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Seeing similarities quells most health quandaries

Digger Phelps coached the University of Notre Dame basketball team when they ended UCLA's 88-game winning streak. He wrote a book about the upset and everything that led up to it that as a teenager I read a time or two (or more like 12).

In it, Phelps discusses a free-spirited senior who had been a starter as an underclassman, was now relegated to the bench, but practiced with such intensity that he made the current starters better. When the free spirit tells Phelps he plans to bum around Europe after graduation, Phelps expresses a wish he has for all his players.Whether after graduation they play in the NBA, work in the corporate world, or just bum around, Phelps wants them to be "together." In the slang of the time, that means to be appropriately prepared, organized, and balanced regardless of the setting or situation.That's also my wish for you.That wish remains the same whether you're a recent college grad running 70 miles a week with the goal of breaking three hours in the marathon, a working mother working out at a gym five days a week to drop 15 pounds before your reunion, or a retiree taking fast walks with your dog nightly so you both get exercise. Often, that wish determines what's covered in this column.For you to be truly "together," you need to be able to bring together two outwardly conflicting health opinions. And I need to explain how to do so - especially when one is a long-held opinion of mine and the other is expressed in prestigious publications such as The New York Times and the Journal of the American Medical Association.I subscribe to the Tufts University Health & Nutrition Letter, and last November it featured a Special Report titled "Stop Worrying About Total Fat," inspired in part by its editor-in-chief, Dariush Mozaffarian, M.D., Ph.D., and dean of the Tufts' School of Nutrition Science and Policy, co-authoring the opinion pieces for the previously mentioned publications. Now "worry" may be too strong a word for my stance on dietary fat, but I always suggest that you be highly aware of your total ingestion of it and limit it - sometimes significantly - based on your health-and-fitness aspirations.Yet in the opinion pieces Mozaffarian and his co-author, David Ludwig, MD, Ph.D. and Boston Hospital staff member and director of the New Balance Foundation Obesity Prevention Center, summarize their stance by writing, "It's long past time for us to exonerate dietary fat."To me, you're now faced with a quandary. The local columnist with only two English degrees but 30 years of personal experience professes one thing, yet two important doctors with all sorts of important titles profess another. You'll have clarity instead of quandary, however, if you see similarities among the differences.And what are those here? The views on refined carbohydrates and their portion sizes.Nearly 20 years ago when so many dieters were losing weight on low-carb diets, particularly the Atkins diet, I wrote an explanation rather similar to the one in the Tufts article. Since fat contains 9 calories per gram and carbohydrates only 4 per gram, the pervading advice as obesity escalated in the early 1990s was to replace the former with the latter.As a result, food producers devised a marketing strategy to dovetail on that advice: what I now call the Fat-Free Craze.In short, and as the Tufts article points out, fat-free or low-fat products flooded the market and met with massive popularity; for instance, Snack Well's fat-free cookies were outselling Oreos by 1994.Meanwhile, the obesity rate for adults between 1980 and 2000 doubled partially because reducing dietary fat enticed many to eat larger amounts. But what was most often replacing dietary fat, refined carbohydrates in the forms of added sugars or refined grains, serve no nutritional purpose and transform into body fat as readily as dietary fat.Add to those facts that eating refined carbs generally causes you to eat more refined carbs and reducing your ingestion of dietary fat can -with the emphasis on can - have the opposite effect intended, for the unchecked consumption of refined carbs creates the problem their consumption was supposed to eliminate.That's why Mozaffarian and Ludwig want Americans to stop worrying about dietary fat. Predominantly, what Americans use to replace it is almost always worse for them.But it doesn't have to be.If most dietary fats - even the good sources, monounsaturated and polyunsaturated - are replaced by complex carbs and high-quality proteins, it's not only easier to lose weight but also leads to enhanced health, especially if you want to work out hard and have your body look its best.But if you have your weight under control and are content with the quality of your workouts and the shape of your body, you can do what the Tufts article suggests and stop worrying about total fat.That's far better cutting back on fat and adding refined carbs to your diet.