Book Review: "The South Beach Heart Program: The 4-Step Plan That Can Save Your Life"

Wednesday, May 23, 2007 - 10:35am

By Katie Clark, MPH, RD

While most health-conscious Americans are familiar with Dr. Agatston's 2003 best-seller The South Beach Diet, many are unaware of his expertise in the field of cardiology. In The South Beach Heart Program, Dr. Agatston takes the reader on a whirlwind tour of the human heart and the numerous tasks needed to keep it healthy. He addresses a multitude of factors that increase risk for heart disease and provides straightforward recommendations for maximizing prevention.

Building a Broad Base

Do not be misled: This is not a diet book. Rather, it is a comprehensive, quick and dirty overview of the necessity for preventive medicine in the management of heart health. While the title may indicate otherwise, this book is not intended for a small, niche population personally affected by heart disease. The appeal is much more widespread:  You and your grandma can both get into this one.

The original South Beach Diet continues to have far-reaching success because of its broad appeal base and inspiring, documented weight loss outcomes. Bill Clinton and Oprah did it...but so can you! The broad appeal factor this time around is a little more sobering than vanity and weight loss: Heart disease is the number one killer of Americans, and it is the author's opinion that something can and should be done about preventing it.

An Ounce of Prevention

Dr. Agatston is a preventive cardiologist, an unusual but admirable spin on the traditional curative approach to heart health endorsed by many of his colleagues. While the extent of other diet and health books' preventive advice is "eat less, exercise more," The South Beach Heart Program takes prevention a few steps further.

The entire first half of the book is dedicated to familiarizing the reader with the history of heart disease management and the pathophysiology of various diseases of the heart. Dr. Agatston has an exceptional ability to communicate complex concepts in laymen's terms; that is evident in these introductory chapters. He explains the importance of going beyond the standard lipid panel for heart attack risk assessment and explains the various diagnostic procedures and tests he considers paramount to a comprehensive cardiac workup.

The second half of the book, The South Beach Heart Program, is split into four distinct steps: diet, exercise, diagnostic tests, and medication. The diet portion is a brief review of the three stages of the traditional South Beach Diet, with a few sample menus and food lists. The following exercise section is rather uninspiring, but it gives way to what is by far the best feature of the book-a straight-talk overview of what diagnostic tests to get and what medicines are available should you be at increased risk for heart attack or stroke.

The Focus on Food

The South Beach Heart Program is unique among books written by physicians because it emphasizes food and prevention - not pills and cures - as the primary way to manage disease. The food-based advice is not entirely new. The book carefully toes the National Cholesterol Education Program nutrition guidelines: Reduce saturated fat, eliminate trans fat, and increase fiber and omega-3 fatty acids for optimal heart health.

If you are looking for a beefed-up version of The South Beach Diet, this book won't offer you much. It is largely a cut-and-paste job, retaining the first phase exclusion of bread, pasta, and rice so notorious of its predecessor The South Beach Diet. The two subsequent phases also revisit the original South Beach Diet and just like the first time around, are more nutritionally well-balanced and realistic alternatives to the overly restrictive first phase.

Great...But What About My Doctor?

While Dr. Agatston puts professional emphasis on prevention, the book fails to acknowledge that not all other cardiologists do. It is disappointing to note the exclusion of any mention of referral to a Registered Dietitian as a component of an effective heart disease management program. Readers are almost left to educate themselves about some of the more intricate nutrition principles of heart disease risk management. There are limited two-day menus for Phases 1 and 2, but the entire non-menu nutrition text constitutes only a slim 24-pages of the book.

While the food information in the book may be brief, there is no doubt that it is sound. The tried and true methods for reducing triglycerides, LDL, and blood pressure through diet are clearly spelled out. The author does a nice job linking dietary intake with the expected effects on lipid lab values and wisely points out the limitations of dietary supplements.

Medicine for the Mindful

A nice feature of the South Beach Heart Program is that the book is peppered with vignettes of historical scientific studies and publications that have affected the state of cardiology care and medicinal therapy today. Everything from the Framingham Heart Study to the recent cautionary vitamin E results is broken down in concise, readable summaries.

While this historical information and the explanation of the various classes of drugs to treat heart disease may be more than the average American wants to know, it should be more commonly known and is quite applicable for the millions of Americans affected by heart disease.

Dr. Agatston's passion for preventing heart attack and stroke is evident in The South Beach Heart Program book. His patient case studies, years of experience, and impressive publication record substantiate his preventative approach to heart disease management. This approach is summarized in a concise and easy to read manner. The South Beach Heart Program is highly recommended reading for all Americans affected by or interested in preventing heart disease.