Anyone taken a look at the South Beach Diet?

I met with our cardiologist last week in prep for my annual stress test next month. He suggested that we take a look at the book, not because we have any significant problems, but because many of his patients are having good luck with it. He also said that from a scientific point of view it made sense to him.

I've read through the book, and have mostly positive reactions. Seemed sensible and maintainable way of living.

Any reactions?

Thanks, Bob

Can you give a brief summary?

Personally, I use the Physics Diet: eat less, exercise more, let the First Law of Thermodynamics do the work.

I have diabetic loved ones, so have investigated a lot of these things. From a biochemistry angle it looks sound to me, Bob. It will help control insulin levels and help to normalize cholesterol. If insulin is controlled the body is much less likely to store fat and will burn more. I could expound on this more if you like.

Please do, Cynthia. You would answer Stuart's question as well, and I'm sure I'd learn a great deal. Thanks.

Can you give a brief summary?

Personally, I use the Physics Diet: eat less, exercise more, let the First Law of Thermodynamics do the work.

Let's let Cynthia do the heavy lifting, Stuart. Dr. Agatston certainly peddles that law! As well as a bit of Physicians Diet law. Bob

I met with our cardiologist last week in prep for my annual stress test next month. He suggested that we take a look at the book, not because we have any significant problems, but because many of his patients are having good luck with it.

Hi Bob,

I am glad to hear that you do not have any significant problems. If your current routine is working, why make any significant changes?

I'm rather suspect of these recent diet books because a broad sample of our species has not been studied under very controlled conditions for any considerable amount of time, in relation to our existence on this planet, for these authors to make sweeping general conclusions about the long term effects of the diets they espouse. And I should place emphasis on the word "general". We know what a diabetic should avoid, but the broader, long term conclusions some of these books draw are less than reliable.

I hope your test next month goes well.

Cynthia, I found this quote from the "Saturday Evening Post" for July 1, 2007; it doesn't include the importance of exercise, but the rest captures the essence of the three books I've read by the doctor. Do you agree?


The doctor's passion for prevention remains clearly in focus.

"Preventing heart attacks is not something that we can hope for in the future," he stresses. "We can prevent them today, right now. Unfortunately, we're not applying what we know. And if we do not curb the present epidemic of obesity and diabetes, we're not going to have the resources to treat all the resulting chronic, debilitating diseases. We're literally not going to be able to afford it. So it's very important to apply what we know now to practice prevention and for individuals to partner with their physician and be knowledgeable, because your physician has less time today than he had ten years ago to work with you. Individuals have to take responsibility and understand risk factors and go to their physicians with some knowledge and, frankly, a game plan."

Three Principles of the South Beach Diet

1. Eat good fats. Choose good fats from olive oil, canola oil, peanut oil, flaxseed oil, walnut oil, avocados, nuts, and fish. Omega-3 (fish oil) supplements are also fine.

2. Eat good carbs. Good carbs include high-fiber, nutrient-dense fruits, vegetables, legumes, and whole grains.

3. Eat lean protein. Eat eggs, low-fat dairy, nuts, seeds, legumes, white-meat poultry, fish, shellfish, and lean cuts of meat.

I am glad to hear that you do not have any significant problems. If your current routine is working, why make any significant changes?

Three reasons, Dave:

1. I have high cholesterol, apparently genetics. I've been able to keep it below 200 mg/dL with diet, exercise and a statin for several years, but the last test was 207. If I could keep it consistently below 200, and even stop the statins, I'd be happier.

2. The LDL was less than 100 mg/dL as usual, but Triglycerides were 165, borderline high, not really concerning but increasingly thought to be an important indicator. Maybe I can improve the number with a more careful diet.

3. Wine -- empty calories from a nutritional point of view but apparently healthy for geezers like me. I'm earning my 30 activity points every week, but my weight is a bit higher than I would really like it.

So, I don't anticipate any trouble on the stress test -- I always huff and puff -- but I've always done that. So, just a bit of preventative medicine, that's all.

Thanks for asking. Bob

Didn't one of those fad diet gurus drop dead of a coronary while jogging a year or two ago? The Atkins guy, maybe? Just goes to show, jogging will kill ya, so should be avoided at all costs!

Didn't one of those fad diet gurus drop dead of a coronary while jogging a year or two ago? The Atkins guy, maybe? Just goes to show, jogging will kill ya, so should be avoided at all costs!

No, I believe he cracked his head when he slipped on some ice.

I hear that Jim Fixx's body was found by a smoker.

And I note with amusement that the commercials for some statin that featured Robert Jarvik doing manly stuff have been pulled. One reason was that they used a double for him in some of the scenes...

I wrote an article several years ago about all the diets out there, and I recall that South Beach was one of the good ones.

Atkins did, indeed, die slipping on ice and hitting his head.

Personally, I use the Physics Diet: eat less, exercise more, let the First Law of Thermodynamics do the work.

And this is wonderful.... if it works for you.

However, many people have various health challenges that make this impractical. For example, anyone who is unable to exercise can certainly reduce their caloric intake. However without the exercise to help keep metabolism steady (or optimally increase it), they are only going to have limited success losing weight or maintaining a healthy weight. After a while the body senses that less food is available than it is used to, and it will slow the metabolism via various hormonal shifts to compensate for what it views as a life-threatening deficit.

Of course, everyone is different and some people can manage to lose weight anyway, even without exercise. But it is unfortunately not always as easy as it sounds on the face of it.

Please do, Cynthia.

Happy to, Bob.

Disclaimer: I am not a doctor or biochemist, nor do I play one on the Internet. But I've been looking at these things for over ten years now.

The South Beach approach is not what I would consider "low carb." I would call it a "moderate" or "modified" carb way of eating. It's been shown that very low carb ways of eating work in much the same way, but are nearly impossible for the average person to maintain long term. It seems to me that the South Beach Diet would be much more sustainable, theoretically prolonging the good effects. As we all know, once people go back to their former eating habits, they also go back to the problems that were caused by them.

The primary cardiovascular benefits of a modified carb approach are that it will go a long way toward normalizing blood levels of cholesterol and triglycerides, and help someone to drop excess weight if they have any to lose.

An *extremely* simplified explanation of how this works follows, with a particular emphasis on cholesterol levels for the sake of length.

First, let's note that somewhere around 80% of the cholesterol in the human body at any given time was manufactured by the body, not taken in through dietary sources. About 93% of the cholesterol in the body is located within cells, providing many wonderful benefits such as: absorption of fat-soluble vitamins; coating of nerve cells; working to maintain the structure of cells; regulating nutrient intake for the cells; and being intimately involved in the production of hormones such as testosterone, estrogen, and the adrenal hormones. It is essential.

Where we get into trouble is when too much cholesterol is floating around in the bloodstream. Cholesterol levels in the cells are naturally regulated, but bloodstream levels are not.

If cells do not have enough cholesterol within to perform their vital tasks, they either must signal the body to produce more or take it up from the bloodstream. So, obviously, if we can get the cells to slow their rate of production, they *must* make up the difference by harvesting cholesterol, particularly low-density lipoprotein (LDL - the "bad" cholesterol*), from the bloodstream.

This is precisely how the statins lower blood levels of cholesterol. They interfere with a critical step in the intracellular production of cholesterol, forcing cholesterol to be brought in from the bloodstream.

The main hormone that drives cholesterol manufacture in the body is insulin. (It is also the hormone that drives fat storage.) As with many mechanisms in the body, it has an opposite player, the hormone glucagon. Glucagon inhibits the production of cholesterol.

Therefore, in order to slow down cholesterol production without using statins, what we want to accomplish is to somehow keep insulin levels low and glucagon levels high.

Obviously we cannot eliminate insulin since we need it to live, as it plays several vital roles, the most familiar one being blood glucose regulation.

However, since insulin is released in response to an increase of glucose in the bloodstream, if we can limit the amount of carbohydrate available to be broken down into glucose, we can reduce and level off the amount of insulin available to drive cholesterol production in the cells.

That's basically how a reduced carb eating regimen works to reduce cholesterol levels.

Make sense?

The South Beach approach is not as radical as many others. However, a modified carb diet such as this still seeks to keep the level of insulin as low and steady as possible. This is accomplished by the amount and kind of carbohydrate ingested, as well as the amount and kind of fats taken in.

The emphasis is on complex carbohydrates (including goodly amounts of both soluble and insoluble fiber), protein, and beneficial fats so that the breakdown to glucose is much slower and less dramatic. This keeps insulin levels in check.

And as we have seen, if you keep insulin levels in check the body will harvest more cholesterol from the bloodstream, reducing those levels.


I'd be happy to talk about the other benefits and issues raised here if you have a particular question about them, but this is probably long enough already.


* I'm not going to get into the LDL vs HDL part of all this unless someone particularly wants to hear about it.

Thanks very much Cynthia. I have to synthesize my learning against yours. I'm having a stress test and comparing blood levels -- all this is preventative medicine in my case -- and will revert once my cardiologist checks my summary.

Regards, Bob