In 1968, Congress convened a senate committee on malnutrition that, once it had some success with federal food assistance programs, set its political meat hooks into promulgating American dietary guidelines.[1] Part of this committee’s investigation included interviewing practitioners, such as Dr. Robert C. Atkins, whose ideas on weight management had irked the mainstream professionals of the American Medical Association and caused concern in the halls of Congress.[2] Dr. Atkins defended his low carbohydrate diet to this less than receptive audience. However, his somewhat terse statements did nothing at the time to redeem his reputation or his diet.[3] The committee chose to follow the advice of those advocating a low fat diet, high in carbohydrates, and released its findings in 1977 as Dietary Goals for the United States. This plan called for individuals to increase carbohydrate consumption until carbohydrates constituted 55-60 percent of calories consumed and to decrease fat consumption from 40 percent to 30 percent with no more than a third of that from saturated fats.[4]

Americans enthusiastically embraced the call for more carbohydrates in their diets. American companies began producing all sorts of low fat and nonfat food items.[5] Angel food cake, fat free cheese, and low fat cookies were on everyone’s grocery list. As portion sizes increased, so did their jeans, yet Americans were still hungry.[6] Twenty-five years following the publication of Congress’ dietary goals, there was evidence that incidences of diabetes and heart disease were on the rise. And by 2003 and 2004, one in three Americans would be considered clinically obese, 30 percent would be diagnosed with diabetes, and the number of inpatient medical procedures for heart disease would increase 470 percent.[7] Something had gone very wrong.

This essay will examine the ideas held by proponents of low carbohydrate diets, such as Dr. Atkins, and compare those ideas to the conclusions reached by acclaimed science journalist, Gary Taubes in his recently published book, Good Calories, Bad Calories.

At the close of the millennium, a familiar name shot to the top of the popular diet scene. Dr. Robert C. Atkins published a follow up book to his 1973 edition entitled, Dr. Atkins’ New Diet Revolution. This time, after years on pasta and skim milk, the American public was apparently ready for a fat, juicy steak – which is exactly what his diet offered. As in the original, Adkins’ approach involved strictly limiting the intake of carbohydrates in the first two weeks and, after that, slowly and carefully adding carbohydrates back to the diet until an individual’s critical carbohydrate level was reached. At that point, according to Adkins, the body would stop burning its own fat and again begin producing insulin in order to manage the blood sugar level. Insulin production would signal the body to store fat.[8] Interestingly in this edition (and perhaps bowing to some public pressure), Dr. Atkins came close to softening his view on dietary fat, advising some individuals to be tested for “fat sensitivity because they may “develop a less than favorable cholesterol level on a high fat diet.”[9] For the rest of us without such sensitivity, however, Dr. Adkins spoke even more eloquently than in 1973 about dietary fat; calling it luxurious and claiming that it could even improve our appearance.[10]

Dr. Arthur Agatston is a cardiologist and associate professor at the University of Miami School of Medicine who became disillusioned with the low fat, high carbohydrate diet advocated by the American Heart Association.[11] He agreed with Dr. Atkins’ assessment of the negative impact of carbohydrates but had a major problem with the “liberal intake of saturated fats.”[12] suggested in the Atkins’ diet. Dr. Agatston believes that there is evidence (although, he doesn’t share what that evidence might be) that eating a meal of saturated fats may actually bring about a heart attack.[13] (On the other hand, Dr. Agatston earlier wrote that there was only scant evidence that saturated fats might lead to heart disease.) In 2003, Dr. Agatston published his own low carbohydrate diet, The South Beach Diet that makes a point of limiting saturated fats and categorizing all fats as bad or good. The South Beach diet also separates carbohydrates according to bad and good while limiting the overall amount.

An intriguing, and some may say frightening, approach to the issue of dietary fat is offered by Barry Groves in his recently published book, Natural Health and Weight Loss. It is a follow up to his successful Eat Fat Get Thin published in 1999 and continues the discussion of deliberately increasing fat in the diet to compensate for a reduction in carbohydrates.[14] Mr. Groves refers to this as a “low carb, high fat” diet.[15] Throughout the book he supports his argument for this type of diet writing that “saturated fats are particularly beneficial and play many important roles in our bodies”[16] such as bolstering our immune system, providing energy to the heart, structure for cell walls, and helping to incorporate calcium in to our bones. He specifically states that “the scientific evidence does not support the idea that saturated fats cause heart disease”[17] and provides no less than forty-eight endnotes in this chapter alone to support his claims. Mr. Groves discusses, in some detail, how fats, proteins and carbohydrates are utilized by the body, i.e. only 10% of fats are converted to glucose as opposed to 58% of protein and 100% of carbohydrates.[18] As we have come to know, limiting glucose in the blood is a key concept in low carbohydrate diets. Finally, Mr. Groves argues that a high fat, low carbohydrate diet is the “natural” way to eat because man has evolved from Paleolithic hunter-gatherers who lived off of meat (and, of course, its fat) and supplemented their diets with a very limited supply of carbohydrates such as berries.[19] Dr. Atkins made a similar argument in his original 1972 edition of …Diet Revolution[20].

Gary Taubes writes in his prologue to Good Calories, Bad Calories that his “aim is to look critically at a straightforward question to which most of us believe we know the answer: What constitutes a healthy diet?”[21] He then proceeds through the evidence and reaches conclusions that seem to surprise him. Consider this from Mr. Taubes’ epilogue, “Throughout this research, I tried to follow the facts wherever they led…tried to let the science and the evidence speak for themselves. When I began… I had no idea that I would come to believe that obesity is not caused by eating too much, or that exercise is not a means of prevention. Nor did I believe that diseases such as cancer and Alzheimer’s could possibly be caused by the consumption of refined carbohydrates and sugars.”[22] He then continues with a list of conclusions that “seem inescapable”[23] to him including a few (paraphrased here) that sound eerily familiar: 1) Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization, 2) Carbohydrates in the diet, particularly refined and easily digestible ones, and their effect on insulin levels are the dietary cause of coronary heart disease and diabetes. They are most likely the dietary causes of cancer, Alzheimer’s and other diseases of civilization, 3) The fewer carbohydrates we eat the leaner we will be, and 4) Obesity is a disorder of excess fat accumulation caused by excess insulin, not overeating and not sedentary behavior.

Mr. Taubes seems not only surprised at some of these conclusions but, like Dr. Agatston, is a little concerned about dietary fat and somewhat reluctant to let his conclusion on that subject stand unequivocally. He writes that the fat content of our diets to which we presumably evolved “…will always be questionable” [24] since it is truly impossible to know how the diet of hunter-gatherers was affected by the natural circumstances of their primitive lives.

In spite of his reservations about fat, Mr. Taubes’ findings clearly support Dr. Atkins’ diet claims. It remains to be seen whether these claims will withstand the ongoing scrutiny of the scientific and medical communities. But, for now, the low carbohydrate enthusiasts have scored a victory. Congratulations, Dr. Atkins.

 Bibliography

Agatston, M.D., Arthur (2003) The South Beach Diet, New York.

Atkins M.D., Robert C. (1972) Dr. Atkins’ Diet Revolution, New York.

Atkins M.D., Robert C(1997) Dr. Atkins’ New Diet Revolution, New York.

Groves, Barry (2007) Natural Health and Weight Loss, London.

Taubes, Gary (2007) Good Calories, Bad Calories, New York.

[1] Taubes, Gary, (2007) Good Calorie, Bad Calories, p.45

[2] ibid, p.415

[3] Atkins M.D., Robert C. (1972) Dr. Atkins’ Diet Revolution, pp. 299-312

[4] Taubes, p.46

[5] Agatston, M.D., Arthur (2003) The South Beach Diet, p.19

[6] Agatston, M.D., Arthur (2003) ‘How Eating Makes You Hungry’ in The South Beach Die,t pp. 61- 74

[7] Taubes, p.xviii

[8] Atkins M.D., Robert. C. (1997) Dr. Atkins’ New Diet Revolution, p.103

[9] ibid p. 180

[10] ibid, p. 192

[11] Agatston, p. 7

[12] ibid, p.21

[13] ibid, p.21

[14] Groves, Barry (2007) Natural Health and Weight Loss, p. 21

[15] ibid, p.12

[16] ibid, p 222

[17] ibid, p. 222

[18] ibid, p.229

[19] ibid, p.245

[20] Atkins, p.5

[21] Taubes, p.xx

[22] ibid, p.453

[23] ibid, p.453

[24] ibid, p.455