WILLIAM BANTING:
The Father of the Low-Carbohydrate Diet
Whether we like it or not Low Carb Diets are here to
stay. It matters not if we blame Atkins, Willett, the Hellers or even
Suzanne Summers there is going to be someone who will be touting Low
Carb Diets for our patients and there will be controversy. But where
it all start.
Part III
The Banting Diet Is Confirmed
Banting's Letter on Corpulence travelled widely. In the 1890s, an
American doctor, Helen Densmore, modelled 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 'civilized' 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:
- Does the withholding of vegetable foods cause scurvy?
- Will an all-meat diet cause other deficiency diseases?
- Will it cause mineral deficiencies, of calcium in particular?
- Will it have a harmful effect on the heart, blood vessels or kidneys?
- 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.
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 counselling 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.
Part 1
Part 2
Part 3
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