Giving up the apple a day

"Steven, you need to eat less fat," my doctor told me at my last visit. "Do you know where you're getting fat in your diet?"\nI admit that I was paying little attention to this lecture. I was too busy deciding what distressed me the most: 1) my elevated cholesterol, 2) the $100 charge for this doctor's visit or 3) my big fat condescending doctor telling me how to eat.\nA few years earlier, I started a low-carbohydrate regimen after reading Dr. Atkins's New Diet Revolution. My cholesterol subsequently went up but so did my good cholesterol, and my triglycerides were low. Many health experts believe those last two numbers are more important than total cholesterol.\nThe Atkins diet might end up giving me a heart attack and killing me, but I still consider him one of the most admirable men of my lifetime because he challenged conformity and conventional wisdom and thus changed the way people think.\nIt wasn't long ago when the low-fat gospel and the food pyramid dominated American culture. In one commercial, POWERade boasted that it contained 33% more carbs than Gatorade. Subway guy Jared was already a big star losing weight on low-fat subs. And Fruit Loops had the American Heart Association seal of approval.\nAlthough others were challenging the low-fat dogma at the time, Atkins was the most outspoken and threatening to mainstream health professionals. He basically said they were wrong and their messages were contributing to the obesity epidemic and other health problems.\nNaturally, health professionals vilified him. But Atkins steadfastly withstood the criticism, and his diet has slowly gained acceptance. Recent studies have indicated that in the short-term, the Atkins diet not only promotes weight loss but, contrary to my own experience, is not harmful to cholesterol levels.\nNow beer companies are advertising the low-carbohydrate content of their products. Hardee's is offering a bunless burger. And Subway, after promoting Jared and its low-fat subs for years, is offering "Atkins-friendly wraps." Its latest commercial ends with their new slogan, "Good, so you don't always have to be." Who would have thought that something with two strips of bacon might ever be considered good for you?\nDespite the growing popularity of the Atkins diet, it will probably never become the conventional wisdom. It has, however, compelled many health experts to question it. We're hearing fewer messages from health experts to avoid fat and more messages to avoid sugar, refined carbohydrates, saturated fats and trans fats.\nThere has also recently been a movement to revise the well-known food pyramid, which emphasizes high-carbohydrate foods like bread, cereals and pasta, to one that separates good carbohydrates from bad carbohydrates and good fats from bad fats. A revised food pyramid is expected to be released in 2005.\nBut there is more research to indicate that those messages might still not be specific enough. For instance, studies indicate that stearic acid, a form of saturated fat, is at worst, harmless. According to a 2001 article in Science, calculations show that eating a porterhouse steak, because of its high monounsaturated and stearic acid content, improves cholesterol levels compared to eating bread, pasta or potatoes. Other research indicates that conjugated linoleic acid, which contains a natural form of trans fat found in beef and dairy products, reduces the risk of cancer and promotes muscle retention.\nSimplistic messages like, "You need to eat less fat" are clearly too simplistic to be much use.\nBut some doctors still insist on preaching what they learned in medical school, or maybe it was their fourth-grade lesson on the food pyramid. Some just aren't going to consider alternatives or admit they were wrong. As far as I know, medical schools don't teach humility or open-mindedness. That's why I'm abandoning another conventional wisdom -- listen to your doctor.