Book Notes
Zip Dobyns
During the summer of 1997, I had the luxury of a little more time to read and enjoyed several books on diet and exercise. Unfortunately for readers who might want to buy the books to obtain fuller information, most are out of print or being sold as remainders. I buy most of my book from discounters who handle books returned to the publishers by bookstores or sold at a discount when the remaining numbers are too low for the publishers to deal with them.
As readers know, I lost 70 pounds on a low carbohydrate diet some years ago, and I have maintained the lower weight the same way. When I travel, I eat what is available, which usually means high carbohydrates, and I gain some weight back—20 pounds earlier this year when I was on the road more than home for five months. Then I come home, increase my protein and fat, cut the starchy carbohydrates, and take it off again. Of course, the daily swimming here is helpful. Exercise is important.
One of my “new” books was actually published in 1958. I found it when going through 25 boxes of books stored in the garage in L.A. Most of them were from my mother’s library, and one was called Eat Fat and Grow Slim by Dr. Richard Mackarness. The author quotes work from the 1800s which demonstrated that people who had trouble losing weight could be successful on a diet which was mostly protein and fat. He adds that “recent” research from the 1950s supported this earlier knowledge and he hoped that the belief that eating fat was the primary cause of obesity would soon be seen to be mistaken. Obviously, this was a vain hope. The belief that dietary fat is the enemy is more solidly entrenched than ever, despite the efforts of doctors like Atkins, whose research demonstrated by 1994 that people lose weight and most Type II diabetics no longer need insulin when they avoid sugar and starchy carbohydrates.
Among other bits of information, Mackarness describes a research study at the Jefferson Medical College in Philadelphia which was reported in the Journal of Biological Chemistry in 1955. Lipogenesis is the technical term for the formation of fat in the body. The research conclusions were: “Fasting or feeding a high-fat diet abolished lipogenesis (fat formation) in adipose tissue and reduced glucose oxidation markedly…lipogenesis increased to the highest level on a high-carbohydrate, fat-free diet.” (p. 55) The latter is, of course, the diet currently being advocated for everyone. No wonder the struggling obese, whose problem is insulin resistance, became hooked on FenPhen, which has just been found to cause heart-valve problems and less often fatal lung problems and possible brain damage. While the high carbohydrate diet is being pushed as the “only way,” more people than ever are getting fatter and the only alternative they are offered is the old one of starvation with low calories. As two other more current books point out, starvation diets are one of the best ways to produce insulin resistance in the body. They do produce weight loss, but it is as much or more muscle rather than fat which is lost. Since muscles burn fat, when the dieters return to anything close to a normal diet, they promptly gain back what they lost, and usually more.
Another very interesting study reported by Mackarness involved two men who for a whole year ate only protein and fat. The arctic explorer, Dr. Vilhjalmur Stefansson, and Dr. Kirsten Anderson entered the Dietetic Ward of Bellevue Hospital, New York in 1928 to be human guinea pigs on an exclusively meat diet. They remained under the strictest medical supervision of this diet for twelve months. The project was supervised by a panel of experts. Dr. McClellan and Dr. DuBois published the results in the American Journal of Biological Chemistry in 1930 under the title “Prolonged Meat Diets with Study of Kidney Functions and Ketosis”. I will quote the summary of results given by Mackarness. “Stefansson, who was a few pounds overweight at the beginning, lost his excess weight in the first few weeks on the all-meat diet. His basal expenditure of energy (metabolism or general rate of food using) rose from 60.96 calories to 66.38 calories per hour during the period of the weight loss, indicating an increase of 8.9%. He continued the diet for a full year, with no apparent ill effects. His blood cholesterol level at the end of the year, while he was still on the diet, was 51 milligrams lower than it had been at the start. It rose a little after he resumed an ordinary, mixed diet. After losing his excess weight he maintained constant weight the rest of the year, though food was taken as desired. His total intake ranged from 2,000 to 3100 calories a day. He derived, by choice, about 80 per cent of his energy needs from fat and 20 per cent from protein. These proportions are close to those derived by a person from his own tissues during prolonged fasting. The instinctive choice of about 80 per cent of the calories from fat seems to be based on selection by the metabolic processes of the body. It was found that with carbohydrates restricted in the diet, the appetite for fat greatly increased. The body adapted itself to a greater use of fat for energy when this substance was supplied in increased amounts.” P 66-67
Despite the lack of any vegetable foods, the two men did not develop scurvy or any other deficiency disease and there were no harmful effects on the heart, blood vessels, and kidneys. There was also no indications of the growth of harmful bacteria or deficiencies of essential minerals including calcium. Mackarness emphasizes that in contrast to this experiment, high protein diets which limit fat have been shown to be harmful!!! Fat is an essential food element. In addition to the natural fat on their meat, the two men ate cream and butter. A preface to the book by Stefansson’s wife adds another benefit which was a consequence of the meat diet. Stefansson’s arthritis, which had bothered him for years and which he assumed was due to old age, disappeared during the diet.
Obviously, people are individuals, so a total meat diet will not suit most people. Stefansson was Norwegian. He had lived in the arctic with Eskimos who were still eating largely fish and mammals from the sea which have a high proportion of fat as a protection against the cold. Stefansson had stayed well on their diet and said he had never seen a fat Eskimo. As a side note, he commented that he could see their body shapes since they did not wear clothes inside their igloos. However, now that many of them have switched to modern diets of white flour, sugar, and soft drinks, many Eskimos are becoming obese and diabetic. I have mentioned previously the theory that our heredity plays a basic role in determining the diet that will keep us healthy. Those who are descended from agriculturists may do well as vegetarians while those descended from herders and hunters, especially from the far north, may need more meat. We have to find out through personal testing which diet will work for us. But this “one diet fits all” mentality being pushed by most current “experts” may be increasing the chronic health problems in our society.
One of the most interesting books which I read this past summer is Healthy for Life by a husband-wife team, Dr. Richard and Dr. Rachael Heller. It was published by Dutton and the paperback version is still available from Barnes & Noble, but I bought the hardback original for half the paperback cost from the Barnes & Noble catalogue. The central theory discussed by the Hellers and backed up by over 21 pages of scientific references is that insulin resistance (which they call profactor-H) is the underlying problem which can produce a variety of chronic health problems. They write that the assumption that obesity is the root cause of heart problems, high blood pressure, diabetes, etc. is blaming what is just another health problem from the same root—insulin resistance. Depending on different factors, including genetic ones, when the body stops handling insulin effectively, a variety of problems can result, in succession or simultaneously. If the insulin is not coping with the carbohydrates being eaten, the body produces more. The excess insulin may successfully convert the carbohydrates to fat and store it, which produces obesity. Or the converted fat, instead of being stored, may remain in the blood and produce arteriosclerosis and heart problems. Or it may induce water retention, high blood pressure, and a stroke. Or, if the insulin is unable to convert enough glucose into fat, the glucose from the carbohydrates may stay circulating in the blood and produce Type II diabetes. Excess sugar intake, including the starchy carbohydrates which turn immediately into sugar in the body, is even implicated in some cancers. The Hellers say that the same remedy can help all of these problems: reducing the carbohydrates in the diet. They offer a graduated program to move away from junk food, which includes most commercially prepared and packaged foods, to healthy eating. Their program includes a gradual increase in physical exercise and methods to reduce emotional stress in the life. If you are in the market for one book, this is the one to get.
Two more of the diet books I read this summer are less impressive, but have some interesting material in them. Like the Hellers, Philip Lipetz Ph.D., who wrote The Good Calorie Book, recognizes the problem of insulin resistance, but his main focus is on handling Type II diabetes by reducing the starchy carbohydrates in the diet. He provides five pages of a glycemic index which spells out how efficiently one calorie of different foods can produce an increase in blood sugar. A rapid increase is shown by a high number in the index. Eating foods with a high glycemic index does produce a rush of quick energy but also puts diabetics on a roller coaster ride with their blood sugar. Such foods also encourage the development of insulin resistance and fast conversion of the glucose into fat. Lipetz calls the insulin resistance the “starvation response.” He claims that once it has developed, overweight people can create up to four times as much fat as thin people do from the same meal. He provides many pages of menus and recipes to thwart the “starvation response,” claiming that the foods with a low glycemic index inhibit fat formation. The only bread permitted is true rye and pumpernickel make from rye flour. You have to read labels, since most store bread called rye or pumpernickel lists wheat as the top ingredient. The only pasta he approves is protein-enriched spaghetti. Rice cakes have a higher glycemic index than almost any other food. How many dieters eat them and think they are helpful? Dried beans and vegetables are highly approved as primary diet foods. Normal bread is the standard with an index of 100. To show the variety, a russet baked potato comes in at 120 while a boiled new potato registers 80. Mashed potato is listed at 98 while peeled, sliced, microwaved potato is 117 and instant potatoes are 120. Ice cream gets an 80 while tofu ice cream substitute is 155! Dried fruit and fruit juices come out in the 90s along with ripe bananas. Slightly green bananas and most fresh whole fruits have lower numbers. The index is based on laboratory work.
The Princeton Plan by Dr. Edwin Heleniak and Barbara Aston MS offers still another approach to the problem of overweight. The authors recognize that when individuals simply cut calories, their bodies react by slowing the metabolism, a starvation response. It is then harder to lose the excess weight, often more muscle tissue is lost than fat, and the weight is quickly regained with any return to normal eating. The new information provided by Heleniak and Aston is an emphasis on the role of “brown fat” as the body tissues which actually burn the stored fat, and lists are included of the foods which increase the body’s ability to produce heat and burn fat. The authors also repeat what I have seen in other sources, that keeping the room temperature cooler helps stimulate the process, and they list a variety of supplements which can also help. They also provide the usual lists of menus. Their other less-frequently suggested technique calls for eating quite different foods on alternate days and their plan includes different exercises on alternate days. To avoid setting off the “starvation” response which slows the metabolism, the so-called Princeton plan calls for alternating high-calorie, high carbohydrate days with low-calorie, low carbohydrate days. The latter actually turn out to be days when you eat more protein and fat. Most other authors, such as Dr. Atkins, who have acknowledged the failure of high carbohydrate diets to help many obese people, would just say that such a program would only slow the weight loss and lengthen the time it took to reach the goal of lower weight. But the authors claim that this program has helped many to return to normal weight and to stay there without hunger or deprivation.
Moving from diet books, which do recommend exercise along with changing food habits, to one which is strictly devoted to motion, I was very impressed by a book called The Egoscue Method of Health Through Motion by Pete Egoscue. Unfortunately, it may be impossible to find since it was one of the remaindered books in a local discount store. I was impressed enough to buy all the copies they had and am giving it to relatives and friends as well as starting some of the recommended exercises myself. Pete (which is quicker to write than his last name) has a studio in Del Mar just north of San Diego where he teaches people how to move to correct joint pains, including the pervasive lower-back problems and the increasing carpal-tunnel syndrome. His basic premise is that these problems stem from lack of motion and/or asymmetrical posture and motion. His Condition I includes the head tilted forward, the shoulders and hips tilted to one side, and the feet angled out rather than pointing straight ahead. Pete writes that the shoulders, rather than what is done with the wrists, are the source of the carpal-tunnel syndrome. The hips produce the knee and ankle joint problems, and the everted feet contribute. A forward tilt of the pelvis is also part of this Condition I.
I can’t cover all three conditions or the exercises to correct them, so if anyone can locate the book, I recommend it. Pete lists the common sports and exercises which can help, are neutral, or actually harm the different conditions. Running is bad news for all three. I was pleased to find that swimming is good for Condition I, which is mine. I have always walked with my toes angled out and had weak knees and ankles. An inordinate amount of reading has encouraged the forward tilt of the head, and carrying books and babies mostly with the right arm produced a general tilt to the right. Since my problems are relatively mild, if I can add the right exercises to my schedule, they may fix them. There are a couple of very impressive case studies included in the book—a famous golfer and a professional football player who had been told by orthodox medicine that they had to have spinal fusion to correct severe back problems. They report in the book that as a result of Pete’s exercises, they are both fully recovered, out of their chronic pain, and back in their sports.
We will conclude with one more book review—this time a book on psychotherapy for physical problems for which doctors cannot find a physical cause. This is another book from the Barnes & Noble catalogue; The Body Speaks by a husband and wife team named Griffith. The husband is an M.D. psychiatrist, professor at the University of Mississippi School of Medicine. Melissa Griffith M.S.N. is director of the Family Therapy Program at the same institution. The book is full of fascinating case studies with examples of how the Griffiths help people become aware of their emotional blocks and find alternative ways to handle their stress. Four clinical approaches to mind-body (somatoform) problems are briefly described along with their limitations. The Neuropsychiatric approach classes somatoform symptoms as “real” diseases whose physical causes remain undiscovered but are assumed to lie in brain or nervous system malfunctions. Their concept of faulty information processing by the brain has failed to help most patients and is less popular today. The Psychoanalytic approach originated by Freud assumes that emotional repression is the cause of the problems and becoming aware will cure them. But poor results resulted in a sharp decline in psychoanalytic treatments of somatic symptoms by the 1950s. The Behavioral Medicine approach became more popular in the 1960s as researchers found that people could learn to control some body functions that were formerly considered purely automatic, controlled by the unconscious. Actions were classed as habits and procedures developed to extinguish “bad” habits and encourage good ones. This approach was helpful for some areas: quitting smoking, controlling eating, etc., but of little value to the type of physical problems discussed in this book. The Biopsychosocial approach widened its perspective, including the personal physical functioning of the first school and the personal emotional/mental functioning of the second and third schools, and it added the role of the patient’s family and society as relevant keys to the problems.
But, though this was an advance in understanding, the results were still usually disappointing for a variety of reasons. Each system operates from a set of beliefs about reality, including a language expressing those beliefs, which assumes its own expert knowledge and tends to devalue the view of the patient who then often ends up feeling humiliated. Biofeedback, however, usually empowers people. The approach described by the Griffiths is mostly one which respects the patient and keeps asking questions until unexpressed feelings can be uncovered and alternative ways for handling stress can be discovered by the patient. An important part of the technique is respect for and openness to discussing the spiritual beliefs of the patient. The first three systems tend to ignore or discount such beliefs, but they can be absolutely basic to the problems. I have many books on the emotional roots of physical illness, and recommend this one for anyone interested in that area.