Eggs, Marvellous Eggs!

Anthony Colpo,
November 15, 2004.

Over the years, foods rich in saturated fat have been blamed for causing just about every ailment known to befall humankind: Heart disease, cancer, diabetes, military conflicts, bad judging decisions on Idol…okay, so I made those last two up, but you get my drift.

One of the foods whose popularity has been hardest hit by the modern-day avalanche of anti-cholesterol tomfoolery is the humble egg. Despite egg yolks being a good source of vitamin A, vitamin D, vitamin E, lecithin, choline, lutein, zeaxanthin and other carotenoids, we have been repeatedly told to curb their consumption to piddling levels because they contain saturated fat and cholesterol (insert big gasp of horror or disinterested yawn here, depending on your degree of resistance to anti-cholesterol hyperbole).

Eggs, kids, and CHD risk

Evidence exonerating eggs of any wrongdoing continues to mount. In a recent study, children aged 8-12 years were randomly assigned to eat either 2 whole eggs per day or the equivalent amount of egg whites for 30 days. After a 3-week 'washout' period, the children were assigned to the alternate treatment.

The researchers observed that all the kids had an increase in LDL peak diameter during the egg period and a decrease in smaller LDL. Individuals with a preponderance of small dense LDL particles--who are classified as 'phenotype B'--have been shown in numerous studies to be at higher risk of CHD. Researchers postulate that these smaller particles are more susceptible to free radical damage, and that they can weasel their way into damaged sections of artery with greater ease.

In addition to the beneficial increase in LDL size observed in all subjects, 5 of the children having LDL phenotype B (15%) shifted from this high-risk pattern to pattern A after the egg treatment.

'Eye-healthy' nutrient absorbed better from eggs

In another recent study, researchers compared the absorption of the lutein from various foods. Lutein is a nutrient that has come under increasing scrutiny for its possible role in protecting against age-related macular degeneration and cataract. After subjects ingested equal amounts of lutein from either eggs, spinach or lutein supplements, it was observed that lutein absorption was significantly higher during the period of egg consumption.

For the last forty-plus years, health authorities--in all their magnificent stupidity--have been hysterically denouncing the foods that are good for us and steering us towards those that are far less nutritious. The results of this bizarre campaign can be seen all around us, in the current epidemic of diabetes and obesity.

Take a stand against establishment misinformation and enjoy an egg--or two, or three--today!

References

Nydia Ballesteros M, et al. Dietary cholesterol does not increase biomarkers for chronic disease in a pediatric population from northern Mexico. Am J Clin Nutr 80: 855-861.

Chung H-Y, et al. Lutein Bioavailability Is Higher from Lutein-Enriched Eggs than from Supplements and Spinach in Men. J. Nutr, 2004 134: 1887-1893.

Source: The Omnivore

More Saturated Fat = Less Coronary Artery Disease!

Anthony Colpo,
November 9, 2004.

The latest issue of the American Journal of Clinical Nutrition has just published a study that gives saturated fat-defending heretics like yours truly something to smile about.

Researchers took 235 postmenopausal women with established coronary heart disease and performed coronary angiographies at the start of the study and after a mean follow-up of 3.1 years. A total of 2243 coronary segments were analyzed.

The women were also divided into four categories according to their level of saturated fat intake.

Saturated fats found to be protective

After adjusting for multiple confounders, a higher saturated fat intake was associated with less narrowing of the arteries and less progression of coronary atherosclerosis during follow-up. Compared with a 0.22-mm narrowing in the lowest quartile of intake, there was a 0.10-mm narrowing in the second quartile, a 0.07-mm narrowing in the third quartile, and no narrowing in the fourth and highest quartile of saturated fat intake.

Carbohydrates found to be harmful

The protective association of saturated fat was more pronounced among women with lower monounsaturated fat and higher carbohydrate intakes. Carbohydrate intake was positively associated with atherosclerotic progression, particularly when the glycemic index was high.

Polyunsaturates found to be harmful

Polyunsaturated fat intake was positively associated with progression of atherosclerosis when replacing other fats, but monounsaturated and total fat intakes were not associated with progression.

The bottom line

The authors concluded: "In postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis, whereas carbohydrate intake is associated with a greater progression".

"Our findings are not consistent with the hypothesis…that saturated fat intake increases atherosclerotic progression in postmenopausal women but instead suggest that saturated fat intake may reduce such progression, especially when monounsaturated fat intake is low or carbohydrate intake is high. Our findings also suggest that carbohydrate intake may increase atherosclerotic progression, especially when refined carbohydrates replace saturated or monounsaturated fats".

Mere association or direct causation?

After examining the baseline data for the study subjects, it becomes apparent that the results can not be explained away by otherwise healthier lifestyles among those eating the most saturated fat; the high saturated fat group, in fact, had the greatest number of current smokers.

Studies like this do not prove causation, but we do know that saturated fatty acids, because of their lack of vulnerable double bonds, are the least susceptible to free radical damage; polyunsaturates are the most vulnerable. We also know that increased carbohydrate consumption, especially of the refined variety, does a sterling job of raising blood sugar and insulin levels, which accelerates glycation, free radical activity, blood clot formation, and arterial smooth muscle cell proliferation.

Furthermore, the contention that increased polyunsaturated fat and carbohydrate consumption can worsen cardiovascular disease is supported by evidence from clinical trials and by the observation that increasing heart disease incidence throughout the twentieth century has been accompanied by increasing polyunsaturate and refined carbohydrate consumption. Animal fat consumption, in contrast, has remained stable over the last 100 years.

Anti-saturate stupidity

You know, I could take this opportunity to really dump on those who have been incessantly slandering saturated fat all these years, but I won't, because some of my more sensitive readers might write me and accuse me of unfairly impugning the personal and professional integrity of these upstanding citizens. I could point out how many of these anti-saturated fat commentators have built their status and careers on a completely erroneous bunch of nonsense, but again, I won't, because, hey, that wouldn't be nice. I could also point out how their unbridled vitriol against these naturally-occurring fats has probably cost hundreds of thousands, even millions, of lives, but, gee, that wouldn't be a politically correct thing to do.

Nope, I won't mention any of these things (or did I do just that...oops!)…all I will say is that next time you hear some misguided fanatic wailing on about the evils of saturated fat, run--straight to the nearest tub of butter!

Source: The Omnivore

If Everybody Believes the Same Thing, It Must Be True, Right? Wrong!

Anthony Colpo,
October 2, 2004.

Hi Anthony,

I am not going to change my diet now, but why is Loren Cordain so stuck on saturated fat and cholesterol?

Hi,

thank you so much for the kind words about the site, and sincere congratulations on the health improvements you have made. I also find it highly encouraging that you are recommending non-ketogenic reduced carb eating to your patients--avoiding both high and extremely low carbohydrate intakes will help stabilize blood sugar and avoid those hypoglycemic lows that can produce depression-like symptoms and irritability.

As for why Loren Cordain is so "stuck on saturated fat and cholesterol", I really can't tell you with any certainty--he would have to answer that question for himself. All I can say is that his angst against saturated fat completely lacks any scientific backing.

Fat facts versus fantasy

Cordain claims in his writings that the wild game available to our ancestors was leaner than the domesticated animals we eat today, and on the allegedly rare occasion when our ancestors did get naughty and eat high fat animals, the saturated fatty acid content of these wild animals was proportionately lower than it is today.

Cordain obviously knows little of rhinos, hippos, mammoths, etc, all hunted enthusiastically by many Paleo populations and all carrying a hefty load of body fat (an adult hippo, for eg, carries 90kg of adipose tissue). Cordain must also be unfamiliar with east African nomad populations such as the Masai and Samburu tribespeople, that have been observed to eat very large amounts of animal fat year round and yet exhibit outstanding cardiovascular health.

As for the claim that the fat from wild game is proportionately lower in saturated fat than domesticated meats, a quick check on the USDA database shows otherwise. The fat from wild bison, for example, has a similar percentage of saturated fatty acid content to beef fat. Animals like antelope, buffalo, caribou, wild boar, elk, and so on contain 30-38% saturated fat--the fat from domesticated pork, by comparison, contains 37% saturated fat.

Cordain also harps on about how the individual saturated fatty acid profile differs in modern-day meat, which I think is really getting pedantic. If it bothers you, just eat grass-fed meat for crying out loud, which will have the fatty acid profile nature intended!

I think that instead of endlessly pontificating over the finer points of myristic/palmitic/stearic acid ratios, it would be far more productive to avoid the hell out of omega-6-rich polyunsaturated vegetable oils and to consume or supplement with long-chain omega-3 fats on a regular basis (fish oil/cod liver oil is the easiest way to do this). By the way, please don't follow Cordain's bizarre suggestion, featured in many of the recipes in his Paleo Diet book, to marinate meats in flax oil before cooking them. As numerous concerned commentators have pointed out, flax oil is extremely prone to oxidative damage when subjected to high temperatures. Ingestion of heat-damaged polyunsaturated oils increases free radical activity inside the body, and free radical damage is a major player in the pathogenesis of such killers as heart disease and cancer.

I find it highly ironic that a Paleolithic researcher would denigrate saturated fat, a natural component of foods that humans have been eating for millions of years, yet enthusiastically recommend the consumption of heat-damaged flax oil, a food item that did not even exist in the Paleolithic era!

Cholesterol and MRFIT

On the BeyondVeg.com site--which truly is a great resource if you can disregard all the anti-saturated fat nonsense--Cordain claims that the massive MRFIT study, involving over 360,000 men, offers conclusive proof that elevated cholesterol and saturated fat cause heart disease. While increasing cholesterol levels were indeed associated with increasing incidence of CHD mortality in the MRFIT screenees, Cordain does not point out that overall mortality was highest at both the high and low ends of the cholesterol spectrum. The lowest overall mortality was actually seen across the 160-219 mg/dl range of cholesterol.(1)

Cordain also does not mention the results of the actual MRFIT clinical trial itself, which was the primary reason the enormous MRFIT project was instigated in the first place. In the official MRFIT trial, half of the almost 13,000 participants were randomized to receive anti-hypertensive medication, encouragement to quit smoking, and intensive counseling on reducing their fat and cholesterol intake. Despite these extensive interventions, this group did not experience any reduction in cardiovascular or all-cause mortality.

The MRFIT trial is hardly the only clinical trial to fall on its butt when trying to prove that saturated fat is harmful--no properly-controlled clinical trial has ever shown saturated fat restriction to lower mortality.(2)

Repetition--the key to turning myths into 'truths'

Personally, I find the anti-saturated fat sentiment of folks like Cordain--who judging by his published research on Paleolithic diet and health, appears to be an otherwise highly intelligent and perceptive individual--to be a symptom of a much larger problem. The widespread misguided sentiment towards saturated fat and cholesterol is a glowing testimony to the power of repetitive indoctrination. We have all heard, over and over again, that saturated fat is so harmful, so toxic to our arteries, that many of us simply take it for granted that it must be bad for us. If everybody believes and says something, it must be true, right? As Vladimir Lenin, one of history's most heinous masters of propaganda, stated: "A lie told often enough becomes the truth."

Methinks most people need to spend a hell of a lot less time worrying about saturated fat and cholesterol and a hell of a lot more time working on their critical and independent thinking skills...

Cholesterol contradictions

Those who still subscribe to the cholesterol theory have never been able to coherently explain why cholesterol is only associated with heart disease in younger individuals, but not in those over 55--the group in which most CHD fatalities occur. To claim that cholesterol is harmful in younger folks, but benign in older folks is a physiological absurdity.

Even if we close our minds to this disparity, just as so many supporters of the cholesterol theory have done, any association between elevated cholesterol and increased heart disease does not mean the former causes the latter. And it certainly does not 'prove' that saturated fat causes heart disease. In Framingham, for example, researchers noted that increasing cholesterol levels were indeed associated with higher CHD rates but also observed that those who ate the most saturated fat had the lowest rates of CHD and overall mortality!(3)

The fact is, there are numerous factors that promote CHD and also raise cholesterol levels--eg stress, inactivity, high blood sugar, low intakes of various vitamins and minerals, etc. Like an innocent bystander apprehended at the scene of a crime after the real crooks have made their getaway, cholesterol--a substance absolutely critical to our continued well-being--gets blamed for a crime it did not commit.

Cholesterol does not cause heart disease, and I never cease to be amazed by the massive numbers of so-called health 'professionals' who subscribe to the idiotic notion that it does!

For sale: one freshly-painted cholesterol myth

To help readers appreciate how utterly stupid the whole 'lower your cholesterol and you can lower your risk of heart disease' charade is, I will use the example of an article I read several years ago, about how red cars were involved in a disproportionately higher number of road accidents and therefore attracted higher insurance premiums.

If we used the mentality of the anti-cholesterol crowd, the solution to this problem would be to sneak into red car owners' driveways at night and repaint their vehicles another color. This of course, wouldn't achieve a damn thing, because red paint has never been demonstrated to cause car accidents, just as cholesterol has never been demonstrated to cause heart disease.

Any relationship between red cars and increased vehicular accidents is likely due to the type of people that typically drive them. If we were to examine a large subset of individuals who drive red cars, we may find that they are more likely to be younger and less experienced drivers, to posses more impulsive personalities, to drive faster, to own cars whose performance capabilities far exceed their own driving skills, and so on. To lower the rate of accidents among this population, we would need to successfully change their attitude towards motor vehicle use and on-road behavior. In contrast, instituting a nationwide car-repainting campaign would simply be an unproductive and self-delusional wank.

For the last fifty years, mainstream medicine has approached the heart disease problem like a bunch of spray painters who believe the road toll can be lowered by repainting red cars. This moronic approach is no doubt why the incidence of heart disease has not declined one iota,(4-6) and why CHD is still our number one killer.

Independent thinking associated with lower risk of believing establishment hogwash!

I'm not sure what the hell they teach in medical and dietetic courses these days--my experience with universities is limited to the area of their faculties that actually contain factual, solid data--that is, their libraries. It is in the libraries where one finds journals replete with research showing the cholesterol theory to be a complete bunch of crap. Obviously, most graduates never see these articles, because their indoctrination, uh, I mean education curriculum evidently does not allow for facts that contradict the reigning anti-cholesterol dogma.

I make the following appeal to all those young student minds that still have some semblance of independent cognitive function remaining inside them--as you embark on your tertiary education, be aware that it is highly geared towards making you a faithful and obedient servant of the reigning health and medical monopoly. Oh, sure when you establish your own practice and plunk down the first down payment on your new Lexus, you may well feel that you are truly the master of your domain. Don't kid yourself. As long as you fail to verify the claims of the medical hierarchy for yourself; as long as you merely glance over the abstracts in journals instead of reading the full text; as long as drug companies remain your primary source of drug information; as long as food and drug companies control the flow of information emanating from the health associations, institutes, and organizations that you look to for professional guidance, then you remain simply a puppet of our disgustingly corrupt orthodoxy.

If you think I am I exaggerating and being a wee bit hyperbolic, if you think that the present system isn't as bad as I make it out to be, then explain to me why the current health system is America's third leading cause of death,(7) and why the anti-saturated fat, pro-carbohydrate campaign has endowed us with unprecedented levels of obesity and diabetes?

The sooner more of us wake up to the inescapable reality that most of our health authorities are, quite frankly, full of shit; the sooner we start thinking for ourselves; the sooner we start taking more responsibility for our own health; and the sooner we start demanding that health officials start paying attention to the facts instead of vested corporate interests; then the sooner we can bring about meaningful improvements in public health.

Until then, expect more of the same old same old…

References

1. Iso H, et al. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Intervention Trial. New England Journal of Medicine, April, 1989. Vol. 320, No. 14: 904-910.

2. Corr LA, Oliver MF. The low fat/low cholesterol diet is ineffective. European Heart Journal, 1997; 18: 18-22.

3. Castelli WP, Concerning the Possibility of a Nut… Archives of Internal Medicine, Jul, 1992; 152: 1371-1372.

4. Rosamond WD, et al. Trends in the Incidence of Myocardial Infarction and in Mortality Due to Coronary Heart Disease, 1987 to 1994. New England Journal of Medicine, Sep 24, 1998; 339 (13): 861-867.

5. Center for Disease Control. Hospitalization Rates for Ischemic Heart Disease - United States, 1970-1986. MMWR Weekly, Apr 28, 1989; 38 (16); 275-276, 281-284.

6. Sytkowski PA, et al. Changes in risk factors and the decline in mortality from cardiovascular disease. The Framingham Study. New England Journal of Medicine, Jun 7, 1990; 322 (23): 1635-1641.

7. Starfield B. Is US health really the best in the world? Journal of the American Medical Association, Jul 26, 2000; 284 (4): 483-485.

Source: The Omnivore

Interview: Gary Taubes

FRONTLINE DIET WARS
Science journalist Gary Taubes wrote the controversial July 7, 2002 New York Times Magazine article, What If It's All Been a Big Fat Lie? which turned the spotlight onto high-fat, low carbohydrate diets. In this interview, Taubes explains his motivation for writing his piece, the science behind the low-carbohydrate diet, and the contention he faced when he published his findings. "I got crucified in a variety of publications," he says "... It was fascinating. They go after the messenger as much as the message." He is currently writing a book that is a historical and scientific exploration of the hypothesis that weight gain and chronic disease are caused by excess consumption of easily digestible and refined carbohydrates. This interview was conducted Dec. 10, 2003.

What made you go after this topic in the first place?

Two things. I'd been reporting on salt and blood pressure, which is a huge controversy, and some of the people involved in that were involved in the advice to tell Americans to eat low-fat diets, and they were terrible scientists. These were some of the worst scientists I'd ever come across in my 20-odd year career of writing about controversial science.

I literally called up my editor and said, "I just got off the phone with so-and-so, and he's [taken] credit for getting Americans to eat less eggs and less fat. This guy's one of the worst scientists I've ever talked to, and if he was involved in this, then there's a story there." And that was it. I didn't know what the story was. I just knew there was a story.

Was there a personal motivation?

Before I did it, I was up at MIT, interviewing an economist about another story, a guy who runs a laboratory of financial engineering. He told me about being on the Atkins diet, and how effective it was. He was an Asian-American who had lost 40-50 pounds by giving up white rice, in effect.

I thought I would try it as an experiment, since I was going to write about fat and whether it really did cause heart disease and weight loss. I tried it, and it was amazing. You know, it's everything -- the 20 pounds that I'd never been able to lose, in six weeks, and I stopped exercising. It was kind of a surreal experience, and probably, in a sense, informed my opinions from there on in. I mean, after that happens, you say, "I want to know what's happening, and I want to know why."

Why is it so easy for us to believe that fat is a bad dietary ingredient?

The idea is that fat has nine calories per gram, and carbohydrates and protein have four calories per gram, and somehow the theory is that the denser the calories, the more easier it is for us to eat more of them. What happened is in the '50s and '60s, when researchers started fingering fat as a cause of heart disease, the obesity researchers, the obesity community started advocating low-fat diets, which they had never done before. A low-fat diet is by definition a high-carbohydrate diet.

But you had this sort of synchronicity where you had the heart disease people saying, "Give up fat, saturated fat, for heart disease," and the obesity people started saying, "Give up fat because it must be the best diet because fat is the densest calories." They moved from there without ever testing actually either of those hypotheses, so the obesity people start recommending low-fat diets; the heart disease people are recommending low-fat diets. They have actually no idea whether it's going to cure heart disease, and the obesity people have no idea whether these diets even work. But because they believe that it's only the calories that [are] important, obviously if you give up the major source of calories in the diet, you must lose weight...

Read the full interview here: pbs.org

Adventures in Diet - By Vilhjalmur Stefansson (Part 1)

Harper's Monthly Magazine, November 1935

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.

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 coarse 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.

II

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.

III

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.

End of Part 1 | Part 2 | Part 3

Adventures in Diet - By Vilhjalmur Stefansson (Part 2)

Harper's Monthly Magazine, December 1935

Now that the experiments in diet which Karsen 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."

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).

End of Part 2 of 3 | Part 1 | Part 3

Adventures in Diet - By Vilhjalmur Stefansson (Part 3)

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.

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 coarse 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-coarse-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 coarser 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.

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.

End of Part 3 of 3 | Part 1 | Part 2

Book Review: The Cholesterol Myths

The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease

by Uffe Ravnskov, M. D., Ph. D.
Published by the New Trends Publishing Co., Washington, D. C., 2000, xiv + 297 pp, ISBN 0-9670897-0-0 $20.00 To order, call New Trends Publishing at 877-707-1776, or on the web at http://www.newtrendspublishing.com.

With courage and care Dr. Ravnskov exposes the lack of experimental evidence for the diet-heart theory, which claims that eating less fat and cholesterol will prevent atheroslcerosis (hardening of the arteries) and myocardial infarctions (heart attacks). By examining original peer-reviewed literature, the author finds no support for the diet-heart theory. He gives examples of scientific fraud among efforts to support the theory, including the deliberate selective omission of data points, and the deliberate assignment of subjects in a clinical trial to treatment or to control groups by physicians with the subject's medical records in hand. He shows how the abstract or conclusions of a number of papers are at odds with the actual data in the papers. He demonstrates how the use of one statistical method in preference to another can give a false impression that there is an effect, where there is, in fact, none. He shows how the reporting of differences in fatality rates by per cent reduction (say, a 50% reduction in relative risk) is actually misleading when the actual death rates are quite small in both the treatment and control groups of subjects in diet or drug studies. For example, a treatment that changes the absolute survival rate over a multi-year period from 99.0% to 99.5% represents a 50% reduction in relative risk, from 1% to 0.5% absolute. This is often described in papers as a 50% reduction in death rate. However, when the difference is barely significant statistically, as was often the case, Ravnskov points out that there is no real reason to recommend adoption of the treatment, especially if there are serious side-effects.

I have provided an abnormal number of quotations in order to show how meticulous this author is, and how skeptically we should regard some of the peer-reviewed literature, or recommendations from the medical establishment, or claims of effectiveness of anti-cholesterol drugs. Surprisingly, this author has included about 2 dozen cartoons to make this very wrenching exposé more palatable. The chapters are called Myths. Here are the chapter titles along with some quotations from and discussion of each:

"Myth 1: High-fat foods cause heart disease." In a striking graph from one of the papers of John Yudkin, M. D., Dr. Ravnskov shows that the number of deaths from coronary heart disease (CHD) in England and Wales between 1910 and 1956 is closely correlated with the number of new radio and television sets purchased each year. This is a perfect example of a correlation without a cause. Another line on the same graph shows that the number of grams of animal fat consumed per day changed by only ± 10% during this period. There is no correlation whatever between fat consumption and death rates from CHD, which increased 6-fold during this time period. "In the US, coronary mortality increased about ten times between 1930 and 1960, leveled off during the '60s and has since decreased slowly. During the decline of heart mortality the consumption of animal fat declined also, but during the thirty years of sharply rising coronary mortality the consumption of animal fat decreased [also]."

"While the death rate from coronary disease increased in most countries after World War II, it decreased in Switzerland. If this decrease had been preceded by a decline in the intake of animal fat, Switzerland would have been a model for health care in other countries. But the diet-heart proponents never mention Switzerland because during the decline in heart mortality, the Swiss intake of animal fat increased by 20%."

"The Masai [of Kenya] drink 'only' half a gallon of [whole] milk each day...Their parties are sheer orgies of meat; on such occasions four to ten pounds of meat [eaten] per person is not unusual, according to Professor [George] Mann [of Vanderbilt University in Nashville, TN, USA]. If the diet-heart idea were correct, coronary heart disease would be epidemic in Kenya. But Professor Mann found that the Masai do not die from heart disease - although they might die from laughter if they heard about the campaign against foods containing cholesterol and saturated fat. But this was not the only surprise. The cholesterol of the Masai tribesmen was not sky-high as Mann had expected; it was the lowest ever measured in the world, about 50% lower than the value of most Americans."

"In Puerto Rico and in Honolulu, heart attack victims had consumed more polyunsaturated oils than those who had not had a heart attack [in a study conducted by Dr. Tavia Gordon]. Although this observation is contrary to what was expected and thus most discouraging for those who advise people to consume more vegetable oils, the study authors did not mention this fact in the summary of their research."

"By 1998, a total of 27 studies had been published including 34 groups (cohorts) of patients and control individuals...[totaling more than 150,000]. In 3 of these 34 cohorts, patients with coronary disease had eaten more animal fat than the control individuals, and in 1 cohort they had eaten less. In the rest of the groups - 30 in all - investigators found no difference in animal fat consumption between those who had heart disease and those who did not. In 3 cohorts the patients had eaten more polyunsaturated vegetable oils than the control individuals, and in only 1 had they eaten less..."

"If you go to the library and look into the tables of these papers [all are fully cited in the book] you will see that the differences found were not statistically significant, which means that the results were simply due to chance."

"...[T]here is a weak association between the coronary mortality in various countries and the amount of fat available [in each] for [the citizens] to eat, but no difference between the amount of fat [actually] eaten by coronary patients and by healthy individuals."

"Myth 2: High cholesterol causes heart disease." "Most supporters of the diet-heart idea think that the increased risk of CHD is present at all cholesterol levels. Those who have a cholesterol level of 200 mg/dL, for example, are worse off than those with a cholesterol level of 150 mg/dL; and those who have a cholesterol level of 250 mg/dL are at even greater risk. The pharmaceutical companies love this concept for it implies that almost everyone should be treated, even those with normal cholesterol levels."

"The truth, were it known, would send pharmaceutical stocks plunging. In most studies, the increased risk is present only above a level of cholesterol that includes just a small percentage of the total population. [These are the approximately 1% of people with a genetic defect called familial hypercholesteremia.] And women can stop worrying immediately because high cholesterol is not a risk factor for the female sex. Few comments have been made on this peculiar fact in all the vast literature on cholesterol. When it is mentioned at all, it is said that female sex hormones protect against heart attacks."

"In fact, it seems more dangerous for women to have low cholesterol than high. Dr. Bernard Forette and a team of French researchers from Paris found that old women with very high cholesterol live the longest. The death rate was more than 5 times higher for women who had very low cholesterol. In their report, the French doctors warned against cholesterol lowering in elderly women. But they could as well have warned against cholesterol lowering in any woman, or, to be more precise, in anyone at all."

Dr. Ravnskov showed how the results of many studies, including those of Dr. Ancel Keys, as well as MRFIT and others, have conclusions that are at odds with the authors' own data, albeit sometimes this problem was confined to the abstract of a paper, as though no further funding would be obtained if honest and complete interpretations had been made.

Your reviewer checked one of the citations on MRFIT [O. Paul et al., J. Amer. Medical Assoc. 248 (12), 1465-1477 (1982)], to find that the summary noted honestly that the treatment group had less mortality from CHD and more overall than the controls did. That the former was not statistically significant was in the abstract; that the latter was not statistically significant was not in the abstract, but in the body of the paper. The problem with both this and some other studies is that the interventions included diet, anti-hypertensive drugs and smoking cessation all at once. The authors thought that less smoking was beneficial and that anti-hypertensive drug therapy was harmful. But the diet for the treatment group called for lower saturated fat and cholesterol intake and higher polyunsaturated fat intake. The authors did not admit the possibility that this intervention could have been harmful. In an end-note Ravnskov simplified a table in this paper and showed that the entire difference in death rates of sub-groups was due to quitting smoking, which cut the death rate in half for those who quit.

"Thus, high cholesterol is said to be dangerous for Americans but not for Canadians, Stockholmers, Russians or Maoris. High cholesterol is said to be dangerous for men, but not for women; it is said to be dangerous for healthy men, but not for coronary patients; and it is said to be dangerous for men of 30, but not for those of 48 [or older]. And high cholesterol may even be beneficial for older people. Such discrepancies indicate that the association between high cholesterol and CHD is not due to simple cause and effect. The most likely interpretation is that high cholesterol is not dangerous in itself but [that it is] a marker for something else."

Dr. Ravnskov went on to show that higher levels of high-density-lipoprotein (HDL, "good" cholesterol) are not protective against CHD, and that lower levels of low-density-lipoprotein (LDL, "bad" cholesterol) are not beneficial, although the expected associations of each with CHD are present. Here again, conclusions at odds with the researchers' own data were presented. Intimations that there are "many" or "definitive" studies in reports and papers were shown to be false by showing that citations often led to other reviews, each trusting the last, and ending at very few original studies.

Studies in test animals that artificially raised their LDL-cholesterol levels, thereby supposedly creating atherosclerosis, were shown to be misinterpretations. While the topic should have been in Myth 1, not in Myth 2, triglycerides were said to be even less correlated with CHD than cholesterol is; that the assay for triglycerides is worthless unless the patient has been fasting 12 hours; and that the assay is only accurate to ± 50%.

"Myth 3: High-fat foods raise blood cholesterol." Dr. Ancel Keys was one of the main proponents of this myth. In a paper published in 1958, Keys showed a graph of the per cent calories from fat in the food of various countries vs. the mean serum cholesterol levels. The data points fell on a straight line, showing an excellent correlation. Dr. Ravnskov added data points from a number of countries deliberately ignored by Dr. Keys. These fall nowhere near the line. Furthermore, CHD death rates among subjects in Finland, Greece and Yugoslavia with similar serum cholesterol levels varied 5-fold depending on which area of the country they lived in!

Four studies in the US, one in the UK, one in Israel and one in Finland failed to show any correlation between diet and serum cholesterol levels.

"Numerous studies have shown that in people who eat a normal Western diet, the effect on blood cholesterol of eating 2 or 3 extra eggs per day over a long period of time can hardly be measured..."

"To find out how egg consumption influenced my own blood cholesterol, I once used myself as a human guinea pig without asking the ethics committee at my university. Before and during the experiment I analyzed my [total serum] cholesterol. My usual egg consumption is one or two eggs per day, and my cholesterol value at the start of the experiment was 278 mg/dL, very close to a determination of blood cholesterol made 10 years earlier." On day 0, Dr. Ravnskov ate 1 egg; on day 1, 4 eggs; on day 3, 6 eggs; and on days 3-8, 8 eggs per day! "The data from my daring experiment showed that instead of going up, my cholesterol went down a little [to 246 mg/dL]."

"Myth 4: Cholesterol blocks arteries." "As early as 1953 Ancel Keys wrote: 'It is a fact that a major characteristic of the sclerotic artery is the presence of abnormal amounts of cholesterol in that artery.' And he added: 'This cholesterol is derived from the blood.' No proofs and no arguments - not from Keys and not from his followers. The cholesterol comes from the blood, and that's the end to it."

Dr. Ravnskov explains that older people have higher concentrations of cholesterol in their blood than younger people. If the serum cholesterol is graphed against the degree of atherosclerosis with all age groups lumped together, there seems to be a direct relationship. But if only people of about the same age and sex are considered, there is only a weak relationship with a correlation coefficient of 0.29. (A perfect correlation would have a correlation coefficient of 1.00.) When the subjects with familial hypercholesteremia are left out, even the weak correlation vanishes.

"The first study designed to demonstrate a possible correlation between blood cholesterol and degree of atherosclerosis was published by the pathologist Kurt Landé and the biochemist Warren Sperry of the Department of Forensic Medicine at New York University. The year was 1936. They studied large groups of individuals who had died violent deaths. To their surprise, they found absolutely no correlation between the amount of cholesterol in the blood and the degree of atherosclerosis..."

"Because Landé and Sperry were cautious and methodical, their study should have nipped the diet-heart idea in the bud. Or, more accurately, if those who promoted the diet-heart idea later on had read Landé and Sperry's paper before beginning their research, they would probably have dropped the idea at once... But the few who remember Landé and Sperry misquote them and claim that they found a connection, or they ignore their results by arguing that cholesterol values in the dead are not identical with those in the living..."

"In the city of Agra in India, Dr. K. S. Mathur and his co-workers performed a similar study [in 1961]. Their first step was to measure blood cholesterol in 20 patients shortly before death and then a varying number of hours afterwards. They found that the cholesterol values were nearly the same if samples [were taken] before death and within 16 hours afterwards. Thus, blood samples taken very shortly after death are reliable - an important confirmation of the study done by Drs. Landé and Sperry. Dr. Paterson's group in Canada did a similar test and obtained a similar result.

"Next Dr. Mathur and his colleagues studied 200 people who had died in an accident, without any preceding disease. Like Drs. Landé and Sperry, and like Dr. Paterson, the Indian researchers could find no connection between cholesterol values and the degree of atherosclerosis. Those with low cholesterol had just as much atherosclerosis as those whose cholesterol was high.

"Similar studies have also been performed in Poland, in Guatemala, and in the US, all with the same result: No correlation between the level of cholesterol in the blood stream and the amount of atherosclerosis in the vessels."

A report from the Framingham Study found a weak correlation coefficient, 0.36. Dr. Ravnskov found what distinguished this report from all the others he studied: only 14% of the Framingham dead were chosen for autopsy, not close to 100% as in the other studies. The risk of preferentially selecting subjects who probably had familial hypercholesteremia was said by Ravnskov to be great. To prove that high cholesterol is the villain - and not just an innocent bystander - demands that a change in the cholesterol concentration in each individual is followed by a change in degree of atherosclerosis in the same direction. Examination of all studies on this relationship showed no correlation.

"Myth 5: Animal studies prove the diet-heart idea." "When it comes to cholesterol, none of the other mammals is like us. They have other amounts of it in their blood, different dietary habits, and most of them do not become atherosclerotic.

"Many mammals never eat food containing cholesterol . If they are force-fed a cholesterol-rich diet, the cholesterol level of their blood rises to values many times higher than ever seen in normal human beings. And since such animals cannot dispose of the cholesterol they have eaten, every organ soaks up the cholesterol like a sponge soaks up water...

"Using cholesterol-rich fodder, it is possible to induce arterial changes that vaguely resemble human atherosclerosis in rhesus monkeys, but it was not possible in baboons. How do we know whether man reacts like a rhesus monkey or like a baboon or in some other way?...

"It is true that cholesterol is also deposited in the arteries of the [force-fed] rabbit, but these deposits do not even remotely resemble those found in human atherosclerosis. Cholesterol appears in different places in a rabbit's vessels than in man's, the microscopic changes are different, no hemorrhages or clefts appear as they do in man, and no thrombus or aneurysm formation in the arterial wall is seen. The most striking fact is that it is impossible to induce a heart attack in a rabbit by dietary means alone."

"Myth 6: Lowering your cholesterol will lengthen your life." Dr. Ravnskov reviewed the evidence presented earlier - that cholesterol levels in blood, or HDL or LDL levels, or the ratio of the latter are not correlated with either atherosclerosis or heart attack rates. It follows that forcible reductions of cholesterol levels by drugs (since diet alone does not change the levels much) would not be expected to change the rate of CHD. However, two things are possible with allopathic drugs. First, some unknown mechanism unrelated to cholesterol could lengthen lifespan. Second, some side-effect unrelated to cholesterol could shorten lifespan. The pervasive misconceptions about cholesterol has made it nearly impossible to carry out a placebo-controlled trial of new drugs because it is mistakenly considered unethical not to treat people with high cholesterol levels!

"In the 1960s, Professor Jeremy Morris of London, England, led a team of physicians and scientists in an investigation to see whether the replacement of animal fat with soybean oil could have some preventive effect on CHD. This oil is rich in polyunsaturated fatty acids, those that are considered [erroneously to be] protective against atherosclerosis and CHD. Enrolled in the trial were about 400 middle-aged men who had previously been admitted to 4 London hospitals because of a heart attack; half of these received a diet containing large amounts of soybean oil. (This is one of the few trials sponsored solely by a government, and not by a drug company or any other vested interest.)"

"When the researchers analyzed the results 4 years later, they could find no beneficial effects from using soybean oil. Although, in this particular trial, blood cholesterol had decreased considerably in the treatment group, 15 had died of a heart attack. In the control group, 14 had died; and the number of non-fatal heart attacks was the same in both groups." Other trials gave the same result.

These trials on patients who already had symptoms of CHD are called "secondary prevention" trials. Now Ravnskov describes some of the "primary prevention" work, that is, trials with healthy or, at least, symptomless patients. Much larger numbers of subjects are needed to obtain good statistical results, and compliance is always suspect because of the severe side-effects of many of the treatments or drugs used in subjects who are basically healthy, and thus may not be compliant because of lack of fear of poor health. When you recall the conclusions in Myth 2, that high cholesterol does not cause CHD, you will not be surprised at the negative findings now to be described.

In 1967 the Coronary Drug Project tested nicotinic acid, clofibrate, thyroid hormone, and estrogen to lower cholesterol levels in middle-aged men who had already had at least one heart attack. After 7 years the death rates were the same as that of the controls. Worse, all 4 drugs had severe side-effects. The researchers fell victim to the "surrogate endpoint". This is the use of an easily measured factor, such as total cholesterol level or blood pressure, as a surrogate or substitute for what is really important - increasing lifespan or the quality of life. In a later chapter Ravnskov calls this a "surrogate outcome".

In 1970 the Upjohn Co., Kalamazoo, MI, US, sponsored a trial with controls on 2000 men and women with high cholesterol of its then new drug colestipol. Two years later no effect was seen in the women. The number of heart attacks in the men in the treatment group was cut in half, a remarkable result never seen before or since. But Ravnskov found the snag: The selection of the patients to be in either the treatment or control groups was done by Upjohn's scientists with the results of the participants' blood assays in hand; it was anything but random. Ravnskov noticed that there were too many control patients with familial hypercholesteremia. Your reviewer notes that, in the 1996 Physicians Desk Reference entry for this drug, there is not a shred of evidence for longer lifespan; moreover, there were no restrictions on prescribing this drug for women.

For the World Health Organization trial, researchers assayed blood cholesterol in 30,000 healthy, middle-aged men in Edinburgh, Prague and Budapest. The 10,000 men with the highest blood cholesterol levels were selected for the trial, half to receive clofibrate, half placebo. After 5 years there were more fatal heart attacks in the clofibrate group. There were 128 total deaths in the clofibrate group and 87 in the placebo group. "Yet clofibrate is still recommended in many countries as a useful drug."!!

The Oslo, Norway, trial was shown to be typical of several such trials in that dietary advice to lower cholesterol intake, cessation of smoking and loss of weight were all varied at once. The barely significant difference in death rate - those in treatment did better than the control subjects - could not be assigned to any one factor.

The Multiple Risk Factor Intervention Trial (MRFIT) sponsored by the National Heart, Lung and Blood Institute (of the NIH, US) selected the 12,000 men considered most at risk for heart attack from 360,000 middle-aged men from 18 American cities. Those in treatment smoked less, took drugs for blood pressure, and ate less cholesterol. After 7 years the number of deaths from all causes was 265 in the treatment group and 260 in the control group! When a scientific experiment does not produce results supporting a hypothesis, the scientists are supposed to admit it immediately; such honorable actions have engendered respect for scientists. Not in this case, however. The researchers arbitrarily excluded the results from certain groups of subjects, changed the type of statistics used, and reported that MRFIT was a success in some media, according to Ravnskov, although not in the paper by O. Paul cited above.

The National Heart, Lung and Blood Institute embarked on a new jumbo trial called The Lipid Research Clinics Coronary Primary Prevention Trial (LRC) to test the effectiveness of cholestyramine (Bristol-Myers Squibb). To find about 4,000 test subjects, the 0.8% of 500,000 middle-aged men with the highest cholesterol levels were selected. All were given a few weeks of dietary indoctrination to solve the supposed ethical dilemma of not otherwise treating the controls. Half received cholestyramine and half placebo for 7-8 years. Of those treated, 190 (10%) had nonfatal heart attacks against 212 (11.1%) of the controls. For fatal heart attacks the figures were 1.7% and 2.3%, a difference of 0.6% absolute or 12 individuals. In the summary of the paper on this trial these unimpressive results were presented as a 19% lowering (relative risk) of nonfatal heart attacks and a 30% lowering of fatal heart attacks.

"And this was not the only way in which the LRC figures were manipulated. In order to reach their 30% figure, the LRC directors included the uncertain cases, those who may or may not have died from a heart attack, and to reach their 19% figure, they excluded the uncertain cases. If it had been the other way around the results would have been 24% rather than 30, and 15% rather than 19. In other words, they selected data that gave them the results they were seeking." Even worse, the directors abandoned the 99% confidence level with a 2-tailed t-test and settled for a 95% confidence level with a 1-tailed t-test. [In an end-note Ravnskov points out that scientists have agreed that a 1-tailed t-test should be used only when it is certain that the result will go in just one direction. It is not supposed to be used when the drug (or other intervention) may do harm rather than good.] Very revealing is the absence of the number of deaths from all causes. More men in the treatment groups died by violence or suicide (11 vs. 4). In the misleading manner used by the LRC to present results, they could have said that violent death was 175% more likely in the treatment group. In order to achieve essentially nothing, the treatment group suffered gas, heartburn, belching, bloating, abdominal pain, nausea and vomiting. The study's report assured readers that the side-effects were not serious. Some promoters then claimed that now that it had been proven that it is worthwhile to lower cholesterol no more trials were necessary!"

Ravnskov goes on to show that trials with a seemingly positive result are cited much more frequently than trials with a negative result. This gives a positive feedback effect, reinforcing the dogma than reducing cholesterol level is beneficial, but this sort of misdirected effort actually does not produce better health.

A study showed that patients treated with lovastatin and colestipol had their coronary arteries narrowed as shown by X-rays. The title of the paper on this study indicated the opposite: "Regression of coronary artery disease as a result of lipid lowering therapy..."

Ravnskov then presents the results of a meta-analysis of 26 cholesterol-lowering trials that met his standards. Result - no benefit.

Ravnskov presents the results of a number of trials of statin drugs in which total death rates are slightly lower than those of the controls. In an early trial of lovastatin (EXCEL) on 8,000 subjects the absolute death rate from all causes after just 1 year was 0.5% vs. 0.2% in the placebo group.

Your reviewer checked the report on the results of another study, this one lasting 5.2 years [Downs et al., J. Amer. Medical Assoc.279 (20), 1615-1622 (1998)]. There were no results given for death from all causes in this study, which was called AFCAPS/TexCAPS. So, even though lovastatin reduced the incidence of first coronary events by 37% in this trial, there is still not enough evidence to warrant using this drug. Nevertheless, Downs et al. suggest that 6 million Americans may benefit from LDL-cholesterol reduction by lovastatin!

Regarding studies carried out on lovastatin lasting 10 years, Ravnskov found no reports on total death rates. Ravnskov queried Merck & Co. directly and was told that the trial was not designed to measure the total clinical outcome!

Deaths from heart attacks were significantly lower in some trials of other statin drugs, but total deaths were 3% absolute lower at best. In the CARE trial Ravnskov showed that a 12% reduction in heart attacks (-1% absolute) was overbalanced by a 1500% increase in cases of breast cancer (+4% absolute). Total deaths were not given. Once again this shows that women should not be treated with statin drugs (or at all), and the benefit for men is quite limited at best with simvastatin and pravastatin.

The incidence of breast cancer was said to be a fluke, and was not observed in the LIPID trial lasting 6 years, in which overall mortality was said to be reduced by 22%; but this was relative risk, an overall drop in mortality of 3% absolute was achieved in subjects with a broad range of initial cholesterol levels [Tonkin et al., New England J. Medicine 339 (19), 1349-1357 (1998)].

In middle-aged men with hypercholesteremia treated with pravastatin for 5 years, death from all causes was reduced by 22%; but this was relative risk; an overall drop in mortality of 1% absolute was achieved [Tonkin et al., New England J. Medicine 333 (120), 1301-1307 (1995)].

"Myth 7: Polyunsaturated oils are good for you." Ravnskov tries to explain what the polyunsaturates are chemically. His effort is one of the few weak points in this book. The degree of saturation actually refers to whether hydrogen can be added to the oil. If so, some of the carbon-carbon bonds in the fatty acid portion of the oil molecule must have been double bonds in which 4 electrons are shared, rather than 2 electrons in the much more common single bonds. Olive and canola oils are the best examples of monounsaturated oils (a sole double bond in each fatty acid portion), and safflower, cottonseed and soybean are examples of polyunsaturates (two or more double bonds in each fatty acid portion). If hydrogen cannot be added in the presence of a catalyst, the oil (or more likely the fat) is said to be saturated, meaning that it cannot take up any more hydrogen. Palm and coconut oils are the best examples. Tallow, lard and chicken fat have some saturated and some monounsaturated fatty acids in their molecules.

Ravnskov cites a survey that showed that high consumption of polyunsaturates leads to premature aging. Also, researchers at a San Francisco, CA hospital thought that babies admitted with edema, anemia and blood cell disturbances were victims of commercial baby milk formulas containing skim milk and polyunsaturates.

Chickens fed polyunsaturates develop brain damage very quickly, but perhaps this should not be expected to apply to humans. A study cited in Myth 1 found that heart attack victims in Puerto Rico and in Honolulu consumed more polyunsaturated oils than those who had not had a heart attack.

The risk of eating transfats is presented at some length. (The reader may avoid transfats by not eating or drinking anything for which the words "partially hydrogenated" appear in the ingredients list.)

"Myth 8: The cholesterol campaign is based on good science." Ravnskov gives examples of reports of interventions with little or no statistical significance being denied time for presentation at meetings, and that offers to write minority dissenting reports on certain trials were being denied on the grounds that the conference was supposed to produce a consensus. Statements of diet-heart proponents and their recommendations are quoted followed by a Ravnskov's refutation of the claimed evidence. He reiterates that even drastic lowering of cholesterol levels with drugs (diet being ineffective) is of no benefit to women and of marginal benefit to men. Ravnskov presents arguments against trying to lower cholesterol levels in children.

"Myth 9: All scientists support the diet-heart idea." If Ravnskov were a lone voice among the Philistines his credibility would be lowered. In this chapter he gives the names of several of the scientists who support his position. This includes Mary Enig, President of the Maryland Nutritionists Association, whose research concerned the hazards of transfats, and who has written a book on the composition and effects of fats in the diet.

Michael Gurr, Professor of Biochemistry, School of Biological and Molecular Sciences, Oxford University, pointed out the insufficient correspondence in vascular pathology between animal models and man, the selection bias in epidemiologcal evidence, the lack of correlation between CHD and fat consumption, and the lack of improvement in coronary mortality after dietary and drug intervention.

George Mann, Professor of Medicine and Biochemistry at Vanderbilt University, TN, realized, from his studies of the Masai in Kenya, that animal fat could not possibly be the cause of high cholesterol and CHD, and he has been open and fearless in his criticism of the LRC directors, and has called the diet-heart theory "the greatest scientific deception of this century, perhaps of any century".

Michael F. Oliver, former Professor and Director of the Wynn Institute for Metabolic Research, London, UK, has warned against campaigns for cholesterol lowering in the general population; criticized those who think that the increased mortality from non-medical causes in trials, such as suicide, is due to chance; and is uneasy about the link between low cholesterol and cancer.

Edward R. Pinckney, editor of a number of medical journals, published a book in 1973 called The Cholesterol Controversy which summarized all the inconsistencies in the cholesterol literature, describes the dangers of lowering one's cholesterol , and devotes an entire chapter to the political drama preceding an early anti-cholesterol campaign.

Raymond Reiser is a former Professor of Biochemistry at Texas A & M University. He decried the practice of referring to other reviews, each taking the last on faith, which has led to the acceptance of a phenomenon (diet-heart) that may not exist. He reviewed work on fatty acids in the diet, found flaws in most of the studies, and concluded that the type of fat in the diet does not make much difference. He analyzed the references used by the American Heart Association in its rationale for dietary recommendations, and found no supportive studies, but instead, some that contradicted the recommendations.

Ray Rosenman is the retired Director of Cardiovascular Research in the Health Sciences Program at SRI International in Menlo Park, CA, and Associate Chief of Medicine, Mount Zion Hospital and Medical Center in San Francisco, CA. He has been a cardiologist and researcher since 1950. In a recent review he wrote that neither diet nor the identity of serum lipids (fats or oils) can explain wide national or regional differences in rates of CHD, or the 20th century variations in rates of CHD. Also that the CHD-preventive effects of diets and drugs have been exaggerated by a tendency in trial reports, reviews, and other papers to cite and inflate supportive results, while suppressing discordant data.

The late Russell Smith was an American experimental psychologist with a strong background in physiology, mathematics and engineering. In his 1989-91 review of the diet-heart theory he wrote: "...studies are often poorly designed and data are often inappropriately analyzed and interpreted... Much of the literature, therefore, is nothing less than an affront to the discipline of science..." He considered much of the work of the National Heart, Lung and Blood Institute and of the American Heart Association to be "incompetent" and "sloppy", and that their political and financial power is enormous and without equal, producing a juggernaut willing and able to suppress evidence and logic. "Equally culpable are the editors of the many journals who publish articles without regard to their quality or scientific import. It is depressing to know that billions of dollars and a highly sophisticated medical research system are being wasted chasing windmills."

William E. Stehbens, Professor at the Department of Pathology, Wellington School of Medicine, New Zealand, exposed the cholesterol myths in reviews: "...Scientific evidence for the role of dietary fat and [also] hypercholesterolemia in the causation of atheroscleosis is seriously lacking..."

Now retired, Lars Werkö, previously Professor of Medicine at Sahlgren's Hospital, Gothenburg, Sweden, Scientific Director at the Astra Co. (now Astra-Zeneca), and head of the Swedish Council on Technology Assessment in Health Care, criticized the design of the Framingham Study, and pointed out inaccuracies and sloppy data gathering in the MRFIT trial.

In the Introduction and Epilogue of this book, Dr. Ravnskov invites the reader to study original papers and follow the arguments. Without the detail he has provided, his voice might be considered "just another opinion". As it happens, a number of other physicians and scientists in addition to the ones in Myth 9 agree with his positions.

Linus Pauling, in his 1986 book: How to Live Longer and Feel Better, quotes John Yudkin, M. D., who found that the correlation between CHD and fat intake is not as good as the correlation with sugar intake. He noted that the Framingham Study showed no correlation between CHD and fat intake, or with cholesterol intake. However, Pauling was fooled by the study on cholestyramine, and failed to note total death rates.

Thomas J. Moore, a medical reporter based in Washington, DC, wrote an article in the September, 1989 issue of The Atlantic Monthly actually called The Cholesterol Myth in which he examined the literature much as Ravnskov did. Moore's conclusions: "Lowering your cholesterol is next to impossible with diet, and often dangerous with drugs - and it won't make you live any longer." This review was also used in Moore's 1990 book Heart Attack.

William Campbell Douglass, Jr., M. D., in 1993 wrote a brochure called Eat Your Cholesterol: How to Live off the Fat of the Land and Feel Great! This might still be available from Second Opinion Publishing, P. O. Box 467939, Atlanta, GA, 30346-9989. Many of the dietary studies and trials are the same ones evaluated by Ravnskov, but are treated in a very popular tone.

John B. Allred came to nearly all the same conclusions as Dr. Ravnskov in his article Lowering Serum Cholesterol: Who Benefits? in the Journal of Nutrition 123: 1453-1459 (1993).

Kilmer S. McCully, Ph. D., M. D., in technical papers and a book: The Heart Revolution: the Extraordinary Discovery that Finally Laid the Cholesterol Myth to Rest, Harper Perennial, 2000, wrote: "But no study anywhere has ever proven that lowering the amount of cholesterol in the diet reduces the risk of heart disease. And lowering cholesterol through drugs won't prevent arteries from hardening if homocysteine is high." McCully is the discoverer of the fact that the undesirable amino acid called homocysteine is an actual cause of atherosclerosis and CHD.

Based on Ravnskov's meticulous analyses as well as the considerable support for his stance shown by others who have also studied the cholesterol data, this book is recommended without reservation. Physicians and other health professionals as well as anyone threatened with cholesterol-lowering treatments would be enlightened, and better able to resist worthless treatments. Health insurers might reconsider compensation for frequent (or any) clinical assays for cholesterol or triglycerides, let alone expensive treatments to lower cholesterol levels that reduce quality of life without prolonging it significantly.

Disclaimer: Any recommendations herein are based on studies published in peer-reviewed scientific journals. I am not an M. D. and cannot engage in the practice of medicine. (My degrees are: B. S. in Chemistry from the Philadelphia College of Pharmacy and Science, and a Ph. D. in Organic Chemistry from the Massachusetts Institute of Technology. My experience includes about 10 years of exploratory drug development at the former and 4 years at the Massachusetts College of Pharmacy.)

Joel M. Kauffman
Research Professor Chemistry
University of the Sciences in Philadelphia
600 South 43rd St.
Philadelphia, PA 19104

Source: health911.com

The book is available at Amazon

Effect of a High Saturated Fat and No-Starch Diet

Effect of a High Saturated Fat and No-Starch Diet on Serum Lipid Subfractions in Patients With Documented Atherosclerotic Cardiovascular Disease

JAMES H. HAYS, MD; ANGELA DISABATINO, RN, MS; ROBERT T. GORMAN, PHD;
SIMI VINCENT, PHD, MD; AND MICHAEL E. STILLABOWER, MD

Full article: Mayo Clinic [PDF file]

The Mediterranean Paradoxes

The 'French Paradox' has been well documented over the years. This paradox describes the low levels of heart disease enjoyed by the French, despite the fact that they eat an 'unhealthy' high-fat diet. This is, of course, seen as a 'paradox' because conventional wisdom has it that such a diet should increase heart disease rates...

Read full article: Second Opinions - Barry Groves, PhD

Diet and Disease: Not What You Think

by Sally Fallon and Mary G. Enig, Ph.D.

Heart disease is America's major killer; it's prevention is our most urgent public health priority. Americans must change their diet, say the experts. Steer clear of traditional foods like butter, cream, cheese, eggs, and meat, they tell us. Rich foods contain cholesterol and saturated fats — "artery clogging substances."

The accumulation of hardened plaque in the arteries, or atherosclerosis, is indeed a major cause of heart disease in Western nations.

The accepted explanation for its prevalence in civilized countries is the lipid hypothesis, namely that dietary saturated fat and cholesterol lead to elevated levels of cholesterol in the blood, and that these elevated levels of cholesterol cause the pathogenic atheromas that block blood vessels.

This theory has been promoted by the American Heart Association since the mid-1960s. It forms the basis of governmental nutritional recommendations, which in turn have spurred consumer acceptance of a vast array of low-fat, cholesterol free food products, most of which contain ingredients that are new to the American diet.

Numerous studies, both national and international, have explored the lipid hypothesis — and consumed the lion's share of research dollars in this area — including three major projects funded by the National Heart Lung and Blood Institute, a division of the National Institutes of Health (NIH).

The first and best known of these studies was the Framingham Heart Study, carried out in the town of Framingham, Massachusetts.

Although Framingham is often associated with proof of the lipid hypothesis, the results of this 40-year study have been a disappointment to its promoters.

Investigators claimed that there was a 240% increase in "risk" of coronary heart disease, or CHD, between cholesterol levels of 182 and 244. But the actual rate of increase was only .13%.

Between cholesterol levels of 244 and 294, the rate of CHD actually declined.

Thus Framingham investigators found virtually

no difference in heart disease for serum cholesterol levels between 182 and 284

the vast majority of the U.S. population.

Nor did they find that diets high in fat and cholesterol predisposed an individual to heart disease.

As Dr. William Castelli, the current director of the Framingham project, admitted as recently as 1992: "In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more lories one ate, the lower people's serum cholesterol...we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories weighed the least and were the most physically active."

The second government-funded study was the Multiple Risk Factor Intervention Trial (MRFIT) for 362,000 men.

Researchers found that annual heart disease deaths increased from about 1 per 1,000 for cholesterol levels of 180 to slightly less than 2 per 1,000 for cholesterol levels of 300 — a 100% increase in "risk" but a trivial increase in rate of less that .1%.

A more significant finding was an increase in total deaths for cholesterol levels below 160.

The final major NIH study was the Lipid Research Clinics Coronary Primary Prevention Trial (LRC), a project that cost $150 million and received intense media attention.

All subjects in the trial were put on a low-cholesterol, low-saturated fat diet. One group received a cholesterol lowering drug, the other a placebo. Average cholesterol reduction for the drug group was 8.6% which had, according to researchers, a 17% reduction in rate of heart disease.

This led to the oft repeated statement: "For each 1% reduction in cholesterol, we can expect a 2% reduction in CHD events." But when independent researchers tallied the LRC data, they found no difference in CHD between the two groups. An unequivocal but rarely published finding of the LRC was an increase in deaths from cancer, intestinal disease, stroke, violence, and suicide in the group taking the cholesterol-lowering drug.

Both the popular press and medical journals portrayed the LRC as the long-sought proof that animal fats and dietary cholesterol are the cause of heart disease. The 1984 government-sponsored Cholesterol Consensus Conference called for mass cholesterol screening and defined all Americans with cholesterol levels over 200 as "at risk."

Participating scientists recommended the prudent diet for "at risk" Americans, one low in saturated fat and cholesterol. A specific recommendation was the replacement of butter with margarine. The ensuing National Cholesterol Education Program instructed American physicians in techniques for lowering serum cholesterol through diet ant drugs.

The estimated current cost for cholesterol screening and treatment in the United States now exceeds $60 billion annually.

The application of a modicum of common sense could have prevented the massive expenditures lavished on the lipid hypothesis during the past 30 years.

The lipid hypothesis implies that animal fat consumption must have increased significantly since 1920 to correlate with the rise in heart disease, but in fact the consumption of saturated animal fats in America declined steadily during that period, while use of vegetable fats increased dramatically.

Autopsy studies of vegetarians reveal that although they have lower serum cholesterol values than non-vegetarians, they have as much atherosclerosis as non-vegetarians.

In fact, the International Atherosclerosis Project, which analyzed 31,000 autopsies from l5 countries, found no correlation between animal fat intake and degree of atherosclerosis or serum cholesterol level.

Michael DeBakey, the famous heart surgeon, surveyed 1,700 patients with atherosclerosis and found no relation between levels of serum cholesterol and degree of hardening of the arteries. Other U.S. studies — the Veterans Clinical Trial, the Minnesota State Hospital Trial, the Honolulu Heart Program, and the Puerto Rico Heart Health Study — found no significant relation between a diet high in cholesterol and saturated fats with CHD.

Unfortunately, these studies do not receive front page coverage in American newspapers, and dissenting voices must content themselves with publication in obscure medical journals. One of these voices is the eminent researcher Dr. George Mann, who states categorically:

"The diet-heart hypothesis has been repeatedly shown to be wrong, ant yet, for complicated reasons of pride, profit, and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprises, food companies, and even governmental agencies. The public is being deceived by the greatest health scam of the century."

Michael Gurr, Ph.D., renowned expert on lipids and author of the authoritative textbook on lipid biochemistry, recently stated that "whatever causes coronary heart disease, it is not primarily a high intake of saturated fat." He criticized "...the degree of self delusion in research workers wedded to a particular hypothesis despite the contrary evidence!"

So if it ain't saturated fats ant cholesterol, what causes heart disease? There are, in fact, a number of dissenting theories, most of which dovetail into a compelling list of dietary and lifestyle factors that are unique to civilized societies. Consider the following:

• In the 1940s and 1950s, researchers Yudkin and Lopez discovered a link between consumption of refined sugar and heart disease. Sugar consumption lowers the body's resistance to bacteria, viruses, and yeasts that may cause inflammation in both the heart and the arteries. Excess sugar leads to deficiencies in the entire B-vitamin complex, needed for healthy arteries. Ongoing research at the U.S. Department of Agriculture indicates that fructose may be even more dangerous than sugar. Fructose, mainly in the form of high-fructose corn syrup (HFCS), has become the sweetener of choice for soft drinks, condiments and many so-called health foods.

• Also in the 1960s, a researcher named Annand discovered a correlation between the consumption of heated milk protein and a tendency to thrombosis — the formation of blood clots — and noted that the rise in coronary heart disease began in the 1920s with laws requiring milk pasteurization.

• Researcher Kilmer McCulley has found a positive relationship between deficiencies in folic acid, B 6 and B l2 , and severity of hardening or stiffness of the arteries, as well as the buildup of pathogenic plaque. B 6 and B 12 are found almost exclusively in animal products — the very foods that proponents of the lipid hypothesis advise us to avoid. B 6 deficiency is also associated with hardening of the tendons leading to carpel tunnel syndrome. Deficiencies of this heat-sensitive vitamin are widespread in America, partly because B 1 and B 2 added to white flour interfere with its proper use, and partly because it is destroyed during milk pasteurization. (Although pasteurization may help prevent foodborne illness, the process destroys nutrients.) Although McCulley's research has gained widespread, albeit grudging, recognition in the scientific community, it continues to lack appropriate funding and public recognition.

• Vitamin C deficiency makes arterial walls more subject to inflammation and tearing. A diet rich in natural vitamin C complex helps maintain the integrity of both blood vessels and heart muscle. Vitamin C also plays a role in collagen synthesis, along with copper, through the enzyme lysyl oxidase. Deficiencies occur in diets that lack fresh fruits and vegetables.

• Heart disease has been correlated with mineral deficiencies. Coronary heart disease rates are lower in regions where drinking water is naturally rich in trace minerals, particularly magnesium, which acts as a natural anti-coagulant and aids potassium absorption, thereby preventing heartbeat irregularities. Mineral-rich water and soil also supply iodine, needed for a healthy thyroid gland. People with poor thyroid function are very prone to heart disease. Calcium also plays a role in protecting the heart and arteries. Potassium helps maintain proper blood pressure. Traditional meat broths are rich in magnesium, potassium, calcium, and iodine. In America, these have largely been replaced by imitation broth products containing MSG and hydrolyzed protein.

• The most important change in the American diet during the years of CHD increase has been the gradual substitution of vegetable fats for those of animal origin. Hydrogenated fats — in the form of margarine and shortening — have replaced butter and lard, while the consumption of vegetable oils has increased more than 10-fold. Since as early as 1956, a number of researchers have found that consumption of trans-fatty acids in hydrogenated oils contributes to heart disease, including most recently Mensink and Katan in the Netherlands, and Walter Willett at Harvard University.

• An excess of vegetable oils, even when not hydrogenated, seems to play a role in causing heart disease because they cause an imbalance in the production of prostaglandins, localized tissue hormones that play a role in all of the body's complex chemical processes; and because industrially processed vegetable oils contain bee radicals that damage the arteries, thereby initiating plaque deposits.

• Arterial plaque contains cholesterol because the body actually uses cholesterol to repair injuries, tears, and irritations to artery walls. However, like rancid vegetable oils, cholesterol that has been oxidized by high temperatures and exposure to air can itself irritate the arterial walls and initiate pathological buildup. High temperature spray production of powdered milk and eggs, used as additives in many processed foods, began in the early part of the century. Consumption of both hydrogenated fats and products containing oxidized cholesterol increased greatly after the war.

• A recent study found that excess consumption of omega-6 fatty acids, the kind found in commercial vegetable oils made from corn, soy, safflower, and canola, increases the amount of oxidized cholesterol in the arterial plaque. Like sugar and white flour, these vegetable oils, produced by high temperature industrial processing, are new to the human diet. It is the polyunsaturated omega-6 fatty acids — not saturated fat — that form the major fat component of arterial plaque, yet for many years the American Heart Association and many establishment nutrition writers advocated consumption of polyunsaturated oils for the heart.

• The role of vitamin D in protecting against heart disease has been neglected. Vitamin D is essential for the intestinal absorption of many minerals, but particularly calcium and magnesium. Vitamin D deficiency is associated with defective calcification of the bones and pathogenic calcification of the arteries. Synthetic vitamin D added to milk has the same effect as vitamin D deficiency — it causes abnormal calcification of the soft tissues, particularly the blood vessels. Our bodies can manufacture vitamin D from cholesterol by the action of sunlight on the skin, but natural dietary sources give added protection. Vitamin D is found only in animal fats.

• Short- and medium-chain saturated fatty acids have anti-microbial effects and protect against the kind of viruses and bacteria that contribute to heart disease. Best sources of these helpful fats are the tropical oils, especially coconut oil, which have largely disappeared from the American food supply due to unfounded assertions that these healthy fats contribute to heart disease.

• Caffeine in coffee causes the body to excrete calcium and stresses the adrenal glands, leading in some cases to general exhaustion, including exhaustion of the heart muscle. This theory has been subject to intense criticism. Detractors note that heavy coffee drinkers tent to indulge in a number of habits considered unhealthy by orthodox researchers — such as smoking and lack of exercise — as well as consumption of sugar and processed foods, leading to deficiencies not yet accepted by the medical establishment as being contributors to CHD.

• Anti-oxidants such as beta-carotene, selenium, and vitamin E may protect us against damage from highly processed vegetable oils and oxidized cholesterol. Orthodox medicine has ignored or ridiculed vitamin E therapy for heart disease, pioneered by the Shute brothers, physicians in Canada, who found that 100 mg of natural vitamin E from wheat germ oil gave excellent long-term protection from coronary heart disease. Fresh fruits and vegetables supply beta-carotene and hundreds of other carotenoids; butter is a particularly rich source of selenium.

• Other theories related to heart disease include lack of exercise, overweight, high blood pressure, smoking, and exposure to carbon monoxide gas.

Heart Disease Has Many Forms

What emerges is a clear association of heart disease with the increased consumption of devitalized, processed, fabricated food items, including sugar and fructose, pasteurized milk, soft drinks, fortified white flour, miller and egg powders, caffeine, imitation broth products, synthetic vitamins, vegetable oils, and hydrogenated fats.

The lipid hypothesis not only clouds this picture, but inhibits necessary research that could illuminate these connections more clearly. Instead of adding to medical and nutritional understanding, it may be undermining public health — promoting the substitution of newfangled, altered, imitation products for nourishing traditional whole foods, including butter, cream, cheese, eggs, and meat.

Although not unknown, heart disease was relatively rare at the turn of the century, accounting for approximately 8% of all deaths in the United States.

Today coronary heart disease, or CHD, accounts for about 45% of all deaths.

Incidence of heart disease rose precipitously between 1920 and 1960. Since that time, mortality rates from CHD have declined somewhat. This means that victims of heart disease are living longer, due most likely to improved surgical techniques and the advent of angioplasty; but morbidity rates — the incidence of heart disease — continue to rise, although at a lower rate than before.

Of greatest concern is the high rate of heart disease in American men between the ages of 45 to 65.

Heart disease is not a single malady, but a complex of disease coming under a single rubric.

Damage to the heart muscle or myocardium may be due to a congenital defect, or result from inflammation and damage associated with any number of viral, bacterial, fungal, rickettsial or parasitic diseases; from rheumatic fever or syphilis; from toxic chemicals such as carbon monoxide or drugs; from auto-immune reactions or genetic disorders in which important cellular proteins in the heart muscle are deranged; or from disruption of enzymes affecting cardiac function.

The heart may also be damaged by an imbalance between the blood supply and the demands of the heart muscle leading to ischemia, a local deficiency of blood supply, and infarction, the death of an area of heart tissue.

Such deficiency may be caused by physical exertion or emotional trauma, increasing the heart's need for blood; or from a drop in blood supply due to excess bleeding, a spasm in an artery, a blood clot (thrombus) or by coronary artery disease, a condition in which the arteries become gradually blocked by the buildup of abnormal plaque (atheromas) and hardened through calcification. Blockage often occurs in the large arteries feeding the heart (the coronary arteries), or in those supplying the brain, increasing the risk of stroke.

In cases of moderate blockage of the coronary arteries, the patient may suffer from angina pectoris, bouts of brief chest pain; moderate blockage combined with increased demands on the heart, due to exertion or trauma; or severe blockage due to arterial plaque, a clot, a spasm, or any combination of these, may lead to a myocardial infarction, the dreaded heart attack, resulting in cardiac dysfunction and often rapid death. Sudden death is often triggered by an acute arrhythmia — disruption in the rhythms of the heart beat — during a heart attack.

While coronary artery disease is a common cause of heart attack, myocardial infarction may also occur in the absence of arterial blockage, due to a spasm, clot or organic failure of the heart muscle.

Heart disease due to syphilis and infectious disease has been around a long time and probably accounts for a good portion of CHD deaths before 1920. Fatty streaks, lesions, and plaque in the arteries are found in many primitive people, but coronary artery disease, the pathological buildup of hardened plaque leading to partial or total occlusion of major arteries, seems to be a disease of civilization, and probably accounts for a great deal — though not all — of the increase in heart disease between 1920 and 1960, and its continued menace to the present day.

Sally Fallon is the author of Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats and Mary G. Enig, PhD is the author of Know Your Fats: The Complete Primer for Understanding the Chemistry of Fats, Oils and Cholesterol .

The Health Myths

Myth: "It's that evil cholesterol and saturated fats that cause heart disease"

Book excerpt here

About canola oil

A discussion at Thincs.org

bantransfats.com

"BanTransFats.com, Inc. is a non-profit corporation based in California. Our goal is the reduction and elimination of trans fats from all food products. Our founder is Stephen Joseph, a lawyer based in San Francisco, who is originally from Britain. Our principal consultant is Mary Enig, Ph.D. She is widely regarded as one of the world's foremost authorities on trans fats.

There are four kinds of fats: saturated fat, trans fat, monounsaturated fat, and polyunsaturated fat. Trans fat is the most dangerous.

Many British food products contain trans fat, including Digestive biscuits. It's not just in biscuits. It's in all kinds of foods, even some "health" foods. If you see the words "hydrogenated" or "partially hydrogenated" in the ingredients, the product contains trans fat.

Recent medical research has shown that trans fat causes significant and serious lowering of HDL (good) cholesterol and a significant and serious increase in LDL (bad) cholesterol; major clogging of arteries; type 2 diabetes; and other serious health problems."

Full article, further information and links on the subject: bantransfats.com

Know your fats

Confused About Fats?

These nutrient-rich traditional fats have nourished healthy population groups for thousands of years:

• Butter
• Beef and lamb tallow
• Lard
• Chicken, goose and duck fat
• Coconut, palm and sesame oils
• Cold pressed olive oil
• Cold pressed flax oil
• Marine oils

These new-fangled fats can cause cancer, heart disease, immune system dysfunction, sterility, learning disabilities, growth problems and osteoporosis:

• All hydrogenated oils
• Soy, corn and safflower oil
• Cottonseed oil
• Canola oil
• All fats heated to very high temperatures in processing and frying

All articles: Weston A. Price

About Lard

Not all lard is created equal.

-- Freshly rendered lard: This is the best kind to use in cooking, but it might be hard to find. Some old-fashioned butcher shops may carry it. But, your best bet is to look for it in Latino markets, such as La Palma Mexicatessen in the Mission District of San Francisco.

If you simply can't find freshly rendered lard, and need only a few tablespoons, cook a couple of strips of fatty bacon and use the grease left in the pan. Bacon fat is lard, too.

Or, you can render your own lard from fresh pork fat.

Full article: sfgate.com

For Thais, palm oil always has been a good thing

When Kasma Loha-unchit recently saw a can of palm oil labeled as "organic shortening" on the shelf of her local natural foods store, she didn't know whether to laugh or to cry.

The irony cut deeper when she read the second line. "Trans fat free."

The contents? One hundred percent palm oil.

Loha-unchit of Oakland, a 30-year transplant from Thailand who teaches Thai cooking, might well have vented by picking up her cleaver to thwack open some coconuts and cook a traditional Thai meal with the fatty coconut milk. The coconut and palm oils in her kitchen were always organic, pure and trans fat free.

She felt vindicated. In 20 years, with the kind of lightning speed that defines a lifetime in America, coconut and palm oils have come full circle, from full embrace to vilification to comeback.

Full article: sfgate.com

Fat that may benefit Diabetics reduces weight, blood sugar

"COLUMBUS, Ohio – Supplementing the diet with a certain fatty acid may lead to better weight control and disease management in diabetics, a new study suggests.

Diabetics who added an essential fatty acid called conjugated linoleic acid (CLA) to their diets had lower body mass as well as lower blood sugar levels by the end of the eight-week study. Hyperglycemia, or high blood sugar, is a hallmark of diabetes.

Researchers also found that higher levels of this fatty acid in the bloodstream meant lower levels of leptin, a hormone thought to regulate fat levels. Scientists think that high leptin levels may play a role in obesity, one of the biggest risk factors for adult-onset diabetes."

Full article: Ohio State University

Fatty Acids Requirements

This snippet from Low-Carb in the UK with permission from the author Barry Groves, PhD, Author of "Eat Fat, Get Thin!" and Second Opinions.

The Skinny on Fats & Breast Cancer

by Stephen Byrnes, PhD, RNCP

"In today’s nutritional world, fat has become a dirty word. Women in particular are encouraged to eat a low-fat diet to help prevent breast cancer, as well as other ailments, including other cancers. Animal fats such as butter have taken a terrible beating in the media over the past few decades and have been blamed for horrific crimes, including obesity, heart disease and cancer. Accordingly, Western peoples have been virtually brainwashed into thinking that butter and other predominantly saturated fats like coconut oil and tallow are unhealthy. So-called safe substitutes like margarine and various vegetable oils have been heavily promoted and advertised with the result being that the public associates these things with health and well-being.

Unfortunately for us, all of these contentions and claims are false. When it comes to breast cancer prevention, and in some cases treatment, the so-called ‘bad fats’ are actually the good guys, and the ‘safe substitutes’ are increasingly being shown up for what they really are: fabricated foods that cause disease, including breast cancer."

Full article: powerhealth.net