South Beach Diet: How Does It Work? Stages, Differences, Efficacy, Allowed Foods and Special Conditions

It is a weight loss plan described by cardiologist Arthur Agatston, in a best-seller “The South Beach Diet: Foolproof, Delicious, Fast and Healthy Weight Loss Plan.”

The South Beach diet is based on the restriction of carbohydrates in the diet and prohibits the consumption of potatoes, fruits, bread, cereals, rice, pasta, beets, carrots and corn for the first two weeks (induction phase).

After that, most of these foods remain restricted, but some carbohydrate intake is allowed.

Instead of counting the grams of carbohydrates in a particular food, The South Beach Diet looks at the type of carbohydrates in the food.

Eating low-sugar carbohydrates, those with a low glycemic index (they don’t make blood sugar levels rise and fall as fast) are allowed, while sugar-laden carbohydrates are prohibited.

During the first two weeks, you are not allowed to eat bread, potatoes, rice, pasta, baked goods, fruit, sugar, or consume alcohol.

At the next level, carbohydrates are added slowly, but it’s still important that the weight loss continues.

In the third phase, when the goal with respect to body weight has been reached, carbohydrates are added at the individual’s choice.

The author of the South Beach Diet is American cardiologist Arthur Agatston.

Agatston has built a good reputation internationally, particularly for his research in the field of cardiovascular disease imaging.

The principles of the South Beach diet are not very different from the ideology of the Atkins diet.

Despite that, Dr. Agatston has said that weight loss is not the main goal of the South Beach diet.

Rather, it stresses that the South Beach Diet is designed to improve health by changing the “chemistry” of the blood.

The South Beach Diet has benefited from strong commercialization. South Beach in Florida is famous for its beautiful beaches, celebrities, models, and handsome young men.

Many famous people have followed the South Beach Diet and given it their recommendations, including former US President Bill Clinton.

The South Beach Diet also received rave reviews among professionals; it is convenient and relatively simple to implement.

The final stage of the South Beach Diet is designed to be a life-long diet, based on eating normal foods in normal portions, following some basic guidelines.

How does the South Beach diet work?

Agatston’s theories are based on the same ideology as most other low carb diets.

He believes that too much insulin production is a major contributor to obesity.

By reducing carbohydrate intake, there will be less fluctuation in blood sugar levels and insulin production will stabilize.

Agatston believes that the faster sugar and starch are absorbed, and the faster they enter your bloodstream, the fatter you will get.

He suggests that eating a combination of foods like protein, fat, and small amounts of carbohydrates, causes a gradual spike rather than a spike in blood sugar.

Agatston makes the distinction between good and bad carbohydrates. This is based on the glycemic index (GI). GI tells you how quickly 50 grams of a particular food turns into sugar.

Carbohydrates with a high GI raise blood sugar levels quickly, while carbohydrates with a low GI make it much slower.

Examples of high GI foods are white wheat bread, potatoes, and various types of cereals.

Green vegetables, whole grains, and beans are examples of low-GI foods.

The three stages

The first stage lasts for two weeks and is expected to reduce your craving for sugar and artificial starch and lead to weight loss.

The goal is to reduce fluctuations in blood sugar levels. The consumption of foods rich in fiber and nutrients is emphasized.

You can eat meat, fish, chicken, plant fiber, lean cheese, eggs, fat-free dairy products, healthy unsaturated fatty acids that can be found, for example, in avocado, nuts and seeds.

Use cooking oil, for example olive oil, which contains high levels of polyunsaturated fatty acids.

Agatston has said that this way he will lose between two and three kilos (4-6 pounds) in two weeks. The second step takes much longer.

People who don’t need to lose a lot of weight can skip the first step and go straight to the second level.

Here you can eat everything that is allowed in the first step and “good” carbohydrates such as whole wheat bread, brown rice, whole wheat pasta, fruits, vegetables, sweet potatoes and green beans.

It is emphasized that you eat healthy desserts and snacks of all kinds, even dark chocolate. The goal is to continue losing weight, but not more than 1/2 to 1 kilo (1-2 pounds) per week.

Once you reach your target weight, you need to move on to the third step. The third step. Here the South Beach diet has become a lifestyle.

You reach this level when you reach your goal regarding body weight. The third step defines your diet for a longer period, preferably for life.

Here you can eat whatever you want. There are no restrictions on what type of carbohydrates you eat.

However, it is expected that the amount of carbohydrates does not exceed certain limits and your goal is not to start gaining weight.

What’s the difference between the South Beach and Atkins diets?

What Atkins and South Beach have in common is that carbohydrate consumption is kept to a minimum.

However, Atkins is much stricter when it comes to carbohydrate amounts, while the South Beach Diet places more emphasis on choosing “good” carbs with a low GI rather than “bad carbs” with a high GI. Both diets warn against trans fats.

Although there are many similarities to the South Beach and Atkins philosophy, the main difference lies in their approach to fats.

The South Beach Diet cautions against consuming saturated fat, while the Atkins explicitly endorses it.

Therefore, the South Beach Diet has been more readily accepted by physicians, dietitians, and other specialists, as it is more in line with official recommendations for the type of fat you should prefer.

The promise

South Beach and Atkins are the celebrities of the low carb scene. But even though they share the best billing, they choose different paths to weight loss fame.

The key to losing weight quickly and staying healthy isn’t cutting all carbohydrates and fat from your diet, says Miami-based cardiologist Arthur Agatston, MD and author of The South Beach Diet.

The key is learning to choose the correct carbohydrates and the correct fats.

This approach is part of a three-step program that Agatston developed to help heart disease patients lose weight and lower cholesterol.

Emphasizing foods that are loaded with fiber and nutrients, the South Beach Diet promises to help you quit smoking, speed up your weight loss, and keep those unwanted pounds off for life.

In the first 2 weeks, Phase 1 of the diet, you can expect to lose between 8 and 13 pounds, says Agatston.

It works?

Yes. It is a healthy approach to eating that can help you shed pounds. However, nutrition experts caution against the restrictive first phase.

There are three phases, with Phase 1 being the most restrictive: no bread, rice, potatoes, pasta, or fruit.

In Phase 2, you gradually add in some of these foods again, then move on to Phase 3 when you reach your target weight, and you stay there for life.

For long-term success, exercise regularly as recommended in the South Beach Diet Supercharged plan.

What you can eat and what you can’t

That depends on the phase you are in. Phase 1 is the strictest and includes:

  • A lot of protein – like beef, chicken, seafood, eggs, and cheese.
  • Some fats: including canola oil, extra virgin olive oil, and avocado-
  • Carbohydrates with the lowest glycemic index: which include vegetables such as broccoli, tomatoes, spinach and eggplants.

What is off limits in Phase 1 are fruits, fruit juices, starchy foods, dairy products, and alcohol.

In Phase 2, you slowly reintroduce healthy carbohydrates into your diet: fruit, whole wheat bread, brown rice, whole wheat pasta, and sweet potatoes.

Expect weight loss to decrease 1 to 2 pounds per week, on average.

As mentioned above, phase 3 is about maintaining your weight. There is no list of foods to follow.

By this time, you will know how to make good food choices and how to get back to normal if you overindulge from time to time.

If cravings return or you stray from your diet, the plan recommends going back to Phase 1 or 2.

Effort level: medium

The South Beach diet should be practical and simple. No need to count calories or calculate fat, carbohydrate and protein percentages.

Their meals are normal size.


It’s okay to bend or break the rules from time to time.

If it exceeds you in Phase 2, Agatston suggests going back to Phase 1 until you lose the weight you put on. Then go back to where you left off.

Cooking and shopping

The dishes are easy to prepare, with ingredients found in supermarkets or most restaurants.

The plan calls for snacks between meals, but they are “the kind that you can toss in a briefcase or backpack in the morning and eat on the run,” as the book puts it.

Food or packaged meals

Yes, although you don’t have to buy them.

South Beach diet foods for sale include everything from bars to smoothies.

Tickets for lunch and dinner are also available for purchase; food delivery is for 4 weeks in meals.


The South Beach diet does not depend on exercise to function.

But The South Beach Diet Supercharged, Agatston’s updated version of his original book, has an exercise program that includes walking and strengthening your core muscles.

Do you allow dietary restrictions or preferences?

Yes. Flexibility is one of the guiding principles of the diet.

Vegetarians and vegans

This diet is both vegetarian and vegan. Protein alternatives to lean meat include beans, legumes, and soy products.

Without gluten

Gluten is not prohibited, but since you are cutting down on carbohydrates, you can ditch those that include gluten.

You will still need to read food labels to be sure.

Agatston has also written the South Beach Gluten Solution book and online program to help people who are sensitive to gluten.

What else should you know?


Healthy eating can be expensive.

The South Beach Diet website offers tips for saving money, such as buying food in bulk, shopping at farmers markets, using coupons, and preparing simple meals.


South Beach Diet Online offers tools you can use to track your weight, recipes, a personalized meal plan, dining guides, and community support.

Membership is $ 4 per week, but the first 7 days are free.

Optional online membership is $ 5 per week.

Is it good for certain conditions?

Body weight can be many times healthy, and the South Beach Diet is flexible enough to work for people with diabetes, high cholesterol, high blood pressure, and heart disease.

But check with your doctor before starting a new diet.

The final word

The South Beach Diet is a nutritious diet plan that offers a wide variety of delicious meals and a practical exercise plan, at least in the supercharged version.

And it depends on proven ways to lose weight – eating smart carbs, healthy fats, lean protein, low-fat dairy, and plenty of fiber to keep hunger at bay.

Starting a weight management program is a step toward better health. Even small weight losses can have significant health benefits.

However, because changing your diet can affect some medical conditions or interact with some medications, we would like you to share this information with your doctor before beginning.

In summary, the South Beach Diet offers portion-controlled, low-calorie, low-carb entrees and snacks that customers supplement with grocery items (e.g., healthy fats, lean protein, vegetables) to achieve a lower intake of carbohydrate, low-calorie diet that provides approximately 1,200 – 1,500 calories per day.

The first phase of the South Beach Diet offers approximately 15-20% of calories from carbohydrates.

The second phase of the South Beach Diet offers approximately 30 to 35% of calories from carbohydrates.

For most clients, following the South Beach diet means that the quality of their diet will improve significantly, while their total calories are reduced.

What conditions or medications can be affected by a change in diet?

Although we do not consider these conditions to be contraindications to using the South Beach Diet, we would like to raise the following for your consideration.


  • Individuals using insulin or sulfonylurea medications will require a taper to avoid hypoglycemia. Other diabetes medications may also require adjustment.
  • We recommend that all appropriate medication adjustments be made early in the patient’s weight loss attempt.


  • Supplementation with Anemia Iron is recommended. Blood thinning medications (eg, Coumadin).
  • Many customers significantly increase their vegetable intake when they follow the South Beach Diet.
  • Due to the action of warfarin or another anticoagulant, medications can be affected by an increase in vitamin K in the diet.


  • Intentional weight loss may not be appropriate if the cancer is active.
  • Treatment can affect appetite and food tolerance.
  • For patients with a history of estrogen-positive tumors, the diet can be customized to limit the amount of soy if necessary.

Congestive heart failure or ischemic heart disease

  • Sodium restrictions may be required. Averages of <2,400 mg sodium / day during phase 1 and <2,300 mg / day in phase 2.
  • Your patient can contact the Diet Services department for assistance in adjusting the meal plan.
  • Various medications used to treat this condition can interact with a change in diet.
  • Patients who wish to increase physical activity should have medical authorization.

Epilepsy (seizure disorder)

  • The levels of phenytoin, phenobarbital, carbamazepine can vary with diet changes. Folate, B12 and vitamin.
  • Vitamin C supplementation is recommended for patients taking phenytoin or phenobarbital.
  • Vitamin D is recommended for patients taking carbamazepine or valproic acid.
  • High doses of vitamin B6 can lower the seizure threshold.
  • Psyllium and ginseng interact with valproic acid and lithium.
  • Patients requiring a ketogenic diet should NOT use the South Beach diet.

Digestive tract disease

  • Digestive tract disorders can be aggravated by changes in diet (especially changes in dietary fiber intake) and / or require specific dietary restrictions.


  • Various medications used to treat this condition can interact with a change in diet.


  • Intake of vitamin D and calcium may need to be adjusted on a smaller scale.
  • The South Beach diet averages are <2,400 mg sodium / day in Phase 1 and <2,300 mg / day in Phase 2.
  • Sodium restricted below 2,000 mg / day may be necessary if the patient is treated with corticosteroids.


  • Consistent protein and carbohydrate intake is necessary to maintain consistent levels of medical drugs in the body.
  • Changes in caffeine intake should be avoided.


  • Isoniazid therapy (INH) for tuberculosis requires B6 supplementation.

What conditions or medications requires a doctor’s approval to use the South Beach diet?

Kidney transplant history

  • Patients must be at least 5 years after kidney transplant and must have written approval from their nephrologist.

Monoamine oxidase inhibitors (MAOI)

  • Tyramine is present in some foods in the South Beach diet and can interact with these medications to cause dangerously high blood pressure.
  • The dietary protein Levodopa can reduce the absorption of this medication.

Women weighing more than 400 lbs. And men weighing more than 450 lbs.

  • Those who exceed these weights should have their meal plans adjusted to adjust the amount of calories.
  • Due to increased morbidity associated with extreme obesity, the South Beach Diet is believed to be prudent for patients above these weights to be supervised by their physician during weight loss.

What conditions are contraindicated to using the South Beach diet?

  • People under 18 years of age.
  • Allergies to peanuts, soybeans or latex (used in food).
  • Anorexia or bulimia nervosa (presence or recent history).
  • Celiac Disease.
  • Body mass index less than 19 kg / m2.
  • Kidney Disease / Insufficiency.
  • Pregnant women.