Sugar Does Not Make People Fat, Case-In-Point: Kempner’s Rice And Sugar Diet

I want to revisit this post about Kempner’s Rice Diet that I posted back in 2014. First, no one is saying or even suggesting that a person should eat only rice, fruit, and sugar. Kempner designed this diet for people with advanced kidney disease. It wasn’t even intended to be a weight loss diet. Second, as you can see from the photographs, eating sugar, and lots of it, in some cases up to 2000 calories a day in pure white sugar, did not make people gain weight. In fact, people lost weight. What makes people gain weight? When they eat fat along with sugar.

What would happen if you fed people only white rice, fruit, juice, and sugar? At up to 2400 calories a day? Would they gain weight, lose weight, or stay the same?

This is what happened when, in the 1940’s, doctor Walter Kempner began feeding his patients a rice diet:


His initial intention was to feed patients who had advanced renal disease with a diet that would lessen the amount of filtering the kidneys had to do. The diet would reduce nitrogen (from dietary protein), sodium (from salt), etc. White rice fit the bill since it was low in protein and fat while providing all the essential amino acids, and it was widely available. The diet was a success.1

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. Namely, we could radically alter the patients’ diets and thereby save lives.” The (Duke University) students challenged the Herr Professor. “Sounds cool but prove it!” And so he did. 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.

It was by accident that he discovered the diet could do a lot more than treat kidney disease: 2

A major breakthrough occurred by accident in 1942 when one of Dr. Kempner’s patients, a 33-year-old North Carolina woman with chronic glomerulonephritis (kidney disease) and papilledema (eye disease) failed to follow his instructions. Because of Dr. Kempner’s heavy German accent she misunderstood his instructions to return in two weeks, and after two months, she finally returned, with no signs of deficiency, but rather with robust health. The woman had experienced a dramatic reduction of her blood pressure, from 190/120 to 124/84 mmHg, resolution of eye damage (retinal hemorrhages and papilledema), and a noticeable decrease in heart size.

Rice, fruit, and sugar really was all they were eating. This was not just a diet to which lots of rice was added. It was a diet very low in protein, fat, and sodium: 2


  • Dry rice of 250 to 350 grams daily forms the basis of the diet. Any kind of rice is used as long as it contains no milk or salt. The rice is boiled or steamed in plain water or fruit juice, without salt, milk or fat. (One cup of dry white rice weighs about 200 grams, and contains about 13 grams of protein, 150 grams of carbohydrate, 1 gram of fat, and 700 calories.)
  • Fruit and fruit juices are allowed.
  • Dried fruits can be used as long as nothing but sugar has been added.
  • White sugar may be used as desired (ad libitum); on average a patient takes in about 100 grams daily (400 calories) but, if necessary (to maintain body weight), as much as 500 grams (2000 calories) daily has been used.
  • The nutrient breakdown is about 2,000 to 2,400 calories per day (depending on the patient’s body weight): 95% carbohydrate, 4 to 5% protein (20 to 25 grams), 2 to 3% fat (rice is relatively high in the essential fat linoleic acid), 140 milligrams of calcium, and 150 milligrams of sodium daily.

These photos of a retina that show reversal of diabetic retinopathy (bleeding/hemorrhages and leaking/exudates from blood vessels) are nothing short of remarkable:3


And this: 2

His numbers also showed how a high-carbohydrate diet improved blood sugars and often cured type-2 diabetes.

A diet of essentially all refined carbohydrate – white rice and white sugar – often cured type 2 diabetes. Why is this knowledge being lost on us? How did it come to pass that high-fat, meat-based diets reign? Because there’s little money to be made in telling people to eat rice? 3

In the 1950s, diuretics were introduced for the management of high blood pressure. And still later the direct application of Kempner’s dietary regimen diminished as a large array of blood pressure medications — Beta blockers, ACE inhibitors, angiotensin antagonists, and calcium channel blockers — became available for the management of hypertension. Kempner could take solace in knowing, nevertheless, that his regimen could provide comparable, if not better, results.

Many of today’s high-carb, plant-based diets are incarnations of Kempner’s rice diet from the 1940s.

1 Who And What Drove Walter Kempner? The Rice Diet Revisited, Hypertension, October 2014
2 Walter Kempner, MD – Founder Of The Rice Diet, McDougall Newsletter, December 2013
3 Fifty-year Anniversary: Reversal of Diabetic Retinopathy With Rice Diet, Retinal Physician, 2008

Dietary Treatment Of Hypertension. Clinical And Metabolic Studies of Patients On The Rice-Fruit Diet, Journal of Clinical Investigation, September 1950
Treatment of Massive Obesity With Rice/Reduction Diet Program, An Analysis of 106 Patients With at Least a 45-kg Weight Loss, JAMA Internal Medicine, December 1975

7 thoughts on “Sugar Does Not Make People Fat, Case-In-Point: Kempner’s Rice And Sugar Diet

  1. Pingback: What Is A Low-Fat Diet? | Fanatic Cook

  2. Anonymous

    This sounds interesting, I don’t think I could do the original diet but I will get the book The Starch Solution from the library. Thanks for posting this.


  3. Pingback: People In The UK Ate More Sugar In The Past But Had Lower Rates Of Obesity | Fanatic Cook

  4. Pingback: Indigenous Bolivian Tsimane Eat High-Carb, Low-Fat – Have “Lowest Levels Of Coronary Artery Disease Of Any Population Recorded” | Fanatic Cook

  5. ben

    This is a fake diet. 400calories is a starvation diet. It works because carbohydrates is restricted. Twinkies for the same calories will also work.


    1. Bix Post author

      “This is a fake diet.”
      This was a real diet.

      “400calories is a starvation diet.”
      The participants ate up to 2400 calories a day.

      “It works because carbohydrates is restricted.”
      The foods they ate, rice and sugar, are essentially all carbohydrate.

      “Twinkies for the same calories will also work.”
      Twinkies are high in fat. Kempner’s diet was very low in fat.
      2400 calories/day is about 16 Twinkies a day. It would be interesting to see if eating that many Twinkies could treat kidney disease and reverse diabetic retinopathy.


  6. Pingback: What Is The Fate Of Excess Carbohydrate? Does It Turn Into Fat? | Fanatic Cook

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