The "Great Nutrition Debate" Sparks Controversy

"Corn is for cattle and potatoes are for pigs!" according to Dr. Morrison Bethea, cardiologist and co-author of Sugar Busters! Cut Sugar to Trim Fat. Dr. Bethea and other well-known authors of weight-loss books and leading nutrition experts participated in the U.S. Department of Agriculture's symposium, "The Great Nutrition Debate," on February 24, 2000, in Washington, DC. The seven speakers presented their signature diets and weight-loss advice to an auditorium filled with health professionals, the media, and the general public. Carolyn O'Neil, who founded CNN's coverage of food, nutrition, and cuisine and served as executive producer and senior correspondent for CNN's "Food and Health" unit, moderated the symposium.

While Bethea advised avoiding high-glycemic carbohydrates such as potatoes, beets, corn, and carrots, Dr. John McDougall, chairman of "Dr. McDougall's Right Foods," promoted eating a starch-based diet and said the potato is among the most satisfying of all foods. "It is seven times more satisfying than croissants and twice as satisfying as cheese and beef."

Dr. Robert Atkins discussed and defended his low-carbohydrate diet, which has received much criticism from other health professionals for its high-fat content and nutrient imbalance. Atkins has been on his own diet for 36 years, and gives two main reasons for its effectiveness: it eliminates hunger, and it offers a metabolic advantage (more weight is lost on the low-carbohydrate diet than on balanced diets identical in calories). Atkins, a cardiologist, alleges his diet is heart healthy and has been able to reverse heart disease in the majority of his patients with the disease. Other speakers questioned the lack of controlled studies to support this claim, and also warned of the dangers of placing the body in a ketonic state, as the Atkins diet does.

"High animal protein diets...are hazardous to your health," said Dr. Dean Ornish, author of Eat More, Weigh Less. Dr. Ornish recommends eating a whole-food, low-fat, plant-based diet. A plant-based diet, according to Ornish, has no cholesterol, is low in saturated fat, low in oxidants, high in antioxidants, and high in fiber. In addition, plants contain substances that have anti-cancer, anti-heart disease, and even anti-aging properties, says Ornish.

The hormone insulin—not dietary fat—is the culprit contributing to the current obesity epidemic, according to Dr. Barry Sears, author of The Zone. Sears, a developer of intravenous drug delivery systems for cancer patients, began applying the same philosophy to food 20 years ago. He treats food as if it were a drug to maintain the hormone insulin in a therapeutic zone. "If you have high levels of carbohydrate in your diet and you're genetically predisposed to develop high levels of insulin, that will lead to fat accumulation and increased likelihood of cardiovascular disease," says Sears. On The Zone diet, you eat more carbohydrates than protein, according to Sears, but it is not a high-carbohydrate diet.

Several of the popular weight-loss programs presented at the symposium recommend a diet fundamentally different from Federal nutrition and health association guidance. Dr. Keith-Thomas Ayoob of the Albert Einstein College of Medicine, speaking on behalf of the American Dietetic Association, said that all the diets work by cutting calories, but they are all restrictive and people have difficulty staying on them. "The more foods you eliminate from the diet, the more likely people are to feel deprived, and the greater the chance that their diets are going to be deficient in the very nutrients that can enhance their health," said Ayoob. He added that diets are a "quick fix," and that managing weight is a long-term issue, taking a long-term solution and a lifetime commitment.

Dr. Denise Bruner, president of the American Society of Bariatric Physicians, concurred that weight reduction and maintenance must focus on the whole lifestyle—not solely on the diet. Bruner said that no disease—including obesity—has one unique cause and therefore cannot be treated with one "prescription" or "diet" for every patient.

Despite some heated discussion, all the panelists agreed on several points: Americans are eating less fat, but getting fatter; we eat too much refined sugar and processed grains; and exercise is an important component of any weight-control plan.

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