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Steak and Ail 

From a medical standpoint at least, Jody Gorran had no reason to diet.

Gorran was 50 in May 2001 when he began the Atkins diet. He exercised regularly and was far from obese with 148 lbs. on his 5'7" frame. Yet, he says, "I was overweight for myself. Š I had been a 32-inch waist my entire adult life, and at 50, I'm hitting 33 inches. I didn't want to buy new clothes."

As a teen, Gorran was an overweight 165 lbs. He spent most of his adult life on a low-fat diet, counting calories and exercising regularly, but suddenly and unnervingly started gaining weight. "I looked around for a new approach to dieting," he says, speaking by phone from his home in south Florida. "I was always intrigued by the concept behind Atkins, that by reducing the amount of carbs you eat, your body naturally switches to burning fat and you get thinner. And, as long as it's not carbs, you can eat anything you want."

After one month of eating how he pleased, including his beloved cheesecake every third day and a steady supply of New York strip steaks, Gorran's cholesterol level increased significantly. Six months before the diet, Gorran -- a non-smoker who has a family history of heart disease, including a sister who died from it at age 59 despite a low cholesterol count -- had an excellent cholesterol level of 146. He scored 53 for HDL (high-density lipoprotein, or good cholesterol), 44 for LDL (low-density lipoprotein, or bad cholesterol) and 42 for triglycerides. During the same December 2000 exam, Gorran had a CT scan of his heart that returned a 0 score, translating into a 95 percent certainty he had no heart disease and would not develop it within the next two to five years.

But, following one month of Atkins, Gorran measured a cholesterol level of 230, with 65 HDL, 144 LDL and 42 triglycerides. Concerned, he consulted his copy of the 1999 edition of the Dr. Atkins New Diet Revolution. In the chapter "Good Protection for Your Heart," Dr. Robert Atkins writes, "I admit that there are individuals who are fat-sensitive and will develop a less favorable cholesterol level on a high-fat diet than on a low-fat diet." Atkins recommends for this segment of the population, estimated at 30 percent, that they stick with the "induction" portion of the Atkins diet -- the initial phase that allows almost no carbohydrate intake (20 grams) per day, but has no ceiling on fat intake. He then says that, after this phase, a dieter should consult his or her doctor and check HDL, LDL and triglyceride levels against baseline scores from before the diet. "If the results are not to your liking, you may be a person who is fat-sensitive," Atkins writes in the same chapter. "So for the next interval, eat only the lean proteins -- turkey roll, skinless chicken breast, fish. Š However, if you're not happy on the low-fat version of the diet or get hungry or don't feel well on it, then don't bother with it; go back to the regular Atkins diet that you enjoyed more."

Gorran followed that advice, continued eating cheesecakes and steak, and "stayed on the Atkins diet for the next two-and-a-half years and extolled the virtues of the diet to anyone that would listen." He lost 10 pounds and kept his 32-inch waist. In October 2003, Gorran and his wife were vacationing in New York, when he began experiencing chest pains while out on a walk. He went to a cardiologist, who performed an angioplasty that revealed a heart artery that was 99 percent blocked.

"Heart disease is a silent killer, at least 50 percent don't know they have it until they're dead from their first heart attack," Gorran says. "If that artery had completely closed, I'd be dead, too." Gorran then switched to a low-fat diet, and says his cholesterol is now back to 146.

"Atkins sold his diet as a gift wrapped in a bacon cheeseburger -- no bun, but with a cheesecake on the side," Gorran says. "I wanted to lose weight, so I made a Faustian deal with the devil, and the devil was Robert Atkins."

Tens of millions of Americans are now estimated to be on Atkins. Beers market themselves as low-carb; McDonald's is changing its menu to fit the trend. Some experts say Atkins is helping an obese nation rapidly lose weight, begin exercise programs and start on the path to good health. Others contend that a diet high in fat is a no-brainer for increased heart problems. Still others say that the human body's functions and reactions are too complex and varied to evaluate solely in relation to a diet, and that a balanced, healthy lifestyle is the one proven way to live well.

Last November, Gorran told his story before the National Press Club in Washington D.C.. His experiences are supported by a growing segment of the medical community opposed to the Atkins diet, led by the Physicians Committee for Responsible Medicine (PCRM), founders of the Web site www.atkinsdietalert.org. However, medical opinion varies fiercely on the benefits and risks of a low-carbohydrate diet without restrictions on fat consumption.

"Relying on anecdotes subverts the scientific, peer-review process of study," says Dr. Stuart Trager, the Philadelphia-based director of Elite Health and Wellness, which teaches the Atkins diet. "That's the agenda of PCRM -- they're a bunch of animal-rights activists masquerading as nutritionists. It's troubling that they attempt to exploit the epidemic of obesity to promote their agenda.

"There have been several studies, conducted by the Atkins company and the American Heart Association, that contrast [Gorran's story]," Trager says. "These studies find that the risk factors for those on Atkins don't worsen. The safety and efficacy of this approach is well documented."

However, Trager's statement of support from the American Heart Association (AHA) doesn't jibe with a report released by AHA in 2002, which called any AHA endorsement of the Atkins approach "an erroneous impression." In a press release attached to the report, AHA President Dr. Robert Bonow, says: "Bottom line, the American Heart Association says that people who want to lose weight and keep it off need to make lifestyle changes for the long term -- this means regular exercise and a balanced diet."

One concern with Atkins is its astounding popularity. "I don't like Atkins the way most people do it," says Molly Kimball, a dietician at Ochsner Clinic's Elmwood Fitness Center. "It's too much of an all-or-nothing mentality. The majority of the people I meet with coming to me on Atkins have never read the book, they're just eating meat and cutting out carbs. I have one client who eats 15 slices of bacon every day for breakfast and thinks it's OK because of Atkins."

Kimball also recommends everyone have at least some carbs in their diet. "Carbs give us energy, they fuel our muscles," she says. "They're especially important in the morning. But we just eat too much of them now. If you go to a restaurant and order pasta, the portion they'll bring is eight to 10 times the proper serving."

Not eating enough carbs causes the short-term health problem of constipation and long-term concerns of kidney disease, she says, and the lack of B vitamins will make you feel lethargic. Sticking to whole-grain carbs and whole-wheat breads are a great way to take in carbs, Kimball says, along with yogurt and fruits.

However, Kimball has seen Atkins work wonders for some clients. "I have a very obese client that went on Atkins, lost 100 pounds pretty quickly and can now move around enough to exercise, which they couldn't before. They told me, ŒI know I can't live and eat like this forever. I have 50 pounds more to go, and I'm done.' While I encouraged a more balanced diet, that's an example of what Atkins has done for people."

"The trouble with fads is that they're what they are -- fads," says Dr. Thomas Giles, a cardiologist with LSU Health Sciences Center. "But what you can glean from low-carb diets is that they make sense; your body burns excess fat and you lose weight. You just have to make sure you don't go off the deep end with it."

Medical opinion changes all the time, Giles says, citing the fact that many doctors now believe butter may be healthier than margarine, and once-bedeviled eggs are today considered good for you. Yet, Giles says that his concern with Atkins is that it doesn't restrict calories from fats and proteins. He prefers instead the South Beach diet, which he describes as going one step further than Atkins by differentiating between good fats and bad fats, and how much you should ingest.

Good fats? Bad fats? Such disparity may be hard to ascertain for the average eater. Giles says: "Olive oil is a good fat. Crisco is a bad fat. If a fat is so liquid it pours, then generally it's OK."

Following Atkins doesn't necessarily mean your cholesterol will increase, Giles contends. "You can't count your cholesterol by what you put in your mouth," Giles says. "The human body is much more complicated than that. We're carnivorous animals; we evolved killing animals and eating berries. Your body metabolizes everything you eat as it should. Problems that show up in our arteries decades later in life are due to a huge multiplicity of factors -- the aging process, smoking; some of it's genetic and inherited.

"The long and short of it is that America has been overdosing on carbohydrates for far too long," Giles says. "This nation is suffering for an obesity epidemic, and Atkins is bringing that problem to the forefront. Basically, we need to have balance in our lives."

But as the popularity of the Atkins diet continues to spread, any balance between its supporters and detractors remains elusive. "We know that this one diet is not right for everyone," Dr. Trager says about Atkins. "There might be some for whom resistance to this approach might occur. But, the majority of reports, the diet's popularity and clinical studies show that it works. Š Fighting the causes of obesity that cost 400,000 lives in America every year requires a new solution. That's what Atkins is. Dr. Atkins dedicated his life to fighting obesity." But to Jody Gorran, the late Atkins represents a threat, not a promise. "According to his own words, it's an eat-anything diet," Gorran says. "He's such an outrageous fraud. I didn't plan on risking my life to lose weight, but that's what happened. I almost died."

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