Heart Healthy Diet: Hypertension & Heart Disease (cont.)

Popular diets like Atkins drastically oversimplify what the term carbohydrate means. I quite agree the typical U.S. diet contains far too much processed starch and refined sugar. The way to fix this, however, is to eat more whole grains, fruits, and vegetables -- not to replace processed sugar with saturated and trans fat. In general the best evidence we have supports a diet that is based largely on sources of complex carbohydrates with the right balance of fat and moderate, overall protein.

Popular diets that use a single class of nutrients as a scapegoat for epidemic obesity are putting up a dangerous and distracting smoke screen. We struggle with our weight because we take in more calories than we need and can control our weight with the very same diet that serves to optimize our health. This requires learning skills and strategies for exercising portion control and creating a safe nutritional environment. There are few sources for such information. Consider referring to my recently published book, The Way to Eat (You can find out more at www.thewaytoeat.net). It details the skills and strategies needed to get around the many obstacles we encounter every day in our efforts to eat well and control our weight. Empowered with these skills and strategies bad diets will lose their appeal.

Member: I have battled weight all my life. I say I have lost three and a half people in my life. I am fat again. Would you suggest I talk to a nutritionist before I venture to another diet?

Katz: My advice to you first and foremost is that you should never go on a diet again. I am sorry you have had this experience with your weight. It is extremely common. I've seen it countless times in my patients over the years. One thing I want to tell you is that it's not your fault -- 65% to 80% of adults in the U.S. are overweight. This tells us it's a population-wide struggle, not just the struggle of any individual.

In fact, I frequently equate our weight control difficulties with the plight of polar bears in the Sahara Desert: We are naturally designed for a high level of physical activity and having barely enough to eat. We live in a world where it's easy to be inactive and to overeat. Until or unless you learn how to resist the challenges of this "toxic" nutritional environment we live in, you will inevitably struggle with your weight just like a polar bear in the Sahara would struggle with the heat. We are smarter than the average bear and can, with the proper guidance, think our way through this.

I think you would benefit from meeting with a nutritionist as you suggest. But I strongly encourage you to make today the first day of eating well for the rest of your life rather than the start of another diet to go on and get back off. Learn to eat well, let your weight take care of itself, and never go on a diet again.

Member: What about someone who doesn't need to control his or her weight? Do I have to eat low fat too?

Katz: Recall I am not emphasizing a low-fat diet. Roughly 25% or so of calories from fat is ideal. However, this figure is not etched in stone, and provided the fats in the diet are health-promoting fats a bit more is fine. As is, for that matter, a bit less. Most important, however, is to recall that the way we eat profoundly influences overall health in countless ways. Whether thin or overweight, whether working to control your weigh or not, eating well matters for us all. So for you, as well as those who find weight control challenging, a prudent diet, moderate and balanced, rich in grains, vegetables, fruit, is vitally important to overall health.

Moderator: Thanks to David Katz, MD, for being our guest. For more information on a heart-healthy diet and lifestyle, read The Way to Eat: A Six-Step Path to Lifelong Weight Control, by David L. Katz, MD.

And explore the WebMD Weight Loss Clinic Community. Goodbye and good health!

Originally published Feb. 19, 2003.

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