Fats on the Fire

In the continuing controversy over the importance of fats as a cause of artery disease, heart attacks and strokes, no investigator has been more conservative than the Cleveland Clinic's Research Director Irvine H. Page (TIME Cover, Oct. 31, 1955), onetime president of the American Heart Association. In 1957 he joined other A.H.A. bigwigs in insisting that the evidence to date does not justify a major change in national eating habits. But now in the A.M.A. Journal, Dr. Page describes a revision in eating habits that he suggests is worth a wide-scale trial. If it pans out, physicians might start a revolution in the U.S. kitchen.

Spread on Bread. In a report written jointly with Dr. Helen B. Brown. Dr. Page notes that in the average U.S. diet today, 42% of calories are taken in form of fats, 14% as protein and 44% as carbohydrates. Of the fats, 85% are of animal origin or artificially hydrogenated, and therefore mainly saturated.* while 15% are of vegetable origin and comparatively unsaturated.

As Drs. Brown and Page saw it, the trick was to reverse the animal-vegetable fat ratio while disturbing the eating patterns as little as possible. They did this by: 1) eliminating most of the saturated fat from the diet by cutting out fatty meats, butter, whole milk, cream, most cheeses, egg yolks, oleomargarine, hydrogenated shortenings, coconut and cocoa products; 2) adding cottonseed oil (though soybean, corn or peanut oil would have done as well) to make up the fat deficit.

For Large Appetites. In the clinic's rigidly controlled tests, the cottonseed oil was a special brand that could be used as a spread on bread and emulsified in a blender with nonfat milk solids to make "milk," "cream" or "ice cream," thus permitting a normally varied menu. But this was a matter of taste and convenience, not medical necessity. The ordinary commercial oils, say Drs. Page and Brown, "are excellent for cooking and baking"; also, "two or three teaspoons added to each serving of a low-fat food convert it to a satisfying, flavorful product." Large appetites "can be satisfied with large servings of veal, fish and poultry." In any case, a single serving of up to 5 1/2 oz. of lean meat is allowed at one meal, preferably dinner.

Medical students with normal blood patterns were fed the cottonseed oil diet from the clinic's kitchens for three weeks, and showed consistent drops in their circulating cholesterol--a clue as to whether the system is being overloaded with fat. Patients with atherosclerosis--some with diabetes or high blood pressure, and some who had already had heart attacks--were kept on the diet for as long as eight months, usually with home cooking. In every case their abnormally high cholesterol levels showed a gratifying drop.

To nail down the relationship between on-the-job physical activity and heart-artery disease, Drs. Jeremy N. Morriss and Margaret D. Crawford of Britain's Medical Research Council persuaded 206 hospitals to report on post-mortem examinations of the hearts and coronary arteries of 5,000 men, regardless of the cause of death. The findings, reported in the British Medical Journal, show that heart disease occurs in inverse ratio to the heaviness of work. Large, healed scars in the heart muscle--evidence of a long-ago heart attack--were three times commoner in light workers (schoolteachers, bus drivers, clerks) than in heavy workers (boilermakers, dock laborers, coal hewers). Most striking, such scars were four to five times commoner among light workers in the 45-59 age group.

Also significant: although some narrowing of coronary arteries occurred regardless of occupation, the most severe shutdowns, of the type that causes clear-cut heart attacks, were more frequent among light workers and occurred when they were younger--as often in their 45-59 age group as among heavy workers aged 60-70.

The researchers' tentative conclusion: physical activity is a protection against heart-artery disease: as compared with sedentary types, heavy workers get less of the disease, get it in less severe form, get it later in life.

* To the organic chemist, a saturated fat is one whose molecules have hydrogen atoms at all the points where they can be attached. It stays solid at room temperature. Most vegetable fats are liquid, and unsaturated to varying degrees.

This file is automatically generated by a robot program, so reader's discretion is required.