- The Washington Times - Sunday, October 19, 2003

There’s a magic formula to having a best-selling diet book — the book itself must offer a magic formula. Namely, it must claim to have found a way to fool human physiology so weight is no longer determined by how much you eat and exercise.

Cases in point: The Atkins diet spent about 2,000 years on the New York Times best-seller list while “The South Beach Diet” reached No. 1 and is still going strong.

Although the very first sentence in cardiologist Arthur Agatston’s book is “The South Beach Diet is not low-carb,” like the Atkins diet that’s precisely what it is.

Otherwise, Dr. Agatston wouldn’t have invoked the same magic formula of the late Dr. Atkins, that of “hyperinsulinemia.” This says foods high on the hypoglycemic index, invariably carbohydrates, send sugar rushing into the bloodstream. The pancreas then shoots insulin like a fire hose to clear the sugar out of the blood and into the organs. But now that same insulin makes the body hunger for more sugar, creating a vicious cycle and causing obesity.

Yet, “There is no compelling evidence that in normal individuals day-to-day fluctuations of the blood glucose level are an important determinant of how much food is consumed,” University of Washington endocrinologist Michael Schwartz told me. But “Although the concept that insulin triggers weight gain has little scientific merit,” he wrote earlier in the journal Science, “it remains a key selling point for advocates of diets that are low in carbohydrate and high in protein and fat.”

Advocates like Drs. Atkins and Agatston.

And because “South Beach” is indeed low-carb, Dr. Agatston feels compelled to claim, “When we eat fats, we become satiated.” False. The literature on this is both voluminous and clear. Fat and carbohydrates reduce hunger equally, although protein may have a slight edge.

Were either the hyperinsulinemia or fat-satiety theories true, it would certainly show up in the decades of studies comparing diets of varying fat and carbohydrate content. It does not.

For example, in April 2001, the Journal of the American Dietetic Association reviewed “all [such] studies identified,” a total of more than 200. Conclusion: “Weight loss is independent of diet composition.”

Most recently, a review in the April 9, 2003, Journal of the American Medical Association found “insufficient evidence to conclude that lower-carbohydrate content is independently associated with greater weight loss compared with higher-carbohydrate content.”

In fairness, “South Beach” is superior to Atkins in two ways. First, it encourages consumption of healthier unsaturated fats, while saturated fats like lard and those in bacon are emblematic of Atkins.

Second, while the “South Beach” allows carbohydrates, it promotes higher-fiber ones. Fiber is good for overall health. Further, by adding noncaloric bulk to food, it can aid weight control. But “South Beach” still can’t be called a high-fiber diet since it discourages carbohydrate consumption.

Ultimately neither regimen favors permanent weight loss, which is why both authors fall back on anecdotes without having published a single study supporting their diets.

Obesity experts who do publish such studies, including those directly comparing Atkins dieters to high-carb dieters, say Atkins works only because it excludes so much of what we normally consume that we end up eating fewer calories. But soon people get bored and repack the pounds. A 12-month study in the May 22, 2003, New England Journal of Medicine showed as much.

Both Atkins and “South Beach” induce rapid weight loss in the first couple of weeks, because all low-carb diets promote quick water loss. Water is heavy, but it is not fat.

If you lose fat with “South Beach” it’s because you’re following the recipes (comprising two-thirds of the book), which amount to a low-calorie diet. But the spontaneously eating Omnivorous Americanus will not stick to recipes very long.

That’s why, although the subtitle of Dr. Agatston’s book modestly calls it “foolproof,” a whole chapter is devoted to why people fail on it.

“The South Beach Diet” does have one other advantage over Atkins, at least in terms of salability. Strangely, it has become more chic to talk about losing weight than to actually do so; hence a glamorous title draws readers. “South Beach” is chic; “Atkins” is not. (Dr. Agatston’s hospital, incidentally, is in the drabber Miami Beach.)

Alas, “chic” is not a scientifically proved method of weight loss and maintenance, while magic is the stuff of fairy tales. Only proper eating and exercise will cause permanent weight loss, as I and countless other former fatties can attest. Seven years later, when I look at myself in the mirror it still seems, well, magical.

Michael Fumento is a senior fellow at the Hudson Institute, author of “Fat of the Land” (Viking, 1997) and a syndicated columnist with Scripps Howard News Service.

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