President William Howard Taft, the country's heaviest commander in chief and a high-profile yo-yo dieter in his day, lost 60 pounds in the early 1900s on a low-carb diet with the help of a diet doctor.
Dozens of letters between Taft and his English physician provide "a detailed look at patient care for obesity during this time," says historian Deborah Levine, an assistant professor of health policy and management at Providence (R.I.) College and author of an article, out Monday, in the Annals of Internal Medicine. She says that although the letters have been available for years, she believes this is the first time they have been analyzed. "People today may be surprised that patients were seeking care for obesity as early as the beginning of the 20th century."
The 27th U.S. president was lugging around 354 pounds on his 6-foot-2 frame when he was inaugurated in 1909. His obesity was the subject of jokes, editorial cartoons and newspaper articles, including one account that he got wedged into a White House bathtub and couldn't get out, Levine says. "A lot of people know that story. I can't verify it happened, but it's a rumor that created a lot of talk."
Taft, who struggled with his weight for years, believed that his excess pounds contributed to many of his health issues including heartburn, indigestion, fatigue and restless sleep. He thought the key to longevity, health and restful sleep depended on losing weight and adhering to a physician-prescribed diet.
So in 1905, when Taft was serving as secretary of war, he hired London-based physician Nathaniel Yorke-Davies, the author of a popular diet book Foods for Fat: A Treatise on Corpulency and a Dietary for its Care, to supervise his weight-loss regimen, Levine says.
For 10 years, Taft and the doctor exchanged letters about food intake, weight loss, digestive issues and even bowel movements. Taft weighed himself almost every day and once a week his secretary sent copies of the weight records to the doctor, she says.
Yorke-Davies encouraged his patient to be physically active. Horseback riding was Taft's main activity (he didn't like how he looked sitting on a horse), but he also enjoyed golf, Levine says. "He did calisthenics and other exercises with what he called a physical culture man, which we would call a personal trainer."
The physician spelled out exactly what Taft should eat and at what time of day. The diet included lots of lean meat, fish and vegetables without butter and gluten (wheat) biscuits, which Taft ordered from a bakery in London, Levine says. There was a list of forbidden (sugar, sweets) and permitted foods (vegetables, lean meat).
Taft dropped from 314 pounds in December 1905 to 255 pounds in April 1906 during the first course of treatment. His weight-loss plan "seems quite similar to what we would call a low-carb diet, but people didn't even talk about carbs at that time," Levine says.
The diet was roughly 2,000 to 2,100 calories a day with about 30% of the calories coming from carbohydrates; 30% from protein and about 40% from fat, says Catherine Champagne, professor of dietary assessment at the Pennington Biomedical Research Center in Baton Rouge. She wasn't involved in writing this article but did a nutrient analysis of the diet for USA TODAY.
Taft would have needed about 3,600 calories a day to maintain his heavier weight so this diet would have cut out 1,500 to 1,600 calories a day, and his weight loss on that plan is what you'd expect, says obesity researcher Donna Ryan, professor emeritus at the Pennington Biomedical Research Center.
The interesting aspect of this paper "is how much the behavioral techniques at the time are similar to today's techniques. The emphasis on self monitoring is there. We advise daily weighing, and food diaries are a mainstay now," Ryan says.
A big predictor of success is adherence, and you can tell from the completeness of his self-recorded weights that Taft was an adherent patient, she says. "The doctor is doing his part with frequent visits, albeit by mail, and encouragement, not scolding."
When Taft's progress was unsatisfactory, Yorke-Davies wrote letters encouraging him to return to the diet and to send more detailed lists of "everything you eat and drink, and stating how cooked," Levine writes in the paper. After Taft regained 19 pounds, the physician sent him a letter encouraging him to return to close care or else "in another three or four years you will be almost back to your original weight."
In fact, by the time, Taft was inaugurated as president in 1909, his weight was much higher (354 pounds) than his starting weight on the diet (314 pounds), Levine says. She says she doesn't know what eating habits led to the weight regain.
Ryan says Taft probably regained his weight because he went back to his old eating habits and lifestyle.
Levine says this article illustrates the long-standing problem of patients' not sticking with a plan, something that still frustrates doctors, dietitians and nutritionists today, she says.
Taft, who was also the 10th Chief Justice of the United States, continued to struggle with his weight for years and worked with other doctors, Levine says.
In 1913, his 70-pound weight loss under the direction of a different physician got front-page coverage in newspapers across the country. Taft was often interviewed in newspapers about his weight and discouraged people from fad diets, she says.
Taft died in 1930 at age 73 from heart failure. He weighed 280 pounds.
Yorke-Davies' diet plan for Taft included:
• 8 a.m. A tumbler of hot water with lemon, to be sipped slowly.
• 9 a.m. Breakfast: unsweetened tea or coffee, two or three gluten biscuits, 6 ounces of lean grilled meat.
• 12:30. Lunch: 4 ounces of lean meat, 4 ounces of cooked green vegetables without butter, 3 ounces of baked or stewed unsweetened fruit, 1 gluten biscuit, and 1 of the recommended "sugarless" wines.
• An afternoon cup of tea, coffee, or beef tea (beef broth) without milk or sugar was advised.
• 7 p.m. to 8 p.m. Dinner. Clear soup, 4 ounces of fish, 5 ounces of meat, 8 ounces of vegetables, 4 ounces of stewed fruit, plain salad. 2 gluten biscuits, if desired.
This plan included a list of vegetables, salads and condiments that could be used for variation.