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Conquer Fat
By Sheryl Gay Stolberg, March-April 2003
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More physicians are agreeing with him. "We used to think about the over-60 group like we did about children under age 17: They're in a delicate state, and if you disturb their nutrition you will disturb their health," says Schumacher. "We now know that in both groups that is untrue. Older Americans are not a feeble generation. They're a generation that wants to be healthy."
Although doctors disagree about whether losing weight can help people over 50 live longer, there's little doubt that it can help them live better—with greater energy, mobility, and independence. This reality, and our ever-increasing life span, is changing the medical establishment's conventional wisdom, says Schumacher. For example, the National Heart, Lung, and Blood Institute, a branch of the National Institutes of Health, now advises doctors that it is safe to put healthy people as old as 80 on a weight loss program.
That's good news to many people. One is Richard T., a retired purchasing agent from Minneapolis who weighed 273 pounds when he turned 70 six months ago. He was taking medication to control his high blood pressure and cholesterol. Worried he was "headed for a stroke,'' he sought help from a Minneapolis obesity specialist, Harold C. Seim, M.D., a staunch proponent of treating obesity in the elderly. Richard is now 80 pounds lighter and no longer needs to take daily medications. "A lot of people want to look better, and that's okay,'' he says. "I did this for my health."
The growing obesity epidemic among people over 50 may be a side effect, so to speak, of modern medical success. As more Americans are living vigorously beyond their 70s, we're avoiding many of the physical ailments that, years ago, may have been mitigated by our carrying a so-called safety layer of fat. Our greater vitality also allows us to eat with the same gusto we did at age 40—but with a body that is far more prone to storing the leftover calories.
"A couple of things happen past the age of 50 that could help explain the increasing obesity rates,'' says Allan Geliebter, Ph.D., a researcher at Columbia University and the New York Obesity Research Center of St. Luke's-Roosevelt Hospital Center. Most important, he explains, our resting metabolic rate goes down as we age. Simply put, you now burn fewer calories while sitting still than you did in your 30s and 40s, so you need to eat less food to keep your weight from increasing. And in this society, that's easier said than done.
Along with being constantly tempted by food, we've also been given bad—or at least incomplete—advice from the very people we trusted to tell us how to eat: the U.S. government and the nation's largest and most respected health organizations. For decades, Americans were told that the primary cause of weight gain was eating fatty, greasy foods. A healthy diet, according to the federal government, the American Heart Association, and others, was heavy in carbohydrates—the rice, bread, cereals, and pasta that form the wide base of the government's much-touted "food pyramid." Fresh fruits and vegetables come next in the pyramid, then meat and dairy, and then, most sparingly, fats and oils.
At the time, this seemed to make sense medically. Research showed that the animal fats contained in red meat and dairy products—the saturated fats like lard and the trans fats like margarine—are particularly likely to clog your heart arteries. So Americans have taken this nutrition advice. We eat much less dietary fat now than we did in the 1950s. But if the statistics are a guide, our national low-fat, high-carbohydrate diet has been a miserable failure in the fight against obesity.
"The evidence is very clear that low-fat, high-carbohydrate diets are not really effective in weight loss in the long run,'' says Walter C. Willett, a professor at the Harvard School of Public Health.
The problem is that the typical American diet is high in refined carbohydrates such as white bread, white rice, pasta, and potatoes, as opposed to unprocessed carbohydrates—whole grains such as wheat and oats. Scientists have established that refined carbohydrates are quickly digested and send natural sugar (glucose) into your bloodstream. This causes your pancreas to release insulin and absorb the sugar, and the resulting sudden drop in glucose can make you hungry again. Some physicians believe these fluctuations in blood sugar represent a bigger cause of obesity—and are more dangerous to your health—than the simple amount of fat you eat.
"There is growing evidence that these rapid swings up and down in blood sugar do stimulate the appetite and make it harder for some people to control what they eat and lose weight," explains Willett. Experts think that a diet high in carbohydrates may also raise your levels of artery-clogging triglycerides while lowering your HDL cholesterol, the beneficial form that helps prevent heart disease.
Enter Robert Atkins, M.D., and dozens of other diet gurus. As anyone who's been on a diet in the last 15 years knows, these people claim that the road to leanness comes from avoiding not fatty burgers but the bun—that starchy refined bread that causes the evil process described above. Atkins has made millions of dollars promoting a diet that allows people to eat all the fat and protein they want in the form of meats, eggs, and cheese, so long as they avoid most carbohydrates, fruits, and sugar. It is, in effect, the exact opposite of the government's low-fat, high-carb plan.
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