Zero grams of fat! Never mind that an Oreo has a skimpy 2.3 grams of fat per cookie and approximately the same number of calories as a Devil’s Food. Zero means none, and that means a lot. America is in the grip of a fat fanaticism, obsessed with the furtive grams of fat that lurk in our food plotting hostile takeovers of our health and our waistlines. Fat is the leading nutritional preoccupation of grocery shoppers-60 percent of them, according to the Food Marketing Institute, a trade association; cholesterol worries only 21 percent and calories a measly 7 percent. Fat propelled “In the Kitchen with Rosie” into the bookselling hall of fame: published only six months ago, the low-fat cookbook by Rosie Daley, Oprah’s personal chef, has more than 5 million copies in print and is widely acknowledged to be the fastest-selling book in history. Fat brought the 10 largest movietheater chains to their knees last May, when the advocacy group Center for Science in the Public Interest released a study showing that a medium tub of movie popcorn, popped in coconut oil but without the fake butter, has 31 grams of saturated fat-the kind that clogs your arteries. That’s as much as three Big Macs. Moviegoers gagged, and sales sagged. “Nine out of 10 of the chains have abandoned coconut oil,” says Art Silverman of CSPI; they’ve switched to less-saturated vegetable oils. “The 10th has added air-popped popcorn.” Fat is why students at American University in Washington, D.C., are monitoring the nutrients in their food using a touch-screen computer in the cafeteria; why restaurants from Taco Bell to “21” have introduced nutritionally correct menu items; why Patty LaNoue Stearns, food writer at the Detroit Free Press, found her phone ringing off the hook one day recently. “There was a fat-free pizza I had written about,” says Stearns. “I must have gotten a hundred calls about that pizza.” Sometimes Maggie Soch, shopping at Tom Thumb supermarket in Dallas, is overwhelmed by it all. “There’s ’light,’ ‘fat free’ and ’low fat’,” she says wearily. “I spent an hour one day just looking at brownie labels.”
Dietary fat is a problem, all right: it’s been linked to heart disease, cancer and obesity. But whatever we’re doing in the way of anti-fat frenzy, it isn’t working. Americans are tubbier than everyone in three of us is obese now, up from one in four as recently as 1980. Rates of breast, colon and prostate cancer, the cancers most often associated with a high-fat diet, continue to climb. And heart disease remains the No. 1 killer of both men and women. All this despite a flock of good-news headlines recently that proclaimed, as did The New York Times, AMERICANS REDUCING FAT IN DIET. What’s going on?
Two things. First, most Americans probably are not REDUCING FAT IN DIET, at least not by much, simply because most Americans have no idea what’s in the food they’re eating. In fact, many are being misled by the labels and numbers and definitions that were meant to help them bushwhack their way to more healthful choices. Healthful choices? That’s the second problem: few people can figure out what those are anymore. New studies are raising ever more complicated questions about fat and disease, even about the link between dietary fat and obesity. While nobody in the scientific community has a good word to say for the typical, high-fat American diet, there’s little agreement on how, why or whether it’s leading us straight to perdition. No wonder the surveys show that Americans are more confused than ever. “We found a lot of people buy low-fat foods but balance them with high fat,” says Tom Dybdahl of Prevention Magazine, which polls shoppers in conjunction with the FMI. “They’ll buy premium ice cream and nonfat salad dressing.”
Reader, take heart. You can control the fat you eat without resorting to mucilaginous fake salad dressings. Besides, the butterfat in the ice cream is a million times worse for you than the olive oil you’re giving up. So have a little oil and vinegar on your salad, have a little ice cream; and then stop eating. (Frankly, that’s the important part.) And read on.
Good question. unfortunately, there’s no single good answer. You certainly need some fat – it’s an essen-tial nutrient, just like protein and carbohydrate. But start talking about amounts, and the experts start arguing.
For years, researchers have been producing graphs showing high rates of cancer and heart disease in hamburger-and-milkshake countries like ours and low rates in Asian countries, where people eat mostly fish, grains and vegetables. Now that Japan is becoming a hamburger-and-milkshake country itself, chronic-disease rates are rising there, too. This was the data that encouraged the U.S. government to start beaming out the dietary advice, ““30 percent of calories or less from fat,’’ back in 1977. It quickly became a mantra; today it’s invoked by most of the medical establishment and enshrined on food labels. It means if you consume, for example, 1,800 calories a day – the recommended amount for an active woman weighing about 130 pounds – then 30 percent, or 540, of those calories can come from fat. That’s about 60 grams of fat per day, or aboutas 14 teaspoons’ worth. No more than 10 percent of the 60 grams should be saturated fat, the kind in meat and dairy products (and coconut oil). (If you must know, saturation refers to the molecular structure of the fat. All fats contain atoms of carbon and hydrogen; the more highly saturated the fat, the fewer spaces it has for extra hydrogen atoms. Highly saturated fats promote clogged arteries; monounsaturated and polyunsaturated fats do not.)
However: most experts freely admit that 30 percent won’t offer much protection against cancer or heart disease. But they saw little hope of getting Americans to slash their fat intake from close to 40 percent, which it was at the time, to the Asian level of 20 percent or less. ““Many of us think of 30 percent as a practical, intermediate step,’’ says Peter Greenwald, director of Cancer Prevention and Control at the National Cancer Institute. Most Americans could get down to 30 percent fairly easily by cutting way back on meat, junk food and fast food. Eliminate those sources of fat entirely, or save them for occasional treats, and you’re closer to 20 to 25 percent, the level many experts choose for themselves.
The saturated fats in meat, butter and whole milk have long been demonized, and for the most part rightly so. Recent research on heart disease and sever-al cancers – including colon, prostate and ovary – points to one overwhelming message: eating a lot of red meat is a really bad idea. The beef industry promotes a three-and-a-half-ounce serving of meat, about the size of a deck of cards, as perfectly healthful, which it would be if anybody actually ate a serving that small and indulged only occasionally.
Olive oil and canola oil, on the other hand, are getting the best press since oat bran. These monounsaturated oils were once carelessly lumped with their polyunsaturated siblings – corn oil, sunflower, soy and the rest – as an improvement over butter and lard, but still (ugh) fat. No more. While the polyunsaturates remain a better choice than butterfat, they’re less effective than olive and canola oils at lowering blood levels of LDL, the ““bad’’ cholesterol, while maintaining HDL, the ““good’’ cholesterol. And some experts believe that generous amounts of olive oil help account for the low rates of heart disease traditionally enjoyed by people in Mediterranean countries. Then there are the wild cards, the fats that make shopping so irritating because the news on them keeps changing. Margarine, for instance: it was never a very pleasant butter substitute, but at least it seemed to be a prudent one. Now studies indicate that fats called trans-fatty acids, found in margarine as well as in other solid shortenings, may clog arteries just as efficiently as butter. And cheese: it used to be a high-fat dairy product, end of discussion. Now it appears that, unlike milk, cheese may not promote clogged arteries, at least among those happy laboratory animals in which the most convincing data has turned up. According to Serge Renaud, research director of INSERM, the French equivalent of the National Institutes of Health, one reason the inhabitants of Toulouse, France (big cheese-lovers), have only half the incidence of heart disease as their compatriots in Lille and Strasbourg (butter mavens) may be the difference in the dairy fats they consume. So far, alas, nobody but Renaud is as confident about these early findings as he is. Most American nutritionists approve of the fat-free cheeses now on the market; too bad they taste like rubber.
Most scientists say that it’s way too soon for people to put their faith in one fat as opposed to another, because – sorry – more research is needed. ““I’d rather see the data accumulate over a few years,’’ says Greenwald. The exception may be the monounsaturated oils. Many experts are willing to recom-mend a change from butter to olive or ca-nola oil, as long as total fat remains low. ““If you switch from saturated fat to olive oil, there’s no question that it’s probably a benefit to your heart,’’ says John Potter, head of the Cancer Prevention Resource program at the Fred Hutchinson Research Center in Seattle. ““But if you’re already eating a huge amount of fat, just switching to olive oil wouldn’t solve the problem.’’ Olive oil on toast in the morning? The diehards for monounsaturates swear by it, but if the thought is repellent, use a small amount of butter or margarine. That little of anything doesn’t matter.
Lisa Young knows. a doc-toral candidate and adjunct professor of nutrition at New York University, Young can detect a fat gram at 40 paces. ““Look!’’ she exclaims at lunch in a Fifth Avenue restaurant. She reaches over to the next table, swipes a linen napkin and gently presses it over her plate of grilled vegetables. Then she holds up the napkin, now stained yellow with oil. ““You can blot pizza, too,’’ she says. Young is no anti-fat crusader – she’s a devotee of peanut butter and ice cream, among other foods – but she believes one reason people are eating too much fat is that they don’t know what they’re eating. In the course of her doctoral research she has studied both restaurants and street food, and her findings indicate that it’s the hidden fat that puts the bulge in the American diet. There’s no sense patting yourself on the back for choosing chicken instead of steak, for instance, if you go ahead and eat most of an entire chicken. ““In the ’80s and ’90s, portion sizes blew up, and that’s when people blew up, too,’’ says Young. ““I saw bagels blow up, muffins, restaurant portions. People just aren’t paying attention.’’ Bagels used to weigh a couple of ounces, the same as two pieces of bread, she says. ““Now they’re two or three times that size. If we had ordered the salmon here it would have been 10 ounces – that’s enough for two people.’'
For a truly powerful invitation to overeat, look no farther than the alluring term ““fat free.’’ Consumed at the rate of one a day, SnackWell’s fat-free chocolate cookies do no harm. But they’re packaged 12 to a box – ““And around here, we call that a single serving,’’ says Mark Gutsche, spokesman for Nabisco. He’s joking – probably – but there’s plenty of anecdotal evidence that Americans devour fat-free junk food, most of it loaded with sugar, as if calories had never been in-vented. ““I saw a lady in a grocery store buying a box of Entenmann’s fat-free cookies,’’ says Young. ““She must have eaten 14 cookies in the line.’’ Everyone knows by now that there’s no free lunch, but hope springs eternal for dessert.
Hah! nice try. you probably drink 2 percent milk, too. After all, the label says it’s ““low fat,’’ just like skim and 1 percent. But that label is deceptive. Two-percent milk gets about 36 percent of its calories from fat – that’s nearly twice as much as 1 percent. (Whole milk gets 50 percent of calories from fat.)
The FDA’s new food-label regulations, which went into effect last May, did impose clarity on what used to be a jungle of meaningless terms. Now ““low fat’’ (except for milk) means that the product has no more than three grams of fat per serving. A ““reduced fat’’ product, such as mayonnaise, has to have at least 25 percent less fat than regular mayonnaise; a ““light’’ mayo must have 50 percent less fat than regular. ““Fat free’’ means less than half a gram of fat per serving.
But labels can still hide surprises. David Allison, associate research scientist at the Obesity Research Center of St. Luke’s/ Roosevelt Hospital Center in New York, ran tests on several foods to see if the labels were accurate. He found that national brands tended to give correct information but that locally made products went their own way. Some of the local muffins, frozen yogurts, candy and other foods had fat and calorie counts up to 85 percent higher than the labels claimed. People should use common sense, he says. ““Fat-free chocolate chips simply aren’t possible.’’ The FDA is now testing a random sample of 300 packaged foods to see if the labels are, in fact, telling the truth.
Another minefield for deception is food advertising, as last week’s settlement between the Federal Trade Commission and Haagen-Dazs indicates. The ice-cream company had run ads describing its frozen-yogurt products as 98 percent fat-free. Down at the bottom in small type, the ads explained that only the yogurt-and-sorbet products were that low in fat. Other frozen-yogurt treats, especially the ones with chocolate or praline in them, were higher in fat. The company does not admit wrongdoing but has agreed to make its ads fully accurate from now on.
Not quite. according to a recent survey by the National Center for Health Statistics, fat in our diet dropped from 36 percent of calories in 1978 to 34 percent in 1990. That statistic led to many an excited headline, but Marion Nestle, chair of the Department of Nutrition, Food and Hotel Management at New York University, is skeptical – in part because Americans were also found to be consuming 231 more calories per person, per day. ““It’s possible people really are eating less fat, and making up for it with more protein and carbohydrates,’’ says Nestle. ““But there is a great deal of research showing that people commonly underreport food they know is bad for them and overreport food they know is good.’’ A drop in blood cholesterol, from an average of 213 in 1978 to 205 today, reflects an undeniable decline in the consumption of such artery-clogging fats as beef and butter. But Nestle notes that the American food supply has more vegetable oil in it than ever before. That’s the stuff used in fast food and junk food – our staples. We don’t necessarily consume it all – some is wasted – but it’s likely that the drop in animal fat has been made up in vegetable fat. Leaving us – fat.
Maybe. maybe not. a low-fat diet used to be considered one of the best steps that women could take to protect against breast cancer. Then along came 89,494 nurses, participants in a huge study of diet and health headed by Walter Willett, chair of the nutrition department at the Harvard School of Public Health. In 1992 Willett and his colleagues published the startling results of the breast-cancer phase of the study: researchers found no relation between how much fat the nurses ate and their incidence of breast cancer. Suddenly, fat was out of the picture as a risk factor for breast cancer; Harvard said so.
Since then, however, a few nutrition scientists have begun to warn against taking the nurses’ study as the last word. Several note that most of the nurses’ diets got more than 30 percent of calories from fat, a level that critics say isn’t low-fat at all. ““Even the people, including me, who think fat is likely to be important in breast cancer think you have to go to 20 percent,’’ says Greenwald.
Other researchers are looking at the possibility of more subtle, and in some ways more troubling, relationships between dietary fat and breast cancer. ““It’s possible we’ve been studying dietary factors too late in life,’’ says Tim Byers, chief of the chronic-disease-prevention branch at the division of nutrition in the Centers for Dis-ease Control. ““We have indirect evidence that nu-trition early in life may be more relevant.’’ The is-sue is what’s called ““overnutrition’’ – the high-fat diet of American kids, the same diet that makes second-and third-generation Asian-Americans taller than their parents. Many studies have shown an association between height and breast cancer: tall women have a greater incidence of the disease. A relatively early age at menarche, or first menstruation, is also associated with breast cancer. Both of these factors are determined in part – although only in part – by childhood eating patterns. Nobody advises restricting the diets of children under 2, but many experts now say that older children should aim for the same goal as adults: 30 percent of calories from fat.
The percentage of fat you eat doesn’t seem to make much difference.’’ (Walter Willett)
““Obesity is caused by too many calories. Fat’s a good place to begin.’’ (Marion Nestle)
““There’s a lot of controversy in this area.’’ (John Potter)
It sounds self-evident. Eat fatty foods and you get fat. After all, the legendary ease with which the body converts chocolate cake to stored fat is no fluke; it’s nature’s finely tuned mechanism for sustaining humans through winter hunger without so much as a woolly mammoth chop to gnaw on.
But the process may not be that simple, as the sad history of dieting shows. Back in the ’50s, people dieted by counting calories: if you ate few enough calories, you were hungry, but you lost weight (at least until you started eating normally again). By the ’80s, dieters were counting fat grams instead. Fat calories are converted to body fat much more readily than are calories from carbohydrates. ““If you want to keep trim, cutting down on fat is a good step,’’ says Greenwald.
But if it were really that easy to lose weight by cutting down on fat, fewer diets would end in depression and failure. ““Probably the most telling tale is that the average person eats 10 percent fewer calories now than a hundred years ago,’’ says Kelly Brownell, a psychologist at Yale specializing in eating disorders. ““Yet the prevalence of obesity has doubled.’’ Our breakfasts, lunches, dinners, drinks and diets may be low-fat, but we sure aren’t. Willett says low-fat, high-carbohydrate diets don’t work in the long run, because replacing a fat calorie with a carbohydrate calorie doesn’t make any difference to the body after the initial shock. ““Over a period of months and years, it’s very clear that the body readjusts,’’ he says. Deprived of eating fat, in other words, the body learns to store as fat whatever calories are at hand. Unfortunately, there’s research to back up both the efficacy and the futility of low-fat dieting. The only approach to weight loss that seems beyond debate is one so old it was probably first scratched in cuneiform: eat less, exercise more.
First, stop thinking about fat so much. ““It may make more sense to think about the whole diet, rather than focus on a single nutrient,’’ says Potter of the Hutchinson Center in Seattle. ““I don’t want to deny the importance of fat, but people consuming a low-fat diet think they’ve solved all the problems, and that’s not the case.’’ A great deal of evidence suggests that fruits, vegetables and grains protect against cancer and heart disease far more effectively than a fat-free Fig Newton and make a smarter guideline than fat grams. ““You don’t have to think, what is the fat content of this banana?’’ says Potter. ““It isn’t an issue.’’ With these foods in the center of the plate, and fattier foods used sparingly, it doesn’t much matter if an occasional steak goes on the grill.
Byers of the CDC goes further: he says diet isn’t enough. ““You can’t achieve a healthy life by choosing the right foods,’’ he says. ““You have to be physically active.’’ For most of us that’s a lot more challenging than cutting out bacon or adding broccoli. The problem isn’t just that we fail to make time to exercise, or drive instead of walk – most of us don’t do anything anymore. Brownell has his patients keep track of the labor-saving devices they use in a week. ““In most automobiles, you don’t have to roll down the window with a crank,’’ he says. ““You use a garage door opener. Radios don’t even require you to turn your wrist to change the station. These are small caloric expenditures, but how many times a year do you do these things? We’ve never been more inactive.’’ And we’ve never been more susceptible to many diseases. ““Physical activity, along with good nutrition, will protect against coronary heart disease, colon and breast cancer, and certainly obesity,’’ says Byers.
Say goodnight, fat grams; the trumpet is sounding for a new dietary commandment. Exercise. Oi.
