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Wellness Wednesday for November 22, 2023

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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In the 1930s, Walter Kempner treated over 18,000 patients with obesity, diabetes, heart disease, and renal failure by changing their diet. At the time, treatments for malignant hypertension were few, and those with the disease had a life expectancy of months. With Kempner's magic diet, many patients saw their conditions improved or reversed.

I thought the prevailing twitter-narrative is that obesity and related conditions like diabetes and hypertension were non-existent or unheard of until the 80s--and then boom! So much for that. it goes to show how narratives are popular because they confirm our preexisting beliefs about how society is or ought to be, not what is actually true. 18,000 is hardly rare or unheard of , especially for a single doctor, so we're easily talking millions of obese people. Obesity must have been widespread but massively underreported, particularly among middle aged people and older people in the '30s , not some rarity as commonly assumed by the internet-experts.

As for the diet itself , yes, consuming rice or any macro or food in a calorie deficit will cause weight loss. AFIK, there is nothing in particular special about rice. As for it 'working', it's way easier to treat diabetes and hypertension than reverse obesity, as shown by the dearth of effective drugs to treat the latter and the very low success rates of diets. If it worked it would be widely reproducible and 'common knowledge', but it only seemed to work for select patients for weight loss.

There's a huge difference between 1-2% of kids being obese and 20% of kids being obese. Even if less than 10% of people were overweight, that would still provide doctors with millions of patients in the 30s. There is plenty of evidence that the overweight population has increased dramatically, even just in our lifetimes it is obvious.

One thing that could effect the obesity rate in the past is that many people with diabetes or heart disease just died. If someone dies, they aren't counted in the population obesity statistics.

But the Twitter Bros have their own explanation - by the 1930s many people in the American South were eating shortening, peanut butter, and other foods laden with Poly-Unsaturated Fats. We can actually see a difference in metabolic rates between Northerners and Southerners in the 1930s.

For the diet part, I don't think that rice has a "thinning" quality like opium has a "soporific" quality (sorry if you don't get the reference, that's a philosophy joke.) But one of the more interesting things about the Kempner Rice Diet is that even people who did not eat at a calorie deficit and did not lose weight still saw diabetes reverse and insulin sensitivity go up:

As Kempner pointed out, any obese patients were indeed encouraged to lose weight—but the improvements in blood sugar levels and insulin requirements occurred “both in patients who lost weight and in those who did not have a significant weight change” (his words). Kempner’s data, both in this paper and in the massive collection of his work filed away at Duke University, showed that the diet could benefit diabetics even when their weight and energy intake didn’t budge.