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A Mutable Feast

If Bill Clinton and his doctors can't settle on a diet, what hope is there for the rest of us?

Joe Raedle/Getty Images

In March, Chelsea Clinton called her father “probably the world’s most famous vegan.” And she was probably right. There’s only one problem: Bill Clinton is not actually a vegan.

Clinton’s vegan credentials became a topic of debate last month after the New York Times profiled one of his doctors, bestselling diet-book author Mark Hyman. Clinton has spoken openly about becoming a vegan in 2010 after another of his famous diet doctors, Dean Ornish, convinced him that the diet could reverse his heart disease. So it was confusing to read in the Times  that one of the first things Hyman did upon treating Clinton was to “wean” him off of his vegan diet. More confusing still, Ornish told me that Clinton has not changed his diet since 2010 and that the Times piece was misleading.

Clinton’s office didn’t respond to a request for comment. (Clinton has previously admitted to eating salmon or an omelet once a week and hasn’t let that stand in the way of calling himself a vegan.) But while the debate has focused on whether Clinton is technically a vegan, the most interesting revelation from the Times article may be the very fact that Hyman has been advising Clinton at the same time as Ornish.

Getty/Timothy Clary

Hyman and Ornish share plenty of beliefs about nutrition. They both insist that the right diet and lifestyle can transform your health without pharmaceutical intervention. And they both recommend a plant-heavy diet that’s low in sugar and refined carbohydrates. Ornish has even blurbed one of Hyman’s diet books. 

But Ornish’s name is almost synonymous with “low-fat.” The diet he prescribes for reversing heart disease allows for almost no saturated fat and less than 10 percent of total calories from fat. Hyman, meanwhile, has practically turned his blog into a paean to dietary fat—last year, he wrote that "fat does not make you fat or sick"—and he sees nothing wrong with animal products so long as the animals are properly raised. In February, he published an article on The Huffington Post, “Eggs Don't Cause Heart Attacks — Sugar Does,” in which he wrote, “We've been told to swap eggs for cereal. But that recommendation is dead wrong. In fact, it's very likely that this bad advice has killed millions of Americans.”

If it seems strange that Clinton, who suffers from cardiac disease, ended up with two doctors who have diametrically opposed beliefs about the dietary causes of heart attacks, it makes at least a little more sense in the context of his broader nutrition journey. Clinton has often joked about his bad eating habits. While his love of McDonald’s and Arkansas barbecue made him a more relatable candidate, what makes him most like the masses isn’t his mindless gluttony but his decades-long struggle to figure out what he should be eating. If Bill Clinton—an extremely smart man who has had access to the best medical minds in the world—can't decide which diet is best, then what hope is there for the rest of us?

In his 2004 memoir, My Life, Clinton describes his younger self as a “fat band boy.” By age 13 he weighed 185 pounds. One summer, while still a teenager, he designed his own diet: a high-protein, low-carb plan that allowed for only one meal a day. Clinton claims he lost 20 pounds in one month. 

While he didn’t stick to that first diet, Clinton remained serious about his health as an undergraduate at Georgetown, where he first took up jogging. He continued to jog through law school and as governor of Arkansas and then president. Clinton wasn’t exercising only for the energy or endorphins: As far back as his 30’s he had been subjecting himself to treadmill tests nearly every year out of concern for the history of heart disease on his mother’s side of the family.

That Clinton took up jogging in the 1960s, just as it was taking off as a national health trend, is in keeping with his lifelong pattern of being at the forefront of health fads. Hillary usually gets the credit, but it’s likely that Clinton was fully onboard when Dean Ornish made a visit to the White House in 1993 to enlighten the chefs about the benefits of a diet that’s low in fat and animal products. “Clinton has been a serious student of nutrition for many decades, which is why he brought Dean Ornish into the White House,” Mark Hyman told me via email. The Clintons took the banishment of fat very seriously. When the White House’s fat-loving French chef Pierre Chambrin couldn’t get with the program, he was asked to resign.

The White House's crusade against fat was another example of Clinton's following the latest health trends. In 1998, Dean Ornish appeared on the cover of Newsweek next to the headline “Can This Man Save Your Heart?” And Ornish was far from alone in arguing against fat. It was almost universally accepted by nutrition researchers and government health agencies at the time that dietary fat, particularly saturated fat from animal products, was unhealthy. 

Getty/Joyce Naltchayan

If getting the fat out of the White House menu improved Clinton’s health, it wasn’t obvious from the president’s annual physicals. At his 1994 physical he weighed in at 210 pounds, with a total cholesterol of 204. The next year he was up to 216 pounds and his cholesterol numbers were virtually unchanged. Things began to look better for Clinton by 1997, when he was said to be particularly proud to have slimmed down to 196 pounds. But by his last physical as president, Clinton was back up to 214 pounds and his total cholesterol had risen to 233. His doctors put him on the statin drug Zocor.

How closely Clinton stuck to a low-fat diet during his presidency is difficult to say. At some point in the years after his presidency ended, he moved on to another diet. In a strange Associated Press report from January 2004, Clinton revealed that he had begun following the trendy South Beach Diet, which allows for more fat and fewer carbs than Ornish’s diet. Clinton also announced that he had begun "working out with a German man." 

Whether it was the South Beach Diet or the mysterious German man, Clinton reportedly lost 35 pounds with his new approach to diet and exercise. But if this plan was helping his heart, it didn’t reverse the existing damage. Later that year Clinton, then 58, underwent an emergency quadruple-bypass operation.

Though Clinton needed a second procedure six months later to remove fluid and scar tissue, the surgery was deemed a success. Clinton again tried to improve his diet in the aftermath of the surgery, reportedly eating fewer calories and eliminating all junk food. “I weigh myself every day,” Clinton told the Times in October 2006, “and it’s a painful thing to do.” The same article noted that Clinton believed his struggles with nutrition could be traced to erratic eating habits, such as his late-night dinners.

In February 2010, Clinton again experienced chest pain and needed emergency surgery. His doctors inserted two stents into one of his coronary arteries. Ornish says that he met with Clinton at a hotel in San Francisco shortly after the 2010 procedure and reviewed the scientific literature on diet and heart disease with him. Considering that Clinton hadn’t succeeded in staving off heart disease by switching the White House to a low-fat menu, it would have been understandable if he had told Ornish he wasn’t interested in trying again. Instead, Clinton dove into the Ornish diet with a newfound seriousness. He began reading (and recommending) the books of other prominent vegans as well.

Getty/Timothy Clary

To Ornish’s credit, the new diet appears to be working for Clinton. In 2011, Clinton told CNN’s Sanjay Gupta that he was a vegan and had lost more than 20 pounds. The only animal product he could remember eating in more than a year was a bite of turkey on Thanksgiving. Clinton, now 67, has succeeded in keeping his weight down ever since. Earlier this year, Chelsea said her father’s doctor had recently told him that his heart was much younger than it was 10 years ago.

Which brings us back to the question of why Clinton may or may not have been weaned off of his vegan diet. In an email, Hyman downplayed any difference between how he and Ornish advise Clinton, and he seemed unwilling to acknowledge their very different views on dietary fat. “We both believe in a whole foods predominately plant-based diet with healthy fats,” Hyman wrote.

Hyman's evasiveness may reflect a hesitancy to speak about his famous patient. Both Ornish and Hyman (through his publicist) expressed concern for Clinton’s privacy.But if Clinton’s shifting health regimens can be traced back to the prevailing wisdom or trends of the moment, it’s understandable that he’s currently being advised by two doctors with opposing views. For most of the last three decades, there was a near consensus that a low-fat diet was the only way to be healthy. Now, both because it’s obvious that America’s low-fat experiment didn’t make us more healthy and because a new body of research has emerged—a recent meta-analysis found no evidence that eating saturated fat contributes to heart disease—the consensus of the last decades is falling apart. There’s no longer a prevailing wisdom for Clinton, or anyone else, to follow.

The vegan movement continues to argue that eating lots of animal products will destroy your heart, and, as Clinton discovered, they have a number of prominent doctors, including Ornish, who lend scientific validity to the cause. The fat-happy crowd has its own set of celebrity doctors, including Hyman, who can point to their own body of research. Clinton, always the centrist and always in step with the country, now appears to have one foot planted comfortably on each side of the debate.

The good news for Clinton: both the higher-fat Hyman diet and the low-fat Ornish diet may turn out to be good for weight loss and heart health because of the primary feature they share: a restriction on sugar and refined carbohydrates. If nutrition research one day definitively shows that this is the secret to any good diet, that will be good news for all of us—if bittersweet for Clinton. A low-sugar, low-carb regimen is more or less the diet he designed himself as a teenager.