What's So Hot About South Beach?

Hillary Clinton is said to have lost weight using the South Beach Diet
Hillary Clinton is one of those said to have shrunk themselves with this diet.

By Elena Serocki, DietPower Senior Editor

Bill Clinton is on it. Hillary's on it. Even Oprah claims to have tried it (but then, she also tried the Hot Dog, Banana, and Egg Diet). Yes, the South Beach diet is on everyone's lips, and chances are you know at least one person who's raving about it. Some of what they say is true.

It started by accident. Arthur Agatston, a prominent Miami Beach cardiologist, was worried about his overweight patients' getting heart attacks and strokes. To lower the risk, he referred them to the conventional low-fat, high-carbohydrate diets recommended by the American Heart Association. Trouble was, the diets weren't working. They were too rigid and hard to stick with. To make matters worse, many patients following these diets were gaining weight, and their cholesterol and blood sugar levels were rising.

Good vs. Bad Carbs

Dr. Arthur Agatson
Dr. Arthur Agatston invented the South Beach diet. (Photo from www.amarillonet.com.)

Agatston decided to create his own diet based on his theories about the "glycemic index," which ranks carbohydrates according to how quickly they affect your blood sugar, or glucose—the fuel that powers your cells. Foods high on the glycemic index turn to glucose quickly. When you eat them, your pancreas releases a flood of insulin, which is needed to sweep the glucose out of your blood and into your cells. As Agatston and other glycemic-index proponents explain it, when your blood glucose level drops, you start feeling hungry again. Even if you have the willpower of a U.S. Marine, you can't help wanting to eat more. These rapidly digested foods, which Agatston calls "bad" carbs, include white bread, white potatoes, pretzels, corn flakes, graham crackers, rice cakes, donuts, and soda.

Low-glycemic foods are digested more slowly. Since they cause a smaller rise followed by a slower decrease in blood sugar, you won't feel hungry right away, says Agatston. "Good" carbs include milk, apples, artificially sweetened low-fat yogurt, lentils, and chickpeas.

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The key to better health, according to Agatston, is to control your blood sugar by eating the right types and amounts of carbohydrates—to seek "good" carbs and shun "bad" ones.

A study of people who tried the new diet showed that they had achieved Dr. Agatston's main objective: improving insulin and cholesterol levels. But the heart doctor also noticed that these folks were experiencing dramatic weight loss.

Agatston presented his findings at a medical conference, and news of his success spread quicker than waistlines at a pig roast. The doctor named his diet "South Beach" after a popular local hangout, and last spring he published the book The South Beach Diet: The Delicious, Doctor-Designed Foolproof Plan for Fast and Healthy Weight Loss. Even though the title took up an extra line on the bestseller list, it has remained there for months.

The South Beach Diet is broken down into three phases:

Phase One...

...is a two-week boot camp. At first glance it sounds quite reasonable: You eat three balanced meals a day, with normal portions of lean meat, chicken, turkey, fish, and shellfish. Vegetables, eggs, cheese, and nuts are permitted, as are coffee and tea. Salads with olive-oil dressing may accompany your meals. Other "good" fats, such as canola and fish oils, are also acceptable. You're urged to eat mid-morning and mid-afternoon snacks, whether or not you want them. And you can even have dessert after dinner.

Now here's the hard part: During phase one, you are forbidden to eat bread, rice, potatoes, and baked goods such as cake and cookies. No candy or ice cream. Fruits and sugar are also banned. Alcoholic drinks? Forget it. (Basically, all the stuff you love is off limits.)

Download DietPower free trialThe objective of this first phase is to banish your cravings for processed carbs and sweets, which Agatston says are the real culprits behind weight gain. But the doctor promises that your body will gradually and painlessly adjust to being without these foods, and that you won't feel hungry all the time.

If you survive these 14 days without hanging yourself, you will enjoy a noticeable change when you step on the scale: typically a loss of 8 to 13 pounds. Most of the loss will be belly fat, so it will easier for you to zip up your pants and button your shirt. (The drawback is you'll find it harder to attach your navel ring.) This will give you a big psychological boost, making you feel good about the money you spent on Agatston's book.

During Phase Two...

...you reintroduce some of the forbidden foods back to your diet, in moderation. You can choose bread, potatoes, rice, pasta—whatever you like—but not all of them. You are permitted a limited amount only. Moreover, the foods you add will be "good" carbs, whole-grain versions (bread, pasta, rice) of the products you enjoyed before.* Agatston says you'll lose one to two pounds a week throughout this phase, which continues until you reach your target weight.

* Despite what many South Beachers believe, there's nothing magic about whole grains—they simply contain more fiber and certain other nutrients than their processed counterparts.

Phase Three...

...is the maintenance phase. You add even more of the foods that were banned and, Agatston notes, you'll continue to eat more sensibly with your new understanding of how various foods contribute to weight gain. By this time, he says, "the plan feels less like a diet and more like a way of life." This part of the diet is yours to have and to hold until death do you part. But from time to time, says Agatston, you may find yourself returning to phases one and two to get back on track.

Download DietPower free trialIs South Beach safe for everyone? "I hate to tell people they must consult a doctor before starting a diet, because most people don't have that kind of relationship with their doctor," says Ann Coulston, an authority on carbohydrate and fat metabolism who has conducted clinical research at Stanford University Medical Center.** "But people with any known medical condition, such as heart disease, diabetes or kidney disease, should see a doctor first. Also, I wouldn't recommend a low-carbohydrate diet for women who may not realize they are pregnant."

** Coulston, a former president of the American Dietetic Association, serves on DietPower's scientific advisory board.

An Atkins Knockoff?

People who've tried South Beach give it mixed reviews on message boards. Proponents praise the fast, impressive weight loss in the first couple of weeks. Critics call it merely a takeoff on the Atkins Diet. Others find it impractical because of the diet's many complicated recipes that must be cooked at home (spinach quiche for breakfast, for example), and take-along snacks that need refrigeration. Still others wish the book focused more on exercise, an important factor in weight loss. And some scientists disagree with Agatston's interpretation of the glycemic index, claiming that a food's index differs with the amount eaten and what is eaten with it.

"There is controversy about whether the glycemic index is clinically useful," says Dr. Frank Hu, associate professor of nutrition and epidemiology at the Harvard School of Public Health. Low-glycemic foods may reduce weight short-term, he says, but whether they help in the long run is unknown. "My feeling is that the glycemic index is useful," says Hu, "but it's only one aspect. People must also consider healthy types of fats, protein, adequate fruits and vegetables, and omega-3 fatty acids."

The South Beach Diet

In addition to laying out the diet itself, The South Beach Diet discusses the basics of weight loss, food components, popular diets, the science behind Dr. Agatston's diet, and tips for eating out. It provides readers with meal plans and recipes from some of Miami's top chefs. The book is published by Rodale and has a list price of $24.95, but you can get it from Amazon for considerably less.

The book has a web companion, South Beach Diet Online, which includes interactive features such as chats and Q&A sessions with Agatson and nutritionists, customized meal plans and shopping lists, and a "beach buddy" program that pairs you with a dieting partner. Membership costs $5 a week.

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