ONE SMART COOKIE

So we all relate to high fat diets as were doing the ATKINS,what a load of codswollap,this type of diet has been around for over a century and millenia if you go by different diets from different cultures,so over the next week I am going to post up all the different articles I have in this one thread(so please have patience with me)and when you`ve read em post your questions and I`ll ty my hardest to answer them,these articles I have got from all over the place so it will be nice to see them all in one place for all to read on this board.

Enjoy



When one thinks of low-carbohydrate diets today, one tends to think that they are "new" or "revolutionary" in some way. Popular books certainly give that impression. But nothing could be further from the truth. I started eating a low-carbohydrate diet in 1962 when a doctor advised me that this was the best way to lose weight.

You may also think that these "new" low-carbohydrate regimes have been pioneered by far-seeing and learned medical men. Again, this is incorrect. The truth is that we would probably never have heard of diets where people could lose weight eating that most calorific of foods: fat, if it had not been for a 19th century English carpenter by the name of William Banting.

Only three men in history have been immortalized by having their names enter the English language as verbs. The first was an Irishman, Captain Boycott, whose name entered the language in the 1860s. Another was Louis Pasteur and the third was the subject of this article—William Banting, a man who came to have a great impact on many peoples' lives, one of whom is me.

Being overweight has affected a small proportion of the population for centuries but clinical obesity was relatively rare until the 20th century. Indeed obesity remained at a fairly stable low level until about 1980. Then its incidence began to increase dramatically. By 1992 one in every ten people in Britain was overweight; a mere five years later that figure had almost doubled. In the USA it is even worse: by 1991 one in three adults was overweight. That was an increase of eight percent of the population over just one decade despite the fact that Americans spend a massive $33 billion a year on "slimming."

It may be hard to believe, but this has occurred in the face of increasing knowledge, awareness and education about obesity, nutrition and exercise. It has happened despite the fact that calorie intake has gone down by twenty percent over the past ten years and exercise clubs have mushroomed. More people are cutting calories now than ever before in their history yet more of them are becoming overweight. There is now a pandemic of increasing weight across the industrialized world.

But it needn't be like that, for nearly 140 years ago one man changed the thinking on diet completely. It all started with a small booklet entitled Letter on Corpulence Addressed to the Public, not written by a dietician or a doctor, but by an undertaker named William Banting. It became one of the most famous books on obesity ever written. First published in 1863, it went into many editions and continued to be published long after the author's death. The book was revolutionary and it should have changed western medical thinking on diet for weight loss for ever.

William Banting was well-regarded in 19th century society. He was a fine carpenter and an undertaker to the rich and famous. But if he had remained only that, his name would probably be remembered today merely as the Duke of Wellington's coffin maker, if indeed it were remembered at all.

None of Banting's family on either parent's side had any tendency to obesity. However, when he was in his thirties, William started to become overweight and he consulted an eminent surgeon, a kind personal friend, who recommended increased "bodily exertion before any ordinary daily labours began." Banting had a heavy boat and lived near the river so he took up rowing the boat for two hours a day. All this did for him, however, was to give him a prodigious appetite. He put on weight and was advised to stop. So much for exercise!

He was then advised that he could remedy his obesity by "moderate and light food" but wasn't really told what was intended by this. He says he brought his system into a low, impoverished state without reducing his weight, which caused many obnoxious boils to appear and two rather formidable carbuncles. He went into hospital and was ably operated upon—but also fed into increased obesity.

Banting went into hospital twenty times in as many years for weight reduction. He tried swimming, walking, riding and taking the sea air. He drank "gallons of physic and liquor potassae," took the spa waters at Leamington, Cheltenham and Harrogate, and tried low-calorie, starvation diets; he took Turkish baths at a rate of up to three a week for a year but lost only six pounds in all that time, and had less and less energy.

He was assured by one physician, whom he calls "one of the ablest physicians in the land," that putting weight on was perfectly natural; that he, himself, had put on a pound for every year of manhood and he was not surprised by Banting's condition—he just advised "more exercise, vapour baths and shampooing and medicine."

Banting tried every form of slimming treatment the medical profession could devise but it was all in vain. Eventually, discouraged and disillusioned—and still very fat—he gave up. By 1862, at the age of 64, William Banting weighed 202 pounds and he was only 5 feet 5 inches tall. Banting says that although he was of no great weight or size, still, he says: "I could not stoop to tie my shoes, so to speak, nor to attend to the little offices humanity requires without considerable pain and difficulty which only the corpulent can understand. I have been compelled to go downstairs slowly backward to save the jar of increased weight on the knee and ankle joints and have been obliged to puff and blow over every slight exertion, particularly that of going upstairs."

He also had an umbilical rupture, and other bodily ailments. On top of this he found that his sight was failing and he was becoming increasingly deaf. Because of this last problem, he consulted an aural specialist who made light of his case, sponged his ears out and blistered the outer ear—without the slightest benefit and without enquiring into his other ailments. Banting was not satisfied: he left in a worse plight than when he went to the specialist.

Eventually, in August of 1862 Banting consulted a noted Fellow of the Royal College of Surgeons: an ear, nose and throat specialist. Dr. William Harvey. It was an historic meeting. Dr. Harvey had recently returned from a symposium in Paris where he had heard Dr. Claude Bernard, a renowned physiologist, talk of a new theory about the part the liver played in the disease of diabetes. Bernard believed that the liver, as well as secreting bile, also secreted a sugar-like substance that it made from elements of the blood passing through it. This started Harvey's thinking about the roles of the various food elements in diabetes and he began a major course of research into the whole question of the way in which fats, sugars and starches affected the body.

When Dr. Harvey met Banting, he was interested as much by Banting's obesity as by his deafness, for he recognised that the one was the cause of the other. So Harvey put Banting on a diet. By Christmas, Banting was down to 184 pounds and, by the following August, 156 pounds.

He had, he says, "little comfort and far less sound sleep."

Harvey's advice to him was to give up bread, butter, milk, sugar, beer and potatoes. These, he was told, contained starch and saccharine matter tending to create fat and were to be avoided altogether. When told what he could not eat Banting thought that he had very little left to live on. His kind friend soon showed him that really there was ample and Banting was only too happy to give the plan a fair trial. Within a very few days, he says, he derived immense benefit from it. The plan led to an excellent night's rest with 6 to 8 hours' sleep per night.

Fortunately for us today, Banting was quite a remarkable man. It is for this reason alone that we can know today what this miraculous diet was. In May 1863, at his own expense, Banting published the first edition of his now famous Letter on Corpulence in which he tells us of Harvey's diet plan (see below).

On this diet Banting lost nearly 1 pound per week from August 1862 to August 1863. In his own words he said: "I can confidently state that quantity of diet may safely be left to the natural appetite; and that it is quality only which is essential to abate and cure corpulence."

He went on: "These important desiderata have been attained by the most easy and comfortable means. . . by a system of diet, that formerly I should have thought dangerously generous."

After 38 weeks. Banting felt better than he had for the past 20 years. By the end of the year, not only had his hearing been restored, he had much more vitality and he had lost 46 pounds in weight and 12 1/4 inches off his waist. He suffered no inconvenience whatsoever from the new diet, was able to come downstairs forward naturally with perfect ease, go upstairs and take exercise freely without the slightest inconvenience, could perform every necessary office for himself, the umbilical rupture was greatly ameliorated and gave him no anxiety, his sight was restored, his other bodily ailments were ameliorated and passed into the matter of history.

BANTING'S DIET PRIOR TO 1862

BREAKFAST: Bread and milk, or a pint of tea with plenty of milk and sugar, buttered toast.
DINNER: meat, beer, much bread (of which he had always been fond) and pastry.
TEA: a meal similar to breakfast.
SUPPER: generally a fruit tart or bread and milk.

HARVEY'S DIET PLAN

BREAKFAST: 4-5 ounces beef, mutton, kidneys, broiled fish, bacon or cold meat of any kind except pork,<SUP>1</SUP> a large cup of tea (without milk or sugar), a little biscuit or one ounce of dry toast.
DINNER: 5-6 ounces of any fish except salmon, any meat except pork, any vegetable except potato, one ounce of dry toast, fruit of any pudding,<SUP>2</SUP> any kind of poultry or game, and 2-3 glasses of good claret, sherry or Madeira (champagne, port, beer were forbidden).
TEA: 2-3 ounces fruit, a rusk or two and a cup of tea without milk or sugar.
SUPPER: 3-4 ounces of meat or fish, similar to dinner, with a glass or two of claret.
NIGHTCAP:Tumbler of grog: gin, whisky or brandy (without sugar) or a glass or two of claret or sherry.

1. Pork was not allowed as it was thought then that it contained starch.
2. Banting was not allowed the pastry. Banting was delighted. He would have gone through hell to achieve all this but it had not been necessary. Indeed the diet allowed so much food, and it was so easy to maintain, that Banting said of it: "I can conscientiously assert I never lived so well as under the new plan of dietary, which I should have formerly thought a dangerous, extravagant trespass upon health."

He says that this present dietary table is far superior to what he was eating before—"more luxurious and liberal, independent of its blessed effect, but when it is proved to be more healthful, the comparisons are simply ridiculous.

"I am very much better both bodily and mentally and pleased to believe that I hold the reins of health and comfort in my own hands.

"It is simply miraculous and I am thankful to Almighty Providence for directing me through an extraordinary chance to the care of a man who worked such a change in so short a time." It is quite obvious from these comments that Banting didn't need the strength of willpower that today's slimmer needs; that he found his weight-loss diet very easy to maintain.

He goes on to wish that the medical profession would acquaint themselves with the cure for obesity so that so many men would not descend into early graves, as he believed many did, from apoplexy, and would not endure on Earth so much bodily and mental infirmity.

Banting was so pleased with his progress that on top of Harvey's fees, he gave the doctor 350 pounds to be distributed amongst Harvey's favourite hospitals. Although despite this he still felt deeply obligated in a way that he could never hope to repay.

In fact, in 1868, Banting published a prospectus and started a fund to found and endow a new institution for the service of humanity— the Middlesex County Convalescent Hospital.

It was to be for those working-class people who could not afford to convalesce but had to return to work to make ends meet thus allowing no time to get over their hospital ordeal and so succumbed to relapses.

There was a small home at Walton-on-Thames which, although small, was, he thought, possibly sufficient for the purpose. Banting estimated that 312,000 pounds per year was needed to run it.

He put up 3,500 pounds, his son 3,100 and two other members of his family a further 350, With other patrons he raised a total of 35,000 pounds.

Banting charged nothing for the first two editions of his book—he didn't want to be accused of doing it merely for profit. He had printed 1,000 copies of the first edition and he gave them away.

The second edition numbered 1,500 which he also gave away although they cost him 6 pence each. Copies of the third edition, still in 1863, were sold at 1 pound each.

When Banting's booklet, in which he described the diet and its amazing results, was published, it was so contrary to the established doctrine that it set up a howl of protest among members of the medical profession. The "Banting Diet" became the center of a bitter controversy and Banting's papers and book were ridiculed and distorted. No one could deny that the diet worked, but as a layman had published it—and medical men were anxious that their position in society should not be undermined—they felt bound to attack it. Banting's paper was criticized solely on the grounds that it was "unscientific."

Later, Dr. Harvey had a problem too. He had an effective treatment for obesity but not a convincing theory to explain it. As he was a medical man, and so easier for the other members of his profession to attack, he came in for a great deal of ridicule until, in the end, his practice began to suffer.

However, the public was impressed. Many desperate overweight people tried the diet and found that it worked. Like it or not, the medical profession could not ignore it. Its obvious success meant that the Banting Diet had to be explained somehow.

To the rescue from Stuttgart came a Dr. Felix Niemeyer. He managed to make the new diet acceptable with a total shift in its philosophy. At that time, the theory was that carbohydrates and fat burned together in the lungs to produce heat. The two were called "respiratory foods." After examining Banting's paper, Niemeyer came up with an answer to the doctors' problem. All doctors knew that protein was not fattening, only the respiratory foods—fats and carbohydrates. He, therefore, interpreted "meat" to mean only lean meat with the fat trimmed off and this subtle change solved the problem. The Banting Diet became a high protein diet with both carbohydrate and fat restricted. This altered diet became enshrined in history and still forms the basis of slimming diets today.

Banting's descriptions of the diet are quite clear, however. Other than the prohibition against butter and pork, nowhere is there any instruction to remove the fat from meat and there is no restriction on the way food was cooked or on the total quantity of food which may be taken. Only carbohydrate—sugars and starches—are restricted. The reason that butter and pork were denied him was that it was thought at this time that they too contained starch.

Banting, who lived in physical comfort and remained at a normal weight until his death in 1878 at the age of 81, always maintained that Dr. Niemeyer's altered diet was far inferior to the one that had so changed his life. THE BANTING DIET IS CONFIRMED



Banting's Letter on Corpulence travelled widely. In the 1890s, an American doctor, Helen Densmore, modelled diets on Banting. She tells how she and her patients lost an average 10-15 pounds in the first month on the diet and then 6-8 pounds in subsequent months "by a diet from which bread, cereals and starchy food were excluded." Her advice to would-be slimmers was: "One pound of beef or mutton or fish per day with a moderate amount of the non-starchy vegetables will be found ample for any obese person of sedentary habits."

Dr. Densmore was scathing of those others of her profession who derided Banting's diet. She says of them: "Those very specialists who are at this time prospering greatly by the reduction of obesity and who are indebted to Mr. Banting for all their prosperity are loud, nevertheless, in their condemnation of the Banting method."

Over the following seventy years many epidemiological studies and clinical trials were conducted in several countries and the evidence mounted. There was by the mid-1950s no doubt that the low-carbohydrate diet worked and clinical trials at the Middlesex Hospital in London had demonstrated how it worked. Doctors could now put their overweight patients on a dietary regime which enjoyed overwhelming evidence of benefit and which was easy to follow and live on for life.

But it was not to be. Dieticians just couldn't seem to get their heads round the concept that eating what looked like a high-calorie diet could possibly be effective for weight loss. Or, perhaps they were afraid to lose face by admitting that they had been wrong. So they continued, myopically, to recommend that if you were overweight, it was your own fault —you were eating too much or not taking enough exercise, or both. That made life very easy for the dietician while it ruined the life of the patient. By the late 1970s fat was getting a bad name as a cause of heart disease (quite incorrectly as we now know). Now fat was banned for other health reasons and carbohydrates were advocated even more strongly.

Which is why, at the start of the 21st Century, at a time when most of us are dieting, are eating fewer calories and less fat, and taking more exercise than ever before in our history, we are getting fatter than ever before in our history.

It is no coincidence that obesity is sky-rocketing today—healthy eating advises a high-carbohydrate, lowfat diet. The exact opposite of Banting's diet.

Not long after Banting's Letter on Corpulence was published the verb "to Bant" entered the language and people losing weight said they were "Banting." It remained in common parlance well into this century and one still hears it occasionally today. Jan Freden, of Uppsala, Sweden, tells me that in Sweden, "Banting" is still the word most commonly used for dieting to achieve weight loss. So in Sweden they say: "Nej, tack, jag bantar" or "No thank you, I am banting."

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ONE SMART COOKIE

In 1906 I went to the Arctic with the food tastes and beliefs of the average American. By 1918, after eleven years as an Eskimo among Eskimos, I had learned things which caused me to shed most of those beliefs. Ten years later I began to realize that what I had learned was going to influence materially the sciences of medicine and dietetics. However, what finally impressed the scientists and converted many during the last two or three years, was a series of confirmatory experiments upon myself and a colleague performed at Bellevue Hospital, New York City, under the supervision of a committee representing several universities and other organizations.

Not so long ago the following dietetic beliefs were common: To be healthy you need a varied diet, composed of elements from both the animal and vegetable kingdoms. You got tired of and eventually felt a revulsion against things if you had to eat them often. This latter belief was supported by stories of people who through force of circumstances had been compelled, for instance, to live for two weeks on sardines and crackers and who, according to the stories, had sworn that so long as they lived they never would touch sardines again. The Southerners had it that nobody can eat a quail a day for thirty days.

There were subsidiary dietetic views. It was desirable to eat fruits and vegetables, including nuts and co**** grains. The less meat you ate the better for you. If you ate a good deal of it, you would develop rheumatism, hardening of the arteries, and high blood pressure, with a tendency to breakdown of the kidneys - in short, premature old age. An extreme variant had it that you would live more healthy, happily, and longer if you became a vegetarian.

Specifically it was believed, when our field studies began, that without vegetables in your diet you would develop scurvy. It was a "known fact" that sailors, miners, and explorers frequently died of scurvy "because they did not have vegetables and fruits." This was long before Vitamin C was publicized.

The addition of salt to food was considered either to promote health or to be necessary for health. This is proved by various yarns, such as that African tribes make war on one another to get salt; that minor campaigns of the American Civil War were focused on salt mines; and that all herbivorous animals are ravenous for salt. I do not remember seeing a critical appendix to any of these views, suggesting for instance, that Negro tribes also make war about things which no one ever said were biological essentials of life; that tobacco was a factor in Civil War campaigns without being a dietetic essential; and that members of the deer family in Maine which never have salt or show desire for it, are as healthy as those in Montana which devour quantities of it and are forever seeking more.

A belief I was destined to find crucial in my Arctic work, making the difference between success and failure, life and death, was the view that man cannot live on meat alone. The few doctors and dietitians who thought you could were considered unorthodox if not charlatans. The arguments ranged from metaphysics to chemistry: Man was not intended to be carnivorous - you knew that from examining his teeth, his stomach, and the account of him in the Bible. As mentioned, he would get scurvy if he had no vegetables in meat. The kidneys would be ruined by overwork. There would be protein poisoning and, in general hell to pay.

With these views in my head and, deplorably, a number of others like them, I resigned my position as assistant instructor in anthropology at Harvard to become anthropologist of a polar expedition. Through circumstances and accidents which are not a part of the story, I found myself that autumn the guest of the Mackenzie River Eskimos.

The Hudson's Bay Company, whose most northerly post was at Fort McPherson two hundred miles to the south had had little influence on the Eskimos during more than half a century; for it was only some of them who made annual visits to the trading post; and then they purchased no food but only tea, tobacco, ammunition and things of that sort. But in 1889 the whaling fleet had begun to cultivate these waters and for fifteen years there had been close association with sometimes as many as a dozen ships and four to five hundred men wintering at Herschel Island, just to the west of the delta. During this time a few of the Eskimos had learned some English and perhaps one in ten of them had grown to a certain extent fond of white man's foods.

But now the whaling fleet was gone because the bottom had dropped out of the whalebone market, and the district faced an old-time winter of fish and water. The game, which might have supplemented the fish some years earlier, had been exterminated or driven away by the intensive hunting that supplied meat to the whaling fleet. There was a little tea, but not nearly enough to see the Eskimos through the winter - this was the only element of the white man's dietary of which they were really fond and the lack of which would worry them. So I was facing a winter of fish without tea. For the least I could do, an uninvited guest, was to pretend a dislike for it.

The issue of fish and water against fish and tea was, in any case, to me six against a half dozen. For I had had a prejudice against fish all my life. I had nibbled at it perhaps once or twice a year at course dinners, always deciding that it was as bad as I thought. This was pure psychology of course, but I did not realize it.

I was in a measure adopted into an Eskimo family the head of which knew English. He had grown up as a cabin boy on a whaling ship and was called Roxy, though his name was Memoranna. It was early September, we were living in tents, the days were hot but it had begun to freeze during the nights, which were now dark for six to eight hours.

The community of three or four families, fifteen or twenty individuals, was engaged in fishing. With long poles, three or four nets were shoved out from the beach about one hundred yards apart. When the last net was out the first would be pulled in, with anything from dozens to hundreds of fish, mostly ranging in weight from one to three pounds, and including some beautiful salmon trout. From knowledge of other white men the Eskimos consider these to be most suitable for me and would cook them specially, roasting them against the fire. They themselves ate boiled fish.

Trying to develop an appetite, my habit was to get up soon after daylight, say four o'clock, shoulder my rifle, and go off after breakfasts on a hunt south across the rolling prairie, though I scarcely expected to find any game. About the middle of the afternoon I would return to camp. Children at play usually saw me coming and reported to Roxy's wife, who would then put a fresh salmon trout to roast. When I got home I would nibble at it and write in my diary what a terrible time I was having.

Against my expectation, and almost against my will, I was beginning to like the baked salmon trout when one day of perhaps the second week I arrived home without the children having seen me coming. There was no baked fish ready but the camp was sitting round troughs of boiled fish. I joined them and, to my surprise, liked it better than the baked. There after the special cooking ceased, and I ate boiled fish with the Eskimos.

By midwinter I had left my cabin-boy host and, for the purposes of anthropological study, was living with a less sophisticated family at the eastern edge of the Mackenzie delta. Our dwelling was a house of wood and earth, heated and lighted with Eskimo-style lamps. They burned seal or whale oil, mostly white whale from a hunt of the previous spring when the fat had been stored in bags and preserved, although the lean meat had been eaten. Our winter cooking however, was not done over the lamps but on a sheet-iron stove which had been obtained from whalers. There were twenty-three of us living in one room, and there were sometimes as many as ten visitors. The floor was then so completely covered with sleepers that the stove had to be suspended from the ceiling. The temperature at night was round 60*F. The ventilation was excellent through cold air coming up slowly from below by way of a trap door that was never closed and the heated air going out by a ventilator in the roof.

Everyone slept completely naked - no pajama or night shirts. We used cotton or woolen blankets which had been obtained from the whalers and from the Hudson's Bay Company.

In the morning, about seven o'clock, winter-caught fish, frozen so hard that they would break like glass, were brought in to lie on the floor till they began to soften a little. One of the women would pinch them every now and then until, when she found her finger indented them slightly, she would begin preparations for breakfast. First she cut off the head and put them aside to be boiled for the children in the afternoon (Eskimos are fond of children, and heads are considered the best part of the fish). Next best are the tails, which are cut off and saved for the children also. The woman would then slit the skin along the back and also along the belly and getting hold with her teeth, would strip the fish somewhat as we peel a banana, only sideways where we peel bananas, endways.

Thus prepared, the fish were put on dishes and passed around. Each of us took one and gnawed it about as an American does corn on the cob. An American leaves the cob; similarly we ate the flesh from the outside of the fish, not touching the entrails. When we had eaten as much as we chose, we put the rest on a tray for dog feed.

After breakfast all the men and about half the women would go fishing, the rest of the women staying at home to keep house. About eleven o'clock we came back for a second meal of frozen fish just like the breakfast. At about four in the afternoon the working day was over and we came home to a meal of hot boiled fish.

Also we came home to a dwelling so heated by the cooking that the temperature would range from 85* to 100*F. or perhaps even higher - more like our idea of a Turkish bath than a warm room. Streams of perspiration would run down our bodies, and the children were kept busy going back and forth with dippers of cold water of which we naturally drank great quantities.

Just before going to sleep we would have a cold snack of fish that had been left over from dinner. Then we slept seven or eight hours and the routine of the day began once more.

After some three months as a guest of the Eskimos I had acquired most of their food tastes. I had to agree that fish is better boiled than cooked any other way, and that the heads (which we occasionally shared with the children) were the best part of the fish. I no longer desired variety in the cooking, such as occasional baking - I preferred it always boils if it was cooked. I had become as fond of raw fish as if I had been a Japanese. I like fermented (therefore slightly acid) whale oil with my fish as well as ever I liked mixed vinegar and olive oil with a salad. But I still had two reservations against Eskimo practice; I did not eat rotten fish and I longed for salt with my meals.

There were several grades of decayed fish. The August catch had been protected by longs from animals but not from heat and was outright rotten. The September catch was mildly decayed. The October and later catches had been frozen immediately and were fresh. There was less of the August fish than of any other and, for that reason among the rest, it was a delicacy - eaten sometimes as a snack between meals, sometimes as a kind of dessert and always frozen, raw.

In midwinter it occurred to me to philosophize that in our own and foreign lands taste for a mild cheese is somewhat plebeian; it is at least a semi-truth that connoisseurs like their cheeses progressively stronger. The grading applies to meats, as in England where it is common among nobility and gentry to like game and pheasant so high that the average Midwestern American or even Englishman of a lower class, would call them rotten.

I knew of course that, while it is good form to eat decayed milk products and decayed game, it is very bad form to eat decayed fish. I knew also that the view of our populace that there are likely to be "ptomaines" in decaying fish and in the plebeian meats; but it struck me as an improbable extension of the class-consciousness that ptomaines would avoid the gentleman's food and attack that of a commoner.

These thoughts led to a summarizing query; If it is almost a mark of social distinction to be able to eat strong cheeses with a straight face and smelly birds with relish, why is it necessarily a low taste to be fond of decaying fish? On that basis of philosophy, though with several qualms, I tried the rotten fish one day, and if memory servers, like it better than my first taste of Camembert. During the next weeks I became fond of rotten fish.

About the fourth month of my first Eskimo winter I was looking forward to every meal (rotten or fresh), enjoying them, and feeling comfortable when they were over. Still I kept thinking the boiled fish would taste better if only I had salt. From the beginning of my Eskimo residence I had suffered from this lack. On one of the first few days, with the resourcefulness of a Boy Scout, I had decided to make myself some salt, and had boiled sea water till there was left only a scum of brown powder. If I had remembered as vividly my freshman chemistry as I did the books about shipwrecked adventurers, I should have know in advance that the sea contains a great many chemicals besides sodium chloride, among them iodine. The brown scum tasted bitter rather than salty. A better chemist could no doubt have refined the product. I gave it up, partly through the persuasion of my host, the English speaking Roxy.

The Mackenzie Eskimos, Roxy told me, believe that what is good for grown people is good for children and enjoyed by them as soon as they get used to it. Accordingly they teach the use of tobacco when a child is very young. It then grows to maturity with the idea that you can't get along without tobacco. But, said Roxy, the whalers have told that many whites get along without it, and he had himself seen white men who never use it, while the few white women, wives of captains, none used tobacco. (This, remember, was in 1906.)

Now Roxy had heard that white people believe that salt is good for, and even necessary for children, so they begin early to add salt to the child's food. That child then would grow up with the same attitude toward salt as an Eskimo has toward tobacco. However, said Roxy, since we Eskimos were mistaken in thinking tobacco so necessary, may it be that the white men are mistaken about salt? Pursuing the argument, he concluded that the reason why all Eskimos dislike salted food and all white men like it was not racial but due to custom. You could then, break the salt habit as easily as the tobacco habit and you would suffer no ill result beyond the mental discomfort of the first few days or weeks.

Roxy did not know, but I did as an anthropologist, that in pre-Columbian times salt was unknown or the taste of it disliked and the use of it avoided through much of North and South America. It may possibly be true that the carnivorous Eskimos in whose language the word salty, mamaitok, is synonymous with with evil-tasting, disliked salt more intensely than those Indians who were partly herbivorous. Nevertheless, it is clear that the salt habit spread more slowly through the New World from the Europeans than the tobacco habit through Europe from the Indians. Even today there are considerable areas, for instance in the Amazon basin, where the natives still abhor salt. Not believing that the races differ in their basic natures, I felt inclined to agree with Roxy that the practice of slating food is with us a social inheritance and the belief in its merits a part of our folklore.

Through this philosophizing I was somewhat reconciled to going without salt, but I was nevertheless, overjoyed when one day Ovayuak, my new host in the eastern delta, came indoors to say that a dog team was approaching which he believed to be that of Ilavinirk, a man who had worked with whalers and who possessed a can of salt. Sure enough, it was Ilavinirk, and he was delighted to give me the salt, a half-pound baking-powder can about half full, which he said he had been carrying around for two or three years, hoping sometime to meet someone who would like it for a present. He seemed almost as pleased to find that I wanted the salt as I was to get it. I sprinkled some on my boiled fish, enjoyed it tremendously, and wrote in my diary that it was the best meal I had had all winter. Then I put the can under my pillow, in the Eskimo way of keeping small and treasured things. But at the next meal I had almost finished eating before I remembered the salt. Apparently then my longing for it had been what you might call imaginary. I finished without salt, tried it at one or two meals during the next few days and thereafter left it untouched. When we moved camp the salt remained behind.

After the return of the sun I made a journey of several hundred miles to the ship Narwhal which, contrary to our expectations of the late summer, had really come in and wintered at Herschel Island. The captain was George P. Leavitt, of Portland, Maine. For the few days of my visit I enjoyed the excellent New England cooking, but when I left Herschel Island I returned without reluctance to the Eskimo meals of fish and cold water. It seemed to me that, mentally and physically, I had never been in better health in my life.

During the first few months of my first year in the Arctic, I acquired, though I did not at the time fully realize it, the munitions of fact and experience which have within my own mind defeated those views of dietetics reviewed at the beginning of this article. I could be healthy on a diet of fish and water. The longer I followed it the better I liked it, which meant, at least inferentially and provisionally, that you never become tired of your food if you have only one thing to eat. I did not get scurvy on the fish diet nor learn that any of my fish-eating friends ever had it. Nor was the freedom from scurvy due to the fish being eaten raw - we proved that later. (What it was due to we shall deal with in the second article of this series.) There were certainly no signs of hardening of the arteries and high blood pressure, of breakdown of the kidneys or of rheumatism.

These months on fish were the beginning of several years during which I lived on an exclusive meat diet. For I count in fish when I speak of living on meat, using "meat" and "meat diet" more as a professor of anthropology than as the editor of a housekeeping magazine. The term in this article and in like scientific discussions refers to a diet from which all things of the vegetable kingdom are absent.

To the best of my estimate then, I have lived in the Arctic for more than five years exclusively on meat and water. (This was not, of course, one five-year stretch, but an aggregate of that much time during ten years.) One member of my expeditions, Storker Storkersen, lived on an exclusive meat diet for about the same length of time while there are several who have lived on it from one to three years. These have been of many nationalities and of three races - ordinary European whites; natives of the Cape Verde Islands, who had a large percentage of Negro blood; and natives of the South Sea Islands. Neither from experience with my own men nor from what I have heard of similar cases do I find any racial difference. There are marked individual differences.

The typical method of breaking a party into a meat diet is that three of five of us leave in midwinter a base camp which has nearly or quite the best type of European mixed diet that money and forethought can provide. The novices have been told that it is possible to live on meat alone. We warn them that it is hard to get used to for the first few weeks, but assure them that eventually they will grow to like it and that any difficulties in changing diets will be due to their imagination.

These assertions the men will believe to a varying degree. I have a feeling that in the course of breaking in something like twenty individuals; two or three young men believed me completely, and that this belief collaborated strongly with their youth and adaptability in making them take readily to the meat.

Usually I think, the men believe that what I tell of myself is true for me personally, but that I am peculiar, a freak - that a normal person will not react similarly, and that they are going to be normal and have an awful time. Their past experience seems to tell them that if you eat one thing every day you are bound to tire of it. In the back of their minds there is also what they have read and heard about the necessity for a varied diet. They have specific fears of developing the ailments which they have heard of as caused by meat or prevented by vegetables.

We secure our food in the Arctic by hunting and in midwinter there is not enough good hunting light. Accordingly we carry with us from the base camp provisions for several weeks, enough to take us into the long days. During this time, as we travel away from shore, we occasionally kill a seal or a polar bear and eat their meat along with our groceries. Our men like these as an element of a mixed diet as well as you do beef or mutton.

We are not on rations. We eat all we want, and we feed the dogs what we think is good for them. When the traveling conditions are right we usually have two big meals a day, morning and evening, but when we are storm bound or delayed by open water we eat several meals to pass the time away. At the end of four, six or eight weeks at sea, we have used up all our food. We do not try to save a few delicacies to eat with the seal and bear, for experience has proved that such things are only tantalizing.

Suddenly, then we are on nothing but seal. For while our food at sea averages ten percent polar bear there may be months in which we don't see a bear. The men go at the seal loyally; they are volunteers and whatever the suffering, they have bargained for it and intend to grin and bear it. For a day or two they eat square meals. Then the appetite begins to flag and they discover as they had more than half expected, that for them personally it is going to be a hard pull or a failure. Some own up that they can't eat, while others pretend to have good appetites, enlisting the surreptitious help of a dog to dispose of their share. In extreme cases, which are usually those of the middle-aged and conservative they go two or three days practically or entirely without eating. We had no weighing apparatus; but I take it that some have lost anything from ten to twenty pounds, what with the hard work on empty stomachs. They become gloomy and grouchy and, as I once wrote, "They begin to say to each other, and sometimes to me, things about their judgment in joining a polar expedition that I cannot quote."

But after a few days even the conservatives begin to nibble at the seal meat, after a few more they are eating a good deal of it, rather under protest and at the end of three or four weeks they are eating square meals, though still talking about their willingness to give a soul or right arm for this or that. Amusingly, or perhaps instructively, they often long for ham and eggs or corned beef when, according to theory, they ought to be longing for vegetables and fruits. Some of them do hanker particularly for things like sauerkraut or orange juice; but more usually it is for hot cakes and syrup or bread and butter.

There are two ways in which to look at an abrupt change of diet - how difficult it is to get used to what you have to eat and how hard it is to be deprived of things you are used to and like. From the second angle, I take it to be physiologically significant that we have found our people, when deprived, to long equally for things which have been considered necessities of health, such as salt; for things where a drug addiction is considered to be involved, such as tobacco; and for items of that class of so-called staple foods, such as bread.

It has happened on several trips, and with an aggregate of perhaps twenty men, that they have had to break at one time their salt, tobacco, and bread habits. I have frequently tried the experiment of asking which they would prefer; salt for their meal, bread with it, or tobacco for an after-dinner smoke. In nearly every case the men have stopped to consider, nor do I recall that they were ever unanimous.

When we are returning to the ship after several months on meat and water, I usually say that the steward will have orders to cook separately for each member of the party all he wants of whatever he wants. Especially during the last two or three days, there is a great deal of talk among the novices in the part about what the choices are to be. One man wants a big dish of mashed potatoes and gravy; another a gallon of coffee and bread and butter; a third perhaps wants a stack of hot cakes with syrup and butter.

On reaching the ship each does get all he wants of what he wants. The food tastes good, although not quite so superlative as they had imagined. They have said they are going to eat a lot and they do. Then they get indigestion, headache, feel miserable, and within a week, in nine cases out of ten of those who have been on meat six months or over, they are willing to go back to meat again. If a man does not want to take part in a second sledge journey it is usually for a reason other than the dislike of meat.

Still, as just implied, the verdict depends on how long you have been on the diet. If at the end of the first ten days our men could have been miraculously rescued from the seal and brought back to their varied foods, most of them would have sworn forever after that they were about to die when rescued, and they would have vowed never to taste seal again - vows which would have been easy to keep for no doubt in such cases the thought of seal, even years later, would have been accompanied by a feeling of revulsion. If a man has been on meat exclusively for only three or four months he may or may not be reluctant to go back to it again. But if the period has been six months or over, I remember no one who was unwilling to go back to meat. Moreover, those who have gone without vegetables for an aggregate of several years usually thereafter eat a larger percentage of meat than your average citizen, if they can afford it.

ONE SMART COOKIE

Now that the experiments in diet which K****n Anderson and I undertook at Bellevue Hospital have been accepted by the medical world, it is difficult to realize that there could have been such a storm of excitement about the announcement of the plan, such a violent clash of opinions, such near unanimity to the prediction of dire results.

The feeling that decisive controlled test were needed began to spread after I told one of the scientific heads of the Food Administration in 1918 that I had lived for an aggregate of more than five years with enjoyment on just meat and water. A turning point came in 1920 when I had an hour for explaining a meat regimen to the physicians and staff at the Mayo Clinic. The concluding phase began in 1928 when Mr. Anderson and myself entered Bellevue Hospital to give science the first chance in its history to observe human subjects while they lived through the chill of winter and the heat of summer, for twelve months, on an exclusive meat diet. We were to do it under conditions of ordinary city life.

At the beginning of our northern work in 1906 it was the accepted view among doctors and dietitians that man cannot live on meat alone. They believed specifically that a group of serious diseases were either caused directly by meat or preventable only by vegetables. Those views were still being held when the autumn of 1918, an old friend, Frederic C. Walcott (later Senator from Connecticut), decided that my experiences and the resulting opinions were revolutionary in certain fields, and introduced me to Professor Raymond Pearl of John Hopkins, who was then with the U.S. Food Administration in Washington. Pearl considered several of the things I told him upsetting to views then held; he questioned me before a stenographer, and sent the mimeographed results to a number of dietitians. Their replies varied from concurrence with him (and me) to agreement with David Hume that you are likelier to meet a thousand liars than one miracle.

Pearl was convinced that neither fibs nor miracles were involved and proposed that we write a book on dietetics. I agreed. But cares intervened and things dragged.

In 1920 I had the above-mentioned chance to speak at the Mayo Clinic, Rochester, Minnesota. One of the Mayo brothers suggested that I spend two or three weeks there to have a check-over and see whether they could not find evidences of the supposed bad effects of meat. I wanted to do this but commitments in New York prevented.

Then one day while talking with the gastro-enterologist Dr. Clarence W. Lieb, I told him of my regret that I had not been able to take advantage of the Mayo check-over. Lieb said there were good doctors in New York, too, and volunteered to gather a committee of specialists who would put me through and examination as rigid as anything I could get from the Mayos.

The committee was organized, I went through the mill, and Dr. Lieb reported the findings in the Journal of the American Medical Association for July 3, 1926, "The Effects of an Exclusive Long-Continued Meat Diet." The committee had failed to discover any trace of even one of the supposed harmful effects.

With this publication the Lieb and Pearl events merge. For when the Institute of American Meat Packers wrote asking permission to reprint a large number of copies for distribution to the medical profession and to dietitians, Lieb, Pearl and I went into a huddle. The result was a letter to the Institute saying that we refused permission to reprint, but suggesting that they might get something much better worth publishing, and with right to publish it, if they gave a fund to a research institution for a series of experiments designed to check, under conditions of average city life, the problems which had arisen out of my experiences and views. For it was contended by many that an all-meat diet might work in a cold climate though not in a warm, and under the strenuous conditions of the frontier though not in common American (sedentary) business life.

We gave the meat packers warning that, if anything, the institution chosen would lean backward to make sure that nothing in the results could even be suspected of having been influenced by the source of the money.

After much negotiating, the Institute agreed to furnish the money. The organization selected was the Russell Sage Institute of Pathology. The committee in charge was to consist of leaders in the most important sciences that appeared related to the problem, and represented seven institutions:

American Museum of Natural History: Dr. Clark Wissler.
Cornell University Medical College: Dr. Walter L. Niles.
Harvard University: Drs. Lawrence J. Henderson, Earnest A. Hooton, and Percy Howe.
Institute of American Meat Packers: Dr. C. Robert Moulton.
John Hopkins University: Drs. William G. McCallum and Raymond Pearl.
Russell Sage Institute of Pathology: Drs. Eugene F. DuBois and Graham Lusk.
University of Chicago: Dr. Edwin O. Jordan.
Unattached: Dr. Clarence W. Lieb, private practice, and Vilhjalmur Stefansson.

The Chairman of the committee was Dr. Pearl. The main research work of the experiment was headed by Dr. DuBois, who is now Physician-in-Chief of the New York Hospital and was then as he still is, Medical Director of the Russell Sage Institute of Pathology. Among his collaborators were Dr. Walter S. McClellan, Dr. Henry B. Richardson, Mr. V. R. Rupp, Mr. G. F. Soderstrom, Dr. Henry J. Spencer, Dr. Edward Tolstoi, Dr. John C. Torrey and Mr. Vincent Toscani. The clinical supervision was in charge of Dr. Lieb.

After meetings of the supervising committee, the election of a smaller executive committee and much discussion, it was decided that, while the experiment would be directed at strictly scientific problems, there might be side glances now and then toward common folk beliefs and the propaganda of certain groups. For instance, our definition of a meat diet as "a diet from which all vegetable elements are excluded" would permit us to use milk and eggs, for they are not vegetables. But some vegetarians are illogical enough to allow milk and eggs; we agreed to be correspondingly illogical and exclude them. This forestalled the possible cry that we were saved from the ill effects of a vegetable-less diet by the eggs and the milk.

The aim of the project was not, as the press claimed at the time, to "prove" something or other. We were not trying to prove or disprove anything; we merely wanted to get at the facts. Every aspect of the results would be studied, but special attention would be paid to certain common views, such as that scurvy will result from the absence of vegetable elements, that other deficiency diseases may be produced, that the effect will be bad on the circulatory system and on the kidneys, that certain harmful micro-organisms will flourish in the intestinal tract, and that there will be insufficient calcium. The broad question was, of the supervising doctors and by the testimony of the subjects themselves.

The test was originally planned on me alone, but I might be struck by lightening before conclusions were reached, or I might get run over by a truck, and that would be construed, by mixed-dieters and vegetarians, as showing impairment of mental alertness and bodily vigor through the monotony and poison of meat. It was difficult to find a colleague, for you cannot make this sort of experiment on just anybody that appears if you consider two elementary cases.

Assume the news of a stock market crash that ruins them is conveyed to a number of people after they have eaten a good meal. Digestion may stop almost at the point of the mental shock. Obviously the sickness which follows that meal is not caused by the food, as such.

Or ask some impressionable friend to lunch. Serve them veal, of good quality and well cooked. When dinner is over you inquire about the veal; they will answer with the usual compliments. Then you say that your case has been proved. Rover died and they have eaten him. If your stage setting and acting have been at all adequate, a few at least of your company will make a dive from the room. What sickens them is not the meat of a dog but the idea that they have eaten dog.

The Russell Sage experiment then could not be made upon anybody controlled by any strong dietetic belief, such as that meat is harmful, that abstinence from vegetables brings trouble, that you tire of a food if you have to eat the same thing often. But almost everyone holds these or similar beliefs. So we were practically compelled to secure subjects from members of one of my expeditions; they were the only living Europeans we knew who had used meat long enough to eliminate completely the mental hazards.

One man fortunately was available. He was Karsten Anderson, a young Dane who had been a member of my third expedition. During that time he had lived an aggregate of more than a year on strictly meat and water, suffering no ill result and, in fact being on one occasion cured by meat from scurvy which he had contracted on a mixed diet. Moreover, he knew from experience of a dozen members of the expedition that his healthful enjoyment of the diet was not peculiar to himself but common to all those who had tried it, including members of three races - ordinary whites, Cape Verde Islanders with a strain of Negro blood, and South Sea Islanders.

But there were other things which made Anderson almost incredibility suitable for our test. For several years he had been working on his own in Florida spending most of practically every day outdoors, lightly clad and enjoying the benefits (such as they are) of a sub-tropical sunlight. In that mental and physical environment he had naturally been on a diet heavy in vegetable elements, and had suffered constantly from head colds, his hair was thinning steadily; and he had developed a condition involving intestinal toxemia such as would ordinarily cause a doctor to look serious and pronounce: "You must go light on meat." or "I am afraid you'll have to cut out meat entirely."

We could find no one but Anderson whose mind would leave his body unhandicapped. So, in January 1928, the test began with the two of us. It was under the direct charge of Dr. DuBois and his staff in the dietetic ward of Bellevue Hospital, New York City.

A storm of protests from friends broke upon us when the press announced that we were entering Bellevue. These were based mainly upon the report that we were going to eat our meat raw and the belief that we were using lean meat exclusively. The first was just a false rumor; the trouble under the second head was linguistic.

Eating meat raw, our friends chorused, would make us social outcasts. It is proper to serve oysters raw, and clams, in the United States; herring raw in Norway; several kinds of fish raw in Japan; and beef raw almost anywhere in the world if only you change the name and call it rare. The fashion of giving raw meat to infants was spreading, but we were babes neither in years nor in stature and could not take advantage of that dispensation.

The answer to the raw meat scare was to explain a basic procedure of our experiments - Anderson and I were to select our food by palate (so long as it was meat). It proved that in most of our meals for a year he leaned to medium cooking and I to well done.

The linguistic trouble came from a recent change of American usage. In Elizabethan English meat was any kind of food, as in the expression "meat and drink." In modern England this has narrowed down to what is implied by the rhyme about Jack Sprat eating no fat and his wife no lean, although they both ate meat. In the United States meat, in the last few years has become a synonym for lean. The meaning can become even narrower, as when somebody, usually a woman, tells you that she is strictly forbidden by her physician to touch meat, but that she is permitted all the chicken she wants, with an occasional lamb chop. To that woman meat signifies lean beef.

In the linguistic sense, then we pacified our friends by reference to Mr. and Mrs. Sprat. Our diet would be of meat in the English sense. We were just going to live under modern conditions on the food of our more or less remote ancestors; the food, too, of certain contemporary "primitive hunters."

ONE SMART COOKIE

II

During our first three weeks in Bellevue Hospital we were fed measured quantities of what might be called a standard mixed diet; fruits, cereals, bacon and eggs, that sort of thing for breakfast; meats, vegetables including fruits for lunch and dinner. During this time various specialists examined us from practically every angle that seemed pertinent.

Most tedious, and let us hope correspondingly valuable, were the calorimeter studies. With no food since the evening before, we would go in the late morning to the calorimeter room and sit quite for an hour to get over the physiological effect of having perhaps walked up a single flight of stairs. Then as effortlessly as we could, we slid into calorimeters which were like big coffins with glass sides, and everybody waited about an hour or so until we had got over the disturbance of having slid in. The box was now closed up, and for three hours we lay there as nearly motionless as we could well be while a corps of scientists visible through the glass puttered about and studied our chemical and other physiological processes. We were not permitted to read and cautioned even against thinking about anything particularly pleasant or particularly disagreeable, for thoughts and feelings heat or cool you, speed things up or slow them down, play hob generally with "normal" processes.

(Dr. DuBois told of a calorimeter test ruined by mental disturbance. A nervous Romanian had developed an intense dislike for a fellow-patient named Kelly. During the second hour of an experiment that had been going very well, Max caught a glimpse of the hated Kelly through the window. This raised his metabolism ten percent during that whole hour.)

With the air we breathed and the rest of our intakes and excretions carefully analyzed, with our blood chemistry determined and a check on such things as the billions of living organisms which inhabit the human intestinal tract, we were ready for the meat.

During the three weeks of mixed diet and preliminary check-up, we had been free to come and go. Now we were placed under lock and key. Neither of us was permitted at any time, day or night to be out of sight of a doctor or nurse. This was in part the ordinary rigidity of a controlled scientific experiment, but it was in some part a bow to the skepticism of the mixed diet advocates and to the emotional storms which were sweeping the vegetarian realms.

Not was the skepticism and excitement all newspaper talk. One of the leading European authorities, most orthodox and belonging to no particular school, was touring the United States. He called on us during the preliminary three weeks and assured the presiding physicians most solemnly that we should be unable to go more than four or five days on meat. He had tried it out himself on experimental human subjects who usually broke down in about three days. These breakdowns, I thought, were of psychological antecedents; but our European authority instituted they were strictly psychological - quite independent of emotions.

The experiment started smoothly with Andersen, who was permitted to eat in such quantity as he liked such things as he liked, provided only that they came under our definition of meat - steaks, chops, brains fried in bacon fat, boiled short-ribs, chicken, fish, liver and bacon. In my case there was a hitch, in a way foreseen.

For I had published in 1913, on pages 140-142 of My Life with the Eskimo, an account of how some natives and I became ill when we had to go two or three weeks on lean meat, caribou so skinny that there was no appreciable fat behind the eyes or in the marrow. So when Dr. DuBois suggest that I start the meat period by eating as large quantities as I possibly could of chopped fatless muscle, I predicted trouble. But he countered by citing my own experience where illness had not come until after two or three weeks, and he now proposed lean for only two or three days. So I gave in.

The chief purpose of placing me abruptly on exclusively lean was that there would be a sharp contrast with Andersen who was going to be on a normal meat diet, consisting of such proportions of lean and fat as his own taste determined.

As said, in the Arctic we had become ill during the second or third fatless week. I now became ill on the second fatless day. The time difference between Bellevue and the Arctic was due no doubt mainly to the existence of a little fat, here and there in our northern caribou - we had eaten the tissue from behind the eyes, we had broken the bones for marrow, and in doing everything we could to get fat we had evidently secured more than we realized. At Bellevue the meat, carefully scrutinized, had been as lean as such muscle tissue can be. Then, in the Arctic we had eaten tendons and other indigestible matter, we had chewed the soft ends of bones, getting a deal of bulk that way when we were trying to secure fat. What we ate at Bellevue contained no bulk material, so that my stomach could be compelled to hold a much larger amount of lean.

The symptoms brought on at Bellevue by an incomplete meat diet (lean without fat) were exactly the same as in the Arctic, except that they came on faster - diarrhea and a feeling of general baffling discomfort.

Up north the Eskimos and I had been cured immediately when we got some fat. Dr. DuBois now cured me the same way, by giving me fat sirloin steaks, brains fried in bacon fat, and things of that sort. In two or three days I was all right, but I had lost considerable weight.

III

For the first three weeks I was watched day and night by the Institute staff. My exercise was supposed to be about that of an average business man. I went out for walks, but always under guard. If I telephoned, the attendant stood at the door of the booth; if I went into a shop, he was never more than a few feet away; and he was always vigilant. As Dr. DuBois explained, and as I well knew in advance, this was not because the supervising staff were suspicious of me but rather because they wanted to be able to say that they knew of their own knowledge my complete abstinence from all solids and liquids, except those which I received in Bellevue and which I ate and drank under the watch of attendants.

But my affairs unfortunately demanded that I travel widely through the United States and Canada. This was an added reason why Andersen had been secured for the experiment. When after three weeks, they had to put me on parole, so to speak, they retained him under lock and key for a total of something over 90 days.

Those who believed that a meat diet would lead to death had set at anything from four to fifteen days the point where Dr. Lieb, as clinical supervisor, would have to call a halt in view of danger to the subjects. Those who expected a slower breakdown had placed the appearance of the dread symptoms long before 90 days. In any case, Anderen reported back to the hospital constantly after he left it and I whenever I was in town.

After my three weeks and Andersen's thirteen, and with the constant analyses of excretions and blood when we came back to the hospital for check-ups, the doctors felt certain they would catch us if we broke diet. Moreover, long before the thirteen weeks ended they had satisfied themselves that Andersen had no longing for fruits or other vegetable materials and therefore, no motive for breach of contract.

Toward the end of the covenanted year Andersen and I returned to Bellevue for final intensive studies of some weeks on the meat diet, and then our first three weeks on a mixed diet. At this end of the experiment all went smoothly with me, but not so with Andersen.

My trouble, it will be remembered, had been that at the outset they stuffed me with lean, permitting no fat. His difficulty , or at least annoyance, began on the second day after he completed a year on the meat (January 25, 1929) when they asked him to eat all the fat he could, to the nausea limit, permitting only a tiny bit of lean, about 45 grams per day. There they kept him on the verge of nausea for a week. The second week they added his first taste of vegetables in a year, thrice-cooked cabbage netting about 35 grams of carbohydrate per day. The third week they omitted the cabbage but retained the high proportion of fat to lean.

These three weeks, Andersen says, were the only difficult part of the experiment. Looking back at it now, he thinks if it were possible to separate the nausea from the other unpleasantness there would have been a good deal left over - that he wasn't, properly speaking, well at the end of the third week. However, that is speculation if not imagination.

Returning to facts, we have the ominous one that pneumonia epidemic was sweeping New York. The hospital was crowded with patients; some of the staff got the disease, and with them Andersen. It was Type II pneumonia in his case, and the physicians were gravely worried, for this type was proving deadly in that epidemic, carrying off fifty percent of its Bellevue victims. Andersen, however, reacted quickly to treatment, ran an unusually short course, and convalesced rapidly.

IV

The broad results of the experiment were, so far as Andersen and I could tell, and so far as the supervising physicians could tell, that we were in at least as good average health during the year as we had been during the three mixed-diet weeks at the start. We thought our health had been a little better than average. We enjoyed and prospered as well on the meat in midsummer as in midwinter, and felt no more discomfort from the heat than our fellow New Yorkers did.

In view of beliefs that are strangely current it is worth emphasizing that we liked our meat as fat in July as in January. This ought not to surprise Americans (though it usually does) for they know or have heard that fat pork is a staple and relished food of the Negro in Mississippi. Our Negro literature is rich with the praise of opossum fat, nor did Negroes develop the taste for fats in our Southern States for Carl Akerly relates from tropical Africa such yarns of fat gorging as have not yet been surpassed from the Arctic. A frequent complaint of travelers in Spain is against foods that swim in oil and there are similar complaints when we visit Latin America. We find, when we stop to think that many if not most tropical people love greasy food.

Then there is the parallel belief that the largest meat consumption is in cold countries. True, the hundred-percent centers are way up north, the Eskimos, Samoyeds, Chukchis. But the heaviest meat eaters who speak English are the Australians, tropical and sub-tropical., while the nearest you come to an exclusive meat among people of European stock is in tropical Argentina where the cowboys live on beef and maté. They like their meat fat and (so an Argentinian New Yorker tells me) will threaten to quit work, or at least did twenty years ago, if you attempt to feed them in any considerable part on cereal, greens, and fruits.

It appears that, excepting as tastes are controlled by propaganda and fashion, the longing for fat, summer or winter, depends on what else you eat. If yours is a meat diet then you simply must have fat with your lean; other wise you would sicken and die. But since fats, sugars, and starches are in most practical respects dietetically equivalent, you eat more of any one of them on a mixed diet if you decrease the combined amount of the other two.

Sir Hubert Wilkins, when we were living in the Arctic together, both living exclusively on meats, told me what remains my best single instance of how fats are crowded out by commerce, fashion and expense. The expense is frequently not the least fat, which is only about twice as nourishing as sugar, costs, as I write at my neighborhood grocery 50 cents per pound (bacon) or 35 cents a pound (butter) while sugar is only 5 1/2.

Sir Hubert's father, the first white child born in South Australia, told that when he was young the herdsman, who were the majority of the population, lived practically exclusively on mutton (sometimes on beef) and tea. At all times of year they killed the fattest sheep for their own use and when in the open, which was frequently, they roasted the fattest parts against a fire with a dripping pan underneath, later dipping the meat into the drippings as they ate. But then gradually commerce developed, breads and pastries began to be used, jams and jellies were imported or manufactured, and with the advance of starches and sugars, the use of fat decreased. Now, except that the Australians eat rather more meat per year than people do in the British Isles, the proportion of fat to the rest of the diet is probably about the same in Australia as elsewhere within the Empire.

A conclusion of our experiment which the medical profession seemingly find difficult to assimilate, but which at the same time is one of our clearest results, is that a normal meat diet is not a high protein diet. We averaged about a pound and a third of lean per day and half a pound of fat (this is about like eating a two pound broiled sirloin with the fat such a steak usually has on it). That seems like eating mostly lean; but grow technical and you find, in energy units, that we were really getting three-quarters of our calories from the fat. That is what the scientists meant when they said at the end of our diet had proved to be not so very high in protein.

That meat, as some have contended is a particularly stimulating food I verified during our New York experiment to the extent that it seems to me I was more optimistic and energetic than ordinarily. I looked forward with more anticipation to the next day or the next job and was more likely to expect pleasure or success. This may have a bearing on the common report that the uncivilized Eskimos are the happiest people in the world. There have been many explanations - that a hunter's life is pleasant, and that the poor wretches just don't know how badly off they are. We now add the suggestion that the optimism may be directly caused by what they eat.

Some additional fairly precise things can be said of how we fared during the year on meat. For instance, with Dr. DuBois as a pacemaker, we used every few weeks to run around the reservoir in Central Park and thence to his house, going up the stairs two or three at a time, plumping down on cots and having scientific attendants register our breathing, pulse rate, and other crude reactions. These tests appear to show that our stamina increased with the lengthening of the meat period.

Andersen, who had had one head cold after another when working nearly stripped outdoors in his Florida orange grow, suffered only two or three attacks during the meat year in New York, and those light. He did not regain his hair but he reported that there had been a marked decrease in the shedding. As said, according to the reports of the doctors, Andersen was troubled when he came from Florida with certain toxin-producing intestinal micro-organisms in relation to which physicians at that time ordinarily prescribed elimination of meat from the diet. This condition did not make trouble for him while on the meat.

A phase of our experiment has a relation to slimming, slenderizing, reducing, the treatment of obesity. I was "about ten pounds overweight" at the beginning of the meat diet and lost all of it. This reminds me to say that Eskimos, when still on their native meats, are never corpulent - at least I have seen none. They may be well fleshed. Some especially women, are notably heavier in middle age than when young. But they are not corpulent in our sense.

When you see Eskimos in their native garments you do get the impression of fat round faces on fat round bodies, but the roundness of face is a racial peculiarity and the rest of the effect is produced by loose and puffy garments. See them striped and you do not find the abdominal protuberances and folds which are numerous at Coney Island beaches and so persuasive in arguments against nudism.

There is no racial immunity among Eskimos to corpulence. You prove that by how quickly they get fat and how fat they grow on European diets.

Only one serious fear of the experiments was realized - our diet for the year turned out low in calcium. This was not demonstrated by any tests upon Andersen or me, and certainly you could not have proved it by asking us or looking at us, for we felt better and looked healthier than our average for the years immediately previous. The calcium deficiency appeared solely through the food analysis of the chemists.

Part of our routine was to give the chemists for analysis pieces of meat as nearly as possible identical with those we ate. For instance, lamb would be split down through the middle of the spine and we had the chops from one side cooked for us, while they got the chops from the other side to analyze. When the diet was sirloin steaks, they received ones matching ours. The only way in which the diet was not identical with the food analyzed was that Andersen and I followed the Eskimo custom of eating fish bones and chewing the rib ends; from these sources we no doubt obtained a certain amount of calcium.

Toward the latter part of the test it became startlingly clear, on paper that we were not getting enough calcium for health. But we were healthy. The escape from that dilemma was assume that a calcium deficiency which did not hurt us in our one year might destroy us in ten or twenty.

You study bones when you look for a calcium deficiency. The thing to do then, was to examine the skeletons of people who had died at a reasonably high age after living from infancy upon an exclusive meat diet. Such skeletons are those of Eskimos who are known to have died before the European influences came in. The Institute of American Meat Packers were induced to make a subsidiary appropriation to the Peabody Museum of Harvard University where Dr. Earnest A. Hooton, Professor of Physical Anthropology, under took a through going study with regard to the calcium problem in the relation to the Museum's collection of the skeletons of meat eaters. Dr. Hooton reported no signs of calcium deficiency. On the contrary, there was every indication that the meat eaters had been liberally, or at least adequately, supplied. The had suffered no more in a lifetime from calcium deficiency than we had in our short year (really short, by the way for we enjoyed it).

ONE SMART COOKIE

Adventures in Diet
Part 3


By Vilhjalmur Stefansson
Harper's Monthly Magazine, January 1936.

Scurvy has been the great enemy of explorers. When Magellan sailed around the world four hundred years ago many of his crew died from it and most of the others were at times so weakened that they could barely handle the ships. When Scott's party of four went to the South Pole twenty three years ago their strength was sapped by scurvy; they were unable to maintain their travel schedule and died. Nor has scurvy been the nemesis of explorers only. Twenty years ago the British Army in the Near East was seriously handicapped, and last October an American doctor reported a hundred Ethiopian soldiers per day dying of scurvy. The disease worked havoc during the Alaska and Yukon gold rushes following 1896. Scores of miners died and hundred suffered.

Medical profession and laity equally believed for more than a hundred years that they knew exactly how to prevent and cure the disease, yet the method always failed on severe test.

The premise from which the doctors started was that vegetables, particularly fruits, prevent and cure scurvy. Since diet consists of animals and plants, the statement came to take the form that scurvy is cause by meat and cured by vegetables. Finally the doctors standardized on lime juice as the best of preventatives and cures. They name it a sure cure, a specific. Lawmakers followed the doctors. It is on the statute books of many countries that on long voyages the crews are to be supplied with lime juice and induced or compelled to take it.

Obtained from officers of the Royal Canadian Mounted Police, and from sourdoughs, I have in my diaries and notes many a case of suffering and death caused by scurvy in the Alaska and Yukon gold rushes. The miner generally began to sicken toward the end of winter. He had been living on beans and bacon, on biscuits, rice, oatmeal, sugar, dried fruits and dried vegetables. When he recognized his trouble as scurvy he made such efforts as were possible to get the things which he believed would cure him. Apparently the miners had the strongest faith in raw potatoes. These had to be brought from afar, and there are heroic tales of men who struggled through the wilderness to succor a comrade with a few pounds of them. There were similar beliefs in the virtues of onions and some other vegetables. Curiously, there was either no belief in those vegetables which were obtainable, or else there was a belief that they should be treated in a way which. we now understand, destroys their value. For instance a man might have been cured or at least helped with a salad of leaves or even bark of trees. What the miners did with the pine needles and willow drink the tea. If they had fresh meat they boiled it to shreds and drank the broth. Death frequently occurred in two to four months from recognized onset of the disease.

Ignoring the decimation of armies, and the burden of this disease in many walks of civil life through past ages, we turn to the explorers, the class most widely publicized as suffering from and dying of scurvy.

It is unusual to rank James Cook of a hundred and fifty years ago with the foremost explorers of all time. Part of his fame may be attributed to his having discovered how to prevent and cure scurvy. Medical books name him as pioneer in the field, saying that we owe to him the conquest of a dread disease. For he demonstrated that with vegetables (again particularly fruits) scurvy could be prevented on the longest voyages. By statement or inference these books assert that from this developed the knowledge according to which we extract and bottle the juice of the lime, stock ships with it, prevent and cure scurvy.

As show above intimated, however, the good physicians, with their faith in lime juice as a specific, overlooked its constant failure upon severe test.

How stoutly the faith was kept is shown by the British polar expedition of Sir George Nares. When he returned to England in 1876 after a year and a half, he reported much illness from scurvy, some deaths, and a partial failure of his program as a result. In his view fresh meat could have saved his men. But the doctors, as we shall see when we consider how they later advised Scott, soon forgot whatever impression was made by Nares. They seem to have scared themselves with the old doctrines by a series of assumptions: that the lime juice on the Nares expedition might have been deficient in acid content; that some of the victims did not takes as much of it as needed; and that perhaps it was too much to expect of even the marvelous juice to cope with all the things which tended to bring on scurvy - absence of sunlight, bad ventilation, lack of amusement and exercise, insufficient cleanliness.

Particularly because Nares medical court of inquiry had closed on a note of cleanliness and "modern sanitation," you would think the medical world might have felt a severe jolt when they read how Nansen and Johansen had wintered in the Franz Josef Islands, (now Nansen Land) in 1895-96. They had lived in a hut of stones and walrus leather. The ventilation was bad, to conserve fuel; the fire smoked, so that the air was additionally bad; there was not a ray of daylight for months; during this time they practically hibernated, seldom going outdoors at all and taking as little exercise as appears humanly possible. Yet their health was perfect all winter and they came out of their hibernation in as good physical condition as any men ever did out of any kind of Arctic wintering. Their food had been lean and the fat of walrus.

Tens, if not hundreds of thousand of scientists in medicine and the related branches must have seen this account, for Nansen's books were bestsellers in practically every language and newspapers were full of the story. Yet the effect was negligible. The doctors and dietitians still continued to pontificate on meat producing scurvy and on the contributory bad effects of what they called insufficience of ventilation, cleanliness, sunlight and exercise. They still prescribed lime juice and put their whole dependence on it and other vegetable products.

Excuses for lime juice have persisted to our day. It was for instance, demonstrated with triumph recently that the meaning of "lime" had changed during the last hundred years, explaining the claim that it worked better in the eighteenth than in the nineteenth century - then the juice was made from lemons called limes; now it is made from limes called limes.

The antiscorbutic value of lemons may be far greater than that of limes per ounce, but that does not go to the root of the matter. For proof of this consider how Nansen's experience was re-enforced and interpreted by four expeditions during two decades, two of them commanded by Robert Falcon Scott, one by Ernest Henry Shackleton, one by me.

II

Scott, in 1900, sought the most orthodox scientific counsel when outfitting his first expedition. He followed advice by carrying lime juice and by picking up quantities of fruits and vegetable things as he passed New Zealand on his way to the Antarctic. He saw to it that the diet was "wholesome," that the men took exercise, that they bathed and had plenty of fresh air. Yet scurvy broke out and the subsequently famous Shackleton was crippled by it on a journey. They were pulling their own sledges at the time so they must of had enough exercise. There was plenty of light with the sun beating on them, and there was plenty of fresh air. To believers in the catch words and slogans of their day, to believers in the virtues of lime juice, the onset of the scurvy was a baffling mystery.

That is was Shackleton's scurvy which most interfered with the success of the first Scott expedition was particularly unfortunate, if you think of the jealousies it aroused, the enmities it caused. Scurvy, as disease go, is really one of the cleanest and least obnoxious; but in English the name of it is a term of opprobrium - "a scurvy fellow," "a scurvy trick." Shackleton may have smarted as much under that word-association as he did under the charge that his weakness had been Scott's main handicap. The passion to clear his name, in every sense, drove him to the organization of an expedition, which many in Britain considered unethical - a subordinate, with indecent haste and insistence, crowding forward to eclipse his commander.

The crucial element in the first Shackleton expedition, to the students of scurvy, is the fact that Shackelton was an Elizabethan throwback in the time of Edward VII. He was a Hawkins or a Drake, a buccaneer in spirit and method. He talked louder and more than is good form in modern England. He approached near to brag and swagger. He caused frictions, aroused and fanned jealousies, and won the breathless admiration of youngsters who would have followed Dampier and Frobisher with equal enthusiasm in their piracies and in their explorations.

The organization, and the rest of the first Shackleton expedition, went with a hurrah. They were as careless as Scott had been careful; they did not have Scott's type of backing, scientific or financial. They arrived helter skelter on the shores of the Antarctic Continent, pitched camp, and discovered that they did not have enough food for the winter, nor had they taken such painstaking care as Scott to provide themselves with fruits or other antiscorbutics in New Zealand. Compared with Scott's, their routine was slipshod as to cleanliness, exercise, and several of the ordinary hygienic prescriptions.

What signifies is that Scott's men, with unlimited quantities of jams and marmalades, cereals and fruits, grains, curries, and potted meats, had been little inclined to add seals and penguins to their dietary. With Shackleton it was neither wisdom or acceptance of good advise but dire necessity which drove to such use of penguin and seal that Dr. Alister Forbes Mackay, physician from Edinburgh, who was a member of that Shackleton expedition and later physician of my ship the Karluk, told me he estimated half the food during their stay in the Antarctic was fresh meat.

In spite of the lack of care, (indeed, as we now see it, because of their lack), Shackleton had better average health than Scott. There was never a sign of scurvy; every man retained his full strength; and they accomplished that spring what most authorities still consider the greatest physical achievement ever made in the southern polar regions. With men dragging the sledge a considerable part of the way, they got to latitude 88° 23 S., practically within sight of the Pole.

Scott began his second venture as he had begun the first, by asking the medical profession of Britain for protection from scurvy and by receiving from them once more the good old advice about lime juice, fruits, and the rest. In winter quarters he again placed reliance on that advice and on constant medical supervision, on a planned and carefully varied diet, on numerous scientific tests to determine the condition of the men, on exercise, fresh air, sanitation in all its standard forms. The men lived on the foods of the United Kingdom, supplemented by the fruit and garden produce of New Zealand. Because they had so much which they were used to, they ate little of what they had never learned to like, the penguins and seals.

Once more they started their sledge travel after a winter of sanitation. The results had previously be disappointing; now they were tragic. While scurvy did not prevent them from reaching the South Pole, it began to weaken them on the return and progressed so rapidly that the growing weakness prevented them, if only by ten miles, from being able to get back to the final provision depot.

Those who have ignored the scurvy have sometimes claimed that if Scott had reached the depot he would have been able to reach the base camp eventually. This becomes more than doubtful when you realize that the progressive decrease of vigor, both mental and bodily, was not going to be helped by even the largest meals, if those meals were of food lacking antiscorbutic value.

The story of Scott and his companions, especially through the last few weeks, is among the boldest in any language; through it they became national heroes and world heroes. But in the speech of their countrymen (though not in many another European tongue), scurvy sounds unclean. It appeared necessary to Scott's surviving comrades, and to those in Britain who knew the truth, to take care that the tabooed word should not sully a glorious deed.

To suppress the association of a disease with the beauty and heroism of Scott's death may have been worth while at the time; but it can scarcely be deplored by anyone - and must be praised by scientists - that Commander Edward G. R. Evans, now Admiral, Scott's second-in-command, after a time gave out the scurvy information, including the statement that he himself had been ill.

It is irrational, at least now that emotions have calmed, to blame Scott. No one was to blame, for they all acted according to the light of their day. If anybody was to blame it was primarily those who gave medical advice to the expedition before it sailed; secondarily, it was the chief medical officer, rather than the commanding officer, of the expedition.

It seems strange, now, that a comparison of the Scott and Shackleton experiences did not fully enlighten the doctors on the true inwardness of scurvy; but of course part of the explanation is that the Scott medical information was suppressed. Therefore, it remained for my own expedition to demonstrate, so far as polar expeditions are concerned, and for the Russell Sage experiments to call to the attention of the medical profession, the most practical and only simple way of curing scurvy. For no matter how good the juice of limes (or lemons), it is difficult to carry, it deteriorates, and you may lose it, as by a shipwreck. The thing to do is to find you antiscorbutics where you are, pick them up as you go.

On my third expedition it happened as circumstantially related in a book called "The Friendly Arctic", that three men came down with scurvy though disobeying the instructions of the commander and living without his knowledge for two or three months chiefly on European foods when they were supposed to be living chiefly on meat.

It seems to take from one to three months for even a bad diet to produce recognizable scurvy, but there after developments are rapid through the next few weeks. In the case of my men it was about three weeks ( as they later thought) after they noticed the trouble and about ten days after they complained of it to me, when one of them was so weak we had to carry him on a sledge, while the other was barely able to stagger along, holding on behind. By then every joint pained, their gums were as soft as "American" cheese, their teeth so loose that they came out with almost the gentlest of pulls.

We were 60 or 80 miles from land on drifting sea ice when the trouble stared, and we hastened ashore to get a stable camp for the invalids. It would have been no fun, with sick men on your hands, if the site of your camp started disintegrating under pressure and tumbling about.

We reached an island (about 900 miles north of the Arctic Circle) the coast of which was known although the interior had never been explored. We traveled a few miles inland, established a camp, hunted caribou (there were two of us well, out of four) and began the all-meat cure. Fuel was pretty scarce, so we cooked only one meal a day; besides, I thought raw food might work better. We cooked the breakfast in a lot of water. The patients finished the boiled meat while it was hot and kept the broth to drink during the rest of the day. For their other meals they ate slightly frozen raw meat, with normal digestion and good appetite. We divided up the caribou Eskimo style, so the dogs got organs and entrails, hams, shoulders, and tenderloin, while the invalids, and we hunters got heads, briskets, ribs, pelvis and the marrow from the bones.

On this diet all pain disappeared from every joint within four days and the gloom was replaced by optimism. Inside a week both men said that they had no realization of being ill as long as they lay still in bed. In two weeks they were able to begin traveling, at first riding on the sledges and walking alternately. At the end of a month they felt as if they had never been ill. No signs of the scurvy remained except that the gums, which had receded from the teeth, only partly regained their position.

By comparing notes later with Dr. Alfred Hess, the leading New York authority on scurvy, I found that when I was getting these results with a diet from which all vegetable elements were absent, he was getting the same results in the same length of time through a diet where the main reliance was upon grated raw vegetables and fruits and upon fresh fruit juices.

There is no doubt, as the quantitative studies have shown, that the percentage of Vitamin C, the scurvy preventing factor, is higher in certain vegetable elements than in any meats. But it is equally true that the human body needs only such a tiny bit of Vitamin C that if you have some fresh meat in your diet every day, and don't over cook it, there will be enough C from that source alone to prevent scurvy. If you live exclusively on meat you get from it enough vitamins not only to prevent scurvy but as said in a previous article, to prevent all other deficiency diseases.

Closing the subject of vitamins in relation to long expeditions, we had better emphasize that there has recently been such progress in the extraction, concentration and storage of Vitamin C that it is now possible to carry with you enough to last several years and of such quality that it will not deteriorate to the point of uselessness. But why carry coals to Newcastle? if you are in the tropics, pick a fruit, or eat a green; if you are at sea, throw a line outboard and catch a fish; if you are in the Antarctic, use seals and penguins; if in the Arctic, hunt polar bears, and seals, caribou and the rest of the numerous game. True enough, if you make a journey inland into the Antarctic Continent or toward the center of Greenland, where there is no game because the land is permanently snow-covered, you have to carry food with you. In that case you might as well take lemon juice. It is one of the most portable sources and they know now how to make and pack it so that its qualities as well as quantities will last you.

ONE SMART COOKIE

III

A bulletin conspicuous in the subways co-operated some time ago with the New York Commissioner of Health by displaying this notice:

FOR SOUND TEETH
BALANCED DIET with
VEGETABLES : FRUIT : MILK
BRUSH TEETH
VISIT DENTIST REGULARLY

Shirley W. Wynne, M.D.
Commissioner of Health

During the same time the ether was full and the magazine pages were crowded with advertising which told you that mouth chemistry is altered by a paste, a powder, or a gargle so as to prevent decay, that a clean tooth never decays, that a special kind of toothbrush reaches all the crevices, that a particular brand of fruit, milk or bread is rich in elements for tooth health. There were toothbrush drills in the schools. Mothers throughout the land were scolding, coaxing, and bribing to get children to use the preparations, eat the foods, and follow the rules that insured perfect oral hygiene.

Meantime there appeared a statement from Dr. Adelbert Fernald, Curator of the Museum of Dental School, Harvard University, that he had been collecting mouth casts of living Americans, from the most northerly Eskimos south to the Yucatan. The best teeth and the healthiest mouths were found among people who never drank milk since they had ceased to be suckling babes and who never in their lives tasted any of the other things recommended for sound teeth by the New York Commissioner of Health. These people, Eskimos, never use tooth paste, tooth powder, tooth brushes, mouth wash, or gargle. They never take any pains to cleanse their teeth or mouths. They do not visit their dentist twice a year or even once in a lifetime. Their food is exclusively meat. Meat, be it noted, was not mentioned in the advertisement issued by Dr. Wayne.

Teeth superior on the average to those of the presidents of our largest tooth-paste companies are found in the world to-day, and have existed during past ages, among people who violate every precept of current dentifrice advertising. Not all of them have lived exclusively on meat; but so far as an extensive correspondence with authorities has yet been able to show me, a complete absence of tooth decay from entire communities has never existed in the past, and does not exist now, except among people in whose diet meat is either exclusive or heavily predominant.

Our Bellevue experiments threw a light on tooth decay, but the key to the situation lies more in the broad science of anthropology. I now give, by sample and by summary, things personally known to me from anthropological field work.

My first anthropological commission was from the Peabody Museum of Harvard University when they sent John W. Hasting and me to Iceland in 1905. We found in one place a medieval graveyard that was being cut away by the sea. Skulls were rolling about in the water at high tide, at low tide we gathered them and picked up scattered teeth here and there. As wind and water shifted the sands we found more and more teeth until there was a handful. Later we got permission to excavate the cemetery, and eventually we brought with us to Harvard a miscellaneous lot of bone which included 80 skull, and as said, a great many loose teeth.

The collection has been studied by dentists and physical anthropologists without the discovery of a single cavity in even one tooth.

The skulls in the Hastings-Stefansson collection represent persons of ordinary Icelandic blood. There were no aborigines in that island when the Irish discovered it some time before 700 A. D. When the Norsemen got there in 860 they found no people except the Irish. It is now variously estimated that in origin the Icelanders are from 10 percent to 30 percent Irish, 40 percent to 50 percent Norwegian, the remainder, perhaps 10 percent, from Scotland, England, Sweden, and Denmark.

None of the people whose blood went into the Icelandic stock are racially immune to tooth decay, nor are the modern Icelanders. Then why were the Icelanders of the Middle Ages immune?

An analysis of the various factors make it pretty clear that their food protected the teeth of the medieval Icelanders. The chief elements were fish, mutton, milk and milk products. There was a certain amount of beef and there may have been a little horse flesh, particularly in the earliest period of the graveyard. Cereals were little important and might be used for beer rather than porridge. Bread was negligible and so were all other elements from the vegetable kingdom, native or imported.

My mother, who as born on the north coast of Iceland, remembered from the middle of the nineteenth century a period when bread still was as rare as caviar is in New York to-day - she tasted bread only three or four times a year and then only small pieces when she went with her mother visiting. So far as bread existed at her own house, it was used as a treat for visiting children. The diet was still substantially that of the Middle Ages, though the use of porridge was increasing. She did not remember hearing of toothache in her early youth but did remember accounts of it as a painful rarity about the time when she left for America in 1876. Soon after arrival in the United States (Wisconsin, Minnesota, Dakota,) and in Canada (Nova Scotia, Manitoba) the Icelandic colonists became thoroughly familiar with the ravages of caries. They probably had teeth as bad as those of the average American long before 1900.

There is then at least one case of a north-European people whose immunity from caries (to judge from the Hastings-Stefansson collection and common report) approached 100 percent for a thousand years, down to approximately the time of the American Civil War. The diet was mainly from the animal kingdom. Now that it has become, both in America and Iceland approximately the same as the average for the United States or Europe, Icelandic teeth show a high percentage of decay.

I began to learn about another formerly toothacheless people when I joined the Mackenzie River Eskimos in 1906. Some of them had been eating European foods in considerable amount since 1889, and toothache and tooth decay were appearing, but only in the mouths of those who affected the new foods secured from the Yankee whalers. The Mackenzie people agreed that toothache and cavities had been unknown in the childhood of those then approaching middle age while there were many of all ages still untouched, the ones who kept mainly or wholly to the Eskimo diet. Here and in many other places, this is somewhere between 98 and 100 percent from animal sources. There are districts, like parts of Labrador and of western and southwestern Alaska, where even before the coming of Europeans there was considerable use of native vegetable elements nowhere furnished as much as 5 percent of the average yearly caloric intake of the primitive Eskimos, even in south-western Alaska.

Dr. Alex Hirdlicka, Curator of Anthropology in the National Museum, Washington, writes me that he knows of no case of tooth decay among Eskimos of the present or past who were uninfluenced by European habits. Dr. S. G. Ritchie, of Dalhousie University, wrote after studying the skeletal collection gathered by Mr. Diamond Jenness on my third expedition: " In all the teeth examined there is not the slightest trace of caries."

I brought about 100 skulls of Eskimos, who had died before Europeans came in, to the American Museum of Natural History, New York. These have been examined by many students, but no sign of tooth decay has yet been discovered.

Dr. M. A. Pleasure examined at the American Museum of Natural History 283 skulls said to be Eskimo of pre-European date. He found a small cavity in one tooth; but when the records where check it turned out that the collector, Rev. J. W. Chapman of the Episcopal Board of Missions, who now lives in New York City, had sent that skull to the Museum as one of an Athabasca Indian, not of an Eskimo.

The slate is, therefore, clean to date. Not a sign of tooth decay has yet been discovered among that one of all peoples which most completely avoids the foods, the precepts, and the practices favored for dental health by the New York Commissioner of Health, the average dentist, the toothbrush drillmasters of the schools, and the dentifrice publicists.

IV

When addressing conventions and societies of medical men, I usually state the oral hygiene case somewhat as above but in more detail. If there is rebuttal from the floor, it invariably takes the form of contending that the tooth health of primitive people is due to their chewing a lot and eating co**** food. The advantage of that argument to the dentist, whose best efforts have failed to save your teeth is obvious. It gives him an excuse. He can from the doctrine make a case that not all your care, even when support by his skill and science, can preserve teeth in a generation of soft foods, that give no exercise to the teeth and no friction to the gums.

But it is deplorably hard to square anthropology with this comfortable excuse of the dentist. Among the best teeth of a mixed-diet world are those of a few South Sea Islanders who as yet largely keep to their native diets. Similar or better tooth condition is described, for instance, from the Hawaiian Islands by the earliest visitors. But can you think of a case less fortunate for the chewing-and-co****-food advocates? The animal food of these people was chiefly fish, and fish is soft to the teeth, whether boiled or raw. Among the chief vegetable elements was poi, a kind of soup or paste. Then they used sweet potatoes.

It would be difficult to find a New Yorker or Parisian who does not chew more, and use co****r food, than the South Sea Islanders did on the native diets which gave them in at least some cases 97 percent freedom from caries, a record no block on Park Avenue can approach.

Nor do Eskimos chew much, as compared with us. So far as their meat is raw it can be chewed like a raw oyster - slips down similarly. When perfectly fresh meat is cooked, two main causes determine toughness: the age of the beast and the manner of cooking. The chief food animal of inland Eskimos is the caribou. A young caribou is as fleet as a heifer; an old one is as slow as a cow. Therefore the wolves get the clumsy old which drop behind when the band flees, and the Eskimos seldom have a chance to secure an animal that is more than three or four. Such young caribou are not tough, no matter how cooked.

I do not know a corresponding logical demonstration for seals, but I can testify from helping to eat thousands that their meat is never tough - at least not in comparison with the beefsteaks you sometimes get in New York chophouses.

Then there are Eskimos who live practically exclusively on fish. As said, you can't chew them when they are raw; there is not much chewing when they are eaten boiled. the only condition under which fish become tough, or rather hard, is when they are dried. Some Eskimos use dried fish; others do not.

There is for separated districts a wide difference in the amount of Eskimo chewing, but no one has reported that health of the teeth is better among heavy chewers. How could it be when as yet no caries has been found either among the lightest or heaviest masticators?

It is used as a second line of defense by the mastication advocates that even if Eskimos perhaps don't chew their food so very much they do chew skins a great deal. Their chewing of leather is far less than you might believe from what has been said by a particular kind of writer and pictured in certain movies. In any case, skin chewing is mainly by the women, and it is not easy to bring under the conditions of modern scientific thought the idea that the wife's chewing preserves her husband's teeth.

Once at a talk to a medical group I encountered a further argument. Is it not true that Eskimo men use the teeth a great deal in their crafts? Do they not bite wood, ivory, or metal to hold, pull out, twist, and so one? The best I could think of was to agree that Eskimos pull nails with their teeth because they have good teeth than that they have good teeth because they pull nails.

There are several reasons why the teeth of many Eskimos wear down rapidly. They usually meet edge to edge, where ours frequently overlap, and that tends to cause wear. Some Eskimos wind-dry fish or meat, sand gets in, and to an extent makes them like sandpaper. Both sexes, but especially men, use their teeth for biting on hard materials. Both sexes, but especially the women, use their teeth for softening skins. A wearing toward the pulp may, therefore, take place in early middle-life. What then happens is stated by Dr. Richie (whom we have already quoted) with relation to the Coronation Gulf Eskimos:

"Coincident with this extreme wear of the teeth the dental pulps have taken on their original function with conspicuous success. Sufficient new dentine of fine quality has been formed to obliterate the pulp chambers and in some cases even the root canals of the teeth. This new growth of tissue is found in every case where access to the pulp chambers has been threatened. There has therefore been no destruction of the pulps through infection and consequently alveolar abscesses are apparently unknown."

Total absence of caries from those who live wholly on meat is then definite. Cessation of decay when you transfer from a mixed to a meat diet happens usually, perhaps always. The rest of the picture is not so clear.

Caries has been found in the teeth of mummies in Egypt, Peru, and in our own Southwest. These ancient people were mixed-diet eaters, depending in considerable part on cereals. Their teeth were better than ours, though not so good as the Eskimos. If you want a dental law, you can approximate it by saying that the most primitive people usually have the best teeth. You can add that in some cases a highly vegetarian people while not attaining the 100 percent perfection of meat eaters, do nevertheless, have very good teeth as compared with ours.

It is contended by the Hawaiian Sugar Planters Association Health Research Project that the shift from good to execrable teeth among the mixed diet Polynesians there has been due to years of cereals. I have seen no comment of theirs upon the (I should think) great increase of sugar consumption that has been synchronic with the deterioration of Hawaiian teeth.

On the view that diet is the greatest factor in saving teeth, the anthropologists have been getting support from experiments conducted by institutions and by scattered students. Some dentists are here contributing nobly to a research, and to a campaign of education, that seems bound to deplete their income. My probing has not revealed thus far corresponding unselfishness among the dentifrice manufacturers.

A serious mouth disease, next after caries, is pyorrhea. He who runs cannot read the marks so readily on human skeletons; but it seems at least probable that the medieval Icelanders, the Eskimos, and others who have left teeth free from cavities, were also free from, or at least not severely afflicted by, pyorrhea. Similarly, the modern investigators have found Eskimos who are still living on their native foods to have an unusually good average condition of general oral health, therewith absence of pyorrhea.

One of the things we noticed in the general well-being of our New York year on meat and similar years in the Arctic was the absence of headaches. I used to have them frequently before going north and have them occasionally whenever I am on a mixed diet. The whys and wherefores are not clear and what we say on this point is more tentative than any other part of this statement.

It was noticed in the X-ray pictures during our New York meat year that we had far less gas in the intestinal tract when on meat than when on a mixed diet - practically no gas. The work of Dr. John C. Torrey showed that neither did digestion and elimination produce those offensive smells which are found in vegetarianism and on a mixed diet But whether the freedom from a certain kind of intestinal food decomposition was what led to the freedom from headache is no more than a working hypothesis.

The prevention of headache by abstaining from vegetables has been recorded in books. An outstanding case is that of Francis Parkman, the historian, who suffered with headaches all his life except, as he states, during one period when he was living with an Indian tribe chiefly or exclusively on meat. This testimony, though by an eminent man widely read, and though a fair sample of the testimony of meat eaters, commanded little attention for the physicians. It should be said in their defense, however, that Parkman himself does not proclaim the experience as a triumphant discovery. He rather puts it the other way about, that in spite of being compelled to live on meat, he was free from the headaches that plagued him the rest of his days.

Professor Raymond Pearl, nearly twenty years ago, while he was at the Maine Agricultural Experiment Station, proved that chickens know more than professors about what is good for chickens to eat. Now several experiments appear in a good way to establish that children, if given complete freedom to choose among foods undisguised by sauces and artificial flavors will select better for their own health and strength than the mother or child specialist. One of the things frequently noticed about these children is that they eat large quantities of a single item which they happen to like. Our living for years on a single item which we liked was from the point of view no more than carrying forward a childhood tendency.

ONE SMART COOKIE

V

More than twenty-five years have passed since the completion of my first twelve months on meat and more than six years since the completion in New York of my sixth full meat year. All the rest of my life I have been a heavy meat eater, and I am now fifty-six. That should be long enough to bring out the effects. Dr. Clarence W. Lieb will report in the American Journal of Gastroenterology that I still run well above my age average on those points where meat has been supposed to cause deterioration. The same is the verdict of my own feelings. Rheumatism, for instance, has yet to give me its first twinge.

The broadest conclusion to be drawn from our comfort, enjoyment, and long-range well-being on meat is that the human body is a sounder and more competent job than we give it credit for. Apparently you can eat healthy on meat without vegetables, on vegetables without meat, or on a mixed diet.

Two stories summarize one of the most interesting sides of the case, the dental. In 1903 I heard the Dean of the dental school of the University of Pennsylvania say in a lecture that he thought dentists to that year had done more harm than good, but would thereafter be doing more good than harm. In 1928 when I told this to Dr. Percy Howe, Director of the Forsyth Dental Infirmary for Children, he said he thought the good Dean had been premature by at least twenty years. As I understand Dr. Howe, much good was done in particular cases by dentists long ago, but it is only within the past ten years or so that the average for good has overbalanced the harm by any very heavy proportion.

While meat eaters seem to average well in heath, we must in our conclusion draw a caution from the most complete modern example of them the Eskimos of Coronation Gulf, when he was anthropologist on my third expedition, that the two chief causes of death were accidents and old age. This puts in a different form my saying that these survivors of the stone age were the healthiest people I have ever lived among. I would say the community, from infancy to old age, may have had on the average the health of an equal number of men about twenty, say college students.

The danger is that you may reason from this good health to a great longevity. But meat eaters do not appear to live long. So far as we can tell, the Eskimos, before the white men upset their physiological as well as their economic balance, lived on the average at least ten years less than we. Now their lives average still shorter; but that is partly from communicated diseases.

It has been said in a previous article that I found the exclusive meat diet in New York to be stimulating - I felt energetic and optimistic both winter and summer. Perhaps it may be considered that meat is, overall, a stimulating diet, in the sense that metabolic processes are speeded up. You are then living at a faster rate, which means you would grow up rapidly and get old soon. This is perhaps confirmed by that early maturing of Eskimo women which I have heretofore supposed to be mainly due to their almost complete protection from chill - they live in warm dwellings and dress warmly so that the body is seldom under stress to maintain by physiological processes a temperature balance. It may be that meat as a speeder-up of metabolism explains in part both that Eskimo women are sometimes grandmothers before the age of twenty-three, and that they usually seem as old at sixty as our women do at eighty.

So you could live on meat if you wanted to; but there is no driving reason why you should. Moreover vegetables are fundamentally economical. You can get several times more food value from an acre of corn than from the pigs that ate the corn.

The thing to do then, probably, is to go on as you have been doing, but adding to your mental equipment, if it be a novelty, the idea that several at least of the disadvantages of a meat diet are compensated for by advantages

ONE SMART COOKIE

Comments About Stefansson's Conclusions

Some people who disagree with a low-carbohydrate lifestyle are quick to grasp at some of Stefansson's conclusions as evidence the Eskimos' all fish diet was unhealthy. The Eskimos probably did not have an optimal diet, but their diet cannot be blamed for all of Stefansson's concluding remarks. The Eskimos proved that our current Recommended Daily Allowance (RDA) for vitamins and minerals must be wrong. Their diet would appear to be low in vitamin C and vitamin K, but they did not develop scurvy or develop illnesses as the result of a vitamin K deficiency. The Eskimos proved the current nutritional theory of a "balanced diet" is nonsense. The most healthy diet has the majority of calories coming from meat and natural animal fats while avoiding carbohydrates.

Humans would quickly die on a diet of all fruit. Humans would suffer multiple nutritional deficiencies and diseases on a diet of all grains, legumes or rice. Humans live wonderfully healthy on a diet of all meat and natural animal fats which includes the organ meats.

Stefansson's opinion that people would be better off by raising grains instead of animals for food was wrong at the time and continues to be wrong today. There are no scientific facts to prove this statement. Primitive societies that switched from being primarily meat eaters to becoming primarily grain eaters suffered a sharp decline in health as proven by multiple studies.

The Eskimos may have appeared to age more quickly than white Europeans for several reasons:

They were exposed to extreme temperature ranges their entire life.
They may have been exposed to excessive smoke from fires in their huts.
They may have been effected by the reduced amount of sun light.
The life span of the Eskimos would naturally be shorter than that of other societies for several reasons which have nothing to do with nutrition:

The extreme temperature exposure is expected to cause some percentage of deaths.

The hunting and fishing practices are high risk endeavors that cause deaths by accident.
Fluctuations in food supply are known to have caused starvation among the Eskimos.
Infection was a major cause of death for which the people had little understanding.
The Eskimos had many health advantages compared to white Europeans of their day. These health benefits can be clearly credited to their all meat diet of salmon, such as:

Perfect dental health. They had no dental caries within the entire community.

Excellent skeletal health without any signs of osteoporosis.
They had no cancer of any kind.
They had no heart disease or cardiovascular disease of any kind.
They had no intestinal diseases that have been reported by Stefansson or others.
They had no Type 2 diabetes because it is caused by eating carbohydrates.
They had no obesity because obesity is caused by eating carbohydrates.
Stefansson continued to live on the Eskimo diet for many decades, in very good health, until his death at the age of 83.

Jock

Superb read and very interesting info, you really must be one smart cookie!

SA12

Can someone post a 3 line summary? :p

Nice post! lol

Biker

The atkins diet shouldn't even be called the atkins diet, it's been about for many years and long before he was even born.

That do mate?

ONE SMART COOKIE

The tragedy of science is the slaying of a beautiful hypothesis by an ugly fact. T H Huxley

Over the past couple of decades there has been a growing concern about fats and cholesterol. Dieticians, nutritionists and doctors have been telling us that fat is a killer. Governments have introduced national policies based around its reduction. Eat less cholesterol, saturated fat and salt, eat more fibre-rich foods we are all told. The evidence is incontrovertible that if we do not, we are doomed to the West's greatest killer - heart disease.

But is the evidence so clear? Despite the certainty implied by the propaganda, the debate continues in the medical journals, behind the scenes. Is diet a killer? Apart from those with a very rare disease, has cholesterol got anything to do with heart disease - or any other disease? And even if it has, will a change of diet be beneficial?

Like all debates, this one about cholesterol has two sides. The Cholesterol Myth explores the evidence on which present healthy eating' dietary recommendations are based.

Much of the evidence used in the cholesterol debate is complex. Nevertheless, with so much of only one side of the debate having been published and your having been subjected to so much that is misleading, I will try to explain the other side in as much detail as this paper allows.

THE B. M. A. AND THE GOVERNMENT RECOMMEND THAT THE BRITISH PEOPLE SHOULD DRINK EIGHTY PERCENT MORE MILK, EAT FIFTY-FIVE PERCENT MORE EGGS, FORTY PERCENT MORE BUTTER AND THIRTY PERCENT MORE MEAT.

On the basis of research in the 1920s and 1930s by Sir John Boyd Orr and others, that was the advice given to the British people in 1938. The Government introduced free school milk - full cream, that is - and later we 'went to work on an egg'. As a consequence, child deaths from diphtheria, measles, scarlet fever and whooping cough fell dramatically - well before the introduction of antibiotics and widespread immunisation. Rickets, called 'the English Disease' because it was so wide-spread, and other deficiency diseases were relegated to the past. Other factors helped, but most important of all was the better nutrition that gave children a higher resistance. The recommendations above shaped our diet for nearly fifty years and helped to give us a mean life expectancy that is now among the highest in the world. Sixty years in 1930, our mean life expectancy had climbed to seventy years by 1960 and to seventy-five years by 1990. Now we are told they are shortening our lives - killing us with coronary heart disease. Why the sudden change? To discover that, we need to know something of the history of coronary heart disease and how the strategy to combat it evolved.

Coronary heart disease
There are many diseases that affect the heart but the one that the 'healthy eating' strategies seek to prevent is Coronary Heart Disease (CHD), more correctly called ischaemic heart disease (IHD). CHD is a condition where the coronary arteries that supply blood to nourish the heart muscle are narrowed by a build-up of material on their walls (an atheroma) to such an extent that they become blocked. This cuts off the blood supply to part of the heart muscle, and we have a heart attack. The narrowing also encourages the clotting of blood and, in consequence, it is possible for a clot to cause a heart attack long before the atheroma is large enough to do so. The material generally blamed for the build-up is cholesterol and the 'healthy eating' advice given to the public to reduce the incidence of CHD is aimed simply at reducing the levels of cholesterol in the blood.

Cholesterol
Because of the propaganda, you can be forgiven for thinking that cholesterol is a harmful alien substance that should be avoided at all costs. In fact, nothing could be further from the truth. Cholesterol is an essential component in the body. It is found in all the cells of the body, particularly in the brain and nerve cells. Body cells are continually dying and new ones being made. Cholesterol is a major building block from which cell walls are made. Cholesterol is also used to make a number of other important substances: hormones (including the sex hormones), bile acids and, in conjunction with sunlight on the skin, vitamin D <SUB>3 </SUB>. The body uses large quantities of cholesterol every day and the substance is so important that, with the exception of brain cells, every body cell has the ability to make it.

Cholesterol may be ingested in animal products, but less than twenty percent of your body's cholesterol needs will be supplied in this way. Your body then makes up the difference. If you eat less cholesterol, your body merely compensates by making more. Although the media and food companies still warn against cholesterol in diet, it has been repeatedly demonstrated that the level of cholesterol in your blood is affected very little by the amount of cholesterol you eat.

Cholesterol and CHD
For reasons still unknown, coronary heart disease suddenly took off during the 1920s throughout the industrialised world. By the 1940s it was becoming the major cause of premature death. And nobody knew why.

In 1950 an American doctor, John Gofman, hypothesised that blood cholesterol was to blame. This was supported in 1951 when pathologists were sent to Korea to learn about war wounds by dissecting the bodies of dead soldiers. To their surprise they discovered unexpected evidence of coronary heart disease: unexpected for they knew that death from heart disease was extremely rare under middle age and these men averaged only twenty-two years of age. So the pathologists performed detailed dissections on the hearts of the next 300 corpses. In thirty-five percent they found deposits of fibrous, fatty material sticking to the artery walls. A further forty-one percent had fully formed lesions, and in three percent of the soldiers these lesions were sufficiently large that they blocked at least one coronary artery. Thus, over three-quarters of all the men examined showed evidence of serious coronary heart disease - and they were barely out of their teens.

Doctors now had a problem. As there are no symptoms with the partial blockage of the coronary arteries, how could they tell, without resorting to surgery, who was in danger? They had to find what was different in those with the disease and those free of it.

To cut a long story short, they found cholesterol in the material that builds up on artery walls and causes them to become blocked; people who died of heart disease often had high levels of cholesterol in their blood; and those who suffered the rare hereditary disease, familial hypercholesterolaemia (hereditary high blood cholesterol), also suffered a higher incidence of CHD. And so, not unnaturally perhaps, cholesterol and heart disease became linked.

But there are a number of significant points that the cholesterol theory overlooks. For example, there is a marked difference between the build-up found in those with familial hypercholesterolaemia and those with coronary heart disease: hypercholesterolaemia causes large deposits at the mouths of the coronary arteries, often leaving the arteries themselves unblocked, and so does not reproduce the type of obstruction found in coronary heart disease. People with myxoedema or nephrosis also have high blood cholesterol levels - yet in them, there is no increase in the incidence of CHD. Neither is raised blood cholesterol a predictor of CHD in people over sixty. It has also long been known that simple events, such as putting a cuff around the arm prior to taking a blood sample, or fear of the needle, can result in raised cholesterol values. And, even where these are avoided, large fluctuations are known with peak to nadir variations of as much as twenty-three percent. Lastly, cholesterol is only one of the constituents of an atheroma and, if you think about it, cholesterol is so necessary and so widespread in the body, it would have been surprising if it had not been found. Nevertheless the lowering of blood cholesterol became the sole objective in the fight against CHD; and the two principal methods used to achieve this are with diet and drugs.

ONE SMART COOKIE

Part 2: Dietary Fats and Heart Disease

For what a man would like to be true, that he more readily believes. Francis Bacon
That diet might play a part as a cause of CHD was hypothesised by another American doctor, Ancel Keys, in 1953. Using data from seven countries in his 'Seven Countries Study', Keys compared the death rates from CHD and the amounts of fats eaten in those countries to demonstrate that heart disease mortality was higher in the countries that consumed more fat than it was in those countries that consumed less. (At that time, data from many more countries were available. It seems that Keys ignored the data from those that did not support his hypothesis.) And so the 'diet/heart' hypothesis was born.

But how do we know it is true? It is all very well having a theory, what you have to do then is prove it. In medicine, the usual way is to select two groups of people, as identical for sex, age, and lifestyle as possible. One group called the control group , carries on as normal while the other, called the intervention group , tries the new diet, drug or whatever. After a suitable time, the two groups are compared and differences noted.

Keys' fat-diet/heart disease hypothesis was persuasive so, to test it, several large-scale, long-term, human intervention studies were set up in many parts of the world. These involved hundreds of thousands of subjects and hundreds of doctors and scientists and cost billions of dollars in an attempt to prove that a fatty diet caused heart disease.

Framingham Heart Study
The most influential and respected investigation of the causes of heart disease is the Framingham Heart Study. This study was set up in the town of Framingham, Massachusetts, by Harvard University Medical School in 1948 and is still going on today. It was this study that gave rise to the dietary 'risk factors' with which we all are so familiar today. The Framingham researchers thought that they knew exactly why some people had more cholesterol than others - they ate more in their diet. To prove the link, they measured cholesterol intake and compared it with blood cholesterol. As Table I shows, although subjects consumed cholesterol over a wide range, there was little or no difference in the levels of cholesterol in their blood and, thus, no relationship between the amount of cholesterol eaten and levels of blood cholesterol was found. (Although it is interesting that women who had the highest levels of cholesterol in their blood were ones who had eaten the least cholesterol.)



<TABLE cellSpacing=4 cellPadding=4 width="70%" bgColor=#c0c0c0 border=2><TBODY><TR><TD align=middle colSpan=4>Table I: Cholesterol intake - The Framingham Heart Study </TD></TR><TR><TD align=middle></TD><TD align=middle></TD><TD align=middle colSpan=2>Blood Cholesterol in Those </TD></TR><TR><TD align=middle></TD><TD align=middle>Cholesterol


Intake

</TD><TD align=middle>Below Median


Intake

</TD><TD align=middle>Above Median


Intake

</TD></TR><TR><TD></TD><TD>


</TD><TD>





</TD><TD>





</TD></TR><TR><TD>Men </TD><TD>





</TD><TD>





</TD><TD>





</TD></TR><TR><TD>Women </TD><TD>





</TD><TD>





</TD><TD>





</TD></TR></TBODY></TABLE>


Next, the scientists studied intakes of saturated fats but again they could find no relation. There was still no relation when they studied total calorie intake. They then considered the possibility that something was masking the effects of diet, but no other factor made the slightest difference.

After twenty-two years of research, the researchers concluded:

"There is, in short, no suggestion of any relation between diet and the subsequent development of CHD in the study group."

On Christmas Eve, 1997, after a further twenty-seven years, the Journal of the American Medical Association (JAMA) carried a follow-up report that showed that dietary saturated fat reduced strokes. As these tend to affect older men than CHD, they wondered if a fatty diet was causing those in the trial to die of CHD before they had a stroke. But the researchers discount this, saying:

"This hypothesis, however, depends on the presence of a strong direct association of fat intake with coronary heart disease. Since we found no such association, competing mortality from coronary heart disease is very unlikely to explain our results."

In other words, after forty-nine years of research, they are still saying that they can find no relation between a fatty diet and heart disease.


Multiple Risk Factor Intervention Trial
One of the largest and most demanding medical studies ever performed on humans, The Multiple Risk Factor Intervention Trial (known in the medical world, by its initials, as MR. FIT) involved 28 medical centres and 250 researchers and cost $115,000,000. The researchers screened 361,662 men and deliberately chose subjects who were at very high risk to ensure that they achieved a statistically significant result. They cut cholesterol consumption by forty-two percent, saturated fat consumption by twenty-eight percent and total calories by twenty-one percent. Yet even then they didn't succeed. Blood cholesterol levels did fall, but by only a modest amount and, more importantly, coronary heart disease was unaffected. Its originators refer to the results as "disappointing" and say in their conclusions:





<B>

"The overall results do not show a beneficial effect on Coronary Heart Disease or total mortality from this multifactor intervention."

</B>The Tecumseh Study


The Tecumseh Study attempted to correlate blood cholesterol levels measured one day with the amounts of fats eaten the previous day - but found none. Interestingly, Table II demonstrates that the people who ate the least cholesterol had the highest levels of blood cholesterol. Although not looking for it, this study also found that blood cholesterol levels were quite independent of whether the dietary fats were saturated or unsaturated. Thus another 'diet-heart' hypothesis, that only saturated fats are to blame, was invalidated.



<TABLE cellSpacing=4 cellPadding=4 width="70%" bgColor=#c0c0c0 border=2><TBODY><TR><TD align=middle colSpan=4>Table II : Fat intake and blood lipids - The Tecumseh Study </TD></TR><TR><!-- Row 2 Column 1 --><TD></TD><!-- Row 2 Column 2 --><TD align=middle colSpan=3>Blood Cholesterol in Thirds </TD></TR><TR><!-- Row 3 Column 1 --><TD>Daily Intake: </TD><!-- Row 3 Column 2 --><TD>


</TD><!-- Row 3 Column 3 --><TD>





</TD><!-- Row 3 Column 4 --><TD>





</TD></TR><TR><!-- Row 4 Column 1 --><TD>Fat - total (g) </TD><!-- Row 4 Column 2 --><TD>





</TD><!-- Row 4 Column 3 --><TD>





</TD><!-- Row 4 Column 4 --><TD>





</TD></TR><TR><!-- Row 5 Column 1 --><TD>Fat Saturated (g) </TD><!-- Row 5 Column 2 --><TD>





</TD><!-- Row 5 Column 3 --><TD>





</TD><!-- Row 5 Column 4 --><TD>





</TD></TR><TR><!-- Row 6 Column 1 --><TD>Polyunsat/Sat ratio </TD><!-- Row 6 Column 2 --><TD>





</TD><!-- Row 6 Column 3 --><TD>





</TD><!-- Row 6 Column 4 --><TD>





</TD></TR><TR><!-- Row 7 Column 1 --><TD>Cholesterol (mg) </TD><!-- Row 7 Column 2 --><TD>





</TD><!-- Row 7 Column 3 --><TD>





</TD><!-- Row 7 Column 4 --><TD>





</TD></TR></TBODY></TABLE>


WHO European Coronary Prevention Study
The results of the World Health Organisation's European Coronary Prevention Study were called "depressing" because once again no correlation between fats and heart disease was found. They had cut saturated fats down to only eight percent of calorie intake daily, yet in the UK section there were more deaths in the intervention group than in the control group.

The North Karelia Project
North Karelia, which had Finland's highest rates of heart disease, was compared with neighbouring Kuopio in The North Karelia Project. In North Karelia, risk factors were cut by seventeen percent over the period of the study. As Table III shows, in North Karelia there was a reduction in both CHD mortality and total mortality. Table III also shows, however, that in Kuopio, the control group, where there were no restrictions, there was an even bigger decline in both CHD and total mortality.



<TABLE cellSpacing=4 cellPadding=4 width="70%" bgColor=#c0c0c0 border=2><TBODY><TR><TD align=middle colSpan=5>Table III: Age Adjusted Rates/1,000. Age Group 30-64 years - The North Karelia Project. </TD></TR><TR><TD align=middle colSpan=2></TD><!-- Row 2 Column 3 --><TD>

1970/1

</TD><!-- Row 2 Column 4 --><TD>

1976/7

</TD><!-- Row 2 Column 5 --><TD>


</TD></TR><TR><!-- Row 3 Column 1 --><TD colSpan=5>Total Mortality </TD></TR><TR><!-- Row 4 Column 1 --><TD>Men </TD><!-- Row 4 Column 2 --><TD>N Karelia </TD><!-- Row 4 Column 3 --><TD>





</TD><!-- Row 4 Column 4 --><TD>





</TD><!-- Row 4 Column 5 --><TD>





</TD></TR><TR><!-- Row 5 Column 1 --><TD></TD><!-- Row 5 Column 2 --><TD>Kuopio </TD><!-- Row 5 Column 3 --><TD>





</TD><!-- Row 5 Column 4 --><TD>





</TD><!-- Row 5 Column 5 --><TD>





</TD></TR><TR><!-- Row 6 Column 1 --><TD>Women </TD><!-- Row 6 Column 2 --><TD>N Karelia </TD><!-- Row 6 Column 3 --><TD>





</TD><!-- Row 6 Column 4 --><TD>





</TD><!-- Row 6 Column 5 --><TD>





</TD></TR><TR><!-- Row 7 Column 1 --><TD></TD><!-- Row 7 Column 2 --><TD>Kuopio </TD><!-- Row 7 Column 3 --><TD>





</TD><!-- Row 7 Column 4 --><TD>





</TD><!-- Row 7 Column 5 --><TD>





</TD></TR><TR><!-- Row 8 Column 1 --><TD colSpan=5>CHD Mortality </TD><!-- Row 8 Column 2 --></TR><TR><!-- Row 9 Column 1 --><TD>Men </TD><!-- Row 9 Column 2 --><TD>N Karelia </TD><!-- Row 9 Column 3 --><TD>





</TD><!-- Row 9 Column 4 --><TD>





</TD><!-- Row 9 Column 5 --><TD>





</TD></TR><TR><!-- Row 10 Column 1 --><TD></TD><!-- Row 10 Column 2 --><TD>Kuopio </TD><!-- Row 10 Column 3 --><TD>





</TD><!-- Row 10 Column 4 --><TD>





</TD><!-- Row 10 Column 5 --><TD>





</TD></TR><TR><!-- Row 11 Column 1 --><TD>Women </TD><!-- Row 11 Column 2 --><TD>N Karelia </TD><!-- Row 11 Column 3 --><TD>





</TD><!-- Row 11 Column 4 --><TD>





</TD><!-- Row 11 Column 5 --><TD>





</TD></TR><TR><!-- Row 12 Column 1 --><TD></TD><!-- Row 12 Column 2 --><TD>Kuopio </TD><!-- Row 12 Column 3 --><TD>





</TD><!-- Row 12 Column 4 --><TD>





</TD><!-- Row 12 Column 5 --><TD>





</TD></TR></TBODY></TABLE>


These figures suggest that adopting a 'healthy' lifestyle may actually have inhibited the decline in heart disease. They certainly give it no support.

This paper does not allow me to go through the more minor studies but they all show little convincing correlation between either the amount of fat eaten and heart disease or the type of fat eaten and heart disease. A review of twenty-six studies published in 1992 concluded that:


"Lowering serum cholesterol concentrations does not reduce mortality and is unlikely to prevent coronary heart disease. Claims of the opposite are based on preferential citation of supportive trials."
One that seemed to support the 'healthy' recommendations was a Finnish trial published in 1975. In the five years that the trial ran, cholesterol levels were lowered significantly, and the study was hailed as a success. But in December 1991 the results of a 10-year follow-up to that trial found that those people who continued to follow the carefully controlled, cholesterol-lowering diet were twice as likely to die of heart disease as those who didn't - some success! Professor Michael Oliver, writing in the British Medical Journal commenting on the results, writes


"As multiple intervention against risk factors for coronary heart disease in middle aged men at only moderate risk seem to have failed to reduce both morbidity and mortality such interventions become increasingly difficult to justify. This runs counter to the recommendations of many national and international advisory bodies which must now take the recent findings from Finland into consideration. Not to do so may be ethically unacceptable."



I find difficulty understanding how the fat hypothesis gained such credibility in the USA as its history more than most does not support it. The North American continent had been opened up by explorers and trappers who lived, very healthily, as did the Amerindians, almost entirely on fresh meat and pemmican. As real pemmican is half dried lean meat and half rendered animal fat, and as fat has over twice the calorific value of protein, more than seventy percent of the energy in their diet came from fat.

Dieticians also say that the British had less CHD in the 1940s when fat was rationed. However, the decade of rationing went on into the early 1950s with fat being the last food to come off ration in 1954. Again the graph shows clearly that the most rapid rise in CHD occurred during that period.

Also, during the period of rationing, British farmers had a very low incidence of heart disease when one would have expected their intake of fats, particularly animal fats, to have been higher than most.

Experience in other countries
Keys based his fat-causes-heart disease hypothesis on a comparison between countries. When we are told that we are 'the sick man of Europe', we are also compared to other countries. So let me do a similar comparison.

1. In Japan, intakes of animal fat have more than doubled since the end of the Second World War. Over the same period their incidence of coronary heart disease has fallen consistently. In Israel too an increased consumption of saturated fats was followed by a fall in coronary deaths.
2. The dietary changes in Sweden parallel those in the USA, yet heart disease mortality in Sweden was rising while American rates were falling.
3. There is also a threefold variation in rates of heart disease between France and Finland even though fat intake in those two countries is very similar.
4. Among south Asians in Britain there is an unusually high incidence of heart disease, yet living on largely vegetarian diets, they have low levels of blood cholesterol and eat diets that are low in saturated fat.
5. Indians in South Africa have probably the highest rates of coronary disease in the world yet there is no apparent reason why they should based on the current dietary hypotheses.
6. Until recently, Indians in India had a very low incidence of heart disease while using ghee (clarified butter), coconut oil and mustard seed oil - all of which are highly saturated. The epidemic of heart disease in India began only after these were replaced with peanut, safflower, sunflower, sesame and soybean oils, all of which are high in polyunsaturated oils.
7. Lastly, the World Health Organisation is apparently in ignorance of epidemiological data that do not support its recommendation to reduce dietary saturated fat. While it talks of coronary heart disease being responsible for most deaths in Caribbean countries, fat intake there is remarkably low.

Polyunsaturated fats
The arguments for the polyunsaturated fat hypothesis are no more convincing than those for the cholesterol theory. The claim is that unsaturated fats have a protective or preventative effect on CHD. But in Israel, when consumption of polyunsaturated fats was about twice that of most Western countries, there was a very high incidence of CHD. Those given high polyunsaturated diets in a trial in New South Wales fared significantly worse than those on a free diet. And this is the finding in most trials that have increased the ratio of polyunsaturated fats.

From as early as 1971, an excess of cancer deaths has been reported in trials using diets that were high in polyunsaturated fats. Polyunsaturated fats are also blamed for a doubling in the incidence of gallstones in the general public.

One of the pioneers of the polyunsaturated-fat-prevents-CHD hypothesis was the American cardiologist E. H. Ahrens Jr.. After twenty-five years of further research, however, he concluded that it was "irresponsible" to continue to press the polyunsaturated fat recommendations on the general public. He went on:


"If the public's diet is going to be decided by popularity polls and with diminishing regard for the scientific evidence, I fear that future generations will be left in ignorance of the real merits, as well as the possible faults in any dietary regimen aimed at prevention of coronary heart disease."
Another of the original proponents of the low-fat, low-cholesterol hypothesis, and a member of the Norwegian Council for Diseases of the Heart and Arteries, Professor Jens Dedichen of Oslo, also changed his mind. In the 1950s Norway launched a cholesterol-lowering regimen in which soy margarine, that is high in polyunsaturated fatty acids, replaced butter, and soy oil was used extensively. During the subsequent 20 years the increase in the use of soy-based products was accompanied by a steep and continuing rise in deaths from coronary thrombosis. Professor Dedichen drew attention to the failure of the programme - and received a very hostile reaction from his colleagues.

Also castigated were members of the National Academy of Sciences and the National Research Council of America when in a report of May 1980, they stated that prevention of heart disease could not be achieved by reducing blood cholesterol using either diet or drugs, and said that such measures should be abandoned.

Margarine - a natural food?
The polyunsaturated fats used to make margarine are generally obtained from vegetable sources such as sunflower seed, cottonseed, and soybean. As such they might be thought of as natural foods. Usually, however, they are pressed on the public in the form of highly processed margarines, spreads and oils and, as such, they are anything but natural.

In 1989, the petroleum-based solvent, benzene, that is known to cause cancer, was found in Perrier mineral water at a mean concentration of fourteen parts per billion. This was enough to cause Perrier to be removed from supermarket shelves. The first process in the manufacture of margarine is the extraction of the oils from the seeds, and this is usually done using similar petroleum-based solvents. Although these are then boiled off, this stage of the process still leaves about ten parts per million of the solvents in the product. That is 700 times as much as fourteen parts per billion.

The oils then go through more than ten other processes: degumming, bleaching, hydrogenation, neutralization, fractionation, deodorisation, emulsification, interesterification, . . . that include heat treatment at 140 <SUP>o </SUP>-160 <SUP>o </SUP>with a solution of caustic soda; the use of nickel, a metal that is known to cause cancer, as a catalyst, with up to fifty parts per million of the nickel left in the product; the addition of antioxidants such as butylated hydroxyanisol (E320). These antioxidants are again usually petroleum based and are widely believed to cause cancer.

The hydrogenation process, that solidifies the oils so that they are spreadable, produces trans -fatty acids that rarely occur in nature.

The heat treatment alone is enough to render these margarines nutritionally inadequate. When the massive chemical treatment and unnatural fats are added, the end product can hardly be called either natural or healthy.




Recent United States studies showed that heart disease worsened in those who switched from butter to polyunsaturate-rich margarine. Research published in March 1993, confirmed this. In a study that involved 85,000 nurses, women who ate just four teaspoons of polyunsaturated margarine a day had a sixty-six percent increased risk of CHD compared to those who ate none. A review of men's experience in the Framingham Study published in 1995 also found that 6 teaspoons a day (mean of lowest intake vs mean of highest), increased risk by nearly a third. The authors conclude:

"Intake of margarine may predispose to development of CHD in men".

You may be interested in a list of the ingredients that may be present in butter and margarine:

Dietary fat patterns
The total amount of fats in our diet today, according to the MAFF National Food Survey, is almost the same as it was at the beginning of this century. What has changed, to some extent, is the types of fats eaten. At the turn of the century we ate mainly animal fats that are largely saturated and monounsaturated. Now we are tending to eat more polyunsaturated fats - it's what we are advised to do.

It is interesting to compare the growth of heart disease in this country with intakes of different fats. The next graph illustrates the birth of CHD in Britain together with the intake of animal fat since the beginning of the century. When compared with the CHD curve, it is clear that there is no obvious relationship


If we plot CHD together with intakes of margarines and vegetable shortenings, however, we find a different curve.

Margarine use began around the turn of the century. Butter was expensive. The poor bought margarine as a substitute for butter and sales were brisk. The rapid rise in margarine consumption was followed a couple of decades later by that dramatic rise in heart disease deaths.

If there is a causal relationship between fat intake and heart disease, these two graphs suggest to me that it is the margarines that are the more likely candidates for suspicion.

Polyunsaturated fats and Cancer
Body cell walls are made of cholesterol. The graph below demonstrates that the human body's fat make-up is largely of saturated and monounsaturated fatty acids. We contain very little polyunsaturated fat. Cell walls have to allow the various nutrients that body cells need from the blood, but stop harmful pathogens. They must be stable. An intake of large quantities of polyunsaturated fatty acids changes the constituency of cholesterol and body fat. Cell walls become softer and more unstable.

ONE SMART COOKIE

Many laboratories have shown that diets high in polyunsaturates promote tumours. It has been known since the early 1970s that it is linoleic acid that is the major culprit. As Professor Raymond Kearney of Sydney University put it in 1987:

<B>

"Vegetable oils (eg Corn oil and sunflower oil) which are rich in linoleic acid are potent promoters of tumour growth."

</B>Carcinogens - background radiation, ultraviolet radiation from the sun, particles in the air we breathe and the food we eat - continually attack us all. Normally, the immune system deals with any small focus of cancer cells so formed and that is the end of it. But linoleic acid suppresses the immune system. Indeed it is so good at this that in the 1970s sunflower oil was given to kidney transplant patients to prevent kidneys being rejected - until an excess of cancer deaths was reported. With a high intake of margarine, therefore, a tumour may grow too rapidly for the weakened immune system to cope thus increasing our risk of a cancer.

Since 1974, the increase of polyunsaturated fats has been blamed for the alarming increase in malignant melanoma (skin cancer) in Australia. We are all told that the sun causes it. Are Australians going out in the sun any more now than they were fifty years ago? They are certainly eating more polyunsaturated oils: even milk has its cream removed and replaced with vegetable oil. Victims of the disease have been found to have polyunsaturated oils in their skin cells. Polyunsaturated oils are oxidised readily by ultra-violet radiation from the sun and form harmful 'free radicals'. These are known to damage the cell's DNA and this can lead to the deregulation we call cancer. Saturated fats are stable. They do not oxidise and form free radicals.

Malignant melanoma is also said to be increasing in this country. Does the sun cause this? In Britain the number of sufferers is so small as to be relatively insignificant. Even so, it is not likely that the sun is to blame since all the significant increase is in the over-seventy-five-year-olds. People in this age group tend to get very little sun.

Melanoma occurs ten times as often in Orkney and Shetland than it does on Mediterranean islands. It also occurs more frequently on areas that are not exposed to the sun. In Scotland, for example, there are five times as many melanomas on the feet as on the hands; and in Japan, forty per cent of pedal melanomas are on the soles of the feet.

In 1991, two studies, from USA and Canada, found that linoleic acid, the major polyunsaturated fatty acid found in vegetable oils, increased the risk of breast tumours. This, it seems, was responsible for the rise in the cancers noted in previous studies. Experiments with a variety of fats showed that saturated fats did not cause tumours but, when small amounts of polyunsaturated vegetable oil or linoleic acid itself was added, this greatly increased the promotion of breast cancer.

A study of 61,471 women aged forty to seventy-six, conducted in Sweden, looked into the relation of different fats and breast cancer. The results were published in January 1998. This study found an inverse association with monounsaturated fat and a positive association with polyunsaturated fat. In other words, monounsaturated fats protected against breast cancer and polyunsaturated fats increased the risk. Saturated fats were neutral.

All polyunsaturated margarines, from the brand leader to shops' 'own brands' are around thirty-nine percent linoleic acid. Of cooking oils, sunflower oil is fifty percent and safflower oil seventy-two percent linoleic acid. Butter, on the other hand, has only a mere two percent and lard is just nine percent linoleic acid. Linoleic acid is one of the essential fatty acids. We must eat some to live, but we do not need much. The amount found in animal fats is quite sufficient.

Because of the heart disease risk, in 1994 the manufacturers of Flora changed its formula to cut out the trans fats and other manufacturers have since followed. But that still leaves the linoleic acid.

The anti-cancer fat
Linoleic acid is one of the essential fatty acids that our bodies need but cannot synthesise. We must eat some to survive. Fortunately there is one form of linoleic acid that is beneficial. Conjugated linoleic acid (CLA) differs from the normal form of linoleic acid only in the position of two of the bonds that join its atoms. But this small difference has been shown to give it powerful anti-cancer properties. Scientists at the Department of Surgical Oncology, Roswell Park Cancer Institute, New York and the Department of Biochemistry and Molecular Biology, New Jersey Medical School, showed that even at concentrations of less than one percent, CLA in the diet is protective against several cancers including breast cancer, colorectal cancer and malignant melanoma.

Conjugated linoleic acid has one other difference from the usual form - it is not found in vegetables but in the fat of ruminant animals. The best sources are dairy products and the fat on red meat, principally beef. It is another good reason not to give up eating red meat or to cut the fat off.

Scientists at the University of Wisconsin also believe that CLA has a slimming action. They put the dramatic increase in obesity in the USA down to Americans not eating beef fat.

Monounsaturated fats
Several populations in the world, Eskimos and those in the Mediterranean countries for example, eat high-fat diets yet have very low incidences of heart disease. This realisation has led to research scientists switching their attentions to monounsaturated fats found in fish oils and olive oil.

Although the supposed virtues of monounsaturated fats are being talked of in the press as possible saviours of Western man, the monounsaturated theory is not new. It was first demonstrated over thirty years ago that giving people more unsaturated fats could lower blood cholesterol. However, surveys of countries with different tastes in fats and oils have failed to show that this protects against heart disease. For example, Norwegians, who eat a lot of saturated fats, have lower rates of the disease than New Zealanders who eat a similar amount. But if, as has been suggested, the Norwegians are protected by the monounsaturated oils in the fish that they eat, then why is it that in Aberdeen, where a lot of fish is also consumed, the heart disease rate is double that of Oslo? Proponents also forget that many other people, such as the Maasai tribes of Africa, who don't eat either fish or olive oil, also have a low incidence of heart disease.

There is also no evidence that either mono- or polyunsaturated oils are of benefit to those who have already suffered a heart attack. As long ago as 1965 survival rates were studied in patients eating different oils. Splitting patients into three groups, who were given polyunsaturated corn oil, monounsaturated olive oil and saturated animal fats respectively, it was found that only the corn oil lowered blood cholesterol levels. At first sight, therefore, it seemed that men in the polyunsaturated group had the best chance of survival. However, at the end of the two-year trial only fifty-two percent of the polyunsaturated corn oil group were still alive and free of a fresh heart attack. Those on the monounsaturated olive oil fared little better: fifty-seven percent survived and had no further attack. Those eating the saturated animal fats, however, fared much better with seventy-five percent surviving and without a further attack.

Breast Cancer. The Swedish study by Alicia Wolk and colleagues mentioned above did find, however, that monounsaturated fats were protective against breast cancer.

Animal fats such as lard are around 43% Saturated, 47% Mono-unsaturated and 10% Polyunsaturated - which the evidence suggests is just about ideal.

ONE SMART COOKIE

Part 3: The Bran Wagon

The belief that regular bowel movement is important for health is very ancient. But the present theory is based on Dr. Dennis Burkitt's discovery that relatively few rural black Africans suffer from cancer of the colon. He attributed this to their relatively crude diet.

The theory was that, as fibre made food travel through the gut faster, it allowed less time for cancer-inducing agents to form. This, of course, presupposed that food became carcinogenic in the gut and there was no evidence that it did. Neither was there any evidence that moving food through the intestine at a faster rate decreased the risk of colon cancer. Moreover, the rural Africans' lifestyle was far from that of the Western city dweller: their diet is different, but also they were not exposed to so many pollutants, toxins or mental stresses. Indeed, there were many factors that could have been responsible for a difference in disease patterns. Other communities - the Mormons of Utah, for example - also enjoyed a low incidence of colon cancer yet they ate a low-fibre diet.

So the theory was unsubstantiated at the time and it was to be disproved in practice later as the rural Africans moved into towns and adopted a Western style low fibre diet. Their incidence of colon cancer has remained low and this has continued with the second generation. Nevertheless, these later findings were not publicised. Burkitt's theories caught the attention of the media. Always ready to exploit a good story, they expanded what was at best a very weak hypothesis into a treatment dogma that teaches that fibre is a panacea for all manner of illnesses.



Commercial interests were quick to see the potential in the recommendation and jump on the bran wagon. Burkitt's recommendation was based on vegetable fibre, but bran (cereal fibre) has a far higher fibre content and bran was a practically worthless by-product of the milling process that, until then, had been thrown away. Almost overnight, it became a highly priced profit maker. Although totally inedible, backed by Burkitt's fibre hypothesis, bran could now be promoted as a valuable food. But Dr. Hugh Trowell, Burkitt's partner and another strong advocate of dietary fibre, stated in 1974 that: <B>

"A serious confusion of thought is produced by referring to the dietary fibre hypothesis as the bran hypothesis, for many Africans do not consume cereal or bran"

</B>Fibre and coronary heart disease
The idea that fibre could protect against heart attacks was hypothesised by Trowell in 1972, again based on research on rural Africans. The dietary intervention trials mentioned earlier, however, concluded that increasing dietary fibre had no beneficial effect on heart disease.

Fibre and other diseases.
It may be useful at this stage to consider the claims for fibre in curing or preventing other diseases. For example, bran has been a popular way to manage irritable bowel syndrome (IBS) for about thirty years, despite the fact that no placebo-controlled study of bran in IBS has yet shown any convincing beneficial effect. A study, published in 1994, found that while fruit fibre was effective, bran only made the situation worse. Far from being a cure for IBS, they found that it was the bran that was causing it! Bran also caused bowel disturbances, abdominal distension and pain.

Moreover, there is no direct evidence that an increase of fibre by itself will prevent or cure the other diseases. With respect to colon cancer, Burkitt's theory was questioned with the suggestion that the low cancer rates in rural Africans may be due to their high early death rates from other causes, so that they do not reach the age at which cancer peaks in Europeans. As the Africans' life expectancy was only forty years at the time Burkitt did his research and Western cancers don't peak until the age of sixty-five, one wonders why this wasn't noticed before.

There is also a growing scepticism in the USA that lack of fibre causes cancer; some studies even suggesting that a fibre-enhanced diet increases the risk of colon cancer.

Other adverse effects
Tests into the supposed benefits of dietary fibre soon showed that there could be other harmful side effects. All the nutrients in food are absorbed through the gut wall and this takes time. Fibre, by speeding food through the gut faster so that less nutrients are absorbed, inhibits the absorption of iron, calcium, phosphorus, magnesium, energy, proteins, fats and vitamins A, D, E and K. This happens with all types of fibre although with a normal Western-style, nutrient-rich diet, the loss caused by vegetable fibre intake is unimportant. More importantly, phytate found in cereal fibre (bran) also binds with calcium, iron and zinc making them indigestible, which in turn causes malabsorption. One study, for example, showed that subjects absorbed more iron from white bread than from wholemeal bread even though their intakes of iron were fifty percent higher with the wholemeal bread. Bran has also been shown to cause faecal losses of calcium, iron, zinc, phosphorus, nitrogen, fats, fatty acids and sterols, thus depleting the body of these materials.

These findings are a cause for concern in several sections of the population who are at considerable risk from eating too much fibre - and bran fibre in particular:

1. The incidence of osteoporosis (brittle bone disease) is increasing and now affects one in two post-menopausal women, one in five of whom will die as a direct result. Osteoporosis is also increasingly affecting men. Osteoporosis is caused by several factors, but lack of calcium is the basic problem. Bran both inhibits the absorption of calcium from food and depletes the body of the calcium it has. Moreover, zinc, which bones need to heal, is another mineral whose absorption is adversely affected by bran.
2. Sufferers from Alzheimer's Disease (senile dementia) are found to have abnormal amounts of aluminium in their brains. Tests on the people of Guam and parts of New Guinea and Japan, who get Alzheimer's disease at a much younger age, suggest that it is lack of calcium, causing a hormonal imbalance that permits the aluminium to penetrate the brain.
3. Infants may suffer similar brain damage if fed soy-based baby milk as this too has a high phytate content, inhibiting the absorption of zinc, which is essential for proper brain development.
4. Vitamin deficiency diseases such as rickets that were common in Britain until a diet high in dairy products and meat was advocated are on the increase again. The situation is getting so bad here that doctors suggest that vegetarian-based fad diets should be classified a form of child abuse.
5. In the UK, USA, Canada and South Africa the intake of 'anti-nutrients' such as dietary fibre that impair the absorption of iron, accompanied by a low intake of meat (another result of the diet-heart recommendations), is producing a real risk of iron deficiency anaemia.
6. Depression, anorexia, low birth weight, slow growth, mental retardation , and amenorrhoea are associated with deficiencies of zinc and the first five of these are also associated with a deficiency of iron.
7. Lastly, excess fibre affects the onset of menstruation, retards uterine growth and, later, is associated with menstrual dysfunction .

Because of the phytate, Professor David Southgate, arguably the world's leading authority on the effects of fibre, concludes that infants, children, young adolescents and pregnant women whose mineral needs are greater should be protected from excessive consumption of fibre.

Writing of the colon cancer risk, Drs. H. S. Wasan and R. A. Goodlad of the Imperial Cancer Research Fund stated in 1996:

<B>

"Until individual constituents of fibre have been shown to have, at the very least, a non-detrimental effect in prospective human trials, we urge that restraint should be shown in adding fibre supplements to foods, and that unsubstantiated health claims be restricted." . . . "Specific dietary fibre supplements, embraced as nutriceuticals or functional foods, are an unknown and potentially damaging way to influence modern dietary habits of the general population."

</B>Until fibre can be shown not to be detrimental they suggest that

<B>

"restraint should be shown in adding fibre supplements to foods, and that unsubstantiated health claims should be restricted".

</B>January 1999 saw the publication of the largest trial into the effects on fibre on colon cancer ever conducted. After studying 88,757 women for sixteen years, doctors at the Brigham and Women's Hospital and Harvard Medical School say that

<B>

"No significant association between fiber intake and the risk of colorectal adenoma was found." . . . "Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer or adenoma."

</B>Summary
Bran is bad news. While there is not too much harm from fruit fibre, the usual bran that is pushed at us - wheat bran- should be avoided like the plague it is.