Interesting Atkins Article

Chewing the fat

http://www.theaustralian.news.com.au/common/story_page/0,5744,8662827%5E28737,00.html

By Giles Whittell
February 13, 2004
FOR a man who changed millions of lives, Robert Atkins's own ended in an awful mess. Last April he slipped on an icy pavement, banged his head, suffered (possibly) a heart attack, then went into a coma from which he never emerged. He died within a week.

And then the trouble started. The state of Atkins's heart and arteries instantly became a subject of fevered speculation, for he it was who launched the low-carb, high-protein Atkins diet 30 years ago, and practised what he preached. But his family ruled out an autopsy. The effect of a lifetime's righteous consumption of steak, eggs and bacon to the exclusion of bread and pasta, by the man who swore this was the surest route to weight loss and coronary health, was never to be made public.

To enemies of the Atkins diet it looked like a heinous cover-up at the expense of the ill-fed and the credulous, and on Wednesday these enemies had their chance to gloat. It turns out that Atkins died obese, with a history of heart disease and a score of 35 on a standard index that put him 10 points over merely overweight. "To us," says a spokeswoman for a group of US doctors called Physicians' Committee for Responsible Medicine, "the significance is we've been saying for years and years that the Atkins diet is a diet that's likely to cause heart disease."

But where did the PCRM get its information about Atkins's corpse? And is this argument really about a global public health emergency, or something altogether simpler? Determined dieters who've spent small fortunes trying weight-loss programs from both ends of the medical opinion spectrum may have an idea of the answer.

The PCRM is a fiercely anti-meat, pro-vegetarian brains trust that has opposed the Atkins diet for years, apparently with the best of intentions. It obtained its information on Atkins's body from Richard Fleming, a Nebraska-based cardiologist, outspoken critic of the Atkins diet and author of two high-profile books on how to minimise your risk of heart disease without a high-protein diet.

Fleming is doubtless an unimpeachable professional with the health of all our hearts his primary concern. But like all authors he must promote his books. He is also the founder and director of the Fleming Heart and Health Institute in Omaha, to which, according to publicity material accompanying his books "thousands of people from around the world come ... for treatment of heart disease, cancer and nutrition-related disorders".

Clearly a natural investigator, Fleming wrote on the off-chance to the New York medical examiner's office requesting a copy of Atkins's death report, even though he will have known that such information is normally kept private and that an autopsy had not been carried out. He was duly sent a copy. "There was a mistake," the examiner's office admits.

The stakes in the debate over Atkins's health at death are high, and not just for Fleming. Since the Atkins "Diet Revolution" passed the critical test of public acceptance and took off in the mid 1990s, the effects on American waistlines have been endlessly debated - but those on corporate bottom lines are easy to measure.

Atkins's books have sold 15 million copies worldwide. He and his imitators have sold a whopping 32 million in the US. Thanks largely to them, American egg consumption rose by 18 eggs per head per year between 1997 and 2002, while US flour consumption fell by 4.5kg per head per year in the same period.

In business terms, such shifts are seismic. Because of Atkins's once heretical theories, the Fortune 500 giants of the New York Stock Exchange's food sector have spent much of the past decade hiring, firing and frantically repositioning. In the past year the stock price of the leading fresh egg producer in the US, Cal-Maine Foods, has risen by 800 per cent. Kraft Foods Inc, which produces foods in every conceivable category, has nonetheless been wrong-footed by the low-carb craze and last month announced cuts of 6000 jobs, or 6 per cent of its workforce.

Heinz and Kellogg Inc, ketchup and cereal monsters respectively, have likewise been hit, according to one New York financial analyst who last month produced a stock-by-stock report on "the low-carb revolution" (Kelloggs have tried to hit back with cereals that trumpet their high-protein content). Hormel, Smithfield and Tyson, by contrast, meat packers to the American masses, are riding high.

Is the exposure of Atkins's obesity merely a smear campaign by the American grain lobby? Far from it. It is even simpler. Consider the response of his widow, Veronica, who immediately expressed her outrage at this effort "to twist and pervert the truth in an attempt to destroy the reputation and great work of my late husband". And consider what's at stake for her: a fortune in book royalties and revenues from a newly launched Atkins food range that is said to be worth $US30 million ($38 million).

This feud is about business. This is not to say it is not also about health, but it does emphasise with the concision of a fine haiku that in the US, and increasingly here too, health is business.

At the outset, Atkins himself might well have doubted this. When he first published his Dr Atkins' Diet Revolution in 1972 he was ridiculed by the medical establishment. As Gary Taubes wrote in The New York Times magazine: "People were coming to terms with the proposition that fat - particularly the saturated fat of meat and dairy products - was the primary nutritional evil. Atkins managed to sell millions of books promising that we would lose weight eating steak, eggs and butter because it was carbohydrates - pasta, rice, bread and sugar - that caused obesity and even heart disease. Fat, he said, was harmless."

Atkins's views, the Pooh-Bahs of American public heath declared, were quackery. But then the '80s came and wrecked that cosy high-carb consensus: exhortations to eat pasta and rice were heeded (while mountains of McDonald's fries were also consumed for good measure), and American obesity took on the dimensions of an epidemic.

The coincidence of the American obesity crisis and the rise of carbohydrate-based diets did not necessarily mean the two were causally linked, and indeed respectable science showed that Americans' sedentary lives and fondness for "fast" rather than healthy carbohydrates were the likely villains. But the coincidence did Atkins no harm.

That - and two other factors. First, there is equally respectable science that suggests advocates of high-carbohydrate diets gravely over-simplified the role of fats in what we eat, and equally seriously underestimated the importance of a steady supply of protein. Second, followers of Atkins could lose weight or gain it, but at least what they ate tasted good. There was some joy in life again.

Atkins was not slow to emphasise this considerable advantage to his diet: it was edible! But for all his services to lovers of the mixed grill, the question remains: was he obese when he died, and if so why?

His staunchest defender denies the original claim. The problem, says Stuart Trager of the less-than-impartial Atkins Physicians Council, was not weight gain but fluid retention caused by a virus that also weakened his heart. Trager also insists the Atkins diet, while high in fat, can actually lower "bad" cholesterol levels and thereby lower the risk of heart attack by keeping both weight down and blood flowing freely through the arteries.

Yet our bodies are messy, complex things. That debate will run on and on. As Veronica Atkins grieves anew, the industry her husband ambushed so successfully can agree, if it is honest, on only one thing: to lose weight, eat less.