South Beach diet is awash in lean protein, modest fat

By Bev Bennett, Globe Correspondent, 10/1/2003

The hottest thing to hit Miami since the thong is the South Beach diet. If you can go for two weeks without an apple or a bowl of pasta, you may be a candidate for it.

It's easy to dismiss this new eating pattern as just another low-carbohydrate scheme. But the low-saturated fat, high-fiber, and low-starch regime outlined in "The South Beach Diet" (Rodale, 2003) is designed in three phases that gradually become more liberal -- so you can follow it for life.

Developed by Miami cardiologist Arthur Agatston, the program was devised originally to prevent obesity-related heart disease. Unlike diets that ignore fat content, the South Beach diet is low in saturated fat but allows "good" fats such as olive oil, canola oil, and nuts in moderation.

Protein choices include fish and seafood, fat-free or reduced-fat cheese, skinless chicken breast, and fat-free lunch meats. You can eat beans and most vegetables and gradually add whole grains to meals.

But you do have to say goodbye to a starch-filled life. That's the key to the plan Agatston lays out in his best-selling book. Starchy foods such as a French baguette or a baked potato are high on the glycemic index, which is the guide to how much food raises blood sugar. The higher the food on the glycemic index, the more it raises blood sugar, according to Agatston, who thinks that high-glycemic-index foods harm weight-loss efforts.

That's why the cardiologist starts the regimen with a purge. For two weeks you're off fruits and fruit juices; potatoes, corn, and carrots; all grains including breakfast cereal; all fluid dairy products such as skim milk; and all alcohol.

The break from high-glycemic-index foods allows your body to control insulin and sugar levels, according to Agatston. Otherwise you suffer cravings and fatigue that can sabotage your efforts. Instead of cereal for breakfast, you can eat Canadian bacon and egg substitute; for lunch a chef's salad; for dinner London broil. You can snack on a few nuts.

By eating more lean protein and modest amounts of fat, maintains the doctor, you feel satisfied and not tempted by doughnuts on your morning break. That's been the result for Jennifer Smartt, a public relations executive at Cone Inc. in Boston. Smartt gained a few pounds after knee surgery and started the South Beach diet. "I discovered I wasn't eating enough. I was always starving in the morning and cranky at night. The three meals a day and two snacks in this diet keep me fueled," she says.

The diet is supposed to rid participants of that very un-South Beach gut. Overeating -- especially refined carbohydrates -- and weight gain can lead to insulin resistance, in which the body stores fat around the midsection, according to the physician. "When we put on a certain amount of weight in middle age, it's laid down on the belly," says Agatston. "What comes off in the first two weeks is belly fat."

Some dietitians are skeptical. "The South Beach diet promises an eight-pound loss in the first two weeks. That may happen, but a lot will be water loss," says Peggy O'Shea, a registered dietitian who counsels weight-loss patients here. "I think the first phase is too restrictive and a little heavy on protein. But a lot of his advice is sound."

Agatston realizes Phase I may be difficult. Phase II allows a greater food variety: fruit, except for those such as bananas and watermelon that are high on the glycemic index, high-fiber cereal, skim milk, whole-grain bread, and the occasional glass of wine. Phase II stays in place as long as you need to lose weight. Phase III is a maintenance plan.

If you're dissatisfied with the results, says the doctor, it could be your expectations. Some dieters aren't realistic about how much weight they should lose, he says. "Or they may have to exercise more or practice portion control."