Name: Period: Date:

Diets and

Introduction. One of the biggest health problems in the United States is . Many people are overweight and being overweight increases the risk of cancer, diabetes, and an early death. The risks are particularly severe for children because being overweight as a child makes a person more prone to obesity as an adult. People have developed a huge range of possible treatments for obesity. Dieting is the most popular approach. However, there are many different types of diets. The Atkins diet, in which like starch and sugar are rejected in favor of and protein, is one possible approach. There are also other types of diets such as Learn, which is a low-protein, high-carb diet, and Ornish, an extreme low-fat plan. With all these options, many people wonder:

Which diet is the best way to lose weight?

Literature Review. You must learn more about diets and how they work before you can give a sufficient answer this question. Read the following articles, and using evidence from the research, develop a claim that best answers the guiding question.

 Atkins diet marginally better than rivals by Debora MacKenzie

 Popular but often faulted, Atkins diet made its mark by Sally Squires

 Atkins wins for losing: Diet study ranks the low-carb regimen No. 1, but critics weigh in by Denise Gellene

 Carb Supporters Rejoice as Atkins Goes Belly Up by Jerry Hirsch

 Mediterranean diet backed as a whole by Peter Farley

 Weight-Loss Winner: A Diet High in Fiber, Low in Calories by Coco Ballantyne

After reading an article, your group will need to discuss the questions below. Your group will need to agree upon a single answer for each one.

Article 1: Title of the Article

Author Date Published

Publisher Url

1. What claim does the author make?

2. What evidence does the author give in support of his or her claim?

3. Is the author’s evidence of high quality (from a scientific perspective)?

0 1 2 3 4 No Somewhat Absolutely

4. Explain your ranking.

Article 2: Title of the Article

Author Date Published

Publisher Url

1. What claim does the author make?

2. What evidence does the author give in support of his or her claim?

3. Is the author’s evidence of high quality (from a scientific perspective)?

0 1 2 3 4 No Somewhat Absolutely

4. Explain your ranking.

Article 3: Title of the Article

Author Date Published

Publisher Url

1. What claim does the author make?

2. What evidence does the author give in support of his or her claim?

3. Is the author’s evidence of high quality (from a scientific perspective)?

0 1 2 3 4 No Somewhat Absolutely

4. Explain your ranking.

Article 4: Title of the Article

Author Date Published

Publisher Url

1. What claim does the author make?

2. What evidence does the author give in support of his or her claim?

3. Is the author’s evidence of high quality (from a scientific perspective)?

0 1 2 3 4 No Somewhat Absolutely

4. Explain your ranking.

Stop Here – Wait for your Teacher’s Instructions Initial Argument. Once your group has finished reading the four articles, you will need to develop an initial argument. Your argument must include a claim, which is your answer to the guiding question. Your argument must also include evidence in support of your claim. The evidence will include findings from the articles that you read and your interpretation of those findings. Finally, you must include a justification of the evidence in your argument. You will create your initial argument on a whiteboard. Your whiteboard must include all the information shown in Figure at right. Argument presentation on a whiteboard

Argumentation Session. The argumentation session allows all of the groups to share their arguments. One member of each group stays at the lab station to share that group’s argument, while the other members of the group go to the other lab stations one at a time to listen to and critique the arguments developed by their classmates. The goal of the argumentation session is not to convince others that your argument is the best one; rather, the goal is to identify errors or instances of faulty reasoning in the initial arguments so these mistakes can be fixed. You will therefore need to evaluate the content of the claim, the quality of the evidence used to support the claim, and the strength of the justification of the evidence included each argument that you see. To critique an argument, you might need more information than what is included on the whiteboard. You might, therefore, need to ask the presenter one or more follow-up questions. Once the argumentation session is complete, you will have a chance to meet with your group and revise your initial argument. Your group might need to look for additional articles as part of this process. Remember, your goal is to develop the most valid or acceptable answer to the guiding question!

Your Final Argument. On the next page, write a one to three paragraph argument to share and support the answer to the guiding question that you think is the most valid or acceptable. Your argument must also include a challenge to at least one alternative claim. As you write your argument, remember to do the following:  State the explanation you are trying to support  Include genuine evidence (information of the articles + analysis + interpretation)  Explain why the evidence is important and relevant (why it matters)  State the claim(s) you are trying to refute  Explain why the alternative claim is invalid or unacceptable  Provide citations to the articles you read  Organize your argument in a way that enhances readability  Use a broad range of words including vocabulary that we have learned  Correct grammar, punctuation, and spelling errors

Atkins diet marginally better than rivals1 by Debora MacKenzie

One of the largest studies to date has found that overweight women lost a little more weight on the popular Atkins diet than on three other well-known diet plans. However, the effect was small, and it is not clear that the Atkins diet works the way it claims.

The 1998 Atkins diet, which calls for replacing "carbs" (carbohydrates, starch and sugar) with fat and protein, has been among the most popular "miracle" diets. Christopher Gardner and colleagues at Stanford University in California, US, put 311 overweight women between 20 and 50 years old on either Atkins, or one of three other popular diets:

 Zone, which cuts carbs less severely than Atkins  LEARN, a low-protein, high-carb diet based on US national guidelines  Ornish, an extreme low-fat plan

After a year, all the women had lost some weight. The Atkins group lost more on average than the groups on all other diets - 4.7 kilograms (10.3 pounds) versus 1.6 kg (3.5 lbs) for Zone, 2.6 kg (5.7 lbs) for LEARN and 2.2 kg (4.8 lbs) for Ornish. However, only the difference between the Atkins and Zone groups was statistically significant.

Underlying mechanisms There are fears that the increased fat consumed with the Atkins diet could lead to cardiovascular problems. In this study, however, the Atkins group had the best "good" , blood triglycerides (fat), and blood pressure. "Apparently the predicted adverse effect of more in the diet is counterbalanced by losing even just slightly more weight," Gardner told New Scientist.

It is less clear, though, how the weight is actually lost. "Was the slight benefit on Atkins due to the low carbs, or the high protein, or the eight glasses of water a day which may have replaced sweetened beverages?" asks Gardner. "We don't know."

Atkins claims that changing the ratio of and fat in the diet changes a person's fat-storage metabolism. But, says Gardner, the diet may just make it easier to eat fewer calories from any source, possibly because most modern caloric excess comes from carbohydrates.

Less is more Arne Astrup at the University of Copenhagen also suspects the advantage of Atkins may simply be fewer calories, not a changed metabolism. This is because eating more protein fills you up more per calorie, so you eat less. But he says more tightly controlled studies are needed to resolve the question. Other studies comparing diets, he notes, have found no significant difference between them and even opposite results for the same diet in some cases. Astrup thinks this is probably because people rarely stick to these diets.

"After one year no-one was sticking very closely to any of the plans," agrees Gardner, who says his aim was test the actual, real-world use of diet books. He adds that while some books can help achieve short- term weight loss, the real test of weight loss is keeping it off.

1 Published on 3/6/2007 in the New Scientist. See http://www.newscientist.com/article/dn11321-atkins- diet-marginally-better-than-rivals.html Popular but often faulted, Atkins diet made its mark2 Sally Squires

Many nutrition experts see the recent bankruptcy filing by Atkins Nutritionals Inc. as the proper outcome for a diet that seemed to encourage virtually unlimited consumption of steak, cream and pork rinds. After all, the eating plan was often at odds with the large body of nutritional research showing the benefits of a diet rich in fruit, vegetables, whole grains, lean protein and a moderate or low percentage of fat.

But some also see value in the popularity of the weight-loss method, created by Dr. Robert C. Atkins, even if they don't agree with it.

"The good that Atkins did is that he made people more mindful about the importance of limiting refined carbohydrates like sugar and white flour," said cardiologist , a proponent of a very low-fat, high-carbohydrate approach to losing weight and lowering the risk of heart disease. "The bad is that he taught people that in the short run, you can sell a lot of books and make a lot of money telling them what they want to hear." Atkins "taught the scientific community a good lesson," said Gary Foster, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania.

"Don't be so quick to judge new approaches. "The bestselling success of Atkins diet books was a cultural phenomenon that researchers couldn't ignore. "We can't test every ," Foster said. "So why did we test this one? Because 10 million people had bought the book."

In studying Atkins, researchers found some surprises. "It's clear that the Atkins diet does better in the short term and doesn't do any worse in the long run in terms of weight control," said Walter Willett, professor of nutrition at the Harvard School of Public Health. "That was so contrary to the general nutritional dogma that it really did shake things up a bit."

Also unexpected: Participants' blood fat levels either were the same as or slightly better than those of people who followed a conventional low-fat weight regimen for a year. "Who would have predicted that?" said Foster, author of the study, which was published in the New England Journal of Medicine. "Certainly, it wouldn't have been me."

The long-term health effects of limiting fruit, vegetables, whole grains, fiber and such popular dairy products as milk, yogurt and cheese are not known. Those questions may be answered by a two-year, federally funded study of 300 people on a very low-carbohydrate diet. "Whether anyone will care about the results, I don't know," said Foster, who heads this study as well. "But we're going to continue."

Here's what else leading nutrition experts said the Atkins experience has shown:

* Quick weight loss doesn't last. Severe restriction of carbohydrates depletes the body of glycogen, a substance that helps retain water. The quick weight loss on Atkins is initially due to loss of water, not fat.

* Protein is important. Studies show that protein increases satiety -- the feeling of fullness. When University of Cincinnati School of Nursing researchers put overweight women on an Atkins diet, their

2 Published on 8/15/2005 in the LA Times. See http://articles.latimes.com/2005/aug/15/health/he-lean15 hunger decreased and they lost weight. Initially, the pounds came off faster than for women on a conventional low-fat diet. But by six months there was no statistical difference between the two groups. Women on the Atkins diet "had protein with breakfast, protein with lunch and protein with dinner," said Bonnie Brehm, lead author of the study. "I was amazed at how satisfied they were, and they didn't crave snacks."

* Taste counts. The Atkins diet launched numerous new lines of low-carbohydrate products from many food manufacturers. "Two years ago they filled half a grocery wall. Now they're just a stand-alone unit because they didn't taste very good and they were expensive," Brehm said.

* Diets don't work. It takes consistent lifestyle changes to lose weight and maintain it. "Americans tried [Atkins]," Brehm said. "It worked for a while and then it didn't continue to work, so they abandoned it.... The message is moderation, moderation, moderation."

* Too many processed, sugary carbohydrates are unhealthy. "Atkins was good in pointing out that refined grains can be a problem, but bad in making any carbohydrate out to be a toxin," said Michael Jacobson, executive director of the Center for Science in the Public Interest.

Atkins wins for losing: Diet study ranks the low-carb regimen No. 1, but critics weigh in3 Denise Gellene

The largest and longest-running comparison of diet plans found the low-carbohydrate Atkins regimen produced greater weight loss than three other popular programs -- the Zone, the Ornish and the U.S. nutritional guidelines.

The average weight reduction was small, and participants started regaining pounds by the end of the one-year study, according to the report in today's Journal of the American Medical Assn. Still, Atkins dieters -- who consume prodigious amounts of long- demonized saturated but shun carbs, such as pasta and breads -- experienced significant drops in blood pressure and cholesterol. The finding showed that even a small weight reduction can improve overall health, researchers said.

Atkins dieters lost an average of 10.4 pounds after one year, according to the report, compared with 5.7 pounds for those on a traditional balanced diet based on federal nutritional guidelines, 4.8 pounds for the high-carbohydrate Ornish diet and 3.5 pounds for the , which calls for a set ratio of carbohydrate, protein and fat.

The study's results cast further doubt on the benefits of low-fat, high-carb diets, which have been touted for decades as the model of healthy eating.

"This study confirms the importance of reducing carbohydrates," said Dr. Frank Hu, associate professor of nutrition and epidemiology at the Harvard School of Public Health, who was not involved in the research. "Bagels, white bread, potatoes and soft drinks are the real bad guys in our diet."

The study was quickly criticized by some Atkins competitors.

Dr. Dean Ornish, president of the Preventive Medicine Research Institute in Sausalito, Calif., said the differences among the weight loss plans detected in the study were

3 Published 3/7/2007 by the LA Times. See http://articles.latimes.com/2007/mar/07/science/sci-diet7 insignificant. He added that Atkins dieters saw an increase in levels of LDL, or "bad," cholesterol. "The conclusions of this study are highly misleading," he said.

But Atkins backers saw the study as vindication of their approach and predicted a revival of interest in the Atkins diet, whose popularity peaked five years ago but then swiftly faded. Atkins Nutritionals Inc., which sold packaged foods based on the diet, sought bankruptcy protection in 2005. Today, the $2-billion carb-conscious food market is dwarfed by the $14.7 billion spent on low-fat products, according to AC Nielsen.

"Those of us who have been in the low-carb community for decades are not surprised by these [study] results," said Jacqueline Eberstein, coauthor of "Atkins Diabetes Revolution" with Dr. Robert C. Atkins, who died in 2003.

The $2-million diet faceoff, funded by the National Institutes of Health and the Community Foundation for Southeast Michigan, was conceived several years ago to sort out the cacophony of claims made by competing diet plans.

More than 300 overweight, pre-menopausal women were randomly assigned to follow one of the four diet plans, which were chosen to represent a range of low- to high- carbohydrate diets. The Zone and the traditional diet, called LEARN, included calorie- restriction goals, but the Atkins and Ornish diets did not.

When the study began, the women weighed an average of 190 pounds and had an average body mass index of more than 30, putting them in the obese range. BMI is a standard measure that takes into account a person's weight and height. Participants attended weekly diet classes for the first eight weeks and received a book outlining their specific dietary program. The women's weight and metabolism were regularly checked, and their diets were monitored by phone. The women prepared their own meals, and some had trouble sticking to their diet regimens, mimicking real-world conditions.

Lead author Christopher D. Gardner, a Stanford University assistant professor of medicine, said one reason the women on the Atkins diet lost the most weight was because the program was easy to follow.

"It has a very simple message: Get rid of all the junk carbohydrates," he said. In fact, Gardner said he suspected that the bulk of the weight loss in the Atkins program came from women substituting water for soft drinks. In addition, Gardner said, the Atkins diet's reliance on higher amounts of protein, which is more filling than carbohydrates, may have kept women from feeling too hungry.

He also noted that Atkins dieters saw sharper drops in triglycerides, a type of fat, and blood pressure, and steeper increases in HDL, or "good," cholesterol than women on the other diets, according to the study.

The improvements could have important public health implications, Gardner said.

"The good news is that a small amount of weight loss is very powerful," he said.

The results show the Atkins diet is a reasonable choice for short-term weight loss, said Gardner, a vegetarian.

Carb Supporters Rejoice as Atkins Goes Belly Up4 Jerry Hirsch

In Boise, staff members of the Idaho Potato Commission gave one another gleeful high- fives when they heard the news. In Houston, the folks at the U.S. Rice Producers' Assn. declared "good riddance." And fruit farmers in California's Central Valley said they were "happy to see them go."

Across the nation, producers of carbohydrate-laden food exulted at the decision by Atkins Nutritionals Inc., the Ronkonkoma, N.Y.-based designer of the once-popular low- carbohydrate weight-loss program, to file for bankruptcy protection.

The company said it planned to reorganize and focus mainly on selling nutrition bars and shakes. But analysts and nutritionists said Atkins' bankruptcy filing effectively signaled the demise of the low-carb lifestyle and an era when tens of millions of Americans embraced high-protein diets rich in meat and cheese while eschewing carbohydrates and sugars in grains, fruits and vegetables.

"It just proves that what Atkins was trying to do was just too extreme," said Jeff Yankellow, a South San Francisco baking instructor and winner of the World Cup of Baking in Paris in April. "Bread has survived as a nutritional food for thousands of years, and Atkins isn't going to kill it."

In court papers, the company indicated that it was a victim of fierce competition from large food companies such as Unilever, Kraft Foods Inc. and General Mills Inc., which in the last few years rolled out their own lines of low-carb food.

When the diet was at its peak, fast-food chain Carl's Jr. pushed its lettuce-wrapped Low Carb Six Dollar Burger, Round Table Pizza developed a low-carb crust, Kraft came out with low-carb Oreos and Frito-Lay pitched low-carb Doritos, Tostitos and Cheetos. Many companies, even winemakers, changed their packaging to tout the low-carb content of their products.

4 Published 8/2/2005 by the LA Times. See http://articles.latimes.com/2005/aug/02/business/fi-lowcarb2

The diet was first outlined in a book, "Dr. Atkins' Diet Revolution," developed by weight- loss guru Dr. Robert C. Atkins in 1972. Atkins claimed that his diet prompted "ketosis," a metabolic state in which fat is burned more efficiently. Atkins died two years ago after falling and hitting his head on a New York sidewalk.

His books have sold more than 20 million copies in more than 20 languages. Apart from the book, Atkins Nutritionals peddles chocolate shakes and energy bars on its website.

Many Americans -- and dieters across the world -- loved the program's decadent appeal. No longer would they have to obsess about cutting high-fat foods for so-called lean cuisine. They could feast on meat and fats without guilt if they followed the Atkins diet. Pork rinds, prime rib and Camembert cheese were in; oranges, whole wheat bread and pasta were out.

Dieters who stuck to the regimen said they lost weight rapidly even as nutritionists warned about the negative long-term effects of eating high-fat foods.

The counterintuitive nature of the diet caught the public's imagination, said Barbara Rolls, a professor of nutritional science at Pennsylvania State University. "It just flew in the face of what we thought we knew," Rolls said.

But that didn't stop millions of Americans from embracing Atkins' principles. Up to 17% of the population reports having tried a low-carb diet at some point, according to NPD Group, a market research firm that tracks Americans' eating habits.

While the Atkins diet helped fuel demand for beef, chicken, cheese and other foods rich in proteins, the producers of carbohydrate-laden foods, even those regarded as healthful by nutritionists, saw sales fall.

Hurt by plunging demand for French fries, hash browns and baked potatoes, Idaho farmers have slashed their production by about 13% since 2002, said Frank Muir, chief executive of the Idaho Potato Commission.

"We have been working for years to send the message that the Atkins diet is wrong," Muir said, adding that a medium-size potato has only 100 calories and is rich in vitamin C and potassium.

Many large companies complained that they were casualties of the low-carb diet craze.

Executives at Interstate Bakeries Corp., whose cream-filled Twinkies have found a spot in the lunch boxes of American schoolchildren since the 1930s, said the low-carb trend contributed to its bankruptcy filing in September. A few months earlier, New World Pasta Co. -- maker of the Ronzoni and Creamette brands -- also filed for bankruptcy protection, saying it was hurt by the popularity of Atkins and similar diets. Even onetime Wall Street darling Krispy Kreme Doughnuts Inc. blamed Atkins for its financial troubles, which now appear to be a result of accounting rather than eating irregularities.

Like other diet fads, Atkins and the low-carb craze could not be sustained. NPD said the fad peaked early last year, when about 9% of the population reported that they were adhering to a low-carb regimen. By the end of last year, less than 4% reported following the diet, the firm said.

Mediterranean diet backed as a whole5 Peter Farley

A large-scale study has backed the health benefits of the Mediterranean diet, but indicates that it is the combination of foods, not any single ingredient, that is beneficial. The research, conducted in Greece, showed that the diet significantly prolongs life and reduces the risk of coronary heart disease and cancer.

Study leader Antonia Trichopoulou says that one simple guideline encapsulates the team's results: "Try to find recipes for vegetables cooked in olive oil as a main dish." She says this strategy is a sure-fire way to eat enough vegetables, reduce meat consumption, and realise the well-known health benefits of olive oil.

The Mediterranean diet emphasises vegetables, fruit, cereals, and olive oil. Dairy products and meat are consumed moderately, as is alcohol, usually in wine taken with meals. Fish is a staple in Greece and also has known health benefits, so it was included in the new study.

This diet has been touted by doctors and nutritionists for more than 20 years, but these recommendations have been based on small studies or on retrospective analyses of data originally collected for other purposes.

Apples to zucchinis In the new study, released on Wednesday, researchers from the University of Athens and the Harvard School of Public Health recruited over 22,000 healthy Greeks. They gave each person a score based on their usual intake of nine basic components of the diet: vegetables, peas and beans, fruits and nuts, dairy products, cereals, meat and poultry, fish, olive oil, and wine.

Based on other studies, the researchers presumed that most of these components were beneficial, and assigned a score of one for a component if a participant ate more on average than others of their sex and zero if they ate less. However, meat and dairy products were considered detrimental, and subjects received a score of one if they ate less. An aggregate score of nine therefore indicated adherence to the most healthful form of the diet.

The researchers tracked participants' health and mortality for an average of almost four years, and found a strong correlation between the subjects' scores and the likelihood that they would develop disease or die. For every two-point increase in a subject's score, there was a 25 per cent lower chance of death during the follow-up period, a 33 per cent lower risk of coronary heart disease, and a 24 per cent lower risk of cancer.

Complete diet But the correlations between the score for any one food component and the risk of disease or death was weak. This suggests there could be biological interactions among the diet's components that promote health, the researchers say, and they recommend using recipes that incorporate several healthful ingredients from the diet.

Walter Willett of the Harvard School of Public Health, says that the study is an important contribution, and agrees that complete diets, not ingredients, promote health: "You don't become Mediterranean by pouring olive oil on your steak."

Journal reference: New England Journal of Medicine (vol 348, p 2599)

5 Published on 6/23/2006 in the New Scientist. See http://www.newscientist.com/article/dn3879- mediterranean-diet-backed-as-a-whole.html Weight-Loss Winner: A Diet High in Fiber, Low in Calories6

By Coco Ballantyne

Some say the secret to losing weight is forgoing greasy, fatty foods like French fries; others swear that shunning carbs in favor of all-protein grub is key. Many popular weight loss plans recommend that dieters consume specific ratios of fat, protein and carbohydrates. (The Zone diet, for instance, prescribes 40 percent carbs, preferably complex carbs like veggies and whole grains, 30 percent protein and 30 percent fat). But a study published today in The New England Journal of Medicine suggests that the smartest way to lose weight is to eat heart healthy foods (think: Mediterranean diet—lots of veggies and fish, limited amounts of red meat) and reduce your caloric intake.

"Reduced calorie, heart-healthy diets can help you lose weight, regardless of the proportions of fat, protein and carbohydrates," says study co-author Catherine Loria, a nutritional epidemiologist at the National Heart, Lung and Blood Institute in Bethesda, Md.

The researchers, led by Frank Sacks, a professor of prevention at the Harvard School of Public Health in Boston, focused their study on 811 overweight and obese adults ages 30 to 70 in Boston and Baton Rouge, La. ("Overweight" includes those with a body mass index (BMI) between 25 and 29.9; people are considered obese if they have a BMI over 30. The BMI is a standard index used to gauge body fat based on a person's height and weight.)

The study subjects were divided into four groups, each assigned to a special diet. One group ate a "low- fat, average-protein" diet (20 percent fat, 15 percent protein, 65 percent carbs); a second consumed a "low-fat, high-protein" diet (20 percent fat, 25 percent protein, 55 percent carbs); a third followed a "high- fat, average-protein" diet (40 percent fat, 15 percent protein, 45 percent carbs); and the remaining group ate a "high-fat, high-protein" diet (40 percent fat, 25 percent protein, 35 percent carbs). All four regimens were heart-healthy (low in saturated fat and cholesterol) and included 20 grams (0.7 ounce) of daily dietary fiber. For each study participant, the researchers calculated personalized daily consumption levels ranging from 1,200 to 2,400 calories per day.

When the researchers measured the body weight of the participants at various points over two years, they found that all four groups were shedding roughly the same number of pounds over time.

"No matter which way you look at it, there were no [statistically significant] differences between any of the groups," Loria says. At six months, the average total weight loss for all of the groups was approximately 14 pounds (6.5 kilograms); by the end of two years that number had dipped to about nine pounds (four kilograms). "A lot of times in these weight loss studies, people tend to regain," notes Loria, adding that she will now study strategies that help people keep lost pounds off.

"This study dispels the long-held idea that a low-fat diet has an advantage over other diets," says Christopher Gardner, a nutrition scientist at Stanford University School of Medicine, who was not involved in this research. The only downside of this or any weight loss trial for that matter, he notes, is that people do not always stick to the diets assigned to them. (The study authors acknowledge that many participants failed to meet their target fat–protein–carb ratios, even though they were given regular counseling and feedback from nutritionists throughout the two-year period).

None of the individuals in the diet groups reduced their average carb consumption to less than 43 percent, including those given a 35 percent target, Gardner says, noting that tighter restriction of carbs

6 Published 2/25/2009 in Scientific American. See http://www.scientificamerican.com/article.cfm?id=diets- protein-carbohydrates-fat-fiber may have led to greater weight loss. "I would like to see the results of a study testing a diet that was about 30 to 35 percent carb, about 40 to 45 percent fat [and] about 25 percent protein," he says.

Another weakness of this study, according to Susan Roberts, a nutrition professor at Tufts University's Friedman School of Nutrition Science and Policy, is that it did not recognize the importance of fiber, which she refers to as "the up-and-coming weight loss factor." All four of the study diets called for 20 grams of daily fiber, which falls short of the daily intake recommended by the U.S. Institute of Medicine of approximately 35 grams (1.2 ounces) for men and 25 grams (0.9 ounce) for women.

Roberts says that studies she has led show that the more fiber one eats daily (up to about 50 grams, or 1.8 ounces), the more weight he or she is likely to lose. She speculates that is because fiber—which is found in veggies, fruit and whole grains— creates the sensation of fullness after eating by activating stretch receptors, nerve cells that are probably part of the group of signals sending the "I am full" message to the brain, in the digestive tract; it also slows digestion, extending the time that nutrients are dribbling into the blood stream from the intestine, which may lead to feelings of satiety. She notes that the average daily fiber intake in the U.S. is around 13 to 15 grams (0.5 ounce).

So what's the best way to slim down? "Focus on high-fiber, minimally processed, plant- based foods," Gardner says, "which translates into lots of vegetables, beans, nuts and seeds, whole grains, and fruits." Doctor Wants 'South Beach' To Mean Hearts, Not Bikinis7 By Alex Witchel

At the end of our two-hour lunch, Dr. Arthur Agatston shook hands, relieved. ''Thank you for not making me talk too much about food,'' he said.

Not quite what you would expect from the man who created the South Beach diet, but as he says repeatedly, he is not a diet doctor. He is a cardiologist who conceived the diet (along with Marie Almon, the former chief clinical dietician at Mount Sinai Medical Center in Miami Beach) to lower his patients' risk of heart attack and stroke -- not to help them look better in their bikinis.

Which is clearly a distinction without a difference to the general public. Since it was published last April, ''The South Beach Diet'' (Rodale) has gone back to press 23 times with more than 7.7 million copies in print. The trade paperback ''South Beach Diet Good Fats/Good Carbs Guide'' (Rodale) has 3 million copies in print. And yesterday 1.75 million copies of ''The South Beach Diet Cookbook'' (Rodale) went on sale. But if Rodale is suddenly fat and happy, Dr. Agatston is less so.

'I'm not Mr. Food, I've got to tell you,'' he stated uncomfortably. ''I love to eat. But I'm worried about people asking me details about different cuts of meat.''

That didn't concern me. His forbidden meats include brisket, liver, rib steak and prime rib, all of which I can live without -- now that I don't live with my mother -- if only a baked potato were allowed. It's not. Neither are white rice, bread, pasta and almost any dessert known to man beside ricotta cheese mixed with artificial sweetener, which to my mouth, if not my hips, is somehow not in the same league with Entenmann's Fudge Iced Golden Cake.

Leaving all fantasies of cake in the dust, I met Dr. Agatston at Bolo, 23 East 22nd Street, between Park Avenue South and Broadway, because its chef, Bobby Flay -- along with other restaurateurs in New York and Miami -- has provided a recipe for the new cookbook. His is called ''Spanish Spiced Rubbed Chicken With Mustard-Green Onion Sauce,'' which tastes better than it reads. Dr. Agatston, apparently uninterested in exploring the menu, ordered brick-roasted chicken with tarragon black pepper sauce and eggplant couscous with romesco sauce. The couscous remained untouched.

7 Published: April 14, 2004 in the New York Times. Retrieved from: http://www.nytimes.com/2004/04/14/dining/doctor-wants-south- beach-to-mean-hearts-not-bikinis.html?pagewanted=all&src=pm

''I went back on Phase 1 of the diet in January,'' he said, referring to the strict two-week induction period. This phase excludes all starches and sugars, which Dr. Agatston said cause the large swings in blood sugars that trigger food cravings. (One tablespoon of ketchup, for instance, has four grams of sugar while one Hershey's Kiss has three.)

For those who consider diets as mind-numbing as accountants on awards shows, here's South Beach as fast as I can: The low-fat movement of the last 20 years was a failure. We're eating too much processed food stripped of fiber and nutrients, and not enough omega-3 oils, which keep the heart healthy. The way to beat this system is to undergo the first two weeks of relative boot camp, essentially a high lean-protein diet (forget the butter and bacon of Atkins glory) with an assortment of vegetables and low-fat cheeses. But no alcohol, fruit or any of the aforementioned roads to nirvana. In Phase 2, you can add them in a measured way, while substituting whole grains for processed white flour, rice and pastas. Phase 3 is maintenance, a more lenient version of the same idea.

What really describes the plan best is Dr. Agatston's original name for it: the Modified Carbohydrate Diet. Not as glamorous as South Beach, but to the point.

''Even in the first two weeks you eat enough vegetables and salads that you don't go into ketosis,'' Dr. Agatston said, referring to the preferred state of ecstasy espoused in the Atkins diet where the body runs out of recently eaten carbohydrates and burns stored fat instead. Whether that harms you or helps you physically has been a subject of heated debate. But because the South Beach diet does not advocate it, Dr. Agatston seems to have escaped extreme criticism from the medical and nutritional establishments.

Dr. Marion Nestle, a professor and former chairwoman of the department of nutrition at New York University, said: ''I don't understand why it's gotten the attention it has. For the first two weeks it's a standard low-carbohydrate diet. It's very hard to argue with restricting bread, white rice, pasta, soft drinks, all great ideas when trying to lose weight. But the hype is he never talks about quantity. It's calories that make a difference in losing weight or not.''

Dr. Agatston responded: ''When choosing the right fats and the right carbohydrates, in general, the quantity takes care of itself. Weighing foods is not a lifestyle. Also, I'm not claiming any unique vision; I've learned a lot from other people. The diet is a consensus of current opinion. Whether you need to lose weight or not, this is the healthiest way to eat.'' At 57, he looks trim and healthy himself, taking an aspirin, fish oil capsules and a statin drug daily. Not that he has heart problems, he just spends every day with people who do. ''South Beach starts way after my bedtime,'' he said. ''The models are not my patients.''

Clearly, Dr. Agatston runs with a different crowd. Dressed in a crisp navy suit, blue shirt and tie, sporting a gold wedding band like a banner, he is the ultimate incarnation of ''my son the doctor.'' This is a man used to asking other people about themselves and their most intimate health concerns, and despite his year of fast fame, he still does not seem comfortable being the subject of others' scrutiny. His wife, Sari, a former lawyer who manages his South Beach industry, has prepared him to answer cookbook questions, though he much prefers talking lipids to lunch.

His blockbuster books aside -- the publishing equivalent of winning Powerball -- Dr. Agatston remains very much who he has been these past 20 years, an associate professor of cardiology at the University of Miami School of Medicine. A native of Roslyn, on Long Island, whose father and grandfather were both eye doctors, he graduated from medical school at New York University and completed his residency and internship at Montefiore Medical Center in the Bronx. He did a fellowship at N.Y.U. before relocating to Miami, where he developed a heart scan using an ultrafast CT scanner. He likens it to ''a mammography of the heart.''

''I knew right away that the calcium in the arteries reflected the amount of plaque,'' he went on. ''The measure of coronary calcium is called the Agatston Score and the protocol for calcium screening is called the Agatston Method. That was all the celebrity I needed or deserved. My background is academic, and advertising and glitz was not what I was thinking of.'' He smiled ruefully. ''My wife says people in South Beach don't care when they die just so they're thin when they do.''

Indeed, it is the women on his diet, he said, who make him crazy. ''They lose weight and look absolutely fine to me, but they say, 'No, I need to lose an inch more here,' '' he said, shrugging. ''We claim to take off bellies but we don't body sculpt,'' he went on. ''If the blood chemistry is good, the rest is a cultural problem, not a health problem.'' His tone was firm. ''And it's not my problem.''

It was Dr. Agatston's own belly that got him started on the diet track. He was always thin, he said, but despite his avid golfing, middle age -- and Wheat Thins by the box -- caught up with him. ''What you want is nutrient density, fiber and some good oils,'' he said. ''My basic message is, everything in moderation. It does come down to calories in, calories out.'' Which was the perfect moment for the dessert menu to arrive. He perused it and offered to share one -- Human Weakness, Up Close and Personal! -- but, you should excuse the expression, his heart just didn't seem in it. We settled for decaf cappuccinos, instead.

He talked about some of the benefits of his newfound celebrity and wealth: the creation of the Agatston Research Institute, dedicated to research in nutrition and education in heart attack and stroke prevention, and which includes a new imaging center.

He has turned down business offers like endorsing outdoor grills, but he is talking to food companies about starting a line of South Beach meals with lean meats, vegetables and added omega oils. ''A food line is an opportunity to educate the public,'' he said.