The newest example of the same old diet book principles re-dressed, in this case unashamedly for a bikini, is The South Beach Diet by Arthur Agatston, M.D. The popularity of The South Beach Diet is due more to clever (and massive) marketing than to dieters’ success. Although better in some ways than previous top-selling diet books, at the end of the day South Beach is just another very imbalanced, low-carbohydrate, low-calorie, ketosis-inducing diet promoting lifelong diet thinking and customers for the not-too-coincidentally-released Kraft line of South Beach diet foods which were rolled out at peak time conveniently following the book’s release and popularity (call me suspicious). The South Beach Diet demonstrates many popular diet book elements--big claims, food lists, bad nutrition advice, ketosis, and the assumption that weight-loss means better health, all draped with the legitimacy of the convincing doctor.
Point-Counterpoint
Part 1 of The South Beach Diet Book Review
There’s no doubt about it--popular diets are popular. The money spent on popular diets could rival the national budget deficit and there is an abundance to choose from. Going on the newest
media-endorsed diet is near to a cultural norm--the “in” thing to do. But there are concerns, major concerns, especially since “everyone is doing it”. Following is a review of one recent popular diet book--The South Beach Diet. It doesn’t take a rocket scientist, or even a nutritionist, to be concerned. However, Christian discernment often seems lacking when cultural influence moves in, and popular diets are no exception.
There’s no doubt about it--popular diets are popular. The money spent on popular diets could rival the national budget deficit and there is an abundance to choose from. Going on the newest
media-endorsed diet is near to a cultural norm--the “in” thing to do. But there are concerns, major concerns, especially since “everyone is doing it”. Following is a review of one recent popular diet book--The South Beach Diet. It doesn’t take a rocket scientist, or even a nutritionist, to be concerned. However, Christian discernment often seems lacking when cultural influence moves in, and popular diets are no exception.
There are multiple concerns with the South Beach diet including broad recommendations for a ketosis-inducing diet and a consistently high animal protein intake including shellfish, tuna and pork, numerous carbo-phobic testimonies, a deprivation diet mentality, Dr. Agatston’s misplaced focus on killing hunger, misinformation about metabolic syndrome, inappropriate generalizations about carbohydrates, and encouragement to engage in harmful yo-yo dieting. Dr. Agatston’s recommendations are noticeably lacking in evidence and in conflict with other experts and public health recommendations based on significant evidence.
Dr. Agatston makes too many all-inclusive recommendations to the broad population which are not appropriate, nor even safe. He mistakenly handles several important pieces of nutrition information which most readers will not recognize. Dr. Agatston relies heavily on semantics to persuade the reader that his recommendations are OK, and even good. This diet will continue to feed the voracious appetite the American public has for weight-loss diets as well as the growing carbo-phobia of the population.
Dr. Agatston makes too many all-inclusive recommendations to the broad population which are not appropriate, nor even safe. He mistakenly handles several important pieces of nutrition information which most readers will not recognize. Dr. Agatston relies heavily on semantics to persuade the reader that his recommendations are OK, and even good. This diet will continue to feed the voracious appetite the American public has for weight-loss diets as well as the growing carbo-phobia of the population.
8-13 pounds in 2 weeks, or 4-6.5 pounds per week. The (not new) formula for quick weight-loss is the high-protein ketosis-inducing diet. Simply put, the high-protein diet with its concomitant deficiency of carbohydrates leads to an initial water loss and also requires the body to burn a lot more fat than usual. The by-product of fatty acid breakdown is ketone bodies, and an excess produces a state called “ketosis”. The diet book “experts” profess that ketosis is not harmful, which is debatable. What is not debatable, however, is the proven harm of the high-animal protein intake recommended to produce ketosis. Consider the following:
“The South Beach Diet teaches you to rely on the right carbs and the right fats--the good ones--and enables you to live quite happily without the bad carbs and bad fats. As a result, you’re going to get healthy and lose weight--somewhere between 8 and 13 pounds in the next 2 weeks alone.” p. 3.
Stick[ing] with the program” implies the option of going “off” the program, the pattern of yo-yo dieters. This “diet thinking” comes through Agatston’s wording repeatedly and places this book in the diet category, even though he works very hard at trying to convince the reader that The South Beach Diet is not like a diet. Time will tell if it is reality or a matter of semantics--calling something that which it is not. Agatston indicates that Phase 1 is a diet and gradually individuals work their way off of a diet. He preaches the virtues of healthier dietary habits as a new lifestyle implying lifelong change, however, reading the testimonies in his own book, it is doubtful if this translates to the actual experience of the majority of readers. Perhaps Dr. Agatston underestimates the “diet thinking”. He openly encourages restrictive dieting for the first few weeks, repetitive if need be, then expects people to disengage from the diet thinking because they are allowed to add foods back in later phases. I have seen the opposite in my classes. Even with much more flexible and liberal eating plans I have seen individuals who have been on diets continue to self-impose “diet thinking” and unnecessary restrictions, struggling with feelings of guilt and fear of food and eating. If the “success” testimonies in Dr. Agatston’s book are any indication, many South Beach dieters also need help with breaking through the diet mentality. I do not see any help from Dr. Agatston in this regard.
Further thoughts (from Parts 2 - 13 of The South Beach Diet Book Review):
“The physical cravings that ruled your eating habits will be gone, and they’ll stay away for as long as you stick with the program.” p. 4
This is merely conjecture at this point. First of all, Dr. Agatston’s own research has shown that the South Beach diet does not reduce LDL-cholesterol (a discussion on this point between Dr. Dean Ornish and Dr. Agatston is presented in the final part of this review). Secondly, Dr. Agatston’s claim that “the cosmetic benefits of losing weight are extremely important because they so effectively motivate the young and the old” is up for debate, and that debate hinges upon the definition of what Dr. Agatston defines as “effectively” motivating individuals. If he is implying that weight-loss effectively motivates people to make the changes necessary that actually translate to cardiovascular health and longevity, the data are sorely lacking in his book and in his research. Furthermore, he mentions the “psychological lift” that comes from an improved appearance, but more often than not diets result in a psychological despair which continues in a downward cycle until the individual finally frees him/herself of the diet mentality and diets altogether. Finally, the good doctor writes that this psychological lift that comes from the improved appearance keeps many a patient from backsliding. Not only has this not been observed with the majority of patients on diets, it is not even borne out by the evidence from The South Beach Diet.
Although Dr. Agatston professes he feels “nearly as comfortable in the world of nutrition as [he does] among cardiologists” he is clearly not an expert in nutrition and he lacks understanding of the plight of dieters. No doubt Dr. Agatston is an expert in his field of cardiology, where he should continue to focus. As for the “world of nutrition”, Dr. Agatston’s recommendations put readers of The South Beach Diet at risk of bondage to diets, calorie and nutrient deficiency, excess animal protein and shellfish-borne illness (and there’s more ahead). Hopefully you are beginning to see there are better ways to lose weight.
Although Dr. Agatston professes he feels “nearly as comfortable in the world of nutrition as [he does] among cardiologists” he is clearly not an expert in nutrition and he lacks understanding of the plight of dieters. No doubt Dr. Agatston is an expert in his field of cardiology, where he should continue to focus. As for the “world of nutrition”, Dr. Agatston’s recommendations put readers of The South Beach Diet at risk of bondage to diets, calorie and nutrient deficiency, excess animal protein and shellfish-borne illness (and there’s more ahead). Hopefully you are beginning to see there are better ways to lose weight.
"So how is it that I am also responsible for a weight-loss program . . . that’s helped countless women and men . . . get down to string-bikini and Speedo-swim-trunks-shape?” p. 6
In the best case, Agatston may be using literary exaggeration to make a point. In the worst case, he is using body image to motivate people to change--an empty, often bondage-increasing pursuit. As Christians, if we are encouraged by this statement we ought to pause and ask ourselves why. At the very least we ought realize where Dr. Agatston is coming from and be careful to realize from whom we are taking our advice.
“Today, I feel nearly as comfortable in the world of nutrition as I do among cardiologists. I speak regularly before physicians, researchers, and other health-care professionals who devote their lives to helping patients eat sensibly and lose weight. Although my interest in diet started from the therapeutic perspective, I see now that the cosmetic benefits of losing weight are extremely important because they so effectively motivate the young and the old--even more than the promise of a healthy heart, it often seems. The psychological lift that comes from an improved appearance benefits the entire person, and keeps many a patient from backsliding. The end result is cardiovascular health--my only goal when this journey began.” p. 7
End of Part 1 of The South Beach Diet book review.
It is refreshing to read a diet book that mentions the metabolic syndrome without the misleading hype which accompanied some of the earlier high-protein/low-carbohydrate diets. What Dr. Agatston fails to mention, however, is that Phase 1 of The South Beach Diet averages 30% calories from protein and Phases 2 and 3 each average 23% protein calories, all significantly higher than the 15% protein recommended by the premier authority on metabolic syndrome, Dr. Gerald Reaven, the researcher who discovered the syndrome. Dr. Reaven’s protein recommendation is upheld in the ATP III report of the National Cholesterol Education Program, the current “gold standard” for cholesterol-lowering recommendations. Dr. Agatston further fails to mention that the metabolic syndrome is at its root hyperinsulinemia and that protein stimulates insulin secretion further!
Dr. Agatston shares more incorrect information about the metabolic syndrome:
“And there was another, not terribly well-understood diet-related problem that they shared, a silent, so-called metabolic syndrome (prediabetes) found in close to half of all Americans who suffer heart attacks.” p. 8
“By the latest count, somewhere around 47 million Americans--close to one in five--are estimated to have prediabetes. But the percentage of adults with cardiovascular disease who also have this syndrome is much higher; maybe half of my practice shows signs. Here’s a list of the criteria, according [to] the National Cholesterol Education Program.
· High cholesterol
· High ratio of bad cholesterol to good
· High blood pressure
· Central obesity
· High triglycerides” p. 76
· High cholesterol
· High ratio of bad cholesterol to good
· High blood pressure
· Central obesity
· High triglycerides” p. 76
However, from the Third Report of the National Cholesterol Education Program, Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), p. 16:
While the NHLBI report targets LDL-cholesterol as the “primary target of therapy”, and while the ratio of total cholesterol/HDL-cholesterol is a long-used and still-much-respected indicator of risk, the two sections of the report which define metabolic syndrome (pre-diabetes as Dr. Agatston calls it) as a secondary target of therapy most definitely do not mention “high cholesterol” and “high ratio of bad cholesterol to good” as Dr. Agatston indicates. Since the ã publication date of The South Beach Diet is 2003, this is information which Dr. Agatston should have been aware of, especially as a cardiologist. Then he adds:
While the NHLBI report targets LDL-cholesterol as the “primary target of therapy”, and while the ratio of total cholesterol/HDL-cholesterol is a long-used and still-much-respected indicator of risk, the two sections of the report which define metabolic syndrome (pre-diabetes as Dr. Agatston calls it) as a secondary target of therapy most definitely do not mention “high cholesterol” and “high ratio of bad cholesterol to good” as Dr. Agatston indicates. Since the ã publication date of The South Beach Diet is 2003, this is information which Dr. Agatston should have been aware of, especially as a cardiologist. Then he adds:
“To which I would add”
Small LDL (bad cholesterol) particles” p. 77
Small LDL (bad cholesterol) particles” p. 77
But the NHLBI report does include these:
“Many persons have a constellation of major risk factors, life-habit risk factors, and emerging risk factors that constitute a condition called the metabolic syndrome. Factors characteristic of the metabolic syndrome are abdominal obesity, atherogenic dyslipidemia (elevated triglyceride, small LDL particles, low HDL cholesterol), raised blood pressure, insulin resistance (with or without glucose intolerance), and prothrombotic and proinflammatory states. ATP III recognizes the metabolic syndrome as a secondary target of risk-reduction therapy, after the primary target--LDL cholesterol. Diagnosis and treatment of the metabolic syndrome is described beginning on page 15 under ‘Benefit Beyond LDL Lowering: The Metabolic Syndrome as a Secondary Target of Therapy.’” p. 6
I am a little confused as to why Dr. Agatston lists LDL and TC/HDL cholesterol as “criteria according to the National Cholesterol Education Program” and why he feels the necessity to indicate he is “adding” the small LDL particle criteria when the authors of ATP III have already done so.
As the book continues it becomes evident that Dr. Agatston places a higher priority on killing hunger (to lose weight) than on eating healthy food. His recommendations to eat ice cream, dark chocolate candy bars and trans fatty acid laden french fries as better than a baked potato border on the outrageous unless one understands that the South Beach diet goal of weight-loss trumps all other goals (i.e., health). Similarly, the premise of the South Beach diet is a liberal consumption of animal protein in place of fruit, vegetables, and breads. It’s bad enough that multitudes of health-conscious Americans are incorrectly assuming (with help from the media and medical profession) that weight-loss always means better health. It is unconscionable that Dr. Agatston adds to the confusion by indicating that his dietary recommendations are actually good for health, using his authority as a cardiologist for credibility. I hold our free market economy and commitment to freedom of speech in high regard, but these cherished and protected ideals are increasingly being used by individuals who profit from the ignorance of others. Often readers of diet books are led to the slaughter by their own misguided desires (in this case, a focus on body image). Freedom of speech is all well and good, but authors are not being held accountable for what they say, and therein lies the problem. A slick advertising campaign leading to a new diet that “everyone is doing” is enough to convince a large body of Americans that “it must be true”. Add to this the subtle semantics and incorrect generalizations spoken by a cardiologist and we have a recipe for misinforming the masses. For example, just because vegetables and breads are added back into the diet does not negate the fact that the South Beach diet replaces eating enough fruit, vegees and whole grains with an excess of animal protein. Since Dr. Agatston incorporates these healthy foods into the diet the reader may hardly notice that the real problem that remains is the excess of animal food at the expense of the deficiency of plant foods. As Christians who have been baptized with the Holy Spirit we have discernment, if only we care to listen to the One who will guide us into all truth.
One has to think that perhaps Dr. Agatston was having fun with the dietitians out there when he bravely set his pen to paper and made this comparison. The good doctor might begin to lose credibility even with the lay reader with these kinds of recommendations (or maybe not--ice cream and chocolate bars may go a long way with this promotion!) While I enjoy ice cream as much as the next guy (perhaps more) and it is certainly not a diet taboo around our house, we don’t fool ourselves to think it stacks up nutritionally against a potato. A potato supplies complex carbohydrates, unlike the ice cream which is full of simple carbohydrates (and isn’t that the whole premise upon which Dr. Agatston bases his recommendations in The South Beach Diet--replacing junky carbs in the diet?). With 45% of the Daily Value for vitamin C, potatoes are the leading source of vitamin C in the American diet by virtue of the quantities eaten. They are also rich in fiber, iron, calcium, phosphorus, potassium, zinc, and B vitamins, and contain anthoxanthins and glutathione (antioxidants). In fact, when compared to bell peppers, carrots, and onions, potatoes have the highest overall antioxidant activity, topped only by broccoli. And historically the potato is responsible for feeding a whole nation--its lack even led to a massive emigration of the Irish people to the United States in the 1840’s. I wonder if we will fare the same if the whole of the American people were to base their diet around ice cream?
But the more important question is this: What’s so bad about craving carbs at times? I find myself filling the craving with a variety of carbs (often with protein and fat combined) such as fruits, vegees, wholesome breads with peanut butter and jelly or oil/butter, whole grain crackers with cheese or walnut/blueberry cream cheese, whole grain cereals with soy or skim milk (add a myriad of fruit according to desire), flax/granola bar snacks, nuts, yogurt with berries and Grape-Nuts, or you-name-it-with-creativity according to desire which increases my intake of hundreds of vitamins, minerals, phytochemicals, and fiber. If we think that weight-loss is the measure of a healthy diet we are sorely misled. What if those cravings are the means by which we eat a healthier diet to prevent disease, and have more energy and health? In other words, perhaps not all carbohydrate cravings are bad, but rather a way to a healthier diet if responded to correctly. Why don’t we hear about the allowance of carbohydrate cravings for health in Dr. Agatston’s book or any of the other popular carbo-phobic books? Everyone is intent on killing our hunger rather than learning how to respond to it for optimal health. After all, since everyone is so into evolution (which I am not) and so many recent popular diet books in fact promote the theory as the basis for their dietary conclusions and recommendations, then wouldn’t it make sense to conclude that we have evolved with hunger cues being a strong part of our nature for some not-too-hard-to-figure-out reason? Personally, I believe it is part of our Creator’s wisdom.
But the reader has often tamed their appetite, at least for a time, and often finishes these books feeling confident in their newfound knowledge. Whether armed with simple new understandings or a virtual arsenal of heady information, their confidence is truly astounding, as in the case of this reader:
“Still, don’t think that when you’re at the mall and stop for a quick baked potato at one of those franchise places that you’re having a healthy snack. A baked potato in midafternoon practically guarantees that you’ll be starving for carbs by dinner. You’d be better off having a small ice cream or even a dark chocolate bar instead of that baked potato.” p. 54
“But I know a lot more about what I eat than I did before. Like, people don’t realize that the MSG in their Chinese food is made from beets, which contain a lot of sugar. Or that carrots have a high glycemic index, too. I used to eat a lot of carrots, especially when I was trying to lose weight. I even traveled with little bags of them. So I was shocked to learn that carrots have so much sugar in them. You don’t realize that those carrots, or those onions, just turn right into sugar that gets stored in your body as fat.” p. 60
The fact that this reader has the fearful idea that healthy foods “just turn right into sugar that gets stored in your body as fat” is unnerving to say the least. There are a lot of other foods we should be worrying about (not to mention the epidemic lack of activity) that get stored in our body as fat--carrots, beets, and onions being the least of our concerns. I would feel better (slightly) about people following these diets if they were pre-screened with a 5-7-day food diary to see what their real dietary problems are and evaluated for activity in the lifestyle. Many of these diets set people up for losing sight of the forest for the trees, and my guess is they are not overweight because they eat too many beets and carrots.
This proponent of the South Beach diet is not alone when she professes that she knows “a lot more” about what she eats. She is part of a virtual American army of nutritionally “educated” experts. But does she really know a lot more about what she eats? Does she know about onions as a good source of fiber, vitamin C, vitamin B6, potassium, and the flavonoid quercetin which protects against cataracts, cardiovascular disease, and cancer (and that the absorption of quercetin from onions is twice that from tea and more than three times that from apples)? Does she know that beets are a great source of vitamin C and folacin, as well as iron and fiber, or that their leaves offer protein, calcium, fiber, beta carotene, vitamins A and C, and some B vitamins? Does she realize that no other vegetable or fruit contains as much carotene as carrots, which the body converts to vitamin A, and that they are also rich in vitamins B1, B2, C, and E, and a good source of potassium, vitamin B6, copper, folic acid, magnesium and calcium pectate (a cholesterol-lowering pectin)? Carrots are rich in alpha carotene (both alpha and beta carotene are antioxidants), glutathione, and also contain iron, manganese, phosphorous, and sulphur. Does she know that beta carotene boosts the immune system and is also a potent antioxidant, and that antioxidants fight free radicals and help prevent them from causing membrane damage, DNA mutation, and fat oxidation, all of which may lead to many of the degenerative processes and diseases? Does she know that more than 900 different phytochemicals have been found in plant foods (and likely many more will be discovered) and that research suggests that phytochemicals, working together with nutrients found in fruits, vegetables, and nuts, may help slow the aging process and reduce the risk of many diseases, including cancer, heart disease, stroke, high blood pressure, cataracts, osteoporosis, urinary tract infections, as well as balance hormonal metabolism and have antiviral and antibacterial properties?
To use a phrase I first heard from Jennifer Anderson, Ph.D., Extension Specialist at Colorado State University, you get more for your “calorie salary” to get so much in return from “spending” so little calories--more bang for the caloric buck. By cutting out these “high glycemic carbohydrate sources” (vegees, fruits) that Dr. Agatston warns about it is harder (we have to eat more calories from other sources) if not impossible to achieve the same intense nutritional intake we achieve when we eat the fruit or vegee in question. And all because it has sugar. What if it was indeed created with more sugar to be more appetizing to us to encourage us to eat more of it for the benefits we receive when we do so? While I wholeheartedly agree that the diets of many Americans would benefit from modification to achieve better blood glucose/insulin control, to focus on fruits and vegees is highly suspect as the best place to start! However, because this reader of The South Beach Diet knows more about the sugar content she feels she knows more than she did before. A good case of knowing enough to be dangerous, and I believe we will see the effects, even in one generation, of just how dangerous this “increased knowledge” will be.
This proponent of the South Beach diet is not alone when she professes that she knows “a lot more” about what she eats. She is part of a virtual American army of nutritionally “educated” experts. But does she really know a lot more about what she eats? Does she know about onions as a good source of fiber, vitamin C, vitamin B6, potassium, and the flavonoid quercetin which protects against cataracts, cardiovascular disease, and cancer (and that the absorption of quercetin from onions is twice that from tea and more than three times that from apples)? Does she know that beets are a great source of vitamin C and folacin, as well as iron and fiber, or that their leaves offer protein, calcium, fiber, beta carotene, vitamins A and C, and some B vitamins? Does she realize that no other vegetable or fruit contains as much carotene as carrots, which the body converts to vitamin A, and that they are also rich in vitamins B1, B2, C, and E, and a good source of potassium, vitamin B6, copper, folic acid, magnesium and calcium pectate (a cholesterol-lowering pectin)? Carrots are rich in alpha carotene (both alpha and beta carotene are antioxidants), glutathione, and also contain iron, manganese, phosphorous, and sulphur. Does she know that beta carotene boosts the immune system and is also a potent antioxidant, and that antioxidants fight free radicals and help prevent them from causing membrane damage, DNA mutation, and fat oxidation, all of which may lead to many of the degenerative processes and diseases? Does she know that more than 900 different phytochemicals have been found in plant foods (and likely many more will be discovered) and that research suggests that phytochemicals, working together with nutrients found in fruits, vegetables, and nuts, may help slow the aging process and reduce the risk of many diseases, including cancer, heart disease, stroke, high blood pressure, cataracts, osteoporosis, urinary tract infections, as well as balance hormonal metabolism and have antiviral and antibacterial properties?
To use a phrase I first heard from Jennifer Anderson, Ph.D., Extension Specialist at Colorado State University, you get more for your “calorie salary” to get so much in return from “spending” so little calories--more bang for the caloric buck. By cutting out these “high glycemic carbohydrate sources” (vegees, fruits) that Dr. Agatston warns about it is harder (we have to eat more calories from other sources) if not impossible to achieve the same intense nutritional intake we achieve when we eat the fruit or vegee in question. And all because it has sugar. What if it was indeed created with more sugar to be more appetizing to us to encourage us to eat more of it for the benefits we receive when we do so? While I wholeheartedly agree that the diets of many Americans would benefit from modification to achieve better blood glucose/insulin control, to focus on fruits and vegees is highly suspect as the best place to start! However, because this reader of The South Beach Diet knows more about the sugar content she feels she knows more than she did before. A good case of knowing enough to be dangerous, and I believe we will see the effects, even in one generation, of just how dangerous this “increased knowledge” will be.
Dr. Agatston appropriately educates the reader on the simple harmful facts about saturated and trans fats, and the healthful benefits of “unsaturated, non-trans fats” which are good for us. But he once again slips in fact with fiction, whether intentional or out of ignorance:
“The Recommended Dietary Allowance (RDA) for carbohydrate is set at 130 g/d for adults and children based on the average minimum amount of glucose utilized by the brain. This level of intake, however, is typically exceeded to meet energy needs while consuming acceptable intake levels of fat and protein.” (Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids [Macronutrients] 2005; National Academy of Sciences, Institute of Medicine, Food and Nutrition Board, Chapter 6, p. 265).
In other words, the brain needs a minimum of 130 grams of carbohydrate a day, and that’s before adding the carbohydrates necessary for energy all day. The South Beach diet Phase 1 meal plans average approximately 79 grams of carbohydrate daily, a full 50 grams lower than the established minimum needs for the brain. While the Phase 2 meals average 140 grams/day and the Phase 3 meals average 144 grams/day, this is still only 10-14 grams of carbohydrate in excess of the brain requirements, leaving only 1-2 slices of bread worth of carbohydrate for energy for the whole day! The daily deficiency of nutrient-dense carbohydrate (plant) sources is very concerning indeed.
The popular diet books claim that a long list of carbohydrates are to blame for hyperinsulinemia, insulin resistance, and a host of associated maladies, but this is not supported by the research. Studies have shown that these authors are on the right track--the excess intake of refined carbohydrates are to blame for erratic insulin/blood sugar responses. This is nothing new! However, to blame pasta, and to put many nutrient-dense fruits, vegetables, and complex carbohydrate starches on an “out” list is not only highly misleading, but downright harmful, exacerbating an already too-low-nutrient-dense Standard American Diet (S.A.D.). How is it that anyone could really believe that a healthy diet is one with an excess of animal protein and low in plant foods? Could it be that these popular authors are “tickling the ears” of this generation of meat-indulging Americans, and that many Americans are so ready to believe the unsubstantiated claims because of the “success” they experience with initial ketotic weight-loss?
The potential for harm in making broad recommendations for ketosis to the population at large and the very low brain-and-energy-depriving carbohydrate meal plans of Phase 1 are truly concerning. To make matters even worse, Dr. Agatston further advises to stay on Phase 1 for longer than 2 weeks:
“The weight loss slows a little during Phase 2, which is why some dieters stay on Phase 1 longer than the 2-week period. If you’re confident that you can stick to the stricter plan for another week or two, feel free.” p. 183
Dr. Agatston also encourages the reader to switch back to Phase 1 (ketosis) for a week or two an undefined amount of times:
“There will always be times when you’ll switch back to Phase 1 for a week or two. You’ll get back to where you were, and then you’ll return to Phase 3.” p. 243
“Where Mediterranean oils are used abundantly, heart attack and stroke rates are very low.
The most impressive diet study ever reported was the Lyon Heart Study. Here, the mostly monounsaturated fat, canola oil, (with omega-3 fat as well) was used in a spread by one-half of the patients studied. All those in the study had already had heart attacks, but those receiving the good fat had a 70 percent decrease in subsequent heart attacks.” p. 32
The most impressive diet study ever reported was the Lyon Heart Study. Here, the mostly monounsaturated fat, canola oil, (with omega-3 fat as well) was used in a spread by one-half of the patients studied. All those in the study had already had heart attacks, but those receiving the good fat had a 70 percent decrease in subsequent heart attacks.” p. 32
One would think that the impressive results of the Lyon Heart Study were due to canola oil, not from the other 1/2 of the spread which was olive oil, nor from the rest of the very healthy Mediterranean diet.
Dr. Agatston takes the liberty to “educate” the reader about important concepts in nutrition, but not very accurately.
Whereas Dr. Agatston demonstrates an apparent lack of “fine-tuned” dietary discernment and knowledge, he writes with much ease and clarity regarding cardiovascular disease and risk factors. This makes it a pleasing read when he writes about an area he is well-versed in. He even teaches about small LDL cholesterol and why these molecules are more dangerous, albeit still untested for by many labs.
Dr. Agatston takes the liberty to “educate” the reader about important concepts in nutrition, but not very accurately.
Whereas Dr. Agatston demonstrates an apparent lack of “fine-tuned” dietary discernment and knowledge, he writes with much ease and clarity regarding cardiovascular disease and risk factors. This makes it a pleasing read when he writes about an area he is well-versed in. He even teaches about small LDL cholesterol and why these molecules are more dangerous, albeit still untested for by many labs.
Since Dr. Agatston uses testimonials to support his diet it is only fair ground to critique them. A strong “diet mentality” comes through their comments, even while extolling the virtues of the plan, seeming to tout (or deny) their diet mentality because of the success they are having on this more realistic, more palatable, more appropriate-for-the-human-body diet. But the “not-a-diet” testimonials are often contradictory, even to the point of being confusing:
"For lunch or breakfast I’ll have a little bread sometimes. Never later than that. And I don’t feel denied at all. That’s the difference between now and the past. There are times where I see bread and think: Oh, gee, I’d really love a piece. But I’ve taught myself to go without it.” p. 21
I’m confused. Did this guy say he is denying himself bread or that he is not denied? Another “satisfied customer” testifies after 8 months on the diet:
“I started this diet because my mother had seen a segment about it on the local TV news here in Miami. . . I had tried diets before, and had lost weight, too. Once I stayed on a diet for 4 months. But when I stopped, all the weight came back.
“I finally went on this one, about a year ago, when I weighed more than I ever had. It had gotten to where my clothes no longer fit, and I just was refusing to go out and buy all new clothing. That’s when my mother gave me the gift of the nutritionist visit.
“The first days weren’t so bad. The nutritionist explained to me the initial, strict phase of the diet, and said I could stick with it for 2 to 4 weeks. I’m a real meat eater. So in the initial phase, which allows you unlimited amounts of lean protein, I was all right. What I gave up in carbs I added in meat, so I wasn’t hungry. Eggs for breakfast with some ham in there . . .
“That would pretty much hold me until lunch, which would be a small salad with a decent-size serving of cut-up ham or turkey or chicken. In the afternoon I’d feel hungry, so I snacked on low-fat cheese. I drank a lot of water. Dinner was chicken breast or grilled steak. And that was pretty much it. A small serving of vegetables, but not a lot. . .
“. . .The Fourth of July came during the first week of my diet. We had people over and they were drinking and having all kinds of good stuff. But I stuck to my diet.
“After that first month, I started introducing carbs from the low end of the glycemic index. I’d have bigger salads, and I added some fruit back in, which I had really missed. I began having an apple or a pear after lunch. I found a whole grain bread in the health food section of the local market. It was very low in carbs, and some days I’d have a sandwich on that instead of a salad. I went on vacation that summer and did okay. I stuck to my diet pretty much. . .
“. . . It just takes a little discipline and willpower. . .” pp. 39-40
“I finally went on this one, about a year ago, when I weighed more than I ever had. It had gotten to where my clothes no longer fit, and I just was refusing to go out and buy all new clothing. That’s when my mother gave me the gift of the nutritionist visit.
“The first days weren’t so bad. The nutritionist explained to me the initial, strict phase of the diet, and said I could stick with it for 2 to 4 weeks. I’m a real meat eater. So in the initial phase, which allows you unlimited amounts of lean protein, I was all right. What I gave up in carbs I added in meat, so I wasn’t hungry. Eggs for breakfast with some ham in there . . .
“That would pretty much hold me until lunch, which would be a small salad with a decent-size serving of cut-up ham or turkey or chicken. In the afternoon I’d feel hungry, so I snacked on low-fat cheese. I drank a lot of water. Dinner was chicken breast or grilled steak. And that was pretty much it. A small serving of vegetables, but not a lot. . .
“. . .The Fourth of July came during the first week of my diet. We had people over and they were drinking and having all kinds of good stuff. But I stuck to my diet.
“After that first month, I started introducing carbs from the low end of the glycemic index. I’d have bigger salads, and I added some fruit back in, which I had really missed. I began having an apple or a pear after lunch. I found a whole grain bread in the health food section of the local market. It was very low in carbs, and some days I’d have a sandwich on that instead of a salad. I went on vacation that summer and did okay. I stuck to my diet pretty much. . .
“. . . It just takes a little discipline and willpower. . .” pp. 39-40
Although Dr. Agatston professes the South Beach diet is to become a lifestyle (does that mean dieting is to be a way of life?) I have many concerns about what is actually translated to the client, what they actually receive from the experience. First of all, this patient uses the word “diet” to refer to his experience 11 times in his short testimony, and throws in recommendations for “discipline” and “willpower”. I am all for encouraging individuals towards more discipline, but people have lost the discernment regarding the difference between the futility of willpower vs. the fruitfulness of discipline. Self-control is a fruit of the Spirit, not of ourselves. Paul writes to the Colossians:
“Since you died with Christ to the basic principles of this world, why, as though you still belonged to it, do you submit to its rules: ‘Do not handle! Do not taste! Do not touch!’? These are all destined to perish with use, because they are based on human commands and teachings. Such regulations indeed have an appearance of wisdom, with their self-imposed worship, their false humility and their harsh treatment of the body, but they lack any value in restraining sensual indulgence. Colossians 2:20-23
Secondly, in the example testimony above, excessive “unlimited” amounts of animal protein have been legitimized. Thirdly, the carbo-phobia persists even after this dieter introduces carbs back into his diet (why the low-carb bread?) I venture to say the carbo-phobia will remain the rest of his life even though he knows he needs to have some carbs. Will they always be “bad” to him? Fourthly, ham is mentioned a lot throughout this man’s first days on the diet, and throughout the book in general, even referred to as a “good” source of fat and protein. And all of this reinforced because of the dramatic weight-loss!
And more testimony that makes me cringe for the bondage:
“That was 2 years ago, when I went on this diet. I lost 30 pounds since then, and I’ve kept if off. The best thing about this diet is that it is easy to stick to. It’s even flexible. For instance: I cheated almost from day one. Maybe not during the first 2 weeks, the strict phase. But after that. You could have nuts, let’s say, but you were supposed to count out just 30 of them as a portion. Well, some nights I didn’t count.” p. 59
And that, I daresay, summarizes the South Beach diet--a “doable” diet compared to previous ones. Doable, but still a diet. Why must someone carry guilt for cheating if they do not count their nuts exactly?
She continues:
“Lately I actually gained a few pounds back--I’ll be honest with you--because I cheated with those nuts. I’m into cashews now, but I’ve done the whole gamut. I’ve done peanuts. And almonds. Again, you don’t realize that there’s sugar in nuts, too. Pistachios are wonderful on this diet, because you can have only 15 almonds but 30 pistachio nuts, because they’re so small. And I think I’ve begun to overdo it with the pistachios, and I may have put a few pounds back on. But I don’t even get on the scale anymore. I go by how I feel in my clothing. Because I don’t want to do a number on my head with weighing myself every day. If I feel like I’m getting too carried away with the nuts, I back off. And I drop a few pounds. Just recently I found a baker who makes sugar-free cheesecake. I buy it and cut it into very small portions. Then, when I get a yen for it--it’s not every night, it might be two or three times a week--I’ll just go ahead and take a piece and defrost it. It’s something that I can have. It’s enough. And so I never feel like I’m missing a thing.” p. 60
If she never feels like she is missing a thing (this is beginning to sound like a mantra), why does she feel the need to “cheat”? And there’s her “realization” that there is sugar in nuts too (can you imagine how unpalatable carrots, beets, onions, and nuts would be without any sugar?) Our wonderful Creator has Provided us with a variety of different-tasting foods to enjoy. Food is a blessing. The South Beach Diet is one in an arsenal of diet books which have served to convince many vulnerable people to fear, and be robbed of, the blessing. In the testimonials of South Beach dieters who confess obsessive nut counting and severe restrictions of bread, fruit, and many vegetables, and Dr. Agatston’s “expert” recommendation that ice cream or a dark chocolate bar are both better than a baked potato, it is clear that instead of a focus on consuming healthy food the tables have been turned for many a reader whose focus on weight-loss has become the all consuming priority.
I would like to hear this woman’s testimony 2-10 years from now:
“And, still, to this day, I miss my bread--I really do. I would kill to sit down and eat Italian bread with some butter. But I won’t do it. Because I know I can’t control myself with that stuff. In the past few weeks I found myself close to slipping a little--like wanting just a taste of this or that. Things I wouldn’t even think of tasting before. I asked somebody I know at work, ‘Do you notice me doing anything different?’ And he said, ‘Yes, I do--when we have lunch in the office, before you wouldn’t touch one morsel of something that you weren’t supposed to have. Now you’ll take a spoon or two.’ So maybe I’ve slipped a little. But that’s good to know. I’m going to have to watch it with carbs for the rest of my life.” p. 83
The mark of a good lifestyle diet (as the South Beach diet professes to be) is that someone does not feel the need to “slip” or “cheat”. If this gal is “going to have to watch it with carbs for the rest of [her] life” meaning watch the refined junky carbs, then The South Beach Diet has done a good thing for this woman. But she doesn’t say that. One would think she will have to restrict the very staff of life for the rest of her life, and for that I am not only saddened for a lot of people, but concerned that Dr. Agatston’s advice is being taken so absolutely as the gospel truth (or in actuality, as greater than the gospel truth, which emphasizes grains!)
Furthermore, there is absolutely no discernment regarding some foods with proven harms to health:
Furthermore, there is absolutely no discernment regarding some foods with proven harms to health:
· “I’m a big seafood person. I’ll eat mussels, crab legs, shrimp. . . Iced tea with Sweet’N Low or diet soda. . .
“Now I even try to eat breakfast. I’ll have Egg Beaters and maybe two slices of bacon. . . p. 84
“Now I even try to eat breakfast. I’ll have Egg Beaters and maybe two slices of bacon. . . p. 84
With results like this Dr. Agatston will have no problem keeping himself in business as a cardiologist!
“No baked goods. At work, if they bring in tuna on French bread, I might eat a little of the bread with the tuna. But the times I do that are very few and far between. I can’t allow myself. Even now, I’m in a little bit of a stall. I’ve been yo-yo dieting with the same 10 pounds for the last 3 months. I was back home in Pennsylvania for 3 weeks, and I went to a wedding, a birthday party, and Thanksgiving--and I didn’t gain anything. At my nephew’s wedding I had the salmon, I ate the salad, and that was it. I didn’t have any wedding cake.” p. 84
More tuna and no wedding cake--that takes the cake! Hopefully her nephew will never have another wedding, but I am saddened that this good relative was not allowed to participate in one of the most traditional parts of this one-time family celebration. Feasting is right and good (not feasting 21x/week like Americans have sometimes come to do).
With positive testimony, this dieter is sold, at least for now:
With positive testimony, this dieter is sold, at least for now:
“I’m still heavy, don’t get me wrong, but on this diet I went from a size 32 to a size 18. This is the only diet that has ever really worked for me.” p. 84
After reading The South Beach Diet one feels that perhaps more people are successful with this “diet”. One has to wonder if there won’t be a future line of products for the South Beach dieters to acquire with this huge market of individuals being primed to capitalize on. (Sure enough, after I wrote the original version of this review Kraft rolled out a huge line of South Beach Diet foods).
The testimony of this “backslider” reflects why I am so concerned about this diet for so many people:
“Then, the way you’re supposed to, I stated adding some carbs back to my diet. I’d have a slice of bread every couple of days, for instance, or instead of bread I’d have a serving of rice. I kept losing weight, and I stayed with the diet for a whole year.
“That’s about when we had a big family outing to attend. A huge party. I had been good for so long that I said to myself I was going to eat anything and everything I wanted. I told myself that it would just be for one day, and that tomorrow I’d go back on the program.
“But tomorrow never came. I liked eating everything so much I didn’t want to stop. In the past, if I added too many carbs and stopped losing weight, I’d just shift back on Phase 1 and take it off. This time I couldn’t bring myself to do it. Before I knew it, all the weight I had lost--almost 50 pounds--was back. Now I’m planning to go back to Phase 1 again, but it’ll be starting all over. This is a very good diet, and it really works. But you still have to actually follow it.” p. 105
“That’s about when we had a big family outing to attend. A huge party. I had been good for so long that I said to myself I was going to eat anything and everything I wanted. I told myself that it would just be for one day, and that tomorrow I’d go back on the program.
“But tomorrow never came. I liked eating everything so much I didn’t want to stop. In the past, if I added too many carbs and stopped losing weight, I’d just shift back on Phase 1 and take it off. This time I couldn’t bring myself to do it. Before I knew it, all the weight I had lost--almost 50 pounds--was back. Now I’m planning to go back to Phase 1 again, but it’ll be starting all over. This is a very good diet, and it really works. But you still have to actually follow it.” p. 105
A “very good diet”. And it “really works”, but that obviously depends on what your definition of “works” is. After a whole year of this changed way of eating, if it is a “very good diet” his desires and physiology would have been changed enough to have noticed a difference when he went back to "eat anything and everything [he] wanted”. He would have felt physically bad on the same foods he used to eat to excess and that would be the strongest motivation supporting true, lifelong change. But this doesn’t seem to happen on the South Beach diet, at least not in any of the testimonies included in the book. This poor chap “just couldn’t bring [himself] to do it”, as if he was dreading something. Interestingly, this gentleman had an early heart attack in his fifties. Heart attack patients are notoriously most successful at making change and sticking with it because they have had the fear of death to motivate them. But even that experience was not enough to overcome the desires this man struggled with and, I believe, the diet likely exacerbated for him.
“By the time this phase [1] ends, your unhealthy cravings, especially for sweets, baked goods, and starches, will have essentially vanished.” p. 111
In contrast to this claim by Dr. Agatston, so many testimonies in his own book do not show this to be true, at least for a lot of people:
“I can live without pasta and potatoes. But bread is the one I’m still weak for. And so I’ve just forced myself to do without it. At a restaurant I ask the waiter not to bring bread to the table. That’s not to say I haven’t had bread in the last year . . . There are times where I see bread and think: Oh, gee, I’d really love a piece. But I’ve taught myself to go without it.” p. 31
“There are days when I still want to stop at Krispy Kreme. But now I say, ‘oh, no, no--I’m not going to do that again.’” p. 51
“Just recently I found a baker who makes sugar-free cheesecake. I buy it and cut it into very small portions. Then, when I get a yen for it--it’s not every night, it might be two or three times a week--I’ll just go ahead and take a piece and defrost it. It’s something that I can have.” p. 60
“And, still, to this day, I miss my bread--I really do. I would kill to sit down and eat Italian bread with some butter. But I won’t do it. Because I know I can’t control myself with that stuff.” (and she’s been on the diet a year or so, lost 135 pounds). . . In the past few weeks I found myself close to slipping a little--like wanting just a taste of this or that. Things I wouldn’t even think of tasting before. . . I’m going to have to watch it with carbs for the rest of my life. . . I buy sugar-free Popsicles. When I want something sweet, I’ll eat them. And if I have a bad night where I really crave something, I might eat three or four of them. But it gets me over that hump.” pp. 83-84
“In the 6 months I’ve been on the diet, I’ve lost about 50 pounds. I put some of that back on due to stress eating lately, but I know I can go back to the strict phase and lose it again. And with Dr. Agatston’s blessing, if there’s something we feel an urgent craving for, we just go have it. If you fall off the wagon occasionally, you hop back on.” p. 107
“There are days when I still want to stop at Krispy Kreme. But now I say, ‘oh, no, no--I’m not going to do that again.’” p. 51
“Just recently I found a baker who makes sugar-free cheesecake. I buy it and cut it into very small portions. Then, when I get a yen for it--it’s not every night, it might be two or three times a week--I’ll just go ahead and take a piece and defrost it. It’s something that I can have.” p. 60
“And, still, to this day, I miss my bread--I really do. I would kill to sit down and eat Italian bread with some butter. But I won’t do it. Because I know I can’t control myself with that stuff.” (and she’s been on the diet a year or so, lost 135 pounds). . . In the past few weeks I found myself close to slipping a little--like wanting just a taste of this or that. Things I wouldn’t even think of tasting before. . . I’m going to have to watch it with carbs for the rest of my life. . . I buy sugar-free Popsicles. When I want something sweet, I’ll eat them. And if I have a bad night where I really crave something, I might eat three or four of them. But it gets me over that hump.” pp. 83-84
“In the 6 months I’ve been on the diet, I’ve lost about 50 pounds. I put some of that back on due to stress eating lately, but I know I can go back to the strict phase and lose it again. And with Dr. Agatston’s blessing, if there’s something we feel an urgent craving for, we just go have it. If you fall off the wagon occasionally, you hop back on.” p. 107
This type of thinking and body training is a set-up for deprivation-rebound overeating and justified yo-yo dieting! The encouragement to yo-yo diet is, perhaps, the most concerning aspect of the South Beach diet. In his excellent book, Big Fat Lies, Glenn Gaesser, Ph.D. presents a convincing review of overwhelming evidence for the harm of yo-yo dieting, which I also explore in Part 12 of The South Beach Diet Book Review.
To his credit Dr. Agatston does address the metabolic syndrome, and to the degree that he does he incorporates an added dimension to the popular diet book selection. To that degree, The South Beach Diet has a little more to offer. However, his South Beach diet does not offer the correct solution to this growing problem. Gerald Reaven, MD is the researcher at Stanford University responsible for discovering the metabolic syndrome and coining the term Syndrome X” (the malady is also known as “hyperinsulinemia”, “pre-diabetes” and “insulin resistance”) which 1 out of 5 Americans will become all too familiar with. Dr. Reaven became so frustrated with the popular high-protein diet book authors hijacking his research and misusing the information about carbohydrates and insulin to justify their own recommendations that he wrote his own book, Syndrome X: Overcoming the Silent Killer That Can Give You a Heart Attack to set the record straight. While he and his team most definitely did determine that insulin is the root of the metabolic problems responsible for so much diabetes and cardiovascular disease, what he most definitely did not say was that a high-protein, low-carbohydrate diet would ameliorate the problem. Unrefined, high-fiber, complex carbohydrates have never been shown to do all the terrible things the diet books blame carbohydrates for. Furthermore, protein stimulates insulin secretion, hyperinsulinemia being the fundamental problem! A high-protein diet is not recommended, by Dr. Reaven nor by the American Heart Association. Instead Dr. Reaven verifies what the Greeks have known all along--45% carbs (not low-carb), 15% protein (not high-protein), 40% fat (high-fat compared to previous American recommendations) with a preponderance of plant, monounsaturated, and fish fat will remedy the symptoms of Syndrome X and prevent impending problems. I have seen metabolic syndrome resolve in my clients within 3-6 months with these recommendations. A diet based on whole grains, beans, fruits, vegetables (without regard to their glycemic indices which Dr. Agatston uses to warn readers about many plant foods) with olive oil, nuts, seeds, plant and fish fats, higher in carbohydrates (45%) than the South Beach diet (21-39%), and lower in protein (15%) than South Beach (23-30%) is the remedy for the problem of metabolic syndrome. Red meat and dairy is included, but reduced. Call it “Mediterranean” if you like, but there are actually many ways to be healthy--variations on the theme. Healthy people throughout the world, and even from the older generation in our own land, demonstrate this type of healthy eating. While nutrition research has proven to be very valuable to our understanding of nutrition, epidemiological research remains the gold standard. What we should be doing is verifying our nutrition research conclusions, investigated within the 4 walls of our American labs, with the BIG nutrition lab in the world--healthy cultures around the world. And so should a reader verify the information he receives from a diet book. While Dr. Agatston educates the reader about metabolic syndrome, his solution--the South Beach diet--is significantly different from the dietary recommendations given by Dr. Reaven, the National Cholesterol Education Program, and the time-tested Mediterranean diet, even counterintuitive to remedying the hyperinsulinemia at the root of metabolic syndrome (remember, protein stimulates insulin secretion!). Many of the recent popular diet books hold fast to the conclusions drawn from research, treating them akin to gospel truth, using a particular conclusion confidently as the basis for their particular diet. While I agree that it is good to validate the nutrition recommendations we make, the misuse of research conclusions for an author’s own gain has caused an incredible amount of confusion.
Through the lens of Scripture and her professional wisdom, Diane has written the Diet Book Reviews to expose the harmful misinformation in recent popular diet books and to provide reviews of highly recommended books which the public and media are sorely unaware of. Diet Book Reviews will educate you and give you a firm foundation from which to build healthy behaviors. The time spent reading the Reviews can save you years of wasted time, money and effort.
Read Diet Book Reviews to prevent the physical, emotional and spiritual damage of dieting and learn of alternatives worth your money, time and efforts.
You do not need to have a master's in nutrition to discern myth from fact. Read Diet Book Reviews to become better at discerning truth in nutrition and to help break through a diet mentality.
Diet Book Reviews by Diane Preves, M.S., R.D., developer and instructor of
N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE):
Read Diet Book Reviews to prevent the physical, emotional and spiritual damage of dieting and learn of alternatives worth your money, time and efforts.
You do not need to have a master's in nutrition to discern myth from fact. Read Diet Book Reviews to become better at discerning truth in nutrition and to help break through a diet mentality.
Diet Book Reviews by Diane Preves, M.S., R.D., developer and instructor of
N.E.W. LIFE (Nutrition, Exercise, Wellness for LIFE):
End The South Beach Diet Book Review excerpts.
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The South Beach Diet |
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Eat Right 4 Your Type (alias "The Blood Type Diet") |
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The Omega Diet |
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The Zone |
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Big Fat Lies |
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Potatoes Not Prozac |
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Syndrome X: Overcoming the Silent Killer That Can Give You a Heart Attack |
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and 7 complimentary short reviews with every order (bonus!) |
As Christians, we should not need the “proof” of science to convince us, however scientific proof is indeed accumulating for the Bible in direct contradiction to many of Dr. Agatston’s recommendations. God’s Word, an ample guidebook for healthy living, comes complete with the examples of the benefit of a diet based on plant foods (Garden of Eden, Daniel and his buddies), warnings about eating pork, shellfish and tuna (clean and unclean food) and animal fat (which was to be burned as an offering to the Lord, not eaten). Perhaps unknowingly, Dr. Agatston challenges each of these categories. He includes “foods to avoid” lists which include numerous fruits and vegees, recommendations (even recipes) for pork, shellfish and tuna, and a restriction of bread that develops into aversion and fear in the testimonials included in the book, while our Lord and Savior calls himself the “bread of life”.
High-protein diets are by nature carbo-phobic because eating an excess of protein crowds out carbohydrates. The South Beach diet is no exception. While Dr. Agatston is forthcoming about recommendations to severely restrict carbohydrates in Phase 1 of his diet, he professes a liberal addition of carbohydrates are added back in Phase 2 and 3. But an analysis of the 14-day Meal Plans shows otherwise. While the carbohydrate allowance does rise, the diet remains very low-carbohydrate throughout. The Phase 1 Meal Plan contributes a mere 21% calories from carbohydrates, Phase 2 only 37% and Phase 3 only 39%. These figures are estimates, determined as accurately from the menus as possible. While there will certainly be some variability among individuals who choose more vegetables in the open-ended recommendations to eat “a lot” of them, it is likely that many, if not most, people will not eat that many more. Compared to the 50-60% carbohydrate recommendation in the Third Report of the National Cholesterol Education Program Adult Treatment Panel III issued in May 2001 by the National Institutes of Health National Heart, Lung, and Blood Institute, or even the lower 45% carbohydrate recommendation of the Syndrome X Diet for the metabolic syndrome, Dr. Agatston’s carbohydrate recommendations of 21-39% calories from carbohydrates falls 6-39% short of well-established carbohydrate recommendations to support health. Furthermore, the National Academy of Sciences has established the following minimum carbohydrate needs of the brain:
High-protein diets are by nature carbo-phobic because eating an excess of protein crowds out carbohydrates. The South Beach diet is no exception. While Dr. Agatston is forthcoming about recommendations to severely restrict carbohydrates in Phase 1 of his diet, he professes a liberal addition of carbohydrates are added back in Phase 2 and 3. But an analysis of the 14-day Meal Plans shows otherwise. While the carbohydrate allowance does rise, the diet remains very low-carbohydrate throughout. The Phase 1 Meal Plan contributes a mere 21% calories from carbohydrates, Phase 2 only 37% and Phase 3 only 39%. These figures are estimates, determined as accurately from the menus as possible. While there will certainly be some variability among individuals who choose more vegetables in the open-ended recommendations to eat “a lot” of them, it is likely that many, if not most, people will not eat that many more. Compared to the 50-60% carbohydrate recommendation in the Third Report of the National Cholesterol Education Program Adult Treatment Panel III issued in May 2001 by the National Institutes of Health National Heart, Lung, and Blood Institute, or even the lower 45% carbohydrate recommendation of the Syndrome X Diet for the metabolic syndrome, Dr. Agatston’s carbohydrate recommendations of 21-39% calories from carbohydrates falls 6-39% short of well-established carbohydrate recommendations to support health. Furthermore, the National Academy of Sciences has established the following minimum carbohydrate needs of the brain:
| • | Animal protein is usually linked with saturated fat and cholesterol, which increase “bad” LDL-cholesterol in the blood. |
| • | High-protein diets may be dangerous for people with liver or kidney disease because they lack the ability to get rid of the waste products of protein metabolism. A high-protein diet, even for short lengths of time, can speed progression of diabetic kidney disease. |
| • | Increased blood level of homocysteine, a by-product of animal protein breakdown, increases risk for cardiovascular disease. High homocysteine levels in the blood are also correlated with low levels of folic acid, and vitamins B6 and B12. Many plant foods, restricted on a low-carb diet, are good sources of folic acid and vitamin B6. |
| • | Protein stimulates insulin secretion, exacerbating hyperinsulinemia (also known as “Metabolic Syndrome”, “insulin resistance”, “pre-diabetes”, or “Syndrome X”) in 1 out of 5 Americans. Hyperinsulinemia greatly increases the risk of developing diabetes and heart disease. |
| • | Excess animal protein intake crowds out a sufficient intake of protective nutrients and fiber in fruits, vegetables, whole grains, beans, nuts and seeds which protect against cardiovascular disease and hypertension, cancer, diabetes, digestive diseases, and a host of other lifestyle diseases. |
| • | Strong evidence indicates that “meat factors” in red meat/animal protein promote cancer. Furthermore, restricting fruit, vegees, beans, and whole grains may increase cancer risk. |
| • | A high animal protein intake delivers a marked acid load to the kidney increasing the risk for kidney stones and, along with a shortage of plant foods in the diet, increases urinary calcium losses contributing to osteoporosis. |
| • | High-protein foods such as meat, poultry, seafood, eggs, seeds and nuts are high in purines. An excess of purines may cause gout in susceptible individuals. |
| • | When carbohydrates (the high-energy nutrient) are severely restricted with high-protein diets fatigue often occurs. Lack of activity is one of the strongest predisposing risk factors for cardiovascular disease and diabetes, and activity also seems to be protective against cancer. While the most beneficial thing you can do for your health and your weight is to stay active, it is difficult to stay active when battling fatigue. |
(author Arthur Agatston, M.D.)
Review by Diane Preves, M.S., R.D.
copyright 2009
The South Beach Diet
Book Review (excerpts)
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