Nitrogen Balance Studies on the Kempner Rice Diet

Schwartz, William B.; Merlis, Jerome K.

doi:10.1172/jci101983

Cited by 24 publications

(4 citation statements)

References 18 publications

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“…Two reports (14,15) indicate that it is adequate; two others, that it is not (16,17). The present data support the conclusion of the first group and suggest an explanation for the discrepancy, namely, that the observations of the latter workers were made while adaptation was incomplete.…”

Section: Discussionmentioning

confidence: 99%

Dietary Treatment of Hypertension. Clinical and Metabolic Studies of Patients on the Rice-Fruit Diet

Dole¹,

Dahl²,

Cotzias³

et al. 1950

J. Clin. Invest.

113

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This report is based on a study of six patients who were treated for hypertension by means of the rice-fruit diet of Kempner (1). During the six months of study with the patients in continuous residence on a metabolic ward observations were made to follow the evolution of both clinical and metabolic changes.The purpose of this study was the analysis of certain aspects of the necessity and the sufficiency of the rice-fruit program as applied to selected patients in a controlled environment. To this end evidence will be presented to demonstrate that objective clinical improvement actually occurred in these patients while they were under detailed metabolic observation.Whether the high incidence of clinical improvement observed was due to the selection of relatively young and uncomplicated hypertensive subjects or due to the detailed supervision of dietary intake or even whether the sheltered environment of a metabolic ward may have contributed to the favorable effects was not investigated. These considerations, although pertinent to the general problem of dietary treatment (2), are not directly relevant to the present issue of association between clinical and metabolic change. ProcedureWhile on the metabolic ward the patients remained ambulatory but with activities limited to light hand work. The environmental temperature remained in the comfort range during the period of study. No patient was aware of sweating at any time except when thermal sweating was induced for the purpose of collection of sweat.The recumbent blood pressure of each patient was measured by the same physician each morning following a 20 minute rest period. A mercury sphygmomanometer was used; systolic pressure was read at the beginning and diastolic pressure at the cessation of sound. The fundi were examined after full dilatation weekly by three observers, and a map made of any lesions seen. Electrocardiographic tracings were obtained approximately every four weeks. Chest X-ray films, exposed at two meter distance for determination of heart size, were taken every two to four weeks. Blood samples of 50 cc. volume were taken weekly.Preliminary period (14-30 days). During this time the patient became adjusted to ward procedure, with unrestricted hospital diet.Period I (70-95 days). The initial rice diet consisted of only 90 gm. of rice per day with the fruits and fruit juices admitted in Kempner's regimen and a vitamin supplement.' The patients were allowed to select their levels of caloric intake through variation of sugar and fruit consumption. The rice intake, however, was held constant. On this schedule the patients received a calculated protein intake of 20-25 gm. per day, of which 7 gm. were from rice.After the patients had been on this diet for intervals which varied from 18 to 56 days as a result of starting Period I at different times, they all were changed to a 1 The calculated amounts of certain vitamins provided by a typical daily rice-fruit intake are: vitamin A, 115 I.U.; thiamin, 1.1 mg.; riboflavin, 0.25 mg.; nicotinic acid, 18 mg....

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Section: Discussionmentioning

confidence: 99%

Dietary Treatment of Hypertension. Clinical and Metabolic Studies of Patients on the Rice-Fruit Diet

Dole¹,

Dahl²,

Cotzias³

et al. 1950

J. Clin. Invest.

113

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“…In some patients small amounts of non-leguminous vegetables, potatoes, lean meat, and fish can be added later, but this is often followed by a rise in blood pressure, which always occurs on return to normal food. Yet prolonged adherence to the strict diet may lead to a negative nitrogen balance (Schwartz and Merlis, 1948). These results have in part been confirmed (Flipse and Flipse, 1947;Canter, 1948;Contratto and Rogers, 1948).…”

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confidence: 82%

“…The part played by the sodium metabolism in these conditions favours the hypothesis that overproduction of adrenal mineralocorticosteroids may be one of their essential features. H. Selye (1946) has shown that " diseases of adaptation " may originate from a faulty mechanism of adaptation to unspecific damaging stimuli, and that overproduction of adrenal corticosteroids under pituitary stimulation constitutes one of the most important physiological events in the defence mechanism of the body. It is therefore conceivable that intoxication of the body with adrenal mineralocorticoids may occur as a result of maladaptation and that deficiency or loss of sodium may prevent or mitigate such an intoxication in the same way as it lessens the effect of D.C.A.…”

Section: The Figures Inmentioning

confidence: 99%

“…While the addition of salt doesi not affect the blood pressure of normal people (Grant and Reischman, 1946), Goldzieher and Salmovitz (1943) observed salt retention in hypertensives and decrease in blood pressure after salt restriction and ammonium chloride medication. The latter is capable of preventing the effects of D.C.A.-overdosage in animals (H. Selye, 1946) and returns to normal the increased Na/Cl ratio in the serum of D.C.A.-treated animals (F. L. Selye, 1947). An increased Na/Cl ratio was found by the last-named author also in the blood of some hypertensive patients with high diastolic pressures, and Goldzieher and Stone (1949) have shown that sodiumn and chloride can be retained independently of each other.…”

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confidence: 99%

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Dietary Treatment of Hypertension

Ucko¹

1950

BMJ

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Cardiovascular Diseases

Schaaf¹

1950

Arch Intern Med (Chic)

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It has been hypothesized that Helicobacter pylori (Hp) infection may contribute to reduced stature, risk of hypertension or obesity. The aim was to evaluate body indices in Hp positive and negative persons. A total of 2436 subjects (4-100 years old) were tested for Hp status by 13 C-urea breath test. Data on height and weight were collected for 84%, and blood pressure for 80% of the study subjects. The prevalence of Hp infection was 41.6%. The odds ratio for a 10-year increase in age was 1.21 (95% CI 1.17-1.25, p-value <0.001). Statistically significant negative association of Hp positivity with body height was most pronounced in the younger age groups, while a positive association of Hp positivity with body mass index was only seen in those aged 15+ years. There was a negative effect of Hp positivity on systolic and diastolic blood pressure in subjects below 25 and a relatively strong positive effect on blood pressure in subjects over 65 years. Residual confounding by social characteristics as a possible explanation for the associations of Hp positivity with height and blood pressure cannot be excluded. Unmeasured factors related to social and family environment may cause the apparent association between Hp positivity and children's growth and blood pressure.

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Nitrogen Balance Studies on the Kempner Rice Diet

Cited by 24 publications

References 18 publications

Dietary Treatment of Hypertension. Clinical and Metabolic Studies of Patients on the Rice-Fruit Diet

Dietary Treatment of Hypertension. Clinical and Metabolic Studies of Patients on the Rice-Fruit Diet

Dietary Treatment of Hypertension

Cardiovascular Diseases

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