By Maureen Callahan, M.S., R.D
Updated: April 18, 2008

With appearances on public television, 20/20, and Oprah, Nicholas Perricone, MD, is fast becoming one of the country's most visible skin doctors. Initially, his advice in such best-selling books as The Wrinkle Cure (Warner Books, 2001) and The Perricone Prescription (HarperCollins, 2002) centered on keeping skin wrinkle-free and halting aging. Now the Connecticut dermatologist hints that weight loss could be an unexpected benefit of his eating plan. While this former professor at Yale University School of Medicine doesn't actually dish out specific weight-loss strategies in The Perricone Promise (Warner Books, 2004), he suggests that those who follow the 28-day menu plan are likely to lose weight. Wrapped up with Perricone's diet advice is a big plug for an arsenal of his special supplements and skin treatments, some of which cost close to $600 each.

It's enticing to think that eating specific foods, popping supplements, and applying special skin creams can not only make you look and feel 10 years younger but also might peel off unwanted pounds. Yet Perricone fails to back up his nutrition-and-skin-care regimen with any published clinical trials that show it actually works. Don't be fooled by the long lists of references he provides in his books, say critics, since the bulk of these studies don't directly support Perricone's promises. Ditto for the before-and-after pictures of clients; photos aren't scientific evidence. Even if you think you see a difference in the "after" photos-and believe us, it's hard to notice one-critics say the change in skin tone could be due to lighting, makeup, or even positioning (the face has fewer wrinkles if you're lying down.) On a side note, while Perricone was once affiliated with Yale University School of Medicine, school authorities there are critical of both his books and his theories.

Basic principles:

Perricone believes inflammation is the root cause of aging and all the ills that go with it, including wrinkles, heart disease, and cancer. He theorizes that the two major causes of inflammation are diet and stress, both of which can be improved and relieved with his three-step program. Those three steps include a diet jam-packed with antioxidant-rich foods, supplements, and skin creams. Antioxidants, he says, suppress "bad" neuropeptides, chemicals that accumulate in the body and promote inflammation.

How the diet works:

Everyone follows the same 28-day eating plan. Menus spell out specific serving sizes and call for cooking several of the book's recipes each day. The idea is to eat whole foods (whole grains, legumes, vegetables) that are rich in antioxidants. Highly processed, sugary, or fried foods like soda, pastries, and candy are avoided since they promote inflammation. Eight to 10 glasses of water a day are a must.

What you can eat:

A lot of wild salmon; this fish is listed frequently on the 28-day menu, including two breakfast meals. Perricone also emphasizes 10 "superfoods": garlic (along with onions and similar foods), barley, cereal grasses, buckwheat, beans, hot peppers, nuts, sprouts, yogurt, and a tropical fruit called açai that's typically sold frozen in many health-food stores. His rule of thumb: The richer in color a fruit or vegetable, the more antioxidants it contains.

Does the diet take and keep weight off?

Hard to say. Perricone suggests weight loss could be an unexpected benefit of his antiaging diet, but he offers no proof, not even the anecdotal kind.

Is the diet healthy?

Probably. The doctor encourages healthful foods like fruits, vegetables, nuts, olive oil, and seafood and discourages sugary, fried, and processed ones.

What do the experts say?

It's a mixed bag of eating and skin-care advice, some of it good and some of it questionable. Karen Burke, MD, a spokeswoman for the American Academy of Dermatology and a dermatologist at New York's Mt. Sinai Medical Center, thinks Perricone's advice about staying out of the sun and eating fish oils is good for the skin, but she's skeptical of other recommendations. Take the advice he gives to eat large quantities of salmon for a few days in order to plump up skin and erase wrinkles: "That's virtually impossible," Burke says. "Collagen in the skin takes at least three weeks to regenerate." Moreover, she adds, "there's no nutrient that can change your skin in anything less than 4 to 6 months." As for the idea that antioxidant-rich foods and pills influence aging, that's also tricky to pin down. "Research with antioxidant supplements like beta-carotene and vitamin E has not been very favorable lately," says registered dietitian Kathleen Cappellano, nutrition-information manager at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. "Typically, it's diets that are high in fruits and vegetables and whole grains that have been associated with decreased risk of age-associated diseases like heart disease and cancer." It's not single "superfoods" or pills, but the quality of the diet as a whole that seems important to healthy aging, she adds. Cappellano suspects Perricone may be right about his diet promoting weight loss, though, since the menus are restrictive and fattening items like pastry, sugary sodas, and fried foods are all taboo.

Who should consider the diet?

Dieters with deep pockets. Between the money shelled out for gourmet groceries, 17 different supplements, and pricey skin treatments, this is one high-cost regimen.

Bottom line:

Following the plan isn't harmful since the foods Perricone recommends are healthful ones. There's just no guarantee that eating this way will produce weight loss. It might not improve skin tone or minimize the effects of aging either.
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