Dr. Alan R. Koslow has seen the effects of obesity from the inside. A cardiovascular surgeon who recently left the Iowa Heart Center, he’s performed more than 300 major operations, many of which could have been prevented through dietary adjustments.

Ninety-five percent of Koslow’s patients were obese, diabetic or both. “I wanted to help people with dieting and controlling diabetes,” he said.

So he’s taken a year off from the practice of medicine to open Piques Diets and Desserts at 2687 86th St. in Urbandale’s Westmark II shopping plaza. The store, a combination grocery store and dessert and coffee bar that features an array of diet-friendly sweets, opens April 15, though the official grand opening isn’t until May 14-16.

His new business will open on the heels of a report earlier this month from the Centers for Disease Control that said obesity is expected to become the leading cause of preventable deaths in the nation by 2005. The CDC believes obesity’s toll will reach 500,000 deaths next year, surpassing those related to cigarette smoking.

“We have a health crisis on our hands,” said Koslow, whose business venture reflects the surgeon’s shift in priority from treating the results of obesity to helping to prevent it.

The 2,000-square-foot store will be staffed by two licensed dieticians who tailor diet plans to meet individual customers’ needs. Koslow said he decided to employ the dieticians, who must attend three years of college, serve a one-year internship, pass a national proficiency exam and obtain certification from a state licensing agency, because they can give customers the reassurance that the selected diets are medically sound. Referral to a dietician by a physician for weight or diabetes control is also covered by most insurance policies, while the services of a nutritionist – a profession requiring no formal training with certification available through myriad sources — are not.

Koslow said Piques Diets and Desserts fills a niche in the growing diet market. As he developed his business model, he discovered a menagerie of health food and nutritional stores whose shelves were stocked with supplements and unproven treatments that were geared not for weight loss, but for people who want to eat healthfully. He also found branded stores offering products that are, for example, “Atkins-diet-friendly,” businesses offering both diet products and weight-loss counseling, and, of course, doctors’ offices.

“Not every customer out there fits a particular diet,” said Koslow, adding that Piques’ dieticians in some cases may meld two different diets together to fit an individual customer’s needs.

Upscale in its design, Piques Diets and Desserts will feature a floor-to-ceiling waterfall, a pair of 24-inch television screens flashing “eye-candy” messages instead of programming and a cozy book nook for reading. On the retail side of the business, floor-to-ceiling shelves will be filled with a melange of foods for specific diet plans, be they low-carbohydrate, low-salt or gluten-free foods. As many as 90 ready-to-heat meals, some of gourmet quality, will also be offered.

In the back of a store is a fix for one of the common self-sabotages associated with dieting. “What most people miss when dieting is desserts and sweets,” Koslow said. A variety of upscale ice-creams and desserts will satisfy that craving without compromising success with a diet, he said.

Koslow plans to open two more such stores in the metro area within a year. He’s also working on franchising the concept nationally.