SBD Not the Best for CVD

Dr. Agatston said when he began working on the South Beach Diet (SBD) the only other diets recommended for heart patients were the American Heart Association’s diet or the “…extremely low-fat regimes popularized by Dean Ornish, MD and Nathan Pritikin.” (p. 137). He then states, “The problem with low-fat, high-carb diets was that they did not distinguish between good, high-fiber carbohydrates, and refined, low-fiber, high sugar carbs.” (p.138) Obviously Dr. Agatston is not very familiar with the Pritikin Diet which has severely restricted the use of refined carbohydrates.

On the next page, he stated, “I observed that some patient’s triglycerides rose in response to a strict low-fat, high diet…..”. Dr. Barnard at UCLA has published many studies showing triglycerides drop on average over 30% on the Pritikin Program. Agatston also claims “..with the low-fat diet …..[LDL-C] would go down a few points …. but then it would return to baseline or go even higher.” (p.139). Clearly Dr. Agatston is confused about the impact of very low fat, near vegetarian (VLFNV) diets on LDL-C levels. Clinical trials using VLFNV diets as the sole treatment of advanced coronary disease patients have shown a dramatic and long lasting reduction of LDL and nearly all other known and suspected CVD risk factors. Published clinical trial data are at odds with Dr. Agatston’s claims. More importantly, a VLFNV diet has been shown to regress atherosclerosis, reduce angina, and dramatically reduce total mortality in people at high risk of CVD. By contrast when Dr. Agatston was asked if he would do a clinical trial with his SBD program as the sole treatment for CAD, his response was, “I was adamant that I would not.” (p. 95 South Beach Diet Heart Program). To go from the SBD to the Pritikin Diet one would just eat less fruits, vegetables and whole grains and more refined fats, salt, low-fat dairy, eggs, and lean meats. Such a change in diet would increase LDL and blood pressure and promote weight gain. Clearly the SBD is not the best dietary approach for preventing and treating coronary heart disease.By James J. Kenney, PhD, RD, FACN.