Cracking the Fat Riddle

SHOULD YOU COUNT CALORIES OR CARBS? IS DIETARY FAT YOUR BIGGEST ENEMY? THE LATEST RESEARCH MAY SURPRISE YOU

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If Kerry Sieger were a stone age hunter-gatherer instead of a 21st century molecular biologist, chances are she would have the taut, trim body of her dreams. In college, however, Sieger underwent such a dramatic weight gain that, ever since, she has been a size 6 butterfly struggling to emerge from a chrysalis of size 20 clothes. Over the years, she has tried a succession of diets--the Scarsdale diet, the Nutri/System diet, the Michael Thurmond 6-Week Body Makeover diet, even the cabbage-soup diet--but the pounds she has repeatedly lost have relentlessly crept back.

Now Sieger, 34, a research associate at a Houston-based biomedical research firm, has turned to the Atkins diet, a weight-loss program that seems to defy nutritional wisdom. Most health experts advise you to favor carbohydrates, found in everything from fruits to grains, while going easy on the protein and fat. On the Atkins diet, one is allowed to eat all the protein- and fat-drenched meat and butter one wants but must cut out cereal and bread. And if Sieger is puzzled by certain aspects of the diet--among other things, the initial phase is so low in fiber that constipation is often a problem--she finds merit in others. "I guess I'm curious to see if it works," she says. "I'm willing to give it a try."

Sieger is just one of the latest wave of Americans willing to try a regimen first promulgated by Dr. Robert Atkins three decades ago. His is the diet that refuses to die, slipping in and out of favor every few years, persistently bucking the skepticism of mainstream nutritionists. Could it really be, as Atkins argues, that low-fat diets, which are typically high in carbohydrates, are bad and that low-carbohydrate diets, which often contain considerable fat, are good? Is it really O.K., as Atkins advocates, to slather mayonnaise all over salmon and tuna and douse asparagus and lobster with butter while friends look on in envy? Shades of the 1973 movie Sleeper, in which Woody Allen plays a 20th century Rip Van Winkle who awakens after a couple of hundred years to a world in which fatty delights like steak and cream pies are deemed beneficial to one's health.

Alas, Sleeper was and is a fantasy. The indictment of excessive amounts of saturated fat--the kind found in steaks and butter--as a major contributor to heart disease and stroke has not changed and seems unlikely to do so. A formidable lineup of experts holds to the low-fat approach, none more tenaciously than Dr. Dean Ornish, whose regimen prescribes no more than 10% of daily calories from fat. With the latest resurgence of the Atkins program, the clash of the two theories is sharper than ever--low fat vs. low carbs, Ornish vs. Atkins. But here is what is new and somewhat startling: there are hints that Atkins may have struck a vein of truth--hints that are intriguing enough to convince some mainstream obesity experts that the approach merits more serious consideration. "Is it just that the Atkins diet is monotonous, and so people eat fewer calories?" wonders Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University in St. Louis, Mo. Or is there something more interesting going on? Something unexpected about food itself, perhaps, or the way we eat it or even what our genes have programmed us to like?

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