The Perils of Eating, American Style
>Paul Bragg, 91, claims that his lifeguard's physique was the result of two hours of daily exercise at Honolulu's Waikiki Beach and his special diet. He eats natural foods--fresh fruits, vegetables, seeds, but little meat and no salt; he plans to live to 120.
>A California farmer who markets produce supposed to be "organic"--free of insecticide and chemical fertilizer--is known to spray his crops at night to protect them from insects and himself from his customers' wrath.
> A young Chicago secretary looks up from her fourth salad of the day with a frown. "If you eat right," she says, "you're supposed to want to jump up and down even if you have a gimpy leg or are mentally retarded. Only it doesn't work out that way. I mean, I eat the things I'm supposed to, but I don't feel any healthier."
>Lyn Duddy, a New Yorker who writes music and lyrics for television and nightclub acts, once weighed 268 Ibs. He is now down to about 170 and hopes to stay there thanks to an unusual regimen that permits him to eat heavy cream, dressings and certain other rich food, but allows almost no fruit, cake or candy.
> Dr. Arthur Simon, a Beverly Hills, Calif., physician who specializes in the problems of the overweight, worries that any further Government crackdowns on amphetamines, which are used as appetite suppressors, may curb his practice (see following story).
In their own way, these people are part of a mounting U.S. obsession with food. Whether they are simply trying to get thin, or whether they are pursuing health or even salvation through diet, Americans are perhaps more preoccupied than any other nation with what to eat, what not to eat, how to eat and even when. It seems that the American kitchen has become a battleground as people in growing numbers rebel against the American way of eating. If the methods are sometimes dubious, the cause is worthy. While a small minority in the U.S. is still underfed because of poverty, the huge majority packs away enormous quantities of edibles. The superficial cost is low; Americans spend less of their disposable income on food than any other nationality. The real cost is horrendous, because many of the affluent are shortening their lives by committing caloric harakiri.
Disagreement. Among the principal weapons are excessive salt and an overabundance of sugars and fats, which fill the stomach without fulfilling all the body's nutritional needs. The dietary death wish is acted out according to lifestyle: by habitual snacking, by gorging on gourmet treats and rich desserts, by a heavy reliance on processed foods and the no-breakfast, lunch-on-the-run schedule--or all of the above. Even when they eat a sensible variety of foods, Americans and citizens of other prosperous nations tend to eat more than their bodies consume in physical activity, given the sedentary habits of the post-agrarian era.
In recent years, there has been considerable improvement in popular comprehension of the problem. Reasons: medical research linking overeating and heart disease, consumer campaigns against low-quality food and incomplete labeling, the counterculture's war on all things artificial, the conviction that thin is chic. The popular response, however, has been confused. Having begun to suspect that eating as usual is not good for them, Americans are often frustrated in their quest for something better. Dietary prescriptions tend to be contradictory. Nutritionists disagree on the merits of milk drinking, argue over the value of vitamins and debate long and learnedly over the role of diet in health and weight control. Their disagreement and a shortage of conclusive scientific data on nutrition have left Americans sure of only one thing: too much food, one of the perils of plenty, can be dangerous to your health.
Man has long invested the simple and necessary act of taking in nourishment with heavy ritual. Therefore, it is fitting that one of the kinkiest divisions in the army of culinary skeptics, the health-food addicts, should operate with almost religious conviction. Believing that good health, not to mention beauty, longevity and even sexual potency, depend on the proper foods, they spurn most pre-packaged products. Instead they insist upon vegetables grown in soil that has been enriched with manure rather than chemical fertilizers, meat from animals raised without growth-stimulating hormones, bread from which no grain particles have been removed.
The variety of such foods is vast. At Erewhon Natural Foods in Los Angeles, natural-food gourmets can find deep jars full of grains, nuts and buckwheat spaghetti. They can also pick up such exotica as whole-wheat bread with avocado and tomato filling, and ginseng, an herbal root from Red China.
Some eat such foods for religious reasons, believing that certain items nourish the soul as well as the body. "Eating is a spiritual movement," says one of Erewhon's customers. "It upsets me to see people eating junk. It's just an escape, like drugs or alcohol." Followers of the late George Ohsawa, a Japanese-born philosopher, subscribe to a macrobiotic diet that relies on tea, brown rice, beans and nuts. That program may slight fats. A New Jersey girl who followed it too strictly died of malnutrition, and parents who limit their infants to the guru's menu risk rearing mentally retarded offspring.
Durable Experts. Others believe that certain foods can prevent or control disease. Honey is supposed to help those with cancer, pumpkin seeds those with prostate trouble. Beet juice is believed to benefit the blood, while carrot juice, it is claimed, helps dissolve cancers and heal ulcers. There must be some advantages to eating properly. Septuagenarian Gayelord Hauser, who has been writing about health for almost 50 years, is still going strong. In fact, a number of such experts have proved durable. Carleton Fredericks, 62, still has a following as does Jonnie Lee MacFadden, widow of Physical Culturist Bernarr MacFadden.
Not all naturalists seek to control disease through diet; some object to what they consider the artificiality of many food products: the colorings added to enhance their appeal, the chemicals put in to improve their taste, the preservatives to increase their shelf life and the processing that may rob them of their nutrients. Some items pushed by the granddaddies of today's faddists have proved highly beneficial. They long ago touted wheat germ, the vitamin-rich embryo of the wheat kernel, and such health store staples as safflower oil, nuts and unsweetened juices.
But the current interest in organics is unprecedented. In 1965 there were only 500 stores in the U.S. specializing in health foods. Now there are more than 3,000. Virtually every major supermarket chain is either carrying or considering handling a line of health-food items. Some estimate that sales will top $400 million this year and account for 5% of all supermarket sales.
The growth has come despite premium prices. True organic produce costs about 30% more to produce and deliver than conventional items. The extra effort needed to raise certain vegetables organically and the limited distribution may double the retail cost. A pound of Granola, a cereal containing oats, wheat germ and sunflower seeds, can run a customer as much as 89-c-, or just about twice the price of a box of "enriched" breakfast cereal. Fertilized eggs, which contain a tiny chick embryo, average 30-c- a dozen more than standard, unfertilized eggs. Yet demand for such products is so great that profits are almost always assured.
Temptation. Abuses also seem inevitable as some unscrupulous merchants seek to capitalize on the fad. Allen Grant, West Coast editor of the late J.I. Rodale's Organic Gardening and Farming, believes that anywhere from 50% to 70% of the food labeled organic is, in fact, no different from that being sold on supermarket shelves. Even if that estimate is too high, most experts agree that more "organic" food is being sold today than actually grown. "The temptation is obvious," says Mrs. Crissy Rose, a research analyst at California's department of consumer affairs. "The market is there, but the food is not, or is more costly to obtain."
What if the food is genuinely organic? Many nutritionists agree that unprocessed, unadulterated products may often taste better than their conventional counterparts. Fruits and vegetables are usually fresher and come from plant varieties chosen for flavor. But all reject the faddists' claim that such foods are necessarily more nutritious. "Plants produce nutrients to aid their own growth, not to benefit those who will eat them," says Dr. Myron Winick, director of the Institute of Human Nutrition at Columbia University's College of Physicians and Surgeons. "There is no evidence--and no reason to believe--that organically grown plants contain any more vitamins than foods fertilized with nitrates." Nor, Winick says, is there any reason to assume that natural vitamins are better than the synthetic kind. Says he: "The body cannot tell the difference between natural vitamins and those made in the laboratory."
A few nutritionists dismiss the organic-food cult as nonsense. Thomas Jukes, professor of medical physics at the University of California at Berkeley, says that "the movement is dangerous to the consumer because, by misrepresenting science, it brings about a mistrust of the entire food supply." Others see it as a harmless search for nutritional peace of mind.
East River Pop. The majority of nutritionists, though no aficionados of the organic themselves, believe that the trend is beneficial. Jean Mayer, a professor of nutrition at Harvard's Graduate School of Public Health as well as a presidential adviser, thinks that the organic movement has increased public awareness of the chemicals that have become regular ingredients of processed foods. Such knowledge, he feels, has been at least partially responsible for the banning of cyclamates, artificial sweeteners used in soft drinks, and diethylstilbestrol (DES), a synthetic hormone-like substance added to cattle feeds. Both have been linked with cancer in humans. Says he: "Some commercial soft-drink labels read like a qualitative analysis of the East River." He stresses, however, that since the first White House Conference on Food, Nutrition and Health in 1969, there has been a more thorough review of additives. In fact, in discussing the contents of soft drinks, he expressed more concern about their nutritive benefits than their additives.
The organic-food movement has also helped to make consumers more conscious of their general diet and led many people to read the labels of the products they buy. Such scrutiny can be important. Example: a look at the label on a soup can reveals that one of the primary ingredients is salt, something that many with severe hypertension could do well to avoid.
The health-food explosion is only one manifestation of Americans' new interest in nutrition. Many, feeling that no foods can provide them with all the nutrients they need, gobble daily doses of vitamins and other dietary supplements that they believe hold the key to good health. Sales of vitamins have been increasing. A decade ago, vitamins brought the nation's pharmaceutical houses a total of about $300 million; this year, vitamin manufacturers are estimated to gross almost $500 million.
Magic Bullet. Vitamins are unquestionably important to health. A lack of vitamin A, contained in green, leafy vegetables and whole milk, can cause night blindness. Shortages of the various B vitamins, contained in milk, meat and some grains, produce such deficiency diseases as pellagra and beriberi. A deficiency of vitamin C, or ascorbic acid, a substance found in citrus fruits and some fresh vegetables, can result in scurvy. Rickets, a disease caused by calcium deficiency that produces bone deformities, can result from a lack of vitamin D.
From these facts, some vitamin enthusiasts have leaped to the conclusion that the substances can prevent or control many diseases. Irwin Stone, a California-based biochemist, regards vitamin C as a magic bullet that not only can help man avoid scurvy but can serve as a treatment for cancer, heart disease and schizophrenia. Nobel-prizewinning Chemist Linus Pauling has advocated large doses to prevent or cure the common cold. Dr. Wilfrid Shute, a Canadian cardiologist, believes that proper use of vitamin E can aid in treatment of damaged hearts. Others recommend vitamin E for hypertension and rheumatic fever; some claim that it will promote sexual potency.
No one, however, has done more to popularize the use of vitamins than Adelle Davis, whose books and television appearances have established her as one of the country's leading health-food advocates (see box, page 72). But some of Davis' claims, as well as those of her fellow vitamin advocates, are still unproved. Doctors can find no conclusive evidence that vitamin C in large doses prevents heart disease or effectively treats cancer. Vitamin C's function as a cold cure is also uncertain. Its safety--if taken in quantities hundreds of times greater than the recommended daily requirement of about 60 mg.--is questionable. Though deficiencies of vitamin E will produce the symptoms of muscular dystrophy in rats, doctors are not yet convinced that such symptoms may exist in humans. "Vitamin E," say some physicians, "is a cure looking for a disease."
Other vitamins can actually be harmful. Vitamin A can be dangerous if taken in excess. Overdoses of vitamin D can produce demineralization of bone, resulting in multiple fractures after minimal trauma. Though lack of vitamins may cause health problems, the pills are not--and should not be--regarded as panaceas. "People," says Philip White, an American Medical Association nutrition expert, "have been led to believe that positive health benefits will occur: super vitality, great endurance, freedom from illness, resistance to infection. Supposedly these benefits result from supplementing an already adequate diet. They cannot."
Health, however, is not the only concern of food-conscious Americans. Many, aware that to be overweight is to be unattractive, are trying to diet their way to slimness. Broadly speaking, they have two alternatives: they can follow regimens that promise rapid weight loss through the elimination of almost all carbohydrates, or they can try a more sensible system of eating that restricts quantity rather than variety and pares off pounds more slowly.
Many dieters opt for the eccentric. They have no lack of plans from which to choose. Ice cream fiends can find an ice cream diet, lovers of martinis, whipped cream or bananas can find diets that emphasize their favorite foods. Some crash diets seem more popular than others. Among them:
THE DOCTOR'S QUICK WEIGHT LOSS DIET, developed by Dr. Irwin Stillman, allows only protein-rich foods like lean meat, eggs and cottage cheese. Everything else, including most fruits and vegetables, is banned; and at least eight glasses of water a day must be drunk to keep the system flushed. Stillman insists that dieters can lose from five to ten pounds a week. But weight may not be all they lose. The shortage of carbohydrates can cause excessive fat metabolism, which may be harmful.
THE GRAPEFRUIT DIET Consists of little more than eggs, bacon and grapefruit (which is supposed to dissolve body fat) and allows dieters to eat as much of these foods as they wish. Those who follow this diet supposedly lose up to ten pounds a week, but not because of any fat-fighting properties on the part of grapefruit. Most of the people who try this diet get so tired of the limited selection of foods that they simply cut down on their eating.
THE LOVER'S DIET, devised by Dr. Abraham Friedman, at least sounds like fun. He urges the overweight to "reach for a mate instead of a plate," and exercise off their excess weight through intercourse. But unless they follow Friedman's low-fat and low-carbohydrate diet as well, they are unlikely to shed many pounds. A single act of intercourse, according to Friedman, burns an average of only 200 calories.
The true worth and even the safety of most crash diets are questionable. "I'm sure they are of enormous value to their promoters," says the A.M.A.'s White. "Nutritionally, I'm not so sure." Neither are White's colleagues. But they admit that most people who faithfully follow any one of them are bound to lose at least some weight. Any such losses are usually temporary. Many crash dieters regain poundage as soon as they resume their regular eating habits.
For this reason, many doctors eschew eccentric diets and insist that their patients learn instead to eat differently for the rest of their lives. Dr. Robert Atkins, a modishly dressed Manhattan physician who operates out of a plush East Side office, believes that overweight is the result of the body's inability to metabolize carbohydrates properly. He allows his patients such dietary don'ts as mayonnaise, heavy cream, butter, steaks and lobster, but limits them to a maximum of 40 grams of carbohydrates daily. Dr. Charles Roland of the Mayo Clinic says that "despite Atkins' sweeping generalizations and exuberant confidence, his thesis rests largely on unproven assumptions."
Balanced Meals. But Atkins, who claims that more than 90% of his patients succeed in losing weight, envisions a day when even airlines will offer their passengers a choice between a regular meal and one of his "revolutionary" repasts. His patients share his confidence. One 30-year-old woman put herself into a hospital in her unsuccessful attempts to lose weight; she finally came to Atkins carrying 283 Ibs. on her 5-ft. 8-in. frame. She is now an attractive 143 Ibs. and credits Atkins for much of her success (though she has been under psychiatric care as well). "I used to be a potato-chip and Coca-Cola girl," she says. "Now I eat well-balanced meals and am never hungry."
A more conventional approach is advocated by Dr. Morton Glenn of New York City. Glenn, who feels that weight control is as important as reduction, puts his patients on a diet that is high in protein, low in fat and contains moderate amounts of carbohydrates. He also teaches them how to alter their eating habits so that weight that comes off stays off. "People," he says, "should not have to diet for the rest of their lives. But they must watch their diets."
Even with regimens like Glenn's, some people still fail to lose weight. Their failures are frustrating, and many people justifiably wonder why medical science can prevent polio or transplant vital organs but have so little success in coping with overweight. In fact, the field of nutrition is terra incognita for the average doctor. Courses are not widely taught in medical schools, and even among specialists there are substantive disagreements.
At least a hazy line exists between the chronically and seriously obese--those 20% or more above the norm for their physique--and the larger group that is mildly to moderately overweight. The obese are more likely to have had weight problems since childhood, or even infancy. One recent hypothesis has it that infants fed too much fat may manufacture excess fat cells that remain in the body tissue. Heredity probably plays a part as well.
The moderately overweight will generally shed pounds as long as they consume fewer calories than they burn up in activity. That they fail to maintain a favorable balance can often be attributed to a lack of selfdiscipline, knowledge or both. Many people overeat for psychological reasons--nervousness, insecurity, or boredom.
Way of Life. Where willpower is the key element, all sizes can benefit from organizations like Weight Watchers. It has more than 100 franchise operations across the country, which offer flexible, common-sense diets, plus exercise and morale-boosting meetings.
At a session of a New York City chapter recently, members nibbled celery and sipped low-calorie soft drinks as they listened to the lecturer, Sylvia Cataldo, 33, an employee of a Manhattan art gallery. She worked up the audience with evangelical fervor as she preached against poundage and spoke sympathetically about the loneliness of the long-distance dieter. "You're doing it yourself," she replied to a member who credited her with helping him lose 54 lbs. "You are alone with yourself most of the time."
But not at meetings, where Weight Watchers must shout out the number of pounds they have lost since the last gathering. Members who attend 16 consecutive weekly meetings and lose at least ten pounds are rewarded with tie clasps or pins. Some really deserve their decorations. A 23-year-old student who weighed 236 lbs. when she joined last January watched her weight so closely that she brought it down to 161 lbs. Said she: "It has become a way of life."
The simple fact is that Americans eat too much. A century ago, the average American consumed about 3,000 calories a day. He also burned most of them up. Work hours were long, household conveniences and servants a luxury of the rich. The average American today consumes between 2,500 and 3,000 calories a day but is physically idle compared with his ancestors.
Says Harvard's Mayer: "There's no one except an exercise nut who's as physically active as the sedentary person of the last century. And if there's any physical activity left now, you can be sure there are several large corporations searching for ways of eliminating it. Look at those advertisements for extension telephones; all those steps you save probably add up to five pounds a year in fat."
Choice of foods is as crucial as quantity. Americans, who eat more than 1,000 lbs. of food a year, consume less potatoes and starchy foods than their ancestors. But they also eat far more sugar, which provides quick energy as well as calories, and fats, some of which may lead to atherosclerosis, the buildup of fatty deposits in the arteries. Sixty years ago, Americans ate 87 Ibs. of sugar a year; today they eat around 120. Back then, they consumed 39 Ibs. of fats and oils annually; now they take in 55. Fats account for around 17% of the annual intake, flour and cereal products for about one-fifth. Says George Briggs, a professor in Berkeley's department of nutritional sciences, "I think our poor food choices are a national disaster."
Eating habits are also harmful. Many Americans skip breakfast entirely, or have only a cup of coffee. Lunch is often a quick bite. This increases the temptation to nibble snacks and to overeat at the evening meal. Even then, the meal may be a poor one. "The mother doesn't get the satisfactions from preparing food that she once did," says Berkeley Nutritionist Helen Ullrich. "So she wants to be out of the kitchen."
Restaurant meals can also be risky. Few contain the variety of vitamins and minerals needed for health. Some are nutritional time bombs, high in what Harvard's Mayer calls the "deadly trinity" of cholesterol, sugar and sodium. When it comes to gobbling snacks, young people are the worst offenders, consuming as much as half their caloric needs in potato chips, cookies, cakes and other foods high in calories, low in protein; adults are almost as bad.
Berkeley's Briggs believes that food processors are at least partly to blame. Despite the attempts of many in the food industry to stress nutrition, he observes, the industry does not feel that nutrition sells. It feels that flavor and taste are the moneymakers.
Ignorance is also a major factor. Less than half of the states have nutritionists at the administrative level on their boards of education; most students learn little about nutrition in high school or college. Many physicians are of limited help. Says Dr. Michael Latham of Cornell University's Graduate School of Nutrition: "Nine out of ten doctors in New York City would give wrong answers to dietary questions."
Evidence of medical uncertainty is abundant. Some doctors feel that iron enrichment of bread would go a long way toward easing the anemia that is widespread in the U.S., particularly among adolescent girls. Others feel that fortification is dangerous for people who have ample iron in their systems already. Experts are also uncertain about the amounts of vitamins and minerals needed for good health.
But there is one thing on which most medical men agree: that the U.S. is paying a stiff price for its eating habits. Though debate still goes on over the precise role which diet plays in several diseases, doctors have reached a consensus that it is a major factor in several serious ailments. Specifically:
>Heart disease, the major cause of death in the U.S. Doctors have yet to establish conclusively that a rich, fatty diet is responsible for heart attacks, but the statistical case is strong, and not only in the U.S. In Germany, the rising death rate from complications of high blood pressure coincides with the increase in caloric intake that has accompanied a rising standard of living. In Japan, a steady rise in heart disease has been traced to the growth in fat consumption that has resulted from an increasingly Occidental diet. Twenty years ago, when the Japanese diet was still largely limited to rice, fish and vegetables, there were 34,298 deaths linked to atherosclerosis; two years ago the reported death toll was 68,786.
> Diabetes. A predisposition to mild forms of this disease may be brought out by obesity. There are now over 4,000,000 diabetics in the U.S., plus 5,000,000 potential diabetics.
> Dental decay. Although the rate of cavities has declined since the beginning of World War II, tooth decay remains a major health problem despite fluoridation. More than 98% of the U.S. population is afflicted, and an estimated 20 million adults have lost over half their teeth. Adequate diet is essential for the proper development of tooth structure, and for resistance to the tiny organisms that promote decay.
>Mental retardation. Doctors have long suspected that maternal malnutrition was responsible for low birth weight among some babies born at term. A recently released British study has shown that these babies are likely to lag behind their heavier contemporaries when they get to school. Columbia's Winick says that 80% of all brain growth takes place between conception and the age of two; growth that fails to take place during this period because of either fetal or infant malnutrition does not take place at all.
The cost of diet-linked diseases is considerable. Briggs told a congressional hearing last week that as much as $30 billion of the nation's $75 billion medical bill is the result of poor nutrition. The U.S. Department of Agriculture apparently agrees. In a recent report on nutrition it speculated that good eating habits could cut the incidence of heart and vascular diseases by 25%, reduce respiratory infections by 20% and slash arthritis, diabetes and infant mortality by half.
Such far-out visions may be unrealistic, but some changes are taking place. Columbia University's newly established Institute of Human Nutrition is working on the problems of maternal and fetal malnutrition and developing educational materials for use in schools. Food processors, alarmed by the trend toward organic foods and shaken by the growing public reaction against additives, are improving the nutritional quality of many of their products. The Del Monte Corp., the world's largest producer of canned fruits and vegetables, has decided to include nutritional information on the labels of many of its products.
The Federal Government, meanwhile, is moving in several directions. The Food and Drug Administration is preparing guidelines suggesting nutritional labeling of frozen convenience foods, such as TV dinners, and proposing regulations for the labeling of vitamin contents according to recommended rather than minimum daily requirements and the identification of sources and types of fats used in processed foods. It is also planning to place more stringent regulations upon the sale of vitamins. Recognizing that the safety and effectiveness of large doses have yet to be determined, the F.D.A. is planning to classify as drugs all vitamin preparations that contain more than 150% of the recommended daily requirement.
Because they involve the vital interests of the nation's food and drug industries, some of these proposed regulations have met with long and bitter debate in hearings over a two-year period. But Americans need not wait until all the arguments have been settled before they temper their diets. Physicians are already beginning to prescribe a more sensible approach to eating. Doctors to both Presidents Eisenhower and Johnson put their patients on strict low-fat diets and urged them, not always successfully, to get more exercise.
Many doctors interviewed by TIME have decided to follow such diets themselves in the interests of both health and weight control. Cornell's Latham limits his intake of saturated fats by trimming his meat carefully and passing up butter for margarine. He cuts down on sugar and eats only two or three eggs a week. Dr. Richard Rivlin of Columbia also watches his fat intake, eats lots of salads and fresh fruit. Columbia's Dr. Frank Smith not only follows a lowfat, low-cholesterol diet but exercises at least twice a week. Americans interested in avoiding the hazards of the desk and dining table would do well to follow a similar regimen.
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