South Beach Diet Review

Fad diets make me cringe. They tend to leave out whole food groups, ignore human nature, or be lacking in any scientific basis. Today’s current fad, The South Beach Diet, however, is generally balanced, realistic and scientifically grounded. Most Americans would vastly improve their health, if they followed this diet. Still, I have a few quibbles with Dr. Agatston, which keep his diet just short of the mark.

Agatston is a respected cardiologist who became frustrated in the 1980s when he found that the American Heart Association’s low-fat high-carb diet recommendations were not helping his patients lose weight or reduce the risk of heart disease. He researched nutritional studies, then used himself (middle-aged paunch and all) to try out his program. After the diet improved his own health, he started recommending it to his patients.

Dr. Agatston’s basic premise, like Atkins’, is that we are all eating far too many refined carbohydrates with a high glycemic index. As he clearly explains, these foods cause an overwhelming rush of blood sugar, which in turn demands the pancreas work overtime to produce insulin to escort the blood sugar to your cells. The rush of insulin lowers your blood sugar so effectively that before long you’re light-headed and hungry, with your body craving another quick-carb rush. The cycle becomes endless—and before long can lead to serious health problems, including diabetes.

"What most people don’t realize, "says Agatston, "is that diabetes isn’t just about how we process sugars; it’s also the inability to properly process the fats we eat." Diabetes, obesity, heart disease and a myriad of other diseases result from this "bad fuel management." So the goal of is to rebuild your body’s ability to manage its fuel properly.

To start this process, according to Agatston, you need to "reboot" your body—to break the cycle of blood sugar peaks and valleys with a two week Phase I in which the only carbs you eat are selected vegetables (no fruits, no grains, only fat-free dairy products).

This is similar to Atkins’ "Induction Stage" but a bit easier; as long as you stick to the long list of allowed foods, you don’t have to count carb grams as in Atkins. Agatston implies there’s a medical basis to this "reboot" period; though he doesn’t cite studies, recent research at the National Institute on Aging (as reported in the November 2003 issue of Health magazine) supports the idea that a reduced-calorie food break can reset the body’s glucose metabolism. I suspect another benefit of Phase I lies in startling you out of your existing habits and causing rapid weight loss so you’ll be motivated to continue with the program. Either way, the food choices are reasonable and two weeks is not forever.

After Phase I, the South Beach Diet eases up, now allowing most fruits, dairy products and whole grains. This phase continues until you’ve reached your desired weight goal. Then you go to Phase III, lifetime maintenance, where there are no lists of "allowed" and "avoid or eat rarely" foods.

It’s in this Phase III that my quibbles with the South Beach Diet arise. Though Dr. Agatston has mentioned in passing that whole grains are healthier than refined ones, and that trans fats (hydrogenated oils) are the most dangerous of fats, he seems to abandon key points like these in Phase III. "There’s no food list for Phase Three. In other words, if you want it, and it doesn’t undo all your sacrifices, you should enjoy it," he writes.

On this advice, the typical American will revert (either gradually or immediately) to most of his earlier lousy habits. I would have much preferred a reminder from Agatston that refined grains, cookies, cakes, ice cream, etc. should be eaten rarely forever.

This book is about one third nutritional advice that clearly explains how different foods (especially refined carbohydrates) affect our bodies. The remaining two thirds of the book are filled with recipes and meal plans. Unfortunately, the recipes are sometimes at odds with the good doctor’s advice. "Eat whole grains," he says. But many of his recipes include couscous, a form of refined-grain pasta, and very few teach new ways to use bulgur, barley and other easy grains. "Don’t eat trans fats," he says. But several recipes include ingredients commonly containing hydrogenated oils, like vanilla wafers, gingersnaps, flour tortillas, "I Can’t Believe It’s Not Butter" spread, and vegetable shortening.

Good editing might have caught these inconsistencies and others that might confuse readers. For instance, when Agatston explains glycemic index he says that "anything made from white flour is high on the list… including pasta" and "apples are fine; their glycemic index is low." But then his glycemic index table shows apples at 56, spaghetti at 59, whole grain spaghetti at 53 and fettucine at 46. How does that make an apple so much better than pasta, in GI terms? It’s a shame that Agatston’s generally clear writing is overshadowed by this kind of sloppy editing.

But enough about the book. How do I rate the diet overall? How do I compare it to the Atkins Diet? South Beach is simpler than Atkins and healthier for three main reasons:

• South Beach keeps saturated fats to a minimum (not surprising for a cardiologist)
• South Beach is more balanced (a random sample of Phase III recipes broke down to 20% protein, 40% carbs and 42% fat)
• South Beach doesn’t require counting grams or calories

I've given the book four stars because the diet's basically sound; I took one star off for sloppy editing and for Agatston's failure to stress the important role of exercise.

In summary, the South Beach Diet is remarkably sane for a diet as popular as it is. I would not hesitate to recommend South Beach to family and friends. But once they’d followed it for weight loss, I would give them clearer instructions for lifelong good eating, especially stressing the importance of eating lots of whole grains and avoiding trans fats.

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Review © 2003 Cynthia Harriman.
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