Some very good points. Thanks for posting. I didn't think it was long though. Did he have the Pritikin part attached at first?

I thought Fung was using some of his usual humor when he said "Kempner would, on occasion, whip his patients to help compliance." But he wasn't kidding. He links to a newspaper article about a lawsuit against Kempner for whipping patients (because they said they wanted it).
https://news.google.com/newspapers?...=6859%2C6027332

Holy crap! If you have to be physically abused to stay on an eating plan, it is NOT a good thing...

PJ

Dr. Fung mentioned failure to replicate results. I just saw this McDougall Swank-type diet study on MS;


http://www.sciencedaily.com/release...40501101121.htm



MS related fatigue? How do you differentiate MS fatigue from the sort the rest of us get? Improved energy levels are a good thing--but is this necessarily an improvement in MS itself?



Not a very long study. Not much evidence of MS remission. What did improve--weight loss, fatigue--doesn't seem specific to MS.

I'm not sure what Dr. Fung assumed about fruit was correct, that one study that gave an example of a person's daily diet had people eating an enormous amount of fruit, something like half their daily calories. But it looks like he's right about the lower calories for overweight patients;

https://www.drmcdougall.com/2013/12...-the-rice-diet/



The higher calories are for people who don't need to lose weight in the first place...

Found this personal anecdote from when the Rice Diet clinic closed down a couple of years ago;

http://globalnews.ca/news/830532/ri...s-hypertension/



Biggest Loser effect? How does it work on free-living subjects? This was a person with enough drive to be in law school in the first place, never mind if she found it necessary to drop out to go to the clinic. Can't help but notice that she doesn't say "eat rice and fruit to satiety, yet still lose weight," she says starve.

So are we right back at fasting again?

It's interesting as the layers of the onion are peeled, we start to get some confirmation of initial reactions to the rice diet. I was curious about the lack of differentiation that didn't include different dietary approaches and a control group, as Kempner's primary goal didn't favor the rigor of research to disprove his hypothesis; rather, he seemed to be convinced that he had the answer to treat obesity and HBP, which was his primary objective. I wanted a comparison with a low fat wheat group to better understand the differences between a non-wheat rice diet and the wheat consumers. In addition, it would have been great at the time to have a higher fat group as well, but it appears Kempner assumed he already had the answer he required for treatment.

Fung's HBP hypothesis of the resulting reduction due to dietary salt elimination may be correct, but I'm not so sure about that. I eat plenty of salt, and despite that my BP went down once I eliminated all grains including rice, but my prior grain consumption was mostly wheat. Hopefully, more to come on this, as Denise has triggered much examination in a positive way.

It's anecdotal, but I've heard plenty of wrecked metabolism stories which included the fact that the person would be on an IV drip of glucose in the hospital, not eating at all, and they would gain under such circumstances.

In 1936, there was the probable advantage of coming at these folks before they had yo yo dieted?

With the salt, we're looking at extremely low levels. It's possible the "damage" is already done at a very moderate level of salt intake. The body seems to be able to maintain its sodium levels at a wide range of sodium intake, but once you get down to 30 mg or so, that might be outside of the range that it can adapt to.

Denise Minger show's up in the comments, she makes a good point about dietary fat increasing the insulin response when added to carbohydrate. I think she used the word potentiating. If you think about it--this does make sense of insulin decreasing, at some point, as carbs go up. Suppose you ate just fat and starch. At 30 percent fat, there's lots of fat there. Twenty percent fat might not make much difference. Now cut to three or four percent, like in the rice diet. Carbohydrate intake has gone up 20-40 percent. But that potentiating fat has become nil. What happens to insulin at that point? It's not necessarily higher. Even when you look at accumulation of liver fat--I think it's not that obvious whether this would increase that or not. Fructose increased, check. But postprandial free fatty acids greatly decreased--probably, also check. Something that often happens with diabetics, not always, but often, is that when they begin insulin therapy, liver fat will actually go down. A few things work towards this. Liver increases VLDL triglyceride secretion--bad for blood lipids, but good for the liver. And the triglycerides in the liver come from somewhere, a major source is inappropriately high free fatty acids. Fat trapped in fat cells isn't available to fatten the liver.

All this is moot if the diet is a semi-starvation one that needs whips and incarceration to make it work. But at least some people do experience a decrease in appetite when they switch to a very low fat diet.

https://www.youtube.com/watch?v=Ra-egRqAiiE

Dr. Don Rosati and his wife Kitti carried the ball for the rice diet after Kempner. Here they're being interviewed, Dr. Rosati gives a history of how the diet started being used for obesity. He does say that it was hard for some people to maintain bodyweight when the diet was originally used vs. malignant hypertension, patients weren't generally overweight to begin with. Later in the 70's when obesity became more common, he says Kempner adapted the diet for weight loss--800 to 1000 calories a day. Not much need to dig into theories involving nicotinic acid to explain how a plan like that might reduce insulin, very little food equals very little insulin.

The claims made for malignant hypertension are still interesting. And reversibility of diabetic retinopathy--that's interesting whether calories are restricted or not.

From Denise Minger's comment:

She might have a point about Ancel Keys. It's very hard to go back in time and figure out what/who happened to change the general perception of any one thing, such as dietary fat. I thing the Keys=dietary devil theme was first developed by Gary Taubes?

Totally disagreeing with the second point. I don't see anyone saying a low-fat diet in particular causes any disease, other than possibly a deficiency of certain fatty acids. It's the corresponding increase in carbohydrates, to fill the (stomach and caloric) void that is causing problems. The high-carb diet, not the low-fat part. I'm not really understanding why she is focusing so much on the low-fat part of these diets, and not (as Fung is) exploring all the other possible explanations for healing on such a restricted diet. Fat is a perfectly good and yummy macronutrient, but the demonization continues....

Teaser, I wonder if the PH was hard for you because you didn't have much weight to lose?

I did the potato hack in late May 2013, eating about 600-800 cals a day of mostly cold potatoes, and had remarkable lack of hunger on it despite doing heavy gardening/farm work nearly every day. I ate potatoes Mon-Fri, and lower cal LC (1200-1500 cals) on weekends, and didn't get sick of them even after three weeks, probably because of the weekend LC meals. After three weeks, I did a three-way rotation of PH, FF and LC, dropping even more weight.

I lost 17 lbs those three weeks, and my blood sugar dropped the longer I was on it, my mood improved, my basal body temperature rose, and I slept much better. In fact, overall, I felt better physically and mentally on potatoes than I do on high-fat ketosis, which I can't do much of anymore. High-fat ketosis tends to make me very depressed and physically cold, even in summer. The PH is definitely more sustainable for me over the long haul than high-fat ketosis.

When I started the PH, I tracked my blood sugar obsessively, frightened that the PH was going to turn me from pre-diabetic to full-blown diabetic. Instead, I was very surprised to see it come down, AND rise after eating high-fat, low-carb on weekends! Very confusing, after being told all these years that only LC lowers BS. It was my first indication that HF/LC was not all that great for me.

Unfortunately, I did regain those lost pounds the following fall... not because of the PH but because of autumn SAD that always started in August every year. In Michigan, I always regained weight lost the previous spring-summer thanks to SAD, no matter what I tried. Dwindling light and increasing cold always ramped up my appetite, packing on pounds, which often made winter depression worse. Now that I'm in Florida, the annual SAD is not happening and I'm still losing weight.

Anyway, the PH was a great experiment... I learned a lot about how my body works, and learned not to fear whole-food carbs anymore, though I still keep relatively LC, mostly IF.

I tracked and discussed everything on my journal during those three weeks: weight, what and how much I ate, blood sugar meters, theories and research in why the PH works, changes in mental attitude, sleep and other benefits... it's pretty interesting reading, actually: http://forum.lowcarber.org/showthre...1&page=74&pp=15.

Check out the PH highlights under "Potato Hack Info" if you don't want to read the whole three weeks: http://forum.lowcarber.org/showthre...41&page=1&pp=15

I started the PH May 22nd, but didn't mention it until May 26th, after losing 7 lbs in 4 days and everyone wanted to know how I did it.

Here's the 3-week recap, 17lbs in 13 potato days: http://forum.lowcarber.org/showpost...&postcount=1270

I think that may be a factor... my big problem with the potato hack was that my appetite for potato, specifically, just wasn't there, but there was no general appetite suppression. I could probably have done the oatmeal and brown sugar hack, the white rice and soy sauce (or canned fruit like the rice diet) hack, etc. just fine. The banana hack actually did seem to work for me.

Thanks for providing the links. I do think there's something useful to be had in all this.

Somewhat aside, For history buffs, there is nothing new.
This week's podcast on "Stuff you missed in History Class" was "Starvation Heights", a turn of century fasting cure place near Seattle. Thankfully at the beginning the hosts clarified there are some positive studies of fasting as a cure for disease, and it has been used for centuries in many cultures, but this woman starved some of her patients to death.

Others have been about John Harvey Kellogg's Sanatorium:
"At the sanitarium, Kellogg explored various treatments for his patients, including diet reform and frequent enemas. He encouraged a low-fat, low-protein diet with an emphasis on whole grains, fiber-rich foods, and most importantly, nuts. Kellogg also recommended a daily intake of fresh air, exercise, and the importance of hygiene. Many of the theories of John Harvey Kellogg were later published in his book The Road to Wellness. Charles W. Post or "CW" as he preferred also worked with John Harvey Kellogg ( Dr.Kellogg)"
Dr Kellogg also used a mechanical slapping device, so maybe beatings were already considered necessary to keep people low fat
I was really put off by the sleeping outdoors bit..in winter, in Michigan.


Low fat, low protein, vegan, whatever...all around long before Ancel Keys.

http://ajcn.nutrition.org/content/32/4/905.full.pdf



Basically a corn and beans diet. These people are closely related to the Pima Indians. A common argument put forth when looking at a very high carb diet is that yeah, it might work for a person whose metabolism is uncompromised, not for people prone to insulin resistance. A lot of the people hit hardest on the modern diet, though, are people whose ancestors did eat very high carb diets. That doesn't necessarily mean that once they are insulin resistant, the ancestral diet will do them any good.

http://ajcn.nutrition.org/content/53/6/1647S.long




But returning to an ancestral diet, very low in fat, high in carbs (or at least the researcher's idea of what the ancestral diet was) did seem to work for these folk. There seemed to be a decrease in appetite there, as well. Weight loss, improved blood glucose.



That decrease in blood pressure is 3 or 4 times anything I can remember seeing in studies on the idiot DASH diet.

Neither diet was vegan, though meat was low. Corn and bean sounds pretty monotonous, but I'm sure I'd last longer on low fat burritos than I did on potato.





I think there's a place for fearing whole-food carbs, though. I think there are probably people who can benefit from either a ketogenic approach, or one of these high starch ancestral approaches. I don't know that everybody can, though. And I think choosing one is probably safer than the muddy middle--basically, I'm saying fear whole food carbs in a certain context. A real foods approach is dangerous in that it's entirely possible to construct a SAD diet like experience on whole foods. I tried Atkins plus fruit once (basically) after misreading Art DeVaney's blog, years ago. That gave me the worst blood pressure of my life.

Sagehill--just spent some time poking around in your journal. Lots of interesting stuff. I have a different view of nutritional ketosis, but then I respond to it pretty well, not everybody likes it as well as me. It is an extreme, and when you get to the extremes, you are liable to get outliers who respond particularly well and particularly poorly. The same is likely true of carbosis--I would guess, do not try it if you are Inuit.



Your potato recipes look much better than mine. That might be why I could not do the potato hack. Maybe if I had managed to eat more potatoes, I would have ended up satisfied on less calories than usual, I just could not seem to get myself to eat that many.