Rice diet

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The Rice Diet started as a radical treatment for malignant hypertension before the advent of antihypertensive drugs; the original diet included strict dietary restriction and hospitalization for monitoring. Some contemporary versions have been greatly relaxed, and have been described as fad diets.

Contents

Origin and original form

The Rice Diet Program was founded in 1939 by Walter Kempner  [ de ] (1903-1997), a German physician and refugee from the Nazis, who was at that time associated with Duke University. [1] [2] Kempner had many patients with malignant hypertension with kidney failure, and there were no good treatments for those patients. He believed that the kidney had two functions, one excretory and the other metabolic, and "he theorized that if the protein and electrolyte load on the kidney was reduced to a minimum, the kidney might better perform its more essential metabolic role. The details of his reasoning are obscure, but he began to treat patients with malignant hypertension with a diet composed of nothing but rice and fruit, and amazingly, they rapidly improved." [1]

Kempner's implementation was very strict, but also careful - patients were hospitalized for several weeks at the beginning of treatment. The initial treatment was stopping all medication and putting the patient on a diet consisting of "white rice, sugar, fruit, fruit juices, vitamins and iron, and provided about 2000 calories, 20 grams of protein, and 700–1000 ml of liquid as fruit juices. Sodium content was extremely low, about 150 milligrams per day, and chloride content about 200 milligrams per day." If results were good, after several months small amounts of lean meat and vegetables were added to the diet.

Kempner obtained remarkable results, and he was invited to present them at a meeting of the New York Academy of Medicine in 1946. His presentation survives and "presents clear and unambiguous evidence, including blood pressure charts, retinal photographs, chest radiographs, electrocardiograms and laboratory results, documenting the benefits of his diet." [1] [upper-alpha 1]

Kempner described his diet as "a monotonous and tasteless diet which would never become popular.... Kempner's only defense of its use was the fact that “it works,” and that the diet was preferable to the alternative of certain death" [1]

Controversy

Kempner admitted in statements before his death that he whipped patients who avoided his rice diet. In 1993, a former patient Sharon Ryan sued him. [3] Ryan accused Kempner of keeping her as a "virtual sex slave" for nearly two decades. [3] According to the lawsuit, Kempner "persuaded Ryan to drop out of college, moved her into a home he owned, hired her to work for the clinic, and maintained a sexual relationship with Ryan by isolating her from the outside world". [4] The lawsuit ended with a confidential settlement. [5] In 1997, the Raleigh News & Observer reported that, by 1975, Duke University Medical Center (now Duke University Hospital), knew that Kempner had used a riding crop on several patients and reprimanded him, though he continued to be associated with the university. [4] None of these charges were proven in court. Dr Kempner denied the accusations of having a sexual relationship with this patient. [6] "Dr Kempner had whipped this patient on several occasions, and had also whipped several other patients in an effort to motivate them. In all instances, the patients had either themselves suggested or had consented in advance to this punishment for breaking the diet" [7] These events received a great deal of sensationalist media attention.

Contemporary forms

Kempner retired from the Duke Faculty in 1974, but consulted until 1992. The commercialization of drugs to treat hypertension reduced both demand for the program and the need to make it strict in order to prevent death. In 2002 the program became independent of Duke University, and in 2013 the Rice House Healthcare Program opened in Durham, North Carolina. [1] The Rice House Healthcare Program is an inpatient facility where people are put on a diet akin to the original diet and are monitored. [8]

The rice diet has influenced some contemporary advocates of the plant-based diet. For example, physician John A. McDougall has commented regarding the research of Walter Kempner that "all who have followed in his footsteps, including Nathan Pritikin, Dean Ornish, Neal D. Barnard, Caldwell Esselstyn, and myself, owe homage to this man and his work." [9]

The rice diet has been popularized in a modulated form through several modern books. Judy Moscovitz in her book The Rice Diet Report, allows fruit, vegetables and various carbohydrates. [10] Kitty and Robert Rosati authors of The Rice Diet Solution describe their diet as a "low-sodium, good-carb, detox diet". It is based on the consumption of carbohydrates such as whole grains, fruits, vegetables, and beans. [11]

Criticism

The modern version of the rice diet has been categorized as a fad diet with possible disadvantages including a boring food choice, flatulence, and the risk of feeling too hungry. [12]

Nutritionist Yvette Quantz has suggested that although the rice diet has some good short-term benefits in the long term it does not provide "enough calories or protein for most people to sustain." [13]

Notes

  1. ↑ "In Kempner’s original cohort of 192 people, 25 patients died. Of the remaining 167, 60 patients did not substantially improve their blood pressure values. However, 107 patients showed significant improvement (from 200/112 mmHg to 149/96 mmHg) with the diet. Heart size decreased in 66 of 72 patients. Serum cholesterol was reduced in 73 of 82 patients. Retinopathy was reduced or disappeared completely in 21 of 33 patients. We must keep these results in context with the times, during which the life expectancy of anyone with malignant hypertension was 6 months." [2]

Related Research Articles

Nephrology is a specialty for both adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy. The word "renal" is an adjective meaning "relating to the kidneys", and its roots are French or late Latin. Whereas according to some opinions, "renal" and "nephro" should be replaced with "kidney" in scientific writings such as "kidney medicine" or "kidney replacement therapy", other experts have advocated preserving the use of renal and nephro as appropriate including in "nephrology" and "renal replacement therapy", respectively.

<span class="mw-page-title-main">Hypertension</span> Long-term high blood pressure in the arteries

Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms itself. It is, however, a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide.

Antihypertensives are a class of drugs that are used to treat hypertension. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke, heart failure, kidney failure and myocardial infarction. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21%, and can reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. There are many classes of antihypertensives, which lower blood pressure by different means. Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers.

<span class="mw-page-title-main">Kidney disease</span> Damage to or disease of a kidney

Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.

<span class="mw-page-title-main">Chronic kidney disease</span> Abnormal kidney structure or gradual loss of kidney function

Chronic kidney disease (CKD) is a type of long-term kidney disease, in which either there is a gradual loss of kidney function occurs over a period of months to years, or abnormal kidney structure. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include high blood pressure, bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization.

<span class="mw-page-title-main">Hereditary fructose intolerance</span> Medical condition

Hereditary fructose intolerance (HFI) is an inborn error of fructose metabolism caused by a deficiency of the enzyme aldolase B. Individuals affected with HFI are asymptomatic until they ingest fructose, sucrose, or sorbitol. If fructose is ingested, the enzymatic block at aldolase B causes an accumulation of fructose-1-phosphate which, over time, results in the death of liver cells. This accumulation has downstream effects on gluconeogenesis and regeneration of adenosine triphosphate (ATP). Symptoms of HFI include vomiting, convulsions, irritability, poor feeding as a baby, hypoglycemia, jaundice, hemorrhage, hepatomegaly, hyperuricemia and potentially kidney failure. While HFI is not clinically a devastating condition, there are reported deaths in infants and children as a result of the metabolic consequences of HFI. Death in HFI is always associated with problems in diagnosis.

<span class="mw-page-title-main">Ketogenic diet</span> High-fat dietary therapy for epilepsy

The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate dietary therapy that in conventional medicine is used mainly to treat hard-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Hypertensive kidney disease</span> Medical condition

Hypertensive kidney disease is a medical condition referring to damage to the kidney due to chronic high blood pressure. It manifests as hypertensive nephrosclerosis. It should be distinguished from renovascular hypertension, which is a form of secondary hypertension, and thus has opposite direction of causation.

A low-residue diet is a diet intended to reduce certain constituents of the bowel, often with consequence for functional behaviour of the bowel. It may be prescribed for patients with ailments or functional gastrointestinal disorders mitigated by fewer and smaller bowel movements each day.

<span class="mw-page-title-main">Thrombotic microangiopathy</span> Medical condition

Thrombotic microangiopathy (TMA) is a pathology that results in thrombosis in capillaries and arterioles, due to an endothelial injury. It may be seen in association with thrombocytopenia, anemia, purpura and kidney failure.

The Dietary Approaches to Stop Hypertension or the DASH diet is a diet to control hypertension promoted by the U.S.-based National Heart, Lung, and Blood Institute, part of the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services. The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy foods. It includes meat, fish, poultry, nuts, and beans, and is limited in sugar-sweetened foods and beverages, red meat, and added fats. In addition to its effect on blood pressure, it is designed to be a well-balanced approach to eating for the general public. DASH is recommended by the United States Department of Agriculture (USDA) as a healthy eating plan. The DASH diet is one of three healthy diets recommended in the 2015–20 U.S. Dietary Guidelines, which also include the Mediterranean diet and a vegetarian diet. The American Heart Association (AHA) considers the DASH diet "specific and well-documented across age, sex and ethnically diverse groups."

<span class="mw-page-title-main">Nathan Pritikin</span> American nutritionist and inventor (1915–1985)

Nathan Pritikin was an American inventor, engineer, nutritionist and longevity researcher. He promoted the Pritikin diet, a high-carbohydrate low-fat plant-based diet combined with regular aerobic exercise to prevent cardiovascular disease. The Pritikin diet emphasizes the consumption of legumes, whole grains, fresh fruit and vegetables and non-fat dairy products with small amounts of lean meat, fowl and fish.

Prehypertension, also known as high normal blood pressure and borderline hypertensive (BH), is a medical classification for cases where a person's blood pressure is elevated above optimal or normal, but not to the level considered hypertension. Prehypertension is now referred to as "elevated blood pressure" by the American College of Cardiology (ACC) and the American Heart Association (AHA). The ACC/AHA define elevated blood pressure as readings with a systolic pressure from 120 to 129 mm Hg and a diastolic pressure under 80 mm Hg, Readings greater than or equal to 130/80 mm Hg are considered hypertension by ACC/AHA and if greater than or equal to 140/90 mm Hg by ESC/ESH. and the European Society of Hypertension defines "high normal blood pressure" as readings with a systolic pressure from 130 to 139 mm Hg and a diastolic pressure 85-89 mm Hg.

<span class="mw-page-title-main">Mesoblastic nephroma</span> Medical condition

Congenital mesoblastic nephroma, while rare, is the most common kidney neoplasm diagnosed in the first three months of life and accounts for 3-5% of all childhood renal neoplasms. This neoplasm is generally non-aggressive and amenable to surgical removal. However, a readily identifiable subset of these kidney tumors has a more malignant potential and is capable of causing life-threatening metastases. Congenital mesoblastic nephroma was first named as such in 1967 but was recognized decades before this as fetal renal hamartoma or leiomyomatous renal hamartoma.

<i>Fit for Life</i> Book series

Fit for Life is a diet and lifestyle book series stemming from the principles of orthopathy. It is promoted mainly by the American writers Harvey and Marilyn Diamond. The Fit for Life book series describes a fad diet which specifies eating only fruit in the morning, eating predominantly "live" and "high-water-content" food, and, if animal protein is eaten, avoiding combining it with complex carbohydrates.

A health claim found on a food labels and in food marketing is a claim by a food manufacturer that their product will reduce the risk of developing a disease or condition.

The South Beach Diet is a popular fad diet developed by Arthur Agatston and promoted in his bestselling 2003 book. It emphasizes eating food with a low glycemic index, and categorizes carbohydrates and fats as "good" or "bad". Like other fad diets, it may have elements which are generally recognized as sensible, but it promises benefits not backed by supporting evidence or sound science.

Kidney ischemia is a disease with a high morbidity and mortality rate. Blood vessels shrink and undergo apoptosis which results in poor blood flow in the kidneys. More complications happen when failure of the kidney functions result in toxicity in various parts of the body which may cause septic shock, hypovolemia, and a need for surgery. What causes kidney ischemia is not entirely known, but several pathophysiology relating to this disease have been elucidated. Possible causes of kidney ischemia include the activation of IL-17C and hypoxia due to surgery or transplant. Several signs and symptoms include injury to the microvascular endothelium, apoptosis of kidney cells due to overstress in the endoplasmic reticulum, dysfunctions of the mitochondria, autophagy, inflammation of the kidneys, and maladaptive repair.

Alexander Haig was a Scottish physician, dietitian and vegetarianism activist. He was best known for pioneering the uric-acid free diet.

References

  1. 1 2 3 4 5 Estes EH, Kerivan L (Sep 2014). "An archaeologic dig: a rice-fruit diet reverses ECG changes in hypertension". J Electrocardiol. 47 (5): 599–607. doi:10.1016/j.jelectrocard.2014.05.008. PMID   24996514.
  2. 1 2 Klemmer P; et al. (Oct 2014). "Who and what drove Walter Kempner? The rice diet revisited". Hypertension. 64 (4): 684–8. doi:10.1161/HYPERTENSIONAHA.114.03946. PMID   25001270.
  3. 1 2 "Report: 'Rice Diet' Doctor Beat Patients". Los Angeles Times . Retrieved November 30, 2018.
  4. 1 2 "Report: Rice Diet doctor admitted to whippings in depositions". Associated Press. 19 October 1997. Retrieved 24 February 2020.
  5. ↑ "Settlement reached in suit involving rice diet dietitian "Settlement reached in suit involving rice diet dietitian". Deseret News . Retrieved November 30, 2018.
  6. ↑ Newborg p. 224
  7. ↑ Newborg "Water Kempner and the Rice Diet" 2012 p.224
  8. ↑ Rice House Healthcare Program Official website
  9. ↑ Walter Kempner, MD – Founder of the Rice Diet. Retrieved November 30, 2018.
  10. ↑ "Rice Diet Report". Publishers Weekly . Retrieved December 2, 2018.
  11. ↑ Borreli, Lizette. (2013). "The Rice Diet: Weight-Loss Plan Helps Combat Obesity, Weight-Related Diseases". Medical Daily . Retrieved December 2, 2018.
  12. ↑ Alters S, Schiff W (22 February 2012). Chapter 10: Body Weight and Its Management (Sixth ed.). Jones & Bartlett Publishers. p. 327. ISBN   978-1-4496-3062-1.{{cite book}}: |work= ignored (help)
  13. ↑ Iliades, Chris. (2009). "The Rice Diet". Everyday Health. Retrieved December 2, 2018.

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