Speaker Abstract: S-02
The Rational Unfattening of America's Families - Resisting the Contagion of Nutritional Nonsense
David L. Katz, MD, MPH, FACPM, FACP, Director, Yale Prevention Research Center, Yale University
The United States is the epicenter of an obesity pandemic. As more countries acculturate to a Western lifestyle, rates of obesity and its sequelae are rising steadily in both adults and children. In response, a variety of weight-loss diets emphasizing alternative distributions of macronutrient classes have been promoted with considerable success. Among the most popular is the so-called "Atkins Diet," in which carbohydrate restriction is touted as the key to weight loss. Despite claims, however, evidence that sustainable weight loss is enhanced by means other than caloric restriction is lacking. Short-term weight loss is easily achieved on diets that restrict calories and choice by virtually any means. More important, fad diets generally ignore or refute what is known about fundamental associations between dietary pattern and human health. If we are inclined to sanction weight loss by any means, we might as well consider cocaine a weight loss aid. Cancer, cholera, and AIDS induce rapid weight loss, highlighting the potential incompatibility of weight loss by any means with health. Acute and chronic diseases cause lipids to fall, challenging another of the putative benefits of "carbohydrate restriction." The suitability of popular diets for children is dubious even to the nation's parents, who rarely engage their children in their fad diet forays. Consequently, even as children grow alarmingly subject to obesity and diabetes, fad diets invite parents to respond with "do as I say, not as I do." Available data suggest that long-term weight loss is most consistently achieved by adherence to a balanced, energy-restricted diet moderate in fat and protein, and abundant in grains, vegetables, and fruit, along with regular physical activity, a lifestyle notably conducive to the promotion of overall health. Fad diets, potential harms of which are well characterized, should be presumed "guilty" of incompatibility with human health until or unless proved otherwise; the burden of proof should reside with proponents. In the interim, the clinical and public health communities should work to empower individuals with knowledge needed to reconcile weight control with health promotion; support policies that mitigate obesogenic environmental conditions; and offer unified resistance to the contagion of dietary propaganda.
Adapted from: Katz DL. Pandemic obesity and the contagion of nutritional nonsense. Public Health Rev. 2003;31:33-44.
2004 FDA Science Forum | FDA Chapter, Sigma Xi | CFSAN | FDA
Last updated on 2004-MAY-28 by frf