Diet

I can't decide which event was the most traumatic for me, my heart attack or my bypass surgery. But either way, ever since the heart attack, I've been fairly conscious of my diet. Perhaps not as conscious as I should be, but I've tried to eat in a relatively sane way that would simultaneously cause me to lose weight and cause my cholesterol levels to move toward healthier levels (my numbers are 190 total cholesterol and 117 LDL, which were better than I expected. Still, the targets for people in my boat are pretty aggressive, so I started taking simvastatin and Zetia to get them to <170 and <70 respectively).

But as powerful and effective as modern drugs are, diet still plays an important role (one imagines, anyway). So my wife and I went on the South Beach diet on Monday. We happened to see a book called The South Beach Heart Program that contained a lot of useful and interesting information on coronary artery disease. It made its case so convincingly that after reading it and The South Beach Diet we went on the diet.

We're about at the end of the first week of Phase 1, the strictest part of it. A great many things are permissible on the diet, but a great many things are also banned, including anything that would make for a convenient breakfast. No cereal, no muffins, no bagels, no instant oatmeal, no flavored yogurt, no fruit juice, no fruit. Breakfast options generally come down to two things: eggs, or meat. Or eggs and meat, I guess. Not that this is a problem with my taste buds, but it suddenly turns breakfast into an undertaking. That's my only real complaint with the diet so far, that breakfast preparation has become time-consuming and messy. And one could argue that that's not a problem with the diet but with my own faulty application of cooking science.

Still, the diet works. I don't weigh myself every day because my bathroom scale is a notorious liar. It seems to delight in being wrong, and it's often wrong by quite large amounts. As much as I'd like to believe I really weigh seven pounds, I'm pretty sure it's just the scale messing with my head. I gauge my weight by sensing the tightness of my belt, and the belt's testimony is clear: I'm shrinking.

But I knew I would. My wife and I did the Adkins diet four or five years ago, and we stayed on it for a couple of years and lost tons of weight. I can't remember what my total weight loss was, but it was close to 100 pounds. Unfortunately, we didn't stay on the diet permanently and the weight came back and invited some of its friends along for the ride. And, though I can't prove anything, I can't help but wonder whether all that bacon had anything to do with my heart attack. I honestly don't know and I didn't have my cholesterol tested often enough to know what direction it was headed in.

The author of the South Beach diet is pretty adamant that it isn't a "low-carb diet". He prefers to call it a "good-carb diet". But if you compare it to the Adkins diet, you'll see that it's in the same general category, with a strong emphasis on eliminating "empty" carbohydrates and little or no emphasis on "counting calories" in the traditional sense - once you eliminate the empty processed carbs and bring your insulin levels under control, portion size will work itself out automatically.

South Beach differs from Adkins in several important respects, however. One is that Adkins turned a blind eye to fat consumption. If you wanted 83 pounds of bacon in one day, good on you! As far as Adkins was concerned, one fat was about as good as any other. But South Beach is more sophisticated in its handling of fats. Some, like olive oil and canola oil, are encouraged. Others, like animal fat, are tolerated but discouraged. Others, like palm oil and triglycerides, are excommunicated entirely. So while you can have bacon on the South Beach diet, you're expected to demonstrate a little mature restraint and call it quits at two or three pieces, not two or three packages.

Another difference is that the South Beach diet has more wiggle room in what it permits. Cereal and milk were pretty much grub non grata on Adkins, but you can eventually start adding cereal and milk back into South Beach, so long as the cereal isn't reinforced with sugar and the milk is low-fat. This is a boon to people like me who aren't necessarily at their most productive first thing in the morning and for whom cooking a breakfast of steak and eggs at 6 AM isn't a major life goal.

But fundamentally they're about the same things and point at the same basic metabolic fact - that "white carbohydrates" are bad. And unfortunately, white carbohydrates are addictive and convenient so you have to give something up to lose weight and improve your health. For me, it was always the convenience angle that was most difficult. I'd be on my way home from work, tired and drained and hungry, and I'd think "We can cook something at home and fight with pots, pans and cutting boards, and have to clean the stove and wash the dishes, or I can just stop at Taco Bell." That was what eventually did in the Adkins Diet for us, we got lazy and started buying food that was easy, and food that's easy is almost always bad. And once you start down that slope, it takes a conscious decision to stop. We didn't.

And so now I have coronary artery bypasses and a patch of damaged heart muscle, but I like to think that I have a more advanced understanding of myself now. And I think South Beach is something I'm going to be able to stick with and turn into a lifestyle. The alternative is another heart attack.