by Arthur Agatston, M.D. (2003: Rodale)
Healthier than Some Low Carb Diets – Still Unhealthy, Untested Scientifically, and Very Unlikely to Prove Helpful in the Long Run
by Daniel Kirschenbaum, Ph.D., Clinical Director, Healthy Living Academies and Professor of Psychiatry & Behavioral Sciences, Northwestern Universtiy Medical School
The South Beach diet has been touted as a healthier low carbohydrate diet than the Atkins Diet. Certainly it is a less radical approach and it does promote the consumption of lower fat items compared to Atkins. On the other hand, even though the author insists it is neither a low-carb nor a low-fat diet, the facts indicate that it is a low-carb, high fat diet. Arthur Agatston uses three phases to describe his approach. In Phase I “Banishing Your Cravings,” the dieter is instructed to chose from among a group of specific recipes that contain approximately 1400 calories (about 30% lower than average calorie intake for Americans) with 40% of those calories coming from fat. That fat level is about 300% over the ideal from this writer’s perspective and 33% higher than the level recommended by the American Heart Association. The recipes ban the following foods: bread, rice, potatoes, pasta, baked goods, fruit, alcohol, candy, ice cream, and sugar. Agatston reassures the potential dieter that the cravings for these foods will disappear within a day or two. Phases II and III offer nutritionally similar recipes (about 1400 calories, 40% fat), but with the reintroduction of some carbs, some of the time (including chocolate, bread, and pasta).
Arthur Agatston is a cardiologist who has never published even one article in a peer-reviewed scientific journal on nutrition or weight loss. In this book, Agatston states that the program “has been scientifically studied” and “proven effective.” However, he does not provide a single reference in a scientific journal that verified the many benefits of the diet he describes to support these unfortunate claims. Dr. Agatston is a cardiologist, but neither his training nor his demonstrated (published) scientific experience has made him an expert on nutrition or weight loss.
A recent review in the Tufts University Health & Nutrition Letter, entitled “Weighing in on The South Beach Diet” (May, 2004, Vol. 22, No. 3) severely criticized this latest low-carb best seller by citing its “faulty science” and noting that “inconsistencies abound” in this book. The inconsistencies require a bit more explanation. The most disconcerting inconsistency pertains to restricting calories to lose weight. Agatston insists that, “Our diet is also distinguished by the absence of calorie counts; percentage counts of fat, carbs, and protein; or even rules about portion size (p. 13).” This emphasis appears throughout the book including, “You may have noticed that we’re not discussing calorie counts, fat grams, or portion sizes. The South Beach Diet is designed so that you don’t pay attention to any of that. One hallmark of this program is its simplicity ¾life is complicated enough without having to overanalyze your food before you eat it. If you’re eating the right foods you don’t need to obsess over how much of them you eat (pp. 27-28).”
According to the Tuft’s review, Agatston “then proceeds to count calories and measures servings every step of the way (p.8).” In fact, half of the book is devoted to recipes with specific and substantially reduced caloric levels. Consider, for example, that the recommended amount of a serving of meat loaf (p. 221) includes only two ounces of ground turkey. That amounts to a couple of tablespoons of meat loaf for a dinner. Would that be a typical serving size for you or anyone you know who doesn’t very consciously restrict the amount eaten (as Agatston encourages)?
Among the other inconsistencies and illogical elements of this diet are recommendations to avoid eating bananas. Yet, one of the recommended desserts is sliced bananas dipped in chocolate sauce. He also asserts that whole and intact foods are better for you than mashed (which isn’t true); then, he states that mashed potatoes are better for you than whole baked ones.
The Tuft’s review also notes a variety of nutritional inaccuracies, including that whole wheat bread is not whole grain (which it is); that the pulp in juice is a source of fiber (which it isn’t); that couscous is a whole grain (which it isn’t); and that watermelon is full of sugar but that cantaloupe is not (a cup of both contain 14 grams of sugar). Agatston also makes some very odd and inaccurate recommendations, including recommending ice cream instead of white bread because ice cream is less fattening (which it certainly isn’t). Another doozy: that a baked potato topped with low-fat cheese or sour cream is less fattening than a plain one. Agatston also very inaccurately states that drinking beer leads directly to fat deposits on your belly, which like many of his other recommendations is simply not true. In addition, Agatston’s Phase 1 and Phase 2 recommended meal plans contain approximately the same number of calories per day and similar levels of fat, even though Phase 1 is supposed to be more stringent.
The South Beach Diet is a confused and confusing approach that is untested scientifically and follows a nutritional approach (low-carb, high fat) that is not recommended by any national health organization (e.g., American Heart Association). Weight control requires a major lifestyle change involving high levels of activity, consistent low-fat eating, and clear focusing on living a better and healthier life. This book is more likely to side-track serious weight controllers than assist them in this important and challenging quest.