Welcome to Spring! This is the first newsletter I've published since last fall, and with it I'm returning to a monthly schedule once again. I'm particularly excited about the topic of this issue, Healing Heart Disease. We all know that heart health is a major concern for millions of Americans, but we keep hearing conflicting evidence on how to prevent heart–related illnesses. Is it a matter of eating less saturated fat and cholesterol? Is it possible to lower cholesterol or blood pressure without drugs? Is heart disease just genetic? My article will help to demystify these questions and will guide you towards a diet and lifestyle that is good for your heart and for your overall health.

Since it's spring, I've also included a short note on the amazing power of local raw honey to reduce your seasonal allergies and all related symptoms, for anyone who hasn't heard me hold forth on this subject before. If you have seasonal allergies, I strongly recommend that you give raw honey a try.

I'm not totally sure yet of the topic of next month's issue, but since we've recently found out that my wife is pregnant (she'll be giving birth in November), you can probably guess what health subject I'm in the midst of researching now!

I publish this newsletter as a part of my private practice as a Holistic Health Counselor, in which I help people get healthier and happier by guiding them through positive diet and lifestyle changes. I work with my clients either over the phone or in person in individual six–month programs. I also lead group workshops and group programs, and work with schools, businesses and other communities to improve their overall health and wellness. I also give free health history consultations. If you'd like to spend about an hour talking with me about your goals for your health and life, simply send me an email!

Healing Heart Disease

I. Introduction

Heart disease is the leading cause of death for both women and men in the United States. In 2005, 27.1% of all U.S. deaths were from heart disease, and 68.3% of those were from coronary artery disease. More people died from heart disease than from strokes, respiratory diseases, diabetes, flu, pneumonia, Alzheimer's, kidney disease, blood poisoning, and accidental causes (including car accidents) combined. Health care services, medications, lost productivity, and other costs of heart disease are projected to equal more than $304 billion in 2009.

Clearly, heart disease is a major problem in our country (and in many countries around the world, particularly developing countries). The mainstream medical community's approach to reducing heart disease risk depends primarily on prescribing drugs to lower blood pressure, cholesterol, and triglycerides. Your dependence on these drugs is expected to be lifelong, even though they have side effects such as fatigue, dizziness, cough, frequent urination, impotence, heart arrhythmia, and muscle pain. According to mainstream medicine, you can also reduce your risk by following a diet low in saturated fat, cholesterol, and sodium, but most people struggle to follow this diet, and even if they are successful, they don't necessarily see reduced cholesterol, blood pressure, or triglycerides. The failure of these dietary recommendations implies that heart disease is just genetic, and that medication, despite its side effects, is the only way to "fix" the malfunctioning body and thereby reduce heart attack risk.

However, I believe that the real reason why the low–fat, low–cholesterol diet doesn't work is that it is based on flawed reasoning and on poor analysis of dietary studies. A truly healthy and balanced diet, can, in fact, be so powerful in protecting you from heart disease that, regardless of your genetics, you probably do not need the medications at all. In what follows, I'll explain the mechanism of heart disease such that you can clearly see why a healthy diet and lifestyle makes a difference.

II. Heart Disease Pathology

The term "heart disease" covers a wide variety of heart–related health problems, the most common of which is coronary artery disease, or CAD. I'm going to focus on CAD in this article, although other heart health issues such as heart failure, ischemic heart disease, etc., respond equally well to the same diet and lifestyle changes.

CAD is a condition in which the flow of blood to the heart muscle through the coronary arteries is blocked by plaques that have accumulated over time in the arteries. The plaque is made up of cells or cell debris, cholesterol, triglycerides (fatty acids), calcium, and connective tissue. Almost everyone has some plaque built up in their arteries, and the plaques are present not just in the coronary arteries, but also in larger arteries like the aorta and the pulmonary artery, and in arteries that bring blood to the brain (which, if blocked, lead to a stroke). Over the years, the plaques grow in size and number, until finally they are large enough to block blood flow altogether. Blood flow can also be blocked by ruptured plaques getting wedged in between other plaques. The narrow width of the coronary arteries explains why they tend to be blocked before any others. Lacking sufficient oxygen from blood, the heart muscle breaks down, and the heart stops beating unless flow is quickly restored.

Clearly, reducing CAD risk is a matter of reducing arterial plaque, which is mostly made up of cholesterol and triglycerides. Research has confirmed that a person with high levels of cholesterol and triglycerides in the blood is much more likely to develop CAD. Also important is lowering blood pressure, which, if too high, increases the likelihood that a plaque will rupture and block the artery entirely. As stated above, most people try a combination of diet and medication to address these three main "risk factors"—high triglycerides, high cholesterol, and high blood pressure—but the standard recommended diet does not make much of a difference, and the medications don't bring about a permanent cure. We'll look at each of these risk factors one by one, exploring their relation to CAD, and clarifying why the correct diet will eliminate the risk factor at its source.

III. High Triglycerides

A triglyceride consists of three fat molecules (aka fatty acids) joined to a glycerol molecule. Most of the fat that we eat (animal or vegetable) is in the form of triglycerides. When triglycerides enter the body, they are either metabolized for energy or for transporting fat–soluble vitamins, or they are stored as "body fat." Believe it or not, this latter occurrence is actually quite uncommon. Because of its density and complexity, fat digests slowly, which makes it very filling. We can only eat so much of it at once, and that limits the quantity of calories from fat that we can consume. It's very hard to eat so much fat that you would have to store some of it as body fat, or as extra triglycerides floating around in your blood. If you have high triglycerides, or are overweight, those extra triglycerides probably came from refined carbs: white flour, white rice, sugar, and high fructose corn syrup.

Refined carbs are not as calorie dense as fat, but they digest much more quickly. Soon after you eat a cookie, drink a soda, or work your way through a bowl of pasta, you're hungry again. Since you can keep eating carbs without getting satisfied, you can eat many more calories from carbs than you can from fat. When the carbs are digested, they pass into the blood as blood sugar. High blood sugar levels are good when you're about to exercise, but when you're not, they are dangerous to the health of your body. Fortunately, your body can produce insulin to remove the excess sugar from the blood and take it to the liver, which converts it into triglycerides. These are the triglycerides that are stored as body fat and/or circulate in the bloodstream, depending on your genetics (of course, if you eat enough excess calories from carbs, you'll have triglycerides everywhere). Refined carbs are even dangerous before they get turned into triglycerides, because high blood sugar increases blood clotting (just think of how sticky sugar syrup is).

More and more studies are pointing to a link between diabetes and heart disease, and it's not hard to see why: constant insulin production for lowering blood sugar is what exhausts the pancreas and causes diabetes. If we were to get our energy from healthy fats and complex carbs, instead of from refined carbs, we would be unable to eat excessive amounts of calories, while at the same time staying full and satisfied from meal to meal. We'd reduce pressure on the pancreas and we'd lower triglyceride levels.

However, I do need to make a distinction between different kinds of fats when it comes to preventing CAD. It's true that saturated fats don't cause high triglycerides, but that doesn't mean those fats always healthy, and there's a reason why they were linked to heart disease in the first place. It's just not the reason everyone thinks.

Most of the saturated fat that we eat comes from animal products: beef, pork, chicken, eggs, milk, cream, butter, etc. Until the mid–twentieth century, almost all livestock was raised on small family farms, given room to roam, and fed their natural diet of grasses, insects, seeds, etc. Then, as now, we ate saturated fat from these animals, but we didn't have the same heart disease rates that we do today. Heart disease rates only went up after our meat and dairy industry moved from family farms to factory farms, in which animals weren't given room to move, and cows in particular were fed corn and soybeans instead of green plants.

Corn and soybeans are to cows a lot like pure sugar is to human beings. Since their digestive systems are so lengthy and complicated (they're made to digest grass, after all), a diet of grains, even whole grains, gives them way more calories than they could use, and not enough nutrition. This is deliberate: it's a way to fatten cows up, in the same way that people put on weight when we eat our version of refined carbs (sugar and white flour). Cows turn these carbs into triglycerides and store them as saturated body fat. At the same time, they lack the nutrition they got from grasses, so they're unable to synthesize another kind of fat, polyunsaturated omega-3 fatty acids. Omega-3s, although they are fatty acids, actually clear out your arteries, thinning blood clots and lowering blood pressure (they're much better for you than aspirin, too). Prior to the establishment of factory farms, animal products were one of our main sources of the omega-3s: they actually protected us from heart disease! But after we started eating meat from carb–fed, factory farmed animals, we stopped getting those omega-3s, and the heart attack rates started rising.

IV. High Cholesterol

Cholesterol is an waxy substance (an alcohol, in fact) that is manufactured by the liver. It helps form hormones, bile, and vitamin D, and provides stiffness and stability to cells. In addition to making it ourselves, we can get it from eating animal products. Cholesterol is essential to the proper functioning of the human body, but it has a very poor reputation, due to its presence in the arterial plaques that lead to heart attack. If you have high cholesterol levels, the odds are that you have a lot of plaque built up. You probably have been told that to reduce your heart attack risk, you need to lower your cholesterol levels by eating fewer foods with cholesterol and/or by taking cholesterol lowering drugs, such as statins. Twelve million Americans take statins, and many of them experience side effects such as muscle pain, weakness, and mental fatigue. Statins lower cholesterol levels, but not permanently, so people have to keep taking them all their lives.

Why is it that a substance your own body makes can be so dangerous? Remember that, in preventing heart disease, we're trying to help the body work the way it's supposed to. We want to help the heart keep beating. We trust the heart to beat properly if the blood flow is not blocked. Why don't we trust the liver to manufacture the right amount of cholesterol? Why is a statin drug necessary to "fix" our cholesterol levels? In reality, it's not: you can achieve healthy cholesterol levels without drugs. To understand why, we need to address the root cause of high cholesterol.

An arterial plaque, which contains not only cholesterol, but also triglycerides, calcium, connective tissue, and cell debris, is essentially a scab covering an area where an artery has been damaged. The source of the damage could be a micro–organism—some form of bad bacteria—but in most cases the artery wall has probably been damaged by free radicals.

Free radicals are molecules that have become unstable by undergoing a chemical reaction with oxygen, usually due to a heat catalyst. These "oxidized" molecules are highly reactive because they contain unpaired electrons. In the human body, free radicals will attack stable cells and "steal" an electron from molecules in them to stabilize themselves. The attacked molecule then becomes a free radical and attacks another molecule, and so on, ultimately disrupting the function of the cell. Your body sometimes makes free radicals as a defense mechanism against viruses and bad bacteria, but an excess of free radicals is dangerous to the body's cells. Excessive free radicals come from stress, cigarette smoking, pollution, toxins in foods, and, most of all, rancid vegetable oils. To neutralize them, your body must rely on antioxidants, which are capable of safely "donating" an electron to the free radical. Antioxidants are found in many fresh fruits and vegetables and other natural plant foods. But if, like most people, you're not eating enough of those foods, your body will have to manufacture antioxidants of its own. And the primary antioxidant that it manufactures is cholesterol.

Your body sends cholesterol to the damaged site via low–density lipoproteins (LDLs. LDL, the "bad" cholesterol, refers to cholesterol being carried on its way to the arteries). Cholesterol helps in repairing the arteries (giving stability to the cells, as stated above) and neutralizing the free radicals. Afterwards, high–density lipoproteins (HDL, the "good" cholesterol) carry cholesterol back to the liver. All of this is a natural and necessary process. But if you're taking in too many free radicals, the damaged sites can't fully heal, and cholesterol just accumulates, getting tangled up with triglycerides and also with calcium, a mineral whose health benefits have been overemphasized in order to benefit the milk industry. Calcium is an essential nutrient, but it can't be properly absorbed unless you also have enough magnesium in your diet, and most people don't. Excess calcium contributes to the cholesterol plaques, making them stiff and difficult to break down (hence the term, "hardening of the arteries.").

High cholesterol levels are not the result of a genetic defect, nor are they traceable to a diet high in fat and cholesterol (except to the extent that fat from factory farmed animals contains many toxins). High cholesterol is your body's attempt to deal with marauding free radicals, which come from poor diet and a stressful lifestyle. Artificially lowering cholesterol will not solve the problem, because you're just fighting against your body's efforts to protect you. Now it's clear why cholesterol–lowering drugs must be taken continually: they only address the symptom, not the source of the problem. For real healing, you must cut down on the sources of free radicals in your life, and increase your levels of antioxidants. In doing so, you'll find that your cholesterol levels are able to get down to normal all on their own.

V. High Blood Pressure

Blood pressure refers to the force of the blood against the blood vessels (veins and arteries). "High blood pressure," also known as hypertension, refers to a condition in which the blood pressure is chronically elevated. There is a clear connection between high blood pressure and incidence of heart attack, stroke, and kidney disease, so lowering your blood pressure to normal levels is extremely important for your long–term health.

The standard medical view is that the cause of high blood pressure is unknown. However, studies have shown that stress, tobacco, alcohol, drugs, lack of exercise, and a high–sodium diet are all correlated to high blood pressure. In fact, blood pressure can have more than one cause, and it can cause more than one kind of damage in the body. In the case of heart disease, if blood pressure is chronically high, the blood vessels suffer increased wear and tear. They are more likely to need continual repair, which sets the stage for the formation of plaques. And if the plaques get large enough, high blood pressure can cause them to break off and clog the arteries.

If we don't know the cause of high blood pressure, and just chalk it up to genetic factors, we're more likely to rely on medications like beta–blockers and diuretics, even though they interfere with the body's natural processes, and have side effects including mental fatigue, depression, impotence and nightmares. In my opinion, what causes high blood pressure isn't all that hard to understand. Obviously, high blood pressure is a sign of increased physical tension. In many cases, that tension a physical response to mental stress. If we're frequently angry, frustrated, anxious, or just "tense," that's going to cause a physical reaction that will increase our heart rate, tighten all our muscles, and keep our blood pressure high. However, we don't have to be stressed out in order to have high blood pressure. We can also get it from a diet that's too high in toxins, and not high enough in nutrients.

oxins are molecules that are either harmful to or unneeded by the body. We can get them from the food we eat, particularly processed conventional foods (organic, whole foods would have very few toxins) and also from our environment—if we're breathing polluted air, for example. We definitely get them from alcohol, cigarettes and drugs, even from medications. These toxins are filtered from the blood by the liver and kidneys, and are eliminated as part of our waste. Or at least, they should be. That's how it works normally. What's crucial is that the liver and kidneys get enough nutrients to carry out their jobs, and that they're not overloaded with more toxins than they can handle.

If the liver and kidneys do have a big workload, it takes longer to filter the blood, and blood flow is not as smooth and regular. If the blood flow is backed up, this increases the pressure on the blood vessels. If at the same time there's a lack of nutrients in the diet, the liver and kidneys can't use those nutrients to neutralize toxins, so it takes even longer to filter the blood. Retention of toxins causes more fluid retention in general, so that increases blood pressure too. Even having an imbalance of needed nutrients can be a problem, as is the case with sodium and potassium. Sodium increases blood pressure while potassium helps reduce it. We need both to have healthy blood pressure, but most people have too much sodium and not enough potassium.

There's parallel between the two causes I've discussed, mental stress and toxins. In the former, we find ourselves becoming more tense and pressured (whether we like it or not) as we try to deal with life's problems. In the latter, the stress placed on the liver and kidneys by physical toxins causes high pressure in the blood vessels. Of course, we can never completely eliminate toxins, just like we can't eliminate the things that cause stress. But we can add into our lives things that help us deal with stress and toxins in a constructive way. Nutrient–rich foods are one example. Exercise is another—it helps with mental stress, by encouraging the production of feel–good hormones, and with toxins, by giving our body the chance to sweat them off instead of relying just on the liver and kidneys (does your sweat taste salty? There goes all that sodium!).

VI. Conclusion

Heart disease, like so many of our other modern–day health concerns, is caused primarily by stress, lack of exercise, and poor diet. Genetics may determine in what way an unhealthy lifestyle affects your body, but it does not directly cause high cholesterol, high blood pressure, or high triglycerides. These are not signs of your body's inherent defectiveness; rather, they're the result of your body trying to heal the damage. For long–term healing, we need to change our lifestyles so that we eliminate or negate the true cause of heart disease. To reduce your risk, try the following recommendations:

Reduce stress. There are many stressful situations in life, but they're not worth dying for. Stress raises blood pressure and inhibits your body's ability to burn triglycerides. It increases the production of free radicals, thereby increasing cholesterol levels. Don't just avoid stressful situations, but try to find peace in the midst of them, so that your happiness doesn't depend on circumstances.

Exercise more. No one looks forward to exercise if they haven't done it in a while, or if their form of exercise is stressful. Exercise can be as simple as walking. Nothing more strenuous is needed to reduce your CAD risk. Start slowly and working up to greater distances, in peaceful settings.

Eat more complex carbs. If you want to get off sugar and white flour, the way to do it is by eating more whole grains (brown rice, whole wheat, oats, barley, quinoa) and natural sweeteners (agave nectar, maple syrup, raw honey). These "complex carbs" are just as satisfying, and they're more filling, so you can't eat excess calories that would be stored as triglycerides.

Eat more saturated fats from grass–fed animals. Yes, I am telling you to eat butter, cream, even red meat—the kind that contains not just saturated fat but the blood–thinning omega-3 fatty acids. Coconut oil is good too. You'll be more full and consume fewer calories in the end. More healthy saturated fats will help you avoid the rancid vegetable oils in clear containers that contain free radicals: soybean oil, canola oil, cottonseed oil, corn oil, etc. Especially avoid hydrogenated vegetable oils (aka trans fats). For a liquid vegetable oil, choose cold–pressed, unrefined olive oil from a dark bottle. Say goodbye to cholesterol plaques!

Eat more organic/locally grown fruits and vegetables. These foods contain many antioxidants, which neutralize the free radicals from stress, toxins, and rancid oil. All vegetables contain some potassium, which lowers blood pressure. Many, especially leafy greens, contain magnesium that helps you absorb excess calcium. Finally, fruits and vegetables have the nutrients that the liver and kidneys need to detoxify the body.

Notice that these recommendations focus on the positive. I haven't stressed cutting out smoking, alcohol, or sugar (though if you do cut back on them, that's great!) It's easier to add good–tasting, healthy foods into your diet than it is to just abstain from processed foods, fighting your cravings with willpower. Once you have healthy foods in your diet, you'll begin to crave them instead, such that not only is your heart attack risk greatly reduced, you'll still be eating what you like! It may be difficult at first to make these lifestyle changes, but there is no doubt that it's worth the effort—for better day–to–day health, for better longevity, and for greater peace of mind. You are welcome to contact me for a free consultation if you would like support with improving your heart health, or with any other health issue.

Seasonal Allergies

Allergic reactions in spring are very common, and it's no wonder. Since we spend less time outdoors, our immune systems are less accustomed to foreign substances, even natural ones. Other factors like long–distance traveling and invasive species continually expose us to new particles our bodies are unfamiliar with. When spring comes and the air fills with pollen, our immune systems overreact and we develop rashes, itchy, watery eyes, other forms of inflammation, sneezing, mucus, fatigue, etc. Fortunately, there is a natural, healthy way to deal with this problem: all you need to do is get your body used to the pollen by vaccinating yourself against it. The perfect vaccine is found in raw honey made by local bees. Processed honey won't work, because all the pollen particles (along with digestive enzymes and other good stuff) has been removed in the processing. Raw honey has a somewhat stiff texture, like peanut butter, and some brands leave a layer of pollen and honeycomb on top of the honey that's extra effective for reducing allergic reactions.

A few years ago I started eating "Really Raw Honey," the brand that's produced nearest to me, in Baltimore, Maryland. Each spring I ate about a pound of the honey, as soon as my allergies started, sometimes more if necessary, until they went away. Each year I've needed to eat less, and this year I haven't needed it at all—I've had no symptoms. This is a really inexpensive, tasty, and permanent way to cure your allergies, so give it a try. The honey has many other health benefits as well. Look in your local health food store to see what brand is produced nearest you, and give it a try!

Recipes

Bolognese Sauce

I chose this recipe, which my wife invented based on the traditional cooking method, because it's delicious, high in carbs, and high in saturated fat and cholesterol. Nevertheless, if you use the recommended ingredients, it will actually help reduce your heart disease risk. It takes a while to cook, but in theory it will last you a long time (I say in theory because, despite the high fat content, you might find yourself eating it compulsively. Good thing there are so many vegetables!)

Ingredients:

2 tbsp each olive oil and butter
3 small onions, finely diced
4 medium carrots, chopped in 1/4 inch pieces
3 large celery stalks, chopped in 1/4 inch pieces
4 oz. fresh crimini mushrooms, halved and thinly sliced
4 slices nitrite–free bacon, cut into small pieces
2 pounds grass–fed ground beef
3/4 pounds organic ground pork
3 cups grass–fed whole milk (or whole buttermilk)
2 cups dry white wine (sauvignon blanc)
2 28 oz. can peeled whole tomatoes, pulsed finely in a food processor
1 tsp. agar (powdered gelatin)
1 to 2 tbsp. dried basil
1 to 2 tsp. chili powder
1 to 2 tbsp. salt (to taste) and pepper (to taste)
3 to 4 gloves garlic, minced

Directions: Heat olive oil and butter in large dutch oven or saucepan. Add onions, then carrots, then celery, then mushrooms. Stirring occasionally, cook for 5 minutes over medium heat after final addition.

Add meat and stir vigorously to break into small pieces. Brown meat evenly, 5 to 10 minutes. Add milk and simmer on high, stirring occasionally, until liquid has been absorbed or evaporated 20 to 30 minutes. Repeat with wine.

Add tomatoes, agar, basil, chili powder, salt, pepper, and garlic. Simmer on medium to low, stirring occasionally for 1 1/2 to 2 hours. Thin sauce with water if it becomes too thick.

Serve sauce over whole wheat fettucine with parmigiano reggiano (for 2 lbs. dried pasta).

Forward to a Friend

It's such a pleasure to help those closest to us become happier and healthier. Please forward this newsletter to friends, family members or colleagues who might be interested and inspired by it. If you received this newsletter from someone else, but would like to be sure to receive it again, email me with your address and I will include you on my mailing list in the future.

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Fall Newsletter

Introduction

Welcome to my first newsletter since March. If this is not your first newsletter, you may recall that in that newsletter I announced I was starting a monthly schedule again. As you can see, that didn't happen! I have been spending less time counseling and writing and more time with my family during the course of mine and my wife Katy's first pregnancy (the baby, a girl we've named Caroline Esther, will be born in mid–November). It's been time well spent, during which I did have the opportunity to read a book given to me by a client, which inspired me to write the following article on the history of nutrition. I hope you will find it both compelling and motivational! Over the next few months I will be preparing for a workshop and updating my website, and then I will take a shot at another newsletter, probably about pregnancy, since by then Katy and I will be experts! Just kidding—I wouldn't want to be an expert, and you might not either after reading the article below.

The History of Nutrition: A Cautionary Tale

What may be the first controlled clinical trial of all time was conducted in 1747 by James Lind, a Scottish surgeon, for the sake of finding a cure for scurvy. Scurvy, of which symptoms include excessive bleeding of the gums, wounds that fail to heal, and open sores, is a fatal disease caused by vitamin C deficiency. In Lind's time, it usually afflicted sailors on long voyages who lacked access to fresh fruits and vegetables, but it could also be found wherever poverty or the ravages of war had made vitamin C–containing foods (such as cabbage) unavailable.

At the time of Lind's study, it had not occurred to doctors and scientists that there might be substances in food essential to life. It was known that food provided energy, but no one imagined that a disease might result from a lack of a nutrient normally provided in the diet, rather than from the presence of something dangerous, such as a virus or bacteria. The purpose of Lind's experiment was simply to see if there was a food that would suffice to protect a man from the mysterious scurvy–causing agent (whether it was damp sea air, or perhaps clogged pores).

Twelve scurvy–ridden sailors were divided into six groups of two, each group receiving a different remedy. One lucky group got two oranges and a lemon per day. The other groups got such miracle cures of the day as sulfuric acid, vinegar, sea–water, cider (the alcoholic version), and an "electuary" of various roots and herbs. The results of the experiment were stunningly definitive. After six days the men on citrus fruit were symptom–free. The men on cider were a tiny bit better. Everyone else was the same or worse. James Lind concluded that oranges and lemons were the necessary cure for eliminating the scourge of scurvy throughout the world's navies.

This story is described in a book by the biophysicist Walter Gratzer, entitled Terrors of the Table: The Curious History of Nutrition. In the course of writing this article, I have drawn heavily on the material in Gratzer's book, which I highly recommend as one both informative and entertaining. In the context of Terrors of the Table, what's significant about Lind's trial is not the remarkable discovery that he made. Rather, it's how long it took for that discovery to be put to use. Lind didn't publish his results until ten years later, in a magnum opus devoted to muddled theories about probable causes of scurvy. Because Lind didn't know why the oranges and lemons worked as a cure, he didn't put much emphasis on them. In fact, he recommended an extract of the fruits instead, as a way to avoid spoilage, but the process of extraction destroyed the vitamin C, so the extract was useless. Lind eventually realized his mistake, but was unable to publicize the error effectively. Scurvy continued to plague the British Navy until the end of the 18th century, after Lind's death, when another Scottish surgeon, Gilbert Blane, managed to distribute lemon and lime juice to sailors (with positive results) despite stiff resistance from the skeptical Admiralty Board. Finally, Admiral Lord Nelson, who had been able to observe the efficacy of the juice, ordered 30,000 gallons for his men during the war with Napoleon. It eliminated scurvy from the navy and thereby aided Napoleon's defeat. Medical authorities could no longer ignore the curative powers of fruits and vegetables, even if they didn't understand why they worked. In the time between Lind's experiment and Nelson's order, thousands of men had died every year from this easily preventable disease.

If you read in Terrors of the Table the scientific histories of the other vitamin deficiency diseases (such as beriberi, pellagra, rickets, night blindness, and pernicious anemia), you will see that they follow the same pattern as the history of scurvy. First, something essential is removed from the diet, whether by poverty, war, food processing, or other causes. This leads to a disease of malnutrition. Second, science demonstrates that whole foods can cure the disease, but these conclusions are rejected either by the individual researchers themselves or by the medical establishment. Third, the establishment proposes some form of processed extract or medicine as a cure instead, but the disease persists. Finally, the establishment either concedes its error and upholds the original science pointing to whole foods, or its guardians simply pass away. With reference to this phenomenon, Gratzer quotes the following saying of the physicist Max Planck: "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." This triumph of new truth is what scientist and philosopher Thomas Kuhn called a "paradigm shift."

The scientific truth of vitamins triumphed for good in the early 1930s, and we are not just familiar with them; we take them for granted. This despite the fact that nutritionists of the 18th and 19th centuries outright rejected the possibility that food contained essential nutrients. But the acceptance of vitamins has been only a partial victory for human health. On a deeper level, our paradigm for handling health crises has not shifted at all. People are still suffering from poor health due to war, poverty, and food processing. The mainstream medical establishment is still rejecting whole, natural foods as the main prevention and treatment for disease. And that same establishment (both mainstream and alternative) is still pushing drugs and supplements to treat chronic illness. Vitamins are now among those supplements, and are added back in to processed foods, so we no longer have to fear scurvy. But vitamins aren't everything. There's still a health crisis in America, which indicates that the old paradigm, described above, is still at work. In order to better understand what's going on today, let's take a look at how this paradigm has repeated itself in the past, starting with the most common sources of malnutrition: processed foods.

For most of human history, malnutrition popped up as a result of the destruction or theft of crops. In times of peace, and in the absence of natural disasters, traditional diets and methods of food production were usually sufficient to keep a society fed and healthy. Processing food to make white flour or sugar was difficult and expensive, so only the wealthy could enjoy that blessing—and the diabetes or gout that accompanied it. But as the advancement of technology picked up speed during the Enlightenment, so did the ease of food processing for various purposes, like taste and preservation. And a whole host of foods that were previously available only in "whole," "natural," and "organic" form began to suffer improvement by the scientists and processors.

I warn against processed foods with regularity in this newsletter. And yes, they are bad for you. But in truth, they could be much worse. Take white bread, for example. Modern white bread is fortified with the B vitamins that are lost in processing it from whole wheat. But in the 18th and 19th centuries, no one knew about vitamins, so white bread was unfortified and even less nutritious than it is now. A French scientist, Francois Magendie, tested white bread and whole grain bread on dogs during the Napoleonic wars; dogs eating only white bread died within weeks, while the dogs on whole grain bread survived. When technology arrived to mass produce white bread, the poor could finally eat it, but unfortunately, since the poor were able to afford very little besides bread, they stopped getting as many B vitamins and started to suffer from malnutrition accordingly. The millers resisted going back to producing whole grain bread, because they made a greater profit from refining the flour and selling the wheat germ separately as cattle feed, than from keeping the constituents of the bread together. And it's not just what wasn't in the bread that caused problems; it's what the bakers used to adulterate it. Chalk, pipeclay, plaster of Paris, sawdust, bonemeal and lime were all added to flour to make it go farther. Even potassium aluminum sulphate was included—it caused rickets as well as kidney, nerve and brain damage.

Milk was even more dangerous. With the growth of towns and cities, particularly during the Industrial Revolution, hygiene and health of cows raised in or near these areas plummeted, so their milk often contained pus and blood. Suppliers also watered down the milk to sell more product. To eliminate translucency, the popular chalk and plaster of Paris, along with sugar and ground rice, could be added. To reintroduce creaminess, they added snails or calves' brains. The creamy color was provided by a poisonous yellow pigment, lead chromate. Drinking this milk raw would have been deadly. Pre–refrigeration, milk producers used formaldehyde and boric acid to preserve their product. Only by means of pasteurization and refrigeration were bacteria from pus rendered harmless and preservatives unneeded (modern day cows are just as sickly as these 19th–century cows, due to being raised in factory farms, which is why pasteurization is still with us).

Infants suffered perhaps more than any other group during this period of history. If a family was poor and both parents had to work, the infants would be given the watered cow's milk described above, which lacked vitamin D among other nutrients, increasing the incidence of rickets. Children of the middle class and wealthy, while not starving, fell victim to a new invention: infant formula. Heavily advertised and doctor–recommended, these formulas (Nestl�'s first among them) sold like crazy, but, despite claims of complete nutrition, usually consisted of nothing but flour, sugar, salt, and dried milk. Again, rickets was the result. Wealthier children could afford cakes and candy, which relied on poisonous chemicals such as mercuric sulfide, lead chromate, copper carbonate, lead carbonate, and others to provide brilliant, enticing colors. To quote Gratzer again, "These and related substances would have caused anemia, bone disease, and rotting teeth." It's enough to make one wish for a relatively innocent package of M&Ms.

These are just some of the breakthroughs in food processing that wreaked havoc on the health of millions. In accordance with the second and third stages of our paradigm, doctors and scientists were reluctant to promote a return to natural foods, regardless of the evidence that processed foods were dangerous. Instead, they trusted in their own abilities when it came to curing disease, and produced and marketed a vast quantity of useless, or even harmful, medicines and remedies, in response to the problems caused by the poor quality foods that were flooding the market.

We already know about the extract of lemons and limes that James Lind recommended in place of fresh fruits for treating scurvy. He was legitimately concerned about the problem of preservation on long voyages, and his proposed solution was at least reasonable. Scurvy treatments loudly promoted by his contemporaries, however, were based on a magnitude of nonsense only exceeded by their widespread adoption. "Doctor James' Fever Powder," of which the main ingredient was the toxic metal antimony, similar to arsenic, was one recommended by the British Admiralty Board. Heavily marketed, Dr. James's powder was also tried on the mad King George, and was probably responsible for the death of novelist, poet, and physician Oliver Goldsmith. The powder and another panacea, the "Pill and Drop," also antimony–based, killed many sailors. Another doctor, William Cockburn, held that scurvy was the result of laziness. Nevertheless, he claimed that his "Electuary" (made of vinegar) could cure it. It didn't, but at least it wasn't lethal. Richard Mead, Physician to the King, recommended sulfuric acid. One thing these respected doctors could all agree upon was that citrus fruit was useless for curing scurvy. In fact, they even accused citrus of being "the commonest cause of fevers and obstructions of the vital organs."

Other deficiency diseases inspired similar treatments, or worse. Early methods for dealing with rickets included cauterizing veins and strapping infants with the disease into leather and iron straitjackets for months. But in the 19th century, as processed foods multiplied, so did medicines. Crying, malnourished infants who had difficulty sleeping could be given cordials with names such as "Mother's Helper" or "Soothing Syrup." These contained drugs such as opium and morphine. As Gratzer comments, "It is little wonder that infant mortality throughout the 19th century could reach 80% in some places." Cure–alls for gullible adults multiplied, such as "Lydia Pinkham's Blood Purifier" or "Bile Beans for Biliousness." These supplements, as we could call them today, usually consisted of nothing more than milk, sugar, flour, and occasionally alcohol. Sometimes remedies were promoted by amateurs and quacks, some by doctors and experts, but all were ineffective regardless. The only question was whether they were actually harmful or just made no difference.

Fortunately, there were many doctors, scientists, government workers and concerned citizens who were not a part of this deadly pattern and who did their best to break the cycle—such as Gilbert Blane, Francois Magendie, Frederick Accum (who exposed the food adulterators) and Harriet Chick, (who demonstrated that rickets was a nutritional deficiency disease and saved lives with cod liver oil). Terrors of the Table is full of stories of brilliant and courageous researchers such as these who spent many years of their lives, often despite stiff resistance, uncovering many of the truths about nutrition that we are taught today. There were also a few who demonstrated timeless wisdom, such as Hermann Boerhaave, a 17th–century Dutchman who was the most eminent physician and scientist of his day. His theory of the digestive process was surprisingly accurate for his time, and he was renowned for continuously being able to diagnose his patients' diseases with great accuracy. He founded the first academic hospital, and he also understood the importance of nutrition, saying that with the right diet, "a long life, untroubled by ill–health, would be the reward." Gratzer relates the following story about Boerhaave: after his death, a notebook was found among his belongings that claimed to contain inside it "every secret of medical practice." All the pages were blank except one, which read "Keep the head cool, the feet warm, and the bowels open." This is still excellent advice today.

In an ideal world, we would have a modern–day attitude towards health inherited from Boerhaave, but we have a received a decidedly more mixed inheritance best represented by the most eminent scientist of the 19th century, Justus von Liebig, a German chemist and agriculturalist. Liebig made many important discoveries (including that nitrogen was a plant nutrient), but he also committed himself to many incorrect theories of nutrition and physiology. This is typical for even a great scientist, but once Liebig had risen to the top of his field, he devoted much of his energy to protecting his reputation and slandering any scientist who disagreed with him. Consequently, he was responsible for many instances in which promising research was set back or abandoned entirely by scientists who found themselves at the wrong end of his wrath.

Liebig believed that the only important constituents of food were protein, fats, and carbohydrates. He did believe in the importance of minerals, but these were easy to isolate in the laboratory or find in nature and were not unique to food. He considered foolish the idea that food might contain unique "accessory factors" (vitamins) essential to life. Consequently, to protect his standing in the scientific community, he had to take every opportunity to shoot down evidence of their existence. However, even though Liebig did not believe in vitamins, he was something of an entrepreneur, and could see the commercial potential in medicinal extracts of food. When he was informed by a friend of an overabundance of beef being produced in Uruguay, he hit upon the idea of producing a liquid extract made from crushed and steamed meat, and selling it as a nourishing tonic.

Liebig's reputation helped this extractum carnis to become widely accepted as a universal panacea, with many leading doctors jumping on the bandwagon to claim it could cure typhus, dyspepsia, tuberculosis, and ulcers. "Beef tea" became a popular nineteenth–century drink, even though it had little nutritive value and had no effect on the above–mentioned diseases. At one point a London hospital was buying 12,000 jars of the extract each year for its patients. Eventually, however, no one could ignore that Liebig's beef liquid had no effect on health, even if it did have a pleasant flavor. It is still available today, as Liebig's company's descendant produces the Oxo beef broth cubes. Liebig is also responsible for other developments in chemistry and food processing that may have harmed more than they have helped, such as instant coffee, artificial fertilizer, and the very first baby formula. Liebig's "Perfect Infant Food" contained wheat flour, malt flour, cow's milk, and potassium bicarbonate. Obviously deficient in vitamins, it was not the worst of the many formulas that it later inspired.

Liebig's worldview, like the paradigm described above, somehow combined the contradictory notions that food did not provide essential nutrition, but that extracts from food, or processed foods, could be medicinal and nourishing. This is a worldview that has come down to us today; we downplay the importance of mundane whole foods and instead flock to vitamins, supplements, and extracts made from exotic or rare foods that, like Liebig's beef broth, are supposed to cure all our ills. At the same time, we're inundated with processed foods like white flour, white sugar, corn syrup, and pasteurized dairy, and our factory farmed animals eat a version of these foods as well. This marriage of extremes leaves us vulnerable to a wide range of chronic health problems.

The state of nutrition is at least somewhat better than it was in the past. As we have seen, mass production of processed foods became possible in the 18th and 19th centuries, people were vulnerable to foods lacking vitamins, foods adulterated with toxic and inedible substances, and putrefied animal foods. The poor in particular were in danger of simply not getting enough food. In the time since then, laws and regulations have caught up to the developments in technology and there are many government bodies, such as the FDA, that regulate the quality of our food, ensuring the presence of vitamins, the pasteurization of milk, and the elimination of many of the toxic chemicals from the 19th century. There are also regulations in place to limit the harmfulness of medicines and remedies that purport to cure our ills, resulting in the disclaimers and warnings listed on drugs and supplements.

Consequently, few people in Europe and the U.S. now suffer from vitamin deficiency diseases, and if they do, they are easily cured. There are toxins in our foods, but none of them immediately poisonous, like antimony or lead. And milk may be hard to digest, but at least it doesn't give us tuberculosis. So there have been many improvements in our health. But there is still a health crisis in America. As journalist Michael Pollan points out in this recent editorial, health care is a $2.3 trillion dollar industry, and three–quarters of that spending goes towards the "preventable chronic diseases" that we suffer from today. If our food is so much better regulated, and better quality, who so much disease? The answer is that we're still stuck in the same paradigm, in which we eat processed foods, skip whole foods, and medicate ourselves instead of addressing the cause.

Today, when it comes to diet, there are three main contributors to poor health. The first is simple carbohydrates. White flour, white sugar, white rice and high fructose corn syrup are high in calories but low in nutrients, even with added vitamins. We can eat more than we need without getting full. Eating these foods leads to obesity, diabetes, heart disease, and gout, diseases of excess that were once the province of the rich, but now afflict all the classes, especially the poor. The second contributor is hard–to–digest foods such as pasteurized milk and commercial deep–fried foods. These contain complex proteins and trans fats, respectively, both of which build up in the digestive system until they form such a significant presence that the body's immune system starts to attack not just them but the body itself in confusion. Crohn's disease, Type 1 diabetes, multiple sclerosis, rheumatoid arthritis, allergies, eczema, chronic fatigue syndrome, fibromyalgia, migraines, and depression are just some of the possible consequences. Finally, despite improvements from a century ago, our diet is still filled with substances that are not really foods—artificial sweeteners, artificial pesticides and fertilizers, artificial flavorings and colorings, preservatives, sweeteners, fat substitutes, thickeners, leaveners, firmers, stabilizers, and emulsifiers, all designed to preserve food or make it look or taste better, thereby masking its low quality, and harming your body in the process. Such artificial ingredients will hasten and contribute to cancer, strokes, and Alzheimer's.

Most people instinctively seek medical help, such as drugs or surgery, for these health problems. A growing minority seek out gentler alternative treatments—supplements, acupuncture, herbs, homeopathy, and more. As helpful as these remedies are, they are never able to eliminate the health problem completely, only the symptoms, and only temporarily.

There are two sides to the problem of getting more people to adopt a truly healthy diet and lifestyle. On the one hand, most doctors, scientists and pharmacists are looking for something distinct to discover, patent or prescribe. They would like to come forward with a name–brand product that everyone thinks they need to be healthy. In the coming years, they will be promoting patented, genetically engineered foods as improvements over the boring old whole foods we have today. The other part of the problem is that the public feeds this desire. We want a miracle cure, a quick fix that will guarantee our health without making any demands on us. We want to add something to our lives that will enable us to keep doing things the way we've always done them, without any change or sacrifice, even if that sacrifice actually leaves us stronger and happier. This is why we need self–awareness, and historical awareness.

Fortunately, more people today are aware of the influence of diet and lifestyle on health, and of the fact that food can be healing and detoxifying. And just as in the past, there are a few experts and investigators, like Mr. Pollan, who keep drawing attention to the need for a healthy lifestyle. The number of voices, professional and otherwise, in favor of whole organic foods as a preventative measure for health, and simply as a more pleasurable eating experience, is increasing, and there are signs that we may break out of our destructive paradigm at last. In a time like this, awareness of the past is crucial.

The value of knowing the history of nutrition is the perspective it gives us on the present. We might be inclined to trust the experts over our own experience, unless we know how often (and to what degree) they have been wrong. We might disdain the healing powers of food unless we see that throughout history, food has always been able to heal. We might get excited about the latest miracle cure unless we have in our mind the awareness that miracle cures are never what they claim to be. We might run the risk of thinking that we've finally figured out everything there is to know about nutrition, unless we see that the people who've thought that have always been wrong in the past. We might commit the fallacy of thinking we've discovered all the essential nutrients, and that we don't need to eat whole foods any more—unless we know that more nutrients are discovered all the time.

Knowing the science of nutrition is valuable and helpful. But knowing the history of nutrition should teach us to trust whole foods, even when we don't know everything about them, and to trust our bodies' cravings for them. Do you think the sailors with scurvy who got to experience the benefits of citrus fruit would have thereafter rejected it because they didn't know why it helped them? Ultimately, what matters is that it did. If we're fortunate enough to have access to whole grains, beans, fruits, vegetables, herbs, spices, and naturally farmed meat and dairy, let's build a diet around them and prevent disease, instead of just treating it, while at the same time enjoying the blessing of these delicious foods and the nourishing meals we can make from them.

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