I smiled as you noted that Kempner demanded strict adherence to his diet, that other modified it and it didn’t work…… then described your version which was markedly different from his! I’m glad you admitted those differences.
A few years ago I went through a stage of reading a lot of the “whole food plant based” doctors books including McDougall’s Starch Solution - obviously derived from Kempner, again the low fat and salt were always stressed as essential.
Anyway an interesting read on the man and his history.
Yea it's always difficult to even copycat a diet if you don't know what makes it tick. Either you completely copy & paste to the best of your ability, or any modification you do could completely change the outcome.
E.g. if you did my diet but with soybean oil instead of cream because "it's just fat right?" I'd say it obviously isn't the same. or if you added protein.
But if you're not PUFA-woke or protein-woke, you probably would think of those as innocuous changes and that you gave my diet a fair shake.
The idea that you'd be learning biology by coming to a lab and sitting in the corner, observing, is considered heretic today. Invariably, whenever I read biographies of people who came before us, it feels like the world was much smaller, much more local, much more grounded. You could walk in anywhere and, provided you had a some savoir-vivre (which everybody seems to harbor in these times), anything was possible. Now that might be because the people who have biographies written on them are, more often than not probably, smart, charming bastard, but still. It was, in lots of way, a simpler but busier life. There was just much less regulations, laws and technologies dictating aspects of our social lives -- it was pretty much all customs and "tacit knowledge".
I had no idea it was this popular and that his lab had recurring patients. This undeniably casts serious doubts on the long-term efficacy of the diet.
As you accurately pointed out, it still looks like his diet was another instance of potassiummaxxing, or at least sodium-reducing, diet. Fruit juices are a efficient addition in this regard. I'd just go potato diet + dairy if I had to go for something similar-- too bad it didn't work for you though!
Yea it seems to have been way more "self-regulating" back then. Let's also not forget that these are basically aristocrats in a sense; your average Joe in 1920 or 1930 wasn't in any position to move to the big city and walk into a lab and sit in the corner.
So they would've been trained by their parents (very clearly Kempner was) to behave correctly & know important tacit skills that Warburg could then take for granted once Kempner showed up at his lab.
Sort of like officers in the military were apparently aristocrats.
Both hedonic value and salt are very important (combined ?) factors here. Salt will manipulate the microbiome and (thus) HPA axis in ways we are not (yet) aware of. It is afterall a 'preservative'. For me, my diets always work better with (near) zero salt. Mc Dougalls also has always put a lot of emphasis on it. I'm still experimenting if 'fake' salt (KaCl) with Potassium instead of Sodium (NaCl) helps but I have no definitive answer yet. It seems to help somewhat with blood pressure, but not with dieting. Does the body/microbiome respond to the Cl anion or the metal anion ? The typical taste of salt (and so the hedonic value ?) comes from the Cl anion and that is also the anion that yields the preservative power. For people that worry they will not get enough electrolytes in when going zero salt: use sodium citrate (or something, just not Cl).
Yea the salt->HPA axis thing is pretty much what I think Kempner was after. Funny, I was just listening to a podcast about stress/HPA axis, I'd never heard the term before.
If I ever do a Kempner type trial again, I would have to do without the sauce (and therefore salt) and include fruit & maybe fruit juice. That will also lower overall protein from 8% or so to 4%.
I wonder if part of it was the result of arsenic, which can cause weight loss. According to Wikipedia, it was in commonly used pesticides in the 1930s, especially on fruit trees. And we know rice accumulates it from the soil. Maybe folks were getting a double whammy for a few weeks?
Ha, that could be. Would be unfortunate, but even today rice is known to contain a lot of arsenic. It's just in the soil now. I briefly mentioned it in my recent rice diet post.
A good post, and I have unknowingly reproduced many of his thoughts a decade later :)
1. We don't know why it worked
2. It might've "just" been extreme caloric restriction, which "works" in the short-term but then you gain it all back
My biggest hint for that last point: by adding tomato sauce and subtracting fruit/juice, I found the diet completely tolerable for a month. I certainly wasn't starving, and it wasn't particularly unpleasant. I'd give it a 6/10.
That certainly doesn't sound like the stories from patients, or even how Kempner himself describes the diet.
Of course, if you did only 1,000kcal of this, I'd be starving after 3 days too.
Kempner took detailed notes, saved fluid samples, tested everything…. and nowhere recorded calories per day or correlated that data to weight loss?? What a quack.
The rice diet is low in PUFA, as you say. I wonder if it would also be low in Vitamin A; I guess it might depend on what fruit you eat. You mentioned that dieters experienced "reversal of ... damage to the retina of the eye," which strikes me as something that a low Vitamin A diet might achieve.
BTW, I love that photo of the two dieters. What a difference!
Yes. Grant G's anti-vitamin-A diet consists largely of white rice. I am not super deep into vA so I don't know if there are any fruits that are low in it, but presumably if there are, you could totally add them. I do think that long-term, a little meat is crucial.
Yea, the difference is quite astounding. There are a few more like this in the book.
An interesting read. Thanks for writing it.
I smiled as you noted that Kempner demanded strict adherence to his diet, that other modified it and it didn’t work…… then described your version which was markedly different from his! I’m glad you admitted those differences.
A few years ago I went through a stage of reading a lot of the “whole food plant based” doctors books including McDougall’s Starch Solution - obviously derived from Kempner, again the low fat and salt were always stressed as essential.
Anyway an interesting read on the man and his history.
Yea it's always difficult to even copycat a diet if you don't know what makes it tick. Either you completely copy & paste to the best of your ability, or any modification you do could completely change the outcome.
E.g. if you did my diet but with soybean oil instead of cream because "it's just fat right?" I'd say it obviously isn't the same. or if you added protein.
But if you're not PUFA-woke or protein-woke, you probably would think of those as innocuous changes and that you gave my diet a fair shake.
An interesting piece!
The idea that you'd be learning biology by coming to a lab and sitting in the corner, observing, is considered heretic today. Invariably, whenever I read biographies of people who came before us, it feels like the world was much smaller, much more local, much more grounded. You could walk in anywhere and, provided you had a some savoir-vivre (which everybody seems to harbor in these times), anything was possible. Now that might be because the people who have biographies written on them are, more often than not probably, smart, charming bastard, but still. It was, in lots of way, a simpler but busier life. There was just much less regulations, laws and technologies dictating aspects of our social lives -- it was pretty much all customs and "tacit knowledge".
I had no idea it was this popular and that his lab had recurring patients. This undeniably casts serious doubts on the long-term efficacy of the diet.
As you accurately pointed out, it still looks like his diet was another instance of potassiummaxxing, or at least sodium-reducing, diet. Fruit juices are a efficient addition in this regard. I'd just go potato diet + dairy if I had to go for something similar-- too bad it didn't work for you though!
Yea it seems to have been way more "self-regulating" back then. Let's also not forget that these are basically aristocrats in a sense; your average Joe in 1920 or 1930 wasn't in any position to move to the big city and walk into a lab and sit in the corner.
So they would've been trained by their parents (very clearly Kempner was) to behave correctly & know important tacit skills that Warburg could then take for granted once Kempner showed up at his lab.
Sort of like officers in the military were apparently aristocrats.
Both hedonic value and salt are very important (combined ?) factors here. Salt will manipulate the microbiome and (thus) HPA axis in ways we are not (yet) aware of. It is afterall a 'preservative'. For me, my diets always work better with (near) zero salt. Mc Dougalls also has always put a lot of emphasis on it. I'm still experimenting if 'fake' salt (KaCl) with Potassium instead of Sodium (NaCl) helps but I have no definitive answer yet. It seems to help somewhat with blood pressure, but not with dieting. Does the body/microbiome respond to the Cl anion or the metal anion ? The typical taste of salt (and so the hedonic value ?) comes from the Cl anion and that is also the anion that yields the preservative power. For people that worry they will not get enough electrolytes in when going zero salt: use sodium citrate (or something, just not Cl).
Yea the salt->HPA axis thing is pretty much what I think Kempner was after. Funny, I was just listening to a podcast about stress/HPA axis, I'd never heard the term before.
If I ever do a Kempner type trial again, I would have to do without the sauce (and therefore salt) and include fruit & maybe fruit juice. That will also lower overall protein from 8% or so to 4%.
Very interesting piece. Thanks for writing it.
I wonder if part of it was the result of arsenic, which can cause weight loss. According to Wikipedia, it was in commonly used pesticides in the 1930s, especially on fruit trees. And we know rice accumulates it from the soil. Maybe folks were getting a double whammy for a few weeks?
Ha, that could be. Would be unfortunate, but even today rice is known to contain a lot of arsenic. It's just in the soil now. I briefly mentioned it in my recent rice diet post.
I'm at work and only skimmed your article, so apologies if this isn't relevant, but Jason Fung has an interesting (skeptical) take on Kempner's diet:
https://www.thefastingmethod.com/thoughts-on-the-kempner-rice-diet/
A good post, and I have unknowingly reproduced many of his thoughts a decade later :)
1. We don't know why it worked
2. It might've "just" been extreme caloric restriction, which "works" in the short-term but then you gain it all back
My biggest hint for that last point: by adding tomato sauce and subtracting fruit/juice, I found the diet completely tolerable for a month. I certainly wasn't starving, and it wasn't particularly unpleasant. I'd give it a 6/10.
That certainly doesn't sound like the stories from patients, or even how Kempner himself describes the diet.
Of course, if you did only 1,000kcal of this, I'd be starving after 3 days too.
Kempner took detailed notes, saved fluid samples, tested everything…. and nowhere recorded calories per day or correlated that data to weight loss?? What a quack.
He probably did, we just don't have them.
The rice diet is low in PUFA, as you say. I wonder if it would also be low in Vitamin A; I guess it might depend on what fruit you eat. You mentioned that dieters experienced "reversal of ... damage to the retina of the eye," which strikes me as something that a low Vitamin A diet might achieve.
BTW, I love that photo of the two dieters. What a difference!
Yes. Grant G's anti-vitamin-A diet consists largely of white rice. I am not super deep into vA so I don't know if there are any fruits that are low in it, but presumably if there are, you could totally add them. I do think that long-term, a little meat is crucial.
Yea, the difference is quite astounding. There are a few more like this in the book.