For practical reasons I distinguish three degrees of reduction diet. I have utilized the above example to illustrate my meaning:

Maintenance diet calculated as 2500 calories.

I. Degree of reduction diet 4/5 of the demand = 2000 calories

II. Degree of reduction diet 3/5 of the demand = 1500 calories

III. Degree of reduction diet 3/5 to 2/5 of the demand = 1500 down to 100 calories

It is not difficult to arrange Diet I or Diet II. All that is required is to omit all visible fat (butter, oil, meat fat, etc.), to prepare vegetables and dishes made from flour with little fat and to restrict the use of beer and wine; in this way the caloric intake is reduced below the lower boundary of Diet I (in our example 2000 calories). In the case of Diet II dishes made from flour, stewed fruits, milk, and soups containing flour would also have to be forbidden.

Rules of this kind can be carried out at home as well as in sanatoria or health resorts. Their effect is slow, but, provided they are carried out conscientiously, sure. The patients should be instructed, in order to compensate for the lack of the above articles of diet, to eat abundant albuminous pabulum, chiefly lean meat and cheese. Only in cases undoubtedly suffering from arthritis urica or from nephritis should the patients be advised differently.

In Diet III of a reduction cure the bill of fare should consist essentially of the following articles of food:

Coffee, tea without additions, meat broth (fat skimmed off) with vegetables, lean meat or fish (total weight 250 to 350 g, weighed cooked), lean cheese, abundant green vegetables and salads prepared with as little fat or oil as possible, vinegar, lemon, vinegar pickles, brine pickles, tomatoes, celery, radishes, abundant raw fruit, with a small percentage of sugar (apples, peaches, strawberries, raspberries, currants, blueberries, sour cherries, grape fruit, early oranges, etc.), coarse bread (bran bread, Graham bread) in quantities of from 40 to 70 gm. potatoes (prepared without fat) in quanties of from 80 to 150 g., Mineral waters ad libitum, Wine, in weak persons, up to 200 gm, preferably omitted altogether, 1 to 2 eggs, Skimmed milk, Buttermilk.

With a little experience in practical dietetics a diet can be arranged from the above articles that offers sufficient variety, while at the same time incorporating a very small caloric value. It is, of course, essential to calculate the latter carefully and to adapt it to the requirements of each individual case, as otherwise many unpleasant surprises will be experienced. I must emphasize again that I do not consider it permissible to inaugurate a reduction cure with so great a restriction of the caloric intake (Third Degree of Reduction Diet) in patients who are following their usual occupation. This method must remain limited to institutions. I could demonstrate the truth of this claim by numerous examples that constitute a serious warning.

A few important details relative to the above diet list call for elaboration.