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The South Beach diet is a popular short-term fast-weight-loss diet combined with a long-term calorie-controlled diet. The South Beach diet sets itself apart form several other popular diets by differentiating between ‘‘good carbohydrates’’ and ‘‘bad carbohydrates’’ based on their glycemic index and ‘‘good fats‘‘ and ‘‘bad fats’’ based on their degree of saturation.
Arthur Agatston, the originator of the South Beach diet, is a medical doctor. He is has a cardiology practice that emphasizes disease prevention and is an associate professor at the University of Miami Miller School of Medicine in Miami, Florida.
Agatston first developed the South Beach diet for his obese cardiac patients who were having trouble staying on the standard low-fat diet recommended by the American Heart Association. After these patients had success with his diet, Agatston began promoting the diet to the public, shifting the emphasis away from heart health and toward rapid weight loss. In 2003, he published The South Beach Diet: The Delicious, Doctor-designed, Foolproof Plan for Fast and Healthy Weight Loss.. Television coverage boosted the popularity of the South Beach diet, and in 2004, Kraft Foods entered into an agreement that allowed it to use the South Beach diet name on line of foods that were nutritionally compatible with the diet.
The South Beach diet is part a fast-weight-loss diet and part a calorie-restricted, portion-controlled long-term diet. Agatston says that the South Beach
(Illustration by GGS Information Services/Thomson Gale.)
diet is neither a low-carbohydrate nor a low-fat diet, although it restricts both these food groups.
The South Beach diet is divided into three phases. Phase 1 lasts the first two weeks of the diet. During this time Agatston claims that people can lose up to 13 lb (6 kg) on the diet, and that they will lose mainly belly fat. Phase 1 eliminates all carbohydrates, both ‘‘good’’ and ‘‘bad’’ from the diet. This means that the dieter eats no bread, pasta, rice, potatoes, fruit, milk, baked goods, ice cream, alcohol, anything containing sugar or flour, and any fatty meats. Portion size is not strictly controlled. The total calorie intake during phase 1 is usually between 1,200 and 1,400 per day spread out over three meals and two or three snacks.
Some permitted foods in phase 1 include:
- meat: veal and lean cuts of beef; low fat or fat-free lunchmeat
- poultry: skinless chicken and turkey breast and Cornish hen
- seafood: any kind of fish or shellfish
- cheese: many types, low-fat and fat-free only, excluding any type of cream cheese except dairy-free cream cheese substitute
- tofu: soft low-fat or calorie-reduced types only
- eggs: whole eggs, egg substitute, egg whites
- vegetables: non-starchy such as salad vegetables excluding tomato, artichokes, asparagus, broccoli, cauliflower, collard greens, eggplant, mushrooms, turnips, and zucchini
- fats: olive oil and canola oil
- spices: any seasoning that does not contain sugar
- artificial sweetened treats and artificial sweetener: sugar free only and limited in amount
After two weeks on the very rigorous phase 1 diet, the dieter is permitted to start adding back a limited amount of ‘‘good’’ carbohydrates that have a low
glycemic index. Weight loss in phase 2 is expected to be 1–2 lb (0.6–1 kg) per week. The permitted foods are the same as in phase one with the addition of whole grain cereals, oatmeal, whole-grain bread and whole-grain pasta, barley, low-fat milk, nuts, beans, starchy vegetables, wine, and most fruits. These items are portion-controlled. Watermelon, bananas, raisins, white bread, baked goods, and sugary foods are not allowed. Saturated fats and trans fats (animal fats, butter, cream, fatty meats, some solid-type margarines) are forbidden.
Dieters stay on the phase 2 diet until they have achieved their desired weight, at which time they move to phase 3, a maintenance phase. The list of restricted foods in phase 3 is quite similar to phase 2. Foods made with white flour and high levels of refined sugar are sill off limits. Individuals who get off track and violate the diet in phases 2 or 3 are instructed to go back to phase 1 and start again.
For a fee, the South Beach diet Website offers tools to help the dieter stay on track. These include as recipes, advice from dietitians, food journals, and meal planners. Daily moderate aerobic exercise and strength training are recommended for people on this diet.
The South Beach diet is based on the idea that to lose weight, the dieter must replace ‘‘bad carbohydrates’’ with ‘‘good carbohydrates’’ and ‘‘bad fats‘‘ and ‘‘good fats’’. Good carbohydrates are defined as those that have a low glycemic index, while bad carbohydrates have a high glycemic index in order to reduce insulin resistance.
The glycemic index compares foods on a scale of 1–100 for how much they increase the level of glucose (sugar) in the blood. When people eat, the level of glucose in their blood increases. How much it increases depends on the foods they eat. ‘‘Good’’ foods witha low glycemic index (below 50) raise blood sugar less than ‘‘bad’’ foods with a high glycemic index (above 50 or above 65 depending on which authority is consulted). When blood glucose levels increase, cells in the pancreas release the hormone insulin. This signals cells in the body to convert some of the glucose into a compound called glycogen that is stored in the liver and muscles and some into fat, stored in fat cells. When blood glucose levels go down, different cells in the pancreas release the hormone glucagon. Glucagon signals cells in the liver and muscle to release glycogen, which is converted back into glucose and is burned by the body. If glucose levels continue to be low, fat is also burned for energy.
When people eat foods that contain a lot of sugar or carbohydrates that break down rapidly in the body into glucose (the ‘‘bad’’ carbohydrates of the South Beach diet) their insulin level spikes. When people eat carbohydrates that break down more slowly into glucose (the ‘‘good’’ carbohydrates of the South Beach diet), their insulin level rises more slowly and does not reach as high a level. When someone eats too many sugary foods too often, they secrete a lot of insulin, and eventually cells in the body may become insulin resistant. Insulin resistance is a factor in type 2 diabetes. By removing all carbohydrates from the diet for two weeks, the South Beach diet is claims to eliminate insulin resistance.
The fats that the South Beach diet calls ‘‘good’’ fats are unsaturated fats. Unsaturated refers to a certain part of their chemical structure. ‘‘Bad’’ fats are saturated fats that have a slightly different chemical structure. Saturated fats are thought to promote atherosclerosis or ‘‘hardening of the arteries.’’ In this condition, cholesterol and other materials build up on the walls of the arteries (blood vessels) blocking blood flow and causing the arteries to lose their elasticity.
According to Agatston, benefits of the South Beach diet include:
- rapid weight loss followed by lifetime weight control
- loss of weight from the belly region
- fewer hunger pangs because of slower carbohydrate breakdown and frequent small meals
- a heart-healthy approach to fats
- decreased risk of developing cardiovascular disease.
The South Beach diet is unlikely to meet the nutritional needs of growing children.
Many nutritionists question whether this diet provides long-term balanced nutrition. Specific objections are that limiting milk may lead to calcium deficiency and limiting and whole grains even in the maintenance phase may lead to deficiencies in dietary fiber and B-complex vitamins. The initial rapid weight loss also is of concern to many weight-loss experts.
The South Beach diet is relatively new, and no independent scholarly research has been done on it. A few small studies that report decreased blood fats and similar heart-protective effects have been sponsored by organizations with South Beach diet affiliations. However, nutritionists are in general agreement that replacing saturated fats with unsaturated fats in the diet is a healthy choice. Nutritionists also agree that whole grains tend to be more healthful than refined grains, but express concern about the small quantity of whole grains permitted on the diet.?
Of more concern is the rapid weight loss of phase 1. This rate of weight loss is not in line with generally accepted practices for healthy dieting and long-term weight control, and obesity experts find highly questionable the claim that dieters can control weight loss so that they preferentially lose belly fat. The public has
enthusiastically embraced the South Beach Diet, but how many people can stay on this fairly rigorous diet and maintain long term weight-loss remains to be seen.
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Tish Davidson, A.M.