In the pages of this book you will learn: what foods to eat to improve your mental powers, step

up your vigor how to use today's 3 sensational food supplements harmful food cravings and how to overcome them how to take the nuisance out of calorie counting 7 ways to lose weight and keep it lostautomatically how going on and off diets does more harm than good how to figure how long you'll live why you may be wasting money on vitamin pills what the "easy, fast" reducing formulas don't tell you how your eyes, heels, elbows warn of arteriosclerosis how to "cook in" the good in foods you eat

fantastic health miracles performed with the new wonder foodlecithin foods that keep older people from feeling their age how a low-fat intake keeps you off the sick list how food supplements guard against virus infections food secrets of people with outstanding vitality why getting fat is worse than

being fat how alcohol can be beneficial in your diet how to survive a heart attack to a ripe old age the truth about tobacco and health how much fatty food is safe for you 5 "golden rules" of nutrition worth more than all the gold in the world

We deem it a privilege to have the opportunity to disseminate this important health-giving information through the medium of this book. The Publishers

THE LOW-FAT WAY TO HEALTH AND LONGER LIFE

The Complete Guide to Better Health Through Automatic Weight Control, Modern Nutritional Supplements, and Low- at !iet.

THE SIX THINGS THIS BOOK WILL DO FOR YOU

I he reader may well ask"What will this book do for me " or to paraphrase !en "ranklin# "$an it bring me health %whi&h is really wealth'# happiness# and wisdom " It &an# for many reasons. ( growing number of books for laymen on the sub)e&t of health have appeared in the past de&ade. *ever before has there been su&h widespread popular interest in medi&al s&ien&e. +u&h of this interest has been motivated by the unpre&edented advan&es in medi&al resear&h that have been made in our time. ,ne dis&overy has led rapidly to another and many old views are radi&ally &hanged. *ew information# new diagnosti& tools# and new drugs have provided new answers to many old problems that were believed to be without solution. -ven the pra&ti&ing physi&ian &annot always keep abreast of these swift developments in medi&al progress. .e &annot take time from treatment of his patients to evaluate all reports of new findings and new produ&ts that daily flood his offi&e. (t the same time# he &annot shirk the traditional responsi bility of the physi&ian to tea&h the publi& how to prevent illness and how best to treat it when it o&&urs. The answer# therefore# seems to lie in a division of labor

/I0 T.I*1/ T.I/ !,,2 WI33 4, ",5 6,7 among do&tors. -a&h should &ontribute to the nation8s health literature information on the parti&ular phase of medi&ine about whi&h he is best 9ualified to speak. /u&h information# whether derived from resear&h or from his daily pra&ti&e# should be as reliable and as safe as a pres&ription. *ot all books appearing todayeven those written by physi&ians&ome up to this high standard. +any are written merely to entertain# to e:ploit some medi&al novelty# or sometimes to enhan&e the prestige of the author. In preparing the following work for the general reader# the author has aimed at a twofold ob)e&tive: to prolong your life and to save you from &rippling or fatal heart disease resulting from hardening of the arteries. The information offered here is based upon the writer8s ;< years of medi&al pra&ti&e# e:tensive resear&h# and &lini&al e:perien&e. The low-fat diet# weight redu&tion# and nutritional program presented in this book are not a pana&ea for all illnesses. They are not a get-healthy-9ui&k nostrum or &ure for everything that ails you. .owever in the opinion of the author and a large number of s&ientists and physi&ians# these measures are the most effe&tive known to prevent and treat hardening of the arteries or athero s&lerosis# today8s greatest &ause of si&kness and death. There are un9uestionably other still unknown &auses of hardening of the arteries in the heart# brain# and other vital tissues of the body. *ot only is there little or nothing known about them# but there is no effe&tive remedy other than those presented in the following pages. (t this very moment# &ountless resear&h s&ientists and physi&ian-investigators are sear&hing the unknown in the life-or-death 9uest for the various &auses and the &ure for atheros&lerosis. If this mira&ulous dis&overy should &ome to pass# the way of eat ing and living des&ribed in this book may be&ome of histori&al interest only.

/I0 T.I*1/ T.I/ !,,2 WI33 4, ",5 6,7 !ut# until that day of more perfe&t knowledge arrives# I be lieve we should# in all good &ons&ien&e# use the most perfe&t tools that we now have# namely the dietary and nutritional tools set forth in this book. The mounting eviden&e that they &an save the lives and health of &ountless vi&tims is now too powerful to allow us to stand by and wait for the perfe&t &ure or the thera peuti& millennium. If you will read this book &arefully# and apply the simple, easy-to-follow directions given, it is the author8s sin&ere belief that it will enable you to a&&omplish the following:
1. ADD YEARS TO YOUR LIFE

.ow many years depends upon your present age and weight. If you are under ;=# for e:ample# you &an in&rease your lifespan by as mu&h as >< years. -ven if you are over ?=# you &an still en)oy more than two golden# "bonus" years. These figures are based upon a&tual +etropolitan 3ife Insuran&e tables# in &luded in this book. 2. KNOW WHAT FOOD TO EAT

In addition to prolonging your life by &ontrolling your weight# &orre&t diet &an also save you from heart and blood vessel disease. (lmost all heart resear&hers agree that when people who have defe&tive fat metabolism eat a high-fat diet# heart disease often results. In the following pages you will find instru&tions# in detail# on what to eat to maintain a well-balan&ed diet and at the same time to avoid fat-ri&h foods that may undermine your health. $omplete daily menus for a period of several weeks are in&luded.
3. DISCOVER NEW VITALITY THROUGH DIETARY SUPPLEMENTS

+edi&al resear&h has dis&overed a number of important dietary supplements that not onlv improve the body8s general effi-

/-0 T.I*1/ T.I/ !,,2 WI33 4, ",5 6,7 &ien&y and well-being but help prevent hardening and blo&king of the arteriesthe &ondition that sets the stage for heart atta&ks and strokes. The nutritional supplements &ombined with vitamins that are des&ribed in the following pages &an help you over&ome fatigue# nervousness# and loss of energy. +edi&al s&ien&e has effe&tively demonstrated that millions of (meri&ans eat three meals a day but are poorly or badly nour ished @ many are overweight. 6et they suffer from the symptoms of malnutrition or borderline# sub&lini&al illness. This is often e:pressed by feelings of tiredness# nervous symptoms# and loss of vitality. The author will des&ribe the results of &ontrolled studies into new produ&ts that he and his asso&iates have &ondu&ted to prove their effe&tiveness and safety.
4. KNOW WHAT TO DO ABOUT SMOKING

The role that &igarette smoking plays in various diseases has been the sub)e&t of intensive resear&h. The dis&ussion of toba&&o will answer many of your 9uestions &on&erning the effe&t of smoking on the heart and blood vessels.
5. KNOW WHAT TO DO ABOUT USING ALCOHOL

The 9uestion of al&ohol# although not so important to the prevention and treatment of heart disease as it is to some other physi&al disorders# is also dis&ussed# and professional advi&e given for using it safely.
. PUT SUNSHINE INTO YOUR AUTUMN YEARS

It would be only a limited gain if the years added to your life were years of unhappiness or ill health. Therefore# the author has in&luded advi&e for meeting the spe&ial problems of the older years. The writer believes that a longer# happier life will be yours

/I0 T.I*1/ T.I/ !,,2 WI33 4, ",5 6,7 if you make a whole-hearted effort to absorb and follow the dire&tions given here. 3ike most worthwhile undertakings# it will take patien&e and time. !ut the results are so vital to you and to your loved ones# that your utmost efforts &an reward you with a ri&h harvest of health and e:tra years of happy living.

CONTENTS
CHAPTER PACK

1. CLOGGED PIPES TO THE FOUNTAIN OF LIFE........................................................ Why can't we live longer? 1 Advances in medical science have outlawed many diseases, 2 The 20th entury epidemic, 2 What is the cause of this new epidemic? ! Why is the epidemic particularly strong in the "#$#A#? % What is the situation in other countries of the world? & 's the epidemic confined to older people? ( )oes heredity have anything to do with the pro*lem? 10 Women have *etter natural protection against atherosclerosis, 11 an you reverse damage done to your arteries *y e+cessive fat? 11 What is the solution for us? 12

$,*T-*T/
CHAPTER PACE

2. PHYSIOLOGY OF FAT! FAT" FOOD" FACTS AND FICTION.......................................

's fat essential in a healthy diet? 1! What is fat? 1, -rotein is the .eystone of human nutrition, 1, ar*ohydrates are a main source of energy, 1/ 0ats What they are and what they do to you, 11 2ow are fats digested? 1% 2ow are fats a*sor*ed? 1& 2ow fats damage or destroy your arteries, 1( 0at may *e your 3poison, (' 21 2ow much fat are you stowing away? 22 Ta.e a lesson from the pig, 2/

13

3. FAT" THE KILLER" ON TRIAL.....................2#

2ere is how ' entered the race, 2% 's cholesterol and e+cess fat present in the *lood of everyone with atherosclerosis? 2& What a*out the factor of heredity? 2( 's there an e+cess of fat im*edded in the artery wall itself? !1 Are there other conditions that cause heart attac.s and stro.es? !! The role of the liver in protecting you from e+cess fats, !, lsnt there some medicine that will stop fat from causing heart attac.s? !, 4any other fat preventing agents have *een dis covered and found wanting, !/ 2ow the low-fat diet proved its value, !1 The low-fat diet proved to *e effective in reducing weight and promoting general good health, !&

$,*T-*T/
CHAPTER PACE.

4. HOW TO BE REALLY WELL" THE LOWFAT WAY .......................................

5our diet is the .ey to your health, ,! A healthy diet does not mean starvation or tasteless foods, ,, 5ou do not have to lose energy good diet increases vigor, ,, Almost everyone can *enefit from a low-fat diet, ,/ The low-fat, low-cholesterol program, ,%
"oods Permitted: oups! "eats! #ish! $oultry! %ggs! &heeses! 'egetables! #ruits! alads and salad dressings! &ereals! (reads! )esserts! (everages! "oods to (void: oups! "eats! #ish! $oultry! )airy products! %ggs! (reads! )esserts! "iscellaneous foods!

43

5. HOW TO USE DIETARY SUPPLEMENTSLECITHIN" SOYA OIL" VITAMINS . .

6ven a goat wouldn't eat what you eat, /( What is wrong with our diet and our eating ha*its? 10 2ow to supplement your diet with essential nutrients, 11 The five-step program, 12 2ow to use 7ecithin, 12 2ow to use soya oil, 11 2ow to use vitamins, 1%

5$

LOW-FAT MENUS............................................
8eneral considerations for low-fat menus9

$,*T-*T/
CHAPTER PACE

LOW-FAT MENUS %C&'(.) !

oups! "eats! 'egetables! )esserts! 7ow-0at 4enu 1, %1

7ow-0at 4enu 2, 7ow-0at 4enu !, 7ow-0at 4enu ,, 7ow-0at 4enu <# 7ow-0at 4enu 1, 7ow-0at 4enu %, 7ow-0at 4enu &, 7ow-0at 4enu (, 7ow-0at 4enu 10, 7ow-0at 4enu 11 7ow-0at 4enu 12, 7ow-0at 4enu 1!, 7ow-0at 4enu 1,, 1200:calorie menus, 1000:calorie menus, &00:calorie menus#

%! %/ %% %& %( &1 &2 &! &, &/ &1 &% && &( (! (%

. HOW TO COUNT THE CALORIES...........1*1

;verweight is a hidden disease, 101 )iet for health, as well as for *eauty, 102 's overweight due to 3glandular trou*le3? 10! What causes overweight? 10! <ervousness is a primary cause of overweight, 10! A feeling of failure can lead to overeating, 10, =ad food ha*its a second main cause of overweight, 10/ Too much weight can strain your heart, ro* you of energy, 10/

CONTENTS
CHAPTXB

xxi
PACE

. HOW TO COUNT THE CALORIES %C&'(.)!

4ost people today don't have heavy demands made on their physical energy, 101 >ust what is a calorie? 101 2ow to determine the num*er of calories you need, 10% 4aintaining your proper weight *y a regular calorie count, 10& There is only one healthy way to reduce, 10( $even rules for getting your weight down and .eeping it down, 10( )rugs are not the answer, 111 alorie counts of foods listed alpha*etically, 111

#. HOW MANY YEARS WILL LOW-FAT LIVING ADD TO YOUR LIFE+ ..............123
6ven if you've had a heart attac., the low-fat diet can dou*le your normal span of e+pected years, 12, The same low-fat diet may lengthen the life of everyone, 12, 5ou can do something a*out it, 12, 'deal weight can add more 3*onus?? years of life, 12/ What a*out younger people? 12/ Weight ta*les, 121

,. WHAT ABOUT CIGARETTES-SHOULD YOU STOP SMOKING+......................13*

The "se and A*use of To*acco, 1!2

$,*T-*T/

,. WHAT ABOUT CIGARETTES-SHOULD YOU STOP SMOKING+ %C&'(.) "

The agreeable effe&ts of smoking# >A; The indifferent effe&ts of smoking# >AB The effe&t of smoking on health# >A< The effe&t of smoking on the heart# >A< .ow smoking affe&ts the blood vessels# >A? What smoking does to the digestive tra&t# >AC The relationship of toba&&o smoking and &an&er of the lung# >AD /moking is not ne&essarily the sole &ause of lung &an &er# >AD

2ow can you stop smo.ing? 1,1 'f you must smo.e, at least cut down on the num*er of cigarettes, 1,2 $witch from cigarettes to pipe smo.ing, 1,2 0ind a su*stitute chewing gum, peppermints, 1,! An effective approach to the to*acco ha*it, 1,,

$. HOW DOES ALCOHOL AFFECT YOUR HEALTH+...............................................14

What a*out alcohol? 2ow does it affect your health? 1,1 The 3good3 effects of alcohol, 1,%
The influen&e of al&ohol on the mind# >BC (l&ohol not a stimulant but a depressant# >BC It &an be useful as a "toni&#" >BC (l&ohol as a food# >BE The effe&t of al&ohol on the &ir&ulation# >BE (l&ohol &an be used to improve &ir&ulation# >BD +oderation is the key# ><= 4oes al&ohol in any way benefit the &oronary arteries ><> (l&ohol &an rela: tension in heart &ases# ><;

The in@urious effects of alcohol,

1/2

CONTENTS
$. HOW DOES ALCOHOL AFFECT YOUR HEALTH+ %C&'(.)!
(l&ohol &an be harmful to the emotions and the mind# ><A The effe&ts of al&oholi& e:&ess# ><B $hroni& al&oholism# ><< The *rain# Wernic.e's disease# 4archiafava-=ignanis disease# )elerium Tremens# -olyneuritis# Aorsa.offs -sychosis# What does alcohol do to the liver? 1/& What are the conclusions for you? 1/(

1*. HOW TO CARE FOR YOURSELF AFTER A HEART ATTACK...................................1 *

2ow and why the heart heals itself, 112 The low-salt, low-fat diet, 111 1eneral instru&tions for following a low-fat diet# >?? 0oods to avoid# 0oods permitted# ;ne wee. of sample menus for a low-salt diet# Best, 1%0 $hould you e+ercise? 1%1 What .ind of e+ercise is permissi*le? 1%! $hould you smo.e? 1%! $hould you avoid alcohol? 1%, What a*out coffee and tea? 1%, are of the *owels, 1%, an you continue to have se+ relations? 1%/ What is the *est 3coronary climate3? 1%1 When may you return to wor.? 1%% )evelop a constructive, optimistic attitude toward life, 1%& 5our chances for long life are e+cellent, 1&0

$,*T-*T/

11. GROWING YOUNGER WITH THE YEARS 1,3

't's never too late, 1&! The low-fat diet *rought amaCing improvements, 1&, 5ou need more than a 3normal' or 3average3 diet, 1&1 =egin now to feel young and really alive, 1&& There is evidence that the aging process may *e reversi*le, 1&& Weight control also contri*utes to healthy old age, 1(2 an youth *e restored in the prematurely aged? 1(2

INDEX........................................................2*1

W.-* ( /P(*I/.-/P-(2I*1
"5I-*4

wants to wish you the very best that life &an offer# he will often lift his glass with the following toast: "To health and wealth and time to en)oy both." -mbodied in this simple salute are the three basi& desires &ommon to people everywhere in all ages. *hy can't we live longer+ -veryone wants to live longer. It is one of the most deeply rooted instin&ts of mankind. -veryone wants to live a life of usefulness and abundan&e# free of disease and unhappiness. (s we grow older# we look forward even more an:iously to in&reasing our lifespan. We want time to en)oy our a&hievements# time still to make plans. !y the time

we rea&h ?= we realiFe with the great "ren&h painter 1auguin that "life is a split se&ond." We begin to think about all the things we still want to do before we rea&h our seventieth year. If we are fortunate enough to pass our seventieth birthday# we wonder whether we &an8t live even longerperhaps to be E=. Well# why &an8t we We are living mu&h longer than did our an&estors a &entury ago. We have added ;= years to the average life e:pe&tan&y in (meri&a sin&e >D==. >

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

,dvances in medical science have outlawed many diseases- These golden years are ours be&ause of advan&es made by tireless resear&h in medi&al s&ien&e. They represent a de&isive vi&tory over the &ontagious and infe&tious diseases whi&h sometimes wiped out whole se&tions of our population a generation ago. Thanks to the new knowledge provided by re&ent resear&h# we no longer need fear the ravages of su&h diseases as diphtheria# s&arlet and typhoid fever# syphilis andto a great e:tent tuber&ulosis. (ll these pestilen&es# however# were &aused by those invisible but ever-present enemies of healthgerms. Today the pi&ture has &hanged. With the vi&tory over deadly mi&roorganisms# a new threat has emerged in &learer and more frightening perspe&tive.

.he /0th &entury epidemic! A single# fundamental disease of the human body &an now be held a&&ountable for mu&h of the illness and more than half of all deaths o&&urring ea&h year in the 7nited /tates It is a disorder known by the general term of "arterios&lerosis#" whi&h means a hardening and thi&kening of the arteries. It is now so widespread that 4r. Paul 4udley White# the noted heart spe&ialist# re&ently des&ribed it as "a modern epi demi&." (s the disease progressessometimes over a long period of timethe vessels that &arry the blood from the heart to the body8s tissues be&ome stiff# and their inner surfa&es roughened and thi&k. These &onditions lay the groundwork for the three most &ommon &auses of death and disablement in (meri&a: heart atta&k# heart failure# and stroke. Is there anything that &an be done to van9uish this number one killer# whose favorite vi&tims are men in their middle span of life# and even the very young# sometimes those in their twenties The answer is "yes"provided you will take the time and the trouble now to learn a few simple rules. +u&h of the e:a&t nature of arterios&lerosis is still unknown.

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

!ut during the past >= years we have learned a great deal in the fields of pathology# &hemistry# biology# and nutrition that has provided us with &lues to the mystery# and a pra&ti&al approa&h to treatment for the first time. Widespread popular interest in the heart and in the aging pro&ess has helped immeasurably in the &on9uest of disease. !ut at the same time# it has been responsible for a good deal of fear and &onfusion among lay people. /ome of these mis&on&eptions are refle&ted in the 9uestions my patients ask after reading arti&les of the kind that now appear in many newspapers and magaFines. Take diseases of the heart and blood vessels# for e:ample. Terms su&h as atheros&lerosis# &oronary thrombosis# and &holesterol are today fairly &ommonpla&e# even in publi&ations for the general reader. !ut few non-medi&al people know e:a&tly what these words mean.

*hat is the cause of this new epidemic+ !efore taking

up our dis&ussion of ways to forestall a heart atta&k# it might therefore be well to understand more &learly the basi& physi ology involved. 3et us start with a &loser look at the arteries# the vessels that &arry fresh blood from the heart to the billions of &ells in our bodies that are in &onstant need of nourishment. 7pon &areful e:amination# we find that the arteries are not the simple tubes we have pi&tured them to be. Giewing them in &ross se&tion# we see that their stru&ture is more like that of a garden hose# &ontaining three layers of tissue in the walls. The inside layer or lining of the artery# whi&h do&tors &all the intima( &onsists of a slippery membrane somewhat similar to the mu&ous membrane on the inside of your mouth. The in-between layer# known as the media# is formed of mus&le fiber. This enables the blood vessel to e:pand and &ontra&t with the heartbeat# to fa&ilitate the flow of blood through it. The outer layer# &alled the adventitia, is &omposed of &oarse strong fiberH whi&h provide added strength to the artery.

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

In both the outer and the intermediate layers# there are tiny intrinsi& blood vessels whi&h nourish the artery itself. The thi&kness and e:a&t &omposition of the three layers vary# depending upon an artery8s siFe and lo&ation. ,f the &hanges that may o&&ur in the arteries as a result of disease# there are two types whi&h &on&ern us here. !oth kinds have traditionally been known by the general term# "arterios&lerosis#" whi&h means hardening or thi&kening of the arteries. (&tually# however# there are two kinds of hardening of the arteries. ,ne o&&urs when &al&ium deposits in the middle layer of the artery &ause it to be&ome brittle and hard. "or this rea son# it is sometimes &alled a "pipestem" artery. /u&h &al&ifi&a tion does not ne&essarily obstru&t the blood flow# and is usually harmless from a &lini&al point of view. The other type of &hange# on the other handand it is the more fre9uent onehas serious &onse9uen&es. It &onsists of a thi&kening of the inner wall of the artery by deposits of fats: &holesterol %a fatty al&ohol'# fatty a&ids# and the like# together with &al&ium. (s these deposits grow# the passageways or &anals of the arteries be&ome narrower# mu&h in the same way as the drain from your kit&hen sink be&omes &logged with grease deposits. The result is that less and less blood &an flow through the narrowed opening to the tissues or organs that depend on it for life. 6our "pipes" have be&ome &logged. (t the same time# the swelling of the lining &ells and roughening of the inner surfa&e provide sites for formation of blood &lots inside the narrowed artery. If the blo&kage is &omplete in vital arteries that feed the heart mus&le# a heart atta&kor as we physi&ians &all it# a &oronary thrombosiso&&urs. If this disaster o&&urs in the &erebral arteries of the brain# a "stroke#" sometimes &alled a heart atta&k in the head# results. When the small arteries of the kidneys are affe&ted# !right8s disease# formerly &alled "dropsy#" and other diseases ensue. !ut whether the thi&kening and blo&king pro&ess takes pla&e

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"< in the heart# head# or kidneys# it is essentially the same disease. 4o&tors refer to it as atherosclerosis# (bout a &entury ago# during an autopsy# a 1erman pathologist named 5udolph Gir&how laid open an artery to e:amine its interior wall. (long the lining he observed deposits of mushy fat that he &alled atheromata, a 1reek work meaning "porridge." It was from this word that we derived our term# atheros&lerosis. -mbedded among the &ells of the artery wall along with the fat# Gir&how observed some glistening &rystals. These turned out to be &holesterol. !ut how did these fats get into the artery walls This 9uestion has puFFled s&ientists for the past >== years# and it is still being pursued in various fields of resear&h. The first theory advan&ed by resear&hers was that of "imbibition#" whi&h held that fat droplets were absorbed dire&tly from the blood stream through the lining of the artery walls. When a weakening of the "ground" substan&e or a&tual stru&ture of the artery wall o&&urred# &holesterolthe main offenderand its related fats were deposited in the artery wall. This theory has been supported by the re&ent dis&overy that these fatty deposits# espe&ially &holesterol# e:ist in the same proportion in the artery wall as in the bloodstream itself. (nother theory that seeks to e:plain the way in whi&h the fatty deposits get into the artery walls held that they did not &ome from the blood stream primarily# but were manufa&tured within the &ells of the vessel wall. It has also been &laimed that fat mole&ules are normally absorbed by the artery wall without leaving a harmful residue of a&id &rystals. !ut some abnormal &ondition# su&h as high blood pressure# may for&e an e:&essive amount of the fat mole&ules into the wall. Then the artery &annot absorb the full amount# and deposits gradually build up. ,ther resear&hers have believed that the fat droplets find their way into the artery wall through the tiny vessels that supply blood to the artery itself. (&&ording to this theory# a hemorrhage or series of small hemorrhages may o&&ur in these tiny vessels.

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

( &lot is formed# whi&h deposits fat parti&les in the artery wall when the small vessels break down. +y own &on&lusion# based upon years of animal# laboratory# and human resear&h# plus e:perien&e with innumerable patients# is this: (theros&lerosis results from an impairment of the body8s ability to utiliFe %or metaboliFe' normally not only the fats eaten in the diet# but also those that are in the body itself. This im pairment is further aggravated by the body8s inability to with stand stress or tension@ and by defi&ien&ies in the supply of hormones from vital glands su&h as the thyroid# the adrenals# and the se: glands. In addition# there are other fa&tors that influen&e the in dividual8s sus&eptibility to atheros&lerosis# or death from a heart atta&k or stroke. These in&lude su&h things as inherited or &on stitutional fa&tors# and the &oagulability of the blood. It is easy to see how &omple: the problem really is. The danger of oversimplifi&ation is great. .owever# one &ausative fa&tor that stands out &ontinuously above and beyond all others# important as they are# is fat in the diet. (nd it is this fa&tor that we &an &ontrol. These fats from our foods enter our blood stream where# like sharks &ruising about# they seek out the weak or vulnerable spots in the arteries. .ere they atta&k# enter# and deposit or nest themselves. These fatty deposits then a&9uire &al&ium# and the hardening pro&ess begins in the arteries. -a&h parti&le be&omes a &aptain around whi&h rally the silent "+en of 4eath#" who wage a relentless struggle. /oon they begin to throttle our life flow. ,ur blood vessels then engage in a vain effort to halt the armada of killers we now harbor within our arteries. /pe&ial fateating &ells are rushed to these spots# where the fats and &holesterol have brea&hed the barrier or wall and entered the artery. In the life-and-death struggle that ensues# the fat-eating &ells try to engulf the &holesterol and fat parti&les# and may su&&eed temporarily in the "&ounter-atta&k." 4r. Timothy 3eary# the distinguished !oston pathologist# in

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"C >DAA first devised ingenious methods of lighting up# refra&ting# and photographing this deadly drama. It was seen that in evitably the spe&ial fat-fighting &ells are themselves engulfed by the repeated tidal waves of &holesterol and fats washed into the blood and artery walls by fat-&ontaining foods su&h as butter# eggs# &ream# milk# meat fats# and other animal fats in our diet. Why is the epidemic particularly strong in the "#$#A#? If you are a typi&al (meri&an# whether you know it or not you &onsume an unbalan&ed# obesity-produ&ing diet. 4rs. 3ouis 2atF and I. /tamler# prominent resear&hers in this field# &alled it "a perni&ious &ombination of overnutrition and undernutrition e:&essive in &alories# &arbohydrates# lipids and salt@ and fre 9uently substandard in &ertain &riti&ally important amino a&ids# minerals and vitamins." It is not surprising that this situation e:ists. The s&ien&e of nutrition# a &omparative new&omer to the medi&al field# has up until re&ently been &on&erned almost e:&lusively with undernutrition. People have been urged to "eat the right foods" and to provide plently of meat# eggs# milk# and &heese for their &hildren. In most areas of the world# this problem of getting enough nourishing food to eat is still of primary importan&e. !ut it is not the problem in (meri&a. ,ur problem is somewhat the op posite: "living too high on the hog." ,ur diet is too ri&h in fat as well as &alories# refined sugars# star&hes# and oils. (t the same time# it is low in essential nutriments# minerals and other vital re9uirements. The e:a&t relationship between the amount of fat you eat and the produ&tion of &holesterol in your body is still a very &omple: 9uestion. Investigators differ on some points. $on&erning one aspe&t of the problem# though# we are all agreed: the &holesterol found in the blood is made largely in the liver from fats in the diet. It is also believed that &holesterol is produ&ed in the arterial walls themselves. !ut the main sour&e and the one that we &an to a great e:tent &ontrol is fat in our food.

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

*hat is the situation in other countries of the world+ We have eviden&e that a prime fa&tor for the great differen&e between (meri&ans and peoples in various other &ountries is diet. "or e:ample# let us see what happened in *orway during the war years of >DB=->DB<. $onsumption of butter# milk# &heese and eggs %all of them high in fats' had to be sharply &urtailed. 4id the redu&tion of fat &ontent in the national diet have any effe&t on the number of deaths from heart atta&k The *orwegian +inistry of .ealth# whi&h kept a&&urate re&ords# answered that 9uestion with an emphati& "yes." With the redu&tion in fat &onsumption# the death rate from &oronary atta&ks de&lined also. The *orwegians reported that heart deaths were redu&ed by A> per&ent during ea&h year among the urban population. (t the same time# there was a ;; per &ent drop in heart deaths among the rural population. "ran&e# whi&h also had to tighten its belt during the war years# had similar eviden&e to offer. +r. +ar&el +oine# of the "ren&h +inistry of .ealth# reported to me that from >DB> to >DB<# when "ren&hmen were on a low-fat diet# the death rate from heart disease was redu&ed to ;=.? for ea&h >==#=== persons. In the postwar years# when normal fat &onsumption was resumed# the death rate rose to ;<.< per >==#=== population# or a return to the old# prewar death rate. Italy provides another e:ample. There studies were made re&ently in two neighboring provin&es. In one area# where the daily diet in&luded pork produ&ts ri&h in fats# the in&iden&e of &oronary and generaliFed artery disease was found to be mu&h higher than in the ad)oining provin&e where the population followed the &omparatively low-fat pattern of the &ountry as a whole. /imilar studies have been made in various parts of the world&ountries su&h as "inland# 4enmark# /outh (fri&a# $hina# and Iapan. /tatisti&ally the results all point in the same dire&tion: high-fat diet means a high rate of heart deaths. "igures# as +ark Twain and +arilyn +onroe have shown#

CLOGGED PIPES TO THE FOUNTAIN OF LIFE 9 sometimes have a way of misleading us. This is admittedly true of interpreting &ause and effe&t relationships where the health of whole populations are &on&erned. The long arm of &oin&iden&e &an sometimes rea&h around &orners or do a )uggling a&t. "or e:ample# you might &laim# an the basis of statisti&s# that sin&e the use of soap was also sharply redu&ed in some &ountries during the war# with a &orresponding drop in death rate from &ardiovas&ular disease# it was the soap %whi&h is a fat' that &aused the disease. In a more s&ientifi& view# however# the eviden&e weighs heavily on the side of fat as a prime fa&tor in &ausing atheros&lerosis.

1s the epidemic confined to older people+ What has

happened to our way of life to make men between A= and B< the preferred vi&tims of the "silent killer" that strikes without warning (nd why are more and more young women# long believed to be virtually immune to this disease until after menopause# now falling prey to it We do not know the entire answer to this enigma# or even whether there is a single answer. !ut resear&h that has been &arried on by my &olleagues throughout the world# and by myself during the past >= years# has provided some valuable &lues. ,nly re&ently# we dis&overed to our amaFement that over D= per &ent of our adult population has# to a greater or less degree# a degenerative disease of the arteries that do&tors &all atheros&lerosis. That# as you know# is the term meaning the thi&kening and narrowing of &ertain vital blood vessels. It is the way in whi&h the stage is set for heart atta&ks and strokes. +edi&al people on&e thought that it was a result of aging# but the disease is now being found in infants and &hildren. (s &hildren# however# we have the power of absorbing the fatty deposits that atta&h themselves to the artery walls. (s we grow older# we seem to lose this power of absorption. That is when the real trouble begins. (t what age does this happen +u&h earlier than we might e:pe&t. "or e:ample# my asso&iates and I made a study of the arteries of ?== patients who had died of various diseases. (bout >== of

>=

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

them had met sudden death from a&&idents or a&ute illness. To our amaFement we found that atheros&lerosis# a disease of the arteries# was present in many of the young people before they had rea&hed their thirtieth year. !y the time they were B= to <= years of age# the fatty deposits and embedded &rystals of &holesterol were inside the artery walls. /u&h thi&kening and narrowing of the blood vessels interfered with the nourishment and vitality of the tissues in the heart# brain# or kidney. /triking eviden&e of how widespread the disease is among our younger people today &ame also from 2orea. There (rmy do&tors autopsied A== (meri&an soldiers who had died while serving in 2orea. It was the first time su&h a study had been made of a &ross se&tion of the &ountry8s youth@ their average age was only ;;. ( report of the mass autopsies &ontained startling information that %% per cent of the young "#$# servicemen already had atherosclerosisD !alan&ed against this sho&king total was a mere >> per &ent in&iden&e of the same disease among 2oreans and ,rientals who had died on the same battlefield under the same &onditions.

)oes heredity have anything to do with the problem+

(t this point you are probably wondering: why do some people have more &holesterol in their blood than others (t present we do not know the whole answer to that 9uestion. We do# however# know some of the predisposing fa&tors. ,ne of them is heredity. /ome families are affe&ted by what physi&ians &all hereditary familial hyper-%e:&essive' &holesteremia. In su&h a family the tenden&y to high levels of &holesterol in the blood is passed on for several generations. (mong members of su&h families we usually find a large number of indivi duals who suffer heart atta&k and strokes. If no heart atta&ks or strokes have o&&urred in your own family line# you have at least one prote&tive fa&tor in your favor from the beginning. The se&ond fa&tor is one that is pretty mu&h up to you. It &on &erns what you eat and how mu&h you eat. 7nfortunately# it is too late for us to &hoose our parents.

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I">> !ut it is not too late to &hoose our diet. !y learning how to avoid food e:&essive in fat and &holesterol &ontent# we &an help minimiFe the effe&t of heredity. *omen have better natural protection against atherosclerosis! If you are a woman# you are less likely to suffer from a heart atta&k or stroke until well after you pass the half &entury mark. That is when your prote&tive female hormones give out# and you be&ome as sus&eptible to the disease as men. $an8t men take female hormones to prote&t themselves They &an# but if they do# they will "&ross the border" and develop a high voi&e# full enlarged breasts# and other feminine &hara&teristi&s. /o that approa&h to the problem is not pra&ti&al. (nything else 6es# there is something everyone &an do without great in&onvenien&e# and with the added reward of improved health in general. It is this: sele&t a diet that will keep your blood fats down to normal levels. &an you reverse damage done to your arteries by e2cessive fat+ ,nly within the last few years have medi&al resear&h teams produ&ed reliable eviden&e showing that e:&essive fat in our diets may lay the groundwork for heart disease. If you are already past A=# it naturally o&&urs to you to wonder whether the damage done to your arteries is permanent# or whether it is reversible. (t the present stage of our resear&h# we do&tors &annot answer the 9uestion with &ertainty. We &an &ite the hopeful fa&t that e:periments with animals have shown that the &ondition is reversible in animals. We have eviden&e that the &holesterol in the arteries is absorbed in &hildren# as shown by 4r. 5ussell .olman and others. .owever# this metaboli& gift seems to be lost as we grow up. There are many authorities in the field who do believe that sin&e atheros&lerosis is reversible in animals# it &an also be eliminated even after it is established in humans as well. .owever# we must pro&eed &autiously in basing our &on&lusions solely upon studies of laboratory animals# be&ause their metabolism is different from that of humans. (nother 9uestion that patients often ask me is: "$an you

>;

$3,11-4 PIP-/ T, T.- ",7*T(I* ," 3I"-

tell me whether I am already a vi&tim of degenerative artery disease " 7nfortunately# we do not as yet have a test that &an predi&t with &ertainty whether you are sus&eptible to &oronary disease# or are likely to have a heart atta&k. ,ne fa&t# however# is &ertain: if laboratory tests show that you have an e:&essive amount of &holesterol in your blood# your &han&es of avoiding heart and blood vessel disease# whi&h &an lead to heart atta&k or stroke# are mu&h smaller. 6ou are then mu&h more sus&eptible. If you are over A= years of age# you ought to have your physi&ian in&lude su&h a measurement of &holesterol level in your routine &he&k-up. Too many men in the dangerous middle years are so busy playing for high stakes in the fast-moving game of life# that they forget that "hearts are trumps."

*hat is the solution for us+ The many studies that have
been made do not prove &on&lusively that heart disease is &aused solely by diet. !ut they do heavily unders&ore mu&h of the information that I have gathered from my own 9uarter of a &entury of pra&ti&e and laboratory resear&h. Taken together# the eviden&e points strongly to this fa&t: If everyone in the 7nited /tates would redu&e his fat intake by ;< per &ent# we would &ut the number of heart deaths in half within another ;= years. +oreover# the low-fat diet will add immeasurably to your general health and well-being. "!ut#" you ask# "how &an I go about redu&ing the fat in my diet Where do I begin " In the following pages you will find a safe guide@ it in&ludes low-fat menus and dire&tions for using simple and ine:pensive nutritional supplements that I employ in my own pra&ti&e to help my patients forestall heart atta&k# and to treat those who have already had one or more. If you follow these dire&tions &arefully# you will not only add years to your life# but life to your years.

I/ "(T *-$-//(56 I/ 3I2- (/2I*1 "I/

$rime *e&essary " or "Is it *e&essary to be "at " The impli&ation alone is bad# like asking ".ow ,ften 4o 6ou !eat 6our Wife " ,f &ourse# the answer to all of these 9uestions is "no."

1s fat essential in a healthy diet+ /ome nutritionists and

s&ientists believe that a small amount of fatty a&ids or &omponents of &ertain fats are essential to human nutrition. This has never been demonstrated for humans# although apparently it is true in rats. There is the in&ontrovertible fa&t that &ountless millions of human beings in (sia# (fri&a# /outh (meri&a and elsewhere do not &onsume fat in their diet. (nd yet they live to a health-normal or beyond-normal life span@ their physi&al or nutritional development is not infre9uently far superior to the people on a high-fat or average (meri&an fat dietary intake. +ost &ertainly it is known now that these same people on a lowfat or fat-free diet are virtually free from heart atta&ks and strokes# whi&h are so &ommon among people on a fat diet. +any have wondered whether the -skimos have a high rate of heart atta&ks and strokes as a result of their high fat diet. "irst it should be remembered that the -skimo days of e:isting 13

>B

P.6/I,3,16 ," "(T

on blubber and whale alone are mostly over. /everal years ago physi&ians working with the *ational 1eographi& /o&iety found that the -skimos who lived in the more modern settlements and ate and lived like other $anadians or (meri&ans in &ountry vil lages# were sub)e&t to the same degree of atheros&lerosis# high blood pressure# and heart &onditions. ,n the other hand# in those -skimo &ases where fish and whale fats &onstituted the basis of the diet# blood tests revealed that &holesterol and fats in the blood were very low. This surprising fa&t was later found to be due to the high &on&entrations of unsaturated fatty a&ids in the large amount of fish and whale oils &onsumed by these -skimos. (s will be shown later# these unsaturated fatty a&ids have the uni9ue power to lower the blood levels of &holesterol and other fats# thus prote&ting the -skimos from the &ompli&ations of atheros&lerosis in the heart# brain# kidneys# and other organs. *hat is fat+ "irst let us look at food in general. (s long as we are alive# breathing# with our hearts pumping# our bodies are at work burning up energywhi&h is supplied by food. "ood or foodstuffs &onsist of si: groups# all of whi&h are basi& ne&essities essential for normal health. These are proteins# &arbohydrates# fats %whi&h are also manufa&tured by the body'# vitamins# minerals# and water.

$rotein is the keystone of human nutrition! It is essential for every form of life for growth# pregnan&y# formation of blood# bone# and every vital tissue. It is essential for the heal ing of wounds# the warding off of infe&tion# the maintenan&e of body weight# and the &ondu&t of vital organs and glands in the body. +eat is the greatest sour&e of animal protein for human &onsumption and man &an live in good health on virtually an e:&lusive fresh meat diet. (nimal sour&es of proteins are meat# fish# poultry# milk# eggs and &heese. These foods &ontain high sour&es of protein# as well as &arbohydrates and fats. Gegetable sour&es of protein are wheat# beans# peas# lentils# soybeans# nuts#

P.6/I,3,16 ," "(T

><

&orn# rye and yeast# although these also &ontain elements of &arbohydrate and fat. *ormal adults and growing &hildren re9uire one gram of protein for every ;.; lbs. of body weight. This means that the average man or woman weighing >;< to >C< lbs. needs from ?= to E= grams of protein daily for normal nutrition. This would be &ontained in the e9uivalent of >J; pound of steak# one &hi&ken# a pound of fish or a pound of &ottage &heese. -a&h gram of protein supplies four &alories of energy# as shown in $hapter ?.

&arbohydrates are a main source of energy! $arbohydrates in&lude the two main &lasses: star&hes and sugars. They are one of the primary sour&es of energy of our diet. ,ne gram of &arbohydrate yields B &alories of energy. The amount of &arbohydrates ne&essary in the daily diet is very variable and also depends on the amount of it eaten with the protein in meals. The average (meri&an adult &onsumes anywhere from ><= to B== grams of &arbohydrate daily. It takes about <== grams to make a pound. 7sually more than half the &alories in the diet %from <= to C= per &ent' are supplied by &arbohydrate. 7nfortunately# these &arbohydrates are usually refined to e:&ess# as in the &ase of flours and sugars. -ssential vitamins and proteins are lost in this way and &ertain nutritional defi&ien&ies may result. If e:&essive &arbohydrate is eaten in the diet# many individuals will e:perien&e symptoms of gassy distress# flat ulen&e# bel&hing# or bloating. !read# flour# milk# &ereals# potatoes# &ornstar&h# &akes# ri&e# and puddings are e:amples of dietary star&h as are moat vegetables# although these &ontain lesser amounts of both &arbohydrates and protein. /ugars are represented by &ane sugar# &orn syrup# honey# maple sugar and syrup# milk sugar# malt sugar# )ams# )ellies# and most fruits. Two of the most &ommon symptoms or sensations that humans feel daily are dependent on &arbohydrate metabolism: that is# hunger and fatigue. $ertain endo&rine glands in the body &on trol the level of blood sugar in the body and are linked to the

>?

P.6/I,3,16 ," "(T

feelings of hunger# fatigue# and e:haustion. When the blood sugar falls abnormally low# one feels heada&hes# nervousness# diFFiness# or weakness. +any of my patients &ombat these tenden&ies to hypogly&emia or low-blood sugar in the following simple ways: in between meals take fresh fruits# preferably bananas or apples# or &anned fruit )ui&es or fruits@ -nglish "tea" with whole wheat &ookies or &ra&kers# graham &ra&kers# arrowroot &ookies and if needed# some lean meat or fish in sandwi&h form@ skim milk thi&kened and fortified with generous servings of skimmed milk powder@ bread and )am@ fat-free sherbet or i&es@ dieteti& or low-fat i&e &ream@ fruit )ellos are refreshing@ hard &andies or &ho&olate bars are often very handy but not as desirable as the natural# health ful in-between meal "sna&ks#" suggested above# as they often damage the teeth and may have too short-lived a&tion on the blood sugar. *ot infre9uently sugar itself will &ause a "re bound" rea&tion resulting in an even lower blood sugar fall onehalf to one hour after the sugar has been eaten. $ountless business people and fa&tory workers find their effi&ien&y and &apa&ity for work greatly in&reased by following the above dietary aids. It is not ne&essary to wait until the symptoms of low-blood sugar already signal the breakdown of bodily health. The habit of drinking &offee alone at the &offee-break is like whipping the tired old horse harder to get it to &limb up the hill. The artifi&ial stimulant# &affeine# &an never possibly substitute its artifi&ial stimulant drug a&tion for the flow of energy that &omes from healthful# natural foods. Gitamins and minerals are dis&ussed later# in $hapter <. The ne&essity of water for the maintenan&e of life is known to all. This brings us to fats.

#ats*hat they are and what they do to you! The outstanding fats eaten daily in the 7nited /tates and -urope are butter# eggs# whole milk# &ream# meat# fish and poultry fats# and &heese in various &ombinations. These fats# at D &alories per

P.6/I,3,16 ," "(T >C gram# &ontain more than twi&e the amount of &alories than protein or &arbohydrate does at four &alories ea&h per gram. (s we have noted and shall des&ribe in later &hapters# e:&essive intake of fats leads to the shortening of life# premature death by heart atta&ks and strokes# obesity# and numerous &rippling illnesses. "ats %or lipids' &ontain the elements of &arbon# hydrogen# and o:ygen in various &ombinations of animal and vegetable fats. -:amples of animal fats are butter# lard# &ream# milk# eggs# and the fat in meats. Gegetable fats are soyabean oil# olive oil# &ottonseed and &orn oils# and peanut oils@ these are found in nuts# &o&onuts# avo&ados# margarines and other vegetable fats used in &ooking. "ats do not dissolve in water# and when pure they are odor less and tasteless. They are found in most bodily tissues# parti&ularly in &ombination with other elements# proteins# or minerals. "ats or lipids a&t as vehi&les for the absorption of the natural fat-soluble vitamins su&h as vitamins (# 4# and -. In order for fats to be utiliFed by the body# they must first be digested and broken down into &onstituent parts before being absorbed. They are absorbed in the following manner: (fter the food is masti&ated and enters the stoma&h# the digestive system supplies its first fat enFyme &alled lipase# to begin the digestion of the fat. -nFymes or ferments are uni9ue &hemi&al &ompounds manufa&tured by the &ells of the tissues. In the digestive tra&t they are vital for the &hemi&al breakdown of all foods before they &an be absorbed. 3ow are fats digested+ The fat enFyme of the stoma&h# lipase# begins its )ob on the fats eaten. .owever# it is a rather weak enFyme# leaving most of its work to be &arried out by steapsin# the fat enFyme manufa&tured by the pan&reas# and by bile manufa&tured by the liver. In the bile are found bile a&ids and salts whi&h# together with steapsin# split the fats ingested into the smallest mole&ules and parti&les possible. These &an then be absorbed through the lining of the small intestine and

>E

PHYSIOLOGY ," FAT

pass either into the liver or dire&tly into the blood stream as &hyle# a milky or &reamy serum. 3ow fats are absorbed! When the fat parti&les are brought to the liver# they undergo further &hemi&al breakdown and metaboli& &hanges before they enter the blood stream in the form of &holesterol# phospholipids# fatty a&ids# neutral fats %whi&h are neither a&id nor alkaline'# le&ithin# and other fat derivatives. +u&h of the fat is broken down by the liver &ells into &holesterol# whi&h is e:&reted into the bile and goes ba&k again into the intestine in various &hemi&al forms. ,n&e in the intestine# some of the &holesterol is reabsorbed again along with other fats and some is e:&reted from the body in the bowel movement. If the proportion of the &holesterol in the bile be&omes too high# then it pre&ipitates out of the bile and forms gallstones# whi&h &an produ&e atta&ks of pain and indigestion# and so often keep the surgeon busy. *ow that the fats or lipids have entered the blood stream# they &ir&ulate and are deposited in the various bodily tissues and in the great body storehouses &alled fat depots. These are lo&ated in the abdomen# on the hips# the &hest# around mus&les# under the skin# in the liver# and elsewhere. The fats &onsumed in the diet are &alled e:ogenous fats. The liver and other tissues# however# manufa&ture e9ually important 9uantities of fats or lipids normally found in the blood stream. These are &alled endogenous lipids. These lipids are manufa&tured from proteins and &arbohydrates through &ertain remarkable pro&esses inherent in vital bodily tissues and glands su&h as the liver or the adrenal glands. -nergy and vital &ellular &onstituents for the body result from these lipids. When present to e:&ess# their effe&ts be&ome devastating to humans# as shown in the &hapters on overweight and atheros&lerosis. %/ee $hapters C and A.' We now &ome to the fats &ir&ulating freely in the blood stream. 3et8s see how they get into the artery walls to a&tually damage or destroy the artery with atheros&lerosis.

Fig. 1.

C !"" S#$%i!&' C! !&( ) A %# ).

This diagram shows the three coats of the coronary artery and the channel through which the *lood flows to nourish the heart muscles#

Fig. 2.

C !"" S#$%i!& !* C! !&( ) A %# ) i& C! !&( ) T+ !,-!"i".

P.6/I,3,16 ," "(T

>D

3ow fats damage or destroy your arteries! -:tensive resear&h in e:perimental animals has been able to demonstrate how these lipids &an leave the bloodstream and enter the artery wall within ;B hours. The atheros&lerosis produ&ed in these animals be&omes indistinguishable from the atheros&lerosis seen in human arteries. .owever# the e:a&t details of the me&hanism whereby fats a&tually enter into the wall of the artery are not yet known. What is known and what is important is that there is a definite ratio or relation between the amount of fats in the blood stream and in the artery wall# and this is surprisingly predi&table in most &ases. (lso# the relationship of the fats in the artery wall itself is very &lose to that in the bloodstream. This dire&t relationship between the two seems to be in fairly &onstant balan&e. (s des&ribed in the first &hapter# the artery wall &onsists of three different layers. If the reader &an pi&ture a garden hose as representing the artery# it presents an innermost layer &alled the intima# a middle layer &alled the media# and an outer layer &alled the serosa. %/ee "ig. >'. The fats &ir&ulating in the blood stream are of &ourse &losest to the innermost layer of the artery# with whi&h they are in dire&t &onta&t. When &onditions are right for atheros&lerosis# the fats atta&h themselves and enter the inner or intima layer of the artery. ( kind of wart or e:&res&en&e on the artery is then formed# &alled a pla9ue of lat. When the pla9ue grows larger# it en&roa&hes upon the passageway of the artery. (s it grows larger and larger# it may finally blo&k or obstru&t it partly or &ompletely. When this &logging or obstru&tion of the artery takes pla&e in the vital &oronary arteries of the heart# then a &oronary thrombosis or heart atta&k assails the vi&tim. If the blo&kage from these fatty or atheromatous pla9ues o&&urs in the brain# then a stroke strikes down the vi&tim. %/ee "igure ;.' .owever# if the artery is only partly blo&ked by this a&&umulation of fatty pla9ues# then the vital organs supplied by the arteries suffer from a la&k of the ne&essary amount of blood and

;=

P.6/I,3,16 ," "(T

nutriments &ontained in it to sustain normal fun&tion and health. (long with the fatty deposits of &holesterol# fatty a&ids# neutral fats# et&.# whi&h make up these atheromatous pla9ues# &al&ium and other minerals are also deposited. These make the artery feel hard# giving rise to the term &ommonly in use "hardening of the arteries." (&tually we see a softening of the arteries whi&h takes pla&e first be&ause of these fatty deposits. It is often noti&ed in many individuals that this free fat will be floating in the blood stream for hours after a meal &ontaining fat has been eaten. The blood is then &alled lipemi&# whi&h means loaded with fats. When these fats are easily visible to the naked eye# s&ientists speak of su&h neutral fats as &hylomi&rons. These fats in the blood are regarded by many s&ientists to be as dangerous as is &holesterol# in entering the artery wall. ( great proportion of these fats in the blood is &ombined with proteins# &alled lipoproteins# whi&h also have been the sub)e&t of resear&h by many investigators. /&ientists have only re&ently dis&overed by new tools of investigation that in these lipoproteins two separate portions &an be measured: the alpha and the beta lipoproteins. The first have been shown to be prote&tive against the development of atheros&lerosis. They are found predominat ing in infants# &hildren# and young women who have no eviden&e of atheros&lerosis. ,n the other hand# the beta-lipoproteins have been found universally in e:&essive amounts in most &ases of a&tive atheros&lerosis and so are &alled atheros&lerosis produ&ers or "atherogeni&." The prote&tive alpha-lipoproteins are spoken of as "anti-atherogeni&." The problem of preventing atheros&lerosis and its human ravages is the sear&h for ways of in&reasing the prote&tive alphalipoproteins. $hapter < dis&usses le&ithin and other nutritional supplements and shows how to use these prote&tive substan&es against the development of atheros&lerosis. ,ne of the greatest fa&tors influential in the &urrent epidemi& of heart atta&ks has un9uestionably been the startling in&rease in fat intake. In the 7nited /tates alone# the fat &ontent of our

P.6/I,3,16 ," "(T ;> diet has )ust about doubled in re&ent times. Where fat formerly &onstituted some >< to ;= per &ent of our meals <= years ago# it now has )umped to A= and B= per &ent or more. #at may be your "poison"! +any individuals have now developed an intoleran&e to fat. /ome of my patients &an8t seem to handle any fat at all. (s an e:ample# one plump B=-year old mother of three develops severe gas and bloating after eggs or any other fatty food. +rs. 5. is often embarrassed to dine out for fear of overflowing right out of her girdle if friends supply her with a fatty food at their homes. (t other times she has been embarrassed by soli&itious friends who have delightedly &ongratulated her upon her "une:pe&ted" and "surprise" pregnan&y after eating some fat foodK ,ther patients of mine develop a&tual atta&ks of gallstone &oli& following a meal &ontaining fat. /ome ;= years ago# I studied the &auses and effe&ts of gallstones in humans by passing rubber tubes through the mouth and down into the digestive tra&t and then draining off the bile or gall manufa&tured by the liver and stored in the gall bladder. (t that time I e:amined and found the &holesterol and fat &ontent of the bile abnormally high in most patients who suffered from gallstones# liver# and gall bladder diseases. ( fat-free diet was able to eventually redu&e and restore the bile to its normal &holesterol and fat &ontent# not to mention the well established fa&t that most patients felt vastly improved and often free of pain or distress. ,f espe&ial interest to me is the &ase of a B?-year old auto mobile dealer# +r. $# who used to have disabling and terrifying atta&ks of pain over his heart. %We &all su&h pain angina pe&toris.' The pains began only after he had eaten breakfast and was preparing to leave for his business. .is breakfast was a hearty one. It &onsisted of ba&on and two s&rambled eggs# fruit )ui&e# some deli&ious &offee &ake with two pats of butter# plus two &ups of &offee &ontaining generous portions of &ream. .e was a husky# strapping e:-athlete and burned up a great deal of energy in business a&tivities. When +r. $. &hanged his breakfast habits and ate a good

;;

P.6/I,3,16 ," "(T

breakfast on the low-fat diet %as e:plained and des&ribed in later &hapters' his anginal pain stopped as if by magi&. $learly he was one of the many individuals whose &ir&ulation &ould not tolerate fats. This was again )ust re&ently shown in most &onvin&ing and dramati& ways by 4o&tors Peter 2uo and .. Ioyner of the 7niversity of Pennsylvania .ospital and +edi&al /&hool. These investigators studied the effe&ts of fat meals in a series of heart &ases and others affli&ted with atheros&lerosis over a several year period. ,ne group of their patients suffered severe heart atta&ks every time a fat meal was administered to them. /tudies of the heart and the blood were made during a&tual heart atta&ks by -le&tro&ardiographs and other s&ientifi& instruments. It was found that when the blood stream &ontained its peak load of fat &ontent# the heart atta&ks were most severe and threatened the very life of the patients. /u&h striking studies and findings were also the e:perien&e of other resear&h physi&ians. 3ow much fat are you stowing away+ 3ook at the following sample daily menus for fat &ontent that the average (meri&an &onsumes# as taken from the front page of the <ew 5or. World Telegram#
#at &ontent &alories (reakfast4 ,ne-half grapefruit .............................................................. C= Two eggs .......................................................... >; grams ><= Two sli&es of bread............................................................... >A= Two pats of butter ........................................... >; grams >;= ,ne &up of &offee with L tablespoonful of &ream and two teaspoons sugar ................. A grams >== 5unch4 !oiled ham# ; sli&es ........................................ ;= grams Two sli&es of bread .............................................................. Two pats of butter .......................................... >; grams 3ettu&e and tomato .............................................................. +ayonnaise# ; teaspoonsful ........................... ? grams $up of &offee with &ream and sugar................ A grams 4anish bun# prune filled ................................. E grams

;== >A= >;= A= ?= >== ><=

PHYSIOLOGY OF FAT
)inner4 +elon sli&e ............................................................................ /teak or beef with gravy# B oun&es................. B= grams Potato and peas# or salad..................................................... Two pats of butter %or oil dressings' ............. >; grams $up of &offee with &ream and sugar................. A grams I&e &ream ........................................................ >; grams $herry pie ......................................................... >; grams Total fat for the day...................... ><< grams. Total &holesterol ........................... E== milligrams. Total &alories for the day ............ ;E==. Total &alories in fat ...................... >B==. ;= <== >== >;= >== ;<= A<=

23

><< grams;E== &alories

3ow much fat can you really live with+ I& $!&% ("%' $!,.( # %+# "(,./# ,#&0 0"#1 !& %+# /!23*(% 1i#%4
"eal $lan (reakfast4 "ruit )ui&e $ereal /kimmed milk !read $offee# tea# Postum /ugar 6oon "eal4 /oup +eat or &heese Gegetables /alad "ruit or dessert !read +ilk %vening "eal4 "ruit $o&ktail +eat and Potato Gegetables /alad and dressing 4essert !read +ilk ample "enu ,range Iui&e /hredded wheat /kimmed milk Whole wheat toast #at &ontent &alories E= >== ?< ?< >< <= A== <= ;= >== ?< ?<

/kimmed milk pea soup $old roast lamb >= grams /tring beans /li&ed tomato $anned pineapple Whole wheat bread /kimmed milk 1rapefruit &o&ktail 3ean meats !aked potato !anana s9uash (sparagus "resh pear salad !oiled dressing 3emon i&e Whole wheat bread /kimmed milk

>= grams

<= ;<= >== ;< ;= ;< < grams <= ;== ?< ?< ;< grams>E== &alories

25

PHYSIOLOGY OF FAT
Total fat for the day...................... ;< grams Total &holesterol ........................... C< milligrams Total &alories for the day ............ >E== &alories Total &alories in fat ..................... ;;< &alories

What an e:traordinary &ontrast these two sample menus present in fat &ontent and &aloriesK ,n the one hand# the total &alorie &ontent of a typi&al (meri&an daily diet is about ;E== &alories# of whi&h almost <= per &ent is fat. The low-fat diet provides appro:imately >E== &alories %>=== &alories less'# whi&h is the normal healthy amount for the average adult housewife or light worker. .ere the fat &ontent is about >< per &ent of the total dietary &alorie &ontent and is the amount found in the diets of millions of non-(meri&ans who are virtually free of atheros&lerosis or heart atta&ks and strokes. What a &lear-&ut and simple &hoi&e is given us for better health and longer lifeK The 9uestion may still arise# "Isn8t fat ne&essary for normal health and nutrition " (s mentioned previously# the need for fat in humans has never been proven# although &ertain essential fatty a&ids &ontained in some vegetable oils are very valuable for keeping the blood fats lowered. In some people# fat seems to be ne&essary. The .ottentots are an e:ample. These /outh (fri&an tribes# related to the (ustralian bushmen aborigines# are uni9ue amongst humans in that their women have enormously developed butto&ks# due to e:traordinary deposits of fatK (t one time these huge posteriors were thought to be an interesting e:ample of attra&tive# se&ondary se: &hara&tertisti&s in women. !ut anthropologists later found that the e:&essive fat deposits had been developed through the ages by +other *ature to prote&t these women from the &ontinuous famines and droughts from whi&h these tribes suffered. *ature gave these women and their tribes survival by developing in them fat storage depots or warehouses. In times of starvations or drought# these storage warehouses were &alled on to supply food and energy# enabling

P.6/I,3,16 ," "(T

;<

the women and their young &hildren to survive the famine and to perpetuate the spe&ies. *ature had found that the ideal lo&ation for these storage banks of fat was on the butto&ks and hips. /ome of this hered itary tenden&y is still seen in (fri&an des&endants who now live in the 7nited /tates@ their an&estors had been brought over in slave ships only one or two hundred years ago to this &ountry. $uriously enough# this primitive trend seems to be be&oming popular in some "9uarters#" parti&ularly in the world of entertainment# su&h as the motion pi&turesK (nother interesting demonstration of the importan&e of body fat in a so&iety was the old &ustom among Turks and (rab peoples of measuring beauty in their women by the amount of avoirdupoisK +any a ri&h man among them proudly regarded his wealth by the number of fat wives and women in his home or harem. In times of food s&ar&ities and daily un&er tainties of living# an ample supply of food as shown by obesity was the best visible sign of affluen&e and prosperity. The husband8s su&&ess then &arried over into standards of feminine beauty as eviden&ed by his ability to pad and fatten his women. This &on&ept was very popular in the "gay nineties" of our own &ountry. The &omi& "beef trust" troupes in theatri&al vaudeville and burles9ue o&&asioned both fun and admiration for so mu&h &on&entrated female pul&hritude in a &horus-line of ;== to A== poundersK .ake a lesson from the pig! "inally# let us look at the startling new dis&overies made in swine. The hog or pig has always been asso&iated in every mind as the epitome of fatness. The e:pression "to be fat as a pig" or as a hog is one of the most &ommon e:pressions in our language. "at and food from swine is one of the most fre9uent sour&es of nourishment used by humans# i.e. ham# ba&on# pork# lard and so on. 6et only very re&ently has it been dis&overed that pigs are virtually the only animals sub)e&t to the natural or spontaneous development of atheros&lerosis.

;?

P.6/I,3,16 ," "(T

/everal teams of resear&hers have published numerous &onvin&ing photographs of the development of atheros&lerosis in many vital arteries of swine. This startling news was provided by 4o&tors I. .. !ragdon# I. .. Meller# and I. W. /tevenson of the *ational .eart Institute of !ethesda# +aryland# who &onfirmed the original findings made in this resear&h by a team of Wis&onsin s&ientists headed by 4o&tors .. 1ottlieb and I. I. 3ali&h. The amaFing fa&ts were that about <= per &ent of the swine e:amined &arefully showed the natural development of atheros&lerosis in the main arteries of the body. This disease in the arteries was virtually the same as atheros&lerosis seen in humansK In addition# still other investigators su&h as 4o&tors Irving Page and 3ena 3ewis of the $leveland $lini& found that hogs had unusually high levels of blood &holesterol and fats. There was a spe&ial in&rease in the swine studied of the atherogeni& portion of the lipoproteins# so important in the development of atheros&leroti& heart disease in humans. It has always been thought that fat on the hog was natural and did not harm the animal# but )ust those humans who made "hogs" of themselves. *ow all these e:traordinary dis&overies show us that even the pig is vi&tim to fatty deposits in the arteries@ to eat high on the hog even damages the hog. 3et us "eat to live# not live to eat." !y following the instru&tions &ontained in the following pages on what to eat and what to weigh# you &an learn to en)oy your food# and most important# en)oy better health and in&reased vitality and reap a harvest of added years to your life.

I* >D>># I* +,/$,W# 57//I(# ( /$I-* 3

tist named (nits&hkow made the first dis&overy that later led to the identifi&ation of fat as the killer in &ases of hardening of the arteries. .e gave us the first &lue to the role that fat in the blood vessels plays in &ausing heart atta&ks and strokes. Pro fessor (nits&hkow# now a vigorous E?# fed animals with &holesterol# one of the purest of fats. .e found that the arteries of these animals be&ame blo&ked with fatty deposits# in a manner indistinguishable from the blo&king found in human arteries. The e:periment also brought about premature aging in the animals@ they grew old and suffered a loss of health and general vitality long before their time. It was only after a gap of more than a generation that s&ientists got on the tra&k of the killer fat# but now the pursuit is highly a&tive all over the world. The &ulprit is now on trial# and eviden&e for his &onvi&tion is steadily mounting.

3ere is how 1 entered the race! /ome ;= years ago# with

resear&h assistan&e from the (meri&an +edi&al (sso&iation# I was working on the development of a new treatment for &irrhosis of the liver &aused by al&oholism. I was feeding fats# in&luding &holesterol# to e:perimental animals for the purpose of produ&ing &irrhosis in them. *ew &hemi&als were than to be tested# to see whether one of them might be useful in &uring this disease. ;C

;E

"(T# T.- 2I33-5# ,* T5I(3

To my amaFement# I found that in feeding the fat# I not only produ&ed the liver &ondition# but that the heart blood vessels of the animals be&ame plugged with fat# mostly &holesterol. Within a short time# the animals developed heart disease# )ust as it o&&urs in humans# and suffered &hanges &ommon to human beings with atheros&lerosis. This was a fas&inating dis&overy. It e:&ited my interest in the &hallenging problem of fat and its effe&t on the heart# and stimulated me to &ontinue sear&hing for &lues and answers to this universal illness# whi&h &auses more deaths than any other disease. +y &o-workers and I de&ided to &arry the hunt still further. We wanted to tra&k down this killer and to dis&over# if we &ould# how to ward off his devastating atta&k. This is how we went about it. "irst# we looked for the answer to this 9uestion:

1s cholesterol and e2cess fat present in the blood of everyone with atherosclerosis+ The answer &ame to us after
two years of work. We studied ;== patients who had had heart atta&ks and dis&overed that the great ma)ority# and parti&ularly those under ?=# suffered from an e:&ess of fats in their blood. ,ther patients who showed a normal level of &holesterol had other blood fat abnormalities. "or it soon be&ame &lear that &holesterol was not the only important heralding fa&tor an noun&ing the approa&h or a&tual presen&e of atheros&lerosis. /everal other fat &omponents were involved as des&ribed in $hapter ;: beta lipoproteins# fat enFymes %see $hapter ;' &alled &holesterol esterases# large fat globules &ir&ulating in the blood after a meal# &alled &hylomi&rons# and spe&ial large &omple:es of fat mole&ules dis&overed by 4r. Iohn 1ofman and his team of biophysi&ists. (t present we now know that e:&esses or abnormalities in any one or more of these five "publi& enemies" are dire&tly &onne&ted with the produ&tion of a heart atta&k# a stroke# or other &ompli&a tion of atheros&lerosis. It is therefore perfe&tly possible to have a normal &holesterol blood level and yet have some of the other above abnormalities

"(T# T.- 2I33-5# ,* T5I(3 ;D in the fat &hemistry of the blood that help produ&e a heart atta&k or stroke. To date# in two study groups of atheros&lerosis# the &holesterol fa&tor has been found to be the predominant one. This is due to the fa&t that it is a very fre9uent finding in atheros&lerosis# and also be&ause of the great diffi&ulties en&ountered# both by physi&ians and s&ientists# in measuring the other four &ulprits mentioned above in the development of atheros&lerosis.

*hat about the factor of heredity+ (s resear&h information piled up# another fa&t be&ame &lear. ,f the ;== people studied# a substantial number had a family history of heart atta&ks or strokes. That is# members of their families were parti&ularly sus&eptible to these two diseases. The patients we were working with seemed to be unfortunate links in an heredity &hain. 3ater# 4r. 4avid (dlersberg and 4r. $harles Wilkinson# Ir.# dis&overed that in some &ases an e:&ess of &holesterol in the blood was an inborn error of fat metabolism. Inability of some people to handle fat in their systems made them espe&ially prone to atheros&lerosis. This hereditary tenden&y &ould sometimes be tra&ed a&&urately through the family of a patient@ in those &ases where the tenden&y was strong# deposits of fats in the arteries and skin &ould be predetermined# a&&ording to +endelian# or geneti& laws of inheritan&e. ,ne unforgettable &ase that is an e:ample of the hereditary fa&tor was that of +rs. /. /he was admitted to my tea&hing ward servi&e in the hospital >= years ago in a state of sho&k and &oma from an e:&ru&iating &hest pain. This young woman# only ;D years old# had been ironing &lothes in her home when she ap parently was seiFed by a sudden# lightning-like pain. In a fainting &ondition# +rs. /. had &ollapsed to the floor. /he fell with a &ry# and her little girl# aged <# also &ried out and summoned the neighbors. (fter only a few minutes in the hospital the patient e:pired# despite heroi& efforts by our interne and resident# as well as physi&ians and nurses who were on duty at that moment.

36

FAT' THE KILLER' ON TRIAL

-:amination of the heart following death revealed to our surprise that +rs. /. had a &oronary thrombosis from e:tensive atheros&lerosis. This was a rare &ause of death in so young a woman# but one nevertheless that is o&&urring with greater fre9uen&y. We immediately suspe&ted a hereditary &ause in her death and 9uestioned the family# with the following results: The mother of +rs. /. was in good health as late as age <?. .owever# the father had died at age B= of a heart atta&k while driving an automobile. .is only other brother had also died of a heart atta&k at age <;. +rs. /.8s paternal grandfather had died of a heart &ondition in his fifties and his own brother had died of a "stroke." +rs. /. had no sisters and only one older brother# who was A; years old and suffering from angina pe&toris. %This is a heart &ondition &aused# in most &ases# by atheros&lerosis of the &oronary arteries.' This strong family trend towards the in&iden&e of a &oronary artery disease and atheros&lerosis is a striking e:ample in the &ase of +rs. /.# although in this &ase at an unusually young age. (t least one-third of the usual &ases that I see in private pra&ti&e# as well as those seen by other physi&ians of heart disease# are found to have a history of either heart atta&ks or "strokes" in the family. When this atheros&leroti& &oat of arms has been handed down in a family# it is vitally ne&essary that double pre&autions be followed in stri&t adheren&e to the nutritional program set forth in this book. /till another &hara&teristi& e:ample of the powerful influen&e of inheritan&e in the development of atheros&lerosis is the &ase of +r. I.# aged AD. This patient suffered from pains in both &alves of the legs whenever he walked for distan&es more than a blo&k. .e would have to stop and rest until the pains would subside# before he

"(T# T.- 2I33-5# ,* T5I(3

A>

&ould &ontinue again. We found a typi&al advan&ed degree of atheros&lerosis of the arteries affe&ting both legs. The father of +r. I.# a bank offi&ial# had already suffered a &oronary thrombosis when he was <?. .is two older brothers# in turn# had ea&h died of the &ompli&ations of atheros&lerosis one from a heart atta&k# and the other from a "stroke." +r. I. had one sister# age <;# who was troubled greatly by swellings in the ankles of both legs# whi&h were dis&overed to be &aused by !right8s diseaseN This &ondition# sometimes &alled "dropsy" in the old days# is &aused by atheros&lerosis or "hardening of the arteries#" in the kidneys. This is still a very wide spread &ondition and one that a&&ounts for mu&h si&kness and death throughout the world# although it is an insidious pro&ess# like its fellow "assassins" in the heart and brain. +r. I.8s &ase was so advan&ed that nutritional &are# diet# and weight redu&tion were of no avail and surgery had to be resorted to. !y an ingenious te&hni9ue# a team of four vas&ular surgeons who were e:perts in blood vessel surgery# grafted or transplanted two sets of new arteries in both legs# taken from blood vessel "banks." These storage "banks" keep normal healthy blood vessels available for operations and emergen&ies in the same way that blood is stored in blood banks for blood transfusions. +r. I. almost lost his life during the eight-hour operation but is now fully re&overed and walking normally again. .owever# he does follow the low-fat diet and nutritional program that apparently has arrested the progress of his former atheros&lerosis and is well and vigorous on&e more.

1s there an e2cess of fat imbedded in the artery wall

itself+ This proved to be a very diffi&ult 9uestion to answer. ( sear&h through the medi&al literature dis&losed that no one had reported any findings on this &ru&ial 9uestion. We found that there were tremendous &hemi&al problems blo&king the answer to the mystery# but due to good lu&k and a brilliant &hemi&al feat by our team# we dis&overed and reported the following fa&ts.

32

FAT' THE KILLER' ON TRIAL

The &oronary artery that is damaged by an atta&k of atheros&lerosis has four times as much &holesterol and fat &ontent as that of the person who dies of &auses other than heart atta&ks. /ubse9uent to our findings# investigators both here and abroad &orroborated our findings# tra&king down the "killer" fat to his lair dire&tly in the artery itself. We also noted that high blood pressure had the spe&ial effe&t of driving the &holesterol and fats into the artery wall with more speed and greater destru&tive-ness than would normally be the &ase. +any patients with high blood pressure were parti&ularly prone to heart atta&ks and strokes be&ause of the e:tensive destru&tion wrought in their arteries by these fats. This fa&t brings well to mind my patient# +r. *.# a <=-year old business e:e&utive# B= pounds overweight# who had high blood pressure and angina pe&toris. .e &omplained of heada&hes and diFFy spells. .e weighed >D= pounds and suffered from &hest pain and shortness of breath on physi&al e:ertion or emotional e:&itement. (fter a loss of B= pounds by our nutritional methods# his blood pressure be&ame normal and his heart a&hes and diFFy spells disappeared. .owever# whenever he had his regular twi&e weekly# tense &ommittee &onferen&es at the fa&tory# his blood pressure would rise. /trangely enough he dis&overed that if he ate any fatty foods before these tense business &onferen&es he would develop angina or &hest pain and would have to take a tablet of nitrogly&erine to relieve the severe heart pain. .is nutrition-minded wife astutely de&ided to pa&k his lun&hes herself into his brief &ase# along with his business papers and do&uments. Instead of eating the usual restaurant meals with his business asso&iates# +r. *. was able# thanks to his wife# to eat an en)oyable# low-&alorie# fat-free meal. .is heart pains left him. The great fear of death or &rippling illness that had &onstantly oppressed him and made his life miserable disappeared &ompletely. (pparently# emotional stress at business would &ause his

FAT' T.- KILLER' ,* TRIAL

AA

sus&eptible blood pressure to rise. If fatty foods were eaten in addition# e:&ess fat would a&&umulate in the blood and &ould be driven into the &oronary artery blood stream of the heart. This would then produ&e the life-threatening heart pains of angina. The transformation in +r. *.# after diet# weight and nutrition were &orre&ted# was truly remarkable. .is entire fa&ial e:pres sion %as well as his figure' was &ompletely &hanged. In the pla&e of a tense# pasty-&olored# an:ious-looking fa&e was a &heerful# smiling# health-&olored &ountenan&e. .is step had be&ome springy %and no wonder# with ;= pounds less to &arry around'# his walk buoyant# and his en)oyment and &apa&ity for work enormously in&reased.

,re there other conditions that cause heart attacks and

strokes+ To find the answer to this 9uestion we studied the hearts and arteries of ?== hospital patients who had died of various &auses. (fter years of analysis we were able to report that in >== &ases of a&&idental death the great ma)ority of men and women studied showed some degree of fatty deposits in their arteries. This was true in &ases of people as young as ;=# indi&ating that fat is a killer that has no respe&t for age. .e often begins his work very early in a person8s life. In another >== &ases# diabetes was the &ause of death@ in another >==# underfun&tioning of the thyroid gland was evident. In both instan&es# these patients showed e:&ess &holesterol and fats in their blood# with a &orrespondingly high-fat &ontent in their arteries. The degree of atheros&lerosis of the heart and brain far outstripped that of any other &ondition# e:&ept one &alled :anthomatosis. This &ondition showed itself through fatty# yellow-white deposits in the skin around die eyes# hands# arms and legs. Whenever we found this &ondition# we also found that the arteries throughout the body# and espe&ially in the heart# were most e:tensively damaged by fatty deposits. In patients who were thin and wiry throughout their lifetime# the o&&urren&e of atheros&lerosis was generally mu&h less than in all other &ases. Women before the age of <= also proved to be

AB

"(T# T.- 2I33-5# ,* T5I(3

mu&h better prote&ted against degenerative artery disease than men. (fter <=# however# women began to develop heart atta&ks and strokes with the same fre9uen&y as men. The &on&lusion was that female se: hormones played an important role in pro viding prote&tion against the ravages of atheros&lerosis. (s soon as the &hange of life o&&urred in women# the prote&tion of these hormones seemed lost@ they then be&ame the e9uals of men in suffering from heart atta&ks and strokes.

.he role of the liver in protecting you from e+cess fats#

We found that the liver manufa&tures prote&tive &hemi&al substan&es &alled phospholipids. These phospholipids in the blood help to ward off the effe&ts of too mu&h fat and help to prote&t you from heart atta&k. They suppress the damaging effe&ts of &holesterol upon the arteries of the heart and brain. This en&ouraging fa&t was first dis&overed by 4r. (aron 2ellner and 4r. -. .. (hrens# who &ondu&ted e:periments on animals %and brought it to light'. If your liver is not fun&tion ing normally and produ&ing a suffi&ient 9uantity of these prote&tive agents# you &an find them in &ertain foods. /ome foods that &ontain phospholipids in abundan&e are soybeans and the liver of &alves# steers# lambs# and &hi&kens. The Gitamin-! &omple: vitamins also have the ability to in&rease the blood phospho lipids. 4efatted soybean le&ithin in parti&ular is an ideal preparation for in&reasing these prote&tive phospholipids in the blood. %/ee $hapter < for a full dis&ussion of food supple ments that &an be wonderful fighters in the battle against e:&ess fat.' These prote&tive agents lower the blood &holesterol and bring about a better balan&e between the amount of phospholipids and &holesterol in the blood. The lowering in the amount of &holesterol prote&ts you against the development of atheros&lerosis.

1sn't there some medicine that will stop fat from causing heart attacks+ +edi&al s&ien&e has sear&hed diligently for some new &hemi&al or medi&ine that would provide the answer to this 9uestion. /ome progress has been made# and the

"(T# T.- 2I33-5# ,* T5I(3

A<

full answer will &ome in time. .ere8s what we have found out so far: In >DB= I developed an e:tra&t from the arteries of &attle. This e:tra&t was administered first# with su&&ess# to animals for a period of three years. Then for several years it was given to human patients suffering from heart and artery disease. I reasoned that if a weakness or defi&ien&y e:isted in the wall of the damaged artery# then the administration of the healthy# vital substan&e missing in the artery might re)uvenate the diseased artery and restore its health. This same prin&iple was used in the dis&overy of insulin. (lthough the e:tra&t was effe&tive# it had some drawba&ks. ,ne problem was that to be effe&tive# it had to be in)e&ted daily for the duration of life. ( group of resear&h bio&hemists headed by 4r. *. T. Werthessen and spe&ialiFing in atomi& medi&ine studied the preventative and &urative effe&ts of the e:tra&t that I had developed. They used radioa&tive &hemi&als to tra&e the e:tra&t in the blood of e:perimental animals. It was found to be highly effe&tive in preventing atheros&lerosis. *evertheless# I felt it was ne&essary to abandon the use of the e:tra&t# even though we had obtained remarkable results in the treatment of heart# brain# and other &ir&ulatory illnesses. The e:&essive &osts of manufa& turing and testing the e:tra&t# and the need to in)e&t it daily# made its use impra&ti&al.

"any other fat preventing agents have *een discovered

and found wanting! "or e:ample# my asso&iates and I found# more than >= years ago# that in various e:perimental animals &ertain members of the Gitamin-! &omple: were effe&tive in preventing and treating atheros&lerosis. These prote&tive# vitamin-like agents were &alled lipotropi&# or fat preventing. (lthough these findings were repeated and &orroborated by many investigators# many medi&al s&ientists &ould not agree# and the use of su&h fat preventing agents never be&ame generally a&&epted. /ubse9uently# they have been repla&ed by more promis ing medi&ines in the treatment of heart atta&ks and strokes.

A?

"(T# T.- 2I33-5# ,* T5I(3

(nother promising substan&e was heparin# whi&h is a fat&learing# anti-&lotting medi&ine. 4r. .yman -ngelberg and other investigators have found heparin very valuable for &ontrolling blood fats in the treatment of heart &ases. Garious other physi &ians# however# do not agree with these results. +oreover# the ne&essity of in)e&ting heparin at fre9uent intervals and the need for greatest &are in its administration made it diffi&ult to use it on a wide s&ale. In &ertain &ases# thyroid e:tra&t has been effe&tive in redu&ing e:&essive &holesterol and fats in the blood. It was most helpful in those patients who had a sluggish or abnormally low basal meta bolism rate# a sign of an underfun&tioning thyroid gland. !ut unfortunately# it has not proved generally effe&tive in all &ases. 6ears ago# my &o-workers and I e:plored the potential of plant sterols as fighters of fat. These sterols# whi&h are plant or vegtable e:tra&ts# when eaten# blo&k the absorption of &holesterol and fats from the intestine. /ome interesting results were obtained# but their a&tion was variable at best. +any of these plant e:tra&ts were not pra&ti&al be&ause large 9uantities had to be &onsumed before ea&h meal. "emale se: hormones have been widely e:plored. +any investigators have advo&ated their use in &ontrolling fat metabolism in the blood and arteries. .ere too# the results of treatment in &ases of heart disease were interesting# but treatment was handi &apped by the feminiFing effe&ts that su&h hormones had on men. Thus the need for something that would be useful to all people# something that would bring definite results in fighting off the killer# fat# remained. The low-fat diet holds great promise for everyone# whether the person has atheros&lerosis or not. The lowfat way of life &an be followed by anyone# anywhere# and it is simple# safe# effe&tive. 3et us see why.

3ow the low-fat diet proved its value! Throughout the

world# fats and heart disease appear to be inseparable &om panions. When investigators found one# they generally found the other# no matter in what &ountries they sear&hed. ( host of reports began to pour in on the s&ar&ity or absen&e of heart#

FAT' THE KILLER' ON TRIAL

37

brain# and vas&ular disease in those populations where a low&holesterol# low-fat diet were &ommon. %-:ample: (sians# (fri&ans# $osta 5i&ans# ,kinawans# $hinese# $eylonese# and !antus.' In sharp &ontrast# the e:a&t reverse was found in those parts of the world where a high-fat diet was prevalent. ( high rate of atheros&lerosis of the heart# brain# and kidney was &ommon in the &ountries of -urope and in the 7nited /tates and $anada. Pathologists# do&tors# and medi&al resear&hers# have sin&e produ&ed overwhelming eviden&e to show that when blood &holesterol and fats are high# the arteries were &orrespondingly high in the degree of damage or destru&tion by atheros&lerosis. (nd when the blood levels of fat were low# the damage to heart and brain was also low. I be&ame &onvin&ed that the killer had been identified. This &onvi&tion I arrived at in the following way: I de&ided to see what the effe&ts would be of stopping one group of patients from eating fats and &omparing them with another group who &ontinued to eat the usual amounts of fats found in the (meri&an diet. It was important to work with people who had proven &ases of atheros&lerosis. I therefore sele&ted >== patients who had survived heart atta&ks or &oronary thromboses and who had been dis&harged from the hospital. These patients had all had atheros&lerosis of the &oronary arteries and were ideal for the purpose of proving or disproving the whole &on&ept of high fat as the &ause of heart atta&ks. The >== &ases were divided into two groups of <= patients ea&h. ,ne group was pla&ed on a low-fat# low-&holesterol diet@ the other &ontinued on a diet &ontaining the regular fat intake that they had grown a&&ustomed to before their heart atta&ks o&&urred. !oth groups were &arefully observed for over >= years. !y the end of the third year# the answer began to grow &lear. (t the end of eight years of study# the answer was &on&lusive. ,f the <= patients who ate their regular dietary fat 9uota# AE %or C? per &ent' had died of arterial or heart diseases. ,f the <=

AE

"(T# T.- 2I33-5# ,* T5I(3

people who had followed the low-fat diet faithfully# only ;; %or BB per &ent' had died of the same illnesses. In other words# the low-fat diet had enabled heart patients to live twi&e as long as those who followed a regular diet and had saved a signifi&ant number of lives in the pro&ess.

.he lowfat diet proved to be effective in reducing weight and promoting general good health! (n e9ually
important result of this resear&h was this: We found that a substantial weight redu&tion of about ;= pounds was a&hieved by both men and women on the low-fat diet. This took pla&e over a period of three years# and the weight loss was safe# gradual# healthful. Typi&al of this group of patients was +r. !.# a sto&ky# short man of >E= pounds# who had )ust re&ently re&overed from his &oronary thrombosis. !ut he now &omplained of great fatigue and shortness of breath on e:ertion. .e )ust &ouldn8t seem to be able to resume his work as a builder. "or his height and bodily frame# he was easily A? pounds overweight. ,n the low-fat diet he lost a pound ea&h week. (t the end of the year he weighed >B< pounds. In his own words# he "felt like a million dollars." .e found himself vigorously ba&k at work again# &lambering about his &onstru&tion )obs and housing pro)e&ts with ease and en)oyment. The patients on the low-fat diet also gained some remarkable and une:pe&ted health dividends. +any patients# for e:ample# e:perien&ed a striking improvement in energy and vitality. The &ase of BC-year old +rs. 5. is an e:&ellent one in point. /he had made a fairly good immediate re&overy from her &oronary thrombosis. !ut even before her heart atta&k# her house hold a&tivities were always a series of endless &hores to her. To "get through the day#" be&ame a daily and finally a monumental &hallenge. "irst# it had been the ra&e to get her three &hildren off to s&hool and husband off to work without even a &han&e to answer nature8s &all to the bathroom %the new (meri &an mother8s form of &oloni& martyrdomK'.

FAT' THE KILLER' ON TRIAL 39 *e:t the hurry to get the house &leaned and straightened up and the noon meal &ooked before the &hildren were ba&k from s&hool for lun&h. (fter this kind of fire-alarm rush# the 9ui&k run over to shop# buy and prepare dinner. (s the Fero-hour drew near# +rs. 5. often felt like giving up@ she )ust felt too e:hausted# too miserable# and too weak@ the task appeared too formidable and depressing for her dwindling strength. The do&tor who had e:amined +rs. 5. had not been able to find any a&tual disease present. /he was advised to "rela:" and "try to take it easy." The "&hange of life" is hard on some women. +rs. 5. should have wat&hed her weight and her &alories# as she was easily ;< pounds overweight. /he was only < feet tall# a little woman. Then her heart atta&k had stru&k and stunned the patient and the family before +rs. 5. had a &han&e to do anything about it. !ut after a year on the low-fat diet and nutritional program# she made a &omplete re&overy and had lost ;< pounds of weight. +rs. 5. was a &hanged person. !elow the layers of fat emerged an attra&tive# viva&ious woman whose vitality was apparent in her home. 5elieved of the e:&ess tonnage she had &onstantly &arted around her house# +rs. 5. walked with a lightN 9ui&k step. The family &ould not believe the transformation that had taken pla&e@ the entire home had be&ome &heerful and a pleasure to live in. +r. 5. privately &onfided to me that he had also been depressed by his wife8s former miserable state. .e now promptly responded to the new healthy# &heerful atmosphere. .e himself &ame to en)oy his home and family. Previously his footsteps had dragged@ he used to feel nothing but uneasiness and an:iety when he &ame home# when he found an e:hausted and depressed wife. *ow he really &ould barely wait to get home. It was almost like redis&overing his wifeO-his wife as she had been in her youth. ,thers on the low-fat diet found that they gained strength and were able to work and take part in physi&al a&tivities that would otherwise be denied them.

B=

"(T# T.- 2I33-5# ,* T5I(3

(fter the loss of ;; pounds# another patient in this group# +r. 3.# found that after three years on the low-fat nutritional way of life# he now got more out of his )ob as a &arpenter# with a loss of his old fatigue and ( greater ease in a&tual working then ever before. +any patients found their whole philosophy of life &hanging. Those who had been depressed and dis&ouraged &ame to know a surprising sense of well-being. $heerfulness and optimism took the pla&e of morose resignation and negative pessimism. +rs. T. never tired of admiring herself in the mirror after a year on the diet and nutritional supplements. (nd no wonder# for in the pla&e of the unsightly bulk that made her resolve to do something tomorrow# there was a slim# attra&tive figure# a &lear# fresh skin# and a sparkle in the eyes that had never been there before. What pleased her most# however# was the smiling fa&e and &heerful e:pression that habitually greeted her in the mirror and that radiated and was refle&ted in the rest of her family. /ome of the patients had suffered for years from heart %angina' pain and other &ir&ulatory illnesses. +any of those who followed the low-fat diet faithfully found these symptoms gradually disappearing. $ases like +r. $# +r. =. and +rs. W. were typi&al. "ollow ing the diet and nutritional &hanges# weight losses of ;= to B= pounds resulted. In the pla&e of the old &hest pain# dis&omfort or pressure due to angina or heart pain# there was now a feeling of lightness# ease# and freedom from the frightening distress that used to &ome on so 9ui&kly after e:er&ise or e:&itement. These remarkable improvements in all the patients on the low-fat diet were a&&omplished by the healthy teamwork in body &hemistry and tissues of vitamin and nutritional supplements# diet# and weight redu&tion. Identi&al findings were reported by investigators abroad# parti&ularly in -urope. The benefits were espe&ially strong in &ases of atheros&lerosis of the brain %stroke'. These &ases of &erebral atheros&lerosis are so widespread they are virtually universal. $hapter >> &ontains a detailed a&-

FAT' THE KILLER' ON TRIAL

51

&ount of the re&ent and e:traordinary dis&overies that have resulted from treatment of this &ondition by the low-fat diet and nutritional supplements. ( re&ent s&ientifi& publi&ation of mine in the medi&al )ournal 8eriatrics %for elderly people' des&ribes some remarkable &hanges in patients with &erebral atheros&lerosis. ,ver >== of these patients# some of them suffering from strokes# were treated very intensively by the low-fat diet and massive amounts of le&ithin# vitamin-! &omple: supplements# liver e:tra&t# and soya oil %as des&ribed in detail in $hapter ?' showed remarkable &hanges# often within two to three months. In&reased strength as noted by me&hani&al measuring devi&es and in&reased mus&ular ability# &oordination and ability to walkwere fre9uently found.N +ental improvement was often seen by improved powers of &on&entration# greater &larity of thinking# e:pression# and per&eption. -motional &hanges were often remarkable. 4epression and la&k of &ommuni&ativeness gradually disappeared and in its stead there fre9uently developed a feeling of well-being# &heerfulness# and optimism. Patients were mu&h easier to get along with and were keenly interested in their improved nutrition and progress# where as before they had often felt only apathy and a fatalisti& resignation to their &ondition. These en&ouraging dis&overies# although e:tremely important# do not mean that there are no other fa&tors that play a part in &ausing atheros&lerosis or help it to develop. (s I have already mentioned# we must not forget su&h additional fa&tors as heredity# se:# metaboli& and glandular disturban&es# lo&al &onditions within the arteries themselves# and possibly# still other undetermined &auses. .owever# what is important for you to remember is this: diet and weight are two powerful for&es for health that you can control# 6ou &an do something about diet# and you &an follow the low-fat diet with no diffi&ulty# without
.

B;

"(T# T.- 2I33-5# ,* T5I(3

having to suffer a bland# une:&iting series of daily menus. (nd you &an lose e:&ess %unhealthy' weight easily# safely# and without having to starve yourself or restri&t your diet to only a few foods su&h as lettu&e and &ottage &heese. 6ou don8t have anything to say about your heredity or your se:# but you &an do something about what you eat and what you weigh. This book will show you how. In the following &hapters you will dis&over e:a&tly how to eat and what to eat in order to prolong your life and in&rease your health and vitality. The low-fat program given in this book &an do wonders for your general health and well-being. It may even save you or your loved ones from heart atta&ks# strokes# and other illnesses in whi&h the role of the "killer" fat is unmistakable. *ow that we know that fat is guilty# let8s see e:a&tly what we &an do to keep this silent mena&e from destroying your heart and your health.

7our diet is the key to your health! 4iet is an important fa&tor in the &ause and &ure of many ills. The wrong foods &an &ause allergi& rea&tions ranging from the well-known strawberry rash to death from allergi& asphy:iation. The right foods &an help you &lear up su&h allergi& rea&tions. The wrong foods &an bring on overweight# sap your energy# rob you of Fest and well-being. (nd in the degenerative diseases of the heart and blood vessels# diet is the key@ it is the differen&e between a&tive good health and dangerous illness. *ot all do&tors are agreed as to the e:a&t role of the high-fat diet in the development of those &ir&ulatory disorders that a&&ount for more than one-half of the total deaths in this nation ea&h year. !ut a &areful and &ontinuing study of the sub)e&t for more than >< years# both in the laboratory and in my private pra&ti&e# has left no doubt in my mind. It is diet that &o&ks the trigger of the deadly weapon now aimed at the hearts and brains of millions of (meri&ans. Whether that trigger is ever pulled will depend# admittedly# on a number of other things: heredity# o&&urren&e of other diseases in the vi&tim# &ertain hormones# stresses# bio&hemi&al fa&tors# and so on. !ut why play 5ussian roulette with your heart !y eliminating &ertain foods from your diet# by in&luding BA

55

HO8 T, !- 5-(336 W-33# T.- 3,W-"(T W(6

others in the right amounts# and by the use of nutritional supplements# you &an a&hieve at least a <= per &ent prote&tion against heart atta&k. We shall &onsider dietary supplements in $hapter <. *ow let8s see what foods are good for your health and whi&h foods are not. 7nfortunately# as simple as proper dieting is# do&tors have found it to be one of the most diffi&ult measures to pres&ribe for their patients# and one of the most diffi&ult to get them to follow &onsistently. Proper diet is the easiest and safest thing a physi&ian &an pres&ribe. !ut be&ause eating habits are so firmly established with most patients# and be&ause dietary therapy takes time# many follow a stop-and-go routine that offers little long-range benefit.

, healthy diet does not mean starvation or tasteless

foods! 6et a &orre&tive diet does not mean either starvation or the grim ne&essity of eating unpalatable foods. +oreover# a little e:perimenting in the kit&hen will soon produ&e meals that# from the standpoint of taste and estheti& appeal# will be e9ual if not superior to# the high-fat dishes to whi&h you are a&&ustomed. In the following pages you will find ways and means of satisfying your appetite and of stimulating it in su&h a way that it &an be &onstantly surprised and pleased. This is done by a little originality on your part plus a break with old &ooking and eating habits that have grown into fi:ed# and often monot onous# dining patterns. 6our palate will be grateful for the &hange. (nd you will e:perien&e on the low-fat diet a startling in&rease in vigor and vitality# a new sense of well-being.

7ou do not have to lose energy good diet increases

vigor# *either does it mean a loss of energy or a sharp redu&tion in poundage# unless you are overweight# in whi&h &ase the e:&ess fat is melted off. In fa&t# if you adhere to the low-fat# low-&holesterol diet re&ommended in these pages# you will feel better# have more vigor# and firmer mus&les than before. If you have a faulty fat metabolism# the diet may substantially prolong your life. 6ou will find more energy. 6ou will be able to a&&omplish more and en)oy better what you do a&&omplish.

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6 B< The low-fat# low-&holesterol diet is not intended for growing &hildren and young persons under ;=. The fatty a&ids &ontained in an unrestri&ted diet are apparently favorable to their growth and development. (t the same time# there is the in&ontrovertible fa&t that hundreds of millions of &hildren in the ,rient and elsewhere de velop to their normal physi&al growth and healthy adulthood on a low-fat diet. (pparently the reason for this is that nature has endowed them with the ability to synthesiFe or produ&e within the body itself from other foodstuffs eaten# the essential fatty a&ids found in high-fat diets. .owever# additional fats above and beyond those a&tually re9uired and eaten in the diet are metaboliFed and dis&arded by &hildren# or are absorbed without being deposited in harmful amounts on the artery walls. !ut after the period of growth is &ompleted# and nature has e:hausted her prote&tive powers against fats# e:&ess amounts are deposited in the artery walls. This tenden&y in&reases with ea&h de&ade after you are A= years of age.

,lmost everyone can benefit from a low-fat diet! There

are# of &ourse# some individuals whose blood is so low in &holesterol and blood fats that dietary restri&tions are not ne&essary. !ut these persons are de&idedly in the minority@ and su&h a &ondition &an only be determined by a &ompetent physi&ian# who will order a laboratory measurement of serum &holesterol levels in the blood. People who are fortunate enough to possess these low-&holesterol levels %fi:ed around a ;== milligram value' are able to handle all fats ingested. They are usually &hara&teriFed by outstanding vitality and are in&lined to long lives. They rarely suffer from blood vessel diseases and heart atta&ks. I had su&h a person as a patient of mine in one of my tea&h ing wards at the $ounty .ospital. /he was a +e:i&an-Indian woman whose do&umented age was >>= years. 4espite this remarkable fa&t# and despite her other infirmities %whi&h were not asso&iated with degenerative blood vessel disease'# she was

,1

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6

9uite spry. +y resear&h laboratory took samples of her blood and analyFed them with keen interest to see how mu&h &holesterol and blood fats it would &ontain. In repeated tests# we found her &holesterol levels remained &onsistently within the range of >== milligrams. .er other blood fats were &or respondingly low. $ompared with what we regard as "normal" values of blood &holesterol in the 7nited /tates %><=-;<= milligrams'# this patient8s values appeared to be surprisingly low. .owever# the >== milligram level dis&overed in the little old +e:i&an-Indian lady# who was born in >EB= and brought up on a diet of legumes# fruits# and Indian &orn# was probably a more a&&urate e:ample of what the ideal &holesterol level should be. (t the opposite end of the spe&trum from this viva&ious &entenarian are many individuals who have inherited what we of the medi&al profession &all familial hyper&holesterolemia. These words are a term referring to persons who have inherited abnormally high levels of blood &holesterol. These are the unfortunate ones throughout whose families runs the devasta tion of heart atta&ks and strokes# usually &oming in the prime of life. /u&h a &ondition is often dis&overed a&&identally during a routine &he&kup by an able physi&ian. .e may note su&h signs as &holesterol deposits in the form of whitish pla9ues under the eye %&alled :anthalasma'@ or as a &res&ent along the periphery of the pupil in the eye %&alled an ar&us senilis'. /u&h indi&ations may also be observed by the alert physi&ian in various other parts of the body# in&luding the elbows# arms# legs# heels# and hands. +any times the &ondition may reveal itself in the arteries inside the eyes# when they are &he&ked by a &ompetent eye do&tor. Whether su&h danger signals e:ist or not# however# if you are a man over ;= or a woman over B=# a diet &omprising not more than >= to ;= per &ent of fat in &alories &an offer some measure of prote&tion against heart and blood vessel disease. /u&h a low-

HO8 T, !- 5-(336 W-33# T.- 3,W-"(T W(6 BC fat diet &an# in fa&t# help you to en)oy the kind of over-all good health that makes life worth living. /o# for your health8s sake# follow the re&ommendations found in the rest of this &hapter and avoid those foods that may destroy your health and your heart.

.he low-fat, low-cholesterol program4

FOODS PERMITTED S&./0

-mphasiFe bouillons and &onsommes# as they are nutritious# filling# and low in &alories and fats. They are ideal for relieving that hungry feeling 9ui&kly and pi&king you up in the pro&ess. /oups are great to warm you up instantly in &old weather and# in the )ellied form# to &ool you off in hot weather. /oups stimulate the digestive )ui&es# start the stoma&h and intestinal mus&les &hurning and "warmed up" for the )ob ahead# while "flushing out" the stoma&h and getting it ready to stoke the digestive furna&e. 7se fat-free vegetable soups# vegetable broths# and soups prepared with skimmed milk. It is imperative to remove all visible fat and grease from the soup. .ere are some good ways to do this: >. 5efrigerate or &hill the soup first: then &arefully remove the fat and grease that has &aked on the top with a knife# spoon# or other suitable utensil. ;. If there is not time for refrigerating or &hilling the soup first# use bread sli&es by dire&t appli&ation to the top layer of the soup# in order to blot up or absorb the grease. A. Pla&e some lettu&e leaves on top of the heated soup. When you see the fat absorbed onto the leaf or leaves# remove them. The lettu&e leaf may also impart a slight flavor to the soup# helping to lend a little Fest. B. !lot up the top layer of grease by floating one or more paper towels on the surfa&e of the soup. When it is fat-

BE

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6 saturated# dis&ard the towel@ it is a greasy reminder of es&ape from unhealthy &alories.

4ry soup mi:es are 9uite low in fat and are very en)oyable. /ome soup manufa&turers prepare &anned soups that have about a half-teaspoonful of fat per serving of soup when diluted e9ually with water. Gegetable and vegetable-beef &anned soups# however# are very low in fat &ontent and are thus highly desirable for the low-fat diet.
M12(0

!eef# veal# and lamb are naturally high in both visible and "invisible" fat and &holesterol. .owever# sin&e their protein &ontent is most desirable for energy and palatability# and be&ause of &ustom# they are basi& ingredients in the low-fat diet. +u&h of the dietary fat allowan&e is &ontained in meat# whi&h has its greatest amount of &alories predominantly in fat. It must be kept in mind that the but&her will at all times allow a ma: imum of fat to remain on every &ut of meat for reasons of added pri&e and the presumption of "9uality." This visible fat must be &arefully &ut away and trimmed while raw# before &ooking. 4uring the &ooking# baking# or broiling of the meat# the fat should be drained off by keeping the meat or roast on ra&ks. ,ne ideal way of removing most of the fat &ontent of meat and making it almost fat free is to partially &ook it on the day before it is to be eaten. 5efrigerate the meat and the broth. ,n the following day it is now easy to remove the layer of grease that has floated to the top and hardened. !uy and eat lean meats. If you are having ground meat# spe&ify to the but&her that it is to be made from trimmed# lean meat. !ear in mind that the highest fat &ontent is present in the prime and &hoi&e grades of beef# lamb# and veal %whi&h are more e:pensive too'# sin&e they originate from fattened animals. 3ess fat and good 9uality is &ontained in meats that bear the stamp "7./. 1ood." 4o not fry meats. Pan-&ook or brown without fat or grease#

HO8 TO BE REALLY 8ELL' THE LO83FAT 8AY 59 if desired# by using a dry skillet@ heat and salt it first before the meat is pla&ed in it# while turning the meat repeatedly. (fter it is as brown as desired# &ook slowly until well done or rare# whi&hever you wish. ( preparation &alled "Pantasti&" %manufa&tured by 1. *. $oughlan $ompany# West ,range# *ew Iersey' is one method of &ooking with pans and redu&ing fat to a minimum. It prevents meats and other foods from sti&king to the pan so that grease and fat-free &ooking is possible. 5emember that among meats pork# ba&on# and ham are highest in fat and &holesterol &ontent. They should not be eaten on the low-fat diet other than o&&asionally# if permitted by your do&tor or by the virtual absen&e of other fat-&ontaining foods in your menus for the day. The same is generally true of sausages# and organ foods like brains# sweatbreads# and kidneys. 3iver is an e:&eption# however# as we will see later. If gravy is desired for the flavoring of meats# it must be prepared free of its usual very high fat &ontent. The regular brown drippings found at the bottom of the pan after meat is &ooked must have the meat )ui&es separated from the e:&eptionally high melted fats. /eparate the fat in this gravy by &hilling or refrigeration. 5emove the thi&k layer of &aked grease as des&ribed above by spoon and by blotting with bread or absorbent paper. "at-free gravies &an also be made by &onsulting various low-fat &ookbooks. Instead of gravies# meats &an be flavored and made to look appetiFing by the following garnishes: water&ress# parsley# &elery# &arrots# radishes# pimento# pi&kles# paprika# green peppers# &u&umbers# mushrooms# and onions in various shapes and &ombinations. (lso helpful are spi&ed pea&hes# pears# prunes# apri&ots# &innamon apples# spi&ed watermelon rind# applesau&e# &innamon pears# pineapple pie&es# broiled bananas# seasoned tomatoes# herbs# and the various relishes su&h as mint )ellies and sau&es# &hili# &atsup# &ranberry )ellies# &hutney# and many others.

<=

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6

(lso appealing are some of the following seasonings: garli& &loves# thyme# mar)oram# basil# oregano# bay# and peppermint. F304 (s a. rule# fish are often e:&ellent low-fat food sour&es. 7n like meats# very little fats will be &ooked out of the fish# so attempting to drain off fish fats in &ooking is unne&essary. /ome fish are espe&ially low in fat# su&h as per&h# haddo&k# flounder# sturgeon# smelts# s&allops. ,thers like brook trout# porgy# &od# and &roakers are somewhat higher in fat &ontent# but are still 9uite low in fat &ontent when &ompared with meats. /hell-fish are outstandingly low in fat and &holesterol &on tent. 3obster# shrimps# and &rabs are ideal e:amples. $lams are ne:t in line@ oysters are a bit higher in fat &ontent# but are still low in &omparison with beef# lamb# or veal. "or the &on noisseurs# frogs-legs are also low in fat &ontent. Tuna is now pa&ked in dieteti& form &alled "$hi&ken-of-the/ea !rand" and is parti&ularly low in fat. +any &anned fish when not pa&ked in oil are very low in fat.
P&.5(67

$hi&ken and turkey are e:&ellent sour&es of animal proteins for low-fat# low-&holesterol &ontent# provided lean poultry is used. The dark meat of poultry is higher in fat &ontent than white meat. /kin should be dis&arded. 1iblets are very high in fat &ontent. 1uinea hen and s9uab are also &omparatively low in fat &ontent. .owever# du&k and goose are e:tremely high in fat and should not be in&luded unless the fat is drained off and removed by the methods re&ommended in the se&tion under meats. (s a matter of fa&t# the fat from &hi&ken and turkey# even though mu&h less 9uantitatively than that in meat# is best drained off and removed in the same manner as in the preparation and &ooking of all meats.

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6 E880

<>

-gg whites# whi&h are proteins# may be eaten and used for &ooking as mu&h as desired. The yellow portion of the egg# or the yolk# &ontains one of the most &on&entrated forms of fat availablenamely &holesteroland therefore should be avoided.
M359 2': M359 P6&:.;(0

,ne pint or more daily of non-fat or skim milk should be taken. 7se fortified milk with added amounts of vitamin ( and 4# as now &ommonly in use. !uttermilk is also a refreshing sour&e of milk with an e:&eedingly low-fat &ontent. (s an added sour&e of fat-free or low-fat protein# skim or fat-free milk &an be fortified by adding to ea&h glass of milk one or more tablespoonsful of dried# skim milk. This "fortified" milk also has a thi&k &reamy taste and &an be flavored to suit the individual taste with various flavoring agents. 6ogurt made from non-fat milk &an also be used for nutritious variety. C+##"#" The ma)ority of &heeses are very high in butterfat &ontent and so &annot be used in the low-fat diet. There are several important e:&eptions# however. "irst is &ottage &heese made from dry &urd and non-fat milk# as spe&ified by federal law. $ottage &heese must &ontain a minimum amount of butterfat to meet legal re9uirements. ,ne of the most fre9uent pitfalls in the use of &ottage &heese is the user8s failure to noti&e that often she is using or buying &reamed &ottage &heese# whi&h of &ourse does &ontain fat. 5estaurants in parti&ular use &reamed &ottage &heese in their menus# and this should be borne in mind when eating out. This &reamed &ottage &heese &an be &orre&ted by washing it out with &old water through a strainer. Garious brands of &ottage &heese that taste like &reamed &ottage &heese are available# su&h as "/lim $heeF"

<;

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6

or 5i&otta $heese made from milk whey and a favorite of Italian &ooks. There are also other foreign brands of &heeses low or negligible in fat &ontent# whi&h are pro&essed from non-fat milk or whey# su&h as the 1eska type of /apsago &heese %/wiss green &heese'# &ertain /&andinavian &heeses# and in the 7nited /tates brands of )a&k &heese made from skim milk or whey. $heese spreads or dips made from non-fat or &ottage &heeses are also widely used for low-fat menus.
V181(2<510

Gegetables are virtually fat free and &ontain no &holesterol. $ertainly the a&id test or taste % K ' of the good &ook is in the preparation of vegetables. To prepare vegetables without butter or fat means that a little originality is re9uired by the &ook# su&h as by the use of herbs or seasoning. /in&e many of the vital vitamins and minerals in vegetables may be destroyed by &ooking# the ideal use of raw vegetables is the most desirable for any menu# and espe&ially for the low-fat menus. .owever# be&ause many vegetables are &ooked# it is best not to soak them# and to save and use in other dishes the water used for the &ooking# to avoid using soda and to avoid over&ooking or re heating of the vegetables. The addition of bouillon &ubes as a substitute for butter in the &ooking of vegetables is very helpful and palatable. The subse9uent addition of herbs before serving the vegetables adds further to the natural flavor.
F6.3(0

"ruits also &ontain virtually no fat and are entirely free of any &holesterol. Two notable e:&eptions# however# are the avo&ado and the &o&onut# whi&h are both very high in fat &ontent and thus should be avoided. ,therwise there is no restri&tion on the use of fruits# whi&h are also &ertainly ideal for desserts.

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6 <A S(/(1" (&1 S(/(1 D #""i&g" 7se raw vegetables almost e:&lusively# sin&e the vitamin value is at peak this way# and the &rispness of the vegetables is most appetiFing. *o fat or &holesterol is &on&erned unless spe&ifi&ally added. "ruit salads are in the same &ategory and are parti&ularly refreshing and nutritious. Garious &ombinations &an be used with vegetables# &ottage &heese# or gelatin re&ipes. When fresh fruits are not in season# use dried# &anned# or froFen fruits. 1elatin salads are spe&ial favorites to many# espe&ially when made with fruit )ui&es instead of water. (spi& salads are e:&ellent when prepared with vegetables or vegetable )ui&es. If &ottage &heese is added to gelatin and aspi& salads# more protein and "body" results. /alad dressings low in fat &ontent are readily available from various manufa&turers under su&h trade names as +arse 4iet 5ite %3o-$alorie +ayonnaise /ubstitute'# 4iamel 4iet Whip# and others. These do &ontain a relatively small degree of fat# however# so it is best to prepare your own fatfree dressings whenever possible# su&h as the one des&ribed in the re&ipe# page C;. /mall amounts of mineral oil are preferred by some for salads# but if used more than o&&asionally this is not desirable# sin&e mineral oil tends to interfere with absorption of vitamin ( in the food. If allowan&e is made for the &alori& &ontent of the vegetable oils des&ribed in $hapter <# soya-oil# &ornseed oil# and &ottonseed oil are valuable for use in salad dressings. (s e:plained in $hapter <# these vegetable oils are e:&ep tions to other fatty foods in that they &ontain large amounts of unsaturated fatty a&ids. These fatty a&ids are very effe&tive in redu&ing the fats and the &holesterol present in the blood stream. They are thus "prote&tive" against the harmful effe&ts upon the arteries of other fats# su&h as &ontained in butter# milk# eggs# and &ream. 4on8t forget eye-appeal in preparing an appetiFing salad. The

<B

.,W T, !- 5-(336 W-33# T.- 3,W-"(T 8AY

following garnishes are parti&ularly nutritious and appealing: water&ress# &routons# garli&# &hives# pimiento# lemon# lime# orange or tangerine and other fruits# mint# &arrots# beets# green onions# &elery# radishes# &ottage &heese# parsley# pi&kles and peppers# ket&hup# vinegar# non-fat yogurt# herbs# and spi&es.
C161250

These are nutritious# energy produ&ing# and virtually fat free. Therefore# all &ooked or dry &ereals are e:&ellent &arbohydrate foods# if served with non-fat milk. The taste is enormously enhan&ed by the addition of stewed or fresh fruits su&h as bananas# prunes# pea&hes# pears# apri&ots# berries# dates and figs# raisins# or baked apple. Whole wheat and whole grain &ereals are also an important sour&e of vitamin ! &omple: and protein in the low-fat diet. Their &ooking &an be done with skim milk if it is not boiled or burned. The addition of one-to-four tablespoonsful of wheat germ to the &ereal is a most desirable nutritional supplement and is an ideal daily food when added to the &ereal. "or those who work and feel best beginning the day with a substantial breakfast# the in&lusion of the above &ereal# skim milk# fruit# and wheat germ "&ombo" is e:&ellent for energy# proteins# vitamins# and minerals.
B612:0

!oth white and whole wheat breads &ontain only a negligible amount of fat %appro:imately < per &ent by weight' a minority 9uantity of protein %about ;= per &ent' @ the rest is &arbohydrate. Whole wheat bread is the healthiest# most nutritious form of the "staff of life." !akeries &ustomarily in&orporate some lard# butter# or egg yolk in most yeast loaf bread# sweet rolls# rolls# muffins# buns# and &offee &ake. Garious enri&hed breads now on the market are also nutritious as far as vitamin ! &omple: is &on&erned# and often may mat&h >== per &ent whole wheat# rye# or pumperni&kel breads in this regard.

HO8 TO BE REALLY 8ELL' THE LO83FAT 8AY

D10016(0

99

"at-free sweets are great energy produ&ers as well as &omforting for that "sweet-tooth." -:&ellent# but high in &alories be&ause of sugar &ontent# are )ams# )ellies# marmalade# honey# molasses# maple syrup# and sugar@ hard &andies and &andies without nuts# &reams# or &ho&olate are also fat-free.
B1=162810

( wide &hoi&e of fat-free drinks is available to all# su&h as tea# &offee# &offee substitutes# skim# fat-free milk# non-fat milk &o&oa# skim milk powder shakes# and egg white eggnogs. Where desired for additional nutriments# flavoring &an be added to these flavored skim milk drinks in between meals or at bedtime. "ruit and vegetable )ui&es are also appealing and nutritious# as is fat-free yogurt. $arbonated drinks su&h as ginger ale# $o&a-$ola# C-7p# and others are also fat-free and popular.
FOODS TO AVOID S&./0

(ll &reamed soups are high in fat &ontent. The &ommer&ially prepared ones are parti&ularly fat-heavy# and sin&e the fat &annot be readily removed from them# they should not be used. It is always a good idea to read the label &arefully on any pa&kaged produ&t from whi&h soup is being made. The law pertaining to the labelling of foods re9uires a des&ription of any fat &ontained in the produ&t# so undesirable sour&es of fat &an be avoided.
M12(0

1landular organs su&h as sweetbreads# brains# kidneys# &aviar' fish

roe# and giblets are high in &holesterol and fat &ontent# so should be avoided. Pork and pork produ&ts# ba&on# and ham are also high in fat and &holesterol and should not be eaten# e:&ept at an o&&asional meal.

<?

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6

(s already mentioned# liver is an e:&eption to the list of glandular organs to be avoided. It is 9uite desirable as a valuable nutritional sour&e of essential vitamins and minerals# and be&ause of the "prote&tive" &ontent of phospholipids that &ountera&t the a&tion of fat and &holesterol# it is not harmful. F304 $ertain fish are high in fat &ontent and are best avoided. These are: bass# bluefish# butterfish# deviled &rab# eel# herring# ma&kerel# s&alloped or fried oysters# pompano# salmon# sardines# shad# and trout.
P&.5(67

!oth du&k and goose are very high in fat and &holesterol &ontent and so should be avoided unless prepared in the fat-free way des&ribed under the se&tion of "+eats Permitted#" page BE.
D2367 P6&:.;(0

Whole milk# &ream# butter# and &heeses su&h as (meri&an &heddar# /wiss# &ream# &reamed &ottage# &heese spreads# 1ruyere# -dam# 3imberger# 3iederkranF# Parmesan# 5o9uefort# and 6ogurt made from whole milk are all high in fats and should be eliminated from your diet.
E880

-gg yolks are e:&eptionally high in &holesterol and fat &ontent. They are often used by medi&al investigators and re sear&hers to produ&e atheros&lerosis and "hardening of the arteries" in e:perimental animals.
B612:0

.ot breads# pan&akes# waffles# &offee &akes# muffins# buns# doughnuts# 4anish pastry# sweet rollsall &ontain some appre-

.,W T, !- 5-(336 W-33# T.- 3,W-"(T W(6 <C &iable amount of lard# butter# or egg yolk. Those espe&ially interested in home baking &an find re&ipes for these fat-free breads and pastries in low-fat &ook books# if desired.
D10016(0

(ll those made with butter# egg-yolks# or &ream# su&h as pies# &akes# pastries# &ookies# &ustards# e&lairs# gingerbread# short&ake# and puddings. *otoriously high in fat and &holesterol are i&e-&ream# parfaits# and froFen &reams.
M30;1552'1&.0 F&&:0

(vo&ados# &o&onuts# nuts# &holo&ate# &o&oa# fat &ontained in the usual salad dressings# gravies# and sau&es are all very fatty. (nimal fats# in&luding lard and suet# should parti&ularly be avoided in &ooking. "rying should be &ompletely eliminated in the preparation of foods# not only be&ause of its high fat produ&tion# but also be&ause of its unhealthy way of interfering with the normal digestion of foods and essential nutriments and vitamins# the irritating &hara&ter and effe&t on the digestive tra&t of the fried fats# and the destru&tion of vitamins and essential foodstuffs in the food that is fried. -ven vegetable fats are best not used. (n e:&eption &an be made for vegetable oils su&h as soya oil# &ornseed oil# and &ottonseed oils as des&ribed on page ??. (l&ohol has no fat &ontent# so there are no restri&tions on its use other than by the di&tates of &ommon sense and self-&ontrol. 4on8t forget that the &alories in li9uors &an easily mount upK The low-fat# low-&holesterol menus found in this book# if followed conscientiously, will provide you with a nutritious# natural diet# one that will help prote&t you against heart and blood vessel disease. (t the same time# it is a diet that will greatly improve your general state of health and in&rease your vitality.

<E

.,W T, !- 5-(336 W-33# T.- 3,W-"(T 8AY

(s you will dis&over in $hapter C# you &an lengthen your lifespan by a definite number of years by keeping your weight down on this diet. $he&k the tables on pages >;E and >;D to see how many years you may e:pe&t to add to your life )ust by maintaining the proper weight# irrespe&tive of heart disease. Then ask yourself# "Isn8t it worth a &hange in my eating habits "

%ven a goat wouldn't eat what you eat! It is said that goats will eat anything. (t various times their owners have reported that the animals had &onsumed su&h things as items of laundry from the &lothesline# old shoes# paper %in&luding banknotes'# and in one &ase a horse8s tail. With an appetite like that# you would think that !illy or *anny would gladly a&&ept an invitation to have dinner with us. !ut su&h# apparently# is not the &ase. *ot long ago# partly as a )oke and partly out of &uriosity# a man I know offered the same food that had been prepared for his dinner to a neighbor8s goat. .e reported that the animal turned aside in disgust from the dishes offered it. ,f &ourse# man8s dietary re9uirements differ somewhat from those of a goat. !ut in meeting those re9uirements# we have not shown any better sense in &hoosing our food. 7ou are overfed but undernourished! .ealth authorities# nutritional e:perts# and pra&ti&ing physi&ians are agreed that although (meri&ans &an afford to buy more and better food than any other peoples in the world# their diet is sadly defi&ient in &ertain important nutritional elements. We are a nation that is overfed but undernourished. The reason for this is that very often nutritional defi&ien&y <D

?=

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

&an and does o&&ur without any outstanding &lini&al signs. (lso# upper in&ome groups are no more immune than those of a lower e&onomi& level. 4r. *orman Iolliffe# 4ire&tor of the !ureau of *utrition# *ew 6ork $ity .ealth 4epartment# and one of the &ountry8s outstanding authorities on nutrition# re&ently warned:
It is well established that defi&ien&y disease# even without obvious &lini&al signs# may impair growth# mental development# resistan&e to many infe&tions# ability to attain the ma:imum rate of wound healing# and de&rease working ability.

In fa&t# inade9uate nutrition# and in&orre&t nutrition# &omprise a "hidden disease" in the 7nited /tatesa disease &ostly in terms both of dollars and lives.

*hat is wrong with our diet and our eating habits+ +any
things are wrong with our diet and eating habits. *owhere in the world is food treated so badly before it is eaten as in the 7nited /tates. .ere it is raised by the use of artifi&ial &hemi&als. In an all-out effort aimed at 9uantity# rather than 9uality# we do everything humanly possible to de stroy the original &hara&ter that the $reator provided and intended for the yield of the earth. +oreover# by the time most of our food rea&hes the &onsumer# it is too highly pro&essed# refined# and improperly preserved. To add to this inade9ua&y# we destroy what nutrient value remains by flame# fire# by watering it down with tap water# and by overloading it with salt# sugar# or seasoning. Then we sit down during hurried and harried business hours and bolt it down. (nd the result /ome <= million or more (meri&ans# adults and &hildren# suffer from &onstipation# bad teeth# skin troubles# digestive disorders# fatigue# nervousness# and a multitude of other &omplaints. +ost of them are &aused dire&tly by poor nutrition and sub-&lini&al vitamin defi&ien&ies.

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

?>

To add to these digestive troubles# modern man has &ut his o:ygen intake by living indoors# often in artifi&ially heated &ells or rooms# and has lost &onta&t with both sunshine and fresh air. This unnatural way of life is undoubtedly responsible for important metaboli& &hanges that have o&&urred in &iviliFed man. .e has brought &ertain evils upon himself by losing those "&atalysts" or "stokers of the body furna&e." (s a &rowning insult to nature# we fre9uently sit s&run&hed in a &hair most of our days# living in a &onstant state of tension and apprehension at our work. +an was originally very energeti&# physi&ally a&tive and almost &onstantly engaged in some e:er&ise or other. Today# thanks to our me&hani&al genius# we tend to depend upon a push-button instead of a mus&le. (ll these fa&tors make it ne&essary for us to seek "outside help" to make up for our nutritional and hygieni& short&omings.

3ow to supplement your diet with essential nutrients!

,ne way s&ien&e has found of helping us a&&omplish this is to supplement our diet with vitamins and other essential nutrients. 4r. Iolliffe# noted nutritionist whom we 9uoted earlier in this &hapter# not long ago pointed out that the improved nutritional status of our population sin&e >DB= is# in fa&t# largely due to enri&hment of foods and vitamin supplements. /tates 4r. Iolliffe:
The agri&ultural s&ientist and the s&ientifi& farmer alike# know that it is not pra&ti&al nor e&onomi& to raise hogs or &hi&kens from purely agri&ultural produ&ts alone. They supplement the diet of their animals with a variety of vitamins# minerals# and other nutritionals. (lthough man does not like to think of himself as governed by similar nutritional rules as farm animals# we &ould learn and profit mu&h by following what the s&ientifi& farmer pra&ti&es.

"or a number of years# the author has studied the effe&ts of the following food and nutritional supplement programs# re&ommended to a large number of patients. They produ&ed a striking (&1 gratifying improvement in health levels and

?;

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

well-being. (lso of greatest importan&e was the fa&t that they were found to be instrumental in lowering the &holesterol &on tent of the blood and in redu&ing the amount of harmful blood fats. There was a &orresponding de&rease in the number of &olds and infe&tions that patients usually had. They also reported less &onstipation# nervousness# fatigue# and the like. The five-step program# .ere are the five steps that patients were asked to follow: >. In&lude daily as a food supplement at breakfast two to four tablespoonfuls of 3e&ithin e:tra&ted from soya beans. ;. (dd to your diet ea&h day ! $omple: vitamins in the most potent form. (void the &heaper preparations whi&h provide only small and ineffe&tual 9uantities of the vitamins# and have little or no effe&t on the body. 6our do&tor or druggist &an advise you whi&h brands provide potent 9uantities of the vitamins. A. (lso add to your daily diet at least ;<#=== units of Gitamin (# and ><= mg. of vitamin $. B. Take two tablespoonfuls of soya bean oil# &orn oil or safflower oil daily to provide the essential fatty a&ids ne&essary to proper nutrition. The oil may be used as a salad dressing# taken with tomato or fruit )ui&e# or in any way you prefer. <. In&lude in your diet two to four tablespoonfuls of whole wheat germ ea&h day. This may be eaten as a breakfast &ereal with fruit# or sprinkled in your salad. *ow a word about the nature of these health-giving nutrients# and the reason for their use. 2ow to use 7ecithin# *ow I8m going to tell you about one of the most important nutritional supplements developed in the last <= years. +ake a &areful note of it and of how it is to be used# as des&ribed in these pages. The least it &an do for you is to improve your health and give you added vitality. (nd it may even help save your life.

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

?A

The substan&e is 3e&ithina bland# water-soluble# granular powder made from de-fatted soya beans. /oya beans have been an important staple in the diets of people in $hina and the "ar -ast for &enturies. !ut it was only re&ently that the health-giving properties of one of the beans8 &onstituents3e&ithinhave been studied. 3e&ithin is what bio&hemists &all a phosphatide. That means it is an essential &onstituent of all living &ells# both animal and vegetable. (s su&h# it plays a vital role in various phases of body &hemistry and fun&tion. (fter more than >= years of intense e:perimentation# not only with 3e&ithin# but with a large number of other &holesterolredu&ing preparations used in the treatment of heart disease# atheros&lerosis# and allied &onditions# we found 3e&ithin to give the most rewarding result. It was# in fa&t# not only useful in treatment of heart and blood vessel disease# but also in their prevention# 3e&ithin has very re&ently been shown to have the power of removing atheros&lerosis from the arteries of e:perimental animals. 4r. +eyer "riedman# 4r. /anford !yers# 4r. 5ay 5osenman and their resear&h asso&iates in /an "ran&is&o have demonstrated in a most &onvin&ing and dramati& manner how in)e&tions of 3e&ithin remove the &holesterol pla9ues that were deposited in arteries. These fatty pla9ues were produ&ed in the arteries by feeding large amounts of &holesterol and fats to the animals. They were &hara&teristi& of the atheros&lerosis found in humans. 4r. "riedman and his &o-workers believe that in atheros&lerosis# as the fats and &holesterol are removed from the artery walls and flood the bloodstream# the atheros&leroti& pla9ues are dissolved and removed by the 3e&ithin. The e:&ess &holesterol and fats are thought to be &onverted by the liver into the bile and then e:&reted from the body. (l though there is no known method of using 3e&ithin by in)e&tion in humans# the very high &on&entrations in the blood of 3e&i-

?B

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

thin that are desirable for treatment &an be a&hieved by feeding 3e&ithin and in&orporating it into the daily diet. ,ther resear&h workers have also re&ently shown that soy bean 3e&ithin is able to prevent blood &lotting in the arteries. Wherever possible add at least two teaspoonfuls of flavored fresh brewer8s yeast to skim milk# &ereal or whole wheat germ daily. The use of an added two tablespoonfuls or one oun&e of a fresh liver powder e:tra&t to the daily diet is invaluable for good nutrition. !oth of these &an be pur&hased at most drug stores and at all spe&ial diet food stores. +any of my patients have prepared a "+olotov" &o&ktail by mi:ing both the yeast and liver powders in tomato )ui&e or fruit )ui&e. 4rink this "&o&ktail" before meals. 6ou will often find that it a&ts truly like "dynamite" in produ&ing energy and vigorK In the &ourse of our resear&h we have also found that 3e&ithin apparently has the ability to in&rease the &holesterol esterases in the human blood stream. These esterases are enFymes# or a&tivators# that aid in the metaboliFing of fats. 6ears ago# we found that these &holesterol esterases are defi&ient in patients with a&tive atheros&lerosis. 3e&ithin has other remarkable therapeuti& 9ualities as well. ,ne that we are )ust beginning to e:plore is its ability to in &rease the gamma globulin &ontent of the blood proteins. These gamma globulins are known to be asso&iated with nature8s prote&tive for&e against the atta&ks of various infe&tions in the body. In the blood stream of patients who used 3e&ithin as re&om mended# we found eviden&e of in&reased immunity against virus infe&tions. This is of spe&ial interest# sin&e s&ientists have re ported finding this 3e&ithin-indu&ed immunity against pneumo nia. ,ther studies &ondu&ted by various (meri&an medi&al s&ientists have indi&ated that 3e&ithin is also benefi&ial in the treatment and prevention of a variety of disease# in&luding rheumati&

.,W T, 7/- 4I-T(56 /7PP3-+-*T/ ?< &arditis# diseases of the liver# anemia# kidney disorders# and metaboli& disturban&es of the skin# su&h as psoriasis. Patients who su&&essfully followed the oil-free# soybean 3e&ithin program &ontinually volunteered the information that they felt a sense of well-being. They said they had more vitality# did not grow tired so 9ui&kly as they had formerly# and were in better general health than before. These sub)e&tive responses are al ways to be viewed in the light of "suggestion" or the inspirational 9uality that patients re&eive from treatment itself. *evertheless# after more than a de&ade of &areful analysis and evaluation of results# this author is &ertain that 3e&ithin is of one of our most powerful weapons against disease. It is an espe&ially valuable bulwark against development of "hardening of the arteries" and all the &ompli&ations of heart# brain# and kidney that follow. In some instan&es# the &osmeti& effe&t of 3e&ithin did as mu&h for the patients8 mental outlook as it did for their physi&al wellbeing. "or e:ample# +rs. 7.# a housewife of B<# had always been ashamed of the flat pla9ues of yellowish hue that appeared on her skin owing to fatty deposits. /oon after she began adding 3e&i thin to her diet# as pres&ribed# the pat&hes began to disappear. -ventually they vanished altogether. +rs. 7. was more de lighted with what she saw happening in the mirror than with the idea that the same thing might be going on with the fatty deposits inside her arteries. (nother patient of mine# a B<-year old baker# suffered so a&utely from angina %pain in the &hest &aused by interferen&e with the blood supply to the heart mus&le' that he was unable to work. 3ike +rs. 7.# he also had a number of yellowish brown pla9ues under his eyes# where fatty deposits had appeared. When I took his &holesterol level# it was found to be high in the abnormal range. 7pon my re&ommendation# this baker followed the low-&holesterol# low-fat diet given in this book# and supplemented it with the pres&ribed amounts of 3e&ithin and highpoten&y vitamins. Within a few months he was able to return

??

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

to work# free of anginal pain. .is &holesterol level was lowered substantially# and the :anthalasma %fatty pla9ues' disappeared from his fa&e. (s is the &ase in all foods# vitamins# or nutritional supple ments# there are o&&asional persons who find that 3e&ithin does not agree with them. !ut in su&h a &ase# a substitute &an be used. In figuring &alorie &ounts# allow ?= &alories for ea&h tablespoonful of 3e&ithin. 2ow to use soya oil# ,il e:tra&ted from the soybean" provides another valuable nutritional supplement. It &ontains a high per&entage of unsaturated fatty a&ids# and is the most healthful of all food oils. .undreds of millions of people living in (sia have used it for &enturies. Perhaps this is the prote&tive fa&tor in their food that has prevented heart disease and athero s&lerosis# whi&h are &omparatively rare in (sia. 5e&ent resear&h has shown that unsaturated fats or fatty a&ids# su&h as those found in soybean oil# may a&t as "blo&king" agents to keep harmful fats out of the blood. The term "unsaturated" is used by s&ientists to mean that the fat mole&ule still has room to add onto its stru&ture additional mole&ules. $onse9uently# it is lighter in weight# and is more easily handled by the blood. When a fat is "saturated" it has a&hieved its ma:imum weight. Taken into the bloodstream# it probably tends to "settle out" or to form a "bulge#" depositing part of the fat in the artery lining or wall. These fatty deposits tend to blo&k passage of blood through the vessel and may eventually plug it up al together# resulting in a heart atta&k or stroke. (s a rule# you &an regard "soft" fatsthose that are li9uid at room temperatureas unsaturated. They in&lude most vegetable oils# su&h as olive# &ottonseed# &orn# and mineral oils. $o&onut oil is an e:&eption# being saturated even though it is a li9uid. The harmful or "solid" fats are those that are hard at room temperature: butter# lard# oleomargarine# suet# vegetable shortenings that have been hydrogenated# yolks of eggs# butterfat in milk# &ream and &heeses %other than &ottage &heese'.

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

?C

/oybean oil is now being sto&ked by many food markets and all spe&ial diet food stores. If it is not available at your gro&er8s# he or your druggist &an order it for you. It should be used in pla&e of ri&h# fatty prepared oil dressings for your salads. "or those who must wat&h their &alorie &ount# allow >A< &alories for ea&h tablespoonful of soya oil. 3ow to use vitamins! -viden&e that many diseases &ould be &aused by faulty diet has been available for &enturies. (s far ba&k as >C<A# a !ritish naval surgeon named $apt. Iames 3ind dis&overed that s&urvy# whi&h plagued seamen on long voyages and sometimes de&imated entire &rews# &ould be &ured by eating fresh lemons. ( &entury later# another naval do&tor# who was an admiral of the Iapanese fleet# learned that beri-beri# the wasting disease so prevalent among Iapanese sailors# &ould be elimi nated by &hange of diet. ,ther medi&al resear&hers reported similar noteworthy results in &uring other defi&ien&y diseases# in&luding ri&kets. !ut their dis&overies were largely ignored. (s late as the turn of the &entury# physi&ians of good edu&ational ba&kground and wide e:perien&e were still blaming ri&kets on various &auses in&luding infe&tion# la&k of proper thyroid fun&tion# and insuffi&ient e:er&ise. The first widespread attention that the medi&al profession fo&used on the sub)e&t was in >D=? when an -nglish physi &ian# /ir "rederi&k 1owland .opkins# published the results of e:periments that pointed &learly to the e:isten&e of vitamins. /ir "rederi&k fed laboratory rats on a diet of protein fats and &arbohydrates# allowing ea&h of them plenty of this food to grow satisfa&torily. 6et instead of flourishing# they fell ill. When he added small amounts of whole milk to their diet# however# all of them 9ui&kly re&overed and began to grow at a normal rate. This &onvin&ed the s&ientist that a healthful diet re9uires not only ade9uate amounts of proteins and &arbohydrates# but some unknown but important ingredients. It remained for a Polish bio&hemist named $asimir "unk#

?E

.,W T, 7/- 4I-T(56 /7PP3-+-*T/

who &arried on similar resear&h at the 3ister Institute in 3ondon# to give the unknown ingredient a name. .e &oined the word "vitamin#" still in use today. !ut e:a&tly what are vitamins (t first medi&al s&ientists thought they were bio-&atalysts# substan&es that promote &hemi&al rea&tions in the body without taking a dire&t part in these rea&tions. !ut today it is evident that vitamins often do more than merely aid in &hemi&al rea&tions. /ome of them may a&tually be substan&es used stru&turally by the body. ,f the >A vitamins usually &onsidered essential for a healthy body# we are most &on&erned here with the group known as ! $omple:# and with Gitamins ( and $. In ! $omple:# we have a number of substan&es fundamentally ne&essary for normal health. They are vital for normal metab olism# and are very valuable as "lipotropi&" or fat-&ombatting agents. In addition to helping our bodies handle fats# they also "spark" our hormones and aid in preventing diseases of the nervous system. Gitamin (# a yellow &ompound related to substan&es found in &arrots and leafy vegetables# is essential for growth# many bodily fun&tions in the skin and blood vessels# and for resistan&e against &olds and infe&tions. Gitamin $# whi&h should supplement the diet given in these pages in substantial 9uantity# is a &rystalline substan&e easily destroyed by &ooking. "or that reason &ooked foods do not pro vide a very good sour&e of it. It is needed for formation of &on ne&tive tissue and red blood &ells. ( defi&ien&y of this vitamin may be partly responsible for dental &aries and infe&tions of the gums# loss of appetite# anemia# and undernutrition. In addition to these important vitamins# a number of minerals are also essential in our diet# espe&ially a diet aimed at prevent ing and redu&ing atheros&lerosis. "or that reason# a rigid adheren&e to the menus and instru&tions given in this book is important.

LOW-FAT MENUS
G#&# (/ C!&"i1# (%i!&" *! L!23F(% :#&0" The menus presented here in&lude well balan&ed meals of high protein and high nutritional 9uality# with emphasis on very low-fat and low-&holesterol &ontent. (lthough &holesterol is &ontained in all animal and vegetable fats# glandular organs su&h as brains# liver# kidney# sweetbreads# and giblets are espe&ially high in &holesterol. In the &ase of liver# however# there are additional prote&tive nutrients &alled phospholipids# that help over&ome itPs &holesterol &ontent# and therefore make liver a valuable sour&e of nourishment. -gg yolks and all foods with egg yolks are also high in &holesterol and are to be avoided as are egg noodles# pan&ake and waffle mi:es# &ake mi:es with eggs# mayonnaise-type salad dressings# et&. /ome simple suggestions foods are as follows: oups4 $lear &onsommQs may be used# and sto&k from vegetables and meat bones. Thoroughly &hill and remove all fat before using.. $ream soups made from non-fat milk# with the addition of flour %; teaspoonsful to > &up'# thoroughly &ooked until thi&k# then blended with various vegetables or vegetable purees# are e:&ellent. To repla&e &ra&kers you may use +elba toast# toast &ubes# 5y-2risp# or bread sto&k. "eats4 +eats should be served with all fat removed. In the preparation# too# remove all noti&eable fat before &ooking. In some of the methods &ommonly used to prepare meat with a low-fat &ontent are roasting# broiling# pan broiling# braising# and &ooking with li9uids.

;9

C=

3,W-"(T +-*7/

"or roasting A==-A;< degrees is re&ommended. The length of &ooking time depends upon 9uantity and type of meat. 5emove all fat from drippings. When broiling steaks# &hops or patties# pla&e meat A< in&hes from flame. 5emove all fat before serving. In pan broiling# remove all e:ternal fat and pla&e meat in &old pan on low fire without &overing. $ook until meat is brown on both sides. 7se "Pan-tasti&" or Pan-"ree" to keep meat from adhering to pan. /tewing entails adding li9uids# seasonings# and vegetables to meat# but in our diets it is best to remove all fats from meats before &ooking. To remove fat more thoroughly# &hill stew and remove all hard fat film on the surfa&e. 5eheat and serve. Eegeta*les9 Wash# dry# &hill until ready to &ook. $ook in the smallest amount of water and the shortest time to preserve vitamins and &olor. (dd paprika or &hopped parsley to enhan&e eye appeal. (ll vegetable salads may be used# with dieteti& dressings of no fat value. Two basi& types are as follows:
4ayonnaise type9 > &up *on-fat milk# ; tablespoons &ornstar&h# &ook over low heat until thi&k# add >J; teaspoon salt# >J; teaspoon dry mustard and &ool# add ; tablespoons vinegar# egg &oloring# beat until smooth. -gg whites beaten may be folded into the mi:ture. 0rench )ressing style9 (dd the following to handy bottle and shake thoroughly until blended ... A-B tablespoons wine or taragon vinegar# )ui&e of &rushed garli&# seasoned salt# dash pepper# > &up tomato puree# >JB &up lemon )ui&e# ;-A tablespoons &atsup# >J; teaspoon sugar# >JB teaspoon dry mustard# tabas&o and Wor&estershire sau&e if desired. )esserts9 (ll fruit desserts may be used: gelatin dishes

without any added &ream@ fruit whips using beaten eggs@ angel food &akes# sherbets and i&es. FTo all dishes included in the menus on the following pages, add no *utter, margarine, cream, or regular salad dressings#G

In these menus# skimmed skimmed fresh skimmed milk.

milk powder may be added to

L!23I (% :#&0 1 BREAKFAST

#ood 1rapefruit ,atmeal ,mount >J; medium ; tablespoons dry@ >JA &up &ooked >J; pint > sli&e > tablespoon A teaspoons ; oF. or B tablespoons &alories C;

>>> /kim milk...dry EC Whole wheat toast << Iam . <D /ugar ?= /kim milk...dry >=? $offee or tea T,T(3................................................................................................. <<; 37*$. ,pen-fa&ed /andwi&h: White bread > sli&e ?< 1round round steak ; >J; oF.... > patty >C< /li&e onion > sli&e. . . > tablespoon B Tomato > small ;; 3ettu&e > leaf E $ole slaw >JB &up with Fero dressingN >B Iello %regular' B servings to pa&kage EB with di&ed small pear > pear@ > tablespoon )ui&e AE Tea or &offee > teaspoon sugar ;= T,T(3 ................................................................................................. H B A = 4 I**-5 5oast turkey A sli&es# A>J; : ;>JB : >JB in. >D; Potato... browned > small# ;>JB" diameter >== "resh or froFen asparagus <--? stalks# medium ;? +i:ed &ooked vegetable salad +arinated in dressingN /tring beans >JB &up >= Peas >JB &up B; $arrots >JB &up >; 5aspberry i&e >J; &up >;= (ngel &ake > pie&e >B? "rosted orange drink A oF. %>J; ? oF. &an' >?D >J; pt. skim milk EC .ard white roll > average %> oF.' D; +armalade > tablespoon ?A T,T(3 ................................................................................................R>=<D 15(*4 T,T(3......................................................................................... ;=B> 0at9 2/ grams@ -rotein9 D= grams@ ar*ohydrate9 A?< grams.

71

L!23F(% :#&0 1 8&ontinued9 R#$i.#"

Iero )ressing9 >J; &up tomato )ui&e. ; tablespoons lemon )ui&e or vinegar. > tablespoon onion finely &hopped. /alt# pepper# horseradish# mustard may be added. /hake well. 7se > tablespoon mi:ed seasoning. %mayonnaise type dressing' 1 &up buttermilk. 1J, &up tomato puree ; tablespoons &atsup. 1arli&. >JB &up wine vinegar. >JB &up lemon )ui&e ground fresh pepper Thoroughly blend all ingredients. C+i//. /hake before serving. ar*ohydrate9 AB? grams. ?? 7ow-calorie, no-fat dressing9

0at9 ;B grams@ -rotein9 >=B grams@

15(*4 T,T(3 ......................................................................................... ;==A

#2

L!23F(% :#&0 2
BREAKFAST #ood /tewed prunes with sugar 1rapenuts /ugar for &ereal-beverage !aked "ren&h toast: egg- whites# white breadN +aple syrup Tea or &offee /kim milk for "ren&h toast and &ereal S pint /kim milk powder T,T(3...................................... 37*$. $onsomme8: hot or &old if desired /hrimp salad with lemon and ieteti& dressing. 1arnish with s li&ed

(mount B-< med. )&e > oFT.>JB&up A teaspoons

;
> ; tablespoons: > oF.

alories >;D D= #$ %& ?A >=;

; oF. or B tablespoons

EC >=E ##'

10 0
beets. /hrimp $elery /hrimp sau&eNN >J; &up >JB &up di&ed > Tablespoon > Tablespoon > Tablespoon >JB &up B %>B= to lb.' ; pie&es > serving

552

3emon )ui&e "lour

1/2pt. 1 teaspoon sugar 12 56 10 7 11 8 85

$hopped pi&kle /li&ed beets /altines "ig bars /now puddingNNN !uttermilk Tea or &offee T,T(3 4I**-5 Tomato )ui&e &o&ktail !roiled sirloin steak +ushrooms /teamed ri&e "roFen bro&&oli 5omaine salad with Fero dressing A oF. ; pie&es# B : > : > in. >= small or B large 1J2 &up A>J; oF. >J; &up 1J2 &up

;;

;=B
;E DC ;D ?

"resh pineapple /ugar wafers $offee# .sugar T,T(3 .................................... GRAND TOTAL .................................................. #at 9 ;< grams@ -rotein9 D=

>J; -;JA &up ; thin *!$ > teaspoon

<E

A>
;=

BD< >C>C grams; Carbohydrate: 283 grams. 73

L!23F(% :#&0 2 8&ontinued9

U =a.ed 0rench Toast9 ; egg whites. 1J, &up skim milk. 4ash salt# pepper. !eat together@ dip sli&e of bread in batter. $ook in oven or under broiler appro:imately <->= minutes. ?? $hrimp $auce9 >JB &up bouillon@ >JB &up water@ > tablespoon lemon@ > tablespoon sweet pi&kle relish@ > tablespoon flour@ &ook together until sau&e thi&kens# stirring &onstantly#

???$now -udding Becipe F$ouffleG > &up fruit pulp. >JB &up sugar. > tablespoon lemon )ui&e. A egg whites# stiffly beaten. 1J& teaspoon salt. (ny kind of fruitfresh# &anned or preservedmay be used. 4rain off all syrup. 5ub fruit through a sieve@ add lemon )ui&e@ salt@ and sweeten if ne&essary@ heat. "old in stiffly beaten egg whites into hot fruit pulp. Pour into baking dish or individual molds# filling them only L full. /et in pan of hot water. !ake in moderate oven AC<V for ;= minutes. /erve as soon as baked. /erves ?. Alternate for $now -udding ;pen )ish 0ruit Tart9 *o &rust. Top with meringue or toasted angel &ake &rumbs. (ny berries in season or froFen or fresh fruits su&h as boysenberries# pea&hes# or apples may be used.

#4

L!23F(% :#&0 3
BIEAKFAST
#ood Amount ? oF. ,range )ui&e %fresh' Puffed wheat > &up /li&ed banana > medium or > &up 5aisins ; tablespoons /ugar: for &ereal and beverage ; teaspoons 5ye toast %(meri&an' $ottage &heese %A>J; o:.' > sli&e <-? Iam tablespoons /kim milk > tablespoon 5einfor&e with /kim milk S pt. powder ; oF. $offee T,T(3 ............................................... 37*$. dam &howder %$ampbells' > serving. %A to &an' ; wafers &heese is desired in use on 1J2 &up >J; &up di&ed 1J2 &up red ; halves >J; &up > teaspoon > > serving# A>J; oF. > teaspoon 5ye 2risp 3arge fruit platter %if &ottage "resh strawberries $antaloupe $herries# sweet# &anned Pears 1rapefruit /our &ream %add to Fero dressing' Whole wheat roll %no milk# no butter' 3emon sponge puddingN Tea or &offee# sugar T,T(3 .............................................. #* )$ alories EE B< >A= ?> B= <D D< ?= EC >=E

(((

'')

this salad.' A> ;C >>C ?< BB

>; >== >>E 26 ;21

79

L!23F(% :#&0 3 8&ontinued9

5oast leg of lambJ; sli&es $andied sweet potatoes# > teaspoon sugar "resh spina&h with lemon +int )elly for lamb $elery hearts $arrot sti&ks !aked apple !read# > sli&e !uttermilk Tea or &offee# sugar T,T(3 15(*4 T,T(3 4I**-5 ; sli&es A : A>JB : >JE in. >J; &up 1J2 &up > tablespoon A inner stalks ; small > small tablespoon sugar > sli&e white >J; Pt> teaspoon ;=? >;D ;< ?= >; B< ;?D ?A E< ;= 968 2335
/oak gelation in &old water until soft. (dd to boiling water and stir over hot water until thoroughly dissolved. (dd sugar and stir until dissolved. 5emove from heat. (dd remaining li9uids or fruit pulp and mi: thoroughly. When )elly begins to &ongeal# whip until light and frothy and fold in the stiffly beaten whites
of two eggs. /erved &hilled.

< 5emon ponge $udding4 > oF. %; tablespoons' granulated gelatin. 1J2 &up &old water. >J; &up boiling water. ; &ups i&e water. > &up sugar. !J, &up lemon )ui&e with a little lemon rind

0at9 ;? grams@ -rotein9 DB grams@

ar*ohydrate9 B>= grams.

of two eggs. /erve &hilled.

= < = :oman "eal $ancakes >*! :#&0 54 B #(?*("%@ 1 &up 5oman +eal. 1J2 &up flour sifted with ; tablespoons baking powder. > tablespoon salt. > tablespoon sugar. > tablespoon melted margarine >>J; &up skim milk. "old in ; stiffly beaten egg whites. !efore pouring batter# heat pan to medium hot and rub very lightly with &ris&o-oiled paper napkin. %>=->; pan&akes appro:imately ?B &alories per pan&ake'.

L!23F(% % :#&0 5
!5 -(2"(/T
"igs in syrup Pan&akesNNN +aple syrup /kim milk 5einfor&e with skim milk powder $offee# sugar T,T(3.................................. Amount A > ; oF. 1J2 pt. ; oF. > teaspoon

Calorie * 126 64 205 87 108 20 61 0

$ream of pea soupN !roiled lobster %AJB lb.' +ashed banana s9uash !russel sprouts 1elatin with fruit salad *abis&o sugar wafers Tea or &offee# sugar T,T(3 .....................................

37*$.
1J2 &up > 1J2 &up

cup 5-6 1 square 4 small 1 teaspoon

111 95 55 40 95 64 20

480

4I**-5 !aked Geal $hopNN Tomatoes $hopped onion $atsup 1reen pepper *oodles 1rated &arrot and raisin salad with sour &ream and Fero dressing 3ady fingers !uttermilk Parkerhouse roll ,range marmalade Tea or &offee# sugar > &hop loin# >J; &up > tablespoon > tablespoon > tablespoon >J; &up &ooked >J; &up shredded > tablespoon ; tablespoons A large or ? small >J; pt. > > tablespoon > teaspoon

18 0 2 1 5 1 9 3 52 21 30 24 10 8

........................... 717 ................................................. 1807

NN =a.ed Eeal hop9 > Ioin veal &hop >J;" thi&k. !ake with >J; &up tomatoes# > tablespoon &atsup# > tablespoon &h. onions# > tablespoon &hopped pepper. /alt and pepper to taste@ monosodium glutamate. !ake slowly A;<V for ; hours@ keep &overed.

ar*ohydrate9 A>= grams. T,T(3 .................... 15(*4 T,T(3........

N ream of -ea $oup9 2 teaspoons of flour# >J; &up skim milk. >JB &up strained peas. /alt# pepper# dash &ayenne@ make paste of flour and water@ add to heated milk and strained peas# stirring &onstantly@ add seasoning@ serve hot

0at9 ;< grams@ -rotein9 E< g (,"

L!23F(% :#&0 9
0ood !5-(2"(/T Amount alorie s DC DE EC >= E E; << ?=
%$ (((((( #$'

,range se&tions > &up 5alstons ;JA H!J, &up /kim milk S pt. 5einfor&e skim milk powder ; oF. Polish sausage > oF.# >>J; : > in. Whole wheat toast > sli&e /trawberry )am > tablespoon $offee# sugar > teaspoon T,T(3

37*$. $ampbellPs veg. beef soup 5itF &ra&kers "rankfurter /auerkraut !oiled potato Pineapple and &ottage &heese on lettu&e $herry Iello Tea or &offee# sugar T,T(3 > serving %A to &an' A ?E B; >;;

>

;JA &up ># ;>JB" diameter > large sli&e <-? tablespoons ; large leaves > serving %< to pkg.' > teaspoon 4I**-5

>

;? E< EC EC D ?C ?>A ;=

!roiled beef liver "ordhook limas# froFen .arvard beets Tossed green salad with Fero dressing Pineapple sherbet .ard roll (pri&ot )am !uttermilk T,T(3 15(*4 T,T(3 ................................................

; sli&es# A : ;>J; : >>J; in. &up >J; &up# > teaspoon sugar >J; &up
>J;

>A; >>; ?< ? ><= D; ?= '$% E<

A

&up > > tablespoon >J; pt.

>J;

0at9 ;< grams@ -rotein9 DC grams@

ar*ohydrate9 A>A grains.

'&

L!23F(% :#&0 ;
!5-(2"(/T 0ood Amount alories Pineapple )ui&e A>J; oF. <B /trawberries > &up ?; /ugar A teaspoons ?= $reamed egg whites: ; A= $ream sau&e: Peanut oil > teaspoon B< .our > teaspoon B /kim milk >J; &up BA Toast > sli&e BA Plum# )am > tablespoon ?; T,T(3........................................................................................................ A?= 37*$. ,yster stew >J; &up oysters D? /kim milk >J; &up BA ,yster &ra&kers E ;? $hefs salad > &up ;? /hredded /wiss &heese >J; tablespoon ;< /hredded turkey > oF. <? Whole wheat toast > sli&e <D $anned *e&tarines ; medium E< $offeeN sugar > teaspoon ;= T,T(3 .................................................................................................... BA? 4I**-5 1rapefruit se&tions with mint >JA &up 5oast beef > di&e# A : ;>JB + 1J, in. !rowned potato > /hredded Fu&&ini >J; &up /li&ed tomato salad with sere dressing > medium tomato (ngel &ake &up&akeNN > $loverleaf roll > Iam > tablespoon /kim milk >J; pt /kim milk powder ; oF. E= DB >== >D ;A >B? >;= <E E< >=E

T,T(3........................................................................................................ EAA 15(*4 T,T(3........................................................................................... >?AD

0at9 ;? grams@ -rotein9 EB grams@

ar*ohydrate9 ;/D grams. 79

- & *

R#$i.#"
N reamed 6ggwhites9 +ake &ream sau&e of >J; &up milk@ > teaspoon flour# > tablespoon peanut oil. /tir &onstantly until slightly thi&kened. (dd &ut-up# hard-&ooked eggwhites. /erve over toast. ?? Angleca.e upca.e9 >JB &up sifted &ake flour@ AJB &up gran# sugar@ AJB &up egg whites %B' @ >J; teaspoon &ream of tartar@ >JB teaspoon vanilla@ dash salt. Whip egg whites with &ream of tartar@ add vanilla. /ift sugar and flour together and fold into egg whites one at a time. !ake A;<V for > hr. in ungreased muffin tins. 5emove from pan while warm. %(ngel &ake mi: may be substituted if desired.'

Please use these low-fat re&ipes here as alternates or wherever it seems best to you. rac.er Torte9 1J& teaspoon &ream of tartar A egg whites > &up granulated sugar E finely &rushed saltine &ra&kers > oF. walnut meats# finely &hopped >J; teaspoon vanilla e:tra&t > >= oF. pa&kage froFen raspberries. /prinkle &ream of tartar over egg whites in a bowl. !eat until soft peaks form. 1radually add sugar# &ontinuing to beat until meringue is very stiff. "old in &ra&ker &rumbs# nuts and vanilla. Pour into a greased >>J; 9uart &asserole@ bake at A== deg. one hour or until lightly browned and firm on top. $ool in pan. +eanwhile defrost raspberries. Invert torte onto serving plate or serve from &asserole# topped with berries. +akes si: servings. %$alories per serving ;==.' ,f &ourse plain meringues may be made without the nuts and &ra&kers# or bought from a good pastry shop. (lmost any fruit or sherbet is good as a filling. Parti&ularly deli&ious is pineapple sherbet served with mint sau&e. $traw*erry )elight9 7se individual sli&es of (ngel "ood# preferably slightly stale. $over thinly with 5oyal Ganilla Pudding %made with skim milk'. 4e&orate generously with fresh or froFen strawberries. Pour over heated &urrant )elly as a glaFe and &hill. %(ppro:imately >C< &alories.' W.-* T.-5- (5- 17-/T/ ",5 4I**-5 F7ow-fat recipesG *on-fat pie &rust may be made from $orn "lakes. 1!J, &up $orn "lakes rolled &oarse# ? tablespoons honey and A tablespoons skim milk. "ill with vanilla pudding or fruit. %><= &alories per serving.' ,r pie &rust &an be made from toasted (ngel "ood $ake. (ngel "ood $ake may be used to make a kind of 6nglish Trifle, by substituting 5oyal Ganilla pie filling for the high-fat &ustard. (lternate a layer of (ngel "ood $ake with a layer of sherry flavored Ganilla pie filling and 5aspberry Iam or &ooked dried apri&ot )am# until the bowl is filled. %(ppro:imately ><= &alories .# serving.'

,*

F(% :#&0 7
BREAKFAST Amount ? oF. or AJB glass > large ; oF. > &up A -teaspoons 1J2 Pt. ; oF. alories A? ?A ;=< >=E ?= EC >=E

L!2
#ood Tomato )ui&e Waffle +aples syrup 5i&e 2rispies /ugar8 /kim milk /kim milk powder ,mount ? oF. or K glass > large ; oF. > &up A teaspoons L pt. ; oF. &alories A? ?A ;=< >=E ?= EC >=E

T,T(3........................................................................................................ ??C 37*$. ,nion soup %$ampbells' > serving %A to &an' ?B with &routons %>J;>Jsli&e bread' A= $old Plate: $orned beet &anned# leanN ; sli&es A : ;>JB : >JB >;? Potato salad: potato >. potato >=E &elery AJB &up < onion > teaspoon > $ole slaw with grated &arrot >J; &up >B 5ye !read %dark' > sli&e BAJB : A>J; : AJE in. C< Iam > tablespoon ?= (pplesau&e snow puddingNN >J; &up >=A !uttermilk >J; pt. E< Tea or &offee# sugar > teaspoon ;= T,T(3....................................:............................................................... ?D> . 4I**-5 !eef tongue ; sli&es# A : ; : >JB in. >AB "resh spina&h " >J; &up A= /panish ri&e: ri&e >J; &up DC onion > sli&e >D tomato puree >JB &up ;; $u&umber salad with dieteti& dressing ?-E sli&es C "ruit &o&ktailNNN ? tablespoons CC Plain roll > D; Iam > tablespoon <E Tea or &offee# sugar > teaspoon ;= . T,T(3....................................8.................................................................. <<? .15(*4 T,T(3...............................................................................R....... >D>B 0at9 ;? grams@ -rotein9 EE %rams@ ar*ohydrate9 AAB grams. N $anned &orned beef is re&ommended be&ause of its low-fat &ontent. WU 'Applesauce $now
-udding9 1J2 &up applesau&e Whip egg white with sugar. > eggwhite (dd &hilled applesau&e. > tsp. sugar /erve &hilled@ top with maras&hino &herry. NNN 2irs&h# 1renadine# or sweel sherry may be added# if allowed# for flavor .

81

L!23F(% :#&0 8 BREAKFAST

0ood

,range and grapefruit )ui&e !u&kwheat pan&akes +aple syrup /kim milk /kim milk powder $offee# sugar T,T(3

Amount ? oF. A in&h diameter ; oF. >J; Pt. ; oF. > teaspoon 37*$. E oF. <JE &up 1J2 &up

&alories 165 1;9 ;=< EC 168 ;= ;89

Tomato )ui&e &o&ktail !aked limasN /pina&h Pi&kled beet salad with grated egg white Iello with sli&ed banana !uttermilk Tea or &offee# sugar T,T(3

S &up
;
> serving

> small 1J2 Pt> teaspoon 4I**-5 &up >J; broiler E large > wine glass >J; &up >JB &up >JB sm. head as desired ; sli&es# A>JB 3 diam. > teaspoon
1J2

<= ><A ;A 35 A= ?< EE E< ;= 958

Tomato )ui&e &o&ktail Irene8s $hi&ken IubileeNN !ing &herries $ooking sherry 5aked banana s9uash /tewed small onions 3ettu&e heart salad /panish dressing "resh pineapple Tea or &offee# sugar T,T(3 15(*4 T,T(3 >D=?

15 335 A= EB BC AE 15 = EE ;= ;;9

0at9 ;> grams@ -rotein9 >>C grams@

ar*ohydrate9 A=C grams.

? =a.ed 7ima =eans9 /J& &up dried 3imas# ; tablespoons &atsup# > tablespoon brown sugar# >J; teaspoon salt# > tablespoon vinegar# >JB teaspoon dry mustard# >JB onion &hopped fine. /oak 3imas# &over with water and &ook until tender. (dd seasonings and onion and top with brown sugar. %4ark molasses may be added if desired.' !ake in slow oven for several hours. ??'rene's hic.en >u*ilee9 ;-lb. 9uartered broiler# > &hi&ken &ube# > &up water# B tablespoons of sherry# ; &ups pitted &herries# salt and pepper to taste# >J; teaspoon ginger. 5ub &hi&ken with salt# pepper# and ginger. !rown in broiler. !ake slowly in &asserole until tender. +ake sau&e of flour# bouillon# and &herries &ooked until thi&kened. Pour over &hi&ken# add sherry# and serve hot. ,2

L!23F(% :#&0 9
BREAKFAST #ood ,mount &alories >J; 1rapefruit B>J;" diameter <; sugar > teaspoon ;= ,atmeal >J; &up &ooked CB /kim milk >J; pt EC /kim milk powder ; oF. >=E /ugar > teaspoon ;= $offee or tea Whole wheat toast ; sli&es >>= Iam > tablespoon <E T,T(3....................................................................................................... <;D 37*$. $lear &onsomme = Tuna salad platterN 4ieteti& tuna >J; &an %A>J; oF.' >;; -gg whites %;'# &elery# onion# dieteti& dressing <C Xuartered tomato ;A 5ye 2risp B double s9uares E= ,range sherbet >J; &up >CC !uttermilk >J; pt. E< Tea or &offee# sugar > teaspoon ;= T,T(3....................................................................................................... <?B 4I**-5 1round round beef steak ; small patties %A>J; oF.' ;A? !aked potato with &hives > medium ;>J;" DE with ri&otta &heese > tablespoon B= !ro&&oli >J; &up ;A "resh fruit salad >J; &up C= Tea or &offee# sugar > teaspoon ;= $o&oanut bar &ookies# *!$ ; A? T,T(3....................................................................................................... <;A 15(*4 T,T(3.......................................................................................... >?>? 0at9 ;< grams@ -rotein9 >=E grams@ ar*ohydrate9 ;A; grams. N Tuna $alad9 %4ieteti& Pa&k' ; egg whites. >JB &up &elery# di&ed. /li&ed onion if desired. 3ettu&e.

,3

L!23F(% :#&0 16
0ood

!5-(2"(/T Amount
> pie&e ; : C : ? S i n > tablespoon

.oneydew melon 5i&otta /ouffleN: 5i&otta &heese -gg whites Peanut ,il 5ye toast %(meri&an' Iam /kim milk /kim milk powder $offee# sugar T,T(3

alorie s BE B= A= >A >;< <E EC >=E ;= <; D BB CE ?B <; C < BA ;>A >== E< ;= C> > ;>= >=A ;A <D BA ;= ;=

; >JB teaspoon ; sli&es > tablespoon 1J2 pt; oF. > teaspoon 37*$.

(pri&ot )ui&e A oF. /eafood &asserole# with &hopped &eleryNN: /&allops ;-A pie&es /hrimps B-? $rab ;>J; oF. +ushrooms >B &up ,nion > sli&e /kim milk >J; &up !aked apple with ; teaspoons of sugar > large 5oll# whole wheat > !uttermilk >J; PtTea or &offee# sugar > teaspoon T,T(3 4I**-5 !roiled rib lamb &hop %trim off fat' 5i&e# > oF. $arrots# Gi&hy 3ime gelatin with &ooked vegetables Iunket with skim milk sugar $offee or tea# sugar T,T(3 15(*4 T,T(3 ; small AJB &up#&ooked >J; &up > s9uare >J; &up > teaspoon > teaspoon

<> >C<?

N Bicotta $ouffle9 > tablespoon 5i&otta &heese# ; egg whites# >JB teaspoon peanut oil# >JB &up skim milk# salt and white pepper seasoned to taste. !eat egg whites until stiff. "old in mi:ture of &heese# skim milk# and seasonings. !ake in greased &asserole in pan of water at A;< degrees for appro:imately ;< minutes. ?? $eafood asserole9 ;-A s&allops# B-? shrimps# ;>J; oF. &rab# >J; &up mushroom soup# >J; &up skim milk# > teaspoon parsley# > teaspoon grated onion# ; tablespoon sherry. "lake &rab# &ut up s&allops and shrimp# and pla&e in &asserole. +ake sau&e of >J; &up skim milk# >JB &up di&ed &elery# shredded sli&e of onion# seasoned salt# dash of basil# and a few drops of tobas&o sau&e. Pour sau&e over seafood. !ake until thoroughly heated. /prinkle parsley over top.

,4

L!23F(% :#&0 11
BREAKFAST

#ood ,mount &alories /tewed prunes# with sugar A-B med. >>D Puffed wheat > &up B< /kim milk >J; pt. EC /kim milk powder ; oF. >=E /weet roll > average >CE $offee# sugar for beverage and A teaspoons ?= &ereal T,T(3............................................................8..Y....................................... <DC 37*$. $ampbells /&ot&h !roth > serv. %A to &an' D? Platter: &ottage &heese >J; &up >=E (rti&hoke > large ba&k <> $arrot &urls >J; small &arrot >= $auliflower hearts >J; &up E Pea&hes# &anned ; halves ?E Pears# &anned ; halves ?E Italian bread > sli&e <A !uttermilk >J; pt. E? T,T(3....................................................................................................... <BE 4I**-5 5ib roast beef ; sli&es %A : ;>JB :>JB in.' ;EC !aked noodlesN broad noodles >J; &up <A skim milk >JB &up ;; &ornstar&h AJB teaspoon D Peas >J; &up C< 1reen salad@ /panish dressing >J; &up D /kim milk AJB &up ?< /ponge &ake# >J>= average &ake > pie&e . >B< Tea or &offee# sugar > teaspoon ;= U T,T(3-............................:........................................................................ ?E< 15(*4 T,T(3........................................................................................... >EA= 0at9 ;C grams@ -rotein9 >=A grams: ar*ohydrate9 ;EB grams. N =a.ed <oodles9 $ook noodles in salted water. +ake thin &ream sau&e with >J; &up skim milk and AJB teaspoon &ornstar&h. (dd to noodles@ add seasoning ing &araway seed# bake < min. in oven. <oodles ontinental Fas an alienateG9 > &up noodles# >JB teaspoon &innamon# >J; teaspoon sugar# > tablespoon raisins. !oil noodles. (bout B minutes before they are done# add raisins. When 7nder# pour hot water over noodles and drain. Then add &innamon and sugar. Pla&e in A<=-degree oven for >= minutes or until brown. %(ppro:imately >B= &alorie'.

,5

L!23F(% :#&0 12
!57*$. %!reakfast and 3un&h' 0ood Amount /li&ed banana > large Pep &ereal > oF.-l &up Whole wheat toast ; Iam > tablespoon /kim milk /kim milk powder ; oF. /ugarfor &offee# &ereal A teaspoons $reamed ham and egg whites > sli&e# B : > x B in on toast &ooked egg whites ; AJB teaspoon &ornstar&h AJB teaspoon skim milk >JB &up Toast > sli&e !everage T,T(3 ............................................... 4I**-5 !eef stew: !eef# round potato &elery onion Tomato salad with /panishN dressing 5ye bread Iam /weet &herries !uttermilk alories 17; >=< >>= <E 168 ?= 126 A= D ;; ;6 D;A

&arrot

; oF. %; pie&es# B : >:>JBin' ># ;>JB" diameter >JB &up di&ed 1J, &up > medium > medium tomato > sli&e > tablespoon >J; &up

1;5
83 12 < 59

>J; pt.

36 ;6 <E >=< 89
15#*

T,T(3 TTTTTTTTTTTTTTTTTTTTT ?BC 15(*4 T,T(3 .......................................................................................................... 0at9 ;? grams@ -rotein9 ?C grams@ ar*ohydrate9 ;?; g (,".

? $panish )ressing9 > teaspoon dry salad dressing %"ren&h'# >J; teaspoon dry salad dressing %blue &heese'# >JB&up )ui&e of lemon# a few drops of tobas&o sau&e and Wor&estershire# >JB &up vinegar or wine# > teaspoon sugar. Pla&e (// ingredients in &overed bottle and shake thoroughly. +in&ed onion ,() be added or ; tablespoons skim milk powder for variation.

L!23F(% :#&0 13
BIEAKFAST
0ood /li&ed orange Prune )ui&e $hipped beef and egg white ,mount > medium A" diameter >J; &up > oF. beef >J; pt. ; oF. > teaspoon &alorie-

Toast

/kim milk /kim milk powder $offee# sugar -gg whites T,T(3 ....................................

>>=

?E C> ?>
EC

;
37*$.

>=E ;= A=

<<<

$hi&ken livers

!rown ri&e

/tewed onion /tewed tomatoes 1rapefruit se&tion salad *abis&o +ello /9uares !uttermilk Tea or &offee# sugar T,T(3 ....................................

; large livers# A>J; oF. AJB &up &ooked# > oF. > onion 1J2 &up >J; &up

; >J;pt > teaspoon 4I**-5

>B> >=; B< ;A B= >>; ;= ........... <?E

E<

!aked rabbit !aked yam "resh asparagus $ole slaw /herbet !read

B oF. flesh

>J;&up

Iam

Tea or &offee# sugar T,T(3 15(*4 T,T(3 ............................................. ................................................... 0at9 22 g (,"C -rotein9 158 g (,"C

<-? stalks 1J2 &up >J; &up > whole wheat > tablespoon > teaspoon

>CC >=C ;> >; ><= << <E ;= ......... ?==

>C;A

ar*ohydrate9 ;D> g (&%.

&'

L!23F(% :#&0 15
0ood

!5-(2"(/T Amount A AJB &up >J; Pt; oF. A teaspoons > tablespoon ; 37*$. > serving > sli&e ham# A>JB : ;>JB : >JB in. ; sli&es whole wheat ;JA &up > teaspoon 1J2 Pt. 4I**-5

alories >>A >=A EC >=E ;= AC >>=

/tewed figs in sugar $ornmeal# &ooked /kim milk /kim milk powder /ugar for &offee and &ereal (pple butter Whole wheat T,T(3

<CE

$ampbell8s green pea soup /pi&ed ham sandwi&h on wheat with dieteti& dressing /herbet Tea or &offee# sugar !uttermilk T,T(3

>>= >;B >>= >CC ;= E<

?;?

!readed veal &utlet "resh green beans "resh &orn 3arge dill pi&kle -s&arole $u&umbers *e&tarines 5ye bread Iam Tea or &offee# sugar T,T(3 15(*4 T,T(3

> &utlet# A>J ; : ;>JB : >J; in. >J; &up > medium ear > B large leaves B-? sli&es ; medium > sli&e > tablespoon > teaspoon

;>C A< D; >A ;; E ?C ?= <E ;= <D; >CD?

0at9 ;C grams@ -rotein9 C; grams@

ar*ohydrate9 A;E grams.

,,

12**-CALORIE MENUS

:#&0 1
!5-(2"(/T >J; grapefruit >J; &up "arina > glass skim milk > toast $offee > teaspoon )am 37*$. Platter: ; oF. or B tablespoons dieteti& tuna fish > hard egg white>JB &up &elery with dieteti& dressing Xuartered tomato 4ieteti& apri&ots > roll 1J2 oF. di&ed /wiss &heese Tea or &offeeskim milk 4I**-5 +eat loaf> small sli&e ; oF. /mall roast potato /pina&h with lemon Tomato salad with dieteti& dressing 1J2 ne&tarineno sugar Tea or &offee > glass skim milk
:

+enu ;
!5-(2"(/T /mall orange )ui&e AJB &up bran flakes > glass skim milk > rye toast > teaspoon )am Tea or &offee 37*$. /andwi&h; sli&es bread > thin sli&e &heese> oF. lettu&e > thin sli&e lean ham> oF. tomato 4ieteti& dressing /li&ed pea&h Tea or &offee> glass skim milk 4I**-5 5oast turkey; sli&es very thin# A oF. >JB &up yam "resh asparagus Tossed green salad with dieteti& dressing Watermelon# AJB &up Tea or &offee> glass skim milk

. . . .

= ,n all our low &alorie menus no fat# oil# margarine# or batter should be need on any food. /alad dressings should be made with the non-fat re&ipe as given previously. Trim off fats on all mats@ only the lean variety should be used. (ll fruits should be either fresh or dieteti& %&anned without sugar but with sa&&harine or /u&aryl'. *o sugar or &ream should be used for beverages. /u&aryl or sa&&harine may be used if indi&ated by your physi&ian. (G,I4 (33 "5I-4 ",,4/# I5(G6# *7T/# (G,$(4,/@ P(/T5I-/ /W--T-*-4 $(**-4 "57IT/# /71(5. /W--T-*-4 "57IT I7I$-/# /W--T-*-4 $(5!,*(T-4 !-Z-5(1-/# 3IX7,5/.

89

12**-CALORIE MENUS

:#&0 3
BREAKFAST AJB &up strawberries ; shredded wheat > glass skim milk > whole wheat toast > teaspoon )am Tea or &offee 4I**-5 A oF. baked veal &hop /mall baked potato Peas "resh fruit salad 5aspberry i&eN Tea or &offee 37*$. Gegetable &how meinN with ; oF. &hi&ken di&ed lean beef or /li&ed tomato salad >JB &up ri&e "resh pineapple &hunks# >J; &up Tea or &offee > glass buttermilk
? 7ow- alorie how 4ein9 ; oF. di&ed beef or di&ed &hi&ken# >JB lb. $hinese peas# >JB &up bean sprouts# >J; &up $hinese &elery &ut in +t in&h sli&es# >JB &up soy sau&e# > tablespoon dark or bead molasses# > small min&ed onion# >J; &up &onsomme. /team di&ed beef with &onsomme and onion until tender. /team $hinese peas# bean sprouts# &elery until tender but &risp. If steamer is not available# use >JB &up water. (dd soy sau&e and molasses and &ombine with vegetables and meat. /erve on steamed ri&e. 7se &anned $hinese vegetables if others are not available. %A>= &alories'

N ,range i&e is <= &alories higher for >J; &up.

+enu B
!5-(2"(/T 3arge glass tomato )ui&e > thin sli&e broiled ham %> oF' > sli&e rye toast > teaspoon )am $offee > glass skim milk 4I**-5 !roiled small steak %; oF.' > ear &orn on &obsmall ear /tewed tomatoes> &up $rated &arrot and &elery salad with dieteti& dressing "resh strawberries $lass skim milk D= 37*$. $old sli&ed turkey; oF. /li&ed dill pi&kle $ole slaw with dieteti& dressing "ren&h roll with > teaspoon )am /mall baked apple Tea or &offee > glass skim or butter milk

12**-CALORIE MENUS

:#&0 9
BREAKFAST /mall glass grapefruit )ui&e >J; &up oatmeal > glass skim milk > whole wheat toast > teaspoon )am $offee LUNCH Platter: sli&ed pineapple# sli&ed pea&h# sli&ed watermelon# >JB &antaloupe# >J; &up strawberries# B teaspoons &ottage &heese B &ra&kers Tea or &offee 1lass buttermilk I I**-5 5oast lamb sli&e# A oF. >JB &up ri&e !ro&&oli Tomato aspi& salad > bread "resh fruit &up 1lass skim milk

+enu ?
!5-(2"(/T 37*$. A stewed prunes .amburger %; oF.' on bun ; low-&alori& pan&akesN made with ; /li&ed onion# sli&ed tomato# lettu&e egg whites# ; tablespoons syrup >J; &up of i&e &ream $offee Tea or &offee > glass skim milk N 7ow-caloric -anca.es9 !JB &up flour# >JB teaspoon 4I**-5 baking porder#8 >JB teaspoon salt# >JB &ap sldm milk powder# >JB teaspoon sugar# ; egg whites# >J; &up skim !aked filet of seabass milk. $on bine all dry ingredients# add beaten egg /mall baked potato whites and skim milk. !lend and drop on heated skillet 6ellow ne&k s9uash or grill wth )ust enough fat to keep from sti&king. Tossed green salad /erve with maple syrup. with dressing .oneydew melon# AJB &up Tea or &offee /kim milk

91

12**-CALORIE MENUS

:#&0 7
!5-(2"(/T >J; sli&ed banana AJB &up $ornflakes > sli&e Ia&k &heese > whole wheat toast > teaspoon )am $offee 1lass skim milk 37*$. ; hot dogs >JB &up mashed potatoes /auerkraut "resh fruit salad >>J;" angel food &ake $offee 4I**-5 ; oF. beef or &alves liver S &up Italian noodlesN $auliflower 3ettu&e hearts with dieteti& dressing 4ieteti& pears# ; halves Tea or &offee /kim milk N 'talian <oodles# 1J2 &up /pina&h *oodles# > &up water# ; tablespoons 5i&otta &heese. /alt to taste. !oil noodles until tender# appro:imately >= minutes. 5un hot water over noodles# pla&e in oiled &asserole and stir in 5i&otta &heese. .eat through and serve.

92

1***- CALORIE MENUS

:#&0 1
!5-(2"(/T /li&ed orange ; hard egg whites > whole wheat toast > teaspoon )am Tea or &offee > glass skim milk 37*$. >J; broiled lobstersmall with lemon# horseradish with > tablespoon &atsup. +ashed banana s9uash /tring beans 3ettu&e hearts with dieteti& dressing >J; &antaloupe Tea or &offeeB &ra&kers > glass skim milk or buttermilk 4I**-5 Y 5oast beef; oF.@ >J; small sli&e /mall baked potato with ; teaspoons sour &ream >J; &up brussel sprouts $ole slaw with dieteti& dressing >J; grapefruit Tea or &offee > glass skim milk or buttermilk

+enu ;
!5-(2"(/T 37*$. 7nsweetened pineapple )ui&e $lear &onsomme >J; &up oatmeal /mall broiled hamburger>J; roll > glass skim milk /li&ed onion >J; sli&e toast /li&ed tomato $offee 1rated &arrot salad with dieteti& dressing >= !ing &herries Tea or &offee > glass skim milk or buttermilk 4I**-5 N'rene's Tropical hic.en9 11J2 lb. broiler# > teaspoon seasoned salt# >JB teaspoon rosemary# white pepper to taste# A-B &elery stalks# B prunes# S &up orange )ui&e. 5ub &hi&ken with seasoned salt# rosemary# and pepper as desired. Pla&e in pan or pyre: dish over stalks of &elery. Pour orange )ui&e over &hi&ken. Pla&e prunes around it. !ake at A;< degrees for >>JB hours. %>JB broiler serving [ >D= &alories' NN (pples# &elery# > teaspoon raisins# dieteti& dressing. *o nuts.

Irene8s Tropi&al $hi&ken %B o:.' N Peas >JB &up ri&e Wa ldorf sal adNN wit h di eteti& dressi ng "resh fruit &up# >J; &up Tea or &offee > glass skim milk

93

1***-CALORIE MENUS

:#&0 3
!5-(2"(/T S grapefruit ,melet with egg whites %;'N >J;strip &risp ba&on >J; sour dough rolltoasted > teaspoon orange marmalade Tea or &offee > glass skim milk 4I**-5 3amb fri&assee; oF. lean lamb# > small &arrot# > small potato 4Merta with >J; fresh pear Tea or &offee /kim milk or buttermilk 37*$. Tomato )ui&e &o&ktail 3arge platter: >JB &up &rab&ake# > hard egg white# &arrot &url# &elery sti&k# dieteti& dressing ; 5ye 2risps Tea or &offee > glass skim milk /herbet
N ;melet with egg white9 7se skim milk instead of &ream. ,mit egg yolks. Pla&e in &asserole and bake at A;< degrees for >; to >< minutes.

:#&0 5
!5-(2"(/T 1J2 sli&ed banana $ornflakes# AJB &up > glass skim milk > thin rye toast >J;'&ube Ia&k &heese $offee 37*$. 3arge platter: sli&ed fresh pineapple# >J; &up strawberries >JB sli&ed &antaloupe >J; sli&ed pea&h B tablespoons &ottage &heese ; &ra&kers Tea or &offee > glass skim milk 4I**-5 !aked veal &utlet %; oF.' with tomato pureeseasoning >JB &up noodles /tring beans Tossed green salad /mall baked apple Tea or &offee

95

1***-CALORIE MENUS

:#&0 9
!5-(2"(/T /mall glass orange )oke > "ren&h roll > oF. hambroiled > teaspoon )am Tea or &offee > glass skim milk 37*$. ; oF. or B tablespoons dieteti& &anned salmon with lemon on bed of lettu&e with dieteti& dressing > hard egg white Pi&kled beets 4ieteti& 5oyal (nn $herries Tea or &offee > glass buttermilk 4I**-5 !roiled steak %; oF.' /mall baked potato /ummer s9uash +i:ed &ooked vegetable salad with dieteti& dressing 1rapefruit se&tion salad Ganilla 5oyal pudding with >JB &up strawberry sau&e > glass skim milk

:#&0 ;
!5-(2"(/T ; stewed prunes ; stewed apri&ots >J; &up Wheatena > glass skim milk > sli&e whole wheat toast > oF.# ; tablespoons &ottage &heese $offee 37*$. $old sli&e roast beef %; oF.' >JB &up potato salad with dieteti& dressing Xuartered tomatoromaine >J; &antaloupe Tea or &offeeskim milk 4I**-5 !roiled lamb &hop trim "resh asparagus $arrots )ulienne 3ettu&e hearts with dieteti& dressing > small pea&h Tea or &offeeskim milk

D<

1***-CALORIE MENUS

:#&0 7
!5-(2"(/T /mall orange )ui&e > sli&e swiss &heese %> oF.' > whole wheat toast > teaspoon )am > glass skim milk $offee 37*$. > hot dogs>J; !// Tossed green salad "resh fruit &up Tea or &offee > glass skim milk 4I**-5 /mall shrimp &o&ktail !roiled &hi&ken %; oF.' /mall potatowith parsley !aked banana s9uash "resh strawberries Tea or &offeeglass skim milk

9;

(+-+++,-./

,**-CALORIE MENUS

:#&0 1
!5-(2"(/T >J; grapefruit >J; &up &ereal S toastno butter $offee > glass skim milk 37*$. $lear &onsommeno fat 5olled "ilet of /oleN !ro&&oli > glass skim milk or buttermilk Tea or &offeeno sugarno &ream AJB &up strawberries
N Bolled 0ilet of $ole9 ; lbs. rolled filet of sole# >J; &up &ream of mushroom soup# >JB &up skim milk# > tablespoon grated onion# > teaspoon &hopped parsley# ; tablespoons sherry. +ake fish into roll. !ake in &asserole with all other ingredients e:&ept sherry. !ake for appro:imately ;= minutes at A== degrees. (dd sherry and serve. %A oF. serving [ >E< &alories'

4I**-5 /mall broiled tenderloin# A oF.no "resh asparagus with lemon )ui&e >J; &up &arrots 3ettu&e hearts with lemon )ui&e >J; &antaloupe Tea or &offeeno sugarno &ream

fat

:#&0 2
!5-(2"(/T /mall glass orange )ui&e >J; sli&e whole wheat toast ; tablespoons &ottage &heese !la&k &offee > glass skim milk 37*$. Tomato )ui&e &o&ktail# with ; &ra&kers $orned beef hashN /tring beans Pi&kled beet salad 4ieteti& pears# ; halves ; tablespoons )ui&e Tea or &offee > glass skim milk
N orned =eef 2ash9 ; oF. &anned &orned beef# > small onion# ; tablespoons potato# >J; &up &onsomme. 1rind all ingredients and thoroughly heat in oven. %$alories: >?='

4I**-5 >J; baked breast of &hi&ken %; oF' !aked banana s9uash "resh spina&h with lemon Tomato salad with dieteti& dressing 4-Merta with >J; sli&ed banana Tea or &offeeno &ream /kim milk or buttermilkno sugar

DC

i L "Y 8 N \

,** - CALORIE MENUS

:#&0 3
!5-(2"(/T /mall glass unsweetened pineapple )ui&e !aked "ren&h toastN with > sli&e bread# ; egg whites !la&k &offee > glass skim milk 37*$. $lear &hi&ken &onsommeno fat ; oF. or >JB &an dieteti& tuna fish on bed of lettu&e with &arrot sti&kdill pi&klewith dieteti& dressing with 9uartered tomato /mall baked appleno sugar Tea or bla&k &offee 4I**-5 !roiled lamb &hoptrim off all fat >J; &up bro&&oli 1J2 &up &arrots $ole slaw with dieteti& dressing A small or ; large fresh apri&ots Tea or bla&k &offee> glass skim milk N =a.ed 0rench Toast9 > sli&e white bread with &rust &ut off# ; egg whites# >JB &up skimmed milk# > teaspoon &innamon and sugar. !eat egg whites# add milk# and dip bread in mi:ture. !ake in moderate oven until light brown. /erve with sugar and &innamon mi:ture. %>=< &alories'

98

,**- CALORIE MENUS

:#&0 5
!5-(2"(/T A stewed primesno sugar AJB &up Pep or $ornflakes > glass skim milk $offeeno &reamno sugar 37*$. ; hot dogs /auerkraut >JB &up "ordhook limas 1rapefruit and orange salad Iunket made with skim milk Tea or &offee 4I**-5 !roiled beef patty small %A oF' /tring beat is /tewed tomatoes $elery hearts Watermelon balls# AJB &up Tea or &offee

:#&0 9
!5-(2"(/T 3arge glass G-E )ui&e >J; &up 5alstons > glass skim milk $offee 37*$. !ouillon /hrimp salad? shrimp# >JB &up &elery# > egg whites# dieteti& dressing $arrot sti&ks 5oyal (nn &herries Tea or &offee > glass skim milk or buttermilk 4I**-5 .awaiian beef steakN /hredded Fu&&ini Whole baby beets Tossed green salad with dieteti& dressing >J; &up sli&ed fresh pineapple Tea or &offee steak# pepper and salt to taste# ground
? 2awaiian =eef $tea.9 ; oF. round

ginger to taste# > small onion# >JB &up pineapple# >J; &up tomato )ui&e ./aute onion in tomato )ui&e@ add ginger and seasoning. (dd steak and bake with pineapple in &overed dish until tender.

%(ppro:imately ;<E &alories'

99

,** - CALORIE MENUS

:#&0 ;
!5-(2"(/T >J; &up fresh raspberries or dieteti& &anned > oF. or >J; thin sli&e ham broiled >J; toasted roll > teaspoon )am $offeeno &ream > glass skim milk 37*$. /auteed &hi&ken liverN $auliflower with lemon "resh spina&h Tomato salad 4ieteti& plums %A' Tea or &offee> glass skim ,i/? N /aute with &onsomme.

4I**-5 !aked fresh salmon %small sli&eA oF.' /tewed &elery "resh asparagus Tossed green salad with dieteti& dressing /li&ed orange Tea or &offee

:#&0 7
!5-(2"(/T 1J2 sli&ed banana ; small /hredded Wheat > glass skim milk $offee 37*$. !eef stew %; oF. beef' with small onion# &arrot# &elery Pi&kled beet salad >J; &up sherbet Tea or &offee 4I**-5 $lear &hi&ken &onsomme "resh fruit platter: sli&ed fresh pineapple 1J2 &up fresh strawberries >J; sli&ed orange >J; sli&ed pea&h B tablespoons &ottage &heese Tea or &offee > double 5ye 2risp

>==

H0W T0 C01NT TH2 CAL0342S

C42/(16
I" ;= +I33I,* (+-5I$(*/ W-5- T,

appear on the streets tomorrow# ea&h with a &ement blo&k weighing between ;= and B= pounds permanently atta&hed to his person# it would &reate a tremendous stir. .ow# you would ask# &an they &arry a load like that for the rest of their lives They would &ommand the sympathy of the entire nation. It is 9uite likely that our $ongress itself would ena&t some kind of legislation to aid them. "antasti& *ot at all. (s a matter of fa&t# su&h a situation does prevail right at this moment. The only differen&e is that the weights those ;= million (meri&ans are &arrying &onsist of fat rather than &ement. (nd the burdens are less &onspi&uous be&ause they are distributed over the body. !ut from the standpoint of health and the added work load pla&ed on the heart# it makes no differen&e whether the &argo is &ement or adipose tissue. The &ost to the individualin poor health# loss of energy# and in most &ases# a shorter lifespan is the same.

;verweight is a hidden disease! (bout the only people

who seem to take this seriously are physi&ians and insuran&e a&tuaries. (t least they are the only ones &on&erned in terms of health and longevity. They know that overweight is a "hidden disease#" responsible for shortening the life of every average (meri&an adult by almost five and one-half years. >=>

>=;

.,W T, $,7*T T.- $(3,5I-/

Think what that means. ,ur own generation will lose a &ombined >=E million years of life be&ause of overweightK This figure represents many times the number of adult years lost by the premature deaths of young men killed in World Wars I and II. ,nly in the past few years has the publi& be&ome even dimly aware of the &riti&al and dangerous results of being a nation of "fat &ats." It8s time we all began to sit up and take noti&e. If we learn how to &ount the &alories# we will learn also how to &ount on more years of vibrant# healthful life. The tables of &alorie values given in this &hapter &an be&ome your easy-to-use weapon for fighting overweight and the bodily and emotional illnesses it brings on. 4r. 3ouis 4. 4ublin and .erbert .. +arks of the +etropolitan 3ife Insuran&e $ompany were among the first to point to in &reased death rates attributable to e:&essive fat. In &onse9uen&e# there have been a number of &ampaigns aimed at persuading people to redu&e their weights to the normal or even the ideal figure.

)iet for health, not for beauty! 7nfortunately# people are

intensely human and# to give a new twist to an old ma:im# the spirit is willing but the flesh is strong. The result has been a widespread pra&ti&e of "stop-and-go" dieting aimed not at improved health# but at a more fashionable silhouette. *othing &ould be worse than that kind of up-and-down-thes&ales program. In the first pla&e# you benefit from redu&ed weight only if the normal weight is maintained from that time on. Taking it off and then putting it on again is worse than remaining overweight# be&ause it is in the pro&ess of be&oming fat that a large part of the damage is done. This damage o&&urs in the blood vessels# liver# and heartall &riti&al sites of the body. (lthough the pro&ess of be&oming fat is more detrimental than being fat# &arrying around an over-upholstered frame is also a way to shorten the period of your so)ourn on earth. (s you put on e:&essive fat# movement of the blood throughout the body is slowed. The heart has to work harder to keep the &ir&ulation

.,W T, $,7*T T.- $(3,5I-/ >=A going. (nd the added weight pla&es a greater burden upon your )oints# whi&h may develop trouble as a &onse9uen&e.

1s overweight due to "glandular trouble"+ 6ou may

often hear laymen e:press the view that some people are fat be&ause of "glandular trouble." /u&h &ases a&tually are very few. The reason most people are fat is simply be&ause they eat more food than they a&tually need for their a&tivities. The only way to &ut down on weight is to &ut down on eating# to redu&e the number of &alories in your daily diet. *hat causes overweight+ There are many &auses for overweight. +ost people# however# are overweight simply be&ause they overeat. ( very small per&entage of people are obese due to some endo&rine or glandular disorder. /ome &ases possibly are due to an error in the individual8s metabolism. (nd still another small per&entage of &ases result from an inherited or &onstitutional trait that runs in families and is passed on from one generation to another like &oloring# or fa&ial and bodily stru&ture. !ut the &auses of obesity in over D< per &ent of the vi&tims are: %>' nervousness# and %;' bad eating habits.

6ervousness is a primary cause of overweight! People

overeat from nervousness# either &ons&ious or sub&ons&ious# for a variety of reasons. /ome people# when they feel an:ious# &onstantly and regularly relieve their an:iety by the elemental satisfa&tion of eating. (s they be&ome more and more an:ious# they re9uire more and more food and be&ome more and more fatK ( vi&ious &y&le. ,ne of my patients# Iudy /.# aged ><# is very obese be&ause of the la&k of love and appre&iation from her mother# who gives all her love and &enters all her attention on her ;-year old# si&kly little brother. (nother patient# +r. ".# a AE-year old sales manager# is fat be&ause he &an8t seem to stop eating in between meals and all during the evening as he sits by the television. .e has been in danger of losing his )ob be&ause his sales 9uotas &ontinue to fall

165

.,W T, $,7*T T.- $(3,5I-/

off and he feels &ertain that he will eventually lose his )ob. !ut still he eats. The more nervous he gets# the more he eats. /ome people are so habituated to living under &onstant tension in their work or at home that the glands in their nervous and glandular systems &onstantly drive their blood sugars to low levels. (s a result they feel &ontinuously hungry# weak# tired# and tense. "ood momentarily raises their blood sugars to normal levels. !y eating &ontinuously or at least fre9uently in between meals# they are able to have the strength and &on&entration to &omplete their tasks at work or in the home.

, feeling of failure can lead to overeating! +any other

obese individuals eat out of sheer frustration or a feeling of failure. ,ne patient of mine# a ;E-year old man# is a brilliant mathemati&ian. .e wanted badly to be&ome a physi&ist and s&holar# espe&ially sin&e he was of a 9uiet# shy nature. Instead# he was prevailed upon to enter his father8s large and very su& &essful business. (n only son# he was to be "groomed" as his father8s su&&essor in the running of the e:tensive family fa&tories. -a&h day at work was one of frustration for him as he struggled to learn a business in whi&h he basi&ally had no in terest. Probably most frustrating of all was the problem of &oping with a hard-driving# dynami& father who dominated him and virtually threatened to &rush his entire personality. 5esult -very hour or so found him in the &ompany &afeteria for a "breather#" and the &offee breaks were easier to e:tend when some donuts# &andy# or bis&uits went along for the ride. (t meal-hours# getting "oral" gratifi&ation from large meals with se&ond helpings seemed to stave off the time for getting ba&k to work during the day and seemed to make life tolerable. This man ate to ward off his &onstant frustration at his work and his domineering father. !ut his "solution" far from solved his basi& problem@ it &reated a new one on top of it. We all know that the eating of food is man8s most primitive ne&essity for survival. (nd in order to survive the frustrations# tensions# an:ieties# and loneliness that seem to grow worse with time# man often returns to his primitive behavior to give him

.,W T, $,7*T T.- $(3,5I-/ >=< a sense of some se&urity and the feeling of over&oming his grow ing worries. ( subse9uent &hapter dis&usses more fully some ways to &ombat these tensions. +any of these more severe problems re9uire the &are and guidan&e of e:perts espe&ially % (i&#1 in the treatment of emotional disturban&es.

(ad food habits a second main cause of overweight! I%

is remarkable to find how many people eat out of boredom# sheer habit# or to the a&&ompaniment of a newspaper# a book# or a heated business dis&ussion. +any su&&umb to %+# habit of eating at a "minute" diner or lun&h &ounter# gulping their food and running a "hoof and mouth" ra&e with "ather Time. %.e always wins.' ,thers are trained from &hildhood to stuff themselves"finish your plate." (n old reli& of primitive days when food s&ar&ities or the un&ertainties of a ne:t meal or a ne:t day were &onstantly present. /ome &all this "s&avenger eating@" many &hildren a&9uire this habit by imitating their parents who may have been raised under food s&ar&ity &ir&umstan&es. +any men and women are the vi&tims of monotony or plain poor &ooking in their meals. They rarely vary the sele&tion and &hoi&e of foods out of sheer inertia# indifferen&e# or la&k of attention. /o they try to make up in 9uantity what they la&k in 9uality# seeking satisfa&tion from &alories instead of from 9uality and &ontrast.

.oo much weight can strain your heart, rob you of

energy! 4r. (rthur +aster# in a study of a group of patients not suffering from heart disease# found that a signifi&ant loss of weight was followed by an average A< per &ent redu&tion in the work the heart has to do. The lesson to you is &lear: -ven though your heart is strong# overweight ta:es it with work and strain beyond its normal &apa&ity. ( healthy heart is gradually weakened by the e:tra stress imposed on it by ;=# A= or B= pounds of unne&essary fat. 6our energy reserves are depleted@ you feel tired too soon and too often# even when doing simple things like walking and swimming# things that the person of normal weight &an handle with ease and pleasure. 4on8t let

>=?

HO8 T, $,7*T T.- $(3,5I-/

too mu&h weight rob you of a strong heart and the vibrant energy that you need to en)oy a full# healthy life. 3earn to &ount your &alories and you &an &ount on more years of healthy# happy living.

"ost people today don't have heavy demands made on

their physical energy! We must remember that in the past <= years there has been a &onsiderable redu&tion in energy e:penditure# be&ause of a more me&haniFed way of life. People today don8t have to go out to the barn and hit&h up a horse or team when they are ready to go somewhere. They merely step into their &ar# whi&h is as &lose to the front door as they &an manage it# and then drive to their destination# again parking as near the entran&e as possible. The introdu&tion of &ountless labor-saving devi&es in our home# fa&tories# and offi&es has also robbed us of most of the physi&al e:ertion our grandparents knew. In fa&t# when it &omes to &onserving energy# we seem to have approa&hed about as near as we &an get to a vegetable e:isten&e. It was formerly believed that the average adult who engaged in moderate physi&al a&tivity re9uired from ;<== to A<== &alories a day. "igures published by the (meri&an .eart (sso&ia tion today pla&e the figures mu&h lower. ,ne of the reasons overweight is a problem with so many persons is that it has a way of sneaking up on you. 6ou may gain only two or three pounds a year and not noti&e it. !ut in >= years# this means an e:&ess of ;= or A= pounds. "or e:ample# a pound of body weight e9uals about A<== &alories. Iust one e:tra pat of butter ea&h day %E< to >== &alories' will add eight to ten pounds a year to your weightK /imilarly# a pie&e of pie %;<= &alories' eaten )ust on&e a week# will add over three pounds of body weight in a year8s time. <ust what is a calorie+ ( &alorie is a unit of heat and energy# &reated by the body "burning up" the food we eat. This &alorie or measurement of heat unit is the basis for determining what our weight should be and what our diet should be.

.,W T, $,7*T T.- $(3,5I-/ >=C In determining how many &alories you a&tually need# s&ientists use the term "basal &alori& re9uirements" to indi&ate how many &alories you need )ust to stay alive# keep your heart going# and your temperature normal. We need appro:imately a &alorie ea&h minute# simply to keep living. -ven while you are asleep you "burn up" an average of <== &alories. +ost men and women need from >=== to ><== &alories as their basal &alori& re9uirement. .owever# when you work or think you burn up additional &alories. .ere is a list of a&tivities with the appro:imate number of &alories that these &ost you# as an adult: %>' +ental Work ................>= $alories -a&h .our
%;' %A' %B' %<' %?' %C' %E' %D' %>=' /itting at 5est ................... /tanding ............................. 4ressing ........................... Walking %easy' ................. 3ight .ousework................ 3ight -:er&ise ................... /trenuous -:er&ise ............ 1olf .................................... /wimming ......................... ;= ;< A< >==->;< C= C<-><= ;==-<== ;== ;== " " " " " " " " D " " " " " " " " D " " " " " " " " D

3ow to determine the number of calories you need! To

determine the number of &alories you re9uire ea&h day from your food# it is ne&essary to make very e:a&t mathemati&al &al &ulations based on detailed knowledge of your metabolism# body frame# hereditary and &onstitutional fa&tors# spe&ifi& energy e:penditure ea&h day# &limati& &onditions# emotional state# digestive tra&t stru&ture# physiology# and still other variable fa&tors. /in&e this is an impossible or impra&ti&al method for those who want to redu&e# I re&ommend for the average person the following simple "rule of thumb" method: "or: 4ABA6) ;E6BW6'82T$ ( person who is markedly overweight is one who is A= per &ent or more above his normal weight. This means that if# for e:ample# you weigh >E= lbs. but should# a&&ording to our table#

>=E

.,W T, $,7*T T.- $(3,5I-/

weigh >A< /-".' %+#& you ( # B< lbs# overweight. In that &ase you should redu&e your weight by using the E== &alorie diet menus shown in the &enter# green se&tion of this book. "or: 4;)6BAT6 ;E6BW6'82T$ If you are moderately overweight %i.e. ><-A= per &ent@ you are# say# ;= to B< lbs. over and weigh from ><< to >E= lbs. but should weigh >A< lbs.'# use the diet menus for the >=== &alorie daily food intake shown in the green se&tion in the middle of the book. "or: 4'7) ;E6BW6'82T$ If you are only mildly overweight %< to >< per &ent above your normal weight@ let us say you are C to ;= lbs. over and weigh from >B; to ><< lbs.# whereas you should weigh >A< lbs.' then follow the >;== &alorie diet des&ribed in the &enter# green se&tion. (fter you have lost an average of ; lbs. ea&h week and have a&hieved your normal weight# you should then follow the low-fat maintenan&e diets shown in pages C>EE. These diets range from appro:imately ><== &alories to ;;== &alories. They are re&ommended for the average individual who does light work with a moderate e:penditure of &alories in average daily a&tivities su&h as housework# offi&e work# light fa&tory employment# sales work# driving of &ars# or a moderate degree of walking.

"aintaining your proper weight by a regular calorie

count! .owever# sin&e individuals vary so widely# it is impera tive that you wat&h your weight &arefully by your household s&ale. If you find that you are gaining a little or a moderate amount of poundage %say > or ; lbs. ea&h week' then you must subtra&t ;== to <== &alories from your daily menus. 6ou &an then redu&e a pound a week and stay on this "maintenan&e" diet to keep your weight on an even level. This may mean that your maintenan&e diets re9uire only ( daily food intake of >;== ! ><== &alories every day from

.,W T, $,7*T T.- $(3,5I-/ >=D then on. Perhaps the elimination of one or two sli&es of bread and )am# or &utting down on sugar# may be all that is ne&essary to take ;== or A== &alories off your daily menus. To eliminate the re9uired <== &alories from your daily meals# it may be ne&esary to omit in addition some potatoes# or to avoid &ompletely sugar and star&h foods. In any &ase# the &alorie &ounter in this &hapter will guide you on whi&h food items you should eliminate from your diet. ,n&e you have de&ided to do so# it is simple to follow the menus. It does take a few minutes of your time to look at these &alories# but you will be giving yourself a reward of years added to your life. That8s the biggest health bargain in modern historyK

.here is only one healthy way to reduce! ,ur bookstores

and newstands bristle with literature full of spe&ta&ular &laims and 9ua&k formulas# all shouting# "3ose those e:tra pounds the fast# easy way." !ut the truth is %unless you like to be fooled at the e:pense of your own health' that there is only one safe and effe&tive way to a&hieve the &orre&t poundage and to keep it at that figure. That way is to follow a &orre&t nutritional program# and to follow it &onsistently# one might almost say religiously. To do that means taking over a lifetime )ob of vigilan&e and self-dis&ipline. !ut first you have to make up your mind that you want to do it# and then do it. (nd then stic. to it#

even rules for getting your weight down and keeping

it down! ,n&e you have given yourself a powerful in&entive# and have de&ided# "I will get my weight down and keep it down#" then the following rules will help you: >. "ollow the menus and dietary supplements suggested in this book as &losely as possible. ;. (s an appetite &urb# nibble a few low-fat hors d8oeuvres a little while before mealtime. %This raises the blood sugar level and takes the edge off your appetite.' A. -at a substantial breakfast and a small lun&h as provided in the menus given in this book.

110

HO !O "O#$! !H% "&'O()%*

B. Try to have small servings of the food you #(%. <. (void se&ond helpings. ?. "orego dessert if it is high in &alories or fats. B. To know e:a&tly where you stand ea&h day# be a &alorie &ounter# but a serious one. 7se the table of foods and &alori& values at the end of this &hapter. !y glan&ing at the following table that shows the total number of &alories needed daily for a man %or woman' of average weight and height at various ages# you will be surprised to see how mu&h you really overeat. 6ou will observe also that the &alori& re9uirement de&lines with age. Thus a man who is < feet >= in&hes tall and has the normal weight of ><= pounds# re9uires ;=;= &alories between the ages of >B and ><# but only >?== when he is ?=. /imilarly# a woman of average height %< feet# ; in&hes' and weight %>;< pounds' re9uires >?== &alories when she is >B# but only >;?= &alories when she is ?=.
5 -3(TI,*/.IP ," (1- T, $ (3,5I$ 5-X7I5-+-*T/ =asal alories 2, 2ours ;=;= >ED= >E== >CA= >CA= >?D= >?<= >?== ><?= >?== >BD= >B>= >AC= >A?= >AB= >A== >;?= >;A=

,!-/IT6 (*4 .-(5T 4I/-(/-

$e+ +(3-

Weight F-oundsG ><=

Age

5>2?

"-+(3-

>B->< >?->C >E->D ;=-;D A=-AD B=-BD <=-<D ?=-?D C=-CD >B->< >?->C >E->D ;=-;D A=-AD B=-BD <=-<D ?=-?D C=-CD

>;<

.,W T, $,7*T T.- $(3,5I-/

>>>

)rugs are not the answer! 7nless they are needed for other reasons# I always &ounsel my patients against them. Taking thyroid e:tra&t# for e:ample# when it is not indi&ated from a medi&al point of view# &an damage the heart. ( number of other &ommer&ial preparations now on the market# used for dulling the appetite# have the undesirable side effe&ts of overstimulating the nervous system or# in some &ases# of interfering with the body8s metabolism. In the game of redu&ing# there are no "wild" &ards# and there is no way to &heat. 6ou will win or lose# depending upon how well you follow the rules and play your hand. 5emember that the amount of money you spend for food is not half so important as the way you spend it. Whether your in&ome is ]A#=== a year or ]<=#===# the proper food in the proper amount is within your rea&h. *ot only is su&h a program wise and helpful for you# but think how many years of good health and happiness you &an offer your &hildren. ( survey made not long ago revealed that of almost three-fourths of the nation8s &hildren studied# not a single one rated top health grades in stri&t medi&al e:aminationsK /u&h a deplorable and widespread epidemi& of malnutrition &an easily be &orre&ted if you will bring to the vital sub)e&t of nutrition the same dedi&ated parental &are that you do to other phases of your &hildren8s lives. 6ou have nothing to lose# and pre&ious years of life to gain.
CALORIE COUNTS OF FOODS LISTED ALPHABETICALLY= ,bbreviations tbsp. tablespoon tsp. teaspoon oF. oun&e 0ood B oF. >J; &up or glass appro:imately E oF.>J; pt. or > glass or &up appro:. >? oF. %B<B grams-> lb.' Appro+imate 2ousehold 4easure alories A< B== <=

(balone# &ooked ................ > pie&e# > : ;>JB : > in. (lmonds ........................... >J; &up > tbsp.

N These &alorie &al&ulations are appro:imate figures. Garious sour&es differ slightly. We have endeavored to use average figures.

112
#ood

HO8 TO COUNT THE CALORIES

,ppro2imate 3ousehold "easure &alories >= C< <= >;< ?< B== >== <= C= >B= <= ;= E= >< ;= ><= ;== >== >== >>= A= >;= >=< >>< A< >< ?< ><< ;<= >D= D? D= >=; >== ;< C< >== <= >;< <= D=

(n&hovies .......................... > fillet (pples: fresh .............................. > medium )ui&e ............................. > &up baked with sugar ............ > small# with > tbsp. sugar baked without sugar .... > small (pple pie .......................... >J? of D" diam. (pplesau&e# sweetened #### 1J2 &up unsweetened .... >J; &up (pri&ots: &ooked or &anned............ ? halves dried .............................. E small halves fresh .............................. A medium (rti&hokes# &anned ............ >J; small Ierusalem# &ooked .......... > large (sparagus# &ooked: .......... &anned............................. < tips or >J; &up fresh .............................. E stalks# B in. long (vo&ado: >JB peeled 1J2 &up !a&on# broiled# &risp# and drained .................... ; sli&es !anana# fresh ..................... > medium !arley# pearled ................... A tbsp. !ass# sea# &ooked .............. > pie&e# > : ;>JB N > in!eans# baked# &anned ........ A tbsp. kidney# &anned ............... B tbsp. lima# fresh &ooked ......... B tbsp. string# fresh ....................;JA &up !eef: broth .............................. >J; &up &orned &anned................... > sli&e# A : ;>JB : >JB in. dried ............................. ? sli&es# thi&k# B : < in. hamburger# med. patty .... < to > lb. liver# &ooked .................. A sli&es# ; : > : >J; in. roast# lean ....................... > sli&e# A : ;>JB +1J, soup %homemade' ............ > &up steak# med. fat broiled .. > pie&e# B : > : > in. !eer# average >J2 bottle .... ? oF. !eets# fresh or &anned . . . . >J2 &up !everages all sweet &arbonated types ............ ? oF. !la&kberries# &anned in syrup .............................. >J; &up fresh .............................. >J2 &up !lueberries# &anned in syrup .............................. >J2 &up fresh .............................. >J; &up !luefish# &ooked ................ > pie&e# B : >>J; : > in.

HO8 TO COUNT THE CALORIES

#ood ,ppro2imate 3ousehold "easure

113
&alories ;?= >= >== D= ;>< C= E< >;= ?< ?< << B= >; B= <= E< <= ;== >=? ;== BA= B== A< ;<

!ologna# sausage ............... B oF. !ouillon ........................... >J2 &up !ran# wheat %>==L bran' ;JA &up !randy %D= proof' .............. > oF. !raFil nuts ......................... B nuts med. !read: gluten .......................... > small sli&e mis&ellaneous ................. > small sli&e pumperni&kel ................. > sli&e rye ................................. > sli&e# A : A>J;H : >J; in. white# milk ..................... > sli&e# A : A>J; : >J; in. whole wheat .................. > sli&e# A : A>J; : >J;Mweiba&k ...................... > pie&e !ro&&oli ........................... >J2 &up !russels sprouts.................. >J; &up !utter ................................ > tsp. !uttermilk# skimmed-milk buttermilk .................... > &up !utternuts ......................... > tbsp. $akes: (ngel "ood..................... B>J; : A : A in. se&tor "ruit .............................. ; : ; : >J; in. se&tor /ponge .......................... B>J; : A : A in. se&tor $andy: $aramels ......................... >= pie&es .ard &andy...................... >= pie&es $antaloupe .......................... >J; pie&e $arrots# fresh raw .............. > medium

&ooked .......................... >J; &up

$auliflower ...........................>J; &up $elery ............................... ; stalks $heese: (meri&an ...................... > oF# $amembert ...................... > oF. $ottage# from skim milk ; oF. %>JB &up.' $ottage .......................... > round tbsp. $ream ............................ > oF. > tbsp. -dam ............................ > oF. 5o9uefort ....................... > oF. /wiss or 1ruyere............ > oF. $herries# &anned# bla&k in syrup .......................... >J2 &up in syrup# white................ >J; &up fresh# sour ..................... >J; &up sweet ............................. >J2 &up

;<
>; >; >== D= C< ;< >== <= >== >== >== ><= >== <= >==

115 0ood

HO8 TO COUNT THE CALORIES Appro+imate 2ousehold 4easure alories >;= >;< >>< >A< ;== >C< ><= <= <= E= B= = A= >C< >== = C< >=== >= ;< <= <= <= <= ;< <= <= AD ;< ;< EB C= >== <= <= A< >== C=

$hi&ken# broiler .................>JB med. lean# no skin# boiled...... ; sli&es# B : B : >JE in. with skin# boiled............ > sli&e# A>J; : A>J; : >JE in^ liver ............................... A>JA oF. roast# with skin.............. >J; breast $hile &on &ame# &anned with beans.................. >J; &up $ho&olate# bitter or unsweetened# sweetened# plain or milk bar ........... > oF. $ho&olate syrup ................ > tbsp. $ider# sweet ...................... >J; &up $lams# long# in shell ........ ? round# in shell................ ? $lam bouillon ................... >J; $7P $o&oa# dry.......................... > tbsp. $o&onut# fresh# prepared# dried# sweetened............ >J2 $7P $od ................................... B oF. $offee# bla&k ..................... > &up $ola drinks# all varieties .. ? oF. $ondensed milk ............... > &up $onsomme ....................... >J; &up $ookies: (rrowroot bis&uit.......... > bis&uit $ho&olate wafer ............ > wafer# ;AJB diam. "ig bars %*ewtons' .... > bar 1ingersnaps ............... > snap# A" diam. +a&aroons ..................... > ma&aroon *abis&o wafers ............. > wafer ,reo sandwi&h .............. > wafer# ;" diam. Peanut ........................ > &ookie# ;" diam. /hortbread %3orna 4oone' ....................... > &ookie# >AJB" s9uare /o&ial Tea bis&uits ...... > bis&uit Ganilla wafers .............. > wafer# ;>JE" diam. $orn# &anned or fresh# white or yellow.............. > ear popped ......................... > &up $orn bread or muffins...... > muffin $orn flakes ....................... >J2 &up $orn meal# whole# white or yellow &ooked ............... >J; &up $ornstar&h# dry ................ > tbsp. $rabmeat# &anned or fresh B oF. $rabs# &ooked ................. >

HO8 TO COUNT THE CALORIES

#ood ,ppro2imate 3ousehold "easure $ra&kers: (nimal ............................ A oF. $heese ......................... < &ra&kers 1raham or whole-wheat A &ra&kers ,yster ........................... ;B &ra&kers 5iti .............................. A &ra&kers /oda .............................. > &ra&ker 7needa ......................... > &ra&ker $ranberries# raw ................. >J; &up $ranberry sau&e# &anned or &ooked......................... >J; &up $ream# heavy# whipping .. > tbsp. light# table or &offee........ > tbsp. A=L sour ......................... B tbsp. $ream of Wheat# dry B tbsp. &ooked ..............................AJB &up $ress# water ....................... >J; &up $ris&o.................................. > tbsp. $u&umbers ........................ >J; &up $urrants ............................. >J; &up 4andelion greens................ >J; &up 4ates# fresh and dried......... >J; &up B dates 4oughnuts# &ommer&ial# &ake type......................... > doughnut sugared ........................... > doughnut 4u&k ................................. B oF. ; sli&es# >AJB : >>J; : >JB in. 4-Merta .............................. > serving -ggplant# &ooked................ >J; &up fresh .............................. >J; &up -ggs# raw .......................... > avg. white# raw ...................... > avg. yolk# raw......................... > avg. -ndive .............................. >J; &up -s&arole ............................ >J; $7P -vaporated milk.................. > &up "arina# white# &ooked......... ;JA &up "ats# &ooking %vegetable fats' ............................. > tbsp. "igs# &ooked or &anned .... B dried .............................. B with )ui&e# &ooked "ilberts .............................. >= nuts "innan haddie .................... > pie&e# B : >>J 2 : one in&h "lounder %baked' ................ > pie&e# B oF. %B to lb.'

119
&alories A?= ;< >== >== <= ;< ;< ;< ;C< <= ;< ;C= >>= >>= >; ><= >; ;< >A ;<= >== ><= >C< A<= ;E< >= >< ;< C< >< ?= >; >; A<= >== >>= >C= A;< D< >?= ;==

11;
0ood

HO8 TO COUNT THE CALORIES

Appro+imate 2ousehold 4easure alories

"lour: barley ........................ > tbsp. bu&kwheat .................. AJB &up soy bean ....................... > tbsp. gluten ........................ > &up gluten ........................ > tbsp. graham ...................... > &up rye ............................. > &up white ......................:... > &up white .......................... > tbsp. "rankfurters .................. >#<>J; in. /!&g "ruit &o&ktails# &anned: syrup pa&k .................. >J; &up fresh or water pa&k...... >J; &up 1arli& ............................ > &love 1elatin# granulated ......... > tbsp. 1in %D= proof' ................ > oF. 1inger ale ....................... ? oF. 1oose ............................. A sli&es# A : A : >J E in. 1ooseberries ................. >J; &up 1rapefruit )ui&e# fresh or &anned unsweetened .... >J; &up &anned# sweetened ....... >J; &up 1rapefruit# raw .............. >J; med. 1rape )ui&e...................... >J; &up 1rapenuts ..................... >J; &up 1rapes# all varieties......... >J; &up .addo&k ......................... B oF. .alibut .......................... B oF. .am# baked ................... > thin sli&e# B : ;>J; : >JE %> oF.' smoked# lean# boiled .... > sli&e# B : ;>J; : >JEin. 4evilled .am .................. > tablespoon spi&ed# &anned ............. > sli&e# A>JB : ;>JB : >JB .eart# beef# lean ............. B oF. .erbs# all varieties ......... tra&es .erring# &ooked .............. > pie&e# > : ;>JB : > in. pi&kled ...................... ; small smoked ....................... > pie&e# ;>J; : ;>J;: > in. .oney ............................ >J; &up > tbsp. .oneydew melon ............. > wedge# ;" se&tor .orseradish ................... > tbsp. .u&kleberries# fresh ....... ;JA &up or B tbsp. I&e &ream......................... ; tbsp. soda ........................... > glass

?= A== ;= <;= A= B;< B== B<= ;< >;< >== <= = ;< D= C< AD= ;< <= C< < C< ;;= <= >== >C= >;= >;= D< >;< >== = <= >>< ;D= <== C< <= = C= ;=< B==

HO8 TO COUNT THE CALORIES

#ood ,ppro2imate 3ousehold "easure Iams# )ellies# marmalades# preserves ....................... > tbsp. Iello .................................... > serving %< to the pkg.' Iunket ................................ > serving 2ale ................................. >J; &up 2idney# beef ...................... B oF. pork# lamb ..................... B oF. 3ady "ingers....................... > large or ; small 3amb: &hop# broiled................... > large or two medium ground patty ................. ; : >J; in. leg# roast......................... ; sli&es# A : A>JB + 1J& &hop# broiled................... > small# > in. &ube meat 3eeks .................................. >J2 &up 3emon: fresh ............................. > medium )ui&e ............................. >J2 &up 3emon +eringue pie.......... >JB in. se&tor# D" diam. 3entils# &ooked ................... >J2 &up# or B tbsp. 3ettu&e ............................. >= leaves 3imes ................................ > medium 3it&hi nuts........................... ? nuts liver# beef# &alf# &hi&ken .. B oF. 3iver sausage and liverN wurst .............................. B oF. 3obster# fresh boiled or &anned .......................... B oF. 3oganberries# fresh or &anned# )ui&e pa&k.......... >J; &up 3un&heon meats ................. B oF. 3ungs ............................... B oF. +a&aroni# dry .................... >J; &up &ooked ............................ >J;&up +a&kerel: fresh# &ooked ................. > pie&e# > : ;>JB : > in. salt# &ooked..................... > pie&e# > : 21J,, : > in. +aple syrup ....................... ; tbsp. +argarine ......................... > tsp. +armalades# )ams# )el lies# preserves................. > tbsp. +ayonnaise ...................... > tbsp. +eat# fat ............................ > tbsp. +eat# lean# &ooked %avg.' B sli&es# thin# B>JB: ;>J; med. fat# &ooked.............. B sli&es# thin# B : ; in. +ilk# &ow# li9uid# whole .. > &up &anned# evaporated ......... > &up

117
&alories <= ?< <= ;= >C= >== AE A<< >A= ;== >=< ;< ;< A< B== >;< >< ;< B< >C= ;?= >== <= A<= >== ;<= >== C< >;= D= A< ?= >;< >A< ><= ;== >C= A<=

118

HO8 TO COUNT THE CALORIES alories E< >=== ?<= A< ;C B== ;= = ?= >== = ;< >== = >= A=< B= >== >== >>= >>= ><= B< B= ;< <= << <= <= <= >== >< <= >; <= >== <= <= >== >A= C= ?=

#ood Appro+imate 2ousehold 4easure skim .......................... > &up &ondensed .................. > &up powdered# whole........... > &up > tbsp. powdered# skim ........... > tbsp. +in&e pie ....................... >JB" se&tor# 9D 1i(,. +ineral oil dressing......... > tbsp. +ineral water ................ +olasses# &ane ................ > tbsp. +uffin ............................ > medium +ushrooms# fresh (&1 &anned ......................... >J; &up +ussels ........................... B oF. +ustard# dry ................. > tsp. +ustard greens .............. >J; &up +utton# leg roast ............ A sli&es# A : AAJB : >JE i&. *e&tarines ..................... >#>AJB" diam. *oodles# dry ................... >J; &u p &ooked ......................... ;JA &up ,atmeal &ooked .............. ;JA &up ,ther &ooked &ereals........ ;JA &up ,ils# salad or &ooking %&orn# &ottonseed# olive# peanut' ............... > tbsp. ,lives# green .................. ; large ripe .......................... ; large ,nions# &ooked# plain ..... A med. fresh or s&allions.......... B small ,range Iui&e .................. >J; $7P ,ranges# fresh ................ > med. ,range se&tions .............. >J2 $7P ,valtine# dry.................... > tbsp. ,ysters: solid# raw .................... > &up solid# raw .................... ; med. Papaya .......................... >J; &up Parsley .......................... >J; &up Parsnips ........................ > &up Pate de foie gras ............ > oF. Pea&hes# fresh ................ > medium &ooked or &anned ........ ; large halves Peanut butter .................. > tbsp. Peanuts .......................... >< nuts Pears: &ooked or &anned......... ; halves fresh .......................... > small

HO8 TO COUNT THE CALORIES

#ood ,ppro2imate 3ousehold "easure

119
&alories >== D< << ;A= ;= ?< >B= >< >== B== <= >B< B= A< >== ;< >== <= ;<= >D= AB= ;<< A< >== >== >== >== >A< >== <= ;?A >?< >C= >== C< <= >;.< B==

Peas# dried ...................... A tbsp. green .............................. >J; &up# or B tbsp. green# very young# &ooked or &anned............ B tbsp. Pe&ans ................................ >= nuts# large Peppers# sweet# green# &ooked ......................... > medium Persimmons# fresh .............. >J2 small Pheasant ............................. > breast Pi&kles# &u&umber .............. l # B : > J ; : A J B i n . sweet ............................. >J; &up Pies# all varieties................ B" se&tor or >J? of D" diam. Pineapple: )ui&e# &anned .................. >J2 &up &ooked or &anned............ ; small sli&es fresh .............................. > sli&e# AJB in. thi&k Pista&hios .......................... >= nuts# large Plums# &anned# water pa&k or )ui&e pa&k.................... B plums fresh .............................. > plum Pomegranate ..................... > pomegranate Pop&orn# popped# unbuttered ......................... ;JA &up Pork &hop: loin# lean ........................ > large loin# lean ........................ > medium loin# med. fat ................. > large loin# med. fat ................. > medium Postum# without sugar or &ream ............................ E oF. Potato &hips ....................... E->= large pie&es Potatoes# white# boiled or baked .............................. > medium mashed .......................... >J; & u p Prune )ui&e ......................... >J; &up Prunes ................................. < very large or ? medium &ooked# no sugar ........... C Pumpkin# fresh or &anned >J; &up Pumpkin pie ....................... B" se&tor# D" diam. Xuail# broiled ..................... A>J; oF. 5abbit ................................. B oF. 5aspberries# &anned in syrup ............................. >J; &up )ui&e pa&k ...................... >J; &up fresh ............................... >J; &up 5hubarb ............................. >J; &up 5hubarb pie......................... B in&h se&tor# D in&h diam.

120
#ood

HO !O "O#$! !H% "&'O()%*

,ppro2imate 3ousehold "easure &alories >== >== >== <= >== >== <= ;< ;< <== ;?= >C= ;?= ;= ;== ;<= ;<= B== C< ><= >== >== C< >== <= = <= >== ?< >== ><= >== >== >== C< <= >;< A<= ><= >== >= >A<

5i&e# brown# &ooked............ > oF. dry or AJB &up &ooked white# &ooked ................. > oF. dry or AJB $7P &ooked 5i&e $rispies &ereal# flakes or toasties.............. ;JA &up 5i&e# puffed ....................... ;JA &up 5olls# white# average.......... B oF. 5um# %E< proof' ................. > oF. 5usk# .olland .................. > rusk 5utabagas# &ooked.............. >J; &up 5y-2risp ............................ > double s9uare wafer /alami ................................ B oF. /almon# fresh ..................... B oF. &anned ............................. B oF. /ardines# &anned in oil .... >= sardines or B oF. /auerkraut ......................... >J; &up /ausages: bologna............................ A sli&es frankfurter ...................... ;#? in. liver sausage ................ A sli&es pork sausage.................... < links or ; patties /&allops# broiled.................. >J; $7P /herbet ............................. >J2 &up /hredded Wheat.................. > bis&uit /hrimp .............................. B oF. /oup &anned: asparagus ........................ >J; &up bean ................................ >J; &up beef ............................... >J; &up bouillon# broth or &onsomme ...................... >J; &up &hi&ken ......................... >J; &up &hi&ken noodle ............... >J; &up &lam &howder ................. >J; &up &orn &howder ................. >J; &up &ream .............................. >J; &up green pea......................... >J; &up o:tail .............................. >J; &up split pea........................... >J; &up tomato ............................. >J; &up vegetable ......................... >J; &up /oybean# flour# high fat# medium fat# low fat........ >J; &up /oybeans# dried .................. >J; &up green# fresh..................... >J; &up /paghetti# &ooked................ >J; &up /pina&h# fresh or &anned .. >J; &up /9uab# with skin# &ooked# roast ................................ > whole

HO8 TO COUNT THE CALORIES

#ood ,ppro2imate 3ousehold "easure &alories ;= ><= ;< >== >== ;= ?= E== ;< ;< ?= E== ?= C== >== B== >CB ;== >< >C= <= <= <= = ><= >< A= ;< ;< ;?= ;< >== >C= ;C< A< ;B= ;<= ;;< >= ;< >;< >== >?= /9uash# summer.................. >J; &up /trawberries# &anned in syrup ............................. >J; &up fresh ............................. >J; &up /turgeon ............................ B oF. /u&&otash ......................... >J; & u P /ugar# brown........................ > tsp. > tbsp. > &up granulated ..................... > lump > tsp. > tbsp. > &up powdered ...................... > tbsp. > &up maple .............................. > oF. pie&e /weetbreads ...................... > pair# raw &ooked ............................ AJB &up /weet potatoes..................... > medium /wiss &hard# &ooked............ AJB &up or ? tbsp. /wordfish .......................... B oF. /yrup# &orn# table mi:ture .......................... > tbsp. Tangerine ........................... > Tapio&a# granulated# dry .. > tbsp. Tea# without sugar or milk Thousand Island dressing > tbsp. Tomato &atsup...................... > tbsp. Tomato# med........................ > Tomatoes# fresh or &anned >J; &up Tomato )ui&e ..................... >J; &up Tongue# beef....................... B oF. Tris&uit .............................. > wafer ;" s9. Trout# brook ........................ B oF. lake ............................... B oF. Tuna fish: &anned in oil................... >J; &up &annedno oil................ >JB &up or > pie&e# > : ;>JB : > in. Turkey# dark and light .... B sli&es# A>J ; : ;>J; : >JB in. dark meat......................... B oF# white meat only.............. B oF. Turnip greens...................... >J; &up Turnips# white...................... >J; &up Geal: &hops# lean....................... > med. loin# medium fat.............. > sli&e# ; : 2!J, : >JE in. roast# lean....................... B sli&es# B>J; : ;>J; : >JE in.

121

122

HO !O "O#$! !H% "&'O()%*

alorie s = ;< = A< = > == >= = >= = < = >= = >== ;= = ;; < A < >= = C< >== >C= >C< A= = >== >== ;< ; < >= = alorie s >=<-><< >=< >=< C< >?< >B= >E= >E= <<-C< A<= >== >C= >=<->>< >?< E< C;

0ood Appropriate 2ousehold 4easure Ginegar ........................... > tbsp. Waffles ............................. > waffle# ?" diam. Walnuts# -nglish ............. >J; & u p WatermelonTTTTTT > sli&e# _` : ?` Weakfish .......................... B XM Wheat# $ream of# &ooked .. ;JA &up Wheat# Puffed ;JA &up Wheat# /hredded ............. > /( g# -i"$0i% Wheat flakes %Pep# Wheaties# et&.' ............. ;JA &up Wheat flour# white# patent and whole .................... /ifted >J; &up 7nsifted >J; &up > tbsp. Wheat germ...................... ;JA &up Wheatena# dry.................. ; tbsp. Whisky %>== proof' ......... > oF. Whitefish ....................... B oF. White sau&e ................... >J2 $7P Wild ri&e# un&ooked.......... >J; $7P &ooked .......................... 1J2 &up 6ams .............................. >J; &up 6east# &ompressed# baker8s > tbps. dried# brewer8s and baker8s ....................... > oF. Mwieba&k ....................... A pie&es (44ITI,*/ T, (3P.(!-TI$(3 $(3,5I- $,7*T-5 Alcoholic =everages /&ot&h 1in 5um !randy$ogna& +anhattan +artini Tom $ollins ,ld "ashioned $ordials -ggnog (le !eer 5ye Whiskey .ighball $hampagne Wine %$alif# red' +us&atel or Port %> )igger>.< oF.' " " %> !randy glass' oc.tails

> &ordial glass > pun&h glass$hristmas type > glass > bottle > )igger>>J; oC# > glass > wine glass > wine glass > wine glass

><E

H0W MAN5 52A3S W4LL L0W- AT L464NG A!! T0 5013 L4 27

.ow +(*6 6-(5/ $,734 6,7 (44 T,

your life by redu&ing your weight to normal# and maintaining it there This is a 9uestion that &an be answered# and the answer is a dramati& one. *o matter what your age may be# you &an in&rease your life span by a definite number of years. What8s more# those additional years &an be healthy# happy years# full of things that make life worth livingreally worth living. In the first si: &hapters of this book we have heard the part that diet plays in warding off heart disease and in promoting over-all good health. We have seen how your arteries work# and have dis&overed the nature of the health wre&kerfat. 6ou have been given a program of what foods to eat and what foods to avoid to a&hieve health# by low-fat living. 6ou have learned how to use dietary supplements and how to &ount the &alories# so as to keep your weight at the proper level. (ll of these things have been given to you for one purposeto show you how to live the low-fat way# be&ause the low-fat way is the key to healthier# longer life. *ow let8s find out how many e:tra years of health and life you &an &ount on# on&e you have followed the low-fat way of life. 123

>;B

6-(5/ 3,W-"(T 3IGI*1 WI33 (44 T, 6,75 3I"-

%ven if you've had a heart attack, the low-fat diet can double your normal span of e2pected years! 4uring the
past >; years# my asso&iates and I have studied the effe&ts of low-fat redu&ing diets on men and women who had survived heart atta&ks. We found that those who followed a low-fat# low&holesterol diet su&h as you have found in this book# and who redu&ed their weight to normal# gained twice as many years of life as the non-dieters who had also suffered heart atta&ks.

.he same low-fat diet may lengthen the life of everyone! The logi&al &on&lusion is that if# as we have seen# &oronary atheros&lerosis is already e:tensively present in the entire population# then this normal-weight-through-diet health program would give an over-all additional five years to every person in the nation. This &on&lusion is borne out by authoritative figures that will be given at the end of this &hapter. The amaFing advan&es of (meri&an medi&ine sin&e >DB<# with all the new wonder drugs# surgi&al innovations# improved treatment te&hni9ues# and publi& programs# have resulted in e:tending the average (meri&an8s life five years. This was a&hieved by the &reative genius of many resear&hers and the e:penditure of billions of dollars. *ow similar results &an be a&&omplished by a simple# intelligent health program# aimed at proper nutrition for &ontrolling weight and at the same time providing better health. (s a physi&ian# I have been fa&ed many times by the tragi& spe&ta&le of a family that will impoverish itself to e:tend the life of an unfortunate vi&tim of &an&er or leukemia only a few months or a year. With these e:amples in mind# it would seem well worthwhile to &onvin&e people as a whole of the urgent ne&essity of maintaining normal weight through proper nutri tion. 6et# being only human# we forget the unpleasant aspe&ts of living unless we have a strong motive to &hange them by &hanging our habits.

7ou can do something about it! That is why I am basing

this advi&e on an appeal to self-preservation. (t any age# it is

6-(5/ 3,W-"(T 3IGI*1 WI33 (44 T, 6,75 3I">;< natural for you to want to stay alive# in good health# as long as possible# and to e:tend your years to the ultimate possible hour. *ow# with what you have learned in this *oo., you can do something a*out it, on your own# with little effort# and with amaFing results in health and longevity. The tables found in this &hapter are based on more than <=#=== individuals studied by insuran&e &ompanies. 3ook at them# and you will be able to see at a glan&e e:a&tly how many years you &an add to your life span through proper nutrition and weight &ontrol.

1deal weight can add more "bonus" years of life! The

figures in the tables are &onservative ones be&ause they are &omputed on the basis of average weight rather than ideal weight. It is &lear that if you aim for ideal weight still more "bonus" years of life &an be yours. !ut you &annot e:pe&t to re&eive this "bonus" without working to earn it. ( wit re&ently observed that it takes more than a plaid waist&oat to keep a &he&k on your stoma&h. (lthough said in )est# there is a great deal of truth to the statement. /u& &ess will &ome through &areful study of the suggestions given here# as well as the &areful and &onsistent appli&ation of them. (nd it is never too late to begin. 3et us suppose# for e:ample# that you are <= years old and markedly overweight. .ow many years &an you add to your life by redu&ing to normal weight and staying that way ( &he&k of our table reveals that if you are more than A= per &ent overweight# you &ould add a little over four-and-a-half years. That is well worth the effort# isn8t it *hat about younger people+ ,ur studies# and those made by life insuran&e &ompanies# all point to the same &on&lusion: -:&essive weight put on in young adulthood# and maintained through life# &arries the risk of shortening life by a frightening number of years. 3et us say# for instan&e# that you are in your early twenties# and are markedly overweight. If you do not redu&e %! ( &! ,(/ *ig0 #' (&1 stay %+(% way# )!0 ( # "($ i*i$i&g

>;?

6-(5/ 3,W-"(T 3IGI*1 WI33 (44 T, 6,75 3I"-

over fifteen and a half years of lifeK Whatever your age# if you are obese# it is important to get your weight down as 9ui&kly as it is safe to do so. This does not mean that you should "fall" for the widely advertised but ineffe&tual and even dangerous redu&ing pills that promise to "melt the fat off" within a few days without mu&h dieting. -very pra&ti&ing physi&ian has at one time or another sadly shaken his head at the spe&ta&le of so many (meri&ans trying to redu&e the 9ui&k and easy way# without sa&rifi&ing their deeply entren&hed dietary habits. The safe way# the effe&tive way# is through the low-fat diet program presented in this book. The low-fat way is the healthy way# the way of longer life. 6ow let => look at the tables! Table ( shows desirable average weights for men ;< and over# a&&ording to height and frame or build. Table ! gives desirable weights for women ;< and over. T(!3- (
D ESIRABLE 8 EIGHTS FOR : EN 29 AND O EER =

Weight in -ounds according to 0rame FAs ordinarily )ressedG 2eight %With shoes on' 0eet 'nches
<

$mall 0rame >>?->;< >>D->;E >;;->A; >;?->A? >;D->AD >AA->BA >A?->BC >B=-><> >BB-><< >BE-><D ><;->?B ><C->?D >?A->C< >?E->E=

4edium 0rame >;B->AA >;C->A? >A=->B= >AB->BB >AC->BC >B>-><> >B<-><? >BD->?= ><B->?B ><C->?E >?>->CA >??->CE >C>->EB >C?->ED

7arge 0rame >A>->B; >AA->BB >AC->BD >B>-><A >B<-><C >BD->?; ><A->?? ><C->C= >?>->C< >?<->E= >?D->E< >CB->D= >CD->D? >EB-;=;

< <
<

< < < < < < ? ? ?

?

; A B < ? C E D >=

>> = > ;
A

N This table is based on numerous +edi&o-(&tuarial studies of hundreds of thousands of insured men. %+etropolitan life Insuran&e $o.'

YEARS LO83FAT LIEING 8ILL ADD TO YOUR LIFE

TABLE B DESIRABLE 8EIGHTS FOR 8O:EN 29 AND OEER= 1# eight in $ounds according to #rame 8,s ordinarily )ressed9 3eight %With shoes on' 0eet 'nches B >> < = < > < ; < A < B < < < ? C < < E < D < >= < >> mall 0rame >=B->>> >=<->>A >=C->>< >>=->>E >>A->;> >>?->;< >>D->;E >;A->A; >;?->A? >;D->BC >AA->BA >AA->BC >AD-><= "edium 0rame >>=->>E >>;->;= >>B->;; >>C->;< >;=->;E >;B->A; >;C->A< >A=->B= >AB->BB >AC->BC >B>-><> >B>-><< >BE-><E

127

5arge 0rame >>C->;C >>D->;D >;>->A> >;B->A< >;C->AE >A>->B; >AA->B< >AE-><= >B;-><B >B<-><E >BD->?; ><;->?? ><<->?D

N This table is based on numerous +edi&o-(&tuarial studies of hundreds of thousands of insured women.

Table $ shows the relationship that e:ists between your age and time of death as they are affe&ted by your weight# and gives the per&entage in&rease in your mortality rate &aused by overweight. It shows &learly that no matter what your age# your &han&es for longer life are greatly redu&ed if you are overweight.
TABLE C ACE AND :ORTALITY AS RELATED TO EXCESS 8EIGHT= ;verweight "en ;verweight *omen 10-!0K 4ore than !0K 10-!0K 4ore than !0K >ACL >C?L ;;AL >>DL >C= ;>< >;D >BC >?B ;=E >AE ><C ><E ;== >BC >?? ><> >D= >B? >?< B= B< >BA >E> >B; >?B >C> >AD ><E <= >A< << >;E >?; >A< ><A >;= ><; >A= >BE ?= 4etropolitan 7ife 'nsurance ompany $tandard Bis. Would =e Bepresented *y 100K in 6ach Bow and olumn N 4erived from statisti&s &ompiled by 4ublin and +arks. Age ;= ;< A= A<

128

YEARS LO83FAT LIEING 8ILL ADD TO YOUR LIFE

Tables 4# -# "# and 1 show the number of years of gain you &an a&hieve by maintaining normal weight. "igures for both men and women are given# and for people who are either markedly overweight or moderately overweight. /tudy these tables &arefully. Their eviden&e is unmistakable. "ind the figures that fit your own age# frame# and weight &ondition. $he&k the normal situation as it applies to you. If you are not &lose to that ideal# begin now to do something about it. 6ou have only good health and more years to gain# and noth ing to lose.
TABLE D :EN "arkedly ;verweight 8?reater .han 30@9 %stimated ,ge of )eath if ;verweight 's 4aintained <A.? <E.; ?;.; ?B.A ?<.E ?C.; ?C.D ?E.B %2pected ,ge of )eath with 6ormal Weight? ?D.B ?D.E C=.> C=.B C=.D C>.< C;.< CA.E ?ains in 7ears of 7ife ><.E >=.? C.D ?.> <.> B.A B.? <.B $ompany.

Age ;= ;< A= A<

B=
B< <= <<

N !ased on

standard risk statisti&s of +etropolitan 3ife Insuran&e T(!3- +-* 4oderately ;verweight F10 to !0KG 6stimated age of )eath if ;verweight 's 4aintained <<.B ?=.; ?B.? ??.; ?C.? ?D.> ?D.D C>.E 6+pected Age of )eath with <ormal Weight? ?D.B ?D.E C=.> C=.B C=.D C>.< C;.< CA.E

Age ;= ;< A= A< B= B< <= <<

8ains in 5ears of 7ife

>A.E

D.? <.< B.; A.A ;.B ;.B ;.=

!ased on standard risk statisti&s of +etropolitan 3ife Insuran&e $ompany.

YEARS LO83FAT LIEING 8ILL ADD TO YOUR LIFE TABLE F

8O:EN

129

Age %$ %) 8 $ 8) *$ *) )$ ))

4ar.edly ;verweight F8reater Than !0KG %2pected ,ge of )eath with 6ormal *eightC<.B ')(# ')(' C<.D C?.; C?.? CC.> CC.? 6stimated age of )eath if ;verweight 's 4aintained ?E.; ?D.< C=.; C>.= C>.? C>.< CA.= CB.? ?ains in 7ears of 7ife 12 #(9 <.< B.D B.? <.> B.> A.;

FB("#1 !& "%(&1( 1 i"? "%(%i"%i$" !* :#% !.!/i%(& Li*# I&"0 (&$#

C!,.(&).

TABLE G
8O:EN "oderately ;verweight 8A0 to 30@9 %stimated age of )eath if ;verweight 1s "aintained C=.? C=.C C;.> C>.D C;.C C;.E %2pected ,ge of )eath with 6ormal *eightC<.B C<.? C<.C C<.D C?.; C?.? ?ains in 7ears of 5ife

,ge ;=

;<
A=

B.E
B.D B.= A.E 22

A<
B= B< <=
<<

A.? A.< ;.E

CB.A
C<.?

CC.>
CC.E

? !ased on standard risk statisti&N of +etropolitan 3ife Insuran&e $ompany.

WHAT ABOUT CIGARETTESSHOULD YOU STOP SMOKING+

/ +,2I*1 I/ T.- !75*I*1 X7-/TI,* of the day. -veryone wants to know# for &ertain# the answer to this 9uestion: "What is the effe&t of smoking on my health " "To smoke or not to smoke" is a fre9uent topi& of &onversation of the more than >== million (meri&an smokers. 7ntil re&ently# the publi& has been as &onfused as the medi&al profession was in the past. *ow overwhelming eviden&e on the harmful effe&ts of e:&essive use of toba&&o &an no longer be disregarded. In spite of all this eviden&e# however# the publi& is either un&ertain or resistant. This is perfe&tly e:emplified by my patient# +r. 5. .e was suffering from "toba&&o angina#" an old term used to des&ribe &hest pains in &oronary artery disease indu&ed in his &ase by e:&essive &igarette smoking. "4r. +orrison#" he said# "I guess I should stop smoking# what with all the news paper stories on the relationship of e:&essive &igarette smoking and &an&er of the lungs. !ut I play golf with my family do&tor# 4r. 0# who is a &hain smoker# and I noti&e my dividends from investments in toba&&o sto&ks keep going upK *ow# if &igarettes are harmful to health# why do so many do&tors &ontinue to smoke and why does the (meri&an publi& smoke more and more " >A=

SHOULD YOU STOP S:OKINGG

131

moking has been with us for a long time! The smoking habit is known to be deeply ingrained from the very dawn of man8s history. (r&heologists tell us of their finding eviden&e of smoking pipes among the /outh (meri&an Indians in GeneFuela# ?#=== years before $hrist. The legendary origin of the birth of toba&&o and the "toba&&o habit" is even told &harmingly in 1reek mythology. Meus was ban9ueting with his gods and goddesses on +ount ,lympus. 4uring the dan&ing after the ban9uet# Gul&an# the god of fire# forging and smelting# was urged to dan&e. .e was ashamed to dan&e# however# be&ause of his hun&hba&k# and his fear of ridi&ule. In his nervousness and embarrassment he sought &omfort by lighting his pipe with a burning &oal and filled ,lympus with a dense &loud of foul toba&&o smoke. Meus was enraged at Gul&an8s e:tremely bad behaviour. .e &ast a thunderbolt at the pipe# whi&h smashed it and spread bits of the pipe and the toba&&o all over the world. 5ain then fertiliFed the seed and the toba&&o plant grew lu:uriantly forever afterK ,ne of my patients# +rs. (# tells me she is &ompletely at a loss as to whi&h do&tors and statisti&ians to believe. /o many seem to be in &omplete disagreement on the harm from smoking. I tell her that differen&es in opinion make medi&al meetings and horse ra&es possible# and that virtually the same &ontroversy raged over A<= years ago. In >?=B# 2ing Iames I was an:ious to improve the health and well-being of his loyal sub)e&ts. (fter &areful medi&al advi&e from his &ourt physi&ians he issued the following frightening but delightful pro&lamation on toba&&o: "( $ustom loathsome to the eye# hateful to the nose# harmful to the brain# dangerous to the lungs %itali&smine'# and in the bla&k stinking fumes thereof# nearest resembling the horrible /tygian smoke of the hell pit that is bottomlessJ8 The king8s apparent first-hand knowledge of hellfire is a triumph of the imagination. ( little later# in >?ED# the +edi&al /&hool of Paris studied

>A;

/.,734 6,7 /T,P /+,2I*1

and reported the effe&ts of toba&&o smoking upon health and its influen&e on the span of life. They &on&luded and maintained for long after that toba&&o definitely shortens life# and that it &auses &oli&# diarrhea# 3ulcerations of the lungs,3 asthma# &oughs# "pains in the heart#" undernourishment and impoten&e. -nough to frighten even the stoutest of "ren&hmenK 6et despite the death penalty for toba&&o smoking# imposed by many kings and rulers in the >?th and >Cth &enturies# smoking flourished. The reason# apparently# was and is that it is an ingrained part of man8s very so&ial life. It is something that must be &on 9uered by intelligen&e and will-power. ,therwise it be&omes a bio-&hemi&al as well as so&ial "addi&tion."

*hat is the truth about smoking+ 3et us now e:amine the

toba&&o habit in the light of modern s&ientifi& knowledge# and group the advantages and disadvantages of smoking as# "good# bad# and indifferent."
THE USE AND ABUSE OF TOBACCO

.he agreeable effects of smoking! /moking toba&&o is

known from time immemorial to produ&e the following agreeable and en)oyable rea&tions: >. /moking is part of the so&ial life from the days of primi tive man. It introdu&es a note of friendliness# rela:ation# and so&iability. It often &reates a subtle bond between strangers# or may help "&ut the i&e" in a hostile atmosphere. It has its origins in an&ient rites and religious &eremonies and so is most wel&ome to both primitive and &iviliFed man on so&ial o&&asions. To e:tra&t every possible en)oyment and benefit from toba&&o# man has smoked it# swallowed it# &hewed it# drunk &on&o&tions of it# gargled it# sniffed it up his nose# li&ked it during &eremonies# smoked it through the nose instead of the mouth# used enemas of it# applied poulti&es of it# and healed wounds with it. +an has even used toba&&o to &ommit sui&ide and murder. *ow hundreds of thousands# probably millions# of people the world over earn their "daily bread" thanks to toba&&o.

/.,734 6,7 /T,P /+,2I*1 >AA ;. /moking "soothes" the nerves for many people# and will often help tide them over an:ious periods of emotional &rises. A. /moking often is used to relieve pain and sho&k# as seen after an a&&ident# in war# or in disasters. It may a&t for many as a sedative and even permit the smoker to go to sleep after a smoke# whi&h might have been impossible without one. /ome of my patients who were addi&ted to smoking &ould not sleep through the night without getting up at least on&e during the night for a smoke. %+ore about this later.' B. /moking is known to &ause a "&ooler" sensation in the skin due to the temporary &onstri&tion or tightening up of the blood vessels in the skin of the body. This temporary "&ooling" sensation is momentarily wel&ome in times of hot weather or when people are nervous# e:&ited or generally "hot under the &ollar." <. /moking may# temporarily# give en)oyment by the a&tion of ni&otine# &oal-tars# or other ingredients &ontained in toba&&o# by the resultant rise in blood pressure# in&rease in heart a&tion# release of adrenalin# and &onse9uent in&rease in blood sugar. These latter physiologi&al and pharma&ologi&al effe&ts often &ause a temporary feeling of lightness or light-headedness# mental &larity# and what appears to feel like in&reased physi&al and mental effi&ien&y. ?. /moking after meals has been &onsidered one of the most en)oyable aspe&ts of dining. "or &enturies# it has been regarded as an aid to digestion# and a fitting end to ea&h meal. -ven in ><DD# .enry !uttes# in his "4yets 4ry 4inner $onsisting of eight severall $orses" pla&ed toba&&o as the last &ourse of the meal# be&ause of its value in over&oming "sorrow# pain# and &onstipation." C. /moking often establishes a habit# whi&h# like other habits# gives a &ertain sense of se&urity and e:pe&tan&y to many people who look forward to their "smoke." It may give a rhythm-like pattern to daily living# )ust like the rhythm involved in smoking a &igarette# &igar# or pipe@ a kind of "ebb and flow" in the breathing pro&ess itself.

>AB

/.,734 6,7 /T,P /+,2I*1

.he indifferent effects of smoking! +illions of people

smoke toba&&o merely as an in&idental habit# whi&h they adopt solely to be so&iable in the business world. 3ike some of my patients who may be businessmen# salesmen# or in other walks of publi& life# they smoke to put their business asso&iates# &ol leagues# &lients or &ustomers at ease. /ome of my patients# following my &aution# will merely light the &igarette ne&essary for so&ial or business amenities# keep it burning# and simply hold it without smoking. /imilarly# the woman who smokes at a bridge game# or who smokes after meals to keep their husbands or friends "&ompany#" &an "take" smoking or "leave it." These smokers usually do not smoke to e:&ess and fre9uently avoid the to:i& effe&ts of toba&&o smoking. It is very easy for them to stop smoking and when they have done so# they rarely miss it. (s a rule# these individuals have strong will-power and are not "&ompulsive#" as habitual smokers are apt to be.

.he effects of smoking on health! Toba&&o is a poison. If

you were to &onsume ; or A &igarettes# the effe&t might easily prove fatalK This is be&ause ni&otine# one of the main ingredients of toba&&o# is an old established to:in# or poison# affe&ting the brain# the heart# and other vital organs. The toba&&o plant is dire&tly related to the deadly nightshade family of plants. The average &igarette weighs one gram and &ontains only from > to ; per &ent of ni&otine>== to ;== milligrams %thousandth of a gram'. The lethal dose of ni&otine re9uired to kill a man usually is only from ?= to >;= mgK In smoking a &igarette the average amount of ni&otine inhaled is generally about ; milli grams. There are thousands of &ases of sui&ides# a&&idental deaths# and murder re&orded in the 7nited /tates by the 7./. 4epartment of $ommer&e# !ureau of $ensus# as a result of &onsuming ni&otine preparations. /ome investigators have found that only a few drops of ni&o tine base kills wild animals# su&h as the lion or wolf# within a few se&onds. /ome animals# like sheep# &an tolerate large

/.,734 6,7 /T,P /+,2I*1 >A< doses of toba&&o. "ortunately# the body e:&retes or gets rid of ni&otine rapidly# not allowing the average amount inhaled to a& &umulate# unless heavy or e:&essive smoking is indulged in. If the latter is permitted# then the &lini&al symptoms of ni&otine poisoning often o&&ur# even in the habitual# heavy smoker# who

may have developed some toleran&e to ni&otine.

-ven when the &igarette is not &ontinually inhaled# there is still at least about >J; to ;JA of the ni&otine absorbed into the system through the lining of the mouth# the tongue# and the saliva. (side from the &hief poison# ni&otine# there are other wellknown poisons present in toba&&o: &arbon mono:ide %when toba&&o is burned'# arseni&# and &oal tar substan&es are some. The latter &ontribute to the formation of &an&er of the mouth# the esophagus %the gullet' and the respiratory tra&t# in&luding the laryn:# bron&hial tubes# and the lungs. 3et us &onsider some of the a&tions of these poisons that may o&&ur in man from e:&essive toba&&o smoking.

.he effect of smoking on the heart! 3ike many other

physi&ians# in my ;< years of pra&ti&e I must have treated literally thousands of patients who at one time or other suffered from symptoms of some degree of toba&&o poisoning. /ome were dramati&# some resistant# some funny and some tragi&. 7sually the to:i& effe&ts on the heart will be noti&ed by the patient from "skipped" heart beats or palpitations of the heart# nervousness# or a rapid heart rate often produ&ing diFFiness# shortness of breath# espe&ially on e:ertion# heada&hes from rises in blood pressure# or pains and distress over the front portion of the &hest. (s des&ribed in $hapter A# I had the opportunity of study ing the effe&ts on the heart of various stimuli in a series of volunteers. I e:amined the effe&ts of stoma&h distention on the heart through an apparatus I devised at the time# as published m the Iournal of the (.+.(. ,ne male patient of mine# in parti&ular# was an instru&tor in our own medi&al s&hool# and had

>A?

/.,734 6,7 /T,P /+,2I*1

a mild &ase of &oronary artery disease. This showed itself by &hest pain after e:ertion or e:&itement. ( habitual smoker# he had improved so greatly under treatment# whi&h in&luded his abstaining from toba&&o# that he was now it&hing to get ba&k to the "weed". In order to demonstrate to him the effe&ts of smoking on his own heart# I asked him to resume smoking for one test period# a habit whi&h I had asked him to stop# be&ause of his angina. (fter smoking and delightedly inhaling two and one-half &igarettes he developed severe anginal pain over the &hest# whi&h refle&ted itself in striking abnormalities in his ele&tro&ardiogram# whi&h I was running &ontinuously during the smoking e:periment. "ortunately# I abolished the anginal pain immediately by pla&ing a tablet of nitrogly&erine under his tongue. This rela:es and dilates the &oronary arteries promptly# thereby stopping the pain. This e:perien&e has been redupli&ated in &ountless patients# sin&e it is well known that toba&&o will produ&e pain and emharassment of the heart when it is already damaged or weakened by some &ondition# parti&ularly &oronary atheros&lerosis. .ere additional &onstri&tion of the &oronary arteries by toba&&o smok ing# in the already narrowed passageways of the &oronary arteries# &an lead to further damage to the heart. The term "toba&&o angina" or "toba&&o heart" was originally employed to des&ribe these &hest pains due to the to:i& effe&ts of toba&&o on the heart. 3ike many physi&ians# I advise my patients with heart &ondi tions to refrain from smoking# even in moderation# be&ause of the in)urious effe&ts of toba&&o on their hearts. The blood pressure is known to rise on an average of AE points %the systoli&# or higher one' in patients with normal but unstable# sensitive blood pressure. (nd in patients with high blood pressure# toba&&o smoking in moderate to heavy amounts has a strong tenden&y to send the blood pressure even higher than the above mentioned AE points.

3ow smoking affects the blood vessels! "or many years

/.,734 6,7 /T,P /+,2I*1

>AC

s&ientists and physi&ians have studied the effe&ts of smoking on the peripheral blood vessels# i.e.# those parti&ularly in the hands and legs. These studies were &arried out by all kinds of ingenious instruments that measured the rate of blood flow# the temperature of the tissues around the blood vessels# the degree of narrowing and opening or &onstri&tion and dilation of the blood vesselsin all siFes and lo&ationsas influen&ed by smoking. (s a result of these studies it is thoroughly established now that toba&&o &auses a marked interferen&e with the &ir&ulation in the hands# the feet# and the legs. These findings# of &ourse# though very important# are not new to the pra&tising physi&ian# who has seen numerous instan&es of disease of the blood vessels &aused by e:&essive smoking# mainly through prolonged spasm and &onstri&tion of these peripheral blood vessels. *i&otine is the most no:ious substan&e that &an effe&t the blood vessels in man. This is aptly demonstrated in &ertain diseases su&h as !uerger8s disease %a &ondition of obliteration of the blood vessels# usually in the legs' whi&h not infre9uently re9uire amputation due to gangrene. /till another disease as so&iated with the e:&essive use of toba&&o is 5aynaud8s /yn drome# a &ondition &hara&teriFed by spasm of the small blood vessels in the hands# feet# nose# &heek# and ears. Patients with this disease suffer from blan&hing of the skin and lo&al pain after e:posure to &old# an:iety# fatigue# physi&al pressure# or sho&k. This &ondition may lead to other diseases of the blood vessels. In the &onditions of peripheral arterios&lerosis and atheros&lerosis# espe&ially of the legs# ni&otine has been shown to aggravate and in&rease the &onstri&tion already present in the peripheral blood vessels of human sub)e&ts. Patients with this &ondition are far better off without toba&&o.

*hat smoking does to the digestive tract! +any people

en)oy a good smoke after a meal. They get the impression therefore that smoking aids the digestion. ( host of s&ientifi& studies

>AE

/.,734 6,7 /T,P /+,2I*1

&arried on over a generation# however# are unanimous in demonstrating that toba&&o is an irritant to all parts of the digestive tra&t# and often influen&es pathologi&al or diseased states in it. In the mouth# one of the most dangerous rea&tions to smoking has been "smokers" or geographi& tongue. In this &ondition# the tongue is marked up like a geography map and is very prone to &an&er# whi&h may spread from the tongue into the mouth. Toba&&o smoking to e:&ess is well known to pre&ipitate and redu&e the amount of ne&essary salts and enFymes in the saliva and the mouth# dis&oloring and affe&ting the enamel of the teeth. +u&h work is thus given to dentists and their assistants who must spend &ountless "man-hours" in &hopping and ha&k ing# drilling# and polishing away the in)urious effe&ts of toba&&o on the teeth. Toba&&o is often used to "kill hunger" or stay the appetite. !y &utting the appetite down it &an redu&e weight. In those who have not developed a toleran&e to toba&&o# it will produ&e nausea and even vomiting %as witness many a boy8s first attempt at smoking'. /ome ;= years ago I studied the effe&t of toba&&o and al&ohol on the stoma&hs of two series of patients who were heavy smokers and al&oholi&s. These investigations were &arried out through a gastroe&ope# whi&h is a long# fle:ible tube that is passed through the mouth into the stoma&h. Through a series of ;D lights and prisms in the tube the interior of the stoma&h &an be inspe&ted. (s published subse9uently# my asso&iates and > found that a "gastritis#" or lo&al inflammation of the stoma&h# is often produ&ed by smoking# due to the absorption of ni&otine into the saliva and se&retions of the mouth. These drain into the stoma&h and a&t as lo&al irritants# produ&ing inflammation# &atarrh# and interferen&e with normal fun&tions of the digestive )ui&es and stoma&h movements. /toma&h ul&ers# in parti&ular# are aggravated by smoking# and it has always been my pra&ti&e to forbid it in all patients suffering from a&tive ul&ers of the stoma&h.

/.,734 6,7 /T,P /+,2I*1 >AD

.he relationship of tobacco smoking and cancer of the lung! The in&rease of &an&er of the lung in re&ent years is phenomenal. +any s&ientists# physi&ians# and statisti&ians have presented eviden&e showing that toba&&o smoking is &losely asso&iated with &an&er of the lung %as well as in the laryn:'. This has tou&hed off a &ontroversy that has raged in medi&al meetings# medi&al# )ournals# and the publi& press. !riefly stated# medi&al s&ientists and statisti&ians# su&h as those represented by the (meri&an $an&er /o&iety# have shown the following striking figures on the death rate from &an&er of the lung: %a' +oderate &igarette smokers# from >= to >< &igarettes daily# have < times as many lung &an&ers as non-smokers. %b' .eavy &igarette smokers# from >? to ;< &igarettes daily# have 1/ times as many lung &an&ers as non-smokers. %&' -:&essively heavy &igarette smokers# from ;< to <= &igarettes daily# have 2/ times as many lung &an&ers as non-smokers. moking is not necessarily the sole cause of lung cancer! The fa&t that a goodly number of deaths from &an&er of the lung o&&ur in non-smokers indi&ates that toba&&o smoking is not ne&essarily the sole &ause of lung &an&er. (dditional fa&tors asso&iated with &an&er of the lung are: air pollution# engine e:haust fumes# road dust# and industrial to:ins. These are also heavily suspe&t as &ontributing fa&tors. Prominent among fa&tors involved in &an&er of the lung are so-&alled "&ar&inogeni&" substan&es %&an&er-produ&ing'. These are linked to the &oal tars released in the burning of the &igarette. (pparently about <= per &ent of the solid parti&les inhaled in the toba&&o smoke are deposited in the bron&hial tubes# and in&lude ni&otine# &oal tars# and many other produ&ts. These a&t not only as irritants# produ&ing the well known smoker8s &hroni& &ough# but are &onsidered by many as the sole &ause of &an&er of the bron&hial tubes and lungs.

>B=

/.,734 6,7 /T,P /+,2I*1

!e&ause of the alkaloids %poisons' and irritants in &igar and pipe toba&&os# the smoker does not ordinarily inhale them# in sharp &ontrast to the &igarette smoker. The result is a very marked redu&tion in the in&iden&e of &an&er from the smoking of pipes and &igars. (s &ompared to the non-smoker# pipe and &igar smokers have# as a &onse9uen&e# only a slightly in&reased sus&eptibility to &an&er of the lungs. This slightly in&reased sus&eptibility among pipe and &igar smokers# however# be&omes greater in the &hroni&# e:&essive# heavy smoker. .ere we see an in&rease of o&&urren&e of &an&er of the lips# mouth# tongue# and gums. !y e:&essive# heavy smokers is meant those who smoke from >= to >< or more &igars daily# or over <= grams of pipe toba&&o. %5emember that the average &igarette weighs about one gram.' The attempt to redu&e the ni&otine or &oal tar &ontent of smoking toba&&os by means of filters# deni&otiniFed &igarettes and the like# has not been very su&&essful to date. The to:i& effe&ts of the smoking toba&&o are still present# though redu&ed from >= to A= per &ent. The toba&&o &ompanies have laun&hed powerful &ounter at ta&ks and heavily subsidiFed &ampaigns of advertising to &ountera&t eviden&e of the relationship of toba&&o and &an&er of the lung. The fight has largely devolved in a battle of statisti&s. If the reader will forgive the repetition# it has been pointed out by +ark Twain and +arilyn +onroe that "figures are often misleading." I therefore would like to fall ba&k on my own e:perien&es with &an&er of the lung and laryn:# when I was assistant many years ago in the early days of my pra&ti&e# to 4r. $hevalier Ia&kson and his son# at the famous Ia&kson $lini& in Phila delphia. 4r. $hevalier Ia&kson# one of the greatest do&tors of &ontemporary times and now in his nineties# was virtually the dis&overer and &reator of an entirely new s&ien&e &alled bron&hos&opy. .e developed and invented many new instruments or bron&hos&opes %hollow metal tubes' that &ould be

/.,734 6,7 /T,P /+,2I*1

>B>

passed into the lungs and enable do&tors to remove foreign ob)e&ts swallowed into the lungs. Thousands of swallowed &oins# buttons# stones# glass# bones and what-not have been removed from the &hest by the bron&hos&ope# thus saving the lives of &ountless grateful patients. (mong the other uses of the bron&hos&ope is its ability to inspe&t the interior of the bron&hial tubes and lungs for &an&er. (fter seeing hundreds of vi&tims of &an&er of the lung who passed through the &lini&# I be&ame utterly &onvin&ed# like 4r. Ia&kson and his son# that e:&essive toba&&o smoking was an important &ause in most &ases of &an&er of the lung. The &lini&al impression of this fa&t was so overwhelming that no amount of statisti&al &al&ulations and mathemati&al figures &ould shake it. With very few e:&eptions# patient after patient who were vi& tims of the disease gave the same monotonously tragi& history of &hroni& toba&&o habit. /o# in &on&lusion# don8t let your own &on&lusion be made by e:&essive toba&&oK 3ow can you stop smoking+ Perhaps the best insight into ".ow to /top /moking" is +ark Twain8s &omment: "It8s easy to stop smokingI8ve done it hundreds of times"K "4o&tor#" a harassed advertising e:e&utive patient of mine said desperately# "I8ve tried so hard for five years now to give up this awful smoking habit# whi&h I know is so harmful to me# but I )ust &an8t seem to be able to. If I stop or even try to# I be&ome so nervous that living with me is utterly impossible. I &an8t even live with myself. I &an8t sleep# I &an8t &on&entrate# I &an8t do my work properly# I tremble and go around like /hakespeare8s young lover# Nsighing like a furna&e#8 life doesn8t seem worth living. I8ve tried everything I know or hear of hypnosis# auto-suggestion# pipes# prayer# preparations on my tongue to make smoking taste bitter# "gimmi&ks" of all kinds but I always &ome ba&k to these&igarettes. What can I do " /igmund "reud# the founder of psy&hoanalysis# was trained originally as a pharma&ologist# and was an inveterate# heavy &igar smoker. 7ndoubtedly# this habit &ontributed to his death

>B;

/.,734 6,7 /T,P /+,2I*1

and great suffering from &an&er of the mouth and throat. .e re&ogniFed his addi&tion to &igar smoking and its to:i& effe&ts on his heart. 6et after stopping several times# he &ouldn8t hold out any longer and found it impossible to work or &on&entrate without smoking. In a letter to a friend he des&ribes this &raving as follows: "I have started smoking again sin&e I still missed it after >B months8 absen&e# and be&ause I must treat that mind of mine decently, or the fellow will not wor. for me#3 %Itali&s mine.' (nd still later he wrote# "It was impossible for me to entirely stop smoking# be&ause of my present burden of theoret i&al and pra&ti&al worries." $learly these vi&tims of my "lady ni&otine" have be&ome "addi&ts" of toba&&o# and are addi&ted to it like so many other unfortunates who &annot live without opium# sedatives# or mari huana. The moment they stop toba&&o they develop "with drawal" symptoms that &an be truly distressful and even agoniFing. 3u&kily most smokers are not addi&ts enslaved by toba&&o. They &an break or modify the habit# so that it be&omes harmless although still yielding en)oyment.

HH you must smoke, at least cut down on the number of

cigarettes! +any patients who find they &annot or will not give up smoking are like +r. 4. .e told me# "4o&tor# you want me to give up smoking for my health8s sake. 6ou know# I have very few pleasures in life. I have to work hard to support my family# have no hobbies# and I must diet to redu&e my heavy overpoundage. $ouldn8t I )ust 8&ut down8 from one and one-half pa&ks of &igarettes ea&h day# to say# five or si: &igarettes with filter tips and 8ration8 myself this way " (s a rule this is a fairly good solution# although not ideal for many# and it makes it easier for them later to stop smoking entirely# if ne&essary. This "step-by-step" method is also less likely to produ&e severe withdrawal symptoms in many people.

witch from cigarettes to pipe smoking! There are many

ways to stop. ,ne way to do it is to ease into it by the healthful and still satisfying way of swit&hing to a pipe. This method of

/.,734 6,7 /T,P /+,2I*1 >BA gratifi&ation gives distin&tion to some %they look elegant with pipes'# o&&upation to others %keeping the pipe going with mat&hes'# 9uality to others %&onnoisseurs and pipe &olle&tors'# fragran&e to a few %some toba&&os are refreshingly aromati&'# and a feeling of male superiority to still others %few women# smoke a pipe"it8s a man8s )ob"'. ,ne of my patients# +r. P.# who was a &hain smoker of &igarettes# solved his &raving for toba&&o by be&oming a pipe smoker. .e redu&ed his ni&otine intake substantially %one-fifth' in this way. /in&e he no longer inhaled# whi&h both &igar and pipe-smokers do not do# he found life and toba&&o still en)oyable# without suffering from his heart symptoms &aused by &igarette addi&tion. Pipe smoking hag been a wel&ome relief to many of my &igarette or &igar smoking patients# and its in)urious ef fe&ts have proved to be minimal as &ompared to those from &igarettes.

#ind a substitute chewing gum, peppermints! /till

another patient &ould stop smoking only if she kept something sweet in her mouth# like peppermints# &andy or &hewing gum. (fter the dentist protested# she &hanged over to non-sugar&ontaining &andies and en )oy ably substituted and triumphed over her toba&&o habit. I tell some of my patients# like +r. 5.# that he must have a substitute in his mouth su&h as &hewing gum# peppermints or /en-/en# so he sma&ks away merrily all day# feeling fresh# healthy# and with his mouth and )aws working. +rs. I. finds she &uts down and maintains an even temper with her &hildren and husband by a "rationing" program of one &igarette after ea&h meal and one on retiring. /he says she has something to look forward to all the timeK (nother man "&ured" himself of the toba&&o habit by painting the tip of his tongue with a preparation &ontaining silver nitrate. /moking would &ause su&h a bitter# disgusting taste that toba&&o be&ame repulsive to him and he stopped gratefully. This method is similar to that re&ently introdu&ed to &ure al&oholism by using

155

/.,734 6,7 /T,P /+,2I*1

a medi&ine &alled antabuse. If al&ohol is drunk by the al&oholi& while taking antabuse# he be&omes violently si&k and thus de velops an aversion to al&oholi& li9uors.

,n effective approach to the tobacco habit! (n unusual

middle-aged woman patient of mine# who was highly intelligent# edu&ated# and raised in a very religious home %her father was a minister'# &ombined both prayer and auto-suggestion to &ure herself of the toba&&o habit. It was imperative for her to do so# as she suffered from both a stoma&h ul&er and a heart &ondition. The .er&ulean struggle within herself to give up a fi:ed toba&&o habit made her a nervous wre&k and intolerable to live with. /he refused to allow toba&&o to "demoniFe" her life. /he would set aside three daily "self-&ommunion" periods of about >= minutes ea&hon arising# on retiring# and at middaywhen her &hil dren were still at s&hool. 4uring these periods she repeated to herself over and over again her affirmation of abstinen&e from smoking# her determination to abandon toba&&o forever# and her prayers for guidan&e in over&oming the toba&&o habit. The re markable thing about her prompt toba&&o &ure in this way was her &ontinuan&e for many years and up until now# %without thought of toba&&o' of this program of self-enlightenment and self-&ommunion. This has helped immeasurably in her health and in the philosophy and psy&hology of better and healthier living. Today she is a serene and healthy human being# loved and admired and a &onstant inspiration to her family and friends.

#or most, the best cure is the application of will power!

To many patients who wish to stop smoking# /hakespeare8s words are pertinent# pra&ti&al# and simple: "If it were done when 8tis done# then 8twere well it were done 9ui&kly." In other words# will power dire&ted by intelligen&e is still the best way for many people to stop smoking the moment they have de&ided to stop. -very day in my offi&e# for the past ;< years# at least a doFen patients ask me# "4o&tor# how shall I stop smoking I8ve tried so many methods before." I tell them: "+r. M.# I want you to take up a new e:er&ise that will make it possible." +r. M. asks e:pe&tantly and delightedly: "Why# 4o&tor# what is this new

/.,734 6,7 /T,P /+,2I*1

>B<

system of e:er&ise " "+r. M.# I want you to -:er&ise your Will PowerK 6ou8ve never used this kind of e:er&ise beforeK" +ost of my patients# however# are like President -isenhower. .e told a news &onferen&e %as 9uoted in the <ew 5or. Times for Tuesday# Iuly ;D#>D<C' "The only way I knew how to stop smoking %after the heart atta&k' was )ust to stop." In other words# it all boils down to will power, the &heapest &ommodity in the world and the easiest to useif you only will do soK (nd the will to do so must &ome from a motive. The motive is your own health and well-being. *ow ni&otine is a well-known poison# as is demonstrated to every medi&al student in his se&ond year of s&hooling by personal testing in the laboratory. /o every heavy smoker takes a little poison daily. It gives him a momentary pi&k-up and nervous tension release# but the subse9uent rea&tion is a slowdown in mental or physi&al effi&ien&y. +any of my patients suffer far-rea&hing effe&ts on the blood vessels of their hearts and other vital parts of the body. I shall never forget the horrible feeling I had when I first attended a large series of &lini& pa tients who suffered from !uerger8s diseasea disorder of the arteries in the legs asso&iated with heavy smoking. +ost of these unfortunate vi&tims were amputees and had lost one or two legs from gangrene. In this &hamber of horrors# one man stands out &learly in my memory. .e had lost both legs and &ould not stop smoking@ he was now about to lose his arm. !ut +r. 0. stoutly maintained he would rather die than give up smoking. .e simply &ouldn8t do it. (nd die he didK ,f &ourse# !uerger8s %or smoker8s' disease &laims &omparatively few vi&tims. .owever# it is still a good# although e:treme# e:ample of what heavy smoking &an do to your blood vessels. +ost of us# however# are not +r. 0.# willing to sa&rifi&e health or life for a fi:ed habit. We now know that heavy smoking# parti&ularly inhaling# is in)urious to the heart and blood vessels and the lungs. /o why not &hange your habit to another safe and pleasant onesay# a pipeor &ut those &igarettes or &igars down to a few daily@ or best of all# "be like Ike")ust stopK

*hat about alcohol+ 3ow does it affect your healthB

(l&ohol is both a blessing and a &urse# a poison and a food# a 8pi&k-me-up8 and a 8lay-me-down8# both an appetite stimulator and a destroyer@ it is truly a mass of &ontradi&tions. The very name whiskey originates from the an&ient 1aeli& word "us9uebrugh"water of lifeK ,ver ?< per &ent of the 7nited /tates population %more than >== million (meri&ans' drink al&oholi& beverages. ,f these# C? per &ent are men and ;B per &ent are women. The o&&asional drinkers total BE per &ent@ ;C per &ent of men and E per &ent of women are regular drinkersthat is# people who drink moderately or heavily at least three times a week. There are over A million heavy# &onstant drinkers# and over C<=#=== al&oholi&s or addi&ts of "hard li9uor". !illions of dollars are spent ea&h year on al&ohol in the 7./.(. alone# more than is spent by (meri&ans for their own health and medi&al &are. (ll figures show the growing in&rease in the drinking habit as part of life and so&ial &ustom in our &ountry. 3et us then take a s&ientifi& look at the 8uses and abuses8 of al&ohol# parti&ularly where our health is &on&erned. >B?

HO8 4,-/ (3$,.,3 (""-$T 6,75 .-(3T.

>B

THE ?GOOD? EFFECTS OF ALCOHOL .he influence of alcohol on the mind! The poet says# "What wonders does not wineK It dis&loses se&rets# ratifies and &onfirms our hopes# thrusts the &oward forth to battle# eases the an:ious mind of its burden# instru&ts in arts. Whom has not a &heerful glass made elo9uent. Whom not 9uite free and easy from pin&hing poverty." ,lcohol not a stimulant but a depressant! The most important &hemi&al effe&t of al&ohol is on the brain and the nervous system. (lthough it is &alled by the publi& a "stimulant#" it is a&tually a depressant that tends to lower inhibitions and results in impulsive behavior. (l&oholi& beverages have been advised in moderate amounts for many years by physi&ians to rela: nervous or high-strung patients# to &alm their an:ieties# and generally to sedate them. Gery often )ust the psy&hologi&al idea of a glass of wine# beer# or whisky is enough to suggest or indu&e rela:ation in many people# parti&ularly at a so&ial fun&tion. (l&ohol is often used as an out-and-out sedative# nar&oti&# or analgesi& to relieve pain or distress or fatigue. !ut in order to avoid to:i& effe&ts# the amount must be kept small to moderate. The temporary release from the nervous and physi&al strains of daily living# whi&h most people get by taking one or two drinks before dinner# is well-known to all. (nd as for that rela:ant drink before bedtimeI pres&ribe it for many of my patients upon whom it a&ts as a helpful sedative. 1t can be useful as a "tonic," (l&ohol is used e:tensively in &ompounding pres&riptions# parti&ularly as a tin&ture. *ot only is it an e:&ellent solvent and preserving agent# but it stimulates the appetite through in&reasing the gastri& )ui&es# it rela:es the stoma&h mus&les# and enables greater 9uantities of food and drink to be taken. In older patients# the pres&riptions &ontaining al&ohol serve additionally as dilators of the blood vessels and seem to be helpful to the &ir&ulation.

158

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T.

(l&ohol in small or moderate amounts is a mild stimulant to the kidneys# &ausing an in&rease in the output of urine. (l&ohol also tends to in&rease the heart rate and the metaboli& rate. (s is universally known# al&ohol is an e:&ellent antisepti&# and e:erts a &ooling effe&t on the skin. ,lcohol as a food! The &alori& &ounts of the various al&oholi& beverages are des&ribed in the &hapter on &alories and are selfe:planatory. ,ne &an readily gain weight by indulging in those e:tra drinks daily. !ut these are "empty &alories" being burned up or o:idiFed in the form of heat and are not developed into useful# healthy bodily tissue. (l&ohol is sometimes given intravenously# espe&ially following surgi&al operations# to supply a &on&entrated form of &alories and energy.

.he effect of alcohol on the circulation! (l&ohol has been

used e:tensively as a vasodilating agentthat is# one that "opens up" and in&reases the flow of &ir&ulation by widening the peripheral blood vessels on the body surfa&es and e:tremities su&h as in the fa&e# the hands# the legs and the feet. Through this vasodilation the rise in skin temperature after two oun&es of whiskey is as great as DV to >;V "ahrenheit. The florid fa&e of the drinker# the red nose of the tippler# and the traditional method of "warming up" with a "few good ones under the belt" are well-known to all of us. *ew drugs have been introdu&ed for vasodilatation in the treatment of arterios&lerosis and atheros&lerosis of the legs and feet and !uerger8s disease# and I have pres&ribed many of them. These diseases often give rise in many individuals to severe pain or &rippling effe&ts %even gangrene' of the legs and feet# parti&ularly if &ompli&ated by other illnesses su&h as diabetes or simply by advan&ing years. In my e:perien&e# none of these new drugs has mat&hed the physiologi&al effe&ts on the peripheral &ir&ulation that al&ohol gives. I have seen and helpfully treated with al&ohol many sufferers from arterios&lerosis of the legs who were unable to walk and at times fa&ed gangrene and amputation of the toes

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. >BD or feet. .owever# to be effe&tive the al&ohol must be given )udi&iously at fre9uent intervals# in the &orre&t amounts and in &ombination with other vitamin and dietary supplements. This must be done in a manner best )udged only by the physi&ian# be&ause of the fre9uently deli&ate balan&e in whi&h the peripheral &ir&ulation is maintained. This varies from person to person. The fa&tor of al&oholi& addi&tion must be &onstantly kept in mind by physi&ian# patient# and family. The needs of ea&h individual &ase should be determined by the do&tor and )udged a&&ordingly.

,lcohol can be used to improve circulation- 3ike many

other do&tors# I have found the use of al&ohol in moderation to be an e:&ellent means of improving the &ir&ulation. ,ne patient of mine# +r. I.# is a BE-year-old su&&essful advertising e:e&utive who is sub)e&t to an unusual amount of tension and harassment in his business. +r. I. was getting severe atta&ks of angina %&hest pain from poor &ir&ulation in the &oronary arteries' every time he had lun&h and supper. It was apparent that he had to eat in order to live# and yet he was afraid to eat for fear of dyingthe anginal pain was so severe. (fter a loss of over A= lbs. and a problem of underweight# > urged +r. I. to take one brandy or whiskey before ea&h meal and to have ; glasses of wine at lun&h and supper. This man had always been a teetotaler@ he had a parti&ular aversion to al&ohol due to a &hildhood broken home &aused by a drunken father. (fter mu&h personal persuasion and great trepidations# +r. I. tried the new "treatment." +ira&ulously# the pain disappeared. *ormal weight was restored and a great &hange took pla&e in +r. I.8s personality. $learly the al&ohol had be&ome an effe&tive "tran9uilliFer." .e was now mu&h at ease# ate his food in a rela:ed manner and en)oyed it# and the anginal pain had disappeared. This &learly showed how nervous tension blo&ks normal digestion and thus pla&es a severe strain on the heart. ,ne of my earliest series of e:periments to demonstrate this

150

HO

+O%* &'"OHO' &,,%"! -O#( H%&'!H.

o&&urred some ;= years ago. I &alled for a group of volunteers among my heart patients. "ive of them volunteered for the e:perimenttwo men and three women of &ourage and with interest in medi&al s&ien&e. (fter two years of &onstant e:perimentation# I devised a series of balloons that &ould be swallowed and blown up in the stoma&h. (t the same time# I &onstru&ted the balloons %made from ordinary toy balloons' so that I &ould measure and &ontrol the pressure in the stoma&h and re&ord the movements of the stoma&h walls. In addition# I arranged matters so that I &ould simultaneously re&ord the heart a&tion by ele&tro&ardiograms. "or the first time it was possible to simulate indigestion and e:amine its effe&ts on the heart. To my great surprise# I was able to measure all kinds of bad effe&ts on the heart from distention in the stoma&h# a very &ommon daily o&&urren&e with many individuals. !ut to my &onsternation# in one of my volunteers# the effe&ts on the heart distention were so dramati& that the heart suddenly stopped beating# and the patient fainted as I almost didK We revived him 9ui&kly by releasing the "gas pressure" in the stoma&h# and of &ourse the heart immediately resumed its normal beating. What a dramati& way to show how a&ute indigestion &an and does kill a personK "ortunately# when the (meri&an +edi&al (sso&iation published the results of my resear&h in its Iournal# it stimulated further resear&h in this field# su&h as that whi&h showed how gallbladder &onditions will also provoke heart symptoms and heart atta&ks. !ut even after reviving my &ourageous volunteer patient# a reviving drink of brandy did mu&h to rela: and improve his &ir&ulationand mine tooK "oderation is the key! *ow all this does not mean that I advo&ate "tippling" or addi&tion to al&ohol. (l&ohol should always be taken with dis&retion and in moderation. In most &ases# "the man who is a drinker before B= is either si&k or a fool." (nd the man who doesn8t take a drink after B= may be&ome either si&k or foolishK

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. ><> There were many pathologists who believed that al&ohol a&ted as a "solvent" in the arteries against &holesterol and the fatty deposits that make for arterios&lerosis and atheros&lerosis. !ut to get the proper amount of al&ohol in the blood stream to indu&e this ideal state would re9uire a &ontinuous al&ohol bath in the arteries# or a "pi&kling" pro&ess# that not only would dissolve the &holesterol in the arteries# but would surely dissolve the liver first. This we see in the unfortunate vi&tims of &irrhosis of the liver asso&iated with al&oholismK /o with al&ohol# as with so many other things# follow the an&ient 1reek advi&e: "(ll things in moderationK"

)oes alcohol in any way benefit the coronary arteries+

"inally# we &ome to the possible benefits of al&ohol on the &oronary arteries. It was formerly thought that al&ohol was benefi&ial in dilating the &oronary arteries and that all patients with heart disease should drink al&ohol regularly. +any patients found from e:perien&e that they had less heart pain# as from angina# if they took al&ohol before and during meals and in between# as often as feasible. 5epeated and re&ent resear&h has found that these results %from drinking moderate amounts of al&oholi& beverages' in relieving &hest pains due to heart &onditions su&h as &oronary artery disease# are not due to any improvement or dilation in the &oronary &ir&ulation of the heart. The relief and improvement in pain was found to be due to two things: >' the analgesi& or "nar&oti&" pain-alleviating effe&t of al&ohol whi&h raises the threshold at whi&h pain is felt# and ;' the ability of al&ohol to allay worry and an:iety and indu&e psy&hi& as well as physi&al rela:ation. This also tends to raise the threshold of pain toleran&e. The analgesi& 9uality of al&ohol has an element of risk involved. /ome heart patients may overe:ert or strain their hearts while under the influen&e of the al&ohol# sin&e it may have removed *ature8s warning signalpainK ,ne of my patients# +r. *.# when he first &onsulted me regard-

152

HO

+O%* &'"OHO' &,,%"! -O#( H%&'!H.

ing his anginal pains following his &oronary atta&k# insisted that a few highballs before his lun&h and his supper diminished the number and severity of his atta&ks of angina. .is wife# who a&&ompanied him to my offi&e# turned to me and said# "!ut 4o&tor# I keep telling Iim that ever sin&e he started taking these highballs# he falls asleep after his meals# and is 9uite groggy even when he awakens from his NnapsZ (nd sin&e he loves to smoke his pipe right after meals# he has already set himself on fire several times when falling asleepK I really think he gets 'drugged? after his highballs. 4on8t you " +rs. *. puts her finger pre&isely on the diagnosti& spot. +r. *.# it was true# felt less pain after his drinks. !ut in +rs. *.8s words# it was an abnormal or 8drugged8 kind of relief. It &ame as a result of the nar&oti& a&tion of al&ohol in deadening his pain# and stupefying his senses. It a&tually did nothing in any way to improve or relieve the strain on his heart.

,lcohol can rela2 tension in heart cases! ,n the whole#

however# I find that al&ohol# when used wisely# is helpful to most heart &ases and is an e:&ellent way to rela: the tension that many heart patients &ons&iously or un&ons&iously e:perien&e.
THE IN@URIOUS EFFECTS OF ALCOHOL

*ow# having &onsidered the benefi&ial effe&ts of al&ohol# we &ome to the in)urious ones. I shall mention here only in passing the well known blights of the e:&essive use of al&ohol on the home# the individual# and so&iety. Golumes have been written on the devastating effe&ts of al&oholi& e:&ess on &rime# sui&ide# divor&e# general misery in the home and to the individual# venereal disease# )uvenile delin9uen&y# traffi& a&&idents# e&onomi& and industrial losses. .ere we are &on&erned only with al&ohol as it affe&ts your health. The effe&ts of al&ohol have been so profound that it is startling to &onsider that the 7nited /tates of (meri&a e:ists today prob ably as a result of al&oholi& e:&essK In the words of the "father

HO8 DOES ALCOHOL AFFECT YOUR HEALTHG 193 of our &ountry#" the !ritish were defeated on 0mas eve# after the epo&hal &rossing of the 4elaware# be&ause "$ornwallisN men had drunk not wisely# but too wellK" What would have happened to the &ause of world demo&ra&y and freedom if Washington8s tattered# froFen# and de&imated men had fa&ed a sober and effi&ient fighting army instead of a band of drunken soldiersK 3et us now &onsider briefly some of the main systems of the body and the effe&ts of al&oholi& damage upon them.

,lcohol can be harmful to the emotions and the mind!

/in&e we began this dis&ussion with the benefi&ial effe&ts of al&ohol on the psy&hi& and mental pro&esses# let us now see what the pharma&ologists like /ollman find in their te:ts on the sub)e&t. The habitual# even moderate# use of al&ohol %not even to the point of into:i&ation' indu&es rela:ation# the easing of strain %tension'# of malad)ustments# of e:&essive inhibitions# indeed euphoria# all of whi&h may be benefi&ial. !ut it also leads to diminished effi&ien&y# espe&ially in a&&ura&y# impaired )udgment# in&reased liability to auto a&&idents# loss of self-relian&e# perhaps diminished resistan&e to disease# danger of e:&esses# higher in&iden&e of venereal disease and general disrespe&t for law and order. In answer to the popular notion that al&ohol is a "stimulant#" the prin&iple that al&ohol is a&tually a depressant was first advan&ed in >EEA by the noted 1erman pharma&ologist# /&hmeideberg. The following 9uotation is from the (meri&an translation by 4o&tors 5. *. .arger# .. 5. .ulpieu and 1. *. Thompson: The sub)e&tive and ob)e&tive states and manifestations# from whi&h al&oholi& drinks are &onsidered stimulants# are usually attributed to the stimulating effe&t of the al&ohol. ,ne refers to the manifestations whi&h we observe under these &onditions# namely to &ertain e:altations of the psy&hi& fun&tions resulting in loud and profuse spee&h# and viva&ious a&ts# also to a&&elerated pulse rate# engorgement and flushing of the body surfa&e and the fa&e# and a sensation of

><B

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. in&reased warmth. .owever# a &loser &onsideration of these manifestations shows that they are the results of a *eginning paralysis of certain parts of the *rain, %itali&s mine'K

/in&e this finding was first e:pressed in >EEA# the idea that al&ohol a&ts as a stimulant to the nervous system has been dis proved in a host of pharma&ologi&al laboratories by &ountless s&ientists. To &ontinue: In the psy&hi& sphere there is first lost the finer grades of attention# )udgment# refle&tion# and ability to &omprehend. This serves to e:plain the typi&al behaviour of persons under the influen&e of al&oholi& drinks. The soldier be&omes more &ourageous sin&e he observes the danger less# and refle&ts upon it less. The speaker is not tormented and influen&ed by the pro:imity of the publi&@ he# therefore# speaks freer and with more animation. ,ne8s self-appraisal rises greatly. ,ften one is astounded at the ease with whi&h he e:presses his thoughts and with the keeness of his )udgment in matters whi&h are beyond his mental sphere when sober# and is later ashamed of this delusion. The drunken indi vidual attributes to himself great mus&ular strength and wastes this through una&&ustomed and useless e:hibits of strength without thinking of the harm whi&h may ensue# while the sober person willingly spares his strength.

This &on&lusion is now verified and a&&epted by all presentday pharma&euti&al e:perts in the field of medi&ine and drugs. -ven the publi& is thoroughly versed in the e:&essive effe&ts of al&ohol in &ausing poor or double vision# the unsteady# &lumsy gait# the impairment of mus&ular &oordination# the delayed rea&tion time# and the loss of normal )udgment and self-&ontrol.

.he effects of alcoholic e2cess! I% is remarkable that the

sour&e of relief with whi&h man most fre9uently seeks to relieve his nervous tension# with whi&h to rela:# should be so free from poisonous or to:i& effe&ts when used in moderation. The fatal dose of al&ohol is often very diffi&ult to determine be&ause of the wide variability of its a&tion and its toleran&e. In those &ases where death has o&&urred from a&ute al&oholism# it usually is impossible to get the e:a&t information from the &ompanions

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. ><< of the departed one# sin&e they have been too befuddled to give an intelligible a&&ount of the events pre&eding death# in&luding the amounts of li9uors drunk. (s a rule# however# to those una&&ustomed to al&ohol# appro:imately ; to A oun&es of al&ohol will result in a&ute symptoms of al&oholism and three times this 9uantity usually produ&es stupor in the average ><= lb. manK ( fatal dose of al&ohol ranges from > pint to > 9uart of whiskey# or E to >? oun&es of pure al&ohol. $hildren seem to have a parti&ular sus&eptibility to a&ute al&oholi& poisoning due to their smaller body weight and low toleran&e. +ost &ases of fatal al&oholi& poisoning will show blood al&ohol levels between =.A per &ent and =.< per &ent@ that is# only a fra&tion of > per &entK The into:i&ating blood level of al&ohol# as generally used in drunkdriving tests# is generally =.> per &ent or only one-tenth of one per centD +edi&al )ournals are filled with reports of silly wagers by would-be heroes an:ious to show their virility and drinking prowess. Their post-mortem studies# after the &oma# show that death is usually due to paralysis of the respiratory &enter# even though the heart may &ontinue to beat for a while after breath ing &eases. In these &ases the brain# when opened# usually has the faint odor of al&ohol# is swollen and often bulges over the edges of the opened skull. &hronic alcoholism! I shall not attempt to dis&uss the so&ial and e&onomi& evils of this disease@ it is universally &ondemned# while being universally talked about. !ut unlike the weather# something is being done about it. A# The *rain9 The &hanges in this organ are often those related to vitamin ! and $ defi&ien&ies. .emorrhages fre9uently are found throughout the &erebral tissue in &hroni& al&oholism. The brain is parti&ularly sus&eptible to in)uries# su&h as a blow on the head. 5upture of the blood vessels with subse9uent death is a fre9uent &lose to an al&oholi& bout where the vi&tim has been lodged in the "drunk tank" overnight at the lo&al )ail# and

><?

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T.

has either fallen on his head or sustained a kno&k on his "noggin." =# Wernic.e's disease# !a&k in >EE># 4r. $. Werni&ke in 1er many first des&ribed three al&oholi& patients with paralysis of the eye mus&les# un&oordinated walk# &louding of the &ons&ious ness and finally# &oma. /u&h &ases are &aused by a destru&tion of &ertain brain tissue and are &ommon. I have had this kind of patient during my ward servi&e in Philadelphia and 3os (ngeles $ounty 1eneral .ospitals. # 4archiafava-=ignani's disease# This is a rather unusual disorder# o&&urring only in those who drink the &ommon Italian red wine without proper food intake and is seen espe&ially in Italy. 4estru&tion of the brain tissue here is also &hara&teristi&# the patient usually being e:&ited# &onfused# and finally psy&hoti&. )# )elirium Tremens# This interesting &ondition was first des&ribed in >E>A by /ir Thomas /utton and is asso&iated with a "wet brain." (n al&oholi& &ompli&ation that is very fre9uent# it is &hara&teriFed by &onfusion# an:iety or terror# auditory and visual hallu&inations# and delusions. /ome patients I have seen and treated for this disorder are obsessed with snakes# others with animals# and still others with people following# wat&hing# or perse&uting them. Giolent tremors and shaking fre9uently )oin with delirious episodes in this devastating form of al&oholi& disease. I shall never forget an e:perien&e during my internship days with an al&oholi& suffering from delirium tremens. .e was in terror of the usual "pink elephant#" animals# and inse&ts &rawling all around him# the walls of his room# and on his own body. This unfortunate man had lost his business and his wife and &hildren. They had to leave him be&ause of his abnormal be haviour and his &hroni& al&oholism. .e had be&ome psy&hoti&# shook like a leaf# and now had severe hallu&inations. When my "&hief %the attending physi&an' and I entered his room at the hospital together with the floor nurse# the patient was lying 9uietly in bed. .e looked up at us and let out a blood-

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. ><C &urdling s&ream. .e leaped out of bed# seiFed the ne&ktie around his physi&ian8s ne&k and tried to yank it off# strangling the do&tor in the pro&ess and letting out a salvo of pier&ing shrieks strong enough to awaken the dead. (fter we had wrestled him free and sedated him# it &ame out that he had imagined the do&tor8s ne&ktie to be a snake. .e had only attempted to yank it free and had heroi&ally tried to save the do&tor8s lifeK The realism of these hallu&inations to the patient with 4.T.8s is patheti&# and their terror and suffering tragi& to see. 6# -olyneuritis# This most fre9uent &ompli&ation of &hroni& al&oholism is &aused spe&ifi&ally by &hanges or destru&tion# in the peripheral nerves of the body due to la&k of vitamin !. The feet are usually numb# tender# or painful and fre9uently para lyFed so that walking may be&ome impossible. This is &alled "foot drop#" and is often asso&iated with other &ompli&ations of &hroni& al&oholism. 0# Aorsa.offs -sychosis# This disease is also believed to result from a vitamin defi&ien&y and is a most &urious one. The patient is highly suggestible to any idea and is &ompletely with out any )udgment regarding its &redibility. .e tells in&redible stories that outdo !aron +un&hausen@ he &an imagine the tallest of tall tales. ,ne &ase of this biFarre &ondition that stands out in my memory is that of a waiter whom I took &are of some ;< years ago. .e had been a &hroni& al&oholi& for many years and was installed in the psy&hiatri& ward for observation and &ommitment. ,ne day# during my ward rounds# he informed me that he had )ust learned I was leaving for 3ondon# on a fellowship in medi&ine and wished me good lu&k. Then to my surprise he dis&ussed and advised me in the greatest detail imaginable about many of the hotels in 3ondon and their advantages and disadvantages for an (meri&an. .e knew with the knowledge of a &onnoisseur the virtues of &ertain restaurants and pubs# transportation fa&ilities# entertainment spots. .e reminis&ed fondly over many en)oyable hours and delightful memories of his life in

><E

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T.

3ondon. (nd yet his family assured me with utter finality that he had never left the 7nited /tates# and was never seen to read a bookK In the &ase of this psy&hoti& patient# it was his e:traordinary imagination that gave to his stories the ring of &onvi&tion and truth. I finally dis&overed that this patient had worked for years with a bartender at a restaurant. 4uring slow periods many an hour was passed drinking with this bartender# a "$o&kney" who regaled my patient with endless reminis&en&es of his life and e:perien&es in 3ondon. !ut the patient# who was e:&eedingly suggestible %like many normal individuals under hypnosis'# believed &ompletely that he himself had lived through these past e:perien&es of another person.

*hat does alcohol do to the liver+ $irrhosis of the liver is

a se9uel to &hroni& al&oholism. It is basi&ally a nutritional dis ease# brought on by inade9uate and improper diet &oupled with e:&essive al&oholi& intake. In this disease# the liver is usually swollen and enlarged at first# but later it be&omes small# shrunken# and atrophied. It is a&&ompanied by a series of signs and symptoms that are &hara&teristi&. These range from nervousness# fatigue# dyspepsia# vomiting and passage of blood# &hest and abdominal pains and swelling# to )aundi&e# &oma# and death. /ome years ago I introdu&ed a program of treatment for this &ondition based on a high protein diet# nutritional and vitamin supplements# and &ertain in)e&tions of liver and vitamins. I reported in various medi&al )ournals the results of this temporarily effe&tive treatment for over >== &ases with this disease# and it was used e:tensively by physi&ians in the &ountry and abroad. Psy&hiatri& &are did not help in D< per &ent of the &ases I have des&ribed. .owever# (l&oholi&s (nonymous was a tremendous help in at least half of them# a striking demonstration of the value of group psy&hotherapy and a blessing to &ountless unfortunate vi&tims.

.,W 4,-/ (3$,.,3 (""-$T 6,75 .-(3T. ><D +oderation in drinking al&ohol is a term with very wide latitude. /ome people have only to take the proverbial whiff from the &ork of a whiskey bottle# and they already feel 8giddy.8 ,thers seem to have the 8hollow wooden leg#8 and feel no effe&ts from al&ohol unless they have had < or >= times the amount re 9uired by the average person to feel their drink. 7sually# an average of one or two highballs or &o&ktails# or glasses of wine or beer# on&e or twi&e a day is regarded as drinking in moderation. The main thing to remember is that drinking is not to be indulged in to the point of e:&ess# where into:i&ation o&&urs# or where the &riti&al )udgment# the physi&al or mental fa&ulties are in the least way impaired or interfered with.

*hat are the conclusions for you+ What are the &on&lusions to be gained from all the des&riptions of these "medi&al &hambers of horrors" /imply that drinking al&oholi& beverages in moderation is a great help to rela: you# to put you at ease from your &ares and worries@ and in general it is good for your &ir&ulation. If you find that you &annot stop at "moderation#" then before it8s too late don?t touch it againD (nd if it is too late for that# then see your do&tor for further help# and )oin (l&oholi&s (nonymousK

*,T 3,*1 (1,# 4(GI4 /.# *,W ( P(tient of mine# was rushed to the hospital after he had &ollapsed during a meeting of his newspaper8s editorial board. .e had had a heart atta&k. The people who work with 4ave# and those who knew him well# were astonished and a little frightened. ".e8s younger than I am#" said the publisher apprehensively. "(nd a real dynamo. !est &ity editor I ever had. I didn8t know he had heart trouble." 4ave didn8t know it either. There were some premonitory signs of trouble# it is true. !ut 4ave ignored them or dismissed them lightly. That morning# for instan&e# he had &ome to the offi&e a little earlier than usual to make sure his paper didn8t miss any newsworthy angles in the running story of a big forest fire that was raging not far from his &ity. The telephones were ringing &onstantly@ there were instant de&isions to be made in &overing the day8s fastbreaking news@ there were several appointments with important peoplea lun&heon engagement with the &hief of poli&e# and an afternoon editorial meeting. 4ave was only B>. .e had &limbed fast in his profession
1 *

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>?>

be&ause# as his publisher said# he was a dynamo. .e felt that he had to keep the flow of news moving like a *iagara of &opy into the presses. 4uring the past week he had not been feeling as well as usual. .e felt a little tired# and had to keep himself going by sheer for&e of will. It was )ust that he needed a little va&ation# he told himself. .e was a little too tense# that was all. That8s why he "boun&ed ba&k" when he got a &han&e to rela: a bit over the weekend. 4ave was late getting ba&k to the offi&e after his lun&heon with the &hief of poli&e. The offi&ial had been detained# and that had thrown 4ave8s s&hedule off &ompletely. /o he ate rapidly and dis&ussed his business with the &hief as he for&ed down his food. .e was not very hungry# but he ate a hearty meal on the theory that he needed the energy to keep going. !y the time he got ba&k to the offi&e# 4ave was a little short of breath and somewhat diFFy. (lso# he was annoyed by a pain in his &hest that o&&asionally ran down into his left arm and hand. .e barely had time to see the fourth edition out before hurrying into the editorial meeting. In the meeting he rela:ed a little in his &hair and felt some what better until the national advertising manager made him angry by &harging that the paper was losing revenue be&ause the editorial department would not support advertisers with lo&al newstories. (t that point# 4ave )umped up and began a heated oration on the responsibilities of the press. (nd )ust as his remarks had rea&hed fever pit&h# 4ave suddenly felt a sharp# pressing pain deep inside his &hest# under his breastbone. !eads of perspiration broke out on his forehead. .e felt nauseated and very weak. .is voi&e faltered and he &ollapsed to the floor. In his 9uiet room at the hospital# after the administration of o:ygen had made his breathing easier# and an in)e&tion of medi&ine had relieved the pain in his &hest# 4ave began to realiFe what had happened. (s a reporter he had on&e been as-

>?;

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

signed to the &ity8s re&eiving hospital# and he re&ogniFed his own symptoms. .e had suffered a heart atta&k. !ut what was going to happen now Patients who had not died at the hospital or who had not been dead upon arrival# were always sent to other hospitals and he never had had o& &asion to follow up the story to see what happened afterward. Was he going to die ,r would he be an invalid the rest of his life# a burden to his family and an ob)e&t of pity to his friends and &olleagues ( generation ago 4ave8s do&tor probably would have given him only slight en&ouragement. "or when &oronary thrombosis first began to be a&&urately diagnosed in the mid-twenties# medi&al authorities regarded a three-year survival period as the best of good fortune. Today the average survival span# whi&h in&ludes the e:tremely bad &ases as well as the good# may be about >= years. /o when I later dis&ussed 4ave8s own &ase with him# I &ould &ite from my own medi&al e:perien&e &ases of patients who are in good health as mu&h as A= years after the atta&k.
HOW AND WHY THE HEART HEALS ITSELF

To understand the real basis for hope# following a heart at^ ta&k# let us look briefly at that vital organ that for &enturies has been referred to in our &ommon language as the sour&e of feeling %as in su&h e:pressions as "heartbreak#" "affairs of the heart#" "heartless#" and so on'. (s you &an see from the a&&ompanying diagrams %see "igs. A and B' the heart is a large mus&le %about the siFe of your fist'# whi&h is divided into four &hambers. The two smaller &hambers at the top of the heart are &alled the auri&les@ the two larger ones at the bottom# ventri&les. The auri&les re&eive that impure blood that is being returned to the heart through the veins. This blood# be&ause its supply of o:ygen is almost e:hausted# appears blue. The larger &ham-

Fig. 3.

H#( % >i&%# i! Ii#2@.

'n this diagram of the inside of the heart, four cham*ers are shown# The two upper small ones FauriclesG receive the venous *lood from the *ody# The right auricle pumps the *lood through a valve into the right ventricle whence the *lood is pumped into the lungs to *e refreshed with o+ygen# 0rom there it flows *ac. into the left ventricle# 0rom the left ventricle, the fresh *lood is pumped through the aorta and its arterial *ranches into all parts of the *ody#

Fig. 5.

Rig+% Si1# !* %+# H#( %.

This diagram shows the interior of the right side of the heart# Eenous *lood flows from the right auricle into the right ventricle# The Aortic Arch is the *end of the Aortic Artery through which the heart then pumps the fresh *lood to all parts of the *ody#

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>?<

bers# or ventri&les# pump the fresh blood# after it has been o:ygenated by the lungs# out through the arteries again# to nourish every part of the body. The heart mus&le itself# of &ourse# has to re&eive nourishment. This is a&&omplished by means of a pair of blood vessels# &alled &oronary arteries# that in diameter are about the siFe of soda straws. They en&ir&le the heart# supplying it with the blood it needs to keep it fun&tioning. When the inner lining %&alled the intima' of these arteries is filled with fatty deposits# they may be&ome blo&ked# &utting off the heart8s own blood supply# and "starving" a se&tion of that vital organ. When this o&&urs# the mus&le &an no longer fun&tion in the affe&ted area. 4epending on the siFe and the lo&ation of the area involved# the result is that the heart is either &rippled# until healing o&&urs and a s&ar forms# or it stops beating altogether and death ensues. When a patient survives a heart atta&k# as 4ave did# the heal ing or repair of the damaged portion is as dramati& as any biologi&al pro&ess known to s&ien&e. This is the way it works: *ature rushes defensive for&es to the s&ene. 7ndamaged arteries now grow buds into the tissues where famine e:ists. Thus a new network of blood vessels gradually spreads through the disaster area# &reating what physi&ians &all "&ollateral &ir&ulation." In this way# the heart "detours" around the road blo&ks that have &logged the &oronary artery. The normal "traffi&" of blood flow may thus &ontinue# and the heart &an go on pumping. The patient survives# and a s&ar of healing grows a&ross the portion of the heart mus&le that was damaged. Treatment following a heart atta&k will vary a&&ording to the nature of the &ase. /ometimes anti-&oagulant medi&ines are used to prevent further blood &lotting. These are used only under the supervision of the do&tor# and after a time are usually dis &ontinued altogether. The diet thereafter must be wat&hed &losely# however. In my own pra&ti&e# as I pointed out in another &hapter# &oronary patients who followed the stri&t diet I devised

166

"&()$/ ,O( -O#(*%', &,!%( & H%&(! &!!&"0

and pres&ribed for them lived twi&e as long as those who did not adhere to su&h a low-fat# low-&holesterol diet. 4uring the &riti&al two-week period immediately following the atta&k# if there are no &ompli&ations# the patient is often allowed to sit up in a &hair. 7sually another one to three weeks of absolute rest is re9uired before limited physi&al a&tivities are allowed. This restri&tion avoids serious &ompli&ations that might develop if any strain is pla&ed upon the heart while it is healing. The ele&tro&ardiograph# a ma&hine that re&ords the ele&tri& pulsations made by the heart when it beats# is used in all hos pitals to follow the patient8s progress after he has survived a &oronary o&&lusion %heart atta&k'. !y studying the tra&ings made by the up-and-down motion of the re&ording needle-pen# the physi&ian &an determine e:a&tly whi&h portion of the heart is damaged# and how it is responding to treatment. (fter the initial rest-period stage of re&overy# the do&tor offers the patient guidan&e that# in its details# will differ a&&ording to individual needs. In general# however# the following rules of health and manner of living are followed by most physi&ians and patients: Weight'# $ontrol of weight is a vital fa&tor# as shown in $hapter C. )iets 4iet is also &ru&ial# both to re&overy and in adding years to the remaining lifespan after an atta&k. %/ee $hapter ?'. We present the following dietary prin&iples for those individuals who# be&ause of high blood pressure# a heart &ondi tion# or some other &ause# are re9uired by their do&tors to fol low a low-fat# low-salt %sodium' diet:
THE LOW-SALT" LOW-FAT DIET

?eneral instructions for following a low-salt diet! 6ou

should eat only foods low in sodium &ontent. 7se no table salt %sodium &hloride' in food preparation or at the table. *eo&urtasal# 4iasal# 3a&asal# $o-/alt %sodium free substitutes' may

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>?C

be used to season foods while &ooking or at the table. 4o not use bi&arbonate of soda %baking soda' either in &ooking or as an anta&id. 7se distilled water.

F!!1" %! AI!i1
:EAT ....................................... Pro&essed meats# su&h as salted# smoked# &an ned# spi&ed and pi&kled meats. !a&on# .am# /ausages# !ologna# "rankfurters# 3iverwurst# /alami. "I/. ......................................./hell fish# $lams# ,ysters# 3obsters# /hrimp# Pro&essed fish. -11/ .....................................6olks G-1-T(!3-/ ........................$anned vegetables %unless spe&ially pa&ked without salt'# !eets# $elery# -ndive# 2ale# /pina&h# /auerkraut. /,7P/ ..................................!roths# +eat soups !5-(4 ...................................5egular &ommer&ial bread and rolls# $ra&kers salted $-5-(3 P5,47$T/............+ost &ommer&ially prepared &ereals. 4(I56 P5,47$T/ ..............(ll hard &heeses# all salted &heeses. C!,3 mer&ial i&e &ream# /alted butter. "57IT/ ...................................,lives# 5aisins

+%**%(!* .......... 1%2%(&/%* ........ * %%!%$%(* .......

/-(/,*-5/ ........................./alt %sodium &hloride'# $atsup# +ayonnaise# Pi&kles# 5elish# /alted meat gravy# salted meat sau&e. *o seasoned or preserved foods.

F!!1" P# ,i%%#1
+-(T/ ..................................!eef# 3amb %e:&ept brain and kidneys'# F;nly fresh or froCen Pork# Geal. meat, fish or poultry# <ot more than ! or , oC# dailyG? "I/. ......................................"ish %e:&ept shellfish' -11/ .....................................-ggwhites only G-1-T(!3-/ .......................(rti&hoke# $u&umbers# Pumpkin# (sparagus# F0resh only, not canned# -ggplant# 5adishes# !eans# -s&arole# 5husince these are usually barb# !ro&&oli# 2idney !eans# /oybeans# !russaltedG sels /prouts# 3eeks# /9uash# $abbage# 3entils# /weet Potatoes# $auliflower# ,nion# Tomatoes# $hard# Parsnips# Turnips# $orn# Peas# Water&ress. /,7P/ ..................................$ream soups %low-fat types'. !5-(4 .................................../pe&ially prepared salt-free bread or rolls.

>?E

$(5I*1 ",5 6,75/-3" ("T-5 ( HEART ATTACK

F!!1" P# ,i%%#1 >C!&%.@

$-5-(3 P5,47$T/...........!arley# $ream of Wheat# "arina# 5i&e %plain or puffed'# .ominy# +a&aroni# 5ye# Wheat %plain or puffed'. 4(I56 P5,47$T/ .............$ottage &heese %> oF.'# I&e $ream %fat free without salt'. "57IT/ (*4 *7T/ ...........(lmonds# $hestnuts# 3imes# (pples# $o&onuts# F0resh, coo.ed or canned, ,ranges# (pri&ots# $ranberries# Pea&hes# $urunless salt sodium *en- rants# Peanuts# 4ates# Pears# (vo&ados# "igs Coate has *een addedG %fresh'# Pineapples# !ananas# Plums# !lueberries# 1ooseberries# Prunes# $antaloupes# 1rapefruit# 5aspberries# $herries# .aFel *uts# /trawberries %fresh &anned'# .u&kleberries# Tomatoes# 3emons# Watermelon. 4-//-5T/ ..........................."ruits# fresh or &ookedsee pre&eding1ela tin desserts. Puddings# 5i&e# Tapio&a# $ornstar&h# et&.# I&e $ream %fat free low salt'. !-G-5(1-/ .....................(pple )ui&e# ,range )ui&e# $o&oa# Pineapple )ui&e# $offee# Postum# 1ingerale# Prune )ui&e# 1rapefruit )ui&e# Tea# 1rape )ui&e# Wine# 3emonade# +ilk %A &ups &ow8s milk whole'. /W--T-*-5/ ...................Iam# Ielly# .oney# +aple /yrup# +olasses# +armalade# /ugar U The re&ommended amounts of meat# fish# poultry and white of eggs should not be e:&eeded# be&ause the sodium &ontent of these foods is not suffi&iently low to permit their unlimited use.

O&# 8##? !* S(,./# :#&0" *! ( L!23S(/% Di#%

-lease note9 all vegeta*les are either fresh or dietetic salt free . . . . no fat added# $alt-free *read or toast is used ### salt-free crac.ers ------)istil led water used in coo.ing .... $.im mil. or low sodium mil. may *e used wherever needed . . . . >ello or fruit may *e ta.en *etween meals .... =rea.fast <oon <ight

,range Iui&e Wheatena %no salt' /alt-free toast Iam# marmalade or honey $offee# skim milk

/alt-free &on some /alt-free roast %beef or pork' /alt-free roast potato /alt-free asparagus Tossed green salad with dieteti& dressing Iunket /alt-free bread# )elly Tea or &offee %made with distilled water' 3ow sodium milk

!roiled lamb &hop !aked potato "resh spina&h with lemon Potato salad with dieteti& dressing /herbet /alt-free bread Ielly Tea or &offee

CARING FOR YOURSELF AFTER A HEART ATTACK

(reakfast /alt-free tomato )ui&e /hredded wheat# skim milk /alt-free toast# )elly Tea or &offee# skim milk =rea.fast "resh strawberries "rosted "lakes /kim milk /alt-free toast# )elly Tea or &offee <oon !roiled steak /alt-free ri&e /alt-free s9uash with lemon "ruit salad with saltfree dressing /alt-free bread# )elly Tea or &offee <oon !roiled hamburger# no salt /alt-free toast# sandwi&h /alt-free dressing "ruit )ello Tea or &offee night !aked &hi&ken /alt-free noodles /alt-free string beans 3ettu&e hearts with dieteti& dressing "resh fruit &up /alt-free toast# )elly Tea or &offee

1;9

=rea.fast /li&ed /mall !anana and ,range $ream of Wheat with /kim +ilk /alt"ree Toast Iam Tea or $offee

<oon 3arge "ruit /alad . . . (ny Gariety of "resh or $anned "ruits (vailable . . . .oneydew# $anteloupe# Pear# Pea&h ... !erries /alt-"ree .oop $heese /alt-"ree $ra&kers ... <oon !aked "resh .alibut with 3emon $reamed /tyle $orn .arvard !eetsaaaa %small serving' $ole /law with Pineapple (pplesau&e... Tea or $offee

<ight !aked fresh trout !aked yam /hredded Fu&&ini $ole slaw with salt-free dressing "resh pineapple /alt-free bread# )elly Tea or &offee 6vening "resh !eef /tew /teamed Potato "resh or 4ieteti& $anned Peas /li&ed $u&umber and /li&ed Thin ,nion in Ginegar (ngel food $ake Tea or $offee 6vening 5oast 3ean !eef !rowned Potato# *o "at Peas "ruit and $ottage $heese /alad +a&aroon Tea or $offee

=rea.fast $renshaw +elon Wheatena /alt-"ree Toast... Iam Tea or $offee /kim +ilk

170

"&()$/ ,O( -O#(*%', &,!%( & H%&(! &!!&"0

<oon $old Platter $old /li&ed Turkey $old /li&ed 5oast or +eat 3oaf Potato /alad with 4ieteti& 4ressing Xuartered Tomato /alt-"ree $ra&kers ... .oney !aked "resh Pearaaaa Tea or $offee <oon $lear $onsomme with /alt-"ree $ra&kers Toasted !eef /andwi&h with 4ieteti& 4ressing /li&ed Pea&hes Tea or $offee Pineapple Iui&e 6vening !roiled Tenderloin /teak !aked 6am $aulifloweraaaa Tossed 1reen /alad with 4ieteti& 4ressing 3ime /herbet Tea or $offee

=rea.fast 1rape Iui&e ,atmeal Toast... Iam Tea or $offee /kim +ilk

=rea.fast ,range Iui&e $ream of Wheat Toast... Iam Tea or $offee /kim +ilk

6vening !roiled Geal /teak /li&ed ,nion !aked Potato !aked !anana /9uash +i:ed Gegetable /alad with 4ieteti& 4ressing ,range I&e Tea or $offee

:est! /leep and rest are important. With a return of normal health# the heart patient may be in&lined to do more than he should. (voidan&e of fatigue from work or so&ial a&tivity# however# is the wisest &ourse. +ost patients should get from eight to nine hours of sleep in these he&ti& times. /ome people# it is true# seem to get by with only five or si: hours of sleep. !ut they are e:&eptional people. Patients must also be guided by their own rea&tion to work and daily a&tivities. If they find themselves feeling tired or "run down" during the day# they should take a little time out for a nap. ( good time for su&h &at-naps is the middle of the day and )ust before the evening meal. I often advise businessmen patients of mine to take a halfhour to rest# either in their offi&es or &lubs# on&e or twi&e during the day# while their se&retaries or business asso&iates "&over" for them. They find that being "out" a half hour on&e or twi&e a day &auses no great in&onvenien&e# o&&asions no &omment from their &lients and is most refreshing. /o&ial a&tivities must be pleasant# non-ta:ing# (&1 of %+#

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>C>

kind that indu&e a &heerful and rela:ed mood. The &oronary patient has always to bear in mind that he is better off away from s&enes of an:iety# tension# or &onfli&tat play as well as at work. The value of rela:ation to the &oronary &ase and development of keen interest and en)oyment in a&tivities outside work is espe&ially appre&iated by the physi&ian. /everal years ago in 3os (ngeles# a number of my &olleagues formed a "$oronary $lub." To be eligible# you had to be a physi&ian and you had to have suffered a &oronary thrombosis. $lub members have developed the highest skills in their hobbies. /ome of the most widely en)oyed of these hobbies are oil paintings# &hess# s&ulpt ing# and water-&olor painting. /everal of the do&tors have already won re&ognition and priFes during the annual "shows" that lo&al and national medi&al so&ieties give for painting and s&ulpture. Indeed# one of my &olleagues finds that he &an hardly wait to get away from his offi&e in order to work on an oil painting of his daughterK $hould you e+ercise? The kind and amount of e:er&ise you take assumes a more important role in your life following a heart atta&k. /ome people are almost fanati&al in their belief that physi&al e:er&ise is the only way to maintain good health. They are the persons who insist upon the effi&a&y of su&h gadgets as treadmill ma&hines# Indian &lubs# bar bells# and a variety of e:er&ising ma&hines. They will assure you that your heart trouble was &aused in the first pla&e by la&k of e:er&ise. The only way to regain your health now is to "restore the vitality and mus&le tone that &an &ome only from e:er&ise." /ome years ago I treated 4r. !.# a brilliant and well-known bio&hemist and ba&helor. (fter he re&overed from his &oronary atta&k he tried to live the e:emplary# perfe&t life# living at home alone with his mother. (fter one year of e:&ellent physi&al health# a new symptom developed: severe and persistent heada&he. The following &onversation took pla&e in my offi&e: "4o&tor +orrison# this heada&he of mine is )ust about killing

>C;

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

me. I feel as though a vise were s9ueeFing and &rushing my head." "Well# 4r. !.# you know your heart and blood pressure as well as the rest of your 8physi&al e:am8 are now perfe&tly normal". "!ut# 4r. +orrison# why do I suffer from this infernal head a&he I lead an ideal life. I wat&h my diet# I don8t smoke# don8t drink# retire every night at >= p.m.# never keep late hours# am home every night with mother# never go out# don8t even bother with women. What &an it be " 3ooking him straight in the eye and with a grin# I said: "It8s simple# !en# your halo is )ust too tight". There was a startled minute of surprise and silen&e. Then 4r. !. himself grinned and saw through this )oke into his own overstriving for perfe&tion# having forgotten that the body needs more than physi&al tending toit needs diversion# re&reation# mental rela:ation. I pres&ribed a holiday# a large dose of fun# a deep draught of gaiety and diversion# to be followed by regular# fre9uent doses of the same "medi&ine." .is heada&he# obviously from tension and a&&umulated an:iety# vanished 9ui&klyK (&tually# the e:tent of your physi&al e:ertion in any a&tivity is a matter that must be de&ided by your physi&ian. .e knows that patients vary widely in their &apa&ity for e:er&ise and their body8s toleran&e to physi&al e:ertion. .e knows also that e:er&ise is nothing more than a means of stimulating the body8s metabolism# of &hanging the body8s &hemistry through its effe&t on both &ir&ulation and on improved elimination. (t least one half of all patients who e:perien&e a &oronary thrombosis make a &omplete re&overy and are able to resume normal physi&al a&tivities. ,f the other <= per &ent of patients# about one 9uarter find they are definitely limited as to their physi&al e:ertion or work. The remaining ;< per &ent are either retired from work and normal a&tivities entirely# or assume a disabled status. President -isenhower is a good e:ample of those who re&over

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>CA

&ompletely. 4espite the &ompli&ation of ileitis added to his initial trouble# he made a satisfa&tory &omeba&k following a &oronary thrombosis. (lthough he was pla&ed on a prolonged program of anti-&oagulants %drugs that prevent &lotting in the blood'# he &ontinued to play golf o&&asionally@ he e:er&ised with &are and moderation# and returned to his &ustomary Presidential duties.

*hat kind of e2ercise is permissible+ (mong mus&ular

a&tivities that are suitable to patients who have re&overed from heart atta&ks are swimming# walking# s9uare dan&ing# fishing# gardening# bowling# and horseba&k riding. They may also resume normal se:ual relations and otherwise live normally. +ore violent forms of e:er&ise# su&h as tennis or s9uash# how ever# are definitely dangerous. +oderate physi&al a&tivity is re&ommended for &oronary patients be&ause during mild e:er&ise# there o&&urs a nutrient withdrawal from the blood to meet in&reased metaboli& needs. This withdrawal# in turn# results in a lower serum &on&entration of fats and &onse9uently of &holesterol. hould you smoke+ ,ne of the first 9uestions a smoker will ask his physi&ian following a heart atta&k is# "4o&tor# do I have to give up smoking " In most instan&es# the do&tor will have to say "yes." In general# smoking is not good for the &ir&ulation. In fa&t# it is often 9uite in)urious to &ir&ulation in the legs# if the patient is sensitive to ni&otine# as many are. In some persons# smoking produ&es a tightening or further narrowing of the blood vessels# an a&tion that physi&ians &all vaso-&onstri&tion. In &ases of &oronary artery disease# the added s9ueeFing down of the ar teries as a result of smoking &an be 9uite dangerous. (vailable eviden&e from resear&h is not suffi&ient to show that smoking &auses heart atta&k# but physi&ians know that some patients with angina pe&toris %a form of &oronary artery dis ease' may easily aggravate their &ondition by heavy smoking. +any of my patients have found it e:tremely diffi&ult to give up the toba&&o habit. "or them# I usually re&ommend filtered

>CB

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

pipes instead of &igarettes or &igars. "or others# deni&otiniFed toba&&o# or a substantial redu&tion in smoking is effe&tive. ( dis&ussion of the role of smoking and its effe&ts on your health may be found in $hapter E. $hould you avoid alcohol? The use of al&ohol in moderation is permitted and is# in fa&t# often benefi&ial. 5efer to $hapter D for the full story on al&ohol and health. Iust a few reminders will be tou&hed on here. Temperate use of distilled li9uors and wines is usually health ful# for they tend to dilate or open up the arteries# and thus to improve &ir&ulation. (s a rule# I do not re&ommend the use of beer# be&ause it is a gas-former. When beer is taken with a heavy meal# the resulting gas in the stoma&h may embarrass the heart or restri&t its free fun&tion. +y e:periments# as reported in $hapter D# showed that severe gas-pressure &ould damage the heart or even arrest its a&tion and thus affe&t the &oronary arteries adversely. +any deaths that have been attributed to "a&ute indigestion" o&&urred in this waygaseous ballooning of the stoma&h that a&tually s9ueeFed life out of the heart. (n additional disadvantage of beer# other than its gas-forming properties# is its salt &ontent# whi&h may be harmful to &ertain patients. "or most &oronary patients# moderate amounts of /&ot&h# brandy and wines# however# are re&ommended. What a*out coffee and tea? $offee and tea are also stimu lants whi&h# if used in moderation# may be helpful# sin&e they too tend to dilate the blood vessels# permitting an in&reased flow of blood. !ut# as in the &ase of other stimulants# they &an be harmful if they are used to e:&ess. are of the *owels# Proper &are of the bowels is essential. $onstipation# whi&h often results in straining at the stool# is harmful and may even be dangerous. *ot infre9uently I have known patients to pre&ipitate heart atta&ks by straining to for&e a bowel movement.

CARING ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>C<

!e&ause the importan&e of easy elimination in treatment of &oronary patients is not generally known to the lay publi&# there was a good deal of surprise and amusement throughout the &ountry when 4r. Paul 4udley White# the President8s &ardi ologist# issued his now famous medi&al bulletin on the se&ond day after the $hief -:e&utive8s &oronary atta&k. (t that time he stated that the President8s &ondition was en&ouraging and that he had had a good bowel movementK This &elebrated event is said to have been reported around the world. (nd the re)oi&ing was refle&ted in an upward swing in the sto&k marketK ,n the matter of regulating the bowels your do&tor is# of &ourse# the best advisor. +ost individuals re9uire a well- bal an&ed diet# &ontaining fruits and vegetables# together with an ade9uate intake of water. They also need to take suffi&ient time for a rela:ed bowel habit. +any of my patients have found that a glass of prune )ui&e on arising in the morning# or one or two glasses of hot water with lemon )ui&e or tea# are benefi&ial. ,thers have found that strained vegetable )ui&es %&abbage )ui&e# for e:ample' or fruit )ui&es taken upon arising stimulate natural bowel fun&tion. /till others have to resort to the natural# bulk-produ&ing mild vegetable la:atives su&h as plantago %&alled +etamu&il'# psyllum seeds# "/araka#" "/erutan" and so on.

&an you continue to have se2 relations+ +r. 3.# BA# had
)ust re&overed from his first &oronary atta&k and was about to leave the hospital. .is attra&tive young wife# who was his &onstant bedside &ompanion# stepped out of the room to pay the hospital bill# leaving us albme for the first time without either his wife or his nurse in the room. The first 9uestion he asked: "4o&tor# when will it be safe for me to have se:ual relations with my wife " This is one of the most pressing 9uestions in the mind of most male patients under ?= %and even in some who are olderK'. This spoken or unspoken fear is so intimately linked with the patient8s fear that he has "lost his manhood" or his virility# or that he is to be an invalid or

176

CARING FOR YOURSELF AFTER A HEART ATTACK

semi-invalid from then on# that it is a deep psy&hologi&al &on&ern to men. It is a fear profoundly linked to the male personality# so shaken by a threat to e:isten&e as brought on by a &oronary atta&k. /ome men are like my patient# +r. (.# aged ?A# who# whenever he attempted the se: a&t following his &oronary atta&k# developed severe anginal pains. -ven administration of nitrogly&erine for pain prevention was to no avail. +r. (. finally had to resign himself to the inevitable and seek gratifi&ation from other things in his life. This he did with resour&efulness. .e developed the hobby of water-&olor painting and derived keenest pleasure and pride from this art. To most men and women who have made a good re&overy from their "&oronary#" however# the se: a&t is an e:pression of love and devotion and is generally a rela:ing# healthful e:perien&e. .owever# this is always so when &arried out in modera tion# never to the point of strain# or when fatigued or during unfavorable &ir&umstan&es# sin&e the heart a&tually does signi fi&antly in&rease its a&tion during the se: a&t# as shown by re&ent published medi&al resear&h. ,ne businessman# a BB-year old -uropean patient of mine# +r. ..# is an e:ample of a well-re&overed "&oronary" &ase with ( rela:ed# philosophi&al attitude toward life. ( devoted hus band# deeply in love with his attra&tive# loving wife# he finds great satisfa&tion from fre9uent se:ual relations. +r. .. assures me this is the best "sedative" he knows# and that it banishes the daily tensions of his work. 3ove-making both refreshes and soothes him and is as ne&essary to "nourish" his love-life# as his daily food is ne&essary to nourish his body.

*hat is the best "coronary climate"+ The ideal &limate#

as far as the &oronary patient is &on&erned# is a temperate one. -:tremes of heat and &old should be avoided. .igh altitudes# espe&ially those above <=== feet# are also a strain on the heart. *ewspaper readers are well aware that during heat waves or hot spells# hospitals and emergen&y treatment rooms are kept busy treating patients who have &ollapsed from both heat strokes

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

>CC

and heart strain. /imilarly# patients who suffer from angina a heart or &oronary diseasee:perien&e their worst pains when they walk about in &old or freeFing weather. /e&tions of the 7nited /tates that are favorable to the &oronary patient are the &entral and southern areas of $alifornia# the southern portions of *ew +e:i&o# (riFona# and "lorida. There are other temperate lo&alities in the &ountry where the &oronary patient will e:perien&e no dis&omfort from the weather. 6our physi&ian &an advise you whi&h lo&ality would be best for you. To demonstrate how some men with initiative li&k a &limati& problem# there is a <D-year old former patient of mine who &ame to see me >= years ago from a northern part of the state of Washington. +r. =. had had a &oronary but# on e:ertion# suffered from anginal &hest pains only during &old weather# in the winter season. I persuaded him to leave his wheat farm after harvest time to the &are of his son-in-law# who farmed with him# and to drive down and live in a trailer during the winter months in a &harming spot between 3os (ngeles and /an 4iego# by the o&ean and the desert. .e now spends pra&ti&ally half the year working on his Washington farm and half the year living with his wife in their trailer in /outhern $alifornia. "or >= years now he has had no anginal pain# but here is the "pay-off": (fter his first winter spent in /outhern $alifornia# he returned to Washington so tanned# healthy# and happy that his friends %and even people he did not know but who had heard of him' formed a "$oronary" $lub# and established a trailer settlement in this /outhern $alifornia spot. .ere a siFeable settlement from *orth Washington was formed# and the amount of fishing# bathing# &ard playing# and general fun and rela:ation for members of this "$oronary" $lub are a delight not only to those who have had a &oronary atta&k# but to those men and women who are desirous of avoiding one and who wish to en)oy life and good health in their older years.

*hen may you return to work+ When the &oronary pa-

>CE

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

tient8s heart has healed and its fun&tion has returned to normal %as determined by his do&tor'# he is usually allowed to return to his &ustomary a&tivities as soon as is pra&ti&al. ,f &ourse# it is wise to do this gradually# rather than to plunge into a )ob where he left off. -ven if it means only part-time a&tivity at first# most people derive a great satisfa&tion and a lift to their morale when they &an return to some useful routine of life. If the patient was engaged in very strenuous physi&al labor or fa&tory work whi&h he really did not en)oy# but whi&h he was for&ed to do to earn a living# he is usually better off to find a lighter kind of work# provided it does not involve the frustrations of a long apprenti&eship. There are many ways of reevaluating the kind of work a man or woman has been doing. +any of my patients were engaged in o&&upations that were a &ontinued sour&e of irritation# &ausing a state of alarm. Their &oronary at ta&k may even have been partly due to the unbearable and pro longed tension. "or su&h patients I always re&ommend a different o&&upation or way of life. Then the 9uestion arises# ".ow &an I find the right work for myself " The (meri&an .eart (sso&iation has developed splendid programs in most of the large &ities# aimed at rehabilitation of heart patients. (n important part of these programs is helping the patients find the right kind of )ob. /ome &enters have also &reated 8heart kit&hens#" where housewives who have suffered heart atta&ks are taught many labor saving devi&es. .ere women learn for the first time that housekeeping need not be a drudgery. The (sso&iation also sponsors vo&ational rehabilitation servi&es whi&h analyFe ea&h patient8s skill# edu&ational ba&kground# physi&al &ondition# and so on# to produ&e a profile of his )ob 9ualifi&ations. ,ften it turns out that the average person possess es hidden talent or unsuspe&ted skills that may open up entirely new vistas that might have remained &losed to him all of his life# if he had not suffered a heart atta&k.

)evelop a constructive, optimistic attitude toward life!

The &ase of W. 2.# a brilliant and su&&essful lawyer# is a perfe&t

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2 >CD e:ample of the vital ne&essity for the right attitude and philosophy of life. W.# who was <;# &ertainly had a frightening family history. .e was the only one of four brothers still alive. .is three brothers had all died of heart atta&ks. $learly# W. was a familial or hereditary &andidate for &oronary thrombosis# parti&ularly sin&e his blood &holesterol level was abnormally high. !ut !ill was a &yni&# a disappointed father# and an unhappy man. !y nature a pessimist# he believed that it was his fate to die of a &oronary thrombosis. .e pro&eeded to help fate alongas had the rest of his former family. *o amount of pleading by a devoted and &on&erned wifeN no amount of urging by his do&tor# &ould indu&e W. to &hange his philosophy and his living habits. !ill insisted on eating everything# the ri&her and fatter the better. .e drank to e:&ess# smoked heavily and took as little rest as possible. In short order the a: fell. !ill had his &oronary thrombosis and )oined the rest of his familyBE hours after his atta&k. ,n the other hand# $harles# an optimist and# of all things# an airplane pilot# was &onfronted with the same problem. .e also had lost A brothers from &oronaries# but $harles believed in helping to dire&t his own fate in a positive way. (t the age of AC# he had the most vital of reasons# other than himself# for re maining in good health. The lives of thousands of passengers were in his hands. $hara&teristi&ally enough# $harles also had an abnormally high blood &holesterol level. !ut being of a pra&ti&al turn of mind# he set to work immediately in following a stri&t low-fat diet with dietary and vitamin supplements out lined in $hapter <. .is blood tests rapidly be&ame absolutely perfe&t in every way. .e felt and looked marvelous. Today# >= years after the original e:amination# he is the perfe&t physi&al spe&imen. What a sharp &ontrast in attitude and philosophy of living between !ill and $harles. What a striking &ontrast that meant perfe&t health in one &ase and death in the otherK (n e9ually dramati& instan&e of the importan&e of a &on-

>E=

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

stru&tive and optimisti& attitude toward life and health is the &ase of Iohn# a railroad engineer# << years of age. Iohn piloted a &ra&k trans&ontinental e:press for many years. .e had be&ome a little overweight and first suffered from mild anginal &hest pains. .e feared to bring this to the attention of the railroad do&tors# for he was &ertain that he would lose his )ob. ,n e:amining him# I found that he already had &oronary artery disease# was overweight# and had a high blood &holesterol level. ,ur engineer was also a man of &onstru&tive a&tion. .e put himself on a rigorous low-fat diet# he redu&ed his weight to the ideal one# and in two months be&ame &ompletely free of all pains. (nd in his own words# N8he never felt better in his life." .e said his own engine had be&ome tired of hauling "e:&ess freight on the line" and "sin&e dis&onne&ting" %to 9uote his own terrible puns' "the fat in his freight had given him a fright." *ow# after eight years of &ontinual work# he has still a sense of well-being. .e is in e:&ellent health. .is blood tests# his ele&tro&ardiograms# and his physi&al e:aminations are all perfe&tly normal for a man of his age. This then is an inspiring e:ample of how a man &an help dire&t his own fate and those of the &ountless others entrusted to his &are. 6our &han&es for long life are e:&ellent. If you have had a &oronary thrombosis# a key point to remember is this: your &han&es are e:&ellent for many years of useful# produ&tive living# provided you follow your do&tor8s advi&e. If you will redu&e your weight to a normal figure and stay on the low-fat diet and nutritional health program des&ribed in this book# you &an live )ust as long as the average overweight man or woman who does not follow the rules of good health given in these pagesK The age at whi&h you have an atta&k is not the important fa&tor in your re&overy. ,ne patient of mine# for e:ample# a business man in whom I am parti&ularly interested# had his first heart atta&k at the age of ?A. It was a severe &oronary thrombosis.

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2 >E> *either his family nor# to speak frankly# his former physi&ians e:pe&ted him to live very long after the atta&k. !ut I re&ommended the diet and the health rules that I have in&luded here. .e took them seriously# and followed them faithfully. .e is now E; years of age# and so a&tive in the &ondu&t of his business that his BB-year old son# who is physi&ally able and in good health# &annot keep up with his father8s drive and vitality. ( widower# he married a woman many years his )unior# and they lead a normal# a&tive# happy life together. They are &onstantly off on business trips# attend dan&es %he learned to dan&e when he was past C='# and take trips abroad. !ut it is important to bear in mind that this patient has wisely kept his weight to normal@ he remains on a low-fat diet# avoids fatigue# naps often during the day# does not smoke or drink# worships regularly# and fallows the 1olden 5ule in both his business and private life. .is outlook on life is vibrant# positive# &onstru&tive. *o doubt many physi&ians in (meri&a &ould relate similar &ases in their own pra&ti&e. In short# you &an be vi&torious over modern man8s most deadly opponent if you play the game a&&ording to the rules. .ere# in summary# are the >= most important: >. .it that waistline hardK 2eep your weight normal. "ol low $hapter ? on "$alling all $alories." 6our belt in the front should not make you deserve a 8belt in the ba&k8K ;. "ollow religiously the low-fat diet and nutritional way of living. In this way you will "add years to your life and life to your years." A. $onsult your do&tor for advi&e and &he&k-ups regularly %)ust as you would your dentist' at least on&e a year. $ertainly do so more often whenever there are spe&ifi& 9uestions or problems# "(n oun&e of prevention.............." B. !e sure to get your &omplete 9uota of sleep and rest. The

>E;

$(5I*1 ",5 6,75/-3" ("T-5 ( .-(5T (TT($2

average adult needs eight to nine hours a night. The night owl is often a s&are&row in the morning. Whenever you &an# steal a &at-nap or rest as often as possible through the day. 6ou re&harge your 8battery8 this way. <. "ind out from your do&tor how mu&h e:er&ise and physi&al e:ertion is safe for you. Then abide faithfully by his in stru&tions. Perhaps your heart has &ompletely re&overed and you &an do anything within reason. Perhaps you have to be moderate in physi&al a&tivities. 6our physi&ian is the best )udge of this. ?. 6ou are best off to stop smoking &igarettes. Ideally you are better off not to smoke at allK If you &an8t give up the weed# try a pipe# or at least &ut down to a few &igarettes. C. (s for al&oholi& beverages# follow the 1reek advi&e# "all things in moderation." +oderate and &ontrolled drinking is a good rela:ant. 5emember# "what8s one man8s meat# may be another8s poison." /ome people don8t tolerate al &ohol well. To some it may have serious effe&ts# espe&ially when taken in e:&ess. E. !e sure that your "plumbing" system is working in the famous (meri&an way: your bowels must fun&tion nor mally. (void &onstipation# as dire&ted. D. Try to avoid e:treme altitudes or e:tremes of temperature. If you have a &hoi&e# try to live in a temperate or e9uable &limate. >=. Whenever possible# try to arrange your work and living so that they may give you a ma:imum of gratifi&ation and a minimum of grief. If you &an# try to en)oy a hobby that will give you rela:ation and mental refreshment. 4evelop a wholesome# &heerful outlook and philosophy of life.

T= T.,/- (+-5I$(*/ (+,*1 T.- ;=

million who are ?= years and over# some may ask# ",f what value is the low-fat diet to me? If I were B= years old# a book like this would be my !ible. !ut it8s too late for me to benefit from this book now# so late in my life. I only wish that it had been written and that I had read it ;< years ago." 1t's never too late! *othing &ould be farther from the truth. -:tensive medi&al resear&h re&ently &arried out in this &ountry and abroad has shown how dramati& &hanges in health and wellbeing result regularly when an intensive nutritional program is followed. There are# in parti&ular# the re&ent /wedish reports of amaFing improvements in the health of older people resulting from the low-fat nutritional program that I originally re&ommended. 4o&tor 1. 3ind9uist and 4o&tor !. Isaksson at the 7niversity of 1othenburg .ospital applied the low-fat diet with nutritional supplements to a series of >D hospital in-patients who were known to be sufferers from hardening of the arteries of the brain. These patients# whose number is tragi&ally legion# ( # generally regarded by moist physi&ians as hopeless and are simply to be kept alive as long as possible. +any do&tors >EA

>EB

15,WI*1 6,7*1-5 WIT. T.- 6-(5/

still view these patheti& people as the inevitable result of old age# the results of wear-and-tear of the arteriesthe hardening of the arteries in the brain. The /wedish physi&ians only re&ently published their remarkable findings# &arried on over a three-month period in men and women patients whose ages ranged from <= to EC. The diet adhered e:a&tly to the original low-fat# low-&holesterol diet that I had published and advo&ated %whi&h they gra&iously a&knowl edged' &ontaining only ;< grams of fat a day. /ome of the patients re&eived a regular daily supply of multiple vitamins. (ll &ases had been previously studied and &arefully e:amined and observed before the dietary treatment was begun# and their &lini&al &ondition was stationary. (ll patients# with one e:&eption# had suffered from a stroke or &erebral thrombosis as a result of hardening of the brain arteries. The one e:&eption suffered from Parkinsonism# or the shaking of the hands %tremors'# so often seen in the elderly. (ll patients had e:perien&ed some disability or paralysis of legs# hands# or arm mus&les following their strokes. The symptoms were &hara&teristi&: nervousness# mental depression# weakness# listlessness# and despair. The following re sults are taken pra&ti&ally verbatim from the published s&ientifi& reports of their resear&h.

.he low-fat diet brought amaCing improvements! (fter

the three months of treatment by supplements were &ompleted# not one &ase worsened. +ost of the men and women showed striking and dramati& improvement both mentally and emotionally# even those who were mentally &onfused prior to treatment. The youngest improved patient was <= years of age and the eldest was EC years old. The patients were found to have grown more lu&id# and to have improved per&eption and )udg ment. (s a result# they established better personal relationships with do&tors# nurses# and members of their families. To further 9uote the /wedish investigators# the &apa&ity for &on&entration and enduran&e was remarkedly in&reased. This

GROWING YOUNGER WITH THE YEARS 185

was demonstrated from the energy with whi&h the patients &arried out their physi&al e:er&ises as part of the physi&al treatment for paralysis and mus&ular weakness. What was even further remarkable was the improvement in mood and personality. (n additional wel&ome surprise was the improvement in a&tual physi&al power and movements in half of the &ases# even after this brief period of treatment. /ome of the patients made su&h e:traordinary mental and physi&al progress that they were suffi&iently well to be dis&harged from the hospital. (s so many other &areful resear&h physi&ians had done# psy&hologi& and suggestive fa&tors were assiduously avoided. The patients were reported as pleased with the palatable and varied diet. The very &autious publi&ation reporting the above results appeared in the world medi&al literature# and &onfirmed my own original resear&h as well as the findings of others. What was of &onsiderable interest was the fa&t that the blood fats and &holes terol had de&reased rapidly in amount during the short threemonth period. ,ne of my patients# whom I shan8t forget# was an EA-year old lady# who was wheeled into my offi&e in a wheel&hair not so long ago by her ?=-year old daughter. +rs. (. was too feeble to walk# almost blind# partly deaf# and too weak to feed herself. The thin flame of life was kept burning in her by the devoted spinster daughter. .er selfless dedi&ation to her mother# her feeding her and tending to her every want was tou&hing# even bibli&al in &hara&ter. /omewhere the daughter had heard that farmers were feeding their animals with Nsuper&hargersN of vitamins and other nutritional produ&ts to make them healthier# more vigorous# and so produ&e finer spe&imens and higher profits. /he reasoned that possibly su&h treatment might help humans# even her mother# who was rapidly be&oming like a vegetable. Two months of our treatment followed. 3arge amounts of natural and syntheti& vitamins# plus nutritional supplements

18;

15,WI*1 6,7*1-5 WIT. T.- 6-(5/

su&h as le&ithin# soya oil and liver e:tra&t were given in addition to the low-fat# high-protein diet. 7nder our very eyes# a nutritional mira&le then took pla&e. +rs. (. walked in to see me# under her own power. /he was able to see# even though not as &learly as at one time. !e&ause her hearing had returned# we were able to &arry on a &onversation. (nd I foundmarvel to beholdKthat she still had a sense of humor. /he was able to poke fun at herself and spoke of my "robbing the grave." ,r take the &ase of +iss 5.# a ?<-year-old maiden lady who had a stroke or &erebral thrombosis# the result of atheros&lerosis. .er vision was failing and she was partly paralyFed# desperate# and depressed. -:&ept for one friend# she was all alone in the world. (fter several months of using the low-fat nutritional program des&ribed in $hapter <# +iss 5. re&overed mu&h of her mus &ular powers# her partial paralysis gradually disappeared# and she be&ame a radiant pi&ture of &heerfulness and optimism. .er vision had greatly improved# and when last seen in my offi&e she asked me brightly# "4o&tor# &ould I go swimming " I replied# "Indeed yes# butno divingK" 4uring the past de&ade# many reports of repeated resear&h in old folks8 homes or &enters for the elderly have shown in these people the failure of many vital organs %like the liver' to keep up with the older persons8 physi&al and mental needs. Poor fun&tioning of the kidneys# liver# heart# and other glands was noted. When tests were made of the vitamin levels in these elderly people# they were shown to be defi&ient. .owever# resear&h &onstantly shows us that humans vary widely in their nutritional needs. The nutritionist for the $ana dian 1overnment# 4r. 3ionel !. Pert# speaks su&&intly of "the illusion of vitamin re9uirements." .e finds# as do most other s&ientists# that there are no known e+act re9uirements of vitamins and nutrients for humans.

7ou need more than a "normal" or "average" diet! It

is emphati&ally not enough to eat merely the listed standards

GROWING YOUNGER WITH THE YEARS 187

of nutrients. They vary widely in their ability to be absorbed# depending on the individual8s vitamin# mineral# nutritional re9uirements and his biologi& pattern. $hapter < on le&ithin and nutritional supplements is therefore of greatest pra&ti&al value Mo the older person as well as the younger one. ,ne perfe&t e:ample gathered from many is the very re&ent and ingenious study &arried out by 4o&tor Tom /pies# one of (meri&a8s great nutritionists. .e studied over EDA men and women who were suffering from weakness# nervousness# poor mental &on&entration# ease of fatiguability following any physi&al or mental e:ertion# and depressive feelings. +any had to stop work# as they were unable to hold a )ob. /ome women found it impossible to &are for their families and homes. In brief# these men and women were "old before aging" and most of them looked it. +ost of these people &omplained of symptoms from various digestive# nervous# or mental ailments. Previous physi&ians had proven that none of these symptoms were due to a&tual physi&al disease# but were merely disturban&es in the normal fun&tion of the body. These people were sent to 4o&tor /pies8 medi&al &enter and resear&h fa&ilities in !irmingham# (labama# by physi&ians who had been unable to help these puFFling and diffi&ult problem &ases. These individuals showed no physi&al or laboratory signs as e:planations for their physi&al or mental breakdowns@ they were on the regular# average (meri&an diet and had seemingly normal food habits. The resear&h team headed by 4o&tor /pies ta&kled the &lini&al puFFle of these EDA "mystery" &ases as a nutritional &hallenge. The nutritional supplements and vitamin supplies used were mainly those des&ribed in $hapter <. They in&luded le&ithin# vitamin supplements# and nutritional aids su&h as liver e:tra&ts and brewer8s yeast. These were administered in an intensive way to all &ases# together with a high protein diet. (stounding &hanges promptly took pla&e in these .#!./#.

188

/(O )$/ -O#$/%(

)!H !H% -%&(*

Within a few months it was diffi&ult to re&ogniFe many of them. 1one was the weakness# malaise# the lethargy# the nervousness# depressions# the e:haustions# and myriad a&&ompanying symp toms &hara&teristi& of &hroni& poor nutrition. $heerfulness# optimism# a sense of well-being# physi&al and mental vigor# a remarkable in&rease in physi&al and mental stamina was evident in the great ma)ority of &ases. Within a few months almost all of them were able to return re)uvenated to work# home# and normal# healthful a&tivities. ( number of the younger ones entered the armed for&es. .undreds of them began to look younger and fresher. The skin developed lustre and a healthy te:ture where before it had been dry and wrinkled. ( sparkle &ame ba&k to the eyes# physi&al movements be&ame vigorous and youthful. /ome of the patients lost the mental symptoms and depressions that had &aused a suspi&ion of a&tual mental disease. These really dramati& lessons and "&ures" are additional demonstrations of the greatly in&reased nutritional re9uirements of both younger and older people# who are vi&tims of our &ur rent food and &ooking habits.

(egin now to feel young and really alive! The point of

des&ribing all these e:traordinary results in making older as well as younger people feel vital# young# and fresh# filled with the Fest and &apa&ity for living# is that it is never too late to feel young and really alive againD *o matter what your age is# the right diet and nutrition des&ribed in this book may do wonders for you. If you really work at it# it &an repay you tenfold. It is not enough )ust to eat " three s9uare meals" a day and take a vitamin pill. That way you &an still age before your time and )ust "e:ist" during your lifetime.

.here is evidence that the aging process may be reversible! ,ut of the horrors of .itler8s &on&entration &amps there &ame )ust re&ently some amaFing news announ&ed at the >D<? International $ongress on (rterios&lerosis. ( &ru&ial 9uestion was asked of the general assembly as to whether there was definite eviden&e that the low-fat diet &ould

GROWING YOUNGER WITH THE YEARS 189

effe&t a&tual absorption %or reversal' of the fatty deposits in the arteries. The 9uestion was also e:panded to ask# "Is the atheros&lerosis or Naging pro&ess8 reversi*le?3 ( 1erman pathologist# who was well-known to many# arose and hesitantly gave the following answer: 4uring World War II he and other pathologists were assigned to study the postmortem &onditions of vi&tims who# after in&ar&eration for several years# had died in -uropean &on&entration &amps. It was found that even in older people there was an astonish ing disappearan&e# through absorption# of atheros&leroti& fatty deposits in the arteries of both the heart and the brain. These amaFing results were attributed to the &omplete absen&e of any fat in the meager s&raps of food given to the vi&tims of perse&ution in the &amps. ,besity was &ompletely unknown. Girtually all vi&tims who had died had e:hausted all fat deposits in the body and were underweight. The medi&al &ongress was even more startled to hear the 1erman pathologist report the following: The absorption and reversal of atheros&lerosis in the World War II vi&tims was the same that he and other pathologists had often found among the 1erman population in World War I. (t that time# the reason for the reversal or absorption of atheros&lerosis was as&ribed to la&k of fat in the 1erman diet resulting from the !ritish blo&k ade of 1ermany. *o fat produ&ts ne&essary for war material &ould get into 1ermany. Therefore# all fats possible had been removed from food for the manufa&ture of war produ&ts. It is thus perfe&tly &on&eivable that the so-&alled aging pro&ess itselfatheros&lerosismay be reversed in many older people by following the low-fat diet and nutritional program. Possibly this a&&ounts for the remarkable &hanges# noti&ed in older as well as middle-aged people# who have &arefully followed our diet and nutritional way of eating and living. *o wonder that people# after the diet# so often report the results in su&h remarks as# "I never felt better in my life"# "I

190

/(O )$/ -O#$/%(

)!H !H% -%&(*

seem to feel younger and younger ea&h day#" or "4o&tor# I feel like doing things I haven8t done sin&e I was a youngster# I feel so youngK" Typi&al also is the &ase of our patient# +r. I.# a ?>-year old manufa&turer. (fter B= years of ba&k-breaking labor# he had built up a nationally-known# su&&essful business that made pre&ision tools for engines in the airplane industry. .is son and sonin-law noti&ed that in the past year dad had "slowed up" patheti&ally. +r. I. seemed suddenly to have be&ome an old man. .e felt tired# listless@ it was a great effort for him to stay awake during important &onferen&es with produ&tion engineers# salesmen# and (rmy (ir "or&e offi&ials who &ame to study the "plant#" its methods of manufa&ture# tooling# and e9uipment. ,n several o&&asions# to his intense embarrassment and utter humiliation# he dis&overed that he had fallen asleep during important &onferen&es. ( visit to his physi&ian# a noted university professor# and a thorough &he&k-up in the hospital yielded no signs of any dis ease. +r. I. was informed he needed a long rest and va&ation# that he was tired out and should take it easy# that he should "a&t his age." There followed a visit to the travel agen&y by +r. I. and his wife. They sele&ted a lu:ury &ruise round the world for four months. They en)oyed it# although +r. I. noti&ed he tired easily when walking around seeing the interesting sights in various &ountries. .e also seemed tired and sleepy most of the time. When he did go to sleep# he slept restlessly and fitfully. ,n awakening# he felt even more tired than he was when he went to bed the night before. It seemed diffi&ult for him to &on&en trate on anything for long. -ven wat&hing the movies aboard ship seemed to ta: his patien&e and he would leave in the middle of a pi&ture# finding himself too restless and "twit&hy" to sit for too long. 6et his appetite was the same as always. (s a matter of fa&t# he was a bit too "portly#" but he &arried his e:tra

GROWING YOUNGER WITH THE YEARS 191

weight well@ in fa&t# it made him look dignified and impressive. When +r. I. returned from his long voyage# he felt not mu&h different than he did on leaving. True# he was rested and eager to get ba&k to the plant to see how the new models being prepared for the (ir "or&e were working out. (fter a week ba&k at work# he found himself feeling e:a&tly the same as before his voyage. /leepy# tired# and now growing nervous and irritable# mu&h to the dismay of his family# for he had always been a model of kindness and emotional stability. In desperation# his wife persuaded him to try the new low-fat diet with the vitamin- nutritional plan of eating and living. .e felt he had nothing to lose and agreed to give it all a "sporting &han&e#" but he really suspe&ted the whole thing was a ridi&ulous fad. (fter all# he ate three good s9uare meals a day. What was the point of losing weight and going to all this fuss about funny "health" foods To his own amaFement and disbelief# in one month he noti&ed sudden &hanges in himself. /till later# he found himself one day hurriedly running upstairs ahead of his son in his eagerness to see a new ma&hine installed. ( few months later# on another o&&asion# he noti&ed that his younger asso&iates were growing tired after a long &onferen&e. They asked for a &offee-break. (nd yet he felt )ust as fresh as when he started. .e really &ouldn8t understand it. .e was sleeping well for the first time in a long while and noti&ed that# although he had lost ;< pounds in weight and had to pull in his belt three not&hes# his step had be&ome light and springy. In another month# the whole world seemed somehow to be a new one# he felt so good. .e &ould hardly wait to get to work in the mornings. .e felt a real )oy in all he did# was &ons&ious of a &ontinuous surge of &heerfulness and optimism in everything he did and said. In short# he felt young againK *ow he is a real &onvert to the low-fat nutritional method and urges it on his &hildren# his business asso&iates# and everyone who will listen. $learly# +r. I. was the typi&al &ase of

192

/(O )$/ -O#$/%(

)!H !H% -%&(*

overweight and &hroni& malnutrition amidst plenty. .is body had great need of severely la&king# vital nutritional ne&essities. .is &hara&teristi& symptoms of &hroni& fatigue and premature aging were repeated hundreds of times in the &ases where 4o&tor Tom /pies and his asso&iates had similar# e:traordinarily su& &essful results.

*eight control also contributes to healthy old age!

The &ase of our manufa&turer +r. I. brings up and emphasiFes also the ne&essity for ideal weight in older people# as well as in the younger ones. Parti&ularly if you are past <= or ?= years of age and are overweight# you &an feel healthier and better by redu&ing your weight to normal. /uppose that you weigh >C= lbs. and should weigh ><= lbs.# so that you are ;= lbs. overweight. If you are the average a&tive person# you take at least a thousand steps ea&h day. This means you "drag" around daily with you ;= lbs. : >=== %steps' or ;=#=== lbs. This is about >= tons. 6our heart then must pump all the harder to &arry this e:tra >= tons around with you %on your ba&k# so to speak' every dayK *o wonder your heart tends to wear out sooner and shortens your life.

&an youth be restored in the prematurely aged+ Perhaps the greatest &hallenge to e:perimental s&ien&e has been the 9uestion# "$an youth be restored in the prematurely aged " In both animals and humans whose premature aging is &ontributed to by vitamin and nutritional defi&ien&ies# nutritional s&ien&e has been able to answer "yes" in many &ases. There is an old saying used by both the medi&al profession and the publi&# "6ou are as old as your arteries." This &on&ept led us to investigate whether it would be possible to produ&e "old age" in the arteries# heart# and brain of e:perimental ani mals# and to attempt the &ru&ial &hallenge of whether these arteries &ould be restored to normal health and youth again afterwards. (&&ordingly# in >DB<# my asso&iates and I fed a high-fat diet

GROWING YOUNGER WITH THE YEARS

193

and &holesterol to a series of BA e:perimental animals. Within A= to D= days we were &ertain that the ma)ority of the animals had already developed from moderate to severe atheros&lerosis in the vital arteries around the heart as well as in other parts of the body. Then# over a ?-month period# we fed daily large 9uantities of &on&entrated e:tra&ts from Gitamin-! &omple: to the ani mals in one group and no vitamins at all to the other group. These spe&ial vitamin e:tra&t feedings were based on the re&ent# original dis&overies of the value of these nutritional substan&es %&alled "lipotropi&" or fat-preventing' made by 4o&tor $harles !est and his asso&iates at the 7niversity of Toronto. 4r. !est was the &o-dis&overer# with 4r. "rederi&k !anting of $anada# of insulin. We soon noti&ed great &hanges in the untreated animals# who had rapidly developed signifi&ant atheros&lerosis. This &on trasted sharply with another group of "&ontrols" that had not been fed the high-fat# high-&hholesterol diet# and who were free of atheros&lerosis. (t the end of a year# the atheros&leroti& animals were sluggish# ina&tive# and disinterested in what went on around them. They showed a drying up and sparseness of hair@ poor tooth and nail growth@ "rheumy" eyes# and poor appetites. In short# they presented the pi&ture of "old age#" even though# &hronologi&ally# they were still young animals. !ut after si: months of intensive feeding of very large 9uantities of Gitamin-! &omple: &onstituents to the atheros&leroti& group of animals# the &hanges that took pla&e in them were startling. (fter e:amination of the artery tissues in the animals# we found %to 9uote from our s&ientifi& reports published in the medi&al )ournals' that "there was re-absorption of athero s&lerosis in the ma)ority of those animals whose atheros&lerosis had been produ&ed by the fat and &holesterol feedings." In other words# the aged arteries# filled and damaged with the fatty pla9ues or deposits that were destroying the blood vessels# had be&ome normal and healthy againK

194

/(O )$/ -O#$/%(

)!H !H% -%&(*

The &hanges that took pla&e in the appearan&e and behaviour of the treated animals were also a pleasure to behold. They were frisky again# full of play and mis&hief# alert to every sound and movement about them# and in great spirits. Their appearan&e was also remarkable. .air growth# &olor# and te:ture had be&ome youthful and lu:uriant# their eyes sparkling# and their appetites vora&ious. /imilar results were also found in the absorption of atheros&lerosis in e:perimental animals at $olumbia 7niversity by 4o&tor (lbert /teiner and his asso&iates. ,ther investigators# as well# demonstrated similar results in the e:perimental produ&tion and reversi*ility of "old age." These nutritional lessons have been very 9ui&kly learned by the farmer. .e saw to it promptly that large daily supplies of vitamins and nutritional supplements were fed to his livesto&k and his poultry. They have be&ome healthier# and yield more milk# butter# and eggs# and tastier beef# ham and pork. In addi tion# they resist illness far better# reprodu&e their young more effi&iently# grow faster# and are far superior in every possible respe&t. I re&all a memorable &ase that brought this lesson home to me in an unforgettable way. ,ver ;= years ago# I was attend ing a group of ward patients at a university hospital in Phila delphia. ,ne of my &harges# 5oy W.# was a patheti& &asea young student who suffered from a &hroni& infe&tion of the bone that he had had sin&e &hildhood. It was imperative that# to &ure the &ondition# he undergo surgery by our brilliant and gifted professor of orthopedi& surgery# 4o&tor Iohn 5oyal +oore. 7nfortunately# this young man8s nutritional statehis ema&iated &ondition from his &hroni& and life-threatening infe&tion was so bad# that he was )udged to be in no &ondition to undergo the badly needed surgery. -ven his liver and other organs had be&ome damaged by the &hroni& infe&tion. !ut the most appalling damage was his visible aging. This >D-year old looked like a very old man and talked and felt like one. .is hair was gray-

GROWING YOUNGER WITH THE YEARS 195

ing# his eyes dulled# his skin was wrinkled and his voi&e feeble. *o types of nutritious diet# routine vitamin pill daily intake# or medi&ines were of any avail in over&oming his weakness. It seemed impossible to improve his health to the ne&essary preoperative level. In desperation# in the attempt to &ounter the boy8s obvious nutritional defi&ien&ies and his premature aging# I de&ided upon a nutritional approa&hwe would feed him massive amounts of nutritional supplements. In addition to .er&ulean doses of all known vitamins# I persuaded his broken-hearted mother to go to the &ity abattoirs and get the freshest liver available. The liver was then pressed by her own chands and s9ueeFed to get the fresh )ui&e. .uge amounts of this were &ombined with large daily doses of flavored !rewer8s yeast and whole wheat germ in addition to the large amounts of vitamins mentioned above. (n amaFing transformation took pla&e in this young boy within two months. .e be&ame strong# bright# alert# and looked his age again. .is whole appearan&e be&ame altered. .is skin# eyes# andstrangely enoughhis graying hair# were rapidly be&oming normal in &olor again. The endless# ba&k-breaking hours that his mother had spent daily preparing and taking his life-sustaining nutritional aids to his bedside at the hospital had been rewarded. 5oy made a splendid re&overy after his operation. .e be&ame the pi&ture of health# and later married and took a position as librarian at a famous university. .is history was truly a triumph of the wonders of nutritionnutrition as it affe&ts the young as well as the old# The ne:t step in our resear&h was to see whether our e:perimental results with animals in "restoring" old arteries to their youthful state meant anything as far as humans were &on&erned. "irst# my &o-workers and I studied for three years the effe&ts of members of the Gitamin-! &omple: group %su&h as &holine# betaine# and inositol' on the atheros&lerosis of ;A= patients suffering from &oronary artery disease. When we published our

>D?

15,WI*1 6,7*1-5 WIT. T.- 6-(5/

en&ouraging results of treatment in the (meri&an .eart Iournal for +ay >D<=# we were persuaded to use a &omprehensive treatment method in atta&king the problem of atheros&lerosis. /everal more years of resear&h on this 9uestion &onvin&ed us of the value of an ideal &ombination of: %a' low-fat# high-protein diet# %b' large amounts of Gitamin-! &omple: together with lipotropi& %fat-preventing' agents su&h as &holoine# betaine# and inositol %all members of the vitamin ! &omple:' and %&' nutritional supplements su&h as liver e:tra&t# le&ithin# and !rewer8s yeast. /in&e it was now apparent to all medi&al s&ientists that the vast ma)ority of the population was already affli&ted with atheros&lerosis by the time age <= or ?= was rea&hed# it was &lear why this &ondition ranked first now as the &ause of death and illness in the 7nited /tates. What was not so &lear# however# to most investigators and physi&ians was that atheros&lerosis# or the "aging pro&ess" as it has so often been &alled# was responsible for the remarkable prevalen&e of premature old age# or "getting older." (nd what was e9ually important was the in&redibly widespread symptoms in those who were past <= or ?= of fatigue# la&k of energy and vitality# nervousness and depressionnot to mention a multitude of digestive tra&t# &ir&ulatory# mental# and other disturban&es that stemmed from the &ombination of atheros&lerosis and &hroni& nutritional defi&ien&ies. To put these realities to the "a&id" test# my &o-workers and I sele&ted from our hospital resear&h servi&e >=; &ases of generaliFed atheros&lerosis and divided them into two main groups. $ases in one group of B= patients in&luded mostly individuals who had proven atheros&lerosis of the brain# heart# and other organs. This group was given the &ombination of diet# massive amounts of vitamins and nutritional supplements as )ust des&ribed and as outlined in $hapter < %"3e&ithin and "ood /upplements"'. (nother and identi&al "&ontrol" group of B= patients# having the same atheros&leroti& &onditions# was

GROWING YOUNGER WITH THE YEARS 197

observed for &omparison. This group re&eived no dietary or nutritional treatment. !oth groups had e9ual representation of men and women. Their ages also were &omparable and ranged from AE to E= years. The average age for both groups# how ever# was ?=. This is an ideal age from an investigative point of view# be&ause &lini&ally this age seems to be the one most widely asso&iated with the /ymptoms of so-&alled "aging#" as previously des&ribed. (t the end of one year# we published the results in the 4e&ember >D<A issue of 8eriatrics,N the offi&ial )ournal of the (meri&an 1eriatri& (sso&iation. %1entries is the medi&al term des&ribing the field of medi&ine devoted to the health and &are of the elderly.' ,ur findings were as follows: 1# Twenty-five per cent of the group of ,0 atherosclerosis cases not treated *y our diet and nutritional program had died of complications from Atherosclerosis, mostly in the heart, *rain, and .idneys# 2# There were no deaths in the group of ,0 cases of athero sclerosis who adhered strictly to the intensive treatment of the diet and massive vitamin-nutritional supplements# A. What was e9ually striking in the treated group was the im provement &onstantly noted in well-being# high spirits# in &reased ability to work# to &on&entrate# and the remarkable vitality that most patients felt. Typi&al remarks# volun teered by patients after a few months on the treatment pro gram# were: "I feel like I have a new lease on life#" "*ever felt better in my life#" "4o&tor# I feel like a million#" "It was like &harging a rundown battery." B. The proof that these remarkable improvements were not psy&hologi&al was also found in &omprehensive bio&hemi &al analyses that my &olleagues and I &arried out in all these &ases. The blood fats and &holesterol levels in the treated series of patients de&reased@ from a previous# pretreatment# slightly abnormal level# they developed into

198

/(O )$/ -O#$/%(

)!H !H% -%&(*

ideal blood bio&hemi&al levels at the end of a year. The prote&tive phospho-lipids and lipo-proteins rose to very high# ideal levels. /ome &ases even showed remarkable improvement in their ele&tro&ardiograms %the ele&tri&al tra&ings made by a spe&ial instrument to measure the health and a&tion of the heart'. <. (s our published findings stated at the time# these &lini&al# &hemi&al# and instrumental findings "indi&ate arrest or regression of the pro&ess of atheros&lerosis in the arteries." This was a &areful# s&ientifi& way of stating that "the eviden&e indi&ates that the aging pro&ess in the arteries &an be stopped or that the arteries may be a&tually improved and restored to a healthier state." In still other words# it is apparently not beyond the realm of possibility to &reate a re)uvenating pro&ess or a return to a healthier# younger state in the body by adhering to the dietary# nutritional program re&ommended in this book. ,ne delightful e:ample among these &ases was Professor 3.# aged C=. ( widower# he had taught at universities for a lifetime# was retired# ina&tive# depressed# and e:tremely unhappy. .e &ould not work for long without feeling e:hausted@ his powers of &on&entration seemed to have gone# he was &onstantly tired and dispirited. To top it all# he suffered &ontinuously from "indigestion#" whi&h he attributed to his own housekeeping# &ooking or eating out in restaurants. Thorough e:aminations and 0-ray studies revealed that there was no physi&al or organi& disease present# other than the usual amount of atheros&lerosis to be found in a man of his years. .e then agreed to follow faithfully our dietary-nutritional program as previously des&ribed. Within a month there was already a surprising &hange. !ut after three months# his improvement was really remarkable. 1one were all the digestive symptoms. Professor 3. literally boun&ed into the offi&e# the pi&ture of vitality and youthful vigor.

GROWING YOUNGER WITH THE YEARS 199

.e &omplained he had so mu&h energy he )ust had to release it# or he felt he would e:plodeK "4o&tor#" he said# "I simply must go ha&k to tea&hing again# I feel so wonderful. Would you please help me fill out these physi&al e:amination forms so I &an get 8medi&al &learan&e8 N8 I did so with pleasure and wished him good lu&k. ( little later he se&ured a position in a private s&hool. Imagine my surprise and delight when he &ame to my offi&e smilingly several months later. With him was a &harming# matronly widow. They had &ome in for their Wasserman tests# as re9uired by the law in the /tate of $alifornia for pre-marriage &ertifi&ates. They were leaving soon for their honeymoonK (pparently it8s not only never too late to feel young# but it8s also never too late to a&t and be youngK We all know that when you have su&h a sense of well-being and feel young# your whole attitude towards life is younger and fresher. ,ne8s entire philosophy &an &hange to a more youthful# optimisti& one# in pla&e of the stagnating and defeatist attitude that so many older people have. When you feel young# you a&t young@ you want to do youthful things and you thin. young. This feeling and philosophy of life prevents many mental and bodily ills that are espe&ially apt to affli&t elderly people. In this way &an you maintain health# vigor# and happiness with the advan&ing years. It has been said that "There is really no &ure for old age@ only those who die young es&ape it." !ut the low-fat nutritional way of life &an really help you "1row 6ounger With the 6ears."

INDEX
( (dlersberg# 4r. 4avid# ;D (drenal glands# ? (ging pro&ess Fsee also (theros&lerosis' due to nutritional defi&ien&ies# >D< eviden&e that it may be reversible# >EE->D; fat &auses premature# ;C restoring youth to prematurely aged# >D;->DD symptoms of# A#>EC (hren# -. ..# AB (l&ohol# use of# <C#>B?-><D addi&tion# >BD# ><E# ><D analgesi& effe&t of# ><> appetite stimulator# >B?# >BC beer# >CB &alorie &ount# >;; effe&t on &ir&ulation# >BE-><= effe&t on &oronary arteries# ><>><; effe&t on health# >B? as a food# >BE "good" effe&ts of# >BC-><; in)urious effe&ts of# ><;-><D &hroni& al&oholism# ><<-><D@ Fsee also (l&oholism' to the emotions and mind# >BC# ><A-><B to:i& effe&ts# >BC# ><B-><< moderation in drinking# ><=-><># ><D not a stimulant but a depressant# >BC# ><A-><B rela:es tension in heart &ases# >BC# ><;# >CB useful as a "toni&." >BC->BE (l&oholi&s (nonymous# ><E# ><D (l&oholism# ><<-><D brain affe&ted by# ><<-><? antabuse used in &uring# >BA->BB &irrhosis of the liver &aused by# ;C#><E-><D delirium tremens# ><?-><C effe&ts of# ><B-><< 2orsakofTs psy&hosis# ><C><E +ar&hiafava-!ignani8s disease# ><? polyneuritis# ><C Werni&ke8s disease# ><? (leromatous plagues# ;= (llergi& rea&tions# due to wrong foods# BA (meri&a# defi&ien&ies in (meri&an diet# C# <D (meri&an $an&er /o&iety# >AD (meri&an .eart (sso&iation# >=? program for rehabilitating heart patients# >CE American 2eart >ournal, >D? (meri&an +edi&al (sso&iation# ;C >ournal, >A<# ><= (ngelfood &ake# C= &up&akes# E= (ngina pe&toris# ;>-;; effe&t of high blood pressure# A;-AA hereditary fa&tor# A= smoking effe&ts# >A?# >CA use of al&ohol to relieve pain# ><>><; (nimals# e:perimental resear&h on# >D# >DA->DB (nits&hkow# Professor# ;C (ntabuse# used to &ure al&oholism# >BA->BB

261

%$% (n:iety# &ause of overweight# >=A>=< (ppetite: al&ohol stimulates# >B?# >BC# ><A drugs for redu&ing# >>> low-fat hors d8ouvres used to &urb# >=D ways of stimulating# BB (pplesau&e snow pudding# E= (rteries: animal e:periments in "restoring" old arteries# >DA->DB !uerger8s disease# >AC# >B<# >BE &onstru&tion of# A-B &oronary: effe&t of al&ohol on# ><>-><; fatty deposits blo&k# >?< fun&tion of# >?< siFe of# >?< way in whi&h heart heals itself# >?<->?? diseases of# B-< e:&ess fat imbedded in wall itself# A>-AA# >?< hardening# B@ Fsee also .ardening of the arteries' layers making up wall# >D reversing damage done by e:&essive fats# >>->; swelling of lining &ells# B ways in whi&h fats &an damage or destroy# >D-;> (rterios&lerosis %see also (theros&lerosis@ .ardening of the arteries' benefi&ial use of al&ohol# >BE definition# ;-A# B-< most &ommon &ause of death# ;# C nature of# ;-C (sia# use of soya oil# ?? (theros&lerosis# <@ Fsee also .ardening of the arteries' animal e:periments# >DA->DB atta&ks old and young people# D->= benefi&ial use of al&ohol# >BE as a &ause of death# >D? &auses# ?# >DA &holesterol present in blood# ;E-;D

I*4-0 (theros&lerosis F ont#G &oronary: effe&t of smoking on# >A? prevalen&e of# >;B# >D? effe&t of vitamin ! &omple:# >DA>D? effe&t of smoking# >AC hereditary fa&tor# ;D-A> in&iden&e in men and women# D->= 3e&ithin used to prevent# ?A-?B low-fat diet proved valuable in fighting# C-E# A?-AE# >DC plus nutritional supplements# >DC->DD problem of preventing# ;= reversing damage done to arteries by e:&essive fats# >>->; in swine# ;<-;? thin and wiry persons not sus&eptible to# AA-AB women have natural prote&tion against# >> in World War II &on&entration &amp vi&tims# >ED (vo&ados# <;# <C

!
!a&on# high in fat &ontent# BD# <<-<? "!anks#" of blood vessels# A> !anting# "rederi&k# >DA !eef# fat and &holesterol &ontent# BE !eer# effe&t on heart# >CB !eri-beri# ?C !est# $harles# >DA !eta lipoproteins# ;E !everages: low-fat diets# << low-salt diets# >?E !irmingham# (labama# nutrition &lini&# >EC !lood: &oagulability fa&tors# ? lipemi&# ;= !lood &lotting# B anti-&oagulant medi&ines# >?<# >CA 3e&ithin used to prevent# ?B !lood pressure: arteries affe&ted by high# <# A;

INDEX
!lood pressure F ont#G emotional stress affe&ts# A;-AA smoking affe&ts# >AA# >A< !lood sugar# effe&t of tension on level of# >=B !lood vessels Fsee also (rteries' al&ohol used to aid &ir&ulation# >BE><= "banks#" A> diseases of# A effe&t of smoking on# >AA# >A<->AC# >CA peripheral# >BE !ragdon# I. ..# ;? !ouillon# BC@ Fsee also /oups' vegetables &ooked in# <; !rain: blo&kage of artery in# >D &erebral atheros&lerosis# B=-B> low-fat diet helped patients with hardening of the arteries of# >EA stroke due to blo&kage of arteries of the brain# B

2*3
$alories: al&oholi& beverages# >;; amount re9uired de&lines with age# >>= amount supplied by fats# >C basal &alorie re9uirements# >=C &ounting# >=>->;; definition# >=? determining number needed# >=C>=E list of foods# >>>->;; maintaining proper weight by a regular &alorie &ount# >=E->=D menus giving &alorie &ount# C>>== Fsee also +enus' pound of body weight e9uals A<== &alories# >=? $an&er: of the laryn:# >B= lung &an&er and smoking# >A<# >AD->B> death rate# >AD in&rease in# >A<# >AD pipe and &igar smokers# >B= smoking not sole &ause# >AD->B= of the tongue# >AE $andy# <C fat-free# << $arbohydrates# main sour&e of energy# ><->? $ereals# low-fat diets# <B# >?E $heeses: butterf at# ?? &ottage# <>-<; low-fat diets# <>-<;# <? $hildren# malnutrition among# >>> $holesterol# A# >E deposited in the artery wall# < due to error in fat metabolism# ;D effe&t of heredity# >=->># B? familial hyper&holesterolemia# B? laboratory &he&ks on level of# >; low-&holesterol levels# B<-B? nutritional supplements used to lower level of# ?; present in blood of patients with atheros&lerosis# ;E-;D prote&tive agents &an lower level of 35' ;2

!read:

baked "ren&h toast# CB with high-fat &ontent# <?-<C low-fat diets# <B# <?-<C low-salt diets# >?C whole wheat# <B !reakfast# ;>-;; need for a substantial# <B# >=D !rewer8s yeast# ?B used to supplement diet# >EC# >D<# >L !right8s disease# B# A> !ron&hos&opy# >B=->B> !uerger8s disease# >AC# >B<# >BE !utter: harmful fat &ontent# ?? vegetables &ooked without# <; !yers# /anford# ?A

c
$akes# angelfood# C=# E= $al&ium# fatty deposits in arteries a&9uire# ?

%$*
$holesterol F ont#G relationship between *(% eaten and# C# ;E-;D sour&e of# C# ;E-;D $hylomi&rons# ;E $ir&ulation: al&ohol used to improve# >BE-><= smoking in)urious to# >CA 1rrhosis of the liver# ;C-;E# ><> due to &hroni& al&oholism# ><E-><D $limate# best suited for &oronary &ases# >C?->CC# >E; $o&ktails# "+olotov"# ?B $o&oa# <C $o&onut oil# ?? $o&onuts# <;# <C $offee: artifi&ial stimulant# >? use following heart atta&k# >CB $olds# nutritional supplements prevent# ?; $onstipation: effe&t on heart# >CB->C< nutritional supplements . #I#&%'
2

INDEX
4eath rate: from atheros&lerosis# >D? overweight &auses in&reases in# >=; 4elirium tremens# ><?-><C 4epression# low-fat diet relieves feelings of# B> 4esserts: angel&ake &up&akes# E= applesau&e snow pudding# E= fat-free# << fruit# C= gelatin# C= with high-fat &ontent# <C )unket# EB lemon sponge pudding# C? lowfat diets# <<# <C low-salt diets# >?E snow pudding# CB 4iabetes# AA 4iets and dieting: (meri&ans are overfed but undernourished# C# <D diffi&ulty in pres&ribing# BB energy in&reased by a good diet# BB-B< fat may not be essential# >A->B for health rather than beauty# BA# >=;->=A high-fat# B<# >DA low-fat Fsee 3ow-fat diet' low-salt# low-fat# >??->C= foods permitted# >?C->?E foods to avoid# >?C one week of sample menus# >?E>C= maintenan&e# >=E->=D need not mean starvation nor tasteless foods# BB number of years to be gained by a&hieving ideal weight Fta*lesG >;E->;D nutritional supplements# <D-?E# >E?->EE Fsee also *utritional supplements' of people in other lands# E-D servings of food should be small#

$orn oil# <A# <C# ?? $oronary arteries# fun&tion of# >?< $oronary o&&lusion Fsee .eart atta&ks' $oronary thrombosis# A-B Fsee also .eart atta&ks' due to blo&kage in the artery# >D due to smoking# >A=# >A? heart heals itself# >?;->?? low-fat diet helpful# AE-B; survival span# >?; treatment after an atta&k# >?=->E; in women# ;D-A= $ottonseed oil# <A# <C# ?? $ream sau&e# E< $reamed egg whites# E= $up&akes# angel&ake# E= 4 4airy produ&ts: with highfat &ontent# <? low-fat diets# <>-<;# 9; /!23"(/% 1i#%"' 1;8

116

INDEX
4iets and dieting F ont#G seven rules for getting weight down# >=D->>= stop-and-go# >=; suggestions for &urbing appetite# >=D 4igestive disorders: e:periment using balloons# ><= heart affe&ted by# ><=# >CB 4igestive tra&t# effe&t of smoking on# >AC->AE 4iseases: effe&t of advan&es in medi&ine on# ; arterios&lerosis# ;# A# < defi&ien&y# ?C due to improper nutrition# ?= overweight a hidden disease# >=>>=; "4ropsy#" A> 4rugs# redu&ing# >>> 4ublin# 3ouis 4.# >=; 4u&ks# high-fat &ontent# <=# <? E -ating habits# in&orre&t# ?=# >=< -ggs: &reamed egg whites# E= low-fat diets# <> yolks# high in &holesterol# <># <?# ??#?D -isenhower# 4wight 4.# >B< heart atta&k# >CA# >C< -le&tro&ardiograph# >?? -motional stress# &auses blood pressure to rise# A;-AA -motions# effe&t of al&ohol on# >><A><B -nergy: modern life re9uires less energy# >=? good diet in&reases# BB-B< overweight &auses loss of# >=< -ngelberg# .yman# A? -skimos# in&iden&e of heart atta&ks# >A->B -urope# high (%# of atheros&lerosis in# AC

2*5
-:er&ises# following heart atta&k# >C>->CA -:haustion# feelings of# ><->? F "ailure# overweight due to feelings of# >=B->=< feelings of# ><->? low-fat diet prevents# B= nutritional supplements prevent# ?; "ats: amount &onsumed by average (meri&an# ;># ;;-;A# ;B animal# >C &alories &ontained in# >?->C &ause of atheros&lerosis# ?# E-D# ;C-B; &oronary arteries blo&ked by# >;# >?< definition# >B deposits# >E digestive pro&ess# >C->E endogenous lipids# >E enFymes# >C# ;D e:&ess amount imbedded in artery wall# A>-AA e:&ess fat present in blood of patients with atheros&lerosis# ;E;D e:ogenous fats# >E foods &ontaining# C how they are absorbed# >E importan&e of body# ;< in the blood# ;=# ;E-;D lipids# >E# >D liver prote&ts body from e:&ess fats# AB may not be essential in a healthy diet# >A->B nature8s way of storing# ;B-;< neutral# ;= overweight Fsee ,verweight' patients develop intoleran&e to# ;> physiology of# >A-;? preventing agents# A<-A? relationship between &holesterol (&1 amount of fat #(%#&' 7

26;
"ats F ont#G relationship between fat in blood stream and in artery wall# >D reversing damage done to arteries by e:&essive# >>->; "soft#" ?? "solid#" ?? unsaturated fatty a&ids# >B# <A# ??-?C vegetable# >C ways in whi&h they &an damage or destroy arteries# >D-;> "atty a&ids# >E unsaturated# >B# <A# ??-?C "emale se: hormones# effe&t on atheros&lerosis# AA-AB# A? "ish: low-fat diets# <=# <? low-salt diets# >?C "ood# nutrient value# ?= "ran&e# diet during World War II# E "ren&h dressings# ;=# C; "ren&h toast# baked# CB "reud# /igmund# >B>->B; "ried foods# avoiding# <C "riendman# +eyer# ?A "ruit: desserts# C= applesau&e snow pudding# E= snow pudding# CB )ui&es# << low-fat diet# <; low-salt diet# >?E for sna&ks# >? whips# C= "rustrations# overweight due to# >=B "unk# $asimir# ?C-?E
G

INDEX 1landular trouble# e:&essive fat seldom due to# >=A 1ofman# Iohn# ;E 1ottlieb# ..# ;? 1ravies# fat-free# BD# <C 1rease# removing fat from soup# BC-BE . .am for low-fat diets# BD# <<-<? .ardening of the arteries@ Fsee also (theros&lerosis' definition# ;= fat as the killer# ;C-B; 3e&ithin used in treating# ?<-?? pro&ess of# ? .arger# 5. *.# ><A .ealth: diet is key to# BA effe&t of smoking on# >AB->A< low-fat diet effe&tive in promoting# AE-B; .eart: auri&les# >?;# >?< &ollateral &ir&ulation# >?< &oronary arteries# >?< diagrams of# >?A->?B effe&t of indigestion on# ><=# >CB effe&t of smoking on# >A<->A? e:periments with animals# ;E failure# ; heals itself# >?;->?? weakened by overweight# >=< .eart atta&ks@ Fsee also $oronary thrombosis' al&ohol rela:es tension# ><;# >CB among -skimos# >A->B &auses# ;# B# AA-AB effe&t of low-fat diet on# E-D# >;# ;;# BB# >;B heart heals itself# >?<->?? medi&ine to prevent fats from &ausing# AB-A< survival span# >?;# >E=->E> treatment following# >?=->E; (meri&an .eart (sso&iation programs# >CE anti-&oagulant medi&ines# >?<# >CA

1allstones# >E# ;> 1amma globulin# 3e&ithin in&reases amount of# ?B 1arnishes: for meats# BD-<= for salads# <B 1elatin desserts# C= 8eriatrics, B># >DC

INDEX .eart atta&ks F ont#G treatment following F ont#G best &limate# >C?->CC &are of the bowels# >CB->C< &ontrol of weight# >?? e:er&ise# >C>->CA follow do&tor8s advi&e# >E= importan&e of a &onstru&tive attitude towards life# >CE->E= low-fat# low-&holesterol diet# >?? low-fat# low-salt diet# >??->C4 returning to work# >CE "#x relations# >C<->C? sleep and rest# >C=->C> smoking# >CA->CB so&ial a&tivities should be rela:ing# >C> ten rules to follow# >E>->E; use of al&ohol# >CB use of &offee and tea# >CB use of ele&tro&ardiograph# >?? vo&ational rehabilitation# >CE .eparin# A? .erbs# for seasoning vegetables# <=# <; .eredity# effe&t on atheros&lerosis# >=->># ;D-A> .igh blood pressure# drives &holesterol into artery wall# <# A; .obbies# value of# >C># >E; .olman# 5ussell# >> .opkins# /ir "rederi&k 1owland# ?C-?E .ormone# diffi&ien&ies# ?# AA-AB# A? .ulpieu# .. 5.# ><A .unger# preventing feelings of# ><>? .ypogly&emia# >?

2*# Italy# low-fat diet during World 8( >>#E

J
Ia&kson# $hevalier# >B=->B> Ioliffe# *orman# ?=# ?> Ioyner# ..# ;; Iui&es: fruit# << vegetables# << Iunket for low-fat diets# EB

K
2atF# 3ouis# C 2ellner# (aron# AB 2idneys: atheros&lerosis of# B# A> 3e&ithin used in treating# ?< 2idneys# re&ipe for &ooking# BD 2orean War# in&iden&e of atheros&lerosis in soldiers# >= 2orsakofPs psy&hosis# ><C-><E 2uo# Peter# 22 L 3ali&h# I. I.# ;? 3amb# low-fat diets# BE 3ard# harmful fat &ontent# <C# ?? 3aryn:# &an&er of# >B= 3eary# Timothy# ?-C 3e&ithin# >E# B> &alorie &ount# ?? &holesterol redu&ing preparation# daily amount to be taken# ?;-?? prevents blood &lotting# ?B therapeuti& 9ualities of# ?B-?< used to supplement diet# >EC# >D? 3egs# smoking affe&ts &ir&ulation in# >CA 3emon sponge pudding# C? 3emons# used to prevent s&urvy# ?C 3ewis# 3ena# ;? 3ife-span# > e:tended five years sin&e >DB<#>;B 3ima beans# baked# E;
#8-#*

I
I&e &ream# high in fat and &holesterol# <C Indigestion# heart atta&ks &aused by# ><=# >CB Infe&tions# nutritional supplements prevent# ?; Isaksson# !.# >EA

%$& 3ind# $apt. Iames# ?C 3ind9uist# 1.# >EA 3ipase# >C 3ipoproteins# ;=# ;E 3ipotropi& %fat-preventing' agents# >D? 3iver: bile# >C &irrhosis of# ;C-;E# ><># ><E-><D prote&ts body from e:&ess fats# AB 3iver %meat': e:tra&t# B> nutritional supplement# ?B# >EC# >D<# >D? used in low-fat diets# B># BD# <? valuable sour&e of nourishment# ?D 3ivesto&k# vitamins and nutritional supplements fed to# >DB 3obsters# low-fat diets# <= 3ongevity: age and mortality as related to e:&ess weight Fta*leG, >;C number of years to be gained by a&hieving ideal weight Fta*lesG >;E->;D overweight as a threat to# >=> 3owfat diet: during World War II# E-D effe&tive in redu&ing weight and promoting good health# AE-B; foods permitted# BC-<< beverages# << breads# <B &ereals# <B &heeses# <>-<; desserts# << eggs# <> fish# <= fruits# <; meats# BE-<= milk and milk produ&ts# <> poultry# <= salads and salad dressing# <A-<B soups# BC-BE vegetables# <;# C=

INDEX 3ow-fat diet F ont#G foods to avoid# <<-<E breads# <?-<C dairy produ&ts# <? desserts# <C fish# <? meats# <<-<? mis&ellaneous foods# <C-<E poultry# <? soups# << for older people# >EA->E? &on&entration and enduran&e in&reased# >EB->E< /wedish e:periment# >EA->E< heart atta&k patients# >;B key to longer life# >;A->;D leads to sense of wellbeing# >ED>D= list of foods and the number of &alories# >>>->;; menus# ;A;B# ?D->== Fsee also +enus' most people &an benefit from# B<B? proved of value in preventing fat and heart disease# A?-AE with nutritional supplements# >EB@ Fsee also *utritional supple ments' + +ar&hiafava-!ignani8s disease# ><? +arks# .erbert ..# >=; +aster# (rthur# >=< +ayonnaise: low-&alorie# no-fat dressing# C; low-fat# C= +eat: &ooking# BE-BD# C= garnishes# BD-<= gravies# BD low-fat diets# BE-<=# <<-<? low-salt diets# >?C sour&e of protein# >B trimming fat from# BE# ?D-C= veal# baked &hops# CC +edi&al &he&k-ups# >E; for &holesterol level# >;

INDEX
+edi&ine: atomi&# A< to stop fat from &ausing heart atta&ks# AB-A< +en: desirable weight for men ;< and in&iden&e of atheros&lerosis in# D->=# >; +ental &ondition: low-fat diet and supplements aid# B> effe&t of al&ohol on# ><A-><B +enus# low-fat# C>->== E== &alories# DC->== >=== &alories# DA-D? >;== &alories# ED-D; ><<= &alories# E? >?== &alories# CD#EA >C== &alories# CA-CB#EB >E== &alories# CC# E< >E<= &alories# CE# EE >EC< &alories# E; >D== &alories# C>-C; >D<= &alories# EC >DC< &alories# C<-C? ;><= &alories# E> for heavy overweights# >=C->=E for mild overweights# >=E for moderate overweights# >=E low-salt# low-fat diet# >?E->C= +etropolitan life Insuran&e $ompany# >=; +ilk and milk produ&ts: butterfat# ?? low-fat diets# <>#<B# << +ineral oil# ?? +inerals# essential to nutrition# ?E +oine# +ar&el# E "+olotov" &o&ktails# ?B +oore# Iohn 5oyal# >DB +outh# smoking affe&ts# >AE

269
*ervousness: nutritional supplements prevent# ?; primary &ause of overweight# >=A>=< *i&otine# poisonous nature of# >AB# >B< *oodles# baked# E< *utrition: (meri&ans are overfed but linden nourished# C# <D# >E?->EE defi&ien&y diseases due to imL proper# ?= fats may not be essential# >A->B malnutrition among &hildren# >>d# symptoms of poor# >EE *utritional supplements# B=# <D-?E &orn oil or safflower oil# ?; 3e&ithin# ?;-?? for older people# >EC->EE soya bean oil# ?;# ??-?C value of# ?>-?; vitamin ( H $# ?;# ?C-?E vitamin ! &omple:# ?;# ?C-?E wheat germ# ?; *uts# omitted from low-fat diet# <C

over Fta*leG, >;?

$
,lder people: low-fat diet for# >EA->DD &aused amaFing improvements# >EB->E< &on&entration and enduran&e in&reased# >EB->E< /wedish resear&h# >EA->E< nutritional supplements for# >EC>EE restoring youth to prematurely aged# >D;->DD vitamin defi&ien&y in# >E? weight &ontrol# >D; ,leomargarine# harmful fat &ontent# ## ,live oil# ?? ,verweight: age and mortality as related to e:&ess weight Fta*leG, >;C

*
*ational .eart Institute# !ethesda# +aryland# ;? *erves# &hanges in peripheral# >]C

216
,verweight F ont#G &auses of# >=A bad eating habits# >=< due to glandular trouble# >=A feelings of failure# >=B->=< nervousness# >=A>=< dieting for health rather than beauty# >=># >=;->=A heart strained by e:&essive# >=;# >=<->=? hidden disease# >=>->=; number of years to be gained by a&hieving ideal weight Fta*lesG, >;E->;D poor health &aused by# >=> seven rules for getting weight down# >=D->>= shortens lifespan# >=># >;< ,ysters# low-fat diet# <= . Page# Irving# ;? Peas# &ream of pea soup# CC Pennsylvania# 7niversity of# .ospital and +edi&al /&hool# ;; Pett# 3ionel !.# >E? Phospholipids# >E# AB Pigs and hogs: development of atheros&lerosis in# ;<-;? Pneumonia# 3e&ithin used to prevent# ?B-?< Polyneuritis# ><C Pork produ&ts# E# BD high in &holesterol and fat &ontent# <<-<? Poultry# for low-fat diets# <=# <? Protein: animal sour&es# >B keystone of human nutrition# >B->< normal re9uirements# >< vegetable sour&es# >B->< Psoriasis# 3e&ithin used in treating# ?< Puddings# lemon sponge# C?

INDEX

R
5aynaud8s /yndrome# &aused by e:&essive use of toba&&o# >AC 5ela:ation# value of# after +#( % atta&k# >C> 5i&kets# ?C 5osenman# 5ay# ?A

"
/alad dressings# <A-<B# <C low-&alorie# no-fat dressings# C; low in fat &ontent# <A "ren&h dressing# C= mayonnaise# C= soya bean oil or &orn oil# ?; vegetable oils# <A# <C# ?; Mero dressing# C; /alads# <A-<B fruit# <A garnishes# <B gelatin# <A low-fat diets# <A-<B# <C tuna# EA /alt# low-salt# /!23*(% 1i#%"' 1;;3176 foods permitted# >?C->?E foods to avoid# >?C one week of sample menus# >?E>C= substitutes *! "(/%' 1;;31;7 /au&es: &ream# E< shrimp# CB /&urvy# ?C /e&urity# eating . !Ii1#" *##/i&g" !*' >=< /edatives: al&ohol# >BC# ><;# 175 smoking a&ts as# >AA /e: glands# ? /e: relations# *!//!2i&g +#( % (%%($?' >C<->C? /herbets# C= /hrimps: low-fat diets# <= sau&e# CB /leep and rest# following +#( % (%3 %($?' >C=->C>

INDEX
/moking# >A=->B< addi&tion# >A;# >AA# >B; agreeable effe&ts of# >A;->A< blood vessels affe&ted by# >A?->AC &an&er and# >A<# >AD->B> diseases &aused by e:&essive use of toba&&o# >AC digestive tra&t affe&ted by# >AC->AE effe&t on health# >A=#>AB->A<#>AC effe&t on the heart# >A<->A? niters# >B= following heart atta&k# >CA->CB habit-forming# >A;#>AA harmful effe&ts# >A=# >AB->B< heavy or e:&essive# >A=#>A<#>B= how to stop# >B>->B< &utting down gradually# >B; substitute gum or &andy# >BA->BB swit&h to pipe# >B;->BA use of prayer and auto-suggestion# >BB use of preparation with silver nitrate# >BA will power# >BB->B< hunger affe&ted by# >AE indifferent effe&ts of# >AB inhaling# >A< lung &an&er and# >A<# >AD->B> death rate# >AD in&iden&e among pipe and &igar smokers# >B= in&rease in &ases# >AD ni&otine in toba&&o# >AB->A< poisons present in toba&&o# >AB>A< slows down mental and physi&al effi&ien&y# >B< stoma&h ul&ers aggravated by# >AE studies of the effe&t of# >A>->A; /na&ks# low-fat diet# >? /now pudding# CB /oups: bouillon# BC &onsomme# BC &ream of pea# CC dry mi:es# BE high in fat &ontent# << lowfat diet# BC-BE# <<# ?D low-salt diets# >?C

211
/oups F ont#G removing fat from# BC-BE /oya oil# <C added to low-fat diet# B> &alori& &ount# ?C &ontains unsaturated fatty a&ids# ??-?C used for salad dressing# <A /oybeans# AB 3e&ithin made from# AB# ?A /pies# Tom# >EC# >D; /9uab# lowfat diets# <= /tamler# I.# C /tar&hes# sour&e of energy# >< /teapsin# >C /teiner# (lbert# >DB /terols# to prevent fat# A? /tevenson# I. W.# ;? /timulants: al&ohol# >BC# ><A-><B &offee and tea# >CB /trokes: &auses# ;# B# AA-AB definition# B /uet# avoid using# <C# ?? /ugar: low-blood# >?# >=B sour&e of energy# >< /upplements# dietary# <D-?E Osee also *utritional supplements' /utton# /ir Thomas# ><?-><C /weden# results of low-fat diet for older people# >EA->EB /wine# development of atheros&lerosis in# ;<;? T Tension: atheros&lerosis affe&ted by# ? affe&ts blood sugar level# >=B normal digestion blo&ked by# >BD Thompson# 1. *.# ><A Thyroid e:tra&t# A? Thyroid gland# underfun&tioning ol ?#AA Toba&&o %see /moking' "Toba&&o angina#" >A=# >A? Tran9uilliFer# al&ohol as# >BD

212
Tuna fish# low-fat diets# <=# EA Turkey# low-fat diets# <= 7 7l&ers# smoking aggravates# >AE 7nited /tates: defi&ien&ies in (meri&an diet# C# <D high rate of atheros&lerosis in# AC E Geal: baked &hops# CC low-fat diets# BE Gegetables: baked lima beans# E; &ooked in bouillon# <; &ooked without butter# <; )ui&es# << low-fat diets# <;# C= low-salt diets# >?C oils# ?? Gir&how# 5udolph# < Gitality# lowfat diet in&reases# AE Gitamins: (# ?;# ?E ! &omple:# AB# A<# B> breads &ontain# <B &ereals# <B daily dosage# ?; effe&t on atheros&lerosis# >DA->D? la&k of# ><C purpose of# ?E $# ?;# ?E Gitamins: defi&ien&ies# ><C# >E? premature aging due to# >D;->DD dis&overy of# ?C fat preventing# A< how to use# ?># ?C-?E nature of# ?E Go&ational rehabilitation# following heart atta&k# >CE

INDEX W Weight: age and mortality as related to e:&es weight Fta*leG, >;C &ontrol of# important following heart atta&k# >?? desirable weight for men ;< and over Fta*leG, >;? desirable weight for women ;< and over Fta*leG, >;C low-fat diet proved effe&tive in redu&ing# AE-B; number of years to be gained by a&hieving ideal weight Fta*lesG >;E->;D older people need to pra&ti&e &ontrol# >D; overweight %see ,verweight' Well-being# low-fat diet in&reases sense of# B=# >ED->D= Werni&ke8s disease# ><? Werthessen# *. T.# A< Wheat germ# <B# ?;# >D< White# Paul 4udley# ;# >C< Will power# needed to stop smoking# >B< Women: desirable weight for women# ;< and over Fta*leG, >;C in&iden&e of atheros&lerosis in# D->=# >># A=# AA-AB
X

0anthalasma# ?? 0anthomatosis# AA# B? 6 6ogurt# low-fat diets# <># <<# <? 6ounger people: e:&essive weight shortens life# >;<>;? in&iden&e of atheros&lerosis in# >=
A

Meller# I. ..# ;?