In the pages of this blog you will learn: what foods to eat to improve your mental powers, step up your vigor how to use today's 3 sensational food supplements harmful food cravings and how to overcome them how to take the nuisance out of calorie counting 7 ways to lose weight and keep it lost—automatically how going on and off diets does more harm than good how to figure how long you'll live why you may be wasting money on vitamin pills what the "easy, fast" reducing formulas don't tell you how your eyes, heels, elbows warn of arteriosclerosis how to "cook in" the good in foods you eat.
Fantastic health miracles performed with the new wonder food—lecithin foods that keep older people from feeling their age how a low-fat intake keeps you off the sick list how food supplements guard against virus infections food secrets of people with outstanding vitality why getting fat is worse than being fat how alcohol can be beneficial in your diet how to survive a heart attack to a ripe old age the truth about tobacco and health how much fatty food is safe for you 5 "golden rules" of nutrition worth more than all the gold in the world
The reader may well ask—"What will this book do for me?" or to paraphrase Ben Franklin, "Can it bring me health (which is really wealth), happiness, and wisdom?" It can, for many reasons.
A growing number of books for laymen on the subject of health have appeared in the past decade. Never before has there been such widespread popular interest in medical science.
Much of this interest has been motivated by the unprecedented advances in medical research that have been made in our time. One discovery has led rapidly to another and many old views are radically changed. New information, new diagnostic tools, and new drugs have provided new answers to many old problems that were believed to be without solution.
Even the practicing physician cannot always keep abreast of these swift developments in medical progress. He cannot take time from treatment of his patients to evaluate all reports of new findings and new products that daily flood his office.
At the same time, he cannot shirk the traditional responsibility of the physician to teach the public how to prevent illness and how best to treat it when it occurs.
The answer, therefore, seems to lie in a division of labor among doctors. Each should contribute to the nation's health literature information on the particular phase of medicine about which he is best qualified to speak. Such information, whether derived from research or from his daily practice, should be as reliable and as safe as a prescription.
Not all books appearing today—even those written by physicians—come up to this high standard. Many are written merely to entertain, to exploit some medical novelty, or sometimes to enhance the prestige of the author.
In preparing the following work for the general reader, the author has aimed at a twofold objective: to prolong your life and to save you from crippling or fatal heart disease resulting from hardening of the arteries.
The information offered here is based upon the writer's 25 years of medical practice, extensive research, and clinical experience.
The low-fat diet, weight reduction, and nutritional program presented in this book are not a panacea for all illnesses. They are not a get-healthy-quick nostrum or cure for everything that ails you.
However in the opinion of the author and a large number of scientists and physicians, these measures are the most effective known to prevent and treat hardening of the arteries or atherosclerosis, today's greatest cause of sickness and death.
There are unquestionably other still unknown causes of hardening of the arteries in the heart, brain, and other vital tissues of the body. Not only is there little or nothing known about them, but there is no effective remedy other than those presented in the following pages.
At this very moment, countless research scientists and physician-investigators are searching the unknown in the life-or-death quest for the various causes and the cure for atherosclerosis. If this miraculous discovery should come to pass, the way of eating and living described in this book may become of historical interest only.
SIX THINGS THIS BOOK WILL DO FOR YOU
But, until that day of more perfect knowledge arrives, I believe we should, in all good conscience, use the most perfect tools that we now have, namely the dietary and nutritional tools set forth in this book. The mounting evidence that they can save the lives and health of countless victims is now too powerful to allow us to stand by and wait for the perfect cure or the therapeutic millennium.
If you will read this book carefully, and apply the simple, easy-to-follow directions given, it is the author's sincere belief that it will enable you to accomplish the following:
1. ADD YEARS TO YOUR LIFE
How many years depends upon your present age and weight. If you are under 20, for example, you can increase your life-span by as much as 15 years. Even if you are over 60, you can still enjoy more than two golden, "bonus" years. These figures are based upon actual Metropolitan Life Insurance tables, included in this book.
2. KNOW WHAT FOOD TO EAT
In addition to prolonging your life by controlling your weight, correct diet can also save you from heart and blood vessel disease. Almost all heart researchers agree that when people who have defective fat metabolism eat a high-fat diet, heart disease often results.
In the following pages you will find instructions, in detail, on what to eat to maintain a well-balanced diet and at the same time to avoid fat-rich foods that may undermine your health.
Complete daily menus for a period of several weeks are included.
3. DISCOVER NEW VITALITY THROUGH DIETARY SUPPLEMENTS
Medical research has discovered a number of important dietary supplements that not only improve the body's general efficiency and well-being but help prevent hardening and blocking of the arteries—the condition that sets the stage for heart attacks and strokes.
The nutritional supplements combined with vitamins that are described in the following pages can help you overcome fatigue, nervousness, and loss of energy.
Medical science has effectively demonstrated that millions of Americans eat three meals a day but are poorly or badly nourished ; many are overweight. Yet they suffer from the symptoms of malnutrition or borderline, subclinical illness. This is often expressed by feelings of tiredness, nervous symptoms, and loss of vitality.
The author will describe the results of controlled studies into new products that he and his associates have conducted to prove their effectiveness and safety.
4. KNOW WHAT TO DO ABOUT SMOKING
The role that cigarette smoking plays in various diseases has been the subject of intensive research. The discussion of tobacco will answer many of your questions concerning the effect of smoking on the heart and blood vessels.
5. KNOW WHAT TO DO ABOUT USING ALCOHOL
The question of alcohol, although not so important to the prevention and treatment of heart disease as it is to some other physical disorders, is also discussed, and professional advice given for using it safely.
6. PUT SUNSHINE INTO YOUR AUTUMN YEARS
It would be only a limited gain if the years added to your life were years of unhappiness or ill health. Therefore, the author has included advice for meeting the special problems of the older years.
The writer believes that a longer, happier life will be yours if you make a whole-hearted effort to absorb and follow the directions given here. Like most worthwhile undertakings, it will take patience and time. But the results are so vital to you and to your loved ones, that your utmost efforts can reward you with a rich harvest of health and extra years of happy living.
CLOGGED PIPES TO THE FOUNTAIN OF LIFE 11
Why can't we live longer? 11
Advances in medical science have outlawed many diseases, 12
The 20th Century epidemic, 12
What is the cause of this new epidemic? 13
Why is the epidemic particularly strong in the U.S.A.? 16
What is the situation in other countries of the world? 16
Is the epidemic confined to older people? 17
Does heredity have anything to do with the problem? 18
Women have better natural protection against atherosclerosis, 19
Can you reverse damage done to your arteries by excessive fat? 19
What is the solution for us? 20
PHYSIOLOGY OF FAT: FAT, FOOD, FACTS AND FICTION 21
Is fat essential in a healthy diet? 21
What is fat? 14
Protein is the keystone of human nutrition, 14
Carbohydrates are a main source of energy, 15
Fats—What they are and what they do to you, 16
How are fats digested? 17
How are fats absorbed? 18
How fats damage or destroy your arteries, 19
Fat may be your "poison,9' 21
How much fat are you stowing away? 22
Take a lesson from the pig, 25
FAT, THE KILLER, ON TRIAL 27
Here is how I entered the race, 27
Is cholesterol and excess fat present in the blood of everyone with atherosclerosis? 28
What about the factor of heredity? 29
Is there an excess of fat imbedded in the artery wall itself? 31
Are there other conditions that cause heart attacks and strokes? 33
The role of the liver in protecting you from excess fats, 34
lsnt there some medicine that will stop fat from causing heart attacks? 34
Many other fat preventing agents have been discovered and found wanting, 35
How the low-fat diet proved its value, 36
Low-fat diet proved to be effective in reducing weight and promoting general good health, 38
HOW TO BE REALLY WELL, THE LOW- FAT WAY 43
Your diet is the key to your health, 43
A healthy diet does not mean starvation or tasteless foods, 44
You do not have to lose energy—good diet increases vigor, 44
Almost everyone can benefit from a low-fat diet, 45
The low-fat, low-cholesterol program, 45
Soups. Meats. Fish. Poultry. Eggs. Cheeses. Vegetables. Fruits. Salads and salad dressings. Cereals. Breads. Desserts. Beverages.
Foods to Avoid:
Soups. Meats. Fish. Poultry. Dairy products. Eggs. Breads. Desserts. Miscellaneous foods.
HOW TO USE DIETARY SUPPLEMENTS-LECITHIN, SOYA OIL, VITAMINS . . 54
Even a goat wouldn't eat what you eat, 54
What is wrong with our diet and our eating habits? 54
How to supplement your diet with essential nutrients, 55
The five-step program, 56
How to use Lecithin, 56
How to use soya oil, 59
How to use vitamins, 59
LOW-FAT MENUS 61
General considerations for low-fat menus:
Soups. Meats. Vegetables. Desserts.
Low-Fat Menu 1, 62
Low-Fat Menu 2, 65
Low-Fat Menu 3, 67
Low-Fat Menu 4, 70
Low-Fat Menu 5, 72
Low-Fat Menu 6, 73
Low-Fat Menu 7, 76
Low-Fat Menu 8, 78
Low-Fat Menu 9, 80
Low-Fat Menu 10, 82
Low-Fat Menu 11, 84
Low-Fat Menu 12, 86
Low-Fat Menu 13, 88
Low-Fat Menu 14, 89
1200—calorie menus, 90
1000—calorie menus, 95
800—calorie menus, 100
HOW TO COUNT THE CALORIES 105
Overweight is a hidden disease, 105
Diet for health, as well as for beauty, 105
Is overweight due to "glandular trouble"? 106
What causes overweight? 106
Nervousness is a primary cause of overweight, 103
A feeling of failure can lead to overeating, 107
Bad food habits a second main cause of overweight, 107
Too much weight can strain your heart, rob you of energy, 108
Most people today don't have heavy demands made on their physical energy, 108
Just what is a calorie? 108
How to determine the number of calories you need, 109
Maintaining your proper weight by a regular calorie count, 110
There is only one healthy way to reduce, 110
Seven rules for getting your weight down and keeping it down, 111
Drugs are not the answer, 111
Calorie counts of foods listed alphabetically, 112
HOW MANY YEARS WILL LOW-FAT LIVING ADD TO YOUR LIFE? 125
Even if you've had a heart attack, the low-fat diets can double your normal span of expected years, 125
The same low-fat diet may lengthen the life of everyone, 125
You can do something about it, 126
Ideal weight can add more "bonus** years of life, 126
What about younger people? 126
Weight tables, 126
WHAT ABOUT CIGARETTES—SHOULD YOU STOP SMOKING? 132
The Use and Abuse of Tobacco, 133
The agreeable effects of smoking, 133
The indifferent effects of smoking, 134
The effect of smoking on health, 135
The effect of smoking on the heart, 136
How smoking affects the blood vessels, 137
What smoking does to the digestive tract, 137
The relationship of tobacco smoking and cancer of the lung, 138
Smoking is not necessarily the sole cause of lung cancer, 139
How can you stop smoking? 140
If you must smoke, at least cut down on the number of cigarettes, 141
Switch from cigarettes to pipe smoking, 141
Find a substitute—chewing gum, peppermints, 141
An effective approach to the tobacco habit, 142
HOW DOES ALCOHOL AFFECT YOUR HEALTH? 144
What about alcohol? How does it affect your health? 144
The "good" effects of alcohol, 144
The influence of alcohol on the mind, 144
Alcohol not a stimulant but a depressant, 144
It can be useful as a "tonic," 145
Alcohol as a food, 145
The effect of alcohol on the circulation, 145
Alcohol can be used to improve circulation, 146
Moderation is the key, 147
Does alcohol in any way benefit the coronary arteries? 147
Alcohol can relax tension in heart cases, 148
The injurious effects of alcohol, 148
Alcohol can be harmful to the emotions and the mind, 148
The effects of alcoholic excess, 149
Chronic alcoholism, 150
The brain. Wernicke's disease. Marchiafava-Bignanis disease. Delerium Tremens. Polyneuritis. Korsakoffs Psychosis.
What does alcohol do to the liver? 152
What are the conclusions for you? 153
HOW TO CARE FOR YOURSELF AFTER A HEART ATTACK 154
How and why the heart heals itself, 155
The low-salt, low-fat diet, 157
General instructions for following a low-fat diet, 166 Foods to avoid. Foods permitted. One week of sample menus for a low-salt diet. 157
Should you exercise? 162
What kind of exercise is permissible? 163
Should you smoke? 164
Should you avoid alcohol? 164
What about coffee and tea? 164
Care of the bowels, 165
Can you continue to have sex relations? 165
What is the best "coronary climate"? 166
When may you return to work? 167
Develop a constructive, optimistic attitude toward life, 168
Your chances for long life are excellent, 169
GROWING YOUNGER WITH THE YEARS 171
It's never too late, 171
The low-fat diet brought amazing improvements, 172
You need more than a "normal' or "average" diet, 174
Begin now to feel young and really alive, 175
There is evidence that the aging process may be reversible, 175
Weight control also contributes to healthy old age, 177
Can youth be restored in the prematurely aged? 178
When a spanish-speaking friend wants to wish you the very best that life can offer, he will often lift his glass with the following toast:
"To health and wealth — and time to enjoy both."
Embodied in this simple salute are the three basic desires common to people everywhere in all ages.
Why can't we live longer? Everyone wants to live longer. It is one of the most deeply rooted instincts of mankind. Everyone wants to live a life of usefulness and abundance, free of disease and unhappiness. As we grow older, we look forward even more anxiously to increasing our lifespan. We want time to enjoy our achievements, time still to make plans. By the time we reach 60 we realize with the great French painter Gauguin that "life is a split second." We begin to think about all the things we still want to do before we reach our seventieth year. If we are fortunate enough to pass our seventieth birthday, we wonder whether we can't live even longer—perhaps to be 80.
Well, why can't we? We are living much longer than did our ancestors a century ago. We have added 20 years to the average life expectancy in America since 1900.
CLOGGED PIPES TO THE FOUNTAIN OF LIFE
Advances in medical science have outlawed many dis-eases* These golden years are ours because of advances made by tireless research in medical science. They represent a decisive victory over the contagious and infectious diseases which sometimes wiped out whole sections of our population a generation ago.
Thanks to the new knowledge provided by recent research, we no longer need fear the ravages of such diseases as diphtheria, scarlet and typhoid fever, syphilis and—to a great extent— tuberculosis. All these pestilences, however, were caused by those invisible but ever-present enemies of health—germs.
Today the picture has changed. With the victory over deadly microorganisms, a new threat has emerged in clearer and more frightening perspective.
The 20th Century epidemic. A single, fundamental disease of the human body can now be held accountable for much of the illness and more than half of all deaths occurring each year in the United States It is a disorder known by the general term of "arteriosclerosis," which means a hardening and thickening of the arteries.
It is now so widespread that Dr. Paul Dudley White, the noted heart specialist, recently described it as "a modern epidemic."
As the disease progresses—sometimes over a long period of time—the vessels that carry the blood from the heart to the body's tissues become stiff, and their inner surfaces roughened and thick. These conditions lay the groundwork for the three most common causes of death and disablement in America: heart attack, heart failure, and stroke.
Is there anything that can be done to vanquish this number one killer, whose favorite victims are men in their middle span of life, and even the very young, sometimes those in their twenties? The answer is "yes"—provided you will take the time and the trouble now to learn a few simple rules.
Much of the exact nature of arteriosclerosis is still unknown.
But during the past 10 years we have learned a great deal in the fields of pathology, chemistry, biology, and nutrition that has provided us with clues to the mystery, and a practical approach to treatment for the first time.
Widespread popular interest in the heart and in the aging process has helped immeasurably in the conquest of disease. But at the same time, it has been responsible for a good deal of fear and confusion among lay people. Some of these misconceptions are reflected in the questions my patients ask after reading articles of the kind that now appear in many newspapers and magazines.
Take diseases of the heart and blood vessels, for example. Terms such as atherosclerosis, coronary thrombosis, and cholesterol are today fairly commonplace, even in publications for the general reader. But few non-medical people know exactly what these words mean.
What is the cause of this new epidemic? Before taking up our discussion of ways to forestall a heart attack, it might therefore be well to understand more clearly the basic physiology involved.
Let us start with a closer look at the arteries, the vessels that carry fresh blood from the heart to the billions of cells in our bodies that are in constant need of nourishment. Upon careful examination, we find that the arteries are not the simple tubes we have pictured them to be. Viewing them in cross section, we see that their structure is more like that of a garden hose, containing three layers of tissue in the walls.
The inside layer or lining of the artery, which doctors call the intima9 consists of a slippery membrane somewhat similar to the mucous membrane on the inside of your mouth. The in-between layer, known as the media, is formed of muscle fiber. This enables the blood vessel to expand and contract with the heartbeat, to facilitate the flow of blood through it. The outer layer, called the adventitia, is composed of coarse strong fiber& which provide added strength to the artery.
In both the outer and the intermediate layers, there are tiny intrinsic blood vessels which nourish the artery itself. The thickness and exact composition of the three layers vary, depending upon an artery's size and location.
Of the changes that may occur in the arteries as a result of disease, there are two types which concern us here. Both kinds have traditionally been known by the general term, "arteriosclerosis," which means hardening or thickening of the arteries.
Actually, however, there are two kinds of hardening of the arteries. One occurs when calcium deposits in the middle layer of the artery cause it to become brittle and hard. For this reason, it is sometimes called a "pipestem" artery. Such calcification does not necessarily obstruct the blood flow, and is usually harmless from a clinical point of view.
The other type of change, on the other hand—and it is the more frequent one—has serious consequences. It consists of a thickening of the inner wall of the artery by deposits of fats: cholesterol (a fatty alcohol), fatty acids, and the like, together with calcium.
As these deposits grow, the passageways or canals of the arteries become narrower, much in the same way as the drain from your kitchen sink becomes clogged with grease deposits. The result is that less and less blood can flow through the narrowed opening to the tissues or organs that depend on it for life. Your "pipes" have become clogged.
At the same time, the swelling of the lining cells and roughening of the inner surface provide sites for formation of blood clots inside the narrowed artery. If the blockage is complete in vital arteries that feed the heart muscle, a heart attack—or as we physicians call it, a coronary thrombosis—occurs. If this disaster occurs in the cerebral arteries of the brain, a "stroke," sometimes called a heart attack in the head, results. When the small arteries of the kidneys are affected, Bright's disease, formerly called "dropsy," and other diseases ensue.
But whether the thickening and blocking process takes place in the heart, head, or kidneys, it is essentially the same disease. Doctors refer to it as atherosclerosis.
About a century ago, during an autopsy, a German pathologist named Rudolph Virchow laid open an artery to examine its interior wall. Along the lining he observed deposits of mushy fat that he called atheromata, a Greek word meaning "porridge." It was from this word that we derived our term, atherosclerosis.
Embedded among the cells of the artery wall along with the fat, Virchow observed some glistening crystals. These turned out to be cholesterol. But how did these fats get into the artery walls? This question has puzzled scientists for the past 100 years, and it is still being pursued in various fields of research. The first theory advanced by researchers was that of "imbibition," which held that fat droplets were absorbed directly from the blood stream through the lining of the artery walls. When a weakening of the "ground" substance or actual structure of the artery wall occurred, cholesterol—the main offender—and its related fats were deposited in the artery wall. This theory has been supported by the recent discovery that these fatty deposits, especially cholesterol, exist in the same proportion in the artery wall as in the bloodstream itself.
Another theory that seeks to explain the way in which the fatty deposits get into the artery walls held that they did not come from the blood stream primarily, but were manufactured within the cells of the vessel wall.
It has also been claimed that fat molecules are normally absorbed by the artery wall without leaving a harmful residue of acid crystals. But some abnormal condition, such as high blood pressure, may force an excessive amount of the fat molecules into the wall. Then the artery cannot absorb the full amount, and deposits gradually build up.
Other researchers have believed that the fat droplets find their way into the artery wall through the tiny vessels that supply blood to the artery itself. According to this theory, a hemorrhage or series of small hemorrhages may occur in these tiny vessels.
A clot is formed, which deposits fat particles in the artery wall when the small vessels break down.
My own conclusion, based upon years of animal, laboratory, and human research, plus experience with innumerable patients, is this: Atherosclerosis results from an impairment of the body's ability to utilize (or metabolize) normally not only the fats eaten in the diet, but also those that are in the body itself. This impairment is further aggravated by the body's inability to withstand stress or tension; and by deficiencies in the supply of hormones from vital glands such as the thyroid, the adrenals, and the sex glands.
In addition, there are other factors that influence the individual's susceptibility to atherosclerosis, or death from a heart attack or stroke. These include such things as inherited or constitutional factors, and the coagulability of the blood.
It is easy to see how complex the problem really is. The danger of oversimplification is great. However, one causative factor that stands out continuously above and beyond all others, important as they are, is fat in the diet. And it is this factor that we can control.
These fats from our foods enter our blood stream where, like sharks cruising about, they seek out the weak or vulnerable spots in the arteries. Here they attack, enter, and deposit or nest themselves. These fatty deposits then acquire calcium, and the hardening process begins in the arteries. Each particle becomes a captain around which rally the silent "Men of Death," who wage a relentless struggle. Soon they begin to throttle our life flow.
Our blood vessels then engage in a vain effort to halt the armada of killers we now harbor within our arteries. Special fat-eating cells are rushed to these spots, where the fats and cholesterol have breached the barrier or wall and entered the artery. In the life-and-death struggle that ensues, the fat-eating cells try to engulf the cholesterol and fat particles, and may succeed temporarily in the "counter-attack."
Dr. Timothy Leary, the distinguished Boston pathologist, in 1933 first devised ingenious methods of lighting up, refracting, and photographing this deadly drama. It was seen that inevitably the special fat-fighting cells are themselves engulfed by the repeated tidal waves of cholesterol and fats washed into the blood and artery walls by fat-containing foods such as butter, eggs, cream, milk, meat fats, and other animal fats in our diet.
Why is the epidemic particularly strong in the U.S.A.? If you are a typical American, whether you know it or not you consume an unbalanced, obesity-producing diet. Drs. Louis Katz and J. Stamler, prominent researchers in this field, called it "a pernicious combination of overnutrition and undernutrition —excessive in calories, carbohydrates, lipids and salt; and frequently substandard in certain critically important amino acids, minerals and vitamins."
It is not surprising that this situation exists. The science of nutrition, a comparative newcomer to the medical field, has up until recently been concerned almost exclusively with undernutrition. People have been urged to "eat the right foods" and to provide plently of meat, eggs, milk, and cheese for their children.
In most areas of the world, this problem of getting enough nourishing food to eat is still of primary importance. But it is not the problem in America. Our problem is somewhat the opposite: "living too high on the hog." Our diet is too rich in fat as well as calories, refined sugars, starches, and oils. At the same time, it is low in essential nutriments, minerals and other vital requirements.
The exact relationship between the amount of fat you eat and the production of cholesterol in your body is still a very complex question. Investigators differ on some points.
Concerning one aspect of the problem, though, we are all agreed: the cholesterol found in the blood is made largely in the liver from fats in the diet.
It is also believed that cholesterol is produced in the arterial walls themselves.
But the main source and the one that we can to a great extent control is fat in our food.
What is the situation in other countries of the world?
We have evidence that a prime factor for the great difference between Americans and peoples in various other countries is diet.
For example, let us see what happened in Norway during the war years of 1940-1945. Consumption of butter, milk, cheese and eggs (all of them high in fats) had to be sharply curtailed. Did the reduction of fat content in the national diet have any effect on the number of deaths from heart attack? The Norwegian Ministry of Health, which kept accurate records, answered that question with an emphatic "yes." With the reduction in fat consumption, the death rate from coronary attacks declined also. The Norwegians reported that heart deaths were reduced by 31 percent during each year among the urban population. At the same time, there was a 22 per cent drop in heart deaths among the rural population.
France, which also had to tighten its belt during the war years, had similar evidence to offer. Mr. Marcel Moine, of the French Ministry of Health, reported to me that from 1941 to 1945, when Frenchmen were on a low-fat diet, the death rate from heart disease was reduced to 20.6 for each 100,000 persons. In the postwar years, when normal fat consumption was resumed, the death rate rose to 25.5 per 100,000 population, or a return to the old, prewar death rate.
Italy provides another example. There studies were made recently in two neighboring provinces. In one area, where the daily diet included pork products rich in fats, the incidence of coronary and generalized artery disease was found to be much higher than in the adjoining province where the population followed the comparatively low-fat pattern of the country as a whole.
Similar studies have been made in various parts of the world—countries such as Finland, Denmark, South Africa, China, and Japan. Statistically the results all point in the same direction: high-fat diet means a high rate of heart deaths.
Figures, as Mark Twain and Marilyn Monroe have shown, sometimes have a way of misleading us. This is admittedly true of interpreting cause and effect relationships where the health of whole populations are concerned. The long arm of coincidence can sometimes reach around corners or do a juggling act. For example, you might claim, an the basis of statistics, that since the use of soap was also sharply reduced in some countries during the war, with a corresponding drop in death rate from cardiovascular disease, it was the soap (which is a fat) that caused the disease. In a more scientific view, however, the evidence weighs heavily on the side of fat as a prime factor in causing atherosclerosis.
Is the epidemic confined to older people? What has happened to our way of life to make men between 30 and 45 the preferred victims of the "silent killer" that strikes without warning? And why are more and more young women, long believed to be virtually immune to this disease until after menopause, now falling prey to it?
We do not know the entire answer to this enigma, or even whether there is a single answer. But research that has been carried on by my colleagues throughout the world, and by myself during the past 10 years, has provided some valuable clues.
Only recently, we discovered to our amazement that over 90 per cent of our adult population has, to a greater or less degree, a degenerative disease of the arteries that doctors call atherosclerosis. That, as you know, is the term meaning the thickening and narrowing of certain vital blood vessels. It is the way in which the stage is set for heart attacks and strokes.
Medical people once thought that it was a result of aging, but the disease is now being found in infants and children. As children, however, we have the power of absorbing the fatty deposits that attach themselves to the artery walls. As we grow older, we seem to lose this power of absorption. That is when the real trouble begins. At what age does this happen?
Much earlier than we might expect.
For example, my associates and I made a study of the arteries of 600 patients who had died of various diseases. About 100 of them had met sudden death from accidents or acute illness. To our amazement we found that atherosclerosis, a disease of the arteries, was present in many of the young people before they had reached their thirtieth year.
By the time they were 40 to 50 years of age, the fatty deposits and embedded crystals of cholesterol were inside the artery walls. Such thickening and narrowing of the blood vessels interfered with the nourishment and vitality of the tissues in the heart, brain, or kidney.
Striking evidence of how widespread the disease is among our younger people today came also from Korea. There Army doctors autopsied 300 American soldiers who had died while serving in Korea. It was the first time such a study had been made of a cross section of the country's youth; their average age was only 22. A report of the mass autopsies contained startling information that 77 per cent of the young U.S. servicemen already had atherosclerosis! Balanced against this shocking total was a mere 11 per cent incidence of the same disease among Koreans and Orientals who had died on the same battlefield under the same conditions.
Does heredity have anything to do with the problem? At this point you are probably wondering: why do some people have more cholesterol in their blood than others? At present we do not know the whole answer to that question. We do, however, know some of the predisposing factors.
One of them is heredity. Some families are affected by what physicians call hereditary familial hyper-(excessive) cholester-emia. In such a family the tendency to high levels of cholesterol in the blood is passed on for several generations. Among members of such families we usually find a large number of individuals who suffer heart attack and strokes. If no heart attacks or strokes have occurred in your own family line, you have at least one protective factor in your favor from the beginning.
The second factor is one that is pretty much up to you. It concerns what you eat and how much you eat. Unfortunately, it is too late for us to choose our parents.
But it is not too late to choose our diet. By learning how to avoid food excessive in fat and cholesterol content, we can help minimize the effect of heredity.
Women have better natural protection against atherosclerosis. If you are a woman, you are less likely to suffer from a heart attack or stroke until well after you pass the half century mark. That is when your protective female hormones give out, and you become as susceptible to the disease as men.
Can't men take female hormones to protect themselves? They can, but if they do, they will "cross the border" and develop a high voice, full enlarged breasts, and other feminine characteristics. So that approach to the problem is not practical.
Anything else? Yes, there is something everyone can do without great inconvenience, and with the added reward of improved health in general. It is this: select a diet that will keep your blood fats down to normal levels.
Can you reverse damage done to your arteries by excessive fat? Only within the last few years have medical research teams produced reliable evidence showing that excessive fat in our diets may lay the groundwork for heart disease. If you are already past 30, it naturally occurs to you to wonder whether the damage done to your arteries is permanent, or whether it is reversible.
At the present stage of our research, we doctors cannot answer the question with certainty. We can cite the hopeful fact that experiments with animals have shown that the condition is reversible in animals. We have evidence that the cholesterol in the arteries is absorbed in children, as shown by Dr. Russell Holman and others. However, this metabolic gift seems to be lost as we grow up. There are many authorities in the field who do believe that since atherosclerosis is reversible in animals, it can also be eliminated even after it is established in humans as well. However, we must proceed cautiously in basing our conclusions solely upon studies of laboratory animals, because their metabolism is different from that of humans.
Another question that patients often ask me is: "Can you tell me whether I am already a victim of degenerative artery disease?" Unfortunately, we do not as yet have a test that can predict with certainty whether you are susceptible to coronary disease, or are likely to have a heart attack.
One fact, however, is certain: if laboratory tests show that you have an excessive amount of cholesterol in your blood, your chances of avoiding heart and blood vessel disease, which can lead to heart attack or stroke, are much smaller. You are then much more susceptible. If you are over 30 years of age, you ought to have your physician include such a measurement of cholesterol level in your routine check-up.
Too many men in the dangerous middle years are so busy playing for high stakes in the fast-moving game of life, that they forget that "hearts are trumps."
What is the solution for us? The many studies that have been made do not prove conclusively that heart disease is caused solely by diet. But they do heavily underscore much of the information that I have gathered from my own quarter of a century of practice and laboratory research.
Taken together, the evidence points strongly to this fact: If everyone in the United States would reduce his fat intake by 25 per cent, we would cut the number of heart deaths in half within another 20 years. Moreover, the low-fat diet will add immeasurably to your general health and well-being.
"But," you ask, "how can I go about reducing the fat in my diet? Where do I begin?" In the following pages you will find a safe guide; it includes low-fat menus and directions for using simple and inexpensive nutritional supplements that I employ in my own practice to help my patients forestall heart attack, and to treat those who have already had one or more.
If you follow these directions carefully, you will not only add years to your life, but life to your years.
IS FAT NECESSARY? IS LIKE ASKING "IS Crime Necessary?" or "Is it Necessary to be Fat?" The implication alone is bad, like asking "How Often Do You Beat Your Wife?" Of course, the answer to all of these questions is "no."
Is fat essential in a healthy diet? Some nutritionists and scientists believe that a small amount of fatty acids or components of certain fats are essential to human nutrition. This has never been demonstrated for humans, although apparently it is true in rats. There is the incontrovertible fact that countless millions of human beings in Asia, Africa, South America and elsewhere do not consume fat in their diet. And yet they live to a health-normal or beyond-normal life span; their physical or nutritional development is not infrequently far superior to the people on a high-fat or average American fat dietary intake.
Most certainly it is known now that these same people on a low-fat or fat-free diet are virtually free from heart attacks and strokes, which are so common among people on a fat diet.
Many have wondered whether the Eskimos have a high rate of heart attacks and strokes as a result of their high fat diet. First it should be remembered that the Eskimo days of existing on blubber and whale alone are mostly over. Several years ago physicians working with the National Geographic Society found that the Eskimos who lived in the more modern settlements and ate and lived like other Canadians or Americans in country villages, were subject to the same degree of atherosclerosis, high blood pressure, and heart conditions.
On the other hand, in those Eskimo cases where fish and whale fats constituted the basis of the diet, blood tests revealed that cholesterol and fats in the blood were very low. This surprising fact was later found to be due to the high concentrations of un-saturated fatty acids in the large amount of fish and whale oils consumed by these Eskimos. As will be shown later, these un-saturated fatty acids have the unique power to lower the blood levels of cholesterol and other fats, thus protecting the Eskimos from the complications of atherosclerosis in the heart, brain, kidneys, and other organs.
What is fat? First let us look at food in general. As long as we are alive, breathing, with our hearts pumping, our bodies are at work burning up energy—which is supplied by food.
Food or foodstuffs consist of six groups, all of which are basic necessities essential for normal health. These are proteins, carbohydrates, fats (which are also manufactured by the body), vitamins, minerals, and water.
Protein is the keystone of human nutrition. It is essential for every form of life for growth, pregnancy, formation of blood, bone, and every vital tissue. It is essential for the healing of wounds, the warding off of infection, the maintenance of body weight, and the conduct of vital organs and glands in the body.
Meat is the greatest source of animal protein for human consumption and man can live in good health on virtually an exclusive fresh meat diet. Animal sources of proteins are meat, fish, poultry, milk, eggs and cheese. These foods contain high sources of protein, as well as carbohydrates and fats. Vegetable sources of protein are wheat, beans, peas, lentils, soybeans, nuts, corn, rye and yeast, although these also contain elements of carbohydrate and fat.
Normal adults and growing children require one gram of protein for every 2.2 lbs. of body weight. This means that the average man or woman weighing 125 to 175 lbs. needs from 60 to 80 grams of protein daily for normal nutrition. This would be contained in the equivalent of 1/2 pound of steak, one chicken, a pound of fish or a pound of cottage cheese. Each gram of protein supplies four calories of energy, as shown in Chapter 6.
Carbohydrates are a main source of energy. Carbohydrates include the two main classes: starches and sugars. They are one of the primary sources of energy of our diet. One gram of carbohydrate yields 4 calories of energy. The amount of carbohydrates necessary in the daily diet is very variable and also depends on the amount of it eaten with the protein in meals. The average American adult consumes anywhere from 150 to 400 grams of carbohydrate daily. It takes about 500 grams to make a pound. Usually more than half the calories in the diet (from 50 to 70 per cent) are supplied by carbohydrate.
Unfortunately, these carbohydrates are usually refined to excess, as in the case of flours and sugars. Essential vitamins and proteins are lost in this way and certain nutritional deficiencies may result. If excessive carbohydrate is eaten in the diet, many individuals will experience symptoms of gassy distress, flatulence, belching, or bloating. Bread, flour, milk, cereals, potatoes, cornstarch, cakes, rice, and puddings are examples of dietary starch as are moat vegetables, although these contain lesser amounts of both carbohydrates and protein. Sugars are represented by cane sugar, corn syrup, honey, maple sugar and syrup, milk sugar, malt sugar, jams, jellies, and most fruits.
Two of the most common symptoms or sensations that humans feel daily are dependent on carbohydrate metabolism: that is, hunger and fatigue. Certain endocrine glands in the body control the level of blood sugar in the body and are linked to the feelings of hunger, fatigue, and exhaustion. When the blood sugar falls abnormally low, one feels headaches, nervousness, dizziness, or weakness.
Many of my patients combat these tendencies to hypoglycemia or low-blood sugar in the following simple ways: in between meals take fresh fruits, preferably bananas or apples, or canned fruit juices or fruits; English "tea" with whole wheat cookies or crackers, graham crackers, arrowroot cookies and if needed, some lean meat or fish in sandwich form; skim milk thickened and fortified with generous servings of skimmed milk powder; bread and jam; fat-free sherbet or ices; dietetic or low-fat ice cream; fruit jellos are refreshing; hard candies or chocolate bars are often very handy but not as desirable as the natural, healthful in-between meal "snacks," suggested above, as they often damage the teeth and may have too short-lived action on the blood sugar. Not infrequently sugar itself will cause a "rebound" reaction resulting in an even lower blood sugar fall one-half to one hour after the sugar has been eaten.
Countless business people and factory workers find their efficiency and capacity for work greatly increased by following the above dietary aids. It is not necessary to wait until the symptoms of low-blood sugar already signal the breakdown of bodily health.
The habit of drinking coffee alone at the coffee-break is like whipping the tired old horse harder to get it to climb up the hill. The artificial stimulant, caffeine, can never possibly substitute its artificial stimulant drug action for the flow of energy that comes from healthful, natural foods.
Vitamins and minerals are discussed later, in Chapter 5. The necessity of water for the maintenance of life is known to all. This brings us to fats.
Fats—What they are and what they do to you. The outstanding fats eaten daily in the United States and Europe are butter, eggs, whole milk, cream, meat, fish and poultry fats, and cheese in various combinations. These fats, at 9 calories per gram, contain more than twice the amount of calories than protein or carbohydrate does at four calories each per gram. As we have noted and shall describe in later chapters, excessive intake of fats leads to the shortening of life, premature death by heart attacks and strokes, obesity, and numerous crippling illnesses.
Fats (or lipids) contain the elements of carbon, hydrogen, and oxygen in various combinations of animal and vegetable fats. Examples of animal fats are butter, lard, cream, milk, eggs, and the fat in meats. Vegetable fats are soyabean oil, olive oil, cottonseed and corn oils, and peanut oils; these are found in nuts, coconuts, avocados, margarines and other vegetable fats used in cooking.
Fats do not dissolve in water, and when pure they are odorless and tasteless. They are found in most bodily tissues, particularly in combination with other elements, proteins, or minerals. Fats or lipids act as vehicles for the absorption of the natural fat-soluble vitamins such as vitamins A, D, and E.
In order for fats to be utilized by the body, they must first be digested and broken down into constituent parts before being absorbed. They are absorbed in the following manner: After the food is masticated and enters the stomach, the digestive system supplies its first fat enzyme called lipase, to begin the digestion of the fat. Enzymes or ferments are unique chemical compounds manufactured by the cells of the tissues. In the digestive tract they are vital for the chemical breakdown of all foods before they can be absorbed.
How are fats digested? The fat enzyme of the stomach, lipase, begins its job on the fats eaten. However, it is a rather weak enzyme, leaving most of its work to be carried out by steapsin, the fat enzyme manufactured by the pancreas, and by bile manufactured by the liver. In the bile are found bile acids and salts which, together with steapsin, split the fats ingested into the smallest molecules and particles possible. These can then be absorbed through the lining of the small intestine and pass either into the liver or directly into the blood stream as chyle, a milky or creamy serum.
How fats are absorbed. When the fat particles are brought to the liver, they undergo further chemical breakdown and metabolic changes before they enter the blood stream in the form of cholesterol, phospholipids, fatty acids, neutral fats (which are neither acid nor alkaline), lecithin, and other fat derivatives. Much of the fat is broken down by the liver cells into cholesterol, which is excreted into the bile and goes back again into the intestine in various chemical forms. Once in the intestine, some of the cholesterol is reabsorbed again along with other fats and some is excreted from the body in the bowel movement. If the proportion of the cholesterol in the bile becomes too high, then it precipitates out of the bile and forms gallstones, which can produce attacks of pain and indigestion, and so often keep the surgeon busy.
Now that the fats or lipids have entered the blood stream, they circulate and are deposited in the various bodily tissues and in the great body storehouses called fat depots. These are located in the abdomen, on the hips, the chest, around muscles, under the skin, in the liver, and elsewhere. The fats consumed in the diet are called exogenous fats. The liver and other tissues, however, manufacture equally important quantities of fats or lipids normally found in the blood stream. These are called endogenous lipids.
These lipids are manufactured from proteins and carbohydrates through certain remarkable processes inherent in vital bodily tissues and glands such as the liver or the adrenal glands. Energy and vital cellular constituents for the body result from these lipids. When present to excess, their effects become devastating to humans, as shown in the chapters on overweight and atherosclerosis. (See Chapters 7 and 3.)
We now come to the fats circulating freely in the blood stream. Let's see how they get into the artery walls to actually damage or destroy the artery with atherosclerosis.
How fats damage or destroy your arteries. Extensive research in experimental animals has been able to demonstrate how these lipids can leave the bloodstream and enter the artery wall within 24 hours. The atherosclerosis produced in these animals becomes indistinguishable from the atherosclerosis seen in human arteries. However, the exact details of the mechanism whereby fats actually enter into the wall of the artery are not yet known.
What is known and what is important is that there is a definite ratio or relation between the amount of fats in the blood stream and in the artery wall, and this is surprisingly predictable in most cases. Also, the relationship of the fats in the artery wall itself is very close to that in the bloodstream. This direct relationship between the two seems to be in fairly constant balance.
As described in the first chapter, the artery wall consists of three different layers. If the reader can picture a garden hose as representing the artery, it presents an innermost layer called the intima, a middle layer called the media, and an outer layer called the serosa.
The fats circulating in the blood stream are of course closest to the innermost layer of the artery, with which they are in direct contact. When conditions are right for atherosclerosis, the fats attach themselves and enter the inner or intima layer of the artery. A kind of wart or excrescence on the artery is then formed, called a plaque of lat. When the plaque grows larger, it encroaches upon the passageway of the artery. As it grows larger and larger, it may finally block or obstruct it partly or completely. When this clogging or obstruction of the artery takes place in the vital coronary arteries of the heart, then a coronary thrombosis or heart attack assails the victim. If the blockage from these fatty or atheromatous plaques occurs in the brain, then a stroke strikes down the victim.
However, if the artery is only partly blocked by this accumulation of fatty plaques, then the vital organs supplied by the arteries suffer from a lack of the necessary amount of blood and
nutriments contained in it to sustain normal function and health.
Along with the fatty deposits of cholesterol, fatty acids, neutral fats, etc., which make up these atheromatous plaques, calcium and other minerals are also deposited. These make the artery feel hard, giving rise to the term commonly in use— "hardening of the arteries." Actually we see a softening of the arteries which takes place first because of these fatty deposits.
It is often noticed in many individuals that this free fat will be floating in the blood stream for hours after a meal containing fat has been eaten. The blood is then called lipemic, which means loaded with fats. When these fats are easily visible to the naked eye, scientists speak of such neutral fats as chylo-microns. These fats in the blood are regarded by many scientists to be as dangerous as is cholesterol, in entering the artery wall.
A great proportion of these fats in the blood is combined with proteins, called lipoproteins, which also have been the subject of research by many investigators. Scientists have only recently discovered by new tools of investigation that in these lipoproteins two separate portions can be measured: the alpha and the beta lipoproteins.
The first have been shown to be protective against the development of atherosclerosis. They are found predominating in infants, children, and young women who have no evidence of atherosclerosis.
On the other hand, the beta-lipoproteins have been found universally in excessive amounts in most cases of active atherosclerosis and so are called atherosclerosis producers or "ather-ogenic." The protective alpha-lipoproteins are spoken of as "anti-atherogenic."
The problem of preventing atherosclerosis and its human ravages is the search for ways of increasing the protective alpha-lipoproteins. Chapter 5 discusses lecithin and other nutritional supplements and shows how to use these protective substances against the development of atherosclerosis.
One of the greatest factors influential in the current epidemic of heart attacks has unquestionably been the startling increase in fat intake. In the United States alone, the fat content of our diet has just about doubled in recent times. Where fat formerly constituted some 15 to 20 per cent of our meals 50 years ago, it now has jumped to 30 and 40 per cent or more.
Fat may be your "poison". Many individuals have now developed an intolerance to fat. Some of my patients can't seem to handle any fat at all. As an example, one plump 40-year old mother of three develops severe gas and bloating after eggs or any other fatty food. Mrs. R. is often embarrassed to dine out for fear of overflowing right out of her girdle if friends supply her with a fatty food at their homes. At other times she has been embarrassed by solicitious friends who have delightedly congratulated her upon her "unexpected" and "surprise" pregnancy after eating some fat food!
Other patients of mine develop actual attacks of gallstone colic following a meal containing fat. Some 20 years ago, I studied the causes and effects of gallstones in humans by passing rubber tubes through the mouth and down into the digestive tract and then draining off the bile or gall manufactured by the liver and stored in the gall bladder. At that time I examined and found the cholesterol and fat content of the bile abnormally high in most patients who suffered from gallstones, liver, and gall bladder diseases. A fat-free diet was able to eventually reduce and restore the bile to its normal cholesterol and fat content, not to mention the well established fact that most patients felt vastly improved and often free of pain or distress.
Of special interest to me is the case of a 46-year old automobile dealer, Mr. C, who used to have disabling and terrifying attacks of pain over his heart. (We call such pain angina pec-toris.) The pains began only after he had eaten breakfast and was preparing to leave for his business. His breakfast was a hearty one. It consisted of bacon and two scrambled eggs, fruit juice, some delicious coffee cake with two pats of butter, plus two cups of coffee containing generous portions of cream. He was a husky, strapping ex-athlete and burned up a great deal of energy in business activities.
When Mr. C. changed his breakfast habits and ate a good breakfast on the low-fat diet (as explained and described in later chapters) his anginal pain stopped as if by magic. Clearly he was one of the many individuals whose circulation could not tolerate fats.
This was again just recently shown in most convincing and dramatic ways by Doctors Peter Kuo and H. Joyner of the University of Pennsylvania Hospital and Medical School. These investigators studied the effects of fat meals in a series of heart cases and others afflicted with atherosclerosis over a several year period. One group of their patients suffered severe heart attacks every time a fat meal was administered to them. Studies of the heart and the blood were made during actual heart attacks by Electrocardiographs and other scientific instruments. It was found that when the blood stream contained its peak load of fat content, the heart attacks were most severe and threatened the very life of the patients. Such striking studies and findings were also the experience of other research physicians.
How much fat are you stowing away? Look at the following sample daily menus for fat content that the average American consumes, as taken from the front page of the New York World Telegram.
Fat Content Calories
One-half grapefruit 70
Two eggs 12 grams 150
Two slices of bread 130
Two pats of butter 12 grams 120
One cup of coffee with % tablespoonful of
cream and two teaspoons sugar 3 grams 100
Boiled ham, 2 slices 20 grams 200
Two slices of bread 130
Two pats of butter 12 grams 120
Lettuce and tomato 30
Mayonnaise, 2 teaspoonsful 6 grams 60
Cup of coffee with cream and sugar 3 grams 100
Danish bun, prune filled 8 grams 150
Melon slice 20
Steak or beef with gravy, 4 ounces 40 grams 500
Potato and peas, or salad 100
Two pats of butter (or oil dressings) 12 grams 120
Cup of coffee with cream and sugar 3 grams 100
Ice cream 12 grams 250
Cherry pie 12 grams 350
155 grams 2800 calories
Total fat for the day 155 grams.
Total cholesterol 800 milligrams.
Total calories for the day 2800.
Total calories in fat 1400.
How much fat can you really live with? In contrast, compare the sample menu used on the low-fat diet:
Meal Plan Sample Menu Fat Content Calories
Fruit juice Orange Juice 80
Cereal Shredded wheat 100
Skimmed milk Skimmed milk 65
Bread Whole wheat toast 65
Coffee, tea, Postum —
Soup Skimmed milk pea soup 50
Meat or cheese Cold roast lamb 10 grams 300
Vegetables String beans 50
Salad Sliced tomato 20
Fruit or dessert Canned pineapple 100
Bread Whole wheat bread 65
Milk Skimmed milk 65
Fruit Cocktail Grapefruit cocktail 50
Meat and Potato Lean meats 10 grams 250
Baked potato 100
Vegetables Banana squash 25
Salad and dressing Fresh pear salad 25
Boiled dressing 5 grams 50
Dessert Lemon ice 200
Bread Whole wheat bread 65
Milk Skimmed milk 65
25 grams 1800 calories
Total fat for the day 25 grams
Total cholesterol 75 milligrams
Total calories for the day 1800 calories
Total calories in fat 225 calories
What an extraordinary contrast these two sample menus present in fat content and calories! On the one hand, the total calorie content of a typical American daily diet is about 2800 calories, of which almost 50 per cent is fat. The low-fat diet provides approximately 1800 calories (1000 calories less), which is the normal healthy amount for the average adult housewife or light worker. Here the fat content is about 15 per cent of the total dietary calorie content and is the amount found in the diets of millions of non-Americans who are virtually free of atherosclerosis or heart attacks and strokes. What a clear-cut and simple choice is given us for better health and longer life!
The question may still arise, "Isn't fat necessary for normal health and nutrition?" As mentioned previously, the need for fat in humans has never been proven, although certain essential fatty acids contained in some vegetable oils are very valuable for keeping the blood fats lowered.
In some people, fat seems to be necessary. The Hottentots are an example. These South African tribes, related to the Australian bushmen aborigines, are unique amongst humans in that their women have enormously developed buttocks, due to extraordinary deposits of fat!
At one time these huge posteriors were thought to be an interesting example of attractive, secondary sex charactertistics in women. But anthropologists later found that the excessive fat deposits had been developed through the ages by
Mother Nature to protect these women from the continuous famines and droughts from which these tribes suffered. Nature gave these women and their tribes survival by developing in them fat storage depots or warehouses. In times of starvations or drought, these storage warehouses were called on to supply food and energy, enabling the women and their young children to survive the famine and to perpetuate the species.
Nature had found that the ideal location for these storage banks of fat was on the buttocks and hips. Some of this hereditary tendency is still seen in African descendants who now live in the United States; their ancestors had been brought over in slave ships only one or two hundred years ago to this country. Curiously enough, this primitive trend seems to be becoming popular in some "quarters," particularly in the world of entertainment, such as the motion pictures!
Another interesting demonstration of the importance of body fat in a society was the old custom among Turks and Arab peoples of measuring beauty in their women by the amount of avoirdupois! Many a rich man among them proudly regarded his wealth by the number of fat wives and women in his home or harem. In times of food scarcities and daily uncertainties of living, an ample supply of food as shown by obesity was the best visible sign of affluence and prosperity. The husband's success then carried over into standards of feminine beauty as evidenced by his ability to pad and fatten his women.
This concept was very popular in the "gay nineties" of our own country. The comic "beef trust" troupes in theatrical vaudeville and burlesque occasioned both fun and admiration for so much concentrated female pulchritude in a chorus-line of 200 to 300 pounders!
Take a lesson from the pig. Finally, let us look at the startling new discoveries made in swine. The hog or pig has always been associated in every mind as the epitome of fatness. The expression "to be fat as a pig" or as a hog is one of the most common expressions in our language. Fat and food from swine is one of the most frequent sources of nourishment used by humans, i.e. ham, bacon, pork, lard and so on. Yet only very recently has it been discovered that pigs are virtually the only animals subject to the natural or spontaneous development of atherosclerosis.
Several teams of researchers have published numerous convincing photographs of the development of atherosclerosis in many vital arteries of swine. This startling news was provided by Doctors J. H. Bragdon, J. H. Zeller, and J. W. Stevenson of the National Heart Institute of Bethesda, Maryland, who confirmed the original findings made in this research by a team of Wisconsin scientists headed by Doctors H. Gottlieb and J. J. Lalich.
The amazing facts were that about 50 per cent of the swine examined carefully showed the natural development of atherosclerosis in the main arteries of the body. This disease in the arteries was virtually the same as atherosclerosis seen in humans!
In addition, still other investigators such as Doctors Irving Page and Lena Lewis of the Cleveland Clinic found that hogs had unusually high levels of blood cholesterol and fats. There was a special increase in the swine studied of the atherogenic portion of the lipoproteins, so important in the development of atherosclerotic heart disease in humans.
It has always been thought that fat on the hog was natural and did not harm the animal, but just those humans who made "hogs" of themselves. Now all these extraordinary discoveries show us that even the pig is victim to fatty deposits in the arteries; to eat high on the hog even damages the hog. Let us "eat to live, not live to eat."
By following the instructions contained in the following pages on what to eat and what to weigh, you can learn to enjoy your food, and most important, enjoy better health and increased vitality and reap a harvest of added years to your life.
IN 1911, IN MOSCOW, RUSSIA, A Scientist named Anitschkow made the first discovery that later led to the identification of fat as the killer in cases of hardening of the arteries. He gave us the first clue to the role that fat in the blood vessels plays in causing heart attacks and strokes. Professor Anitschkow, now a vigorous 86, fed animals with cholesterol, one of the purest of fats. He found that the arteries of these animals became blocked with fatty deposits, in a manner indistinguishable from the blocking found in human arteries. The experiment also brought about premature aging in the animals; they grew old and suffered a loss of health and general vitality long before their time.
It was only after a gap of more than a generation that scientists got on the track of the killer fat, but now the pursuit is highly active all over the world. The culprit is now on trial, and evidence for his conviction is steadily mounting.
CHAPTER 3 FAT, THE KILLER, ON TRIAL
Here is how I entered the race. Some 20 years ago, with research assistance from the American Medical Association, I was working on the development of a new treatment for cirrhosis of the liver caused by alcoholism. I was feeding fats, including cholesterol, to experimental animals for the purpose of producing cirrhosis in them. New chemicals were than to be tested, to see whether one of them might be useful in curing this disease.
To my amazement, I found that in feeding the fat, I not only produced the liver condition, but that the heart blood vessels of the animals became plugged with fat, mostly cholesterol. Within a short time, the animals developed heart disease, just as it occurs in humans, and suffered changes common to human beings with atherosclerosis. This was a fascinating discovery. It excited my interest in the challenging problem of fat and its effect on the heart, and stimulated me to continue searching for clues and answers to this universal illness, which causes more deaths than any other disease.
My co-workers and I decided to carry the hunt still further. We wanted to track down this killer and to discover, if we could, how to ward off his devastating attack. This is how we went about it. First, we looked for the answer to this question:
Is cholesterol and excess fat present in the blood of everyone with atherosclerosis?
The answer came to us after two years of work. We studied 200 patients who had had heart attacks and discovered that the great majority, and particularly those under 60, suffered from an excess of fats in their blood. Other patients who showed a normal level of cholesterol had other blood fat abnormalities. For it soon became clear that cholesterol was not the only important heralding factor announcing the approach or actual presence of atherosclerosis. Several other fat components were involved as described in Chapter 2: beta lipoproteins, fat enzymes (see Chapter 2) called cholesterol esterases, large fat globules circulating in the blood after a meal, called chylomicrons, and special large complexes of fat molecules discovered by Dr. John Gofman and his team of biophysicists.
At present we now know that excesses or abnormalities in any one or more of these five "public enemies" are directly connected with the production of a heart attack, a stroke, or other complication of atherosclerosis.
It is therefore perfectly possible to have a normal cholesterol blood level and yet have some of the other above abnormalities in the fat chemistry of the blood that help produce a heart attack or stroke. To date, in two study groups of atherosclerosis, the cholesterol factor has been found to be the predominant one. This is due to the fact that it is a very frequent finding in atherosclerosis, and also because of the great difficulties encountered, both by physicians and scientists, in measuring the other four culprits mentioned above in the development of atherosclerosis.
What about the factor of heredity? As research information piled up, another fact became clear. Of the 200 people studied, a substantial number had a family history of heart attacks or strokes. That is, members of their families were particularly susceptible to these two diseases. The patients we were working with seemed to be unfortunate links in an heredity chain.
Later, Dr. David Adlersberg and Dr. Charles Wilkinson, Jr., discovered that in some cases an excess of cholesterol in the blood was an inborn error of fat metabolism. Inability of some people to handle fat in their systems made them especially prone to atherosclerosis. This hereditary tendency could sometimes be traced accurately through the family of a patient; in those cases where the tendency was strong, deposits of fats in the arteries and skin could be predetermined, according to Mendelian, or genetic laws of inheritance.
One unforgettable case that is an example of the hereditary factor was that of Mrs. S. She was admitted to my teaching ward service in the hospital 10 years ago in a state of shock and coma from an excruciating chest pain. This young woman, only 29 years old, had been ironing clothes in her home when she apparently was seized by a sudden, lightning-like pain. In a fainting condition, Mrs. S. had collapsed to the floor. She fell with a cry, and her little girl, aged 5, also cried out and summoned the neighbors.
After only a few minutes in the hospital the patient expired, despite heroic efforts by our interne and resident, as well as physicians and nurses who were on duty at that moment.
Examination of the heart following death revealed to our surprise that Mrs. S. had a coronary thrombosis from extensive atherosclerosis. This was a rare cause of death in so young a woman, but one nevertheless that is occurring with greater frequency.
We immediately suspected a hereditary cause in her death and questioned the family, with the following results: The mother of Mrs. S. was in good health as late as age 56. However, the father had died at age 40 of a heart attack while driving an automobile. His only other brother had also died of a heart attack at age 52. Mrs. S.'s paternal grandfather had died of a heart condition in his fifties and his own brother had died of a "stroke."
Mrs. S. had no sisters and only one older brother, who was 32 years old and suffering from angina pectoris. (This is a heart condition caused, in most cases, by atherosclerosis of the coronary arteries.)
This strong family trend towards the incidence of a coronary artery disease and atherosclerosis is a striking example in the case of Mrs. S., although in this case at an unusually young age. At least one-third of the usual cases that I see in private practice, as well as those seen by other physicians of heart disease, are found to have a history of either heart attacks or "strokes" in the family.
When this atherosclerotic coat of arms has been handed down in a family, it is vitally necessary that double precautions be followed in strict adherence to the nutritional program set forth in this book.
Still another characteristic example of the powerful influence of inheritance in the development of atherosclerosis is the case of Mr. J., aged 39.
This patient suffered from pains in both calves of the legs whenever he walked for distances more than a block. He would have to stop and rest until the pains would subside, before he could continue again. We found a typical advanced degree of atherosclerosis of the arteries affecting both legs.
The father of Mr. J., a bank official, had already suffered a coronary thrombosis when he was 56. His two older brothers, in turn, had each died of the complications of atherosclerosis— one from a heart attack, and the other from a "stroke."
Mr. J. had one sister, age 52, who was troubled greatly by swellings in the ankles of both legs, which were discovered to be caused by Bright's disease* This condition, sometimes called "dropsy" in the old days, is caused by atherosclerosis or "hardening of the arteries," in the kidneys. This is still a very widespread condition and one that accounts for much sickness and death throughout the world, although it is an insidious process, like its fellow "assassins" in the heart and brain.
Mr. J.'s case was so advanced that nutritional care, diet, and weight reduction were of no avail and surgery had to be resorted to. By an ingenious technique, a team of four vascular surgeons who were experts in blood vessel surgery, grafted or transplanted two sets of new arteries in both legs, taken from blood vessel "banks." These storage "banks" keep normal healthy blood vessels available for operations and emergencies in the same way that blood is stored in blood banks for blood transfusions.
Mr. J. almost lost his life during the eight-hour operation but is now fully recovered and walking normally again. However, he does follow the low-fat diet and nutritional program that apparently has arrested the progress of his former atherosclerosis and is well and vigorous once more.
Is there an excess of fat imbedded in the artery wall itself? This proved to be a very difficult question to answer. A search through the medical literature disclosed that no one had reported any findings on this crucial question. We found that there were tremendous chemical problems blocking the answer to the mystery, but due to good luck and a brilliant chemical feat by our team, we discovered and reported the following facts.
The coronary artery that is damaged by an attack of atherosclerosis has four times as much cholesterol and fat content as that of the person who dies of causes other than heart attacks. Subsequent to our findings, investigators both here and abroad corroborated our findings, tracking down the "killer" fat to his lair directly in the artery itself. We also noted that high blood pressure had the special effect of driving the cholesterol and fats into the artery wall with more speed and greater destructive-ness than would normally be the case. Many patients with high blood pressure were particularly prone to heart attacks and strokes because of the extensive destruction wrought in their arteries by these fats.
This fact brings well to mind my patient, Mr. N., a 50-year old business executive, 40 pounds overweight, who had high blood pressure and angina pectoris. He complained of headaches and dizzy spells. He weighed 190 pounds and suffered from chest pain and shortness of breath on physical exertion or emotional excitement.
After a loss of 40 pounds by our nutritional methods, his blood pressure became normal and his heart aches and dizzy spells disappeared. However, whenever he had his regular twice weekly, tense committee conferences at the factory, his blood pressure would rise. Strangely enough he discovered that if he ate any fatty foods before these tense business conferences he would develop angina or chest pain and would have to take a tablet of nitroglycerine to relieve the severe heart pain.
His nutrition-minded wife astutely decided to pack his lunches herself into his brief case, along with his business papers and documents. Instead of eating the usual restaurant meals with his business associates, Mr. N. was able, thanks to his wife, to eat an enjoyable, low-calorie, fat-free meal. His heart pains left him. The great fear of death or crippling illness that had constantly oppressed him and made his life miserable disappeared completely.
Apparently, emotional stress at business would cause his susceptible blood pressure to rise. If fatty foods were eaten in addition, excess fat would accumulate in the blood and could be driven into the coronary artery blood stream of the heart. This would then produce the life-threatening heart pains of angina.
The transformation in Mr. N., after diet, weight and nutrition were corrected, was truly remarkable. His entire facial expression (as well as his figure) was completely changed. In the place of a tense, pasty-colored, anxious-looking face was a cheerful, smiling, health-colored countenance. His step had become springy (and no wonder, with 20 pounds less to carry around), his walk buoyant, and his enjoyment and capacity for work enormously increased.
Are there other conditions that cause heart attacks and strokes? To find the answer to this question we studied the hearts and arteries of 600 hospital patients who had died of various causes. After years of analysis we were able to report that in 100 cases of accidental death the great majority of men and women studied showed some degree of fatty deposits in their arteries. This was true in cases of people as young as 20, indicating that fat is a killer that has no respect for age. He often begins his work very early in a person's life.
In another 100 cases, diabetes was the cause of death; in another 100, underfunctioning of the thyroid gland was evident. In both instances, these patients showed excess cholesterol and fats in their blood, with a correspondingly high-fat content in their arteries. The degree of atherosclerosis of the heart and brain far outstripped that of any other condition, except one called xanthomatosis. This condition showed itself through fatty, yellow-white deposits in the skin around die eyes, hands, arms and legs. Whenever we found this condition, we also found that the arteries throughout the body, and especially in the heart, were most extensively damaged by fatty deposits.
In patients who were thin and wiry throughout their lifetime, the occurrence of atherosclerosis was generally much less than in all other cases. Women before the age of 50 also proved to be much better protected against degenerative artery disease than men. After 50, however, women began to develop heart attacks and strokes with the same frequency as men. The conclusion was that female sex hormones played an important role in providing protection against the ravages of atherosclerosis. As soon as the change of life occurred in women, the protection of these hormones seemed lost; they then became the equals of men in suffering from heart attacks and strokes.
The role of the liver in protecting you from excess fats. We found that the liver manufactures protective chemical substances called phospholipids. These phospholipids in the blood help to ward off the effects of too much fat and help to protect you from heart attack. They suppress the damaging effects of cholesterol upon the arteries of the heart and brain.
This encouraging fact was first discovered by Dr. Aaron Kell-ner and Dr. E. H. Ahrens, who conducted experiments on animals (and brought it to light). If your liver is not functioning normally and producing a sufficient quantity of these protective agents, you can find them in certain foods. Some foods that contain phospholipids in abundance are soybeans and the liver of calves, steers, lambs, and chickens. The Vitamin-B complex vitamins also have the ability to increase the blood phospholipids.
Defatted soybean lecithin in particular is an ideal preparation for increasing these protective phospholipids in the blood. (See Chapter 5 for a full discussion of food supplements that can be wonderful fighters in the battle against excess fat.)
These protective agents lower the blood cholesterol and bring about a better balance between the amount of phospholipids and cholesterol in the blood. The lowering in the amount of cholesterol protects you against the development of atherosclerosis.
Isn't there some medicine that will stop fat from causing heart attacks? Medical science has searched diligently for some new chemical or medicine that would provide the answer to this question. Some progress has been made, and the full answer will come in time. Here's what we have found out so far:
In 1940 I developed an extract from the arteries of cattle. This extract was administered first, with success, to animals for a period of three years. Then for several years it was given to human patients suffering from heart and artery disease. I reasoned that if a weakness or deficiency existed in the wall of the damaged artery, then the administration of the healthy, vital substance missing in the artery might rejuvenate the diseased artery and restore its health. This same principle was used in the discovery of insulin.
Although the extract was effective, it had some drawbacks. One problem was that to be effective, it had to be injected daily for the duration of life. A group of research biochemists headed by Dr. N. T. Werthessen and specializing in atomic medicine studied the preventative and curative effects of the extract that I had developed. They used radioactive chemicals to trace the extract in the blood of experimental animals. It was found to be highly effective in preventing atherosclerosis. Nevertheless, I felt it was necessary to abandon the use of the extract, even though we had obtained remarkable results in the treatment of heart, brain, and other circulatory illnesses. The excessive costs of manufacturing and testing the extract, and the need to inject it daily, made its use impractical.
Many other fat preventing agents have been discovered and found wanting. For example, my associates and I found, more than 10 years ago, that in various experimental animals certain members of the Vitamin-B complex were effective in preventing and treating atherosclerosis. These protective, vitamin-like agents were called lipotropic, or fat preventing. Although these findings were repeated and corroborated by many investigators, many medical scientists could not agree, and the use of such fat preventing agents never became generally accepted. Subsequently, they have been replaced by more promising medicines in the treatment of heart attacks and strokes.
Another promising substance was heparin, which is a fat-clearing, anti-clotting medicine. Dr. Hyman Engelberg and other investigators have found heparin very valuable for controlling blood fats in the treatment of heart cases. Various other physicians, however, do not agree with these results. Moreover, the necessity of injecting heparin at frequent intervals and the need for greatest care in its administration made it difficult to use it on a wide scale.
In certain cases, thyroid extract has been effective in reducing excessive cholesterol and fats in the blood. It was most helpful in those patients who had a sluggish or abnormally low basal metabolism rate, a sign of an underfunctioning thyroid gland. But unfortunately, it has not proved generally effective in all cases.
Years ago, my co-workers and I explored the potential of plant sterols as fighters of fat. These sterols, which are plant or vegtable extracts, when eaten, block the absorption of cholesterol and fats from the intestine. Some interesting results were obtained, but their action was variable at best. Many of these plant extracts were not practical because large quantities had to be consumed before each meal.
Female sex hormones have been widely explored. Many investigators have advocated their use in controlling fat metabolism in the blood and arteries. Here too, the results of treatment in cases of heart disease were interesting, but treatment was handicapped by the feminizing effects that such hormones had on men.
Thus the need for something that would be useful to all people, something that would bring definite results in fighting off the killer, fat, remained. The low-fat diet holds great promise for everyone, whether the person has atherosclerosis or not. The low-fat way of life can be followed by anyone, anywhere, and it is simple, safe, effective. Let us see why.
How the low-fat diet proved its value. Throughout the world, fats and heart disease appear to be inseparable companions. When investigators found one, they generally found the other, no matter in what countries they searched. A host of reports began to pour in on the scarcity or absence of heart, brain, and vascular disease in those populations where a low-cholesterol, low-fat diet were common. (Example: Asians, Africans, Costa Ricans, Okinawans, Chinese, Ceylonese, and Bantus.)
In sharp contrast, the exact reverse was found in those parts of the world where a high-fat diet was prevalent. A high rate of atherosclerosis of the heart, brain, and kidney was common in the countries of Europe and in the United States and Canada. Pathologists, doctors, and medical researchers, have since produced overwhelming evidence to show that when blood cholesterol and fats are high, the arteries were correspondingly high in the degree of damage or destruction by atherosclerosis. And when the blood levels of fat were low, the damage to heart and brain was also low.
I became convinced that the killer had been identified. This conviction I arrived at in the following way: I decided to see what the effects would be of stopping one group of patients from eating fats and comparing them with another group who continued to eat the usual amounts of fats found in the American diet. It was important to work with people who had proven cases of atherosclerosis.
I therefore selected 100 patients who had survived heart attacks or coronary thromboses and who had been discharged from the hospital. These patients had all had atherosclerosis of the coronary arteries and were ideal for the purpose of proving or disproving the whole concept of high fat as the cause of heart attacks. The 100 cases were divided into two groups of 50 patients each. One group was placed on a low-fat, low-cholesterol diet; the other continued on a diet containing the regular fat intake that they had grown accustomed to before their heart attacks occurred.
Both groups were carefully observed for over 10 years. By the end of the third year, the answer began to grow clear. At the end of eight years of study, the answer was conclusive. Of the 50 patients who ate their regular dietary fat quota, 38 (or 76 per cent) had died of arterial or heart diseases. Of the 50 people who had followed the low-fat diet faithfully, only 22 (or 44 per cent) had died of the same illnesses. In other words, the low-fat diet had enabled heart patients to live twice as long as those who followed a regular diet and had saved a significant number of lives in the process.
The lowfat diet proved to be effective in reducing weight and promoting general good health. An equally important result of this research was this: We found that a substantial weight reduction of about 20 pounds was achieved by both men and women on the low-fat diet. This took place over a period of three years, and the weight loss was safe, gradual, healthful.
Typical of this group of patients was Mr. B., a stocky, short man of 180 pounds, who had just recently recovered from his coronary thrombosis. But he now complained of great fatigue and shortness of breath on exertion. He just couldn't seem to be able to resume his work as a builder. For his height and bodily frame, he was easily 36 pounds overweight. On the low-fat diet he lost a pound each week.
At the end of the year he weighed 145 pounds. In his own words, he "felt like a million dollars." He found himself vigorously back at work again, clambering about his construction jobs and housing projects with ease and enjoyment.
The patients on the low-fat diet also gained some remarkable and unexpected health dividends. Many patients, for example, experienced a striking improvement in energy and vitality.
The case of 47-year old Mrs. R. is an excellent one in point. She had made a fairly good immediate recovery from her coronary thrombosis. But even before her heart attack, her household activities were always a series of endless chores to her. To "get through the day," became a daily and finally a monumental challenge. First, it had been the race to get her three children off to school and husband off to work without even a chance to answer nature's call to the bathroom (the new American mother's form of colonic martyrdom!).
Next the hurry to get the house cleaned and straightened up and the noon meal cooked before the children were back from school for lunch. After this kind of fire-alarm rush, the quick run over to shop, buy and prepare dinner. As the zero-hour drew near, Mrs. R. often felt like giving up; she just felt too exhausted, too miserable, and too weak; the task appeared too formidable and depressing for her dwindling strength.
The doctor who had examined Mrs. R. had not been able to find any actual disease present. She was advised to "relax" and "try to take it easy." The "change of life" is hard on some women. Mrs. R. should have watched her weight and her calories, as she was easily 25 pounds overweight. She was only 5 feet tall, a little woman. Then her heart attack had struck and stunned the patient and the family before Mrs. R. had a chance to do anything about it. But after a year on the low-fat diet and nutritional program, she made a complete recovery and had lost 25 pounds of weight. Mrs. R. was a changed person. Below the layers of fat emerged an attractive, vivacious woman whose vitality was apparent in her home. Relieved of the excess tonnage she had constantly carted around her house, Mrs. R. walked with a light* quick step. The family could not believe the transformation that had taken place; the entire home had become cheerful and a pleasure to live in.
Mr. R. privately confided to me that he had also been depressed by his wife's former miserable state. He now promptly responded to the new healthy, cheerful atmosphere. He himself came to enjoy his home and family. Previously his footsteps had dragged; he used to feel nothing but uneasiness and anxiety when he came home, when he found an exhausted and depressed wife. Now he really could barely wait to get home. It was almost like rediscovering his wife^-his wife as she had been in her youth.
Others on the low-fat diet found that they gained strength and were able to work and take part in physical activities that would otherwise be denied them.
After the loss of 22 pounds, another patient in this group, Mr. L., found that after three years on the low-fat nutritional way of life, he now got more out of his job as a carpenter, with a loss of his old fatigue and a greater ease in actual working then ever before.
Many patients found their whole philosophy of life changing. Those who had been depressed and discouraged came to know a surprising sense of well-being. Cheerfulness and optimism took the place of morose resignation and negative pessimism.
Mrs. T. never tired of admiring herself in the mirror after a year on the diet and nutritional supplements. And no wonder, for in the place of the unsightly bulk that made her resolve to do something tomorrow, there was a slim, attractive figure, a clear, fresh skin, and a sparkle in the eyes that had never been there before. What pleased her most, however, was the smiling face and cheerful expression that habitually greeted her in the mirror and that radiated and was reflected in the rest of her family.
Some of the patients had suffered for years from heart (angina) pain and other circulatory illnesses. Many of those who followed the low-fat diet faithfully found these symptoms gradually disappearing.
Cases like Mr. C, Mr. 0. and Mrs. W. were typical. Following the diet and nutritional changes, weight losses of 20 to 40 pounds resulted. In the place of the old chest pain, discomfort or pressure due to angina or heart pain, there was now a feeling of lightness, ease, and freedom from the frightening distress that used to come on so quickly after exercise or excitement.
These remarkable improvements in all the patients on the low-fat diet were accomplished by the healthy teamwork in body chemistry and tissues of vitamin and nutritional supplements, diet, and weight reduction. Identical findings were reported by investigators abroad, particularly in Europe. The benefits were especially strong in cases of atherosclerosis of the brain (stroke).
These cases of cerebral atherosclerosis are so widespread they are virtually universal. Chapter 11 contains a detailed account of the recent and extraordinary discoveries that have resulted from treatment of this condition by the low-fat diet and nutritional supplements.
A recent scientific publication of mine in the medical journal Geriatrics (for elderly people) describes some remarkable changes in patients with cerebral atherosclerosis. Over 100 of these patients, some of them suffering from strokes, were treated very intensively by the low-fat diet and massive amounts of lecithin, vitamin-B complex supplements, liver extract, and soya oil (as described in detail in Chapter 6) showed remarkable changes, often within two to three months. Increased strength —as noted by mechanical measuring devices and increased muscular ability, coordination and ability to walk—were frequently found.*
Mental improvement was often seen by improved powers of concentration, greater clarity of thinking, expression, and perception.
Emotional changes were often remarkable. Depression and lack of communicativeness gradually disappeared and in its stead there frequently developed a feeling of well-being, cheerfulness, and optimism. Patients were much easier to get along with and were keenly interested in their improved nutrition and progress, where as before they had often felt only apathy and a fatalistic resignation to their condition.
These encouraging discoveries, although extremely important, do not mean that there are no other factors that play a part in causing atherosclerosis or help it to develop. As I have already mentioned, we must not forget such additional factors as heredity, sex, metabolic and glandular disturbances, local conditions within the arteries themselves, and possibly, still other undetermined causes.
However, what is important for you to remember is this: diet and weight are two powerful forces for health that you can control. You can do something about diet, and you can follow the low-fat diet with no difficulty, without having to suffer a bland, unexciting series of daily menus. And you can lose excess (unhealthy) weight easily, safely, and without having to starve yourself or restrict your diet to only a few foods such as lettuce and cottage cheese. You don't have anything to say about your heredity or your sex, but you can do something about what you eat and what you weigh. This book will show you how.
In the following chapters you will discover exactly how to eat and what to eat in order to prolong your life and increase your health and vitality. The low-fat program given in this book can do wonders for your general health and well-being. It may even save you or your loved ones from heart attacks, strokes, and other illnesses in which the role of the "killer" fat is unmistakable. Now that we know that fat is guilty, let's see exactly what we can do to keep this silent menace from destroying your heart and your health.
CHAPTER 4 - HOW TO BE REALLY WELL, THE LOW-FAT WAY
Your diet is the key to your health. Diet is an important factor in the cause and cure of many ills. The wrong foods can cause allergic reactions ranging from the well-known strawberry rash to death from allergic asphyxiation. The right foods can help you clear up such allergic reactions. The wrong foods can bring on overweight, sap your energy, rob you of zest and well-being. And in the degenerative diseases of the heart and blood vessels, diet is the key; it is the difference between active good health and dangerous illness.
Not all doctors are agreed as to the exact role of the high-fat diet in the development of those circulatory disorders that account for more than one-half of the total deaths in this nation each year. But a careful and continuing study of the subject for more than 15 years, both in the laboratory and in my private practice, has left no doubt in my mind. It is diet that cocks the trigger of the deadly weapon now aimed at the hearts and brains of millions of Americans. Whether that trigger is ever pulled will depend, admittedly, on a number of other things: heredity, occurrence of other diseases in the victim, certain hormones, stresses, biochemical factors, and so on. But why play Russian roulette with your heart?
By eliminating certain foods from your diet, by including others in the right amounts, and by the use of nutritional supplements, you can achieve at least a 50 per cent protection against heart attack. We shall consider dietary supplements in Chapter 5. Now let's see what foods are good for your health and which foods are not.
Unfortunately, as simple as proper dieting is, doctors have found it to be one of the most difficult measures to prescribe for their patients, and one of the most difficult to get them to follow consistently. Proper diet is the easiest and safest thing a physician can prescribe. But because eating habits are so firmly established with most patients, and because dietary therapy takes time, many follow a stop-and-go routine that offers little long-range benefit.
A healthy diet does not mean starvation or tasteless foods. Yet a corrective diet does not mean either starvation or the grim necessity of eating unpalatable foods. Moreover, a little experimenting in the kitchen will soon produce meals that, from the standpoint of taste and esthetic appeal, will be equal if not superior to, the high-fat dishes to which you are accustomed.
In the following pages you will find ways and means of satisfying your appetite and of stimulating it in such a way that it can be constantly surprised and pleased. This is done by a little originality on your part plus a break with old cooking and eating habits that have grown into fixed, and often monotonous, dining patterns. Your palate will be grateful for the change. And you will experience on the low-fat diet a startling increase in vigor and vitality, a new sense of well-being.
You do not have to lose energy—good diet increases vigor. Neither does it mean a loss of energy or a sharp reduction in poundage, unless you are overweight, in which case the excess fat is melted off. In fact, if you adhere to the low-fat, low-cholesterol diet recommended in these pages, you will feel better, have more vigor, and firmer muscles than before. If you have a faulty fat metabolism, the diet may substantially prolong your life. You will find more energy. You will be able to accomplish more and enjoy better what you do accomplish.
The low-fat, low-cholesterol diet is not intended for growing children and young persons under 20. The fatty acids contained in an unrestricted diet are apparently favorable to their growth and development.
At the same time, there is the incontrovertible fact that hundreds of millions of children in the Orient and elsewhere develop to their normal physical growth and healthy adulthood on a low-fat diet. Apparently the reason for this is that nature has endowed them with the ability to synthesize or produce within the body itself from other foodstuffs eaten, the essential fatty acids found in high-fat diets.
However, additional fats above and beyond those actually required and eaten in the diet are metabolized and discarded by children, or are absorbed without being deposited in harmful amounts on the artery walls. But after the period of growth is completed, and nature has exhausted her protective powers against fats, excess amounts are deposited in the artery walls. This tendency increases with each decade after you are 30 years of age.
Almost everyone can benefit from a low-fat diet. There are, of course, some individuals whose blood is so low in cholesterol and blood fats that dietary restrictions are not necessary. But these persons are decidedly in the minority; and such a condition can only be determined by a competent physician, who will order a laboratory measurement of serum cholesterol levels in the blood. People who are fortunate enough to possess these low-cholesterol levels (fixed around a 200 milligram value) are able to handle all fats ingested. They are usually characterized by outstanding vitality and are inclined to long lives. They rarely suffer from blood vessel diseases and heart attacks.
I had such a person as a patient of mine in one of my teaching wards at the County Hospital. She was a Mexican-Indian woman whose documented age was 110 years. Despite this remarkable fact, and despite her other infirmities (which were not associated with degenerative blood vessel disease), she was quite spry.
My research laboratory took samples of her blood and analyzed them with keen interest to see how much cholesterol and blood fats it would contain. In repeated tests, we found her cholesterol levels remained consistently within the range of 100 milligrams. Her other blood fats were correspondingly low.
Compared with what we regard as "normal" values of blood cholesterol in the United States (150-250 milligrams), this patient's values appeared to be surprisingly low. However, the 100 milligram level discovered in the little old Mexican-Indian lady, who was born in 1840 and brought up on a diet of legumes, fruits, and Indian corn, was probably a more accurate example of what the ideal cholesterol level should be.
At the opposite end of the spectrum from this vivacious centenarian are many individuals who have inherited what we of the medical profession call familial hypercholesterolemia. These words are a term referring to persons who have inherited abnormally high levels of blood cholesterol. These are the unfortunate ones throughout whose families runs the devastation of heart attacks and strokes, usually coming in the prime of life.
Such a condition is often discovered accidentally during a routine checkup by an able physician. He may note such signs as cholesterol deposits in the form of whitish plaques under the eye (called xanthalasma); or as a crescent along the periphery of the pupil in the eye (called an arcus senilis). Such indications may also be observed by the alert physician in various other parts of the body, including the elbows, arms, legs, heels, and hands. Many times the condition may reveal itself in the arteries inside the eyes, when they are checked by a competent eye doctor.
Whether such danger signals exist or not, however, if you are a man over 20 or a woman over 40, a diet comprising not more than 10 to 20 per cent of fat in calories can offer some measure of protection against heart and blood vessel disease. Such a low-fat diet can, in fact, help you to enjoy the kind of over-all good health that makes life worth living. So, for your health's sake, follow the recommendations found in the rest of this chapter and avoid those foods that may destroy your health and your heart.
The low-fat, low-cholesterol program:
FOODS PERMITTED Soups
Emphasize bouillons and consommes, as they are nutritious, filling, and low in calories and fats. They are ideal for relieving that hungry feeling quickly and picking you up in the process. Soups are great to warm you up instantly in cold weather and, in the jellied form, to cool you off in hot weather. Soups stimulate the digestive juices, start the stomach and intestinal muscles churning and "warmed up" for the job ahead, while "flushing out" the stomach and getting it ready to stoke the digestive furnace.
Use fat-free vegetable soups, vegetable broths, and soups prepared with skimmed milk.
It is imperative to remove all visible fat and grease from the soup. Here are some good ways to do this:
1.Refrigerate or chill the soup first: then carefully remove
the fat and grease that has caked on the top with a knife,
spoon, or other suitable utensil.
2.If there is not time for refrigerating or chilling the soup
first, use bread slices by direct application to the top
layer of the soup, in order to blot up or absorb the grease.
3.Place some lettuce leaves on top of the heated soup. When
you see the fat absorbed onto the leaf or leaves, remove
them. The lettuce leaf may also impart a slight flavor to
the soup, helping to lend a little zest.
4.Blot up the top layer of grease by floating one or more
paper towels on the surface of the soup. When it is fat-saturated, discard the towel; it is a greasy reminder of escape from unhealthy calories.
Dry soup mixes are quite low in fat and are very enjoyable. Some soup manufacturers prepare canned soups that have about a half-teaspoonful of fat per serving of soup when diluted equally with water. Vegetable and vegetable-beef canned soups, however, are very low in fat content and are thus highly desirable for the low-fat diet.
Beef, veal, and lamb are naturally high in both visible and "invisible" fat and cholesterol. However, since their protein content is most desirable for energy and palatability, and because of custom, they are basic ingredients in the low-fat diet. Much of the dietary fat allowance is contained in meat, which has its greatest amount of calories predominantly in fat. It must be kept in mind that the butcher will at all times allow a maximum of fat to remain on every cut of meat for reasons of added price and the presumption of "quality." This visible fat must be carefully cut away and trimmed while raw, before cooking.
During the cooking, baking, or broiling of the meat, the fat should be drained off by keeping the meat or roast on racks. One ideal way of removing most of the fat content of meat and making it almost fat free is to partially cook it on the day before it is to be eaten. Refrigerate the meat and the broth. On the following day it is now easy to remove the layer of grease that has floated to the top and hardened.
Buy and eat lean meats. If you are having ground meat, specify to the butcher that it is to be made from trimmed, lean meat. Bear in mind that the highest fat content is present in the prime and choice grades of beef, lamb, and veal (which are more expensive too), since they originate from fattened animals. Less fat and good quality is contained in meats that bear the stamp "U.S. Good."
Do not fry meats. Pan-cook or brown without fat or grease, if desired, by using a dry skillet; heat and salt it first before the meat is placed in it, while turning the meat repeatedly. After it is as brown as desired, cook slowly until well done or rare, whichever you wish.
A preparation called "Pantastic" (manufactured by G. N. Coughlan Company, West Orange, New Jersey) is one method of cooking with pans and reducing fat to a minimum. It prevents meats and other foods from sticking to the pan so that grease and fat-free cooking is possible.
Remember that among meats pork, bacon, and ham are highest in fat and cholesterol content. They should not be eaten on the low-fat diet other than occasionally, if permitted by your doctor or by the virtual absence of other fat-containing foods in your menus for the day. The same is generally true of sausages, and organ foods like brains, sweatbreads, and kidneys. Liver is an exception, however, as we will see later.
If gravy is desired for the flavoring of meats, it must be prepared free of its usual very high fat content. The regular brown drippings found at the bottom of the pan after meat is cooked must have the meat juices separated from the exceptionally high melted fats. Separate the fat in this gravy by chilling or refrigeration. Remove the thick layer of caked grease as described above by spoon and by blotting with bread or absorbent paper. Fat-free gravies can also be made by consulting various low-fat cookbooks.
Instead of gravies, meats can be flavored and made to look appetizing by the following garnishes: watercress, parsley, celery, carrots, radishes, pimento, pickles, paprika, green peppers, cucumbers, mushrooms, and onions in various shapes and combinations. Also helpful are spiced peaches, pears, prunes, apricots, cinnamon apples, spiced watermelon rind, applesauce, cinnamon pears, pineapple pieces, broiled bananas, seasoned tomatoes, herbs, and the various relishes such as mint jellies and sauces, chili, catsup, cranberry jellies, chutney, and many others.
Also appealing are some of the following seasonings: garlic cloves, thyme, marjoram, basil, oregano, bay, and peppermint.
As a. rule, fish are often excellent low-fat food sources. Unlike meats, very little fats will be cooked out of the fish, so attempting to drain off fish fats in cooking is unnecessary.
Some fish are especially low in fat, such as perch, haddock, flounder, sturgeon, smelts, scallops. Others like brook trout, porgy, cod, and croakers are somewhat higher in fat content, but are still quite low in fat content when compared with meats.
Shell-fish are outstandingly low in fat and cholesterol content. Lobster, shrimps, and crabs are ideal examples. Clams are next in line; oysters are a bit higher in fat content, but are still low in comparison with beef, lamb, or veal. For the connoisseurs, frogs-legs are also low in fat content.
Tuna is now packed in dietetic form called "Chicken-of-the-Sea Brand" and is particularly low in fat. Many canned fish when not packed in oil are very low in fat.
Chicken and turkey are excellent sources of animal proteins for low-fat, low-cholesterol content, provided lean poultry is used. The dark meat of poultry is higher in fat content than white meat. Skin should be discarded. Giblets are very high in fat content.
Guinea hen and squab are also comparatively low in fat content. However, duck and goose are extremely high in fat and should not be included unless the fat is drained off and removed by the methods recommended in the section under meats. As a matter of fact, the fat from chicken and turkey, even though much less quantitatively than that in meat, is best drained off and removed in the same manner as in the preparation and cooking of all meats.
Egg whites, which are proteins, may be eaten and used for cooking as much as desired. The yellow portion of the egg, or the yolk, contains one of the most concentrated forms of fat available—namely cholesterol—and therefore should be avoided.
Milk and Milk Products
One pint or more daily of non-fat or skim milk should be taken. Use fortified milk with added amounts of vitamin A and D, as now commonly in use. Buttermilk is also a refreshing source of milk with an exceedingly low-fat content.
As an added source of fat-free or low-fat protein, skim or fat-free milk can be fortified by adding to each glass of milk one or more tablespoonsful of dried, skim milk. This "fortified" milk also has a thick creamy taste and can be flavored to suit the individual taste with various flavoring agents. Yogurt made from non-fat milk can also be used for nutritious variety.
The majority of cheeses are very high in butterfat content and so cannot be used in the low-fat diet. There are several important exceptions, however. First is cottage cheese made from dry curd and non-fat milk, as specified by federal law. Cottage cheese must contain a minimum amount of butterfat to meet legal requirements.
One of the most frequent pitfalls in the use of cottage cheese is the user's failure to notice that often she is using or buying creamed cottage cheese, which of course does contain fat. Restaurants in particular use creamed cottage cheese in their menus, and this should be borne in mind when eating out. This creamed cottage cheese can be corrected by washing it out with cold water through a strainer. Various brands of cottage cheese that taste like creamed cottage cheese are available, such as "Slim Cheez" or Ricotta Cheese made from milk whey and a favorite of Italian cooks. There are also other foreign brands of cheeses low or negligible in fat content, which are processed from non-fat milk or whey, such as the Geska type of Sapsago cheese (Swiss green cheese), certain Scandinavian cheeses, and in the United States brands of jack cheese made from skim milk or whey. Cheese spreads or dips made from non-fat or cottage cheeses are also widely used for low-fat menus.
Vegetables are virtually fat free and contain no cholesterol.
Certainly the acid test or taste (!) of the good cook is in the preparation of vegetables. To prepare vegetables without butter or fat means that a little originality is required by the cook, such as by the use of herbs or seasoning. Since many of the vital vitamins and minerals in vegetables may be destroyed by cooking, the ideal use of raw vegetables is the most desirable for any menu, and especially for the low-fat menus. However, because many vegetables are cooked, it is best not to soak them, and to save and use in other dishes the water used for the cooking, to avoid using soda and to avoid overcooking or reheating of the vegetables.
The addition of bouillon cubes as a substitute for butter in the cooking of vegetables is very helpful and palatable. The subsequent addition of herbs before serving the vegetables adds further to the natural flavor.
Fruits also contain virtually no fat and are entirely free of any cholesterol. Two notable exceptions, however, are the avocado and the coconut, which are both very high in fat content and thus should be avoided. Otherwise there is no restriction on the use of fruits, which are also certainly ideal for desserts.
Salads and Salad Dressings
Use raw vegetables almost exclusively, since the vitamin value is at peak this way, and the crispness of the vegetables is most appetizing. No fat or cholesterol is concerned unless specifically added. Fruit salads are in the same category and are particularly refreshing and nutritious. Various combinations can be used with vegetables, cottage cheese, or gelatin recipes. When fresh fruits are not in season, use dried, canned, or frozen fruits.
Gelatin salads are special favorites to many, especially when made with fruit juices instead of water. Aspic salads are excellent when prepared with vegetables or vegetable juices. If cottage cheese is added to gelatin and aspic salads, more protein and "body" results.
Salad dressings low in fat content are readily available from various manufacturers under such trade names as Mar-se Diet Rite (Lo-Calorie Mayonnaise Substitute), Diamel Diet Whip, and others. These do contain a relatively small degree of fat, however, so it is best to prepare your own fat-free dressings whenever possible, such as the one described in the recipe, page 72. Small amounts of mineral oil are preferred by some for salads, but if used more than occasionally this is not desirable, since mineral oil tends to interfere with absorption of vitamin A in the food.
If allowance is made for the caloric content of the vegetable oils described in Chapter 5, soya-oil, cornseed oil, and cottonseed oil are valuable for use in salad dressings. As explained in Chapter 5, these vegetable oils are exceptions to other fatty foods in that they contain large amounts of unsaturated fatty acids. These fatty acids are very effective in reducing the fats and the cholesterol present in the blood stream. They are thus "protective" against the harmful effects upon the arteries of other fats, such as contained in butter, milk, eggs, and cream.
Don't forget eye-appeal in preparing an appetizing salad. The following garnishes are particularly nutritious and appealing: watercress, croutons, garlic, chives, pimiento, lemon, lime, orange or tangerine and other fruits, mint, carrots, beets, green onions, celery, radishes, cottage cheese, parsley, pickles and peppers, ketchup, vinegar, non-fat yogurt, herbs, and spices.
These are nutritious, energy producing, and virtually fat free. Therefore, all cooked or dry cereals are excellent carbohydrate foods, if served with non-fat milk. The taste is enormously enhanced by the addition of stewed or fresh fruits such as bananas, prunes, peaches, pears, apricots, berries, dates and figs, raisins, or baked apple.
Whole wheat and whole grain cereals are also an important source of vitamin B complex and protein in the low-fat diet. Their cooking can be done with skim milk if it is not boiled or burned. The addition of one-to-four tablespoonsful of wheat germ to the cereal is a most desirable nutritional supplement and is an ideal daily food when added to the cereal.
For those who work and feel best beginning the day with a substantial breakfast, the inclusion of the above cereal, skim milk, fruit, and wheat germ "combo" is excellent for energy, proteins, vitamins, and minerals.
Both white and whole wheat breads contain only a negligible amount of fat (approximately 5 per cent by weight) a minority quantity of protein (about 20 per cent) ; the rest is carbohydrate.
Whole wheat bread is the healthiest, most nutritious form of the "staff of life." Bakeries customarily incorporate some lard, butter, or egg yolk in most yeast loaf bread, sweet rolls, rolls, muffins, buns, and coffee cake. Various enriched breads now on the market are also nutritious as far as vitamin B complex is concerned, and often may match 100 per cent whole wheat, rye, or pumpernickel breads in this regard.
Fat-free sweets are great energy producers as well as comforting for that "sweet-tooth." Excellent, but high in calories because of sugar content, are jams, jellies, marmalade, honey, molasses, maple syrup, and sugar; hard candies and candies without nuts, creams, or chocolate are also fat-free.
A wide choice of fat-free drinks is available to all, such as tea, coffee, coffee substitutes, skim, fat-free milk, non-fat milk cocoa, skim milk powder shakes, and egg white eggnogs. Where desired for additional nutriments, flavoring can be added to these flavored skim milk drinks in between meals or at bedtime.
Fruit and vegetable juices are also appealing and nutritious, as is fat-free yogurt. Carbonated drinks such as ginger ale, Coca-Cola, 7-Up, and others are also fat-free and popular.
FOODS TO AVOID
All creamed soups are high in fat content. The commercially prepared ones are particularly fat-heavy, and since the fat cannot be readily removed from them, they should not be used. It is always a good idea to read the label carefully on any packaged product from which soup is being made. The law pertaining to the labelling of foods requires a description of any fat contained in the product, so undesirable sources of fat can be avoided.
Glandular organs such as sweetbreads, brains, kidneys, caviar, fish roe, and giblets are high in cholesterol and fat content, so should be avoided. Pork and pork products, bacon, and ham are also high in fat and cholesterol and should not be eaten, except at an occasional meal.
As already mentioned, liver is an exception to the list of glandular organs to be avoided. It is quite desirable as a valuable nutritional source of essential vitamins and minerals, and because of the "protective" content of phospholipids that counteract the action of fat and cholesterol, it is not harmful.
Certain fish are high in fat content and are best avoided. These are: bass, bluefish, butterfish, deviled crab, eel, herring, mackerel, scalloped or fried oysters, pompano, salmon, sardines, shad, and trout.
Both duck and goose are very high in fat and cholesterol content and so should be avoided unless prepared in the fat-free way described under the section of "Meats Permitted,".
Whole milk, cream, butter, and cheeses such as American cheddar, Swiss, cream, creamed cottage, cheese spreads, Gruy-ere, Edam, Limberger, Liederkranz, Parmesan, Roquefort, and Yogurt made from whole milk are all high in fats and should be eliminated from your diet.
Egg yolks are exceptionally high in cholesterol and fat content. They are often used by medical investigators and researchers to produce atherosclerosis and "hardening of the arteries" in experimental animals.
Hot breads, pancakes, waffles, coffee cakes, muffins, buns, doughnuts, Danish pastry, sweet rolls—all contain some appreciable amount of lard, butter, or egg yolk. Those especially interested in home baking can find recipes for these fat-free breads and pastries in low-fat cook books, if desired.
All those made with butter, egg-yolks, or cream, such as pies, cakes, pastries, cookies, custards, eclairs, gingerbread, shortcake, and puddings. Notoriously high in fat and cholesterol are ice-cream, parfaits, and frozen creams.
Avocados, coconuts, nuts, cholocate, cocoa, fat contained in the usual salad dressings, gravies, and sauces are all very fatty. Animal fats, including lard and suet, should particularly be avoided in cooking.
Frying should be completely eliminated in the preparation of foods, not only because of its high fat production, but also because of its unhealthy way of interfering with the normal digestion of foods and essential nutriments and vitamins, the irritating character and effect on the digestive tract of the fried fats, and the destruction of vitamins and essential foodstuffs in the food that is fried. Even vegetable fats are best not used. An exception can be made for vegetable oils such as soya oil, cornseed oil, and cottonseed oils as described on page 66.
Alcohol has no fat content, so there are no restrictions on its use other than by the dictates of common sense and self-control.
Don't forget that the calories in liquors can easily mount up!
The low-fat, low-cholesterol menus found in this book, if followed conscientiously, will provide you with a nutritious, natural diet, one that will help protect you against heart and blood vessel disease. At the same time, it is a diet that will greatly improve your general state of health and increase your vitality.
As you will discover in Chapter 7, you can lengthen your lifespan by a definite number of years by keeping your weight down on this diet. Check the tables on pages 128 and 129 to see how many years you may expect to add to your life just by maintaining the proper weight, irrespective of heart disease.
Then ask yourself, "Isn't it worth a change in my eating habits?"
CHAPTER 5 - HOW TO USE DIETARY SUPPLEMENTS
Even a goat wouldn't eat what you eat. It is said that goats will eat anything. At various times their owners have reported that the animals had consumed such things as items of laundry from the clothesline, old shoes, paper (including banknotes), and in one case a horse's tail. With an appetite like that, you would think that Billy or Nanny would gladly accept an invitation to have dinner with us. But such, apparently, is not the case.
Not long ago, partly as a joke and partly out of curiosity, a man I know offered the same food that had been prepared for his dinner to a neighbor's goat. He reported that the animal turned aside in disgust from the dishes offered it.
Of course, man's dietary requirements differ somewhat from those of a goat. But in meeting those requirements, we have not shown any better sense in choosing our food.
You are overfed but undernourished. Health authorities, nutritional experts, and practicing physicians are agreed that although Americans can afford to buy more and better food than any other peoples in the world, their diet is sadly deficient in certain important nutritional elements. We are a nation that is overfed but undernourished.
The reason for this is that very often nutritional deficiency can and does occur without any outstanding clinical signs. Also, upper income groups are no more immune than those of a lower economic level.
Dr. Norman Jolliffe, Director of the Bureau of Nutrition, New York City Health Department, and one of the country's outstanding authorities on nutrition, recently warned: It is well established that deficiency disease, even without obvious clinical signs, may impair growth, mental development, resistance to many infections, ability to attain the maximum rate of wound healing, and decrease working ability.
In fact, inadequate nutrition, and incorrect nutrition, comprise a "hidden disease" in the United States—a disease costly in terms both of dollars and lives.
What is wrong with our diet and our eating habits? Many things are wrong with our diet and eating habits.
Nowhere in the world is food treated so badly before it is eaten as in the United States. Here it is raised by the use of artificial chemicals. In an all-out effort aimed at quantity, rather than quality, we do everything humanly possible to destroy the original character that the Creator provided and intended for the yield of the earth. Moreover, by the time most of our food reaches the consumer, it is too highly processed, refined, and improperly preserved.
To add to this inadequacy, we destroy what nutrient value remains by flame, fire, by watering it down with tap water, and by overloading it with salt, sugar, or seasoning.
Then we sit down during hurried and harried business hours and bolt it down.
And the result?
Some 50 million or more Americans, adults and children, suffer from constipation, bad teeth, skin troubles, digestive disorders, fatigue, nervousness, and a multitude of other complaints. Most of them are caused directly by poor nutrition and sub-clinical vitamin deficiencies.
To add to these digestive troubles, modern man has cut his oxygen intake by living indoors, often in artificially heated cells or rooms, and has lost contact with both sunshine and fresh air. This unnatural way of life is undoubtedly responsible for important metabolic changes that have occurred in civilized man. He has brought certain evils upon himself by losing those "catalysts" or "stokers of the body furnace."
As a crowning insult to nature, we frequently sit scrunched in a chair most of our days, living in a constant state of tension and apprehension at our work. Man was originally very energetic, physically active and almost constantly engaged in some exercise or other. Today, thanks to our mechanical genius, we tend to depend upon a push-button instead of a muscle.
All these factors make it necessary for us to seek "outside help" to make up for our nutritional and hygienic shortcomings.
How to supplement your diet with essential nutrients. One way science has found of helping us accomplish this is to supplement our diet with vitamins and other essential nutrients.
Dr. Jolliffe, noted nutritionist whom we quoted earlier in this chapter, not long ago pointed out that the improved nutritional status of our population since 1940 is, in fact, largely due to enrichment of foods and vitamin supplements.
States Dr. Jolliffe:
The agricultural scientist and the scientific farmer alike, know that it is not practical nor economic to raise hogs or chickens from purely agricultural products alone. They supplement the diet of their animals with a variety of vitamins, minerals, and other nutritionals. Although man does not like to think of himself as governed by similar nutritional rules as farm animals, we could learn and profit much by following what the scientific farmer practices.
For a number of years, the author has studied the effects of the following food and nutritional supplement programs, recommended to a large number of patients. They produced a striking and gratifying improvement in health levels and well-being. Also of greatest importance was the fact that they were found to be instrumental in lowering the cholesterol content of the blood and in reducing the amount of harmful blood fats.
There was a corresponding decrease in the number of colds and infections that patients usually had. They also reported less constipation, nervousness, fatigue, and the like.
The five-step program.
Here are the five steps that patients were asked to follow:
1. Include daily as a food supplement at breakfast two to four tablespoonfuls of Lecithin extracted from soya beans.
2. Add to your diet each day B Complex vitamins in the most potent form. Avoid the cheaper preparations which provide only small and ineffectual quantities of the vitamins, and have little or no effect on the body. Your doctor or druggist can advise you which brands provide potent quantities of the vitamins.
3.Also add to your daily diet at least 25,000 units of Vitamin
A, and 150 mg. of vitamin C.
4.Take two tablespoonfuls of soya bean oil, corn oil or
safflower oil daily to provide the essential fatty acids
necessary to proper nutrition. The oil may be used as a
salad dressing, taken with tomato or fruit juice, or in any
way you prefer.
5.Include in your diet two to four tablespoonfuls of whole
wheat germ each day. This may be eaten as a breakfast
cereal with fruit, or sprinkled in your salad.
Now a word about the nature of these health-giving nutrients, and the reason for their use.
How to use Lecithin. Now I'm going to tell you about one of the most important nutritional supplements developed in the last 50 years. Make a careful note of it and of how it is to be used, as described in these pages. The least it can do for you is to improve your health and give you added vitality. And it may even help save your life.
The substance is Lecithin—a bland, water-soluble, granular powder made from de-fatted soya beans.
Soya beans have been an important staple in the diets of people in China and the Far East for centuries. But it was only recently that the health-giving properties of one of the beans' constituents—Lecithin—have been studied.
Lecithin is what biochemists call a phosphatide. That means it is an essential constituent of all living cells, both animal and vegetable. As such, it plays a vital role in various phases of body chemistry and function.
After more than 10 years of intense experimentation, not only with Lecithin, but with a large number of other cholesterol-reducing preparations used in the treatment of heart disease, atherosclerosis, and allied conditions, we found Lecithin to give the most rewarding result. It was, in fact, not only useful in treatment of heart and blood vessel disease, but also in their prevention.
Lecithin has very recently been shown to have the power of removing atherosclerosis from the arteries of experimental animals. Dr. Meyer Friedman, Dr. Sanford Byers, Dr. Ray Rosenman and their research associates in San Francisco have demonstrated in a most convincing and dramatic manner how injections of Lecithin remove the cholesterol plaques that were deposited in arteries.
These fatty plaques were produced in the arteries by feeding large amounts of cholesterol and fats to the animals. They were characteristic of the atherosclerosis found in humans.
Dr. Friedman and his co-workers believe that in atherosclerosis, as the fats and cholesterol are removed from the artery walls and flood the bloodstream, the atherosclerotic plaques are dissolved and removed by the Lecithin.
The excess cholesterol and fats are thought to be converted by the liver into the bile and then excreted from the body. Although there is no known method of using Lecithin by injection in humans, the very high concentrations in the blood of Lecithin that are desirable for treatment can be achieved by feeding Lecithin and incorporating it into the daily diet.
Other research workers have also recently shown that soy bean Lecithin is able to prevent blood clotting in the arteries.
Wherever possible add at least two teaspoonfuls of flavored fresh brewer's yeast to skim milk, cereal or whole wheat germ daily. The use of an added two tablespoonfuls or one ounce of a fresh liver powder extract to the daily diet is invaluable for good nutrition. Both of these can be purchased at most drug stores and at all special diet food stores.
Many of my patients have prepared a "Molotov" cocktail by mixing both the yeast and liver powders in tomato juice or fruit juice. Drink this "cocktail" before meals. You will often find that it acts truly like "dynamite" in producing energy and vigor!
In the course of our research we have also found that Lecithin apparently has the ability to increase the cholesterol esterases in the human blood stream. These esterases are enzymes, or activators, that aid in the metabolizing of fats. Years ago, we found that these cholesterol esterases are deficient in patients with active atherosclerosis.
Lecithin has other remarkable therapeutic qualities as well. One that we are just beginning to explore is its ability to increase the gamma globulin content of the blood proteins. These gamma globulins are known to be associated with nature's protective force against the attacks of various infections in the body.
In the blood stream of patients who used Lecithin as recommended, we found evidence of increased immunity against virus infections. This is of special interest, since scientists have reported finding this Lecithin-induced immunity against pneumonia.
Other studies conducted by various American medical scientists have indicated that Lecithin is also beneficial in the treatment and prevention of a variety of disease, including rheumatic carditis, diseases of the liver, anemia, kidney disorders, and metabolic disturbances of the skin, such as psoriasis.
Patients who successfully followed the oil-free, soybean Lecithin program continually volunteered the information that they felt a sense of well-being. They said they had more vitality, did not grow tired so quickly as they had formerly, and were in better general health than before. These subjective responses are always to be viewed in the light of "suggestion" or the inspirational quality that patients receive from treatment itself.
Nevertheless, after more than a decade of careful analysis and evaluation of results, this author is certain that Lecithin is of one of our most powerful weapons against disease. It is an especially valuable bulwark against development of "hardening of the arteries" and all the complications of heart, brain, and kidney that follow.
In some instances, the cosmetic effect of Lecithin did as much for the patients' mental outlook as it did for their physical well-being.
For example, Mrs. U., a housewife of 45, had always been ashamed of the flat plaques of yellowish hue that appeared on her skin owing to fatty deposits. Soon after she began adding Lecithin to her diet, as prescribed, the patches began to disappear. Eventually they vanished altogether. Mrs. U. was more delighted with what she saw happening in the mirror than with the idea that the same thing might be going on with the fatty deposits inside her arteries.
Another patient of mine, a 45-year old baker, suffered so acutely from angina (pain in the chest caused by interference with the blood supply to the heart muscle) that he was unable to work. Like Mrs. U., he also had a number of yellowish brown plaques under his eyes, where fatty deposits had appeared. When I took his cholesterol level, it was found to be high in the abnormal range. Upon my recommendation, this baker followed the low-cholesterol, low-fat diet given in this book, and supplemented it with the prescribed amounts of Lecithin and high-potency vitamins. Within a few months he was able to return to work, free of anginal pain. His cholesterol level was lowered substantially, and the xanthalasma (fatty plaques) disappeared from his face.
As is the case in all foods, vitamins, or nutritional supplements, there are occasional persons who find that Lecithin does not agree with them. But in such a case, a substitute can be used.
In figuring calorie counts, allow 60 calories for each table-spoonful of Lecithin.
How to use soya oil. Oil extracted from the soybean" provides another valuable nutritional supplement. It contains a high percentage of unsaturated fatty acids, and is the most healthful of all food oils. Hundreds of millions of people living in Asia have used it for centuries. Perhaps this is the protective factor in their food that has prevented heart disease and atherosclerosis, which are comparatively rare in Asia.
Recent research has shown that unsaturated fats or fatty acids, such as those found in soybean oil, may act as "blocking" agents to keep harmful fats out of the blood. The term "unsaturated" is used by scientists to mean that the fat molecule still has room to add onto its structure additional molecules. Consequently, it is lighter in weight, and is more easily handled by the blood.
When a fat is "saturated" it has achieved its maximum weight. Taken into the bloodstream, it probably tends to "settle out" or to form a "bulge," depositing part of the fat in the artery lining or wall. These fatty deposits tend to block passage of blood through the vessel and may eventually plug it up altogether, resulting in a heart attack or stroke.
As a rule, you can regard "soft" fats—those that are liquid at room temperature—as unsaturated. They include most vegetable oils, such as olive, cottonseed, corn, and mineral oils. Coconut oil is an exception, being saturated even though it is a liquid.
The harmful or "solid" fats are those that are hard at room temperature: butter, lard, oleomargarine, suet, vegetable shortenings that have been hydrogenated, yolks of eggs, butterfat in milk, cream and cheeses (other than cottage cheese).
Soybean oil is now being stocked by many food markets and all special diet food stores. If it is not available at your grocer's, he or your druggist can order it for you.
It should be used in place of rich, fatty prepared oil dressings for your salads.
For those who must watch their calorie count, allow 135 calories for each tablespoonful of soya oil.
How to use vitamins. Evidence that many diseases could be caused by faulty diet has been available for centuries. As far back as 1753, a British naval surgeon named Capt. James Lind discovered that scurvy, which plagued seamen on long voyages and sometimes decimated entire crews, could be cured by eating fresh lemons. A century later, another naval doctor, who was an admiral of the Japanese fleet, learned that beri-beri, the wasting disease so prevalent among Japanese sailors, could be eliminated by change of diet. Other medical researchers reported similar noteworthy results in curing other deficiency diseases, including rickets.
But their discoveries were largely ignored. As late as the turn of the century, physicians of good educational background and wide experience were still blaming rickets on various causes —including infection, lack of proper thyroid function, and insufficient exercise.
The first widespread attention that the medical profession focused on the subject was in 1906 when an English physician, Sir Frederick Gowland Hopkins, published the results of experiments that pointed clearly to the existence of vitamins.
Sir Frederick fed laboratory rats on a diet of protein fats and carbohydrates, allowing each of them plenty of this food to grow satisfactorily. Yet instead of flourishing, they fell ill. When he added small amounts of whole milk to their diet, however, all of them quickly recovered and began to grow at a normal rate. This convinced the scientist that a healthful diet requires not only adequate amounts of proteins and carbohydrates, but some unknown but important ingredients.
It remained for a Polish biochemist named Casimir Funk, who carried on similar research at the Lister Institute in London, to give the unknown ingredient a name. He coined the word "vitamin," still in use today.
But exactly what are vitamins? At first medical scientists thought they were bio-catalysts, substances that promote chemical reactions in the body without taking a direct part in these reactions. But today it is evident that vitamins often do more than merely aid in chemical reactions. Some of them may actually be substances used structurally by the body.
Of the 13 vitamins usually considered essential for a healthy body, we are most concerned here with the group known as B Complex, and with Vitamins A and C.
In B Complex, we have a number of substances fundamentally necessary for normal health. They are vital for normal metabolism, and are very valuable as "lipotropic" or fat-combatting agents. In addition to helping our bodies handle fats, they also "spark" our hormones and aid in preventing diseases of the nervous system.
Vitamin A, a yellow compound related to substances found in carrots and leafy vegetables, is essential for growth, many bodily functions in the skin and blood vessels, and for resistance against colds and infections.
Vitamin C, which should supplement the diet given in these pages in substantial quantity, is a crystalline substance easily destroyed by cooking. For that reason cooked foods do not provide a very good source of it. It is needed for formation of connective tissue and red blood cells. A deficiency of this vitamin may be partly responsible for dental caries and infections of the gums, loss of appetite, anemia, and undernutrition.
In addition to these important vitamins, a number of minerals are also essential in our diet, especially a diet aimed at preventing and reducing atherosclerosis. For that reason, a rigid adherence to the menus and instructions given in this book is important.
General Considerations for Low-Fat Menus
The menus presented here include well balanced meals of high protein and high nutritional quality, with emphasis on very low-fat and low-cholesterol content. Although cholesterol is contained in all animal and vegetable fats, glandular organs such as brains, liver, kidney, sweetbreads, and giblets are especially high in cholesterol. In the case of liver, however, there are additional protective nutrients called phospholipids, that help overcome it’s cholesterol content, and therefore make liver a valuable source of nourishment. Egg yolks and all foods with egg yolks are also high in cholesterol and are to be avoided as are egg noodles, pancake and waffle mixes, cake mixes with eggs, mayonnaise-type salad dressings, etc.
Some simple suggestions foods are as follows:
Soups: Clear consommés may be used, and stock from vegetables and meat bones.
Thoroughly chill and remove all fat before using..
Cream soups made from non-fat milk, with the addition of flour (2 teaspoonsful to 1 cup), thoroughly cooked until thick, then blended with various vegetables or vegetable purees, are excellent. To replace crackers you may use Melba toast, toast cubes, Ry-Krisp, or bread stock.
Meats: Meats should be served with all fat removed. In the preparation, too, remove all noticeable fat before cooking.
In some of the methods commonly used to prepare meat with a low-fat content are roasting, broiling, pan broiling, braising, and cooking with liquids.
For roasting 300-325 degrees is recommended. The length of cooking time depends upon quantity and type of meat. Remove all fat from drippings.
When broiling steaks, chops or patties, place meat 3—5 inches from flame. Remove all fat before serving. In pan broiling, remove all external fat and place meat in cold pan on low fire without covering. Cook until meat is brown on both sides. Use "Pan-tastic" or Pan-Free" to keep meat from adhering to pan.
Stewing entails adding liquids, seasonings, and vegetables to meat, but in our diets it is best to remove all fats from meats before cooking. To remove fat more thoroughly, chill stew and remove all hard fat film on the surface. Reheat and serve.
Vegetables: Wash, dry, chill until ready to cook. Cook in the smallest amount of water and the shortest time to preserve vitamins and color. Add paprika or chopped parsley to enhance eye appeal.
All vegetable salads may be used, with dietetic dressings of no fat value. Two basic types are as follows:
1 cup Non-fat milk, 2 tablespoons cornstarch, cook over low heat until thick, add 1/2 teaspoon salt, 1/2 teaspoon dry mustard and cool, add 2 tablespoons vinegar, egg coloring, beat until smooth. Egg whites beaten may be folded into the mixture.
French Dressing style:
Add the following to handy bottle and shake thoroughly until blended ... 3-4 tablespoons wine or taragon vinegar, juice of crushed garlic, seasoned salt, dash pepper, 1 cup tomato puree, 1/4 cup lemon juice, 2-3 tablespoons catsup, 1/2 teaspoon sugar, 1/4 teaspoon dry mustard, tabasco and Worcestershire sauce if desired.
Desserts: All fruit desserts may be used: gelatin dishes without any added cream; fruit whips using beaten eggs; angel food cakes, sherbets and ices.
(To all dishes included in the menus on the following pages, add no butter, margarine, cream, or regular salad dressings.)
In these menus, skimmed fresh skimmed milk. milk powder may be added too.