Man in the Iron Mask: The Holistic Treatment of Men’s Diseases
Posted on December 8, 2004 by Tom Cowan • 1 Comment 
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Holistic medicine begins with the premise that we can achieve an understanding of human illness by studying a corresponding process in nature. For example, insights into the treatment of women’s diseases come to us from the mythology of the moon and the metal silver. So too, we can look to nature for enlightenment on the subject of men’s diseases. Not surprisingly, the challenges to the health of the male anatomy are bound up in the metal iron, the characteristic metal of Mars or Ares.
The correspondence of iron to the biochemistry of the male organism shows up at puberty, which usually occurs around the age of 13 or 14. Puberty marks the entrance into the third phase of a boy’s life and the beginning of a third major physical transformation. The first physical transformation in any life is, of course, the birth of the physical body. After an average of seven years, most individuals begin the next major physical transformation, marked by the loss of baby teeth and the development of adult or permanent teeth.
The eruption of permanent teeth heralds an important step in the development of the child. The whole face undergoes a dramatic restructuring. The child begins school and embarks on a more independent life, often preferring the company of friends of his own choosing to that of parents and siblings. According to Steiner, the age of seven marks the birth of the etheric body, in which the force of pure growth becomes at least partially freed from the demands of physical growth and available for the development of other faculties. For example, academic learning is possible for the first time during this second seven-year period.
THE THIRD PHASE
We then come to the start of the third seven-year stage, the stage that affects the underlying dynamics of men’s health. Many traditional cultures mark the transformation called puberty with a ceremony, such as the Jewish bar mitzvah, the Christian confirmation and the traditional African rites of passage. All these traditions mark the boy’s passage into manhood, both in his physical body and in that portion we call the soul. We must therefore look at what actually happens both physically and in the soul of the boy at this time.
Physically, we see a number of changes. Pubic hair begins to develop under the arms, followed by the gradual growth of hair all over the body. The musculature of the boy’s body starts to develop, growing heavier, thicker and stronger. The voice deepens, the penis enlarges and the production of sperm and semen begins.
Another change that takes place, one that is not visible, is a slight rise in the iron content of the blood. This change is especially striking because it contrasts with the blood changes of adolescent girls, who experience a slight lowering of their blood iron levels at this time. This phenomenon has perplexed the medical profession for many years. No one knows just why this happens, but the fact that it occurs is unmistakable. Researchers have devised many experiments to help them understand how or why these changes come about and in the process have discarded many theories. One explanation was that the decline in blood iron levels in girls was due to loss of blood in the menses. However, studies of girls who never menstruate have shown that this drop still occurs. Other explanations, such as lower activity levels and differences in the diet, also fail to provide a conclusive answer.
The answer can be found in the relationship between the human being and iron, and to the soul changes we undergo during puberty. For it is during this period that the characteristics of the inner life manifest in the physical world. During this phase, boys generally become more inward, more withdrawn and less communicative. Those who have been parents of teenage boys count themselves lucky to get one sentence a week. Girls, on the other hand, often turn outward. They can become very social, very chatty and, in more extreme cases, even coquettish. The manifestation of these inner changes–highly “feminine” for girls and “masculine” or “macho” for boys–usually lasts throughout this seven-year phase, after which a more balanced personality emerges.
How, then, does this essential male process shed light on the illnesses men experience later in their lives? One conclusion is that the challenge of the male lies in balancing the heaviness or inwardness to which he is first subjected at puberty with more buoyant and outward tendencies. According to Steiner, it is during puberty that the emotional body or soul force is born. Consequently, for the first time, the developing man can work with the world of emotions. However, this newborn emotional life finds itself trapped in a world characterized by the qualities of iron–martial, somber and heavy.
Iron is an interesting substance. It is the only metal found in significant quantities in the human body, and therefore the only metal not called a trace metal. Instead, it is a substantial metal, substantial not only in quantity but also in its effect. It is the component of red blood cells that carries oxygen throughout the body. Iron is also a component of certain enzyme systems where its ability to change easily from a 2+ to a 3+ valence allows for the transference of oxygen in the cellular respiratory cycle.
Thus, the metal associated with clanking armor and impassible barriers (the iron mask, the iron curtain) is the very metal that allows oxygen to be transported in the body and used by the cells. And because iron can exist as a 2+ or 3+ valence with equal ease, this weighty metal can transform itself according to the amount of oxygen available. We are all familiar with the phenomenon of iron oxidation because when iron becomes saturated or filled with oxygen, rust forms. The more oxygen it takes on, the heavier and more weighed down it gets.
Metaphorically speaking, iron is the perfect substance to modulate the process of puberty, and even to physically distinguish man from woman. Increased iron brings more robust life to the youthful frame while its heaviness presages the weightier matters of adult life.
As we have seen, illness often results from a normal process taken too far. For example, mineralization is the normal way we form our bones. However, mineralization in the gall bladder can lead to gall stones and excessive mineralization in the joints can lead to osteoarthritis. Likewise, the process of oxidation as mediated by the iron in our blood is normal, but oxidation is akin to burning and brings about tissue destruction when it becomes excessive. Heaviness is also not an illness in and of itself, for heaviness also confers strength and power to our muscles. However, when we are too subject to the forces of gravity, we can become stiff, even leaden.
Heaviness in the soul is not a pathology either, for emotional heaviness leads to depth of ideas and feelings. However, when taken too far, the result can be the uncommunicative, somber, middle-aged man so common in our culture. It is a sign of the biochemical dominance of the traits conferred by iron.
Thus, the intriguing phenomenon of elevated serum iron levels in men tells us that being male is intimately connected to the properties of iron. Just as iron assumes its unique place in our physiology because of its ability to change valences and become heavier, so, too, is the male physiology largely dependent upon the mediation of this tendency to become heavy. If the attribute becomes extreme and stiffness and inflexibility prevail, the stage is set for the appearance of the illnesses to which men are subject later in life.
Many traditional forms of medicine associate the metal iron with the planet Mars. Mars was the patron and protector of Rome, a culture that epitomized the masculine or macho tendencies of the human spirit. The Martian properties thought to rule the male character include aggression, passion, dominance and fire, in contrast to the more feminine or Venusian attributes of passivity, receptivity and openness.
An interesting confirmation of the thesis that excess iron causes disease, especially in men, comes in the form of reports that men who donate blood regularly live longer, healthier lives than those who don’t. Besides the positive feedback from the altruism involved, regularly losing some blood helps keep the iron stores low and prevents the kinds of oxidative and inflammatory diseases to which men are prone. The ancient practice of bloodletting may indeed have some basis in fact.
It is clear, then, that iron serves as one of the body’s primary modulators of the oxidative processes. We know that excessive iron in the blood has a toxic effect on the heart and liver and can be a primary cause of early coronary artery disease. We can also say that, in general, the higher level of iron in men predisposes them to a greater tendency for oxidative damage. Chronic inflammation follows, with scarring and sclerosis (hardening). This conclusion is supported by epidemiological data which suggests that coronary artery disease is highest in the same geographical areas where other diseases of oxidative stress are high–diseases like cancer, diabetes and macular degeneration. All of these diseases are thought to be caused by oxidative damage to the tissue.
In addition, oxidative damage in the blood vessels leads to other developments characteristic of male tendencies, causing the arteries to become stiffer, harder, heavier and constricted. It is as though the blood vessels themselves show the physical corollary to the physiological and soul tendencies of men. The situation is aggravated when a man demonstrates all the typical or exaggerated male characteristics. Repeatedly, studies have shown that dominant, aggressive, uncommunicative men–men with the “Type A” personality–have a greater tendency to coronary artery disease. We might say that the working of iron is too strong in their physiology. As a result, they become subject to the oxidative damage characterized by iron excess.
Unbeknownst to many patients and even some physicians, the understanding of the underlying dynamics of coronary artery disease has undergone a major change in the past decade or so. The old theory was that plaque in one of the coronary blood vessels blocks the blood flow through that vessel downstream to the heart muscle. According to the old theory, when sufficient blockage occurs, ischemia or lack of blood supply in the heart muscle causes that part of the heart muscle to die. However, a recent study, reported in a major cardiology journal, found that only 10 percent of heart attack victims have greater than 70 percent occlusion or blockage in one of the major coronary blood vessels. (An occlusion level of 70 percent is considered necessary for a heart attack to occur.) The authors commented that heart attacks seemed to occur not so much because of the amount of occlusion but because of what goes on within the arteries. They found that arteries that had friable plaque, that is plaque that is easily broken apart, were much more likely to lead to heart attacks than arteries with stable plaque. It only remains to find the source of friability of this plaque. Although excess iron has not yet been studied as a cause, it is tempting to compare friable plaque to rusted iron, which easily flakes off. Interestingly, new data indicates that adequate levels of copper protect against the breaking off of plaque. When copper, the feminine element, is adequate, the plaque in the blood vessels is stable, and heart attacks do not occur.
THE ROLE OF ZINC
Another substance that plays an important role in reproductive and prostate health is the trace mineral zinc. While the connection between zinc and iron is not immediately obvious, a deeper examination of the characteristics of zinc reveals important similarities to iron, as well as interesting distinctions. In nature zinc is mostly found in carbonate deposits, always in conjunction with iron. Zinc has the same relation to the process of oxidation as does iron, in that it forms different oxidative states known respectively as carbonates, hydrates and oxides. Like iron, zinc is necessary for mammalian life, and also like iron, it is needed in substantial, not minute, amounts. The mammalian organs richest in zinc, besides the prostate gland, are the muscles and bones, exactly the organs that outwardly differentiate the male from the female physiognomy. As shown by the sites in which it localizes, zinc participates with iron in the process of heaviness or earthiness of the male muscle and bone structure. Brittle bones and weak muscles are a defining sign of zinc deficiency.
Zinc’s opposition to iron most clearly reveals itself in the fact that while iron may be called the central element of the red blood cells, zinc has an analogous role in the white blood cells, the cells that mediate our immune function. Zinc functions as a kind of inner armor, protecting us from invasion and occupation by invaders of many sorts. Like the physical outer armor made of iron, we also have an inner armor in the form of white blood cells, which contain large amounts of zinc.
Semen, the secretion product of the prostate gland, contains large amounts of zinc and the prostate gland concentrates this nutrient. In animal studies, zinc deficiency results in complete sterility. In addition, zinc is a cofactor in many reactions involving our immune system. Zinc deficiency is often associated with immune dysfunction, resulting in a number of disease conditions, from chronic viral infections to cancer. Zinc deficiency is also related to prostate enlargement. Many researchers believe that chronic zinc deficiency results in gradual enlargement of the prostate in much the same way that chronic iodine deficiency results in enlargement of the thyroid gland.
MALE REPRODUCTIVE DISORDERS
As recently as 20 years ago, when I was in medical school, doctors avoided discussion of male reproductive disorders. Male impotence, now called “erectile dysfunction,” was relegated to the domain of sex clinics. Doctors considered benign prostatic hypertrophy a normal part of aging, and prostate cancer occurred much less often than it does today.
Other issues affecting the health of the American male have yet to receive the same national attention. For example, the average sperm count of today’s adult male is about 50 percent lower than it was 50 years ago. Infertility rates among American couples now approach 25 percent, a heartbreaking situation that can be partially explained by lower sperm counts and decreased viability of the sperm. These changes parallel the findings seen in other mammalian species, including lowered fertility rates, decreased sperm counts and anatomical changes in the male reproductive organs.
Clearly, environmental changes that have accelerated during the past 40 to 50 years affect the reproductive health of males of different species. Exogenous estrogens in our environment undoubtedly contribute to the feminization of males in many mammalian species, as well as the lowered sperm counts of the American male.
DIETARY FACTORS
Another cause, one far less recognized or discussed in scientific circles, involves the huge change in the American diet during the past 80 years. The decline in soil fertility translates into lower mineral content in our food, and the substitution of vegetables oils for animal fats has robbed the developing male of the fat-soluble vitamins (vitamins A and D) that he needs to make testosterone out of cholesterol. In addition, the vegetable oils are invariably rancid, causing irritations and inflammation in the arteries. The trans fats in margarines and shortenings used in processed foods also interfere with the production of testosterone.
Another nutrient that has declined in the modern diet is vitamin E, normally found in whole grains, cold pressed vegetable oils, egg yolks, butterfat and dark green vegetables. Modern processing destroys vitamin E in grains and oils, and consumption of vegetable oils actually increases the body’s need for vitamin E. The scientific name for vitamin E is “tocopherol,” which in Greek means “to beget or carry offspring.” Numerous experiments with animals have shown that vitamin E, originally used in the form of wheat germ oil, is absolutely necessary for an animal to achieve and maintain fertility. Studies have also shown that the purified products, such as alpha-tocopherol, are not nearly as effective in maintaining fertility as feeding whole wheat germ oil or an ample supply of whole grains. In addition, vitamin E is a powerful antioxidant and can protect us from overly exuberant oxidation of substances like iron.
SOURCES OF ZINC
The best dietary sources of zinc are red meat and seafood, especially oysters. Any man suffering from problems with the reproductive tract should eat oysters once or twice a week. Other animal foods include wild, ocean-going fish, butter from pastured cows and eggs (particularly the yolks) from pastured chickens.
An important source of zinc is unrefined sea salt, another commodity that has disappeared from the American diet during the past 50 years. When salt is refined, most of its minerals, including zinc, are removed. Today, the typical American male will never eat any salt in his whole life that contains even a trace of this valuable mineral. Nutritionists have been relatively successful in spreading the word about the dangers of refined sugar, but few voices warn us about an equally severe problem of mineral deficiencies caused by the consumption of refined salt. This is why I strongly encourage all my patients to use Celtic sea salt exclusively for all their cooking, as this is one of the few commercially available salts that still has its full complement of minerals, including valuable zinc.
OMEGA-3 FATTY ACIDS
Another dietary component vital for men’s health is sufficient fatty acids of the omega-3 type, including the forms with two double bonds found in flax oil, organic whole grains and leafy green vegetables. The longer and more unsaturated forms occur in cod liver oil, seafood (especially wild salmon, fish eggs and shell fish), organ meats and eggs from pastured chickens. These foods also provide many of the nutrients mentioned earlier–vitamins A, D, E, iron and zinc. Fish eggs, in particular, provide a complete packet of minerals, fat-soluble vitamins and elongated omega-3 fatty acids–many traditional cultures value fish eggs as an aphrodisiac.
FOODS TO AVOID
In addition to incorporating certain nutrient-dense foods in the diet, men should also avoid consumption of foods fortified with iron. Most men have no need for any more iron than that which occurs naturally in food. Consumption of iron-fortified foods, or of supplements containing iron, can cause a toxic overload and contribute to heart disease, liver disease and perhaps even cancer–numerous studies have shown a relationship between high iron levels and increased cancer incidence. Plentiful fat-soluble vitamins in the diet help the body absorb the iron it needs without accumulating an excess.
My caveat against iron-fortified foods does not include liver. Although liver is rich in iron, it is also our best dietary source of copper, so vital for healthy arteries. I recommend including liver in the diet at least once a week.
Any therapy for reproductive disorders and prostate problems must include avoidance of all processed foods, vegetables oils, white flour products (“fortified” with inorganic iron) and extruded grain products. Cold whole-grain breakfast cereals made by the extrusion process not only contain rancid vegetables oils, they are also high in phytic acid, an organic acid that blocks zinc. All grain products must be properly soaked to neutralize phytic acid. Soy foods not only block zinc, but they contain plant-based estrogens that can have feminizing effects.
Caffeine, found in coffee, tea, soft drinks and chocolate, is best avoided as it stresses the adrenal glands, ultimately affecting male potency.
SUPPLEMENTS
Supplements for men’s health include cod liver oil for vitamins A and D (providing at least 10,000 IU vitamin A per day) and wheat germ oil for vitamin E. I recommend Standard Process wheat germ oil, 4 capsules per day. For those who don’t like oysters, I recommend zinc-liver chelate from Standard Process, 1-2 tablets 3 times per day. Avoid supplements of vitamin C as the synthetic form increases iron absorption and blocks copper.
ACUTE PROSTATITIS
The prostate gland is a walnut-sized muscular organ responsible for making and secreting semen. As with any muscular structure, it is susceptible to contractions, spasms and overuse. Many cases of acute prostatitis result from overworking the gland, as in a burst of abnormally high sexual activity (when previously there was no sexual activity). The prostate becomes enlarged, painful and swollen, often felt as an uncomfortable lump in the rectal area, occasionally accompanied by difficulty or pain in urination. Often the patient has a fever and occasionally a pus-like discharge from the penis. On examination of the prostate through the rectum, the gland will be very painful to touch. It often feels swollen and even warm or hot.
One of the controversies surrounding the etiology and treatment of prostatitis is whether or not this condition is an infection or an inflammation of the gland. As a result, it is unclear whether the conventional treatment with oral antibiotics really addresses the problem. In my experience, only the most extreme cases require antibiotics.
Taking our cue from the fact that the prostate is a muscular gland, one can treat acute prostatitis in the same way one treats other strained and inflamed muscles, with rest and Epsom salts. Ejaculation should be avoided for at least two weeks. I recommend regular soaking in a warm or hot bath, to which is added 1 cup of Epsom salts. If possible, soak in the bath 20 minutes, 2 times per day for 10 days. This bath treatment will relax the muscle as the Epsom salts help cleanse the gland by promoting secretion of its contents. Many patients experience immediate relief with this intensive bath therapy.
I also suggest oral medicines that work in an anti-inflammatory way on the prostate including Echinacea Premium (by Mediherb), 2 tablets every 2-3 hours until better, saw palmetto extract (by Mediherb), 1 teaspoon 2 times per day, prostate PMG (the Standard Process protomorphogen extract) 1-2 tablets 3 times per day, and Erysidoron 1, an anthroposophical anti-inflammatory medicine, at a dose of 10-15 drops 4 times per day. This regimen should resolve the problem in less than one week. If not, antibiotics may be prescribed.
BENIGN PROSTATIC HYPERTROPHY (BPH)
BPH is relatively easy to control with the proper intervention and the cooperation of the patient. The major symptom is difficulty in urination, which happens as the gland swells and puts pressure on the urethra, directly adjacent to the prostate gland. As a result of this pressure, the caliber of the urethra gets smaller and the urine has a more difficult time passing through. The patient experiences this as a weakening of the urine stream, a need to urinate more often while passing only small amounts at any one time, and finally, nocturia, or the need to make frequent trips to the bathroom during the night. This is the symptom that usually brings the male patient to the doctor, as the disturbed sleep begins to interfere with his ability to function optimally during the day.
I should stress that as far as we know there is no relationship between BPH and prostate cancer. The current understanding is that large, swollen glands are no more likely to be prone to cancer than glands of normal size.
As BPH is a chronic rather than an acute condition, its treatment must be based first and foremost on the dietary protocols given above. The medicine that many practitioners, including myself, have found effective is a lipid extract of the saw palmetto plant. Saw palmetto is a small woody shrub that produces berries with high concentrations of a medicinal oil rich in a cholesterol-like substance that has a direct influence on testosterone metabolism. It may seem surprising that a kind of plant cholesterol would be the therapy for BPH, but a closer examination makes sense of this phenomenon. Research shows that chronic overstimulation of certain types of the hormone testosterone is one of the reasons for enlargement of the prostate gland. As mentioned earlier, testosterone, like the other sex hormones, is a derivative of cholesterol. Men who take medicines that block the action of testosterone, or men who have been castrated, do not suffer from prostate disease. This is why doctors consider prolonged exposure to excessive testosterone as one of the causes of BPH. The active ingredient in saw palmetto seems to act as a kind of testosterone mimic that binds to the testosterone receptors in the prostate and thereby prevents the testosterone from having its influence. As we have seen, a common way for plants to exert their effect is to mimic the normal action of an endogenous hormone or neurotransmitter. Thus it is with saw palmetto, which mimics the body’s own testosterone, thereby blocking its exuberant and injurious effects on the prostate gland. I use the saw palmetto extract from Mediherb, 1-2 teaspoons per day, sometimes along with nettle root extract by Mediherb, another plant with a therapeutic effect on BPH, also at the dose of 1-2 teaspoons per day.
PROSTATE CANCER
Just a few decades ago, prostate cancer was uncommon and considered nonvirulent. Today it is the second most common form of cancer leading to death in men. In addition, a study of autopsies suggests that more than 70 percent of men older than 70 who die from other causes have some prostate cancer which may not have been detected. Thus, prostate cancer truly qualifies as an epidemic in our time.
In many ways the epidemiology of this disease is like that of breast cancer; it has had the same recent dramatic rise in incidence, it has the same pattern of growth, and even shares in the medical controversies on the best type of treatment. This controversy centers on a fundamental issue with cancer in general and these two cancers in particular, which is whether cancer is a localized phenomenon or a general, systemic illness. In conventional medicine, cancer is believed to start in one location, then spread to many sites in the body. This view holds that while the cancer is still encapsulated, one can effectively remove all traces of it by removing the tumor.
Both breast and prostate cancer, with their often confounding histories, frequently contradict this rule. In both these types of cancer, removal of the encapsulated tumor does not necessarily render the patient cancer-free, although in some cases the cancer will not return until almost 20 years later. This phenomenon has led some prominent breast and prostate cancer doctors to claim that the only true way to say that someone has been cured of these cancers is for them die of some unrelated disease after a long period during which they were cancer-free. What this means is that removal of the gland or the breast does not eliminate the disease, for it doesn’t change the underlying dynamics that led to its emergence.
The practical consequence of this conclusion is that the physician has difficulty in counseling the many men who have newly diagnosed prostate cancer. Usually their cancer is discovered by a Prostate Specific Antigen (PSA) screening test and then confirmed by biopsy. At this point the patient often goes through an agonizing decision process. On the one hand, removal of the prostate results in the best chances for five-year survival, according to current statistics; on the other hand, we all know that removal cannot be considered a cure. In addition, a high percentage of men have symptoms of incontinence or impotency following prostate removal. We also know that because removing the prostate cannot be considered a complete solution, the patient still has many other issues to address.
My advice at this point is to go ahead with the prostatectomy only if there is a very high chance that the disease is still totally confined to the prostate gland. This is usually the case when the PSA is relatively low, the biopsy shows encapsulation, and all the other tests (liver enzymes, CT scan of pelvis, and bone scan) are normal. I then encourage the patient to follow the advice given about diet and mistletoe therapy for cancer in my book The Fourfold Path to Healing. Even in those patients who choose prostatectomy, I still urge them to follow the cancer diet, and to do mistletoe therapy for at least three years.
Like breast cancer, prostate cancer has a profound effect on the body and soul of the patient. It provides a kind of life-training in living with uncertainty in that the patient can never be sure the disease has truly been eliminated. As a result, many prostate cancer patients find they have to reorient how they think and feel about their life. There can be no more waiting another five years to reconcile with an estranged loved one, no more putting off beginning the type of work one has always longed to do. One of the clarion calls of this disease is that the time to act–the time to change, the time to make of one’s life what one wants, the time to fulfill one’s goals–can only be in the present. For many, life becomes clearer, as though the camera lens of perception is brought into a sharper focus through the very uncertainty that this illness presents. The epidemic of prostate cancer is a message to all of us that it is time to clean up our environment, improve our diet, enjoy relationships and apply ourselves to meaningful work in the present, before we are forced to do so under the threat of cancer. Cancer is the modern voice that reminds us of the uncertainty and transitory nature of all of our lives and urges us to live as though we really knew this truth.
IMPOTENCE
Surprisingly, the treatment of impotency has a long history. Over two thousand years ago, traditional Chinese physicians theorized about the causes and treatments of this common dilemma. In fact, almost without exception, all traditional medical schemes have included the treatment of male impotency as one of their central concerns. Curiously, when one looks behind the disparate terminology, one finds a general uniformity of opinion as to the cause and treatment of this situation. In many ways, the traditional views on impotency and its treatment are in agreement with current scientific information about this condition.
Impotency is not an isolated event, but is closely related to aging and loss of vitality. The Chinese held that this vitality was closely aligned with overall physical vigor and was also organ-specific. They associated male potency with Kidney Yang energy, which refers to the ability of the kidney area, particularly the adrenal glands, to generate warmth or fire. Many other traditional medical schemes relate loss of “fire” to the problem of impotency and conclude that the kidney/adrenal system is the generative organ for this fire. According to the principles of anthroposophical medicine, the kidney/adrenal system is the house of the Emotional or Soul body. It is not a huge stretch to conclude that the Emotional body has some role to play in our ability to engage in healthy sex, one of the most important manifestations of our emotional life.
The interconnection between the kidney/adrenal system and male sexuality contains further mysteries. If asked which organ is most related to impotence, most modern physiologists would choose the testicles or, if they were more emotionally inclined, the brain. Why the adrenal gland?
The adrenal gland is the master organ of the endocrine system. Through their adaptation to stress mechanisms, the adrenal glands direct the synthesis and flow of virtually all the other hormones. The adrenals also have the ability to produce hormones that are normally made by other glands. A particularly striking example of this is the hormone estrogen. After menopause, when the ovaries reduce the production of estrogen and progesterone, healthy adrenal glands can make up the difference and set the basis for a long healthy life with little or no repercussions from the loss of ovarian function.
In a similar way, while science has clearly demonstrated that sexual drive and performance in both men and women relates to testosterone levels, the traditional medicines for treating impotency have had their main field of action on the production of adrenal hormones. Thus, there is no sense in speaking of a therapy for impotence that does not address the patient’s overall health. You cannot separate sexual function and treat it as though it were unrelated to the whole.
Moreover, the level of potency is intimately related to the emotional, or soul health, of the man, as well as his overall physical vigor. When a boy or man suffers undue pressures on his emotional life, either through childhood traumas, repressed feelings or the everyday strains of life in modern America, his emotional balance and sexual ability may suffer.
Impotency is not primarily a problem of testicular dysfunction or testosterone deficiency. Rather, it involves an imbalance of the entire hormonal axis–pituitary gland, adrenal glands, testicles and even the thyroid gland. All of these glands are governed by the same feedback loops between the brain and the body. They function as a group and have much to do with determining our overall health. Impotency is not simply due to deficiency of testosterone–or Viagra; the treatment of impotency must involve the restoration of health. Science actually corroborates the practices of ancient physicians, who treated impotency by restoring male vigor. This is best accomplished by relieving emotional blocks, often old lingering impediments that still stand in our way, and by taking steps to restore the health of the adrenal gland.
In addition to the diet and the work on soul connections and our relationships, I recommend several interventions that have proven useful in treating impotency. The first is the herbal extract of Tribulus terrestris, from Mediherb. Tribulus is adaptogenic, meaning that it helps our bodies adapt to stress by improving adrenal hormonal production. A number of studies involving both animals and people indicate that the herb improves erectile function, decreases the latency period (that is the time between ejaculations), and increases the length of time that an erection can be sustained. It does not provide any testosterone, nor is it clear that it improves the ability of the testicles to produce testosterone. Rather, the herb seems to directly stimulate the adrenal glands to produce their hormonal products and therefore adapt to stress, even the stress of aging. Studies also indicate that tribulus improves cardiovascular endurance and slightly dilates the coronary arteries, thereby allowing improved oxygenation of the heart. The recommended dose is 1 tablet 3 times per day, for at least 6 months. Many men report an improvement in their potency during the third to fourth month of treatment.
In more severe cases, or with men who have lost overall vitality in addition to sexual potency, I recommend Bacopa complex, a Mediherb preparation that combines schisandra (a liver herb) and Siberian ginseng (a well-known adaptogenic herb) with bacopa (an adaptogenic herb that has a specific effect on improving memory). Together these herbs help strengthen the nervous system, liver and adrenal glands. The dose is 1 tablet 3-4 times per day for at least 6 months.
Finally, to help restore the glandular health of the entire pituitary-adrenal-testicular-thyroid axis, I use the Standard Process preparation Symplex M, which contains the proto-morphogen extracts from each of these glands. In fact, it was the genius of Royal Lee who recognized, well before it was appreciated by normal science, that effective treatment of any of these glands requires treatment of the whole group or axis, rather than treatment of each in its own fiefdom. The dose is 1-2 tablets 3 times per day for 6 months.
FROM SWORDS TO PLOWSHARES
The mystic and philosopher Rudolf Steiner made an interesting remark when speaking about the nature of the genders. He stated that the soul of the human being has the opposite gender to that of the physical body. Thus, those living in male bodies have feminine souls. Many other religious traditions have hinted at the dual nature of the human being. In Hinduism, for example, the road to salvation is depicted as the merging of opposite genders in one person. In contemporary thought, Carl Jung’s psychological philosophy includes the notion that each of us harbors the opposite gender within our souls. According to Jung, one of the main tasks of self-actualization involves the reconciliation of these opposites. For men this means blending one’s feminine side into the overall personality–a notion that has taken on a certain triteness these days with frequent repetition. Nevertheless, it is a profound insight, one that has reemerged after centuries of darkness. In fact, it is the most important challenge any man faces in working with his soul life.
The soul that dwells in a masculine body can automatically express the typical masculine attributes of aggression, action and decisiveness. However, to achieve optimal health, these need to be balanced with the more feminine, intuitive nature that most males struggle so mightily to comprehend. As predicted from our earlier discussion, iron and the male attributes may lead to action but they also lead to disease, particularly to the sclerotic diseases that afflict so many in our culture. The feminine, on the other hand, is the healer. Most traditional cultures clearly recognized this fact and consigned the healing arts to the hands of women. In our time we need both, and each person needs to make space within to accommodate both genders. Living in a culture that struggles to value the feminine side of life only makes this reconciliation harder for today’s males as they find themselves caught between the outer demands of their culture and their own, often weak inner voice.
There is no magic formula for finding one’s inner feminine aspects. But the most important step is simply to understand that this is necessary and then to try to open oneself to what life brings, paying particular attention to the feelings and intuitions that arise. As you contemplate the events of your life, focus on those actions that integrated feeling and intuition with action. Those who carry out this process in earnest will find themselves on the path that transforms the sword of iron and destruction into the plowshare of peace and good health.

Sidebar 
Summary for Men’s Health
Acute Prostatitis
Hot sitz baths with 1 cup of Epsom salts, 20 minutes, 2 times per day for 10 days.
Echinacea Premium by Mediherb, 2 tablets every 2-3 hours.
Saw palmetto extract by Mediherb, 1 teaspoon 2 times per day.
Prostate PMG by Standard Process, 1-2 tablets 3 times per day.
Erysidoron 1, 10-15 drops 4 times per day.
In cases unresolved by the above, antibiotics are usually needed.
Benign Prostatic Hypertrophy (BPH)
Saw palmetto extract by Mediherb, 1-2 teaspoons per day.
Nettle root extract by Mediherb, 1-2 teaspoons per day.
Prostate Cancer
Use the cancer therapeutics described in Chapter 2 of The Fourfold Path to Healing.
Impotence
Tribulus herbal extract by Mediherb, 1 tablet 3 times per day, for at least 6 months.
Bacopa complex, 1 tablet 3-4 times per day for at least 6 months.
Simplex M by Standard Process, 1-2 tablets 3 times per day for 6 months.
Splendid Specimens: The History of Nutrition in Bodybuilding
Posted on December 14, 2004 by Randy Roach • 3 Comments 
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The sport called bodybuilding demands the ex-treme in body presentation. No other athletic endeavor requires such high levels of regimentation for muscle development and body fat reduction. To outsiders, such efforts may appear vain and self-centered, even looming out there on the lunatic fringe. Nevertheless, the sport has had considerable influence on other fields of athletics, not to mention the general public.
We must remember that the men (and women) who sweat it out in the gym year after year were using the low-carbohydrate diet long before Dr. Atkins made it popular. Many other dietary strategies of today such as all-raw diets, protein supplementation, eating multiple small meals a day, carbohydrate loading, meal replacement packages and macro-nutrient balancing all derived their initial popularity from the bodybuilding field.
Physical Culture
Credit for the Physical Culture movement in North America, the precursor to the bodybuilding movement, goes to Bernarr Macfadden, an extraordinary entrepreneur who published physical culture magazines, organized physique competitions, wrote 150 books and accumulated millions in the publishing industry. Macfadden preached clean living and whole natural foods. He ate vast quantities of raw carrots, beet juice, fruits, dates, raisins, grains and nuts. He abstained from meat but recommended copious amounts of raw milk. In fact he even recommended an exclusive raw milk diet for extended periods.
The dominant star of the early years was Eugen Sandow, whose career spanned the late 1890s and the early part of the 20th century. He did not display the typical burly brute image, but a finely chiseled body, resembling those of Roman and Greek athletes. With the help of Florenz Ziegfeld, he marketed and displayed his physique in artistic fashion. In fact, it was through this artistic expression that Sandow inspired Macfadden in the mid 1890s. In an 1894 interview on his dietary habits, Sandow claimed to abstain from hard liquor, coffee and tea, but consumed the occasional beer. He ate mostly wholesome foods, but indulged at selected opportunities. Sandow, along with most of the other Physical Culturists of his day, placed more emphasis on the mechanical aspects of diet as opposed to the chemical. He believed in doing what was necessary to facilitate good digestion, including eating at regular intervals, selecting simple foods, applying thorough mastication, eating slowly and tying it all together with a good night’s sleep. He was critical of over-indulgence and recommended foods with a high nutrient value, although he admitted to eating what he wanted, when he wanted, and however much he wanted during his younger years.
Earle Liederman, author and friend of Sandow, also advocated whole natural foods. Liederman pointed out the importance of a strong digestive system enhanced by proper food mastication for men of strength and large appetites. He described the popularity of “beef juice” or “beef extract” for rapid muscle recovery. Liederman also felt obliged to mention that ice cream was very popular, referring to one lifter who often felt it necessary to finish his meals with a quart of vanilla ice cream.
Arthur Saxon of the famous Saxon brothers trio and a contemporary of Eugen Sandow, also recommended nutrient-dense foods for endurance athletes. He warned against the dangers of hard liquor, but condoned beer. In fact, Saxon had a reputation for hefty beer drinking as did many men of strength of the time. He warned against smoking while admitting to being a smoker himself. For gaining muscle, Saxon recommended milk mixed with raw egg after a workout, milk with oatmeal, cheese, beans, peas, and meat. He called milk the perfect food.
According to his brother Kurt, all three of the Saxon brothers had very hearty appetites. Along with his participation in the strength act, Kurt was also the trio’s chef. Kurt’s list of food consumed by the three brothers each day indicates substantial daily intake, with little self-denial. Milk is largely absent from Kurt’s menus.
Raw vs. Cooked
A debate that has been on-going since the early days of Physical Culture is the relative virtues of raw food versus cooked. Sandow referred to the eating of raw eggs and under-cooked meats as nonsense and a practice that was “passing away.”
In the raw food corner was champion wrestler George Hackenschmidt, the “Russian Lion,” a man rivaling Sandow’s strength, and surpassing him in athletic ability. Like Sandow, he was small by today’s standards, standing just under 5’10″ and weighing about 200 pounds. However, he was enormously strong. Both a gentleman and sportsman, George Hackenschmidt reflected a spiritually conservative philosophy towards nutrition. In his book The Way to Life, he stated:
“I believe I am right in asserting that our creator has provided food and nutriment for every being for its own advantage. Man is born without frying-pan or stewpot. The purest natural food for human beings would, therefore, be fresh, uncooked food and nuts.” He stated that a diet of three quarters vegetable food and one quarter meat would appear to be most satisfactory for the people of central Europe but conceded a hearty appetite which, in his early training years, was based on 11 pints of milk per day, presumably raw, along with the rest of his diet. A prophet before his time, he warned about the dangers of refined sugar and meat from artificially fed and confined animals. He believed that most people ate too much flesh food from these improperly raised animals and encouraged more emphasis on natural raw foods.
Vegetarianism
The early bodybuilders also debated the pros and cons of vegetarianism. Macfadden and Hackenschmidt inclined towards diets that excluded meat, or that at least derived a preponderence of calories from plant foods. Juicing was popular among some. In his book Remembering Muscle Beach, Harold Zinkin describes fellow beach comrade Relna Brewer. At 17, Brewer worked in one of California’s first health food stores, located in Santa Monica. Relna’s job was to run the juice press. Because the owners of the store could not afford to pay much, Relna took out her pay in the celery, watermelon, orange and carrot juice she made each day.
Jack Lalanne was probably one of Relna’s customers. Jack began his carreer as a vegetarian, bringing his own food, such as apple or carrot juice and vegetables, to train at the beach during the 1930s. However, Lalanne later ate meat when focussed on bodybuilding. In fact, Armand Tanny says that Jack would visit the local stockyards to acquire cow’s blood to drink while in training. Later Lalanne reverted back to his vegetarian ways, but allowing some fish and eggs.
Lalanne opened one of the first health studios in Oakland in 1936. A colleague writes that Lalanne would work 14 hours a day then drive through the night 400 miles so he could be with the gang at Muscle Beach to participate in all the activities. When it came to pure energy and vitality, Lalanne was, and at 90 today, still is unbridled.
Another vegetarian was Lionel Strongfort who promoted a system of raw foods based on fruits, vegetables, eggs and milk. He recommended very little meat and cooked fat. Strongfort suggested eating only two meals a day, a strategy shared by Macfadden that would re-emerge in the 60s and 70s. Strongfort and Macfadden both advised against overconsumption of food. They claimed overconsumption created a negative stress on the body’s systems, sensible advice that bodybuilding publications would ignore in the coming years.
Perhaps the most accepted food across all the early eating models for bodybuilders was milk. One of the most popular protocols for building size and strength was the combination of back squatting and drinking large quantities of milk. Joseph Curtis Hise was a pioneer of this system in the 1930s and after 70 years this strategy is still going strong in the drug-free world of bodybuilding.
Tony Sansone
Another Physical Culturalist who advised against over-consumption was Tony Sansone, but Sansone understood the importance of flesh foods, including animal fats and organ meats. He wrote extensively on nutrition for bodybuilders and recommended nutrient-dense “foundation” foods such as milk, eggs, butter, meat, vegetables, fruits, and some whole grains, in that order. He also stressed the importance of organ meats such as liver, kidney, heart and cod liver oil and recognized the need to drink whole raw milk instead of pasteurized and skimmed. He believed goats milk was more nutritious and easily digested than cows milk. Fresh butter and cream were his preferred fats. He also recommended six to eight glasses of water per day.
Tony Sansone wisely stressed the importance of generous amounts of fat in the diet to allow the complete utilization of nitrogenous (protein) foods in building muscle tissue–a fundamental and important fact that would be lost as the era of protein supplements took hold. He also knew that weight loss was not a matter of simple calorie counting, as cellular uptake or utilization of food varied on an individual basis. In anticipation of Dr. Atkins, Sansone recommended his foundation foods of milk, eggs, meat, vegetables and fruit for strength and health, and starchy foods as weight manipulators. His recipe for gaining weight was to add more high-carbohydrate foods such as bread and potatoes to the diet, and for losing weight to simply reduce or remove them. Tony Sansone’s caveat to lose no more than two pounds of fat per week is still the standard used in bodybuilding today.
Muscle Beach
Muscle Beach got its start in the 1930s as the meeting place of young athletes who lifted weights, built human pyramids, tumbled, juggled and engaged in any other athletic endeavor they could think of. That era gave us many recognizable names such as Harold Zinkin (creator of the Universal weight machine), Joe Gold (creator of Golds Gym), Jack Lalanne, Harry Smith, and the Tanny brothers, Armand and Vic (who created a popular gymnasium chain). In fact, it is safe to say that much of the fitness industry grew out of Muscle Beach–gyms, gym chains, TV exercise programs, fitness equipment, women lifting weights, even aspects of the natural organic food movement stemmed from this small stretch of sand.
According to Harry Smith, long-time gym owner, ex-pro wrestler and Muscle Beach alumnus, body builders didn’t think much about specialty food or supplements in those days. The emphasis was on training rather than eating and resting. Harry did state that many of them tried to keep their eating clean, and that on a number of occasions they would frequent a small deli about one-half block from the beach. The deli offered freshly ground beef to which some of the guys would mix some raw onions and a little salt and pepper. The meat was eaten raw along with raw milk. Harry said it was a cheap and easy way to eat hearty and keep out of the restaurants.
One important Muscle Beach raw food enthusiast was Armand Tanny. Originally a weightlifter, Armand had a fantastic physique and the strength to qualify him for the wrestling circuit. He visited the Hawaiian Islands just after the Second World War and came away with a lasting impression of the Samoans. “They ate everything raw,” he noted. “You name it, fish, meat, beetles–everything! They were so strong and healthy.” On his return to the US, he became interested in the work of Weston A. Price, stating that Price’s book Nutrition And Physical Degeneration served as his Bible.
In 1948 he shut off his stove and ate just about everything raw from then on–tuna, beef, liver, lobster, oysters, clams, nuts, seeds, fruits and vegetables. Armand recalls wading out into the surf along the Santa Monica Pier and using his feet to kick up 6- to 7-inch Pismo clams, smashing them together to get at the pink and white flesh. Armand also took brewer’s yeast, desiccated liver, yogurt, black strap molasses and wheat germ oil, all recommendations of Gaylord Hauser, a nutritional guru of the era. Hauser also recommended fish liver oil, but Tanny felt he was getting plenty from all the raw fish he was consuming.
Armand credited his 1950 Mr. USA and the Pro Mr. America titles to his raw meat diet. In the 1950s, he helped his brother Vic in the gym business and appeared in a Mae West act. His bodybuilding articles appeared prominently in bodybuilding publications for the remainder of the century, thus providing a link to Weston Price during the decade of the 50s.
Bulking Up with John Grimek
The biggest influence on bodybuilding in the 1930s and 1940s was John Grimek, the second American Athletics Union (AAU) Mr. America and the first to win back-to-back titles, in 1940 and 1941. Many commentators believe that Grimek represents the beginning of modern bodybuilding as we know it today, describing him as the best physique of the mid century.
During the early 1930s, at the start of his career, Grimek came under the influence of Mark Berry, editor of Strength magazine and an advocate of an eating protocol in which an athlete would bulk up in bodyweight and then train it off. At one point, Berry had Grimek beef up his 5’ 8″ frame to 250 pounds. The practice would become commonplace by the 1950s and maintain a foothold for several decades after.
Grimek bulked up on whatever was put in front of him, reports his wife Angela in a 1956 Health and Strength article entitled “Life with John.” “John has an enormous appetite. . . John has yet to find a restaurant that can do justice to his appetite. . . . Sometimes he goes on a restricted diet–and it is surprising how little he can get by on then. But when he goes all out, he can never be filled. . . . but the ‘hog’ (our pet name for John) just eats and eats and still remains trim and muscular.”
By the 1950s, Grimek’s diet included Hershey chocolate bars and hi-protein tablets manufactured and promoted by Bob Hoffman, publisher of Strength and Health, a magazine that provided a platform for Grimek along with the new-fangled supplements coming on the market. Hoffman used Hershey chocolate in his products, so Grimek and the rest of the York gang had easy access to some empty calories.
Protein Powders and Supplements
In the late 1930s a young pharmacist named Eugene Schiff developed a method of processing whey from milk for human consumption. He created Schiff Bio-Foods, a whey packaging company. This was a half century before whey concentrates would emerge as a popular supplement in the bodybuilding scene. For a short time he sold his packaged whey to local drug stores, then sold his own store to enter into the manufacturing and packaging of health foods.
Schiff focused on supplements made from natural products. He began to experiment with whole foods such as brewer’s yeast, wheat germ and liver. He found that these foods were naturally rich in vitamins and minerals. The Schiff company claims that he was first to discover that rose hips was a superior source of vitamin C. Along with the first rose hip vitamin C supplement, he also launched one of the first multi-vitamin products, called “V-Complete.”
The demand during World War II for non-perishable foods allowed the food industry to expand and popularize the market for powdered or dehydrated foods and bodybuilders would eventually find their way into this market. Powdered milk and eggs, and later powdered soy protein, were promoted as an easy way to get additional protein into the diet. Breakfast drinks based on a protein powder emerged into the diet of the legendary Steve Reeves who years later wrote about this practice in his book Building The Classic Physique. Reeves’ impressive natural physique landed him starring roles in the films Hercules and Hercules Unchained in the late 1950s and inspired thousands of young men to adopt weight training. His recipe for a breakfast drink included fresh orange juice, Knox gelatin, honey, banana, raw eggs and a blend of skim milk, egg white and soy protein.
The first protein powders “tailored” specifically for athletes appeared around 1950. One of these was called 44, “The Supplemental Food Beverage,” produced in California by a company called Kevo Products. The principle ingredient was dehydrated powdered whole soy beans, along with kelp, wheat germ, dextrose, and various dehydrated plants, herbs and flavorings. The supplement was sold at health food stores, body-building studios, and health institutes.
Another popular product was Hi-Protein, “a protein food supplement derived from soya flour, milk proteins, and wheat. The free amino acids which include natural tryptophan and the other natural essential amino acids where produced by an acid hydrolysis.” The product was developed by bodybuilder and nutrition guru Irvin Johnson with before and after photographs of weaklings turned musclemen. Bob Hoffman quickly capitalized on Johnson’s success by following immediately with his own soy-based product marketed heavily in Strength and Health. Hoffman’s infamous protein claimed many a victim with hives or gym-clearing gas.
The debates on raw versus cooked and vegetarianism versus meat eating that appeared in bodybuilding magazines during the 1940s gave way to numerous articles on protein supplements in the 1950s, including “Building Biceps Faster With Food Supplements (Iron Man, December 1950,” “More and Better Protein Will Keep you Well (Strength & Health, March 1953),” “The Magical Power Of Protein (Mr. America, February 1958),” “Food Supplements Build Rock Hard Definition (Muscle Builder, June 1958)” and “Everyone Needs More Protein (Strength & Health, July 1959).
Meal replacement products also appeared during the 1950s, with much hype. One product, called B-FIT, was recommended as a replacement for two or three regular meals per day. According to its promoters, B-FIT “is scientifically formulated to contain all the needed vitamins and minerals, plus ample supplies of the effective proteins and yet is so low in calories that the fatty tissue literally melts away. . . . You will not suffer from any nutritional deficiencies because B-FIT is a complete food insofar as scientific experiment and research is possible to develop. Approved by dieticians.”
Advocates for new diet theories–food combining, alkaline-forming diets, even strict vegetarianism–promoted their ideas throughout the 1950s, but the big emphasis was on protein powders and supplements. For the 1954 world weightlifting championships, team coach Bob Hoffman hauled more than 100 pounds of his Hi Protein powder to Vienna, hailing it as the “secret weapon” for his athletes. But Russia, whose athletes finished no lower than second place, had a secret weapon of their own.
The Secret Weapon
It was John Ziegler, a doctor accompanying the American team to Vienna, who exposed just what this Soviet weapon was. Ziegler claimed that after a few drinks, a Russian doctor told him that the Soviet athletes were using–and abusing–testosterone. Ziegler was no stranger to testosterone. With his background in rehabilitation therapy and his connection with CIBA Pharmaceuticals, he was already experimenting with testosterone on himself, his patients and some novice athletes. In fact, author and historian John Fair writes that even the great John Grimek was cooperating with Ziegler and trying his drugs in the summer of 1954. Grimek reported disappointing results.
Both American and German research scientists had identified testosterone and noted its effects as far back as the mid 1930s. CIBA Pharmaceuticals was already targeting bodybuilders with ads for synthetic testosterone in 1947. With Ziegler’s help, CIBA manufactured the most popular anabolic steroid of the 20th century. The drug was Dianabol, which came out in1958.
The acceptance of steroid drugs among bodybuilders got off to a slow start. Drinking a gallon of milk or swallowing 2000 protein pills seemed more logical to them than taking a tiny pill to do the job. Even those who did take them were slow in accepting or acknowledging the fact that it was the steroids that were giving them such tremendous gains in muscle mass.
Out on the West Coast, bodybuilding great Bill Pearl was also curious as to what the Russians were doing, so he took it upon himself to do his own research. During a visit to the University of California at Davis in 1958, he learned from a veterinarian about the successful use of steroids in beefing up cattle. Bill figured that if it was good enough for a bull, then it was good enough for him. While continuing to train hard, he took 30 mg of the steroid drug Nilevar (three times the recommended dose for humans, but an absolute joke by today’s practices) for 12 weeks and brought his bodyweight up from 225 to 250 pounds.
Steroid use among athletes paralleled the challenge to conservative moral standards that characterized the era of the 1960s. It was a time that seemed ripe for the liberation of one’s desires. Individual freedoms took precedence over the rules, morals and ethics dictated by a long established culture–and by Mother Nature. If the new generation could take mind-altering drugs, it could take body-altering drugs as well. Anabolic (“building-up”) steroids such as testosterone ushered in a new bodybuilding look that was larger and more muscularly pronounced than ever before.
During the early 1960s, the magazines emphasized caution about steroids. They acknowledged the rumors concerning Bill Pearl and others but tried to steer their readers away by stating that the drugs didn’t work, wouldn’t produce what bodybuilders expected, or were outright dangerous. Both Iron Man and Muscle Builder magazines warned of side effects and published articles claiming much better results with high-protein products. But behind the scenes, the athletes knew that they worked. Pearl openly acknowledged that he used them for a final time in 1961 to prepare for the 1961 National Amateur Bodybuilding Association (NABBA) Mr. Universe contest. He stated that the drugs by then were no longer underground but well known to the top bodybuilders.
Steroids and Cream
Still, most athletes relied on diet for strength-building, and protein occupied a large percentage of that diet. In the early 1960s, Irving Johnson targeted elite bodybuilders with a milk-and-egg protein blend considered far superior to competing products–including an earlier product of his own–based on soy. By the mid 60s, ads for Johnson’s protein blend began appearing in the bodybuilding magazines. At that time he changed his name to Rheo H. Blair. Blair claimed that his protein powder was made from milk and eggs obtained from animals raised on the rich soil of Wisconsin and that the proteins were extracted at very low temperatures. Wary of the difficulty some might have digesting all that protein, he endorsed hydrochloric acid supplements, to be taken with any protein meal. He also sold supplements such as amino acids, liver extract, B-complex and soybro (a combination of wheat germ, rice germ and soy germ oils). In 1966 he introduced a new protein formula which he claimed had a biological value resembling mother’s milk.
Blair promoted his products with skillful salesmanship but he also made an important suggestion that would ensure that his products actually worked–he insisted that his protein be taken with raw cream or half and half. He was smart enough to know that you must replace the fat removed from protein during processing. He also recognized the benefits of raw dairy products. Athletes of the 1960s used a variety of recipes, varying the proportions of Blair’s protein product with raw cream, raw milk and raw egg yolk. Weight-trainer Don Howorth remembers eating 3 dozen eggs, 1 quart raw cream, and 2 pounds ground sirloin along with 2-3 cups of Blair’s protein powder per day.
Blair had a special method for cooking his eggs. He did not cook them in boiling water but recommended cooking many eggs at one time in water maintained at 181 degrees for 31 minutes. The eggs were then left in the water to cool down slowly. Blair claimed that putting the eggs under cold water “shocked” many of the nutrients, rendering them ineffective and that cooking eggs in this fashion preserved much of their nutritional value.
It is interesting to read Perry Rader’s “Reader Roundup” column in his Iron Man magazine during this time. He tries to explain the spectacular gains made by some of the popular bodybuilders who were using Blair’s products. Many of them were eating 6000 to 9000 calories a day in the same fashion as Don Howorth and gaining muscle while maintaining or even trimming their waist size. Rader published Blair’s response in a 1966 issue of Iron Man. Blair claimed that his protein powders, along with all of his other supplements, were formulated in a special manner to metabolize fat more efficiently. He also warned that taking cream with any protein powder other than his own would result in fat accumulation.
But Blair could not help knowing that these dramatic results were not achieved on food and protein powders alone. Bodybuilders knew that they could expect to build muscle consuming 8000 calories per day, but not lose fat at the same time. That required some additional anabolic assistance. Blair knew his guys were taking steroids. Don Howorth readily admitted his past use of Dianabol, but was adamant about the importance of diet along with it. In fact, some bodybuilders were quite open about drugs. When Larry Scott, two-time winner of Mr. Olympia, was asked about his steroid use he said without hesitation, “Sure, doesn’t everyone?” However, the bodybuilding magazines continued the deception that the new, larger physiques were built on powders and supplements. Thus steroid use artificially inflated the already marketable commodities of bodybuilding.
Vince Gironda
One man who had definition dieting mastered and who never used drugs was the Iron Guru Vince Gironda. Pioneer of a technique involving intense abbreviated training routines rather than long workouts, Gironda began competing in the 1950s and then trained both athletes and movie stars for many decades after. So defined was his physique, he often found himself penalized by judges who seemed confused over his appearance. Says Gironda, “The men who judged physique contests at this time were puzzled by so much muscularity. Quotes from physique magazines stated I didn’t place higher in whatever contest because of too much muscularity. They thought that this type of cut-up physique was slightly repugnant so I lost most muscular titles to smoother men who had that type of definition for that day.”
Gironda often stated that nutrition was 85-90 percent of bodybuilding. His alternative to drugs was eggs. Like Blair, he advocated up to 36 eggs a day for 6 to 8 weeks to produce muscle buildup. (He also took, among many other supplements, “orchic tissue tablets,” that is, dried testicles.)
He recommended following this “anabolic phase” with a short-term vegetarian diet to “re-alkalize” the body. Similarly he alternated a low-carbohydrate diet with periods of carbohydrate loading. He was careful to point out the difference between natural and refined carbohydrate foods. He presented research data that strongly indicted refined carbohydrates as the real culprit in much of the century’s degenerative disease. His articles went into surprising detail on the biochemical pathways through which sugar did its damage, pointing out the relation between sugar and atherosclerosis, abnormal increases in height and weight and skeletal anomalies.
As for protein, he believed the average American could get along fine with just 45 grams of quality protein a day. However, he insisted that bodybuilders needed over 300 grams daily for several weeks to force the growth process. He believed in quality protein powders and used Blair’s milk-and-egg blend until he came out with his own product. When he used the powders, he blended 1/3 of a cup with a dozen eggs and 12 ounces of raw cream or half & half. He was also big on steak and often ate his meat raw.mmended germ oils, amino acids, vitamin and mineral supplements, and hydrochloric acid (HCL). He recommended mineral rich sea kelp for its iodine content and dried liver extract for blood building and oxygen capacity boosting. Many bodybuilders used desiccated liver after the early 1950s experiments of Dr. Benjamin Ershoff. Ershoff who conducted the famous liver study wherein rats fed 10 percent desiccated liver swam far longer compared to controls.
Macronutrientland
In his early years, Blair recommended a very low carbohydrate diet. Later he advocated a diet consisting of 1/3 protein, 1/3 fat and 1/3 carbohydrates to build muscle; then he reversed himself and again urged avoidance of carbohydrate foods. But other bodybuilders included high levels of carbs in their diets. For example, teenage sensation Casey Viator, who became the youngest Mr. America ever at age 19, had his own special peanut butter pudding that consisted of 2 pounds of peanut butter, 1 jar of grape jelly and 3 or 4 bananas. The bananas were optional. This was part of a diet that also included 2 dozen eggs and 2 gallons of raw milk per day. Casey recalls his father not shedding too many tears when he finally moved out.
A columnist in Strength & Health magazine recommended the following carbohydrate-rich concoction for “getting big” along with a diet that allowed unlimited meat and eggs:
A one day supply of Hoffman’s Gain Weight formula (based on soy protein)
2 quarts milk
2 cups skim milk powder
2 raw eggs
4 tablespoons peanut butter
½ brick ice cream
1 banana
4 tablespoons malted milk powder
6 tablespoons corn syrup
By the 1960s, bodybuilders had figured out what they had to do to attain specific goals. Getting lean or “ripped” for a contest required stripping the diet of all carbohydrates, including milk and cream. Milk was a favorite for building muscle, but for losing fat, it contained too much carbohydrate and held water under the skin. Ketogenic diets consisting of meat and water were commonly used to prepare for the shows. During the 1950s, two English researchers–Professor Kekwick and Dr. Pawan–claimed to have isolated a fat-mobilizing substance that showed up in the urine along with ketone bodies after 24 hours on a no-carb diet. In spite of considerable scientific debate, the Ketogenic diet remained a constant in the field of bodybuilding until the 1980s.
Yet it was in the early 70s that the lipid hypothesis began to take hold. The result was a series of diets that emphasized carbohydrates over protein and fats. The pre-game meal of beef was giving way to one of lasagna or spaghetti.
The magazines of 1970 mirrored this confusion. For example, in an issue of Strength & Health, publisher Hoffman praises the African Masai tribe for their reverence of whole milk, while in his other publication, Muscular Development, he recommends skim milk because it is lower in saturated fats. (The vast majority of the nation was now drinking pasteurized milk–long time strength trainer Jim Bryan remembers avoiding raw milk because he was given the impression that it was dangerous.) MuscleMag publisher Bob Kennedy told his readers not to let anyone scare them away from eggs. Frank Zane, Mr. Olympia champion from 1977-79, was still eating the old way with plenty of eggs, lamb, beef, pork, heart, liver, raw milk, protein powder, vegetables, fruit with some potato and brown rice, educating his readers on the misconception of cholesterol and warning against over-consumption of polyunsaturated vegetable oils. But in Iron Man, Sterri Larson was telling readers that the diet of the bodybuilder was not necessarily one to produce good health. He believed that eggs were the best for both building muscle and losing fat, but that saturated fat and cholesterol could prove hazardous. According to bodybuilder Brian Horton, some of the athletes were now eating chicken and fish instead of beef and eggs.
Steroid Use
Meanwhile, by the end of the 1970s, professional bodybuilders were using a number of metabolism-enhancing substances such as amphetamines, Armour (Thyroid), human and animal growth hormone, and multiple steroids (a method referred to as “stacking”). Some of the top pros worked with physicians to monitor their blood parameters as they prepared for their competitions. During the months before an event, these athletes would swallow and inject any substance that would facilitate tremendous muscularity. Very few, if any, bodybuilders could attain such condition without this assistance.
Steroid use suffered a setback with the revelation that 1988 Olympic gold medal sprinter Ben Johnson had tested positive for anabolic steroids, which had been banned from use in the Olympic games since 1975. In 1990, the Food and Drug Administration added steroids to the Schedule III list of the Controlled Substance Act. Since then, any athlete seeking to build muscle via anabolic steroids could just as easily find his next workout conducted in a Federal prison gym — and several have, to the dismay of many in the legal, medical and sports arenas.
The ban on steroid use was no surprise to the bodybuilding world since abuse of the drugs, even at the high school level, was well known. Not only was the number of users growing, but so were the dosages and arsenals in professions where size and strength really made the difference.
The magazines were not yet labeling heart disease as a side effect of steroid use. However, by 1970 they were starting to mention the fact that a number of strength athletes were succumbing at their prime. Columnist Bob Brown described his concern over losing friends at an early age to heart disease and wrote an article in Iron Man entitled “Will Weight Training Kill You?” Brown compiled some death statistics on prominent men of the iron game throughout the century and compared them to some mortality stats supplied from an insurance company. He concluded that even though strength trainers were not immune to early death, they fared better than the average American and stood a much better chance at living a longer life.
Others noted the shortened careers of top bodybuilders. The 1967 Mr. America Don Howorth considered a comeback, but stated he knew his body would not do well with what he had to take at that stage of his life. Even the genetically blessed Casey Viator who was a serious contender for the Mr. Olympia title, walked from any more attempts in 1983 knowing that his body had had enough.
New Dietary Trends
In the early 1980s, bodybuilders became interested in the glycemic index of carbohydrate foods. A team of researchers at the University of Toronto, led by Dr. David Jenkins, demonstrated that different foods affected blood glucose levels at different rates. They developed the Glycemic Index in which many carbohydrate foods were measured against selected reference foods on how quickly they raised glucose levels.
Many bodybuilders and other athletes used the glycemic index to plan their daily menu and carbohydrate selection. With the insurgence of carbs into the diet, along with a well-established reverence for protein, bodybuilders discovered there wasn’t much room left for fat. In fact, by the end of the decade, many found themselves in a competition for who could get their dietary fat the lowest. Some even attempted a theoretical zero fat diet.
But not everyone was taken in. I interviewed bodybuilder Ron Kosloff who said he didn’t change a thing. “I knew what I saw,” he told me. “My grandparents lived on a farm and ate whole milk, cream, eggs, butter, meat, potatoes and homemade bread. My grandfather often ate 6 eggs a day for years, many of them raw, along with lard sandwiches. He lived to 98 while my grandmother lived to 101. What astounded me most was their farmhand who went by the name of Indian Joe. When I first saw him he looked in his 40s and was incredibly cut and muscular. He looked like Conan. I was shocked when I found out he was well into his 70s. Indian Joe lived to 115 years of age and ate nothing but meat, glands and intestines!” Kosloff had consumed a minimum of 6 eggs daily for the previous 20 years with no ill effects. Ron also noted that bodybuilders like Gironda and Blair were warning him back in the late 60s of the real hazardous fats–hydrogenated oils!
Armand Tanny, now in his 60s, was also writing articles contradicting this new trend. All through the 1980s he wrote articles for Joe Weider’s Muscle and Fitness magazine such as: Caveman Diet (March 1986), Meat and the Bodybuilder (Dec 1986), Good Nutrition and Sex (June 1987), Streamline Meat (Oct 1987), Uncooked Delicacies (Dec 1986), and Those Beefs About Meat (Oct 1985).
In the midst of the cholesterol scare in 1984, Vince Gironda released his book Unleashing The Wild Physique, still recommending 36 eggs a day to produce an anabolic effect. However, he also wrote an article defending carbohydrates and warning of the potential risks of high protein consumption.
Putting Those Carbs to Work
A major trend in the 80s and 90s was the concept of carbohydrate loading, first popularized by Vince Gironda back in the 50s and 60s. “I believe that every 3 to 5 days you need to get a ‘carbohydrate loading meal’ into your body
. . . I feel that carbohydrate is necessary every third or fifth day in order to get the glycogen back into the liver.”
Also back in the 1960s, cyclists were using a technique of loading their muscles with carbohydrates to give themselves an endurance edge. Bodybuilders were also loading their muscles just before a competition to give them a fuller look. Into the 1980s, the competitive bodybuilders had brought it into a science with their knowledge of the hormones vasopressin and aldosterone and how they controlled the sodium/water balance in the body. The challenge was to stand on stage on competition day with as much body fluid sucked into the muscles with the carbohydrates and not under the skin. The effect of this technique was so dramatic that hit or missed timing could represent a victory or looking terrible for bodybuilding standards. Often bodybuilders would be banging their heads off the wall one to three days after a big show when all the fluids would shift into the right places–too late!
Similar diets followed including Cyclical Ketogenic Dieting (CKD) variously known as the “Ultimate Diet,” the “High-Fat Diet,” the “Anabolic Diet,” “Bodyopus,” the “Metabolic Diet,” “Anabolic Solution,” and the “Ultimate Diet 2.0.”
The Supplement Boom
Amino acids in their many forms (peptide-bonded, free-form, branch chained, L-crystalline) were popular in the 80s, based on the notion that certain isolated amino acids could stimulate the pituitary gland to release growth hormone. Claims that the free-form amino acids arginine and ornithine could help bodybuilders lose fat and gain muscle actually led to a world-wide shortage of arginine and ornithine. I remember contributing to that shortage. Others touted the amino acid lysine as a growth hormone releaser. Lysine is plentiful in milk, which is what bodybuilders used in the days before amino acid supplements.
Soy protein powder made a big comeback in the 1990s with enough market hype to force the bodybuilding community to take another look. However, soy has never been accepted as a quality protein by the bodybuilders who knew anything about protein. Blair dumped it decades ago for the higher quality from milk and eggs. Vince Gironda simply referred to soy as “that s***!”
Carbohydrate loading was made easier with drinks like CarboPlex, containing maltodextrin. Other products contained medium chain triglycerides (MCTs) derived from coconut oil, to provide energy while bypassing the normal fat-assimilating channels in the body.
It was almost impossible to keep up with the new ergogenic and anabolic aids promoted in the magazines. They had bizarre names like Gamma Oryzanal, Osterolwere, Dibencozide and Inosine. A product called Metabolol containing glucose polymers, MCTs and various ergogenic agents became popular. Completing products–with names like “Ultimate Orange” and “Hot Stuff”–were promoted with clever and outlandish marketing tactics.
More Anabolic Aids
During the 1980s, the world of competitive bodybuilding could be summed up in one name–Lee Haney. Haney ruled the Mr. Olympia competition from 1984 to 1991. He was followed by Dorian Yates, winner for six straight years and then Ron Coleman who is the reigning Mr. Olympia in 2004. These two men ushered in a big jump in size and hardness. To put the size in perspective, Arnold Schwarzenegger was a huge athlete back in the 70s competing at 235 pounds at 6 feet 2 inches. In the 2003 Mr. Olympia contest, Ron Coleman stood under 6 feet and weighed 287 pounds–and he was even leaner than Schwarzenegger!
Were these men better bodybuilders than Schwarzenegger and Haney? Not necessarily, just more daring chemists. Two very anabolic compounds had muscled their way to prominence in the pro ranks in a much bigger way than ever before. These compounds were insulin and growth hormone. Bodybuilders were using natural growth hormone from human cadavers and rhesus monkeys back in the 1970s. However, with the introduction of recombinant Human Growth Hormone in 1985, this product became more widely available. Another anabolic compound was creatine monohydrate, a muscle-hydrating substance. Whey protein came into prominence. Bodybuilders will ingest just about anything in the quest to build muscles–powders, pills, raw meat, blood, glands, and a whole assortment of esoteric concoctions that have been slam-dunked for the sake of the gain.
Until the end of the 1980s, athletes sat on two distinct sides of the line–those who took steroids and those who did not. As Nelson Montana once stated, “Steroids do what all bodybuilders want –they build muscle!” That distinct line became blurred in the 1990s with the fall of the Berlin wall and the introduction of Eastern Block performance enhancing compounds known as “pro-hormones.” In the mid-1990s, supplements of Androstenedione, Androstenediol, Norandrostenedione, Norandrostenediol and DHEA appeared in the magazines. Originally deemed safe alternatives to steroids, the same side effects that manifested with steroids soon became apparent–male pattern baldness, prostrate enlargement, acne, reduced libido, liver and kidney toxicity, and–every bodybuilder’s favorite–gynecomastia (bitch tits).
As more side effects revealed themselves, more precursors (pro-hormones) came on the scene to replace their predecessors. Baseball’s Mark McGuire helped the market in a big way. Bodybuilders started stacking these hormones like regular anabolic steroids along with estrogen blockers, growth hormone enhancers, cortisone inhibitors, stimulators (ephedra), creatine, protein powders and, if there was any cash left, perhaps some vitamins. The recommended diet today is high-carb, high-protein, and low in fat–skim milk, egg whites, protein powders. . . anything but real whole foods. It’s no surprise that early natural bodybuilders, such as LaLanne, Tanny, Gironda and Grimek, enjoyed good longevity in the sport while the health of today’s muscle stars is a huge question mark. As five-time Mr. Universe Bill Pearl recently remarked: “The guy left standing on the stage today at the end of a bodybuilding show is probably the guy in the arena who is closest to death.”
It’s unfortunate that today’s young athletes who have that genetic potential to excel in bodybuilding really have no choice but to go down that pharmaceutical road if they want to achieve top honors at the shows. A friend of mine and long time gym owner Marty Hodgson stated to me, “We must remember it was in fact drugs that played a significant role in building those comic book characteristics that attracted us to the sport over the past 40 years. But those very substances that help make the sport are the same ones that are, with no doubt, destroying it.”
Sidebars

Daily Menu for the Three Saxon Brothers
Breakfast 
24 eggs
3 pounds smoked bacon
Porridge with cream and honey
Tea with plenty of sugar
Dinner 
10 pounds of meat
Vegetables
Sweet fruit (raw or cooked)
Sweet cakes
Salad
Tea
Sweet puddings
Cocoa and whipped cream
Supper 
Cold meat
Smoked fish
Lots of butter and cheese
Beer

Sansone’s Weight Gain Diet
Breakfast
Fresh fruit
Medium serving of whole grain Cereal with cream and sugar
2 eggs
2 pieces whole grain toast, buttered
1 glass of milk
Dinner
Steak, lamb, mutton or other meat
1 baked potato with butter
2 pieces whole wheat toast,buttered
1 large leafy green salad
1 large serving of berries or other fruit
1 small piece of plain cake
Supper
1 cup of bouillon or puree
1 medium serving of meat
1 large serving of cooked vegetables
2 pieces whole grain toast, buttered
Pudding or custard
1 glass of milk
Sansone’s Weight Loss Diet
Breakfast
Fresh fruit
2 pieces whole grain toast, buttered
1 egg
1 cup coffee or tea
½ cup hot milk
Dinner
Steak, roast beef, mutton or other meat
1 piece whole grain toast, buttered
1 large serving vegetables
Berries
Supper
1 cup of soup or tomato puree
1 small serving meat or fish 1 large serving vegetable
1 piece whole grain toast, buttered
1 glass milk

Steroid Side Effects
Anabolic steroids are synthetic derivatives or chemically altered versions of the hormone testosterone. Testosterone is the main androgenic or masculinizing hormone in males. In females, it plays a secondary role and occurs at about 1/20th the amount that occurs in adult men.
Testosterone has two primary characteristics that concern the athlete pursuing performance enhancement. The first and most sought-after attribute for the sport of bodybuilding is its anabolic effect, the ability to stimulate protein synthesis for muscle, bone and blood building. The second and less desired effect, especially with women, is the adrogenic response, the stimulation of secondary male sexual characteristics. Synthetic steroids are designed to enhance the anabolic effects of testosterone, while reducing the masculinizing properties. Unfortunately, the more you reduce the androgenic properties, the more you reduce the anabolic effect. Over the years, many different derivatives of the testosterone molecule have made their way through the sports arena. All of these synthetic versions have had varying degrees of androgenic and anabolic potencies. The more androgenic, the more anabolic and therefore more effective the drug for building muscle.
Anabolic steroids can be taken orally, sublingually or via injection. Oral steroids usually act faster than their oil-based injectable counterparts. Injectable steroids such as Deca-Durabolin have been designed to reduce the androgenic attributes and can stay in the body much longer than oral steroids such as Dianabol. Dianabol travels quickly to the liver where it is broken down to a large degree. This type of steroid places more stress on the liver.
The side effects of steroids can vary depending on gender and individual physiological characteristics. Age, dosage and duration of time on steroids also affect the degree of adverse reactions. Some of the side effects are also surrounded with controversy. For example, much of the media attention towards the serious liver disease through steroid use comes from patients with preexisting illnesses under longterm treatment with steroid medication. Nevertheless, steroid-using atheletes need to have their liver function monitored by health practitioners as the liver is definitely stressed by the practice.
One common side effect of steroids is water retention leading to elevated blood pressure in some athletes; another is kidney damage. The most feared reaction among the male bodybuilders is the paradoxical feminizing known as gynecomastia. This involves the enlargement of the tissue around the nipples. For females, it is the masculinizing effects that do the most damage. Male pattern baldness, facial and body hair, deepening of the voice, and clitoral enlargement are all potential threats to the female taking androgenic steroids. Stimulation of the sebaceous glands may lead to acne in both male and female athletes.
Behaviorial changes are also tied to steroid use. Almost everyone has heard of “roid rage.” Steroid use does not typically turn a mild mannered individual into a madman as the media would have us believe but anabolic steroids can increase aggression to some degree. If you are already an S.O.B., then steroid use may make you a bigger S.O.B. Psychological dependency also occurs, mainly because some athletes cannot deal with the loss of muscle, strength and desired appearance when withdrawing from steroids.
Other possible side effects that may occur during the use of anabolic and androgenic steroids include prolonged bleeding time, headaches, nausea, feeling poorly, increased risk of injury, abcesses resulting from injection, anaphylactic shock (life-threatening reaction) and early death from heart disease.

Vince Ginonda’s “Hormone Precursor Diet” for Muscle Build-Up
Gironda recommended this diet for four to six weeks, followed by a mostly vegetarian “alkalinizing” diet.
Breakfast
Vince’s special protein drink made of 12 oz half and half, 12 raw eggs, 1/3 cup milk-and-egg protein powder, 1 banana. (Make one to three mixtures of this formula and drink throughout the day, between meals, and before retiring)
Supplements
1 multi-vitamin tablet	3 vitamin A and D tablets or 3 halibut oil capsules	1 vitamin B complex	
1 vitamin B-15 tablet	1 vitamin C comlex (300 mg)	2 vitamin E capsules (800 iu)	
1 zinc tablet	1 chelated mineral tablets	5 alfalfa tablets	
10 kelp tablets	3 tri-germ and wheat germ oil capsules	1 RNA/DNA tablet	
3 Lysine tablets
(400 mg)	1 hydrochloric acid tablet
(before meal)		
3 digestive enzyme tablets (after meal)	3 multi-glandular tablets
(nucleo glan male or female)		
Lunch
1 pound hamburger or other meat
Mixed greeen salad or raw vegetables
Supplements
1 iron tablet
4 calcium tablets
Repeat of breakfast vitamins with omission of vitamin E, tri-germ, wheat germ, halibut oil
Dinner
1 to 2 pound steak or roast meat
Raw or steamed vegetables or salad and cottage cheese
Supplements
Same as lunch
Special Supplements
10 amino acids and desiccated liver tablets (every 3 hours) 5 yeast tablets with the protein drink
4 raw orchic tissue tablets (before and after workouts)
6 each of the following before retiring: arginine, ortithine, tryptophan, calcium tablets

High-Carb Diet for Bodybuilders
Typical of the new carb-rich diets was the 1979 diet of Clarence Bass, known for his “ripped” appearance:
Breakfast
2 eggs
1 toast
Cereal consisting of:
2 tablespoons wheat germ
5 tablespoons bran
1 tablespoon sunflower seeds
1 tablespoon raisins
1 cup whole raw milk
Lunch
Peanut butter sandwich on whole grain bread
1 cup yogurt from whole raw milk
1 apple or pear
Supper
2 poached eggs
1 piece dry toast
Huge salad
Evening Meal
1 cup whole raw milk mixed with
1 cup water
1 tablespoon Fyblend fiber
1/2 grain saccharin
1/2 teaspoon decaffeinated coffee

Big Ron’s Confusing Nutrition Advice
Nowhere is confusion on what constitutes a healthy diet more evident than on the website of current bodybuilding champion Ron Coleman (bigroncoleman.com).
His contradictory and watered-down nutritional advice:
1. Eat, eat and eat some more.
2. To add strength and mass, try to consume four to six meals a day. Choose from a variety of food groups at mealtime. Try to include lots of potatoes, rice, pasta, fruits and vegetables.
3. Make sure you are eating enough. A low fat diet and avoiding refined foods are good, but it won’t help you build mass. On the same note you don’t want to eat a high fat diet all the time. Fat provides additional calories, the fat-soluble vitamins A, D, E and K and raw materials for important hormones that stimulate muscle growth.
4. Monitor the amount of mass you are gaining. Measure your body parts and weigh every week to see if you are going in the right direction.
5. Lastly, continue to train hard. And remember gaining mass won’t happen overnight.

Copyright: This article is excerpted from Randy Roach’s book Muscle, Smoke & Mirrors, available at prfit.com.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2004.
Randy Roach

Bodybuilder and trainer Randy Roach has followed most of the bodybuilding diet trends over the past 30 years including methods not so embraced in bodybuilding circles, such as complete vegan vegetarianism. During his protein-drink phase he ate egg whites and discarded the yolks. He has discovered that too many carbohydrates give him all sorts of problems. Over the past 3 years he has migrated to a total raw diet. This includes raw meat, dairy, eggs (especially the yolks), honey, green juices, and some fruits with their seeds. Food for a typical day includes 1/4-1/2 pound raw chicken,1/2 pound raw beef, 1/4 pound raw liver, 16- 32 ounces of raw milk, 2-3 ounces raw cream, 6-8 tablespoons raw honey, 32 ounces raw green juice (celery, parsley, lemon, zucchini, honey, beets) and occasional 
Vitamin A: The Forgotten Bodybuilding Nutrient
Posted on December 14, 2004 by Christopher Masterjohn • 3 Comments 
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The dense forest of bodybuilding nutrition contains a paradox: the quantity of information available is abundant, but the wisdom of traditional diets to satisfy the primary concerns of bodybuilders is sparse and hard to find. Typical recommendations include very low-fat diets rich in protein foods like salmon and chicken.
You will search in vain through mainstream men’s health magazines to find so much as a mention of the importance of vitamin A to bodybuilding. Yet this nutrient is essential to muscle-building and may be the bodybuilder’s most potent weapon. Vitamin A is necessary for the utilization of protein and the production of testosterone and other growth factors. In fact, one human study, discussed below, found the administration of vitamin A and iron to have results equivalent to the administration of testosterone itself. Rather than advocating the consumption of vitamin-A rich foods such as liver and natural food-based supplements such as cod liver oil, mainstream men’s health writers are advocating diets very high in protein, which deplete vitamin A reserves, leaving one to wonder whether the athletes who resort to over-the-counter steroid supplements might be able to achieve similar results by consuming a traditional diet, rich in vitamin A.
Vitamin A and Testosterone
Abundant animal research indicates the importance of vitamin A to the production of testosterone. Vitamin A crosses the blood-testis barrier in its alcohol form as retinol, where it is stored in the Sertoli cells and converted as needed to its more biologically active form, retinoic acid. Experiments with rats show that greater concentrations of vitamin A in the testes increase basal testosterone secretion, as well as transferrin, which is responsible for the transport of iron; and a variety of growth factors including IGF-binding protein 4 (which transports IGF), androgen-binding protein (which transports androgens), transforming growth factor-beta (which causes cell growth but suppresses cancer) and steroidogenic acute regulatory protein (which is responsible for the transport of cholesterol into the mitochondria for its conversion to steroids). Vitamin A also decreases estrogen production in the male testes. Rats that are deficient in vitamin A experience decreased testosterone until the accessory sex organs atrophy, indicating that vitamin A not only aids in, but is essential to, testosterone production.1
One experiment using guinea pigs, which corroborates the many experiments done with rats, found a decrease in plasma testosterone associated with a deficiency in vitamin A.2 A human study comparing the dietary intakes of 155 pairs of male twins found a correlation between testosterone levels and vitamin A intake.3
The most compelling study is one that assigned 102 teenage boys with short stature and delayed puberty into four groups: a control, a testosterone-supplemented group, a vitamin A- and iron-supplemented group, and a group that received both testosterone and the nutritional supplementation. All treatments were effective in inducing growth and puberty, whereas the control group did not gain weight or begin puberty in the same period of time. What is most amazing is that the degree of growth acceleration was similar in the testosterone-treated group and the vitamin A-treated group. Pubertal onset occurred in 9-12 months in the testosterone group, and by 12 months in the vitamin-A group.4
This study suggests two things. The first is that the growth problems these boys experienced could have been avoided if their parents only had known the importance of serving a meal with liver on a weekly basis, as liver is very rich in both vitamin A and iron. The second is that, with equivalent hard work and dedication, athletes and body builders may be able to achieve similar results from their training by taking high-vitamin cod liver oil and eating foods rich in vitamin A on a regular basis as others receive from the common practice of supplementing with testosterone precursors.
Vitamin A and Prostate Cancer
Although some researchers have expressed concern that androgens such as testosterone may be involved in the etiology of prostate cancer, from vitamin A we can expect only more good news. Scientists in one controlled study administered doses of cyproterone acetate, an anti-androgen, and testosterone proprionate, to rats, followed by N-methyl-N-nitrosourea, a carcinogen, with one group treated with large doses of vitamin A. The incidence of prostate cancer in the group not treated with vitamin A was 65 percent, while only 18 percent and 20 percent of vitamin A-treated rats experienced dorsolateral and anterior prostate cancer, respectively.5
Vitamin A and Protein Utilization
The utilization of protein requires vitamin A. Several animal studies have shown that liver reserves of vitamin A are depleted by a high dietary intake of protein, while vitamin A increases in non-liver tissues. One explanation for this is that adequate protein is necessary for vitamin A transport. In one study researchers fed radioactively-labeled vitamin A to rats on low-protein and high-protein diets, using the amount of radioactivity present in exhaled gases, urine and feces as a measure of the metabolism of vitamin A, and found that vitamin A is indeed used at a higher rate on a high-protein diet.6
Vitamin A is not only depleted by a high intake of protein, but it is also necessary for the synthesis of new protein, which is the goal of the bodybuilder. Rats fed diets deficient in vitamin A synthesize protein at a lower rate than rats fed adequate vitamin A.7 Cultured skeletal muscle cells increase the amount of protein per cell when exposed to vitamin A and D, but not when exposed to vitamin D alone.8
Eat Your Liver
Bodybuilders and other athletes interested in gaining muscle have an interest in boosting their levels of testosterone and other growth factors and maximizing their utilization of protein and its incorporation into muscle cells. Typical recommendations usually include very high amounts of protein, but exclude foods like liver that are high in vitamin A, and low-fat recommendations all but banish vitamin A entirely from the diet by excluding foods such as full-fat milk. The combination of a high-protein diet that depletes vitamin A and a low-fat diet that fails to provide vitamin A is a clear recipe for deficiency of this vital nutrient. Exercises that elicit a high demand for testosterone, such as squats and deadlifts, are often recommended for muscle growth, but without vitamin A the body cannot meet that demand for testosterone. It’s high time for athletes to forget the modern mantras and remember the dietary wisdom of the past, achieving a lean, muscular physique through traditional foods such as liver, egg yolks, full-fat milk, butter from grass-fed cows and cod liver oil.
Editor’s Note: Many health conscious individuals avoid cod liver oil and other foods rich in vitamin A because of concerns about vitamin A toxicity. Yet, according to the Merck Manual, vitamin A poisoning is rare. In adults, vitamin A toxicity has been reported in Arctic explorers who developed drowsiness, irritability, headaches and vomiting, with subsequent peeling of the skin, within a few hours of ingesting several million units of vitamin A from polar bear or seal liver. These symptoms cleared up with discontinuation of the vitamin A rich food. Other than this unusual example, however, only vitamin A from “megavitamin tablets containing vitamin A. . . when taken for a long time” has induced acute toxicity, that is, 100,000 IU synthetic vitamin A per day taken for many months. Unless you are an Arctic explorer, it is very difficult to develop vitamin A toxicity from food. The putative toxic dose of 100,000 IU per day would be contained in 3 tablespoons of high vitamin cod liver oil, 6 tablespoons of regular cod liver oil, two-and-one-half 100-gram servings of duck liver, 150 grams of beef liver, seven pounds of butter or 309 egg yolks. Bodybuilders undergoing strenuous exercise can consume even higher amounts without adverse effects. For further information see “Vitamin A Saga.”
Eating by the Seasons in Russia
Posted on March 28, 2009 by Katherine Czapp • 3 Comments 
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Like all great national cuisines, the Russian tradition developed as a unique response to its climate, geography and history. Over the centuries its culinary richness evolved as it absorbed and then transformed the influences brought by trade with Western Europe and the Orient, as well as through foreign invasion and its own territorial expansion. The highly sophisticated cuisine of the 17th and 18th centuries, with its elaborate courses, ornate table service, and exotic imported delicacies existed only for a rare few—the landed aristocracy and wealthiest city dwellers. The bulk of Russia’s population was scattered across a vast terrain in tiny villages, isolated by great distances, and feeding themselves from their own small farms and the forests, rivers and lakes nearby. Challenged by a harsh and often fickle northern climate, yet endowed with a creative native ingenuity, these peasants created a “cuisine of the people” out of simple ingredients that was nevertheless nourishing, appealing and enduring. With some additions and refinements, this peasant cuisine became the solid basis of Russian cooking up until the twentieth century.
Medieval Rus
The early Russian diet depended heavily on grain products, and especially those that could be grown during its short, cool growing season. Medieval records vividly depict in a few words the regular disasters and famine befalling both men and livestock in frequently undependable weather. These extracts describe a four-year span from The Chronicle of Novgorod, 1017-1471:
AD 1125…The same year there was a great storm with thunder and hail… it drowned droves of cattle in the Volkhov, and others they hardly saved alive.
AD 1127….And in the autumn the frost killed all the [grain] and the winter crop; and there was famine throughout the winter…
AD 1128…This year it was cruel; the people ate [linden] leaves, birch bark, pounded wood pulp mixed with husks and straw; some ate buttercups, moss, horse flesh; and thus many dropping down from hunger, their corpses were in the streets, in the market place, and on the roads, and everywhere. . . fathers and mothers would put their children into boats in gift to [foreign] merchants [to be slaves], or else put them to death.
When nature obliged, rye, spelt, millet, barley, oats and buckwheat were the primary grain crops, and provided the foundation of the diet in the form of bread, kasha, and grain product called kissel.
The Russians likely learned the art of sourleavening bread from the Scythians—Central Asian nomads who ruled southern Russia for three centuries from about 300 AD. Sourdough rye bread has been recorded as a staple in the diet since at least the 9th century. It has remained a favorite and respected mainstay for centuries; revered even as the very essence of life. In the typical peasant diet an adult would consume close to two pounds of this dense, sour bread per day.
Wheat flour was introduced as a trade item during the 15th century, but was not suitable for growing in the northern European portion of Russia. After Ivan IV (the Terrible) conquered Kazan and Astrakhan in the 16th century, Russia gained territory where wheat could be grown, and this was transported to the rest of the country. In this era, filled, leavened pies, such as pirogi, made from wheat flour were introduced into the cuisine. The peasants continued to rely upon rye as the source of their daily bread, however.
The great reliance on grains resulted in creative ways of preparing each one, both to provide variation in the diet and to maximize their nutritive value. Grain kissel, for instance, is a method of soaking, fermenting and cooking grain (and also dried peas) that produces a jelled liquid “concentrate” of the grain, and is usually eaten cool with sour cream or kvas. The procedure for oat kissel, for example, involves drying whole oats carefully on the floor of a warm brick oven, and then pounding the oats in a mortar to partially crush them. The oats are covered in hot water and left to sour in a warm place for a day and a half. The soured oats are then pushed through a sieve and the thick oat “milk” that is extruded is slowly cooked until it thickens further like a jelly. It is then poured into a wide plate and left to cool, becoming even more jelled. This oat “aspic,” served with sour cream or kvas, is considered especially good for children, the elderly and convalescents, as it is nutritious and very easy to digest. The soured oat remnants did not go to waste, but were stirred into flour, left for 24 hours to sour further, and then baked into flat breads called lepyoshki.
Kasha, or porridge, ascended to the status of a mass ritual dish between the 10th and 14th centuries. To mark great undertakings, such as the ground-breaking for a cathedral or fortress, a wedding, baptism, and so on, kasha was prepared to feed a large crowd. The word “kasha” became synonymous with “feast” and indeed there were many delicious ways to prepare it. The preferred grain for kasha was buckwheat, although barley, spelt and green rye were also made into kashas. The kasha was cooked in an oven in earthenware pots with a strong meat bouillon and any number of additions such as meat, mushrooms, and onions.
Shchi and Soups
Accompanying bread and grain was the other great mainstay of the traditional Russian peasant diet—soup, and in particular shchi. Shchi is a soup made from green cabbage in the summer and soured cabbage or sorrell in the winter. Depending upon the wealth of the household it could be very plain, made with just vegetables and herbs, or quite rich, made with a strong meat broth and cooked with a large piece of meat that was served alongside. Often a thick shchi might make up the entire meal. Its popularity transcended all economic classes and was regularly served on the tables of the rich and poor alike. In a climate that experienced six months of winter each year, hot soup was a comfort as well as a nourishing centerpiece in the diet, and Russian cuisine has never lost the requirement of a first course of soup in the daily menu.
Borshch and ukha are two other basic soups common to Russian cuisine, although borshch is actually of Ukrainian origin. There are literally hundreds of borshch recipes, some including sausages and other cuts of meat and even beans, some are vegetarian, but the primary and sole requirement is that it must contain beets. Borshch is traditionally enhanced with sour cream in the soup plate, and often the broth is spiced with pickle brine.
Ukha is made from fish, yet is not technically a fish soup. The simplest method was to poach a whole fish in water with herbs and seasonings and the entire fish (including softened bones) would be eaten with its broth. A more elaborate variation calls for several varieties of bony fish to first be cooked to produce a stronger broth. These fish are then discarded and whole pieces of better quality fish are poached in this broth.
Dairy Products
Peasants with a bit of land to support a few pigs, chickens and a cow or two greatly improved their diets with meat, eggs and dairy products for most of the year. Most milk products were eaten fresh, or soured, such as clabbered milk (prostokvasha) and sour cream (smetana). Cheese was traditionally the simple dry-curd pot cheese (tvorog) made from raw milk that soured naturally into curds and was then strained. Tvorog is eaten as is with sweet or sour cream or spread thickly on bread, and can also be used in baked dishes. Another ancient means of preparing milk was “baking” it in an earthenware jug at very low temperatures in the brick oven overnight or all day until a thick, honey-brown skin appeared on the milk and it soured slightly. This toplyonnoye moloko was an early delicacy, somewhat similar to custard.
Kefir was originally a product of the tribal peoples of the northern Caucasus region and became a popular Russian food later on. Cultured dairy products (never sweetened) have always been a permanent fixture in the Russian diet, and even today a wide variety of fermented dairy products is commercially available in Russia, including several varieties of kefir cultures and two varieties of “baked” fermented milk (varenets and ryazhenka) with special bacterial cultures added. Bifidok and Acidophilin contain kefir cultures with yet other beneficial lactic acid bacteria.
The Russians had known of and enjoyed the nutritive and medicinal benefits of fermented mare’s milk, kumyss, since earliest times. This was another food introduced many centuries before by the Scythians and in widespread use as noted in the oldest Russian chronicles. In the 17th century the Russian Orthodox Church proscribed the eating of horse flesh and drinking of mare’s milk as unclean, and kumyss dropped from the scene until appearing again in more recent times.
Kvas: Drink of the People
Kvas is a lightly fermented, slightly alcoholic beverage commonly made from rye bread sweetened with a bit of honey or fruit juices. Its widespread use among Russian peasantry has been recorded since at least 1000 AD. The sweetsour drink contains a good supply of B vitamins and active enzymes and was used, along with beet kvas, as a frequent addition to soups. Large pieces of meat were often oven-braised in kvas.
Besides kvas, early Russians enjoyed mead (medok, medovukha) and other forms of fermented honey, some mildly alcoholic and some much stronger. In the tenth century a form of mead was soured with hops and berry juices, and a method similar to wine making and requiring a five- to 35-year aging period produced a potent honey drink resembling Cognac. Earlier still, the Russians fermented birch sap into a sort of “beer.” Beer-making with grains did not develop until the end of the 13th century, and vodka made from rye grain appeared in Moscow somewhere in the mid to late 15th century. There was already a state monopoly on its production by the 16th century.
Mongol Influence
The Mongol invasion and conquest of Kievan Rus by Batu Khan occurred in 1237 and lasted until Ivan III terminated their “yoke” in 1480. For nearly 250 years the Russian people were subjected to waves of brutal sieges by the Golden Horde, as well as extortion exacted in the form of ransom tributes paid to forestall annihilation.
In spite of its destructive impact on Russian society, the Mongol presence also enriched the Russian diet in several important ways. With the reopening of the old Silk Road to China the Mongol invaders introduced spices such as saffron and cinnamon. Even more important than spices, however, the Mongols brought from China the art of fermenting cabbage. Although the Russians had long grown cabbage, they did not know how to preserve it in brine as sauerkraut. Once introduced, soured cabbage and other vegetables quickly became central in the Russian and Eastern European diet. In fact, it is nearly impossible to imagine Russian cooking without sauerkraut, pickled cucumbers and the many other brined vegetables and fruits, which greatly enlivened the table year round with much longed-for variety and important nutrients. Fresh vegetables and herbs included radishes, parsley, dill, chervil, green onions and garlic. Wild-growing chickory, nettles, sorrel and purslane were most often cooked in soups.
Russian Orthodoxy
In 988 Prince Vladimir of Novgorod converted to Christianity and established the Byzantine rite of Orthodox Christianity as the Russian national faith. Legend has it that Vladimir chose the Orthodox Church because he didn’t like the dietary restrictions of either Judaism or Islam, and rejected the western Catholic tradition of an unleavened Eucharist host. Russian Orthodoxy nevertheless exerted a strong influence on the national diet through the imposition of a strict regimen of fast days. Depending on the calendar year, there are about 250 fast days each year, including every Wednesday and Friday, and the Great Fast (or Lent) of 50 days.
Among a people inured to food scarcity and occasional famine it seems heartless to impose further dietary restrictions, but the Russian diet actually expanded after the adoption of Orthodoxy. The prohibition from eating meat during fast days led to a blossoming in the creativity of fish dishes. Russia’s many rivers, streams, ponds and lakes were stocked with an astonishing variety of fish and crayfish, and its inland population had regular recourse to this rich bounty. Mushroom dishes also abounded, aided in great part by the many prolific mushroom species native to Russian forests. Here are two menus from a 19th century fast day of a comfortable, but not aristocratic, household:
Mushroom and sturgeon marrow pirog
Sturgeon head soup
Potatoes with herring
Cranberry kissel
Plum soup with wine
Pike in yellow sauce
Potato cutlets with mushroom sauce
Stewed fruit compote
Feast Days
The Russian ecclesiastical calendar culminates in the spring with the progression of Butter Week, or Maslenitsa, through the Great Lenten Fast and finally the joyous feast of Easter (Paskha). Maslenitsa is an ancient holiday celebrated in mid winter that has been incorporated into Russian Orthodoxy, and in fact is so beloved it has been celebrated without interruption up to the present day. Originally a festival in honor of the coming spring, increasing sunshine and hoped-for fertility, the week-long holiday is one of a merry-making and carnival mood, with sleigh rides, dancing, and the eating of great quantities of blini drenched in butter and sour cream—two favorite foods that would be banned during the upcoming seven-week fast. Blini are themselves an ancient leavened pancake—thicker than crèpes, but not as thick as American breakfast pancakes. They were originally made of buckwheat flour and round in shape to remind one of the sun.
In rural Russia the long fast period also served to ensure that livestock would not be eaten but survive to fatten and reproduce in the spring. When the fast was broken with the great feast of Easter, celebrants of every ilk presented a holiday table as lavish as families could afford.
Several ritual foods are always required for the Easter table. Boiled eggs, usually decorated simply, are symbols of the fertility of spring and are presented in great quantity. Kulich, a very rich yeasted cake made with wheat flour, butter, eggs, and milk is only prepared for Easter. Its traditional accompaniment is paskha, a sweet cheese dish made from tvorog, sour cream, egg yolks, ground almonds, vanilla and sugar, shaped in a truncated pyramidal mold. A 19th century Easter table of a prosperous country family might look like this:
Paskha
Kulich
Babas
Mazurkas
Tortes
Decorated eggs
Butter sculpted in the shape of a lamb
Boar’s head
Baked ham
Stuffed turkey
Cold roast hare
Roast veal
Wood grouse
Cold roast antelope or venison
Roast elk
Roast marinated beef
Stuffed suckling pig
Bread, horseradish, mustard, vinegar, olive oil
Various vodkas and wines
The Russian Oven
Perhaps one of the most profound influences on Russian traditional cuisine is the Russian oven (russkaya pechka) around which all family life centered in rural Russia. Of colossal size and weighing a ton or two, the Russian oven was made of clay, stone or brick. The multi-purpose oven was built with an ingenious internal channel system that directed hot smoke through a series of chambers before it exited the hut (izba). A fire was built in the main chamber, and controlled via several flue dampers. The structure burned fuel very efficiently, and a single firing was enough in all but the coldest weather to prepare the oven both for cooking all meals and heating the izba for the entire day. When the fire had died down, and the oven was very hot, the coals and ashes would be swept out or pushed to the side and food could then be cooked or baked. The hottest temperatures were used to bake bread, and as the oven slowly cooled other foods would be placed inside to “stew.” Nooks and shelves built on the sides of the oven were perfect spots for souring foods at a steady warm temperature. The tops of the ovens were flat and provided a cozy spot for the old folks (and cats) to sleep.
The oven had no burners, so all food was cooked inside the oven by the experienced housewife. Most food was cooked in earthenware containers that had rounded sides to maximize heat exposure. A long-handled tool with a U-shaped end served to move the jars in and out of the oven. Other oven utensils were bread peels and wooden paddles for turning grain that was dried on the oven floor. Long, slow cooking in radiant heat characterizes most of early Russian dishes, such as kasha and even soup, which was “stewed” more than boiled. Meat stews, interestingly, were not typical Russian fare as the traditional method of preparing meat was baking it on trays in large pieces, or even, if possible, cooking the whole animal. Chopped meat dishes, pâtés, ground meat and pureéd soups were introduced to Russian cuisine from western, mostly French, sources. Western-style stoves—enclosed metal ranges with burners that could deliver high heat—were introduced toward the middle of the 19th century in Russia, mostly for city dwellers and the provincial gentry, although the Russian oven was preferred for most traditional cooking and processing of raw ingredients.
Enduring Traditions
The most novel refinements in Russian cuisine introduced in the 17th through the 19th centuries came largely from the west, and particularly from France. The influence turned out to be a mutual one, producing a grand Franco-Russian culinary style that featured hallmarks of both traditions, but was largely enjoyed only by the nobility and large landowners. Changes to the diet and daily lives of the peasants came much more slowly, due in good part to their deep suspicion of novelty. Potatoes, for example, were first introduced during the reign of Catherine the Great, yet took another 70 or 80 years before they were accepted and widely cultivated.
In some ways it could be said that Russia’s medieval period, as far as the bulk of the population was concerned, continued largely intact until it collided abruptly with the twentieth century. Upheaval in the shape of civil war, revolution and world war touched and forever altered every soul in the country. Collectivization ended the tradition of the peasant class, and also changed the face of agriculture for decades to come. A second world war and the long, hard recovery that followed, with chronic food shortages and deficits, made permanent because of Cold War military spending, ended only in the 1990s with the fall of the Soviet Union. Although consumer goods have since multiplied greatly, with many expensive foreign food imports, it will still take time for private ownership of the land to recreate a domestic food production economy to feed the people, although already there are some beginnings.
In the wake of such history, it is revealing to learn that during the period of perestroika, one of the first books to be reprinted after long neglect was an 1861 classic, Elena Molokhovets’ A Gift to Young Housewives. This beloved cook book had been continually in print and revised for 20 editions by its author until 1911. Written at a time that some consider the zenith of Russian cuisine, the book was condemned as decadent and bourgeois after the 1917 Revolution. Found only rarely at high prices in used book stores, the book recalled the culinary glory of a vanished age. The renewed popularity of Molokhovets’ masterpiece among modern ordinary people as well as restaurateurs speaks of the enduring pride in the cultural heritage of Russian traditional dishes and cooking methods.

Sidebar
A French View of 17th Century Muscovy
This excerpt is from the account of a French soldier of fortune, Jacques Margeret, who entered the services of Tsar Boris Godunov from 1600 to 1606. He returned home to France and in 1607 published his Estat de l’Empire de Russi et Gran de Duche de Muscouvie. His account provides a clear picture of the country’s possessions and natural resources, as well as the behaviors of its people, court officials and rulers. Margeret comments below on the general constitution of Muscovites and in particular their love of the banya, or sauna, as a health aid.
“’Tis almost a miracle to see how their bodies, accustomed to and hardened by cold, can endure so intense a heat, and how that, when they are not able to endure it any longer, they come out of the stoves, naked as the back of a man’s hand, both men and women, and go into the cold water…and in winter how they wallow in the snow….The Muscovites are of a healthy and strong constitution, long lived and seldom sick; which when they are, their ordinary remedies, even in burning fevers, are only garlic and strong waters…
“There are among the Russians many people aged 80, 100, to 120 years old. They are not subject to illness as in these parts. Except for the emperor and some principal lords, they do not know about physicians. They even consider to be unclean several things which one uses in medicine. Among other things, they do not take pills voluntarily. As for enemas, they abhor them…If the common people are sick, they usually take a good draught of aqua vitae, place in it…a peeled clove of garlic, stir this and drink it. Then they go immediately into a hot house which is so hot as to be almost unendurable, and remain there until they have sweated an hour or two. They do the same for all sorts of maladies….”

References
Medieval Russia: A Source Book, 850-1700, Basil Dmytryshyn, Harcourt Brace, Third Edition, 1991.
Classic Russian Cooking, Elena Molokhovets’ A Gift to Young Housewives, Joyce Toomre, Indiana University Press, 1992.
The Art of Russian Cuisine, Anne Volokh with Mavis Manus, Collier Books, MacMillan Publishing Co., 1989.
Russian Cooking, Helen and George Papashvili, Time Life Books, 1969.
Кулинарный словарь, В.В. Похлебкин, Москва Центрограф, 1999.
Обрядовая кулинария, Е. Й. Высоцкая, составитель, Мн.: Литература, 199
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2008.
Katherine Czapp

Katherine Czapp was raised on a three-generation, self-sufficient mixed family farm in rural Michigan. After studying Russian language and literature at the University of Michigan, she is gratified to discover that the skills and experiences of her anachronistic upbringing are useful tools in the 21st century. She works independently as a three-season organic gardener and WAPF staff editor. She and her husband Garrick live the slow life in Ann Arbor, Michigan. To learn more about authentic sourdough bread recipes and to obtain a live culture starter, visit www.realsourdoughbreadrecipe.com.
Food in China: Variety and Monotony
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 0 Comments 
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Many have wondered why Weston Price did not include the Oriental countries like China and Japan in his monumental studies; and what he would have discovered had he done so. The answer to the first question is that the major nations of the East did not fit his criteria-that of isolated, nonindustrialized groups whose foodstuffs were entirely indigenous, with none of them coming in from the outside. China and Japan, while still relatively “traditional” in the 1930s, both had a long history of trade with other nations; and both had a considerable amount of industry.
There is a widespread feeling, however, that it would have been worthwhile for Price to study the peoples of both nations, especially in light of recent controversy over high rates of degenerative disease among Western nations, and the notion that China and Japan, with their low-fat, largely vegetarian diets, are relatively free of such problems. Indeed, popular writers have portrayed the nations of China and Japan as regions in which a fiber-rich diet based on grains and vegetables offers substantial protection against cancer, heart disease and osteoporosis. Americans, they argue, should reduce consumption of meat, milk and animal fats and follow the Oriental model.
Unlike Japan, China is a vast country with a wide diversity of ethnic groups and eating habits-and large differences in the life-styles of rich and poor. In general, however, the Chinese recognize the relationship of diet to good health, and believe that the ideal diet is one that stresses both diversity and balance. Ancient texts stress the importance of the five flavors (pungent, sour, sweet, bitter and salty); the five grains (wheat, glutinous millet, millet, rice and beans); the five tree-fruits (peaches, plums, apricots, chestnuts and dates); the five vegetables (mallows, coarse greens, scallions, onions and leeks); and the five domestic animals (fowl, sheep beef, horses and pigs.)1 Meat, although not to be eaten in excess, was valued for its strengthening properties.
Chinese restaurant meals today are rich in animal foods, but the truth is that the vast majority of Chinese cannot afford to include much in the way of meat or fish in their diets. Herein lies the great paradox of Chinese foodways. For whereas a fundamental feature of Chinese heating habits is the inclusion of a wide diversity of food items-everything from pickled ant eggs to dog hams-most Chinese, especially most Chinese in rural areas, consume a diet that is dull and limited in the extreme. A 1946 survey of rural China indicated that 88% of the diet was composed of cereals and legumes, with only 5% as vegetables, 3% as meat and fish and 4% as fats. 2
Rice is China’s most important cereal. In the Southern regions it is consumed at all three meals. A 1939 survey found that adult males in the region ate as much as 485 pounds of rice per year. In other parts of China, however, rice is not consumed at all. Millet and wheat production dominate the more arid regions of northern China-with millet consumed principally in the form of a fluffy porridge, and wheat made into noodles and bread, although in the poorest regions, wheat is consumed as a rough porridge. Barley, sorghum, corn, buckwheat, rye and oats constitute minor crops in China, but the total of them all adds substantially to the amount of carbohydrate food consumed by the populace.
Traditionally, rice and wheat were eaten as whole grains or whole meal, probably after a long, slow steaming in the case of rice, or a soaking procedure in the case of wheat. Noodles were made by a process of stretching and sun drying that amounted to a partial fermentation. Today these grains are consumed as white polished rice and white wheat flour, shorn of their valuable vitamins and minerals. But millet and the other minor grains continue to be consumed in whole form, as porridges, gruels or cakes. ” Congee”, a watery porridge made from rice or other grains, is a common food, either eaten plain or with other ingredients such as meat, fish, vegetables or flavoring.
Animal foods in the Chinese diet, while beyond the reach of many, are characterized by great diversity. Scavenger, omnivorous animals such as pig, chicken and duck are preferred to beef and lamb, although beef and lamb-and more meat in general-are consumed by the northern Chinese, who are admired for their size and strength. Whatever the animal, it is entirely consumed-organs, feet, tail and tongue. Packages of duck’s tongues are available even in Chinese markets in America. Goose, pigeon, turkey, dog, frog, monkey and snake are available in Chinese markets, often sold live, for the Chinese put a great store on freshness. Even rat figures in accounts of traditional cuisine and bear paw was considered a great delicacy by the aristocracy. Insects such as flies, gnats, earthworms, bees, cicadas, beetles, crickets, silkworm cocoons, waterbugs, locust and stinkbugs are valued both as food and as medicine. The Chinese also cultivate caterpillars that have become infected with a fungus that roots in the caterpillar’s neck and grows upward to a height of six to eight inches. When both die, they become dry, hard and brown and may be prepared in a broth. Insects are a valuable source of protein and fat soluble vitamins in the Chinese diet, especially that of the poor, but their use and importance are generally overlooked by researchers.3
Traditionally lard was used in cooking, by those who could afford it, along with small amounts of sesame oil that was produced by vendors who set up their stone grinders in the street and sold the fresh oil as soon as it was extracted. Today most cooking oil is extracted in factories from rapeseed, soybeans, peanuts and cottonseed.
Eggs are highly valued as a brain food throughout the Orient. In China, they are consumed preserved or fresh, often scrambled with vegetables and other ingredients. In the northern areas, a breakfast dish is prepared by placing a raw egg in a bowl and pouring hot soy milk over it. The mixture is eaten with a flat pancake. Sometimes a raw egg is mixed with hot rice and soy sauce.
Soy foods are widely used in China as an adjunct to animal foods. The Chinese have perfected numerous ways of fermenting soy in order to neutralize phytic acid (which blocks minerals like zinc and calcium), enzyme inhibitors (which block digestion) and goitrogens (which inhibit thyroid function.) Traditional preparation of soymilk begins with soaking until the beans become soft. The softened beans are ground into a mush on a stone grinder, using copious amounts of water. The mush is then put into a cloth bag and placed under a weight or heavy rock so that all the liquid is squeezed out. The resulting soy paste is then cooked in fresh water. Large amounts of dirty scum that rise to the surface are carefully removed. To serve, raw egg or dried shrimp are placed in a bowl along with scallions, soy sauce, flavorings and vinegar, and the scalding soy milk is poured over. The vinegar causes the soy milk to curdle slightly. In traditional times, homemade soymilk was consumed by the elderly and by nursing mothers in the belief that it stimulated breastmilk, but was not normally used in feeding infants.4
Industrial methods for the production of soymilk leave out the all-important squeezing and skimming steps. The presoaking is shortened by using an alkaline solution. This process helps deactivate some of the enzyme inhibitors, but not the other antinutrients. The high pH value of the soaking solution results in a decrease in cystine content when the beverage is heated, thus lowering total protein availability and soymilk’s usefulness as a protein source.5 Various refined sweeteners, preservatives and stabilizers may then be added.
The real value of the soybean is that it can be made into soy sauce, the salty elixir that gives Oriental food its unique character. Traditional soy sauce is made by a fermentation process that takes six to eight months to complete. This long and careful procedure creates a mix of phenolic compounds, including a natural form of glutamic acid, that contribute to the unique taste and aroma of traditionally brewed soy sauce. The modern bioreactor method produces a product by rapid hydrolysis, rather than by complete fermentation, in the space of two days, and uses the enzyme glutamase as a reactor, so that the final product contains large amounts of the kind of unnatural glutamic acid that is found in MSG.6
Various types of vinegars, fermented sauces made from oysters or fish, ginger, garlic, ginseng and a wide variety of peppers and spices are used with great imagination in traditional Chinese cuisine; these too, have been replaced in large measure with preparations in which MSG allows manufacturers to cut corners and use only minimal amounts of basic ingredients.
Salt in general is not added to Chinese food during cooking-rice is prepared without salt, for example-but because it is used in the production of condiments and pickled vegetables, Chinese food has a salty taste, and overall salt consumption is high. Most salt is produced by the evaporation of sea water in the coastal areas so that, unlike industrially processed salt in America, it provides a rich source of natural iodine.7 There is a large black market in salt in China. 8
Since antiquity, the Chinese have used a number of sweeteners including honey, rice or barley malt, palm sugar (jaggery), sorghum syrup and dehydrated sugar cane juice, but only in moderation in accordance with the Oriental concept of balance. Chinese living overseas have adopted Western habits of high sugar consumption. A recent study found that Chinese children in Malaya had as much as 30 percent of the total caloric intake as sugar in the form of candy, cookies, soft drinks and other sweets.9 However, it is unlikely that mainland Chinese will adopt such expensive habits in the foreseeable future.
Chinese cuisine includes a large variety of vegetables, although the diet of the poor is limited to a very few, notably cabbage and various forms of radish. Sweet potato consumption is high, especially among the poor.
Many vegetables are pickled by acid fermentation methods that provide valuable enzymes to a diet in which much of the food is cooked. In the past, lactic-acid fermentation methods were also used in the production of traditional beers made from grains. These were opaque beverages, with a low alcohol content but rich in vitamins, minerals and enzymes. 10 Such traditional beers have given way to modern, factory produced, pasteurized beers. The national drink, of course, is tea. In Manchuria, sweetened tea is fermented to make kombucha.
In general, the modern Chinese diet does not protect them against cancer. The overall rate of cancer in China is twice that of the United States. The Chinese have less cancer of the colon, lung and breast, but far greater levels esophageal, stomach and liver cancer. Heart disease mortality is greater in the US but the Chinese have more stroke-in some districts the rate of death by stroke for those under 65 is as high as 8 percent. While the Chinese have made great strides in reducing the incidence of infectious disease and rates of infant mortality, these still remain major public health problems, especially in areas that are either crowded or remote. TB and parasite infections remain common.
Of particular concern is the high rate of mental retardation-over ten million cases in China, including hundreds of thousands with overt cretinism, especially in the central regions.11 This is blamed on a lack of iodine and the United Nations has called for a World-Bank-financed campaign to iodize salt in China. This will help the Chinese government eliminate the thriving black market in salt, but as Chinese salt is already rich in iodine, it is not likely to solve the problem. Another explanation is the blinding poverty of the region, where each village sports a population of “idiots” whose families can afford to eat nothing more that wheat porridge.
In the 1980s, a group of researchers from Cornell University carried out a massive dietary survey, covering all 25 of China’s farflung provinces, in an effort to determine food consumption and disease patterns. This study is often cited as proof that plant-based diets are healthier than those based on animal foods like meat and milk. Study director T. Colin Campbell claims that the Cornell findings suggest “that a diet high in animal products produces disease, and a diet high in grains, vegetables and other plant matter produces health.”12 But the Cornell survey data, when carefully studied, does not support such claims.13
What the Cornell researchers discovered was that meat intake in China was highest in the western border region and very low in a number of impoverished areas centering on Sian. They found that meat eaters had lower triglycerides and less cirrhosis of the liver-and that they took more snuff-but otherwise they found no strong correlation, either negative or positive, with meat eating and any disease.
Some surprising and contradictory findings were associated with egg consumption, with averages of about 15 grams per day in the northern most parts of China, about 12 grams per day in the Shanghai region and amounts bordering on zero in the impoverished area around Sian in central China. (An egg weighs about 50 to 60 grams.) These figures are at odds with statistics that show per capita egg consumption in all of China to be roughly one third that of the United States14, as well as with another study showing per capita egg consumption of 50 to 80 grams per day in the northern part of China15, and suggests that the participants in the Cornell study were not truly representative of the Chinese population. American egg consumption is roughly 40/grams/day, yet the China study showed egg consumption at expected ratios in only two underpopulated northern areas and in the Shanghai region. There was a positive association of egg consumption with the consumption of meat, beer, soy sauce, sea vegetables, sugar and “other oils” and a strong correlation with university education and employment in industry. Egg eaters had more cancers of the brain, lung and bowel, perhaps because large numbers of them live in the polluted Shanghai region. They had less cirrhosis of the liver, fewer peptic ulcers and lower triglycerides. Egg consumption appeared to confer high protection against pulmonary diseases such as TB. There was no significant correlation of egg consumption with heart disease.
Fish consumption ranged from about 120 grams per day on seacoast areas, to zero in remote inland regions. Fish consumption was positively associated with consumption of sugar, “other oils,” beer, liquor, meat, and rice and negatively associated with consumption of salt, wheat and legumes. Fish eaters had more diabetes, nasal cancer and liver cancer, but less TB, infectious disease and rheumatism. Fish eaters had lower triglycerides. There was no significant correlation, either positive or negative, of fish eating with coronary heart disease. There was a negative correlation of fish eating with pipe smoking.
Milk consumption was zero in the vast majority of the provinces. However, in the western border region, milk consumption averaged 856 grams (about 1 quart) per person per day. (Whether this figure includes fermented milk products is not specified.) The rate of coronary heart disease in the western border region was about half that of Jiangxain and Longxian, where no milk products are consumed and where lipid intake is under 10% of total calories. Milk consumption showed no strong correlation, either negative or positive, with any disease but there was a high correlation of milk drinking with taking snuff.
Likewise, percentage of caloric intake from lipids, as determined by a three-day diet survey, was found to have no strong correlation, either positive or negative, with any disease. Fat intake ranged from 45 percent in the remote regions on the western border, to as low as 6 percent in the impoverished Songxian district. Not surprisingly, people who drank milk and ate meat had the highest levels of dietary lipids. Investigators lumped fats and oils together in the dietary recall questionnaire so that no conclusions could be drawn about the effects of animal fats such as lard, which is a good source of vitamin D, versus the effects of vegetable oils such as sesame, soy, cottonseed and peanut oil; nor did they look at consumption of insects and concentrated animal foods like shrimp paste, both of which provide fat soluble vitamins. They did, however, find that the high fat group tended to take snuff while people on low fat diets smoked pipes.
In his introduction to the research results, study director T. Colin Campbell states that there is considerable contemporary evidence supporting the hypothesis “that the lowest risk for cancer is generated by the consumption of a variety of fresh plant products.”16 Yet Cornell researchers found that the consumption of green vegetables, which ranged from almost 700 grams per day in Jingxing to zero on the western border, showed no correlation, either positive of negative, with any disease. Dietary fiber intake seemed to protect against esophageal cancer, but was positively correlated with higher levels of TB, neurological disorders and nasal cancer-perhaps because there was a strong correlation between total fiber intake and pipe smoking. Fiber intake did not confer any significant protection against heart disease or most cancers, including cancer of the bowel.
Given the current emphasis on soy foods, it is puzzling that the Cornell Study researchers did not single out soy foods for study as a separate food item. Instead soyfoods are lumped together with other pulses in the category of legumes. Legume consumption varied from 0 to 58 grams per day, with a mean of about 12. Assuming that two-thirds of legume consumption is soy, then the maximum consumption is about 40 grams (about 3 tablespoons) per day with an average consumption of about 9 grams. Mark Messina, author of The Simple Soybean and Your Health, recommends 1 cup, or 230 grams, of soy products per day in his “optimal” diet as a way to prevent cancer, heart disease and osteoporosis.17 However, the Cornell study found that consumption of legumes was not strongly correlated with the prevention of any degenerative disease, results that cannot be extrapolated to the extravagant health claims of soy promoters, who advocate industrially processed soy products in amounts far greater than those found in the typical Chinese diet.
Cornell researchers found a relatively strong correlation between salt consumption with oesophageal cancer and hypertension. Salt eaters had higher triglycerides but no significantly higher rates of stroke or coronary heart disease. Salt eaters ate less fish and consumed less liquor that those with lower dietary levels of salt.
The Cornell project did not take data on the amount and extent of osteoporosis in China so it is difficult to assess the claims that bone loss is rare among Orientals. They did determine that both dietary calcium and vitamin A-both needed for healthy bones-is low in China. The many references in Chinese medicine to the use of broth for old people and pregnant women indicates that bone loss is indeed a problem. Dishes considered important for pregnant women include fish heads in broth, eggshells dissolved in vinegar, pork ribs cooked in a sweet and sour sauce made with vinegar, and pickled pigs feet prepared with vinegar and sugar. Pigs feet chopped into small pieces and cooked in rice vinegar for as much as 12 hours, then sealed in containers, are traditionally given as gifts to pregnant women and nursing mothers. A 1978 survey of the Peking area reported mild rickets in 20 percent of children under seven years of age, but rickets appears to be rare in southern China where consumption of seafood is high.18
While the Cornell Study, for all the millions spent on it, does not tell us much about the various effects of food on the etiology of disease in China, it does present some intriguing findings about tobacco habits. Those who consumed more animal protein were more likely to take snuff; while those who consumed more plant foods tended to be pipe smokers. Snuff takers had a higher caloric intake than pipe smokers, but total caloric intake had no strong correlations, either negative or positive, with any disease. Researchers found an intriguing indication that handrolled cigarettes protected against cancer, while manufactured cigarettes were associated with increased rates of cancer, albeit very weakly.
Before we throw up our hands and decide that no conclusions can be made about diet and health in China, let us turn our attention to the mixed peoples of Okinawa, situated equidistant from Hong Kong and Tokyo. The average lifespan for women in Okinawa is 84 (compared to 79 in American), and the island boasts a disproportionately large number of centenarians. Okinawans have low levels of chronic illness-osteoporosis, cancer, diabetes, atherosclerosis and stroke-compared to America, China and Japan, which allows them to continue to work, even in advanced years. In spite of Okinawa’s horrific role in World War II, as the site of one of the bloodiest battles of the Pacific, Okinawa is a breezy, pleasant place, neither crowded nor polluted, with a strong sense of family and community and where the local people produce much of what they consume.
And what do Okinawans eat? The main meat of the diet is pork, and not the lean cuts only. Okinawan cuisine, according to gerontologist Kazuhiko Taira, “is very healthy-and very, very greasy,” in a 1996 article that appeared in Health Magazine.19 And the whole pig is eaten-everything from “tails to nails.” Local menus offer boiled pigs feet, entrail soup and shredded ears. Pork is cooked in a mixture of soy sauce, ginger, kelp and small amounts of sugar, then sliced and chopped up for stir fry dishes. Okinawans eat about 100 grams of meat per day-compared to 70 in Japan and just over 20 in China-and at least an equal amount of fish, for a total of about 200 grams per day, compared to 280 grams per person per day of meat and fish in America. Lard-not vegetable oil-is used in cooking.
Okinawans also eat plenty of fibrous root crops such as taro and sweet potatoes. They consume rice and noodles, but not as the main component of the diet. They eat a variety of vegetables such as carrots, white radish, cabbage and greens, both fresh and pickled. Bland tofu is part of the diet, consumed in traditional ways, but on the whole Okinawan cuisine is spicy. Pork dishes are flavored with a mixture of ginger and brown sugar, with chili oil and with “the wicked bite of bitter melon.”
Weston Price did not study the peoples of Okinawa, but had he done so, he would have found one more example to support his conclusions-that whole foods, including sufficient animal foods with their fat-are needed for good health and long life, even in the Orient. In fact, the Okinawan example demonstrates the fallacy of today’s politically correct message-that we should emulate the peoples of China by reducing animal products and eating more grains; rather, the Chinese would benefit by adding more strengthening animal foods to their daily fare.
Proponents of the low-fat school argue that the Chinese cannot afford to devote more land to animal husbandry. Consider, however, the fact that the Chinese grasslands, concentrated in the semi-arid lands of the north and west, cover nearly forty percent of China, an area three times that under cultivation. Such lands do not support crop production but are highly suited for grazing purposes-for the production of meat and milk-and many Chinese have proposed that efforts be made in this direction. The Beijing Food Research Institute, however, has opposed such measures. Its director, Wang Qing, who is credited with turning China away from dairy development, contends that cow’s milk is a food for the elite, and dairying much too expensive for China to pursue.20 He argues that the Chinese cannot consume dairy products because they are lactose intolerant-but even the lactose intolerant can consume dairy products in limited amounts21, especially fermented dairy products. Meat and dairy products from land that currently is not being used would provide just those nutrients now lacking in the typical Chinese diet-protein, calcium and fat soluble vitamins. Under Qing’s direction, however, China has opted for increased cultivation of valuable agricultural lands in soybeans, in order to provide factory-produced, mineral-blocking, protein-poor soymilk to the populace.
The authors are grateful to Mr. and Mrs. Eugene Yen for their help in preparing this article.
Inside Japan: Surprising Facts About Japanese Foodways
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 8 Comments 
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Japan is presented to the American public as a nation benefitting from all the dietary paradigms deemed politically correct. Their diet is low in fat, high in carbohydrates, devoid of dairy foods and rich in soy foods, we are told, and for this reason the Japanese enjoy the longest life-span in the world, with much lower rates of heart disease, osteoporosis, breast and prostate cancer than the US.
These are partial truths and the relationship between diet and disease in Japan is more complex than we are led to believe. Close examination of the traditional Japanese diet proves that, although very different from Western diets, Japanese cuisine embodies all the principles of nourishing traditional foodways. It is rich in fat-soluble vitamins from seafood and organ meats and in minerals from fish broth, and contains plenty of lacto-fermented foods. Japanese preparation techniques eliminate most of the antinutrients in grains and legumes. As long as the Japanese get enough to eat, their diet is a healthy diet in surprising ways.
Staples
Rice is the main carbohydrate food in Japan, consumed with every meal. For the poor, it is the chief source of calories. However, the real basis of the Japanese diet is not rice but fish, consumed at more than 154 pounds per person per year1-almost one-half pound per day. This is about the same amount by weight as rice, but in terms of calories, fish provides a greater amount for most of the Japanese.
Fish consumed in Japan come from waters surrounding the island nation and from around the world. Japan imports millions of dollars worth of shrimp, salmon, trout and tuna every year. In addition, carp is farmed in fresh inland waters.
Fish is usually eaten fresh-even delivered to the door by fishmongers-but it is also consumed in salted, dried and pickled form. Fresh fish is grilled or baked and also eaten raw (sashimi). Generally there are two fish courses at each meal, one of cold fish and one of hot.
A typical fish dish is hoshizakana, which is fish that has been marinated for 20 hours in a mixture of soy sauce and sweet white wine, then hung up for one day to dry. Then it is baked in the oven and served plain, without any sauce.2
Soups made of fish, including the organs and bones, are considered strengthening foods and good for anemia. Carp soup is traditionally given to women after childbirth. It is made from the whole carp, including the head, bones, eyes and all the organs except the gall bladder, and cooked four to eight hours with barley miso and burdock root. It is eaten four days in a row after the birth of the child, even longer if the mother has difficulty producing plentiful milk.3
The Japanese also eat many other animal foods including beef, pork, chicken, duck and eel. Beef consumption has climbed in recent years, some of it locally raised but much of it imported. The famous Kobe beef is tender and full of fat. The Japanese even import large quantities of beef offal.4 Consumption of beef liver, tripe and other organ meats is commonplace. Various organ meats are usually served at specialty restaurants. Eel served at restaurants is often accompanied with a soup containing eel innards.
Beef, pork and chicken are usually grilled and served with a sauce that contains soy sauce along with other ingredients such as merin (a sweet wine), sake (rice wine), vinegar or sugar.
Soy beans are a distinguishing feature of the Japanese diet, particularly fermented soy sauce used in most prepared dishes. Almost without exception, Japanese sauces and marinades are based on soy sauce. But it would be a mistake to call soy a “staple” in the Japanese diet, in the way that fish and rice are staples. Dietary surveys indicate that the Japanese consume an average of about 1/4 cup of soy products per day, including the ubiquitous soy sauce.5 Other soy foods include tofu, a precipitated product, and fermented soy foods such as miso, tempeh and natto. Until recently, these foods were produced at home or by artisans. They are added in small amounts to soups or used as seasonings. Natto has such a strong smell that restaurants serving it have separate natto-eating sections so that non-natto eaters can be spared the overpowering odor.
Almost all the soybeans used in Japan today are imported and there is a big demand for organic, non-GMO soybeans.
A typical recipe for homemade miso calls for 5 kg soy beans, a whopping 3 kg salt and 8 wafers of malted rice (about 1″ by 5″ by 10″ each).6 The beans are cooked, mashed, mixed with the malted rice and salt and formed into balls. The balls are put into a big bucket lined with a thick plastic bag. The bag is then closed and a 5 kg weight put on top. Six months later the miso is ready.
A 1935 recipe for tofu calls for soaking dry soybeans in water for a day, pounding them with a stone mortar, straining into square molds and mixing with brine.7 They are then boiled until they become hard and firm.
The Japanese recognize that soybeans need careful processing to remove naturally occurring toxins. When they eat beans that are simply cooked, they use small red ones called azuki. A dish of cooked rice and red beans is made for festive occasions, such as weddings and births. Red beans are also used to make sweet cakes.
The Japanese are said to avoid milk products but the statistics prove otherwise. Average consumption of dairy foods in Japan is about 186 pounds per person per year, more than the total for fish.8 This is only one-third the amount consumed in the US, but it is not negligible. Dairy products used in Japan include milk, yoghurt and butter. Japan has a small dairy industry but also imports milk products from Australia and New Zealand.
In general, the Japanese do not like sugary desserts. But they enjoy pounded rice (mochi) covered with sweet bean paste. They also enjoy mashed sweet potato or chestnuts covered with breading.
Noodles made with wheat flour, egg yolks and salt are an important feature in the Japanese diet. They may also be made with rice, sweet potato or buckwheat. Noodles are usually eaten with chicken or duck, sometimes with lobster and often in broth.
A great variety of vegetables and fruits are sold in the shops and markets. Favorites include daikon radish, eggplant, bamboo shoots and many types of mushrooms. Most vegetables are consumed cooked, not raw. Instead of salads, boiled spinach or watercress is served cold and seasoned with soy sauce.
The Japanese diet may seem monotonous to Westerners, but the Japanese actually put a great emphasis on variety. In nutrition classes, Japanese children are taught to eat thirty different foods a day, and to aim for 100 different foods a week.9
Making Broth
A fundamental component of the Japanese diet is fish broth, made in a variety of ways. Japanese chefs take much pride in developing an individual style with broths. Fish soup made from arajiru, the discarded portions of the fish such as the head and bones, was traditionally a common breakfast food. (The meat is deftly removed from the head with chopsticks, especially the meat behind the eye, which is extremely rich in vitamin A.) Usually, however, fish stock is made with dried sardines (niboshi) or dried bonito flakes or powder (katsuobushi). In the old days, the bonito could be purchased as a block of dried fish. The block was shaved into flakes with a “shaving box,” a wooden box with a thin slot lined with a blade. The block of dried fish was run along the blade and the shavings would fall into a drawer inside the box. When the desired amount of shavings had been produced, the drawer was pulled out and the contents dumped into a pot of boiling water.
Sometimes broken-up chicken bones are added to the stockpot. The broth is transformed into soup with the addition of vegetables, chicken, pork, tofu or eggs.
Other nourishing broths are made with dried kelp (kombu) or dried shiitake mushrooms. The mushrooms are placed in a pot of water and just before the water comes to a boil, the mushrooms are taken out and the dried sardines or bonito flakes are added.
Brain Foods
Egg consumption in Japan is higher than in America (40 pounds per person per year, versus 34 in the US).10 The Japanese consider eggs to be a brain food. The story is told of a woman whose husband was killed during the war. She had an infant son and throughout the following years she gradually sold off all of her furniture to provide her boy with one egg per day, “so that he could go to college.” The boy grew up to be an intelligent child and, in fact, did go to college in the postwar years. Eggs are consumed as omelets, custards and in soups. They are also an important ingredient in noodles and batters.
Another brain food in the Japanese diet is seaweed, added to soups and used for wrapping sushi. It is also served as a vegetable. Agar-agar, a gelatin-like product used extensively in Japan, is derived from seaweed.
Seaweed provides an abundance of minerals, particularly iodine so vital for normal thyroid function. Normal thyroid function is, in turn, vital for normal brain function. It is the presence of adequate iodine in the traditional Japanese diet that makes it possible for the Japanese to consume soy products on a daily basis without adverse effects on the thyroid gland.
Fats and Oils
The Japanese have traditionally used a variety of fats and oils. Delicious tempura-vegetables and fish dipped in batter and then deep fried-was cooked in sesame oil, rapeseed oil, whale oil, lard or beef tallow. That was in the olden days. Today, the Japanese are more likely to fry in cheap commercial vegetable oils. But even today, lard is available at the grocery stores in squeezable bottles and skillets in the better restaurants are greased with beef fat and lard. Use of shortening and margarine is rare.
Since World War II, the pattern of lipid intake has changed markedly in Japan. There has been a threefold increase in the intake of saturated and monounsaturated fatty acids, a reflection of increased prosperity that has allowed the Japanese to subsist on more than fish heads and rice. Unfortunately, with the advent of cheap vegetable oils and processed foods, there has also been an increase in omega-6 fatty acids along with a lowering of the levels of omega-3 fatty acids. In a milestone review, published in 1997,11 Japanese investigators blamed the increase in cancer, heart disease, inflammatory disease such as asthma and allergies, and even behavioral problems in Japan not on increases in saturated fat, but on increases in omega-6 vegetables oils. “Decreasing the n-6/n-3 ratio of foods is recommended for the suppression of ageing, carcinogenesis and atherosclerosis,” they said. “This is because n-3 fatty acids suppress but n-6 fatty acids stimulate ischaemia/inflammation which causes increased free radical injuries. We suggest that a relative n-3 deficiency as evidenced by the very high n-6/n-3 ratios of plasma lipids might be affecting the behavioral patterns of a significant part of the younger generations in industrialized countries.”
Fermented Foods
Fermented vegetables in the form of pickles are served with all traditional Japanese meals. They range from pickled cabbage to eggplant to daikon radish. Pickled foods are an important adjunct to a diet that includes raw fish because they help protect against intestinal worms, which can be a frequent problem in Japan. One folk custom is to consume pickled daikon radish with sushi and sashimi, to “neutralize toxins.” Daikon radish is one of the best vegetables for supporting the growth of protective lactobacilli.
A typical recipe for pickling lettuce, cucumber and turnips calls for sprinkling them with salt and allowing them to stand for about two days.12 This combination is eaten as a separate course with rice. Pickled melon is prepared by covering melon slices with sake (rice wine) and merin (a sweet wine) and sprinkling them with salt. It is allowed to stand for five days and then eaten as the last course of a meal.
In the mountainous regions where salt was not available, ingenious methods for producing pickles evolved. One of these is sunki or pickled leaves of a type of turnip.13 The leaves are boiled and then inoculated with zumi, a small wild apple, and fermented for 1-2 months.
An interesting fermented fish product called kusaya comes from the island of Izu. Mackerel and similar fish are soaked in a brine or “kusaya gravy” that is used over and over again because salt was a rare material. After soaking, the fish is dried. In the unused period, the “gravy” was kept alive by adding just one fish fillet. Kusaya is distinguished from other dried fish by its strong, unique, peculiar odor. “If you broil kusaya in your house, the odor will not leave for three months.”
The typical Japanese dish of sushi originated in funazushi, a type of round shellfish from Lake Biwa in the Shiga prefecture of Japan. The shell fish was cleaned, salted, washed and fermented for 4-12 months. During fermentation, funazushi develops several kinds of organic acids such as lactic acid, acetic acid, propionic acid and butyric acid, all of which contribute to its distinctive sour taste and peculiar odor. The pickled crustacean was sliced and served on rice. In former times, it was said that if you could enjoy funazushi, you were recognized as a gourmet. Once an important dish in the area around Lake Biwa, the catch of the shellfish is decreasing year by year, due to water pollution, introduced species and shoreline destruction, thus making funazushi a rare and expensive food.
The main fermented drink in Japan is a rice drink called amazake, prepared by boiling a block of malted rice until it becomes soft and drinkable. Salt and sugar are added to taste. In winter, amazake can be bought from vending machines.
Surprisingly, a fermented milk drink is sold in Japanese vending machines right next to Coke or Pepsi. Unfortunately, the first ingredient listed is sugar.
Beverages
All meals in Japan are served with a weak green tea, made with one teaspoon of tea to six teacups of water. Black tea, coffee and milk are also common beverages. Milk is available to school children and is recognized as a healthy food, one that helps Japanese children grow taller than their ancestors.
The Japanese have interesting ideas about beverages. On a hot day, most Japanese people, especially older Japanese, prefer hot green tea to anything cold. They say they want something the same temperature as their body or that something cold will make them sweat more. In winter time, they often add ginger to warm drinks as ginger is said to be warming. Water is avoided as it is said to make one fat!
Beer is a common beverage, and also recognized as one that causes weight gain. Sumo wrestlers, who can weigh as much as 500 pounds, put on weight by consuming large quantities of beer, as well as lots of rice and a nourishing stew called chankonabe.
Factory vs. Traditional Foods
While the Japanese diet is held up as the paradigm of natural eating, Japan is also home to the world’s quintessential imitation flavor, MSG. Originally extracted from seaweed, MSG or monosodium glutamate activates glutamate receptors on the tongue and tricks the body into thinking it has eaten meat. Today most of the world’s MSG is produced by Ajinomoto, a Japanese company, through a chemical process. It is no longer derived from a natural food.MSG is used to make cheap soy sauces, thus driving out artisanal producers who traditionally took great care and up to three years to produce the delicious fermented elixir. Factory-produced soy sauce can be turned out in the space of three days and contains, besides neurotoxic MSG, many carcinogens.
MSG was used to flavor Japanese rice rations during the war and it is said that Americans who loved the taste of these rations helped introduce the flavoring into the US. Today it is found in almost all processed foods, including those now manufactured in Japan. Yet health-conscious Japanese recognize the dangers and the more expensive noodles and processed foods there are labelled “No MSG.”
Many Japanese also recognize the dangers of McDonald’s and other fast foods that are making inroads in Japan, and they deliberately adhere to traditional foodways. Some housewives still make all traditional foods at home, from amazake to miso. Typical of foods still produced by housewives and artisans are various preparations of the famous umeboshi plum. The plum trees grow in the region of Mito Ibaraki where a park is home to 2000 plum trees, attracting three million visitors per year. Each year thousands of Japanese ladies gather the famous umeboshi plums to make all sorts of plum delights, including salty pickled plums. Well-aged pickled umeboshi plums are a great delicacy-some of them are fermented for as long as 30 years!
Presentation Is Everything
The manner in which food is presented in Japan is always attractive and distinctive, usually with handsome serving dishes and a great sense of proportion and harmony. Meals are often served with elaborate ceremony. On ceremonial occasions and at banquets, a number of bowls and dishes are set before each guest, so that he may have a wide choice. Those dishes not partaken of are carefully packed in decorated boxes and presented to the guest as he leaves.
Even lunch boxes are an art form in Japan, containing beautifully decorated foods such as large prawns, rice rolled in seaweed, fish and pieces of fruit. One company in Japan prepares as many as 50,000 of these lunch boxes per day.14 Many Japanese mothers get up very early to make lunch boxes containing neatly arranged portions of fish, meat, rice balls, pickles, and fruit for their children and husbands.
The Japanese Paradox
The Japanese suffered greatly before and during World War II. There were many food shortages, particularly of fats and animal foods. TB was common. Many Japanese lived almost entirely on rice during the war.
It was during the postwar years that the American researcher Ancel Keys wrote his famous Seven Countries Study in which he included groups from the Japanese districts of Tanushimaru and Ushibuka. He noted that the Japanese in these two regions had very low levels of serum cholesterol, consumed a diet extremely low in saturated fat and cholesterol and had low rates of coronary heart disease. It was primarily the Japanese data that allowed Keys and others to conclude that consumption of saturated fat and cholesterol caused heart disease.
Keys has been criticized for omitting from his study many areas of the world where consumption of animal foods is high and deaths from heart attack are low, including France. This is the so-called French paradox, one of many. But there is also a Japanese paradox. In 1989, Japanese scientists returned to the same two districts that Keys had studied. In “Lessons for Science from the Seven Countries Study,”15 they noted that per capita consumption of rice had declined while consumption of fats, oils, meats, poultry, dairy products and fruit had all increased. Between 1958 and 1989, protein intake rose from 11 percent of calories to about 15 percent and fat intake rose from a scanty 5 percent to over 20 percent. Mean cholesterol levels increased from 150 in 1958 to 188 in 1989. During the period, mean body mass gradually increased, with overweight rising from 8 percent to about 13 percent of the population. High blood pressure became more common while the percentage of smokers decreased from 69 percent in 1958 to 55 percent in 1989.
During the postwar period of improved nutrition the Japanese average height increased three inches and the age-adjusted death rate from all causes declined from 17.6 to 7.4 per 1000 per year. Although the rates of hypertension increased, stroke mortality declined markedly. Deaths from cancer also went down in spite of the increased use of animal foods.
The researchers also noted-and here is the paradox-that the rate of myocardial infarction (heart attack) and sudden death did not change during this period, in spite of the fact that the Japanese weighed more, had higher blood pressure and higher cholesterol, and ate more fat, more beef and more dairy.
Misconceptions
Misconceptions about the state of health in Japan abound. It is true that the Japanese have lower rates of cancer than the US, although they are by no means cancer-free. For all types of cancer, the death rate for Japanese males is 149.8 per thousand versus 163.2 per thousand in the US. For Japanese females total cancer deaths are 78.1 per thousand versus 109.7 per thousand for the US.16 Japanese have low rates of lung cancer (even though they smoke far more than Americans) and low rates of breast, prostate, reproductive, colon and rectal cancer compared to the US. This is said to be due to the fact that they consume more soy and less meat, fat and dairy than Americans. But cancer rates went down in Japan during the period when consumption of animal foods went up. And the Japanese actually consume far less soy than Americans because even today, they do not consume much partially hydrogenated soybean oil. In fact, the most likely explanation for high levels of breast and prostate cancer in the US compared to Japan is the high levels of trans fatty acids from partially hydrogenated soybean oil in American convenience foods.
Fresh fish, rich in vitamin A and omega-3 fatty acids, is one component of the Japanese diet that protects them against lung cancer. A study carried out at the Cancer Centre Hospital in Aichik Mapan looked at the diets of more than 4,000 healthy people and another 1,000 with lung cancer.17 They found that both men and women who ate large amounts of fresh fish were significantly less likely to develop lung cancer. A diet that included salted or dried fish in place of fresh fish did not confer the same protective qualities.
The Japanese do suffer from very high rates of stomach cancer, and relatively high rates of cancer of the pancreas, liver and esophagus, the so-called Asian types of cancer. There are many explanations for this trend, none of them proven. The most common theory is that the use of highly salted foods such as soy sauce and salted fish is the cause of stomach cancer. But other dietary components are equally suspect, including high levels of irritating talc present in white rice and carcinogens in modern processed soy sauce. A final explanation is the widespread use of microwave ovens by modernized Japanese. Japan was the first country to adopt the microwave, which seemed to many Japanese housewives a safer and more sensible way to cook food in tiny Japanese kitchens than the old-fashioned gas burner or stove.18
Japan has many lessons to teach us about the risk of generalization in scientific studies. All claims about heart disease in Japan should be viewed with skepticism because the Japanese consider it shameful to die of heart disease but honorable to die of stroke. Predictably, deaths reported as due to stroke are much higher than deaths reported as due to a heart attack.
Japanese women are said to be free of hot flashes but some investigators believe that hot flashes are “under-reported,” due to the shyness of Japanese women. Soyfood promotion material states that “there is no word for hot flashes in Japan” without acknowledging that there is no word for hot flashes in English either. We use two words to describe the condition and it is likely that Japanese ladies use some sort of euphemism.
Another claim is that the Japanese do not suffer from osteoporosis. But according to a 1998 study carried out by the Tokyo Institute of Gerontology,19 Japanese women have much higher rates of osteoporosis than American women-one in three versus one in eleven. Furthermore, they found that bone mass deterioration begins much earlier in Japanese women, at age 20 versus age 34 in the US.
According to the statistics, the Japanese have the longest life-span in the world. Built into those numbers is a very low rate of infant mortality compared to the US. The Japanese were one of the first countries to practice widespread birth control and they deliberately keep their families small. Great care and attention is lavished on children, starting with the mother’s diet during pregnancy, and outright poverty in Japan is rare. When the high infant mortality rate in America is discounted, American men have life-spans equal to Japanese men and American women have longer life-spans than Japanese women.20
Stress-Free Living?
In his doctoral thesis about coronary heart disease in Japanese emigrants, British physician Dr. Michael Marmot also described a Japanese paradox.21 Dr. Marmot discovered that when the Japanese in Hawaii maintained their cultural traditions, they were protected against heart attacks, even though their cholesterol increased as much as in Japanese emigrants who adopted a Western life-style and who died from heart attacks almost as often as did native-born Americans. The most striking aspect of Dr. Marmot’s findings was that emigrants who became accustomed to the American way of life, but preferred lowfat Japanese food, had heart disease twice as often as those who maintained Japanese traditions but preferred high-fat American food.
Dr. Marmot proposed the theory that certain factors in the traditional Japanese culture protected the Japanese from heart attacks in spite of a high-fat diet. He noted that the Japanese place great emphasis on group cohesion, group achievement and social stability. Members of the stable Japanese society enjoy support from other members of their society and thus are protected from the “emotional and social stress” that Marmot believed to be an important cause of heart attacks. The Japanese traditions of togetherness contrast dramatically with the typical American emphasis on social and geographic mobility, individualism and striving ambition, said Dr. Marmot.
But is life less stressful among the traditional Japanese? “Group cohesion” and “group achievement” can also translate into unrelenting pressure and stress. Is the traditional Japanese family man, striving to perform and bring honor to his family, under less pressure than the westernized Japanese bloke who has decided to chuck it all and hang out on the beaches? And is the Japanese-American living under America’s wide open skies, where opportunity abounds, under more pressure than his relatives in Japan, where opportunities are fewer and where crowding is commonplace? The Japanese people, including school children, work long hours, travel miles to school and work and often have only one day a week free. The pressure on children to do well in school is intense and the suicide rate among Japanese young people is among the highest in the world.
What Dr. Marmot’s study really tells us is that increased animal fat in the Japanese diet protects them from heart disease in spite of their stressful life-style, not the reverse. High rates of heart disease among Americans should be blamed on processed foods based on vegetable oils, not animal fats and a high-stress life style.22
Saturated Fat
Saturated fat from animal sources is said to be the enemy in the American diet. Researchers espousing this dogma have consistently ignored evidence that saturated fats actually protect against heart disease and cancer. The many studies of the Japanese also ignore two very important sources of saturated fat in their diet.
One of these sources is spam, a canned pork product provided to American soldiers during the war. Americans may have loved the taste of Japanese rice rations, but the Japanese loved our rations even more. Spam provided exactly those dietary components that had been missing through the years of poverty and privation-animal protein and fat. In a nation that has been unusually resistant to foreign influence, spam was quickly embraced and transformed into a popular snack food. Spam musubi consists of a slice of spam soaked in soy sauce on top of a bed of rice and wrapped in seaweed-a convenient morsel resembling sushi. Spam musubi can be purchased in local convenience stores, including 7-11 stores, in Hawaii. In fact, spam consumption in Hawaii is higher than the total spam consumption in all the other 49 states combined due to its popularity among Japanese Americans.
The other source of saturated fat in the Japanese diet is . . . white rice, a refined carbohydrate that the body efficiently turns into saturated fat. As long as the diet is rich in fat-soluble vitamins from fish and organ meats, and minerals from broth and seaweed, white rice can be consumed without adverse effects. In fact, for the Japanese, it is beneficial, providing the substrate for saturated fats that the diet still lacks. Macrobiotic proponents claim that the traditional Japanese diet was based on whole brown rice, not refined white rice. It is said that the first Samurai warriors ate brown rice while the rest of the nobility ate white rice. Then the samurai slowly “softened” and started eating white rice. But the true explanation for the use of white rice may be somewhat different. Brown rice that is not soaked and fermented, as was done traditionally in India, may block mineral absorption and cause intestinal problems. The Japanese prefer the taste and texture of white rice and this preference may reflect a profound intuition that when rice is consumed on a daily basis, it should be refined not whole, unless a long and careful preparation is observed.
The Modern Challenge
The challenge for the Japanese, like the challenge for all countries in the process of modernization, will be to resist the temptations of processed foods. But Japan faces an additional challenge and that is to resist the advice of meddling American health researchers who are telling them to eliminate vital components of their traditional diets-beef, pork, lard, tallow and even white rice. Better to pay attention to a few problematic additives such as talc in rice and impurities in salt, and to protect artisanal food protection from the cutthroat policies of the food processing industry.
And one more piece of advice to the Japanese: throw out the microwave.
The authors would like to thank Steven Gist for his help with this article. 

Sidebars
Japanese Meals
Recipes of All Nations, published in 1935, gives the following menus for typical Japanese meals, although dietary habits of modern Japanese have suffered from western influences since World War II. Today a high percentage of urban Japanese have English-style white bread for breakfast.
Breakfast: Fish broth and vegetable soup with rice; omelet, baked fish, seaweed and pickles
Lunch: Egg or rice soup, fish, chicken, vegetable dish and fruit
Dinner: Broth soup with pieces of meat and vegetables, raw fish with grated horseradish, lobster with lettuce and cucumber salad, hot fish, cold noodles, vegetable soup and rice, fruit.
The French Paradox
Foods Eaten per Person per Year (in Pounds)				
	Japan	France	US	
Cereals	232	188	150	
Potatoes & Starches	82	168	69	
Sugars	47	75	155	
Total Carbohydrates	361	431	374	
Meats	84	239	258	
Eggs	40	31	34	
Fish	157	40	16	
Dairy Foods	186	788	576	
Total Animal Foods	467	1098	884	
High consumption of animal foods compared to the Japanese is said to be the cause of heart disease in America. But the French consume much higher levels of animal foods and have much lower rates of heart disease. Americans consume much higher levels of sugar.
Adopted from A Taste of Japan, 1993
The Macrobiotic Diet–Is It Really Japanese?
Americans have become familiar with many Japanese foodways through the macrobiotic diet, popularized by Michio Kushi and practiced by thousands of adherents. Proponents advocate a diet based on brown rice and containing only small amounts of animal foods, if any. But is the macrobiotic diet actually representative of the Japanese diet? Not really. The Japanese eat white rice, not brown, and consume large amounts of animal foods, particularly fish but also beef, pork and chicken. Americans following the macrobiotic diet tend to use soy foods instead of meat, and in amounts much greater than are found in the typical Japanese diet.
Macrobiotic cookbooks contain recipes for broth and pickled foods, but the importance of these is not stressed and they are often left out in practice.
Macrobiotics introduced Americans to the use of seaweed, but caution is advised in adopting this habit. Seaweed contains complex carbohydrates that are difficult for many Westerners to digest.
Comments from Resident of Japan
We received the following comments from a resident of Japan:
In your article, you mention “baking” as a preparation technique employed by Japanese; in fact, most Japanese until quite recently did not have an oven at all! Baking is not a preparation method used for fish or much of anything else in Japan. Nowadays that has changed, but traditionally it was not so. Steaming, grilling, stewing, saute…those are the traditional preparation methods.
Traditionally, fishmongers delivered fresh fish to people’s doors, but this is no longer true and probably has not been common for most people for quite a long time. Until recently, fish markets were most common and women went shopping for the day’s groceries everyday. Now, like in America, supermarkets are replacing specialty stores and women are turning away from shopping daily but there are still specialty fish stores and the farmers’ markets held every few days include fish stands where fresh and salt cured fish (as well as pickled) is sold. The freshness of fish in an island country like Japan makes possible eating it raw. Since I grew up in Ohio, I almost never ate decent fish until I moved to Minnesota where Scandanavian descendants and their dietary preferences created a market for fresh fish. Differences in location do impact food selections, don’t they!
Soy products are “ubiquitous” in Japanese cuisine and I suspect consumption may be more than the 1/4 cup per day you noted. I have never heard of “tempeh” being used in Japan until recently when the “soy craze” that hit the West extended backwards to Japan as well. I do not know any Japanese who eat tempeh. They do eat soy products like shoyu (soy sauce), miso, natto, tofu, yuuba and fresh soy beans that are steamed and salted. As you have noted, I suspect the negative impact of soy on thyroid function is modulated by mineral intake – particularly iodine – afforded by consumption of sea vegetables and fish.
Within the “Japanese Foodways” text, you mention consumption of “lobster” in several places. I question this as lobster is “Ise Ebi” in Japanese and this is an expensive and seldom consumed item. Perhaps “shrimp” would have been more accurate. In addition, “funazushi” is not a shellfish; it is a fish albeit a small one that is used to prepare this fermented food.
When your discussion of umeboshi (pickled plums), the text implies that plums used come only from Mito Ibaraki and are famous. Those Ibaraki plums may be famous, however the plums grow almost everywhere in Japan. In fact, I have two trees here at the temple where I live and I make umeboshi yearly. If I want to go for the really “famous” plums, I buy plums from Kii Hanto which are supposed to be the best for making big juicy umeboshi. Nowadays, young Japanese women seldom learn how to prepare their own “tsukemono” or pickles; they just buy them somewhere. But the traditional pickling recipes are numerous and, although salty by western standards, offer a great method for included lactofermented foods in the diet. In particular, “nukazuke”.
Overall with regard to traditional Japanese dietary customs, I think we can safely say that vegetables are the main item along with rice and fish base products. I would want to note however that “poor” Japanese cannot afford rice; traditionally the poor of past times were left to eat millet or barley instead of rice OR very thin rice gruel with some vegetables in it. Modern Japanese (post war) pay a huge portion of their monthly food allowance for rice which, (it is true) they feel they cannot do without. Nowadays, Japanese have come to love bread too (they invented the personal bread bakery electric device) but, for most, if they cannot eat rice for a few days, they feel something is lacking. If we allow that rice is the “wheat” of Asia, then dietary differences are most notably in the area of amount of fish consumed and soy product consumption PLUS (I feel this is very important) amounts of vegetables consumed. Compared to the typical American diet, not only is the overall amount of vegetables consumed greater but the preparation techniques used probably reduce nutritional loss. With the exception of B Vitamins which are notoriously lacking due to the white rice thing, intake of fat soluble and water soluble vitamins plus minerals probably exceeds by far intake characteristic of traditional American diets. Antioxidant consumption in traditional Japanese diets is considerable, in part thanks to green tea. This is, however, changing as Japanese turn to coffee and fried food consumption increases at the expense of vegetable dishes. Without a question, Japanese cuisine was never intended to be “vegetarian” and vegetable dishes are almost without exception flavored with meat or fish and, of course, soy sauce. But, vegetables are very important in Japanese cuisine. They are not the side dishes that Americans relegate their vegetables to.
I should say that the overall points of your article were, without question, correct. I really am glad to see this kind of information made available to people. I also think it is great to use the Japanese dietary profile to correct misconceptions about fat intake and heart disease, etc. and to make clear to those who would promote the idea that soy is the cure-all for osteoporosis that, indeed, Japanese women have a terribly high rate of osteoporosis despite soy consumption. Japan is not the land of Michio Kushi as many westerners would like to think. Thank you for bringing such points to light.
So, if we are careful with our generalizations about Japanese food habits and take care not to transmit mistakes in information, then I think Americans might be able to learn from the Japanese example. That is, providing the Japanese do not turn to western habits like McDonald’s and Mister Donut.
Emyo Jennifer Nakayama
Japan
Merrie Olde England
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 0 Comments 
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Pullets; Boiled capon; Shoulder of mutton; Veal roast; Boiled chickens; Rabbits roast; Shoulder of mutton roast; Chine of beef roast; Pasty of venison; Turkey roast; Pig roast; Venison roast; Ducks boiled; Pullet; Red deer pye cold; Four capons roast; Poults [young chickens] roast; Pheasant; Herons; Mutton boiled; Wild boar pye; Jiggits of mutton boiled; Jiggits of mutton burred [buttered]; Gammon of bacon; Chicken pye; Burred [buttered] capon; Dried hog’s cheek; Umble pye; Tart; Made dish.
Thus read the menu for a Monday morning breakfast served in honor of King James I’s visit to the northern English town of Preston in August of 1607. Dinner the previous evening featured thirty dishes for the first course and twenty-seven in the second.
Travelers of less exalted station did not find such elaborate banquets at the end of their day’s journey but nevertheless expected a variety of meats for their evening meal. John Byng, a guest at the White Swan Inn at Middleham in 1792 made the following inscription in his dairy: “I now felt a haste for dinner, and this is a description of it: Cold ham; A boiled fowl; Yorkshire pudding; Gooseberry pye; Loyn of mutton roast; Cheesecake.”1
Animal foods of every description served as the basis of the English diet for all but the poorest during the Shakesperean period-from game for the aristocrat, including beaver and boar, pheasant and heron, to domestic animals for the less privileged-beef, veal, lamb, mutton, pork, rabbit, chicken, pigeon, turkey, goose and duck. The diet also included organ meats such as liver, kidneys, tongue, calf heads, sweetbreads, brains, heart, ears and feet. The English Housewife, written during the early part of the 17th century, contains recipes for “puddings of a calf’s mugget [entrails]” and “roast cow’s udder.”2 Umble pie, made from the entrails or umbles of deer, was regarded as peasant food-the nobleman keeping the musclemeats of the deer he hunted, while the umbles went to his huntsman and servants. Haggis, made from finely minced organ meats mixed with oats and aged or fermented in a sheep’s stomach, nourished the hardy yeoman, particularly in the more northern parts of the island and in Scotland. Tripe (cow’s stomach) formed an important part of the diet, especially among the poor. Organ meats began to go out of fashion, particularly among the upper classes, during the Victorian era, but even today tripe is still sold in special shops in some parts of the British Isles.
Various sorts of puddings-black pudding, kidney pudding, marrow pudding, blood pudding, suet pudding and so on-also supplied nutrient-dense organ meats and fat to the English diet. These puddings came to the British Isles from the Romans who made urpuddings by pouring meat or blood, salt, spices and other ingredients into a skin of animal’s intestines. Sometines these puddings were then smoked. At some unknown date, the animal intestines were replaced with a pudding cloth and puddings came to be distinguised from sausages, smaller versions still encased in animal intestines. Later sweet things like raisins began to be added to these puddings, resulting finally in the Christmas pudding, containing sugar, pastry, dried fruits and suet. In some parts of the British Isles, these Christmas puddings still contained meat as late as the early 1800’s.3
Seafood for fast days (which amounted to almost half the days of the year) included trout, turbot, sole, whitebait, carp, cod, mackerel, anchovies, cockles, mussels, oysters, eel and crab. Salmon was brought in fresh from the Northwest of England to the London markets. According to the novelist Daniel Defoe, “This is performed with horses, which changing often go night and day without intermission, and, as they say, very much outgo the post, so that the fish come very sweet and good to London.” Fresh shellfish were available in season in the largest towns, paticularly near the seacoast. However, inhabitants of inland smaller towns had to content themselves with preserved seafoods, such as pickled or salted oysters. Oysters, being cheap, were a favorite food of the poor. “Poverty and oysters always seem to go together,” observes Sam Weller in Pickwick.
Dairy products added to the richness of the diet and, unlike meat and fish, were available to those on the lowest rung of the social ladder. Most peasant families owned a cow, or a cow together with a goat. “Why, sir, alas, my cow is a commonwealth to me,” says a rustic character A Looking Glass for London and England, “for first, sir, she allows me, my wife and son, for to banquet ourselves withal: butter, cheese, whey, curds, cream, sod [boiled] milk, raw milk, sour milk, sweet milk and buttermilk.”4 Eggs were used liberally in omelets, puddings and pastries.
Without refrigeration and cookstoves, food storage and preparation presented challenges to the housewife and innkeeper alike. Fortunately, salt needed for preservation was plentiful in England. Cattle were brought into the market towns in September and October. The beef was salted and then hung up in smoke to preserve it. Pork was likewise both salted and smoked to make bacon and ham. For poorer families, these were practically the only meats eaten during the winter months. Fish such as cod was preserved by salting, or, in the case of salmon, by pickling in salt brine, and transported in tubs to the larger markets. Another preservation method was “potting” in which shrimp and smaller fish such as trout were placed in small containers and covered with butter or other fat, mixed with spices.5
Dinners in the houses of the gentry could be elaborate affairs, with roast meats and “made” dishes-elaborate concoctions featuring dozens of ingredients, including a variety of spices. Chefs for the great lords often used a “cullis,” which was a stock made from large quantities of meat and bone cooked in water over a long period to extract all the goodness, after which the meat and bones were discarded, leaving a rich broth that could be used for sauces and “made dishes.”6
But most English households lacked ovens and utensils necessary for complicated dishes. Food preparation was achieved by slow boiling in pots hung over the hearth fire-the Christmas turkey or goose had to be carried to the baker’s for roasting. This meant that soups formed the mainstay of peasant diet, prepared by boiling bones, meat and vegetables in a pot over the fire. Soups were known either as “running” or “standing” pottages. A running pottage, or broth, was a thin soup containing bits of meat, and vegetable and herbs that were in season. A standing pottage was thickened with breadcrumbs or rice until it was similar in consistency to a present-day mousse.7 Sausages could be cooked on a grill or in a skillet-or even speared with a stick and held over the fire. Preparation of pudding-purchased from the butcher-was a simple matter of seething it in a pot over the hearthfire, resulting is a dish that was satisfying, nutritious and easy to prepare-a kind of Shakesperean take-out.
As for grains, rye, barley and oats were staple crops, made into coarse gruels or cakes. Oats and other grains were prepared as porridges or “frumenty,” by soaking them in warm water for 24 hours. They were served with butter or cream and honey or sugar.8 A Welsh recipe for “Llymru” reads as follows: “Mix oatmeal with sufficient buttermilk and water to make a liquid consistency. Leave for 2 nights then rinse through a hair sieve. Let it stand and pour off the surface water. Simmer for 40 minutes and keep stirring. Serve with sweet milk.”9
Oats and barley were also made into cakes, often cooked on a griddle. Before baking soda made its appearance, in the middle of the 19th century, such cakes would have been prepared using a natural yeast, and allowed plenty of time to rise before they were baked. In the north, dough made from oats was “clapped and driven out as thin as paper on a round board, then transferred to a round iron plate of like size and baked over the coals.” Such “clapbread” was crisp and wafer thin, like modern day crackers, and was eaten with butter and cheese.
Wheat was used for breadmaking among the upper classes and in the large towns. White bread made from refined flour was available from medieval times and held in high prestige. While the lower classes ate dark coarse bread, usually made with rye and often with peas or other pulses mixed into the dough, the upper classes regarded black and brown breads with aversion.10 White flour was also used for making pastries of various sorts-both those that enclosed meat dishes such as umble pie or chicken pasties, and those that served as a basis for dessert tarts and pies. Pastry dough was prepared by mixing butter, lard or suet with “fine white flour.”
Grains were also fermented into various sorts of ales and lagers-either by the housewife or in alehouses that existed in almost every town. These beers were an excellent source of nutrients including B vitamins, minerals and enzymes. Small beer, which contained only a small amount of alcohol but large amounts of lactic acid and beneficial enzymes, was traditionally consumed in the morning, accompanying a heavy breakfast of fish or cold meat, bacon and eggs.11 Strong beers, with their high content of alcohol, were recognized as providing “comfort for the poor.” The poet John Taylor recorded a total of nine different ales served at the same meal, during a visit to Manchester in 1618. Eight of them were herbal ales, flavored with hyssop, wormwood, rosemary, betony and scurvygrass. Wines from France and Spain were imported to England and found their way to almost every region; but they were beyond the means of most.
Farm families drank milk, buttermilk or whey. Whey, in particular, was recognized as a digestive aid and beneficial to the skin.12 It was served at the spas or baths-frequented by the well-to-do for “cures”-often mixed with herbs, fruit or wine.
Cookbooks from the period attest to the availability of a wide variety of vegetables including those of the onion family-onions, leeks and garlic-plus root vegetables, spinach, asparagus and artichokes. These were used in soups and stews, rather than served plain. Most cookbooks list a salad made of lettuces and herbs. In general, the upper classes looked upon vegetables with disdain, as a lower class food, to be eaten by the farmers who grew them.13 Potatoes and tomatoes did not gain acceptance until the Victorian era. As with meats, preservation of vegetables was a problem and most recipes books of the period contain a number of recipes for pickled vegetables-French beans, cucumbers, onions, cabbages, artichokes, mushrooms, asparagus, beet root, cauliflower, radishes, herbs and even walnuts and grapes-prepared with a salt and vinegar brine, then protected from the air with a weighted cover or a layer of butter or tallow. A number of foodstuffs, including mushrooms, walnuts, cucumbers and oysters, were added to “catsup,” originally a pickled fish sauce made from anchovies or other small fish, something like Worcestershire sauce. Writing in 1730, Dean Swift mentions catsup as one of several fermented foods favored by the English: “And for our homebred British cheer, Botargo (fish roe relish), catsup and cabiar (caviar).”
The British considered raw fruits to be “unwholesome.” Medical books of the period warned that fresh fruits “filled the body with crude and waterish humours, that dispose the blood unto putrefaction.”14 Apples, pears, quinces and berries were stewed or made into tarts, pies and other “puddings.”
Not all foodstuffs in wide use were locally produced. Since the Crusades, a variety of spices and other exotic foods had been available to the upper classes and to townspeople. In the Winter’s Tale, Shakespeare’s Perdita instructs the Clown to obtain foods for the sheep-shearing feast. Her shopping list includes rice, saffron, mace, dates, nutmegs, ginger and sugar. Almonds were another imported food, widely used, often made into almond milk which served as a thickener for sauces on feast days when dairy products were forbidden.15 Sugar and spices were used liberally to make piquant sauces, served with the ubiquitous cold meats, and in “made dishes” for the tables of the well-to-do.
Inhabitants of the British Isles enjoyed sweet desserts, sometimes made with honey but more often with sugar, which was available since the time of the Crusades. In fact, it was the British demand for sugar, even more than spices, that fueled the era of exploration and colonization. The English Housewife, published in Shakespeare’s day, calls for sugar in almost every dish-salads, omelets, fritters, pancakes, broth, boiled meat, stewed fish, roast meats, meat pies and of course dessert pies, tarts and puddings.16 Later it became unfashionable to use too much sugar in sauces and meat dishes, but the consumption of sugared foods continued to grow with the advent of confectioners and pastry shops in every town, and the popularity of a new custom-taking tea with sweet cakes in the afternoon. The widespread use of sweet wines added to the amount of sugar in the diet-often sugar was added to wines to make them sweeter.17 Large quantities of sugar in the diet were the cause of the proverbial English bad teeth. A visitor to England in 1598 said of the sixty-four-year-old Queen Elizabeth that her “teeth [were] black, a defect the English seem subject to from their too great use of sugar.”18
Until the Victorian Age, the British diet contained many protective factors that offset the deleterious effects of sugar-most notably organ meats, eggs and butter rich in fat soluble vitamins. Bone broths and whole grain products, including hearty ales, provided minerals in abundance and fermented foods provided enzymes. During the 19th century, these homespun foodstuffs were gradually replaced by factory produced foods-canned and pasteurized. Organ meats fell out of favor and the hearty English breakfast was replaced by toast and tea. In fact, tea became the national drink, replacing buttermilk and whey at the morning meal. The disruption of industrialization left many in extreme poverty. A survey taken in the 1840’s revealed that most factory workers were limited in their choice of food to white bread (now become cheap and available to the poor), cheese, butter, sugar, tea, salt and potatoes, with a small amount of bacon or other meat used for flavoring.19 The decline in the use of traditional foods, accompanied by crowding and unsanitary conditions in the major cities, paralleled the great rise of disease in the 1800’s-cholera, TB, diphtheria, typhoid fever and typhus. Later in the century fresh meat, vegetables and fruit became more available but the trend towards the use of fabricated foods was exacerbated with the introduction of margarine, as a substitute for butter, and bouillon cubes, as a substitute for the rich broths of earlier days.
In recent years, the English have been beguiled by claims for the “Prudent Diet,” one in which vegetable oils are substituted for animal fats and the use of cholesterol-rich foods is minimized. The suet, lard, butter, eggs and shellfish of Shakespeare’s day are spurned as unhealthful. These are the very foods that Weston Price discovered to be so necessary for attractive development, good health and successful reproduction. The diet of Merrie Olde England may not have been perfect, but it nourished a race that was energetic, curious, lusty, capable and strong. “Prudence,” said the English poet William Blake, “is a rich, ugly old maid, courted by incapacity.”
References
C. Anne Wilson, Traditional food east and west of the Pennines, Page Bros, Ltd, Norwich, England 1991, p 61.
Gervase Markham, The English Housewife, McGill-Queen’s University Press, 1986
Daniel Pool, What Jane Austen Ate and Charles Dickens Knew, Simon and Schuster, 1993, p 207
Michael R Best, Introduction to The English Housewife, Mc-Gill-Queen’s University Press, 1986, p xlvi
Wilson, op cit, p 49
Michelle Berriedale-Johnson, Olde Englishe Recipes, Judy Piatkus (Publishers) Limited of Loughton, Essex, 1981, p 13
Ibid, p 10
Ibid, p 122
Janet Douglas Pennant, More Llandegai Recipes, Sackville Printing Works, p 5
Stephen Mennell, All Manners of Food, Illini Books edition, 1996, p 303
Wilson, op cit, 59-60
Virginia Holsinger, et al, “Whey Beverages: A Review,” Journal of Dairy Sciences, Vol 57, August 1974, pp 849-859
Mennell, op cit, p 46
Best, op cit, p xxv
Constance B Heiatt, et al, Pleyn Delit: Medieval Cookery for Modern Cooks, University of Toronto Press, 1997, p xx
Gervase, op cit
Best, op cit, p xliii
Ibid, p xxxvi
Sally Mitchell, Daily Life in Victorian England, Greenwood Press, Westport, CT, 1996, p 122
Copyright: © 1999 Sally Fallon and Mary G. Enig, PhD. All Rights Reserved. First published in Price-Pottenger Nutrition Foundation Health Journal Vol 21, No 4. (619) 574-7763.
Dem Bones: Do High Protein Diets Cause Bone Loss?
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 0 Comments 
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Read this article in: Dutch

Myths & Truths About Osteoporosis
An estimated 15 to 20 million Americans suffer from osteoporosis–thinning of the bones leading to back pain, increased fractures, and frailty, frequently with extensive suffering. One theory proposed to explain its prevalence in the US is a diet that is high in protein, from excessive consumption of meat.
The protein theory was first presented in 19681 and followed up in 1972 with a study comparing bone density of vegetarians and meat eaters.2 Twenty-five British lacto-ovo vegetarians were matched for age and sex with an equal number of omnivores. Bone density, determined by reading X-rays of the third finger metacarpal, was found to be significantly higher in the vegetarians. Two years later, a study on North Alaskan Eskimos reported that bone loss, determined by a technique called direct photon absorptiometry, was significantly greater in Eskimos than in whites, and began at an earlier age.3 Although growth patterns and bone densities in children were similar for both groups, by age 70, Eskimos were found to have bone densities 15% below comparable whites, with Eskimos females at 30% below comparable whites. The authors of the study attribute the decline in bone mass to the high protein diet of the Eskimos, especially its high meat content. Some studies with animals, as well as further studies with humans, given diets high in protein also indicate a greater loss of calcium and thinner bones than controls on low protein regimes.
But the pioneering research of Dr. Weston Price indicates that we should not accept the protein theory without further study. Dr. Price found many groups throughout the world subsisting on high meat diets. Although he did not directly study bone density in these peoples, he did study their teeth. He found that groups on high meat diets–including Alaskan Eskimos–had a high immunity to tooth decay, were sturdy and strong, and virtually free from degenerative disease. Groups subsisting mainly on plant foods were less robust and had more tooth decay. Pre-Columbian skeletons of American Indians whose diets consisted largely of meat show no osteoporosis, while those of Indians on largely vegetarian diets indicate a high incidence of osteoporosis and other types of bone degeneration. The implication of Dr. Price’s research and other anthropoligical studies is that high meat diets protect against osteoporosis. How do we explain this discrepancy?
The research of Dr. Herta Spencer, of the Veterans Administration Hospital in Hines Illinois, supplies us with clues. She notes that the animal and human studies that correlated calcium loss with high protein diets used isolated, fractionated amino acids from milk or eggs.4 Her studies show that when protein is given as meat, subjects do not show any increase in calcium excreted, or any significant change in serum calcium, even over a long period.5 Other investigators found that a high protein intake increased calcium absorption when dietary calcium was adequate or high, but not when calcium intake was a low 500 mg per day.6
The textbooks tell us that the body needs vitamin D for calcium utilization, and vitamin A for both calcium and protein assimilation. Protein given as a powder lacks these fat-soluble co-factorsthat the body can use to build and maintain healthy bones.
Synthetic vitamin D, on the other hand, can cause hypercalcemia, a disturbance of calcium equilibrium leading to excessive blood calcium and calcification of soft tissues.7 Synthetic vitamin D added to commercial milk does not have the same beneficial effect as vitamin D from cod liver oil in preventing rickets and strengthening the bones.
Fats, especially animal fats, also supply usable vitamin K. This nutrient is associated with blood clotting–individuals who lack the ability to use vitamin K suffer from hemophilia and risk uncontrolled bleeding when injured. But Vitamin K also plays an important role in bone metabolism. Vitamin K is more available in dairy fats than in the oils found in green vegetables. Studies indicate that vitamin K is more completely absorbed from vegetables consumed with butter than with vegetables eaten plain.8 Vitamin K is also manufactured by intestinal flora. Use of antibiotics can inhibit vitamin K production, leading to bone loss. Consumption of lacto-fermented foods such as yoghurt and old fashioned sauerkraut promotes the growth of beneficial flora in the intestines, and hence contributes to healthy bones.
Fat soluble vitamin E also plays a role in promoting bone health, by protecting the calcium depositing mechanism from free radical disruption. In a recent study, investigators at Purdue University found that high levels of free radicals from omega-6 linoleic acid (found principally in corn, soy and safflower oils) interfered with bone formation, but that vitamin E gave needed protection in a diet high in polyunsaturates.9 In addition, they found that high levels of saturated fat also gave protection. That’s right, the much-maligned saturated fats, found in tropical oils, butter and other animal fats, play an important role in bone modeling. This may be a major reason that population groups in tropical areas, where coconut and palm oils form a major component of the diet, have very little osteoporosis.
Bone loss in women coincides with diminution of estrogen and progesterone at the onset of menopause. But archeological evidence indicates that menopause does not necessarily initiate osteoporosis. Human skeletons of Huguenot women ages fifteen to eighty-nine recently exhumed in London showed little difference in bone density between premenopausal and post menopausal women.10 Once again, the role of animal fats in the diet can explain this contradiction. Vitamin A in animal fats is absolutely essential for the health of the entire glandular system, and hence the continued production of regulating hormones throughout life. Hormone replacement often recommended for the prevention of osteoporosis is not an ideal substitute for the natural hormones produced in properly nourished bodies. Estrogen is also synthesized in the adipose (fat) tissue.11 Perhaps this is why women naturally gain some weight at menopause. The extra body fat supplies them with additional estrogen and protects them from bone loss. Maintaining a svelte figure in middle age, either through weight loss or liposuction, does not necessarily confer health benefits. Very thin women are much more at risk for bone loss than those who allow themselves to enjoy good, wholesome food and become pleasingly plump.12 Many women smoke cigarettes to keep their weight down, a habit that lowers estrogen concentration in the blood stream and inhibits its effects.13
Only a rich, wholesome and varied diet can supply the many nutrients needed for the complex process that maintains the integrity of our bones. Dairy products, vegetables, nuts, meat and old fashioned bone broths supply calcium. Dr. Spencer’s research indicates that post-menopausal women need about 1200 mg of calcium per day–400 more that the recommended daily allowance of 800 mg.14 One quart of whole milk, or six ounces of whole natural cheese supply the optimum 1200 mg of calcium. Individuals with a poor tolerance to milk products must take extra care to obtain sufficient dietary calcium. Fish, chicken or beef broth, prepared with a little vinegar to pull calcium from the bones, are excellent sources, and have supplied easily assimilated calcium to pre-industrialized peoples throughout the globe. Leafy green vegetables and grains, nuts and seeds are also good sources if properly prepared. Vegetables and grains should be consumed with animal fats like butter or eggs; and nuts, legumes and grains should be soaked, sprouted or sour leavened to neutralize phytic acid, a substance that can block calcium absorption.15
The “acid-ash” of meat is given as the reason high meat diets cause bone loss. But meats also supply phosphorus, which counteracts this acidity. Phosphorus is needed for the phosphate component of bone matter. Meats are also excellent sources of vitamin B12, which plays a recently discovered but little understood role in maintaining the integrity of the bones.16
Plant foods such as fruits, especially apples, nuts and grains supply boron, needed for the conversion of vitamin D to its active form, and for the formation of estrogen. Iodine found in natural sea salt, sea foods and butter helps maintain healthy ovaries and thyroid gland, both of which play a role in maintaining bone integrity. Magnesium, found in whole foods, also contributes to bone health as does natural fluoride, present in hard water as calcium fluoride. Chromium may also contribute to bone health by normalizing insulin activity. Type I diabetics are prone to osteoporosis. Chromium picolinate has been found to reduce the amount of calcium excreted in the urine and therefore may protect against bone loss.17 Refined carbohydrates such as sugar and white flour can cause chromium deficiency.
But sodium fluoride added to drinking water is one of a number of substances that is harmful to our bones. It causes an apparent increase in bone mass, but the bone structure is abnormal and weak.18 Recent studies indicate that hip fractures are more common in areas where water is fluoridated.19
The late distinguished dentist, Dr. Melvin Page, demonstrated that sugar consumption upsets the natural homeostasis of calcium and phosphorus in the blood. Normally, these minerals exist in a precise ratio of ten to four. Sugar consumption causes serum phosphorus to decrease and calcium to rise.20 The excess serum calcium, which comes from the bones and teeth, cannot be fully utilized because phosphorus levels are too low. It is excreted in the urine or stored in abnormal deposits such as kidney stones and gallstones. Caffeine also upsets the natural balance of calcium and phosphorus, and causes increased calcium to be excreted in the urine. Phosphoric acid in soft drinks is a major cause of calcium deficiency in children and osteoporosis in adults.21 Aluminum from antacids, cans and pollution also contributes to bone loss.22
Osteoporosis is often associated with excess consumption of alcohol.23 This is the likely explanation of bone loss in Eskimos, who are highly prone to alcoholism. The fact that the Eskimo is an obligate carnivore may also explain his susceptibility to both alcoholism and bone loss. Isolated groups like Eskimos and Irish sea coast peoples, whose traditional diet has been rich in marine oils, lack the desaturating enzymes needed to produce very long, highly unsaturated fatty acids needed for prostaglandin production.24 People with arctic or sea coast ancestry would be wise to supplement their diet with cod liver oil, a rich source of very long chain fatty acids needed for virtually every metabolic process.
Even small changes in the native diet of carnivorous populations render them vulnerable to degenerative disease like osteoporosis and alcoholism. A recent article on the Canadian Inuits indicates that commercial foods like jam, white bread and peanut butter have replaced some of the meat in their diet, even while they continue to maintain a traditional lifestyle.25
The 1972 study comparing British vegetarians and omnivores calls for additional comment. Bone density determinations through absorptiometry or X-ray are highly subject to error26, especially in unblinded studies where researchers may be biased towards obtaining pre-determined results. Subjects were matched merely for age, height and sex, but not for body composition and dietary habits such as smoking and sugar, coffee and alcohol consumption. A group of omnivores that smokes, drinks and indulges in a calcium-poor diet of refined carbohydrates will naturally have more of a tendency to bone loss than a group of health-conscious lacto-ovo vegetarians who consume plenty of dairy products. (British vegetarians do, in fact, tend to be very health conscious, avoiding not only meat but also alcohol, cigarettes, coffee and soft drinks. Unlike American vegetarians, they understand the importance of calcium-rich whole dairy products in the diet and eat plentifully of milk, cheese, butter and eggs.) When researchers compare the effects of high-meat diets to normal diets in the same person, no adverse effects are found, even over extended periods of time.27
Individuals who find they do better on high meat diets need not, therefore, worry about osteoporosis, as long as their diet includes complementary animal fats, plenty of calcium and a variety of other properly 
Liver Detoxification: Starve or Nourish?
Posted on November 17, 2014 by Tabitha Farrar • 19 Comments 
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Liver cleanses are in style these days, with many doit- yourself diets out there on the Internet. Detox and cleanse advocates will usually produce a bulletpointed list of why their specific liver cleansing protocol is healthy for you, why your body needs it, and why you are practically irresponsible if you choose not to go through with their protocol. However, upon closer inspection one soon realizes the lack of medical literature to support these claims.
In fact, many liver detox proponents seem to be blowing hot air. Even “The Master Cleanse,” a popular detox regimen which claims to be the most successful cleanse diet of its type and which thousands of people undertake each year, has no scientific grounding—a shocking fact considering the number of people who participate in it on a regular basis! This so-called “Lemonade Diet,” promoted by Mike Olaski, claims to “rest and relieve” the digestive system. However when viewed from a biological understanding of the liver and how it functions, it is clear that the master cleanse does no such thing. In fact, it might actually work to put stress on the liver and deprive it of nutrients, and consequently have the opposite effect of its purported claims.
Other liver detox diets, such as the liver cleanse promoted by Jon Barron, or Dr. Oz’s forty-eight hour liver cleanse, are similar, promising magical results on a starvation regime of vegetable juices and vegetable broth. These regimes often include detox formulations that contain a mix of herbs and other compounds. In this article I will address the claim that a juice cleanse is an effective way to detoxify or cleanse the liver.
DETOXIFICATION
Detoxification is a term given to the process of removing toxins from the body. A toxin is a poison, so it is understandable why many people feel that embarking on a detox diet in order to lower their levels of toxicity is a good idea. Lowering the levels of toxicity in one’s body is something that all health enthusiasts, regardless of their particular school of thought, agree is beneficial to health. However, how to achieve this goal is a much more controversial issue.
Detoxing and cleansing product advocates will claim that the most effective way of removing toxins from the liver is via a detox diet or cleanse, usually one that involves some form of juice or a product that can be purchased on the Internet. It is important to understand that the detoxification industry is an industry like any other, and like any industry, there are people who want to make money from your belief that you need their product. Many seemingly genuine health gurus who tout the acclaimed health benefits of liver cleanses have an underlying motivation to promote their own special detox plans. That motivation often comes down to a desire for cash.
However, the idea of lowering the amount of toxins within one’s body is arguably a commendable route towards greater health. It is undeniable that we exist in a toxic environment: pesticides sprayed on vegetables, phthalates in plastics and cosmetics, chlorine in household cleaners, PCBs and heavy metals in farm-raised fish, and antibiotics and dioxins in commercially produced animal products are just a few examples of toxins that are in most people’s environment every day. Even those of us who take extreme care to eat only organic foods, avoid commercial cleaners, and make our own skincare products are affected by the levels of chemicals that industrial mechanisms have put into our environments.
It is helpful to understand that every chemical is toxic at a certain dose, even water! Dose is important to consider, not only because it teaches us that balance is relevant to everything in our lives, but also because the dosage levels of toxins in our environment are accumulating to higher amounts each year. For example, according to the Environmental Protection Agency, releases of toxins on land rose by 19 percent from 2010 to 2011, primarily due to increases in land disposal at metal mines. As a result of all these factors, discussion of detoxification is now more relevant than ever before, but that does not mean that a juice cleanse will help lower levels of overall toxicity, or that doing so is actually beneficial to one’s liver.
CLEANLINESS AND CLEANSING
Cleansing is a term that is commonly used to describe the process of cleaning one’s system by severely restricting food intake. Liver detox juice cleanses are purported to work on the assumption that in abstaining from food, one is giving one’s system a chance to push out the toxins that may have accumulated. Interestingly, the dictionary definition of “cleanse” is “to free from dirt or guilt; purge or clean.” Utilizing the term “cleanse” is a clever subliminal marketing word choice that leads consumers towards lofty aspirations of greater purity.
It is important to understand before embarking on a detox protocol the role the liver plays in the body, and whether a detoxification diet will in fact be effective in supporting the liver.
The word “liver” is rather aptly derived from the Old English word for “life,” in full regard of the many functions that the liver has within the body. The liver has the ability to synthesize the proteins that the body needs and also makes bile so that food can be digested, but the function that the liver is most famous for is detoxifying the blood.
Most people understand that their liver is where the toxins go, although thinking of it as a dumping point for toxins is not entirely accurate. Most food substances that enter the human body go to the liver from the small intestine for sorting via the portal venous system. The liver sorts out what to keep and what to get rid of.
The blood passes through the liver, which takes out harmful chemicals before, one hopes, they reach toxic levels. They are then made water-soluble so that they can be sent out of the body via sweat or urine. Therefore what happens in the liver is a form of filtering, but it is not like the lint filter in your tumble dryer that regularly clogs up. In a healthy body, toxins leave the liver pretty soon after they come in. They are not merely dumped there as though the liver were a landfill.
Because many toxins are fat-soluble, large quantities of such toxins that enter the body can be stored in fat. It is true that they may be stored in the fat cells in the liver, and that this is not desirable. However, in a healthy functioning body, which is being fed a balanced diet, this is rarely a problem as the liver does a very good job of discarding the toxins that enter the system in a timely manner.
Should one want or need to detoxify the liver at all, it is not quite as instant, simple and easy as spending a day or two (or ten) on a juice cleanse. To get these fat-soluble toxins out of storage is a multi-stage affair. Cleansing for a few days is unlikely to affect the liver directly and may actually deplete it of essential vitamins and minerals. For the majority of the population it seems somewhat misguided to go on a cleanse regimen in order to clear the liver, which is probably doing a good job already!
The truth is that most detoxification diets have less of a direct effect on cleansing the liver than advocates would have you believe. While detox diets might be a step towards healthier eating for a person whose standard diet is high in processed foods and toxic beverages, in reality most people who undertake liver cleanses are those who already eat a relatively healthy diet. Unfortunately, it is the more health-conscious individuals who are attracted to the health-boosting claims touted by detox gurus.
So from this biological point of view, one could argue that a detox diet may be somewhat ineffective, but there are also researchers who point to detox diets as being potentially damaging, mostly because people wrongly believe that if they “do” a detox once a year, that gives them a free ticket to eat and drink whatever they like the rest of the time.
Another concern arises from the premise that when a person embarks on a detox diet, the drastic reduction in calories, fat and protein forces the body to metabolize its fat stores for energy. As the fat stores are rapidly converted into more usable energy, any fat-soluble toxins that have been stored within them are released into the bloodstream in larger amounts than is normal. This means that the liver suddenly has a massive amount to process in a short space of time. This is how detoxification diet advocates claim that their cleanse protocols force the body to release toxins, and this is why some people claim that they feel slightly euphoric when on a detox regimen while others can feel headachy or sick.
In order to clarify the importance of proper nutrition in the way the liver works when detoxifying naturally, we must understand the process by which the liver breaks down unwanted chemicals. The process can be divided into two main stages.
STAGE ONE: OXIDATION
A special set of enzymes, called the cytochrome P450, are needed to alter the chemical makeup of the toxin that is being stored within the fat cell. The particular enzyme from the group that is used at any one time is different depending on the specific toxin that needs to be altered, but usually this reaction makes the toxin more reactive and more water-soluble. This chemical reaction causes free radical release, so antioxidants are important here, as they reduce the damage that free radicals can cause. Nutrients that are required in this part of the process include the fat-soluble vitamins A, D and E; therefore a diet that eliminates fat can be problematic for the liver as these vitamins may be depleted.
After stage one is complete the toxin is very reactive, so it is important that the body has the enzymes that are required for stage two so that it can happen soon after.
STAGE TWO: CONJUGATION
Here the liver continues to work on the chemical that it is trying to release from the fat cell. Its job now is to make this toxin even more water-soluble, so that it can be excreted via urine or bile. The liver usually achieves this by adding another substance to the toxin which dilutes it. Sulfur-containing foods such as egg yolks and amino acids such as taurine and cysteine are important in this stage of detoxification. These amino acids are also found in grass-fed meat and dairy products. If you are not eating these foods regularly, a detox regimen could potentially deplete your stores of these amino acids or the elements that are needed to synthesize them. Should this happen, your body might not be able to process the toxin from stage one into stage two, which will leave you with highly reactive toxins in your system.
So far this is a massive simplification of a very complicated system, yet it will give you a basic understanding of the incredible process involved in detoxification, and just what a great job your liver does on a daily basis. This should also help you understand that your liver needs specific nutrients in order to detoxify well. Your liver does not require a juice cleanse to do its job, and such measures could potentially be unhelpful and even rather meddlesome. This is because you are giving your liver much work all at once and may have depleted the enzyme stores that it needs in order to break down the fat-soluble toxins released in response to your detox regimen.
FATS HELP LIVER FUNCTION
There is another way that you can detoxify your liver, and that is by eating healthy fats. In the simplest form, when you eat fat, your liver releases bile to metabolize the fat. Bile helps the body metabolize those essential fat-soluble vitamins. As bile is a crucial part of the natural detoxification process within your body, if your bile levels are adequate you will eliminate toxins efficiently. One of the ingredients in bile is cholesterol; therefore if you are not consuming enough cholesterol your body will not be able to produce an adequate amount of bile. Cholesterol is found along with healthy fats from grass-fed animals, so eating these foods is a wonderful way to help your body detoxify. The key to a healthy detoxification regime is to do it gradually so that you do not overwhelm your body with a flush of toxins.
Detox cleanses seem to treat the body like a machine, as if it were a car that one could drain of its dirty oil at once and swap it for clean oil. Bodies are not cars, and changes in what is introduced into one’s body usually need to be made slowly so we can adjust and make the necessary metabolic changes. Few systems in the body change instantly. By design our bodies tend to alter themselves incrementally. For this reason, a better way to cleanse the liver is a long-term habit of eating healthy fats rather than a short bout of juice cleansing.
Another consideration when you are thinking about ways to detoxify is to look at the stressors present in your life. When you are stressed, your liver will focus less on detoxification because your body will be operating within its sympathetic nervous system. When the body is dominated by the sympathetic nervous system it diverts resources to the muscles (fight or flight) and away from organs (rest and digest). Stress affects our bodies in many different ways: our muscles tighten and energy is shunted away from our repair and renewal system—and this means that we will not be detoxifying optimally. For this reason, our bodies will store more toxins in fat cells when we are stressed because they do not have the energy required to convert and excrete them.
GELATIN AND RAW MILK
If your diet is full of highly processed foods and toxic drinks, a better plan than a cleanse would be turning to long-term healthy eating. As far as detoxing and the liver are concerned, if you already have a relatively healthy diet, you may be better off focusing on adding more of the foods that deliver those nutrients your liver uses to detoxify. To do something wonderful for your liver, give it a greater supply of nutrient-dense foods, such as cod liver oil, pastured butter, egg yolks, liver and bone broth. Bone broth in particular is an incredible source of nutrients, especially gelatin, which is very beneficial for the digestive tract as well as the immune system and heart.
Gelatin contains proline and glycine, which are amino acids that support liver detoxification. The human body can generate both of these amino acids itself, but if the idea of a cleanse is to give the body a restful experience, then eating foods that offer an abundant supply of such wonderful nutrients is surely the most advisable route to greater health.
You might also consider adding more exercise to your life. In a study with laboratory rats whose running wheels were removed from the cages, it was shown that they began to show signs of fatty liver disease after only a week of a sedentary life. In fact, this study demonstrated that fatty liver disease developed in 100 percent of the rats that had their running wheels removed—a staggering case for the role of physical activity in health.
The best thing that one can do for one’s liver is to eat foods that are low in toxins in the first place; choose organic produce that has not been sprayed with chemicals and limit the intake of processed, commercially produced foods as much as possible. These foods are nutrient-sparse and abundant in toxins. Grass-fed meats and dairy are richer in healthy fat-soluble vitamins A and E, which are involved in synthesizing those enzymes the body needs to break down the fat-soluble toxins in stage one of the detoxification process.
You may also want to consider raw milk produced by cows that are grazing on fields that have not been sprayed by toxic pesticides—an incredibly good source of fat-soluble vitamins A and D. When cows are fed commercial feed, shut in small stalls and deprived of sunlight, these vitamins are diminished. Because pasteurization destroys enzymes, denatures proteins, and lowers the vitamin content of the milk, raw milk is a much more nutrient-dense food.
Raw milk is also a wonderful source of glutathione. Glutathione is an incredible detoxifier and has been elevated to the status of “master antioxidant” by many nutritionists because it increases the activity of all the other antioxidants as well as vitamins C and E. Glutathione is comprised of three amino acids: glycine, glutamate, and cysteine, all found in undenatured form in raw milk. One can take oral supplements of glutathione, but these have been shown to be poorly absorbed rendering them a waste of time and money. There is also some evidence that supplements in this form may interfere with the natural process of glutathione production in the body. The best way to increase levels of glutathione is to digest it by consuming raw milk, as well as red meats and organ meats. Additionally, raw whole milk provides vitamin D, which increases intracellular glutathione.
The same “supplement charade” is true of calcium. Calcium glucarate is helpful in the stage two part of the detoxification process, specifically, in the glucuronidation stage where toxins are bound to water substances such as bile so that they can be removed. Raw milk and raw milk products are our best sources of usable calcium however it is believed that it is not the calcium that is active but the glucarate (http://examine.com/supplements/Calcium-D-Glucarate/).
The take-home message is that your liver is an incredible organ that seamlessly performs a number of essential functions in your body every day, and it can do its job without the intervention of a commercial cleanse. If you want to help your liver detoxify your body, the best thing that you can do is eat nutrient-dense foods such as organic free-range eggs, liver and meats, homemade bone broths, as well as full-fat raw dairy. These healthy foods will provide your liver with a rich supply of vitamins, amino acids and minerals and help it do what it does best: detoxify.

SIDEBARS
MIKE OLASKI’S MASTER CLEANSE OR LEMONADE DIET
The Master Cleanse involves three phases:
Ease-In: 3 days of slowly removing processed foods from your diet.
The Lemonade Diet: “10 days to lose weight fast, and feel great at last.”
Ease-Out: 3 days of slowly eating more and more complex foods.
The magic “lemonade” consists of fresh lemon juice, maple syrup, cayenne pepper and water. Olaski suggests drinking a minimum of six to twelve glasses per day, for a total of ten days.
Apparently this cleanse is not so great for the bowels because Olaski recommends taking a laxative before bed and doing the “salt water flush” in the mornings. This consists in drinking a quart of warm water to which is added one tablespoon of salt.
Says Olaski, “Every day of the Master Cleanse that you overcome the psychological need to eat, you feel a growing sense of control that motivates you to complete the process.”
DR. OZ’S 48-HOUR WEEKEND CLEANSE
Dr. Oz’s 48-Hour Weekend Cleanse “is based upon eating certain ‘detoxifying’ foods that he thinks will keep [your] systems running smoothly. The plan couldn’t be simpler to follow so you’re not always focused on what to eat next.”
The cleanse starts with a breakfast of quinoa with prunes, nutmeg, grated ginger, flaxseed oil and rice milk. Lunch is a smoothie of almond or hemp milk, flaxseed, frozen blueberries and banana, all blended with ice. Dinner is a vegetable broth soup served with a side of sauerkraut.
Snack items allowed include a blended drink of kale, pineapple and ginger or a mixture of pineapple, lemon and
pomegranate juices. Raw vegetables are also allowed as snacks.
Dr. Oz’s also promotes a three-day detox cleanse that will “eliminate harmful toxins and reset your body.” The program consists of a morning detox tea, multivitamins, and smoothies containing flax seeds, fruit, spinach, kale, almond butter, almond milk, coconut water and coconut oil.
JON BARRON’S LIVER DETOX & BLOOD CLEANSE
This program is promoted with the following promise: “By cleansing the liver, we’re talking about inducing the liver to purge all of the fats, old cholesterol deposits, gallstones, poisons, drug residues, and toxic waste stored therein. Probably nothing else you do (including even the colon detox) will make a greater difference in your overall health. The liver is so important to our well-being that many healers maintain that most diseases cannot develop in the body (that, in fact, no form of cell degeneration can occur) if the liver is functioning in an efficient, healthy manner. Conversely, an unhealthy liver is very likely at the root of most serious health problems.”
The cleanse begins with 8 ounces of pure water on arising, “to flush your digestive tract,” followed by a smoothie
made with fresh citrus juice, fresh apple or grape juice, garlic, olive oil, and ginger, blended with water. Liver detox teas and tinctures are consumed throughout the day. Fresh salads with homemade dressing are allowed. He also recommends potassium broth (made with potato skins), grated beets, digestive enzymes and herbal “blood cleansers.”
TRUE DETOX SOUP
This recipe incorporates a number of potent ingredients for a most nourishing and detoxifying broth:
Several pounds of bones optimally from grass-fed/pastured animal sources
1 diced onion (onions contain cystine, an amino acid which the liver uses to produce the powerful antioxidant glutathione)
1 head of garlic, crushed
A couple of pounds of mixed, chopped organic vegetables. (Sulfur-rich vegetables will increase your stores of glutathione.)
Celtic sea salt to taste
A dash of raw apple cider vinegar to help extract the minerals from the bones
About 1 gallon of water, or enough to cover the bones
Place all ingredients in a large pot and bring to the boil, reduce the heat and simmer for 4 hours or longer. The longer it cooks the better, as the simmering water will extract more gelatin from the bones. Don’t be afraid to allow it to simmer for up to 72 hours! Drain broth and discard the bones.
To serve as soup add some chopped vegetables, fresh garlic and chopped ginger. Once the vegetables are cooked blend and serve with sourdough bread and grass-fed butter.

RESOURCES
•	Rector, RS et al. Cessation of Daily Exercise Dramatically Alters Precursors of Hepatic Steatosis in Otsuka Long-Evans Tokushima Fatty (OLETF) Rats. The Journal of Physiology, Sept. 2008. 
•	Harvard Health Publications. The dubious practice of detox. HealthBeat Newsletter July 2008. 
•	Lipid Detoxification, Whole Health Network, Mark Squibb, http://publications.whnlive.com/. 
•	Naish, J. (2011, December 12). The great detox deception: From mud wraps to drinking syrup, detoxes are ‘pointless, dangerous claptrap.’ 
•	Tendler D., Lin S., Yancy Jr. W.S.,Mavropoulos J., Sylvestre P., Rockey D.C., Westman E.C. The Effect of a Low-Carbohydrate, Ketogenic Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study. Digestive Diseases and Sciences. 2007. 
•	Alternative Detox, British Medical Bulletin, http://bmb.oxfordjournals.org/content/early/ 2012/01/31/bmb.lds002.full.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2014
Tabitha Farrar

Tabitha Farrar is author of the book Love Fat which is due to be released at the end of this year. She works as a health editor and writer, yoga instructor, and is a strong advocate for a diet high in nutrient-dense foods. Her twitter handle is @Love_Fat_
Meat and Wapatos—Was the Paleolithic Diet Actually Low in Carbohydrates?
In a most interesting thesis, anthropologist Melissa Darby postulates that in the Northern hemisphere as the ice sheet was retreating, there were considerable wetlands that supported Sagittaria latifolia, an emergent wetland plant spread by waterfowl and known as a pioneering plant because it was one of the first to colonize these areas. It grows as a monoculture and can take over a wetland. On the lower Columbia River and in the Mississippi delta there are places where there is no other plant except S. latifolia for hundreds of acres. The Chinook Indians called these tubers wapatos. Darby suggests that S. latifolia was widespread in 10,000 BC in the shallow lakes, ponds, streamsides and wetlands that were draining the water from the ice sheet (PhD Thesis 1996, Portland State University).
S. latifolia produces a tuber that tastes like a potato, cooks as fast or faster than a potato and does not need to be processed with stone tools. It can be baked in hot ashes so it is hard to find in the archaeological record. It is available and harvestable from early fall to mid-spring when plant foods are generally considered to be scarce, and was very cost effective to harvest. It dries well and can be stored for long periods of time. It has been recovered in Paleolithic sites in Poland and in the caves in the Great Basin.
This does not mean that the Paleolithic diet was high in carbohydrates in the same way that modern diets are high in carbohydrates (mostly refined carbohydrates), but it does indicate that the diets of primitive man contained some high-carbohydrate foods.

The Optimal Diet
Taking Dr. Atkins one step further is Polish doctor Jan Kwasniewski, who recommends an extremely high-fat, low-carb diet in his book Optimal Diet. His rationale is the claim that mother’s milk contains the proportions of 1:3.5:0.3 of protein to fat to carbohydrates. Actually, the proportions of mother’s milk are more like 1:7:5. Human milk contains only 6 percent of calories as protein, with 54 percent of calories as fat and 40 percent as carbohydrates—proportions that definitely exclude human milk from USDA recommended foods! While Kwasniewski is mistaken about the composition of mother’s milk, his adherents claim relief from many ailments. Kwasniewski forbids all refined carbohydrates and recommends consumption of plenty of saturated fat and bone broth, both of which supply nutrients sadly lacking in modern western diets.

Can Low-Protein, High-Carbohydrate Diets Be Healthy?
Although most of the diets described by Dr. Weston Price contained generous amounts of animal foods, a few were characterized by low levels of animal foods and a high carbohydrate intake. Several African groups consumed insects, small dried fish and shrimp, and small amounts of shrimp paste as their chief animal foods, with large amounts carbohydrates from tubers, grains, fruits like bananas, and vegetables. Natives of the high Andes consumed small amounts of animal foods in the form of Guinea pigs and dried seafood, particularly dried fish eggs, with large amounts of carbohydrates from potatoes and grains. Even the Swiss diet was relatively low in protein (milk has 2 percent of calories as protein, Swiss cheese has 23 percent of calories as protein) and high in carbohydrates from bread and milk. Protein intake may have been less than 10 percent in these diets, and carbohydrate intake in the range of 60 percent, yet these groups had excellent dental health and a high level of overall good health.
These healthy high-carbohydrate, low-protein diets have several factors in common. One is that the animal foods were of exceptional quality. Insects, dried fish, shrimp, fish eggs and butter from pasture-fed cows are all excellent sources of the fat-soluble activators. Secondly, the carbohydrate foods were usually fermented, a process that greatly increases nutrient values and makes minerals more available. Finally, these diets contained no refined or devitalized foods.
A low-protein, high carbohydrate diet is risky for those living in the industrialized world, where nutrient-dense animal foods like insects and fish eggs are avoided, where carbohydrate foods are not usually fermented, and where it is difficult to completely avoid refined and devitalized foods. Higher levels of animal foods in conjunction with quality animal fats supplying ample amounts of vitamins A and D, provide an extra measure of protection in western diets.
The following letter was received in April 2006 from a member in Poland: Dear WAPF Team, Further to your comment may I point out to you that it is not Dr Kwasniewski who is mistaken in his calculations. It is your analysis, which mistook calories for grams. Dr K gives his proportions in grams, as this is the practical way to control food intake. However, in energy terms, he clearly says in his writings that in human milk, depending on mother’s diets, well over 70% comes from fats. Plus, the baby’s body converts 90% of the lactose into TGL & fats, too, so a baby’s body runs mostly on fats, protein and the remaining 10% of lactose – for the building purposes. Best regards and thank you for your wonderful work, especially that you are doing it in the U.S., the land of the profit above all.–Izabela Niewiadomska (Poland)	

BALANCE OF PROTEIN AND CALORIES
Proteins need to be consumed in the right proportion to fats. Studies with chickens tell us more about proteins, fat and cholesterol. In one study,21 we varied the fat-to-protein ratio in the diet. When the amount of protein in the diet was increased compared to the amount of fat in the diet, the cholesterol level in the chicken’s blood dropped, and they had less fat on their bodies. The type of fat consumed made no difference. A “hard” fat such as beef tallow gave results similar to a “soft” fat such as corn oil.22,23 Translating this to people means that if you’re going to eat lots of fat of any kind, make sure you eat enough protein to lessen the increase in cholesterol and weight gain.
One way of monitoring the level of protein-to-fat is through the E/P ratio (energy/protein) of a food item or diet.21 Energy here is measured in calories, which are really units representing the energy-producing potential of a food. The E/P ratio is calculated by dividing the total calories in the food item or diet by its protein content. For example, white bread has an E/P ratio of 32 (275 calories divided by 8.5 percent of protein.) It is possible to label a food item for its energy content (E/P ratio) and thus add information to present food labeling. This ratio can be a measure of “empty calories,” that is, foods likely to contribute to obesity, but without the nutrients required for good health. Low E/P ratios are good and high E/P ratios, bad, for our diets; thus an E/P ratio of 12 is good, and one of 65 is bad. As you can see from Figure 18, fish products, meats, milk, and eggs have a low E/P ratio; candy bars, doughnuts, cookies, and pies have a high energy-to-protein ratio. The E/P ratio of a meal can be drastically changed by an increase of a single food item such as a doughnut or by the deletion of a food item such as an egg.
We’ve explained how the balance between protein and calories is measured. Now we need to look at why this balance is important. The physiological reasons for needing a certain balance of protein and calories are complex; in general they have to do with the fact that it is the proteins that carry the fat, or lipids, in the blood. As previously stated, any excess calories we take in are converted into fat in our bodies, and we need additional protein to cope with it. It is a vast oversimplification, but we might think of protein as a kind of “fat-antidote.” However, too many calories from any source overwhelm the system so protein no longer can work as an antidote and the antidote analogy breaks down. The total caloric intake is the problem, not just the fat-to-protein ratio. Eventually that extra fat is deposited in various places in our bodies.
DANGER OF PROTEIN EXCESS
Because protein is such an essential building block and has that fat-antidote link, some diet specialists have suggested making it the key food to consume. But this is not a good idea nutritionally. When no other nutrients are available, the body has only protein to use for energy. In order for protein to be converted to calories, the kidneys must remove nitrogen from the amino acids to convert them into a usable form of energy. This process is called deamonization. It overworks the kidneys, which can have some long-lasting, negative effects. An illustration of this comes from some early explorers in the U.S. who died after consuming a diet of rabbits. Rabbit meat is very lean and very high in protein. These early explorers had what was called “rabbit-starvation,” since they relied on rabbits for their food.4 Without other nutrients, their bodies could not cope with the protein. Even Lewis and Clark noted the effects of too much protein in the diet. However, when explorers ate what was called “pemmican,” they survived; pemmican contains both protein and fat. Today, a diet overloaded with protein also taxes the kidney. In other words, good diets must include a variety of nutrients.
PROTEIN DEFICIENCY
As previously stated, protein deficiency is a serious matter. Growing children, especially, need large amounts of protein and are particularly sensitive to its quality. If they do not get enough of the right kind, their general growth and development suffers—their minds as well as their bodies. In the unborn child and young infant, too little protein means that the cells do not form in sufficient numbers, and the cells that are formed are smaller in size. The child’s growth is stunted, and no amount of protein consumed later in life can repair the damage. Protein deficient infants face a lifetime of being smaller, weaker, and less vital—physically, mentally and emotionally—than they need to be.
Protein deficiency can also be lethal. Children studied in hunger-torn Bangladesh in 1970-71 who were protein-deficient had a death rate four and one-half times higher than better nourished children in the same locality. Increases in protein can make a dramatic difference in the average physical development in whole populations. In Japan, over the period 1900-1955 when the national consumption of animal protein was increasing, sons grew two inches taller than their fathers, and daughters matured two years earlier than their mothers.6
PROTEIN AND HEART DISEASE
Protein is not only important for growth, but also for the prevention of heart disease. Protein carries fat throughout the body. If it is deficient, then fat gets deposited on the body, rather than whisked through it. However, if there is too much fat, even the protein cannot handle it and it still gets deposited. It’s been shown that people in lower income brackets even in industrialized nations have more heart disease than those in higher brackets; this may be due to the former eating less protein in relationship to the amount of fat consumed.

Mineral Primer
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 3 Comments 
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As the remarkable properties of vitamins have revealed themselves to investigators, so too have those of the various minerals in our food and water. The seven macrominerals– calcium, chloride, magnesium, phosphorus, potassium, sodium and sulphur–now share the research spotlight with a longer list of essential trace minerals. These are needed only in minute amounts, but their absence results in many disease conditions. The number of trace minerals known to be essential to life now exceeds thirty, and some researchers believe that for optimum health we need to take in every substance found in the earth’s crust. Along with familiar trace minerals, such as iron and iodine, the body also needs others less well known, like cobalt, germanium and boron.
Mankind ingests minerals in a number of different forms. He can take them in as salts; that is, as molecules in which a negatively charged atom is bonded ionically to a positively charged atom as in common table salt (sodium chloride) or less well-known salts such as magnesium chloride, calcium phosphate or zinc sulfate. In water and other liquids, these form a solution as the salts dissolve into positively and negatively charged mineral ions.
Minerals are also ingested as integral parts of the foods we eat, in which case the minerals are held ionically in a claw-like way or “chelated” by a large molecule. Examples include chlorophyll (which chelates a magnesium atom), hemoglobin (which chelates an iron atom) and enzymes that chelate copper, iron, zinc and manganese.
Minerals are usually absorbed in ionic form. If they are not in ionic form when consumed, they are ionized in the gut, with salts dissolving into their two components or chelates releasing their key elements. The system by which mineral ions are then absorbed is truly remarkable. If, for example, the body needs calcium, the parathyroid gland will send a signal to the intestinal wall to form a calcium-binding protein. That calcium-binding protein will then pick up a free calcium ion, transport it through the intestinal mucosa and release it into the blood.1 Manganese and magnesium have similar carriers and their absorption, retention and excretion is likewise governed by complex feedback mechanisms involving other nutrients and hormonal signals. Absorption and excretion of phosphorus is regulated in part by activity of the adrenal glands and vitamin D status.
There are a number of factors that can prevent the uptake of minerals, even when they are available in our food. The glandular system that regulates the messages sent to the intestinal mucosa require plentiful fat-soluble vitamins in the diet to work properly. Likewise, the intestinal mucosa requires fat-soluble vitamins and adequate dietary cholesterol to maintain proper integrity so that it passes only those nutrients the body needs, while at the same time keeping out toxins and large, undigested proteins that can cause allergic reactions. Minerals may “compete” for receptor sites. Excess calcium may impede the absorption of manganese, for example. Lack of hydrochloric acid in the stomach, an over-alkaline environment in the upper intestine or deficiencies in certain enzymes, vitamin C and other nutrients may prevent chelates from releasing their minerals. Finally, strong chelating substances, such as phytic acid in grains, oxalic acid in green leafy vegetables and tannins in tea may bind with ionized minerals in the digestive tract and prevent them from being absorbed.
Several types of mineral supplements are available commercially including chelated minerals, mineral salts, minerals dissolved in water and “colloidal” mineral preparations. A colloid is a dispersion of small particles in another substance. Soap, for example, forms a colloidal dispersion in water; milk is a dispersion of colloidal fats and proteins in water, along with dissolved lactose and minerals. Colloidal mineral preparations presumably differ from true solutions in that the size of the dispersed particles is ten to one thousand times larger than ions dissolved in a liquid. Colloidal dispersions tend to be cloudy; or they will scatter light that passes through them. Shine a flashlight through water containing soap or a few drops of milk and its path can be clearly seen, even if the water seems clear.
There is no evidence that the body absorbs colloidal mineral preparations any better than true solutions of mineral salts or minerals in chelated form. Many so-called “colloidal” formulas often contain undesirable additives, including citric acid, that prevent the mineral particles from settling to the bottom of the container. Furthermore, these products may contain an abundance of minerals that can be toxic in large amounts, such as silver and aluminum. Even mineral preparations in which the minerals are in true solution may contain minerals in amounts that may be toxic. If a product tastes very bitter, it probably should be avoided.
Some commercial interests sell minerals chelated to amino acids which they claim do not break down in the gut, but which pass in their entirety through the mucosa and into the blood, thus bypassing certain blocks to mineral absorption. However, such products, if they work, bypass the body’s exquisitely designed system for taking in just what it needs and may cause serious imbalances. Obviously, such formulations should be taken only under the supervision of an experienced health care practitioner.
The proper way to take in minerals is through mineral-rich water; through nutrient-dense foods and beverages; through mineral-rich bone broths in which all of the macrominerals–sodium, chloride, calcium, magnesium, phosphorus, potassium and sulphur–are available in ready-to-use ionized form as a true electrolyte solution; through the use of unrefined sea salt; and by adding small amounts of fine clay or mud as a supplement to water or food, a practice found in many traditional societies throughout the world. Analysis of clays from Africa, Sardinia and California reveals that clay can provide a variety of macro- and trace minerals including calcium, phosphorus, magnesium, iron and zinc.2 Clay also contains aluminum, but silicon, present in large amounts in all clays, prevents absorption of this toxic metal and actually helps the body eliminate aluminum that is bound in the tissues.3
When mixed with water, clay forms a temporary colloidal system in which fine particles are dispersed throughout the water. Eventually the particles settle to the bottom of the container, but a variety of mineral ions will remain in the water. These mineral ions are available for absorption, while other minerals that form an integral part of the clay particles may, in some circumstances, be available for absorption through ionic exchange at the point of contact with the intestinal villi.
Clay particles, defined as having a size less than 1-2 microns, have a very large surface area relative to their size. They carry a negative electric charge and can attract positively charged pathogenic organisms along with their toxins and carry them out of the body,4 Thus, clay compounds not only provide minerals but also can be used as detoxifying agents. As such, they facilitate assimilation and can help prevent intestinal complaints, such as food poisoning and diarrhea. They also will bind with antinutrients found in plant foods, such as bitter tannins, and prevent their absorption.
The seven macrominerals, needed in relatively large amounts, are as follows:
Calcium: Not only vital for strong bones and teeth, calcium is also needed for the heart and nervous system and for muscle growth and contraction. Good calcium status prevents acid-alkaline imbalances in the blood. The best sources of usable calcium are dairy products and bone broth (although the amounts are much smaller in bone broth). In cultures where dairy products are not used, bone broth is essential. Calcium in meats, vegetables and grains is difficult to absorb. Both iron and zinc can inhibit calcium absorption as can excess phosphorus and magnesium. Phytic acid in the bran of grains that have not been soaked, fermented, sprouted or naturally leavened will bind with calcium and other minerals in the intestinal tract, making these minerals less available. Sufficient vitamin D is needed for calcium absorption as is a proper potassium/calcium ratio in the blood. Sugar consumption and stress both pull calcium from the bones.
Chloride: Chloride is widely distributed in the body in ionic form, in balance with sodium or potassium. It helps regulate the correct acid-alkaline balance in the blood and the passage of fluids across cell membranes. It is needed for the production of hydrochloric acid and hence for protein digestion. It also activates the production of amylase enzymes needed for carbohydrate digestion. Chloride is also essential to proper growth and functioning of the brain. The most important source of chloride is salt, as only traces are found in most other foods. Lacto-fermented beverages and bone broths both provide easily assimilated chloride. Other sources include celery and coconut.
Magnesium: This mineral is essential for enzyme activity, calcium and potassium uptake, nerve transmission, bone formation and metabolism of carbohydrates and minerals. It is magnesium, not calcium, that helps form hard tooth enamel, resistant to decay. Like calcium and chloride, magnesium also plays a role in regulating the acid-alkaline balance in the body. High magnesium levels in drinking water have been linked to resistance to heart disease. Although it is found in many foods, including dairy products, nuts, vegetables, fish, meat and seafood, deficiencies are common in America due to soil depletion, poor absorption and lack of minerals in drinking water. A diet high in carbohydrates, oxalic acid in foods like raw spinach and phytic acid found in whole grains can cause deficiencies. An excellent source of usable magnesium is beef, chicken or fish broth. High amounts of zinc and vitamin D increase magnesium requirements. Magnesium deficiency can result in coronary heart disease, chronic weight loss, obesity, fatigue, epilepsy and impaired brain function. Chocolate cravings are a sign of magnesium deficiency.
Phosphorus: The second most abundant mineral in the body, phosphorus is needed for bone growth, kidney function and cell growth. It also plays a role in maintaining the body’s acid-alkaline balance. Phosphorus is found in many foods, but in order to be properly utilized, it must be in proper balance with magnesium and calcium in the blood. Excessive levels of phosphorus in the blood, often due to the consumption of soft drinks containing phosphoric acid, can lead to calcium loss and to cravings for sugar and alcohol; too little phosphorus inhibits calcium absorption and can lead to osteoporosis. Best sources are animal products, whole grains, legumes and nuts.
Potassium: Potassium and sodium work together–inner cell fluids are high in potassium while fluids outside the cell are high in sodium. Thus, potassium is important for many chemical reactions within the cells. Potassium is helpful in treating high blood pressure. It is found in a wide variety of nuts, grains and vegetables. Excessive use of salt along with inadequate intake of fruits and vegetables can result in a potassium deficiency.
Sodium: As all body fluids contain sodium, it can be said that sodium is essential to life. It is needed for many biochemical processes including water balance regulation, fluid distribution on either side of the cell walls, muscle contraction and expansion, nerve stimulation and acid-alkaline balance. Sodium is very important to the proper function of the adrenal glands. However, excessive sodium may result in high blood pressure, potassium deficiency, and liver, kidney and heart disease; symptoms of deficiency include confusion, low blood sugar, weakness, lethargy and heart palpitations. Meat broths and zucchini are excellent sources.
Sulphur: Part of the chemical structure of several amino acids, sulphur aids in many biochemical processes. It helps protect the body from infection, blocks the harmful effects of radiation and pollution and slows down the aging process. Sulphur-containing proteins are the building blocks of cell membranes, and sulphur is a major component of the gel-like connective tissue in cartilage and skin. Sulphur is found in cruciferous vegetables, eggs, milk and animal products.
Although needed in only minute amounts, trace minerals are essential for many biochemical processes. Often it is a single atom of a trace mineral, incorporated into a complex protein, that gives the compound its specific characteristic–iron as a part of the hemoglobin molecule, for example, or a trace mineral as the distinguishing component of a specific enzyme. The following list is not meant to be exhaustive but merely indicative of the complexity of bodily processes and their dependence on well-mineralized soil and food.
Boron: Needed for healthy bones, boron is found in fruits, especially apples, leafy green vegetables, nuts and grains.
Chromium: Essential for glucose metabolism, chromium is needed for blood sugar regulation as well as for the synthesis of cholesterol, fats and protein. Most Americans are deficient in chromium because they eat so many refined carbohydrates. Best sources are animal products, molasses, nuts, whole wheat, eggs and vegetables.
Cobalt: This mineral works with copper to promote assimilation of iron. A cobalt atom resides in the center of the vitamin B12 molecule. As the best sources are animal products, cobalt deficiency occurs most frequently in vegetarians.
Copper: Needed for the formation of bone, hemoglobin and red blood cells, copper also promotes healthy nerves, a healthy immune system and collagen formation. Copper works in balance with zinc and vitamin C. Along with manganese, magnesium and iodine, copper plays an important role in memory and brain function. Nuts, molasses and oats contain copper but liver is the best and most easily assimilated source. Copper deficiency is widespread in America. Animal experiments indicate that copper deficiency combined with high fructose consumption has particularly deleterious effects on infants and growing children.
Germanium: A newcomer to the list of trace minerals, germanium is now considered to be essential to optimum health. Germanium-rich foods help combat rheumatoid arthritis, food allergies, fungal overgrowth, viral infections and cancer. Certain foods will concentrate germanium if it is found in the soil–garlic, ginseng, mushrooms, onions and the herbs aloe vera, comfrey and suma.
Iodine: Although needed in only minute amounts, iodine is essential for numerous biochemical processes, such as fat metabolism, thyroid function and the production of sex hormones. Muscle cramps are a sign of deficiency as are cold hands and feet, proneness to weight gain, poor memory, constipation, depression and headaches. It seems to be essential for mental development. Iodine deficiency has been linked to mental retardation, coronary heart disease, susceptibility to polio and breast cancer. Sources include most sea foods, unrefined sea salt, kelp and other sea weeds, fish broth, butter, pineapple, artichokes, asparagus and dark green vegetables. Certain vegetables, such as cabbage and spinach, can block iodine absorption when eaten raw or unfermented. Requirements for iodine vary widely. In general, those whose ancestors come from seacoast areas require more iodine than those whose ancestors come from inland regions. Proper iodine utilization requires sufficient levels of vitamin A, supplied by animal fats. In excess, iodine can be toxic. Consumption of high amounts of inorganic iodine (as in iodized salt or iodine-fortified bread) as well as of organic iodine (as in kelp) can cause thyroid problems similar to those of iodine deficiency, including goiter.5
Iron: As part of the hemoglobin molecule, iron is vital for healthy blood; iron also forms an essential part of many enzymes. Iron deficiency is associated with poor mental development and problems with the immune system. It is found in eggs, fish, liver, meat and green leafy vegetables. Iron from animal protein is more readily absorbed than iron from vegetable foods. The addition of fat-soluble vitamins found in butter and cod liver oil to the diet often results in an improvement in iron status. Recently, researchers have warned against inorganic iron used to supplement white flour. In this form, iron cannot be utilized by the body and its buildup in the blood and tissues is essentially a buildup of toxins. Elevated amounts of inorganic iron have been linked to heart disease and cancer.
Manganese: Needed for healthy nerves, a healthy immune system and blood sugar regulation, manganese also plays a part in the formation of mother’s milk and in the growth of healthy bones. Deficiency may lead to trembling hands, seizures and lack of coordination. Excessive milk consumption may cause manganese deficiency as calcium can interfere with manganese absorption. Phosphorus antagonizes manganese as well. Best sources are nuts (especially pecans), seeds, whole grains and butterfat.
Molybdenum: This mineral is needed in small amounts for nitrogen metabolism, iron absorption, fat oxidation and normal cell function. Best sources are lentils, liver, grains, legumes and dark green leafy vegetables.
Selenium: A vital antioxidant, selenium acts with vitamin E to protect the immune system and maintain healthy heart function. It is needed for pancreatic function and tissue elasticity and has been shown to protect against radiation and toxic minerals. High levels of heart disease are associated with selenium-deficient soil in Finland and a tendency to fibrotic heart lesions is associated with selenium deficiency in parts of China. Best sources are butter, Brazil nuts, seafood and grains grown in selenium-rich soil.
Silicon: This much neglected element is needed for strong yet flexible bones and healthy cartilage, connective tissue, skin, hair and nails. In the blood vessels, the presence of adequate silicon helps prevent atherosclerosis. Silicon also protects against toxic aluminum. Good sources are grains with shiny surfaces, such as millet, corn and flax, the stems of green vegetables and homemade bone broths in which chicken feet or calves’ feet have been included.
Vanadium: Needed for cellular metabolism and the formation of bones and teeth, vanadium also plays a role in growth and reproduction and helps control cholesterol levels in the blood. Deficiency has been linked to cardiovascular and kidney disease. Buckwheat, unrefined vegetable oils, grains and olives are the best sources. Vanadium is difficult to absorb.
Zinc: Called the intelligence mineral, zinc is required for mental development, for healthy reproductive organs (particularly the prostate gland), for protein synthesis and collagen formation. Zinc is also involved in the blood sugar control mechanism and thus protects against diabetes. Zinc is needed to maintain proper levels of vitamin E in the blood. Inability to taste or smell and loss of appetite are signs of zinc deficiency. High levels of phytic acid in cereal grains and legumes block zinc absorption. Zinc deficiency during pregnancy can cause birth defects. As oral contraceptives diminish zinc levels, it is important for women to wait at least six months after discontinuing the pill before becoming pregnant. Best sources include red meat, oysters, fish, nuts, seeds and ginger.
Not all minerals are beneficial. Lead, cadmium, mercury, aluminum and arsenic, while possibly needed in minute amounts, are poisons to the body in large quantities. These come from polluted air, water, soil and food; lead finds its way into the water supply through lead pipes. Sources of aluminum include processed soy products, aluminum cookware, refined table salt, deodorants and antacids. Baking powder can be another source of aluminum and should be avoided. Amalgam fillings are the principle source of toxic mercury in the system–linked to Alzheimer’s and a number of other disease conditions. Minerals like calcium and magnesium, and the antioxidants–vitamin A, carotenes, vitamin C, vitamin E and selenium–all protect against these toxins and help the body to eliminate them. Adequate silicon protects against aluminum.
REFERENCES
Linder, Maria C, ed, Nutritional Biochemistry and Metabolism with Clinical Applications, 2nd ed, 1991, Appleton & Lange, Norwalk, CT, 191-212.
Johns, T, and M Duquette, American Journal of Clinical Nutrition, 1991, 53:448-56.
Jacqmin-Gada, H, et al, Epidemiology, 1996, 7(3):281-85; Bellia, J P, et al, Annals of Clinical Laboratory Science, 1996, 26(3):227-33.
Damrau, F, Medical Annals of the District of Columbia, Jun 1961, 30:(6):326-328.
Ensminger, A H, et al, The Concise Encyclopedia of Foods & Nutrition, 1995, CRC Press, Boca Raton, FL, 586.
Copyright: Nourishing Traditions: The Cookbook that Challenges Policitally Correct Nutrition and the Diet Dictocrats by Sally Fallon and Mary G. Enig, PhD., Revised Second Edition, ©2001, pp-40-45, NewTrends Publishing (877) 707-1776, www.newtrendspublishing.com.
Vitamin Primer
Posted on January 1, 2000 by Sally Fallon and Mary G. Enig, PhD • 2 Comments 
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Note: After reading this article, please also read the Vitamin A, Vitamin D and Cod Liver Oil: Some Clarifications section in our Cod Liver Oil Basics and Recommendations article.	
The discovery of the first vitamins, in the early 1900s, began the era of modern interest in diet and nutrition. Pioneering chemists found that certain “unknown substances” in food were essential to life. They discovered that fat-soluble vitamin D and water-soluble B vitamins were necessary to prevent diseases like rickets, beriberi and pellagra; and that vitamin C, a factor present in many fresh foods, prevented scurvy. By the 1930s, scientists had discovered many more vitamins and had catalogued their effects. Public interest in the subject was intense, and articles on vitamins often appeared in magazines and newspapers.
The study of vitamins has not waned since the early days of research, and the subject of food science has proved to be far more complex than scientists at first imagined. The early discoveries led some researchers to conclude that all vitamins necessary to life could be supplied in their isolated factory-produced form as vitamin pills. We now know that vitamins do not exist as single components but as parts of a complex of compounds, each part contributing to the whole. For example, vitamin C used to treat scurvy and other deficiency conditions is more effective when given as a natural food concentrate, which includes minerals, rutin and other analogs.1
As many as seventeen water-soluble vitamins labeled B have been discovered, present in different proportions in different foods, but all working together synergistically; vitamin D may have as many as twelve components of which several are active;2 vitamin P has at least five components. Most vitamins produce optimum results in the presence of certain naturally occurring “cofactors,” such as trace minerals, enzymes and coenzymes, as well as other vitamins.
The bewildering array of factors in foods now known to be essential has led well-informed nutritionists to recognize the futility of providing all factors necessary to life in pill form. While supplementing the diet with certain isolated vitamins has proven temporarily beneficial for many disease conditions, the best source of vitamins for most of us in the long term is properly prepared whole foods. For this reason, the importance of eating nutrient-dense meals, rich in vitamins and their cofactors, cannot be underestimated.
Vitamin and mineral content of food varies enormously with farming methods.3 Nitrogen fertilizers produce initial high yields, in part by pulling minerals from the soil. In time, commercially fertilized soils become depleted, and the foods grown on them suffer accordingly. Overall, vitamin and mineral content of American fruits and vegetables has declined significantly during the last fifty years.4 The revival of interest in compost and natural fertilizers, rich in minerals including trace minerals, is due in part to the realization that healthy soil is the basis of health for all life forms. Scientific assays have shown large differences in vitamin and mineral content between foods grown with nitrogen fertilizers and food grown organically. For example, cabbage can vary in its iron content from 94 parts per million to 0 parts per million; tomatoes can vary in iron content from 1,938 parts per million to 1 part per million. Vitamin A content of butterfat varies with the season as well as the soil; even the protein portion of grains and legumes will vary with soil fertility. Some commercially raised oranges have been found to contain no vitamin C!
Food processing affects vitamin content to varying extents. Some vitamins are heat-sensitive while others survive heating fairly well. Steaming and waterless methods of cooking preserve vitamins better than rapid boiling, and vegetables cooked in an acidic liquid preserve vitamins better than those cooked in an alkaline medium. Oxidation is a prime cause of vitamin loss. Long periods of high heat used in canning are destructive to some vitamins but not all. On the other hand, cold temperatures and freezing have little effect on vitamin content, and air or sun drying preserves or even enhances nutrient content. Some methods of food preservation and processing actually make nutrients more available–these include simmering bones in acidic liquid to make broth, culturing of dairy products, sprouting and traditional methods of pickling, fermenting and leavening.
The Diet Dictocrats have set minimum daily requirements for a few key vitamins and minerals, but many investigators feel that these standards are far too low. These critics contend that minimum daily requirements are sufficient to prevent acute deficiencies but not enough to support optimum health, especially as individual requirements for specific vitamins and minerals vary widely. In fact, a typical profile of nutrient requirements is one in which the individual has average needs with respect to most vitamins and minerals but requirements far in excess of average for a few specific nutrients.5 Consumption of sugar, refined flour and hydrogenated fats, and of alcohol, tobacco and many drugs, depletes the body of nutrients, resulting in higher vitamin and mineral requirements for users. Stress of any sort causes the body to use up available nutrients at a faster-than-normal rate.
Space permits only a most cursory summary of the major nutrients in our food.
Vitamin A: This all-important vitamin is a catalyst on which innumerable biochemical processes depend. According to Dr. Price, neither protein, minerals nor water-soluble vitamins can be utilized by the body without vitamin A from animal sources.6 Vitamin A also acts as an antioxidant, protecting the body against pollutants and free radicals, hence against cancer. Vitamin A stimulates the secretion of gastric juices needed for protein digestion, plays a vital role in building strong bones and rich blood, contributes to the production of RNA and is needed for the formation of visual purple. Sources of preformed vitamin A (called retinol) include butterfat, egg yolks, liver and other organ meats, seafood and fish liver oils. Provitamin A or carotene is also a powerful antioxidant. It is found in all yellow, red, orange or dark green fruits and vegetables. Carotenes are converted to vitamin A in the upper intestine. Vegetarians claim that the body’s requirements for vitamin A can be met with carotenes from vegetable sources, but many people–particularly infants, children, diabetics and individuals with poor thyroid function–cannot make this conversion.7 Furthermore, studies have shown that our bodies cannot convert carotenes into vitamin A without the presence of fat in the diet.8 Dr. Price discovered that the diets of healthy isolated peoples contained at least ten times more vitamin A from animal sources than found in the American diet of his day. The high vitamin A content of their diets insured them excellent bone structure, wide handsome faces with plenty of room for the teeth and ample protection against stress of all types. It is best to obtain vitamin A from natural sources like yellow butter, egg yolks, organ meats, fish, shellfish and cod liver oil as high amounts of synthetic vitamin A from supplements can be toxic, especially to those with impaired liver function and to those whose diets are otherwise poor. High levels of natural vitamin A have no toxic effects, in spite of the medical establishment’s dire warnings to the contrary. Antibiotics, laxatives, fat substitutes and cholesterol-lowering drugs interfere with vitamin-A absorption.
Vitamin B Complex: All the water-soluble B vitamins work as a team to promote healthy nerves, skin, eyes, hair, liver, muscle tone and cardiovascular function; they protect us from mental disorders, depression and anxiety. Deficiency of the B vitamin complex can result in the enlargement and malfunction of almost every organ and gland in the body. The best source of B vitamins is whole grains–refinement thus wastes this essential source. They are also found in fresh fruits, vegetables, nuts, legumes, seafood and organ meats; they can also be produced by intestinal bacteria. B1 (thiamine) was the first water-soluble vitamin to be discovered. Deficiency leads to the disease beriberi. Recent evidence indicates that B1 deficiency is the root cause of anorexia and other eating disorders.9 It is essential for the manufacture of hydrochloric acid and has been used to treat constipation, fatigue, herpes and multiple sclerosis. Sugar consumption rapidly depletes vitamin B1. B2 or riboflavin is found in a variety of whole foods. Frequent cracks in the lips and corners of the mouth is a sign of deficiency. Deficiency of B3 or niacin results in the disease pellagra, characterized by dermatitis, dementia, tremors and diarrhea. The amino acid tryptophan can be converted to niacin and has been used to treat a variety of symptoms indicative of niacin deficiency. Pantothenic acid, vitamin B5, found in organ meats, egg yolks and whole grains, is essential for the proper function of the adrenal glands. It plays a vital role in cell metabolism and cholesterol production. Pantothenic acid can improve the body’s ability to withstand stress. Recent studies have revealed that vitamin B6 or pyridoxine, found mostly in animal products, contributes to the proper functioning of over one hundred enzymes. Deficiencies in B6 have been linked to diabetes, nervous disorders and coronary heart disease. They are widespread in the US because excess B1 and B2, added to white flour, interferes with B6 function and because Americans no longer have access to one of the best sources of this heat-sensitive nutrient–raw milk. The B vitamin folic acid counteracts cancer by strengthening the chromosomes; folic acid deficiency can result in babies born with neural tube deformities like spinal bifida. B12 is needed to prevent anemia and nervous disorders as well as to maintain fertility and promote normal growth and development. Usable B12 is found only in animal foods. An early symptom of B12 deficiency is a tendency to irrational anger. B15 (pangamic acid) and B17 (nitrilosides) protect against cancer; the former is found in grains and seeds; the latter in grasses, sprouts, buckwheat, legumes and many fruit seeds. Traditional diets were much richer in nitrilosides than our own.
Vitamin C: A water-soluble vitamin best known for its use in treatment of the common cold, it is also needed for a host of processes including tissue growth and repair, strength of capillary walls, lactation and adrenal gland function. It is vital for the formation of collagen, the body’s structural substance. It promotes healing of wounds and is a powerful antioxidant. Dr. Linus Pauling and others have promoted megadoses of Vitamin C for cancer while others have used large doses to treat schizophrenia and drug addiction. But megadoses of isolated ascorbic acid may lead to imbalances and deficiencies in vitamin P. New evidence suggests that vitamin C works synergistically with vitamin E. Hypoglycemics and individuals on a high-protein diet require more vitamin C as these conditions interfere with the metabolism of ascorbic acid. It is found in many fruits and vegetables and in certain animal organs. Vitamin C is destroyed by heat. Alcohol and many common drugs including aspirin and oral contraceptives may reduce vitamin C levels in the body.
Vitamin D: Like vitamin A, vitamin D is needed for calcium and phosphorus absorption and thus is essential for strong bones, healthy teeth and normal growth. It seems to protect against cancer and multiple sclerosis. Deficiency can cause rickets and myopia. The body manufactures vitamin D3 out of cholesterol in the presence of sunlight. Although some claim that we can obtain all the vitamin D we need by spending a short amount of time each day in the sun, Price found that healthy primitive diets were rich in vitamin D-containing foods like butterfat, eggs, liver, organ meats, marine oils and seafood, particularly shrimp and crab. Synthetic D2 has been linked to hyperactivity, coronary heart disease and other allergic reactions. New research indicates that optimal intake should be ten times higher than the US Recommended Daily Allowance, thus confirming the findings of Dr. Price.
Vitamin E: This fat-soluble vitamin is needed for circulation, tissue repair and healing. It seems to help in the treatment of fibrocystic conditions, sterility, PMS and muscular dystrophy. It seems to retard the aging process. A vital role of vitamin E is the deactivation of free radicals. This powerful antioxidant works in concert with certain trace elements, notably selenium and zinc, to prevent cancer and cardiovascular disease. Increased ingestion of polyunsaturated oils requires greater amounts of vitamin E in the diet. It is found in unrefined vegetable oils, butter, organ meats, grains, nuts, seeds, legumes and dark green leafy vegetables.
Vitamin K: This fat-soluble compound is needed for blood clotting and plays an important role in bone formation. Vitamin K given to postmenopausal women helps prevent bone loss. It is found in liver, egg yolks, butter, grains, dark leafy vegetables, vegetables of the cabbage family and fermented soy foods like miso. (Update: Price’s “Activator X”–see below–is now believed to be vitamin K2.)
Vitamin P: Also called the bioflavonoids, these water-soluble compounds enhance the absorption of vitamin C to promote healing and protect the structure of blood capillaries. Bioflavonoids stimulate bile production, regulate menstrual flow, help prevent cataracts and have antibacterial effects. One of the bioflavonoids, rutin, has been shown to have a sedative-stimulant effect on the brain. Sources include peppers, grapes, buckwheat and the white peel of citrus fruits.
Coenzyme Q10: Coenzyme Q10 (CoQ10), or Vitamin Q, is a substance present in every cell of the body which is essential for the production of energy and which also functions as powerful anti-oxidant. While it is naturally present in a wide variety of foods, almost all of the needs of healthy individuals are met by the body’s synthesis of CoQ10. To put dietary intake in perspective, one pound of beef heart, three pounds of beef, or four pounds of peanuts provide 50 mg of CoQ10, or about 10% of daily needs. The heart utilizes a lot of CoQ10 because of its high energy requirements. Deficiency of CoQ10 causes stiffening of the walls of the heart which results in incomplete filling of the heart, or diastolic dysfunction, and causes increased heart rate and blood pressure, and can lead to heart failure if not corrected. Synthesis of CoQ10 decreases with age and its deficiency causes some degree of diastolic dysfunction in a large percentage of those over 65. CoQ10 deficiency can result from deficiency of any of the seven vitamins required for its synthesis, or by interference with its synthesis by cholesterol-lowering drugs or hormone replacement therapy (HRT). Deficiency can also result from increased utilization of CoQ10 due to excessive stress on the heart or immune system. CoQ10 deficiency is common in the elderly and vegetarians, and among those with heart disease, high blood pressure, asthma, diabetes, cancer, or HIV. In clinical studies, improvement in patients with heart failure supplemented with CoQ10 has been nothing short of dramatic. In addition to protecting the heart, CoQ10 supplementation has proven beneficial in treatment of diabetes, asthma, and high blood pressure. Bio-identical CoQ10 supplements, which are widely available over the counter, are fat soluble and are better absorbed when taken with a high fat meal.
Activator X or the Price Factor: Discovered by Weston Price, this fat-soluble nutrient is a potent catalyst to mineral absorption. It is found in certain fatty parts of animals that feed on young green growing plants or microorganisms, such as organ meats, fish and shellfish, fish eggs and butter from cows eating rapidly growing green grass of spring and fall pasturage. Largely absent today, the Price Factor was present in all traditional diets. (Update: Activator X is now believed to be vitamin K2.)
REFERENCES
Baker, H, and O Frank, Journal of the International Associates of Preventive Medicine, Jul 1982, 19-24.
Price, Weston, DDS, Nutrition and Physical Degeneration, 1945, Price-Pottenger Nutrition Foundation, San Diego, CA, 278.
Smith, B, Journal of Applied Nutrition, 1993, 45:1.
Bergner, Paul, The Healing Power of Minerals, Special Nutrients and Trace Elements, 1997, Prima Publishing, Rocklin, CA.
Burton, B T, ed, The Heinz Handbook of Nutrition, 1959, McGraw Hill, New York, NY.
Price, Weston, DDS, Nutrition and Physical Degeneration, 1945, Price-Pottenger Nutrition Foundation, San Diego, CA. Dr. Price referred to vitamins A and D as “fat-soluble activators,” and his “Activator X” is now believed to be the fat-soluble vitamin K2.
Dunne, Lavon J, Nutrition Almanac, 3rd ed, 1990, McGraw Hill, New York, NY; Jennings, I W, Vitamins in Endocrine Metabolism, 1970, Heineman, London, UK.
Solomans, N W, and J Bulox, Nutrition Reviews, Jul 1993, 51:199-204.
Douglas, W C, MD, Second Opinion, Atlanta, GA, May 1995, Vol V, No 5.
Copyright: Nourishing Traditions: The Cookbook that Challenges Policitally Correct Nutrition and the Diet Dictocrats by Sally Fallon and Mary G. Enig, PhD., Revised Second Edition, ©2001, pp36-39, NewTrends Publishing (877) 707-1776, www.newtrendspublishing.com.
Beyond Good and Evil
Posted on December 10, 2012 by Christopher Masterjohn • 15 Comments 
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Article Summary
• Successful traditional diets provided many nutrients that cooperate with one another to produce excellent health. This article provides several illustrative examples of this type of cooperation.
• Methionine from muscle meat contributes to cell growth and repair, cellular communication, antioxidant defense, and detoxification. In order to fulfill these functions, however, methionine must be balanced with B vitamins, choline, and glycine from organ meats, egg yolks, legumes, leafy greens, skin and bones.
• Vitamins A, D and K cooperate to protect our soft tissues from calcification, to nourish our bones and teeth, and to provide children with adequate growth. We obtain these nutrients together by consuming organ meats, cod liver oil, fatty fish, grass-fed animal fats, green and orange vegetables, and fermented plant foods.
• Magnesium is required for every process in the body. Among its many interactions, magnesium is required for proper calcium metabolism. Magnesium is abundant in many plant foods and some seafood, but there is little magnesium in meat and almost none in refined sugar and refined grains. Consuming a balanced diet devoid of refined sugar and refined grains is the best way to obtain adequate magnesium.
• These interactions demonstrate that biology is very complex. Rather than thinking about whether certain nutrients from traditional diets are good for us or bad for us, we should seek to understand how they all work together in proper balance to promote radiant and vibrant health.

Synergy and Context with Dietary Nutrients
Successful traditional diets provided a rich array of nutrients that cooperated with one another to produce vibrant health. As modern diets have shifted towards nutrient-poor foods fortified with the favored nutrients du jour, we have gazed askance at the degeneration that has resulted and embarked on a series of searches for the dietary villains that we imagine lurking in the shadows.
We have blamed heart disease on cholesterol, mortality on meat, osteoporosis on vitamin A, and diabetes on fat. Yet somehow it has eluded us that we are asking all the wrong questions. Biology is not a war between good molecules and evil molecules, nor is it a war between “wholesome” natural foods like vegetables and “poisonous” natural foods like meat. Biology is a system wherein many parts work together in synergy to produce a context within which each part benefits the whole. Several examples of this type of synergy follow.
METHIONINE, B VITAMINS, GLYCINE
Successful traditional diets provided muscle meats together with organ meats and gelatinous materials such as bones, gristle and other connective tissue. These combinations provided a healthy balance between the methionine found in muscle meats, the B vitamins found in organ meats, and the glycine found in connective tissue. Modern diets, by contrast, provide abundant quantities of methionine-rich muscle meats while organs and connective tissue have fallen by the wayside. The result of this imbalance is that methionine is unable to fulfill its proper cellular functions and generates toxic byproducts instead, while the supply of glycine is depleted. Together, these changes are likely to contribute to reduced longevity and chronic disease (Figure 1).
Methionine is an amino acid that we obtain from most dietary proteins, but is especially abundant in animal proteins (Table 1). As shown in Figure 2,1-3 folate and vitamin B12, and to a lesser extent vitamin B6, niacin, and riboflavin, assist methionine in carrying out one of its major cellular functions: the addition of a single carbon atom together with a small assortment of hydrogen atoms to a wide variety of molecules, a process known as “methylation.” Methylation is important for the synthesis of many cellular components and for the regulation of gene expression. As a result, it is critical for the maintenance and repair of existing tissue, the building up of new tissue, and cellular communication. Methylation is especially important for the passing along of epigenetic information from parent cells to their daughter cells as they multiply. Liver is rich in all of the B vitamins important to this process. Muscle meats provide smaller amounts of most of them, but are relatively poor in folate. Folate is found primarily in liver and legumes, with modest amounts in egg yolks and some seeds, seafood, and leafy greens (Table 2). When any of these vitamins is missing, methionine fails to contribute properly to methylation and instead generates homocysteine, a potentially toxic byproduct that may contribute to cardiovascular disease.4
In support of the relevance of these pathways to human nutrition, a randomized, placebocontrolled trial showed that three months of combined supplementation with folic acid and vitamin B12 lowered homocysteine concentrations.5 In the same study, a single large dose of methionine temporarily increased homocysteine concentrations, while supplementation with B vitamins protected against this effect. This study demonstrates the critical need for balance between methionine and these B vitamins, and suggests that many people may not be getting enough folate or vitamin B12 to properly handle the methionine they are obtaining from muscle meats.
As shown in Figure 2,1-3 once our needs for methylation are met, we use vitamin B6 and glycine to convert any additional methionine in our diet to glutathione, which is the master antioxidant and detoxifier of the cell as well as a key regulator of protein function. The conversion of methionine to glutathione is not instantaneous, however, and our liver requires a buffer system to protect itself against excessive methylation and the accumulation of homocysteine.
This buffer system is comprised primarily of three nutrients: glycine, which is found most abundantly in bones and other connective tissue (Table 3); choline, which is found primarily in liver and egg yolks (Table 4); and betaine, which we can either make within our own bodies from choline or obtain directly in our diets from spinach, wheat, and beets (Table 5). Muscle meat provides its own vitamin B6, but provides relatively little glycine, choline and betaine. In order to safely use extra methionine from muscle meat to support our antioxidant defenses and detoxification systems, we therefore must balance muscle meat with liver and egg yolks as well as with soups, gravies, sauces, or other creative dishes made from bones and other connective tissue, including skin. As useful adjuncts to these foods, some people may also benefit from incorporating spinach, wheat or beets into their diet.
Several studies support the relevance of these pathways to human nutrition. In one such study, a large dose of methionine increased the excretion of a metabolic byproduct of glycine, choline and betaine in the urine,6 suggesting that excess methionine causes the irreversible loss of these nutrients. Randomized, placebo-controlled trials have shown that two weeks’ supplementation with choline7 or six weeks’ supplementation with betaine7 lowered homocysteine levels both in the fasting state and after consuming a large dose of methionine. In a similar study, three months’ supplementation with vitamin B6 made a small improvement in homocysteine levels after a large dose of methionine.5
There are, unfortunately, very few nutritional studies using glycine because scientists have not considered it an “essential” amino acid. Although our bodies can synthesize glycine, primarily from the amino acid serine, one group of scientists recently estimated that our ability to produce glycine may fall short of our needs for this amino acid by up to ten grams per day.1 This is roughly the equivalent of an ounce of bone meal each day. These authors pointed out that markers of glycine deficiency appear in the urine of vegetarians, people consuming low-protein diets, children recovering from malnourishment, and pregnant women. They further suggested that most of us adapt to a subtler degree of glycine deficiency by decreasing our own turnover of collagen, which may lead to the accumulation of damaged collagen with age, thereby contributing to arthritis, poor-quality skin, and many of the other negative consequences of aging. Indeed, while some studies have shown that restricting dietary methionine lengthens the lifespan of rats and while these have generated a great deal of interest, a similar study recently showed that the same effect can be achieved by supplementing the diet with extra glycine.8
Some authors have recently suggested that a vegan diet would lengthen lifespan because of its naturally low methionine content.9 If methionine restriction primarily increases lifespan by increasing the ratio of glycine to methionine, however, then this suggestion could not be more wrong, because vegetarians show signs of glycine deficiency.1 Vegan diets are low in total biologically available protein, not just methionine. Human studies suggest that low-protein diets waste glycine by using it simply as a source of much-needed nitrogen.10
A better way to improve the balance of glycine to methionine would be to replace a substantial proportion of muscle meats in the diet with bones and skin. Adding organ meats, egg yolks, and plant foods rich in folate and betaine to the diet would also be likely to improve longevity by working with glycine to support the safe and effective utilization of methionine. When these nutrients are all provided in rich supply, methionine supports the growth and repair of tissues, our defense against oxidants, detoxification and proper cellular communication.
VITAMINS A, D AND K2
Successful traditional diets also provided a balance between vitamins A, D, and K2. Vitamin A is most abundant in liver and fish liver oils, such as cod liver oil.11 Plant foods rich in carotenoids also provide vitamin A, although they do so much less reliably than liver and cod liver oil because the ability to convert carotenoids to vitamin A varies about ten-fold between individuals. 12
Vitamin D is most abundant in cod liver oil and fatty fish. Sunshine is also an important source of vitamin D, though our ability to use sunshine to synthesize this vitamin depends on where we live, our skin color, how much time we spend outdoors, and the type of clothing we wear.13
Vitamin K2 is found primarily in animal fats and fermented foods.14 We can also synthesize vitamin K2 from the vitamin K1 found in leafy green vegetables, but this conversion seems to be very inefficient in humans. To a certain extent vitamin K1 can also substitute for vitamin K2, but this substitution is limited because our bodies distribute vitamin K1 primarily to the liver and vitamin K2 primarily to other tissues. The specific form of vitamin K2 found in animal fat, moreover, has unique functions that are shared neither by the forms of vitamin K2 found in fermented plant foods nor by the vitamin K1 found in leafy greens.15 As shown in Figure 3, toxicity results when the supply of these vitamins is thrown off balance. When vitamins A, D, and K2 are all available in rich supply, by contrast, as shown in Figure 4, they cooperate to promote growth, to nourish strong bones and teeth, and to prevent the calcification of soft tissues.
When large imbalances between vitamins A and D favor vitamin A, phosphorus accumulates at the expense of calcium, promoting bone loss.16 Vitamin A may also overwhelm the storage capacity of the liver under these conditions, contributing to liver damage. When the imbalance favors vitamin D, calcium accumulates in soft tissues, leading to stones in the kidney and bladder, and calcification of the blood vessels and aortal valves.13 In a growing child, this imbalance would be likely to favor premature calcification of the growth plates, thereby preventing the child from reaching his or her full potential for growth.14 This aberrant pattern of calcification occurs at least in part because the imbalance contributes to the overproduction of vitamin K-dependent proteins in great excess of the capacity for vitamin K2 to activate them.17 These include proteins that direct calcium to our bones and teeth and away from our soft tissues. Since vitamin K2 fails to activate these proteins, the proteins in turn fail to ensure the adequate nourishment of our bones and teeth and fail to protect our soft tissues. One remaining question is whether vitamin K2 protects against vitamin D toxicity just as vitamin A does. This seems likely, but no studies have yet shown it to be true.
One study thus far has demonstrated the interaction between vitamins A and D in humans. In 1941, Irwin G. Spiesman published a trial showing that massive doses of vitamins A and D caused toxicity when either vitamin was provided alone and failed to protect against the common cold. When massive doses of both vitamins were provided together, by contrast, they failed to induce any toxicity and offered powerful protection against the common cold.18 Some authors have argued that a second study published in 2001 showed antagonism between the two vitamins.19 This study, however, did not show a true interaction. Vitamin A decreased blood levels of calcium by 1.0 percent when given alone, and by 1.4 percent when given in combination with the hormone form of vitamin D. The authors did not measure blood levels of phosphorus, and failed to show that vitamin A did anything different in the presence of vitamin D than in its absence.
Recent evidence from experiments performed on isolated cells suggests that vitamins A and D may synergistically suppress the development of autoimmune diseases20 and perhaps even cure diabetes by causing the regeneration of pancreatic stem cells.21 Forming any conclusions from these studies would be premature, however, since we need to follow them up with nutritional studies in humans or live animals.
Altogether, the available evidence supports the rich provision of vitamins A, D, and K2 together by consuming organ meats, animal fats, fermented foods, fatty fish, cod liver oil, and colorful vegetables, while spending plenty of time outdoors. Obtaining a rich supply of these vitamins together allows each of them to carry out its biological functions safely and effectively.
Magnesium : The Universal Metal
Some nutrients play so many roles in the body that literally everything depends on them. One such nutrient is magnesium.22 Magnesium is abundant in many whole grains, nuts, seeds, legumes and vegetables, some fruit, and some seafood. It is less abundant in meat, by contrast, and almost entirely absent from refined grains and sugar (Table 6). Modern diets rich in refined grains and sugar thus provide far less magnesium than traditional diets wherein these “displacing foods of modern commerce” were absent.
Magnesium contributes to more than three hundred specific chemical reactions that occur within our bodies.22 The most basic energy currency of our cells, ATP, exists primarily bound to magnesium. Magnesium is thus essential for every reaction that depends on ATP. Magnesium also activates the enzyme that makes copies of DNA, as well as the enzyme that makes RNA, which is responsible for translating the codes contained within our genes into the production of every protein within our body. Magnesium is thus literally involved in every single process that occurs within the body, making a specific enumeration of all of its interactions impossible to contain even within a large book, far less an article such as this. The well known interaction between magnesium and calcium, however, provides a classic example (Figure 5).
Magnesium deficiency decreases blood levels of calcium in humans and most animals.22 The reasons for this are complex and reflect the universal importance of magnesium rather than a specific interaction between the two minerals. In a healthy individual, parathyroid hormone activates vitamin D to its hormone form, which in turn maintains blood levels of calcium within the appropriate range, in part by helping us absorb calcium from our food.
Magnesium deficiency causes a failure in this system through several mechanisms. Without magnesium, the liver cannot convert vitamin D to its semi-activated storage form, 25-hydroxyvitamin D. When we are deficient in magnesium, we not only produce less parathyroid hormone, but even what we do produce fails to work properly. This resistance to parathyroid hormone appears to result from the failure of at least four different categories of biochemical reactions that are needed to support the hormone. Without properly functioning parathyroid hormone, our kidneys fail to fully activate the storage form of vitamin D to its hormone form, 1,25-dihydroxyvitamin D. On top of all of this, even fully activated vitamin D fails to function properly when we are deficient in magnesium, probably because all of the proteins it controls are at least indirectly dependent on the mineral. This cascade of biochemical failures ultimately depresses calcium absorption, and obtaining sufficient magnesium from food or supplements is the only remedy that will restore calcium levels to normal.
Not only do we fail to absorb enough calcium when we are deficient in magnesium, we also fail to put calcium where it belongs.22 Over 99 percent of the calcium in our body belongs outside of our cells, primarily in our bones and teeth. While only a small amount is found in our blood at any given moment, it is our blood that provides calcium to our bones and teeth where the bulk of it is stored. Only a small portion of calcium belongs inside our soft tissue cells. Our cells keep this small amount in storage vesicles, and release it when needed to stimulate certain functions such as muscular contraction.
Magnesium is needed to utilize the most basic energy currency of our cells, ATP, which is in turn needed to activate the pumps and channels that maintain the proper distribution of calcium and other minerals within our cells. When we are deficient in magnesium, our cells accumulate sodium and lose potassium. The potassium is lost in our urine, while the sodium draws excess calcium into the cell. In the absence of magnesium, our cells are unable to store calcium in the appropriate vesicles. The accumulation of calcium within our cells robs calcium from the blood, which means less calcium is available to our bones and teeth. This total failure of mineral metabolism contributes to excessive excitation of nerves and muscles, disturbances in the rhythm of the heart, a tendency of the blood to clot too much, and poor mineralization of the bones and teeth.
Synergy and Context
The human body is a biological system characterized by astounding complexity. Nutrients often cooperate with one another to produce vibrant health. Quite often when one or more nutrients is missing, others may appear to contribute to disease. Methionine from muscle meats may appear to contribute to disease, for example, when the B vitamins, choline, and glycine found in bones, skin, organ meats, egg yolks, legumes, and leafy greens are absent. Vitamins A and D may each appear to contribute to disease when the other is absent. In the absence of other nutrients such as magnesium, some nutrients such as vitamin D and calcium may simply fail to function at all. The complex biology that makes the human body tick may operate very differently in the context of a diet rich in magnesium than in the context of a diet poor in magnesium.
Nutrient-dense, traditionally balanced diets, however, provide all of these nutrients together so that they synergize with one another to nourish our bodies to health and protect them from harm. Rather than seeking dietary villains from among our most ancient traditional foods to blame for our most recent modern diseases, we should elaborate our understanding of how the many components within successful traditional diets work together to promote radiant and vibrant health.

SIDEBARS
Figure 1: SYNERGY BETWEEN METHIONINE, B VITAMINS, CHOLINE, AND GLYCINE1-3
The figure presents a simplified model of the synergy between methionine, B vitamins, choline, and glycine. See text as well as Figure 2 for a more detailed view.
A. Excess methionine from muscle meats, in the absence of protective nutrients, generates homocysteine, a toxic byproduct that may contribute to vascular disease.
B. With adequate B vitamins and choline, found especially in organ meats and egg yolks, methionine will not generate excess homocysteine, but it may lead to excessive methylation, a breakdown of cellular communication, and depletion of glycine, all of which may contribute to the negative consequences of aging. See text as well as Table 2, Table 4, and Table 5 for additional sources of protective nutrients.
C. Adequate glycine from gelatinous materials such as bones, skin, and other connective tissue, works together with B vitamins and choline to prevent excessive methylation and to ensure adequate conversion of methionine to glutathione. This in turn ensures that methionine will be used for proper cellular communication and as part of the cellular defense against oxidants and environmental toxins.
Animal products have a higher percentage of their total protein as methionine than plant products. Although not shown in the table, they also contain much more protein per unit of weight or volume. The main sources of methionine in the diet, then, are milk, eggs, fish and meat. Although liver and egg yolks provide methionine, they are also rich in nutrients that cooperate with methionine to render it safe and effective (see the main text as well as Table 2 and Table 4). Muscle meats, by contrast, including fish, are rich in methionine but poor in key cooperative nutrients.
Folate is especially abundant in liver and legumes, with moderate amounts in egg yolks, some seeds, some seafood, and some leafy greens, but very little in muscle meats. Folate content tends to be widely variable within a food group, and only a small selection of foods is reported in the table above.
Figures 2A and 2B (below):
METHIONINE METABOLISM AT LOW AND HIGH CONCENTRATIONS OF METHIONINE.1-3
We obtain methionine from most dietary proteins, but primarily from muscle meats. We use it to build our own proteins, but also for two other important processes: methylation and the synthesis of glutathione. Of these, methylation takes priority. Methylation is the addition of one-carbon units to a wide variety of molecules, which aids in the synthesis of many cellular components and in the regulation of gene expression.
When cellular concentrations of methionine are insufficient or just barely sufficient to meet the demand for methylation, the pathways shown in panel A predominate. During each methylation reaction, methionine is converted to homocysteine, which is potentially toxic. Folate and vitamin B12 help recycle homocysteine to regenerate methionine, which allows methylation to continue and prevents homocysteine from accumulating to toxic levels. Although not shown in panel A, niacin, riboflavin and vitamin B6 also assist in this process.
When the supply of methionine exceeds that needed for methylation, the excess is metabolized mainly in the liver and the pathways shown in panel B predominate. Glycine accepts the extra methyl groups, while choline and betaine recycle part of the extra homocysteine. These processes all result in the accumulation of dimethylglycine, part of which is lost in the urine.6 Vitamin B6 and glycine assist in the conversion of part of the extra homocysteine to cysteine and then to glutathione, which is the master antioxidant and detoxifier of the cell, and a key regulator of protein function. When the flux through this latter pathway exceeds the capacity for glutathione synthesis, the excess cysteine is converted to taurine and sulfate. Thus, B vitamins, choline, betaine and glycine all cooperate with methionine to allow optimal methylation and synthesis of glutathione. When methionine is provided in the absence of these partners, methylation and glutathione synthesis fall by the wayside and homocysteine accumulates to potentially toxic levels. It may also be the case that if only glycine is limiting, the capacity to absorb extra methyl groups diminishes and rogue methylations occur.
A. During each methylation (reaction 3), methionine adenosyltransferase uses ATP to convert methionine to S-adenosylmethionine (SAM). Methyltransferases then use SAM to methylate a wide variety of molecules, generating S-adenosylhomocysteine (SAH). S-adenosylhomocysteine hydrolase then allows a small amount of SAH to generate homocysteine, which is potentially toxic. Vitamin B12 and folate assist in the recycling of homocysteine back to methionine. 5-methyltetrahydrofolate (a form of folate, abbreviated as methyl-folate in the figure) methylates vitamin B12 (reaction 1), and methionine synthase then uses B12 to methylate homocysteine and thereby form methionine (reaction 2). Folate is then remethylated through several different pathways not shown in the figure, which depend on niacin, riboflavin, and vitamin B6.B. When methionine concentrations are high, an alternative set of reactions predominates in the liver. Choline dehydrogenase and betaine aldehyde dehydrogenase convert choline to betaine with the assistance of niacin and oxygen (reaction 1). Betaine-homocysteine methyltransferase uses betaine to convert homocysteine to methionine, generating dimethylglycine (reaction 2), part of which is converted to glycine and part of which is lost in the urine.6 More SAM igenerated than is needed for methylation reactions.
With the assistance of vitamin B6, cystathionine b-synthase and cystathionine g-lyase use serine to convert homocysteine to cysteine in two successive steps (reaction 5). Serine is obtained directly in the diet or derived from glycine with the assistance of vitamin B6 (reaction 4). Using glycine, glutamate, and ATP, glutamate cysteine ligase and glutathione synthase convert cysteine to glutathione in two successive steps (reaction 6). Excess cysteine is converted to taurine and sulfate (reaction 7). As a result, glycine, obtained directly from the diet or synthesized from dietary serine with the assistance of vitamin B6 (reaction 4), accepts methyl groups from SAM, generating dimethylglycine (reaction 3), part of which is lost in the urine.6 N-methyltransferases catalyze this reaction in two successive steps.
Glycine makes up only five percent of the amino acids in typical muscle meats, but is much richer in proteins such as collagen and elastin, found in connective tissues like skin and bone. Most of the protein in bone is collagen, which is about one-third glycine, making any dishes made from bone, including soups and sauces, excellent sources of this amino aciFigure 3: IMBALANCES BETWEEN VITAMINS A AND D LEAD TO TOXICITY13,When a severe imbalance between vitamins A and D favors vitamin A, phosphorus accumulates at the expense of calcium and bone loss ensues. When such an imbalance favors vitamin D, the production of vitamin K-dependent proteins greatly exceeds the capacity of vitamin K to activate them. This results in defective proteins, which in turn fail to direct calcium away from soft tissues and into bones and teeth. This results in soft tissue calcification, including the formation of kidney and bladder stones, and the calcification of blood vessels and aortal valves.
SYNERGY BETWEEN VITAMINS A, D, and K213,14,17
When vitamins A and D are available in an appropriate balance, cells produce a healthy amount of vitamin K-dependent proteins. When vitamin K2 is available in rich supply to activate them, these proteins protect against soft tissue calcification and direct calcium to where it belongs: in the bones and teeth. During growth, these proteins protect the growth plates from premature calcification, ensuring that a child will reach his or her full growth potentialTable 6. Magnesium Content of Selected Foods23
Magnesium is especially abundant in many seeds, and also found abundantly in many whole grains, nuts, and vegetables. Some fruits and types of seafood are also good sources. Meat, however, even liver, is low in magnesium. In contrast to whole grains, refined grains contain almost no magnesium. Like refined grains, refined sugar also contains almost no magnesium.
Figure 5: Contribution of Magnesium to Calcium Metabolism 22
Magnesium (Mg2+) is necessary for virtually every function in the body. As a result, proper calcium metabolism breaks down in the absence of sufficient magnesium. Magnesium helps convert vitamin D to the semi-activated storage form, 25-hydroxyvitamin D, abbreviated in the figure as 25(OH)D. It contributes both to the production of parathyroid hormone (PTH) and to its conversion of 25(OH)D to the fully activated hormone form of vitamin D, 1,25-dihydroxyvitamin D or 1,25(OH)2D. Magnesium helps 1,25(OH)2D stimulate calcium absorption, and assists the variety of pumps and channels that help distribute calcium properly into the bones and teeth, blood, and storage vesicles where it belongs. In the absence of sufficient magnesium, we fail to absorb enough calcium from our food. The calcium we do absorb accumulates within our cells rather than in our blood, bones, and teeth, where it belongs. Our cells, moreover, fail to sequester it in storage vesicles. These changes as well as other failures of mineral metabolism that occur during magnesium deficiency contribute to excessive excitation of nerves and muscles, blood coagulation, and poor mineralization of bones and teeth.
The Neglected Mineral We Cannot Live Without

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Magnesium is an alkaline earth metal, the eighth most abundant mineral found in the earth’s crust. Because of its ready solubility in water, magnesium is the third most abundant mineral in sea water, after sodium and chloride. In the human body, magnesium is the eleventh most plentiful element by mass—measuring about two ounces. Most magnesium contained in the body is found in the skeleton and teeth—at least 60 to 65 percent of the total. Nearly the entire remaining amount resides in muscle tissues and cells, while only one percent is contained in our blood.

The importance of magnesium ions for all life itself, as well as for overall vibrant health, is hard to overstate. Magnesium is required to give the “spark of life” to metabolic functions involving the creation of energy and its transport (ATP, the body’s fundamental energy currency), and the creation of proteins—the nucleic acid chemistry of life—RNA and DNA, in all known living organisms. In plants, a magnesium ion is found at the center of every chlorophyll molecule, vital for the creation of energy from sunlight. Magnesium is an essential element for both animals and plants, involved in literally hundreds of enzymatic reactions affecting virtually all aspects of life.
Every single cell in the human body demands adequate magnesium to function, or it will perish. Strong bones and teeth, balanced hormones, a healthy nervous and cardiovascular system, well-functioning detoxification pathways and much more depend upon cellular magnesium sufficiency. Soft tissue containing the highest concentrations of magnesium in the body include the brain and the heart—two organs that produce a large amount of electrical activity, and which can be especially vulnerable to magnesium insufficiency.
Magnesium works in concert with calcium to regulate electrical impulses in the cell—magnesium concentration inside healthy cells is ten thousand times greater than calcium, and there are crucial reasons for this safeguard. Cellular calcium channels allow that mineral to enter the cell only as long as needed to conduct an impulse; it is ushered out immediately by magnesium once its task is fulfilled. This vigilance is necessary to prevent calcium accumulation in the cell, which could cause dangerous hyper-excitability, calcification, cell dysfunction and even cell death. When excess calcium enters the cells because of insufficient magnesium, muscle contraction is sustained for too long, and we suffer, for example, twitches and tics in mild cases. When magnesium deficiency becomes chronic, we suffer the symptoms of heart disease such as angina pectoris, hypertension and arrhythmia, or the spasms and contractions characteristic of asthma, migraine headache or painful menstrual cramping.
Magnesium operates as a natural calcium channel blocker and is responsible for relaxation—counter to calcium’s contraction. Thus magnesium is pivotally important to the healthy functioning of our parasympathetic nervous system. It may be hard to believe, but our bodies were actually designed to operate for the most part in a calm, relaxed parasympathetic state, rather than in the heart-pounding, stress- and adrenaline-driven mode of sympathetic nervous system dominance that is nearly constant for many of us today, and which uses up great quantities of magnesium.
Magnesium is so important to so many vital body functions, and its deficiency is integrally involved in so many diseases, that more than one researcher has dubbed magnesium a miracle in its ability to resolve or improve numerous disorders. The current list of disorders with direct and confirmed relationships to chronic and acute magnesium deficiency is long, and includes many diseases whose conventional medical treatment does not commonly address magnesium insufficiency (see below). Ongoing research promises to uncover further associations between magnesium deficiency and other illnesses.
MAGNESIUM DEFICIENCY IS WIDESPREAD
Unfortunately, it is difficult to reliably supply our bodies with sufficient magnesium, even from a good, balanced whole foods diet. First of all, modern agricultural methods favor the universal use of NPK fertilizers (nitrogen, phosphorus, and potassium). Both potassium and phosphorus are antagonists of magnesium in the soil, and on calcareous soils create a relative magnesium deficiency (the magnesium present is bound and therefore unavailable to the crop). On sandy or loamy soils that are slightly acid, an actual magnesium deficiency often exists, as the magnesium leaches from the soil and is also unavailable to the crop. This leaching also occurs in response to acid rain. Magnesium, in fact, is one of the most depleted minerals in farm soils. To add insult to injury, new plant hybrids are continually introduced that have been bred to survive on these mineral-depleted soils. Of course, when mineral-depleted crops are eaten by animals or by us, they will sooner or later cause disease. Even though organically raised crops should be a better bet nutritionally, this isn’t always the case, and it pays in terms of your health to learn how your farmer replenishes the minerals on his fields.
“Do you know that most of us today are suffering from certain dangerous diet deficiencies which cannot be remedied until depleted soils from which our food comes are brought back into proper mineral balance? The alarming fact is that foods (fruits, vegetables, grains) now being raised on millions of acres of land that no longer contain enough of certain minerals are starving us—no matter how much of them we eat. The truth is that our foods vary enormously in value, and some of them aren’t worth eating as food.” These words of warning are from the 74th Congress, 2nd session, Senate document number 264, of 1936. It is truly sobering to learn that the decline in soil mineral balance was a topic of serious national concern more than seventy years ago, and the deficit has been affecting us—while steadily getting worse— since our grandparents’ generation.
Magnesium and other nutrients are diminished or lost in produce after harvest, through handling, refrigeration, transport and storage, even if all these steps were done “properly.” Buying produce and then storing it for days in your own refrigerator continues the nutrient loss, whether the produce is from the supermarket or your local farmers’ market.
Food processing causes enormous loss of magnesium in foods that are commonly fairly good sources of it, such as leafy greens, nuts, seeds and whole grains. Most of the magnesium in grain— found in the bran and germ—is lost in milling whole grains for white flour, which is used nearly exclusively for hundreds of devitalized processed food items. When nuts and seeds are roasted or their oils extracted, magnesium is lost. Cooking greens causes whatever magnesium they might contain to leach into the cooking water. Foods tend to lose less calcium than magnesium through these processes, adding to a troublesome dietary calcium overload that we will discuss shortly.
Fluoride in drinking water binds with magnesium, creating a nearly insoluble mineral compound that ends up deposited in the bones, where its brittleness increases the risk of fractures. Water, in fact, could be an excellent source of magnesium—if it comes from deep wells that have magnesium at their source, or from mineral-rich glacial runoff. Urban sources of drinking water are usually from surface water, such as rivers and streams, which are low in magnesium. Even many bottled mineral waters are quite low in magnesium, or have a very high concentration of calcium, or both.
A diet of processed, synthetic foods, high sugar content, alcohol and soda drinks all “waste” magnesium, as a lot of it is required for the metabolism and detoxification of these largely fake foods. According to Dr. Natasha Campbell-McBride, the body requires at least twenty-eight molecules of magnesium to metabolize a single molecule of glucose. Phosphates in carbonated drinks and processed meats (so-called “luncheon meats” and hot dogs) bind with magnesium to create the insoluble magnesium phosphate, which is unusable by the body.
Tannins, oxalates, and phytic acid all bind with magnesium, making it unavailable to the body unless extra care is taken to neutralize some of these compounds during food preparation. It is interesting to note that foods commonly containing magnesium (provided they were grown in mineral-rich soil) also contain lots of these anti-nutrients, such as spinach (oxalates) and whole grains (phytates).
Many commonly prescribed pharmaceutical drugs cause the body to lose magnesium via the urine, such as diuretics for hypertension; birth control pills; insulin; digitalis; tetracycline and some other antibiotics; and corticosteroids and bronchodilators for asthma. With the loss of magnesium, all of the symptoms being “treated” by these drugs over time inevitably become worse.
Magnesium absorption is impeded with the use of supplemental iron. If you take calcium supplements, your need for magnesium increases, and in fact calcium will not be properly absorbed or metabolized if adequate magnesium is missing, and will mostly end up dangerously deposited in soft tissues. Magnesium is responsible for converting vitamin D to the active form that allows calcium to be absorbed, and also regulates calcium’s transport to hard tissues where it belongs. Lactose is another inhibitor of magnesium absorption (and milk is not a good source of the mineral to begin with), along with excess potassium, phosphorus and sodium.
Mental and physical stress, with its related continuous flow of adrenaline, uses up magnesium rapidly, as adrenaline affects heart rate, blood pressure, vascular constriction and muscle contraction— actions that all demand steady supplies of magnesium for smooth function. The nervous system depends upon sufficient magnesium for its calming effects, including restful sleep. Hibernating animals, by the way, maintain very high levels of magnesium. Magnesium deficiency will accelerate a vicious cycle and amplify the effects of chronic stress, leading to more anxiety, irritability, fatigue and insomnia—many of the symptoms of adrenal exhaustion—as well as to hypertension and heart pains—symptoms of heart disease.
Depression is related to stress and magnesium deficiency as well. Serotonin, the “feel good” hormone, requires magnesium in its delicate balance of release and reception by cells in the brain. Only when adequate levels are present can we enjoy mental and emotional equilibrium.
For reasons not fully understood, the body does not retain magnesium very well; certainly not as well as it holds onto calcium or iron, for example. Heavy sweating from endurance sports such as marathon running or strenuous exercise workouts can dangerously deplete magnesium stores and other electrolytes—although calcium is not wasted, by the way— resulting in trembling, faintness and even seizures and death. The drenching sweats that some menopausal women suffer cause magnesium loss as well, and their diminishing magnesium levels worsen their jagged nerves, sleep disturbances, panic attacks, body aches and depression. If these women have been tempted to consume modern soy products in a misguided attempt to moderate their symptoms, they will in fact lose even more magnesium because it will be bound to the abundant phytates in these concoctions.
A healthy gut environment is necessary for proper absorption of magnesium from the diet. Irritable bowel syndrome, leaky gut, candidiasis and other gut disorders can severely limit the amount of magnesium that the body will be able to absorb. Older adults often experience decreased stomach hydrochloric acid production, which can impair mineral absorption in general. And with so many treating their “heartburn” with antacids, a healthy digestive environment is hard to maintain.
CALCIUM AND MAGNESIUM PARTNERSHIP
Both calcium and magnesium are necessary for the healthy body—in proper balance to one another, as well as to other necessary minerals. Considered biochemical antagonists, one cannot act without eliciting the opposite reaction of the other. Yet calcium and magnesium must both be present in balanced amounts for either one to function normally in the body. Some researchers suggest that the healthy ratio of calcium to magnesium in the diet should be 2:1. Others consider 1:1 to reflect ratios that we evolved with based on our diet prior to the advent of agriculture. In modern industrialized countries the ratio from diet is from 5:1 to as much as 15:1. The imbalance of these two very important minerals produces many dire consequences in the body that are often overlooked by medical practitioners when treating the disease states they cause.
Aside from the intricate electrical dance that calcium and magnesium perform together, magnesium is necessary to keep calcium in solution in the body, preventing its inappropriate deposition in soft tissues. As long as we have sufficient hydrochloric acid in our stomachs we can dissolve calcium from the foods we eat. After calcium leaves the acidic environment of the stomach and enters the alkaline milieu of the small intestine however, it is magnesium that is necessary to keep calcium soluble. Without sufficient magnesium, a whole host of physiological aberrations can occur with serious health consequences.
As Dr. Carolyn Dean, author of The Magnesium Miracle, explains, “In the large intestine it [precipitated calcium] interferes with peristalsis, which results in constipation. When calcium precipitates out in the kidneys and combines with phosphorus or oxalic acid, kidney stones are formed. Calcium can deposit in the lining of the bladder and prevent it from fully relaxing, and therefore from filling completely with urine. This leads to frequent urination problems, especially in older people. Calcium can precipitate out of the blood and deposit in the lining of the arteries, causing hardening (arteriosclerosis). . . It can coat and stiffen. . . plaque in the arteries. . . [and] can cause blood pressure to rise as well as increase the risk of heart attack and stroke. Calcium can even deposit in the brain. Many researchers are investigating it as a possible cause of dementia, Alzheimer’s and Parkinson’s disease. Calcium can deposit in the lining of the bronchial tubes and cause asthma symptoms. Calcium in extracellular fluid. . . can decrease the permeability of cell membranes. This makes it increasingly difficult for glucose (a large molecule) to pass through the cell membrane to be converted to ATP in the cells’ mitochondria. High glucose levels created by excess calcium may be misdiagnosed as diabetes.”
MAGNESIUM IS A POTENT DETOXIFIER
Magnesium is utilized by the body for all sorts of detoxification pathways and is necessary for the neutralization of toxins, overly acidic conditions that arise in the body, and for protection from heavy metals. It plays a vital role in protecting us from the onslaught of man-made chemicals all around us. Glutathione, an antioxidant normally produced by the body and a detoxifier of mercury, lead and arsenic among others, requires magnesium for its synthesis. According to Mark Sircus, in Transdermal Magnesium Therapy, a deficiency of magnesium increases free radical generation in the body and “causes glutathione loss, which is not affordable because glutathione helps to defend the body against damage from cigarette smoking, exposure to radiation, cancer chemotherapy, and toxins such as alcohol and just about everything else.”
When our bodies are replete with magnesium (and in balance with the other essential minerals) we are protected from heavy metal deposition and the development of associated neurological diseases. As Dr. Carolyn Dean explains, “Research indicates that ample magnesium will protect brain cells from the damaging effects of aluminum, beryllium, cadmium, lead, mercury and nickel. We also know that low levels of brain magnesium contribute to the deposition of heavy metals in the brain that heralds Parkinson’s and Alzheimer’s. It appears that the metals compete with magnesium for entry into the brain cells. If magnesium is low, metals gain access much more readily.
“There is also competition in the small intestine for absorption of minerals. If there is enough magnesium, aluminum won’t be absorbed.”
MAGNESIUM DEFICIENCY IN TOOTH DECAY AND OSTEOPOROSIS
Ask anyone—your neighbor or even your dentist or doctor—what bones and teeth require to be strong and healthy, and you will undoubtedly hear the response, “Plenty of calcium.” Bones and teeth certainly do require calcium—as well as phosphorus and magnesium, but without adequate amounts of the latter, calcium will not be deposited in these hard tissues, and the structures will not be sound. “When you load up your system with excess calcium,” writes William Quesnell, in Minerals: the Essential Link to Health, “you shut down magnesium’s ability to activate thyrocalcitonin, a hormone that under normal circumstances would send calcium to your bones.” Instead of providing benefits to the body, the displaced calcium actually becomes toxic, causing trouble in soft tissues of the kinds we’ve already discussed.
Numerous studies, in fact, have established the fact that it is dietary magnesium, not calcium, (and certainly not fluoride) that creates glassy hard tooth enamel that resists decay, and strong and resilient bones. Regardless of the amount of calcium you consume, your teeth can only form hard enamel if magnesium is available in sufficient quantities.
According to J. I. Rodale, in Magnesium: the Nutrient that Could Change Your Life, “For years it was believed that high intakes of calcium and phosphorus inhibited decay by strengthening the enamel. Recent evidence, however, indicates that an increase in these two elements is useless unless we increase our magnesium intake at the same time. It has even been observed that dental structures beneath the surface can dissolve when additional amounts of calcium and phosphorus diffuse through the enamel at different rates. Thus milk, poor in magnesium, but high in the other two elements, not only interferes with magnesium metabolism, but also antagonizes the mineral responsible for decay prevention.”
To revisit Deaf Smith County, Texas, and the justly famous residents whose teeth refused to succumb to decay, Rodale quotes the observations of Dr. Lewis Barnett, presented in a paper before the Texas Medical Association in Dallas, 1952. Dr. Barnett, an orthopedic surgeon, remarked on the low incidence of tooth decay and rapid healing of broken bones among these residents, and offered this explanation: “[The local] water and foods have a very high magnesium and iodine content and recently we have proven that all of the trace minerals known to be essential are present in the water and foods grown in that area.” Further, Dr. Barnett had found that the magnesium bone content of the average Deaf Smith County resident was up to five times higher than that of a resident of Dallas, while the concentrations of calcium and phosphorus were about the same in both groups. His observations led him to state that “[o]ne of the most important aspects of the disease osteoporosis has been almost totally overlooked. That aspect is the role played by magnesium.”
Rodale emphasizes the fact that Dr. Barnett gave much of the credit for these health benefits to the high magnesium content of the local water, and noted many signs of superior bone development among people in the area: “Dr. Barnett makes mention of the fact that people in older years frequently have fracture of the cervical neck of the femur and these are very difficult to heal in many localities. However, he noted that this fracture rarely occurs in Deaf Smith County, whereas it was common in Dallas County, Texas, where he also practiced. When a fracture did occur in Deaf Smith, healing was easy and rapid even in people eighty to one hundred years old. In contrast, fractures in Dallas were common and very difficult to heal, if not impossible.”
Over fifty years ago Dr. Barnett tested the magnesium levels of five thousand people and found sixty percent of them to be deficient. How much more of the population is deficient today, when all of the negative conditions contributing to that deficiency have been certainly amplified?
FOOD SOURCES OF MAGNESIUM
As we’ve mentioned, if farm soils are well-mineralized, leafy green vegetables, seeds, tree nuts and whole grains are fairly good sources of magnesium. Certain wild-crafted forage foods really stand out, however, such as nettles (860 mg per 100 grams) and chickweed (529 mg per 100 grams), and add many tonic and nutritive benefits to both human and livestock diets largely due to their high mineral content. Kelp, ancient denizen of the sea, contains spectacular levels, as do most sea vegetables. Remember that they are continually bathed in a solution whose third most abundant mineral is magnesium. And authentic, unrefined sea salt is a very good source of magnesium, along with trace minerals. Utilizing bone broths on a daily basis will provide another excellent source of minerals, including magnesium, in a highly assimilable form.
STRATEGIES FOR MAGNESIUM SUPPLEMENTATION
Even with ideal digestive conditions, only a percentage of magnesium in foods will be absorbed—less when amounts in the body are adequate and more if there is a deficiency. This is also true of magnesium supplements, and there are many of them on the market to confuse you. For the average person, magnesium supplementation is safe to experiment with on your own, especially if you know you have symptoms that could be related to magnesium deficiency or are under extra stress, and so on. Excess magnesium is excreted in urine and the stool, and the most common response to too much magnesium is loose stools. Those with renal insufficiency or kidney disease, extremely slow heart rate, or bowel obstruction should avoid magnesium therapy.
General dosage recommendations range from about 3 to 10 milligrams per pound of body weight, depending upon physical condition, requirements for growth (as in children), and degree of symptoms.
Oral magnesium supplements are available in organic salt chelates, such as magnesium citrate and magnesium malate. These are fairly well absorbed, especially in powder forms to which you add water and can tailor your dosage. It is important to divide your dosage during the day so that you do not load your body with too much magnesium in any single dose. Carolyn Dean recommends taking your first dose early in the morning and another in the late afternoon—these correspond to times when magnesium levels are low in the body. Is it just a coincidence that these times of low magnesium and low energy also correspond to the cultural rituals of morning coffee and afternoon tea?
Loose stools indicate you are not absorbing the magnesium, but that it is acting as a laxative. When the magnesium travels through the intestines in less than twelve hours, it is merely excreted rather than absorbed. If you find you cannot overcome the laxative effect by varying your dosages, you may want to try an oral supplement that is chelated to an amino acid, such as magnesium taurate and magnesium glycinate, which some consider to be better absorbed than the salt forms and less likely to cause loose stools. For those who need a little help with digestion, such as young children, older adults, and anyone with reduced stomach acid or bowel dysbiosis, consider homeopathic magnesium, also referred to as tissue salts or cell salts. Magnesia phosphorica 6X is the appropriate dosage, and it works to usher magnesium into the cells where it belongs. It is also indicated as a remedy for muscle spasms and cramps of many varieties. Mag phos can help reduce and eliminate loose stools while you are supplementing with oral magnesium, giving you a positive sign that your body is indeed taking the magnesium into the cells.
Yet another option for oral magnesium supplementation is ionic magnesium in liquid form, such as that offered by Trace Minerals Research. This is a sodium-reduced concentration of sea water from the Great Salt Lake in Utah. Only about a teaspoon is needed to deliver about 400 milligrams of magnesium (along with seventy-two other trace minerals), which should be taken in divided amounts during the day. I recommend adding this to soups (made with bone-broth bases of course) as the strong mineral taste is hard to take straight. You can also add this to spring and other drinking water to up the magnesium content and use it in cooking. By “micro-dosing” your food and water in this fashion you greatly reduce any laxative effects a large dose of magnesium might elicit.
Another potential way to get more magnesium into your system is via the pleasant method of soaking in a bath of magnesium sulfate, otherwise known as Epsom salts. Commonly used to ease muscle aches and pains, magnesium sulfate also importantly helps with detoxification when sulfur is needed by the body for this purpose. When used intravenously, magnesium sulfate can save lives in such crises as acute asthma attack, onset of myocardial infarction, and eclampsia in pregnancy.
A couple of cups of Epsom salts added to a hot bath will induce sweating and detoxification; after the water cools a bit, the body will then absorb the magnesium sulfate. According to Mark Sircus in Transdermal Magnesium Therapy, the effects from a bath of Epsom salts, although pleasant, are brief as magnesium sulfate is difficult to assimilate and is rapidly lost in the urine. Magnesium chloride, which can also be used in baths, is more easily assimilated and metabolized, and so less is needed for absorption.
Finally, magnesium may be applied topically in a form commonly called magnesium “oil.” This is actually not an oil at all, but a supersaturated concentration of magnesium chloride and water. It does feel oily and slippery when applied to the skin, but it absorbs quickly, leaving a slightly tacky, “sea salt” residue that can be washed off. There are many advantages to transdermal magnesium therapy, since the gastrointestinal tract is avoided altogether and there is no laxative effect. Next to intravenous magnesium administration, transdermal therapy provides a greater amount of magnesium to be absorbed than even the best tolerated oral supplements, and can restore intracellular concentrations in a matter of weeks rather than the months required for oral supplementation.
MISSING LINK?
It is likely safe to say that most people would benefit from an increased supply of magnesium in their diets, especially in these times of so many dietary, environmental, and social stressors. Of course no single nutrient stands alone in relation to the body, and the first priority is to eat a varied diet of whole plant and animal foods from the best sources near you. Adding extra magnesium, however, might be the missing nutritional link to help us guard against heart disease, stroke, depression, osteoporosis and many other disorders. In the prevention and alleviation of these diseases, magnesium can be truly miraculous.

SIDEBARS
THE MANY EFFECTS OF MAGNESIUM DEFICIENCY
• ADD/ADHD
• Alzheimer’s
• Angina pectoris
• Anxiety disorders
• Arrhythmia
• Arthritis—rheumatoid and osteoarthritis
• Asthma
• Autism
• Auto-immune disorders
• Cerebral palsy in children of Mg deficient mothers
• Chronic Fatigue Syndrome
• Congestive Heart Failure • Constipation
• Crooked teeth/narrow jaw in children from Mg deficient mothers
• Dental caries
• Depression
• Diabetes, types I and II
• Eating disorders—bulimia and anorexia
• Fibromyalgia
• Gut disorders including peptic ulcer, Crohn’s disease, colitis
• Heart disease
• Hypertension
• Hypoglycemia
• Insomnia
• Kidney stones
• Lou Gehrig’s disease
• Migraines
• Mitral valve prolapse
• Multiple sclerosis
• Muscle cramping, weakness, fatigue
• Myopia—in children from Mg deficient mothers
• Obesity—especially associated with high carbohydrate diet
• Osteoporosis
• Parkinson’s disease
• PMS—including menstrual pain and irregularities
• PPH (Primary pulmonary hypertension)
• Reynaud’s syndrome
• SIDS (Sudden Infant Death Syndrome)
• Stroke
• Syndrome X
• Thyroid disorders
Source: Primal Body—Primal Mind, by Nora Gedgaudas.
THE MAGNESIUM CONTENT OF MILK
In general, milk is not a rich source of magnesium, but many cultures throughout the ages have depended upon dairy foods as the foundation of balanced, healthy diets that conferred strength and vitality. Weston Price, for example, investigated residents of the Swiss Alps as well as the African Maasai whose sturdy, disease-resistant individuals had little or no tooth decay. But can we replicate those diets with the same health-giving properties if we depend upon today’s industrialized food model?
The mineral composition of milk depends upon many factors, including the breed of animal, stage of lactation, frequency of milking, environmental conditions, type of pasture, soil makeup and amount of soil contamination. Grass tetany, for instance, is a serious and potentially fatal condition in cattle characterized by extremely low levels of serum magnesium. Also called “grass staggers” or “wheat pasture poisoning,” it is the result of animals grazing on fast-growing young grass in spring or fall on soil that is severely magnesium deficient, as can happen when the pastures have been fertilized with high nitrogen and potassium fertilizers. In acute poisoning, the animal can be saved by injections of magnesium sulfate; yet subclinical magnesium deficiency in the herd may go undetected.
By contrast, pastures that offer a great deal of plant diversity to grazing animals also offer diversity to the soil ecology as well as nutrient diversity to the ruminant. In a Swiss study that examined thirty plant species of alpine pastures, researchers found that “the botanical composition of an alpine pasture has a significant influence on the nutritive value of the forage…. Compared with grass species, legumes and herbs showed a lower content of cell walls but a higher content of crude protein, as well as four times the content of calcium and twice the content of magnesium.” The Swiss visited by Dr. Price grazed their cattle on alpine slopes populated by numerous plant species and watered by the mineral-rich glacial run-off—water the villagers also used in drinking and cooking.
Numerous stresses can take their nutritional toll on the dairy animal and therefore on the quality of her milk. Crowding, confinement, filth and unnatural fodder come to mind instantly as obvious offenders, but too frequent milking— more than once a day—can result in dilution of nutrients in the milk. The daily output is greater, but the nutrients are fewer by volume.
“The mineral content of milk and popular meats has fallen significantly in the past 60 years, according to a new analysis of government records of the chemical composition of everyday food,” begins an article in the Guardian about researcher David Thomas’s comparison of food tables from 1940 and 2002. The research was done for the consumer watchdog group in the UK, the Food Commission, and published in their quarterly journal, The Food Magazine. Mineral declines in dairy products showed that milk lost 60 percent of its iron, 2 percent of its calcium, and 21 percent of its magnesium. Compared to 1940, currently “[m]ost cheeses showed a fall in magnesium and calcium levels. According to the analysis, cheddar provides 9 percent less calcium today, 38 percent less magnesium and 47 percent less iron, while parmesan shows the steepest drop in nutrients, with magnesium levels down by 70 percent.”
Ignoring the declining magnesium content in foods such as dairy products may have confounded some analyses of disease etiology in large populations. Anti-animal-fat proponents tend to blame the rampant incidence of heart disease among the Finns on their high intakes of dairy products. However, according to Dr. Mildred Seelig, of New York University Medical Center, “In Finland, which has a very high death rate from IHD (ischemic heart disease), there is a clear relationship with heart disease and the amount of magnesium in the soil. In eastern and northern Finland, where the soil content is about a third of that found in southwestern Finland, the mortality from ischemic heart disease is twice as high as is that in the southwest. Ho and Khun surveyed factors that might be contributory both to the rising incidence of cardiovascular disease in Europe, and the falling levels of magnesium both in the soil and in the food supply. They commented that in Finland, which has the highest cardiovascular death rate in Europe, the dietary supply of magnesium has decreased by 1963 to a third of the intake common in 1911.”
Modern, urban Finns of course consume pasteurized dairy products, which not only have reduced magnesium levels to begin with thanks to modern farming practices, but also have less soluble calcium as a result of the denaturing of the enzyme phosphatase during pasteurization. Calcium that is not soluble precipitates out to soft tissue, such as the vascular system, and can contribute to a cascade of ominous events linked to heart disease.
We might surmise from these observations, then, that dairy products must be produced with reverence not only to the beast herself, but also to the soil that feeds the pasture that feeds her. When all nutrients are in balance with one another we can expect the food to have the power to truly nourish us.
Countless stressors in life today increase the body’s demands for magnesium—by our challenged endocrine systems, by environmental poisons that must be neutralized, by excess refined carbohydrates in our diets, to name a few. The balance of nutrients provided in the foods in the groups that Dr. Price visited was also in felicitous balance with those peoples’ physical, emotional, and social ecologies. We can only strive, both as consumers and producers of food, to achieve that equilibrium in the ecologies we inhabit.
FOOD SOURCES OF MAGNESIUM
In milligrams per 100 grams
Kelp	760	Pecan	142	Beets	25	
Wheat bran	490	Walnut	131	Broccoli	24	
Wheat germ	336	Rye	115	Cauliflower	24	
Almonds	270	Tofu curdled by Mg nigiri	111	Carrot	23	
Cashews	267	Coconut meat, dried	90	Celery	22	
Blackstrap molasses	258	Collard greens	57	Beef	21	
Nutritional yeast	231	Shrimp	51	Asparagus	20	
Buckwheat	229	Corn, sweet	48	Chicken	19	
Brazil nuts	225	Avocado	45	Green pepper	18	
Dulse	220	Cheddar cheese	45	Winter squash	17	
Filberts	184	Parsley	41	Cantaloupe	16	
Peanuts	175	Prunes	40	Eggplant	16	
Millet	162	Sunflower seeds	38	Tomato	14	
Wheat whole grain	160	Sweet potato	31	Milk	13	
MAGNESIUM SUPPLEMENTATION CAN BE TRICKY
Even when it seems obvious that magnesium supplementation is called for to alleviate typical deficiency symptoms such as anxiety or heart palpitations, finding the best means to raise intracellular levels can be difficult. Most often, oral supplements will cause laxative effects at levels too low to restore magnesium supplies to the cells, where it is needed. Marina, whose husband Alex was recovering from heart surgery, had to be persistent. “I noticed in the hospital that he was given intravenous magnesium during intensive care, but the doctors never mentioned it later on, when Alex was overcome with panic attacks, bouts of low energy, hypertension and arrhythmia. We were offered drugs for all of these conditions, but we both wanted to avoid the medications if at all possible, although we couldn’t at first. A couple of alternative doctors had mentioned magnesium along with other supplements that could help, but with no particular emphasis on the magnesium, so it was by trial and error that we discovered just how effective the magnesium could be. But first we had to find the best way for Alex to take it.
“Capsules of magnesium citrate and magnesium taurate both caused diarrhea at only a quarter of the recommended dose. I learned that chronic magnesium deficiency can unfortunately leave you with a much reduced capacity for intestinal absorption, and it was likely that Alex had been deficient for a long time. This was hard for me to accept at first, since he had been eating a superb diet for many years—full of mineral-rich bone broths, soups with seaweeds and nettles, and no sugar or caffeine. But his history included decades of intense stress and obvious signs of adrenal exhaustion.
“I next tried liquid ionic magnesium, which included trace minerals as found in the Great Salt Lake in Utah. I felt that magnesium in isolation might not be the best way to try to absorb it. Starting with just a few drops in his soup, Alex was able to take more magnesium over time in this fashion, although we still had to be very careful not to exceed a certain amount or the diarrhea would return. Nevertheless, we were starting to see positive results. First came better sleep. Alex had been waking every ninety minutes during the night—he’d get up to pee, come back to bed and struggle to fall asleep only to wake again in ninety minutes to repeat the process. He was certain his prostate was failing, but after about a month with the ionic magnesium, he was able to sleep uninterrupted for three-, then four-, then six-hour spans. We realized his prostate was fine, but his traumatized adrenals had been regularly firing an adrenaline rush to jolt him awake. When they began to be pacified his sleep finally became restful; he now usually only wakes once during the night and can easily return to sleep. And, dare I say, he sleeps better these days than he has for years. Also, with a good night’s sleep his daytime energy level is much improved.
“Alex still had bouts of arrhythmia which had been very frightening at times, and although his hypertension was improving with energy work and flower essences, we knew there was a nutritional component that needed to be addressed. A friend happened to suggest using homeopathic magnesium to help with absorption—she herself was starting to use magnesium supplements and was also experiencing the common problem of loose stools when this solution dawned on her. The concept was brilliant—we needed a way to gently get the cells to accept the magnesium, and so we began using the tissue salts Magnesia phosphorica in the 6X potency. After the very first dose Alex had improvement with his stool and was able to keep up the same dosage of the ionic magnesium. It was as though a key had opened a lock, and the magnesium was now entering the cells where it could do its good.
“One day Alex casually mentioned that he hadn’t had a single moment of arrhythmia in a week. This was stunning news, since he had had at least slight arrhythmia daily for months. Everyone told us this was extremely common after heart surgery and we thought we’d have to accept this fact. Encouraged by his progress, I next purchased some magnesium ‘oil’ in order to have yet another means to deliver the magnesium without involving the intestinal tract at all.
“Our current protocol includes a once-daily use of the magnesium oil. I add ionic magnesium drops to our drinking and cooking water, as well as to every pot of soup, pan of sautéed vegetables, tray of stuffed peppers. I call this ‘microdosing’ and it is in addition to using sea vegetables and plenty of bone broths. Along with the Magnesia phosphorica, Alex takes the tissue salt Kali phosphorica (potassium phosphate) which is indicated for all conditions of nervous debility; the two together make a very good heart tonic. At bedtime, Alex has a single dose of magnesium citrate with a food complex
vitamin C powder. This is a relaxing evening ritual and now causes no intestinal upset.
“The only medication Alex still takes is a beta-blocker for hypertension—a small dose that we hope to be able to quit soon. If you supplement with magnesium and have hypertension you will need to pay close attention to your blood pressure. You will have to reduce your medication accordingly or your blood pressure could get too low too fast! You must do this slowly, though, to give the vascular tissue time to recondition itself and regain elasticity—as it will.
“Finally, Alex himself wanted me to add that the magnesium therapy allowed him to shift the intensity of his focus from his physical condition to his spiritual life, and sparked new creativity. He has begun to write and will be publishing the first in a series of his memoirs early next year. Truly, who would have thought so much healing could be initiated by finally replenishing this neglected mineral?”

REFERENCES
The Magnesium Miracle, by Carolyn Dean, M.D., N.D., Ballantine Books, 2007.
Transdermal Magnesium Therapy, by Mark Sircus, Ac., O.M.D., Phaelos Books, 2007.
Magnesium Therapy, by Patricia Ann Braun, M.D. http:// pbraunmd.org/magnesium.htm.
Magnesium: The Nutrient that Could Change Your Life, by J.I. Rodale http://www.mgwater.com/rod06.shtml.
Leaky gut and magnesium deficiency: http://magnesiumforlife.com/medical-application/magnesium-and-autism/.
The dangers of magnesium deficiency in endurance athletes: http://findarticles.com/p/articles/mi_m0FDL/is_4_14/ai_n24940334/.
Primal Body-Primal Mind, by Nora Gedgaudas, Primal Body-Primal Mind Publishing, 2009.
Healing Wise: Wise Woman Herbal, by Susun S. Weed, Ash Tree Publishing, 1989.
Put Your Heart in Your Mouth, by Dr. Natasha Campbell- McBride, Medinform, 2007.
Salt and our Health
Posted on March 26, 2012 by Morton Satin • 16 Comments 
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Exposing Mainstream Myths
by Morton Satin, PhD, Vice President,
Science and Reseach, The Salt Institute
A side from water, salt (sodium chloride) is the most ubiquitous food ingredient consumed by humankind. It is a nutrient that is essential to life and good health and has always been the predominant positive ion in extracellular body fluid for all multi-cellular animals.
Having originally evolved from a marine environment, the human body’s salt-to-water ratio is critical to metabolism. Human plasma contains 0.9 percent sodium chloride, most of it coming from food and a small amount from water. The fundamental indicator of salt intake sufficiency points to 1.5 teaspoons (8 grams) of salt per day as the basic human requirement.

SALT IS AN ESSENTIAL NUTRIENT
In clinical studies, salt is calculated in millimoles (mmol) of sodium, where 100 mmol of sodium amounts to 2300 mg which is contained in one teaspoon (5 grams) of salt.
If we do not consume sufficient sodium, our metabolism, driven by specific feedback mechanisms, goes into a sodium-sparing mode so that the circulatory system can maintain osmotic balance and adequate blood pressure. This has several important consequences for us. A reduced intake of sodium is characterized by the stimulation of the renin-angiotensin-aldosterone hormonal system (RAAS). Renin, the first enzyme taking part in the RAAS was clearly shown in a dose-response curve1 to increase as sodium intakes fell below 150 mmol sodium (or 1.5 teaspoons/8 grams of salt) per day. At a point of intake below 110 mmol (6 grams) sodium per day renin begins to rise rapidly. The RAAS feedback mechanism is the most transparent measure of our dose response to salt intake and is a fundamental indicator of sodium intake sufficiency.
Although this cascade of reactions is designed to sustain osmotic balance and blood pressure, chronically elevated levels of renin and aldosterone have significant negative effects on the condition of the circulatory system and may stimulate inflammatory agents within the body. Included among the negative outcomes of chronically elevated levels of renin and aldosterone are insulin resistance,2 metabolic syndrome,3 cardiovascular disease,4 cognition loss,5 and others.
SALT AND BLOOD PRESSURE
The overwhelming public interest in salt consumption derives from the concern over its perceived universal impact on blood pressure (BP). Unfortunately, this has long been a subject of significant myth-information. The cross-population blood pressure response to salt reduction is heterogeneous.6 With major reductions in salt (more than half of our current consumption), about 30 percent of the population will experience a slight drop (2-6 mm) in systolic BP, while about 20 percent will see a similar increase in BP, and the remaining 50 percent of the population will show no effect at all. Considering the relatively small impact of major salt reduction on blood pressure, it is unfortunate that consumers are not aware of all the other negative consequences that occur as a result of dietary salt reduction.
PUBLIC PRESSURE TO REDUCE SALT
In the late 1980s, in response to the notion that sodium had a major impact on a population’s blood pressure, an international study (Intersalt) was carried out to determine the impact of salt consumption on blood pressure.7 As it turned out, the per capita consumption of sodium in the majority of countries ranged between 130-210 mmol sodium or the equivalent of 1.3 to two teaspoons of salt (7-10 grams) per day. The results indicated that there was no clear pattern between the level of salt intake and blood pressure. However, there were four populations among the fifty-two groups that showed very low salt intakes and far lower than average blood pressures. The lowest consumption population in this group was the primitive Yanomami Indians, who live in the Brazilian rain forest. Normally, data points that are very far from the rest of the pattern are referred to as outliers and are generally omitted from the analysis. In this case, the outliers were included and a line drawn from them to the rest of the population in order to show that a pattern relating salt consumption to blood pressure did exist. (See Figure 1.)FIGURE 1. InterSalt Study
While the advisability of making comparisons between modern Western societies and those that have vastly different lifestyles, levels of physical activity, caloric intakes and environmental stresses is legitimately open to question, the issue of life-long low BP among the Yanomami was repeatedly used as a justification. The Yanomami are described in the ethnographic literature as an aggressive and violence-prone people. The stress associated with this character along with the continual exposure to environmental stresses does not appear to influence the BP of the Yanomami as they would other population groups. While their abnormal BP profile has been attributed to reduced salt consumption, a far more likely reason appears to be the almost complete absence of a D/D genotype—a genetic trait shared with other Amerindians such as the Xingu Indians of the Amazonian rainforest, one of the other four outlier points. Notwithstanding their lack of an age-related rise in blood pressure, the Yanomami are characterized as a small stature, high mortality and high fertility population with a low life expectancy. It is also interesting to note that despite their long history of evolution in a salt-limited rainforest environment, they have never acclimatized to low sodium intake and have chronically high levels of plasma renin. Nevertheless, the inclusion of the Yanomami data in the formal Intersalt analysis, however misguided, initiated the latest round of salt-restriction efforts.
The supposed merits of significant population-wide dietary salt reductions were further justified through the Rose population strategy theory,8 which contended that most risks to health, including hypertension, were evenly distributed as a continuum across the population rather than being confined to high-risk groups as shown in Figure 2.9FIGURE 2. Rose Population Strategy
Accordingly, modest risk reductions in BP (such as those achievable through significant salt reduction) across the entire population, including normotensive individuals, might conceivably reduce the population incidence of cardiovascular disease. This inspired the idea that a great number of lives and millions of dollars in health care costs might be saved through dietary salt reduction. But this notion appears to have a number of obvious flaws.
In the first instance, salt sensitivity and the tendency towards elevated blood pressure is largely driven by genetics and thus not evenly distributed, but rather highly skewed across the population. In addition, if an intervention such as dietary salt reduction demonstrated even a small negative effect (such as any one of the outcomes resulting from stimulation of the renin-angiotensin- aldosterone system), this would tend to shift the risk curve in the opposite direction and result in greater risk of morbidity and mortality. Finally, any intervention that might statistically benefit the public health (such as an insignificant drop in BP) may not translate into any difference at all to an individual’s health—commonly referred to as the “Population Paradox.”10 Considering the apparent shortcomings to this theory, it is remarkable that it was so widely and uncritically accepted.
FLAWED STANDARDS
The intellectual stage was thus set to establish standards on salt consumption that were fundamentally flawed. And that’s exactly what happened with the Dietary Reference Intakes (DRI) for sodium. In fact, they sank a great deal further into the mire of medical myth-information. The DRI for sodium, the foundation publication for our current recommendations for salt consumption, clearly state at the outset that “Because of insufficient data from dose-response trials, an Estimated Average Requirement (EAR) could not be established, and thus a Recommended Dietary Allowance could not be derived. Hence, an Adequate Intake (AI) is provided.”11
This single statement concedes, from the very beginning, the shift away from an evidence-based approach in establishing recommendations to one of subjective inference: opinion. Rather than a plea for more research to enhance the insufficient base of evidence, the text presents a blunt fiat, based upon expediency rather than anything else. The AI was arbitrarily set by the DRI committee at 1,500 mg sodium or a little more than one half teaspoon (3 grams) of salt per day for young adults “…to ensure that the overall diet provides an adequate intake of other important nutrients and to cover sodium sweat losses in unacclimatized individuals who are exposed to high temperatures or who become physically active…” However, no supporting information on young adults was provided to confirm that this arbitrary figure was in any way justified. In fact, this opinion has since been shown to be incorrect.12
The case for setting the upper limit of salt consumption at the equivalent of 100 mmol (2,300 mg) sodium or one teaspoon (8 grams) of salt per day appeared even more problematic. Rather than determining the body’s integrated response to various levels of salt; i.e., the normal and rational dose response methodology used for all nutrients, it was clear from the start that the overwhelming preoccupation with just one surrogate measure for cardiovascular disease—blood pressure—would remain the singular focus: “The major adverse effect of increased sodium chloride intake is elevated blood pressure, which has been shown to be an etiologically related risk factor for cardiovascular and renal diseases.” Furthermore, the use of precisely 100 mmol sodium (contained in 5 grams or one teaspoon of salt) was not the result of any dose-response relationship involving an established suite of health outcomes. It was nothing more than an arbitrary and convenient set point from which to observe any reductions in blood pressure (regardless of how small) when sodium intakes were decreased.
Nevertheless, this was the intellectually bankrupt basis upon which the recommendations for salt were set, with full confidence that the public acceptance of salt-health mythology would serve to allay any critical scrutiny. What were these salt myths?
MYTH 1:
We eat more salt today than ever before.
FACT: Our current salt consumption (1.5 to 1.75 teaspoons per day, 8-9 grams) is about one half of the amount consumed between the War of 181213 and the end of World War II,14 which was about three to 3.3 teaspoons (16-17 grams) of salt per day.
MYTH 2:
Our knowledge of the major sources of salt in our diet (i.e., 80 percent from processed foods) is unquestionable.
FACT: These data, referred to in every medical publication, is based on a single paper from 1991, which involved a dietary recall (a very unreliable method of data gathering) of a total of just sixty-two persons.15
MYTH 3:
Our salt consumption continues to rise every year.
FACT: There has been no change in our consumption of salt since the mid-1950s.16
MYTH 4:
The thirty-year public health initiative in Finland represents a successful model of salt reduction.
FACT: While Finland was able to reduce salt consumption among its population from 2.3 teaspoons of salt (12 grams) per day down to 1.3 teaspoons (7 grams) per day in the period from 1970 to 2000 (in much the same way that the U.S. did from 1945-1960), the health benefits that they have achieved during the same time period were no better (and, in fact, marginally worse) than neighboring and other countries that did not reduce salt consumption.
MYTH 5:
Current levels of salt consumption result in premature cardiovascular disease and death.
FACT: When average life expectancy in various countries is plotted against the average salt intake in those countries, it is clear that the higher the salt consumption, the longer the life expectancy. (See Figure 3.) While no cause-and-effect relationship between sodium intake and lifespan is implied, the data clearly demonstrate the compatibility between life expectancy and the associated levels of sodium intake.
FIGURE 3. InterSalt Life Expectancy
MYTH 6:
Cutting back on salt will improve the overall diet.
FACT: Salt makes the bitter phytochemicals in salad greens and vegetables more palatable. Removing salt from dressings or accompaniments will make these important diet items less acceptable and will discourage people from eating them.
MYTH 7:
Reduced salt levels are critical to the DASH diet.
FACT: When the results of the DASH Sodium trial are examined (see diagram in Figure 4), it is immediately apparent that merely moving to a DASH diet (red line) has a significantly greater impact on blood pressure than simply lowering salt consumption. Dropping from the normal level of sodium consumption to the Dietary Guidelines’ recommended level reduced the systolic pressure in the American diet (blue line) by an average of 2.1 mm Hg. However, simply changing from a
standard American diet to the DASH diet, without any changes to sodium consumption, reduced the systolic blood pressure by 5.9 mm Hg, almost three times the drop resulting from the recommended sodium reduction. More important, reducing salt makes the DASH diet far less palatable and thus discourages people from adopting it.
FIGURE 4. The DASH Sodium TrialMYTH 8:
There is a clear relationship between salt intake and blood pressure.
FACT: The lack of a clear relationship between salt intake and blood pressure is best exemplified with the standard hospital saline IV drip, which supplies an average of three liters of 0.9 percent sodium chloride per day. This is equivalent to twenty-seven grams of salt (4.5 teaspoons) per day while in the hospital in addition to the six grams (one teaspoon) of salt taken in food (if the Guidelines are followed). That is a total of thirty-three grams of salt per day or more than five times the Dietary Guideline recommendations! Yet patients’ BP is checked every four to six hours and does not change. Where is the purported relationship of salt intake to blood pressure?
MYTH 9:
Reducing salt intake can do no harm.
FACT: Reduced salt intakes have repeatedly been linked in the medical literature to the following conditions:
• Insulin resistance (diabetes)
• Metabolic syndrome
• Increased cardiovascular mortality and readmissions
• Cognition loss in neonates and older adults
• Unsteadiness, falls, fractures
• Lifelong avidity for salt
• And more
MYTH 10:
The U.S. Dietary Guidelines process is valid.
FACT: The original Dietary Recommended Intakes (DRI), issued under the imprimatur of the Institute of Medicine (IOM) (National Academy of Sciences), were immediately accepted internationally and spared the critical scientific review normally given to nutritional recommendations. Indeed, any conscientious perusal of the document reveals the numerous compromises and rationalizations made in lieu of actual evidence in order to arrive at the final recommendations. This was reiterated during a 2007 IOM workshop entitled, “The Development of DRIs 1994–2004: Lessons Learned and New Challenges,”17 where several participants stressed that the DRIs were largely based on the lowest quality of information—opinion—rather than on randomized controlled clinical trials which represent the highest quality of evidence. Yet the disposition of the DRIs provides an insight into how far we have strayed from the scientific principle of adherence objectivity and evidence-based medicine.
The five-year Dietary Guidelines for Americans (DGA) review process has always been publicized as being an “independent and objective” reevaluation of the previous DGAs. The 2005 DGA for sodium referred to the DRIs as a foundation document and assumed all its recommendations. The consequent 2010 DGAs reconfirmed the recommendations of the 2005 DGAs with the proviso that the at-risk populations consume 1,500 mg sodium (1/2 teaspoon/3 grams salt) per day for the upper limit. As it happened, the Chair of the original DRIs committee that set the first recommendations for sodium also happened to serve as the Chair of the 2005 Dietary Guidelines Subcommittee on Electrolytes and thus evaluated the very recommendations that he was responsible for promulgating in the first place.
In 2010, the process was repeated and, once again, the same Chair of the Subcommittee on Electrolytes ran the show. This sequence, fully sanctioned by the Institute of Medicine and the U.S. Department of Agriculture, begs the question as to whether any “independent and objective” analytical process can feature a single individual piloting the creation of standards (DRIs) who then is charged with evaluating his own recommendations five years later, and asked once again to evaluate his prior evaluations. This process makes a sham of the concept of independent, objective evaluations and makes a mockery of the integrity of our great scientific institutions!
WHERE ARE WE NOW?
Notwithstanding the myths and limitations described above, the recommendations for sodium have been accepted, without reservation, by virtually every public health agency around the world. Yet, despite the near impossibility of goal achievement in practical terms, the recommendations appear to represent a level of consumption that results in no more than mid-single digit reductions in systolic BP for a limited portion of the population and a similar sized increase in BP for another limited portion of the population. Several meta-analyses have seriously questioned the purported long-term benefits of population-wide salt reduction,18-21 while others have vigorously supported it.22
In fact, conflicting comment and repeated parsing of the “evidence” has become a regular feature of the salt-and-health debate, leading some journalists to complain that “almost every nutritional ‘fact’ is in reality an opinion, often based on poor quality evidence.”23 Considering that overall good health comprises considerably more than a single digit blood pressure response, the current dietary recommendations have served as a decades-long red herring obscuring the need for more research to get more and better dose-response data.
A BETTER UNDERSTANDING OF SALT NEEDS
Several recent publications appear to get us closer to what may be considered to be the human requirement for salt. For example, a very recent study from Harvard Medical School demonstrated that when healthy people were placed on a very low-salt diet (20 mmol sodium or a fifth of a teaspoon (1 gram) of salt per day), they developed insulin resistance within seven days.24 Those placed on high salt diets (150 mmols or 1.5 teaspoons/8 grams of salt) showed no such effect. We conclude that low-salt intakes warrant further investigation in the pathogenesis of diabetes and cardiovascular disease.
In a series of three analyses of consecutive National Health and Nutrition Examination Surveys (NHANES I,25 II ,26 and III27 ), researchers were unable to demonstrate any survival advantage resulting from low-sodium diets; on the contrary, a modest relationship between increased all-cause mortality and low-sodium diets was observed (although non-significant).
A recent study conducted to examine the health outcomes related to salt intake (as measured by twenty-four-hour urinary sodium), demonstrated that lower sodium excretion was associated with an increased risk of cardiovascular death, while higher sodium excretion did not correspond with increased risk of hypertension or cardiovascular disease complications.28 Another meta-analysis of one hundred sixty-seven studies by Graudal and co-workers29 confirmed and expanded upon previous reports that significant dietary sodium restriction from greater than or equal to 150 mmol sodium (1.5 teaspoons/8 grams of salt) per day down to a level of less than or equal to 120 mmol sodium (1.2 teaspoons/6 grams of salt) per day resulted in limited but significant reductions in blood pressure. In white subjects who were hypertensive, the mean reduction was 5.5 mm Hg systolic and 2.8 mm Hg diastolic. For white normotensive subjects these figures dropped down to 1.3 mm Hg systolic and 0.1 mm Hg diastolic. However, the meta-analysis went further to confirm and quantified the unfavorable impacts that sodium restriction had on several other risk factors for cardiovascular disease. These included significant increases in renin, aldosterone, catecholamines (adrenaline, noradrenalin) and lipids (cholesterol and triglycerides). Renin and aldosterone were of particular concern as they have been repeatedly associated with increases in cardiovascular mortality in long-term follow-up studies.
During his Presidential address to the International Society of Hypertension, Alderman referred to a J-shaped response to describe the broader impact of sodium intake on health outcomes, referring to evidence of harm observed at the low and high extremes of consumption, with the least impact noted in a broad middle range centered around 3,500 mg sodium or 1.5 teaspoons/8 grams of salt per day.30
In a recent study, published in the Journal of the American Medical Association (JAMA),31 researchers found moderate salt intake to be associated with the lowest risk of cardiovascular events, whereas low intakes, equivalent to less than or equal to 3,000 mg sodium or 1.5 teaspoons (8 grams) of salt per day, were associated with an increased risk of cardiovascular death and hospitalization for congestive heart failure, and higher intakes of more than 7,000 mg sodium or three teaspoons (15 grams) of salt per day, were associated with an increased risk of stroke, heart attack and other cardiovascular events. Once again, a J-shaped curve appeared to describe the dose-response relatioFIGURE 5. Consolidated Study ResuThe J-shaped or U-shaped curve is a common dose-response occurrence for essential nutrients in both plant and animal species.32 French nutritionist, Gabriel Bertrand, mathematically described the original relationship in 1912.33 What is now known as Bertrand’s Rule applies to a great many micro- and macronutrients. At very low levels of intake, where there is insufficient nutrient flux to support the full range of associated physiological functions, there is a high risk of adverse effects. This is considered the deficiency range. If the adverse effects don’t result in acute catastrophic events, individuals may survive, although at a diminished potential. As the level of nutrient is increased to a point where the deficiency disappears, minimal adverse effects are experienced and homeostasis is established. Continually increasing intake leads to exceeding the homeostasis requirement and adverse effects reappear (though not necessarily the same ones).
Although there is a quantity of data describing storage of sodium within the body, it is difficult at this stage to speculate what role storage plays in maintaining physiological homeostasis. It therefore remains for us to determine what type of data are available to give us an indication of the optimum level of consumption. Simply from a biological feedback perspective, the point at which a deficiency of salt elicits an increase in renin production must be considered a basic biological indicator. Using the study of Alderman, et al.,1 anything less than 170 mmol (3,910 mg) sodium per day (1.7 teaspoons/9 grams salt) appears as a starting point. As increases in renin only occur when sodium intake is insufficient, these data do not permit an estimate for an upper limit.
SALT CONSUMPTION AND LIFE EXPECTANCY
Average life expectancy is often considered a measure of the overall health of a population, (although infant mortality in some countries can be a confounding factor). Comparing the InterSalt study data on average sodium consumption in thirty-two countries around the world34 with life expectancy results in the following picture. If we take the top 20 percent with greatest life expectancy, their sodium intake ranges from 140–205 mmol per day, averaging around 170 mmol (1.75 teaspoons of salt/9 grams). While no cause-and-effect relationship between sodium intake and lifespan is implied, the data do demonstrate the compatibility between life expectancy and the associated levels of sodium intake.
While not providing a continual dose-response relationship, the data in the recent Graudal paper29 illustrate a series of responses to reducing salt consumption from more than 150 mmol (1.5 teaspoons/8 grams of salt) down to less than 120 mmol sodium (1.2 teaspoons/6 grams) per day. Together with a small but significant reduction in blood pressure, there is also a concomitant significant increase in several other risk factors for diabetes and cardiovascular disease. Again, while no continual dose response relationship is implied, the risks appear to outweigh the benefits when reducing sodium consumption below 3,450 mg (1.5 teaspoons/8 grams) per day.
Consistent with the NHANES studies,25-27 the paper demonstrated significant increases in cardiovascular mortality as consumption of sodium dropped from a high of 260 mmols (just over 2.5 teaspoons/13 grams of salt) down to a low of 107 mmols (a bit more than one teaspoon).
Finally, based on a long-term study with a large cohort, the O’Donnell paper31 sets out a J-shaped response curve with the range of lowest risk between a daily consumption of 1.3 (7 grams) and three teaspoons (15 grams) of salt per day.
If the data from the above studies are compiled, it is apparent that the range of sodium intake at which there is least negative health outcome impact is anywhere above approximately 3,000 mg per day or the equivalent of 1.3 teaspoons (7 grams) of salt. This also happens to be the range that most people around the world consume. These data are not based on surrogate end points, but on hard outcomes (mortality) and dose responses involving measurable feedback responses (renin, aldosterone, catecholamines, cholesterol and triglycerides) that, in the words of the DRIs, are not subject to “imprecision in blood pressure measurement.”
These results support the idea that sodium is consumed in a fairly narrow hygienic range,35 which has more recently been approximated as 2,691-4,876 mg sodium or between 1.2 (6 grams) and 2.13 teaspoons (11 grams) of salt per day.36
Considering the available evidence, it is difficult to determine a practical maximum for salt because the data suggest that such a level is outside our current consumption range; i.e., greater than 7,000 mg sodium or the equivalent of three teaspoons (15 grams) of salt per day. In other words, our taste response to salt may be self-limiting.
HISTORICAL RATES OF SALT CONSUMPTION
It is of great interest that available data suggest Western societies consumed between three and 3.3 teaspoons (15-17 grams) of salt per day from the early 1800s until the end of World War II, based on military archives for prisoner-of-war and soldier rations around the world. During the Anglo-American War of 1812, despite its high cost, salt rations amounted to three teaspoons (15 grams) per day.37 American prisoners of war, incarcerated in Britain’s Dartmoor prison, bitterly complained that the 1.5 teaspoons (8 grams) of salt per day they received was part of “…scanty and meager diet for men brought up in the land of liberty, and ever used to feast on the luscious fruits of plenty…”38 Declassified World War II documents regarding rations fed to American prisoners of war show a ration of one hundred forty grams per week or 3.3 teaspoons (17 grams) per day.39
After World War II, when refrigeration began to displace salt as the main means of food preservation, salt consumption in the U.S. (and somewhat later in other countries) dropped dramatically to about half that rate, or nine grams (1.8 teaspoons) per day and, based on twenty-four hour urinary sodium data, has remained flat for the last fifty years.40 During that time, rates of hypertension have increased,41 thus casting doubt on any linkage between the two.
It is telling that this sudden drop took place without pressure or influence from any government Dietary Guidelines, public health institutions or strident warnings from salt-reduction advocates. The massive reduction was the result of an effortless shift to a palatable, cold-chain-based food supply. It is further interesting that this abrupt drop halted at one level of consumption fifty years ago and descended no further. It is equally extraordinary that, without guidance or pressure of any kind, the consumption of salt around the world, for more than two centuries has remained in the range of 1.5 to three teaspoons (8-15 grams) per day, which, from all the available data, appears to hold the lowest risk for us. It lends support to the notion of the “wisdom of the body” at work through a mechanism that may not be as obvious as the typical sodium appetite so common in most other mammalian species, but effective nevertheless.
Regardless of the evidence, we now must face a certain reality resulting from the two decades-long campaign to reduce salt. Because the Dietary Reference Intakes for salt were promulgated by the Institute of Medicine, they were immediately adopted without question by most public health agencies around the world. This position, repeated and amplified by an uncritical press influenced the food industry to consider salt reduction strategies very seriously, not because there was genuine concern for the impact of salt on health, but for two commercial considerations. The first was the concern related to public pressure as the food industry did not want to be perceived as purveyors of unhealthy products. Second, reduced salt product formulations had the potential to become new “low salt” varieties that might capture additional market share.
Salt reduction initiatives are now the largest product development expenditure in the processed food industry, and the chemical senses research institutes—which played a critical role in promoting salt reduction strategies42—are the major recipients of these research funds. Advancements in chemistry may result in reduced-sodium products that have acceptable taste profiles for consumers. If this does occur, the question remains how a reduced-salt food supply might impact the health of the public.
Early indications from the UK indicate that while the salt content of processed foods is reduced, the sales of table salt appear to have increased dramatically.43 Unfortunately, this phenomenon is complicated by the habit of using table salt for de-icing home steps and sidewalks in the UK. As yet, no solid relationship has been established between reduced salt in processed food formulations and increased use of table salt. The results of the Food Standards Agency (FSA) UK salt survey are due in 2012 and it may be possible to determine whether urinary sodium levels have indeed fallen. The 2011 FSA salt survey results coming out of Scotland44 indicate that this had not occurred as yet, and consumers do appear to be making up for the significantly reduced salt levels in processed foods through some means.
If this is indeed the case, a question to consider is whether our relatively stable consumption of salt around the world is the result of our avidity for the taste of salt or a physiological sodium appetite mechanism that drives us to seek out a particular level of salt. This is a critical question. If advances in salt reduction chemistry are able to trick our taste senses and there are no other physiological mechanisms at work, then consumers will be able to reduce their salt consumption, perhaps even as far down as to the DGA recommended levels of 1,500–2,300 mg sodium (a little more than one-half to one teaspoon/3-5 grams of salt) per day. If that were to be the case, then the reported population-wide risks associated with increased plasma renin and aldosterone, catecholamines, cholesterol and triglycerides would be of concern and people may die prematurely as a result.
If, on the other hand, there is some form of sodium appetite mechanism at work, then the chemistry directed at deceiving our taste senses should not be particularly effective, since our hunger for salt would result from something other than organoleptic pleasure. If this were the case, then there is a possibility that reducing salt in processed foods may stimulate increased consumption of food, simply to achieve a set level of sodium intake, thereby exacerbating the obesity epidemic. (The sodium appetite mechanism is currently applied commercially to cattle finishing feed, where total intake is controlled by adjusting the level of salt content. Reducing the salt content stimulates cattle to consume more feed, while increasing salt has the opposite effect.)
Aside from the previous risks noted, there is a possibility that reduced salt in processed food formulations will affect dietary choices. The nutritious phytonutrients associated with dark green vegetables and salads are bitter and generally more palatable with salt added directly, through dressings or in processed accompaniments. The heart-healthy diet practiced around the Mediterranean Basin is considerably higher in salt than that in most Western European and North American countries, because so many of the traditional foods they consume are still preserved with salt. However, salads and vegetables make up a large part of that diet and salt is used liberally to ensure palatability. (The Latin derivation of the word “salad” is “sal,” and refers to salted vegetables.) A reduced dietary salt intake may discourage consumption of salads and vegetables, particularly among children.45 In the UK, where salt has been removed from many school lunches, students avoid their vegetables until they get home. Writing in the UK Telegraph, journalist Paul Eastham complained that since the school ban on salt shakers, his daughter stopped eating vegetables, because they are so bland.
“All the goodness they promise to deliver remains untouched on the plate—a complete waste of nutrients, health potential and money—all because they remain unpalatable…. My daughter might not touch the ‘bland’ vegetables at school, but at home—where she is allowed to use salt—she clears her plate.”46
We appear to be at a crossroads in the salt-health debate. The decades-long impasse regarding the merits of population-wide salt reduction can only be resolved with conclusive research—not to delay the implementation of public health policies but to substantiate them before they are imposed on the public. The study that would best serve the needs of consumers and public health agencies alike would be a large-scale, long-term, randomized, controlled trial on the impact of reduced salt intakes on a suite of agreed health outcomes—not surrogate measures. Considering the food industry’s current focus and expenditures on salt reduction efforts, it is in its interest to financially support such a trial, if only to confirm the importance of their ongoing salt reduction efforts.