According to his theory, bad carbs increase insulin levels sharply, leading to increased fat storage (especially abdominal fat) and increased cravings for carbohydrate as the insulin eventually causes abnormally low blood sugar levels a few hours after the carb intake. Then you eat more carbs to raise your sugar level back to normal. Dr. Agatston spends much time explaining the glycemic index, a measure of how rapid and high a spike in blood sugar is seen after ingestion of particular foods.

This “bad carb” theory is not original or exclusive to Dr. Agatston. Remember “Sugar Busters”? The “bad carb” theory has been popular since around the turn of the century, even though Dr. Robert C. Atkins and others wrote about it many years earlier.

Figuring less prominently in Dr. Agatston’s scheme are his “bad fats”—saturated fats and trans fats. Some of the “good fats” to eat are olive oil, canola oil, peanut oil, and omega-3 fatty acids.

The author had intended to produce a diet with few rules, yet he tells you exactly what and when you will eat for 6 straight weeks. The recipes are prepared from readily available ingredients. How much do you eat? “The meals should be of normal size—enough to satisfy your hunger, but no more than that.” So the author never says how many calories you will eat. Although he says it is not a low-carb diet, it is. Especially the first four weeks.

Strongest points?

* The composition of South Beach is generally reasonable and would tend to improve health and longevity while controlling weight, compared to the usual Western developed-world diet.
* The recipes look tasty and relatively easy.
* High-fiber, minimally processed carbohydrates are indeed healthier than pure sugars and refined starches.
* Plenty of people say it has worked for them.
* Food variety.
* South Beach is an improvement over Atkins, especially to the extent that the author moves Atkins toward a Mediterranean-style diet. [By the way, Agatston never claims his diet is Mediterranean.]

Weakest points?

* Six weeks of prescribed eating, leaving no room for flexibility.
* Exercise is recommended—essentially a brisk walk for 20 minutes daily—but is not stressed nearly enough.
* There is certainly no scientific consensus that sugars and starches—“bad carbs”—have caused our obesity epidemic.
* There in no reference section and very few references are given. You cannot read for yourself the scientific journal articles, if any, that support the author’s opinions.

An improvement to South Beach would move it further away from Atkins and even closer to the time-honored healthy Mediterranean diet of the mid-20th century, in which more “good carbs” and fewer proteins would be encouraged. And myriad benefits of exercise should not be taken lightly.

Steve Parker, M.D.

how did this diet work for you?
Is it expensive?
would you recomend it to other people?
who is this diet ment for?