What is a good way to begin a running regimen?

I’ve never been "athletic" but I used to be more active. I danced, walked, and did the elliptical about 3 times a week. Now I’m out of shape and I’d like to begin running for over all conditioning. I tried running in the past and could never get over the 20 minute "hump". I’d like suggestions on beginnning, what to eat before and after, pointers for more energy and how to get over that "heart exploding in the chest" thing at 20 minutes.

Thanks!

London Marathon Preparations

Alex Hyndman gets ready for the London Marathon.

What about Caffeine and Athletes

By Stephanie Nunes, RD

There is much confusion on the health effects of caffeine. I am going to address specific topics that may be of interest to athletes: Dehydration, Bone Health, Sports Performance, Cancer, and Heart Disease.

Extensive research has been conducted on the health effects and safety of caffeine consumption and the general consensus appears to be that moderate caffeine consumption (approximately 300mg/day) is safe. It is estimated that the average daily caffeine consumption among Americans is 280mg/day.

 

A Few Common Sources of Caffeine
Source	Caffeine
8 oz Brewed Coffee	135 mg
1 oz Expresso	30-50 mg
8 oz Green Tea	25-40 mg
8 oz Black Tea	40-70 mg
12 oz Coca-Cola	34.5 mg
12 oz Diet Coke	46.5 mg
12 oz Mountain dew	55.5 mg
SoBe No Fear	158 mg
1.45 oz Sweet chocolate bar	27 mg
Exedrin	65 mg

Dehydration

Researchers used to believe that caffeinated beverages had a diuretic effect and caused dehydration. Recent research now shows that coffee, tea, and other caffeine-containing beverages do not affect hydration status on those who are already accustomed to consuming caffeine. Caffeine only has a diuretic effect if you consume large amounts of it (500-600 mg/day).

My advice: Enjoy your favorite caffeinated beverage while continuing to focus on maintaining proper hydration with fluids such as water, juices, sports drinks, etc.

Bone Health Research has shown that caffeine is not a significant risk factor for poor bone health when adequate calcium is consumed.

My Advice: Include at least 2 servings of calcium rich foods daily and add milk to your coffee or tea (my favorite is a non-fat mocha!)

Sports Performance

Early researchers thought caffeine's benefit on sports performance was linked to its ability to spare muscle glycogen and increase fatty acid metabolism. Now the current thinking is that the positive effects of caffeine have more to do with "mental energy". Studies on sports performance have shown that caffeine had a 24% improvement in endurance performance and 4% improvement in strength performance. The quantity used which showed the biggest improvement was 6 mg/kg body weight. Less than 3 mg/kg showed a smaller improvement or no improvement at all. It is also thought by some that the amount of caffeine needed for sports performance depends partly on "caffeine sensitivity".

Additional Note: Substances in coffee and tea can interfere with iron absorption.

My Advice: If you suffer from anemia, do not drink tea or coffee with your meals or within one hour after. The best advice would be to drink them an hour before eating. If you don't usually use caffeine but want to try it for sports performance, watch for stomach distress.

Cancer

The American Institute for Cancer Research (AICR) recently released an article, "The Truth about Caffeine and Cancer". The AICR stated that coffee is no longer associated with increased cancer risk. In fact, "because it contains antioxidants and anti-inflammatory compounds, coffee may actually boost health and possibly reduce cancer risk." Tea continues to show cancer combating benefits, especially green tea.

Heart Disease

Recent research has shown no relationship between caffeine ingestion and heart disease. However, there can be exceptions to this rule in that some may react differently to caffeine than others.

My Advice: Check with your physician if you are experiencing elevated blood pressure or arrhythmias.

Summary:

Caffeine beverages can be worked into an athletes meal plan as long as you pay attention to overall daily hydration, continue to eat/drink the recommended calcium products, and follow an overall balanced meal plan that meets your sports- specific nutrient needs.
 

 

Stephanie Nunes is a Registered Dietitian and runner residing in San Luis Obispo, California. Her private practice is "Rock Solid Nutrition" and she provides individual counseling, on-line counseling, lectures or presentations for specific groups, and nutrition related articles. If you would like to contact Stephanie for any of these services, her e-mail address is Rocksolidnutrition@sbcglobal.net.

Cardio; your daily therapeutic dose for feeling better

 

Paramount to any gym workout should be cardio. Although this isn’t life changing news, it can be a life changing realization. Cardio not only helps you to lose weight, but it really does help you to *feel* better — about yourself and about the whole situation you may be facing. And during these uncertain times, we could all benefit from a therapeutic dose of feeling better.

Who hasn’t gone outside for a “walk,” or “air” when facing a difficulty at work? Why does this help? A walk will get our heart rate up and an increased heart rate will get oxygen flowing through our muscles. This is the much needed “air” we are seeking. And when this happens, we begin to feel better.

Now, imagine if we were able to *maintain* this feeling? Cardio, short for cardiovascular exercise will make your heart stronger. A stronger heart, pumps more blood (I know you remember this from high school biology) and blood is the vehicle which carries oxygen from the heart, to all of the organs in our body. And, guess which organ is responsible for processing thoughts? The brain (an A plus in Biology?).

Essentially, it is your *heart* that is getting a workout. And, in order to maintain a strong heart, to facilitate this much needed “air” we need to engage in cardiovascular exercise with a certain amount of daily intensity. Repeat: “daily intensity.”

I often use plants (they convert carbon dioxide into oxygen, by the way), as an analogy for understanding life’s progression. One way to make a plant stronger, with thicker roots and larger blossoms, is to trim it. Trimming forces it to *heal* and once it heals, it grows stronger, thicker. It’s like shaving. What happens when you shave? The hair comes back, with a vengeance — stronger, thicker and greater. We’ve all heard — and affirmed — the saying “that which does not kill me, makes me stronger.” Muscles that are torn during workouts, ultimately become bigger and stronger, and it is only when we put ourselves through a vigorous exercise, that our heart will get the intensity it requires to maintain our clarity and give us that much needed dose of “feeling better.”

Now, it is important that you know what level of intensity you are capable of. It is best to first consult your doctor to determine this. Armed with this knowledge, take 20 minutes out of your day to engage in an exercise that will get your heart rate up. It should be something you can honestly see yourself doing. Sports and other high endurance athletic activities are exceptional cardio workouts. Sports by their nature offer significant benefits as they build self-confidence and camaraderie, additional nutrition for “feeling better” and enhancing our overall outlook.

As always, I am aware of the proverbial lack of time syndrome. If daily cardio is too much (at first!), then three times a week is a fair compromise. Do it for you and for your heart.

How To Lose Belly Fat

 

• Spare Tire
• Love Handles
• Muffin Top
• Pot Belly

All somewhat comical terms for belly fat. Most people don’t like having that extra flab around their midsections, but we tend to just put up with it. There is much conflicting advice out there, and besides, we’ve failed in the past so there’s no guarantee we’ll succeed anyway.

Take heart, there is a truly effective strategy to lose belly fat, but you may have to loosen up some old preconceptions. Please note that in this article I am specifically talking about fat loss as opposed to overall weight loss (fat, muscle & water).

How To Lose Belly Fat – The Guide

The strategy involves both diet and exercise – nothing new there. However, it entails 2 unique ways of going about it.

The Diet – Become a Fat-Burner

Low-carbohydrate nutrition is the most-effective way of shedding pounds of fat from the body.

Why?

Basically, the body burns energy in the following order:

1. Carbohydrate (from food and stored glycogen)
2. Fat (from food and bodyfat)
3. Protein (from food and muscle tissue)

If you eat what most government guidelines recommend you eat, you are a carb-burner. It then becomes obvious that in order to become a fat-burner, you should remove the current primary energy source i.e. carbohydrate.

When you do this, your body takes a few days to flip a ‘metabolic switch’ and become a fat-burning machine. At that point, the fat you eat gets consumed first, and then you start burning away bodyfat as your primary source of energy. Obviously, you don’t therefore consume copious amounts of fat, and you don’t need to go zero carb to benefit. Anything under 100 grams of carbs a day is considered ‘low-carb’, but ideally under 60 grams would produce great results.

On low-fat diets (which by nature are high-carb diets), when your ‘food calories’ are gone, the body will burn a mixture of both fat and muscle tissue (protein). As muscle is ‘metabolically active’ — it burns calories all day long just by being there — losing it is a disaster for the dieter. Their metabolism will continually slow down over time.

This is one of the main reasons why low-fat diets very often produce temporary results: you lose weight for a while, but then it stops working (as your metabolism has crashed) and you pile it back on – and then some!

The Exercise

Loads and loads of cardio, right? Wrong.

Overdoing cardiovascular exercise will also put your body in a state where it breaks down lean muscle tissue (catabolism). So the question is, how do we complement our fat-burning nutritional strategy with fat-burning exercise.

It’s called ‘Interval Training’, or more specifically ‘High Intensity Interval Training’. The idea is to perform some sort of cardio in ‘fits and starts’ i.e. a period of lower intensity followed by a period of higher intensity.

Why?

Research shows that this type of work burns more fat than steady-state cardio, typically by about 50%. In fact, one study showed a 9 fold increase in fat loss for HIIT compared to low-medium intensity cardio.

Also, with respect to belly fat in particular, research has shown (though the reason is not clear at this time) that HIIT can produce more fat loss in this area than other parts of the body. An Australian study found that the HIIT group lost 3 times more fat and significantly more belly fat than the steady-state cardio group who actually exercised for twice as long!

The even better news is that HIIT need only be performed for 10-20 minutes at a time.

Hopefully you can see that these unique approaches to diet and nutrition will work synergistically to produce truly effective fat-loss:

1. Get your body to burn fat for energy.
2. Then add exercise that will utilize the most fat possible.

There’s obviously more to talk about on this topic, but a single post doesn’t permit me to get into it all. I hope you enjoyed it and if nothing else, you feel inspired to find any weight-loss program that you feel you can work with to bring permanent results.

Women+Belly Fat = Not good

 

Belly Fat Doesn’t Bode Well for Women

Having a big waist may raise women’s death rates, even in women who aren’t overweight.

That news comes from a study of 44,600 female nurses enrolled in a long-term health study.

The bottom line: Waists mattered more than weight.

Being in the normal weight range was less important than having a waist less than 34.6 inches and a waist-to-hip ratio of less than 0.88 .To calculate your waist-to-hip ratio, divide your waist measurement by your hip measurement.

"Although maintaining a healthy weight should continue to be a cornerstone in the prevention of chronic diseases and premature death, it is equally important to maintain a healthy waist size and prevent abdominal obesity," the researchers write in the April 1 edition of Circulation.

Belly Fat Study

When the nurses were 40 to 65 years old, they measured their waists and hips for the study. At the time, none had had heart disease or cancer.

Every two years, they updated their health and lifestyle records for the study, including their physical activity, smoking, alcohol use, and menopausal status.

The nurses were followed for 16 years. During that time, a total of 3,507 of the nurses died, including 751 who died of heart disease and 1,748 who died of cancer.

Regardless of other factors, including BMI ( body mass index, which relates height to weight), women with larger waists and greater waist-to-hip ratios had higher death rates from all causes, including heart disease and cancer, which are the top two killers of U.S. women.

For example, among women of normal weight, those with a waist larger than 34.6 inches were three times as likely to die of heart disease, compared to women with smaller waists.

Large hips weren’t a problem, if the waist wasn’t also large. In fact, having large hips and a small waist was associated with lower risk of death from heart disease.

 

Waist Check

Simply measuring the waist will do. The waist-to-hip ratio wasn’t a better predictor of death rates and is more cumbersome, note the researchers, who included Cuilin Zhang, MD, PhD, of the National Institute of Child Health and Human Development.

Zhang’s team used the definitions for abdominal obesity recommended by the American Heart Association and U.S. Department of Agriculture. Those cutoffs are waist circumference of 34.6 inches for women and 40 inches for men.

The study doesn’t prove that abdominal fat is lethal. Observational studies like this one don’t prove cause and effect.

Ten Surprising Nutrition Facts

 

The American diet circa 2007 is a disaster – but positive change has begun. Those were the twin themes of the "Fourth Annual Nutrition and Health Conference" held in San Diego, Calif., May 14-16, 2007. The conference was sponsored by the University of Arizona’s College of Medicine in conjunction with the Program in Integrative Medicine (PIM); PIM was founded and is co-directed by Dr. Weil. 

The three-day event brought together leading nutrition researchers from around the world, bearing plenty of both bad and good news. Some highlights:

 

Bad News:

 

1. Hunter-gatherers in the Australian outback today live on 800 varieties of plant foods. Modern Americans live principally on three: corn, soy and wheat.

   From the presentation, "Phytonutrients: Nature’s Bonus from Plant Foods" by David Heber, M.D., Ph.D. Professor of Medicine and Public Health and Director, UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA

2. One third of Americans get 47 percent of their calories from junk foods.

   USDA" Trends in the United States – Consumer Attitudes and the Supermarket, 2000. From the presentation, "Phytonutrients: Nature’s Bonus from Plant Foods" by David Heber, M.D., Ph.D. Professor of Medicine and Public Health and Director, UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA

3. The average American is eating 300 more calories each day than he or she did in 1985. Added sweeteners account for 23 percent of those additional calories; added fats, 24 percent.

   Putnam et al. USDA. From the presentation, "Cultivating the Common Ground of Food, Nutrition and Ecological Health," by David Wallinga, M.D., Director, Food & Health Program, Institute for Agriculture & Trade Policy, Minneapolis, Minn.

4. Vitamin D deficiency is widespread. The following health problems have been linked to vitamin D deficiency: type 1 and 2 diabetes; multiple sclerosis; rheumatoid arthritis, osteoarthritis, periodontal disease, increased susceptibility to infection; osteoporosis, low birth weight infants; low seizure threshold; cancers of the breast, prostate, colon, pancreas and ovary; non-Hodgkin’s lymphoma; hypertension, myocardial infarction, stroke, congestive heart failure; wheezing in childhood, and compromised muscle strength and falls in the elderly.

   From the presentation, "Vitamin D Deficiency: The Cause of Everything?" by Louise Gagne, M.D., Clinical Assistant Professor, Dept. of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.

5. In real dollars, the price of fresh fruits and vegetables has risen nearly 40 percent since 1985. In real dollars, the price of soft drinks has dropped 23 percent. The reason unhealthy foods tend to be less expensive on average than foods such as fresh fruits and vegetables has much to do with American farm policy.

   Condensed from "Food without Thought: How U.S. Farm Policy Contributes to Obesity" Institute for Agriculture and Trade Policy, Environment and Agriculture Program, from the presentation, "The Omnivore’s Dilemma: Searching for the Perfect Meal in a Fast-Food World," by Michael Pollan, Knight Professor of Journalism, University of California, Berkeley, Calif.

           Hopeful News

6. Ten cups per day of green tea delayed cancer onset 8.7 years in Japanese women and three years in Japanese men.

   From the presentation, "Beef or Broccoli? Nutrition and Breast Cancer" by Victoria Maizes, M.D., Executive Director, Program in Integrative Medicine, Assoc. Professor, Clinical Medicine/Family & Community Medicine, the University of Arizona College of Medicine, Tucson, Ariz.

7. Three meta-analyses of randomized, placebo-controlled trials found a 5-12 percent decrease in cholesterol levels in hyperlipidemic patients after at least 30 days’ treatment with 600-900 mg of garlic extract.

   Warshafsky S., et al Ann Int Med 1993; 19;599-605; Silagy C, et al. JR Coll Phys Longdon 1994; 28:2-8; Ackermann RT, et al. Arch Intern Med 2001: 161: 813-24. From the presentation, "The Medicinal Spices" by Tieraona Low Dog, M.D., Education Director, Program in Internal Medicine, Assistant Professor, Dept. of Medicine, The University of Arizona, Tucson, Ariz.

8. Maternal limitation of seafood consumption to less than 340 grams per week during pregnancy did not protect children from adverse outcomes. In contrast, this observational study [Avon Longitudinal Study of Parents and Children] showed beneficial effects on child development when maternal seafood consumption exceeded 340 grams per week, with no upper limit of benefit…

   Hibbeln et al., The Lancet, 17 Feb., 2007. From the presentation of Joseph Hibbeln, M.D., Senior Clinical Investigator, Sectional of Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md.

9. "I see a lot of hopeful trends, including the rise of alternative agriculture: organic, local, biodynamic…There are now over 4,000 farmers’ markets in the U.S. The number has doubled in 10 years."

   From the presentation, "The Omnivore’s Dilemma: Searching for the Perfect Meal in a Fast-Food World," by Michael Pollan, Knight Professor of Journalism, University of California, Berkeley, Calif.

10. Chocolate…may have a mild hypotensive [blood-pressure lowering] effect.

    From the presentation, "The Medicinal Spices" by Tieraona Low Dog, M.D., Education Director, Program in Integrative Medicine, Assistant Professor, Dept. of Medicine, The University of Arizona, Tucson. Ariz.

 

Why fast foods are bad, even in moderation

 

Eating a diet consisting largely of fast food could cause your waistline to bulge more than eating the same amount of fat from healthier sources.

Monkeys fed a diet rich in trans-fats – commonly found in fast foods – grew bigger bellies than those fed a diet rich in unsaturated fats, but containing the same overall number of calories. They also developed signs of insulin resistance, which is an early indicator of diabetes.

Trans-fats, or partially hydrogenated oils, are found in many fast foods and also in baked goods and processed snacks. They dramatically increase the risk of heart disease – even more than saturated fats found in animal products.

Kylie Kavanagh, at Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina, US, wondered how this "killer fat" would affect the risk of diabetes in 51 vervet monkeys.

She fed one group of monkeys a diet where 8% of their daily calories came from trans-fats and another 27% came from other fats. This is comparable to people who eat a lot of fried food, says Kavanagh. A different group of monkeys was fed the same diet, but the trans-fats were substituted for mono-unsaturated fats, found in olive oil, for example.

Both groups ate the same total calories, which were carefully metered to be just enough for subsistence.

Path to diabetes

After six years on the diet, the trans-fat-fed monkeys had gained 7.2% of their body weight, compared to just 1.8% in the unsaturated group. CT scans also revealed that the trans-fat monkeys carried 30% more abdominal fat, which is risk factor for diabetes and heart disease.

"We were shocked. Despite all our enormous efforts to make sure they didn’t gain weight, they still did. And most of that weight ended up on their tummies," says Kavanagh, who presented her findings at the American Diabetes Association meeting in Washington DC, on Monday. "This is walking them straight down the path to diabetes."

This is the first study to show such a dramatic result on abdominal fat, adds Dariush Mozaffarian at the Harvard School of Public Health in Boston, US. "The days of thinking about fats just as calories are over," he says.

Partially hydrogenated oils can easily be replaced by other oils during food production. Last week, fast-food giant Wendy’s announced that it was cutting partially hydrogenated oils from its food in the US and Canada, while in January, food manufacturers in US were ordered to label all trans-fats on packaged goods.

‘Superfoods’ Everyone Needs to Stay Alive and Healthy

 

Experts say dozens of easy-to-find ‘superfoods’ can help ward off heart disease, cancer, cholesterol, and more.

Imagine a superfood — not a drug — powerful enough to help you lower your cholesterol, reduce your risk of heart disease and cancer, and, for an added bonus, put you in a better mood. Did we mention that there are no side effects? You’d surely stock up on a lifetime supply. Guess what? These life-altering superfoods are available right now in your local supermarket.

"The effect that diet can have on how you feel today and in the future is astounding," says nutritionist Elizabeth Somer, author of Nutrition for aHealthy Pregnancy, Food & Mood, and The Essential Guide to Vitamins and Minerals.

"Even people who are healthy can make a few tweaks and the impact will be amazing," Somer says. "I’d say that 50% to 70% of suffering could be eliminated by what people eat and how they move: heart disease, diabetes, cancer, hypertension can all be impacted."

You don’t need specific foods for specific ailments. A healthy diet incorporating a variety of the following superfoods will help you maintain your weight, fight disease, and live longer. One thing they all have in common: "Every superfood is going to be a ‘real’ (unprocessed) food," Somer points out. "You don’t find fortified potato chips in the superfood category."

Top Superfoods Offering Super Health Protection

 

• Beans
• Blueberries
• Broccoli
• Oats
• Oranges
• Pumpkin
• Salmon
• Soy
• Spinach
• Tea (green or black)
• Tomatoes
• Turkey
• Walnuts
• Yogurt

Blueberries — Antioxidant Superfood

Packed with antioxidants and phytoflavinoids, these berries are also high in potassium and vitamin C, making them the top choice of doctors and nutritionists. Not only can they lower your risk of heart disease and cancer, they are also anti-inflammatory.

"Inflammation is a key driver of all chronic diseases, so blueberries have a host of benefits," says Ann Kulze, MD, of Charleston, S.C., author of Dr. Ann’s 10-Step Diet, A Simple Plan for Permanent Weight Loss & Lifelong Vitality. When selecting berries, note that the darker they are, the more anti-oxidants they have. "I tell everyone to have a serving (about 1/2 cup) every day," Dr. Kulze says. "Frozen are just as good as fresh." Be sure to include lots of other fruits and vegetables in your diet as well. Remember too that, in general, the more color they have, the more antioxidants.

Omega 3-Rich Fish — Superfoods for the Heart, Joints, and Memory

"We know that the omega 3s you get in fish lower heart disease risk, help arthritis, and may possibly help with memory loss and Alzheimer’s," Somer says. "There is some evidence to show that it reduces depression as well."

Omega-3s are most prevalent in fatty, cold-water fish: Look for wild (not farmed) salmon, herring, sardines, and mackerel. Aim for two-to-three servings a week. Other forms of omega 3s are available in fortified eggs, flax seed, and walnuts. These superfoods have the added benefit of being high in monounsaturated fats, which can lower cholesterol.

Soy — Superfood to Lower Cholesterol

A study reported in The Journal of the American Medical Association (2003) showed that a diet of soy fiber, protein from oats and barley, almonds, and margarine from plant sterols lowered cholesterol as much as statins, the most widely prescribed cholesterol medicine. "Look for tofu, soy milk, or edamame — not soy powder," says Somer. In other words, soy sauce won’t do the trick. One caveat: If you have a family history of breast cancer it is not recommended that you eat extra soy.

Fiber — Superfood Aids Weight Loss and Checks Cholesterol

A diet high in fiber will help you maintain healthy cholesterol and blood sugar levels. As a bonus, because fiber helps you feel full longer, it’s a great tool in weight management. Whole grains, beans, fruit, and vegetables are all good sources. Try throwing some beans in your salad, recommends Kulze. "Fresh, frozen, or dried are the best. You can use canned, but they tend to be higher in sodium," Kulze warns.

Tea — Superfood for Lowering Cholesterol and Inhibiting Cancer

"The overall antioxidant power of black tea is the same as green tea," says Kulze, "but green tea does have ECGC, a powerful antioxidant that we really do think is quite special." A recent Japanese study on green tea found that men who drank green tea regularly had lower cholesterol than those who didn’t. Researchers in Spain and the United Kingdom have also shown that ECGC can inhibit the growth of cancer cells. For a double health whammy, replace sugary sodas with tea.

Calcium

OK, OK, you know the drill: Calcium helps build strong bones and prevents osteoporosis. Look for it in dairy products or supplements. Added bonus: Some studies show that calcium helps with weight loss. Here are the calcium levels recommended for adults by the USDA:

• Age 9 to 18 — 1,300 mg
• Age 19 to 50 — 1,000 mg
• Age 51 and over — 1,200 mg

And Finally, the Yummiest Superfood Yet … Dark Chocolate

New research has shown that dark chocolate is packed with antioxidants and can lower blood pressure. Kulze recommends that you look for chocolate with 60% or higher cocoa content; the darker, the better. In addition, the darker it is, the lower the fat and sugar content. Now that’s our kind of health food!

 

South Beach Diet

 

Definition

The South Beach diet is a three-phase, carbohydrate-restrictive diet. It emphasizes foods that are low on the glycemic index (GI) and low in saturated fat, such as lean meats, vegetables, cheeses, nuts, and eggs. Unlike other carbohydrate-restrictive diets, such as the Atkins and Zone diets, the South Beach diet promotes "good" carbohydrates, such as whole grains and fruit.

Origins

The creator of the South Beach diet, Dr. Arthur Agatston, is considered a leading cardiologist and is the director of the Mount Sinai Cardiac Prevention Center in Miami Beach. Originally, he had intended to design an eating plan to improve the cholesterol and insulin levels of his patients. However, Dr. Agatston soon discovered that his patients also lost weight on his plan. After further research, he approached Marie Almon, R.D., chief clinical dietician at the hospital, to help develop the eating plan into an effective diet. The results became the South Beach diet. Having sold more than a million copies since its publication in April 2003, The South Beach Diet book has remained on the New York Times bestseller list for over a year.

Benefits

The primary benefit of the South Beach diet is considered by many to be its initial rapid and significant weight loss—8–13 lb (4–6 kg) in the first two weeks. After the first two weeks, weight loss continues at a slower rate, averaging 1–2 lb (0.4–1 kg) weekly. In addition to weight loss, the diet reduces cholesterol and insulin levels, thus reducing the risks of diabetes and heart disease. It is claimed that the diet is easy to follow because it is designed to eliminate cravings and has more flexible food options after the first two weeks.

Description

In his book, The South Beach Diet, Dr. Agatston states that "this diet is not low-carb. Nor is it low-fat." Instead, the diet focuses on eating the "good" carbohydrates (fruits, vegetables, and whole grains) and "good" fats (olive oil and nuts) rather than eliminating them from the diet entirely.

Dr. Agatston based the core of his dietary plan around the glycemic index –the increase in blood sugar levels by foods containing carbohydrates during a set amount of time.

After consumption, food is metabolized into sugars and promotes the release of the hormone insulin. When the blood contains excess sugar, insulin removes it from the blood stream by storing it in cells, including fat cells. High-glycemic carbohydrates (greater than 70 GI) are metabolized rapidly, which causes elevated insulin production. High levels of insulin result in more blood sugar being stored as fat, thus causing weight gain. This pattern induces craving for more carbohydrates, thus leading to the consumption of more high-GI foods. Low to moderate-GI foods, however, raise insulin levels more slowly and sugars are metabolized more effectively, thus reducing the amount of blood sugar stored as fat. Cravings for more food is reduced. In addition, by eating these low-GI foods, the risk of insulin resistance that can lead to atherosclerosis and diabetes is reduced. As such, Dr. Agatston designed the South Beach diet to promote foods low on the GI and eliminate the body’s craving for high-GI foods.

The South Beach diet consists of three phases. Phase one is the strictest part of the diet and lasts for two weeks. The purpose of Phase one is to banish the dieter’s cravings for high-GI foods such as bread, rice, potatoes, pasta, and sugar. Alcohol, fruits, cereal, and such vegetables as carrots and corn are also restricted during Phase one. Instead, protein-rich foods are emphasized, such as lean meat, fish, eggs, cheese, nuts, and vegetables. Coffee and tea are also allowed. Three regular-sized meals are eaten each day, supplemented by mid-morning and mid-afternoon snacks as well as dessert. During this period, the body chemistry will change dramatically until cravings for high-GI foods are eliminated and insulin resistance is improved/lowered. In addition, rapid weight loss is typically experienced.

Phase two reintroduces several of the restricted foods and encourages eating from all the dietary food groups, the expected result being that the body will neither crave high-GI foods nor store food as excess fat to the same degree. Such high-fiber carbohydrates as whole-wheat pasta and bread and most fruits are now permitted. Moderation remains the key to success for this phase and low-GI foods are strongly encouraged. Phase two continues until the dieter reaches his or her ideal weight, ideally averaging a loss of one to two pounds per week.

Phase three, the ultimate goal, focuses solely on weight maintenance. Having reached the ideal weight, the dieter now makes the changed eating habits a lifestyle from this point forward. Basic dietary techniques are still maintained. Only the high-GI foods and "bad" fats from the previous two phases continue to be restricted. Altered body chemistry will promote long-term cardiovascular health and reduce the risk of diabetes. Should weight gain occur, Phase one of South Beach diet is reintroduced until the weight goal is achieved.

Preparations

There are no initial preparations required for the South Beach diet. However, as with most diets, it is wise to consult with a physician beforehand. Blood testing for insulin, glucose, and cholesterol levels is suggested. It is strongly recommended that dieters taking medications for medical conditions such as heart disease consult a physician before going on the South Beach diet. Similarly, diabetics on insulin or other medications are advised to have a doctor monitor their blood sugar regularly and determine if they are at risk of kidney impairment while on the diet. It is also recommended that a registered dietitian be consulted to determine the dietary needs of certain medical conditions, such as pregnancy.

Precautions

The South Beach diet is not recommended for people suffering from or at risk of kidney problems. The diet’s high protein content can place increased strain on the kidneys, possibly causing long-term damage as well as kidney stones and bone loss. Additionally, the possibility of ketosis-induced dehydration during Phase one can increase the risk of further kidney impairment. Dehydration occurs when the body experiences water loss with accompanying loss of important blood salts like potassium and sodium. Ketosis occurs when carbohydrates are not available and the body burns an excessive amount of fat, during which some ketones, or fat fragments, are excreted. The restrictive nature of Phase one may also induce mineral and vitamin deficiencies. Remaining in Phase one of the diet for longer than two weeks greatly increases the risk of losing bone and muscle mass. Dieters should remain in Phase one for no longer than three or four weeks.

Some nutrition professionals contend that the South Beach diet menus provided in the book lack important nutritional information and detailed portion sizes as well as specific substitutes for foods the dieter cannot or will not eat. They claim that these aspects, combined with the restrictive nature of the diet, can make sticking with the South Beach diet on a long-term basis difficult for some people. Also, they assert that the diet does not emphasize an exercise regimen and that exercise is vitally important to avoid the loss of muscle and bone mass, especially during Phase one of the diet.

Side Effects

Despite Dr. Agatston’s claims to the contrary, the South Beach diet is both a low carbohydrate and a low fat diet. For this reason, one main concern regarding the diet is the risk of ketosis, especially during Phase one. Ketosis can cause such symptoms as dehydration, dizziness, heart palpitations, fatigue, lightheadedness, and irritability. Hypoglycemia, low blood sugar, headaches, and excessive fluid loss are also commonly associated with this diet. Cramping and tired muscles can be incited by salt depletion. Kidney functions can be impaired, possibly leading to serious health issues. Kidney function can be further impaired by the diet’s high protein requirements. These side effects typically lessen or fade at the beginning of Phase two, when a more balanced diet is undertaken.

Research & General Acceptance

Unlike the majority of low-carbohydrate diets, the medical community generally accepts the South Beach diet. The South Beach diet contains all the major food groups, promotes ingestion of "good" fats for maintaining heart health, and is flexible enough to accommodate most dietary needs.

However, many clinicians and dietitians agree that the rapid initial weight loss results mostly from water loss. Much of this weight can return once the dieter rehydrates.

Another important criticism by medical and nutritional professionals is the lack of evidence to support Dr. Agatston’s claims connecting the consumption of low-GI foods and weight loss. They assert that as of the early 2000s, there is no scientific proof that eating low-GI foods will have any more weight loss effect than eating a normal, calorie-reduced diet that includes carbohydrates; that Dr. Agatston also fails to take into account the interaction of different foods when eaten together, which can dramatically alter glucose metabolism; and that this failure means that utilizing the Glycemic Index as a gauge for what foods to eat is not only confusing but also slightly misleading.

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