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Join Date: Aug 2004
Location: Massachusetts
Posts: 244
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Transcript -- Dr. Agatston Chat -- 02/22/05
Transcript -- Dr. Agatston Chat -- 02/22/05
Dr. Agatston: Hello, everyone. It's great to be here answering your questions.
Member Question: This is the third week of Phase 2 for me and my weight is fluctuating up. I've only added back one whole grain and one fruit. I have also started an exercise program this week. Is there anything else I can do?
Dr. Agatston: The test as to whether the diet has worked is loss of cravings and control of what you are eating. If you have indeed lost cravings, you can decrease portion size, but please do not leave a meal hungry or unsatisfied. If you are having large portions due to cravings or hunger that would be an indication to return to Phase 1. Another possibility is that carbs or sugars maybe sneaking into your diet — discussing a food journal with our nutritionist would be a good idea. Also take into consideration that weight loss on Phase 2 is generally slower and there may be some fluctuations during the weight-loss process.
Member Question: Hello. I am a diabetic. How will the diet affect my blood sugar? Is Phase 1 OK for people who have type 2 diabetes?
Dr. Agatston: The diet was really developed to reverse pre-diabetes and type 2 diabetes. In the vast majority of patients with type 2 diabetes there is "insulin resistance," which occurs when fat cells in the belly grow to a size too large for insulin to attach properly, making it difficult for sugars and fats to clear properly after a meal. This results in wild swings in blood sugar and consequent cravings. An illustration of this phenomenon was described in the documentary Super-Size Me, where after eating fast food for three weeks, the documenter develops insatiable cravings due to the development of insulin resistance. By following The South Beach Diet™, insulin resistance and its associated cravings can be reversed and bellies will dramatically melt away. One note of caution, however, is if you are taking blood-sugar-lowering medications or insulin. Then The South Beach Diet™, especially Phase 1, should be started in consultation with your physician. This is because medication levels may need to be adjusted.
Admin_John: In the book, you mention that the belly fat often comes off first. Is this what you are referring to?
Dr. Agatston: Elevated insulin levels that occur due to insulin resistance also result in the selective depositing of fat in the belly — the "apple shape" body type. This fat is more dangerous than fat in other areas of the body. When insulin levels are controlled in the diet, this belly fat disappears.
Member Question: Is eating 1/3 cup of beans mandatory? I don't like any of the beans on the list. Instead, I am eating the full 4.5 cups of veggies per day. Is this OK?
Dr. Agatston: Yes, that is OK — eating veggies instead of beans is fine. Both have a great deal of fiber. Beans tend to have more protein than veggies, so if you are using beans as a source of lean protein and then switch to vegetables, you will have to supplement your diet with other sources of lean protein.
Member Question: I have been following the Atkins Diet since March of 2004 and I lost about 20 pounds during first three months. I have remained the same weight since May of 2004. I keep my carb count daily at under 50. I want to see if your diet can help me. Can you point me in the right direction?
Dr. Agatston: In the Atkins Diet, if you are severely restricting all carbohydrates to the point where you deplete all the sugar stored in the body, you will lose a lot of weight rapidly. Some of that weight is water weight, which is associated with the storage of sugar in the body. The problem with long-term weight loss and weight maintenance is that, while you can burn fat for energy for your muscles or to energize your brain, it is required to maintain adequate levels of blood glucose. To do this once your sugar stores are depleted, it becomes necessary to break down protein to maintain your blood sugar. This means loss of muscle and bone, which results in a slower metabolism. This adjustment to a slower metabolism is a survival mechanism for early man, who frequently experienced famine and near starvation. With a slower metabolism you require less food. For modern man, this slowing of the metabolism leads to yo-yo dieting. This is the reason on The South Beach Diet™, we recommend enough carbohydrates to prevent ketosis and the breakdown of muscle tissues. The other important advantage to maintaining good carbohydrate intake is the nutritional value found in fruits, vegetables, and whole grains (including: vitamins, minerals, and antioxidants).
Member Question: If you can slow your metabolism down with improper eating, how can you speed it up?
Dr. Agatston: You can speed your metabolism by building muscle and bone mass through exercise. Regular aerobic exercise may not burn many calories per session, but if done regularly over the space of a year, you burn many pounds. All resistance exercises, such as weight lifting or Pilates, specifically build muscle mass, which means your metabolism will increase allowing you to burn more calories, even during sleep. As we age, our hormone levels also decrease, which will cause loss of muscle mass and bone tissue, which will also cause a slower metabolism. This is seen in the rapid hormone loss that occurs in menopause. The only way to combat this rapid hormone loss is through regular exercise. The only drugs that currently will speed your metabolism are very unsafe, except for cases of thyroid deficiencies — people who have this trait can safely benefit from the use of medication.
Member Question: I am a big milk drinker and love 2 percent milk. I have tried to like 1 percent nonfat, but just can't take it. Will drinking 2 percent milk greatly hinder my success?
Dr. Agatston: No, our main objection to 2 percent milk is the saturated fat. If you have an elevation of your LDL (bad cholesterol), this can become a problem, but if you overall limit your animal fat (saturated fat) intake, then you can be more liberal with your use of 2 percent milk, particularly with the amounts put in for coffee and tea. For both weight loss and prevention of diabetes, low-fat dairy is looking quite good from recent studies. The calcium in dairy may play a role in weight control, as well as in helping to build and maintain strong bones. Nonfat yogurt may also be a more palatable choice, and is an excellent source of calcium.
Member Question: What do you think of low-carb milk, which has a lot less sugar than standard milk?
Dr. Agatston: There is no reason to chose low-carb milk. The natural sugar in milk, lactose, is low on the glycemic index. There is no benefit to lowering your intake. Please remember that The South Beach Diet™ is not a low-carb diet, but a good-carb diet. The good carbohydrates are essential for good health and will not adversely affect weight loss.
Member Question: How often could I have glass of red wine, being on Phase 2?
Dr. Agatston: Red wine with a meal actually helps slow digestion because it slows stomach emptying. In addition, red wine has antioxidants, which we believe are good for your heart, and alcohol in moderation is associated with lowered risks for diabetes and heart disease. The recent national recommendations define "moderate" as one glass of red wine (4 to 6 oz) per woman and two glasses of wine per man. Too much wine will add calories, as well as stimulate appetites, and can be a diet buster.
Admin_John: Could you comment on beer and liquor as well?
Dr. Agatston: While wine has theoretical advantages over beer and other liquors because of its antioxidant properties, actual studies of heart disease prevention have not shown an increased advantage from wine as expected. Moderate consumption of alcohol of any type is acceptable. However, be careful not to include mixers that contain additional calories. A recent study has indicated that juices alone can be responsible for increased weight gain in children.
Member Question: Is spelt flour OK on The South Beach Diet™? If so, which Phase?
Dr. Agatston: Whole-wheat spelt flour is acceptable on Phase 2. It is a good choice, being rich in both fiber and protein.
Member Question: On Phase 2, after adding fruit and bread, could I still have nuts (30 pistachios) as a snack?
Dr. Agatston: Nuts contain many good fats and are associated with protection from heart disease and diabetes. They are acceptable in all Phases of The South Beach Diet™. Please do remember that we do emphasize portion control when it comes to nuts, because it is possible to overdo it. Please remember to monitor your response to fruits and whole grains as you add them back in Phase 2.
Member Question: I am in the second week of Phase 1. Why do I suddenly feel so tired?
Dr. Agatston: The most common cause of weakness in Phase 1 is not getting enough good carbohydrates and not remembering to snack. In Phase 1 you can still have fairly large swings in blood sugar, and having snacks between meals and in the evenings will help prevent these falls in blood sugar associated with weakness. In addition, make sure that you are getting enough fluids to prevent possible dehydration as well.
Admin_John: Time for one last question!
Member Question: I still am confused as to how many Metamucil capsules I should take before a meal. What do you suggest? Why do you suggest we take fiber with our meals?
Dr. Agatston: The glycemic index of a meal depends on all of its components. The degree that you add fiber, either with a supplement or with the inclusion of high-fiber foods, will lower the glycemic index and slow the digestion of the meal and prevent the swings in blood sugar that will lead to cravings. Fiber supplements should be used gradually, as an excess fiber can result in gas or diarrhea, so we would recommend using small dosages to start.
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I'd be leery of posting them here, if so.
