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Authors: Mary Enig

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Patients in the treatment group did at first report lessened angina (chest pain), but after five years there was no difference between the two groups in the frequency or amount of angina. Nor did the researchers follow up to see how the study group fared in the long term.

Another flaw of this study was that very few people could be persuaded to stay on the diet. Of the 53 initially selected for the experimental group, only 28 agreed to participate after the program was explained to them. Subsequently, a few more dropped out, and one died during heavy exercise. As a result, so few were left in the experimental group that the researchers could not draw any valid conclusions.

Ornish himself admits that his diet alone will not prevent heart disease. His program includes a number of strategies to reduce heart disease risk, including weight reduction, moderate exercise, smoking cessation, and stress relief. With all of these factors in place, it is difficult to determine whether the dietary component plays any significant role. In fact, from our point of view, Dr. Ornish’s results might have been better if his patients were allowed to support their well-being and biology with more satisfying and nutritious food!

The Zone Diet: Moderate Carbs, High Protein, and Restricted Fat

Although this regimen is called a high-fat diet, in reality only 30 percent of its calories come from fat. According to its author, Barry Sears, if you maintain a strict ratio of 30 percent protein, 30 percent fat, and 40 percent carbs, you will enter the Zone, where “the mind is relaxed, yet alert and exquisitely focused…the body is fluid, strong, and apparently indefatigable.” The Zone Diet is said to put one in “a metabolic state in which the body works at peak efficiency.”

Unlike Ornish, who promises good health on low-fat meals, Sears agrees that the body needs fats, but only monounsaturated ones found in avocados, almonds, and olive oil. We should avoid saturated fats, he argues, and also too much of the long-chain fatty acid called arachidonic acid, found in foods like liver, eggs, and butter. Sears claims that his diet is satisfying, with lots of protein and “plenty of fat.” But that’s before you come up against the fuzzy math. Since fat contains 9 calories per gram, compared to 4 for proteins and carbohydrates, and since protein and carbohydrate foods contain a lot of water, whereas fats contain none, you can’t add very much fat to meals before you surpass the 30 percent ratio.

In one Zone Diet meal, composed of 6 ounces of white fish for protein and 2 cups of steamed vegetables, plus 1 piece of fruit for the carbohydrates, the added fat amounts to 4 teaspoons of slivered almonds. Another Zone meal consists of 1 cup of low-fat cottage cheese and 1
1
/
3
cups of cooked oatmeal, with fat supplied by 4 macadamia nuts. An omelet consisting of 6 egg whites and 1 ounce of non-fat cheese gets 1
1
/
3
teaspoons of added olive oil.

If you have trouble keeping your ratios straight, or need a between-meal snack, you can eat a meal replacement bar that contains many processed products but has the correct ratio of 30/30/40. Ultimately, even with the synthetic vitamins in the bars, the Zone Diet is deficient in nutrients and carries the risks associated with diets in which high amounts of protein are not supported by adequate fats, as explained above in the discussion of the Atkins diet.

The Glycemic Index

Several popular diet plans advise people to limit their carbohydrate foods to those that have a low “glycemic index.” The glycemic index indicates how quickly and how much a food raises the blood sugar. High-glycemic foods include grains (especially cold breakfast cereals), potatoes, corn, honey, and glucose (but not fructose, which has to be processed in the liver before it enters the bloodstream). Low-glycemic foods include legumes, non-starchy vegetables, and most fruits. The idea is that eating low-glycemic foods will help you last longer between meals by maintaining steady blood sugar levels.

Diets based on low-glycemic index foods usually overlook one important point: fats lower the glycemic index! Putting butter on a high-glycemic food like bread will lower its glycemic index, meaning that the food is absorbed more slowly into the bloodstream rather than in one quick burst. In fact, when testing foods for glycemic index, researchers found that a sugar-laden Mars bar had a lower glycemic index than cornflakes or potatoes…because the Mars bar contains lots of fat. That’s why using butter as a spread, or including coconut oil in every meal, can further lower the glycemic effect of both high-glycemic foods, like potatoes, and low-glycemic foods, like vegetables.

The South Beach Diet: Low-Carb, High-Protein, Moderate Fat—but No Animal Fats

The South Beach Diet is a low-carb regimen that excludes, or keeps to a bare minimum, the usual carbs like bread (even whole-grain), sweets, fruit, fruit juices, rice, potatoes, and pasta. It emphasizes high-protein foods, non-starchy vegetables, and skim milk and other non-fat foods. White sugar is out, as well as the whole gamut of processed carbohydrate snack foods. While eliminating or greatly reducing your intake of carbohydrates and sugar is a great idea, this diet is full of shortcomings.

For one thing, low levels of dietary fat contributes to low blood sugar between meals, sparking a sudden need to eat. And that’s not all. Despite its popularity, the South Beach diet may actually be one of the more dangerous diets out there. Because it’s high in protein and excludes animal fats, it can rapidly deplete vitamin A stores, resulting in numerous health problems, as noted previously in the discussion of the Atkins diet.

Second, South Beach denies the dieter any source of vital saturated fats. As you now know, your body needs saturated fats to work properly—from the level of the organs right down to the cells. Our only good sources of saturated fat are coconut oil, palm and palm kernel oils, and animal fats; or high-carbohydrate foods like potatoes or grains that the body turns into saturated fat. The South Beach diet allows none of these, setting the hapless dieter up for numerous health problems—from lung disease to heart problems.

Lots of the South Beach recipes look inviting and tasty, but they’re full of low-or non-fat ingredients. Non-fat sour cream and non-fat half-and-half are among the favorites, while the chicken is always skinless, to get rid of the saturated fats that Arthur Agatston, the diet’s creator, thinks are so lethal. (Actually, chicken skin contains mostly monounsaturated fatty acids.) Instead of butter, processed spreads, containing harmful trans fats, appear in many recipes and snack suggestions, as do margarine and egg substitutes.

Olive Oil Can Cause Weight Gain!

Several diet plans recommend monounsaturated oils such as olive and canola as the best oils for weight loss. Actually, these oils can contribute to weight gain! In a study published in
The Lancet
, 1994, researchers noted that the fatty acid they found most prominent in fat tissue was monounsaturated. That’s probably why middle-age weight gain is so common in Mediterranean countries.

In the Eat Fat, Lose Fat plans, we reduce the amount of olive oil in salad dressings and mayonnaise by using Mary’s Oil Blend, which is
1
/
3
olive oil,
1
/
3
sesame oil, and
1
/
3
coconut oil. We also do not recommend most nuts in the calorie-restricted phase of Quick and Easy Weight Loss. Nuts are a wonderful, nutritious food, but they tend to be high in monounsaturated fatty acids, the kind that your body accumulates when it gains weight.

Since Dr. Agatston is an orthodox cardiologist, he is firmly wedded to the lipid hypothesis and argues that saturated fats cause chemical changes in the bloodstream, raising so-called bad cholesterol, LDL, and leading to accelerated atherosclerosis and clogged arteries. In our opinion, however, his diet is a good example of how the lipid hypothesis leads to bad dietary advice.

Weight Watchers: Calorie Restriction

When you consider how many millions have tried this diet, it’s certainly had very few successes. And when you take a closer look at how Weight Watchers really works, the reasons are pretty clear.

Weight Watchers relies entirely on calorie restriction, with no particular warnings against refined carbohydrates and no emphasis on healthy fats. Weight Watchers uses a point system, in which every food is given a value based on its calorie, fat, and fiber content—but not on its quality or nutrient content. Members choose their meals within a daily points range, depending on their current weight. Exercise also has a point value, which can be swapped for additional food points.

Because of the reduced calorie intake, Weight Watchers ends up being a low-fat diet, and most Weight Watchers wind up turning to unhealthy fats like margarine and vegetable oils. Plus, because it’s low in fat, the diet leaves people unsatisfied, undernourished, and vulnerable to boomerang weight gain.

And that’s not theoretical. A British therapist, Susie Orbach, the author of
Fat Is a Feminist Issue
, has accused Weight Watchers of false advertising, claiming that thousands of Brits have shelled out their money to the company, only to wind up fatter than they were before. Orbach further claims that the company’s profits
depend
on the high failure rate. Watch out for Weight Watchers. This diet rapidly leads to nutrient deficiencies and cravings, triggering bingeing and splurging.

Sylvia’s Story: The Perils of Low-Fat

Sylvia had struggled with her weight since her teenage years. She would go on low-fat diets that severely restricted calories. Several times she lost 20 pounds very quickly, but she invariably put them back on, plus extra, so she wound up heavier than when she started. While on these diets, she was prone to mood swings due to low blood sugar. The diets also depressed her metabolism, so that she always came to a point at which even the severest calorie restriction did not help her lose weight. Tired and discouraged, she would begin to eat again and quickly regained the pounds. Worse, over the years Sylvia developed hypothyroidism. She ended up 40 pounds overweight, sluggish, and constantly tired.

Juice Fasts

Numerous diet programs involve fasting on juices made from a variety of vegetables and fruits as a way to lose weight, provide enzymes, and “cleanse the colon, liver, and cells.” Proponents claim that when we chew, we are turning our food into juice, so juicing is therefore natural and healthy.

But the fact that foods made into juices are
not
chewed is actually one of the problems with juice fasts. Chewing actually begins the digestive process by mixing food (particularly carbohydrates) with saliva. The process of chewing and thoroughly tasting our food also sends signals to the digestive tract about what to expect in terms of nutrients and which enzymes will be needed to assimilate them. Juicing bypasses these mechanisms and can actually result in poor digestion!

Also, many foods that are juiced, such as green leafy vegetables and cruciferous vegetables (members of the cabbage family), contain substances that block mineral absorption and depress thyroid function. When these vegetables are cooked, those substances are neutralized. In fact, cooking actually makes the minerals in vegetables much more available.

What’s more, there are very few enzymes in most fruits and vegetables used in juicing recipes. Foods that contain a lot of enzymes are mostly foods that have been lacto-fermented, which we will describe in Chapter 5.

Traditional cultures did not have modern juicers, but they did crush certain foods to produce lacto-fermented beverages in a process akin to digestion that creates copious amounts of enzymes.

Those who claim that fasting on juices can cleanse the body lack a basic understanding of biochemistry. The removal of toxins from the body is an ongoing process involving numerous enzyme systems that are supported mostly by nutrients from animal products. In fact, one of the best ways to help the body cleanse is to consume a lot of bone broth, which provides the liver with certain amino acids involved in the process of clearing the residues of metabolism.

Finally, juice fasts can create the same problems as low-fat diets—they lead to low blood sugar and serious deficiencies in nutrients normally provided by animal protein and fat. Even with added coconut oil, the body is likely to interpret a juice fast as starvation, slow down the metabolism, and put the pounds back on very quickly as soon as the fast is over.

The
Right
Nutritional Strategy

To summarize, all these modern diets depend on some degree of calorie restriction, with different proportions of macronutrients. The original Atkins diet is the best, both for achieving weight loss and for satisfying your body’s nutritional requirements. But like the others, the Atkins diet can lead to cravings, vitamin A depletion, and calcium deficiency (if you don’t eat cheese).

What’s in Your Mayonnaise?

If you reach for the Miracle Whip as you’re preparing tuna salad, you’ll be eating soybean oil, modified food starch, artificial color, and sodium caseinate (a synthetic ingredient made from milk protein). Contrast this with our easy-to-make
Mayonnaise
(for recipe), which keeps well in the fridge and provides many key nutrients from real foods, including MCFAs from coconut oil.

None of these programs take advantage of the metabolism-boosting powers of coconut oil along with the thyroid-supporting powers of cod-liver oil (whose many virtues we’ll explain fully in Chapter 5 ). As a result, all of them can lead to lowered metabolism, either through the body’s feast-or-famine reaction, or through vitamin A depletion that undermines your thyroid function, or both. And once you head in that direction, no matter how severe your calorie restriction,
you won’t lose weight.

That’s why our diet emphasizes a well-rounded array of healthful foods with all the right nutrients to support your health, improve thyroid function, and permit safe, sustainable weight loss.

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