Ask Dr. Salerno The Silver Cloud Diet

Dr. Salerno’s Response to NY Times Article on Diet

This is Dr. Salerno’s response to a recent article published in the NY Times by Dr. Ornish. You can read Dr. Ornish’s article by clicking here.

Dear Dr. Ornish,

As the New York City physician who assumed the practice of Dr. Atkins upon his passing, I respectfully submit my own opinion, in reply to your essay, “Eating for Health, Not Weight,” featured in The New York Times, Sunday, September 22, 2012. (I am Dr. John Salerno, a practicing M.D. and author of Silver Cloud Diet, a book building upon the Atkins concept while also stressing the importance of organic and natural foods.)

As the physician who continues to treat many of Dr. Atkins’ former patients, and as a scientist with access to all of the data from hundreds of Atkins patients, I feel compelled to correct the record regarding the Atkins program, while addressing your other references to the Atkins Diet.

A significant percentage of Dr. Atkins’ patients remain active and vital, many having aged well into their 90’s. We are in possession of extensive data generated from hundreds of Atkins patients, followed over decades. Our data shows conclusively that Atkins patients always experience decreases in CRP (C-reactive protein) and in inflammatory markers – never increases, as you had suggested.

While the evidence of cardiovascular disease reversal from patients on your diet seems impressive, one must also question whether such results might be attributable to the exercise and stress management elements of your program, versus to the diet itself. Studies have shown that exercise and stress management, on their own, have been shown to achieve these same positive results: reversal of heart disease, improved circulation, and reduction in Type II diabetes. Also, your positive results cannot be taken out of context to serve as a commentary on the efficacy or safety of the Atkins diet.

In fact, the efficacy of the Atkins program has been documented in at least one other major study, featured in the JAMA (The Journal of the American Medical Association) in 2007. This study involved 311 overweight premenopausal women, divided into 4 groups pursuing Atkins, Zone, Ornish, and LEARN diets, respectively. As documented in the JAMA article, the Atkins diet group enjoyed results superior to those of every other group, including those on your program, across every major risk category. Specifically, outcomes were assessed after 2, 6, and 12 months, with measurements for insulin, cholesterol, triglycerides, systolic, diastolic, blood pressure, and glucose levels all significantly better for Atkins patients than for patients in any other group. Further, Atkins patients exhibited improvements in HDL levels (HDL is the “good cholesterol,” in layman’s terms) 5x higher than those of Ornish patients, and Atkins patients achieved roughly double the weight loss successes of the Ornish patients.

The Ornish diet requires extreme deprivation, thus compliance is difficult in the absence of a controlled environment, reducing the chances for long-term success. In contrast, my program, the “Silver Cloud” diet, and its predecessor, the Atkins program, promote the consumption of healthy fats, not just for their nutritional value, but also for their ability to induce satiety and reduce overall caloric intake. Because my patients are not hungry, they are able to reduce calories successfully. As a result, my patients enjoy the enhanced telomere length and increased longevity also promoted in your program.

Another study cited in your article, the Howard-University-sponsored Health Professional Study, employs faulty methodology. This study of 37,000 claims to show increased risk of premature death associated with the consumption of red meat. However, the British Journal study never qualified the types of carbohydrates consumed, and it ignored the consumption of trans-fat. For instance, the study did not examine the effects of consumption of “French fries” and bread eaten in conjunction with red meat. French fries and bread are correlated with increased cardiovascular risk, because they contain carbohydrates and trans-fats, both causative agents for cardiovascular risk. Neither study involved the use of grass-fed organic meats, which is critical because hormones and pesticides used in livestock farming also have negative long-term effects on patient health.

Finally, I address your discussion of increased metabolic rate for Atkins-based diet patients. The Honorable Dr. Ludwig of Boston Children’s Hospital has shown this year, in a landmark study, that reductions of carbohydrate consumption result in increases in calorie expenditures by patients. Dr. Ludwig explained that subjects eating low-fat or low-glycemic diets expended 150 to 300 calories less than did Atkins patients. In other words, Ornish patients must perform an additional hour of exercise per day, relative to Atkins patients, just to maintain parity in terms of metabolic rates. What is so wrong with increasing metabolic rate if it means losing weight and maintaining it, without using harmful drugs?

I close with a general comment about the consumption of complex carbohydrates. Any medical expert (or layman) might appreciate the negative effects of eating high-carbohydrate foods, including complex carbohydrates, by considering the following scenario. Feed a Type II diabetic whole wheat pasta and vegetable bean soup, then measure blood glucose levels an hour later. Blood glucose levels will spike after eating then fall precipitously for diabetic patients, due to their lack of ability to regulate insulin production. While non-diabetics have fewer problems with insulin regulation, the need to produce more insulin nonetheless taxes the body. In short, the Atkins program works.