Editorial: Regaining Perspectives about Health and Illness
In recent months, carbophobia has swept North America. It began with a July 7, 2002, New York Times Magazine cover story entitled, “What If It’s All Been a Big Fat Lie?” The article encouraged readers to forget about the risks of steak, fried chicken, and other fatty foods and instead blame America’s obesity epidemic on bread or pasta. Since then, many other magazines, newspapers, and broadcast programs have enthusiastically embraced anyone ready to turn crackers and croutons into new nutritional scapegoats. Journalists and the public developed a sudden amnesia about the dangers of fat, cholesterol, and animal protein.
Never mind that carbohydrates have fewer than half the calories of chicken fat, beef fat, or even olive oil. Or that Asians and vegetarians dining on rice, noodles, and other carbohydrate-rich foods are the thinnest people in the world. Forget the fact that meat-eaters have higher cholesterol levels, more heart attacks, higher blood pressure, and substantially higher cancer rates than vegetarians. Carbophobia has been a goldmine for makers of high-protein snack bars, low-carb beer, and, of course, low-carb fad diet books. Fast-food joints have cashed in, too, pushing bunless hunks of ground beef wrapped in lettuce—with even more calories than their original offerings.
Of course, the truth has come out about low-carb diets. The weight loss they may cause is not due to any magical property of a carbohydrate-free diet. While low-carb diet books go on about appetite-suppressing ketones—chemicals that form in the blood as fat is metabolized—careful studies have shown that ketosis is unrelated to weight loss. Rather, when your calories drop, you lose weight. That is to say, a dieter who eats only the burger and skips the bun gets fewer calories. The same dieter would cut calories just as well—better, in fact—by throwing away the burger and eating the bun instead. Low-carb diets do not trim waistlines any more effectively than low-fat, vegetarian diets do and are dramatically inferior at controlling cholesterol levels. Indeed, they often make cholesterol levels worsen. In this issue, we look at evidence that the late Dr. Robert Atkins, the leading low-carb proponent, hid the truth about his own ill health in order to cast an undeservedly favorable light on the diet he promoted.
If the low-carb trend is based on shaky science, where is it leading? A population that has learned to ignore the risks of saturated fat and cholesterol is not headed for permanent weight control. It is moving toward worsening epidemics of colon and breast cancer, diabetes, high blood pressure, and heart disease.
It is a costly mistake. Forfeiting what we know about the nutritional causes of disease, we pin our hopes on laboratory and clinical research to try to “solve” our escalating health problems. Pharmaceutical manufacturers will commit billions of dollars, millions of animals, and thousands of human research subjects to develop and test more powerful drugs to control our cholesterol, blood pressure, and blood sugar levels. While drugs were once viewed as treatments to be used only temporarily while the patient healed, they have now edged out diet and lifestyle measures as first-line treatments and preventive measures.
But, even while we recognize these unhelpful trends in health and medicine, there is good news, too. In this issue we look at an emerging ray of hope within the research enterprise. A surprisingly large number of health and research charities have signed on to the Humane Charity Seal of Approval. These charities tackle medical problems using modern research methods and clinical services of which they and their donors can feel proud. The Seal also allows donors to influence the research process itself by selecting the kinds of research-funding organizations they support.
The key now is to bring renewed attention to the real causes of disease and to focus treatment-oriented research on the best and most ethical methods. In so doing, we really can revolutionize health.
Neal D. Barnard, M.D.
president of PCRM
Barnard Receives WISDOM WorldView Award