The HEART of the MATTER

The Florida sun streamed into Dr. Arthur Agatston's swanky South Beach office as we chatted over a meal straight out of his bestselling first book.

While in the Sunshine State a few weeks ago, I visited Agatston at his cardiology clinic. Decorated with swirling marble and ebony hardwood, the office -- located in Miami's art deco-influenced South Beach district -- lives up to its glamorous location.

Agatston is known to most as the author of the South Beach Diet, the diet that former president Bill Clinton followed while preparing for his heart bypass surgery.

Even after six years, Agatston's eating plan -- which limits bread intake and touts healthy fats and carbs -- is still the talk of south Florida. The menus of some of the trendiest restaurants there tout options proclaiming to be South Beach Diet-friendly.

Here's what Agatston, who recently released The South Beach Diet Supercharged, had to say about diet, health and the heart:

FP: What role do carbs play in heart disease?

Agatston: It's the processed carbohydrates more than the bad fats that cause the epidemic of obesity because when you have white bread instead of whole grain, it's absorbed faster. When you have fibre with whole-grain bread, it slows the digestion so your glucose goes up slowly and it's a while before it comes down and you're hungry again. When you just take the fibre out and have white bread, it goes up faster and it comes down faster. It just gets into your bloodstream faster and causes a bigger insulin response... so you're hungrier sooner.

FP: Which would you choose: A piece of white bread with no butter or a piece of brown bread loaded with butter?

Agatston: Up against a wall... probably the brown bread with butter. That's the way we ate for centuries, in a sense. There was lard and all that, but people were not obese.

FP: Do kids need to worry about their heart-attack risk?

Agatston: It's not just heart-attack risk... so much of immune response is associated with belly fat. We were never meant to be walking around with big bellies. What we're really doing is pouring out these inflammatory chemicals which are really hurting normal tissue. Alzheimers, macular degeneration, many forms of cancer are all associated with the same metabolism. What's healthy for your heart and blood vessels is for your eyes, for your brain. In kids who are becoming pre [Type 2] diabetic, you can measure differences in the thickness of their carotid arteries even when they are pre-teens.

FP: Do you follow your own diet?

Agatston: Yes. I was frustrated initially because on the low-fat diet I was getting fatter. I always remember one of my cardiology fellows when I was telling him about some of my athletic exploits and said I was an athlete. He looked at me and was laughing. I said, 'What are you laughing at?' He said, 'Look at your belly.' I definitely have the predisposition.

FP: What are you eating right now?

Agatston: This is grilled salmon and veggies. This is not just for you, I do this a lot... I have this several times a week. I'm very good in my base eating habits.

FP: Are there misconceptions about your diet?

Agatston: Because it has the glitzy name, there's sometimes the assumption that it's a fad diet or that the science isn't there.

FP: How do you feel about the Atkins Diet?

Agatston: In (Dr. Robert Atkins') last book before he died, he was talking about the glycemic index and good carbs. I think he should have been taken more seriously.

FP: Did you know him?

Agatston: He called me to meet him. We had a very nice lunch. And then I saw him at some meetings. He was always very friendly.

FP: Do you remember what he ate at that lunch?

Agatston: Yes. He called it an Atkins burger. It was a cheeseburger without the bun. And he cheated on the french fries.

FP: Is there a big difference between the South Beach Diet and the Zone?

Agatston: The principals are the same and I have a lot of respect for Barry Sears. It's just the idea that you need a fixed percentage of carbs, protein and fat is where I disagree. There are successful societies -- as far as weight and heart disease and general health -- with really different percentages.

FP: People are afraid of fat in general. Do you find that's the case?

Agatston: We all need more omega-3 in this country. We get too much omega-6, which is what we get from grains, corn oil and that type of thing. My wife has osteoarthritis -- her fingers get stiff. When she increases her omega-3, it goes away.

FP: What supplements do you take?

Agatston: Only omega-3.

FP: What are the top things people can do right now to protect their heart health?

Agatston: Exercise. You need some high-intensity exercise... with interval exercise you burn more calories in less time. And even with an equal number of calories, you burn more fat. You change your metabolism. You improve your insulin and improve your sugar metabolism. Exercise -- including high-intensity interval exercise -- is the No. 1 thing that's good for the heart.

Have an interesting story idea you'd like Shamona to write about? Contact her at shamona.harnett@freepress.mb.ca

Republished from the Winnipeg Free Press print edition March 2, 2009 D1