Byline: Don Mauer
Taken a peek inside "The New England Journal of Medicine" lately? Probably not. Hey, I don't read it regularly either, but, reader Carl Ball forwarded me a copy of a recent Journal article that he believed I would find interesting reading. He was right.
The article, "Should a Low-Fat, High Carbohydrate Diet be Recommended for Everyone?" appeared in the Aug. 21, 1997, issue in the Journal's Clinical Debate section.
On the "Yes" side were Dr. William and Ms. Connor from the Oregon Health Sciences University. On the "No" side were Martijn B. Katan, Ph.D., of the Wageningen Agricultural University, the Netherlands; Dr. Scott M. Grundy, of the University of Texas Southwestern Medical Center; and Dr. Walter C. Willett of the Harvard School of Public Health.
The Connors believe, based on information from the American Cancer Society, that reducing total dietary fat from an average of 40 percent to 20 percent will prevent certain cancers. They also state that: "There is universal agreement that the dietary level of saturated fat should be greatly reduced ... along with a reduction of dietary cholesterol."
The couple supports recommendations that saturated fat should be replaced with grains, vegetables, legumes and fruits. They believe that "this change would diversify the diet and add protective constituents from plant sources."
In terms of obesity the Connors write: "although obesity remains an unsolved problem, there is good evidence that Americans who follow a low-fat diet high in plant foods lose weight more easily than those whose fat intake is higher."
"The plethora of 'fat-free' foods has offered the opportunity to consume more sugar..." And, the Connors add, sugar consumption is up, way up.
Based on U.S. Department of Agriculture statistics, consumption of sugar and other refined sweeteners increased to 150 pounds a person per year in 1995 from 120 pounds per person per year in 1970. My calculator tells me that's an astonishing 25 percent increase.
In my opinion, an excellent case can be made that this sugar-related caloric increase is why Americans are getting fatter.
Katan, et al, on the other side, show that a diet lower in saturated fats also reduces LDL cholesterol (the bad cholesterol) levels. That's healthy. However, they also note that a diet that uses more sugars and complex carbohydrates (starch) and less saturated fats reduces both LDL and HDL cholesterol (the good cholesterol) levels.
Katan sites studies demonstrating that substituting saturated fats with fats from olive oil and canola oils lower LDL levels without lowering HDL levels.
What about weight loss? Katan, et al write: "Theoretically, high-fat diets could facilitate the overconsumption of calories and promote weight gain; however, controlled trials have not supported this idea. ... fat restriction does not invariably produce weight reduction.
"Overweight persons ... should also eat less sugar and highly …