Platkin: Low-Carb As 'Detrimental' As Obesity

Charles "Diet Detective" Platkin shares his diet beliefs in interview

You know, I'm starting to enjoy doing these interviews with people involved in the worlds of diet, health, and fitness. It seems each one of them comes at weight loss and nutrition from a different perspective despite the fact they are all attempting to accomplish the same goal. It is my hope that you can take something away from these one-on-one interviews I have at my blog and apply those things to your own dieting experience.

I added a list of the interviews I have already conducted as well as some upcoming ones I am working on along the bottom right-hand side of my blog this weekend. Check 'em out if you haven't read them all because they are quite fascinating.

Today we have the distinct pleasure of inviting with us bestselling author and health advocate Charles Stuart Platkin, better known as "The Diet Detective" in his nationally syndicated newspaper column as well as his popular DietDetective.com web site. If you have been reading my blog since the early days when I started it last April, then you know that Charles and I don't exactly see eye-to-eye on how effective the low-carb lifestyle can be for people to lose weight and keep it off. We've even gotten into some rather heated discussions with each other about our respective viewpoints on the subject.

Nevertheless, he was kind enough to accept my invitation to be interviewed about some of those areas of disagreement so we can better understand where he is coming from in that regard. Be prepared to have what you believe to be true about healthy living challenged today as Charles Platkin responds to the tough questions about his weight loss philosophy, what he really thinks about the low-carb lifestyle, why he focuses so much on calories, and the importance of exercise in weight loss, among other things.

1.  Hello and welcome to Charles Stuart Platkin. Thanks so much for agreeing to come on my blog for an interview despite the fact that we have had our differences regarding the definition of what constitutes a long-term, successful weight loss program.  Before I get into that, tell my readers a little about the man now known as "The Diet Detective."  How and why did you become a health expert in the first place?

I began to formulate my own theories on health and wellness when I was a writing a book about how people can and can’t change. Cynically thinking they couldn’t, I discovered to my surprise after years of research and interviews on behavior modification, motivation, achievement, and personal responsibility that a leopard can actually change its spots. However, I really didn’t figure that lesson out until after my first book was already drafted. And even after doing all that research, I still wasn’t a believer. Sure, I believed in the research, but that was "for other people." So it was at that moment that I decided to test out some of the behavior "stuff" that I had learned and written about. However, I had one big problem (at least so I thought) -- my weight. So that’s where I started.

I gradually came to realize it was true that people can change. In fact, the science of behavioral change has a long and successful history. Its principles have allowed people to change their weight and their lives. My first book, "Breaking The Pattern", was a synthesis of what I had discovered.

Then things sort of snowballed. Like you, Jimmy, I was passionate about what I’d found and wanted to spread the word. I started working in the nutrition and fitness area and focused on writing, the Internet, and other outlets. I launched the syndicated column known as The Diet Detective, which is in more than 165 daily newspapers around the U.S.

As a side note, I don’t accept any money from newspapers or commercial sources to fund the column. It's purely to "spread the word." Me and my staff actually put in more than 100 people hours (researching, editing, etc.) into every column.

I consider myself a nutrition and public health consumer advocate. I would say aside from the reasons mentioned above I had discovered firsthand how maddening and futile quick-weight-loss diets were. What I noticed is they all simply reduced calories by limiting the variety of foods I could eat. However, these types of weight loss programs were highly restrictive and impossible to maintain over the long term.

For me personally, all of these kinds of diets failed me. I had been overweight my entire life and I had given the responsibility for my weight loss to one fad diet after another. In fact, when I was just ten years old, I pleaded with my parents to buy me Dr. Atkins' diet book so that I could finally lose weight. But once I understood and was able to apply the principles of behavior change, I did an about-face and was able to lose more than 50 pounds and, perhaps even more importantly, have kept it off for more than 10 years.

I consider this one of the greatest achievements of my life.

2.  Speaking of weight loss, let's talk about that subject for a moment. While there are certainly many avenues for people to choose from regarding weight loss, I'm sure you will agree that it's all about finding what works for you and then sticking with it.  Tell us a little more about what specifically you did to finally lose the excess pounds and what you are doing today to keep that weight off forever.

I have in fact struggled with weight loss in the past, after spending my childhood and early adulthood overweight. At this point, I’ve lost 53 pounds overall. By the time I was in my late 20s and early 30s, I had started working on behavioral issues, which is when I began to see how incorporating behavior modification theories into a diet can make such a difference in long-term success.

Then, believe it or not, I started using a low-fat and low-carb combination diet and exercising everyday and I found this to be very successful for me. However, I should point out that my success was more about my attitude and behavior than anything else and that made the difference to me. It wasn't about the food and exercise, that was merely the means to reach my goal. Over time it became more about my behavior changes and finding what I call "Calorie Bargains" – substitutions for foods that were normally a regular part of my life. That way I don’t have to give up something I love to eat, such as ice cream, but I can instead find versions with fewer calories and thus lose weight without feeling like I’m making a sacrifice.

3.  Although we are all different when it comes to the effectiveness of one diet versus another, it really has seemed to come down to the plethora of low-fat/low-calorie/portion control diets which have almost universally been found to be ineffective for most people over the past three decades going up against the ever-growing body of evidence from scientific researchers that is proving various versions of the low-carb lifestyle might just work for some people.  That has been my personal experience losing 180 pounds on this way of eating.  Tell us your honest opinions about the low-carb lifestyle and why you believe it is a good or bad way to lose weight and keep it off.

Honestly, if it works to help someone who is dangerously obese to lose weight and it proves to be medically safe for them to do, then I’m fine with it. What I do think is most important about choosing a diet is finding one that you can live with, comfortably, for the rest of your life. And it helps if that diet is as unrestrictive as possible. For example, a low-carb, high-protein, moderate-fat diet that monitors the intake of all three can produce similar success with fewer restrictions and better overall health outcomes than any diet that focuses only on one aspect of food consumption.

I guess what concerns me most is that I believe saturated fat really does clog your arteries. And as we all know, this research can change, but it does make sense to me and the evidence is compelling. The selling point in diets that are extremely restrictive in one category is that in other categories you can eat as much as you want.

The problem here, oftentimes, is two-fold: if you can’t make choices about which foods you’re willing to cut out and which are just too important to you, you’re much more likely to, eventually, start eating the foods you miss at some point. The second part of the problem is that it can be dangerous to give the general population carte blanche to eat everything they want as long as it’s, say, high in fat but low in carbs.

As an initial approach for people who are seriously obese, I can get behind an “eat-as-much-as-you-want-of-one-food-group” philosophy -- even if there are some risks -- primarily because the gravity of obesity. Sometimes I can imagine the most important health priority for an individual would be simply to lose weight. In my opinion, I think for an individual who is seriously obese, losing weight can, only in certain situations, be more important than eating a perfectly balanced diet, again with the requirement that they're under medical supervision. But it’s downright risky to even do this.

But once the weight loss is accomplished, the process takes two new turns: one towards weight maintenance and the other towards overall health. That’s when we have to reevaluate the diet that has been selected. Is it livable? Is it personally sustainable? And is it sufficiently healthy?

A lot of the reasons why many diets are ineffective are that they are not really about behavior. Even though weight control is primarily about our behavior -- planning, rehearsing situations, understanding why you’re overeating -- that’s what you need for long-term control. Once you’re out the woods, so to speak, in regards to obesity and all the potential health complications that go along with it, you need to look at your diet and your life in general and make sure that you’re on a plan you can feel happy about for the rest of your life. It would be ideal if you can manage all those components from the very start, but that’s not always possible.

4.  You mentioned at my blog once that 98 percent of people who start a low-carb diet fail at it.  But isn't it true that a similar percentage of people who have gone on a low-fat/low-calorie/portion control diet also failed at their diet plan?  If so, then why are low-carb plans given such scorn and ridicule from diet experts like yourself while low-fat/low-calorie diets basically get a pass?

Ah yes, well, we all know that hindsight is 20/20 and if were I able to go back in time, I would probably rewrite that part. Also, just for clarification, the comments I made were not intended to be an attack on low-carb dieting or Jimmy Moore’s commentary. Actually, we probably believe and agree on many more things then disagree.

Be that as it may, the bigger problem with what I said is that it didn’t make allowances for the nuances and complexities of such statistics. While 98% of all initial dieters may very well fail, the truth is that those who continue trying to lose weight are able to succeed about 10-20% of the time. These still aren't fantastic odds, but a lot better than only 2%.

The reality is that the statistics and research in this area are a bit spotty; there aren’t very many studies on long-term weight control success. In fact, one of the few ongoing studies is the National Weight Control Registry, which I believe you are a part of. Their research on long-term weight control seems to support a low-calorie, low-fat diet. But again, if more people like you who follow a low-carb lifestyle are able to register and become a part of the statistics, then that could change.

As far as your question as in pertains to the response of the medical community to the low-carb diet, I can only speculate that experts probably feel insecure approving diet plans that can be high in saturated fat because of the potential health repercussions. And again, the evidence here is strong in favor of saturated and trans fats leading to heart disease. And I’m aware of some studies which showed positive decreases in cholesterol, etc. from a low-carb diet, but again, long term studies would be nice. And hopefully they will come.

I do think some of the resistance to low-carb and no-carb diets has been a product of concern that the overall eating habits of such dieters will prove just as detrimental to their long-term health as obesity has proven to be.

One more point about low-carb diets: many people often don't follow the low-carb diet the way it was meant to be followed.

Want to hear something funny? When I first started working with registered dietitians and medical doctors for my newspaper column and for other weight control programs I was working on, I used to laugh at them when they said that bread and pasta was okay to eat. I used to believe that I would gain back all my weight if I started eating those foods again. However, when I started to slowly introduce some high fiber, whole grain pastas and breads back into my life, not only did I not gain back the weight, but I actually started to enjoy eating even more.

5.  I know the basic premise of your plan for people to control their weight is to stop dieting and to start making what you have previously discussed in this interview as "Calorie Bargains" to get people to consciously consume lower calorie foods instead of the higher calorie foods which have caused them to become overweight.  Isn't this just a calorie restriction diet?  How do you keep from getting hungry eating this way?

Not exactly. The point of a "Calorie Bargain" is that it replaces a high-calorie food in your diet with a low-calorie food you will enjoy just as much. What that means is not everything can be replaced.

Some people have foods they absolutely love and it’s unrealistic to expect them to cut those foods out forever. However, there are foods that you can find equally satisfying substitutes for or just slightly less satisfying options that are more than adequate. This will only work if you really love the new low-calorie food, so it can take a while to figure them out.

For some people, it might be that they still want to eat hamburgers, but they can do without the mayo. Interestingly, they were only leaving it on the burger because it was already there. We have many of those kinds of behaviors when we eat that we can easily change. Anytime you feel restricted, you have a higher likelihood of falling back into your old behaviors.

Personally, I knew that ice cream was a food I wasn’t prepared to give up. So I bought a number of frozen yogurts and lower calorie varieties. I certainly didn’t like all of them, but I did find brands and flavors that I loved and they had fewer calories than the ice cream I was used to eating a few nights a week.

Another great example is replacing chips with popcorn. Many times you probably just want something salty to crunch on, so air-popped popcorn is great. I make my own popcorn in a paper bag in the microwave. The key is to find a food you really love and then use it as a substitute. You don’t add it to your diet; you use it in place of something else that you typically eat. You can also have carbohydrate bargains just like calorie bargains. But my only caveat would be that the substitute food also be lower in calories.

Also, another key point to losing weight permanently is creating automatic behaviors. People who successfully manage their weight aren't constantly thinking about eating and exercise. Instead, they've figured out ways to make their behaviors and choices second nature to them. It's based on the concept of "automaticity" -- the ways we perform our daily behaviors without having to think about them.

Activities such as setting your alarm clock at night, putting on your shoes before you leave the house and remembering how to drive to the office do not require much thought. The idea is to apply the same principle to your diet.

6.  You have made the statement at my blog that diets are making us "fatter and fatter" as a nation.  I agree with that which is why in my own book I write about making a permanent lifestyle change in the way you eat, move around, and in those bad habits we usually fall into.  What can we do to stop the inevitability of obesity in this country or are we too far gone to make a real difference now?

This is an extremely broad question, since the truth is that there are so many facets and nuances about the weight problems facing our nation. There are differences between childhood obesity and adult obesity, age factors, cultural issues, political factors to consider, etc.

But to speak about it generally, one of the most significant challenges facing all aspects of obesity prevention is that it’s taken a backseat from a public health perspective. On a prevalence basis, a cause such as AIDS/HIV prevention, while important, receives significantly more funding. The fact that obesity isn’t a bigger priority is a national problem.

Take a look at these charts about National Institute of Health funding from the American Obesity Association’s web site:

Obesity-related medical conditions such as diabetes and cardiovascular disease receive far greater funding than the causative condition itself, as shown in Table 1.

TABLE 1

NIH Budget - 2005 Estimate for the Condition and Funding

HIV / AIDS -- $2.9 billion
Cardiovascular Disease -- $2.4 billion
Biodefense -- $1.7 billion
Nutrition -- $1.1 billion
Diabetes -- $1 billion
Smoking -- $566 million
Obesity -- $440 million
Source: NIH Office of Budget online.
Obesity is approaching the level of being the leading cause of preventable death in the U.S. And yet AIDS, another cause of preventable death, receives about 5 times more research funding than obesity. Conditions with lower or similar prevalence rates receive considerably more research funding than obesity, as shown in Table 2.

TABLE 2

U.S. Prevalence and NIH Funding

Cardiovascular Disease -- 64 million -- $2.4 billion
Obesity -- 60 million -- $440 million
Smoking -- 46 million -- $566 million
Diabetes -- 18 million -- $1.1 billion
AIDS -- 566 thousand -- $2.9 billion
Source: NIH Estimates of Funding for Various Diseases, Conditions, Research Areas. HIV AIDS Surveillance Report, Vol. 15, 2003, Table 12. Estimated Number of Adults / Adolescents Living with HIV Infection or AIDS. American Heart Association's "Heart Disease & Stroke Statistics - 2004 Update." American Diabetes Association Online. Diabetes Statistics. CDC Tobacco Information & Prevention Source, "Cigarette Smoking Among Adults United States, 2002" U.S. Census 2003 National Population Estimates, Adults Age 20 and older.

Disparities in priorities of research are also apparent in the number of grants awarded annually by the NIH.

More grants have been awarded to obesity research than in past years, however, Table 2 shows that it still remains considerably less than for some obesity-related conditions and AIDS.

Then there’s the environment we live in -- an obese-friendly one where high calorie foods are cheaper, easier to prepare, and readily available. Healthful eating is not a priority to us as individuals nor is it to our government. And don't get me started on increasing physical activity. We simply pay it lip service, but take very little action. The sad truth is we want to have our cake and eat it, too -- LITERALLY!

7.  Losing weight isn't necessarily the hard part for people, but keeping it off usually is.  I know I lost 170 pounds in 1999 on a low-fat diet, but I couldn't sustain that as a long-term weight maintenance plan.  When I started livin' la vida low-carb in 2004, I knew I would be able to eat this way during my weight loss and long afterwards to keep my weight under control.  What are your thoughts regarding my premise that people should find a plan that works for them, implement that plan, and then keep doing it for the rest of their lives?

I whole-heartedly agree, however, I don’t think low-carb is right for everyone. There are other ways people can lose weight and keep it off. With that said, though, I think you’re absolutely right to encourage people to find what way of eating is best suited for their lives. There is not one diet that would work for every person.

My philosophy and beliefs are centered around doing the investigation for yourself, doing the planning, etc. That way, you know the diet will be livable for you. Most of what you do in life probably requires some degree of strategic planning, even if it’s figuring out the best route from the dry cleaners to the post office to the supermarket when you set out to do errands.

We have no problem coming up with detailed strategies when we’re planning an event like a wedding. In fact, we obsess over every last detail -- the band, the location, the perfect wedding dress, the tuxedos, and the right caterer. But when it comes to our weight, yes we may think about it, but we don’t give it a fraction of the strategic passion it deserves.

8.  Exercise has been just as much a part of my weight loss success as my low-carb lifestyle.  For the non-exerciser reading this right now, tell that person the most compelling reasons why they need to begin an exercise regimen right away and how they can easily implement that into their daily lives.

I don't think there's an easy answer. Physical activity takes more time and effort than many other positive health-related behaviors. The truth is people will continue to choose pleasurable leisure pastimes that are sedentary. Most experts say the key is to make exercise "intrinsic," or internally motivated. To really keep an exercise program going, it needs to be something you're doing because you value the actual activity. You have to get to the point that you appreciate the exercise for the sake of exercising.

I think one of the best ways to get physical activity is walking. Research shows that it works. It really does! A recent study found that people who live in the suburbs -- and therefore drive everywhere -- weigh six pounds more than urbanites in dense cities who are able to walk more. In fact, in Manhattan in the heart of New York City, they have one of the lowest obesity rates in the country and many experts attribute this to the fact that so many of its residents walk regularly.

9.  You have said a lot of negative things about the low-carb lifestyle over the past year or so that I have been reading your columns.  Is there ANYTHING good you would like to say about livin' la vida low-carb apart from the fact that you know someone (ME!) who has been successful at this nutritional approach?

I guess someone who is very focused and in the low-carb world might conclude that I say negative things, but I’m honestly not against the low-carb lifestyle. I even hope to extend an invitation to have you run a section on the DietDetective.com website focusing on low-carb living.

My inclination is to believe, overall, it’s better to be at a healthy weight because obesity is a serious problem and getting people to that healthy weight is a grave concern to me. I support whatever methods of weight loss procure such an end, provided there is no current or lasting health damage because of the diet they used to get there.

10.  The platform you have to share your knowledge and wisdom on the subject of diet and nutrition is a big one with a syndicated newspaper column, your books, and a highly successful web site.  What is the one clear message that you hope people take away from their Charles "The Diet Detective" Platkin experience?

Nutrition, diet, fitness, and exercise are not strictly defined concepts that have been examined comprehensively and solved, so to speak. We are constantly learning new things and the environment therefore continues to evolve. Healthful living is a journey of constant discovery, because there is so much out there that we don’t even understand yet. So examine your sources -- keep checking, keep researching, keep exploring. Remember, do your best to live a moderate healthy life -- it goes fast.

A special THANK YOU to Charles for sharing his comments with the "Livin' La Vida Low-Carb" blog readers. Be looking for that special "low-carb" section at his web site very soon featuring regular columns from me and other writers who have a passion for livin' la vida low-carb. For more information about Charles Stuart Platkin and his dieting philosophy, please visit his web site at DietDetective.com.