2016年10月19日星期三

Extreme Nutrition: The Diet of Eskimos

The carnivorous diet of traditional Eskimo inhabitants of the frozen, northern, circumpolar regions of planet Earth (Siberia, Alaska, Canada, and Greenland), serves as a testament to the strengths and adaptability of the human species. The foods consumed by these hardy people are in "polar" opposition to those recommended by me (the McDougall Diet of starches, vegetables, and fruits): a carnivore vs. an herbivore diet. Unfortunately, misinformation surrounding the all-meat diet of the Eskimo has promoted dangerous eating habits to the modern-day general public.

For more than 6,000 years, natives of the frozen North have lived with almost no contact with the rest of the world. Not until the mid-1800s were reliable records made of their daily lives, their diets, and their health. Early reports describe these people as looking beautiful and athletic when they were young, but then they aged quickly, and "men and women who appeared to be 60 or over were rare."

Rumors have since circulated that traditional Eskimos have lived free of heart disease, cancer, and most other chronic diseases affecting western civilizations these days. Research published in the mid-1970s tried to explain this "Eskimo paradox" of living healthy with very few plant foods, on a high-fat, high-cholesterol, no-dietary-fiber diet. The omega-3 fish fats were noted as the miracle ingredient providing protection. Dietetic and medical experts have uncritically accepted this theory in the face of libraries filled with incriminating evidence to the contrary. They tell patients to eat more fish, poultry, and even red meat—like the Eskimos – and plenty of fish oil - in order to stay healthy.

Pushing the Nutritional Envelope

Hunted animals, including birds, caribou, seals, walrus, polar bears, whales, and fish provided all the nutrition for the Eskimos for at least 10 months of the year. And in the summer season people gathered a few plant foods such as berries, grasses, tubers, roots, stems, and seaweeds. Frozen snow-covered lands were unfit for the cultivation of plants. Animal flesh was, by necessity, the only food available most of the time.

The fat, not the protein, from animal foods provided most of the 3,100 calories required daily for these active people. Plants are the primary source of all carbohydrates, including digestible sugars and non-digestible dietary fibers. Eating raw meat indirectly provided Eskimos with enough carbohydrates in the form of glycogen (found in the muscles and liver of animals) to meet their necessary nutrient requirements and keep them out of a starvation condition called ketosis. Muscle tissue contains almost no calcium, and as a result the daily intake was about 120 mg/day versus the 800 mg and more commonly recommended for good health. Plants (not people) synthesize Vitamin C, yet the Eskimo was able to avoid scurvy with the 30 mg of vitamin C consumed daily found in land and sea animals. Recommendations for vitamin C are 60 mg/day and higher daily. Low levels of sunlight, and preformed vitamin D from fish, met the "sunshine D vitamin" requirement for Eskimo health. By the grace of environmental design, Nature made sure there was just enough nutrition for the Eskimo to survive.

There Is No Eskimo Paradox

The human being is designed to thrive on a diet of starches, vegetables and fruits. The Eskimo experience serves as a testament to the miraculous strengths and adaptability of our bodies. We can survive on raw and cooked meat, but we thrive on starches, vegetables and fruits. These hardy people survived living at the edge of the nutritional envelope, but not in good health. Here are some of the health costs they paid:
Eskimos Suffer from Atherosclerosis
Claims that Eskimos were free of heart (artery) disease are untrue. A thorough review of the evidence concludes that "Eskimos have a similar prevalence of CAD (coronary artery disease) as non-Eskimo populations, they have excessive mortality due to cerebrovascular strokes, their overall mortality is twice as high as that of non-Eskimo populations, and their life expectancy is approximately 10 years shorter than the Danish population."

Mummified remains of Eskimos dating back 2,000 years have shown extensive hardening of the arteries throughout their brains, hearts and limbs; as a direct consequence of following a carnivorous diet of birds, caribou, seals, walrus, polar bears, whales, and fish. The June 1987 issue of National Geographic magazine carried an article about two Eskimo women, one in her twenties and the other in her forties, frozen for five centuries in a tomb of ice. When discovered and medically examined they both showed signs of severe osteoporosis and also suffered extensive atherosclerosis, "probably the result of a heavy diet of whale and seal blubber."

Eskimos Suffer from Severe Bone Loss

Their low-calcium diet and lack of sunshine (vitamin D) are only minor factors contributing to the extensive osteoporosis found in recent and ancient Eskimos. Alaskan Eskimos older than age 40 have been found to have a 10% to 15% greater deficit in bone mineral density compared to Caucasians in the US. This research published in 1974 on 107 elderly people concluded, "Aging bone loss, which occurs in many populations, has an earlier onset and greater intensity in the Eskimos. Nutritional factors of high protein, high nitrogen, high phosphorus, and low calcium intakes maybe implicated."

Protein, and especially animal protein, consumed in excess of our needs places serious burdens on the body. The liver and kidneys work hard to process the excess protein and excrete its byproducts along with the urine. As a result of this extra work, Eskimos have been reported to have an enlarged liver while living on meat, and to produce larger than average volumes of urine in order to excrete the byproducts of protein metabolism. The bones also play a role in managing excess animal protein (acidic by nature) by neutralizing large amounts of dietary acids. In this process bone structure and bone mineral content are lost through the kidney system, depleting the bones into a condition called osteoporosis.

Eskimos Are Infected with Parasites

Diseases of animals are readily transmitted to humans when eaten. One example is trichinosis (an infection with the roundworm Trichinella spiralis), which is found in about 12% of older Eskimos; a result of eating raw and infected walrus, seal, and polar bear meat. In most cases this parasite infestation causes no symptoms, but illness and death can result.

Meat-derived Chemical Pollution

Since the 1970s the diet of the Eskimo has contained high levels of toxic, organic pollutants and heavy metals. These lipophilic chemicals are attracted to and concentrated in the fatty-tissues of land and sea animals. As a direct result of the traditional Eskimo diet (now contaminated by industry wastes), the bodies of these Arctic people contain the highest human concentrations of environmental chemicals found anywhere on Earth: "levels so extreme that the breast milk and tissues of some Greenlanders could be classified as hazardous waste." Eskimo women have been found to have levels of PCBs in their breast milk five to ten times higher than women in southern Canada. These chemicals cause and promote many forms of cancer and cause brain diseases, including Parkinson's disease.

Nutrition Has Gone Downhill for the Eskimo

The notion that consuming meat, fish, and fish oil will promote health and healing has captured the attention of the scientific community in large part because of the misinterpretation** of the Eskimo experience. But life has gotten worse for the Eskimo. Over the past 50 years their traditional diet has been further modified with the addition of western foods. Rather than using a hook, spear, or club to catch their meal, as in the past, people living in this part of the world use the "green lure" (the dollar bill) and catch their meals through an open car window at the local fast-food restaurant. Obesity, type-2 diabetes, tooth decay, and cancers of the breast, prostate, and colon have been added to the Eskimo's traditional health problems of artery disease, bone loss, and infectious diseases.

People living in the frozen north these days have heated homes and drive around in comfortable SUVs. The challenging environment their ancestors barely survived through required a carnivorous diet. Those days of needing 3100 calories a day to counter the freezing cold and hunt for dinner are gone. The idea that current epidemics of obesity and sickness in these Northern people would be best fixed by returning to the old ways of carnivorous diet would not work unless they also returned to living in igloo homes and hunted their lands for every meal. Physicians and dietitians now caring for these people suffering from the western diet with the addition of too much traditional food (ancestral meat) should be prescribing a starch-based diet to help them lose excess weight and cure common dietary diseases.


*The term "Eskimo" comes from a Native American word that may have meant "eater of raw meat." The word "Eskimo" has come to be considered offensive, especially in Canada. Many prefer the name "Inuit," which means "the people" or "real people." However, "Eskimo" is the term used in the scientific and historical literature and will be used here.

**Misinterpretation is easy to spread because:

1) People love to hear good news about their bad habits.
2) Nutritional "facts," even when false and harmful, are used to sell meat, fish, and other foods.
3) The media loves headlines that sell their products, like "The Eskimo Diet proves Meat's Good."

2016年10月6日星期四

Walter Kempner, MD Founder of the Rice Diet

Walter Kempner, medical doctor and research scientist, is the father of modern day diet therapy and creator of the Rice Diet. All who have followed in his footsteps, including Nathan Pritikin, Dean Ornish, Neal Barnard, Caldwell Esselstyn, and myself, owe homage to this man and his work.

Kempner's Rice Diet program began at Duke University in Durham, North Carolina in 1939. The treatment was a simple therapy of white rice, fruit, juice, and sugar, and was reserved for only the most seriously ill patients. Although low-tech, the benefits of the Rice Diet far exceed those of any drug or surgery ever prescribed for chronic conditions, including coronary artery disease, heart and kidney failure, hypertension, diabetes, arthritis, and obesity.

Originally used for only short time periods and under close supervision due to concerns about nutritional deficiencies, subsequent research proved the Rice Diet to be safe and nutritionally adequate for the vast majority of patients.

A major breakthrough occurred by accident in 1942 when one of Dr. Kempner's patients, a 33-year-old North Carolina woman with chronic glomerulonephritis (kidney disease) and papilledema (eye disease) failed to follow his instructions. Because of Dr. Kempner's heavy German accent she misunderstood his instructions to return in two weeks, and after two months, she finally returned, with no signs of deficiency, but rather with robust health. The woman had experienced a dramatic reduction of her blood pressure, from 190/120 to 124/84 mmHg, resolution of eye damage (retinal hemorrhages and papilledema), and a noticeable decrease in heart size.

After this experience Dr. Kempner began treating his patients for extended periods of time, and expanded the indications from only serious troubles (glomerulonephritis and malignant hypertension) to patients with relatively minor illnesses, such as routine hypertension (160/100 mmHg), headaches, chronic fatigue, chest pains, edema, xanthoma, pseudo tumor cerebri, and psoriasis.

Walter Kempner's Medical Records

During his career, fellow professionals wanted Dr. Kempner to set up randomized, controlled studies. However in studies designed this way, half of the patients are treated and half go untreated. His medical ethics would not allow him to deny his proven diet therapy to anyone; therefore, he declined. Furthermore, he correctly pointed out that each patient served as his own control.

Dr. Kempner documented the benefits of his treatments by tracking their changes in cholesterol, blood pressure, blood sugar, and body weight, as well as with pictures. For example, his records showed that 93% of patients with an elevated cholesterol benefited with an average reduction from 273 mg/dL before treatment to 177 mg/dL after. These reductions in cholesterol are greater than those usually seen with powerful statin drugs, and without the costs and risks. His numbers also showed how a high-carbohydrate diet improved blood sugars and often cured type-2 diabetes.

Reducing Massive Obesity:

In one article the results of 106 massively obese patients treated as outpatients with the Rice Diet, exercise, and motivational enhancement under daily supervision were reported. The average weight loss was 63.9 kg (141 pounds). Normal weight was achieved by 43 of the patients.

Curing Severe Hypertension.

In the beginning, Dr. Kempner treated only patients with near-fatal conditions, like malignant hypertension (blood pressures in the 220/120 mmHg range). In this emergency condition people often suffered from heart and kidney failure, and eye damage (with retinal hemorrhages, exudates, and papilledema). Today such patients are treated with powerful medications and laser eye surgery, with far greater risks and costs, and far fewer benefits. The safe and effective Rice Diet treatment for eye damage and kidney damage has been largely forgotten.

Stopping Hemorrhages and Exudates.

The eyes are a window to the condition of the blood vessel system and major organs throughout the body. By looking (with an ophthalmoscope) into the back of the eye (retina) a physician can actually see ongoing damage, which is not limited to the eye, but is also happening in the kidneys and all other tissues. Photos of the retina show how the Rice Diet stops the bleeding (hemorrhages) and leaking (exudates) from blood vessels. This serves as a dramatic demonstration of the body's ability to heal given the supportive environment of a healthy diet.

Reversing Heart Disease.

Narrowing of heart (coronary) arteries due to atherosclerosis (a result of the Western diet) causes chest pains (angina) and changes in the electrocardiogram (EKGs showing inverted "T" waves). The Rice Diet relieves chest pains and corrects EKG abnormalities. In other words, the Rice Diet can cure common heart disease, which affects more than half of Americans. Modern-day heart doctors routinely prescribe heart surgery for blocked arteries, with far greater costs and risks, and far fewer benefits.

Treating Heart and Kidney Failure.

In late stages of disease, the Western diet causes the failure of major organs, including the heart, kidneys, liver, and brain. Enlargement of the heart, as seen on a chest x-ray, is a classic sign of heart failure. The Rice Diet causes enlarged (failing) hearts to revert to normal size and function. Kidney function also dramatically improves, as does the patient in general.

The Rice Diet Components

*Dry rice of 250 to 350 grams daily forms the basis of the diet. Any kind of rice is used as long as it contains no milk or salt. The rice is boiled or steamed in plain water or fruit juice, without salt, milk or fat. (One cup of dry white rice weighs about 200 grams, and contains about 13 grams of protein, 150 grams of carbohydrate, 1 gram of fat, and 700 calories.)

*Calorie intake is usually 2,000 to 2,400 calories daily. Intake varies based upon the patient's condition: underweight people are fed more calories, and vice versa.

*Fruit and fruit juices are allowed.

*Dried fruits can be used as long as nothing but sugar has been added.

*White sugar may be used as desired (ad libitum); on average a patient takes in about 100 grams daily (400 calories) but, if necessary (to maintain body weight), as much as 500 grams (2000 calories) daily has been used.

*No avocados, dates, or nuts.

*No tomato or vegetable juices.

*Supplementary vitamins are added in the following amounts: vitamin A 5,000 units, vitamin D 1,000 units, thiamine chloride 5 mg, riboflavin 5 mg, niacinamide 25 mg, calcium pantothenate 2 mg. (However, none of the Rice Diet patients during five months of treatment showed any signs (epithelial, neural or metabolic) to make one suspect any vitamin deficiency.

*Adaptation to the diet takes about two months.

*Exercise is encouraged. Bed rest is only advised with severe conditions.

*Water intake is restricted in some severely ill patients to less than 1.5 liters (6 cups) a day to prevent water intoxication and electrolyte imbalances.

*A few patients with kidney disease cannot tolerate the diet because of their inability to retain minerals.

*Once the patient's health has returned, then small amounts of non-leguminous vegetables, potatoes, lean meat or fish (all prepared without salt or fat) may be added. However, if these additions result in adverse consequences (elevated blood pressure, enlargement of the heart, abnormal EKG changes, worsening kidney or eye conditions, etc.), then the basic Rice Diet, without modification, must be continued.

*A physician competent in diet therapy should follow anyone in need of the Rice Diet. Sicker patients need closer supervision.

The nutrient breakdown is about 2,000 to 2,400 calories per day (depending on the patient's body weight): 95% carbohydrate, 4 to 5% protein (20 to 25 grams), 2 to 3% fat (rice is relatively high in the essential fat linoleic acid), 140 milligrams of calcium, and 150 milligrams of sodium daily. For more rapid and effective weight loss, the calories are restricted.
Why White Rice And Table Sugar?

One reason Kempner chose rice was because he believed that rice proteins were easily assimilated and there was no concern about getting sufficient amounts of the essential amino acids. (This adequacy and completeness of protein is not limited to rice, and is true for all starches, including corn, potatoes, and sweet potatoes.) He chose rice rather than another starch because in his day, nearly half of the world's population consumed large amounts of rice (sometimes rice made up 80% to 90% of their diet).

White rice, as opposed to brown whole-grain rice, was used because it was considered more palatable to the general public and was more readily available. Plain white rice contains about 8% of calories as protein. The addition of simple sugars brings the protein content of the Rice Diet down to 5% or fewer of total calories. The body only needs a small amount of protein daily (fewer than 5% of calories from food). The liver and kidneys must process and excrete any protein consumed beyond the basic requirements, causing extra work and often organ damage.

The addition of white table sugar adds calories without protein and fat. Fruits and juices are also high in sugar (carbohydrate) calories and low in fat and protein. The primary benefits of the Rice Diet are accomplished by easing the workload on compromised tissues and organs by providing them with clean-burning energy from carbohydrates and avoiding common dietary poisons such as salt, fat, cholesterol, and animal protein. In such a supportive environment the body's healing powers can outpace the damages once caused by unhealthy foods. Dr. Kempner added multivitamins, which may be necessary because of all the refined foods served. Using whole foods (specifically the McDougall starch-based diet), rather than white rice and sugar, provides all necessary vitamins and minerals. No supplements are recommended other than vitamin B12.

The Rice Diet Today

After nearly 70 years, in 2002 Duke University severed its relationship with the Rice Diet. The Rice Diet program, however, continued to run independently until the fall of 2013 under the direction of Robert Rosati, MD, when it closed for business. Kitty Rosati (with her husband, Robert) has published several national best selling books on the Rice Diet.
Francis Neelon, MD, the Rice Diet's former medical director, has joined with business interests to reestablish the Rice Diet, and they plan to open an outpatient facility in Durham, NC beginning in February of 2014.

One of Dr. Kempner's closest collaborators, Barbara Newborg, MD, recently published an extensive biography on the father of modern day diet therapy, Walter Kempner and the Rice Diet: Challenging Conventional Wisdom.

The McDougall Diet vs. The Rice Diet

Walter Kempner, MD was very influential on my career. His published work showed me the power of diet therapy and that nutritional deficiencies do not occur with simple plant-based diets (even with the addition of lots of sugar). Even before I was born, Dr. Kempner had disproven concepts that are still held as true by most medical doctors today, such as, "diet has little to do with heart disease," "additional protein improves health," and "carbohydrates cause diabetes."

I find myself recommending the Rice Diet several times a year to the few patients I see who are on the verge of complete heart or kidney failure. Otherwise, I recommend the McDougall Diet (a starch-based diet with fruits and non-starchy-vegetables along with some salt and sugar for flavorings) to almost all of my patients.

No apology needs to be made for serving pasta and marinara sauce, bean burritos, or rice and Chinese vegetables. The diet I recommend, the McDougall Diet, is for the living. The Rice Diet is one that I reserve for the "nearly dead." I am grateful every day for Walter Kempner's contributions to medical science. Unfortunately, because profits, rather than patients' welfare, dictate common medical practice, diet therapy remains unappreciated and practically unknown.