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CNN SATURDAY MORNING NEWS

"Weekend House Call"

Aired October 25, 2003 - 08:25   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

HEIDI COLLINS, CNN ANCHOR: "Weekend House Call" with Dr. Sanjay Gupta begins right now.
DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.

We're talking about diets, a very popular topic, specifically, the top selling book out there right now, the South Beach diet. It says you can lose up to 13 pounds in just two weeks, the first two weeks.

So, is this another gimmick or could it be a long-term weight loss solution, the one we've all been looking for?

Our medical correspondent Christy Feig takes a look.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Liz Pakkala wanted to lose 20 pounds after the birth of her son John. Natasha De La Court also hoped to shed some pounds after her son Lucas was born. They both tried the South Beach diet. It's based on the glycemic index, a system that ranks foods by how quickly they break down into sugar. The goal? Reducing foods that trigger insulin spikes that might cause you to overeat.

Dieters don't count calories and can eat as much lean meat, fresh vegetables and high fiber foods as they like in the first two weeks, called phase one. Then, when you move onto phase two, carbohydrates are introduced at intervals and in very small portions.

But the American Dietetic Association urges caution.

RACHEL BRANDEIS, AMERICAN DIETETIC ASSOCIATION: If a dieter tells you that some foods are good or some foods are bad, that is always an automatic red flag for an extreme diet or a fad diet.

FEIG: Liz saw immediate results.

ELIZABETH PAKKALA, SOUTH BEACH DIETER: It's been a very positive experience. I love the diet. It's very easy to follow and I love that I lost 20 pounds.

FEIG: It wasn't as easy for Natasha, who struggled to keep the weight off.

NATASHA DE LA COURT, SOUTH BEACH DIETER: Well, in the first two weeks, I would lose three pounds and as soon as I'd introduce some carbohydrates back, I would gain those three pounds literally overnight.

FEIG: Both women say they experienced some mild side effects.

DE LA COURT: Mood swings and sugar cravings, irritability.

BRANDEIS: Light headaches and I didn't have as much energy.

FEIG: Liz says she will continue to follow the South Beach diet. Natasha, who continued to lose and regain the same three pounds for three months, says she will look for something new.

Christy Feig, CNN.

(END VIDEOTAPE)

GUPTA: All right, like it or not, "The South Beach Diet" is currently number one on the "New York Times" best seller list, beating out the other hot diet books like "Atkins For Life." Most people have heard of both of those now.

Experts have linked Atkins and South Beach, calling them both high protein diets, compared to the American Heart Association's eating plan, which incidentally goes something like this. You eat about six servings of bread a day and include at least five servings of fruit and vegetables, plus get in two to four servings of fat-free or low-fat dairy and try not to eat more than six ounces of cooked meat per day.

So which plan should you be following? It all gets very confusing. We want to hear from you and help you work through it. 1- 800-807-2620 or e-mail us, housecall@cnn.com.

And, we've got the perfect guest to help us work through this today, the author of "The South Beach Diet" book, Dr. Arthur Agatston.

Welcome very much, doctor.

I want to point out, as well, before we start taking, giving you questions, that you're a cardiologist, which is how you got your start in nutrition. Is that right?

DR. ARTHUR AGATSTON, AUTHOR, "SOUTH BEACH DIET": Yes.

GUPTA: And how did you come up with this plan specifically?

AGATSTON: Well, my orientation has always been prevention of heart disease, heart attacks and strokes. And at Sinai we developed the heart scan, actually, for early detection of coronary disease. And, but I was very frustrated with the low-fat, high carb nationally recommended diets. I was watching my patients get heavier, the country get heavier, and, frankly, myself, as well.

And while we saw some success with some of the low carb diets, we didn't want to give heart patients, in particular, as lot of saturated fat. And at this time there was new evidence on the benefits of good fats, the benefits of high fiber foods and also understanding of pre- diabetes, how swings in blood sugar was making the country fat.

So we came up with our own plan of the good fats and the good carbs. We were amazed by our success. We started reporting our findings at national meetings and it was picked up by the local media, who asked us to put south Florida on the diet, with great success. And then we went from regional to national and the rest is history.

GUPTA: Yes, it really is. And it is the number one seller on the "New York Times" best seller. You are a cardiologist. That gives it a lot of credibility. But we want to really work through this today, the goods and the bads, and hopefully we can do that with you through some e-mails and some phone calls.

In fact, let's start with this e-mail from Gayle in Virginia. She writes, "How safe is the South Beach Diet?" That's a fair question. And, also, "What makes it different from Atkins?" Because, as you heard, a lot of people sort of associate the two together, doctor.

AGATSTON: Yes, well, it's very safe, and we'll get into that. And really Dr. Atkins did teach us that fat does not necessarily make us fat. And he was absolutely right. But he lumped all fats together and all carbohydrates together. That's because the science was not there of the difference between fats and carbohydrates when he developed his diet.

But we now know that good fats, Mediterranean oils, canola oil, the fish oils, are not neutral. They actually help prevent heart attack and stroke and they help us for that sugar and insulin metabolism long-term. So they help us keep off the weight. So that's one big difference.

And the other is Dr. Atkins felt that you had to restrict all carbohydrates and go into ketosis, where you actually broke down fat rapidly at the beginning of the diet. And that's what he felt had you get rid of the cravings. We actually encourage good carbohydrates from the beginning, particularly a lot of vegetables, salads. And our patients did not go into ketosis and they still lost their cravings. And you can actually be high carbohydrate on our diet if it's the good carbohydrates.

GUPTA: OK, because the first line of your book, which is interesting, says, "This is not a low carb diet." It's an important point that you make right at the top there, right?

AGATSTON: Yes.

GUPTA: OK, let's keep going with the e-mails here.

AGATSTON: And one -- I'm sorry, one other point about the good carbohydrates is they carry so many of the vitamins and nutrients that we need to help prevent heart disease and cancer. And we need those veggies and the whole fruits. GUPTA: OK, and we're going to work through that a little bit, as well, because some important points there about the sort of broad diets versus very specific diets. Along the same lines as the previous e-mail, though, Harvey from Texas is asking, "Is the South Beach Diet high in protein and does a high protein diet have an adverse effect on the kidneys?"

So, are you substituting those carbs for protein and what are the side effects of that?

AGATSTON: Sure. Well, you know, for healthy young people, high protein appears to be perfectly safe. There's no evidence. To the contrary, particularly if you're active, if you're muscle building, protein is important.

For often older patients with hypertension or kidney disease, you don't want high protein. And that's absolutely fine on the South Beach Diet. You can vary the protein. The are societies that do very well both high fat and low fat. The island of Crete; the Mediterranean island, the Greenland Eskimos do very well on high fat; and a lot of underdeveloped countries have done very well on low fat. So it's not high or low, high or low protein. It's the type of fats and the types of carbohydrates that we're eating.

GUPTA: OK. Let's keep going. A lot of questions coming in. Our phone lines are lighting up.

Joanne in Massachusetts, good morning and welcome to House Call.

JOANNE: Oh, good morning.

Thanks for having me.

I tried the diet. I was very pleased with how good I felt. I could sleep better and just had level energy all day long. But the recipes were too good so I ate too much of the stuff. But my main meal that I had a problem with was breakfast. I'm not a bacon and egg person, and how cereal just doesn't turn me on in the morning.

Any other alternatives?

GUPTA: Joanne, let me ask you real quick. How long have you been on the diet?

JOANNE: Well, I've been on -- I tried it for the two weeks and then I kind of went off it again, trying to get my boost. So I'm hoping that you'll energize me this morning.

GUPTA: And did you lose weight in those first two weeks?

JOANNE: Just about two or three pounds.

GUPTA: OK. All right, doctor, what's...

JOANNE: And I felt very good.

GUPTA: So what do you tell someone like Joanne?

AGATSTON: Well, you know, for breakfast, if you don't like hot cereal, there are good high fiber, especially after the first two weeks, high fiber cereals, Fiber One, Kellogg's All Bran, lean meats, low fat chase, also, cottage cheese for breakfast is absolutely fine.

GUPTA: OK, doctor. Well, now that we all know what the South Beach Diet is, next we're going to find out if this is a good diet for you at home. We're also going to find out if your teenager should be on the diet. That's a problem, as well, is it safe for the whole family? We're going to ask Dr. Agatston. He's going to stick around for us, as well. We're going to take that question. We'll also take more of your phone calls, 1-800-807-2620. We'll keep an eye on the e- mails, as well. Send us your questions, housecall@cnn.com.

But first, let's check our Daily Dose health quiz.

Which has a higher glycemic index rating? You've got a few choices here. Is it A, skim milk; B, corn; or C, a bar of chocolate?

That answer when we come back.

Stay with us on Weekend House Call.

COMMERCIAL

GUPTA: Checking the Daily Dose quiz now, we asked which has a higher glycemic index rating, skimmed milk, corn or a bar of chocolate? The answer may surprise you. It's corn. That weighs in with a G.I. number of 78. The chocolate bar measures 70 and skim milk has the lowest ranking at 46.

Welcome back to Weekend House Call.

Now here's what you need to know about the glycemic index. The Index's baseline is a slice of white bread, which has been given the number 100. The closer to 100 you get, the faster that food actually breaks down into sugar in your blood. Canadian researchers developed this Index two decades ago and as of last year, diabetes groups in Canada and Australia have also endorsed it. The American Diabetes Association, meanwhile, says there's not enough evidence to use the glycemic index.

With that said, let's welcome back our guest today, South Beach diet author Dr. Arthur Agatston. I want to make sure I say that right. Lots of questions. I'm sure you get questions everywhere you go about this diet plan, don't you?

AGATSTON: Absolutely. And I enjoy answering them. We've just had great feedback from all over the country.

GUPTA: You know, a lot of people -- I tell people that you're a cardiologist, a lost of people are surprised by that. But I think it does offer a -- lend a little authority to this book, because a lot of questions we get about how safe this is for your heart. And we're going to get to some of those questions as well. Let's go straight to our first e-mail. Janelle from Alabama writes, "I this diet safe for diabetics?" She's a non-insulin diabetic, she adds, as well.

AGATSTON: Well, it was really developed for diabetics and pre- diabetics. They have the biggest swings in sugar and insulin metabolism. And there's an absolute epidemic, both obesity and diabetes, in the country. And this is a way we reverse that, by decreasing the swings in blood sugar. You're not hungry soon after you eat. And you, we've had, we have cases literally every day of diabetes resolving, of blood sugars normalizing on the diet.

GUPTA: OK. A different population of patients, as well, possibly teenagers. Tina from Missouri is asking a question about her teenagers. "Do you recommend this diet for teens?" She has a 14- year-old son on a modified version of the diet, says mostly the second and third phases, and has had success losing weight. But what age is too young to start this sort of thing?

AGATSTON: Well, you know, we're, you know, adult -- what we used to call adult onset diabetes, we call Type 2 Diabetes, is hitting our teens and our pre-teens. And it's all the fast foods, the trans fats and the processed carbohydrates. And the South Beach diet is the ideal antidote to that.

Now, if they're children beginning, you may want to begin with phase two instead of phase one and consult your pediatrician. But overall, it's exactly the way our teenagers should be eating -- more whole foods, whole grains, whole fruits.

GUPTA: OK. And sort of along the same lines now, talking about cholesterol, we have a phone caller, Tallulah in Florida.

Good morning, Tallulah. Welcome to House Call.

TALLULAH: Good morning.

My question for the doctor is how can this diet be used in reducing high cholesterol? My fiance suffers from high cholesterol and is taking cholesterol reducing medication and it doesn't seem to be doing much of a reduction in the cholesterol.

AGATSTON: Well, if there is any diabetes in the family, if there's been adult weight gain, particularly in the center, where also triglycerides are high and HDL is low, it normalizes blood chemistries. It does a great job.

If it's isolated, elevated LDL in somebody who's not overweight, that's a case where we still use the medications, the statin drugs.

GUPTA: OK, lots of good things about this diet. But with everything, there may be some potential down sides, as well. Now that you've heard what this diet is all about, it's time to talk about some of those down sides.

We're going to do that when we come back. From fatigue to headaches, what kind of side effects can happen when you go to a high protein and ditch some of those carbs?

Stay with us, Weekend House Call.

COMMERCIAL

(BEGIN VIDEO CLIP)

BRANDEIS: Americans know how to lose weight. A healthy goal would be for people to find out how they can get some weight off by restricting their calories, by increasing their exercise and maintaining that weight loss. That's the key.

(END VIDEO CLIP)

GUPTA: Burn more calories than you take in, it seems like a pretty simple solution to losing weight.

Welcome back to Weekend House Call.

We're talking with Dr. Arthur Agatston. He's the creator of the South Beach diet.

You've just heard the ADA's recommendation for long-term weight loss, doctor.

We're going to give you your chance, as well. A lot of phone calls coming in on this particular topic.

Sandy from Pennsylvania, good morning and welcome to House Call.

SANDY: Good morning, doctors.

My question is concerning the headaches. I seem to be getting one about every seven days. The first one lasted three days and I didn't think I could go on, but it finally ended. And I got another one -- this is my fourth week and I have lost 12 pounds, so I'm real excited. And I'd like to continue with it, but I really don't know about these headaches. What is causing these?

GUPTA: And you weren't getting headaches before the diet at all?

SANDY: No, never.

GUPTA: Is that common, doctor?

AGATSTON: No, it's not common. But one problem is we do suggest restricting caffeine in the first two weeks because it causes swings in insulin. It's not a diet buster, but if you acutely withdraw or decrease your caffeine intake, you can get rebound headaches. And that's the most common cause of headaches.

You know, otherwise it's unusual, but with any change in metabolism, even decreasing the swings in blood sugar, there may be some temporary symptoms like that. But they generally pass.

GUPTA: And so should Sandy go ahead and reintroduce some caffeine into her diet, then?

AGATSTON: I would try to reintroduce some caffeine. Although once you've withdrawn from the caffeine, then it shouldn't be a problem. But varying intakes of caffeine, caffeine withdrawal is a very common cause of headaches, including exacerbating migraine headaches.

GUPTA: OK. Keeping along the same lines here, Jim from Idaho, good morning and welcome to House Call.

Your question?

JIM: Good morning.

I'm thankful that you had me on here this morning.

To start off with, I do have a history of cardiac problems with three AMIs and a failed back surgery and a knee replacement, which really limits me to any exercise that I could do. And I'm approximately 60 to 70 pounds overweight. And I was concerned about how your diet would help me out and how long I would probably have to stay on the diet and also how could I get a copy of the diet to go by?

GUPTA: OK, doctor, so a couple of questions it sounds like there, one about exercise and one about somebody with a significant heart history, it sounds like, as well.

AGATSTON: Well, yes, our diet was developed to prevent heart attacks and strokes. And one thing we should emphasize, it's a lifestyle, not just a diet. You don't prevent heart attacks and strokes by being on a diet and just losing weight over the short-term. And we really work hard to make the diet a lifestyle.

For anybody with adult weight gain who's had heart attacks, you have to look at the breakdown in the various fractions of cholesterol. Some are more amenable to medication. But a lot is very amenable to diet. And with 60,70 pounds overweight, the healthiest way to lose weight is the principles of the South Beach diet.

The fish oils that we recommend actually decrease sudden death and heart attacks. It's been shown in several large studies to do that, so that the good fats that we recommend are particularly important, as well as the nutrients you get from the vegetables and the whole grains and the whole fruits.

GUPTA: OK, two quick questions before we go to a break.

Doctor, are you on the diet?

AGATSTON: Yes. I originally lost 15 pounds on the diet. I'm a chocoholic. I travel and I teach from time to time and I will go back to an earlier stage.

GUPTA: And the name for the diet, South Beach, is that where you're from? Is that why you named it? AGATSTON: That's Mount, near Mount Sinai and that's where we're from. That's how it got the glitzy name. It started as a serious academic pursuit. GUPTA: All right. OK, grab a pen, everyone at home.

When we come back, we're going to give you the formula to figure out how many calories you need to be burning each day to lose weight.

Stay with us.

Weekend House Call.

COMMERCIAL

GUPTA: To figure out how many calories you use each day, do some simple math. For an active person, multiply your weight by 15 calories and that's going to equal the average number of calories you use each day. That's going to help you figure out how much you should be eating each day, as well. If you're a little less active, change the math a little bit. Multiply your weight by 13 calories for the average calories for each day.

It's been an interesting show today. We've learned a lot.

Dr. Arthur Agatston, author of "The South Beach Diet," has joined us.

Do you have a final thought, sir?

AGATSTON: Yes. While calories count, nobody has lost weight over a long period of time by counting calories. The cause of our epidemic of obesity is the swings in blood sugar because of the types of carbohydrates that have been introduced into the American diet. We're hungry all the time and we're eating too many calories. So it's the types of foods we're eating, not the fact that we're not counting calories.

GUPTA: OK, Dr. Agatston, I'm kind of hungry right now, actually.

Thank you so much for joining us. I appreciate it. I've learned a lot.

Thank you there in Florida, as well.

Thank you the viewers at home, as well.

Tune in tomorrow. We're going to be talking about a totally different topic, about the recent cases of conjoined twins. That's from the Egyptian boys in Dallas to the two Marias. We're going to take your e-mails and calls on that topic, as well. That's Sunday, 8:30 Eastern.

Thanks for watching.

I'm Dr. Sanjay Gupta. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com




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