South Beach Diet--anyone tried it?

[MissMillie]

I'm going to have some elective surgery next year, and it's the consensus of just about every medical professional I've seen that dropping some weight before hand will be a good idea.

Today, I've started the South Beach Diet. I love that it was developed by a cardiologist. I have high hopes.

Anyone else try this one?

[Skinner]

1. I'm a little embarrassed to admit it, but....

...I have tried it.

I've never really had any interest in dieting, and I was not particularly overweight -- just a little soft. I was 6'1" and 200lbs.

My wife wanted to try it, so I just figured it would be easier if we both did it. That way we could both eat the same thing.

After about two weeks on "phase one" I lost 14 pounds(!). Then we basically skipped directly to phase three, and over the next month I dropped down to about 180lbs.

We've been on a variation of phase three, with occasional-to-frequent cheating, ever since. Basically, we're just eating the "New Food Pyramid" -- whole grains are legal, but refined carbs are not. Lots of veggies and proteins. For the last three months, I've fluctuated between 178 and 182.

The cool thing is that I don't feel like I'm starving myself. I certainly eat less than I did before. But I am eating healthier things, and for some reason I just don't feel the need to snack as much.

I'm kinda surprised that it worked. The tough part is going to be continuing to eat healthy for the rest of my life. Check back in a year and find out if I'm back to 200.

[Maddy McCall]

2. As tall as you are...

isn't 178 kinda on the skinny side? Just asking :-)

[HuckleB]

4. No.

It's just about perfect on the BMI.

[DemExpat]

5. Great going, Skinner.......

You know, I think that eating healthfully (less refined carbs) most of the time while enjoying favorite foods sometimes in the weekends, holidays, vacations etc. should be a most sustainable way to do it!

:hi:
DemEx

[onebigbadwulf]

3. All new-age diets

That is atkins, south beach, blah blah, all have the same principle

low carb high protein.

The major problem associated with these diets are fatigue- simply because you're not getting the precious energy that you once got.

For hardcore dieters, you can bypass this fatigue by supplimenting with liquid creatine and liquid vitamins.


Happy dieting.

[MissMillie]

11. "New Age"?

How does one determine if a diet is a "new age" diet?

And yes, South Beach recommends low carb, but more importantly, it stresses "right carbs".

At some point doesn't your body figure out that it needs to burn what it has stored in order to get that energy?

[HuckleB]

12. Yes.

There's still much about the South Beach that remains unproven by science, but it's focus on whole grains and higher fiber is a strong improvement over Atkins and its clones. Check out Harvard Health Newsletters for more science-based info on diet, health and nutrition. There is a very fair critique of South Beach there, though you have to be a subscriber to access it.

Good luck!

[TopesJunkie]

15. Great advice.

Harvard Health rocks!

[papau]

6. glycemic index for diabetes have been around for a long time

South Beach makes a big deal of not counting grams of carbs but looking at glycemic index.

The listings of 750 foods for their glycemic index and glycemic load -need to click on the link at http://diabetes.about.com/library/mendosagi/ngilists.htm for these listings.

[DivinBreuvage]

7. I've given up on them all...

since I've failed at every diet and weight loss gimmick I've ever tried. I have no self control whatsoever and there are some things I just love to eat too much of, and my body doesn't cooperate to begin with. So now I'm trying to learn to love being fat, or, as I prefer to think of it, "lavishly buxom".

That being said, I do wish the the best of luck, MissMillie, both with the diet and your surgery.

Françoise

[elfwitch]

17. lavishly buxom?

I like that. Maybe I'll try that too. I've decided that my body just doesn't want to be thin. I don't eat poorly normally and my weight just hovers around an undiclosed number +/- 10 lbs. If I have to try that hard to be thin-ish, then I figure my body just doesn't want to be that way.

My husband just calls me "juicy"! (The english translation for zaftig)

[DivinBreuvage]

19. Glad to have you in the club, elfwitch :)

It's not nice to fool with Mother Nature when she's trying to tell you something. And besides, without us who would brighten the life of those sweet, wonderful men (or women, as the case may be) who not only appreciate but prefer the warmth and softness that only a more ample, generous figure can provide?

Françoise

[DemExpat]

8. Good luck, MissMillie......

it looks like a healthy, effective diet to try!

:bounce:
DemEx

[VelmaD]

9. I have lost 115 pounds...

since January of 2002 and I'm going to tell you how I did it. I'm one of those people who never could stick to a "diet" so I made little lifestyle changes one at a time so I didn't overwhelm myself. I gave up colas. I took all the fatty meats out of my diet and replaced them with turkey. I got rid of all the snack food in my house and replaced it with fruit. I cut out mayo and replaced it with mustard. I stopped eating in the cafeteria in my building and started bringning my lunch so I could control the calories involved. Once I took a little weight off my knees I started exercising. Started slow and gradually built up to where I am now - at the gym 5 times a week and doing Aerobics or Tae Bo at least 3 of those days.

I pay attention to two things. I'm religious about calories and I sort of pay attention to fat. My diet is almost the anti-Atkins because the percentage of carbs is pretty high (though overall it probably isn't a lot because I get around 1000 calories a day). I eat a ton of bread and pasta and then burn it all off at the gym.

There's only one way to lose weight - burn up more calories every day than you consume. If you do it slow and do it in a way that you can maintain the lifestyle then the odds are you won't ever gain the weight back. Good luck. :-)

[hlthe2b]

10. Supposedly the Clintons are both on it..

SOuth Beach is very much like Sugar Busters-- which was also written by Cardiologists. Both modify Atkins by stressing more low glycemic index carbohydrates (veggies) and leaner, more healthy protein such as fish/chicken/turkey (over steak and bacon). South Beach, like Atkins has an induction period that is fairly restrictive (no Starbucks Lattes!) but then gradually reintroduces other foods in moderation.

For chronic carb cravers (like me), I think these diets make a lot of sense. But, if you go off them for too long, the cravings (and weight) come back. It is a lifestyle change, but people who have unstable blood sugar (insulin resistance) usually feel much better following it.

Several scientific studies have shown the benefits, so don't pay too much attention to those behind the current literature, who tell you you are wrecking your health. (there will be lots of them, who are really stuck on that old food pyramid). It is NOT a diet of bacon, eggs, cheese, steak, and nothing else

[piece sine]

13. great results so far...

Like others here, strict adherance to South Beach during the first 2 weeks enabled me to lose 15 pounds. I've lost an additional ten pounds in the five weeks that followed. Pretty-much lost the weight gaines since college. Now to the task of KEEPING IT OFF.

Thought I'd miss breads, rice and pasta more than I actually do....lots of salads and fish and lean meat. Concentrating on ADDING fiber my diet because one feels full for a longer period and I tend to eat less.

[TopesJunkie]

14. Fiber.

It also clings to fat in your intestines, keeping it from entering your body. Whole grains really do much more than make you feel full.

[TopesJunkie]

16. FYI --

The American Journal of Cardiology
Volume 88(1) 1 July 2001 pp 59-61


Metabolic Effects of High-Protein, Low-Carbohydrate Diets

Denke, Margo A. MD

Weight-losing diets appeal to the growing population of overweight Americans. Fad diets promise rapid weight loss, easy weight loss, limited restrictions on portion sizes of favorite foods, and above all an enhanced sense of well being. The popularity of fad diets points out the honest promises of traditional weight loss diets. Traditional weight loss diets promise slow weight loss of 0.45 to 0.9 kg/week. The weight loss is nothing but easy, because portion sizes of nearly all foods except low-calorie "free foods" must be continuously evaluated and tracked. Claiming an enhanced sense of well being is hardly appropriate for a traditional diet-most patients report dissatisfaction from the constant vigilance over dietary intake. Through discipline and perseverance, traditional weight loss programs try to teach a patient a new lifestyle of healthy eating. Unfortunately, 70% of successful weight losers return to their old habits and within 2 years regain at least half of the weight lost. These patients typically have little insight into the reasons why the weight was regained, and consider themselves "failures" to traditional diet programs. They become prime targets for diets promising rapid and easy weight loss.

PROTOTYPES OF THE HIGH-PROTEIN, LOW-CARBOHYDRATE DIETS

High-protein, low-carbohydrate diets have a long history of cyclic popularity. Greek Olympians ate high meat, low vegetable diets >2,000 years ago to improve athletic performance. Dr. William Harvey recommended a diet prohibiting sweet and starchy foods and permitting ad lib consumption of meats for patients who needed diuresis. As the basic understanding of nutrition and essential vitamins developed, these diets fell out of favor. They regained popularity in the late 1960s and early 1970s with the publication of the Atkins' Diet, Stillman's Diet, The Drinking Man's Diet, the Scarsdale Diet, and the Air Force Diet. The American Medical Association strongly criticized these diets,1 leading to their submergence on the popular diet trend.

Resurgence of low carbohydrate diets has been fueled by rising obesity and insulin resistance in the general population. Although the Atkins' Diet is the prototype of the low carbohydrate diet, The Sugar Busters Diet, Carbohydrate Addicts Diet, Protein Power Diet, and the Zone Diet are all variations on this common theme.

Several diets promise that, as long as you restrict carbohydrates, you will lose weight and you can eat as much food as you want. There may be a kernel of truth to this claim. For some patients, high-protein intake suppresses appetite.2 For other patients, ketosis from carbohydrate restriction suppresses appetite. Restricting carbohydrate eliminates some popular foods that are often consumed in excess such as bread, cereal, soft drinks, french fries, and pizza. By simply excluding carbohydrate foods, patients following the Atkins diet typically consume 500 fewer calories a day.3

HOW LOW-CARBOHYDRATE DIETS PRODUCE INITIALLY GREATER WEIGHT LOSS

Reducing caloric intake by 500 kcal/day should result in a 0.45- to 0.9-kg weight loss each week. However, low-carbohydrate, high-protein diets typically produce a 2- to 3-kg weight loss in the first week. This added weight loss is not due to the miracle of "switching the body's metabolism over to burning fat stores." It is due to a diet-induced diuresis. When carbohydrate intake is restricted, 2 metabolic processes occur, both of which simultaneously reduce total body water content. The first process is mobilization of glycogen stores in liver and muscle. Each gram of glycogen is mobilized with approximately 2 g of water. The liver stores approximately 100 g of glycogen and muscle has 400 g of glycogen. Mobilization glycogen stores result in a weight loss of approximately 1 kg. Patients notice this change as a reduction in symptoms of "bloating" and are very pleased with the effect. The second process is generation of ketone bodies from catabolism of dietary and endogenous fat. Ketone bodies are filtered by the kidney as nonreabsorbable anions.4 Their presence in renal lumenal fluids increase distal sodium delivery to the lumen, and therefore increase renal sodium and water loss.

In a study comparing an 800-calorie mixed diet with an 800-calorie low-carbohydrate, high fat diet,5 10-day weight loss was 4.6 kg on the ketogenic diet and 2.8 kg on the mixed diet. Energy-nitrogen balanced studies documented that the difference in weight lost was all accounted for by losses in total body water.

LONG-TERM WEIGHT LOSS IS INFLUENCED BY CALORIC RESTRICTION, NOT CARBOHYDRATE RESTRICTION

The diuretic effect of low-carbohydrate intake is limited to the first week of the diet. The remaining weight loss is a function of the laws of energy balance. Calories from any source determine the success of additional weight loss.

In the only published study of Atkins diet, patients following the diet reduced caloric intake by 500 kcal/day. The average weight loss was 7.7 kg at 8 weeks, which is no greater than that expected from caloric restriction alone.6 The ability of low carbohydrate intake to generate ketones has been touted as a relative advantage for losing weight. However, this advantage was not confirmed in a 1-month study comparing ketogenic with nonketogenic hypocaloric diets.7 Most comparison studies have evaluated the relative advantages of either a low carbohydrate or low fat hypocaloric diets; some studies found a slight 1- to 3-kg greater weight loss on a low-carbohydrate diet,8,9,10,11 others a slight advantage with a high-carbohydrate diet,12 but most studies have observed no statistical advantage of a low-carbohydrate diet.13-18 The preponderance of evidence suggests that as long as caloric intake remains constant,19 there is no intrinsic advantage to cutting carbohydrate intake.20

UNTOWARD METABOLIC EFFECTS

Complications from ketosis: Eucaloric ketogenic diets have been prescribed as part of an antiepileptic regimen in children with refractory seizure disorders. Children following these ketogenic diets have higher rates of dehydration, constipation, and kidney stones. Other reported adverse effects include hyperlipidemia, impaired neutrophil function, optic neuropathy, osteoporosis, and protein deficiency.21

Because ketogenic diets effect the central nervous system, it has been suspected that ketogenic diets may alter cognitive function. In a randomized weight loss study comparing a ketogenic with a nonketogenic hypocaloric diet, subjects consuming the ketogenic diet had impairments in higher order mental processing and flexibility than those following the nonketogenic diet.7

Complications from high saturated fat intake: Despite the beneficial effects of weight loss, diets that promote liberal intake of high fat meats and dairy products raise cholesterol levels. In a study 24 subjects following the Atkins'-type 4-week induction diet, then 4 weeks maintenance diet,6 low-density lipoprotein cholesterol levels increased significantly from 127 to 151 mg/dl. Similar increases in total cholesterol (13%) were reported in a study of patients following the Stillman diet.22

Complications from high fat intake: High fat diets increase free fatty acid flux and circulating free fatty acids. Fasting plasma free fatty acids may have a pro-arrhythmic effect in cardiac muscle. A number of mechanisms have been suggested including a possible detergent effect of circulating free fatty acids on cell membranes and direct effects of acylcarnitine on cellular ion channels and exchangers.

Complications from exclusion of fruits, vegetables, and grains: Because they exclude fruits, vegetables, and grains, low-carbohydrate, high-protein diets are deficient in micronutrients. Children consuming low-carbohydrate ketogenic diets have reduced intakes of calcium, magnesium, and iron.21 Two sailors following a low-carbohydrate, high-protein hypocaloric diet during an extended voyage developed optic neuropathy from thiamine deficiency.23 Although vitamin deficiencies can be circumvented by supplemental multivitamins, even supplemented low-carbohydrate diets will still be deficient in a growing number of important, biologically active phytochemicals present in fruits, vegetables, and grains.

Complications from high-protein intake: Increasing the protein content of a diet significantly increases glomerular filtration rate.24,25 Increases in glomerular filtration rate are likely explained by increased renal capillary permeability. Unfortunately, this compensatory response to the greater production of nitrogen is insufficient to clear protein by-products, and blood urea nitrogen levels increase. High protein diets significantly lower urinary pH by increasing titratable acid concentrations.25,26 High protein intakes provide a greater uric acid load to the kidney. Despite increases in urinary uric acid excretion, increases in serum uric acid are observed.6,26

UNTOWARD LONG-TERM EFFECTS

Development of nephrolithiasis: Hypercalciuria is a risk factor for nephrolithiasis. High-protein diets induce hypercalciuria by several different mechanisms. High-protein diets increase glomerular filtration rate and decrease renal tubular reabsorption of calcium. The relation between dietary protein intake and calcium excretion (Table 1) is clearly linear.27

The stone-forming propensity of the hypercalciuria induced by high-protein diets is aggravated by other changes in urine composition. A high animal protein diet reduces gastrointestinal alkali absorption, leading to reduced urinary citrate.28 Hyperuricemia and hyperuricosuria are also associated with excess intake of animal protein. Animal protein is a rich source of sulfur-containing amino acids; amino acids have a greater propensity to lower urinary pH.

Adding a carbohydrate restriction to a high-protein diet exacerbates many of these parameters. Low-carbohydrate intake further reduces urinary pH by inducing ketosis. Limiting the intake of vegetables and fruits further reduces urinary citrate by reducing dietary sources of alkali. Thus, high-protein, low-carbohydrate diets are associated with hypercalciuria, hyperuricosuria, and hypocitraturia, which can all contribute to renal calculi formation.

Development of osteoporosis: High-protein, low-carbohydrate diets generate a high acid load, resulting in a subclinical chronic metabolic acidosis. Metabolic acidosis promotes calcium mobilization from bone.29 Osteoclasts and osteoblasts respond to small changes in pH in cell culture; thus, a small decrease in pH results in a large burst of bone resorption.

The effects of varying dietary protein intakes on bone turnover has been carefully documented in young women consuming metabolic diets. High-protein diets increase renal calcium excretion, raised parathyroid hormone levels, and raise urinary N-telopeptide concentrations. Markers of bone formation (alkaline phosphatase and osteocalcin) remain steady, suggesting that high-protein diets increase bone resorption without affecting the rate of bone formation.27 These effects may be exaggerated in older persons who tend to have decrements in renal clearance of acid and higher serum parathyroid hormone concentrations.29

Progression of chronic renal insufficiency: In several small, randomized, controlled dietary trials, dietary protein restriction retarded the progression of diabetic nephropathy to end-stage renal disease.30 High-protein, low-carbohydrate diets have a weak effect at reducing creatinine clearance over time, and could potentially hasten renal failure in patients with baseline renal insufficiency.

Patients are inherently attracted to the simple, permissive dietary instructions: eat as much as you want of foods containing fat and protein, but don't eat foods containing carbohydrate. As promised, almost everyone loses weight during the first week. Low-carbohydrate diets cause a greater initial weight loss from a physiologic diuresis accompanying the obligate loss of glycogen stores and renal clearance of ketone bodies. Once glycogen stores have been liberated, and a new steady state for total body sodium has been achieved, these diets hold no greater promise for weight loss than any other caloric restricted diet. High-fat, low-carbohydrate diets can be harmful. The diet plan is deficient in micronutrients. Consuming ad libitum fatty meats raises total and low-density lipoprotein cholesterol levels. High-protein, low-carbohydrate intakes create a subclinical metabolic acidosis, and increase blood urea nitrogen and uric acid levels. Resultant urine acidification, hyperuricosuria, and hypercalciuria increase urine lithogenicity. Trying to convince a devotee to stop the diet uncovers yet another deleterious effect; ketogenic diets impair higher order cognitive function. High-protein, low-carbohydrate diets have untoward clinical consequences for patients with coronary artery disease, including progression of diabetic nephropathy, exacerbation of gouty diathesis, increases in circulating free fatty acids, and increases in low-density lipoprotein cholesterol levels. High-protein, low-carbohydrate diets are not superior weight-losing diets and should not be recommended.

REFERENCES

1. Anonymous. A critique of low-carbohydrate ketogenic weight reduction regimens. A review of Dr. Atkins' diet revolution. JAMA 1973;224:1415-1419. Library Holdings Bibliographic Links

2. Johnstone AM Effect of overfeeding macronutrients on day-to-day food intake in man. Eur J Clin Nutr 1996;50:418-430.

3. Yudkin J The treatment of obesity by the high fat diet. Lancet 1960;2:939-941.

4. Kolanowski J. On the mechanisms of fasting natriuresis and of carbohydrate-induced sodium retention. Diabetes Metab 1977;3:131-143. Library Holdings Bibliographic Links

5. Yang MU, Van Itallie TB. Composition of weight lost during short-term weight reduction. Metabolic responses of obese subjects to starvation and low-calorie ketogenic and nonketogenic diets. J Clin Invest 1976;58:722-730. Library Holdings Bibliographic Links

6. LaRosa JC, Fry AG, Muesing R, Rosing DR. Effects of high-protein, low-carbohydrate dieting on plasma lipoproteins and body weight. J Am Diet Assoc 1980;77:264-270. Library Holdings Bibliographic Links

7. Wing RR, Vazquez J, Ryan C. Cognitive effects of ketogenic weight reducing diets. Int J Obes Relat Metab Disord 1995;19:811-816.

8. Lewis SB, Wallin JD, Kane JP, Gerich JE. Effect of diet composition on metabolic adaptations to hypocaloric nutrition: comparison of high carbohydrate and high fat isocaloric diets. Am J Clin Nutr 1977;30:160-170. Library Holdings Bibliographic Links

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12. Rabast U, Vornberger KH, Ehl M. Loss of weight, sodium and water in obese persons consuming a high- or low-carbohydrate diet. Ann Nutr Metab 1981;25:341-349. Library Holdings Bibliographic Links

13. Davie M, Abraham RR, Godsland I, Moore P, Wynn V. Effect of high and low-carbohydrate diets on nitrogen balance during calorie restriction in obese subjects. Int J Obes 1982;6:457-462. Library Holdings Bibliographic Links

14. Piatti PM, Pontiroli AE. Insulin sensitivity and lipid levels in obese subjects after slimming diets with different complex and simple carbohydrate content. Int J Obes 1993;17:375-381. Library Holdings Bibliographic Links

15. Rumpler WV, Seale JL. Energy intake restriction and diet composition effects on energy expenditure in men. Am J Clin Nutr 1995;53:430-436.

16. Low CC, Grossman EB, Gumbiner B. Potentiation of effects of weight loss by monounsaturated fatty acids in obese NIDDM patients. Diabetes 1996;45:569-575.

17. Golay A, Allaz AF, Morel Y, de Tonnac N, Tankova S, Reaven G. Similar weight loss with low- or high-carbohydrate diets. Am J Clin Nutr 1996;63:174-178. Library Holdings Bibliographic Links

18. Golay A, Eigenheer C, Morel Y, Kujawski P, Lehmann T, de Tonnac N. Weight-loss with low or high carbohydrate diet? Int J Obes Rel Metab Disord 1996;20:1067-1072.

19. Skor AR, Toubro S, Ronn B, Holm L, Astrup A Randomized trial on protein vs. carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes 1999;23:528-536.

20. Shah M, Garg A. High fat and high carbohydrate diets and energy balance. Diabetes Care 1996;19:1142-1152. Ovid Full Text Library Holdings Bibliographic Links

21. Tallian K, Nahata M, Tsao CT. Role of ketogenic diet in children with intractable seizures. Ann Pharmacother 1998;32:349-361. Library Holdings Bibliographic Links

22. Rickman F, Mitchell N. Changes in serum cholesterol during the Stillman diet. JAMA 1974;228:54-58. Library Holdings Bibliographic Links

23. Hoyt CS III, Billson FA. Low-carbohydrate diet optic neuropathy. Med J Aust 1977;1:65-66. Library Holdings Bibliographic Links

24. Kerstetter JE, O'Brien KO, Insogna KL. Dietary protein affects intestinal calcium absorption. Am J Clin Nutr 1998;68:859-865. Library Holdings Bibliographic Links

25. Schuette SA. Studies of the mechanism of protein induced hypercalciuria in older men and women. J Nutr 1980;110:305-315. Library Holdings Bibliographic Links

26. Fellstrom B, Danielson BG, Karlstrom B, Lithell H, Ljunghall S, Vessby B. The influence of a high dietary intake of purine-rich animal protein on urinary urate excretion and supersaturation in renal stone disease. Clin Sci 1983;64:399-405.

27. Kerstetter JE, Mitnick ME, Gundberg CM, Caseria DM, Ellison AF, Carpenter TO, Insogna KL. Changes in bone turnover in young women consuming different levels of dietary protein. J Clin Endocrinol Metab 1999;84:1052-1055. Ovid Full Text Library Holdings Bibliographic Links

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[piece sine]

18. What a great post!

THANKS! I've learned a lot. This is really useful stuff!

[MissMillie]

20. interestingly enough

While Atkins and its clones are specifically named, South Beach is not.

After an initial restriction on all carbs, South Beach brings healthy carbs (those with a high fiber content) back into the diet, to add both variety and healthy gastro-instestinal benefits.

I do wish there were long-term studies though.... I guess the diet is just not old enough yet.

I guess I will just have to see how it works for me. I have a full physical in 3 months.... not only will I be weighed, but I'll have a full blood work as well. It will be interesting to see how this year is different from last year's blood work.

[TopesJunkie]

21. Unfortunately, long-term studies on safety are not likely.

There will be studies on various parts of the diet via other researchers and contexts, but, unless South Beach breaks the mold, the backers won't spend the money on long-term research. Atkins never did. Nor did any of his competitors.