Letters

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As writer Katharine Mieszkowski correctly noted, leading nutritionists share the concerns of my organization, the Physicians Committee for Responsible Medicine, about the health problems associated with high-protein, low-carbohydrate diets. But Mieszkowski's article omitted several crucial points.

First, Salon readers should know more about the case of Rachel Huskey, a Missouri teenager who died of cardiorespiratory arrest while on a low-carbohydrate diet. Low calcium and potassium levels in Huskey's blood disrupted her normal cardiac functions and caused her heart to stop, according to Paul Robinson, M.D., an assistant professor of child health at the University of Missouri who spoke at the PCRM's recent news conference. An article coauthored by Dr. Robinson and published in the Southern Medical Journal explains that these depletions were likely caused by her adherence to a low-carbohydrate diet.

Moreover, Mieszkowski did not mention that many of the nation's largest public health organizations, from the American Kidney Fund to the American Heart Association, have strongly cautioned consumers against high-protein diets. For example, an advisory on the Web site of the American Heart Association warns, "People who stay on these diets very long may not get enough vitamins and minerals and face other potential health risks."

Because of such concerns, PCRM is calling on the Centers for Disease Control and Prevention to begin an immediate investigation into the prevalence of adverse effects associated with high-protein, low-carbohydrate diets. We believe consumers deserve an accurate account of the risks.

-- Neal D. Barnard, M.D.

Vegans are often attacked, but it seems rare that their claims are held up to even-handed critical examination, and it is refreshing that Ms. Mieszkowski does so in her article. The fact of the matter is that vegans and proponents of the Atkins diet both believe that it is unilaterally beneficial for any and every human being to eliminate an entire class of foods from their diet. And while the meat lobby and the Atkins supporters are not to be trusted because of the obvious conflicts of interest, it must be noted that vegan organizations like PETA and the Physicians Committee for Responsible Medicine are equally untrustworthy because of their ideology. As far as they are concerned, stopping the morally reprehensible practice of eating animals is the first priority.

An objective view of some of the nutty and alarmist arguments proffered by PETA and their ilk makes it clear that they are more concerned about your possible conversion than a balanced look at the facts. To paraphrase Dr. Barnard, vegans don't care why you stop eating meat; if bad science and scare tactics work, good enough. Those unfortunates he highlighted should have seen their doctor before they embarked on the late Dr. Atkins' equally nutty fad diet. People are different, and they need to tailor their diets to what works best for them, not what is morally acceptable to PETA, or financially acceptable to the Atkins crowd and the meatpackers of America.

-- Christopher D. Coccio

One more time: The Atkins diet is not a diet without vegetables. It encourages, indeed it requires, fairly large amounts of green vegetables: salad, broccoli, zucchini, green beans, all that. Nor does it require large amounts of saturated fats; indeed, it explicitly says not to go overboard with the butter and heavy cream. And it requires regular physical exercise. Read the poor man's book.

It just doesn't worry about saturated fats all that much. (In fairness, it's hard to work up a major fear of animal fat, which is a key source of calories in most of our primate relatives.) It's worth remembering that the body produces the great majority of cholesterol itself (not surprising, since it's needed for proper health). Accordingly, a diet high in cholesterol that lowers weight will lower blood cholesterol.

What it does prohibit are breads, potatoes and the like. Some "vegetables" are actually starches -- so yams are not included. Some fruits are really sugar juice with vitamins -- so bananas are not allowed. But once one finishes the very early "induction" phase, one essentially eats a balanced diet full of fruits and vegetables but without starch.

Why is that so scary? It isn't. The "Atkins diet" that is criticized simply isn't the diet that poor Dr. Atkins invented.

The medical data are actually very clear: The healthiest thing you can live on is a low-calorie, low-fat diet. However, the only human beings who actually do live on such a diet are either too poor to eat anything else or have amazing will power. The second-best choice is a low-calorie, higher-fat diet... which apparently human beings can maintain. A low-fat, high-calorie diet, which is what real humans actually eat when they reduce their fat consumption, is a very poor option -- and may indeed be the cause of the current obesity epidemic.

People who disparage the Atkins diet -- the real one, the one he wrote -- have an obligation to present a healthier diet that humans can actually stay on.

-- Alan Kornheiser

I am a longtime vegetarian, but my problem with the Atkins diet is not its promotion of meat eating but its close resemblance to an eating disorder. The Atkins plan claims only to make you lose weight. Not to make you healthier or lower your cholesterol or lower your blood pressure. Just to make you thin. All those other health issues be damned. And desperate people with body-image problems so severe that they'd willingly trade 10 years of their life just to shed pounds throw themselves into it with frightening abandon. Like an anorexic who knows she's killing herself but can't squelch her desire to be even skinnier, these people are killing themselves just to look good.

I work in the health-food industry, and the people I encounter who purchase low-carb products are often quasi-religious in their zeal to eat fewer carbs, to lose more pounds, to get better results from their ketosis urine tests, to convert everyone they encounter. I often wonder if the lack of so many nutrients in their diet is not leading them to dementia.

-- C. Magaro

This article is guilty of a common error of authors that write about low-carb diets. It confuses one phase of the diet with the whole thing. Most low-carb diets have three phases. Phase 1, the two weeks to indefinite period of time that one does not eat many vegetables or any fruits, is only one small part of the diet. This phase gets so much publicity because it is the phase during which the most dramatic weight loss occurs.

In the second phase of the diet, a phase during which weight loss slows but continues, more vegetables as well as nuts and berries are added to the approved menu. In this phase the recommendations are more varied than the diet of the average American. The last, or "maintenance," phase, with its focus on lean meats and complex carbohydrates, sounds more like Dr. Shapiro than Dr. Atkins. Even vegetarian diets require supplements, and most vegans can be recognized by their slender pallor -- neither diet screams robust health.

In my lifetime the food pyramid has been revamped five times and they are still fiddling with it. For every nutritional rule there is not only one person but a whole society breaking it with healthful benefits. As a society we must continue to test, study and learn. As for the rest of us, we can only follow the research and try to decide on the best path.

-- W. Brown

While as a vegetarian I was a little put off by some of the tone of this article, it does make a point often lost on people -- the extraordinary difficulty of getting unbiased and scientifically founded dietary advice. The media is dominated by groups with an agenda, and even the government is precious little help, because of the politicized nature of any guidelines it issues -- mustn't disturb key industries, even in the name of getting out the public-health message.

The message should be the one supported by the best and least-biased science -- a temperate use of rich foods including meat, dairy and sweets; plenty of whole grains, legumes and nuts; and a broad variety of vegetables and fruits. The modern plagues of heart disease and stroke, diet-related cancers, obesity, and myriad lesser ailments ought to be enough reason to depoliticize diet in the public discourse, even when it goes against the grain of Americans' dietary habits and preferences and the bottom line of food industries. Who's going to give it to us straight?

-- Elizabeth Durack

First off, something that is almost always missing from reports on Atkins.

1. Atkins is not the only low-carb diet there is. To be sure it is the most popular ... but there are many more out there.

2. It is entirely possible to be an ovo-lacto vegetarian and low carb. Not on Atkins per se, but on your own version of the diet. (I say this because my partner and I are basically ovo-lacto vegetarians who are also low carb.)

I think much of the low-carb debate gets taken up with Atkins ... there is a lot more to this type of diet than just Atkins.

Might be nice for Salon to also report on nontraditional Atkins types.

-- Drew Oetzel

I was struck by the fact that your article didn't once use the words "cow" or "pig," instead repeatedly using the words "meat," "beef" and "pork." The reason vegans are against eating meat or wearing leather is that it requires causing an animal fear, pain and death. It is not some abstract ideological belief, but a genuine, progressive movement to end a massive source of very real suffering.

Unfortunately animal rights seems to be the one issue most commonly absent from the agenda and Web sites of otherwise progressive organizations or news groups. It is also ironic since it is the one injustice that most people could actually affect by taking a personal action.

Animal rights can also give you an insight into the mentality of mainstream America. If you want to know how the Bush-voting states feel about gay rights or world poverty, think about how you feel about animal rights.

-- Randy Belknap

Thank you Salon, again, for giving us the issues and not shying away from controversy.

Clearly both sides are a bit out of control on the carbo/fat debate. This is not politics -- it is science, so the answer comes from more studies, not more talking heads, not more arguments. I think that there are some surprises that haven't been discovered yet about how the body metabolism works. I think low carb works for some people in some situations, and low fat for others. That's my guess.

I've been on Atkins for about six months, and what works for me is suppression of appetite. You eat fatty food, and it's filling, and you're not hungry four hours later. You just eat less.

A lot of the things the Atkins detractors say are just loony.

"A diet which tells you that you really can't eat all fruits and very few vegetables is not a healthful diet."

Read the book. In the most austere level of Atkins, you can eat no fruit, but most vegetables. You are supposed to stay on that for two weeks, and then loosen up. Some of the things you start eating are berries, which Dr. Atkins recommended specifically because they have lots of nutrients and relatively little sugar.

The key idea is to avoid sugar and white starches like rice and potatoes that burn too quickly. It's like any realistic diet -- you never completely eliminate anything.

"It's pretty tricky to get adequate amounts of calcium on it."

I eat tons of cheese and cream. I might microwave some broccoli and then melt a quarter pound of brie on it. It's like she's making a straw-man diet and then tearing it down.

-- Allan Bonadio