Vegans vs. Atkins

Animal-rights activists claim that low-carb, meat-heavy diets are killing people. Are they raising legitimate health concerns -- or are they just rabid anti-carnivores?

Dec. 8, 2003 | For all the deals with the devil made in Washington, it's not often they're owned up to at the National Press Club, before a roomful of reporters, armed with notepads, tape recorders and TV cameras.

But Jody Gorran, a businessman from Delray Beach, Fla., announced at a press conference on Nov. 20, 2003, "I made a Faustian bargain with the devil."

The trim 53-year-old's dark deal: "I traded a 32-inch waist for heart disease, and the devil was the Atkins diet."

Gorran testified that he had a heart scan six months before going on Atkins that showed no problems. But after two and a half years of losing weight and keeping it off on the high-protein, low-carb diet, while boasting about its incredible benefits to everyone he knew -- eat fat, while you lose the fat! -- he developed heart disease. Suffering from severe artery blockage, he underwent angioplasty to place a stent in his coronary artery.

Gorran shared the podium at the press conference with other self-proclaimed victims of the diet and their aggrieved family members: a 51-year-old hairstylist whose cholesterol went from 160 to 258, suffered kidney stones and had to have surgery to remove her gall bladder; the parents of an overweight 16-year-old from Sturgeon, Mo., who dropped dead from cardio-respiratory arrest at school while suffering from low levels of calcium and potassium in the first days of the diet; the sister of a 41-year-old man from Yardville, N.J., who also died of a heart attack while low carbing.

The master of ceremonies at this media circus of misery was Dr. Neal Barnard, president of the Physicians Committee for Responsible Medicine (PCRM), a nonprofit that promotes the health benefits of vegetarian and vegan diets, and advocates against the use of animals in medical testing and in the training of medical students. As an advocate of "plant-based" diets, Barnard has written several books, including most recently "Breaking the Food Seduction" (St. Martin's, 2003), in which Chapter 4, "Opiates on a Cracker: The Cheese Seduction," asks, "Is cheese a drug?" Oozing with recipes for oven-barbequed tofu steaks and tempeh tostadas, the book also advises dieters how to best fend off "party platters and other torture devices."

Barnard may have considered Atkins, an eat-the-hamburger, not-the-bun approach to weight loss, a bad idea long before his group set up an online registry to record consumer complaints about it. But for vegans and animal-rights activists, for whom meat is as bad ideologically as they believe it is physically, the ever-rising profile of low-carb diets is a major public-relations setback. There may be no consensus on the healthiness of low-carb diets, but there is no denying their increasing popularity.

Meat is back! The magic words "low-carb" are popping up in beer commercials and Weight Watchers products. So clearly, something needed to be done. After a year of soliciting reports from low-carb dieters suffering from everything from gout to bad breath, PCRM collected 188 responses to its informal online survey, and decided to call the press conference to highlight the most heinous among them.

While stressing that the self-reported responses of a self-selected audience on a Web quiz do not constitute a scientific study, Barnard believes that his group has now amassed enough preliminary evidence to justify calling for further research by the feds. "We are asking the CDC [Centers for Disease Control] to go from indictment to conviction," he said at the press conference. "We are calling on the CDC to try to lure Americans away from its honeymoon with the diet that has made its reputation from the fact that it's so counterintuitive -- eat the worst possible food, and lose weight."

As news outlets gobbled up the story -- "Low-Carb, High-Protein Diets Can Be Deadly" and "Doctors Blast Atkins Diet" -- the "Atkins machine," as Barnard refers to the company that's sold millions of diet books, nutritional supplements and low-carb food products to the protein-hungry masses, blasted back. Atkins Health and Medical Information Services issued a statement defending the safety of its diet, and accusing PCRM of seeking to "further its own vegan political and philosophical agenda," while exploiting the "obesity and diabetes crisis in this country."

Was Barnard's press conference less about concern for the health and nutrition of overweight Americans looking to shed those extra 10 or 50 or 150 pounds, than it was about the concern for the beef and pork likely to be consumed by their hungry mouths on a high-protein diet? Had Jody Gorran, the Floridian who'd become convinced that the miracle diet he'd talked up to his family and friends had given him heart disease, just traded one deal with the devil for another? The plot thickens the closer you look -- the only thing for sure is that low-carb diets are becoming a major player in the fight for hearts and minds in a culture-wide struggle over the propriety of eating meat.

"All of us at Atkins are deeply disturbed by PCRM's shameless exploitation of people who have struggled through personal tragedies," the Atkins press release said. "There is no logic and no science to support any association between these individuals and the ANA [Atkins Nutritional Approach], no more and no less than there is logic or science to support an association between the thousands of people who die from heart disease or kidney failure while following a low-fat diet."

In other words: With millions of people on a diet, some of them are going to get sick, and even die, especially if they're already likely to be suffering from the health risks associated with obesity. Should the Atkins diet be made to answer for the sins of the obesity epidemic, when all they're trying to do is help free people from the prison of their extra layers of fat? In short: Don't look at us.

Dr. Stuart Trager, chair of the Atkins Physicians Council, went further, criticizing the Physicians Committee for Responsible Medicine in an "open letter" for eschewing the scientific method, and instead going straight to the TV cameras with its anecdotal evidence that low-carb dieting can kill: "This group of radical vegans and animal rights advocates abusing their medical degrees and masquerading as concerned and 'responsible' physicians must be held to the same standards that all scientists must adhere to, and to cease this practice of sensationalism."

In his letter, Trager cited the research of Dr. Eric Westman at Duke University, which unexpectedly found that cholesterol levels fell on the first six months on the diet, as one example of credible scientific work on the Atkins plan. But Trager conveniently failed to mention that Westman himself had said in a statement upon the publication of his research: "While we're impressed with the weight loss of this diet, we still are not sure about the safety of it. More studies need to be done in order to be confident about the long-term safety of this type of diet."

In turn, Barnard questioned the august credibility of a group of doctors paid to defend a lucrative diet plan. "I understand that they have to say that it's safe because they have a $100 million empire based on that, but the only credible response is to investigate," he said in an interview, adding: "What credibility do the Atkins doctors have? They are paid to do research to sell books. If somebody paid by Atkins wants to questions anyone's credibility, first they should question their own."

But pro-Atkins advocates aren't the only critics of the PCRM press conference. There are others who question the wisdom of taking nutritional warnings about the dangers of eating meat from a press conference set up by a group that works against animal testing.

"They are committed advocates against use of animals in any way, shape, form or manner, so they're not objective," says Robert Baratz, an internist in private practice in Boston, who is president of the National Council Against Health Fraud, a nonprofit that fights medical quackery. "And they are strongly allied with, if not a front organization for, PETA (People for the Ethical Treatment of Animals), but they don't let it be known that that's the case, and that's deceptive."

Jeff Kerr, general counsel for PETA, says that his organization has made some donations to the Physicians Committee for Responsible Medicine in the past to support "areas of mutual interest," and Barnard, who writes the "Dr. in the House" column for PETA's Animal Times magazine, has served as a medical advisor to the group. "But to suggest that there is anything else there is simply ludicrous."

Barnard says his group has a team of doctors and registered dieticians on staff, as well as about 5,000 doctors as members, and more than 100,000 other "supporting" members. And while he may agree with many of PETA's stances, he denies that he's the lab coat and stethoscope puppet for its animal-rights ideology: "I think that PETA has done a great job in many ways of encouraging people toward healthier diets," he says. "Your coronary arteries don't care why you stop eating meat. Having said that, we're not a front for them, or they for us."

The organization that has gone the furthest toward trying to smear PCRM as a bunch of unscientific PETA-sympathizers is the Center for Consumer Freedom, made up of paid flacks for the restaurant industry. The organization's strongly worded accusations about the group Barnard leads are one of the first things to come up after even the most cursory Google search.

But the Center for Consumer Freedom, which has received funding from Tyson Foods and the National Cattlemen's Beef Association among others, is hardly in a position to accuse other organizations of being front groups, says Laura Miller, associate editor of Prwatch.org, a project of the Center for Media and Democracy, which has done investigative work on the organization and its founder.

"They're an interesting group because they illustrate how corporate money is funneled into these front groups that help confuse issues. They're hired P.R. hacks basically working for the industry to promote the industry's viewpoint. Their job is really to attack any organization or anyone who says that maybe Americans shouldn't eat so much meat."

So, if you can't trust the critics of a meat-happy diet, because they're vegetarians opposed to animal testing, and you can't trust the biggest critics of the vegetarians because they're funded by the meat industry, and you can't trust the doctors who are paid to defend a diet, then who should you listen to in this rancorous debate?

The Atkins camp has long viewed mainstream nutritionist putdowns of its diet with suspicion, but some specialists without any direct ties to the health industry or the "plant-based diet" promoters, are adamant that the Atkins diet simply isn't well-balanced.

Dr. Jeanne Goldberg, director of the Center on Nutrition Communication at Tufts University, a dietician with a Ph.D. in nutrition, suggests taking a look at the current issue of the Tufts University Health and Nutrition Letter, which tries to answer the question: "Is it possible to follow the Atkins diet healthfully?"

"The short answer is no," Goldberg observes. "It is virtually impossible to get adequate amounts of a number of essential nutrients. It contains three times the saturated fat as someone consuming an 1,800-calorie diet should. It's pretty tricky to get adequate amounts of calcium on it."

And while she dismisses "many of the arguments that the Physicians Committee for Responsible Medicine makes" as "not grounded in good science," she is unflinching in her impatience for those who tout the health benefits of Atkins: "Here's my take on it: It's not a balanced diet. A diet which tells you that you really can't eat all fruits and very few vegetables is not a healthful diet."

That's not to say that you can't lose weight on the diet, as millions have done and continue to do. "What the data show so far is that people can lose weight on anything from the most sensible balanced diet to the Atkins diet," she says. "The problem comes in terms of maintenance. The Atkins diet as a maintenance diet is really a poor idea, because it is high in saturated fat and low in other essential nutrients. It isn't about losing weight. It's about keeping it off."

Is It Possible to Follow the Atkins Diet Healthfully? [Full Text]

One of the vice presidents of Tufts posed the following questions. Is it possible to do the Atkins diet healthfully? And if not, is there a way to tweak the low-carbohydrate plan to make it more nutritious for those people who want to try it to lose weight?

With Dr. Atkins’ New Diet Revolution on the New York Times bestseller list for six and a half years straight with no sign of its sales letting up, we thought the answers to those questions would be more than timely. So we ploughed through the book—again—to see whether there was any way to reconcile Dr. Atkins’s weight-loss instructions with the principles of good nutrition accepted by the health-promoting community at large.

The most logical way to approach the project, it seemed, was to devise menus based on Dr. Atkins’s advice for the four phases of his plan—Induction, Ongoing Weight Loss, Pre-Maintenance, and Maintenance—and then see where adjustments could be made. It was not easy. As anyone with even a passing familiarity of the Atkins diet knows, there are no calorie restrictions, so deciding on amounts of various foods to include in the menus is something of an arbitrary decision. And the sample menus included in the back of Dr. Atkins’s book are of no help because they don’t jibe with the instructions in the text. For instance, the text says that by the time someone is up to the Maintenance phase, he or she may be able to enjoy up to three “deviations” a week, a deviation being anything from a serving of fruit to a couple of slices of whole- wheat bread to a baked potato. (All get most of their calories from carbohydrates.) But the “Typical Mainten-ance Menu” almost 100 pages later shows at least four or five deviations on a single day: half a cantaloupe, French onion soup (which tends to come with a thick slice of bread floating at the top), half a small baked potato, veal chops that are lightly breaded (the breading is made from carbohydrates), and a “generous cup” of fruit compote.

In the end, we decided to construct menus for the four phases that contained 1,800 calories each. That seemed like a reasonable calorie allotment for most people wanting to lose weight, including women, as long as they consistently logged a half hour to an hour of exercise each day.

Then we got stuck. The book is adamant in its instructions to avoid certain foods. The first phase—the 14-day Induction Diet that people are supposed to start with—contains “no fruit, bread, grains, starchy vegetables, or dairy products other than cheese, cream, or butter.” That means no milk or yogurt, no whole-wheat breads or cereals. And that, in turn, means no easy sources of calcium or vitamin D or whole-wheat phytochemicals that researchers are discovering may play a role in warding off illnesses such as heart disease and diabetes. Dr. Atkins does say to take a multivitamin, but the formula he recommends contains no calcium and too little vitamin D to meet anyone’s needs. And it doesn’t have any of the fiber or other chemicals contained in whole wheat.

The next phase, Ongoing Weight Loss, or OWL, is more lenient, but readers are still warned that fruit-eating will “always” be “somewhat risky.” And Pre-Maintenance, the last two or three months “to shed the last 10 pounds” before transitioning to Maintenance, includes only one to two “deviations” a week.

Then, too, all four phases, devised here according to the letter of Dr. Atkins’s instructions, are extremely high in saturated fat and dietary cholesterol, large amounts of which are not consistent with heart health.

Granted, we could have taken a stab at tweaking the menu for each phase—limiting some of the foods high in saturated fat, like creamy dressings, whipped cream, cream cheese, bacon, and butter and replacing the calories from those items with calories from fruits, whole grains, and low- and nonfat dairy products. But then it wouldn’t have resembled the Atkins plan anymore. It would have begun to morph from the unnecessarily restrictive and nutritionally deficient diet that it is into one that more resembles a plain old healthful diet. And you already know what that looks like: a few servings of whole-grain foods each day, such as whole-grain breads and cereals; at least three servings of fruit and two of vegetables; a couple of servings of high-calcium dairy foods; smallish portions of meat, poultry, and fish; and sparing additions of cooking oil, mayonnaise, and other fats.

So, as to whether it’s possible to follow the Atkins diet healthfully or tweak it to make it safe and healthful, the answers are no and no. To be sure, Americans do eat too many calories in the way of refined or processed (as opposed to whole-wheat) carbohydrates, which means too much cake, candy, pastries, muffins, ice cream, pasta, outsized bagels, soda pop, white bread, pizza, sweetened cereal, and French fries. And inappropriately large (and frequent) servings of all those foods are most definitely contributing to our expanding girth. But you don’t need a 300-page diet book to advise you on making adjustments. Just eat smaller portions less often—and cut down on the junk. [End]

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