In the study, 12 sets of identical twins were overfed by 1,000 calories a day, 6 days a week, for 100 days. The amount of exercise was carefully monitored and exactly the same for all. In other words, all the participants had the same energy intake via food and the same energy output via exercise. By the end of the study, each set of twins had gained virtually the same amount of weight, but between different pairs, the weight gain varied from about 9 to 28 pounds. This study proved that a major contribution to weight gain is metabolic rate, which is largely genetically determined. It’s an important fact for dieters to understand, because your metabolic rate will affect how you respond not only to diet but also to exercise. But don’t be discouraged if your metabolism is slow. It doesn’t mean you should throw in the towel and stop trying to lose weight. You’ll just have to be a little more conscientious about maintaining our diet principles and work a little harder at your exercise routine.
The “You Can Never Be Too Thin” Syndrome
I can’t tell you how often the discussion of metabolic rate comes up in my cardiology practice. Let me share a typical patient story. A 52-year-old woman I’ll call Karen comes to see me with a family history of diabetes and heart disease and the additional complaint of postmenopasual weight gain. Her blood chemistries show evidence of prediabetes, and she experiences frequent cravings. I put her on the South Beach Diet and recommend regular exercise.
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living THE SOUTH BEACH DIET
Alan J., age 52: Finding His Own Fountain of Youth
In May 2006, my cardiologist told me the results of my latest blood work, and they weren’t good. My lack of exercise and love of beer, fried foods, and lots of ice cream had finally caught up with me—and I had a beer belly to show for it. I weighed 250 pounds, and my blood sugar was 140—that was much too high. I’m 6-foot-3, so I always thought I could eat whatever I wanted and get away with it. Even a trip to the emergency room for chest pains 3 years earlier wasn’t enough to make me take care of my health. I thought that all I had to do was take drugs for my blood pressure and cholesterol, and I would be fine. I was wrong.
My cardiologist told me that I was a “sugar cookie away” from entering the prediabetes stage. I immediately thought back to when I was in the ER. I had seen a man whose leg was so black that I thought he was a burn victim. The nurse told me that he would be losing his leg the next morning, thanks to diabetes! When my doctor told me I was a candidate for prediabetes, I was finally scared enough to take action.
My doctor had been trying to get me to read The South Beach Diet for more than a year, but I resisted because I thought it was just for women. But that day, I followed my doctor’s advice and finally got a copy. The book made a lot of sense, explaining why some foods do what they do to your body. The testimonials gave me hope that the diet would work for me. So, like any other red-blooded American male, I immediately decided to start the diet—in a week! That gave me 6 more days to go on a farewell binge, in which I’d eat all my favorite foods. In that week I managed to pile on another 5 pounds, and my waist grew another inch or so to a size 42!
I was really afraid of Phase 1 and saying good-bye to all my comfort foods and beer. What really helped was keeping the book close at hand to refer to when I needed it, along with the support of my wife in making all those Phase 1 recipes work for me. My quiche cups, vegetable juice, turkey wraps, cheese sticks, and all the others became my new best friends. In no time at all, I was learning all kinds of new things, like the fact that chicken doesn’t always come in a bucket and that fish is not a square brown block served on a white bun with tartar sauce and fries.
Now that I no longer came home from work and downed a few brews to unwind, I had a lot more time on my hands. I decided to go to the gym after work. Bad knee and all, I figured out that a simple walk on the treadmill would be a good way to kill 30 minutes. I was surprised to find out that walking felt so good, I wanted to do it every night.
After just a few weeks, I’d lost 25 pounds! By October, when I had my follow-up at the cardiologist’s office, it was obvious that the diet was working. My blood sugar was down to 89, which is very good, and my weight was 213, which was a big improvement. In December 2006, I hit my personal goal of 195 pounds with a size-36 waist. Even though I treat myself to a couple of indulgences every month, I am maintaining my weight. You know why? Because I realized very early on that I didn’t go on a diet. All I did was change the way I live my life. And it works.
Last week, I had an annual stress test, and after pushing that treadmill to six levels to complete the test, my doctor looked at me in amazement and said, “You have added 10 years to your life.” So, after 18 months and nearly 1,000 miles on the gym treadmill, I want to say thank you, South Beach Diet, for being my personal fountain of youth.
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Karen loses 15 pounds over the next 6 months. Her cravings have disappeared, and she feels great. When I see her at her next visit, I remark that she looks wonderful, and I proudly tell her that her blood chemistries have completely normalized.
I’m expecting a response of pleasure based on the fact that Karen has achieved my goals—and what I thought were her goals. I’m also anticipating some gratitude for her wonderful blood chemistries. Instead, she says, “That’s nice, Dr. Agatston, but I am still too fat. I need to lose at least another 5 pounds and another half inch here—and here [she points to her hips and thighs].” Karen’s response is, unfortunately, the rule, not the exception. Too many women tell me the same thing. And it’s due to the fact that our culture has set an unrealistic and disturbing ideal of what women should aspire to look like—what I like to call the “You Can Never Be Too Thin” syndrome. I have deleted the “too rich” part of this famous line (thank goodness my patients don’t come to me with financial issues).
Because I have heard responses like Karen’s so often, my answer is well prepared. I tell her again that she looks fine to me (and to my staff), but that if she wants to lose more weight or another half inch, she can. However, she should not do it by trying to further limit her calorie intake. Once patients have resolved their cravings and normalized their blood chemistries, further caloric restriction can lead to yo-yo dieting (see Chapter 4) and regaining more weight than they carried before.
Karen’s genetically determined metabolism has dictated where her weight has stabilized. So how can she lose more weight and sustain it as part of a lifestyle? She must increase her metabolic rate. This means an exercise program that helps build and maintain muscle and bone mass while it burns calories. Adopting our fitness program is an ideal way to accomplish this.
The Bottom Line on Belly Fat
So, let me try to put the health implications of belly fat into perspective. I firmly believe that the recent epidemic of obesity in this country is primarily due to the types of foods we are eating and to our sedentary lifestyle. Our disproportionate increase in belly fat is due to the survival mechanism of insulin resistance. This has particularly dire implications for our health as a nation because belly fat is simply more dangerous than fat found directly under the skin.
Luckily, if you follow the South Beach Diet principles, your belly fat simply melts away. Moreover, by following a regular exercise program, you speed that weight loss and help maintain it as well. This is true even for those of you who are overweight due predominantly to a slow metabolism rather than insulin resistance. It’s also true for those of you who look fine but just want to lose a few extra pounds.
It has been very satisfying for me to see how far we’ve come in just 5 years in understanding what has caused us to become fatter and sicker. But even more gratifying is seeing how far we’ve come in learning how to prevent these problems by helping people become thinner and healthier for life.
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living THE SOUTH BEACH DIET
Linda S., age 56: My Husband’s Health Is Vastly Improved
My husband, Bill, and I began the South Beach Diet in January 2007 after his doctor told
him that he was on the brink of developing type 2 diabetes. My husband is 5-foot-10 and weighed 289 pounds, which made him very uncomfortable. His blood sugar was too high, and he had lots of belly fat, which we knew wasn’t good. But it wasn’t just the fear of diabetes that worried us. My husband has multiple medical conditions that were being aggravated by his weight—specifically, degenerative bone disease in his back and fibromyalgia, which causes severe muscle pain. He was taking a lot of medication to manage the pain. Both of us knew he had to do something different to improve his health.
At the time, I was about 25 pounds overweight at 174 and a real couch potato. I was pretty disgusted with myself, so I decided to go on the South Beach Diet with Bill. When we started learning about the diet, we realized that we were doing everything wrong. We ate a lot of prepared, processed foods. In fact, white, starchy foods were my favorites! And we didn’t eat enough vegetables and whole grains. I’m not much of a cook, and frankly, I never liked cooking, but I began to experiment with some South Beach Diet recipes. We started eating more lean protein and vegetables…lots of vegetables…and we were really surprised at how good healthy food actually tastes.
Then we took the next step. We joined a local gym and started working out 3 days a week—a really big change for us. With all his medical problems, Bill had to be very careful, but he did what he could. The weight started to come off both of us. I’ve lost 26 pounds and Bill has lost 56 pounds and is feeling much better. In fact, he feels so much better that he’s been able to cut his pain medication in half. And his blood sugar is now normal! There’s no question that my husband’s health has vastly improved.
The funny thing about the South Beach Diet is that we found that healthy eating is more enjoyable than the way we used to eat. We don’t feel deprived (at least most of the time!), and we know that we’ll never go back to the way we used to be.
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7
Supercharged Foods for Better Health
There has been a real revolution in the quality and depth of nutrition information, and it’s going to make you, your family, and your fellow Americans healthier. Until recently, we didn’t know which foods had the most nutrients because many of the nutrients in fruits, vegetables, whole grains, good fats, and other foods hadn’t been discovered yet. Even the role of fiber, which is now known to be crucial to our health, was virtually unknown until a few decades ago. And the knowledge that vitamin supplements cannot compensate for a nutrient-poor diet is an even more recent development.
Thanks to this explosion of knowledge, we know that there are thousands of micronutrients working together in whole, unprocessed foods that help to maintain and optimize our health. Large studies have established that people who eat more fruits and vegetables have less chronic disease, including heart disease. We also know that to obtain the greatest benefits from fruits, vegetables, whole grains, and other good carbohydrates, it’s best to eat a wide variety of each. So let’s explore some of the exciting new nutritional science that’s driving this revolution.
Good Carbs, Great Benefits
When you reach your 100th birthday, you’re going to thank me for urging you to eat lots of fruits, vegetables, and other good carbohydrates. South Beach Diet favorites, such as berries, cruciferous vegetables (broccoli, kale, cauliflower), wheat and oat bran, and even chocolate (my favorite) and red wine have all been making consistent headlines for their positive effects on our health.
Not only are fruits and vegetables chock-full of fiber, they’re also great sources of vitamins, such as C and E; minerals, such as iron, magnesium, and calcium; and phytonutrients, the good health-boosting chemicals found only in plants. Phytonutrients are concentrated in the pigments (often in the skin) that give fruits and vegetables their color. To get the full palette, you need to eat a variety of brightly colored fruits and vegetables every day.
I’ve often said that Americans are overfed and undernourished—in fact, this phrase is the title of the next chapter, which warns about the ramifications of the poor diet being fed to our children today. Our meager consumption of fruits and vegetables is just one example of how we are starving ourselves of life-giving nutrients.
The USDA recommends that we eat two or more servings of fruits and three or more of vegetables each day, but according to a 2007 study published in the American Journal of Preventive Medicine, only 11 percent of Americans do so. Ironically, our hunter-gatherer ancestors, who had to forage widely for their food, ate a much greater variety of fruits and vegetables than we modern men and women do, even though we only have to go as far as the nearest supermarket. What’s even more shocking is that, despite all the miracles of modern medicine, there’s some convincing evidence that the hunter-gatherers were, in many respects, healthier than we are. That’s because, as the research shows, they did not suffer from the chronic and degenerative diseases that plague us today. Most likely this is because of the variety of whole foods they consumed. It’s been shown that later societies, which depended on just one major source of nutrition, such as wheat or rice, were shorter in stature than early man, had weaker bones, and often had evidence of nutritional deficiencies.
Plant Power
There are thousands of phytonutrients commonly found in foods, and we have barely scratched the surface in understanding what they do. Studies show that many phytonutrients act as antioxidants, which protect us against cell-damaging free radicals, chemicals that are produced when we use oxygen to make energy. In excess, free radicals are proinflammatory and attack healthy cells and tissues, which can ultimately lead to heart disease, cancer, premature aging, Alzheimer’s disease, arthritis, and numerous other ailments. Antioxidants help maintain the right level of free radicals in your body.
You can compare antioxidants, which are found mainly in the skin of fruits and vegetables, to the rustproofing that’s used on a car. If you lose the protection, your car rusts and ages prematurely. If we do not have adequate antioxidants in our diets, we in a sense start to rust and age like that car. Have you ever noticed that smokers seem to look older than people their age who don’t smoke? Their skin is frequently wrinkled, and they are often prematurely gray. In addition, smokers’ muscles, bones, and organs tend to age faster than those of nonsmokers. Smoking is well known to stimulate the production of inflammatory free radicals. It could be said that smokers are rusting!
Phytonutrients do much more than protect you from premature aging, however. They also have the power to:
Beat inflammation and improve sex. Take polyphenols, for example. These phytonutrients seem to be particularly good for heart health because they are anti-inflammatory and relax the blood vessels, which improves bloodflow and lowers blood pressure. If you follow nutrition news, you know that there’s been a great deal of buzz about pomegranate juice, which studies show may reverse atherosclerosis (hardening of the arteries) and even improve erectile dysfunction (it’s all about the polyphenols and bloodflow). I usually recommend that people eat whole fruits for their fiber rather than drink fruit juice, but in the case of pomegranates, I make an exception. That’s because most people have trouble getting the pomegranate seeds out of the whole fruit, and drinking the juice for its potent polyphenols has proven health benefits. I like mixing pomegranate juice, which can be quite tart, with sparkling water for a refreshing spritzer.
In addition to improving bloodflow, the polyphenols found in black, white, green, and oolong tea and red wine have several other health benefits. Tea can lower bad LDL (low-density lipoprotein) cholesterol, and red wine can raise good HDL (high-density lipoprotein) cholesterol. One study even showed that regular ingestion of green tea, which is rich in a type of polyphenol called catechins, may decrease body fat and help weight loss. You can enjoy tea, caffeinated (in moderation) or decaffeinated, on all phases of the South Beach Diet and can sip a glass or two of wine with a meal on Phases 2 and 3.
And for those of you who, like me, are chocoholics, I’ve saved the best news for last. Several studie
s have shown that dark chocolate can lower blood pressure, again probably due to the beneficial effect of its polyphenols on bloodflow. I’m not giving you a license to gorge on chocolate. But when you do enjoy it, it’s best to choose brands of dark chocolate that contain the most cocoa and the least sugar. While you won’t be able to eat dark chocolate on Phase 1, you can take heart in knowing that enjoying the occasional piece is allowed on Phases 2 and 3.
Protect the eyes and prostate. Carotenoids, found mainly in yellow, orange, and red fruits and vegetables and in dark green vegetables, are another family of phytochemicals that have been studied extensively for their health benefits. Two carotenoids, lutein and zeaxanthin (both abundant in dark green vegetables), are associated with lower rates of macular degeneration and possibly cataracts. Another carotenoid, lycopene, found in tomatoes, pink and red grapefruit, and papaya, has been associated with lower levels of prostate cancer.
Keep you sharp. Anthocyanins are potent antioxidants found in blueberries, purple grapes, plums, eggplant, cherries, and red wine. If these antioxidants work as well in humans as they do in mice, eating these foods may preserve your brain well into old age. In a 2006 study conducted by the USDA, a blueberry extract was fed to mice that had a genetic mutation causing them to develop the same kind of amyloid plaques found in the brains of human Alzheimer’s patients. Eight months later, the mice performed as well on a maze function test as their normal peers, an indication that their brains were still plaque free. USDA studies have also shown that rats fed blueberries showed fewer signs of physical and mental aging than rats that did not eat blueberries.
The South Beach Diet Super Charged Page 9