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Part
2 of 2 (Part 1)
The Banting
diet is confirmed
Banting's Letter
on Corpulence traveled widely. In the 1890s, an American doctor,
Helen Densmore, modeled diets on Banting. She tells how she
and her patients lost an average 10-15 lbs (4.5-6.8 kg) in
the first month on the diet and then 6-8 lbs (2.7-3.6 kg)
in subsequent months 'by a diet from which bread, cereals
and starchy food were excluded'. Her advice to would-be slimmers
was: 'One pound of beef or mutton or fish per day with a moderate
amount of the non-starchy vegetables given above [tomatoes,
lettuce, string beans, spinach and such] will be found ample
for any obese person of sedentary habits'.
Dr. Densmore was
scathing of those others of her profession who derided Banting's
diet. She says of them: 'Those very specialists who are at
this time prospering greatly by the reduction of obesity and
who are indebted to Mr. Banting for all their prosperity are
loud, nevertheless, in their condemnation of the Banting method'.
Real-life tests
In 1906, Dr. Vilhjalmur
Stefansson, a young Harvard anthropology teacher who later
became a world-famous explorer and anthropologist, revolutionized
polar exploration by crossing the Arctic alone and living
off the land with the Eskimos. It was not quite what had been
planned. Stefansson had gone on ahead of the Leffingwell-Mikkelson
Expedition and had missed a planned rendezvous at Herschel
Island. He was left to spend an Arctic winter with the Eskimos
eating a diet composed only of meat and fish. Unlike the diet
he had been brought up on, it contained no plant material
whatsoever.
It was a golden
opportunity for the young scientist to conduct an experiment
into the effects of an Eskimo diet on a European unaccustomed
to it. The usual Eskimo meal consisted of briefly stewed fish
washed down with water. It was so different from what he was
used to that at first Stefansson was repelled by it.
To try to make
the fish more palatable, he tried broiling it. This resulted
in his becoming weak and dizzy, with other symptoms of malnutrition.
Stefansson reasoned that with such a restricted diet the body
had to have not just the fish but the other nutrients that
had been leached out into the water. And so he tried harder.
Eventually he became so accustomed to the primitive diet that,
by the time he left the Eskimos, Stefansson managed as well
as them. On this regime, Stefansson remained in perfect health
and did not get fat.
The experience
had a profound effect on Stefansson. Like Banting before him,
he became interested in the possibilities of diets high in
proteins and fats and low in carbohydrates. It seemed to him
that a balanced diet in which there was relatively little
meat, 'balanced' by larger amounts of potatoes, bread, rice
and other starchy foods followed by sweet desserts and sugared
coffee might be balanced in the wrong direction. And so, like
Banting, Stefansson questioned the established ideas on diet.
Unfortunately, he had no more success than Banting. Although
he became famous and his position as an anthropologist was
unassailable, still no one took any notice of his ideas on
nutrition.
Some years after
his first experience with the Eskimos, Dr. Stefansson returned
to the Arctic with a colleague, Dr. Karsten Anderson, to carry
out research for the American Museum of Natural History. They
were supplied with every necessity including a year's supply
of 'civilised' food.
This they declined,
electing instead to live off the land. In the end, the one-year
project stretched to four years, during which time the two
men ate only the meat they could kill and the fish they could
catch in the Canadian Arctic. Neither of the two men suffered
any adverse after-effects from their four-year experiment.
It was evident to Stefansson, as it had been to Banting, that
the body could function perfectly well, remain healthy, vigorous
and slender if it used a diet in which as much food was eaten
as the body required, only carbohydrate was restricted and
the total number of calories was ignored.
The First Clinical
Dietary Trial
In 1928, Stefansson
and Anderson entered Bellevue Hospital, New York for a controlled
experiment into the effects of an all-meat diet on the body.
The committee which was assembled to supervise the experiment
was one of the best qualified in medical history, consisting
as it did of the leaders of all the branches of science related
to the subject.
Dr. Eugene F. DuBois,
Medical Director of the Russell Sage Foundation (subsequently
chief physician at the New York Hospital, and Professor of
Physiology at Cornell University Medical College) directed
the experiment. The study was designed to find the answers
to five questions about which there was some debate:
1. Does the withholding
of vegetable foods cause scurvy?
2. Will an all-meat
diet cause other deficiency diseases?
3. Will it cause
mineral deficiencies, of calcium in particular?
4. Will it have
a harmful effect on the heart, blood vessels or kidneys?
5. Will it promote
the growth of harmful bacteria in the gut?
The results of
the year-long trial were published in 1930 in the Journal
of Biological Chemistry and showed that the answer to all
of the questions was: no. There were no deficiency problems;
the two men remained perfectly healthy; their bowels remained
normal, except that their stools were smaller and did not
smell. The absence of starchy and sugary carbohydrates from
their diet appeared to have only good effects.
Once again, Stefansson
discovered that he felt better and was healthier on a diet
that restricted carbohydrates. Only when fats were restricted
did he suffer any problems. During this experiment his intake
had varied between 2,000 and 3,100 calories per day and he
derived, by choice, an average of eighty percent of his energy
from animal fat and the other twenty percent from protein.
One interesting
finding from a heart disease perspective was that Stefansson's
blood cholesterol level fell by 1.3 mmol/l while on the all-meat
diet, rising again at the end of the study when he resumed
a 'normal' diet.
But the published
results had little effect on the people trying to lose weight
in 1930. A diet that allowed as much meat as one could eat
and also allowed a large proportion of fat must contain lots
of calories. To the average slimmer, lots of calories meant
putting on weight.
The evidence
mounts
In 1933, a clinical
study carried out at the Royal Infirmary, Edinburgh studied
the effects of low- and high-calorie diets, ranging from 800
to 2,700 kcals.
Average daily losses:
- high carb/low
fat diet - 49g [like a modern slimming diet]
- high carb/low
protein - 122g
- low carb/high
protein - 183g
- low carbohydrate/high
fat - 205g
Drs Lyon and Dunlop
pointed out that:
'The most striking
feature of the table is that the losses appear to be inversely
proportionate to the carbohydrate content of the food. Where
the carbohydrate intake is low the rate of loss in weight
is greater and conversely.'
In other words,
the less carbohydrate was eaten, the greater was the amount
of weight lost.
In 1955 Dr Albert
Pennington in the USA also found that: 'weight loss appeared
to be inversely related to the amount of glycogenic materials
in the diet. Carbohydrate is 100 per cent, protein 58 per
cent and fat 10 per cent glycogenic.' (In other words, the
more a food increased insulin production, the less weight
was lost - and in this respect, to lose weight, again carbohydrate
was worst and fat best.)
Pennington continued:
'The recommended diet is a calorically unrestricted one, very
low in carbohydrate, high in fat and moderate in protein.
Neither fat nor protein is restricted, however.'
Pennington's diet
was so successful that it was reported in Holiday magazine,
where it became known as 'The Holiday Diet'.
Professor Alan
Kekwick and Dr Gaston Pawan had similar results: In a trial
at the Middlesex Hospital, London, overweight patients:
- lost the most
weight on a high-fat, low-carbohydrate diet
- lost the least
weight on a high-carbohydrate, low-fat diet
- Lost weight
even at 2,600 calories a day - but only on a high-fat diet.
In 1959, Dr John
Yudkin, Professor of Nutrition and Dietetics, Queen Elizabeth
Hospital, University of London, confirmed Kekwick and Pawan's
findings when he showed that a diet with unlimited protein
and fat, but with little or no carbohydrate was far more effective
in causing weight loss than a calorie-controlled, low-fat
diet.
During the 1950s,
another British physician, Dr Richard Mackarness, found that
the low-carb, high-fat diet was so successful with his overweight
patients that he wrote a book that was in print for nearly
twenty years - a feat almost unheard of in the slimming book
industry. It was Dr Mackarness who introduced this concept
to me in 1962 and so dramatically changed the lives of my
family and me. In the forty years since, none of my family
has been overweight, although we were before that date.
As time passed
and praising the value of fat became politically incorrect,
it became more difficult to get such trials published. Nevertheless,
it did happen occasionally.
Published in the
year 2000, a prospective study was conducted to evaluate the
effect of a low carbohydrate, high-protein/fat diet in achieving
short-term weight loss. Researchers at the Center for Health
Services Research in Primary Care, Durham, North Carolina,
reported data from a six-month study that included fifty-one
individuals who were overweight, but otherwise healthy.
The subjects received
nutritional supplements and attended bi-weekly group meetings,
where they received dietary counseling on consuming a low-carbohydrate,
high-protein/fat diet. After six months, they had lost, on
average, more than ten percent of their weight and (remember
this for later) their total cholesterol dropped by an average
10.5 mg/dl (0.27 mmol/l).
Twenty patients
chose to continue the diet after the first six months, and
after twelve months, their mean weight loss was 10.9 percent
and their total cholesterol had decreased by 14.1 mg/dl (0.37
mmol/l).
Dr William S. Yancy,
M.D. admitted that:
'This study of
overweight individuals showed that a low carbohydrate, high-protein/fat
diet can lead to significant weight loss at one year of
treatment.'
All these recommendations
and evidence could have saved a great deal of grief, trauma
and ill-health if two other doctors had been listened to in
1994. Writing in the British Medical Journal, Professor Susan
Wooley and Dr David Gardner highlighted the role of the professional
in people's increasing weight. They said:
'The failure
of fat people to achieve a goal they seem to want - and
to want above all else - must now be admitted for what it
is: a failure not of those people but of the methods of
treatment that are used.'
In other words,
blaming the overweight for their problem and telling them
they are eating too much and must cut down, is simply not
good enough. It is the dieticians' advice and the treatment
offered that are wrong. Wooley and Garner concluded:
'We should stop
offering ineffective treatments aimed at weight loss. Researchers
who think they have invented a better mousetrap should test
it in controlled research before setting out their bait
for the entire population. Only by admitting that our treatments
do not work - and showing that we mean it by refraining
from offering them - can we begin to undo a century of recruiting
fat people for failure.'
But of course there
is a 'better mousetrap'. William Banting wrote of it nearly
a century and a half ago.
Second-opinions.co.uk
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