease. Yet most physicians and lay people are unaware of these effects.

We also need fat to absorb carotenes. Very low-fat diets may cause low rates of carotene absorption and may thereby increase the risks of cancer and heart disease. This is the great concern regarding Olestra (and possibly Orlistat) which has been shown to lower carotenes in the blood. Very reputable scientists have projected an increase in cancer and heart disease because of this effect on carotenes. Can they prove it? No. That would require an enormous study over many years. On the other hand, it is a very real possibility---a risk people should be aware of.

A recent study showed women who ate very low-fat diets had statistically increased rates of breast cancer. While one study doesn't provide proof, it certainly arouses suspicion. Could carotenes be at the heart of it? Maybe. The point is, there is certainly another side to the story, a side people never hear.

Weight loss is yet another issue. Will some people lose weight on a low-fat diet? Sure. But the fact of the matter is that most people put it back on. So, despite individual anecdotal success, as a national strategy low-fat diets have been a failure. Fat intake is down and weight is up. Paradoxically, the result has been to lower the bar further so that most physicians think a healthy diet is less than 20% fat. We think this is extreme. The problem is not fat, nor is it carbohydrates. It is calories.

There are two sides to the fat story and Americans are only hearing one. The real tragedy is that as they flee from the low-fat diet, they run into the arms of Dr. Atkins who wants them to eat steak and eggs all day. They lose weight on this diet too. But most will put it back on because it's not a diet meant to last a lifetime. It's not real cuisine.

It's time for some moderation and common sense. We should focus on foods, not macro-nutrients. If we eat healthy foods and control our portion sizes (calories are the only things that really count--whether from fat or carbohydrates), we will lose weight and maximize our health. But it requires education and understanding. It requires that we provide the whole story.


About the Authors:

Kevin Vigilante, M.D. and Mary Flynn, Ph.D. are co-authors of the book, Low-Fat Lies: High Fat Frauds and the Healthiest Diet in the World.



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