WILLIAM BANTING: The Father of the Low-Carbohydrate Diet

[Guest guest]

Written by Barry Groves.

 

http://www.second-opinions.co.uk/banting.html

 

 

Oxford Symposium paper:

WILLIAM BANTING

 

The following article was awarded the Sophie Coe Prize at the 2002

Oxford Symposium on Food History (aka the Oxford Symposium on Food and

Cooking). The Symposium was held at St Antony's College, Oxford, over

the weekend 7 and 8 September 2002.

 

The Prize, in memory of Sophie Coe, the distinguished food

historian who died in 1994, is awarded annually under the auspices of

the Oxford Symposium for an essay or article on some aspect of food

history, embodying new research or providing new insights.

 

WILLIAM BANTING:

The Father of the Low-Carbohydrate Diet

Summary

For two decades 'healthy eating' propaganda has influenced the way we

eat. Over the same period there has been a consequent dramatic rise in

obesity and associated conditions. This has led to a backlash which

has seen a rash of diet books advocating high-fat, low-carbohydrate

diets described as 'new' and 'revolutionary'.

 

But in reality, they are not. The first low-carbohydrate diet book was

written in 1863 by William Banting as a service to his fellow Man. His

name passed into the language as the verb 'to bant'.

 

That the 'Banting diet' works has been attested to by 140 years of

epidemiological studies and clinical trials.

 

For the sake of our health, it is time we started 'banting' again.

 

WILLIAM BANTING:

The Father of the Low-Carbohydrate Die

 

 

Introduction

For three decades we have been told that for our health and to lose

weight we all should eat a diet based on carbohydrate foods: breads,

pasta, fruit and vegetables, and low in fat. Over the period there has

been such a dramatic increase in obesity and related diseases that

recently there has been a strong backlash: cut out foods high in

carbohydrates and eat a lot more fat. In the 1990s and increasingly

over the past year, this latest 'fad' diet has taken the world by

storm.

 

There seems to be a general belief that the rash of low-carbohydrate,

high-fat diets are 'new' or 'revolutionary' in some way. Popular books

certainly give that impression. But nothing could be further from the

truth. I started eating a low-carbohydrate diet in 1962 when a doctor

advised me that this the best way to lose weight. You may also think

that these 'new' low-carbohydrate regimes have been pioneered by

far-seeing and learned medical men. Again, this is incorrect. The

truth is that we would probably never have heard of diets where people

could lose weight eating that most calorific of foods, fat, if it had

not been for a 19th century English carpenter by the name of William

Banting.

 

 

Only three men in history have been immortalised by having their names

enter the English language as verbs. The first was Irishman, Captain

Boycott, whose name entered the language in the 1860s. Another was

Louis Pasteur and the third was the subject of this article –

William

Banting, a man who came to have a great impact on many peoples' lives,

including mine.

 

Being overweight has affected a small proportion of the population for

centuries but clinical obesity was relatively rare until the 20th

century. Indeed obesity remained at a fairly stable low level until

about 1980. Then its incidence began to increase dramatically. By 1992

one in every ten people in Britain was overweight; a mere five years

later that figure had almost doubled. In the USA it is even worse: by

1991 one in three adults was overweight. That was an increase of eight

percent of the population over just one decade despite the fact that

Americans spend a massive $33 billion a year on 'slimming'.

 

It may be hard to believe, but this has occurred in the face of

increasing knowledge, awareness, and education about obesity,

nutrition and exercise. It has happened despite the fact that calorie

intake has gone down by twenty percent over the past ten years and

exercise clubs have mushroomed. More people are cutting calories now

than ever before in their history yet more of them are becoming

overweight. There is now a pandemic of increasing weight across the

industrialised world.

 

But it needn't be like that, for nearly 140 years ago one man changed

thinking on diet completely.

 

It all started with a small booklet entitled Letter on Corpulence

Addressed to the Public , not written by a dietician or a doctor, but

by an undertaker named William Banting. It became one of the most

famous books on obesity ever written. First published in 1863, it went

into many editions and continued to be published long after the

author's death. The book was revolutionary and it should have changed

western medical thinking on diet for weight loss forever.

 

William Banting was well-regarded in 19th century society. He was a

fine carpenter, and undertaker to the rich and famous. But if he had

remained only that, his name would probably be remembered today merely

as the Duke of Wellington's coffin maker, if indeed it were remembered

at all.

 

None of Banting's family on either parent's side had any tendency to

obesity. However, when he was in his thirties, William started to

become overweight. He consulted an eminent surgeon, a kind personal

friend, who recommended increased " bodily exertion before any

ordinary

daily labours began " . Banting had a heavy boat and lived near the

river so he took up rowing the boat for two hours a day. All this did

for him, however, was to give him a prodigious appetite. He put on

weight and was advised to stop. So much for exercise!

 

He was advised that he could remedy his obesity by moderate and light

food. But wasn't really told what was intended by this. He says he

brought his system into a low, impoverished state without reducing his

weight, which caused many obnoxious boils to appear and two rather

formidable carbuncles. He went into hospital and was ably operated

upon – but also fed into increased obesity.

 

Banting went into hospital twenty times in as many years for weight

reduction. He tried swimming, walking, riding and taking the sea air.

He drank " gallons of physic and liquor potassae " , took the

spa waters

at Leamington, Cheltenham and Harrogate, and tried low-calorie,

starvation diets; he took Turkish baths at a rate of up to three a

week for a year but lost only 6 pounds in all that time, and had less

and less energy.

 

He was assured by one physician, whom he calls " one of the ablest

physicians in the land " , that putting weight on was perfectly

natural;

that he, himself, had put on a pound for every year of manhood and he

was not surprised by Banting's condition – he merely advised

" more

exercise, vapour baths and shampooing and medicine " .

 

Banting tried every form of slimming treatment the medical profession

could devise but it was all in vain. Eventually, discouraged and

disillusioned – and still very fat – he gave up.

 

By 1862, at the age of 66, William Banting weighed 202 lbs (14st 6

lbs) and he was only 5 ft 5 ins tall. Banting says that although he

was of no great weight or size, still, he says:

 

" I could not stoop to tie my shoes, so to speak, nor to

attend to

the little offices humanity requires without considerable pain and

difficulty which only the corpulent can understand, I have been

compelled to go downstairs slowly backward to save the jar of

increased weight on the knee and ankle joints and have been obliged to

puff and blow over every slight exertion, particularly that of going

upstairs. "

 

He also had an umbilical rupture, and other bodily ailments.

 

On top of this he found that his sight was failing and he was becoming

increasingly deaf.

 

Because of this last problem, he consulted an aural specialist who

made light of his case, sponged his ears out – and blistered the

outer

ear – without the slightest benefit and without enquiring into his

other ailments. Banting was not satisfied: he left in a worse plight

than when he went to the specialist.

 

Eventually, in August of 1862 Banting consulted a noted Fellow of the

Royal College of Surgeons: an ear, nose and throat specialist, Dr.

William Harvey. It was an historic meeting.

 

Dr. Harvey had recently returned from a symposium in Paris where he

had heard Dr Claude Bernard, a renowned physiologist, talk of a new

theory about the part the liver played in the disease of diabetes.

Bernard believed that the liver, as well as secreting bile, also

secreted a sugar-like substance that it made from elements of the

blood passing through it. This started Harvey's thinking about the

roles of the various food elements in diabetes and he began a major

course of research into the whole question of the way in which fats,

sugars and starches affected the body.

 

When Dr. Harvey met Banting, he was interested as much by Banting's

obesity as by his deafness, for he recognised that the one was the

cause of the other. So Harvey put Banting on a diet. By Christmas,

Banting was down to 184 lbs and, by the following August, 156 lbs.

 

Banting's diet to that date had followed this pattern:

 

Breakfast: bread and milk for breakfast, or a pint of tea with plenty

of milk and sugar, and buttered toast (this was before the invention

of breakfast cereals but it is actually very similar to the modern

cereal breakfast);

Dinner: meat, beer, bread and pastry for dinner;

Tea: a meal similar to breakfast;

Supper: generally a fruit tart or bread and milk.

Banting says he had little comfort and far less sound sleep.

 

Harvey's advice to him was to give up bread, butter, milk, sugar, beer

and potatoes. These, he told Banting, contained starch and saccharine

matter tending to create fat and were to be avoided altogether. The

word 'saccharine' meant sugar.

 

When told what he could not eat, Banting's immediate thought was that

he had very little left to live on. Harvey soon showed him that really

there was ample and Banting was only too happy to give the plan a fair

trial. Within a very few days, he says, he derived immense benefit

from it: the plan leading to an excellent night's rest with six to

eight hours' sleep per night.

 

For each meal, Harvey allowed Banting:

# up to six ounces of bacon, beef, mutton, venison, kidneys, fish or

any form of poultry or game;

# the 'fruit of any pudding' – he was denied the pastry

# any vegetable except potato;

# and at dinner, two or three glasses of good claret, sherry or

Madeira.

# Banting could drink tea without milk or sugar.

# Champagne, port and beer were forbidden and he could eat only one

ounce of toast.

 

On this diet Banting lost nearly 1 lb per week from August 1862 to

August 1863. In his own words he said:

 

" I can confidently state that quantity of diet may safely be

left

to the natural appetite; and that it is quality only which is

essential to abate and cure corpulence. . . . These important

desiderata have been attained by the most easy and comfortable means .

.. . by a system of diet, that formerly I should have thought

dangerously generous. "

 

After 38 weeks. Banting felt better than he had for the past 20 years.

 

By the end of the year, not only had his hearing been restored, he had

much more vitality and he had lost 46 lbs in weight and 12 1/4 inches

off his waist. He suffered no inconvenience whatever from the new

diet, was able to come downstairs forward naturally with perfect ease,

go upstairs and take exercise freely without the slightest

inconvenience, could perform every necessary office for himself, the

umbilical rupture was greatly ameliorated and gave him no anxiety, his

sight was restored, his hearing improved, his other bodily ailments

were ameliorated and passed into the matter of history.

 

Banting was delighted. He would have gone through hell to achieve all

this but it had not been necessary. Indeed the diet allowed so much

food, and it was so easy to maintain, that Banting said of it:

 

" I can conscientiously assert I never lived so well as under

the

new plan of dietary, which I should have formerly thought a dangerous,

extravagant trespass upon health. "

 

He says that this present dietary table is far superior to what he was

eating before:

 

" more luxurious and liberal, independent of its blessed

effect,

but when it is proved to be more healthful, the comparisons are simply

ridiculous. "

" I am very much better both bodily and mentally and pleased to

believe that I hold the reins of health and comfort in my own

hands. "

" It is simply miraculous and I am thankful to Almighty

Providence

for directing me through an extraordinary chance to the care of a man

who worked such a change in so short a time. "

 

It is quite obvious from these comments that Banting didn't need the

strength of willpower that today's slimmer needs; that he found his

weight-loss diet very easy to maintain.

 

He wish that the medical profession would acquaint themselves with the

cure for obesity so that so many men would not descend into early

graves, as he believed many did, from apoplexy, and would not endure

on Earth so much bodily and mental infirmity.

 

Banting was so pleased with his progress that on top of Harvey's fees,

he gave the doctor £50 to be distributed amongst Harvey's favourite

hospitals. Although, despite this, he still felt deeply obligated in a

way that he could never hope to repay.

 

But in 1868, Banting published a prospectus and started a fund to

found and endow a new institution for the service of humanity –

the

Middlesex County Convalescent Hospital.

 

It was to be for those working-class people who could not afford to

convalesce but had to return to work to make ends meet thus allowing

no time to get over their hospital ordeal and so succumbed to

relapses.

 

There was a small home at Walton on Thames which, although small, was,

he thought, possibly sufficient for the purpose. Banting estimated

that £12,000 per year was needed to run it.

 

Banting put up £500, his son £100 and two other members of his

family

a further £50; with other patrons he raised a total of £5,000.

 

Banting charged nothing for the first two editions of his book –

he

didn't want the accused of doing it merely for profit. He had printed

1,000 copies of the first edition and he gave them away.

 

The second edition numbered 1,500 which he also gave away although

they cost him 6d each. Copies of the third edition, still in 1863,

were sold at 1/- each.

 

When Banting's booklet, in which he described the diet and its amazing

results was published, it was so contrary to the established doctrine

that it set up a howl of protest among members of the medical

profession. The 'Banting Diet' became the centre of a bitter

controversy and Banting's papers and book were ridiculed and

distorted. No one could deny that the diet worked, but as a layman had

published it, and medical men were anxious that their position in

society should not be undermined, they felt bound to attack it.

Banting's paper was criticised solely on the grounds that it was

'unscientific'.

 

Later, Dr. Harvey had a problem too. He had an effective treatment for

obesity but not a convincing theory to explain it. As he was a medical

man, and so easier for the other members of his profession to attack,

he came in for a great deal of ridicule until, in the end, his

practice began to suffer.

 

However, the public was impressed. Many desperate, overweight people

tried the diet and found that it worked. Like it or not, the medical

profession could not ignore it. Its obvious success meant that the

Banting Diet had to be explained somehow.

 

To the rescue from Stuttgart came a Dr. Felix Niemeyer. He managed to

make the new diet acceptable with a total shift in its philosophy. At

that time, the theory was that carbohydrates and fat burned together

in the lungs to produce heat. The two were called 'respiratory foods'.

After examining Banting's paper, Niemeyer came up with an answer to

the doctors' problem. All doctors knew that protein was not fattening,

only the respiratory foods – fats and carbohydrates. He,

therefore,

interpreted 'meat' to mean only lean meat with the fat trimmed off and

this subtle change solved the problem. The Banting Diet became a high

protein diet with both carbohydrate and fat restricted. This altered

diet became enshrined in history and still forms the basis of slimming

diets today.

 

Banting's descriptions of the diet are quite clear, however. Other

than the prohibition against butter and pork, nowhere is there any

instruction to remove the fat from meat and there is no restriction on

the way food was cooked or on the total quantity of food which may be

taken. Only carbohydrate – sugars and starches – are

restricted. The

reason that butter and pork were denied him was that it was thought at

this time that they too contained starch.

 

Banting, who lived in physical comfort and remained at a normal weight

until his death in 1878 at the age of 81, always maintained that Dr.

Niemeyer's altered diet was far inferior to the one that had so

changed his life.

 

Not long after Banting's Letter on Corpulence was published the verb

'to bant' entered the language and people losing weight said they were

'banting'. It remained in common parlance well into the Twentieth

Century and one still hears it occasionally today.

 

A friend of mine, Jan Freden, of Uppsala, Sweden, tells me that in

Sweden today, 'banting' is still the word most commonly used for

dieting to achieve weight loss. So, in Sweden:

# 'Att banta' = to bant.

# 'Nej, tack, jag bantar' = No thank you, I am banting.

 

The Banting diet is confirmed

Banting's Letter on Corpulence travelled widely. In the 1890s, an

American doctor, Helen Densmore, modelled diets on Banting. She tells

how she and her patients lost an average 10-15 lbs (4.5-6.8 kg) in the

first month on the diet and then 6-8 lbs (2.7-3.6 kg) in subsequent

months 'by a diet from which bread, cereals and starchy food were

excluded'. Her advice to would-be slimmers was: 'One pound of beef or

mutton or fish per day with a moderate amount of the non-starchy

vegetables given above [tomatoes, lettuce, string beans, spinach and

such] will be found ample for any obese person of sedentary habits'.

 

Dr. Densmore was scathing of those others of her profession who

derided Banting's diet. She says of them: 'Those very specialists who

are at this time prospering greatly by the reduction of obesity and

who are indebted to Mr. Banting for all their prosperity are loud,

nevertheless, in their condemnation of the Banting method'.

 

Real-life tests

In 1906, Dr. Vilhjalmur Stefansson, a young Harvard anthropology

teacher who later became a world-famous explorer and anthropologist,

revolutionised polar exploration by crossing the Arctic alone and

living off the land with the Eskimos. It was not quite what had been

planned. Stefansson had gone on ahead of the Leffingwell-Mikkelson

Expedition and had missed a planned rendezvous at Herschel Island. He

was left to spend an Arctic winter with the Eskimos eating a diet

composed only of meat and fish. Unlike the diet he had been brought up

on, it contained no plant material whatsoever.

 

It was a golden opportunity for the young scientist to conduct an

experiment into the effects of an Eskimo diet on a European

unaccustomed to it. The usual Eskimo meal consisted of briefly stewed

fish washed down with water. It was so different from what he was used

to that at first Stefansson was repelled by it. To try to make the

fish more palatable, he tried broiling it. This resulted in his

becoming weak and dizzy, with other symptoms of malnutrition.

Stefansson reasoned that with such a restricted diet the body had to

have not just the fish but the other nutrients that had been leached

out into the water. And so he tried harder. Eventually he became so

accustomed to the primitive diet that, by the time he left the

Eskimos, Stefansson managed as well as them. On this regime,

Stefansson remained in perfect health and did not get fat.

 

The experience had a profound effect on Stefansson. Like Banting

before him, he became interested in the possibilities of diets high in

proteins and fats and low in carbohydrates. It seemed to him that a

balanced diet in which there was relatively little meat, 'balanced' by

larger amounts of potatoes, bread, rice and other starchy foods

followed by sweet desserts and sugared coffee might be balanced in the

wrong direction. And so, like Banting, Stefansson questioned the

established ideas on diet. Unfortunately, he had no more success than

Banting. Although he became famous and his position as an

anthropologist was unassailable, still no one took any notice of his

ideas on nutrition.

 

Some years after his first experience with the Eskimos, Dr. Stefansson

returned to the Arctic with a colleague, Dr. Karsten Anderson, to

carry out research for the American Museum of Natural History. They

were supplied with every necessity including a year's supply of

'civilised' food. This they declined, electing instead to live off the

land. In the end, the one-year project stretched to four years, during

which time the two men ate only the meat they could kill and the fish

they could catch in the Canadian Arctic. Neither of the two men

suffered any adverse after-effects from their four-year experiment. It

was evident to Stefansson, as it had been to Banting, that the body

could function perfectly well, remain healthy, vigorous and slender if

it used a diet in which as much food was eaten as the body required,

only carbohydrate was restricted and the total number of calories was

ignored.

 

The first clinical dietary trial

In 1928, Stefansson and Anderson entered Bellevue Hospital, New York

for a controlled experiment into the effects of an all-meat diet on

the body. The committee which was assembled to supervise the

experiment was one of the best qualified in medical history,

consisting as it did of the leaders of all the branches of science

related to the subject. Dr. Eugene F. DuBois, Medical Director of the

Russell Sage Foundation (subsequently chief physician at the New York

Hospital, and Professor of Physiology at Cornell University Medical

College) directed the experiment. The study was designed to find the

answers to five questions about which there was some debate:

 

1. Does the withholding of vegetable foods cause scurvy?

2. Will an all-meat diet cause other deficiency diseases?

3. Will it cause mineral deficiencies, of calcium in particular?

4. Will it have a harmful effect on the heart, blood vessels or

kidneys?

5. Will it promote the growth of harmful bacteria in the gut?

 

 

The results of the year-long trial were published in 1930 in the

Journal of Biological Chemistry and showed that the answer to all of

the questions was: no. There were no deficiency problems; the two men

remained perfectly healthy; their bowels remained normal, except that

their stools were smaller and did not smell. The absence of starchy

and sugary carbohydrates from their diet appeared to have only good

effects.

 

Once again, Stefansson discovered that he felt better and was

healthier on a diet that restricted carbohydrates. Only when fats were

restricted did he suffer any problems. During this experiment his

intake had varied between 2,000 and 3,100 calories per day and he

derived, by choice, an average of eighty percent of his energy from

animal fat and the other twenty percent from protein.

 

One interesting finding from a heart disease perspective was that

Stefansson's blood cholesterol level fell by 1.3 mmol/l while on the

all-meat diet, rising again at the end of the study when he resumed a

'normal' diet.

 

But the published results had little effect on the people trying to

lose weight in 1930. A diet that allowed as much meat as one could eat

and also allowed a large proportion of fat must contain lots of

calories. To the average slimmer, lots of calories meant putting on

weight.

 

The evidence mounts

In 1933, a clinical study carried out at the Royal Infirmary,

Edinburgh studied the effects of low- and high-calorie diets, ranging

from 800 to 2,700 kcals.

 

Average daily losses:

# high carb/low fat diet - 49g [like a modern slimming

diet]

# high carb/low protein - 122g

# low carb/high protein - 183g

# low carbohydrate/high fat - 205g

 

Drs Lyon and Dunlop pointed out that:

 

'The most striking feature of the table is that the losses appear

to be inversely proportionate to the carbohydrate content of the food.

Where the carbohydrate intake is low the rate of loss in weight is

greater and conversely.'

 

In other words, the less carbohydrate was eaten, the greater was the

amount of weight lost.

 

In 1955 Dr Albert Pennington in the USA also found that: 'weight loss

appeared to be inversely related to the amount of glycogenic materials

in the diet. Carbohydrate is 100 per cent, protein 58 per cent and fat

10 per cent glycogenic.' (In other words, the more a food increased

insulin production, the less weight was lost – and in this

respect, to

lose weight, again carbohydrate was worst and fat best.)

 

Pennington continued: 'The recommended diet is a calorically

unrestricted one, very low in carbohydrate, high in fat and moderate

in protein. Neither fat nor protein is restricted, however.'

 

Pennington's diet was so successful that it was reported in Holiday

magazine, where it became known as 'The Holiday Diet'.

 

Professor Alan Kekwick and Dr Gaston Pawan had similar results: In a

trial at the Middlesex Hospital, London, overweight patients:

* lost the most weight on a high-fat, low-carbohydrate diet

* lost the least weight on a high-carbohydrate, low-fat diet

* Lost weight even at 2,600 calories a day – but only on a

high-fat diet.

 

In 1959, Dr John Yudkin, Professor of Nutrition and Dietetics, Queen

Elizabeth Hospital, University of London, confirmed Kekwick and

Pawan's findings when he showed that a diet with unlimited protein and

fat, but with little or no carbohydrate was far more effective in

causing weight loss than a calorie-controlled, low-fat diet.

 

During the 1950s, another British physician, Dr Richard Mackarness,

found that the low-carb, high-fat diet was so successful with his

overweight patients that he wrote a book that was in print for nearly

twenty years – a feat almost unheard of in the slimming book

industry.

It was Dr Mackarness who introduced this concept to me in 1962 and so

dramatically changed the lives of my family and me. In the forty years

since, none of my family has been overweight, although we were before

that date.

 

As time passed and praising the value of fat became politically

incorrect, it became more difficult to get such trials published.

Nevertheless, it did happen occasionally.

 

Published in the year 2000, a prospective study was conducted to

evaluate the effect of a low carbohydrate, high-protein/fat diet in

achieving short-term weight loss. Researchers at the Center for Health

Services Research in Primary Care, Durham, North Carolina, reported

data from a six-month study that included fifty-one individuals who

were overweight, but otherwise healthy. The subjects received

nutritional supplements and attended bi-weekly group meetings, where

they received dietary counselling on consuming a low-carbohydrate,

high-protein/fat diet. After six months, they had lost, on average,

more than ten percent of their weight and (remember this for later)

their total cholesterol dropped by an average 10.5 mg/dl (0.27

mmol/l).

 

Twenty patients chose to continue the diet after the first six months,

and after twelve months, their mean weight loss was 10.9 percent and

their total cholesterol had decreased by 14.1 mg/dl (0.37 mmol/l).

 

Dr William S. Yancy, M.D. admitted that:

 

'This study of overweight individuals showed that a low

carbohydrate, high-protein/fat diet can lead to significant weight

loss at one year of treatment.'

 

All these recommendations and evidence could have saved a great deal

of grief, trauma and ill-health if two other doctors had been listened

to in 1994. Writing in the British Medical Journal, Professor Susan

Wooley and Dr David Gardner highlighted the role of the professional

in people's increasing weight. They said:

 

'The failure of fat people to achieve a goal they seem to want

–

and to want above all else – must now be admitted for what it is:

a

failure not of those people but of the methods of treatment that are

used.'

 

In other words, blaming the overweight for their problem and telling

them they are eating too much and must cut down, is simply not good

enough. It is the dieticians' advice and the treatment offered that

are wrong. Wooley and Garner concluded:

 

'We should stop offering ineffective treatments aimed at weight

loss. Researchers who think they have invented a better mousetrap

should test it in controlled research before setting out their bait

for the entire population. Only by admitting that our treatments do

not work – and showing that we mean it by refraining from offering

them – can we begin to undo a century of recruiting fat people for

failure.'

 

But of course there is a 'better mousetrap'. William Banting wrote of

it nearly a century and a half ago.