HEALTHY AT 100 (16 page)

Unfortunately, the weight lost in this manner doesn’t usually stay off. The “metabolic advantage” doesn’t last. In 2004, the British medical journal
The Lancet
published a study finding that any weight loss advantage Atkins and other low-carb diets may have is gone within a year.
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The report also noted that side effects experienced by those on carb-restricted diets include constipation, headaches, bad breath, diarrhea, muscle weakness, and cramps.

These kinds of side effects are actually quite common on very low-carb diets. In another study, this one funded by Atkins himself, 70 percent of patients on an Atkins diet for six months were constipated, 65 percent had halitosis (bad breath), 54 percent reported headaches, and 10 percent were losing hair.
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Still, the battle of the diets has continued. In 2005,
The Journal of the American Medical Association
published the results of a head-to-head comparison of four popular diets, including Atkins and Or-nish.
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Tufts University researchers randomly assigned each of 160 overweight people to one of the four diets, gave them an instruction book and four educational sessions, and tracked their weight over the next year. At the one-year mark, those following the Ornish diet had the greatest weight loss, while those following Atkins had the least weight loss. Moreover, those following the Ornish program had the greatest reduction in LDL (“bad”) cholesterol, while those following Atkins had the least reduction. Those following the other two diets, Weight Watchers and The Zone, fell between Ornish and Atkins in both weight loss and LDL reduction. Among the participants who completed the study, those on the Ornish diet lost an average of 14.5 pounds and reduced their cholesterol by 21.5 mg/dl—the best results of all the diets tested.

Unlike the other diets tested, Ornish’s low-fat, plant-based diet has been scientifically proven to reverse atherosclerosis, decrease angina (chest pains), bring about permanent weight loss (five years or longer), and dramatically reduce cardiac events such as heart attacks. Studies finding these benefits have been published in the most respected peer-reviewed medical journals. These studies have found
that even people with advanced heart disease can avoid coronary bypass surgery and angioplasty by following the Ornish diet and making the other lifestyle changes in his program. On the other hand, there is significant research pointing to dangers for the low-carb approach. In 2000, for example, the journal
Angiology
published a study that found a worsening of blood flow to the heart on the Atkins diet.
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A central tenet underlying the low-carb diets is that carbohydrates raise blood insulin levels, causing our bodies to store more fat. A chapter in Atkins’s book is titled “Insulin—The Hormone That Makes You Fat.”

In 2003, the researchers who put people on the Atkins diet, the Zone diet, the Weight Watchers program, and the Ornish diet presented their findings to the American Heart Association convention. Of the four diets, Ornish’s was the only one to lower insulin significantly, even though that’s what the Atkins and Zone diets are designed to do.

When Atkins’s book was originally published, the medical community did not exactly applaud. The chair of the Nutrition Department at Harvard University warned physicians that recommending the Atkins diet “borders on malpractice.”
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The president of the American College of Nutrition said, “Of all the bizarre diets that have been proposed in the last 50 years, this is the most dangerous to the public if followed for any length of time.”
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The chief health officer for the state of Maryland was asked, “What’s wrong with the Atkins diet?” He replied:

What’s wrong with…taking an overdose of sleeping pills? You are placing your body in jeopardy.…Although you can lose weight on these nutritionally unsound diets, you do so at the risk of your health and even your life.
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More recently, when the American Dietetic Association called the Atkins diet “a nightmare diet,” Robert Atkins attempted to dismiss
such criticism as “dietitian talk.”
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“My English sheepdog,” he snorted, “will figure out nutrition before the dietitians do.”
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Unfortunately for Atkins and his sheepdog, however, almost every reputable health science organization in the world has issued statements strongly warning against his diet. The list includes the American Heart Association, the National Academy of Sciences, the American Cancer Society, the American Institute for Cancer Research, the American Kidney Fund, the American College of Sports Medicine, and the National Institutes of Health.

In 2002, the American Heart Association published an advisory in the leading medical journal
Circulation
warning the public about the perils of such diets. “They put people at risk for heart disease, and we’re really concerned about this,” said Robert H. Eckel, M.D., senior author of the paper and chairman of the American Heart Association’s Nutrition Committee. “These diets will raise the…bad cholesterol and increase the risk for cardiovascular disease, particularly heart attacks.”
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Eckel, who is professor of medicine at the University of Colorado Health Sciences Center, was commenting specifically on the Atkins, Zone, Protein Power, Sugar Busters, and Stillman diets.

Eckel noted that people often temporarily lose weight on these diets, and as they shed pounds, their overall cholesterol levels may temporarily drop. “But what I see after people have lost weight on such a diet, then their weight stabilizes for a period of weeks or months and often the cholesterol, particularly the bad cholesterol, now becomes more elevated.…Many people’s LDL cholesterol [the bad cholesterol] goes up if they remain on the diet.”
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I was a featured guest on Dr. Atkins’s radio show several times, and I spoke with him on a number of other occasions as well. I am sure that he believed he was helping people to enjoy healthier lives. Similarly, I have no doubt that the people currently advocating other low-carb diets believe in what they are doing. But these diets are deeply misguided in blaming carbs alone for the Western world’s obesity epidemic. They have gotten people to eat fewer refined carbohydrates like sugar and white flour, which is a positive step. But even with that, they have regrettably caused significant harm to some of their followers.

In 2004, Jody Gorran, a fifty-three-year-old man from Delray Beach, Florida, sued the estate of Dr. Robert Atkins and the company that promotes his diet. While he was following the Atkins diet, his cholesterol shot from 146, well within the normal range, to 230, considered in the hazardous range. Before he started the diet, medical tests showed that his arteries were clear, but within two years of following the Atkins approach, he had three episodes of chest pain, and doctors found a 99 percent blockage in a major artery. They needed to perform angioplasty and insert a stent to keep it open.

In 2003, the South Beach diet became the latest low-carb diet to become wildly popular. Like the Atkins diet, South Beach begins with a two-week initiation phase which drastically restricts carbohydrates. Later, the diet differs from Atkins in that it does not encourage saturated fats like butter and sausage, and allows more fibers and whole grains. Although no fruit or whole grains are allowed in the first two weeks of the plan, small amounts are allowed afterward.

South Beach is certainly an improvement over Atkins, but it’s hard for me to be enthusiastic about any diet that looks askance on natural foods like apples, apricots, berries, beets, carrots, and whole-grain bread. Somehow the idea of eating bacon and eggs for breakfast and then taking cholesterol-lowering drugs doesn’t strike me as a healthy approach. But that is what the author of the South Beach diet, cardiologist Arthur Agatston, does, and that is what he ecommends.
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While in the White House, U.S. president Bill Clinton consulted with Dr. Dean Ornish, who advised him to stay away from high-fat animal products. The president, however, loved burgers, and chose instead to follow the South Beach diet. After the former president underwent emergency quadruple coronary artery bypass surgery to relieve clogged arteries in 2004, he said he wished he had never gone on a low-carb regimen of steaks and cheeseburgers, but had instead followed the advice he had received from Dr. Dean Ornish.

He probably would have been better off if he had. The healthy and long-lived people of Okinawa, Abkhasia, Vilcabamba, and Hunza eat a diet very much like the Ornish diet—a low-fat, wholefoods,
plant-based diet made up entirely of natural foods and rich in complex carbohydrates. And they are among the leanest people on earth.

The low-carb diet craze reached its peak in 2004, with far fewer people following diets like Atkins and South Beach in subsequent years. On August 1, 2005, Atkins Nutritionals, Inc., the company that promoted low-carb eating into an international diet craze, filed for bankruptcy court protection. The company had $300 million in debts it could not pay.
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Though this was a sad day for the company and the people who depended on it, it was good news for public health, because it signaled that more and more people were beginning to understand that you do not have to eschew healthy carbs to lose weight. If you are going to heed the example of the world’s longest living cultures, the answer is not to stop eating carbohydrates entirely, but to stop eating refined carbohydrates, and instead eat healthier, unprocessed carbs like whole grains, vegetables, and fruits, along with seeds, nuts, and legumes, as the basic building blocks of your diet.

The evidence is consistent. People who eat plant-based diets centered on whole grains, vegetables, nuts, seeds, and legumes tend to be dramatically slimmer than those whose diets incorporate significant amounts of animal products. In 2004, for example, an intensive four-nation study involving more than four thousand men and women aged 40 to 59 revealed that the thinnest people eat the most healthful carbs. The study’s lead author, Linda Van Horn, Ph.D., professor of preventive medicine at Northwestern University, presented the findings at the 44th American Heart Association Annual Conference. “Without exception, a high-complex-carbohydrate…diet is associated with low body mass,” she said. “Desirable carbohydrates are complex, high-fiber carbohydrates: whole grains, fruits and vegeta-bles.”
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How do the medical researchers who have conducted the Okinawa Centenarian Study feel about the low-carb diets? Having
meticulously analyzed the diets and health of many of the world’s longest lived people, these researchers write:

Never in the history of nutrition research has the evidence been more clear and consistent: a high [unrefined] carbohydrate, low calorie, plant based diet is the best for long-term health. There’s no doubt about it anymore, despite what you might have read in books advocating low-carb, high-protein diets.
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The lifestyles of the elder Okinawans, like those of the Abkhasians, Vilcabambans, and Hunzans may seem spartan compared to the modern world, where we consume so much sugar and other tasty high-calorie, low-nutrient foods. But these long-lived peoples are most certainly not life deniers. They take pleasure in their senses and excel at having a good time. They are life-affirming folks who enjoy the simple delights and transformative joys of the world around them. They rarely consume foods like candy, chips, ice cream, or hot dogs, but they are brimming with life. They smile a lot. They laugh out loud. They sing and dance.

In fact, when I look at our overworked, under-slept, fast-food modern world, I think it may be we who are sensually deprived and they who are the true celebrants.

Take alcohol, for example. I am sure you know how much damage arises in the modern world from the excessive consumption of alcohol. People in each of the long-living cultures enjoy alcoholic beverages. But rather than indulging to excess, they savor their pleasures, drink only in moderation, and have no concept of alcoholism. In fact, they enjoy life far too much to want to escape from it by becoming inebriated.

In their enjoyment and appreciation of moderate amounts of alcohol, these cultures are fully congruent with the modern research that has found substantial heart and other health benefits to
moderate
consumption of red wine. (These benefits, needless to say, disappear when people drink excessively.)

There are people who believe that your health is not greatly affected by what you eat, how you live, or whether you enjoy your life. They believe the only way to ensure a long and healthy life is to be blessed with favorable genes. Are they right?

Not according to one of the foremost experts on the relative importance of lifestyle choices and genetics, John W. Rowe, M.D., president of the Mount Sinai School of Medicine and the Mount Sinai Hospital in New York City. Since its inception, he has chaired the MacArthur Foundation Research Network on Successful Aging, which conducted a major study of both identical and nonidentical twins who were raised apart. Dr. Rowe explains:

The bottom line is very clear: with rare exceptions, only about 30 percent of physical aging can be blamed on genes…and as we grow older, genetics becomes less important.…These findings shatter the myth that our course in old age is predetermined. MacArthur research provides very strong evidence that we are, in large part, responsible for our own old age.
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There are of course some diseases (such as hemophilia, cystic fibrosis, ichthyosis, sickle cell anemia, hemochromatosis, Tay-Sachs disease, and Huntington’s disease) that are strongly or entirely determined by genetics. I do not wish to minimize the importance of knowing all we can about how genes affect health. But we now know that even when there is a genetic predisposition for cancer, heart disease, hypertension, rheumatoid arthritis, and many other conditions, a healthful diet and regular exercise can at the very least substantially delay, and more often completely prevent, the emergence of the disease.