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"Diet Wars"

 

ANNOUNCER: Tonight on FRONTLINE--

ARTHUR AGATSTON, M.D., Author, The South Beach Diet: Fat doesn't necessarily make us fat.

JAMES J. KENNEY, Pritikin Longevity Center: What's the point of looking thin in a casket?

ANNOUNCER: Which diets fail? And which ones work?

Dr. ROBINSON: Your body mass index is approximately 29, and that puts you in a category of being considered overweight.

STEPHEN TALBOT, FRONTLINE Correspondent: High overweight, it looks like.

Dr. ROBINSON: Well, you're getting close to the level of being obese.

STEPHEN TALBOT: Ouch!

NARRATOR: Correspondent Steve Talbot gets the skinny on the Diet Wars tonight on FRONTLINE.

 

WEIGHT WATCHERS EMCEE: Ladies and gentlemen, please join me in welcoming my good friend, Sarah, the Duchess of York!

SARAH FERGUSON, Weight Watchers Spokesperson: It was eight years ago when I'd managed to completely and utterly destroy my life 100 percent. But you might have read about it, I think.

STEPHEN TALBOT, FRONTLINE Correspondent: [voice-over] My name is Steve Talbot. Somehow, I've ended up in a room with a thousand middle-aged women. We're seeking inspiration from the Duchess of York.

SARAH FERGUSON: --boiled eggs, white bread groaning with salted butter, and on went the weight.

STEPHEN TALBOT: Fergie is famous for losing weight.

SARAH FERGUSON: Some of the headlines said, "The Duchess of Pork." You might have known that and--

STEPHEN TALBOT: It's January, diet time, a time when most Americans dream about shedding 20 pounds or more. I've come here as a reporter for FRONTLINE, but it's hard not to get caught up in all this.

SARAH FERGUSON: You can do it.

STEPHEN TALBOT: The atmosphere at Weight Watchers is almost like a revival meeting, with inspiring personal testimony and positive reinforcement.

SARAH FERGUSON: It's weird up here, isn't it, Stephanie.

STEPHANIE, WEIGHT WATCHERS DIETER: It's really weird!

SARAH FERGUSON: I know.

STEPHANIE: I can't believe it!

STEPHEN TALBOT: What's astounding is just how much weight Stephanie has lost, 95 pounds. She told me her weight had become a personal health crisis.

STEPHANIE: I was, like, you're on a roller-coaster towards, like, a downhill slide here, and it's not going to be good. And so that's really what brought me to the door the first time. I had to make a health change.

STEPHEN TALBOT: [on camera] Boy, I can understand that. What about just appearance, though? I mean, that's important. We're in a society. You all look great, you know? I mean, part of a motivation, too?

SANDRA, WEIGHT WATCHERS DIETER,: I went shopping all the time and couldn't find a thing to wear. And I just finally got tired of it. I actually lost 9 pounds the first week, and I found how easy it was, that I just continued to go every week.

STEPHEN TALBOT: [voice-over] Sandra lost 102 pounds, and now she's proudly showing off her new clothes and her new figure.

Until this assignment, I never thought much about America's obsession with losing weight. Truth is, I've never even read a diet book. But I do know that dieting is a $40 billion business, and there are dozens of warring diet plans.

JENNY CRAIG DIETER: I lost 111 pounds. Now I'm half the mom and twice as much fun!

DEAN ORNISH, M.D., Preventive Med. Research Inst: You really can eat more and weigh less, if you know what to eat.

STEPHEN TALBOT: All claim they have the secret to health and weight loss.

JAMES J. KENNEY, Pritikin Longevity Center: The Pritikin diet is basically a healthy diet.

STEPHEN TALBOT: All claim they can help transform us from the way we are to the way we want to be as quickly and painlessly as possible. I've never thought about going on a diet. I figured some day, I'd get around to it, eat a few less French fries or something. But I do have a nagging feeling that it would probably be good for my health.

[on camera] I'm here to see Dr. Robinson, please.

RECEPTIONIST: OK.

STEPHEN TALBOT: Steve Talbot.

RECEPTIONIST: OK, Stephen.

STEPHEN TALBOT: [voice-over] It's one thing to talk about America's weight problem. It's harder to parade your own.

NURSE: You're 210.

STEPHEN TALBOT: [on camera] Glad I took those shoes off.

NURSE: I'll let Dr. Robinson know that you're here.

STEPHEN TALBOT: OK. Thanks very much.

[voice-over] I thought I'd be a few pounds over, nothing much to worry about.

Dr. ROBINSON: Mr. Talbot? Hello.

STEPHEN TALBOT: Hi. How are you?

Dr. ROBINSON: I'm Dr. Robinson.

STEPHEN TALBOT: Oh. Nice to meet you.

Dr. ROBINSON: Very nice to meet you.

STEPHEN TALBOT: How are you?

Dr. ROBINSON: How are you?

STEPHEN TALBOT: I'm OK.

Dr. ROBINSON: Good.

STEPHEN TALBOT: I'm OK.

Dr. ROBINSON: Good.

STEPHEN TALBOT: Yeah.

Dr. ROBINSON: Are you familiar with the body mass index calculation?

STEPHEN TALBOT: I've heard of it. I've heard of it.

Dr. ROBINSON: That's a number that we're using a lot more these days. And basically, this is an estimate of your body fat in relation to your height and weight. What we do now is calculate the body mass index using this chart. And we can see that your height is 5 feet, 11 inches, or 71 inches, and your weight is 210 pounds, which means that your body mass index is approximately 29.

STEPHEN TALBOT: Right.

Dr. ROBINSON: And that puts you in a category of being considered overweight, normal being less than 25.

STEPHEN TALBOT: Kind of high overweight, it looks like.

Dr. ROBINSON: Well, you're getting close to the level of being obese.

STEPHEN TALBOT: Ouch! I mean, I got to say, I don't feel bad. I feel pretty good. But what are the health things that I should worry about?

Dr. ROBINSON: Right. Well, that's a good question.

STEPHEN TALBOT: [voice-over] Dr. Robinson then proceeded to list a series of horrible diseases I might contract.

Dr. ROBINSON: Heart disease, stroke, adult onset diabetes, high cholesterol, osteoarthritis and certain types of cancer. Those are just a few of the things that we associate with being overweight.

STEPHEN TALBOT: [on camera] Wow.

Dr. ROBINSON: What we'd like to do is check on your cholesterol level.

STEPHEN TALBOT: Right.

Dr. ROBINSON: And also blood glucose--

STEPHEN TALBOT: OK.

Dr. ROBINSON: --to make sure that you've not become diabetic. OK?

STEPHEN TALBOT: All right.

Dr. ROBINSON: I'll be back in one moment.

STEPHEN TALBOT: OK. Thanks.

Dr. ROBINSON: OK.

STEPHEN TALBOT: [voice-over] Nearly 55 years old, and I'd just been told I was on the verge of obesity. I had heard the statistic that two thirds of Americans are overweight. I just never realized I was one of them. I don't know what happened. Growing up in the 1950s, no one seemed to care that much about weight. In real life, as much as in the world of Leave It to Beaver, no one seemed to worry about eating too much.

I was actually part of this world.

["Leave It to Beaver"]

BARBARA BILLINGSLEY: Beaver, Gilbert's here!

STEPHEN TALBOT: That's me, playing Gilbert, Beaver's friend.

My mom told me to be sure and not ask for any junk to eat, but she said it'd be OK if you offered me some.

BARBARA BILLINGSLEY: Well, there's plenty of cookies and fruit and things in the kitchen. And don't stay too late, Gilbert. You boys behave yourselves.

STEPHEN TALBOT: You needn't worry about me, Mrs. Cleaver. My dad already yelled at me before I left the house.

The 1950s was a time when almost any food was considered OK. I remember seeing films at school that urged us all to clean our plates.

BOY: Judy and Hank want me to stay for dinner. Is it all right with you? Oh, gee, thanks! Bye!

ANNOUNCER: Eating with others is fun.

STEPHEN TALBOT: But around 1960, some scientists began to argue Americans were eating too much animal fat and cholesterol. Take a look at this old CBS documentary about Ancel Keyes, one of the first scientists to warn that fatty diets could lead to heart disease.

[CBS News "The Search," 1958]

ANCEL KEYES: You know the chief killer of Americans is cardiovascular disease, disorders and degeneration of the heart and blood vessels. Of 10 men, we can expect 5 to get it.

STEPHEN TALBOT: That's not going to happen to me, not if I can help it. I'm going to exercise, and I'm going to find the right diet plan. I've come to Florida, to the mecca of low-fat diets, the Pritikin Longevity Center.

[on camera] You know, for a layperson like me, I know nothing about anything of this stuff. What's the basic thing to know about Pritikin? What is it? What's the diet?

JAMES J. KENNEY, Pritikin Longevity Center: Well, the Pritikin diet is basically a healthy diet. I mean, Pritikin didn't start as a weight-loss program, it started as a way to reverse heart disease, high blood pressure, diabetes.

STEPHEN TALBOT: [voice-over] This is Dr. James Kenney, Pritikin's chief nutritionist. The diet certainly looks like it's working for him.

JAMES J. KENNEY: It's mostly a lot of fruits, vegetables, whole grains, beans, a little bit of seafood, some non-fat dairy products and some soy milk.

COOKING TEACHER: Welcome to cooking class today. My name's Drew, for those of you who don't know me. We're going to do--

STEPHEN TALBOT: Pritikin works hard to convince you that eating an ultra-low-fat diet can be palatable.

COOKING TEACHER: We're going to show you how simple it is to make a beautiful Pritikin fish.

STEPHEN TALBOT: I watched a cooking class where they showed us how to braise a fish with no oil.

COOKING TEACHER: It's going to sear and brown, as well.

JAMES J. KENNEY: What makes eating healthy in America difficult is that most restaurant food, particularly fast food restaurant food, is designed to make people fat and sick.

STEPHEN TALBOT: The clients here pay a lot, $3,000 a week, to eat less in the hope that they will lose weight and stave off heart disease. The food looks great, but the portions are tiny. I don't know how I could survive on this.

JAMES J. KENNEY: It's still really a matter of discipline. You're going to have to change your eating habits. You're going to have to exercise more than most people feel like. But the nice thing about it is the more you do it, the easier it gets and the better you feel. And as a side effect, you don't have to worry so much about heart disease, cancer and diabetes.

STEPHEN TALBOT: In the Pritikin gym, a real-life retired drill sergeant puts paying clients through agony. I know there's an easier way.

Is there anyone who hasn't heard about the Atkins diet? It tells you to eat all the fat you want. It's been around since the 1970s, but it only really caught fire in the last few years.

[CNN "Larry King Live"]

CALLER: I know that you can eat eggs and protein on your diet. Why not any milk?

Dr. ROBERT ATKINS: Well, milk has got lactose in it. Whenever you hear--

STEPHEN TALBOT: And that was when Dr. Robert Atkins became a media celebrity.

Dr. ROBERT ATKINS: And that's--

LARRY KING, Host: Skim milk, too?

STEPHEN TALBOT: What took everyone aback was he said keep the fat but hold the fruit -- too much sugar -- lay off the carbs, no starches, no rice, no bread, no pasta.

Dr. ROBERT ATKINS: So cream is about the one thing that the cow puts out that doesn't have carbohydrate.

LARRY KING: So if you would have-- you don't have cereal, do you.

Dr. ROBERT ATKINS: Well, there are some low-carbohydrate cereals now, and I will--

LARRY KING: You put sweet cream on it?

Dr. ROBERT ATKINS: And I mix it with heavy cream. Yes, I do, sir.

LARRY KING: That sounds-- it sounds--

Dr. ROBERT ATKINS: Delicious!

LARRY KING: --fattening. Oh, it's delicious--

Dr. ROBERT ATKINS: Delicious!

LISA SANDONATO, Atkins Dieter: So I bought the book, and I'm, like, "No way!" Like, I can't have bacon and eggs for breakfast and, you know, like, something really cool for lunch and, like-- like, a prime rib for dinner and, like-- and lose weight. It-- it's not possible.

STEPHEN TALBOT: [on camera] When was this?

LISA SANDONATO: This was a little over a year ago.

STEPHEN TALBOT: Wow. So this is-- this is you?

LISA SANDONATO: Yeah, that's me.

STEPHEN TALBOT: I mean, that's amazing.

LISA SANDONATO: Big girl.

STEPHEN TALBOT: Hard to recognize you now.

[voice-over] Lisa Sandonato says she's tried lots of diets, but she lost 45 pounds on Atkins and enjoyed every minute of it.

LISA SANDONATO: You know what I like the best about Atkins? It's that I can get a big two-pound lobster with a big thing of butter on it and just sit there and go, "Ha, ha, ha." And I see all my little Weight Watcher friends sitting there counting their chicken points. Like, "Yeah, go ahead. Take the skin off, too. Don't forget to take the skin off. You can give it to me. I'll have that."

STEPHEN TALBOT: The Atkins diet defies common sense. One man who wanted to test it was science journalist Gary Taubes.

GARY TAUBES, Science Journalist: I tried it, and it was amazing, you know? It's everything-- the 20 pounds that I'd never been able to lose in six weeks, and stopped exercising, you know? It was kind of a surreal experience and probably, in a sense, informed my opinions from there on in. I mean, after that happens, you say, "I want to know what's happening, and I want to know why."

STEPHEN TALBOT: In 2002, Taubes published an incendiary New York Times Magazine article.

GARY TAUBES: I got crucified in a variety of publications. A Washington Post reporter went after me. The Center for Science and the Public Interest went after me. I've had friends who have accused me of having a brain transplant because suddenly I turned around and said maybe low-fat diets don't work and maybe low-carbohydrate diets are the answer.

STEPHEN TALBOT: By criticizing low-fat diets, Taubes had committed nutritional heresy.

MARION NESTLE, New York University: That particular article has absolutely ruined my life as a nutritionist! I can't go anywhere without being asked about it. And it attracted so much attention that I think it's really caused the nutrition community to stand up and take notice.

STEPHEN TALBOT: The Atkins diet contradicted everything that nutritionists and the government had been telling people for decades. The USDA food pyramid recommends that people fill up on carbs, like pasta, bread and potatoes, and avoid forbidden foods like steak and cheese.

MARION NESTLE: Well, I think the Atkins diet is popular because it waves a magic wand and it says everything that was bad for you is now good for you. What the Atkins diet does is to lower caloric intake. In fact, all diets lower caloric intake. The question is whether it's healthy in the long run and whether it's sustainable. And I think the jury's still out on that one.

Dr. ROBERT ATKINS: Eighty-five percent of those people didn't need a bypass after they went on our program.

STEPHEN TALBOT: The diet wars had become so contentious that in 2000, the USDA put all the diet gurus in one room to thrash out an agreement about what we should be eating.

KEITH-THOMAS AYOOB, M.D.: He said he's working on the data, but he's been making this claim for a long time, and that's what--

Dr. ROBERT ATKINS: No, I haven't.

Dr. KEITH-THOMAS AYOOB: Excuse me.

Dr. ROBERT ATKINS: But I haven't been making--

Dr. KEITH-THOMAS AYOOB: Excuse me!

Dr. ROBERT ATKINS: --that claim.

Dr. KEITH-THOMAS AYOOB: You just did, and you don't have the evidence--

Dr. ROBERT ATKINS: Before.

Dr. KEITH-THOMAS AYOOB: --to back it up. Now, this diet's been out there for 30 years, or close to 30 years--

Dr. ROBERT ATKINS: And I haven't been able to fund a study-- I've asked and asked--

Dr. KEITH-THOMAS AYOOB: Excuse me! Excuse me!

Dr. ROBERT ATKINS: --and asked.

Dr. KEITH-THOMAS AYOOB: Ten million books in print, and you can't fund a study?

Dr. ROBERT ATKINS: Now I can. And I will be the first doctor--

Dr. KEITH-THOMAS AYOOB: Excuse me!

Dr. ROBERT ATKINS: --to dig into his own pocket to do a study!

STEPHEN TALBOT: Agriculture secretary Dan Glickman tried in vain to keep the peace.

DAN GLICKMAN, Harvard University Institute of Politics: I'm reminded-- I think it was H.L. Mencken who once said for every complicated problem there is a simple and a wrong solution. And I think that this is-- these are complicated problems here--

There was not a lot of consensus. And I recall that Dr. Atkins and Dr. Ornish just about went at each other physically.

DEAN ORNISH, M.D., Preventive Med. Research Inst.: Now, I'm not aware of any studies that Dr. Atkins or Dr. Sears have published in any peer-reviewed journal about anything, ever.

DAN GLICKMAN: It was amusing to me, but I don't know if it was edifying to the people who buy books and try to find ways to lose weight.

STEPHEN TALBOT: [on camera] Are you actually saying that the Atkins diet is harmful to your health?

Dr. DEAN ORNISH: I think for many people, it's definitely harmful to their health. And we're seeing-- and it's not just me that's saying that.

STEPHEN TALBOT: In what way? What's the worst thing that can happen?

Dr. DEAN ORNISH: The worst thing that can happen is sudden cardiac death. But even short of that, the blood flow to the heart is reduced. Your kidney function may be compromised. Osteoporosis is increased.

STEPHEN TALBOT: [voice-over] But Taubes argues that anti-fat dogma is more ideology than science.

GARY TAUBES: It's a little frustrating even from my point of view because no matter how much research you do, you're going after monolithic dogma, in effect, and dogmas protect themselves.

STEPHEN TALBOT: [on camera] Gary Taubes attacks what he calls the "low-fat dogma" and says that diets like yours have led Americans to be fatter, that you're part of the problem.

Dr. DEAN ORNISH: Well, it is provocative. It does sell newspapers. And you know, it tells people what they want to hear, which is also a good way to sell newspapers. You know, it tells people that bacon and sausage and pork rinds and butter and brie are good for you, and nothing could be further from the truth.

STEPHEN TALBOT: Brie is not good for me? [laughter] You're killing me here, Dr. Ornish!

[www.pbs.org: The low-fat, low-carb debate]

[voice-over] There was more at stake here than a food fight between diet gurus. What happened back in the early '90s was the food industry cashed in on the low-fat craze and started removing fat from our food.

JEANNE GOLDBERG, Tufts University: Ten or fifteen years ago, somehow we got this notion that, A-ha, if we take the fat out of foods, we will be able to reduce the total caloric intake and people will be able to control their weight. And so industry got very busy making low-fat, reduced-fat, fat-free products, and they flooded the marketplace and they flew off the shelves. Industry turns on a dime. They can do things quickly and resourcefully, and they tried-- they gave it their best shot.

STEPHEN TALBOT: [on camera] I'm a big ice cream guy, so--

JOSEPH HOTCHKISS, Inst. of Food Science, Cornell Univ.: Oh, is that right?

STEPHEN TALBOT: Always have been.

[voice-over] You would think low-fat was not fattening. Think again. Joe Hotchkiss, head of Cornell's food science department, showed me what goes into a product like low-fat ice cream. Turns out it has just as much sugar as regular ice cream. Their trick is to cut back on fat by using less cream.

JOSEPH HOTCHKISS: All foods are really made of a combination of four major components: water, carbohydrate, protein and fats. So you take out the fat in ice cream, you have to add something back. You can't just simply remove the fat. It's not as easy as that. Typically, we'll replace the fat with either one of the other three components. And most often, that component is a carbohydrate.

STEPHEN TALBOT: Their recipe replaces the missing fat with carbohydrate in the form of milk powder and some seaweed extract to help bind it all together.

Boil and trouble, boil and bubble there--

JOSEPH HOTCHKISS: Exactly.

STEPHEN TALBOT: But no eye of the newt.

JOSEPH HOTCHKISS: Have a taste. I have to send it to the blast freezer to get it frozen.

STEPHEN TALBOT: OK.

JOSEPH HOTCHKISS: But it can be tasted.

STEPHEN TALBOT: All right.

JOSEPH HOTCHKISS: Still creamy.

STEPHEN TALBOT: That's low-fat?

JOSEPH HOTCHKISS: That's low-fat.

STEPHEN TALBOT: Wow.

JOSEPH HOTCHKISS: So in order to really--

STEPHEN TALBOT: That does not taste like low-fat, I got to say.

JOSEPH HOTCHKISS: It's a good formulation.

STEPHEN TALBOT: You fooled me.

[voice-over] But while this ice cream does have less fat, says Hotchkiss, what he replaced it with has nearly as many calories. And in losing weight, calories are what really matter. So this isn't exactly diet food.

JOSEPH HOTCHKISS: If you ask a group of people whether they would more likely gain weight taking in 3,000 calories in carbohydrates or 3,000 calories in fat, they almost all say, "Well, certainly, you would gain more weight taking in 3,000 calories as fat," when, in reality, you probably would have an equal weight gain in both of those categories.

["Seinfeld"]

ACTOR: Hey, this yogurt is really something, huh? And it's non-fat! I've been waiting for something like this my whole life, and it's finally here!

STEPHEN TALBOT: TV sitcoms like Seinfeld satirized the public's belief that they could consume all the fat-free products they wanted.

ACTOR: Hey, another round of strawberry for me and my friends!

JEANNE GOLDBERG: And guess what? People ate in excess. They didn't look at the portion size. They didn't look at the calories. They just ate them. And there's no free lunch.

STEPHEN TALBOT: And thus it happened that during the low-fat era of the '90s, Americans got fatter than ever. By 2001, one third of our population was obese.

MARION NESTLE, New York University: The low-fat message was interpreted as if you had a product that was low in fat, it was good for you, without thinking of calories. The best example is the Snackwell phenomenon. Snackwell cookies were advertised as no-fat cookies, but they had almost the same number of calories. And in fact, if you go to the store today and look at Oreo cookies, they have a reduced-fat Oreo cookie that has, I think, only 6 calories less than the regular Oreo cookie.

STEPHEN TALBOT: So if low-fat food is not going to help me lose weight, what about a diet based on the USDA pyramid, which recommends eating lots of bread, rice and pasta? That sounds reasonable. Bad idea, says Harvard nutritionist Walter Willett. Eating too much refined starch is a recipe for disaster.

WALTER WILLETT, M.D., Harvard School of Public Health: White bread, white rice, potatoes are starches that are very rapidly converted to glucose, really pure sugar, and almost instantly absorbed into the bloodstream.

STEPHEN TALBOT: [on camera] A sugar rush from a potato?

Dr. WALTER WILLETT: Actually, you could get a bigger rise in blood sugar after eating potatoes -- a baked potato, say -- than you do from eating pure table sugar.

STEPHEN TALBOT: Really?

Dr. WALTER WILLETT: Really.

STEPHEN TALBOT: That seems pretty extreme. Why is that? Why does that happen?

Dr. WALTER WILLETT: When the blood sugar goes skyrocketing up, the body wants to bring it back down, so our pancreas pumps out a big blast of insulin. And as a result, the blood sugar comes crashing down rapidly. And that stimulates hunger.

STEPHEN TALBOT: [voice-over] So eat refined starches, spike your blood sugar, get hungry, eat more, get fat. That's what happened in the low-fat era. The Atkins diet claimed to solve this problem. It said you could lose weight by skipping the bread and satisfying your appetite with protein and fat. A juicy steak, unlike refined carbs, burns slowly and keeps you full for longer.

TELEVISION COMMERCIAL: Watching your carbs was never this easy. Introducing TGI Friday's new Atkins-approved menu, now--

STEPHEN TALBOT: That's why the Atkins craze is sweeping the nation.

TELEVISION COMMERCIAL: --sizzling strip with crumbled bleu cheese--

GARY TAUBES, Science Journalist: When you look at the history of these Atkins-like diets, they all said the subjects didn't seem to be hungry. Study after study from, like, the '40s onward-- we put them on the diet, they ate-- if they eat less calories, they do it because they just don't seem to be hungry.

Dr. WALTER WILLETT: What is really important, in the long run, is how satisfying a food will be. And as it turns out, many high-fat foods, sometimes like meat, but even think of a handful of nuts, are often very satisfying, even though the physical amount is not very great.

WAITRESS: OK, there's the iced tea for you.

STEPHEN TALBOT: Great. Thank you.

WAITRESS: Would you like any breadsticks?

STEPHEN TALBOT: No.

WAITRESS: No? Doing OK?

STEPHEN TALBOT: No breadsticks, OK?

[voice-over] I can see the appeal of this low-carb diet. I have to give up bread, but I get to eat all those forbidden foods I crave. Why should I even consider going low-fat? But I remembered that conversation I'd had back in Florida.

[on camera] You read the Atkins diet, and they say, "Look, I can lose weight and I get to eat steak." Now, why would I not do that, when Pritikin is saying, "No steak, low-fat"? Seems a little hard to stick with.

JAMES J. KENNEY: Well, they eat the steak, but they can't eat the potato with the butter and the sour cream. They can't have the chocolate cake. They can't have the bread and butter. I mean, you're deprived on the Atkins diet, but you do get to eat the steak. The steak is better than the chocolate cake, as far as your weight is concerned. But both cake and steak are loaded with saturated fat and cholesterol and they're both going to clog up your arteries. So maybe you're thinner with the steak, but you're still-- you know, what's the point of looking thin in a casket?

STEPHEN TALBOT: Wow.

[voice-over] The accusations against the Atkins diet took a controversial turn last year when Dr. Atkins died after he slipped on an icy street. His medical records, which were leaked to the press by some of his critics, showed he suffered from heart disease, aggravated, they say, by his diet.

[CNN "Larry King Live"]

LARRY KING: Veronica, how did you react when you first read that?

VERONICA ATKINS, Widow of Dr. Robert Atkins: Well, I was totally outraged by--

STEPHEN TALBOT: His wife defended him and the company's reputation, accusing his critics of their own bias.

VERONICA ATKINS: It was not coronary--

LARRY KING: So it was not due to poor eating and high cholesterol.

VERONICA ATKINS: Of course. He didn't have high cholesterol. Of course it wasn't. Of course it wasn't. I mean, these are enemies of Bob's that are-- that are ultra-ultra vegetarians, and they-- they just hate the idea that somebody eats meat.

STEPHEN TALBOT: But nothing, it seems, can stop the Atkins craze, what ad people now are calling the "low-carb revolution."

And back in his lab, Dr. Hotchkiss is taking the carbs out of food, just as he once removed fat. This is a low-carb snack made almost entirely of whey protein. Take it from me, it tastes dreadful.

All this leaves me with a culinary conundrum. If fats can clog up my arteries and refined carbs leave me hungry, what am I supposed to eat? There aren't many reliable studies out there. One of the few comes from Harvard. Back in the '70s, researchers began recording the lifetime diets of thousands of health professionals, noting what diseases they contracted. And after 20 years of research, here's the deal. Not all fats are bad. Saturated animal fats are linked to heart disease and cancer, but unsaturated vegetable and fish oils actually protect people. When the food industry removed these healthy fats from salad dressings, they made matters worse, not better.

WALTER WILLETT, M.D., Harvard School of Public Health: The crusade against fat really led the food industry to produce all these fat-free salad dressing products. And the problem is that the fats that were in the salad dressings were the healthy fats, the ones you should be including in the diet. So people were giving up these healthy fats, and what we've seen is actually an increase in risk of heart disease among people avoiding full-fat salad dressings.

STEPHEN TALBOT: [on camera] OK, now, in the great tradition of American reporting, I'll focus this all on myself. I love nuts. And everyone tells me-- my wife harasses me. She's got great advice on most things, but she says, "Don't eat nuts. Lay off nuts." You're my only hope.

Dr. WALTER WILLETT: OK. Well, let me help out because nuts are really one of the neglected health foods on the American grocery store shelves. They've been given a bad rap by nutritionists because they are high in fat. Most of the calories in nuts are from fat. but it's almost all healthy fats. And what we've seen, interestingly, study after study, is that people who eat more nuts do not weight more than people who don't eat nuts, and it's probably because even a small amount can be very satisfying.

STEPHEN TALBOT: [voice-over] The Harvard study found that not all carbs are bad, either. Slowly digested unrefined carbs, like brown bread or brown rice, are filling and nutritious.

By now, most diet programs have gotten this "good fats, good carbs" message, and I was leaning in that direction myself. But first I wanted to speak with the author of the most popular diet of the moment, the South Beach Diet. Now, there's a marketing brand, with its promise of slender bodies on the sand.

[on camera] In my college athlete days, I was about 165. Last 10 years, I think I went from 190 to 210. What would you say to someone like me?

ARTHUR AGATSTON, M.D., Author, The South Beach Diet: Well, your story is really quite typical of American Baby Boomers. It's very predictable. And the more that you've had adult weight gain and the more it's been central weight gain, the more predictable it is that the South Beach diet will work for you.

[www.pbs.org: Read the extended interview]

STEPHEN TALBOT: [voice-over] Everybody thinks their diet is best, but Agatston is this year's winner. South Beach now outsells Atkins's Diet Revolution.

Dr. ARTHUR AGATSTON: I give Dr. Atkins credit for teaching us that fat doesn't necessarily make us fat, and he was absolutely right. And there's been an evolution. The Zone Diet was an advance, I think, over Atkins. I think Sugar Busters is an excellent book. But I think the basic principles that good fats are good for you and the good carbohydrates are good for you, and the processed ones are not-- I think that's current consensus of opinion.

WAITRESS: Here's the Atkins salmon for you.

STEPHEN TALBOT: OK.

WAITRESS: Would you like any breadsticks with that?

STEPHEN TALBOT: No. No breadsticks.

WAITRESS: OK.

STEPHEN TALBOT: [voice-over] So the truth is, all these diet programs are not as different as they claim. At Friday's, they call it an Atkins meal, but really, this salmon and broccoli would be fine on South Beach, Pritikin or Ornish. And they all agree that if I eat like this, the pounds will start dropping off me.

But even I do lose weight, what are my chances of keeping it off?

JAMES HILL, U. of Colorado Health Sciences Ctr.: Keep in mind that somewhere between 80 and 95 percent of people in your situation will regain it.

STEPHEN TALBOT: This is James Hill from the University of Colorado. He's a diet skeptic.

[on camera] Can I do it?

JAMES HILL: Can you do it? The statistics would say no. The problem is, we go on a, say, low-carb diet and it's great and we lose weight and we're doing fine. And then we start craving those carbohydrates. And what we do is not to transition over to a better diet, we sort of say, "OK, I can't do this anymore. I'm going to give up. I'm going to go back to the way I ate before." And voila, the weight comes back.

STEPHEN TALBOT: [voice-over] I'm not sure I want to hear all this. If he's right, then all diets, from low-fat to low-carb, are really just gimmicks. They work at first by limiting variety, but over time, tofu and eggplant's not going to cut it, not for me. Odds are I'll give in to temptation and gain back what I lost.

And that's what had brought me to Weight Watchers. Here you can find people who have defied the experts and kept the weight off for a very long time.

WEIGHT WATCHERS EMCEE: Tell us what you lost.

DIETER: 102.

DIETER: 110.

DIETER: 135 pounds.

STEPHEN TALBOT: [on camera] What is it about Weight Watchers that sets it aside and that worked for you, whereas other diets didn't?

DEBORAH KENNY, Weight Watchers Dieter: It's a whole lifestyle change, it's not a diet. It's a commitment to eat right for the rest of your life, to watch portion sizes, watch what you eat, make sure that you exercise. So it's not just a diet that you go on, you lose the weight and then you go-- slide back to your old eating habits, and pretty soon, the weight comes back on and more.

WEIGHT WATCHERS EMCEE: Eileen and Laura, do you two know each other?

DIETER: Yes. Yes.

DIETER: Absolutely.

WEIGHT WATCHERS EMCEE: Absolutely. So how much did you lose?

DIETER: 115.

DIETER: 105.

WEIGHT WATCHERS EMCEE: 115, 105-- wow! So has there ever been a time that you just wanted to chuck it?

DIETER: Many times.

WEIGHT WATCHERS EMCEE: Many times? OK.

DIETER: But she wouldn't let me.

WEIGHT WATCHERS EMCEE: What a good friend!

DIETER: I'll tell you!

DIETER: Yeah, because I'm not quitting, so she's not quitting.

WEIGHT WATCHERS EMCEE: OK!

DIETER: We're doing it together.

STEPHEN TALBOT: These success stories prove that long-term major weight loss is possible-- if you don't mind feeling like you're in a 12-step program.

WEIGHT WATCHERS EMCEE: And that's what the support is all about. How much did you lose?

DIETER: 200 and counting.

STEPHEN TALBOT: But few people have the discipline to keep it off, even in the supportive atmosphere of Weight Watchers. And that, scientists say, is what makes America's weight problem so very serious. It's an issue, i realized, that totally eclipses my own quest to lose weight.

JAMES HILL, U. of Colorado Health Sciences Ctr.: This is the public health issue of our generation. You see, 65 percent of Americans are overweight or obese.

WEIGHT WATCHERS EMCEE: You're an inspiration to everyone in this room. So thank you.

JAMES HILL: If you look at our ancestors, what they desired more than anything else was to have a constant source of food that was good-tasting and inexpensive and did not have to work very hard. And in fact, if you fast-forward to today, that's the environment we've got. Everywhere you go in America, it's OK to have food. It's OK to have food in your car. It's OK to eat at your desk. What's amazing is that people can actually live in this environment and not become obese.

MARION NESTLE, New York University: We're seeing an epidemic of obesity that is occurring so rapidly that the Centers for Disease Control can track it from year to year, and does so on those beautiful maps on its Web site.

STEPHEN TALBOT: Since 1985, the CDC has been tracking the fattening of America. Just look at what's happened to us, obesity rates rising year by year, state by state, unchecked by diet fads or government food pyramids. And now it's spreading to the rest of the world.

[on camera] Do you notice in England that people are getting bigger or not?

SARAH FERGUSON, Weight Watchers Spokeswoman: No question about it. It's now talked about on a daily basis. We-- you know, they always go, "Well, we're not as big as the Americans." And I say, "Well, incorrect. You are now very close. And when are you going to wake up?"

And when we talk in a minute about weight and about diet--

It is time we talked more and more about educating our children in nutrition. And unless the government really take it seriously, they are going to have a monster problem in years to come-- the health care bills the hospitals. And it's just-- where is this generation going to go?

STEPHEN TALBOT: [voice-over] Fergie has a point. Even if you're not worried about the size of your own belly, you have to worry about the fate of your children and grandchildren.

Dr. David Ludwig runs an obesity clinic in Boston for overweight children like Bill.

DAVID LUDWIG, M.D., Children's Hospital, Boston: One of the things we worry most about is something called type 2 diabetes, and we're seeing this in teenagers. We never saw this before. This used to be only--

STEPHEN TALBOT: What we're

JAMES HILL, U. of Colorado Health Sciences Ctr.: What we're seeing in kids is astonishing. Type 2 diabetes, which is a devastating disease that traditionally has developed in overweight people who are in their 50s and 60s and 70s, we're seeing it in 14-year olds. We have no idea what that's going to do to the lifespan of a 14-year-old. We're seeing the beginnings of heart disease in 12-year-olds and 13-year-olds.

[www.pbs.org: More on the diet/disease connection]

STEPHEN TALBOT: Rose badly wants to avoid this fate for her 10-year-old daughter, Ayana.

Dr. DAVID LUDWIG: Tell me what's concerned you about her weight.

ROSE: The question about her weight is, like, if she's going with that weight, she's going to be having all kind of problem, you know, over--

AVIVA MUST, Tufts Univ. School of Medicine: There was a projection published last summer by the CDC that suggested that for a child born in the year 2000, they faced a 50 percent lifetime risk of developing diabetes. So that means that one child in two, over their lifetime, would become diabetic. And diabetes is a very, very serious disease. It is associated with cardiovascular risk, with blindness, with amputation, with renal failure. So it's-- it will definitely overwhelm our health care system.

Dr. DAVID LUDWIG: You know how your mom and dad are a little bit heavy? Well, you might have gotten that tendency from them. But genes aren't the whole story. How do we know that? In America, everybody is much heavier than we were 30 years ago, but our genes haven't changed. Tell me what you usually have for lunch.

ROSE: Sometime I make-- I make them a sandwich, they don't want it. They just bring it back the same way they bring it.

Dr. DAVID LUDWIG: So what do you eat?

AYANA: I usually buy ice cream or cookies.

Dr. DAVID LUDWIG: That could be lunch. But you're probably hungry-- get hungry in the afternoon. What do you have for the afternoon?

ROSE: Cookies.

Dr. DAVID LUDWIG: Cookies?

ROSE: And eat-- and have some milk.

Dr. DAVID LUDWIG: All right. Then what's for dinner?

ROSE: Rice, chicken.

Dr. DAVID LUDWIG: OK.

ROSE: But she doesn't like it. Sometimes she doesn't eat it.

Dr. DAVID LUDWIG: Do you eat any vegetables?

ROSE: I give her the vegetables. She eat not much.

Dr. DAVID LUDWIG: Not much vegetables.

STEPHEN TALBOT: The schools aren't doing much better. At this middle school, there are a few supposedly healthy lunch choices, but most kids go for the artery-clogging pizza and hunger-inducing chips.

WALTER WILLETT, M.D. Harvard School of Public Health: The food industry has invested many tens of billions of dollars in making their products more attractive, more sweet, more salty, more sexy, more seductive in every way that they can. And we're vulnerable to that promotion, and we are eating more.

MARION NESTLE: And they do that not only through advertising and marketing, but also by enormous efforts to change the social environment so that it is now socially acceptable for children to drink soft drinks in school and all day long and for people to snack all day long and eat food in larger and larger portions.

STEPHEN TALBOT: And it's not just how much junk food kids eat, it's how little they move. It's a different world from the one I grew up in 45 years ago.

["Leave It to Beaver"]

JERRY MATHERS: Hi, Gilbert.

STEPHEN TALBOT: Hi, Beave.

JERRY MATHERS: How come you didn't ring the doorbell?

STEPHEN TALBOT: Well, I didn't know if you were home, and I didn't want to talk to any grown-ups.

There was a certain lifestyle that was portrayed in the show. It's become a cliche, but actually, it mirrored my own kind of family, where kids, for instance, were very, very active. It was a very active life.

JAMES HILL, U. of Colorado Health Sciences Ctr.: It really was. And think about it. You didn't have video games. You didn't have CDs. You had a TV, but you probably only got three stations and two of them didn't come in that good, and there wasn't that much on.

STEPHEN TALBOT: It was black and white.

JAMES HILL: So it was easy to go outside.

Dr. WALTER WILLETT: When I was young and came home after school, we'd all go out and play and our mothers would have to drag us in for dinner. That doesn't happen very often anymore. Often, the mothers are not there. Kids are inside. The television is used as babysitters.

JAMES HILL: But I think your question goes even deeper and illustrates that obesity is a societal issue. Let's go back to that lifestyle. That lifestyle is: You have time to be June Cleaver and take two hours and fix a nice, healthy meal. The family comes together in the evening. Dinner's on the table. We've lost that as our life gets busy and both parents are working and the kids, you know, rarely are together to eat. And so I think part of what's resulted in obesity is the fact that our society values have changed over time in this information age.

STEPHEN TALBOT: Golly, Beave, I didn't think it was going to happen so quick!

JERRY MATHERS: Me neither. Thanks a lot, Mom.

STEPHEN TALBOT: [voice-over] There's an unsettling sequel to all this.

[television commercial]

ANNOUNCER: Jerry Mathers, formerly known as "the Beaver," for Jenny Craig.

JERRY MATHERS: Recently, my doctor said, "You have to lose weight or you won't be around to see your daughters get married."

STEPHEN TALBOT: My friend, Jerry Mathers, put on so much weight he became a diet spokesman.

JERRY MATHERS: I lost 35 pounds. Now I can wait for my kids to get married.

STEPHEN TALBOT: But Jerry has struggled to keep it off and even developed diabetes. That got my attention. And it should scare America, too, because if Beaver and Gilbert are at risk, the prognosis looks far, far worse for today's kids, who watch hours of TV a day. In fact, as a society, we are now so sedentary that we can get fat even without overeating.

AVIVA MUST, Tufts Univ. School of Medicine: The notion that you have to overeat a lot of calories in order to gain weight is actually not true, and it's somewhat surprising to people. To gain a pound a year, which doesn't seem like much, you would only have to eat in excess of maybe 40 or 50 calories a day. Well, if you gain an excess pound a year, that's 10 pounds a decade, or 30 pounds from the time you're 20 to the time you're 50. And that would put you into the overweight or even the obese range.

[www.pbs.org: Test your nutrition knowledge]

STEPHEN TALBOT: That's probably what happened to me. It's all rather depressing. Everything in the modern world, it seems, conspires to make us overweight.

But James Hill thinks he sees a way out. His organization, America on the Move, is taking steps to fight the fattening of America.

JAMES HILL: If you can modify your energy balance by only 100 calories a day, if you could do that, A, you would stop weight gain with that simple little change. Now you go on and do some small changes to begin losing weight.

STEPHEN TALBOT: And to help us make that change, Hill is promoting a simple gadget called the pedometer.

JAMES HILL: Let's see how many steps we have here.

STEPHEN TALBOT: [on camera] All right. You're doing OK for the week.

JAMES HILL: You can strap on this simple little device -- costs less than 20 bucks, very cheap -- and it tells you how many steps you take. And that gives you a goal. You're taking 4,000 steps now? You can set your goal at 6,000, and at the end of the day, you can look and see if you made it.

STEPHEN TALBOT: [voice-over] It might just catch on because Americans love gadgets and they love to keep score.

AEROBICS INSTRUCTOR: So how many steps did everyone do today? Lots of steps? Lots of steps. I think it takes, what, 1,800 steps to burn off a Big Mac.

STEPHEN TALBOT: Here at Denver's Rising Star Church, some of the congregation have joined Hill's war on obesity.

JAMES HILL: We started one of the initiatives in black churches very early on, and the reason we did it is because they came to us. And they said, "Look, when it comes to obesity, we've got it all."

STEPHEN TALBOT: Exercise doesn't bring about rapid weight loss, like crash diets, but Hill says it's essential for maintaining a healthy weight. Americans don't move much, only about 4,000 steps a day. But Hill's research shows to keep weight off requires over 10,000 steps daily. That's five miles, way beyond what most people are willing to do. So America on the Move set a more modest goal, an extra 2,000 steps a day, about a mile.

And they are beginning with the schools, where the trend has been to save money by cutting out physical education. At this middle school, the 7th graders take part in a 12-minute run and seem to enjoy it. Even though this is a showcase program, the sad part is that the kids run only once a week.

MEG FLOWERS, Teacher, No. Arvada Middle School: Five, four, three, two, one--

STEPHEN TALBOT: But I guess once is better than nothing. Just imagine if every American child did a 12-minute run every day. That might, over time, begin to reverse America's obesity epidemic.

MEG FLOWERS: How many of you got 3,000 steps with that run, 4,000, 5,000? Nice work!

I really believe that there needs to be K through 12 physical education daily. We need to get these kids so that when they graduate from high school, they can be their own personal trainer.

STEPHEN TALBOT: Meanwhile, the fast food industry is already coopting the promise of exercise.

TELEVISION COMMERCIAL: All of a sudden, people are loving taking that extra step, going that extra mile, because now McDonald's has the new Go Active Happy Meal-- a bottle of water, your choice of salads, like the new Del Rio, and your very own step-o-meter.

AVIVA MUST: I do think that the food companies understand that they're going to have to be sincere participants in dealing with this problem. I'm not naive enough to think that they're going to do it on their own with out a strong prod from the government and from regulatory agencies.

DAN GLICKMAN, Harvard University Institute of Politics: Food is such an enormous part of our culture in this country. That's why the issue is so complicated to deal with, why it's so hard to pin your finger on a culprit here. The food industry is partly responsible. The government could be doing a lot better, as well. The schools could be doing better. But frankly, as Pogo said, we have met the enemy and he is us.

STEPHEN TALBOT: Tonight I'm celebrating my 55th birthday. It's been two months since I started my diet, and tonight I can drink a little wine. But I won't touch the white bread because, I'll 'fess up, I've been on my own version of a good-fat, good-carb diet. The first two weeks were brutal. I gave up all potatoes, pasta and rice, all fruits, desserts and alcohol. But now in phase two of my diet, I'm allowing myself a little -- a very little -- of the occasional forbidden food. My plan is to stick to this as long as I can. I've been eating less and exercising more, exactly what my wife's been telling me to do for years. She was right about everything. Except the nuts. So tonight I'm on my best behavior because tomorrow I have a date with the doctor.

[on camera] All right, so because my day of reckoning is tomorrow on the scale, I am only allowed two bites. Here goes. Is that good!

[voice-over] Two months ago, I was 210 pounds. It's time to find out how much weight I've lost.

NURSE: And you want to stand up really straight.

STEPHEN TALBOT: All right. Wow.

Dr. ROBINSON: You've lost 15 pounds.

STEPHEN TALBOT: Right.

Dr. ROBINSON: So that puts you around 27, and so you're now in the mid-range of being overweight.

STEPHEN TALBOT: It's still overweight.

Dr. ROBINSON: Yes.

STEPHEN TALBOT: And I could still afford to lose some more weight.

Dr. ROBINSON: Right. Right. And do you have plans to work on that?

STEPHEN TALBOT: I do.

Dr. ROBINSON: OK.

STEPHEN TALBOT: I mean, I-- you know, I definitely want to get to 190, which would be 20 pounds down.

Dr. ROBINSON: OK.

STEPHEN TALBOT: And I think, you know, on this chart, to really get on the BMI to normal, they're saying at 5-11, I should be, like, 180 pounds, right?

Dr. ROBINSON: Actually, fall within the normal limit, 172 pounds.

STEPHEN TALBOT: Wow. Wow.

Dr. ROBINSON: Yeah.

STEPHEN TALBOT: [voice-over] That's worse than I thought. I have more than 20 pounds to go.

[on camera] Well, I'm going to continue to lose some weight and watch it.

Dr. ROBINSON: OK.

STEPHEN TALBOT: I mean, I don't think I'm going to do any kind of rapid descent anymore--

Dr. ROBINSON: Right. Right.

STEPHEN TALBOT: --but I think I'm going to continue to go down.

Dr. ROBINSON: Right. Yeah.

STEPHEN TALBOT: Yeah.

[voice-over] Don't let the diet books fool you. Getting down to a normal weight ain't that easy. But there's some hope. For the first time in ages, I'm exercising regularly. With the help of my new puppy, I now average over three miles a day. And I've got to admit, the less I weigh, the easier it gets. I've learned that all diets are ultimately gimmicks. They give you a quick hit of weight loss, but after that, it's just common sense: Eat healthy food in moderation, and get up off the couch.

It's not the kind of message that sells a lot of diet books. Nobody ever got rich marketing self-control. But something's happening lately. We seem to be talking about all this more. It sure got the attention of the food industry and the government, which has warned that obesity will soon pass smoking as the leading cause of preventable death. I wonder if we've all got what it takes to stop the fattening of America.

JAMES HILL: I'm an optimist. You know, in 1950, if somebody had said, "Oh, we're going to get Americans to quit smoking," I mean, people would have said, "Oh, you're crazy. There's no hope." We're at a very critical stage right now. We're at the stage where we know it's an issue. We know we have to do something. I think we're going to be judged by future generations on our actions within the next few years, in terms of how we begin to deal with this problem.

 

DIET WARS

WRITTEN, PRODUCED AND DIRECTED BY:
Jon Palfreman

CORRESPONDENT
Stephen Talbot

EDITOR
Peter Rhodes

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Barbara Moran

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Tom Williams

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For FRONTLINE

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A FRONTLINE Coproduction with Palfreman Film Group

(c) 2004
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FRONTLINE is a production of WGBH Boston, which is solely responsible for its content.

 

ANNOUNCER: Visit FRONTLINE's Web site for more on this report, including a reporter's notebook from correspondent Steve Talbot detailing his foray into the diet wars, a chronology of Americans' changing relationship with food over the past century, a closer look at the public health implications of the obesity epidemic, a quiz to test your diet and nutrition knowledge, plus extended interviews and streaming video of the full program. Then join the discussion at pbs.org.

 

Next time on FRONTLINE:

RICHARD CLARKE, NSC Chief of Counterterrorism '92-'01: The FBI culture, the FBI organization and the FBI personnel are not the best we could do in this country for a domestic intelligence service.

ANNOUNCER: As the 9/11 commission keeps probing the deadliest intelligence failure in U.S. history, FRONTLINE takes an inside look at what the FBI knew about 9/11 and when it knew it. The Man Who Knew next time on FRONTLINE.

 

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