The South Beach Diet
Arthur Agatston, MD
The same old low-carbohydrate diet fools the gullible
New York Times #1 best seller is now the South Beach Diet – this
is a small step in the right direction away from the hazardous Atkins
Diet – which means on this diet you are closing your arteries and losing
your bones at a slower rate. But like all similar diets – both the
low-carbohydrate and the calorie-restricted diets – you will likely
regain all your lost weight before the year is out. What continues to
amaze me is that desperate people continue to buy the same
low-carbohydrate and/or food-restricted diets simply repackaged in a new
best-selling diet book.
to the success of this diet is you will be eating only the “good”
carbohydrates and fats, and avoiding the “bad” ones, according to Dr.
Agatston. The diet is supposed to cause permanent weight loss, stop
cravings, and improve the cardiovascular system. You don’t even have to
this is a combination of the Atkins diet (phase one) followed by a
high-fat, high-protein, semi-starvation diet, like the Zone or Sugar
Busters diets (phase two). The text tells the reader, “Our diet is
distinguished by the absence of calorie counts; percentage of fats,
carbs, and protein; or even portion control” – essentially, “Don’t even
think about limiting the amount you eat.” However, the menu plans say
otherwise – you are severely restricted in your choice of foods
in phase one and in the kinds and amounts of foods in phase two in order
to lose. If you start to gain weight in phase two or three, the
solution is to return to the tried and true very low-carbohydrate,
high-protein phase one of the diet. This is the only portion of the
diet that has any chance of working at least temporarily – and also the
unhealthiest phase of the diet. The foods served are the very ones
condemned by heart associations and cancer societies worldwide as
causing the deadly and debilitating diseases – like heart attacks,
cancer, diabetes, and arthritis – among people living in affluent
lasting 2 weeks, is to “change yourself internally,” to stop the
physical cravings that rule your eating habits, according to Dr.
Agatston. Actually, the effects will be those expected from any
low-carbohydrate, high-protein, high-fat (Atkins-type) diet. Following
the recipes results in a diet that contains about 50% of the calories
from protein (range of 30% to 80%), and about 40% fat; leaving about 10%
for carbohydrate. Even the desserts are high in protein (30%) and fat
(50%). In actuality, the diet may turn out to be even lower in
carbohydrate and dietary fiber because many people fail to eat the green
and yellow vegetables allowed – rather focusing on the steak, chicken,
and fish portions, containing no carbohydrate or fiber.
Agatston promises 8 to 13 pounds of weight loss during the first 2
weeks. Why not? – All similar diets accomplish this goal. The lost
weight is mostly water, glycogen (stored sugar), and at most 4 pounds of
fat the first 2 weeks. Some of the water loss is due to the diuretic
effects of all that protein; the remainder of the water is lost while
using up stores of sugar mixed with water, known as glycogen.* Although
the first phase of the diet does not insist on a state of ketosis (a
condition of almost total carbohydrate starvation) for success, like the
Atkins diet does, there is a good chance that many followers will
restrict their intake of carbohydrate sufficiently to go into this
metabolic state – causing even greater water loss, along with
suppression of their appetites. Losing that much water weight is a
great incentive for believing in the powers of this book and going on to
the next phase.
body requires glucose (sugar) for certain cells like red blood cells and
kidney cells, and the brain prefers glucose. When insufficient amounts
of carbohydrate (sugar) are in the diet, the body relies upon its
stores, glycogen, found mostly in the muscles and liver. About 2 pounds
of sugar are mixed with 4 pounds of water – both are released when
glycogen is burned for fuel to nourish these vital tissues during this
self-imposed period of deprivation.
of the diet works by restricting calories, primarily by restricting some
of the more usual junk people eat, like highly refined flours and
sugars; and their famous combinations – mixed with fat – like cookies,
cakes, pies, candy bars, and donuts. The meal plans also restricts
calories by using typical “portion control” methods, allowing “1 poached
egg,” “¾ cup cottage cheese,” “4 whole wheat crackers,” “1 whole English
muffin,” “…counting out 15 almonds or cashews...” etc. If phase two
fails then the dieter is to return to phase one.
is essentially anything you want to eat, but hopefully some of the
eating habits from phase one and two have stuck. If phase three fails
then the dieter is to return to phase one.
Brief Summary of the South Beach Diet
Phase 1 – First 2 weeks (basically a
low-carbohydrate, high-protein, high-fat (Atkins-type) diet. You
can follow it longer if you choose for faster weight loss after 2
Allowed: meat, poultry, fish, eggs, cheese, and
vegetables with liberal use of olive oil.
Forbidden: Bread, rice, potatoes, pasta, baked
goods, fruit, alcohol (including beer and wine).
Fed as three “balanced” meals
Promise: 8-13 pounds of weight loss
Phase 2 – Followed until you hit your target
Allowed: Add back the foods you love, like the
“good” carbohydrates – fruit, whole grain bread, whole grain rice,
whole wheat pasta, and sweet potatoes (no white potatoes). Meals
are still high in fat, protein, and cholesterol.
Promise: 1-2 pounds lost/week
If phase 2 fails, you then return to phase 1 to get
back on track.
Phase Three – for the rest of your life. There is
no allowed or forbidden foods list for phase 3 – you can eat
whatever you want. If phase 3 fails, you then return to phase 1
to get back on track.
Protein Diets Are a Health Hazard
common with almost all successful diet books, this one tells you “good
news about your bad habits.” You can still eat all the steak, chicken,
eggs, and Canadian bacon you desire, and on occasion, chocolate cake.
Believe it or not, these are recommendations from a cardiologist. The
fact that the author himself takes statin drugs to lower his cholesterol
(like Mevacor, Lipitor, Zocor, etc.), fish oil, and aspirin to prevent a
heart attack – penance for all that sinful food? – makes me believe he
clearly understands the life-threatening effects of what he is doing.
Every cardiologist knows this, and you would think Dr. Agatston’s fellow
cardiologists knew all about The South Beach Diet when they wrote
their report on high protein diets two years before the book’s
According to the Nutrition Committee of the American Heart
Association (AHA) report in the October 9, 2001 issue of the journal
Circulation,1 high protein diets are hazardous to your
health and are ineffective. They wrote, “High-protein diets typically
offer wide latitude in protein food choices, are restrictive in other
food choices (mainly carbohydrates), and provide structured eating
plans. They also often promote misconceptions about carbohydrates,
insulin resistance, ketosis, and fat burning as mechanisms of action for
weight loss … These diets are generally associated with higher intakes
of total fat, saturated fat, and cholesterol because the protein is
provided mainly by animal sources. In high-protein diets, weight loss is
initially high due to fluid loss related to reduced carbohydrate intake,
overall caloric restriction, and ketosis-induced appetite suppression.
Beneficial effects on blood lipids and insulin resistance are due to the
weight loss, not to the change in caloric composition … High-protein
diets are not recommended because they restrict healthful foods that
provide essential nutrients and do not provide the variety of foods
needed to adequately meet nutritional needs. Individuals who follow
these diets are therefore at risk for compromised vitamin and mineral
intake, as well as potential cardiac, renal, bone, and liver
abnormalities overall.”…“High-protein diets may also be associated with
increased risk for coronary heart disease due to intakes of saturated
fat, cholesterol, and other associated dietary factors.
Hopefully you have learned that the only eating plan that results in
permanent weight control, natural relief of hunger, and great health is
the one that was designed through millions of years of evolution – a
diet of starches, vegetables and fruits (See my July 2003 newsletter).
This is confirmed by the fact that an ongoing study (the National Weight
Loss Registry) of successful dieters with an average weight loss of 60
pounds, maintained for more than 5 years, found nearly all of these
people follow a low-fat diet and exercise.2 Unfortunately,
only a few people learn the truth – the masses wait for the next
best-selling diet book to regurgitate the same old nonsense to them, and
that’s why they continue to fail and remain fat.
St. Jeor, S. Dietary protein and weight reduction: a statement for
healthcare professionals from the Nutrition Committee of the Council on
Nutrition, Physical Activity, and Metabolism of the American Heart
Association. Circulation 2001 Oct 9;104(15):1869-74.
Wing R. Successful weight loss maintenance. Annu Rev Nutr.