This is one of the most important features of dietetic therapy, and is older and better known than any other, probably because of its connection with conditioning athletes for all kinds of contests and also from the cosmetic point of view, as superfluous flesh generally implies advanced years. Unlike many other plans of diet it concerns the nominally healthy rather than the sick and invalid.

1 Diet used at the Massachusetts General Hospital, Boston.

The old trainer of athletes knew little or nothing of any scientific regimen for reducing adipose tissue. For him reduction of weight was merely a matter of getting rid of superfluous water, to be accomplished by sweating, purgation and abstinence from fluids. He rejected certain articles of diet as "bad for the wind," but this is as near as he came to specializing in diet. Exercise, without profuse perspiration, meant nothing to him. The steady grind of a worker who burns up so much excess fat daily, yet without any unusual degree of perspiration, is something he took no account of.

Of recent years it has been learned that abstinence, hot baths and purgation, are far less efficacious in keeping down weight than continuous and vigorous exercise within the fatigue limit. It is much less a matter of starvation and elimination than of a steady oxidation of superfluous tissue by graded and varied exercises extending throughout the day. But while constant exercise is the chief essential, it is also important to curb the appetite for food and drink, and to keep the excretory organs active. Otherwise, in the case of novices at least, increased exercise will provoke increased appetite for food and drink, so that not a few people gain flesh while trying to lose it.

Doubtless the best plan for reducing flesh without suffering and violence is to do a great amount of work daily, severe enough in character to oxidize much body fat, but without profuse waste of fluids by sweating, etc. In regard to the meals, these should be small, light and as frequent as desired. Nothing should be taken to provoke thirst. Any food-article whatever which is especially rich in starch, sugar or fat, along with alcoholics, must be omitted. Such individuals thrive best on toast or biscuit without butter; lean meats, fish and. eggs; and vegetables which grow above ground.

The selection of food differs but little from the diabetic regimen, but some carbohydrates are allowed, while the fatty articles, including milk, permissible in diabetes, are to be avoided. The patient is not to be stinted in quantity provided he takes the necessary amount of exercise. He may breakfast freely on eggs, meat and toast, dine on meats and salad vegetables, etc. He should take as little fluid as possible with his meals, but may quench his thirst between meals. By masticating his food thoroughly he materially reduces the demand, and does away with eating for the mere sake of eating.

By simple measures of this sort an individual may reduce his weight to as great degree as desirable, and the process will not be painful but the reverse. He simply oxidizes and otherwise utilizes a little more matter than he takes in, and thereby prevents a pathological and unsafe accumulation of fat.

Diet: Fish

All fresh white fish broiled or boiled.

Meats

Lean mutton or lamb, beef, chicken, game (sparingly).

Eggs

Cooked in all ways (not fried).

Farinaceous

Dry toast or crusts, stale bread (sparingly).

Vegetables

Lettuce, celery, spinach, cresses, asparagus, cauliflowers, white cabbage, onions, tomatoes, radishes, olives.

Liquids

Coffee or tea, one cup without milk, cream or sugar; pure water one glass, drank slowly after the meal.

Avoid

Dark flesh fish, rich soups, salt fish, veal, pork, sausage, fats, potatoes, oatmeal, hominy, macaroni, spices, rice, carrots, beets, turnips, parsnips, puddings, pastry, pies, sugar, sweets, cakes, cream, milk, spirituous liquors, beers, sweet rums, champagne.