CHANGES IN THE MAINSTREAM Enormous changes have taken place in the public perception of the relationship between food and health, and I’ m thrilled at the rapid progress. It is now accepted without question that our diet affects our health and, particularly, that it can affect serious degenerative diseases, such as heart disease and cancer. Since I wrote this book, the low-fat, high – complex carbohydrate diet, originally espoused by Nathan Pritikin and discussed in chapter four, has become the rallying cry of nutrition. Dean Ornish, M. D., has done magnificent work, demonstrating scientifically that a low-fat vegetarian diet, coupled with exercise and stress reduction, can indeed reverse heart disease. 1 As a result, some insurance companies now reimburse their clients for this dietary treatment, and hospitals around the country are beginning to offer it to their patients. What does distress me is that the general public, and the popular media, has come to the conclusion that low fat means fat free. To serve that erroneous assumption, the market has been deluged with products that proudly announce their fat-free status; included are such oxymorons as“ fat-free mayonnaise”( real mayonnaise is just oil, egg yolk, and seasonings) and“ fat-free margarine,” probably the most absurd product ever invented, as it is an imitation of margarine, which in turn is an imitation of butter. Although I do not necessarily recommend the regular consumption of high-fat foods like butter and mayonnaise, I do believe that the imitation is worse than the original. We’ re better off eating a small amount of the real thing, rather than spoonfuls of the imitations. Fat is one of the three macronutrients( protein and carbohydrate being the other two). It is essential to the functioning of our body, as it insulates, protects, and keeps us warm. The breakdown of fat creates heat, so we especially need it in cold climates since it is a highly effective fuel. In addition, fat keeps our cell walls firm, protects the nerves and brain, keeps the skin supple, is a component of hormones and prostaglandins, and, last but not least, makes foods tasty and satisfying. Fat is also needed for the utilization of the fat-soluble vitamins A, D, E, and K. Specifically, as vitamin D helps in calcium metabolism, an extremely low-fat diet can, in the long run, damage the bones. Insufficient fat in the diet causes dry skin, brittle nails, feelings of cold, crankiness, and binging. On an extremely low-fat diet that does not provide sufficient essential fatty acids( EFA’ s), essential hormonal and regulatory functions of the body are impaired, and people may end up miserable and dissatisfied; they often consume an excess of carbohydrate foods because they’ re so hungry, and may put on weight because of this excess and the imbalance of nutrients. Even on low-fat diets, we need at least 10 percent of our calories from fat; I believe that extremely low-fat diets can be dangerous when followed very long term, say over two years. My experience is that many people feel satisfied and can sustain a diet with about 20 percent of their calories coming from fat. This is what we end up with when following the precepts of my Health-Supportive Whole-Foods Diet. * The secret to the healthful use of fats, of course, is to know which fats to use. As Udo Erasmus points out in his book Fats That Heal, Fats That Kill, 2 heated, hydrogenated, and processed fats are the most damaging, since they deliver the unhealthy trans-fatty acids, which increase the likelihood of strokes, heart attacks, and impaired immune function. Among the hydrogenated fats we have margarine, shortening, and some commercial peanut butters. Heated fats, as well as unstable polyunsaturated fats( such as oils that have been exposed to oxygen and light by being left in clear glass bottles in brightly lit surroundings), may also form an excess of free radicals; these are highly reactive particles that, if unopposed by the antioxidant nutrients in fruits and vegetables, can go haywire in the body and stimulate cancer, heart disease, and aging. The traditional fats are still the best, when stored in dark containers and used in moderation: extra-virgin olive oil( now highly touted in what has been called the Mediterranean Diet), unrefined sesame oil, and butter( preferably organic). For good health, we can use a variety of these natural, only minimally processed oils and fats in moderate amounts. One tablespoon per person in the preparation of lunch and dinner each— in the soup, the salad, the sautéed vegetables— maybe one teaspoon at breakfast, is quite flavorful, not excessive, and will keep us satisfied. Other healthful fats include flaxseed oil, borage oil, and fats found in cold-water fish. The relationship of diet to cancer is now well accepted, particularly after the publication of Dr. Anthony Satillaro’ s well-received book, Recalled by Life. A number of epidemiological studies have proven that a good diet will prevent cancer. The American Cancer Society expends a great deal of effort to encourage people to eat lots of fruits and vegetables. Among the best documented are the cruciferous vegetable category, which includes broccoli, cauliflower, cabbage, kale, kohlrabi, and brussels sprouts, and foods high in beta-carotene, such as yams, sweet potatoes, winter squash, carrots, cantaloupe, and dark greens, such as collards, mustard greens, turnip tops, and parsley. There is a movement afoot called Five-a-Day, which encourages people to consume five servings of fruits and vegetables daily— not a bad place to start! SOY FOODS Miso, tofu, tempeh, and soy milk were already quite popular when this book first came out, and I did discuss