Medicine: The Fat of the Land

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In the Keyses' French provincial home on the shore of Lake Owasso in the St. Paul suburb of Shoreview, dinner is a neatly scripted ritual, played to soft Brahms and candlelight, that often lasts for two hours. At first, recalls Keys, Margaret was not much of a cook: "She fed me — but she was pretty inexperienced." She learned; the walls of kitchen and den are lined with 254 cookbooks, not counting copies of Eat Well and Stay Well, for which Mrs. Keys supplied 200 tasty recipes. The Keyses do not eat "carving meat" — steaks, chops, roasts — more than three times a week, and a single entree normally is not repeated more than once every three weeks. For cocktails they have martinis or negronis (¼ gin, ¼ Campari bitters, ¼ sweet or dry vermouth, ¼ soda water, over ice in an old-fashioned glass). The typical Keys dinner contains 1,000 calories, only 20% of which come from fats of any kind, 5% from saturated fats. A sample menu: pasta al brodo (turkey broth with noodles), veal scallopine a la Marsala, fresh green beans, homemade Italian bread (no margarine or butter), cookies, a tossed salad (dressed with tarragon vinegar and corn oil), espresso coffee and fruit.

No-Cal & Nonsense. One of the paradoxes of this era of affluence is that such civilized dining ceremony is not every body's lot. Prosperity and faddism, suggests the A.M.A.'s Dr. Philip White, go hand in hand. "People are able and willing to seek the easy way out. Today they have the money and leisure time to indulge themselves, and they have been conditioned by the dramatic progress of medicine in the past few decades to believe that almost any pill, capsule or tonic is a miracle drug. People are disease conscious, and their fears about disease set them up for exploitation by the pseudo-scientific huckster."

Most fads are short-lived and harmless. Even the worst usually harms only a relatively few susceptible people. But fads encourage distrust of doctors and self-diagnosis. In such an atmosphere of skepticism, it is difficult for a physician to convince a patient who feels fine that he must give up something he likes, to preserve his health. Yet, says Dr. Keys, that is exactly what many Americans should do. The average blood cholesterol count among middle-aged (40-60) U.S. men, says Keys, is an uncomfortable 240. "People should know the facts," he says. "Then if they want to eat themselves fo death, let them."

Drugs? There is no effortless way to control cholesterol, warns Dr. Keys. Some drugstores peddle bottles of artificially flavored safflower seed oil emulsion (polyunsaturated fat), suggest drinking it by the spoonful to offset the effects of saturated fat in the diet. Says Keys: "Nonsense. All this does is to increase the total fat intake and breed obesity." Although polyunsaturated fats are a healthful substitute for saturated fats, they make an ineffective antidote. It takes more than 2 oz. of polyunsaturated fat, says Keys, to reduce blood cholesterol by the same amount that 1 oz. of saturated fat increases it.

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