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that our problem was not too much fat or too many carbohydrates in our diet but the wrong fats and the wrong carbs, I decided to try a good-fats, good-carbs diet on myself and on my patients. I also chose to recommend lean sources of protein that didn’t have excess saturated animal fat.
    I decided on a three-phase approach, with each phase having a distinct purpose. The first phase would be strict and last just 2 weeks. It would jump-start the diet and get rid of cravings. While studies had shown the positive psychological effects of early rapid weight loss, we intentionally did not want this rapid weight loss to continue for too long. Not only would dieters miss out on key nutrients in fruits and whole grains but, over time, rapid weight loss would become counterproductive. For this reason, we designed the second phase for slower weight loss, so that my patients could learn how they reacted to whole grains and whole fruits as they gradually reintroduced them. It would be an educational stage and a transition from diet to lifestyle. The third phase, or maintenance phase, would become a permanent, healthy lifestyle and a guide for the way we should all eat, whether or not we need to lose weight or improve our blood sugar and cholesterol levels. Because studies showed that well-timed snacks help prevent the sugar lows that can bring on cravings in the late morning, late afternoon, and/or evening, I included what I called strategic snacking on all the phases, but especially the first phase, of the diet.
    I felt that this approach was not only a true departure from the nationally recommended low-fat, high-carb diet at the time but also from the then-popular low-carb, high-fat diet and severely fat-restricted diets. I didn’t want to give my heart patients a high-fat diet that included liberal amounts of saturated fat that might accelerate their heart disease, nor did I want to severely restrict total fat. First, in my experience, patients had great difficulty adhering to such a diet. Second, with a low-fat, high-carb diet, I had seen patients’ good cholesterol decrease and their triglycerides and blood sugar shoot up. Third, I wanted my patients to have the benefit of good fats; studies had convinced me that they were good for both the heart and general health. In addition, having a certain amount of good fat in the diet made the food taste better and improved satiety and compliance.
    The First South Beach Dieter—Me!

    My interest in finding the ideal diet went beyond concern for my patients, however. In fact, it was a little bit selfish. I had had my own bad experience with the low-fat, high-carb approach and had gained weight due to what I now realize were very poor choices when it came to carbohydrates. I had even developed my own middle-age fat-storage depot where my once-trim belly used to be. Furthermore, I found I was running out of steam in the late afternoon, which often led me to a mad dash to the doctors’ lounge, where I would inhale a low-fat (but sugary) muffin and a cup of coffee to help me make it through the rest of the day. I now realize that this was a sign of reactive hypoglycemia due to insulin resistance and that the refined carbs and sugar I was eating only exacerbated the problem.
    So I designated myself as the first candidate for my new diet. I was amazed to observe my belly fat start to disappear in just 2 weeks, and I quickly felt energized. I no longer needed to make those late-afternoon dashes to the doctors’ lounge to hike up my falling blood sugar.
    With the confidence and excitement that resulted from my own experience, I recruited Marie Almon, MS, RD, at that time the chief clinical dietitian at Mount Sinai Medical Center in Miami Beach, to help me develop meal plans for each phase of the diet, based on the principles of nutrient-dense, fiber-rich carbohydrates; healthy fats; and lean sources of protein. When this was accomplished, we began counseling patients, explaining the three phases