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Battling the bulge: high-protein diet or low-fat?

Carolyn O'Neil

Correspondent Carolyn O'Neil looks at the pros and cons

February 29, 2000
Web posted at: 9:50 a.m. EST (1450 GMT)

(CNN) -- The following edited transcript features a chat with CNN Correspondent and registered dietitian Carolyn O'Neil, who recently moderated "The Great Nutrition Debate," sponsored by the U.S. Department of Agriculture. She joined us February 25 to discuss high-protein and low-fat diets.

Chat Moderator: Welcome to Health Chat. Discuss the USDA nutrition debate, including protein diets, with Carolyn O'Neil, CNN Senior Correspondent and anchor of CNN's Travel Now, who moderated the debate.

Chat Moderator: Welcome to our discussion, Carolyn O'Neil!

Carolyn O'Neil: I think it's time a healthy exchange of ideas about popular diets reached as many people as possible because there is so much confusion.

Chat Moderator: Why won't the protein diet craze go away? Does it really work?

Carolyn O'Neil: The protein diets have actually been around for many decades under a number of titles and provided by many authors and doctors. They are appealing because you do lose weight, and you do lose weight quickly. But it can be a very restrictive diet that most people cannot stay on for very long.

Comment from BEZOAR: The basis of the books and the philosophy of the "zone" is that by decreasing carbohydrates, the amount of insulin is reduced in your body, and as your may know, insulin has effects on numerous hormone systems of the body. In essence this changes one's whole metabolism.

Carolyn O'Neil: There is a lot of talk about insulin and insulin levels affecting fat storage. The "Zone" diet operates on the premise that you must limit carbohydrates to control insulin release from the pancreas. The theory is that too much carbohydrate leads to high blood sugar levels, and that insulin turns the blood sugar into fat, which is stored in the cells. This is also the basic premise of Dr. Atkins' diet and other high-protein diets. However, not everyone agrees that eating too much carbohydrate will turn into fat. So, what we have in the diet debate are two clear camps. One camp believes that high carbohydrate diets lead to fat storage -- essentially, weight gain. The other camp (which we haven't even talked about yet) believes that it's total calories -- whether protein, carbohydrates or total fat -- that leads to weight gain. For example, you eat too much of anything, you gain weight.

Comment from Todd: I tried a few diets, including Dr. Ornish's and vegetarianism, and lost no weight. On Dr. Atkins' diet I lost 40 pounds in two months and never felt hungry.

Carolyn O'Neil: Many patients on high protein diets say they don't feel hungry. That is a side-effect. The reason for it is that when eating a high protein diet, especially Dr. Atkins', which is very low in carbohydrates, your body goes into a state of ketosis. And your body essentially thinks it's starving. One of the side-effects of starvation nature has provided is lack of appetite, so as to lessen the blow of starvation. I'm glad that you lost weight on the diet and I hope that you are doing something to help keep it off. There are no long term studies to show that these high protein diets help dieters keep the weight off. Another note: Just because you are on a vegetarian diet does not mean you are on a weight reduction diet. There are many high-calorie foods, such as cheese and even too much salad dressing, that can tip the scales in the wrong direction.

Question from Beth: Doesn't an excess of protein strain the kidneys and liver?

Carolyn O'Neil: There's a great deal of concern about the safety of high protein diets as they relate to heart disease, because of the high animal fat content and concerns about the strain on the kidneys, because the kidneys are the organs that help flush out the toxins that are created in the state of ketosis. That is why Dr. Atkins and other high-protein diet advocates recommend dieters consume 8 to 10 glasses of water a day. High protein consumption can overtax the kidneys, according to a number of studies. Note: High-protein diet advocates promote the fact that their diets actually help reduce the risk of heart disease because people do lose weight. However, no study has been done to measure the effects on other important risk factors such as cholesterol levels, triglyceride levels and other blood lipids.

Comment from BEZOAR: Also, excess protein intake causes calcium to be leached from the bones, a very serious side-effect for many women!

Carolyn O'Neil: There are studies that show that calcium excretion (meaning getting rid of calcium from your body) is elevated in the high protein diet. That may lead to osteoporosis.

Question from why: So what is the answer for the average person?

Carolyn O'Neil: During Thursday's "Great Nutrition Debate," which was held at the U.S. Department of Agriculture, diet doctors disagreed on many things. But here is what everyone agreed on, and maybe this will help. Everyone agrees that regular exercise is vital to weight control. And regular exercise is described as an activity (whatever you want to do) for 20 to 30 minutes at least three times a week. Some doctors, such as Dr. Dean Ornish, believe exercise regimens should be more frequent than three times a week. Another important point that everyone agreed on was that Americans eat too many refined carbohydrates. Refined carbohydrate foods are those very high in sugar such as candies, cake, ice cream, cookies, and other processed foods that, if you read the nutrition label, you will see they have lots of sugar in them. Another way to consume too much sugar in your diet is in drinking too many soft drinks and even popular juice and sports drinks. So, everyone agrees that we should cut back on sugar. So read nutrition labels to decrease the amount of sugar you are eating. An important note: This doesn't mean that you can never eat these foods, but it does mean you have to take a very critical look at what you are eating and drinking if you want to make dietary improvements.

Question from hg: What's a bigger worry? Being 50 pounds overweight or the high-protein risks?

Carolyn O'Neil: That's a very good question. High-protein diets have been used in medical centers and medical research for years to help obese patients get started on the road to weight control. They do work to help you lose the weight. Again, losing the 50 pounds is a wonderful accomplishment, but other nutrition experts stress you have to start eating more varied diets to get all of the nutrients needed from fruits and vegetables, whole grains, because they contain nutrients that aren't in protein foods. Another side-effect of the high protein diet is that they are very low in fiber, which is found in fruits and vegetables and potatoes, beans, and whole grain bread. You need fiber in your diet to help prevent colon cancer.

Question from Beth: Regarding "is it better to be 50 pounds overweight or eat protein"... you may be over an "ideal" weight, but still be fit and have your heart and lungs in good shape. Not everyone is genetically linked to have a lean physique. I would think that one would be healthier with a healthy diet vs. one that consists of mainly protein. Exercise is a key though, too. What do you think?

Carolyn O'Neil: Thank you for that observation. It is very true that not everyone has to be model thin. It is also true that your heart and lungs can be healthy if you are a little overweight. That's where the exercise comes in. Many people put off exercising until they've dropped the pounds. But, with a doctor's supervision, it's important even for those who are 50 pounds overweight to improve muscle tone and their heart health. It has been shown that losing as little as 10 pounds can have a dramatic positive effect on blood cholesterol and blood pressure.

Question from Haley: How about fruit and sugar levels? Aren't oranges high in sugar?

Carolyn O'Neil: The sugar that's in fruit is called fructose. It is handled by the body a little differently than the sucrose that's in table sugar. This is where more diet disagreements come in. The "Sugar Busters" diet actually restricts consumption of foods like beets and carrots because the authors say it turns into blood sugars too quickly. Meanwhile, Dr. Dean Ornish and the "Zone" diet encourage dieters to eat lots of fruits and vegetables. So what should you do? Here's something to keep in mind. It's always healthier to eat the whole orange rather than drink just orange juice because you are getting the fiber. A diet consisting of just fruit would not be healthy, either. The best fruits to eat are those that are deeply colored ,such as mangos or berries or peaches, because those dark pigments are actually powerful phytochemicals or plant chemicals that help prevent cancer and heart disease.

Comment from BEZOAR: The fiber stabilizes your blood sugar.

Carolyn O'Neil: There have been a number of studies specifically with diabetics that have shown fiber does help stabilize blood sugar levels. The theory is, it slows down the uptake of sugars from the digestive system into the blood stream. The "Sugar Busters" diet recommends between 30 and 40 percent protein.

Question from Marty: Why is "Sugar Busters" considered a high-protein diet and a fad? It doesn't recommend eating more than 3-ounce meat portions and advocates whole grain carbohydrates. So where's the "fad" in that?

Carolyn O'Neil: The "Sugar Busters" diet recommends about 30 to 40 percent protein. So it's not really a high-protein diet like Dr. Atkins' diet. The main feature of the "Sugar Busters" diet is emphasis on avoiding such foods as white bread, white rice, all potatoes, and other foods the authors describe as high sugar foods such as carrots, beets, bananas, pineapple. Many of those foods have significant nutrient contributions.

Question from BEZOAR: How many milligrams of protein are we talking here? Lots of people probably don't get 15 grams. They would benefit from more.

Carolyn O'Neil: Actually, surveys of the American diet show that the majority of Americans eat plenty of protein above and beyond the recommended levels. The high-protein diets are in the spotlight not necessarily because of the volume of protein, but because they restrict carbohydrates so severely.

Question from Jan: At the diet session Thursday, did anyone represent eating according to the food guide pyramid?

Carolyn O'Neil: One member of the panel, a Dr. Keith Ayoob, who is a pediatric nutritionist representing the American Dietetic Association, perhaps came the closest to the USDA food guide pyramid. Many people misunderstand the food guide pyramid. At the base of the pyramid, it's recommended that we consume between 6 and 11 servings of breads, cereals and grains. Some people misinterpret that, thinking we have to eat 6 to 11 huge portions of these foods, when in fact a portion size could be a half cup of rice or pasta. If you were an adult woman who weighed 130 pounds, you would chose the 6 servings, not the 11 servings. Therefore, it's really not as much carbohydrates as you would think.

Comment from BEZOAR: I have seen a lot of children who eat virtually no protein at all.

Carolyn O'Neil: You should know that what are described as carbohydrate foods, such as breads and cereals, do contain protein. There are many non-meat foods that are sources of protein. Low-fat dairy products are a good choice, such as yogurt, or milk with cereal. I believe the real danger of these fad diets, whether they are called the "Pineapple Diet" or the "Poultry Diet," or whatever diet, is that they set a bad example to children in the family. One of the best ways to prevent childhood obesity is to set a good example with your own diet and exercise lifestyle. And of course, many of these fad diets would be dangerous for children, who have very different nutritional needs for growth.

Chat Moderator: Any final thoughts for our audience?

Carolyn O'Neil: I applaud everyone who has taken the time and energy to follow a diet to lose weight. There is no magic bullet that we have found yet. There are diets that work for one person and not another. Everyone's lifestyle and food preferences are different. If a diet works for you and you are healthy, that is something you need to stick with. However, the reason this debate needs to continue is that some diets may, in fact, be bad for your health over the long haul. I believe that the more you know about nutrition, the more you can eat. The more you know the more you can eat. Learning as much as you can about nutrition and health will help you understand whether a popular diet is for you.

Chat Moderator: Thank you for joining us, Carolyn O'Neil!

Carolyn O'Neil: Thank you, this was wonderful.

Protein diet vs. low-fat: USDA hosts nutrition debate
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Atkins' Diet: Can We Have Our Turkey and Eat it Too?
November 26, 1999
Beef boosted by protein diets, Y2K
October 28, 1999
Meat, eggs and cheese: Protein diets remain popular
September 7, 1999
'Extreme eating' may equal extreme problems
September 3, 1999
Summertime warning signs of a bad diet
July 20, 1999
Healthy eating: Controlling mealtime portions
April 1, 1999
Survey: Many opt for high-protein, low-carb diets
March 4, 1999

The American Dietetic Association--Your link to nutrition and health!
ADA: High-Protein/Low-Carb Diets
U.S. Department of Agriculture
American Society of Bariatric Physicians (ASBP) - Medical society for the treatment of obesity
Dean Ornish: The Life Choice Diet
The Atkins Center

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