Dieters looking for a nutritionally based approach to weight loss face two diametrically opposed choices today: 1) the low-fat, high-carbohydrate regimen publicized in the nation's official food pyramid, ingrained in the nutritional recommendations of the medical establishment, and endorsed by the American Heart Association; and 2) the low-carbohydrate, high-protein, high-fat program promoted most notably by Dr. Robert Atkins.
Earlier this month, an article in The New York Times Magazine shed considerable light on the medical debate over these competing nutritional theories. For decades, leading experts have been downright hostile to Atkins' approach, and in some cases called it dangerous. But as Gary Taubes writes in the Times, "Now a small but growing minority of establishment researchers have come to take seriously what the low-carb-diet doctors have been saying all along…these researchers point out that there are plenty of reasons to suggest that the low-fat-is-good hypothesis has now effectively failed the test of time."*
One of the circumstantial indications that the low-fat approach doesn't work is Americans' monumental failure to lose weight over the 20-year period that the doctrine has prevailed. Gallup data confirm what national statistics also show: Americans are gaining weight, not losing it.
Close to half of Americans, 44%, tell Gallup they are overweight; a solid majority, 59%, say they would like to lose weight; and 66% indicate they weigh more than their preferred "ideal" weight. This is according to Gallup's most recent health audit survey, conducted each November.
According to Americans' reports of their own body weight, the average adult woman today weighs 153 pounds and the average man weighs 189. For women, this represents an increase of three pounds since 1999 and 11 pounds since 1990. Men's average weights have increased nine pounds since 1990.
Is the explanation for this weight increase a lack of will power, or are there physiological reasons why lower fat intake would have the counterintuitive effect of causing people to gain weight? Is a long-term low-carb, high-fat diet safe? The answers could entirely redefine the nation's approach to not just weight reduction, but all nutritional advice. As Taubes says, "All of this could be settled sooner rather than later, and with it, perhaps, we might have some long-awaited answers as to why we grow fat and whether it is indeed preordained by societal forces or by our choices of foods."
What's clear is that, as of today, the fat-is-bad mindset is entrenched in the American psyche. Despite the commercial success of Atkins' best-selling book, Dr. Atkins' New Diet Revolution, a recent Gallup survey measured Americans' reactions to the two competing theories of nutrition and found overwhelming support for the low-fat version.
This finding also comes through in Americans' answers to the types of food they seek versus avoid in their own diet. One in five Americans** says they avoid eating carbohydrates, but in a separate question, only 6% say they try to avoid grains such as bread, cereal, pasta and rice. Substantially more, 43%, report avoiding sugar, a form of carbohydrate strictly limited on the Atkins program. By contrast, however, more than six in 10 (62%) say they avoid fat. Americans are more averse to fat than they are to salt, sugar, red meat and even pesticides.
These measures represent new polling territory for Gallup. No trends exist to say whether Americans are more fat averse or less fat averse today than in the past. But as the medical debate unfolds, these measures should help document the extent to which the information stemming from it influences the public.
Right now, one thing is clear: most Americans seem to think they know what they should be eating, even if they are not following that advice. Three-quarters deny being confused about what comprises a healthy diet; just 3% say they are "very confused" and another 21% call themselves somewhat confused.
This, too, could change.
*"What If It's All Been a Big Fat Lie?" Gary Taubes, New York Times Magazine, July 7, 2002
**These results are based on telephone interviews with a randomly selected national sample of 1,004 adults, aged 18 and older, conducted July 9-11, 2002. For results based on this sample, one can say with 95% confidence that the maximum error attributable to sampling and other random effects is ±3%. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.