The long history of low-carb diets
The ketogenic diet is not a fad or trend diet, but a proven and efficient diet in the spectrum of low-carb diets.
2021 marks the 100th anniversary of the first definition of a medically formulated ketogenic diet! But its history goes back much further.
Epilepsy and the ketogenic diet
1921
The first scientific report on the use of fasting for epilepsy appeared in the United States in 1921. A well-known New York pediatrician, Dr. Rawle Geyelin, described how he achieved seizure reduction in a 10-year-old child by fasting. In the years that followed, he published reports of several patients who remained seizure-free for 2-3 years by following prolonged periods of fasting.
The caveat was that such long fasts were not feasible, especially in children. At that time it was already known that fasting was accompanied by a drop in blood glucose and simultaneous increase in blood ketone bodies. Therefore, it was prudent to continue research in this direction and develop a diet that mimicked the fasting state.
1941
The first reports of success with this diet are recorded from the Mayo Clinic, Johns Hopkins Hospital, and Harvard University. Between 1941 and 1980, the ketogenic diet was a common treatment for childhood epilepsy. It was not until new medications were developed that the ketogenic became increasingly disused.
1990 – The Charlie Foundation
The “Charlie Foundation” played a significant role in the reemergence of the ketogenic diet. The foundation was founded in the mid-1990s with the aim of raising awareness about the therapeutic use of the ketogenic diet in children with pharmaco-resistant epilepsy. It was founded by the parents of Charlie, who had discovered the ketogenic diet through their own research and were thus able to help their son, who had not responded to drug therapy. The story was even made into a movie (First Do No Harm). More info at: www.charliefoundation.com
In addition to the work of the Charlie Foundation, more and more studies provided evidence for the effectiveness and tolerability of the diet.
Berryman, M. Suzanne. “The ketogenic diet revisited.” Journal of the American Dietetic Association 97.10 (1997): S192-S194.
Low-Carb is not a modern trend
The low-carb and ketogenic diets therefore have established roots.
1848 Jean Anthelme Brillat-Savarin
Brillat-Savarin was a French writer and gastrosophist. He is said to have worked for 25 years on the most famous of his works, “La Physiologie du Goût” [1] (German: “The Physiology of Taste”), published in 1826. It deals not only with the preparation of exquisite dishes, but also with very intellectual theories on the pleasures of the table, a kind of life lesson. Brillat-Savarin was also convinced that sugar and starch were the real cause of obesity:
“One thing is certain, carnivorous animals never get fat (consider wolves, jackals, birds of prey, crows, etc.). Herbivorous animals do not become fat easily, at least until age reduces them to a state of inactivity; but they can become fat very quickly as soon as they begin to be fed with potatoes, cereals, or any kind of flour. … The second of the main causes of obesity are the mealy and starchy substances that humans make the main ingredients of their daily diet. As we have already said, all animals that live on floury foods will probably become fat; and man is no exception to the general law”
from: Brillat-Savarin, Jean Anthelme (1970). The Physiology of Taste. trans. Anne Drayton. Penguin Books. pp. 208–209. ISBN 978-0-14-044614-2.
1864 William Banting
William Banting lived in late 19th century London and worked as a mortician. He was severely overweight and all attempts to lose weight were unsuccessful. At the suggestion ofLondon physician William Harvey, Banting began a low-carbohydrate, high-fat diet. Harvey got the idea from a Parisian doctor named Claude Bernard, who used a low-carbohydrate diet to treat his diabetic patients. It was the only treatment option for insulin-dependent diabetics at the time, because insulin could not be synthesized in large quantities until 1922.
Banting successfully lost weight on the low-carb, high-fat diet and wrote down his experiences in a booklet he published titled “Letter on Corpulence, Addressed to the Public” [2]. Although rejected by the medical community, the book became a bestseller.
1885 Dr. Wilhelm Ebstein
Wilhelm Ebstein came from an upper middle-class family and was born in Lower Silesia in 1836. Ebstein’s research focused on metabolic diseases. Ebstein wrote 237 articles during his scientific career, 72 of which were on metabolic disease. He believed that obesity, gout, and diabetes mellitus were hormonal disorders and that the cause was at the cellular level. Ebstein held the view that starch and sugar, rather than fat, were major contributors to the development of overweight, obesity, gout and diabetes mellitus. In 1882 he published a book on the treatment of obesity and two years later one on the treatment of gout. In both books he recommended a diet low in carbohydrates and high in fat, with only moderate amounts of protein [5].
1930 Vilhjálmur Stefansson
Stefansson, a Canadian of Icelandic descent, was a polar explorer and ethnologist. On behalf of the Canadian government, he led numerous expeditions to the Arctic to map it. The expeditions often lasted many weeks and it would not have been possible to carry enough provisions. Therefore, Stefansson began to copy the Inuit way of life and successfully implemented it for himself and the expedition teams. Life with the Inuit and his own experiences triggered a fascination for extremely low-carbohydrate diets.
However, people had just discovered vitamins and believed that such a diet leads to kidney failure, scurvy and other extreme deficiencies. Stefansson, who had lived with the Inuit for years, and his colleague Anderson agreed to participate in an experiment: They would eat like the Inuit for 1 year under medical supervision. The results were published in the Journal of Biological Chemistry in 1930. Stefansson and Anderson were not only perfectly healthy, but they also showed no signs of deficiency and no loss of muscle mass, strength or concentration; their gums were also healthy [3].
1939 Dr. Weston A. Price
Weston A. Price was a dentist who, among other accomplishments, developed improved dental fillings by creating combinations of porcelain and metal. In 1894, Price became interested in nutrition. Soon he saw it as a major factor in the development of tooth decay and other diseases of civilization. He came to this conclusion by traveling around the world with his wife, studying various communities who lived in seclusion from modern, Western civilization.
In 1939, he published his findings in the book Nutrition and Physical Degeneration. He concluded that certain aspects of the modern Western diet, especially sugar, flour, and vegetable fats, are the cause of nutrient deficiencies, tooth decay, and other health problems [4]
1950 Dr. Wolfgang Lutz
Wolfgang Lutz, born and raised in Austria, studied medicine in Innsbruck and Vienna. After completing his studies, he worked in Vienna at the general hospital until the outbreak of World War II. After the war, he worked as a general practitioner in Salzburg. His passion was nutritional medicine. Disturbed by the dramatic increase in “civilization diseases”, his research put forward the idea that humans are poorly adapted to large quantities of processed carbohydrates, and that a hunter-gatherer diet would be more consistent with our genetic makeup. He recommended a modern “Stone Age diet” – high in fat and low in carbohydrates – to his patients. In 1967, his book “Life without Bread” [6] was published. With a translation into English (1986: “Dismantling a Myth: The Role of Fat and Carbohydrates in Our Diet”) he pushed for scientific exchange. But he fails, as does the U.S. cardiologist Dr. Robert Atkins. Lutz’s book is available free online at: http://www.informed-gmbh.de/cgi-local/informed/iread.pl?befehl=3&buch=lutz
Outlook
However, the tide is beginning to turn. Since the turn of the century, low-carbohydrate diets, and in particular the ketogenic diet, have experienced growing interest among scientists, physicians, patients and consumers. In 2020 alone, more than 70 scientific articles have been published on PubMed (Filter: Humans). This is reason alone to establish a professional society such as KetoMed to undertake the dissemination, research, evaluation, and implementation of low-carbohydrate diets in a systematic and evidence-based manner.