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NEW
YORK TIMES TODAY > May 25, 1999
New
Look at Dieting: "Fat Can Be a Friend"
By Jane E. Brody |

New York City, NY -- Now
hear this: avocados, walnuts, salad dressings with
oil, sautéed vegetables,
fatty fish and some kinds of margarine may be back on
the menu for health-conscious Americans, even for those
trying to lose weight, if the findings of recent studies are to be
believed.
For three decades
now, Americans have been bombarded with advice to eat
less fat for the sake of their hearts and their waistlines.
One well-known expert, Dr. Dean Ornish, advocates stripping
away all added fats and naturally fatty foods to achieve
a diet containing no more than 10 percent of calories
from fat, down from the 44 percent typically consumed
by Americans in the 1960's and the 34 percent now consumed.
But
now a growing number of nutrition, health and obesity
specialists maintain that in trying to squeeze some of the heart-damaging grease
from our high-fat diets, they have sent Americans the wrong message.
It's not fat per se that's the problem, the experts now say, but
the kinds of fats Americans eat and the other kinds of foods they
fill up on when they cut back on appetite-satisfying fat. For while
heart disease has indeed declined as many Americans shun artery-clogging
saturated fats and cholesterol, waistlines have expanded significantly
and obesity has risen by 50 percent since the big push to limit
fat took off in the 1970's.
The very tactic
viewed as the key to weight control -- stripping the
diet of fat -- seems to have backfired. Food companies
responded to fat phobia with a plethora of fat-free,
low-fat and reduced-fat products, especially the dessert
and snack foods that Americans covet. The result was
an overdose of carbohydrates, ranging from fat-free
pretzels, crackers, cookies, cakes and frozen desserts to dinner
plates piled high with pasta.
Many
obesity specialists, as well as popular diet advocates like
Dr. Robert Atkins and Barry Sears, say these carbohydrates
are the cause of the growing American girth. Even
the potato, which once proclaimed "I am not fattening" in
award-winning ads, now heads the hit list being circulated by carbohydrate
bashers, some of whom, like Dr. Atkins, go to the opposite extreme by
recommending that people can lose weight by eating
all the fat they want as long as they eat few or no
carbohydrates.
"The swing back to Atkins is a response to the fact that a low-fat diet hasn't
worked for a lot of people because they stuff in carbohydrates," said Dr. Margo
Denke, an associate professor of medicine and endocrinology at the University
of Texas Southwestern Medical Center in Dallas.
Dr. Alice H. Lichtenstein, a professor of nutrition at
Tufts University in Boston, agrees that "the low-fat pendulum
swung too far."
"People assumed that if a food had no fat, they could eat as much of it as they
wanted," she said. "But many low-fat and fat-free products have nearly as many
calories as their full-fat versions. Reducing fat alone is no guarantee of
weight loss. You must cut calories or increase physical activity."
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And that is just
what Americans have been doing: gaining weight on fat-free
and low-fat foods consumed without regard to their
caloric content. Instead of replacing some of the less desirable
high-fat foods with nutrient-rich but low-calorie fruits
and vegetables, they are filling up on foods loaded with
added sugars and refined starches that have little to
offer nutritionally besides calories, the experts lament.
"In making food choices, we must learn to eat foods that are nutritionally robust
-- fruits, vegetables, legumes," said Dr. Robert H. Eckel, chairman of the American
Heart Association's nutrition committee and professor of medicine and physiology
at the University of Colorado. "There is strong evidence that these kinds of
foods help to reduce disease, not just heart disease but also cancer, diabetes,
hypertension and obesity."
A survey of American consumers, however, conducted in 1997 by the Food
Marketing Institute, revealed that 56 percent of shoppers who had changed
their diets did so by trying to cut down on the amount of fat they consumed,
but only 15 percent said they were trying to eat more fruits and vegetables.
Even people with high cholesterol levels may
not need to go to fat-reduction extremes to protect their hearts. A study of 444 men with high LDL cholesterol
conducted by Dr. Robert H. Knopp and colleagues at the University of Washington
in Seattle showed that reducing total fat to 30 percent of calories from
35 percent and keeping saturated fats at 7 percent to 8 percent was as
effective in lowering cholesterol as diets with less total fat. In fact,
when fat intake dropped to about 20 percent of calories, heart-protective
HDL cholesterol levels fell and heart-damaging triglyceride levels rose.
Study participants had no difficulty sticking to a 30 percent fat diet,
whereas more stringent diets require a dedication that most Americans lack.
There is also growing evidence that regardless
of what else it may contain, a weight-loss diet devoid
of fat may be counterproductive, leaving dieters perpetually hungry or
unsatisfied and susceptible to overeating when their resolve fails. Dr.
Mary Flynn, a nutritionist affiliated with Brown University, addresses
this issue in a new book written with Dr. Kevin Vigilante.
..."A
little fat helps you lose weight," the book
notes. "Fat makes food taste good, and it makes
you feel full. Taste is vital to the success
of any diet." |
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Without
a little fat you're always going to be hungry. The
key is to eat the right kind of fat, in the right amounts.
You need a diet you can live with."
A study of 12 obese boys published
in March in the journal Pediatrics showed
that meals with refined carbohydrates and little fat were less effective
in staving off hunger than fattier meals with the same caloric content.
Dr. David Ludwig of Harvard Medical School and Children's Hospital in Boston
concluded from these findings that substituting processed grains like cereals,
bread and pasta for dietary fat may be making Americans fatter. 
Fat in the diet also
seems to play a psychological role that helps some people
keep their caloric intake in check. In a study at Pennsylvania
State University, normal-weight women given yogurts with
various fat contents ate more at the next meal if they were
told the yogurt was fat-free than if they thought they had
eaten a high-fat yogurt.
Likewise, people given fat-free potato chips ate less fat than those given
regular chips, but over the course of a day, both groups consumed the same
number of calories...
"Within the current American eating pattern, it's probably
wise to stay at a maximum of 30 percent of calories from
fat," Dr. Lichtenstein said. "If
we go above that, Americans tend to increase their consumption of saturated
fats in meats. Maybe if we adopted a Mediterranean diet -- rich in vegetables
and fish and olive oil -- we could go higher than 30 percent fat without
compromising our health, but it's important to remember that the Mediterranean's
low rate of heart disease is not just the result of a diet rich in olive
oil. It's a life style that is far more active than ours and that doesn't
contain all the bizarre foods we have." |
Extreme
reductions in dietary fat can deprive the body of vital nutrients that
play a crucial role in health. Dietary
fat transports the fat-soluble vitamins A, D, E and K. Unsaturated fat
from vegetable and seafood sources supplies the body with essential fatty
acids needed to produce nerve cells and hormones.
There is also growing evidence that unsaturated
fatty acids help protect people from serious diseases. For example, studies in Spain, Italy, Greece,
Sweden and the United States linked diets rich in olive oil to a reduced
risk of breast cancer. The brain, too, may benefit from monounsaturates
like olive oil. A study published this month in the journal Neurology by
Italian researchers found that a high intake of extra-virgin olive oil
was associated with preservation of cognitive functions in healthy elderly
people.
The ongoing Nurses Health Study revealed that among
80,000 women initially aged 34 to 59, total fat consumption did not affect coronary risk, but
the kinds of fats the women ate did. Each 5 percent increase in calories
from saturated fats (primarily from meats and dairy products) raised their
risk of coronary disease by 17 percent.
An
even greater risk was posed by Trans Fatty
acids, which are formed when unsaturated vegetable
oils are hydrogenated to make them solid at room
temperature, for example, to form margarine. Each
2 percent increase in Trans Fat calories raised
the women's coronary risk by 93 percent. A number
of margarines free of harmful Trans Fat are
now available. |

Polyunsaturates and particularly
omega-3 fatty acids like fish oils, on the other hand,
appear to protect against heart disease, especially sudden
cardiac death. Fish oils have been shown to reduce the risk of blood clots
and abnormal heart rhythms and improve blood cholesterol and triglyceride
levels. Studies in the Netherlands and in the United States have indicated
that eating just two fish meals, or seven ounces of fish, a week can reduce
a man's risk of heart attack by 50 percent.
Another type of omega-3 fatty acid called
alpha-linolenic acid, found prominently in canola oil, flaxseeds, soybean oil, walnuts and many dark green leafy
vegetables, also appears to offer strong protection against sudden cardiac
death, according to a new study by Dr. Frank Hu and associates at Harvard
School of Public Health. Among 76,000 participants in the Nurses Health
Study, those with the highest intake of alpha-linolenic acid had up to
a 50 percent lower risk of fatal heart attacks when compared with women
who consumed the least amount of this fat.
"People who choose fat-free salad dressings are missing out on this important
fatty acid," Dr. Hu said. "Fat has been perceived as the enemy, but that's
not true. Some fats are good, some fats are bad. We should be substituting
good fats for bad ones rather than worrying about reducing the total amount
of fat." |
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