The South Beach Diet

Last Editorial Review: 5/25/2005

What It Is

They may seem similar, but the South Beach diet is more than just a heart-friendly version of the Atkins diet. All the same, they have a lot in common.

Both South Beach and Atkins diets are the creation of medical doctors. The father of the South Beach diet is cardiologist Arthur Agatston, MD, director of the Mount Sinai Cardiac Prevention Center in Miami Beach, Fla.

Both the South Beach and Atkins diets are best-selling diet books. Only someone living in a cave hasn't, by now, heard of Agatston's The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss.

Both South Beach and Atkins diets restrict carbohydrates -- carbs, as diet dilettantes like to say. True, "good carbs" are allowed. But South Beach dieters must say goodbye to potatoes, fruit, bread, cereal, rice, pasta, beets, carrots, and corn for the first two weeks. After that, most of these foods remain strongly discouraged.

Both South Beach and Atkins diets have a more severe induction phase, followed by a long-term eating plan.

The difference, really, boils down to two things:

  • Fats. The South Beach diet bans unhealthy fats but strongly promotes healthy ones.
  • Carbs. The South Beach diet doesn't count grams of carbs. The Atkins diet seeks to change a person from a sugar-burning machine into a fat-burning machine. The South Beach diet looks at how much sugar is in a carb. Low-sugar carbs -- those with a low glycemic index (they don't cause the blood sugar levels to rise and fall as quickly) -- are good (this point may sound very familiar to fans of the Sugar Busters diet)

As Agatston says, this means his diet is not -- exactly -- a low-carb diet or a low-fat diet.

What You Can Eat

You won't go hungry. In fact, like the Body-For-Life diet, the South Beach diet promotes strategic snacking. You're not doing it right if you don't snack.

There's no counting calories or strict portion sizes. But there's no gorging, either. The idea is to eat normal portions. To many of us, normal portions will seem small at first. They are enough to satisfy hunger, but no more.

As noted above, sugar-rich carbs are off the menu. These include rice and potatoes, and vegetables -- such as beets and corn -- with high sugar content. Also, there are no pastries or other sugar-filled desserts. And alcohol is forbidden in the induction phase and limited in the long-term diet.

What's on the menu? There are three phases.

The 14-day induction phase bans bread, rice, potatoes, pasta, baked goods, and fruit. And you can't have even a drop of beer, wine, or other alcohol. The diet promises that after a couple of days, you really won't miss this stuff.

The "reintroduce the carbs" stage gradually adds back in some of the banned foods. Not all of them, but if you are a pasta maniac, have some. Fruit makes a comeback, too. Just pick and choose. A little now and then, no more. How long does this last? Until you hit your target weight.

The final stage is your diet for life. Eat normal foods in normal portions, following a few basic guidelines.

How It Works

The diet is based on the observation that Americans are carb crazy. That's the reason for the induction phase. Those first two weeks are meant to help people quit craving carbs. And it's why carbs are minimized throughout the diet.

Highly processed carbs, according to the South Beach theory, get digested too quickly. That makes insulin levels (a hormone the body makes to process sugars) spike. And once those fast-burning carbs are used up, your high insulin level makes you crave more food. So what do you tend to eat? More carbs, of course.

By breaking this cycle, the South Beach diet promises to make you want to eat less food, but better food.

What the Experts Say

Cindy Moore, RD, a director of nutrition therapy at The Cleveland Clinic and a spokeswoman for the American Dietetic Association, discussed the South Beach diet in a May 2003 interview with WebMD.

Moore said the diet truly does meet several of the criteria for a healthy diet. It's rich in vegetables, fruits, whole grains, and lean protein, she said. Most importantly, it doesn't leave out any major food groups.

Moore warned that during the induction phase, much of the lost weight is water weight. Losing this much water can throw your electrolyte balance off. So if you're following the diet, it's a good idea to work closely with a registered dietitian or your doctor.

Despite the popularity of the South Beach diet, Moore warned, there's no one-size-fits-all diet. A dietitian can help you individualize the South Beach diet to fit your health needs.

Food for Thought

Most popular diets work -- at first -- because of their novelty. Also, the first pounds lost usually are water from your tissues, not fat itself. Over time, your tissues will rehydrate. That's no reason to get discouraged. If you're eating less, eating better foods, and getting enough exercise, you will become leaner.


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One big plus for the South Beach diet is that it doesn't leave you in limbo. It recommends healthy eating and a healthy lifestyle long after you give up on ever getting back a loaned-out copy of the book.

The reason you diet may be to look better. There's nothing wrong with that. But the reason to become healthy is to have a strong heart, strong lungs, and healthy bones. There's nothing wrong with that, either.

Reviewed By Charlotte E. Grayson, MD February 2004.

SOURCES: Agatston, A. The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss, Rodale Press, April 2003. The South Beach Diet web site. WebMD Feature: "South Beach Diet Is Hot; Here's Why." WebMD Live Event Transcript: "The South Beach Diet -- Arthur Agatston, MD -- 7/23/03."

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