AT YOUR SERVICE

Diets Be Damned: Eat, Drink And Be Merry For Your Body Knows Best

R. W. SHEPHERD December 1 1970
AT YOUR SERVICE

Diets Be Damned: Eat, Drink And Be Merry For Your Body Knows Best

R. W. SHEPHERD December 1 1970

Diets Be Damned: Eat, Drink And Be Merry For Your Body Knows Best

THE SCIENCE OF NUTRITION is so inexact that nobody has the right answer on what and how to eat. A little learning is a dangerous thing, and the taboos, preconceptions, “scientific” advice and old wives’ tales on food are as numerous as they are unreliable. Yet every day countless numbers of people forfeit part of their freedom by avoiding this food or that food, or by not eating food cooked in a particular manner. The fact is that most dietary restrictions are unnecessary, most advice on nutrition is mere opinion or conjecture. Those who limit their pleasure in food by following such advice, or by relying more on the counsel of experts than on the advice of their own physiology, ignore the central rule of natural dieting: that the healthy man, like the healthy animal, eats what he needs. My purpose here is to outline and, hopefully, to dispel some of the needless restrictions imposed by the three main sources of misinformation on diet: experts, tradition, and doctors.

The experts write books and sell them in the millions. Some, such as Gayelord Hauser, make a profitable and lifelong business out of it. Others with even less science become famous with a single book. Dr. D. C. Jarvis of Vermont wrote a best seller entitled Folk Medicine. The gist of this curious book was that the panacea for all ills, the cure for everything from headaches to fallen arches — to say nothing of sterility in women and cows — was apple cider, vinegar and honey. No matter what ailed you, a lick of honey and a slug from the vinegar barrel brought you back fighting fit, ready to outlive the ancients frorii the green hills of Vermont. The book sold more than 500,000 copies in hard cover, and went through at least 21 printings in the paperback edition. When it comes to advice on what to eat to be healthy, the gullible, apparently, will eat anything.

Even the more reliable experts, such as Adelle Davis, cannot resist the temptation to play God. In her book Let’s Eat Right To Keep Fit, Miss Davis so scares her trusting readers on the need for an adequate protein intake that they must, the very next morning, have a breakfast such as her family had “on our Indiana farm when I was a youngster. We had hot cereal, steaks, ham and/or

Dr. Shepherd, a wartime RCA F fighter pilot, is a former general practitioner who has also practised industrial medicine, worked among the undernourished of Peru and is now a resident psychiatrist at Montreal's Jewish General Hospital. He is married and has three children.

R. W. SHEPHERD

eggs, huge patties of sausage or fried chicken with country gravy.” This for breakfast! She doesn’t say what one should have for lunch.

In this one chapter Miss Davis makes more unsubstantiated dietary claims than a starving man could eat in a week. She suggests that confused thinking in public and political life is due to low blood sugar, and that poor sugar levels underlie the high rate of automobile accidents, blackouts, polio, divorce, cigarette consumption, alcoholism, fatigue, depression and other afflictions. She continues: “Add a few guns, gas jets or razor blades, and you have the stuff murders and suicides are made of.” The destiny of

every citizen, and indeed of nations, rests on a sugar cube. Miss Davis has said so.

The trouble is that such people as Adelle Davis, Gayelord Hauser, Dr. Jarvis, Catharyn Elwood (Feel Like A Million), Sylvia Rosenthal (Live High On Low Fat), Carlson Wade (Instant Health, The Nature Way), Roger J. Williams (Nutrition In A Nutshell) have a wide following. Many read them. Many believe them. Even when they cause no harm, and even if they don't exploit fear and ignorance to promote book sales, the result is the same: a weakening of the natural dietary instinct of their readers and the creation of a state of psychological

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dependence. Instead of eating as they wish, people eat according to a book. Instead of eating foods they enjoy, they must inquire where the foods came from and how they were processed. They no longer follow the guide of their own body mechanisms, but slavishly follow the fad of one ex-0 pert after another.

Even then, they have no peace. Dr. W. D. Currier, National Secretary of the American Academy of Nutrition, warns that if you follow the advice of the nutritionists it won’t do you much good. “Our soils today,” he says in the introduction to Adelle Davis’s book (published in 1954), “are mostly mediocre or poor, and hence the plants do not contain proper or . . . essential nutrients. The animals that eat thesel

pleasures becomes a tangle of conflicting drives and prohibitions.

By tradition, I don't mean the Jewish proscription of pork, or the Hindu avoidance of beef, or the meatless Friday, for these are religious beliefs that an individual follows or not, according to his conscience. What I mean are the ingrained personal eating habits arising from routine, and from social and parental attitudes:

Such as eating when you are not hungry, three or four times a day.

Such as finishing the food on your plate.

Such as eating pasta if you’re Italian, beef if you’re Argentinian, rice if Chinese.

Such as not eating a large meal before going to bed since “you shouldn’t

plants cannot have the proper food chemicals in their meat, milk, or eggs. Also, the processing or improper cooking of these foods further deteriorates them.” So there we have it. The soils are leached out, the plants deficient, the animals anemic. At this rate it hardly seems worth having lunch!

Uncertainty breeds uncertainty, fear grows on fear. With so many eager pundits ready to convert half knowledge into book sales or a reputation, or both, more and more people live in a state of chronic worry over what and how to eat. Now add the underlying taboos and restrictions of tradition — the second poor guide to good eating — and one of life’s finest

go to sleep on a full stomach." Or eating a hefty snack at bedtime since “you shouldn't go to sleep on an empty stomach.”

Or not drinking before meals, since fluids “dilute the gastric juices.”

Or drinking with every meal, especially milk. Most parents are obsessed with the milk consumption of their young, and train them into a lifelong and dangerous habit. A patient of mine was genuinely proud that each of her four children drank up to two quarts of milk a day. To my remonstrance that this was too much she exclaimed, “But, Doctor, milk is the perfect food.”

Of course milk is the perfect food

— for infants, not for others. Each glass of milk contains the equivalent of a pat of butter and the obvious dangers of excessive animal fat to those who drink a lot of it. Glass by glass, whole milk may be more dangerous for some than beer or even whiskey. Notwithstanding the promotion of the dairy industry, milk consumption will fall markedly in the next decades. The switch to 2% and skim milk is already well advanced. The point is that, since a person’s appetite grows by what it feeds on, early family patterns of eating become at first routines and then rules handed down from one generation to the next.

But for sheer obstinacy at table nothing can touch the rules a man discovers for himself about his own stomach. Food fads wax and wane, familial patterns alter, but the indwelling belief that certain foods are harmful are often fixed for life. As Dr. R. H. Salter points out in What Patients Should Eat, the idea that certain foods may be bad is so deeply held that dietary deficiencies and lack of vitamins may occur as a result. “These food fads reach absurd proportions, and any attempt to break the habit meets with strong resistance.”

Take the matter of food allergies. For every true food allergy there are thousands “allergic” to shellfish, milk products, meats, nuts, strawberries, you-name-it-and-I’ll-break-out-in-hivesif-I-eat-it. And they do break out in 4 hives when they eat it. I had a patient convinced he was allergic to liver. He happened to have a type of anemia for which liver was recommended, but he steadfastly refused to touch it. At a party one night he ate a number of liver hors d’œuvres without knowing it, and enjoyed them. When I told him what he had done, he would not believe it, so he ate another, with the greatest of hesitation, and promptly got sick and broke out in welts. The reaction was real enough, but due to psychogenic factors rather than liver.

The knowledge that our bodies are profoundly influenced by our minds surprises no one. And if people’s stomachs turn at the sight of blood, or develop cramps or ulcers in reaction to stress, why not a rash in reaction to liver hors d’oeuvres? Does my patient now eat liver? Of course not: as I said, he breaks out in hives.

The same is true of a large variety of misconceptions. How often does one hear people say, “Oh, I can’t eat that. It’s fried in fat.” Yet two researchers from England, Diana Taggart and B. P. Billington, recently reported on a controlled study with patients

who claimed their digestive symptoms were due to fatty foods, or to food fried in fat. More than 92% of those studied did not experience their symptoms when the same quantity of foods fried in fat were so disguised as to be unrecognizable to them.

For some people these self-imposed diets lead to malnutrition, for others to a life pattern of caution and denial. An elderly patient of mine required minor surgery in hospital. In taking her history, I found that for 50 years she had studiously avoided all roughage in her diet. A doctor had once told her that high-residue foods such as stringy vegetables, rough cereals, bran, some meats and fruits, would aggravate the bowel condition she had at that time. From then on she had become a virtual dietary invalid, never eating out, never traveling. She could visit only those friends and relatives who would prepare her meals specially and though she planned to travel when her husband died she never left home.

After her operation, I was able to persuade her to eat everything put before her. To her astonishment, she suffered no ill effects. Later she made a remark I will never forget. “Oh, Doctor — all those years of misery for nothing.” It was then that I decided to start speaking and writing against needless and senseless restraints in diet and health.

Fortunately many of my colleagues do the same. Since 1940 there has been a shift in medical thinking, away from the conservatism that kept women in bed for a week following childbirth, men on their backs for six weeks after a coronary, and all kinds of people on ulcer diets, liver diets, rice diets, salt-free diets; diets for diabetes, hepatitis, cirrhosis, colitis and gastritis. Sections of textbooks were given over to theoretical discussions on the benefits of certain foods in certain conditions.

But the liberalization of thought since the war changed many things, including the reliance on theory. Doctors now want proof of a medical claim before accepting it. For example, it was written in textbooks that hot, spicy, or rough foods would irritate the raw surface of a gastric or duodenal ulcer, or stimulate acid secretion or spasm. Hence the bland “ulcer diet” of milk, cream and eggs. But since the war doctors have asked what evidence exists that spicy foods aggravate a duodenal ulcer. How about the patients with active ulcers who get better without treatment, and often by eating whatever they like?

Robert Bingham in Toronto did a continued on page 66

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study with alcoholics who had bleeding gastric ulcers. He treated one group with the traditional, bland, noalcohol diet, the other with whatever they wanted to eat, including alcohol. The latter group improved more rapidly than the former, in part, according to Bingham, because they suffered less tension than their friends on the wagon.

E. D. Palmer in Baltimore went further. In charge of a ward where patients with active ulcers were treated with the milk and antiacid gel diet, he overheard a patient complain that a diet of pancakes and shaving cream would do as well. An innovator at heart, Palmer divided incoming patients into two groups of 30 — treating one with the conventional bland diet and the other with crushed pancakes and shaving cream. Both groups improved equally. Palmer reasoned that the healing of ulcers had less to do with diet than to being at rest in hospital, away from the stresses of home and work. His conclusion: “There is no evidence that dietary treatment plays any part in either promoting healing of a gastric ulcer, or in preventing relapses.”

The same can be said about most medical diets. There is no evidence to justify dietary restrictions in liver disease, liver cirrhosis, acne and other skin conditions, ulcerative colitis and other diseases of the small bowel and colon. The low-residue diet of the past may actually aggravate conditions such as diverticulitis by denying the gut the bulk it requires to cure the condition internally.

In our “enlightened” times, the idea that Nature knows best may seem naïve, but the fact remains that the natural choice is often so far ahead of any medical alternative that we would do well to heed it, at least until we know we can improve on it. Too many dietary invalids and food faddists have been created by well-meaning but misinformed physicians to continue the process now.

That goes for advice to the overweight. We make a fetish of reducing diets, a sickness out of being fat. Clearly some people eat more than they need and weigh more than they could. From all available statistical evidence they seem slightly more illness-prone than the lean and live a year or two less. But I believe there are more fat people than obese people, since obesity is a medical term implying sickness, whereas many of the heavies are constitutionally or psychologically that way, and prefer to live free and fat rather than slim and for ever on a.diet.

continued on page 68

This is not to say diet has no place in medical treatment. Diabetics should avoid a lot of sugar. Infants with phenylketonuria will be mentally retarded unless they follow a special diet to age five. There are people allergic to some foods. There are people sensitive to fat. But these are clearly established conditions requiring special care and should not influence the diet of those free to eat as they wish. There is altogether too much publicity given to disease and abnormality and not enough written or said about good health and the freedom that goes with it.

What I am saying here is that since reliable evidence on what to eat is hard to come by, and since what is known about nutrition is only a small part of what is not known, remember, before you hand yourself over to a doctor, a diet, or an expert, that you are a pretty fair expert yourself. If you have to be told what to eat, listen to yourself. You do it when you’re sick, or when running a fever, so why not when you are well?

In a Chicago experiment with young children, they were offered free and unlimited selection of foods, including chocolate, candies, cakes, cream — the lot. Initially, the children gorged themselves on forbidden foods. But by the end of two weeks they were selecting a balanced diet of the foods they required.

The instincts are built in, and we then proceed to blunt them with routine, or to distort them with half knowledge and ignorance. We don’t need to do so. I am convinced that we are not as stupid as we act, and when it comes to eating each of us knows what to eat and when to eat. Most of us, fortunately, are at least that free.D