Manual Menu Confidential: Conquer the Hidden Calories, Sodium and Fat in the Foods You Love

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Ultimate Juicing. Donna Pliner Rodnitzky. The Undiet Diet. Ann Greene. Eat It to Beat It! Troy Adashun. Carb Charts - Low Carb Reference. Lisa Shea. Sione Michelson. The Lean Machines. John Chapman. Healthy Children's Lunches. Mandy Francis. Ani's Raw Food Desserts. Ani Phyo. Baby Bullet Recipes. Gerry Evan. Juice It! Robin Asbell. The Recipe for Radiance. Alexis Wolfer. Healthy eating for children. Infinite Ideas. George Sekonda. Marta Tuchowska.

Marsha Williams. Bobbie Freiberg. The Virtuous Tart. Susan Jane White. Sweet Debbie's Organic Treats. Debbie Adler. Andrew Cooper. The Snack Factor Diet. Keri Glassman. Dana Carpender. Flat Belly Cookbook For Dummies. In , the agency laid out five basic food groups: fruits and vegetables, meats and other protein foods, cereals and other starchy foods, sweets, and fatty foods. In , the Food and Nutrition Board of the U. Academy of Sciences introduced Recommended Daily Allowances, or RDAs, and from the department has produced revised versions at regular intervals.

This committee, which met until , was instrumental in the federal government's promotion of low-fat diets. During the nine years of hearings, the committee's focus shifted from its initial emphasis on hunger and the poor to chronic disease and diet. Committee members became convinced that Americans were not only eating too much, but were also eating the wrong foods.

The committee's work culminated in its early report, Dietary Goals for the United States , which promoted increased carbohydrate and reduced fat consumption along with less sugar and salt. The report recommended that Americans eat more fruits, vegetables, whole grains, poultry, and fish, less meat, eggs, and high-fat foods, and that they substitute nonfat for whole milk. Critics, both scientific and industrial, called the diet-heart hypothesis unproved and the dietary recommendations disputable. Under pressure from many constituencies, but especially the food industry, the committee revised and reissued its report later in the year.

With the publication of the Dietary Goals , the federal government officially supported the low-fat approach. By , a scientific consensus was emerging that a low-fat diet was needed to prevent the two leading causes of death, coronary heart disease and cancer. Thus, by the s, in spite of protests from the food industry and skeptical scientists, federal agencies forged a consensus on dietary advice at the same time that a growing scientific consensus advocated low fat for everyone. Although the food industry had initially worried about the low-fat approach, by the s food producers had begun to realize that low fat could provide profit-making opportunities.

In , after much controversy and negotiation, the USDA released its first and long-awaited food pyramid that lent full support to the ideology of low fat. Wide press coverage gave the pyramid much publicity, and it quickly became an icon. Food companies would pay to label their foods with the AHA seal of approval. By , endorsed food products started to appear in grocery stores, but there was a problem: fresh foods were not labeled.

This exclusion could suggest to consumers that processed foods were the heart-healthiest. Following protests, the AHA withdrew the program, but reinstated it in By , fifty-five companies were participating with over products certified, many of which were cereal products, including Kellogg's Frosted Flakes, Fruity Marshmallow Krispies, and Low-Fat Pop-Tarts.

Four ounces contain mg of sodium. Approving meats injected with salt seems to be at odds with the AHA's long-standing efforts to reduce hypertension. Some hyptertensives are known to be salt-sensitive. Photo taken by me in Blacksburg, Virginia, summer Was low fat the only thing that mattered for good health? Had the ideology of low-fat taken such a hold that that sugar-laden refined processed foods qualified for AHA approval as heart-healthy?

5 Healthy Low Calorie Recipes For Weight Loss

No wonder consumers were confused and assumed that low fat was what really counted in terms of health. It was possible to think that if a food were low fat, one could eat to appetite. We begin to see how a profusion of products low in fat but high in sugar and calories might ironically promote the fattening of America, even while being labeled heart-healthy.

The tradition of low-calorie, low-fat diets, and scientific and federal promotion of low fat could not have conquered America without the participation of the popular press. Two popular health sources, namely, Prevention magazine f. Both have subscribed to and promoted the low-fat diet since the s. One of the main contributions of popular magazines, such as Prevention , the Ladies' Home Journal , and Family Circle , was to include numerous advertisements for low-fat foods, one of the main ways American women learned about low-fat products.

Prevention promoted the low-fat diet for both heart health and weight reduction in the s and s. Jane Brody, personal health columnist for The New York Times since , whose articles have appeared in at least other American newspapers, also promoted the low-fat diet for heart health and weight loss, following the USDA Federal Dietary Guidelines. The attack on dietary fat and cholesterol dominated the s, as scientific studies implicated the American diet as a major cause of coronary heart disease. The first step in the program was the low-fat diet.

Scientific studies suggested that those who ate foods low in animal fat and cholesterol had less cholesterol in their blood. Yet, there was no proof that a low-fat diet would reduce heart disease. Dean Ornish had shown that lifestyle changes could halt or reverse atherosclerosis. Participants in his program reversed atherosclerosis, and cholesterol levels fell from an average of to , with low-density lipoproteins LDL reduced from to Even though Ornish's study involved only twelve participants, his results buttressed the dominant scientific belief that a low-fat diet could prevent, and might even reverse, heart disease.

Scientists wondered if all Americans should try to lower their cholesterol levels. But were these goals appropriate for all Americans? Another consideration was that studies up to then had been done only on middle-aged men, the group most afflicted by heart disease. Scientists had studied neither women nor the elderly in clinical trials of cholesterol reduction. Two studies helped scientists begin to answer the question concerning the general applicability of the low-fat diet as the way to lower cholesterol.

The second attributed lower death rates to drug-induced cholesterol reduction. Scientists interpreted these findings to mean that lowering cholesterol levels by any means had clear benefits for preventing heart attacks. But the studies did not show that lowering cholesterol levels increased longevity, and so long-term outcomes remained unclear. Throughout the s and s, Prevention 's dominant diet recommendation was the low-fat, high complex-carbohydrate diet, labeled the Prevention diet.

This long-standing association of low fat with low calorie would soon be upended, however, as the food industry flooded the market with low-fat—but fattening—foods. In many of these foods, sugar replaced fat so that low fat became high calorie. The early s saw a move from low fat to no fat on the part of some popular health writers. Reflecting the influence of the Ornish studies, the message presented in Prevention in the early s in editorials, columns, and ads was that if low fat was good, no fat was better.

In December , Editor Mark Bricklin introduced a new generation of nonfat foods. The nonfat cookies were a prime example of how, according to some scientists and science writers, low fat made Americans fatter. The low-fat diet reigned supreme in the late s, as scientists, the federal government, and popular health writers declared the low-fat, high-carbohydrate diet the gold standard for heart health and weight control.

Prevention writers warned of the dangers of the popular high-protein diets, even while acknowledging that people overdid the low-fat, high-carbohydrate foods. It seemed that too many Americans thought they could eat as much as they wanted as long as it was low or no fat. They had followed the advice to count fat grams and not calories—with the result that some had gotten fat on low and no-fat foods.

Researchers studied diets in countries where heart disease and obesity were rare to see if Americans could learn from other cultures. Subscribing to a universalizing model, they assumed that all human bodies functioned in the same way. The idea was that we could observe what other people ate, for example, the Chinese or the Japanese, see what effect their diets had on heart health and weight, and then, if need be, emulate them. Investigators reasoned that if a diet worked for the Japanese or the Chinese, it should also work for Americans. Nutritional researchers gathered interesting data from these two Asian diets, leading them to suggest that Americans ate too much fat and protein to the neglect of vegetables.

A healthier diet would be vegetable based, with only modest amounts of fat and animal protein. But sometimes they departed from this dominant positivistic position. Brody, for example, recognized sex differences in her discussion of how women's pattern of heart disease differed from that of men. In the early s, scientists found that males and females experienced heart disease differently.

She reported on a study of , older adults that had found that losing weight had no effect on life span. Although weight loss helped individuals manage diabetes and hypertension, the study found that obesity—and this term was not spelled out in the study—had few effects on mortality as people aged. By the age of seventy-four, there was no relationship between being obese and a higher risk of dying.

A major challenge to the use of diet as a way to reduce weight came from set-point theory.

In the early s, Brody began to question the low-fat dogma on these grounds. According to set-point theory, each person's weight has a fairly stable set point that resists gain or loss of weight. Although the set point may change with age and in some people can be overridden, the set point means that permanent weight loss is extremely demanding—if not impossible—for many people. Drawing on scientific studies, she explained that it was not clear that people could lose weight and keep it off. In a break with her long-standing recommendation of the low-fat diet, she called for an individualized approach, suggesting that a one-size-fits-all diet might not be the most effective for all.

She had not lost faith in the low-fat diet, but as scientists continued to complicate the issues involved in weight loss and maintenance, Brody and others began to moderate their low-fat-for-all message. Increasing knowledge of dietary fats also complicated the low-fat agenda. Again, Brody's solution was a low-fat diet for both heart health and weight loss.

Meanwhile, challenges to low fat diet for heart disease prevention came from two other fronts: success with drug therapy and scientific dissent about the efficacy of the diet for heart health. In the s, statins' ability to reduce cholesterol levels suggested that drugs might be more effective than diet, thus challenging the hegemony of the low-fat diet as a recommendation for heart health. The statins—with four on the market by —promised to change the emphasis on the low-fat diet as the major therapy for cholesterol reduction. Although statins, available since , had been shown to lower cholesterol, until the mids, it was not clear that they saved lives.

But in , a scientific study showed that Merck's simvastatin not only reduced the risk of coronary heart disease, but also saved lives. Kolata suggested that this finding would encourage more aggressive drug treatment of high cholesterol in patients at risk for coronary heart disease and could result in a major change in medical practice. As far back as the s, a minority of scientists and popular health writers had questioned the low-fat diet. Some scientists had argued that it was the kind of fats—not the total amount—that mattered. This skepticism emerged full-blown in the s. He explained that because the scientific community had recommended the diet, people assumed there was proof that the diet worked, even though there was none.

One leading obesity researcher, Dr. Jules Hirsch, physician-in-chief at Rockefeller University and one of the principal contributors to the notion of set-point theory, raised a different challenge. Willett noted that substituting carbohydrates for fats could reduce high-density lipoproteins HDL levels while raising triglyceride levels.

With such challenges, could the ideology of low fat maintain its position of authority? Responding to these critiques, Brody began to modify her recommendations. This diet was high in monounsaturated fat, but low in saturated fat, emphasizing beans, grain, vegetables and fruits, small amounts of yogurt and cheese, fish, eggs, poultry, and a little red meat. At the end of the decade, Kolata wrote about the low-fat diet for heart disease prevention and therapy, noting that there was no longer scientific consensus on the heart-healthiest diet.

Although the official recommendation since the s had been that carbohydrates replace fats in the diet, some scientists disagreed. Willett, for example, consistently argued that it was not total fats that mattered, but the type of fat. He recommended that Americans forget low-fat diets and embrace good fats such as olive oil and nuts.

At the same time, the Atkins diet resurfaced, generating renewed interest in this high-protein, high-fat, low-carbohydrate diet, with over five million copies of the paperback edition in print. The Atkins diet had become a national phenomenon in the s, with ten million copies of Dr. Atkins Diet Revolution sold. Brody dismissed the diet, noting that no long-term studies had been done and arguing that much of the initial weight loss was water.

She suggested that as the diet became boring and unpalatable, dieters consumed fewer calories—and lost weight. Brody opposed this diet, reporting that with sensible eating and regular exercise she had lost thirty-five pounds. Her success convinced her that willpower and a low-calorie approach, along with exercise, could produce weight loss and maintenance. Eat more calories than your body uses and you will gain weight.

Spice up Entrees with Low-Calorie Add-ins

Eat fewer calories and you will lose weight. The body, which is, after all, nothing more than a biochemical machine [my emphasis], knows no other arithmetic. Simple carbohydrates, much loved by Americans, were at fault, Atkins maintained: white flour, sugar, and potato products, those de-fatted processed products that had fattened America. By the end of the century, Brody was moderating her low-fat position to declare that fat can be a friend!

Recounting the history of low-fat diet advice, Brody noted a major shift within the scientific community. Following the findings of Willett and others, scientists were now claiming that it was not the total amount of fat but the kind of fat that mattered. Brody was converting to this point of view. The key to heart health now seemed to be reducing saturated and trans fats hydrogenated plant fat , but not all fats.

Ignoring scientific studies that supported set-point theory, she argued that if low fat was not the answer to weight loss, we must count calories and exercise. The twenty-first century ushered in new enemies and new approaches. Prevention readers were advised that if they wanted to be thin, they must cut out sugar and manage stress.

Scientists showed that stress-induced cortisol promoted abdominal fat—declared the most dangerous kind of fat. The index offered a scientific way for readers to choose healthful carbohydrates that proponents maintained would not promote weight gain. In the new millennium, there was little agreement on which diet was the best either for heart disease prevention or weight reduction. It makes no difference if these calories are in fats or vegetables or cake or ice cream.

Change was at hand on the diet front. In a breakthrough article , Brody moved away from the one-size-fits-all low-fat diet that she had promoted with a religious fervor for more than twenty years to suggest that perhaps different diets worked for different people. Addressing the widespread confusion about fat and fats, she noted that no consensus existed among experts.

She proposed that a one-size-fits-all approach no longer worked in a society as ethnically and culturally diverse as ours. It was becoming more and more apparent that the public health message promoting the low-fat diet had had unintended consequences: it had led some people to adopt an unhealthy diet—just as long as it was low fat. Writing about the high-fat, low-fat controversy in , Brody emphasized the importance of a balanced diet. She pointed out that after three decades of popularity of the Atkins diet, scientists had still not tested it for long-term safety and effectiveness.

She argued that the high-protein diet attracted those who failed on the low-fat diet. Brody maintained that it was not low fat that was fattening Americans, but more calories. Americans were eating on average calories more per day, and they had not reduced their fat consumption—if one used the higher total calorie count to figure percentages.

Home economics

Brody reiterated that it was just calories that mattered—no matter what kind. The Mediterranean diet found new followers as critics challenged the low-fat diet in the face of what many scientists and physicians were calling an obesity epidemic. Low-fat proponents had not foreseen that Americans would overindulge in refined low-fat carbohydrates. One of the unanticipated consequences of industrial food technology was the ability of the food industry to flood the market with highly processed low-fat—but fattening—foods.

They argued that substituting refined carbohydrates for fats was not the answer, explaining that refined carbohydrates—whether low fat or not—raise triglyceride levels and lower both good and bad cholesterol. They maintained that there was no evidence from clinical trials to show that reducing dietary fat would by itself lead to weight loss. Rather, ignoring set-point theory, they maintained that it was too many calories and too little physical exercise that led to weight gain. So, by , the most recent research challenged the low-fat ideology that had held sway for so long, but at least some research affirmed Brody and Kolata's position that what counted was calories consumed and energy expended.

Finally, in , the results of long-term studies on low-carbohydrate, high-protein, high-fat diets, such as Atkins, were published. But it turned out that many people who succeeded on the diet were vindicated. People lost weight—and for many for whom low-fat or low-calorie diets had not worked, it was the first time they had lost weight. So what if the first 5—7 pounds were water? Many lost far more than this. The studies found that, contrary to expectations, the diet did not damage heart and blood vessels; in fact, in some patients readings improved. As proponents had claimed, cholesterol levels did not rise, triglyceride levels fell, and HDLs improved.

At the end of a year, however, both the low-fat and the low-carbohydrate diets produced about the same results in terms of weight loss. This was the same argument opponents of the low-fat diet had used when they argued that the fattening of America coincided with the decades in which the low-fat diet reigned as nutritional orthodoxy. After explaining why some people lost weight on the Atkins diet, Brody reiterated that it was only calories that mattered.

Both the writers for Prevention and the science writers for The New York Times carefully reported on scientific studies. They reflected a great faith in the validity of the studies and the value of reporting them to the wider public. They were not reluctant, however, to include their own point of view, comparing and interpreting these studies for readers. These writers reflect the larger American—journalistic—faith in science during these years before many questions were raised concerning the reliability of such clinical, epidemiological, and laboratory studies.

The popular media, in short, played a pivotal role in preaching the low-fat message, and, then, in more recent years, in questioning it. Several developments that came together in the s and s help explain how the ideology of low fat conquered America in those decades. The dietary context was an established tradition of low-calorie, low-fat dieting for weight reduction that predisposed Americans to accept what was promoted as a heart-healthy diet.

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A plethora of diet-heart studies carried out by scientists and physicians suggested that a low-fat diet might prevent heart disease. These studies drew on research that had been done from the s through the s. By the late s, the federal government started promoting the low-fat diet, and shortly thereafter the food industry began to make low-fat products available and to advertise them widely. Low-fat foods proliferated in the s and s, demonstrated by the number of products available in grocery stores and the ads that appeared in magazines and on television.

The rise of the ideology of low fat seemed to correspond with major reductions in risk factors for heart disease. Was it coincidence, or could a causal effect be identified? These figures suggest that something in the American experience with heart disease did indeed change. These figures did not clarify the role of the low-fat diet, and so its influence in primary and secondary prevention remained in question. The most recent study of the low-fat diet suggests that it does not prevent heart disease.

The low-fat diet was not just intended to prevent heart disease, however. It was aimed at promoting weight loss. It was more difficult—if not impossible—to measure the efficacy of the diet for weight reduction. In the same decades that low fat conquered America, Americans in the aggregate were getting fatter. Were Americans not practicing the low-fat recommendations? Or did they not work? Or did the outcomes vary according to race, class, ethnicity, gender, and age? Brody claimed that most Americans were not eating a low-fat diet. Scientists showed that stress-induced cortisol promoted abdominal fat—declared the most dangerous kind of fat.

The index offered a scientific way for readers to choose healthful carbohydrates that proponents maintained would not promote weight gain. In the new millennium, there was little agreement on which diet was the best either for heart disease prevention or weight reduction.


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It makes no difference if these calories are in fats or vegetables or cake or ice cream. Change was at hand on the diet front. In a breakthrough article , Brody moved away from the one-size-fits-all low-fat diet that she had promoted with a religious fervor for more than twenty years to suggest that perhaps different diets worked for different people.

Addressing the widespread confusion about fat and fats, she noted that no consensus existed among experts. She proposed that a one-size-fits-all approach no longer worked in a society as ethnically and culturally diverse as ours. It was becoming more and more apparent that the public health message promoting the low-fat diet had had unintended consequences: it had led some people to adopt an unhealthy diet—just as long as it was low fat. Writing about the high-fat, low-fat controversy in , Brody emphasized the importance of a balanced diet.

She pointed out that after three decades of popularity of the Atkins diet, scientists had still not tested it for long-term safety and effectiveness. She argued that the high-protein diet attracted those who failed on the low-fat diet.

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Brody maintained that it was not low fat that was fattening Americans, but more calories. Americans were eating on average calories more per day, and they had not reduced their fat consumption—if one used the higher total calorie count to figure percentages. Brody reiterated that it was just calories that mattered—no matter what kind. The Mediterranean diet found new followers as critics challenged the low-fat diet in the face of what many scientists and physicians were calling an obesity epidemic. Low-fat proponents had not foreseen that Americans would overindulge in refined low-fat carbohydrates.

One of the unanticipated consequences of industrial food technology was the ability of the food industry to flood the market with highly processed low-fat—but fattening—foods. They argued that substituting refined carbohydrates for fats was not the answer, explaining that refined carbohydrates—whether low fat or not—raise triglyceride levels and lower both good and bad cholesterol. They maintained that there was no evidence from clinical trials to show that reducing dietary fat would by itself lead to weight loss.

Rather, ignoring set-point theory, they maintained that it was too many calories and too little physical exercise that led to weight gain. So, by , the most recent research challenged the low-fat ideology that had held sway for so long, but at least some research affirmed Brody and Kolata's position that what counted was calories consumed and energy expended.

Finally, in , the results of long-term studies on low-carbohydrate, high-protein, high-fat diets, such as Atkins, were published. But it turned out that many people who succeeded on the diet were vindicated. People lost weight—and for many for whom low-fat or low-calorie diets had not worked, it was the first time they had lost weight. So what if the first 5—7 pounds were water? Many lost far more than this.

The studies found that, contrary to expectations, the diet did not damage heart and blood vessels; in fact, in some patients readings improved. As proponents had claimed, cholesterol levels did not rise, triglyceride levels fell, and HDLs improved. At the end of a year, however, both the low-fat and the low-carbohydrate diets produced about the same results in terms of weight loss. This was the same argument opponents of the low-fat diet had used when they argued that the fattening of America coincided with the decades in which the low-fat diet reigned as nutritional orthodoxy.

After explaining why some people lost weight on the Atkins diet, Brody reiterated that it was only calories that mattered. Both the writers for Prevention and the science writers for The New York Times carefully reported on scientific studies. They reflected a great faith in the validity of the studies and the value of reporting them to the wider public. They were not reluctant, however, to include their own point of view, comparing and interpreting these studies for readers. These writers reflect the larger American—journalistic—faith in science during these years before many questions were raised concerning the reliability of such clinical, epidemiological, and laboratory studies.

The popular media, in short, played a pivotal role in preaching the low-fat message, and, then, in more recent years, in questioning it. Several developments that came together in the s and s help explain how the ideology of low fat conquered America in those decades. The dietary context was an established tradition of low-calorie, low-fat dieting for weight reduction that predisposed Americans to accept what was promoted as a heart-healthy diet.

A plethora of diet-heart studies carried out by scientists and physicians suggested that a low-fat diet might prevent heart disease. These studies drew on research that had been done from the s through the s. By the late s, the federal government started promoting the low-fat diet, and shortly thereafter the food industry began to make low-fat products available and to advertise them widely.

Low-fat foods proliferated in the s and s, demonstrated by the number of products available in grocery stores and the ads that appeared in magazines and on television. The rise of the ideology of low fat seemed to correspond with major reductions in risk factors for heart disease. Was it coincidence, or could a causal effect be identified? These figures suggest that something in the American experience with heart disease did indeed change. These figures did not clarify the role of the low-fat diet, and so its influence in primary and secondary prevention remained in question. The most recent study of the low-fat diet suggests that it does not prevent heart disease.

The low-fat diet was not just intended to prevent heart disease, however. It was aimed at promoting weight loss. It was more difficult—if not impossible—to measure the efficacy of the diet for weight reduction. In the same decades that low fat conquered America, Americans in the aggregate were getting fatter. Were Americans not practicing the low-fat recommendations? Or did they not work? Or did the outcomes vary according to race, class, ethnicity, gender, and age? Brody claimed that most Americans were not eating a low-fat diet.

Others declared the low-fat approach ineffective for weight reduction and maintenance. Among this group was cardiologist Robert Atkins, whose ideas were vigorously attacked in both the scientific and popular press. There were countervailing cultural, social, and economic forces at work that undermined the low-fat approach and may help explain the fattening of America. Students of obesity have cited factors such as the increased availability of processed foods, the introduction of labor-saving and entertainment technologies most prominently television , the rise of car culture, suburbs without sidewalks, the introduction and proliferation of fast foods, and junk machines in public schools.

One science writer has argued that high fructose corn syrup, which became a staple ingredient of the soft drink industry as well as numerous other foods, was a main contributor to the fattening of America from the s onward. Americans ate more processed foods. The changing social structure—for example, the two-worker family, or the single parent family—meant that families ate out more often.

Many Americans found that you can't eat processed food and lose weight. Nor can you eat out and lose weight. In fact, many found that you just can't lose weight at all. Or, if you do lose it, you will gain it back. By , one obesity specialist, Kelly Brownell, argued that Americans were living in a toxic, that is, fat-promoting environment. Low fat conquered America, but while some Americans subscribed to and practiced it, many Americans either could not or did not live by the low-fat rules. Some were confused by the low-fat advice, thinking they could substitute refined carbohydrates for high-fat foods.

Many saw large portions of pasta as an allowed indulgence. Always hungry? Eat to appetite. Just be sure it is low fat. Many Americans did not practice the low-fat regime, resisting the low-fat message out of cultural choice, ethnic tradition, poverty, or sheer perversity. Proscribed were many ethnic and traditional American foods. Out were cream, chocolate, cheese, lard, butter, salad dressings, chicken skin, gravy, fried foods, and baked goods. What could be eaten? Fruit, but no cream. Low-fat advocates preferred processed substitutes, such as Cool-Whip. Bread, but no butter. Salad, but no dressing—unless it was low-fat.

Fish, but no sauce. Vegetables, but no butter. Chicken breasts, but no skin. Lean beef, but no gravy. No fried anything. No pies or cakes. Pasta, but no cream sauces. Complicating matters was the changing state of knowledge about fats. At first the advice was, give up butter: margarine is healthier.

But just recently the advice is, give up margarine: olive oil is best. But, in general, butter and oils were disallowed, in the interest of the low-fat regimen, or the servings drastically reduced. Many staples of what Americans considered good eating were ruled out. Following a low-fat diet was also expensive, inconvenient, and, in fact, elitist. One had to avoid most restaurants and most foods sold in grocery stores. Processed and fast foods were bargains and required little effort to prepare.

The result was two cultures: fat and low fat. On the one hand, there was the dominant fat culture of donuts, pizza, ice-cream, burgers, fries, pastries, and ethnic foods adapted to American tastes, such as Chinese, Italian, and Mexican. These foods were readily available, cheap, and satisfying. Then there was the low-fat counterculture of fruit, vegetables, white meat chicken, fish, and salads—all to be eaten without cream, sauces, or butter.

One irony of low fat was that sugar, being low fat, was still officially okay. But sugar combined with fat was condemned. Although scientists had found no correlation of sugar with coronary heart disease, sugar was a main ingredient in high-calorie treats when combined with fat or white flour, as it typically was. Favorite American desserts such as chocolate-layer cake, apple pie, cookies, and ice cream were off-limits. And, Americans were left with low-fat—but often just as fattening—substitutes. Low-fat sugar-laden cereals proliferated, and consumers were confronted with a dizzying array of choices.

In addition, by the s, even those assiduously subscribing to the low-fat regime for weight reduction and maintenance began to have trouble in restaurants, as both plates and portions got larger. High-fat ethnic food became more popular and more widely available, and it was tough for even for the most religious of low-fat disciples to eat out.

Aside from these two cultures of fat and low fat, there was, dating from the s, a vibrant subculture that was embracing—yet again—French food. A little cream sauce? Roast chicken with skin? Why not? Imported creamy cheeses with crusty bread? Yes, and add a good Bordeaux. Chocolate mousse? For a special occasion. And as more and more middle-class Americans traveled to Europe, they began to realize that there were broader culinary horizons—and they were not low-fat. And it didn't taste so good either! In short, while many Americans paid lip service to the ideology of low fat, they did not live it.

They either could not or did not follow the prescribed dietary rules, or they thought that they could substitute refined carbohydrates for high-fat foods. And then, rather abruptly, at the beginning of the twenty-first century, the end of the ideology of low fat—but not low-fat recommendations—seemed at hand. In , the latest incarnation of the low-carbohydrate craze began to sweep the nation. For Prevention , the date was May , when its cover featured the low-carbohydrate South Beach Diet. Popular magazines started advertising low-carbohydrate foods, and Prevention published a survey rating the best-tasting low-carbohydrate processed foods.

The magazine had done an equivalent special in for low-fat foods. Science writer Sally Squires pointed out that just when we think we have a health problem figured out, a new study is published, and uncertainty prevails. This reality of science and medicine makes it difficult for citizens and policy makers, patients and consumers. High fat? Low Fat? Trans fat? Saturated fat? Polyunsaturated fat? Monounsaturated fat? No fat? Confusion and complexity provide a heyday for the media. Nevertheless, almost three years after the flurry of excitement over the low-carbohydrate South Beach Diet, the enthusiasm for low carbohydrate waned.

Low carbohydrate had its day, spawned many new processed foods, and many Americans found that it worked—at least for a while. With the low-carbohydrate diet, they could lose weight without feeling hungry, but many could not continue the regime forever. Some people did not feel good, lacking the energy to exercise or even climb stairs.

Others felt deprived without bread, baked goods, and pizza. Yet some folks were not hungry, ate nutritious foods, and lost weight. The low-carbohydrate diet appeared to improve the health profiles of some individuals with a variety of medical problems. Blood pressures and cholesterol levels dropped. Low-carbohydrate and low-fat approaches were not necessarily at odds.

Low carbohydrate can mean low fat, but it often doesn't. That said, we have moved well beyond the early high-fat Atkins diet of the s to a more moderate approach. The new low-carbohydrate diet, exemplified by Arthur Agatston of South Beach Diet fame and others, encourages the consumption of complex—not refined—carbohydrates.

Low carbohydrate is in retreat as a national dietary phenomenon. While some people will continue to live and benefit from a low-carbohydrate life, many have tried and rejected it. The low-carbohydrate movement peaked in February , with 9. These data suggest the swift rise and fall of low carbohydrate, from spring to fall Bread sales had been in decline even before the low-carbohydrate craze, but the downward spiral continued with the promotion of low-carbohydrate diets. But think about it: how could bread, the foundation food of so many cultures, stay out of favor for long?

Who could imagine that Americans would renounce bread, pizza, pasta, and sandwiches?

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The push since early has been for whole grains, with a stress on the importance of complex carbohydrates. Robert C. Atkins in New York, shipped fourteen truckloads of food to the Christian Appalachian Project to be used to feed the hungry in Appalachia. A local example of the end of the low-carbohydrate craze. The store had opened in and was featured in an article appearing in the local paper. Meanwhile, even though the major focus of popular health writers and the scientific community was on the low-fat and low-carbohydrate diets, since the early s the Mediterranean diet had been steadily gaining adherents.

Some scientists, low-carbohydrate promoters, and debunking science writers began to challenge the efficacy of the low-fat diet as a preventive measure for heart health and weight reduction. Prominent among these were Walter Willett and his colleagues at the Harvard School of Public Health, who promoted the Mediterranean diet, which had been advocated since the s by Ancel Keys and others.

Willett and his colleagues maintained that trans fats should not be eaten at all and saturated fats kept low. They declared polyunsaturated and monounsaturated fats heart-healthy, to be consumed in moderation. Although vegetable oils were calorie-laden, they were important for weight reduction because they promoted satiety.

A diet with moderate fat intake was more likely to result in long-term adherence, weight loss, and maintenance. These researchers promoted avocados, nuts, and olive oil not only as heart-healthy, but also as an important part of a successful weight-loss, weight-maintenance program. Neither low-fat nor low-carbohydrate, the Mediterranean diet, with its moderate consumption of health-promoting fats, emerged as a middle way. Brody and Kolata had been writing about the work of Willett and colleagues throughout the s, and by both were promoting the Mediterranean diet.

Willett had been arguing since the early s that Americans should forget low fat and embrace good fats. By the end of the decade, Brody acknowledged that the right kind of fat could be a friend: namely, avocados, walnuts, vegetable oils, and fatty fish. She noted a major shift in dietary recommendations. Scientists were modifying the monolithic low-fat diet, the principal recommendation for heart health and weight loss for thirty years.

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With criticisms of low-fat mounting, Brody urged a return to the traditional idea of counting calories and exercise for weight reduction, heart health, and selective fat reduction—away from trans and saturated fats in favor of vegetable fat and fatty fish. By , Brody was suggesting customized diets. Both scientists and popular writers were moving away from the one-size-fits-all low-fat approach. The low-fat diet still had its place in heart-health and weight-loss programs, but it was not the only diet recommendation, and scientists and popular health writers conceded that it might not be the best diet for all.