Home > mint-lounge > business-of-life > Fat or carb: Which one is the real villain?

Welcome to the war of diets. On one side of the ring is fat and on the other, carbohydrate—or its simplest form, sugar. The two have been the subject of debate for decades over which is the more harmful. Over the last few years, new research seems to be tilting the balance in the favour of one over the other.

It’s an old truth: To keep weight in control and stay heart healthy, avoid fat because it can raise cholesterol. So far so good, right? Well, no.

A growing number of studies have tossed this recommendation out of the window. A September study (Effects Of Low-Carbohydrate And Low-Fat Diets: A Randomized Trial) of 148 US adults, for instance, says that people who avoid carbohydrates, like cereals and bread, and eat more fat, like dairy products, lose more body fat and have fewer cardiovascular risks than those on low-fat diet. The research was published in Annals Of Internal Medicine, the same journal which, in March, came out with a meta-analysis of 76 studies, concluding that people who eat higher amounts of saturated fat do not experience more heart disease than those who eat less of it.

A recent Swedish study of 26,930 people, presented at the European Association for the Study of Diabetes, says that eating high-fat dairy products is linked to a lower risk of getting type 2 diabetes.

But before you decide to pick up full-fat milk from the supermarket or have red meat for dinner, let’s first understand whether embracing fats and banishing carbohydrates really is the way to achieve a healthy body.

Round 1: The building blocks

Fats, carbohydrates and proteins are the major building blocks of a healthy diet. The generic guidelines of a healthy diet, advocated by nutritionists and doctors, recommends that the daily intake of calories should be broken down like this: 50% from carbohydrates, 20% proteins and 30% fat. In a low-carbohydrate diet, the division becomes 40% carbohydrates, 30% proteins and 30% fats. “Carbohydrate is divided into two groups—refined and unrefined. Unrefined carbohydrates contain all the naturally occurring nutrients like fibre, vitamins and minerals required for the body, while the refined ones are processed by adding artificial chemicals and sugars and have low nutritional value," explains Somya Shrivastava, head, clinical nutrition and dietetics, Max Super Speciality Hospital, New Delhi. Foods that contain unrefined carbohydrates include wholewheat, oats, vegetables and fruits. While bread, sugar, honey, pasta, cookies, rice and cereals fall in the refined category. “All carbohydrates are broken down to glucose to produce energy. In refined foods, however, there is a greater risk that some of the energy will be converted into fat since they are devoid of natural nutrients," she adds.

When dieting, “we Indians generally prefer vegetarian food and so end up eating more carbohydrates rather than focusing on proteins, which actually helps lose weight", says Anoop Misra, chairman, Fortis C-Doc Centre of Excellence for Diabetes, Metabolic Diseases, and Endocrinology.

“The problem arises when people opt for refined carbohydrates, which are absorbed quickly in the body, leading to a surge in the blood sugar level and more food cravings," says Shubi Husain, nutritionist and owner of healthcare clinic Health Sanctuary in Gurgaon, Haryana.

Research shows that consumption of refined carbohydrates is directly associated with diabetes and heart disease. Studies published in the American Journal Of Clinical Nutrition in 2000 and 2004 found a direct link between increased consumption of refined carbohydrates and increased risk of coronary heart disease and type 2 diabetes among US adults.

“In India, each meal includes carbohydrates, whether it’s roti, bread or rice. Small wonder then, India is on its way to becoming the world’s diabetes capital—and has the highest number of obese people after China and US, putting them at increased risk of heart disease," says Dr Misra.

Round 2: Tricks they play

According to Robert H. Lustig, author of Fat Chance: Beating The Odds Against Sugar, Processed Food, Obesity And Disease and professor of paediatrics at the University of California, US, the food industry is responsible for slipping sugar into processed foods. “When the industry cut fat, the food tasted like cardboard, so they started adding sugar," he said in a lecture posted on YouTube in 2009.

A soft drink, for instance, contains about 11g sugar per 100ml, a McDonald’s burger 13g and 100g of Kellogg’s cornflakes contains 8g sugar. An average adult should have no more than 25-35g sugar per day.

To curb food cravings, dieters or even health-conscious people chew on sugar-free chewing gums, guzzle diet drinks and eat fat-free yogurt or ice cream. “All these so-called fat- or sugar-free items contain artificial sweeteners which spike blood sugar levels—the very problem they are used to prevent," says Dr Misra. Studies corroborate this. One such research published in the Nature journal found that artificial sweeteners increased blood sugar levels both in mice and humans by interfering with gut microbes.

In August, the Union food processing minister asked food and beverages company PepsiCo to reduce the sugar content in its drinks. Health experts in the UK, meanwhile, have suggested that sugar consumption should account for 3% of daily energy intake instead of the 5% proposed by the World Health Organization. “These efforts are in the right direction, especially for India, which is facing challenges like rising obesity, diabetes and cardiovascular disease," says Harsh Wardhan, chairman, cardiology, Rockland Hospitals, New Delhi.

Round 3: Flabby issues

We all assume that fat is bad for us but in fact we need it in our diet. Besides giving us energy, fat provides linoleic acid essential for growth, healthy skin and metabolism. It also helps absorb fat-soluble vitamins A,D,E and K.

There are two types of fats—unsaturated and saturated. Unsaturated fats, found in olive oil, avocados and nuts, are believed to promote good cholesterol and help prevent cardiovascular disease, whereas an overabundance of saturated fats, found in meats and dairy products, is thought to raise bad cholesterol.

“Saturated fats, if taken in moderation, are actually good for the body," says Shrivastava. Studies have shown that coconut oil helps build immunity and butter helps provide vitamin A and D, she adds. “Fat is better than refined carbohydrates because the latter tend to metabolize faster and get converted into low density lipo-protein particles, which is the worst kind of cholesterol," says Husain. “An average person, healthy or with a heart disease, requires 30% of total calories from fats on a daily basis. Of this, 20% (about 45g) can be from saturated fats in a healthy person and 7% or less (16g or less) in the heart disease patient," says Dr Wardhan.

Round 4: Fighting strategy

People on fat-restricted diets have to count calories and control portions, while those on carbohydrate-restricted diets (allowed small amounts of unrefined carbs and no refined carbs) are allowed to eat till they are full. Despite this, the low-carbohydrate dieters eat the same amount or fewer calories than the low-fat dieters, leading to “automatic" weight loss. “This happens because of the fibre present in carbohydrates—it makes people feel full, releases bad cholesterol from the body and helps in digestion and ward off heart disease," says Husain.

So is low-carbohydrate diet the clear winner? “It is too simplistic to say so. There would need to be many more studies to confirm this before we lay to rest this centuries-long debate," says Dr Misra. Besides, there are a few hiccups. Reducing carbohydrates could mean less energy for an exercise routine. Too much reduction in carbohydrates is not sustainable in the long term, says Dr Wardhan, adding: “As far as heart health is concerned, there needs to be more research to fully prove the superiority of low-carbohydrate diet over low-fat or balanced diet."

There are two simple rules for any dieter: exercise and healthy food. “Including fruits, vegetables, pulses, chicken/fish and skimmed milk/milk products in the diet, drinking lots of water and regular physical activity are the way to a healthy body," says Shrivastava. As for sugar, keep it at an arm’s length. Period.

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