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Keywords: kempner, kempner rice diet,cardiovascular morbidity, evolutionary mismatch, hypertension, salt, selection pressure,Low-fat diet, Vegan diet, Vegetarian diet, Hypertension, Cholesterol, Hyperlipidemia, Type 2 diabetes, Weight loss, Heart disease
Summary of Abstracts:
The Relationship of Diet to Blood Pressure Control: The sodium-restricted diet remains the cornerstone of effective blood pressure control. Therefore, nutrition must become an integral part of the hypertensive treatment program.
A plant-based diet and hypertension: Hypertension is an insidious, common, and deadly disease, often detected incidentally at a routine doctor’s visit or workplace health screening. Worldwide, it is estimated that one billion people have hypertension and approximately 80 million Americans 20 years of age and older are hypertensive. In the late 1930 s, Dr. Walter Kempner of Duke University introduced the “rice diet” as therapy for renal failure and hypothesized that “we could radically alter the patients’ diets and thereby save lives.” The rice diet was high in complex carbohydrates, consisting mainly of rice and fruit, and low in fat, protein (< 20 g/day) and sodium (< 150 mg/day). He first demonstrated its effectiveness in a diabetic, hypertensive patient with renal and congestive heart failure: post intervention, this patient exhibited decreased cardiac silhouette size as measured by chest X-ray, normalization of a left ventricular strain pattern on ECG, and improvement in hypertensive retinopathy. Similarly, in his first cohort of hypertensive patients, 107 of 192 patients demonstrated marked improvement, including decreased blood pressure, cholesterol levels, retinopathy, and cardiac silhouette size. Despite his findings, Kempner's work was not widely accepted by the scientific community, which favored randomized control trials to substantiate these findings. We believe that consuming a diet that is mostly or exclusively plant-based appears prudent for the prevention and treatment of hypertension.
Salt and hypertension: why is there still a debate: The recorded history confirms how rare and inaccessible salt has been until recent times. Like all other terrestrial life forms, humans evolved in a salt-free environment under intense evolutionary pressure for the selection of salt-conserving genes. Hypertension is a prototypical evolutionary maladaptation disorder of the modern man a species exquisitely well adapted to low salt conditions suddenly confronted with salt excess.
Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort: A low-fat, starch-based, vegan diet eaten ad libitum for 7 days results in significant favorable changes in commonly tested biomarkers that are used to predict future risks for cardiovascular disease and metabolic diseases.
Who and What Drove Walter Kempner The Rice Diet Revisited: The refugee with the strong German accent explained his ideas about renal failure to his skeptical medical students. “The problem with renal failure is the resultant metabolic dysfunction. The kidneys excrete waste products, amino acids, keto-acid metabolites, hydrogen ions, the salt that is eaten, and all these things are the result of what the people are eating. Theoretically, we should be able to make them better by reducing the amount of work the kidneys have to do. The ideas behind this gallant hypothesis were not that novel. Others had prescribed various similar ideas about reducing renal work by modifying the diet, particularly in terms of sodium content. However, they had not been that successful in sending the kidneys on vacation. Kempner introduced the first comprehensive (global) dietary program to treat chronic renal disease. By doing so, he revolutionized not only that disease but also the treatment of hypertension, obesity, and a host of other disorders.
The History of the Salt Wars: The Salt Blood Pressure Hypothesis states that an increase in the intake of salt leads to an increased in blood pressure and subsequently increases the risk for cardiovascular events, which has been a point of contention for decades. This article covers the history and some of the key players pertaining to “The Salt Wars” during the first half of the 1900s, both in Europe and in the United States. Early studies finding benefits with salt restriction in those with hypertension were based on uncontrolled case reports. The overall evidence in the first half of the 1900s suggests that a low-salt diet was not a reasonable strategy for treating hypertension.
The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes: This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise.
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