Dr. Oz, of You on a Diet fame, faced off with Gary Taubes, author of Why We Get Fat on his show March 7, 2011. Dr. Oz attempted a dramatic upstaging with signs proclaiming that Gary Taubes promotes eliminating all carbohydrates. Trailers introduced Gary as “The Man Who Thinks Everything Dr. Oz Says Is Wrong”. Great television, lousy science.

I spent a few hours surveying the aftermath of Gary Taubes’ guest appearance. Mr. Taubes’ fans and detractors duke it out on his blog in a condensed version of a controversy that has festered over the last fifty years.

A SHORT HISTORY OF CARBOHYDRATE vs. PROTEIN

In the 1960’s the very low carbohydrate Atkins and Stillman diets were popular weight loss plans. In the 70’s Weight Watchers took center stage, in line with the high carbohydrate, low fat recommendations of the 1977 Dietary Goals for the United States.

By the 1980’s both Dr. Ornish and Pritikin promoted a 10% fat diet, making Weight Watchers look moderate. High carbohydrate diets became the norm. Corporate America flooded the marketplace with low fat everything.

Very low calorie, low fat prepared meals and meal replacements soon took center stage. Women were offered high carbohydrate semi starvation at 900 calories a day, while men wasted away on 1500 calories a day.

At the same time medically supervised fasts gained traction. Oprah Winfrey’s infamous moment pulling a wagon of fat on television underscored the opportunity for significant weight loss.

By the 1990’s Barry Sears published The Zone. Soon, Atkins resurfaced and extremely low carbohydrate diets were the rage once more. Weight Watchers and other high carbohydrate programs have endured, but many high carbohydrate plans now allow more protein.

Today we have Dr. Oz championing carbohydrate while Gary Taubes explains the perils of elevated insulin, a condition linked with eating excessive carbohydrate.

GARY TAUBES ON “WHY WE GET FAT”

In Good Calories, Bad Calories (c2006), and more recently in Why We Get Fat (c2010) Gary Taubes explores how the body regulates the calories we eat. Mr. Taubes directs attention to regulators of energy metabolism, specifically the role of insulin. Research tells us that carbohydrate intake drives insulin secretion. Elevated insulin levels drive fat storage. At the same time elevated insulin blocks fat utilization.

Some people are very sensitive to insulin. They secrete little insulin in relationship to their carbohydrate intake, and remain lean. Others are more insulin resistant. They secrete more insulin with a given intake of carbohydrate. The increased insulin makes it easier to store fat, and very difficult to lose what is already stored.

DR OZ CHAMPIONS CARBOHYDRATES

Dr. Oz champions the low fat, low cholesterol mantra of most cardiologists. He celebrates healthy carbs, promotes lean protein, and endorses healthy fats. He is careful to encourage fruits, vegetables and whole grains with plenty of fish, nuts and seeds while demonizing refined sugars and starches, saturated fats and trans fats.

I took the liberty of assessing Dr. Oz’s diet, or at least the food he claims he would usually eat, as shown during the March 7 episode.1 A cursory analysis estimates that his preferred diet contributes a strong 22% of calories from protein, a meager 36% of calories from carbohydrate, and close to 42% of calories from fat. This is not a high carbohydrate diet.

Gary Taubes has been trying to debunk the health halo of a high carbohydrate diet ever since his 2002 article, “What if It’s All Been a Big Fat Lie.” Dr. Oz’s lower carbohydrate diet ironically supports this position.

A PLANT BASED DIET IS NOT NECESSARILY A HIGH CARBOHYDRATE DIET

Dr. Oz’s staged controversy with Gary Taubes is misguided theatrics at best. At worst, it is dishonest.
Dr. Oz appears to prefer a diet with carefully chosen and limited carbohydrates. Despite the abundant plant based foods, it is not a high carbohydrate diet. The distinction is important.

There are people who seem to eat plenty of carbohydrate without negative consequences. They don’t readily store excess fat or develop diabetes, cardiovascular disease or other problems. It doesn’t seem fair, but metabolism is not about fairness.

Most of us live with a metabolism that has evolved to survive scarcity. Many people are insulin resistant—for whatever reason—and will feel better, manage weight more effectively and decrease risk of disease if they eat fewer carbohydrates. Most people do not have to eliminate carbohydrate to accomplish these goals.

IS THERE A RIGHT WAY TO EAT?

There is no single “right way” to eat. A more meaningful discussion could help people figure out what balance of carbohydrate, protein and fat works best for them. In the meantime, it is important to note a few basic guidelines that allow each of us to eat well, no matter what that balance looks like.

1. Eat whole foods. Minimize intake of highly processed, adulterated foods.

2. Eat through your day, and avoid getting over hungry. Feeling over hungry often leads to over eating.

3. Eat foods together for maximum satisfaction.
• Include enough protein for satiety (feeling content)
• Add enough healthy fat. Fats help you feel satisfied longer.
• Preferably choose whole fruits and vegetables, beans, legumes, and whole grains when you include carbohydrates, Limit highly refined sugars and starches.

4. Stop eating before you are full. The goal is to quiet hunger, not store for hibernation.

5. Season for full flavor, not just sweet or salty.

6. Allow enough time to purchase, prepare, and eat your food.

7. As you can, take the opportunity to celebrate food in its rightful place.

Food quantity estimates were based on pictures of preferred meals shown on the March 7 video. While not actual measures, the quantities reflect proportions of food on each of the plates.

Sizing Up Dr. Oz’s “Preferred” Diet

This food is low carbohydrate even if the amounts are only estimated

Breakfast
1 c. low fat plain yogurt
1 c. blueberries

Snack
2 oz. walnuts
1 med sliced orange

Lunch
4 c. wild green salad with 4 oz. seitan
½ c. quinoa
2 T. salad dressing

Snack
1 oz. roasted almonds
1 oz. dark chocolate

Dinner
6 oz. salmon
1 c. spinach
1 c. brown Rice
3 c. field greens w/ ½ c. grape tomatoes
2 T. salad dressing