Admit When You're Wrong—I Do
I made a mistake. I messed up. I goofed. Cometí un error. As a type “A” physician who was raised on the idea that M.D. stood for ‘medical deity,’ this is hard for me to admit. However, I have grown from those early hubristic tendencies, now my daughters insist that M.D. stands for ‘my daddy’, so I am embracing my inner screw up and hope to cleanse my guilty soul through admission and penitence.
I’m coming clean.
In my book Healthy Habits for a Fit Family I spend some time talking about nutrition and weight management. No one would argue that what we put in our bodies plays a huge role in tipping the scales for good and for evil as it relates to our health. I characterize a healthy diet as one that is balanced, low in fat, low in sugar and high in fiber. So far, so good. But then I stumble and fall into the pit of doom as I began berating fat as the poison of all poisons. After reading that chapter you would think that eating fatty foods was akin to ingesting antifreeze. This was my first mistake, and I will elaborate on this in a bit, but the insanity didn’t stop there. I proceeded to propagate what has turned out to be nutritional nuttiness by simplistically stating the age-old formula of calories in and calories out equals weight balance, and then, to my everlasting disgrace, actually use the phrase, “A calorie is a calorie is a calorie.” Oh the humanity!
Let me elaborate.
Since the 1940s and ‘50s, nutritionists, industrialists and, unfortunately, government bureaucrats have embraced the flawed idea that consuming fat made you fat. Fat—in particular saturated fat—was touted as the precursor of everything from heart disease to dementia largely due to the efforts of one man, Dr. Ancel Keys. Dr. Keys was the preeminent expert on everything nutritional at the beginning of WWII and was responsible for the ever-present “K” (after Keys) rations distributed to grunts throughout the war. However, his real claim to fame was his Seven Countries Study that initiated the idea that diet was largely responsible for heart disease. Before this time, heart disease was thought to be due to Michael Bolton ballads and ingesting antifreeze. Anyway, this diet-heart hypothesis was adopted by the media and the government and literally overnight fat and cholesterol were made enemy number one. The only problem was that many of his conclusions were misinterpreted or flat out wrong. He himself stated a few years ago that cholesterol had little impact on heart attacks and dietary cholesterol hardly impacts serum cholesterol at all. As it turns out, the real bad guy when it comes to heart disease is sugar.
The real culprits are…
Since the late 1800s studies have consistently found that excess sugar in the diet (i.e. carbohydrates) is associated with a variety of maladies including heart disease, stroke, obesity and diabetes. Elevated blood sugar in turn elevates insulin which acts like a jack of all trades of hormones in that it not only tries to get the blood sugar back to normal, but it also tells fat cells to hold onto their fat, pumps triglycerides into fat cells and probably types 200 words a minute. The bottom line is that chronically elevated blood sugar, mostly due to ingesting sugar or carbohydrates, drives up the fat stores and down the self-esteem. So I was wrong. Eating fat doesn’t make you fat, unless you eat a bucket full of lard, but eating too much sugar will make you bigger than Chris Christie’s yoga pants.
There are two schools of thought regarding weight loss. One, the equilibrium model, says that to lose weight you either have to take in less or burn off more. This is the classic “calories in versus calories out.” The second is a bit more complicated in that it states that the type of calories you ingest is more important than trying to balance a formula. I was right in my book by saying calories matter, but I was wrong in thinking it was a simple equation. Here’s why.
It is true that in the lab a calorie is a calorie, regardless of the source, but the lab and our bodies are very different animals. The body breaks down fats, carbohydrates and proteins differently and even the process of digestion of a protein, for example, can effect metabolism differently than the digestion of a carb. What we eat is more critical than how much we eat in many cases.
This completes my mea culpa, so let me leave you with some simple wisdom garnished from the halls of food university. Eat balanced meals, avoid trans fats, eat low-glycemic carbohydrates and pack in the fiber. And be careful about taking advice from medical deities.
Dr. Eaker is an Augusta Ob/GYN and author. He and his wife, Susan, have two daughters in college.