November 25, 2004
Heart to Heart With ‘South Beach’ Doc
Carbohydrate-filled days are over. Almost everyone is on the Atkins or Zone Diet. That is unless they've deserted them for The South Beach Diet, which proposes eating the "right carbs" and the "right fats" along with protein, giving dieters the best of both worlds.
This extremely popular diet doesn't count calories or severely restrict the kinds of foods you can eat. The name brings to mind buff, bikini-clad bodies parading Miami's hip beach. But South Beach Diet developer Dr. Arthur Agatston, a cardiologist and pioneer in noninvasive coronary artery imaging, was aiming at offering a palatable, safe diet to his chronically overweight heart patients.
"My concern was not with my patients' appearance," he said. "I wanted to find a diet that would help prevent or reverse the myriad heart and vascular problems that stem from obesity,"
He never found such a diet, so he developed one himself and, in doing so, he also created an overnight sensation among South Beach's body-conscious beach-goers. Why? Agatston's plan claims to help you shed pounds fast -- right from the waistline and belly. His scientifically based program promises immediate results, helping dieters shed 10 to 30 pounds while radically changing their blood chemistry, reversing pre-diabetes, lowering cholesterol and averting a range of chronic illnesses and conditions.
"Our thesis is really that the processing of food in America has caused the epidemic of obesity and diabetes," Agatston said.
The South Beach Diet advocates eating as few processed foods, such as white bread, white pasta and commercial baked goods, as possible. Agatston's quarrel with most carbs we consume today is that they have been overly processed and stripped of almost all healthy fiber.
The plan allows you to eat meat, fish, cheese, healthy fats such as canola, sesame and olive oils, nuts, fruits, vegetables and the right carbohydrates.
"Another basic principle of the diet, even if you have no weight to lose, is to consume all the good oils rather than trans fats, and eat plenty of fruits and vegetables," Agatston said. "That's what we were meant to eat."
Since the doctor knows that nothing undermines a weight-loss plan more than the distressing sensation that you need more food, the South Beach Diet is based on eating three balanced meals a day. To keep dieters from feeling deprived, it also suggests several snacks and dessert after dinner.
The doctor's message is clear: you can count calories or omit an entire food group for a while, but you can't turn it into a lifestyle.
Surprisingly, Agatston's diet does not require exercise to shed pounds. It does require, however, a long-term commitment.
"We started the diet to prevent heart attacks and strokes. The diet takes a few months to alter blood chemistry enough to be effective, so you need to be on the diet for the long haul," Agatston said.
And with the long haul in mind, there are no absolute restrictions on the diet except during the first phase, which spans only a couple of weeks.
The doctor explained that the South Beach Diet also prevents cancer by incorporating ample vegetables and fruits into the regimen. He points out, for example, that the lycopene in tomatoes is known to thwart prostate cancer.
"There are so many phytochemicals in fruits and vegetables, and we thought we could isolate them into a few vitamins and give supplements, but that hasn't worked. You need the natural stuff," he said.
That is the diet in its essence: returning to natural, whole foods -- the kinds our primitive ancestors would have eaten.
Besides trading white flour for its whole-grain counterpart, looking to the sea for sustenance is another place to start. Agatston calls Omega-3 oils, largely found in seafood, "the missing ingredient in the Western diet." Another problem of our Western diet, he said, is that farm-fed animals, including fish, do not have as much Omega-3s as free-range.
"Omega-3 oils, which we emphasize, have been shown to be helpful for depression, arthritis and colitis. I think Omega-3s are helpful for a lot of conditions," he said, adding, "When I talk about Omega-3s, I feel like a snake oil salesman!"
Another tenet of the South Beach Diet: It's not just what you eat; it's how you eat it.
"The faster the sugars and starches you eat are processed and absorbed into your bloodstream, the fatter you get," Agatston said. "Therefore, anything that speeds the process by which your body digests carbohydrates is bad for your diet, and anything that slows it down is good."
In short, the more food is processed, the more fattening it will be.
According to the doctor, a baked potato will be less fattening topped with a dollop of low-fat cheese or sour cream than eaten plain. The calorie count will be slightly higher, but the fat contained in the cheese or sour cream will slow down the digestive process, thereby lessening the amount of insulin that potato prompts your body to make. Surprisingly, he points out that even french fries are better than baked potatoes, because the fat they are cooked in slows down the digestive process. Don't be misled: none of these are good choices for someone on the South Beach Diet -- Agatston uses the examples to explaining how blood chemistry and insulin production (and overproduction) affects weight gain or loss.
Will the American Heart Association change its dietary guidelines, best known for the high carbohydrate content on the bottom of its food pyramid? Agatston thinks so, but says change will be slow to come.
To help dieters learn the tricks of the trade, namely glycemic indexes and discerning the good carbs and fats from the bad, Rodale Books (the "South Beach Diet" publisher) recently published a companion reference book titled "Good Fats, Good Carbs Guide."
As a complement to his New York Times best-seller, Agatston offers more than 200 recipes in "The South Beach Diet Cookbook."
While pleased with the success of his books, they are not Agatston's foremost accomplishment.
"My most rewarding experience was watching the expansion of the heart scan, which I believed in and developed in 1988," he said.
Several years later, at an international meeting of physicians, everyone started referring to it as The Agatston Score. Embarrassed at the time, today the cardiologist is proud of the acceptance of his methodology and its ability to detect early heart disease before the first heart attack.
When not practicing medicine or counseling on nutritional matters (and writing books), Agatston enjoys sports with his wife, Sari, and their two teenage sons. The Agatston family supports an array of philanthropies.
And in Miami, the busy physician continues caring for his cardiac patients.
"I am very much keeping my day job," Agatston said with a warm smile.