I was forwarded a Dr Mercola newsletter titled “In defense of low-fat eating”, which featured a presentation by Denise Minger at the Icelandic Health Symposium in March 2017, discussing possible merits of a high-carb low-fat diet. This presentation led me to revisit the talk and look into the research, including a paper by Walter Kempner published in 1975 titled "Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss."
Kempner called his dietary approach, the rice-fruit-sugar diet, which was designed to provide no more than 5 grams of fat, around 20 grams of protein, and a significant amount of carbohydrates within a 2,000-calorie daily intake. Notably, Kempner allowed for the liberal consumption of white sugar and dextrose, with some patients averaging 100 grams daily (and up to 500 grams in some cases). The macronutrient composition of the diet was approximately 94% carbohydrates, 4% protein, and 2% fat. That was Kempner's base diet. For obese patients, he recommended the same rice-fruit-sugar intake but with calories severely restricted. Such patients were limited to 400-800 daily calories, about the same as liquid meal-replacement diets, followed by a gradual reintroduction of vegetables, lean meat, and poultry. Not exceeding 1,000 calories at any time.
The study involved 106 patients chosen based on their extraordinary weight loss of at least 45 kilograms. The average weight loss among these individuals was 64 kilograms. Kempner used an interesting measure of obesity called relative weight, with patients initially having a relative weight of at least 1.64. Results indicated an average weight loss rate of 0.24 kilograms per day, equivalent to approximately 1.68Kg (3.7lb per week).
The plan extended beyond diet to include daily exercise tailored to each patient's capacity, and patients reported daily to local "rice houses" for monitoring. Kempner's strict enforcement, including public posting of non-compliance, led to allegations of physical discipline against patients who strayed off-plan.
Blood pressure, blood glucose, triglycerides, and uric acid levels significantly improved. Notably, cholesterol levels remained unchanged, challenging the idea that dietary cholesterol affects blood cholesterol.
Walter Kempner's rice diet was a controversial approach to weight loss. Its blend of extreme dietary modifications, discipline, and medical supervision yielded impressive short-term results, although such methods nowadays would likely result in complaints rather than results.