Low-Carb v. Low-Fat

November 25, 2004
CNN Crossfire
by Dean Ornish, Stuart Trager

CARLSON: Welcome back. Yet another food fight today on CROSSFIRE. For years, doctors have been telling us to cut the fat out of our diets, some of us haven’t paid any attention. But then the craze to cut out carbohydrates came along. Atkins and other diets trumpeted the benefits of low carbs. Less pasta and bread, more red meat. Like all crazes, this one is starting to cool, but people have managed to lose weight both ways, though the Atkins obviously works quite a bit better.

In the CROSSFIRE today, two men who faced off on this issue before. On the set, Dr. Dean Ornish, founder, president and director of the Preventive Medicine Research Institute. He joins us from San Francisco, California. And Dr. Stuart Trager, chairman of the Atkins Physicians Council and medical director of Atkins Nutritionals.

BEGALA: Gentlemen, good to see you both again.


BEGALA: Dr. Ornish, thanks for joining us from California, and Dr. Trager, thanks for coming to D.C.

Let’s start with some things in the news this week. This is called, what, a monster burger, it’s from a fast food joint. You can see – it’s Hardy’s – it’s two-thirds of a pound of beef, plus bacon, plus cheese, some kind of white goo here. And you’re telling me If I eat this, you’re not going to open my heart up like a can of sardines? I mean, this ought to kill you, right?

TRAGER: I think we would all agree that that’s not a healthy way to eat. I think that one of the biggest misconceptions about Atkins from the very beginning – Atkins have never been about that. People like Dean and the other animal rights and vegetarian activists would like us to believe it, but Atkins has never been about that. Atkins has been about a useful, effective tool that’s validated by science.

BEGALA: First off, I’ve known Dr. Ornish a long time, and I don’t know if you can term him an animal rights activist. He seems to care about human health. And my question about human health is, tell me why the Atkins diet, if I read the research correctly, allows me to eat this bacon and this beef and cheese and fat, and tell me that my heart is going to be OK? It’s counterintuitive.

TRAGER: Well, but importantly, number one, is that science is in and it shows that it works. People do lose weight when they reject simple carbohydrates, the highly refined carbohydrates that people have been eating way too many of for too long a time. When people stop eating that many carbohydrates…

BEGALA: And just replace it with pure, unadulterated animal fat?

TRAGER: No, when they replace it with protein. Protein is a wonderful source of energy for people. And in fact, it’s a source that the body uses a little less efficiently than carbohydrates. So that little less efficiency lets people consume a few more calories. Studies from Harvard, studies from other universities have shown that people, when they follow Atkins, eat more calories and in fact they lose more weight.

So it works. It’s time to really move beyond the fact that it does work. And when people do it, they don’t worsen their health risk factors. In fact, they improve them. We’ve seen study after study, independent studies have shown this.

CARLSON: I mean, Dr. Ornish, you have seen the props that Paul Begala brought. (UNINTELLIGIBLE). Look, have normal things, have a steak, have some cheese. And I want to contrast that to your recommendation to dieters. Here are some multi-vitamins, vitamin supplements you recommend people following your diet take – multivitamin with iron, vitamin E, vitamin C, folic acid, selenium, (UNINTELLIGIBLE) fish oil, the list goes on. I have got them stacked up in front of me.

How healthy can your diet be if it has to be supplemented with all these chemicals?

DR. DEAN ORNISH, PREVENTIVE RESEARCH INSTITUTE: Oh, you don’t have to supplement them with all these things. And those are supplements that I think Dr. Atkins recommends as well.

But let me clarify a few things that Dr. Trager said. First of all, I’m glad that the Atkins people are moving away from the diet fad. Dr. Atkins himself advocated it. And all you have to do is look at any of the pictures of Dr. Atkins in his books or in the magazine articles, he is always sitting in front of a plate of cheeseburgers, and bacon and sausage. So give me a break, that’s what he was recommending. If it’s changing, more power to them.

Second, the studies that Dr. Trager cites, people can lose weight on an Atkins diet, there no question about it, because Americans eat too many simple carbs. But a study came out just last week that looked at 2,700 people, and in the studies that Dr. Trager cites, like in “The New England Journal of Medicine” and so on, people regain the weight they lost within a year. That’s why people are losing confidence in the Atkins diet, is that you can lose weight on any diet in the short run.

Let me finish, please. You can lose weight on any diet in the short run, it’s keeping it off. And in the study that came out last week of 2,700 people, they found the people who lost weight and kept it off were doing it with low fat rather than low carb. Now, where Dr. Atkins…


CARLSON: I’m going to stop you right there, Dr. Ornish. Dr. Trager said right at the very beginning – I just want to clarify this – he implied that you were a vegetarian and an animal rights activist? Are you? I noticed that a number of your diets are vegetarian diets. Is avoiding meat key to you think weight loss, and are you an animal rights activist?

ORNISH: I’m not an animal rights activist. And I think that to the degree – there’s a spectrum of choices that people have. Where Dr. Atkins and I agree and even where Dr. Trager and I agree, I think it’s important to point out so people can see that there are some things that we all agree on.

One of which is that Americans eat way too many of the bad carbs, the sugar, white flour, white rice. And when you eat a lot of these, you tend to gain weight, because you get all these calories that don’t fill you up, and you’re more likely to convert them into fat.

Where we differ is where you go from there. And the goal is not to go to pork rinds and bacon and sausage, and so on. It’s to go to good carbs, fruits, vegetables, whole grains, legumes…


ORNISH: Every time we have one of those debates, you act rude and belligerent and you interrupt me. And I’m not going to stand for it today, OK?

TRAGER: Boy, Dean, let me tell you, if you want to tell untruths and misrepresent Atkins and mislead people…

BEGALA: If I wanted to have an uncomfortable fight, I would stay at my in-laws. So let’s just – let me ask…

ORNISH: It’s not low-fat versus low-carb is what I’m trying to say. It’s not low-carb – fat versus low-carb, and it’s a spectrum.



TRAGER: … mislead people.

ORNISH: But the degree…

BEGALA: Let me – Dr. Ornish, hang on just a second. Let me try to focus on the problems associated with the Atkins diet. This is a survey that was done by the Physicians Committee for Responsible Medicine…


BEGALA: Just a second…


TRAGER: … PETA, animal rights activists…

BEGALA: Look, I have no idea. Look, I go deer hunting, OK? I’m not an animal rights activist. I like shooting animals. But I like people – I like people to live. OK? People on your diet, sir, Dr. Trager, people on your diet live with the following – constipation, loss of energy, bad breath, difficulty in concentration, kidney problems, heart-related problems, lower sex drive. So maybe your stomach gets smaller, but other things are getting smaller, too. That ain’t my kind of life, man.


CARLSON: Please. Dr. Ornish, you accused Dr. Trager of interrupting…

ORNISH: I apologize.

TRAGER: That study that you talk about is a call-in or self- reported study from the Physicians Committee for Responsible Medicine, a group that’s 5 percent made up of physicians, and actually mostly made up of animal rights activists. They’re closely related to PETA. They’re funded and they share offices with PETA…

BEGALA: Instead of attacking other people, I’d like to…

TRAGER: I agree with you…

ORNISH: Can I jump in for a moment?

TRAGER: No, Dean, you can’t…


TRAGER: … from major – from major universities, Paul, that have shown Atkins as (UNINTELLIGIBLE).

BEGALA: Dr. Trager, hold on just a second. Dr. Ornish, we’re going to let you respond when we come back. But put down that drum stick if you are eating at home. We have more on this debate just ahead. And then, you can find out how to prepare the same presidential pastries that once pleased the pallets of Bill Clinton and George W. Bush from the chef himself, who frankly was once (UNINTELLIGIBLE) with Dr. Dean Ornish. Stay with us.

BEGALA: A lot of us are probably thinking about going on a diet after sitting down for our Thanksgiving dinner tonight. So let’s get back to our diet debate. It is low carb versus low fat. With us are two of the experts in the field. Dr. Stuart Trager, he’s medical director of Atkins Nutritionals, and Dr. Dean Ornish of the Preventive Medicine Research Institute in California.

CARLSON: Dr. Ornish, let’s take a look at what you recommend. Your diets, at least the two I have before me, are both vegetarian. They restrict people to 10 percent calories of fat. They exclude all cooking oils and animal products, except (UNINTELLIGIBLE) milk, and they eliminate avocados, nuts, just about everything. It’s not so much a diet as it is a religion. And I am wondering if it wouldn’t be better to be dead than to live like that?

ORNISH: You know, the old joke is, am I going to live longer or is it just going to seem longer if I eat that way?

CARLSON: Yes, exactly.

ORNISH: But that’s not the case. Let me – let me – first of all, the diet you are talking about is what we found is for reversing heart disease. We have proven you can reverse even severely blocked arteries by making these kinds of changes.

CARLSON: No, that’s not the diet I was talking about. I was talking about the prevention diet that you recommend.

ORNISH: No, no, that isn’t the prevention diet. Let me explain to you, since I came up with the diet, I know what I’m talking about. You have a spectrum of choices if you’re not trying to reverse disease. If you want to indulge yourself on Thanksgiving, then try to eat more healthily the next day. It’s not all or nothing.

And I want to emphasize the point that I tried to make earlier. The studies that Paul quoted earlier showing people getting bad breath, and body odor, and constipation on the Atkins diet were funded by the Atkins Center. And so you might start to lose weight…

TRAGER: There is one study, and you forgot to tell people that their cholesterol (UNINTELLIGIBLE) improved…

ORNISH: Stuart, I want to finish my point here.

TRAGER: But you made (UNINTELLIGIBLE) earlier and you didn’t…

ORNISH: I want to finish my point here.

(CROSSTALK) ORNISH: Are you afraid of what I’m saying, Stuart, is that why you keep interrupting me?

TRAGER: No, I just want people to hear the truth.

ORNISH: Then let me finish. Then how about giving me about 30 seconds to make a point?


CARLSON: All right, go ahead and finish, Dr. Ornish. You’re wasting your time complaining. Finish.

BEGALA: Oh, stop it.

ORNISH: You might start to lose weight, but you – and attract people too, but you’re going to smell so bad you are going to try to drive people away, because that’s how your body excretes toxic waste.

A lot of people just had a big Thanksgiving feast. How do you feel afterwards? You feel sleepy, because your brain is getting less blood. The studies of people who have gone on the Atkins diet show their hearts get less blood, sexual organs get less blood. When you change your diet, your brain gets more blood. You think more clearly, you have more energy. We have proven your heart disease improves, your heart gets more blood, and even sexual potency improves when you eat better. For many people, those are the choices that (UNINTELLIGIBLE).

TRAGER: Dean, now it’s my turn to tell people about the 37 other studies that have been done that have shown from major universities published in major journals that people can lose weight safely and effectively following Atkins. Studies and people, tens of millions of people, Dean, and in fact, the paper you talked about earlier does not talk about people following Atkins. And you know that.

You know that Atkins works.


TRAGER: And it’s time that people now moved beyond it.

ORNISH: What paper? This is your study.

TRAGER: And start recognizing that Atkins works.

ORNISH: This is your study. It was done by Eric Wessman (ph) at Duke…


ORNISH: … was funded by the Atkins Center.

TRAGER: That talked about some of the minor side effects.

ORNISH: All of the papers say that. Every one of them. TRAGER: Again…


BEGALA: You can’t do that to Mr. Happy, that’s not a minor side effect, Stuart.


TRAGER: There’s not one study that shows that when people follow Atkins they do anything but improve their risk factors. And the side effects that Dr. Ornish would like you to believe has not dissuaded people from following Atkins.

BEGALA: Let me ask you this, I don’t want (UNINTELLIGIBLE) scientific studies. There was a market research study from Inside Express that said more than half of the people who were on Atkins last year have dropped off of it this year. Is this kind of last year’s fad?

TRAGER: No, I think it’s important time of the year. Right now people are not dieting. Everybody knows that dieting is seasonal. Come the beginning of the year, when people embrace diets, they’re going to do what works. Atkins works, and…

ORNISH: I love these studies that Dr. Trager cites.

TRAGER: And science shows that it works.


TRAGER: All of these studies are on the Atkins Web site. People should read them, people should be educated and they should understand…

CARLSON: Unfortunately, Dr. Trager and Dr. Ornish, we are out of time. We want to recommend you two get together for a meal in the near future. Great to see you.

TRAGER: I can’t eat his food.

CARLSON: I can’t either. It’s wonderful to have you both here.

ORNISH: Every one of those studies show that people who lose weight gain it all back within a year.

TRAGER: Dean, and following your approach is just too hard for people. Remember that.

CARLSON: Gentlemen, thank you so much. It is excellent to see you. We will see you next Thanksgiving. Thank you.

BEGALA: Thank you, Dr. Ornish, Dr. Trager.