Chapter One Changing the Way America Lives The South Beach Diet was always intended to be more than just a diet. In fact, it was originally developed to help my cardiac and diabetes patients lose weight in order to prevent heart attacks and strokes. As a cardiologist, I have always felt that the South Beach Diet is less about dieting and more about living a long, healthy, and active life. I wrote the original book in 2003 because I wanted to help change the way America eats. Now I have a new goal: I want to change the way America lives, not only by helping people eat healthfully and lose weight, if necessary, but also by helping them become more fit. We must begin to overcome the poor eating habits and sedentary lifestyle that are making us fatter and sicker with each passing year. Over the past several decades, we have witnessed an unexpected epidemic of obesity in this country. One-third of American adults over age 20 are obese, and two-thirds of us are overweight.

The number of seriously overweight children has tripled. Moreover, statistics show that 51 percent of Americans don''t engage in any kind of regular physical activity. The results have been catastrophic. This epidemic of obesity is causing an array of health problems that is much broader than we doctors ever imagined. Beyond the cosmetic concerns that pervade our culture, the list of real problems arising from our toxic lifestyle is getting ever longer. A partial list includes-and you may want to sit down for this-heart attack, stroke, prediabetes, diabetes, many types of cancer, Alzheimer''s disease, macular degeneration, arthritis, osteoporosis, psoriasis, acne, depression, and attention deficit disorders. And this is just a sampling. It also appears that if we do not reverse the health course that we are on, the cost in human and economic terms will reach crisis proportions.

Our poor diet and sedentary lifestyle are already exacting a steep toll in terms of mortality and money. They''re responsible for an estimated 300,000 premature deaths every year and $90 billion in health-care costs, but I believe the real costs are much higher. And as the baby boom generation gets older, these health costs will likely continue to soar. Sadly, this is not only an American problem. Just as our sedentary, fastfood lifestyle is being exported around the world, so are the attendant health problems. The good news is that now that we better understand what''s happening to us, we can start to create solutions. A Sedentary Nation In order to develop strategies to halt and reverse the epidemic of obesity, we must be aware of the trends that have gradually but inexorably brought us to the crisis situation we are in today. I have found in my practice that by putting patients'' current problems into a context they can understand, they can more easily become cooperative partners in moving toward solutions.

Perhaps because I was a history major (not all doctors are bio majors), I also find that tracing today''s health problems back to their original roots is fascinating. The truth is that while our bad diet and unhealthy lifestyle have been many decades in the making, the toxic changes in the way we live have really accelerated in recent years. Our DNA is designed to live, eat, and exercise the way our hunter-gatherer ancestors did, and it hasn''t changed substantially since that time. But we no longer live in the wild. We don''t have famine in this country to keep us thin. We no longer burn calories hunting and gathering our food. On top of that, a completely sedentary lifestyle has gradually crept in, invention by incredible invention. Due to the march of technology, we sit in front of computers both at work and at home.

Machines and gadgets lift, move, and carry things for us. We communicate by e-mail, and many of us don''t even walk down the hall to chat with colleagues as often as we used to! While studies document how much less physical exertion we''re doing, we really don''t need research studies to appreciate the trend. All we have to do is look around. The preponderance of labor-saving devices, from tractors and forklifts to remote controls and the personal computer, has had a major impact on the number of calories we expend daily at home and at work. These devices have also had devastating effects on our muscles, bones, tendons, and ligaments. Sitting bent over at a computer for most of the day is simply not good for our health. In Chapter 5, "Boomeritis: The New Epidemic!" I talk about these evolving physical problems and their solutions. And in Part II of the book, I present the South Beach Supercharged Fitness Program.

Not only will this 20-minute-a-day program help you burn more calories even when you''re not working out, it will also strengthen the key core muscles in your abdomen, back, pelvis, and hips. It''s your core muscles that help you avoid the back pain and other muscle problems that so often result from our sedentary lives. Missing Our Nutrients Our unhealthy lifestyle is made even worse by our poor diet. Since we began growing fields of grain about 10,000 years ago and developed the ability to cultivate fruits and vegetables, the nutritional content of our foods has seriously deteriorated. This is because we tend to breed plants for hardiness, taste, and aesthetics, not nutrients. Today, the fruits and vegetables we find in most supermarkets are larger, sweeter, and better-looking than those our ancestors gathered. The problem is that they also have less fiber and fewer vitamins, minerals, and other nutrients than is optimal for our general health-not to mention our waistlines. Luckily, more and more Americans are embracing organic foods, heirloom fruits and vegetables, and sustainable farming methods, all trends that are bringing food back to its more natural and nutritious state.

In Chapter 7, "Supercharged Foods for Better Health," I recommend some foods with powerful nutritional benefits that can help you stay healthy and avoid the host of chronic and degenerative diseases currently affecting so many of us. A Nation Overprocessed Beyond our desire to cultivate and produce food almost exclusively to please our tastebuds, other social and technological trends have affected our food supply for the worse. A few generations ago, our great grandparents walked to local markets on a daily basis to buy whatever produce they didn''t grow themselves as well as fresh bread and other food for their families'' next meals. They could only travel to local markets and take home what they were able to carry. With the advent of the automobile and the home refrigerator, however, it became possible to travel farther to shop, and people could take home enough food to feed their families for a week or two. But for that to be possible, foods had to have longer shelf lives. This led to supermarkets and to food processing, which, unfortunately, removed important nutrients while adding substances like sodium and trans fats to prevent spoilage. In a sense, we began digesting our food in factories instead of in our intestines.

It''s only now that we are appreciating the deleterious effects these technological "advances" have had on our weight and on our health. In Chapter 3, "A Diet You Can Live With . For Life," I discuss the health and character of a Mediterranean society that thrived without many of our modern advances, and I show you how we can learn from this remarkable example. We Must Act Now If you''re like me, you find how we got into this sad state not only depressing but scary. But there is hope if we take action today. Because we finally understand so much of what has gone wrong, we can use our advanced technologies to turn things around. We now know that our increasing waistlines, poor physical fitness, and worsening health are not different It was 2003, and my husband had very high blood pressure that wasn''t being controlled, even with medication. I was very overweight and knew that we both needed to make a change.

The South Beach Diet had just come out, and I went to the bookstore to look over a copy. The first thing I turned to was the recipe section. It was great. I love to cook and was thrilled that I didn''t have to give it up. After reading the book, I realized that I ate way too many bad carbs all day, like crackers and cookies. Once I stopped eating enriched white flour, I noticed a complete change in everything about me, including my mood and energy level, and I started losing weight. Within a year, I lost 45 pounds, and my husband lost 20. Although he still takes medication for high blood pressure, it''s now under control.

Now I''m the go-to girl at work for healthy-food questions. When we have luncheons, everyone knows they can count on me to bring in something healthy. I have learned how to take bad carbs out of a recipe and replace them with good carbs. I am passionate about telling people to read food labels! Don''t be fooled; buy only whole-grain products. If it says "enriched white flour," find something else. In 2005, we had an 11-year-old foster youth come to live with us. He was overweight and already taking medication for high blood pressure. He lived on junk food.

We took him to a doctor, who told us that he shouldn''t go on a diet-he should start living a healthy lifestyle. I decided to give him the same healthy food my husband and I were eating, but I told him he could eat as much as he wanted. He also started exercising. Simply by eating the right foods and being more active, he started losing weight fairly quickly. By the end of 4 months, he was off the blood pressure medication, and by the time he left us 18 months later, he had lost 30 pounds. While living with us, he learned how to read food labels and make good food choices. I hope he continues to live a healthy life. My husband often jokes that I should open my home to people who want to lose weight.

I am happy with my weight lo.