The Complete Book of Vitamins

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THE
CQ'MPLE-TE
BOOK OF
VITAMINS
ALL NEW EDITION
THE
C'O'M-P'L'E'T'E
BOOK OF
VITAMINS
ALL NEW EDITION
by the editors of Prevention magazine
Rodale Press Emmaus, Pa.

Copyright 1984 by Rodale Press, Inc.
All rights reserved.No part of this pubHcation may be reproduced or

transmitted in any form or by any means, electronic or mechanical,
including photocopy, recording, or any information storage and re-
trieval system, without the written permission of the publisher.
Printed in the United States of America on recycled paper containing

a high percentage of de-inked fiber.
Library of Congress Cataloging in Publication Data
Main entr> under title:
The Complete book of vitamins.
Includes index.
1. Vitamin therapy. 2. Vitamins. I. Prevention
(Emmaus, Pa.)
RM259.C65 1984 615.8'54 83-24583
ISBN 0-87857-495-6 hardcover
ISBN 0-87857-503-0 hardcover deluxe
6 8 10 9 7 5 hardcover
6 8 10 9 7 5 hardcover deluxe
Editors: William Gottlieb, Carl Lowe, Mark Bricklin, Susan Zarrow

Contributions by: Stefan Bechtel, Dominick Bosco, Mark Bricklin,
Randolph Byrd, Colin Covert, Bruce Fellman. John Feltman,
Alan R. Gaby. M.D.. Emil Ginter. Ph.D., William Gottlieb, John
Kalantari, Jane Kinderlehrer. Jody Kolodzey. Laurie Lucas, Eileen
Mazer. Emrika Padus, Kerry Pechter, Linda Shaw, Carl Sherman,
Larry Stains, Debora Tkac. Jonathan Uhlaner, Lewis Vaughn, Tom
Voss, John Yates
Research Chief: Carol Baldwin
.Assistant Research Chief, Prevention Health Books: Christy Kohler
Research Project Coordinator: Carol Sitler Pribulka
Research Associates: Martha Capwell, Tawna Clelan, Christy Kohler,

Christine Konopelski, Joseph Kosch, Pam Mohr, David Palmer,
Carole Rapp, Janice Saad, Nancy Smerkanich, Pamela Uhl,
Diana Witte. Susan Zarrow
Design Project Assistant: John Pepper
Copy Editor: Louise Doucette
Supervisor of Publication Recipe Testing: Anita Hirsch
Office Personnel: Diana Gottshall, Susan Lagler, Carol Petrakovich,
Cindy Harig, Marge Kressley, Donna Strubcck, Cindy Christman
Notice
This book is intended as a reference volume only, not ;is a medical manual or a
guide to self-treatment. If you suspect that you have a medical problem, we urge you
to seek competent medical help. Keep in mind that nutritional needs vary from person
to person, depending on age, sex, health status and total diet, information here is intended
to help you make informed decisions about your diet, not to substitute for any treatment
that may have been prescribed by your doctor.
CONTENTS
List of Tables xii
BOOK I VITAMINS IN YOUR DAILY LIFE

Introduction 2
1. Why We Need Vitamin Supplements 4
2. Supplements for Optimal Health:
Why the RDAs Aren't High Enough 9
3. How Much? A Guide to Personal
Vitamin Supplementation 16
4. Getting the Most from Your Vitamins:
A Plan for Maximal Absorption 23
5. Do You Have "Hidden Hunger"? 29
6. Nutrients for the Critical Years 33
7. Beating the Vitamin Bandits 40
8. Medicines That Create Malnutrition 47
9. Nutritional Supplements Dieters Need 52
10. Vitamins Before and After Surgery 56
11. If You Must Smoke,
At Least Take These Vitamins 60
12. Vitamin Supplements:
How Much Is Too Much? 66
13. Even "Wasted" Vitamins Help Protect Us 72
14. Vitamins: Will the Skeptics
Ever Be Convinced? 76
BOOK II A GUIDE TO THE INDIVIDUAL VITAMINS

Introduction 84
Vitamin A
15. Vitamin A: A Feast for the Senses 85
16. Vitamin A: Insurance against
Circulatory Problems 92
17. Vitamin A for Heavy Menstrual Bleeding 96
18. Vitamin A Cushions Us against Stress 101
19. Vitamin A: A Kind of Internal Gas Mask 108
vi CONTENTS
20. The Number One Anti-Cancer Vitamin 1 13
The B Vitamins
21. Reap the Rewards of Nutritional Teamwork 119
22. The Thiamine Thief
May Be Stealing Your Health 124
23.
Make Up Your Mind Eat More Thiamine 130
24. Keep in the Pink with Riboflavin 138
25. Riboflavin Is Ready to Help 144
26. Niacin for Brighter Moods
and Better Memory 151
27. Why This Epidemic
of Vitamin B^ Deficiency? 159
28. Vitamin B^ for Carpal Tunnel Syndrome 165
29. B6 Maybe the Answer to Heart Disease 171
30. Bft for Common and Uncommon Ailments 179
31. Bi2 More than Anemia Protection 183
32. B,2 for Healthy Nerves and Blood 189
33. Unsuspected B,2 Deficiencies 193
34. Folate, the Gold in the Cooking Water 198
35. Folate: A Woman's Best Friend 208
36.
Pantothenate The Anti-Stress Vitamin 215
37. Tan without Burning with PABA 222
38. Biotin The Little-Known Lifesaver 225
39. Choline for a Sharper Memory 232
40.
Vitamin B15 Miracle or Hoax? 236
Vitamin C and the Bioflavonoids

41. Brimming with Health (and Vitamin C!) 239
42. Vitamin C: Changing Your Body
for the Better 244
43. Vitamin C, Super Healer 254
44. insulate Your Health with Vitamin C 259
45. Keep Cool with Vitamin C 263
46. Make Vitamin C Your Shield against
Pollution 267
47. Clean Chlorine from Your Water with
Vitamin C 274
CONTENTS vii
48. C
Is for Cholesterol And Its Control 276
49. Vitamin C, Pectin and Heart Disease 282
50. Can Vitamin C Prevent the Common Cancer? 287
51. Using Cortisone Drugs? Better Check
Your Vitamin C ! 295
52. Vitamin C and Heroin Addiction 299
53. Bioflavonoids for Healthy Capillaries 303
54. Healing with Bioflavonoids 310
Vitamin D
55. Don't Let Thin Bones Let You Down 318
56. The Sunshine Vitamin
Can Brighten Your Health 322
Vitamin E
57.
Vitamin E Scientists Say It Works 330
58.
Vitamin E Jack of All Trades,
Master of Most 336
59. Vitamin E Lubricates the Circulation 344
60. Help Your Heart with Vitamin E 353
61.
Vitamin E Strong Medicine
for Rare Diseases 358
62. Nutrition That Starts at Skin Level 365
63. Vitamin E, When It's Sink or Swim 369
64. Vitamin E Helps Protect the Breasts 374
65. CF Kids Require Extra Vitamin E 378
Vitamin K
66. Your Foundation Needs Vitamin K 380
BOOK III VITAMIN THERAPY FOR DISEASE

Introduction 389
Acne
67. Vitamin A for Acne 390
Aging
68. Antioxidant Vitamins
versus Premature Aging 394
. 1
viii CONTENTS
69. Vitamins for Living Longer 40

70. B Vitamins Can Keep You on the Beam 407
7\. Age with Ease through Wise Nutrition 411
Cancer
72. The Anti-Cancer Vitamin Combination 415
73. Vitamin C against Cancer 419
Cataracts
74. New Hope for Cataract Prevention 427
Colds. Flu and the Immune System

75. FightOff Flu and Colds the Natural Way 431
76. Vitamins That Perk Up a Sagging Defense 437
77. Boost Your Immunity with Vitamin C 442
Cramps
78. Vitamin E for Those Painful Cramps 446
Crime and Juvenile Delinquency

79. Crime-Buster Vitamins 449
Depression
80. Nutrition: The Silver Lining 455
Fatigue
81 Vitamins for Peak Energy 459
82. Energy Vitamins to Make Life a Breeze 464
Gallstones
83. Cjallstoncs and B,, 469
(jum Problems
84. Keep Your Gums in the Pink 473
Hair Problems
85. Nourishing (and Cherishing) Your Hair 479
Hay ever
1
86. Vitamins to Ncutrali/c Hay Fever 483

CONTENTS IX
Healing Problems
87. Nutrients That Help Your Body Heal Itself 488
Heart Disease
88. Platelets Little Lifesavers
That Can Kill You 494
Hormone Imbalance
89. Vitamins for a Healthy Hormonal System 501
Infertility
90. Vitamins for Weak Seed 504
Kidney Stones
91. Preventing Kidney Stones the Natural Way 511
Menopause Problems
92. How Vitamins Help Menopause 515
Mental Retardation
93. Can Vitamin Supplements
Reverse Mental Retardation? 520
Pollution
94. Breathe Easier with Vitamins A and E 528
95. A and C: Vitamins for a Toxified World 532
96. Cleansing Internal Pollution
with a Vitamin Brush 539
Schizophrenia
97. Healing Sick Minds with Vitamins 543
Shingles
98. Vitamin Relief for Shingles 548
Skin Problems
99. Vitamins That Team Up for Clear Skin 554
Vision Problems
100. Look to Vitamins for Sharper Vision 559
Vitamin Deficiency
101. Avoid Low-Level Vitamin Deficiency 566
CONTENTS
BOOK IVTHE NUTRITIONAL HEALERS

Introduction 574
Audiologist
102. Muffle Those Bells in Your Ears 575
Chiropractor
103. Dr. Hatfield-McCoy 580
Dermatologist
104. Wanted: A Science of Optimal Health 587
Internist
105. Death's Door or Life's Door? 594
106. How Vitamins Revolutionized My Practice 601
107. Mung Beans and Cotton Swabs 608
Nutritionist
108. The "Healthy Houseboat" Is Making
Waves in Nutrition 613
109. A Thoroughly Modern Nutritionist 618
Opthaimologist
110. Your Eyes Are Windows to Health 627
111. Seeing Better, Feeling Better 635
112. Better Vision Naturally 641
Orthopedic Surgeon
113. A New Breed of Surgeon 647
Osteopath
1 14. Ihrcc Heart Attacks by 29: A Physician's
Personal Drama 656
Pediatrician
1 15. The Sugar Generation 662
116. Growing Up Healthy The Natural Way 671
Pharmacist
117. A Complete Prescription for Better Health 678
Preventive Medicine
1 IS. The Doctor Who Found What He Was Missing 683
CONTENTS XI
119. Make Your Body a Safer Place to Live 691

120. The Medical School Where Nutrition Isn't
a Dirty Word 699
121. The Doctor Who Takes His Own Medicine 705
122. Dr. "Live-Right" 711
Psychiatrist
123. Brain Food It Really Works 719
Psychologist
124. Psychological Help through Better Diet 727
Vascular Surgeon
125. A Life-Extension Program from a Doctor
Who's Been There 732
BOOK V VITAMIN-RICH FOODS AND RECIPES

Introduction 740
126. Best Food Sources of Vitamins 741
Vitamin-Rich Recipes
127. Breakfasts 755
128. Appetizers and Hors d'Oeuvres 758
129. Soups 761
130. Eggs 765
131. Main Dishes 768
132. Fish 781
133. Poultry and Liver 785
134. Side Dishes 790
135. Salads 799
1 36. Beverages 802
137. Desserts and Snacks 804
138. Breads and Muffins 811
Index 816
1
1
xii LIST OF TABLES
List of Tables
Dr. Powers' s Diet for Low-Blood-Sugar
Control 667
Best Food Sources of Vitamin A 74
Best Food Sources of Thiamine 742
Best Food Sources of Riboflavin 743
Best Food Sources of Niacin 744
Best Food Sources of Vitamin B6 745
Best Food Sources of Vitamin B 12 746
Best Food Sources of Folate 746
Best Food Sources of Pantothenate 747
Best Food Sources of Biotin 748
Best Food Sources of Choline 749
Best Food Sources of Inositol 749
Best Food Sources of Vitamin C 750
Best Food Sources of Vitamin D 751
Best Food Sources of Vitamin E 75
Best Food Sources of Vitamin K 752
BOOK I
Vitamins
in Your
Daily Life
INTRODUCTION
"A questionable and potentially harmful practice."

That's a quote from researchers at the government's Food
and Drug Administration (FDA). The ''practice" they're talking
about isn't voodoo or child beating. It's taking vitamins.
In a phone survey, the FDA found out that 43 percent of
the thousands of people they talked to used supplements. When
they asked them why, "the most frequently cited benefits of
taking supplements were that they made the person feel better
and prevented illness."
What's questionable and harmful about that?
Nothing. At least not to you and me. But some experts in
the government and the medical establishment seem to have a
fixation about vitamins. They don't believe you need to take
them. If you do take them, they don't believe they work. (And
'\f you say vitamins work, as those folks on the phone did, they
think you're deluding yourself.) And so TV and magazines are

blitzed with programs and articles telling you that, if you eat a
"balanced diet," there's no reason to take a vitamin supplement.
And that if you do take one, you'll probably overdose on it and
VITAMINS IN YOUR DAILY LIFE
killyourself. Well, book 1

Vitamins in Your Daily Life is out
to debunk those official myths.
We'll tell you right off the bat why you probably do need
food supplements. We'll investigate the government's Recom-
mended Dietary Allowances (RDAs) of vitamins and show why
they're not set at levels that keep you really healthy. We'll look
into the possibility of overdosing on vitamins and show you why
a sensible supplement program is virtually risk free. (And we'll
give you a program suited to your individual needs.) We'll also
describe studies which show that older people could use more
vitamins in their diets. And so could people who live where it's
polluted. And people who take prescription drugs. And people
who diet. And people who have surgery. In short, just about
everybody.
So keep up that "practice." It could make your health perfect.
CHAPTER
WHY WE NEED
VITAMIN SUPPLEMENTS
The evidence that many people feel better and do better

when they take vitamin supplements (along with a good diet) is
so overwhelming that few who have investigated the subject with
an open mind doubt it. Besides all that's been published, millions
of people believe it as a result of personal experience.
Yet, even those of us who are convinced of the wisdom of
supplements must stop and wonder every once in a while why
so many people seem to need them. Surely nature didn't design
human beings to gulp down a handful of pills every day in order
to be healthy and strong. Nor is there any famine upon the land:
What we see sticking out is not ribs, but bellies. So why should
it be that so many people do so much better with supplements?
W lull's wroni; with plain old food?

Plenty. Probably more than you ever imagined. For in-
stance, you may have asked yourself why so many people seem
to need supplements of vitamin C in order to keep their resistance
at peak levels. Isn't there enough vitamin C in fresh fruits and
vegetables to keep them healthy?
Sure there is, as long as you eat all your fruits and vegetables
right in ihc orchard or garden. If you eat them as most of us do.
WHY WE NEED VITAMIN SUPPLEMENTS
at home or in a restaurant, you can run into some unexpected

problems.
Take oranges, for instance. The orange peel is nature's nu-
trition preservative. As soon as you take it off and begin to fool
around with the orange, the vitamin C begins disappearing.
If you take a fresh orange and juice it yourself, you might
think you're getting all the vitamin C that was in the orange, but
you aren't. You're leaving about 30 percent of it behind in the
residue of the section membranes.
Even if you eat the residue, you've still lost nutrition. The
simple act of juicing an orange reduces the vitamin C because
vitamin C is very sensitive to oxygen. When you break the orange
segments and let the juice splash around, you start to destroy
vitamin C. When you process oranges (or other C-rich fruits) in
a blender, every whirl of the blades encourages vitamin C
destruction.
If you buy your orange juice in a waxed cardboard container,
pasteurized, and take it to a laboratory, they will probably tell
you that the juice has lostsomething on the order of 20 percent

of its original vitamin C. But what they probably won't tell you,
because they didn't test it, is that half or more of the vitamin C

which is there is biologically inactive of no apparent use in
maintaining or building health.
One of the most surprising examples of unexpected vitamin
C loss was reported by Israeli scientists who found that, when
oranges are blended with bananas (often to make a fruit mixture
for infants), fully 75 to 80 percent of the vitamin C content van-
ishes apparently through a reaction between vitamin C and a
factor in the bananas (International Journal for Vitamin and
Nutrition Research).
Vitamin C is so sensitive to human manipulation that, as
soon as you put a knife to a fruit or vegetable, the bruise causes
vitamin loss. The finer you chop or shred your food, the more
vitamin C is lost. And the longer you keep it before eating
it, the more is lost. Generally speaking, fruits and vegetables
which are processed in the home and kept a day or two before
they're eaten have lost anywhere from 30 to 70 percent of their
vitamin C.
One example: Potatoes are not that high in vitamin C

final
but, because many people eat potatoes on a regular basis, they

are an extremely important source of that vitamin in the diet.
But today, many people eat potatoes reconstituted from instant
mixes or eat potato chips which have been made by reassembling
dehydrated potatoes. How many consumers realize these prod-
ucts contain no vitamin C whatsoever? According to Richard H.
Barnes, Ph.D., former dean of the graduate school of nutrition
at Cornell University, "We wonder if anyone knows of any
values that are realistic in terms of the ascorbic acid [vitamin C]
intake of the American public. It would appear to be something
very, very much less than the values that have been calculated
from food consumption surveys" (Nutrients in Processed Foods).
Government Food Tables

May Be Inaccurate
Other people are wondering, too. When Mary K. Head,
Ph.D., formerly of the department of food science at North Car-
olina State University in Raleigh, investigated the nutritional
content of foods which were actually being served to students
at a cafeteria, she found that the way
was prepared and
the food
served caused considerable nutrient loss (Journal of theAmer-
ican Dietetic Association). When we compare some of her figures
to those in official government food tables, we find some big
differences. Take thiamine, for instance
needed for emotional
health, among other things. Government tables say that a 3'/2-
ounce serving of green beans, even when cooked the worst pos-
sible
way in lots of water and for a long time contains 0.06
milligram of thiamine. But the average value found by Dr. Head
was only one-third that much!
Govcrnmcnl tables also say that about 7 ounces of spaghetti
with sauce contain S milligrams of vitamin C (from the tomato
WHY WE NEED VITAMIN SUPPLEMENTS
sauce), but Dr. Head's figures show that what the students were
eating contained a mere 1.2 milUgrams. Eighty-five percent of
the vitamin C had dropped out.
The examples of how nutrients are missing or lost in un-
expected ways are practically endless. Some of them are no big
secret. A good example is that milling whole grain products to
produce white flour reduces valuable vitamins, minerals and fiber
by an average of 70 to 80 percent. Many also know that boiling
vegetables in water for extended periods of time is nutritional
murder. Folate (folic acid) is vital to healthy blood, energy and
a smoothly functioning nervous system. Boil most vegetables in
water until they're done, and you wind up with more folate in
the water than you have in the vegetables! Boil cabbage until
it's done, and you have only 25 percent of the vitamin C you
had when you dropped it into the pot.

Canning is another killer. One recent study showed that 44
percent of the vitamin C originally present in raw peas is lost in
the canning process. There was no big surprise in that, scientists
reported. Food composition tables will tell you the same. The
surprise, they said, is that 42 percent of the vitamin C which is
left is actually found in the liquid in which the peas are canned,
rather than the peas themselves. So if you want to get the amount
of vitamic C the food tables tell you you're supposed to get,
you'll have to eat your peas with a spoon instead of a fork!
Many people believe that organ meats are rich sources of
the B vitamins and rightly so. The problem, again, is the dif-
ference between theory and practice. When you brown various
organ meats on top of your stove, for instance, you are losing
from one-third to two-thirds of the thiamine (Bi) and about one-
third of the riboflavin (vitamin B2). Just the thaw drip from frozen
meats that you are preparing to cook can seriously deplete B
vitamins. Fully one-third of all pantothenate (pantothenic acid)
in beefsteak, for example, literally drips out of your meat before

you even cook it which will, of course, destroy still more.
Vitamin B(, is another nutrient, particularly important to women
and older people, which is destroyed in cooking. While meat is
generally a good source of vitamin B^, if you eat your meat well
done, you may lose up to 70 percent of the Bt in the cooking
process.
Cooking methods aside, what's in the water you cook with
can also a difference. Baking soda added to vegetables
make
causes considerable destruction to thiamine. Japanese scientists
recently demonstrated that, when rice is cooked in water which
has been chlorinated, there is considerably more destruction of
thiamine than when it's cooked in distilled water because chlor-
ine reacts chemically with thiamine {Journal of Nutritional Sci-
ence and Vitaminology, vol. 25, no. 4, 1979). And speaking of
rice,be aware that, if you wash your rice before boiling it, you
are destroying anywhere from 10 to 25 percent of the thiamine
before you even cook it!
Remember, we aren't even talking about people who need

extra nutrients because of special stress or illness or dieting.
We're only talking about how reasonably healthy people, eating
a normal, typical diet, are being shortchanged of nutrition. But
even without special problems, getting the proper nutrition from
your food isn't as easy as it's cracked up to be. The often-heard
statement that you can get all the nutrition you need from a well-
balanced diet of "ordinary food" is totally out of touch with
reality. Food may be good enough on paper, but not in real life.
It's like getting a salary that's adequate until you pay all your
taxes and deductions!
Our food being taxed the very same way. Only many of
is
the taxes are invisible. We think the food value is there, but it
isn't.
And that, in a nutshell, is why so many people who use

vitamin supplements as one method of improving nutrition so
often find themselves feeling more alert, energetic and less both-
ered by a host of ailments, minor and major. When combined
with smarter food selections and better food preparation, sup-
plements can make a big difference. It's like giving your health
a "raise"!
CHAPTER
SUPPLEMENTS FOR
OPTIMAL HEALTH:
WHY THE RDAs
AREN'T HIGH ENOUGH
Vitamins are powerful substances. We need only micro-

scopic amounts of them in our diets to stay healthy, but take
away those teeny quantities and our bodies soon run into deep
metabolic trouble.
Scientists originally discovered vitamins while examining
deficiency diseases the devastating medical problems that oc-
cur when your diet lacks a particular vitamin. First, they pin-
pointed what foods could cure these diseases, and then they
isolated the chemicals in the foods that were the sources of the
cure.
The chemicals they discovered function in our bodies as
coenzymes. That means they combine with the body's enzymes
to promote the intimate processes each of the
that take place in
cells. They act as catalysts. They help chemical reactions
vital
take place that could not occur without their presence.

All vitamins are organic. In their natural state, they're all
produced by plants or animals and they find their way into your
body when you eat a plant or animal that contains them. But
even though plants and some animals can make vitamins, human
10 VITAMINS IN YOUR DAILY LIFE
bodies generally can't. If you don't take in a vitamin in the food

you eat or in a vitamin supplement, then you don't get it.
RDAs Health Designed

by Committee
Most of us are familiar with the phrase "Recommended
Dietary Allowance (RDA)." You often see the RDAs referred
to as part of the nutrition information on food labels. Or else
they may be used in an advertising campaign: "One ounce of
our cereal contains 75 percent of the Recommended Dietary
Allowances of these seven important vitamins." The RDA is the
amount of each nutrient which, according to a panel of nutrition
authorities, is enough to keep the average person healthy.
Most orthodox nutritionists believe that, if your diet con-
tains the RDA for all nutrients, there is nothing to be gained by
taking additional supplements. A growing group of scientists,
doctors and informed laymen disagree. They contend that many
people can benefit from taking some nutrients in amounts greater
than the RDAs.
This controversy, which has been brewing for many years,
will not be resolved anytime soon. It is therefore important that
anyone interested in nutrition understand what the RDAs ac-
tually mean. How are they determined? To whom do they apply?
How should they be used? What are their limitations?
The Recommended Dietary Allowances are discussed in a
book with the same title. This book is revised about every five
years to keep up with new research. It is written by a panel of
scientists considered to be experts in the field of nutrition. None
of the well-known dissenters in the field, however, such as Linus
Pauling, Ph.D., Roger Williams, Ph.D., Carlton Fredericks, Ph.D.,
or Emanuel Cheraskin, M.D., are members of this panel.
The RDAs are defined as "the levels of intake of essential
nutrients considered, in the judgment of the Committee on Di-
WHY THE RDAS AREN'T HIGH ENOUGH 11
etary Allowances of the Food and Nutrition Board on the basis

of available scientific knowledge, to be adequate to meet the
known nutritional needs of practically all healthy persons/' This
definition seems easy enough to understand, but it is not as
straightforward as it looks. It is a very carefully worded state-
ment which must be just as carefully interpreted.
What, for example, is meant by the phrase "practically all"?
Researchers know that nutrient requirements vary widely from

person to person some need considerably more than others.
Because of this variation, a small group of research subjects
cannot be reliably used to predict the needs of an entire popu-
lation. Since it is not possible to guarantee that everyone will be
protected, a level of intake is chosen which the statistician pre-
dicts will cover the needs of 97 percent. In other words, about
3 percent of the people need more than the RDA for any partic-
ular nutrient. There is, unfortunately, no way of knowing whether
you are among the unlucky few who will develop a deficiency
by consuming what the committee has recommended.
You might argue that a 3-percent risk is not great enough
to justify taking a bunch of supplements. That, of course, is an
individual choice. But your chances of having a deficiency are
actually much greater than 3 percent. That is because you are
taking the same risk with each of the 40 or so essential nutrients.
When you have to take the same 3-percent risk 40 times, your
odds do not look very good. A mathematician would tell you
that, if you take in exactly the RDA for each essential nutrient,
you will have at least a 50-50 chance of becoming deficient in
one or more nutrients. With those odds, it is not unreasonable
to take out an insurance policy of sorts by consuming more than
the RDAs. While that may or may not improve your health, it
is quite unlikely to do any harm.
Another phrase in the RDA definition that requires expla-

nation is "healthy persons." The committee clearly points out
that the RDAs apply only to those in good health. "Special needs
for nutrients arising from such problems as .inherited met-
. .
abolic disorders, infections, chronic disease and the use of med-

ications require special dietary and therapeutic measures. These

conditions are not covered by the RDA."
So if you find that increasing your intake of vitamins and
minerals relieves the symptoms of your arthritis (a chronic dis-
ease), you should get no argument from believers in the RDA.
Likewise, the vitamin C requirement for the common cold (an
infection) is not included in these nutritional guidelines. If you
have developed unexplained depression after using an oral con-

traceptive, that drug has probably caused an unusually large need
for vitamin B^. If you have heart disease, diabetes, cancer, re-
current infections, chronic diarrhea, anemia or other disorders,

your nutritional needs are likely to be increased.
What you do not have any of these diseases? Does that
if
mean you are healthy? Does the RDA apply to you? Actually,
a case could be made that very few of us are truly healthy that
we are a nation of chronically ill people. One out of three of us
will develop heart disease; one out of five will die of cancer.
Three of ten women will develop severe thinning of their bones
after the reproductive years. Millions of men will suffer from
prostate troubles as they get older. While our bodies are slowly
developing these problems, we should not be considered healthy
even though we may fee! well. For if we were better nourished,
the degeneration would probably proceed at a slower pace. It
might even be prevented entirely. The millions who require med-
ication for anxiety, depression or pain are also chronically ill.
Perhaps better nutrition could help these people, too.
Another large group of people for whom the RDAs may not
apply are the elderly. As people get older, they lose the ability
to absorb nutrients efficiently. As a result, nutrient needs become
greater. The committee is aware of these increased needs. But
since few experiments have been done with the elderly, no one
is sure how much to recommend.
So there are quite a few people who are not covered by the
standards set forth RDAs. But what about those to whom
in the
the guidelines do apply? What do the RDAs mean? How are
they determined? The committee answers these questions as
'
follows: For certain nutrients the requirements may be assessed

'
WHY THE RDAS ARENT HIGH ENOUGH 13
as the amount that will just prevent failure of a specific function

or the development of specific deficiency signs
an amount that
may differ greatly from that required to maintain maximum body
stores. Thus, there are differences of opinion about the criteria
that should be used to establish requirements."
In other words, the committee is setting minimal require-
ments for minimal health. It is clear they are not interested in
the question of whether larger amounts can promote metabolic
excellence or optimal health. But accumulating evidence sug-
gests that better nutrition can do just that.
Nutritional supplements can help detoxify environmental
poisons. They may decrease the adverse physical and emotional
effects of stress, minimize the and promote
risk of infections
more healthy skin. The list of possible benefits from optimal
nutrition is long. The goal of promoting excellent health ob-
viously demands different nutritional standards than the mere
desire to avoid serious illness.
We might, therefore, wish to use other criteria than the
committee has decided upon. For example, those with elevated
levels of serum cholesterol may need more of the nutrients that
can lower cholesterol, such as niacin, calcium and vitamin C.
Another criterion that could be used is the activity of our blood
platelets. Many people have overactive platelets, which might
increase their risk of developing a dangerous blood clot in an
artery or vein. These people may have a greater need for vitamin
E, vitamin Bfi and essential fatty acids, all of which can reduce
platelet activity (if you are taking an anticoagulant medication,
consult your doctor before acting on this information).
The requirement for the antioxidant nutrients (selenium, vi-
tamin E, vitamin C and zinc) might depend on the number of
pollutants and cancer-causing agents that are working at oxidiz-
ing your cells. The need for calcium and chromium should vary
with the amount of sugar you consume, since these nutrients are
known to be depleted by excess sugar.
When you use criteria such as these to establish nutrient
needs, a comprehensive nutrition program beings to look more
sensible than the traditionalists would have you believe.
Some Misleading Statements

from the Food Industry
One additional point to keep in mind is that the RDAs can
be used by industry to make a product appear more nutritious
than it really For example, a manufacturer might create a
is.
"fruit drink" from sugar, artificial color, artificial flavor, pre-

servatives and vitamin C. Advertisements for this product would
focus on the fact that it contains 100 percent of the RDA for
vitamin C. It might not occur to the consumer that this drink
has little else to offer and could even be harmful. Or else consider
a cereal made from grain which has been refined to the point
where dozens of different nutrients have been lost. If a few of
these nutrients are added back in the "enriching" process, claims
can be made that the cereal contains 100 percent of the RDA
for various vitamins. Do not let these advertisements persuade
you that everything lost in the refining process has been replaced.
Minimal or Optimal Nutrition?

The RDAs were originally designed to ensure that large
segments of the population would not develop serious nutritional
deficiencies. They were first published during World War II,
when there was concern about the adequacy of the K rations
being fed to our troops. For these purposes, the RDAs have
provided valuable information. But if you are trying to do more
with nutrition, if you are interested in relieving the suffering of
disease, preventing chronic illness, warding off the effects of
stress, increasing your energy level, relieving anxiety or depres-
sion or getting rid of the cramps in your legs or the numbness
and tingling in your fingers, then the RDAs have little to offer.
We are, of course, grateful to the hard-working experts who
have spent much time in producing the Recommended Dietary
WHY THE RDAS ARENT HIGH ENOUGH 15
Allowances. But we must recognize, as they do, the three major

limitations of these guidelines:
1. They apply only to healthy people, a group
that is rapidly becoming extinct in our pol-
luted and stressful environment.
2. Their purpose is to guarantee a minimal,
rather than optimal, level of nutrition.
3. There is a high probability that even a to-
tally healthy person looking only for the
minimum will need more than the RDA for
some nutrients.
So, when planning your nutrition program, be sure to keep
the RDAs in mind. That way you will not forget to include at
least the bare minimum for all the known essential nutrients. But
remember that the ultimate in good health requires more than
just the bare minimum.
CHAPTER
HOW MUCH? A GUIDE

TO PERSONAL VITAMIN
SUPPLEMENTATION
No one can say what level of supplementation is exactly

right for you. With changes occurring almost continuously in our
bodies, our diets and our environments not to mention changes
in nutritional science itself
it is just not possible to be terribly
precise.
Still, we need some general guidelines that will put us in the
right church, if not the exact pew, so far as supplements are
concerned. That's what we're trying to provide here.
Please keep in mind the following:
1. These guidelines are not specific recommen-
dations, but rather general, informational
statements which inevitably reflect a certain
degree of personal opinion as well as current
research.
2. For each nutrient, read the paragraph of de-
scriptive statementsaccompanying the var-
ious amounts. Find the parai>niph which
most sounds like you. It is not necessary, or
in some cases even possible, for each sen-
tence in the paragraph to describe you spe-
16

A GUIDE TO VITAMIN SUPPLEMENTATION 17
Go with the one

cifically. that, overall,
seems most applicable.
3. Don't try to use the information here to pin-
point nutritional causes of symptoms. Ana-
lyzing serious symptoms is your doctor's
job.
Vitamin A
5,000 international units: Your diet regularly includes liver,
carrots, broccoli, apricots, sweet potatoes and spinach. You are
generally in excellent health, your resistance is very high and
the environment inwhich you live is low in pollutants. Naturally,

you are not a smoker and never have been. Nor are there any
smokers in your household. There is nothing in your family his-
tory that makes you particularly concerned about cancer.
10,000 international units: You eat vitamin A-rich foods such
as liver, carrotsand sweet potatoes occasionally, but they're not
on your menu every day. Your health is better than average, but
you are not invulnerable, and you know that when your resis-
tance gets low you tend to become ill, perhaps with upper respi-
ratory symptoms. Skin problems are not unknown to you. You
are exposed to an average amount of pollution from various
sources.
25,000 international units: Occasionally, you notice patches
of dry, bumpy skin on your legs or arms. Not dry and flaky, but
dry and humpy. Recently, you may have been involved in a
serious health crisis such as surgery, an injury, a burn or another
problem that had you out of circulation for more than just a few
days. Your vision, especially at dusk, is not what it could be.
Foods such as liver, spinach and carrots have been known to
appear on your dining room table, but they are hardly fixtures.
(Normally, supplements of vitamin A should not exceed
about 40,000 international units per day. Very large amounts
usually well over 100,000 international units per day
can cause
symptoms of toxicity, such as dry skin and loss of appetite. The
amounts mentioned in this guide, however, are perfectly safe for

adults.)
Thiamine (Vitamin Bi)

5 milligrams: You're practically famous for your perpetual
good mood and unflagging energy. Your diet regularly includes
brewer's yeast, wheat germ, whole grain products, nuts, liver
and sunflower seeds.
10 milligrams: You're generally a frisky sort, even though
you aren't necessarily ready to conquer the world at the dawn
of each and every day. There are times when you wish your
nerves were better behaved, and you sometimes think you drink
too much coffee or tea for your own good. Your diet is average.
25 milligrams: Your nerves are definitely in a state, and you
may be suffering from depression, loss of appetite or similar
emotional and neurological problems. Your energy levels are at
best undependable, as is your memory. Possibly, you are in your
retirement years, when absorption of thiamine as well as other
B vitamins is much reduced.
very
Riboflavin (Vitamin B2)

5 milligrams: You're a great one for dairy foods like milk,
cheese and eggs. Almonds, asparagus, broccoli, liver, wheat
germ and other riboflavin-rich foods appear in your daily fare.
Your eyes are clear and bright and the skin around your mouth
is perfectly smooth
except when you smile, which you do
frequently.
10 milligrams: Milk and liver you don't care for, cheese and
eggs have too much cholesterol for you, and wild rice and as-
paragus are too expensive. So you don't get that much riboflavin
in your diet except from your whole grain bread. You are also
getting up there in years.

25 milligrams: if you look in the mirror carefully, you will
see small cracks around your mouth, or your tongue may be
smooth and purplish. Your eyes may burn, itch, be abnormally

sensitive to bright light or simply feel worn out. You may feel
depressed. You are no spring chicken.
Niacin
10 milligrams: Your diet regularly includes fish, beans, organ
meats, peanuts, poultry, whole wheat products and brewer's
yeast
or at least half of those foods. Your disposition is strictly
blue sky.The only time you are irritable is when enemy tanks
invade your neighborhood.
25 milligrams: Your diet is nothing to brag about, particu-
larly, and occasionally you wonder if there is some reason why
it's becoming so difficult for you to fall asleep or if your head-
aches have some peculiar origin.

50 milligrams: Your nerves and your personality are defi-
nitely not what they used to be and not what your friends or
family would like them to be. You may have thought about
visiting a psychologist or psychiatrist, and you would be grateful
if something could be done about your insomnia.
Vitamin Be (Pyridoxine)
5 milligrams: You practically radiate good health, and your
positive, energetic attitude is reflected in your intelligently varied
diet,which includes wheat germ, brown rice, salmon, peanuts,
liver,bananas and, of course, whole grains.
10 milligrams: You certainly aren't sick, but you sometimes
wonder why your skin isn't better or why your nerves aren't
calmer. You may tend to retain a lot of fluid before your men-
strual periods.
50 milligrams: Your monthly periods cause you considerable
distress, not only because of fluid retention, but because of emo-
tional problems at that time
or perhaps all the time. Possibly,
you are on birth control pills. Life is looking more and more like
an ordeal.
Vitamin B12
5 micrograms: You are healthy, energetic, haven't yet reached
retirement age, and you regularly eat animal foods such as meat,
fish or chicken.
10 micrograms: You've passed your 60th birthday, and your
ability to absorb this vitamin in a useful form may be on the
wane.
25 micrograms: Lately, your energy level, and possibly your
nerves, just haven't been up to snuff. Possibly, you've been ill
or had surgery. You may be a strict vegan, one who avoids all
animal-source foods. These symptoms may well be serious enough
to suggest a thorough medical evaluation.
Folate (Folic Acid)

400 micrograms: You eat a lot of raw green vegetables such
as broccoli, asparagus and spinach. You're a liver lover from
way back, and you eat it with onions. You are full of energy,
and retirement is something that's far in the future.
400 to 800 micrograms: You must remind yourself that you
should eat raw green vegetables more frequently, and you wish
you were able to work out a way to eat beans, broccoli, aspar-
agus, wheat germ, tempeh and whole wheat products more often
than you do. Your health is about average.
800 to 2,000 micrograms: Lately, you feel as though you've
been under considerable emotional stress, and you haven't been
able to handle it as well as you should. Your nerves in general
have been in such a state that you have given serious consid-
eration to seeking some kind of help, whether medical, psycho-
logical or even nutritional. You are over 70 years of age and
your absorption of folate, therefore, is likely to be impaired.
Possibly, you have recently undergone surgery. Your doctor may
have reason to believe you have folate deficiency anemia, which
causes, among other things, inflammation of the tongue, diges-
tive problems and diarrhea. (When taking folate supplements,

always take vitamin Bi: with them.)
Vitamin C
100 milligrams: You can hardly remember the last time you
were ill. Your health is excellent, and your gums are clear, firm
and never bleed. Your daily diet includes generous measures of
such vitamin C-rich foods as broccoli, cabbage, melons, citrus
fruits and green peppers.
500 milligrams: You feel that your resistance must be main-
tained at a high level in order to keep you feeling your best.
There may be some chronic health problem or stress in your life,
such as a bad back, allergies or exposure to cigarette smoke.
Your diet is not bad by a long shot, but it does not supply the
amount of vitamin C you feel you should get.
2,000 milligrams: You are definitely susceptible to stresses
such as infection, pain or skin problems. Possibly, you are re-
covering from surgery, an injury or any other serious bout with
illness. In the past, you have noticed that injury or surgical
incisions seem to heal very slowly. Your diet could be better,
but it is difficult for you to eat raw foods, high in vitamin C,
because they tend to make your gums bleed. You may want to
step down to a lower level of vitamin C supplementation when
the health problem or crisis you are now undergoing disappears.
Vitamin D
200 international units: You live in an area where the
to
sun shines strong and bright, such as Florida or southern Cali-
fornia. What's more, you move around quite a bit outdoors, so
sunlight strikes your body, causing your system to manufacture
its own vitamin D. If you have a year-round tan, you probably
don't need any supplemental vitamin D at all.

400 international units: You live in an area such as Penn-

sylvania or Washington state, where a beautiful sunshiny day is
a real event. You are not a big drinker of milk, which is fortified
with vitamin D, usually at the rate of about 400 international
units per quart. Occasionally, however, you do eat fish contain-
ing vitamin D, such as herring, mackerel, salmon, sardines and
tuna.
800 international units: You probably live in the northern
United States, Canada or England, where, except for a few weeks
in the middle of summer, intense sunshine may be as rare as
rainbows. What's more, for one reason or another, you do not
get very much exercise outdoors. Possibly you have had a prob-
lem with your bones, suffering a fracture or pain. Although a
physician may recommend considerably higher supplements, you
should not ordinarily take more than this amount on your own
each day, as vitamin D tends to accumulate in the body, and
very large amounts (usually many thousands of international
units) can become toxic.
Vitamin E
100 international units: You are relatively young, in fine health,
and you live in an exceptionally clean area, where there is re-
markably little pollution.
400 international units: You may have a health condition
which may be prevented or improved with vitamin E, such as
intermittent claudication (cramping of the calf on walking) or any
one of a number of skin problems. The air you breathe, the water
you drink and. possibly, the food you eat contain the usual amount
of pollutants found in our modern world. Your diet contains a
substantial amount of polyunsaturated fats such as corn oil.
600 international units: You may be concerned about a cir-
culation problem and feel that the beneficial effect of vitamin E
on blood elements is something that you want to take advantage
of in full measure.

CHAPTER
GETTING THE MOST

FROM YOUR VITAMINS:
A PLAN FOR
MAXIMAL ABSORPTION
Even if you're taking all the right vitamin supplements, you

may be getting less out of them than you think you are! But
don't despair nutritional "fuel efficiency" is easy to achieve if
you keep a few simple concepts in mind,

"Generally, vitamins are absorbed best when they are taken
with other foods and minerals," counsels Harold Rosenberg,
M.D., past president of the International Academy of Preventive
Medicine, in The Doctor's Book of Vitamin Therapy (G. P. Put-
nam's Sons, 1974). "The best time is after meals and as evenly
throughout the day as possible."
This matter of good timing can't be overemphasized either,
for taken at the wrong time
on an empty stomach, in particu-

lar even the most beneficial supplement can pass through your
body with less than optimal results. After all, it's only the nu-
trients actually absorbed by your digestive system
this takes
place primarily in your small intestine
that can work their met-
abolic magic.
Combining supplements with meals, then, is the best way
to give nature a helping hand.
"The nutrients were in your food in the first place," Dr.
Rosenberg says. "And when you're eating, tastes and odors
23
the entire range of gustatory and sensual factors

stimulate and
excite the digestive enzymes. Primed by even something as sim-
ple as a piece of fruit or a slice of whole wheat bread, these
enzymes are ready for the vitamins and minerals."
So you needn't fear your supplements will get lost in a
crowd.
"Though everything goes in the kettle at the same time, the
body has a fairly broad tolerance level for unscrambling what
we put in in scrambled form," explains Rebecca Riales, Ph.D.,
a clinical nutritionist from Parkersburg, West Virginia.
And once unscrambled, many nutrients must form partner-
ships with other substances found in food in order to be absorbed
fully.
Vitamins That Need Fat

Fat in your meal acts like a chauffeur service for vitamins
A, D. E and K, the fat-soluble vitamins.
"For example, if you take vitamin E on an empty stomach,
there's almost no absorption," Dr. Riales notes. "And you'll

have the same trouble if you take a multivitamin with, say, a
breakfast of skim milk and cold cereal
there's almost no fat in
the meal and you'll wind up absorbing very little of the fat-soluble
vitamins."
But drink a glass of whole milk, add a pat of butter to your
oatmeal or some vinegar and oil to your salad, and the increase
in nutrient absorption can be "tremendous," according to Hugo
Gailo-Torres, M.D., Ph.D., senior research physician of the de-

partment of gastroenterology, medical research, at Hoffmann-
La Roche, Inc.
"Fat-containing foods may also prolong absorption," he
explains, citing a wealth of recent research from Japan.

But what about the water-soluble vitamins the B complex
and C?
"These are well absorbed with or without food, but taking
thcni with a meal can slow the rate of absorption (although it
won't decrease the total amount absorbed)," says Dr. Riales.
And that can he beneficial.
A PLAN FOR MAXIMAL ABSORPTION 25
Initially, you might absorb more of a B or C supplement on

an empty stomach than you would with a meal. But doses ab-
sorbed too quickly are excreted too quickly to have long-term
effects on body concentrations. On the other hand, stretching
out the absorption time as you digest your food will result in
increased levels of the nutrient in your blood over a longer period
of time.
It's a case of "slow and steady" winning the race, and it
has inspired the suggestion that you take your supplements in

divided doses throughout the day, rather than all at once.
Michael Mayersohn, Ph.D., and his colleagues at the Uni-

versity of Arizona tested this idea with vitamin C. Working with
three people, they gave each agram (1,000 milligrams) of vitamin
C two weeks. One person took the vitamin in a single
daily for
dose, the second received the gram in eight small doses and the
third also took the entire dose of the supplement at once, but
after eating a high-fat meal.
"The divided dose and after-meal treatments produced a
significant increase in AA [ascorbic acid, i.e., vitamin C] ab-
sorption compared to the corresponding control experiment, 72
percent and 69 percent increase, respectively," they wrote {Life
Sciences, vol. 28, no. 22, 1981).
"From a practical point of view, efficiency of AA absorption
may be improved by either dividing up a daily dose into several
smaller doses taken during the day or by ingesting the vitamin
after a meal."
Dr. Rosenberg mentions that the B vitamins are also best
taken throughout the day.
"Every requirement of the human body operates on a twenty-
four-hour cycle.Your cells do not go to sleep when you do, nor
can they survive without continuous oxygen and nutrients."
Nutrient Interactions
Some nutrients just naturally go together, practicing a kind
of vitamin-and-mineral teamwork when it comes to maximizing
absorption.
Take calcium, for example.

Divided doses of the mineral teamed with vitamin C can
increase the percentage of calcium absorbed, notes Dr. Riales.
And combining vitamin C with calcium is "worthwhile espe-
cially if you're older. Vitamin C's acidity seems to help calcium
remain soluble and hence available for absorption.''
And, of course, there's the team of vitamin D the "sun-
shine vitamin"
and calcium. This vitamin regulates how much
of the bone-building mineral is absorbed through your intestine,
so you'll want both on your team.
There are many other examples of nutrient teamwork, but
most of them take place after absorption.
But that's not so with vitamin C and iron.
If you're a woman eating less red meat and gaining more of
your protein from plant sources, this vitamin-mineral pair's
teamwork is especially important.
The iron in plants plays "hard to get," but vitamin C can
overcome that and make a sizable portion of the mineral ready,
willing and able when it comes to intestinal absorption, according
to Sean Lynch, M.D., of the department of medicine at the
University of Kansas.
"But you have to take the vitamin with your meals," he
emphasizes.
And again, taking the C divided doses say, with each
in
meal makes that much more iron available from your food.
Zinc Helps Folate Absorption

If you want maximum folate (folic acid) absorption from
your food or vitamin supplements, it's a good idea to take zinc
along with it.
Researchers at the University of California at Berkeley found

that, when healthy volunteers were put on a diet that depleted
their reserves of zinc, the absorption of folate dropped sharply.
Why? The folate-containing compounds in foods, polyglutamyl
A PLAN FOR MAXIMAL ABSORPTION 27
folates, must be split by an enzyme before folate can be ab-
sorbed. And this enzyme, they suggested, requires zinc (FASi^B

Proceedings).
While you're making sure your diet has all the nutrients
essential for healthy absorption, you might also consider the
negative effect of nonessentials like additives. According to one
study, the common preservative EDTA can reduce the absorp-
tion of iron.
Nutrient Absorption
Declines with Age
In general, the older you are, the greater the chance yoifll
run into absorption problems. A decline of secretions of stomach
acid and digestive enzymes means poorer absorption of iron and
protein.
Less and less of the B vitamins and such minerals as cal-
cium, too, make it out of your digestive tract and into your
bloodstream. This is one reason why older people are so ofien
beset with nutritional ills. Poor absorption means poor nutrition,
which will impair absorption further starting a cycle that is
difficult to stop. Is this inevitable?

"There are widespread differences in the ability to absorb
nutrients," says Mark Tager, M.D., who practices wellness-
oriented medicine in Oregon. "At least part is rooted in individ-
ual history
how a person has used or abused his digestive tract
during his lifetime.'' The continual use of stimulants, like caf-
feine, may take its toll over time. So can years of neglected
stomach and bowel problems.
By the same token, attention to those things that promote
healthy digestion and absorption pays a double bonus: now and
in the future. Making mealtime (and the hours afterward) relaxed
and pleasant is more than just a civilized idea for this reason.
"I'd suggest a quiet period surrounding digestion," says Dr.
Tager. "It does little good to throw in good food and then damage
digestion by stress."
Exercise will give your digestive system the same benefits

it gives the rest of your body. "Individualswho don't exercise,
who don't get enough oxygen to the cells, tend to have poor
absorption patterns," Dr. Tager says. ''Yoga exercises that aim
at using stomach and intestinal muscles can do particular good."
But where digestion and absorption are concerned, the main
thing, appropriately enough, is food. Dr. Tager emphasizes the
virtues of raw foods, whole grains and vegetables. Many people
may want to add vitamin and mineral supplements to sound diets
based on whole, natural foods, to ensure an adequate supply of
all the nutrients necessary for efficient absorption. What it comes
down to is this: A high-quality diet will help your body get from
your food all the good things that nature put into it.
And that logic is hard to question.
CHAPTER
DO YOU HAVE
"HIDDEN HUNGER"?
Suppose for a moment that you were usually so dog tired

you couldn't even get out of your chair to do your household
chores. Or suppose you couldn't sleep at night. Or you were so
cranky most of the time that you felt like snapping everyone's
head off. Or you were just getting sick much too often.
If this sounds like you, then your body may be telling you
it has a "hidden hunger" for the proper levels of vitamins.
Technically, such hidden hunger is called subclinical, or

marginal, malnutrition. "If a person has a subclinical nutritional
deficiency, he or she might appear perfectly normal," says Frank
Beaudet, an instructor at the Leonard Davis School of Geron-
tology, University of Southern California. "There will be no
obvious symptoms that anything is wrong nutritionally. But when
the person under physical or emotional stress, then we will
is
see the impact of marginal levels of nutrition."

full
A person with hidden hunger sounds like an accident waiting

to happen. "In many ways that's true," Beaudet says. "Sub-
clinical malnutrition can lead to, among other things, an in-
creased susceptibility to disease and a longer recovery time from
29
surgery. could even lead to an adverse reaction to a flu vac-

It
cination due to lowered immune response/'

Is subclinical malnutrition something new? ''Not really,"
says Beaudet. "But it has only been recognized within about the
past five years. Our knowledge
and ability to recognize, sub-
of,
clinical malnutrition have developed along with the renaissance

in nutrition, in general, and, geriatric nutrition, in particular."
Is the problem very widespread? "Malnutrition itself is not
an epidemic among older adults," Beaudet says. "But countless
numbers suffer from subclinical malnutrition and may not even
be aware of it."
Your body may have a hidden hunger for one or more vi-
tamins. "In the United States today, we rarely see cases of

classical vitamin deficiency, such as scurvy and pellagra," says
Richard Rivlin, M.D., of the Memorial Sloan-Kettering Cancer
Center and New York Hospital-Cornell Medical Center, New
York City. "But we are now beginning to recognize a vast new
series of marginal deficiencies related to disease and therapy.
. . . Marginal deficiency, it now appears, may be a surprisingly
common phenomenon."
paper presented to the Vitamin Nutrition Issues Sym-
In a
posium in Boca Raton, Florida, in October, 1979, Dr. Rivlin
used riboflavin (vitamin BO to illustrate his point. He noted that
animal studies have shown that, when your body is low in ri-
boflavin, the production of an enzyme that the body needs to
use the riboflavin in the first place is inhibited. "The less [ri-
boflavin] you have," said Dr. Rivlin, "the less you are able to
utilize; once the body gets sick, it gets sicker, because it lacks
the enzyme and therefore cannot utilize what little vitamin there
is in the diet. . . . The important concept is that deficiency itself
produces changes in the ability to utilize that same vitamin.
"Riboflavin is important in blood formation, in the brain, in
fat metabolism, in degrading drugs and foreign substances and
in maintaining the skin. And because one vitamin is involved in
the metabolism of another, the effects of one deficiency are com-
pounded by effects upon others."
DO YOU HAVE "HIDDEN HUNGER"? 31
Several other factors also can create a hidden hunger for

riboflavin. ''Boric acid, for example, which is present in some
400 home products such as mouth washes, suppositories and
imported foods, claws onto the sugar portion of the riboflavin,
binds and takes it out in the urine. The amount of boric acid
it
ingested by the population is obviously variable; but if individ-

uals are taking boric acid over a long period of time in low
amounts, they may be at risk for gradually getting a degree of
vitamin depletion.""
Dr. Rivlin pointed out that drugs such as the tranquilizer
chlorpromazine, if taken over a long period of time, can also
cause a riboflavin deficiency. "The same principle is true for
other nutrients,'' he said. "Drugs and hormones may act as
antagonists or enhancers, and one should really look at nutrition
not only from the standpoint of diet, but also from the standpoint
of metabolism.
"While there are many challenging problems that lie ahead
in nutrition, we are very much concerned with the fact that
marginal deficiencies due to drugs or hormones may be a very
common problem. We are actively pursuing these problems, and
I think this is the type of thing that one will be hearing much
more about in future years."
Guarding against Hidden Hunger

Subclinical malnutrition is a complex problem and one whose
seriousness is only now being fully recognized. Although the
answers aren't all in, health professionals do recommend various
steps you can take to make sure you don't have hidden hunger.
Arnold Schaefer, Ph.D., executive director of the Swanson
Center for Nutrition in Omaha, Nebraska, says that drug-induced
vitamin and mineral deficiencies can be avoided if you take high-
potency nutritional supplements.
Frank Beaudet points out that, since our taste perception
decreases with age, many older people do not eat properly be-
cause their food seems relatively tasteless. "We should increase

the amount of seasoning in our food as we grow older," says
Beaudet. "That means using more of such green herbs as basil
and tarragon and using more garlic or onion for a more flavorful
diet.
"The best recommendation 1 can make for older people is
to try to eat a diet with foods as high in nutrient density as

possible." Beaudet says, "That means foods with high nutrition
per calorie. Foods with low nutrient density, like pastry, should
be avoided.
"Older people are regularly under emotional and physical
stresses, and proper nutrition can cushion the effects of those
stresses. No older person should have to suffer from the effects
of subclinical malnutrition."
CHAPTER
NUTRIENTS FOR
THE CRITICAL YEARS
We all know there are often health problems and pain in-
volved in aging. We know can relieve pain and some-
that drugs
times correct the causes of it. But drugs very seldom act on the
body in one single, beneficial way. There is generally a mixed
bag of effects, and the bag gets larger the more drugs you take.
The really disturbing thing about this situation is that the
medications the elderly take can often deplete nutritional stores
that are already dangerously low. A host of prescription and
nonprescription drugs, everything from aspirin to glucocorti-
coids, have been shown to rob the body of essential nutrients.
Many of those drugs are routinely taken by older people for
years, to counter the effects of chronic illnesses.
At the same time, as people get older, their bodies change.
They make changes in the way they live, including their meal
patterns. Often the result is a system denied the nutrients it needs
to handle the stresses of old age, including the stress of increased
medication.
Large segments of the elderly population of the United States
are suffering from multiple nutritional deficiencies. A survey of
33
older Missouri residents found that half of the women and one-
fifthof the men were getting less than 67 percent of the Rec-
ommended Dietary Allowance for one or more nutrients (Amer-
ican Journal of Clinical Nutrition).
A government survey of low-income districts in ten states
discovered that at least half of the elderly women and a third of
the elderly men were getting inadequate amounts of niacin in
their diets. Thirty percent of the elderly people in that survey

had unacceptably low levels of protein in their blood.
Nearly all of the subjects of a survey of older people in
Montgomery County, Virginia, reported that they took in less
than the recommended allowance for vitamin 65 (Nutrition Re-
ports International).
Drugs That Destroy Vitamins

And the elderly are the people who consume more prescrip-
tion drugs than any other group in the country. People 65 or
over, although just one-tenth of the U.S. population, consume
nearly a quarter of all drugs prescribed. The average elderly
American takes 13 different drugs in the course of a single year.
That means that the people nutritionally least equipped to cope
with the stress of medication receive the most of it.
For example, there is evidence that barbiturates, prescribed
as tranquilizers and sleeping aids, may lower the amount of cal-
cium in the blood by disrupting the metabolism of vitamin D.
Vitamin D is necessary for the proper absorption and utilization
of calcium. Phenobarbital, a barbiturate that in high doses is
used to prevent epileptic seizures, has been linked to altered
vitamin D metabolism and resulting cases of osteomalacia, a
softening of the bone caused by a lack of calcium.
In other research, scientists have found that barbiturates
increase the excretion of vitamin C from the body, as well.
Glucocorticoids
the family of anti-inflammatory drugs used
to relieve the symptoms of arthritis
can also play havoc with
the body's nutritional balance. Glucocorticoid treatment can cause
NUTRIENTS FOR THE CRITICAL YEARS 35
a form of osteoporosis, a classic deficiency disease in which bone

density drops as a result of a lack of calcium. Children receiving
long-term glucocorticoid therapy for kidney disease have been
shown to have low blood levels of the most active metabolic
product of vitamin D (Lancet). Scientists believe the action of
the glucocortocoids against vitamin D produces low levels of
calcium in the blood, which, in turn, can cause bone-weakening
osteoporosis. Treatment with the same drugs may also lead to
potassium deficiency and can have a similar effect on vitamin C
levels.
Older people receiving treatment for heart ailments are up
against an array of drugs which can undermine their nutritional
defenses.
Digitalis, for example, can increase the body's requirements
for thiamine. Hydralazine, a drug used to treat hypertension,
can cause vitamin Bf, deficiency.
Diuretics administered to counter high blood pressure can
flush enough potassium out of the system to cause a deficiency.
The diuretic triamterene works without depleting the body's po-
tassium, but, unfortunately, it interferes with the utilization of
an essential member of the B vitamin group.
folate (folic acid),
Like other diuretics, it can also produce excessive excretion of
calcium.
The Problem with Mineral Oil

Nutritional problems may crop up even in the course of
treatment of minor ailments like headaches and constipation.
Mineral oil and phenolphthalein, used as laxatives, can block
normal absorption Mineral oil dissolves
in the digestive tract.
the naturally occurring source of vitamin A, carotene, and it slips
untouched through the stomach and intestine. Mineral oil inter-
feres with the absorption of all the fat-soluble vitamins A, D,
E and K and chronic use, the kind that older people with chronic
constipation would practice, may cause deficiencies in all those
vitamins.
Headache can be just as costly in nutritional terms.

relief
Aspirin depletes body tissues of vitamin C; even a small dose
can cause the excretion of C from the body to increase threefold.
Aspirin also disrupts the body's utilization of folate.
The more you look at this situation, the more you are struck
by the way the problem acts to make itself worse. You keep
finding vicious circles in which problems turn back in on them-
selves or pile up on top of each other in ways that can be very
discouraging.
For instance, several drugs, including barbiturates, gluco-
corticoids and aspirin, act to deplete vitamin C. Vitamin C, in
turn, is important for the proper metabolism of drugs in the body.
If drugs are not metabolized at the correct rate, their effects can
be prolonged or their possible toxic side effects increased. And

so you have one drug side effect, the depletion of vitamin C,
making the dangers of other side effects even worse.
That puts older people, who are often being treated for a
number of conditions at once, in a scary position. "Multiple
pathology often leads to multiple pharmacy with the increased
risk of interactions between drugs and increased toxicity of drugs
due to a decreased ability to metabolize them," John Dickerson,
Ph.D., professor of nutrition at England's University of Surrey,
warned (Royal Society of Health Journal). "Superimposed on
this is the fact that illness in the elderly predisposes them to
nutritional deficiencies which may be induced by the drugs and
also further exacerbate their toxicity."
It's no wonder the number of adverse drug reactions sky-
rockets with age: The frequency in people age 70 to 79 is seven
times that in people age 20 to 29.
Vicious Cycles
Similar vicious cycles are at work in other aspects of the
ciderly's nutritional problems. Folate deficiency, for example,
is common in older people. One study found that 40 percent of
elderly subjects had low levels of folate in their blood. A team

of scientists led by Herman Baker, Ph.D., of the New Jersey
Medical School school of nutrition, showed that older people
absorb much from natural sources than younger peo-
less folate
ple (Journal American Geriatrics Society). Dr. Baker sug-
of the
gested that the resulting folate deficiency may make the problem
even worse by hindering the secretion of an enzyme crucial to
the proper breakdown of folate from food.
A vicious cycle is thus begun, according to Dr. Baker. "Ag-
ing leads to small-bowel enzyme impairment, which in turn leads
to less folate utilization from food, and this intensifies folate
depletion.'' The result: "Because of an inability to utilize food
folates, deficiency becomes, if not inevitable, at least common
in the elderly."
Life style can also affect nutritional status, particularly in
your later years.
In a journal article, Dr. Masud Anwar, consultant physician
in geriatric medicine at a hospital in England, described a case
history of vitamin D
deficiency he had observed (Journal of the
American Geriatrics Society). An 80-year-old woman was ad-
mitted to the hospital with a history of arthritis that had plagued
her for several years. She suffered from swelling of the legs and
feet, to the point that she was unable to walk properly, and was
chronically depressed. Since she was unable to stand long enough
to do any cooking, she lived off canned food, and because of
her depression, she often skipped meals altogether.
X rays revealed skeletal structure with low mineral content,
and it was apparent from questioning that the woman was getting
almost no vitamin D in her diet. She never ate liver, kidney, fish
or eggs. She seldom got outside and thus received little vitamin
D from natural exposure to sunlight.
The doctors prescribed vitamin D and calcium supplements,
and within six months her condition improved markedly. Her
bone pains disappeared and she was able to get about on her
own, even without the aid of a cane. She became fully indepen-
dent, able to cook nutritious meals for herself and do her own
housework, and she took pride in her independence. Her depres-

sion disappeared without any action by the doctors. Physical
well-being was obviously the best therapy possible.
"This patient believed that the pain in her thighs was caused
by arthritis of the hips." according to Dr. Anwar, "which she
considered was due to aging. She did not want to trouble her
own doctor. She was afraid to go out, because of inability to
walk and lack of confidence, thus depriving herself of exposure
to sunlight. Loneliness made her depressed and she lost interest
in eating. Thus loneliness, depression and poor eating habits
became a vicious cycle which was broken only by admission to
the hospital."
The object of the game is to break out of this cycle before
you end up in the hospital. It has been estimated that eight million
elderly Americans suffer from malnutrition. They are struggling
with problems caused by drugs, problems caused by life style,
problems caused by changes in the way their bodies work. The
sense of taste declines with age, so you want to eat less. The
efficiency of digestion declines, so you absorb less of what you
eat and need to take in more than a younger person to get the
same nutritional benefits.
Modern Diets Are "Diluted"

The peculiarities of the modern diet are no help to older
people struggling with all this. Ruth B. Weg, Ph.D., of the Andrus
Gerontology Center at the University of Southern California,
believes the "dilution" of nutrition in the modern diet poses
particular problems for the elderly. In her book. Nutrition and
the Later Years (USC Press, 1978), she writes, "With the refining
and processing of more and more foods, the character of nutrient
intake has changed: usually with more sodium than needed, and
less potassium, zinc, selenium, chromium, silicon and nickel.
Too many extra calorics (usually through the addition of sugar
and fats) dilute the diet, particularly in relation to minerals and
vitamins."
This may have something to do with the fact that, while

older people are generally judged to take in fewer calories than
the recommended allowance, they are often plagued with obe-
sity. One study found more than 40 percent of its aged subjects
to be overweight. The elderly use inefficient digestive systems
to consume inefficient fuel.
"Empty calories" are especially dangerous for people who
must make the most of everything they eat to stay in decent
condition. "Older persons require food intake with higher con-
centration of micronutrients per calorie than younger individu-
als," Dr. Weg concludes. "This is especially true as the caloric
intake decreases."
So the way out of the malnutrition syndrome is clear. Con-
sume enough calories, but make sure they are nutrient-rich cal-
ories. That means the kind of diet that includes fresh fruit, veg-
etables and low-fat protein like chicken and fish and an
"insurance plan" of supplemental vitamins and minerals to fill
in any gaps.
CHAPTER
BEATING THE
VITAMIN BANDITS
Frank is a middle-aged investment banker, a man whose job

is to help people protect their savings against all the things that
deplete them in complicated, secret ways. He's very good at
what he does, and proud of it. He also is concerned about his
health because lately it hasn't been the greatest.
Today he gets up exactly at seven, dresses nattily and goes
downstairs for breakfast, ready to conquer inflation. If he only
knew the number of ways his health is going to be robbed today.
. Well, he might even crawl back into bed.
. .
He pours himself a big, cold glass of orange juice to make

sure he takes enough vitamin C. A panel on the carton assures
him he's getting plenty. But what it doesn't say is that as much
as 40 percent of that vitamin C may be in a form that is of no
use body.
at all to his
Unfortunately, Frank didn't read the study that showed fresh-
squeezed orange juice provides up to twice as much hioloi^'ically
active vitamin C as pasteurized, carton juice
though total vi-
tamin C levels in the two juices may be the very same (Journal
of the American Medical Association).
40

BEATING THE VITAMIN BANDITS 41
Frank has been robbed even before he has opened his mouth.
Next, he pops a sHce of whole wheat bread in the toaster,
for protein and B vitamins. He doesn't know some of the B
vitamins are destroyed by heat and that toasting steals thiamine
(vitamin Bi)
the darker the toast, the more you lose
as well
as making certain amino acids unavailable to the body. (Actually,
15 to 30 percent of the thiamine originally present in bread dough
has been destroyed already by baking.)
Frank's been trying to beat the coffee habit (with middling
success), so he pours himself a cup of steaming black tea. It

charges his blood but it also makes off with still more thiamine
and iron.

Tannin the stuff that gives tea its astringent, puckery taste
is believed to be the bandit that steals thiamine. In one study,
a thiamine solution was mixed with black tea and allowed to

stand for 90 minutes at 86F. It was discovered that 22 percent
of the thiamine was either destroyed or inactivated (Food Chem-
istry, vol. 6, no. 2, 1980-1981).
A report in the New England Journal of Medicine (January
4, 1979)suggested that, because of its ability to inhibit the body's
absorption of iron, tea might be used to help treat certain anemias
in which iron overload is the main cause of death.
Poor Frank! He's so proud of himself for drinking orange
juice, eating whole wheat toast and avoiding coffee that he treats
himself to a sugar-covered doughnut. Bad move, fella.
Refined carbohydrates such as white sugar and flour have
most of the B vitamins wrung out of them during the milling
process. But because thiamine and others in the B complex are
needed to make an enzyme used in the burning of carbohydrates,
these vitamins have to be stolen from the liver or other storage
places to properly metabolize Frank's doughnut. His little re-
ward is not only deficient in the B complex, it's actually a
B-complex thief! (Whole, natural carbohydrates come equipped
with their own B vitamin supply, so they don't pilfer the body's
store.)
Frank is quite pleased with himself as he strides briskly off
into his day. The only trouble is he's got confectioner's sugar
on his chin and a small army of vitamin bandits are already
plundering the breakfast in his stomach.
Chemicals That Steal Vitamins

Vitamin antagonists, as they are officially known, are the
James Gang of the nutritional world. In one way or another, they
either destroy vitamins directly or alter them in a way that makes
them useless to your health.
An antagonist may interfere with the conversion of a vitamin
to its active, or coenzyme, form often because the antagonist
is so closely related to the vitamin itself. The antagonist may
enhance the development of enzymes that destroy certain vita-
mins. It may cause excessive elimination of nutrients or impair
your body's ability to absorb them.
In fact, there are so many differentways your body can be
burglarized that it's foolish to think you're actually making use
of everything those tidy little nutritional charts promise.
we grew all our own vegetables like people did in grand-
'Tf
pa's day, we might not have as many problems using all the
vitamins we get," says H. Curtis Wood, Jr., M.D., a nutrition-
oriented Philadelphia doctor who is the author of Overfed but
Undernourished (Expo^'iUon Press, "But today, there are
1959).
more than 3,000 chemicals used in the commercial foods we eat.
And in one way or another, many of them can be antagonists."
Insecticide residues and pollutants in the air and water also
can raid our vitamin stores. Dr. Wood told us. Even vitamins
can sometimes act as antagonists to other vitamins. Large amounts
of a single B vitamin actually may increase your need for others
in the B complex. Dr. Wood said, so it's best to take the Bs all
together.
Life's circumstances also can become antagonists stress,
advanced age, disease, pregnancy, increased physical activity
or even lack of sleep all can destroy vitamins at a stepped-up

pace.
"Everyone has individualized nutritional needs," Dr. Wood
points out. "But a single person may also vary rather widely in
his requirements from day to day. depending on stress, exercise,
diet and so on. There are so many things that can act as antag-
onists, it's just unrealistic to think the RDAs [Recommended
Dietary Allowances] will give you all the nutrients you need."
Among the most widespread bandits, he says, are drugs.
Drugs Disrupt Your Body's

Nutritional Balance
That powerful drugs often cause powerful side effects, al-
tering our metabolism of nutrients in complicated ways, isn't
really too surprising. But even "harmless" drugs can take their
toll.
"Among the drugs shown to cause tissue depletion of as-

corbic acid [vitamin C], aspirin is the most important," writes
Daphne A. Roe, M.D., in her book Drug-Induced Nutritional
Deficiencies (AVI Publishing, 1976). Dr. Roe goes on to point
out that diuretics can cause a loss of calcium, meignesium and
zinc and that mineral oil, sometimes used as a laxative, may
cause deficiencies of vitamins A, D and K.

Some drugs act as antagonists by interfering with the ab-
sorption of nutrients through the digestive system. They may
actually change the microscopic structure of the villi, or tiny,
finger-shaped ridges that line the small intestine. That, in turn,
may destroy the enzymes the villi normally produce to break
down and absorb nutrients.
The antibiotic neomycin, for example, was shown to cause
structural changes in the intestinal villi of people within six hours
after it was administered. Neomycin, as a result, interferes with

absorption of potassium, calcium, vitamin B12, iron and other

substances.
Other drugs, such as certain laxatives and cathartics, greatly
speed up the intestinal transit time, causing nutrients to pass
through the intestines too rapidly to be absorbed fully.
And some drugs rob your body by binding with nutrients to
form a new substance that the body cannot use. For example,
a common antacid, aluminum hydroxide, binds with phosphates
in the intestines, causing the phosphates to be passed unused
out of the body. Phosphate depletion, linked with long-term use
of these antacids, can be dangerous because it interferes with
proper bone formation.
Oral contraceptives, currently used by an estimated 10 to
18 million American women, are among the most nutritionally
disruptive drugs. In a review of the medical literature, James L.
Webb, Ph.D., reported that contraceptive steroids have been
shown to lower the levels of six nutrients in the body: vitamins
Bfi, B|2 and C, riboflavin (82), folate (folic acid) and zinc {Journal
of Reproductive Medicine, October, 1980).

Dr. Webb concludes that "females consuming oral contra-
ceptive agents should pay particular attention to vitamin and
mineral intake and, if warranted, consume . . supplements of
.
needed nutrients.''
To which Dr. Wood adds a word of general advice: "Doctors
are so drug oriented it's unbelievable, but the best thing is to
take as few drugs as you possibly can. I'd rather people tried
nutritional means [of healing themselves] calcium or trypto-
phan instead of sleeping pills, for example. That's the safest way
to avoid the nutritional antagonists in drugs."
Smoking and Drinking:

A Deadly Duo
You may be careful about avoiding unnecessary drugs, but
if you smoke or drink, you are flirting with two of the best-known
vitamin antagonists around. In fact, after a two-year study of

alcoholic prisoners in California, Jery Meduski, M.D., Ph.D.,
summed up alcoholism in three scary little words: basic nutri-
tional disaster.
The trouble with alcohol (besides the obvious) is that it
provides only "naked" calories, completely bare of nutritional

value. And though it's not a nutrient, alcohol is metabolized or
processed in the body the same way nutrients are and can in-
terfere with the body's absorption of food.
For example, it has been known for the past 20 years that
alcoholism and its offshoot, cirrhosis of the liver, usually are
accompanied by zinc deficiencies, though exactly how booze
flushes zinc out of the system is not understood. ("Zinc before
you drink" is the warning in some circles.)
But zinc isn't the only nutrient drinking destroys. Alcoholics
also often show deficiencies of thiamine, folate, vitamins Bf,, B12,
C, A and D, and calcium, iron and magnesium. "Basic nutritional
disaster" is no exaggeration!
But there may be vitamin destroyers awaiting even those
who are not long-term heavy drinkers. A researcher at Ohio State
University reports that six or seven drinks a day for as little as
two weeks can throw the digestive system into reverse, causing
the small intestine to begin secreting fluids that flush food from
the body before it's used.
Hagop Mekhjian, M.D., found that folate supplements
S.
could partly correct these alcohol-induced changes and quitting
drinking stopped them completely (Science News, March 10,
1979).
To add insult to insult, it appears that heavy drinkers are
very often heavy smokers, with one researcher even suggesting
that "heavy cigarette smoking constitutes part of the syndrome
of alcohol addiction." In addition to the nutritional devastation
of alcohol, some researchers warn us, smoking drains your body
of vitamin C to the tune of 25 milligrams per cigarette, according
to some estimates.
There are hopeful signs, however. Over the past several years,
a group of Pennsylvania researchers has been examining natural

substances that can block a toxic chemical called acetaldehyde,

which occurs in cigarette smoke and is produced in the body
when alcohol is consumed.
Herbert Sprince. Ph.D., chief of research biochemistry at
the Veterans Administration Medical Center in Coatesville,
Pennsylvania, and his associates describe how they gave rats
lethal doses of acetaldehyde after first administering large doses
of certain nutrients.
The results? A combination of vitamin C, thiamine and an
amino acid called cysteine, plentiful in nuts, eggs, soybeans and
brewer's yeast, "gave virtually complete protection'' (Agents
and Actions).
The researchers caution that these were animal, and not
human, studies, but they go on to add, ''Our findings point the
way to a possible buildup of natural protection against the chronic
body insult of acetaldehyde arising from heavy drinking of al-
cohol and heavy smoking of cigarettes."

Life, it seems, is full of "chronic body insults." And the
vitamin bandits hiding just out of thousand forms
sight in a
always stand ready to rob your system of the nutrients you need
to fight back. Watch your vitamin account!
CHAPTER
MEDICINES
THAT CREATE
MALNUTRITION

Headache, runny nose, sore throat you're under the weather
and decide to go ''over the counter." But before you visit the
shelves packed with fast-rehef formulas, stop and pick up some
vitamin A.
A recent scientific study shows that ingredients used in com-
mon over-the-counter (OTC) pain, cold and allergy remedies
lower blood vitamin A levels in animals.
And that could bebad news if the same holds true for hu-
mans. Vitamin A protects and strengthens the mucous mem-
branes lining the nose, throat and lungs. These membranes shield
you against infection. But without enough vitamin A, they can
break down, providing a cozy home for germs and bacteria. The
very drugs that are supposed to help you get rid of a cold may
actually prolong it!
The researchers who conducted the study

Phyllis Acosta,
Ph.D., a dietitian at Emory University in Atlanta, and Philip
Garry, Ph.D., a nutritionist at the University of New Mexico in

Albuqueruqe fed rats four common ingredients used in OTC
pain, cold and allergy remedies from Allerest to Vanquish.
Dividing the animals into four groups, they fed each group
a different ingredient. But not all of the rats were fed the same
47
dose levels. Some were fed one-half, some normal and some two
times the normal doses suggested for children. After three weeks,
the levels of vitamin A in all four of the groups were tested.
All four ingredients at all dose levels caused a decrease in
vitamin A in the blood.
Some of the decreases were over 40 percent, and the average
decrease was almost 30 percent.
Dr. Acosta reported her study at the 62nd Annual Meeting
of the Federation of American Societies for Experimental Bi-
ology. She told us that future research will show if these four
OTC drug ingredients decrease vitamin A levels in the blood of
people, too.
But there's already plenty of other research that shows drugs
can play nasty tricks on a person's nutrients.
All of us take medicine at some time or another, and all of
us know that medicine has side effects. Antihistamines can
make you drowsy. Aspirin can upset your stomach. But what
few people realize (and that includes doctors) is that a side effect
of a wide array of drugs is a nutritional deficiency.

That's right, a nutritional deficiency even if your diet is
carefully planned to give you plenty of every vitamin and mineral.
Many drugs either stop the absorption of nutrients or inter-
fere with the cells' ability to use them. That means a drug can
cause a nutritional deficiency "even when the diet is adequate,"
says Daphne A. Roe, M.D., author of Drug-Induced Nutritional
Deficiencies (AVI Publishing, 1976).
How to protect yourself? Well, the first step is to find out
which drugs rob the body of nutrients and what these nutrients
are. You already know that aspirin steals vitamin A. But its
thievery doesn't stop there.
Aspirin Axes Vitamin C

There's another nutritional reason for keeping aspirin way
out of the reach of children
and adults. A study has shown that
MEDICINES THAT CREATE MALNUTRITION 49
even a small dose of aspirin can triple the amount of vitamin C

the body excretes (Journal of Human Nutrition).
As you probably know, vitamin C is a powerful cold fighter,
and researchers have suggested that it be used to treat and

prevent infections of all kinds. But vitamin C does more than
fight colds a lot more.
If cells are the bricks that hold your body together, collagen
is the mortar. But without vitamin C to promote the formation
of collagen, your body would be a shambles.

Vitamin C protects you against stress. It's essential to the
health of the adrenal gland, the organ which produces the hor-
mones that keep you alert and full of energy.
Vitamin C aids the body in healing. It detoxifies poisons
from food and air, such as lead and cadmium. And it's essential
for the metabolism of other nutrients: iron, calcium and the vi-
tamin B complex.
So think twice before you take two aspirin.
But sometimes pain can cloud better judgment and taking
aspirin may seem like a good idea. Aspirin for a headache. As-
pirin for a backache. Or aspirin for aching joints the searing
pain of arthritis or rheumatism. If you're taking aspirin to douse
fiery joint pain, take care. Aspirin depletes not only vitamin C,
but folate (folic acid) as well. Researchers have found that the
routine use of aspirin can lead to a folate deficiency.
Folate one of the vitamin B complex. Concentrated in the
is
spinal fluid, a must for calm nerves and clear thinking. In a

it's
study of 51 patients with rheumatoid arthritis, 71 percent had

low levels of folate in their blood. All 71 percent were taking
aspirin (Drug Therapy).
The Preventing the

Pill:
Birth of Health
The Pill is a synthetic hormone. It's powerful: It convinces
a woman's body that she's pregnant. But the Pill is a reaper of
your body's nutrients. It attacks folate and vitamin C, B^ and

B|2 levels within the body.
The evidence shows that the Pill is very bitter.
An editorial in the Journal of the American Dietetic Asso-
ciation reports that half of all Pill users have low levels of vitamin
8,2 in their blood. That could be making these women nervous.
B,2 like all the vitamin B complex helps maintain a well-func-
tioning nervous system.
Frequently, women on the Pill are depressed. Many re-
searchers believe this symptom is a result of vitamin B^ defi-
ciency. In studies, depression in Pill users cleared up after
two
they took supplements. But B6 made these women happy in
B(,
more ways than one. Without B^, digestion of protein would go

on the blink. A Bf, deficiency can also lower your resistance to
infection, and high levels of B(, help you cope better with stress.
In a study of Pill users and vitamin C, 63 women took the
Pill for at least a year and 63 did not. During that time, both
groups got the same amount of vitamin C in their diets. But, at

the end of the year, the average vitamin C levels in the white
blood cells of the women who took the Pill were much lower
than the vitamin C levels in the women who did not {American
Journal of Clinical Nutrition).
Fighting Side Effects

But all scientific research on drugs and nutrition isn't aimed
at finding out which nutrients a drug destroys. A recent study
shows that vitamin E can stop the destructive side effects of a
drug.
The drug is Adriamycin, an antibiotic. It's also the most
commonly used anti-cancer drug, capable of treating at least ten
forms of cancer. Trouble is, it can have a devastating side effect:
the gradual destruction of the heart muscle.
But a team of scientists at the National Cancer Institute
drew up a model of how the drug might damage the heart and
theorized that vitamin E could shield the muscle.
MEDICINES THAT CREATE MALNUTRITION 51
To they gave two groups of mice huge

test their theory,
injections of the drug. One group, however, received vitamin E
before the injection (Science). In the group on Adriamycin alone,
85 percent of the mice died within a month. But in the vitamin
E group, only 15 percent died.

In a longer study, mice were given Adriamycin once a week
for five weeks. Every mouse died. But in a group of mice who
got vitamin E along with their weekly Adriamycin, only 60 per-
cent died.
William McGuire, M.D., author of the study, told us that
more research is needed before vitamin E can be given to cancer
patients on Adriamycin.
But research already shows that vitamin C may protect peo-
ple particularly older people against the toxic effects of drugs.
A group of ten older people who were deficient in vitamin
C were metabolizing the painkiller antipyrine very slowly. When
eight of these people were given supplements of vitamin C for
two weeks, their metabolism of the drug sped up.
"It seems clear that a vitamin C deficiency in man causes
a small but demonstrable impairment in drug metabolism that
can be reversed by correction of the deficiency," writes the
study's author in the British Medical Journal.
And another study warns, "Ascorbic acid [vitamin C] de-
ficiency may contribute to the adverse drug reactions found in
the elderly" (Journal of Human Nutrition).
Taking extra vitamin C may be one way to guard your body
against the side effects of drugs in general. But that leaves the
problem of nutritional deficiency. Which, of course, can be
remedied.
"A drug-induced nutrient deficiency can be corrected only
by giving large enough doses of the deficient nutrient to com-
pensate for the loss caused by the drug," writes Dr. Roe.
But, she continues, "Nutritional side effects are prevent-
able. Most of them occur because physicians are unaware they
exist." But you aren't.
CHAPTER
NUTRITIONAL
SUPPLEMENTS
DIETERS NEED
At some time in life, just about everybody decides to go on

a diet. Young or old, men or women, there comes a point when
we aspire to be slimmer or trimmer if not for life, then at least
for a special occasion. The goal may
be to lose 5 pounds or 50
pounds, to look better or simply feel better. But always we begin
in the same way: by eating less.
Depending on how you go about it, dieting can be either a
health-building or a health-destroying process. The important
thing to remember is that, while cutting back on your total food
intake, you must still be sure to include all the essential protein,
vitamins, minerals and other nutrients your body needs to main-
tain well-being. Wise food selection is imperative, but dietary
supplements can also help bridge the gap and provide nutritional
insurance.
High-Protein Diets
Deficient in Vitamins
Dieting extremes can lead to serious nutrient deficiencies
and health problems. In a study conducted by Bonnie S. Wor-
52
SUPPLEMENTS DIETERS NEED 53
thington, Ph.D., and Lynda E. Taylor while at the University

of Washington, 20 overweight women, age 19 to 53, were placed
on one of two popular reducing diets. Ten followed the so-called
quick-weight-loss diet a high-protein, low-carbohydrate regi-
men. The other women were served a more balanced diet. Each
group was receiving less than 1,200 calories a day.
As the researchers reported in the Journal of the American
Dietetic Association, both diets were deficient in certain impor-
tant nutrients. The first diet, which relied almost exclusively on
lean meats, fish, eggs and cottage cheese, failed to supply enough
vitamin A, vitamin C, calcium and iron. Vitamin A intake (2,655
international units) was only about half of the Recommended
Dietary Allowance (RDA). The vitamin C content of the diet
was a paltry 11 milligrams.
The calcium intake of 308 milligrams fell far short of the
RDA of 800 milligrams. Iron intake was only 14 milligrams, yet
most of the women needed 18 milligrams daily.
The authors concluded, 'Tt is clear that individuals using
such a dietary plan should supplement their food intake with
appropriate sources of vitamin A, ascorbic acid [vitamin C], iron
and calcium."
Even more balanced reducing diet followed by the other
the
ten women enough calcium (only 570 milligrams)
failed to supply
or iron (10.9 milligrams). And the supply of important B vita-

mins thiamine, riboflavin and niacin was really only margin-
ally adequate.
There were other problems. ''Mild dizziness, headaches and
nausea were experienced by four subjects on the high-protein
diet and by only one on the balanced low-calorie regimen," the
authors noted.
Oneserious drawback of the high-protein, low-carbohydrate
diet that might account for the above symptoms is that it actually
forces the body to break down its own protein stores in a frantic
effort to keep up levels of glucose, or sugar, circulating in the
bloodstream. Especially when combined with moderate alcohol
intake, such a diet can lead to hypoglycemia, or low blood sugar,
with accompanying dizziness and fatigue.
But any low-calorie diet can cause problems, particularly
when it dips below the 1,200 calorie per day level. At that point,
you're just not taking in enough food to guarantee an adequate

supply of all the nutrients your body needs.
The sensible and safe way to diet is to cut back moderately
on your food intake while making every effort to make every
calorie count.
One way to do that is on lean meats like chicken,
to rely
turkey and veal, fish, lots of salads, cooked vegetables, cottage
cheese and fresh fruit.
If you're including eggs, you might want to eat only the
whites. That way you'll be getting high-quality protein but with
fewer calories or fat. The yolk of one extra-large egg contains
66 calories and 5.8 grams of fat. But the white of the same egg
contains only 19 calories and a mere trace of fat.
Following such a sensible slimming diet, you'll be getting
adequate protein from the meat and eggs as well as necessary
carbohydrates from the fruit and cooked vegetables. The fruit
and vegetables will also supply good levels of potassium and
vitamin A. For example, 3'/: ounces of romaine lettuce contain
only 18 calories but provide nearly 2,000 international units of
vitamin A and 264 milligrams of potassium. All those greens will
also keep you supplied with much of the folate (folic acid) you'll
need.
Vitamin C will be provided by the
fruits and fresh vegeta-
bles, at least at high enough levels to prevent scurvy and meet
the RDA. But for larger amounts
200 or 300 milligrams, for
instance you'll have to rely on supplements.
Getting enough of certain other nutrients with such a diet
could be even more of a problem, however. For some, you'll
definitely need to turn to supplements.
Vitamins for Dieters

If your reducing diet tends to down-play cereals, rice, bread
and other baked goods, obtaining adequate amounts of thiamine,

niacin, riboflavin and vitamin Bf, could be a problem. Normally,
SUPPLEMENTS DIETERS NEED 55
a super food like wheat germ could help out in this department.
Wheat germ is a richly concentrated source of B vitamins and
other important nutrients. But wheat germ is also relatively high
in calories (although those calories are far from empty), more
than 360 calories per 3'/2-ounce serving. So many dieters may
not want to eat much wheat germ.
A B-complex supplement seems like the best bet here, es-
pecially when you consider that minor nervous aggravation and
irritability too often crop up to plague people while they are
dieting. The B vitamins, especially thiamine, are important in
maintaining sound nerves and good morale.
To sum up, it is possible to successfully take off unwanted
pounds with a sensible dieting plan. But the challenge of selecting
a balanced and nutritious diet a challenge we all face every

day even when we're not dieting is even greater when you start
cutting calories. You still need the same amounts of nutrients
you always did, but you have to obtain them from less food.
Careful food selection can help up to a point, but daily supple-
mentation with key nutrients is the best protection.
CHAPTER
VITAMINS BEFORE
AND AFTER SURGERY
Sooner or later, say the statistics, it's almost inevitable that

your doctor will suggest for you a surgical solution for some
problem. At least 25 million operations are performed on Amer-
icans each year, so odds are pretty good that, in the long run,
one of those procedures will involve you.
It may be as relatively routine as the removal of wisdom
teeth, plantar warts or a gallbladder. Or it could be much more

involved and, as surgeons would say, traumatic. Open-heart
surgery comes immediately to mind.
In any event, after you've sought a second opinion and
it's confirmed the first
take care that your very normal anxiety
doesn't ambush your healthy life style!
The best thing you can do for yourself prior to going into
the hospital is beef up your body's nutritional front lines so you'll
be on the fast track of the road to recovery.
Fortunately, the majority of us are more than halfway there.
"Most patients have to do nothing special," explains James
L. Mullen, M.D., of the hospital of the University of Pennsyl-
vania. "Good nutrition meat, vegetables, fruits is impor-
56
VITAMINS BEFORE AND AFTER SURGERY 57
tant," he says. "Stabilize your weight lose some if you're too

heavy. Keep your muscles active and strong. Don't smoke."
George Blackburn, M.D., Ph.D., at the New England Dea-
coness Hospital of the Harvard medical school, heartily concurs
and stresses the importance of both physical fitness and diet.
Give Your Body the

Nutrients It Needs
"Our bodies have evolved to hold a supply of calories and
micronutrients in reserve," explains Dr. Blackburn. "And long
before special diets, the body drew on its stored nutrients to heal
itself."
Understanding the healing process helps ensure you'll have
your "shelves" stocked with the proper supplies, should the
need ever arise.
"When the body is injured, it sets off an alarm system of
stress-related chemicals," Dr. Blackburn continues. "In turn,
the white corpuscles react to create a fever. If you want to speed
up frying an egg, you turn up the heat, right? In much the same
manner, fever makes enzymatic processes associated with heal-
ing work faster. At the wound site, a clot is created to seal off
the open blood vessels, and from it comes collagen, the wound-
healing tissue."
The protein to make collagen is derived from several sources.
Diet one, but the body can draw on other connective tissues,
is
as well as muscle, if need be. Of course, breaking down one area

to rebuild another leaves a net imbalance. Normally, that is
corrected during the "get well" stage.

The other point worthy of mention is that healing takes extra
energy, which is usually available in the body's "warehouse"
of stored sugars.
So far, so good you are what you eat, and you arc going
to heal well.
But if you're a victim of nutritional deficiencies of various

kinds, you could be heading for trouble.
"Recent surveys have demonstrated an alarming incidence
of malnutrition in hospital patients. Numerous studies have dem-
onstrated a positive correlation between abnormalities in various

objective measures of nutritional status and increased operative
morbidity and mortality in surgical patients/' writes Dr. Mullen
{Annals of Surgery, November, 1980).
Vitamins Critical to Healing

Of the vitamins, C plays the best-understood role, for it is
critical to the formation of collagen and also helps the body resist
infection.
"There is no convincing evidence that wound healing is
accelerated by administration of vitamin C when tissue levels of

it are normal," says Sheldon Pollack, M.D., chief of dermato-
logic surgery of the Duke Unversity School of Medicine. "How-
ever, seriously ill may develop ascorbic acid
or injured patients
[vitamin C] deficiency rapidly because ascorbic acid is not stored
in appreciable amounts" {Journal of Dermatologic Surgery and
Oncology, August, 1979).
Dr. Pollack also mentions vitamin A as important for col-
lagen formation and strength. It also exerts a suppressive action
on certain infections.
Vitamin E deficiency results in abnormally fast blood plate-
let aggregation. Such clumping of cells has been implicated in
thrombosis (clot formation), a problem that sometimes arises

after surgery, according to Peter Thurlow, M.D., and John Grant,
M.D., of the department of surgery at the Duke University med-
ical center {Surgical Forum, vol. 31, 1980).
And it goes without saying that, while there are certain
nutrients that play key roles, all vitamins are doubly important
when you're so exercise and
facing the extra stress of surgery
eat doubly well.
Not only can such measures help deliver a complication-
VITAMINS BEFORE AND AFTER SURGERY 59
free convalescence, they can give you the strength necessary to

handle some of the toughest hospital procedures.
Nutrition Promotes Turnabout

Dwight Harken, M.D., of the Harvard medical school, re-
ports that some malnourished cardiac patients progressively

worsened after surgery. ''The analogy to 'running out of gas'
may be appropriate they are patients who behave as if they
are running out of energy reserves" (Geriatrics).
Augmenting their nutrition built up protein and muscle, and
brought about a "conspicuous improvement" in their appear-
ance, attitude and ability to withstand stress
including major
heart surgery.
For cancer patients, having a proper supply of nutritional
weapons helps in the fight against that disease and reduces sur-
gical complications.
"Nutritionally replenished patients better tolerate chemo-
therapy and may have a better chemotherapy response rate,"
reported Edward Copeland, M.D., and his co-workers at the
University of Texas medical school (Cancer, May, 1979).
Clearly then, eating right is your best medicine before going
into the hospital.
And afterwards, good nutrition is healing insurance and in-
fection protection.
CHAPTER
IFYOU MUST SMOKE,

AT LEAST TAKE THESE
VITAMINS
No one really knows what it is in a cigarette that causes

disease. But that cigarette smoking does cause disease is a well-
estabhshed scientific fact. In the 70s, the World Health Orga-
nization Expert Committee on Smoking and Its Effects on Health
met to reconsider the evidence linking cigarette smoking with ill
health.
Their verdict?
"Evidence from many countries implicates tobacco smoking
as an important causative factor in lung cancer, chronic bron-
chitis and emphysema, ischemic heart disease, and obstructive
peripheral vascular disease, it also shows that smoking plays a
part in the causation of cancer of the tongue, larynx, esophagus,

pancreas, and bladder; abortion, still-birth, and neonatal death,
and gastroduodenal ulcer"" (WHO Chronicle).
If you smoke, you probably know these facts and want to
stop. But you"re caught between ad campaigns telling you to

come "alive with pleasure"" and scare-tactic statistics proving
that it"s more likely that you"ll be dead with cancer; caught
between a will that wants to say "no"" and a nicotine need that
is screaming "yes""; caught between tonight's solemn vows and
60
SMOKERS, TAKE THESE VITAMINS 61
tomorrow morning's humiliating search for butts well, you're

caught in the jaws of an addiction that is chewing up your life
piece by piece.
"Three out of four smokers either wish to or have tried to
stop smoking, yet only about one in four ever succeeds in be-
coming a permanent ex-smoker. Thus most people smoke not
because they wish to, but because they cannot easily stop."
That is the sad pronouncement of M. A. H. Russell of the add-
iction research unit, institute of psychiatry, Maudsley Hospital,
London (Lancet).
Is it also your eulogy?
Maybe. But you can do more than start praying for yourself,
and you can do it with the right vitamins.
Keeping Your Arteries

Clean with Vitamin E
One disease which may be caused or complicated by ciga-
rette smoking is atherosclerosis a narrowing or blockage within
the arteries. And the arteries of the heart, tiny pipes thin as the
So it's
lead in a pencil, are easily rusted shut by atherosclerosis.
no wonder that smokers have a habit of having heart attacks.
And it's the nicotine in cigarette smoke that does the dirty
work. For nicotine speeds up a bodily mechanism platelet ag-
gregation
which may trigger the formation of a nasty blood clot
called a thrombus.
An article in the New York State Journal of Medicine, ex-
ploring previous research in Circulation magazine, discusses the
link between cigarette smoking, platelet aggregation and arterial
disease.
"After smoking a single cigarette, patients demonstrated a
marked increase in platelet aggregation, compared to no signif-
icant effect after smoking a lettuce leaf filled cigarette. This in-
crease in platelet function could be observed as early as 10 min-
utes after smoking."
The article concludes, "The data presented a suggestive

possible direct causative association between cigarette smoking
and thrombotic disease/'
arterial
But if is an arterial killer, it just might have met its
nicotine
match in vitamin E.
Two researchers, Manfred Steiner,-M.D., Ph.D., and his
assistant, John Anastasi, found that vitamin E decreases platelet
aggregation: the exact opposite of cigarette smoking's effect on
platelets.
In his study. Dr. Steiner collected blood samples from sev-
eral normal, healthy volunteers. He then mixed a test-tube brew:
the blood samples, various chemical agents known to trigger
rapid platelet aggregation and vitamin E.
The results?
The more vitamin E that was added to the blood samples,
the greater was the reduction in platelet aggregation.
Then Dr. Steiner focused his attention on the "test tube"
of the human body. Five healthy men and women were given
1,200 to 2,400 international units of vitamin E with their meals.
And again, the more vitamin E given, the less the platelets stuck
together. At the level of 1,800 international units, platelet ag-
gregation was cut down by about half. Yet, at 1 ,800 international
units, the platelets also stopped absorbing vitamin E no more
reduction in aggregation took place even when larger doses of
the vitamin were given. It was as if a natural mechanism made
sure that enough platelet stickiness remained to avert any dan-
gerous hemorrhaging (Journal oj Clinical Investigation).
So if you must smoke, it's wise to protect your arteries.
And vitamin E seems to be just the protection you need.
Vitamin C Is Highly Protective

But nicotine isn't the only villain in this medical melodrama.

Carbon monoxide or, in its chemical abbreviation, CO the
gas of garage-suicide fame, plays a star role in the harassment
of your heart, and its effect on hemoglobin is what puts it under
the spotlight.

Hemoglobin is the beast of burden for oxygen in the blood,

hauHng that life-giving gas to every cell in the body. But hemo-
globin actually takes a fancy to the deadly CO. The affinity of
hemoglobin for CO is 200 times greater than that for oxygen. So
when carbon monoxide is sucked into the circulation during
smoking, it chases a lot of oxygen out of the bloodstream.
If you're a smoker, you know the result of this mix-up:
shortness of breath, an inability to perform strenuous exercise
perhaps even to climb stairs without gasping. Day after day,
month after month, year after year, you're poisoning yourself
with CO.
there any antidote?
Is

Yes vitamin C.
"Very little medical research has been done for finding a
simple means of increasing the resistance of the human organism
to the irritating, toxic, and carcinogenic constituents of cigarette
smoke and detoxicating these constituents in vivo lin the body].
This physiological approach to the smoking problem has been
virtually completely neglected."
These are the words of Irwin Stone, D.Sc, a biochemist
and author of The Healing Factor: "Vitamin C" against Disease
(Grosset and Dunlap, 1972), who has devoted much of his life's
work to the study and research of vitamin C. It was Dr. Stone
who first suggested to Linus Pauling that he begin taking vitamin
C, a suggestion that eventually led Pauling to champion vitamin
C as a simple and effective means of preventing the common
cold. Dr. Stone, writing in The Journal of Orthomolecular Psy-
chiatry, suggests that vitamin C can help shield your body against
the lethal onslaught of cigarette poisons.
Cleaning Up Tobacco's Act

Dr. Stone explains that, in laboratory tests on guinea pigs,
a cancer-causing agent found in cigarettes, called benzpyrene,
was detoxified in the liver by hydroxylation, a process in which
the oxygen content of a chemical compound is increased, ren-
dering it harmless. And it is vitamin C that activates this hy-
droxylation. In guinea pigs with a vitamin C deficiency, the de-

toxification rate was only 10 percent of that in guinea pigs receiving
an adequate supply of vitamin C.
But Dr. Stone, a veteran scientist, does not base his opinion
on one lone study of guinea pigs. ''An important function of
ascorbate [vitamin C] in the mammalian organism is the detox-
ification of poisons, carcinogens, and toxins," he says.
Dr. Stone then cites studies in which vitamin C detoxified
carbon monoxide, arsenic compounds and cyanide all constit-
uents of cigarette smoke. Vitamin C also cleaned up mercury,
lead, ozone, nitrates and strychnine. Dr. Stone concludes, "While
this is only a small segment of the literature, it is clearly evident
that ascorbate is a wide-spectrum detoxicant. . .
."
And Dr. Stone offers sound advice to smokers take vita-

min C: "All this evidence can be used to formulate a simple and
inexpensive megascorbic preventive medical regime for the prac-
tical use by smokers to inhibit or delay or even possibly prevent
the eventual disease consequences of the chronic exposure to
high concentrations of the irritating and toxic constituents of
tobacco smoke. This regime would comprise the daily intake
. . .
of sufficient ascorbate. ..."

But what is "sufficient" vitamin C for a nonsmoker is prob-
ably not sufficient for the smoker. For in addition to all its other
ills,smoking depletes vitamin C.
So when we learn that vitamin C protects us against smok-
ing's poisons, and that smoking depletes vitamin C, it becomes
almost suicidal for a smoker not to supplement his diet with
vitamin C.
The Special Combination

Acetaldehyde is another killer chemical in cigarette smoke.
Herbert Sprince, Ph.D., chief of research biochemistry at the
Veterans Administration Hospital, Coatesville, Pennsylvania, and
his associates describe how they gave rats lethal doses of ace-
taldehyde and then tested the protective value of various nu-
trients and combinations of nutrients. The winning combina-

tion vitamin C, thiamine (vitamin B|) and an amino acid called
cysteine gave "complete protection (zero % lethality) for 72
hours in the 30 rats tested," the authors write {Agents and Actions).
"To the best of our knowledge," they add, "our findings
demonstrate for the first time that direct protective action against
acetaldehyde toxicity and lethality can be obtained with certain
naturally occurring metabolites, namely L-ascorbic acid [vitamin
C], L-cysteine, and thiamine, preferably in combination at re-
duced dose levels."
And although the researchers caution that the findings must
be "further evaluated" before they can be extrapolated for hu-
man use, they have no qualms in asserting that these laboratory
results could "point the way to a possible buildup of natural
protection against the chronic body insult of acetaldehyde arising
from . heavy smoking of cigarettes."
. .
Supplements of vitamin C and thiamine are, of course, read-

ily available. And any good diet including nuts, eggs, soybeans
and brewer's yeast will supply the cysteine.

And while you're taking your vitamins, try again to quit
smoking. Your supplements will do you a lot more good if they
don't have to exhaust themselves fighting smoke.
CHAPTER
VITAMIN SUPPLEMENTS:
HOW MUCH IS
TOO MUCH?
Nutritional therapy is, in many cases, an attractive alter-
native to conventional medical treatments. One of the main ad-
vantages of nutrition is the relative safety with which itcan be
used. Experimenting with drugs can be hazardous, but it is usu-
ally not dangerous to try different nutrients at various doses.
It is a shame that more health professionals are not inter-
ested in or well trained in nutrition.Many people have been
forced to treat themselves, using what they have learned from
books, magazines and friends. It is a testimony to the power of
nutrition that millions, even without professional guidance, have
been able to improve their health greatly.
On the other hand, it is a mistake to assume that nutritional
therapy is totally safe all of the time. Though adverse effects are
can occur. We should be well informed about potential
rare, they
problems with supplements so that we can make better choices
about which nutrients to take and in what doses.
The possible hazards of nutritional therapy can be divided
into three categories:
1. Self-diagnosis may be overemphasized in-
stead of competent professional advice being
sought.
66
SUPPLEMENTS: HOW MUCH IS TOO MUCH? 67
2. Certain nutrients have the abiHty to change

the results of some diagnostic laboratory
tests.
3. Some nutrients can have harmful effects
themselves.
Let's look at the self-diagnosis hazard first. You may be
staying away from the doctor's office because you have no faith
in modern medicine. Or else you may fear being ridiculed for
taking vitamins and minerals. With all of the popular health books
and magazines on the market, it is tempting to try figuring out
what is causing your problems and to prescribe your own treat-
ment. Unfortunately, the diagnosis will frequently be wrong, no
matter how classic your symptoms appear to be. As a result, a
potentially serious but easily treatable disease may be overlooked.
The solution to this problem is easy: Before starting your
own nutrition program, get checked out by your doctor to make
sure nothing serious is being missed. If some disease is found
and you wish to treat it by nutritional means, get the OK from
your doctor. Ask him or her to monitor the progress of your
disease. In some situations, the benefits of orthodox medicine
might outweigh the risks. If your nutrition program is not work-
ing, drugs or surgery might be necessary and helpful.
Test Results Altered by Vitamins

Doctors often perform laboratory tests to help them find out
what is wrong with their patients. If you are taking large amounts
of folate (folic acid) or vitamin C, some of these tests may give
incorrect results. You may therefore be treated for a problem
that you really do not have. Or else a truly abnormal condition
may test normal. It is important that your doctor be aware of
these supplements so that no errors are made in diagnosis.
Folate: One
type of anemia with serious consequences is
called pernicious anemia. Caused by faulty absorption of vitamin
Bi2, can lead to central-nervous-system damage. Pernicious
it
anemia is easy to discover if the doctor is alerted by a low

hematocrit (a measure of red blood cells), which occurs in all
anemias. However, if you are taking folate, your hematocrit

could be normal even though the B12 deficiency might be getting
worse. Fortunately, pernicious anemia does not occur often.
However, any time your doctor orders a hematocrit, you should
inform him if you are taking folate, either by itself or in a B-
complex supplement.
Vitamin C: Diabetics who test their urine for sugar may get
incorrect results if there is a lot of vitamin C in the urine. Your
doctor or pharmacist can recommend a urine testing kit that is
not affected by vitamin C.

Doctors frequently do a simple test to look for small amounts
of blood in the stool. A positive test suggests bleeding from the
bowel, which may occur from cancer or other gastrointestinal
diseases. If thereis a lot of vitamin C in the stool, the test might
not detect the presence of blood.
Toxic Effects of Nutrients

The side effects discussed below are uncommon and usually
(but not always) mild. Each person must weigh the risks and
benefits in deciding on the proper supplements.
Vitamin A: Since this nutrient is stored in the liver, harmful
up gradually. However, it is extremely unlikely
effects can build
that any problems would occur unless you are taking 50,000
international units or more a day. Even at the 50,000 unit level,
you would probably have to continue that dose every day for
months to reach a possibly toxic level. Some people can tolerate
more. Most people, though, probably take 10,000 to 25,000 in-
ternational units a day, and at that level there should be no
problem at all. Serious side effects of vitamin A can be prevented
by heeding early warning signs. These include fatigue, abdominal
discomfort, bone and joint pain, throbbing headache, insomnia,
restlessness, sweating, hair loss, brittle nails, constipation, men-
strual irregularities and swelling of the ankles. If these symptoms
are caused by too much vitamin A, then stopping the vitamin

symptoms.
will relieve the
If you take large amounts of carotene, the vegetal form of
vitamin A, which is found in carrots and nonanimal foods, your
skin may turn orange. That does not appear to be a toxic effect.
The skin change will go away as carotene is stopped.
Vitamin B complex: Because of the many interactions be-
tween the B vitamins, large doses of one can lead to deficiencies
of the others. When B vitamin, it is wise to back
taking a single
it up with the B complex.
entire
Thiamine (vitamin B,): Some people become drowsy after
taking 500 milligrams or more. But that an extremely high and
is
unusual dose. No serious side effects have been reported.

Niacin or niacinamide: Niacin may produce an uncomfortable
warmth and flushing of the skin when taken in doses higher than
75 to 100 milligrams a day. That is not dangerous. Niacinamide,
a form of niacin, will not cause the skin to flush, but it may
produce nausea. The dose should be reduced if nausea occurs.
Prolonged use of several grams (a gram is equal to 1,000
milligrams) per day of niacin or niacinamide may cause eleva-
tions of blood sugar, uric acid or liver function test results. It is
not certain whether these changes are dangerous. However, a
few patients have developed yellow jaundice and liver disease
after taking 3 or more grams of niacin for a long time.
PABA: This nutrient is safe, but it may interfere with the
function of some sulfa drugs.
Folate (folic acid): If you take Dilantin or another anti-
epilepsy medication, folate may interfere with it. Check with
your doctor.
Vitamin Bf,(pyndoxine): Large doses (200 to 600 milligrams
per day) may decrease milk production in nursing mothers. It is
unlikely that smalleramounts (10 to 25 milligrams) would cause

this problem. However, even small doses of B^, can interfere
with the drug L-dopa (used for Parkinson's disease). There is a
substitute for L-dopa which is not affected by vitamin B^,.
Vitamin C: The most common side effects are upset stomach
and diarrhea. Usually, that does not occur at levels under several
thousand milligrams a day. That can be prevented by decreasing

the dose or by taking the vitamin with meals or in the form of
sodium ascorbate and calcium ascorbate instead of ascorbic acid.
Past claims that vitamin C destroyed vitamin B,2 were ap-
parently based on inaccurate measurements of vitamin B,:.
Since vitamin C can increase the amount of oxalate in the
urine, there theory) a slightly increased risk of developing
is (in
oxalate kidney stones. Physicians who use large doses of vitamin

C in their practice have not yet reported any kidney stones.
Vitamin 86 (25 milligrams or more) seems to prevent vitamin C
from increasing the oxalate in the urine. The small risk of kidney
stones may, therefore, be reduced even more by taking B(,.
Vitamin C also helps the body get rid of uric acid. In the
long run, that may be helpful, since excess uric acid is associated
with gout and heart disease. However, in the short run, shifts
in the body's uric acid levels can occasionally trigger an attack
of gout. That is sometimes seen when drugs are prescribed to
lower uric acid. There is no proof yet that vitamin C has caused
an attack of gout. If you have a history of gout, though, it is a
good idea to build up your vitamin C slowly, rather than taking
a large dose from the beginning.
Some scientists believe that large amounts of vitamin C can
interfere with pregnancy or fertility. Others disagree.
Vitamin D: In large doses, this nutrient can cause a danger-
ous elevation of calcium in the blood. At lower doses, vitamin
D may increase cholesterol. Some prevention-minded scientists
are concerned that too much vitamin D may increase the risk of
atherosclerosis (hardening of the arteries). As a general rule, one
should not take more than 1,000 international units per day with-
out medical advice.
Vitamin E: This widely used vitamin is usually very safe.
However, if you have a vitamin K deficiency, large doses of
vitamin E could make it worse. That could impair normal blood
clotting. Fortunately, vitamin K deficiency does not occur very
often. But if you take an anticoagulant or do not eat vegetables,
you might have a deficiency of vitamin K.
Wilfrid Shute, M.D., of the Shute Institute in Ontario, Can-

ada, cautions that those with high blood pressure or rheumatic
heart disease should begin vitamin E carefully (about 100 inter-
national units per day) and increase gradually (add no more than
100 international units every six weeks). Other doctors, how-
ever, have found no problems here.
Diabetes
Some nutrients will improve glucose tolerance; that is help-
ful for diabetics. However, you take insulin, you must carefully
if
monitor how much is needed. If good nutrition decreases your

insulin requirement and you do not decrease the dose, a low-
blood-sugar reaction may result. Supplements to be most aware
of are brewer's yeast, chromium, and vitamins E, C and B^.
All of this is not meant to scare you out of taking supplements.
Nutrients are usually very safe. However, by becoming aware
of potential risks, you may develop a better and safer nutritional
program.
CHAPTER
EVEN "WASTED"
VITAMINS HELP
PROTECT US
"I can't understand what good it does to take all those high-
priced vitamins and minerals," say the nutrition skeptics. "All
they do is go right through you. The body hangs onto what it
needs and excretes the rest. The only thing you get from taking
more than you need is the most expensive urine in town."
You'll hear that type of argument a lot. It's a source of
confusion to people who know they feel better after taking vi-
tamin supplements. And it raises serious doubts, too: "Am I
really popping a bunch of unnecessary pills
and wasting a lot
of money, to boot?"
It's true that, when you take a nutritional supplement, some
part of it ends up in your urine and is excreted. But that it ends

up in the urine isn't bad. There are at least two ways a nutrient
can be beneficial to the body even though it eventually gets
excreted:
1. Its presence in the urine may promote good
health in the bladder and kidneys.
2. The nutrient may perform a useful function
somewhere else in the body before it's
excreted.
72
"WASTED" VITAMINS PROTECT US 73
How can nutrients in the urine help your bladder and kid-
neys? Because there are certain ways that urine can harm them.
Urine is a body fluid, just like blood or spinal fluid, and bacteria
can grow in it and cause infections of the bladder or kidneys.
Also, certain compounds in the urine may produce painful kidney
stones. And some cancer-causing chemicals you're exposed to
pass out of the body through the urine. Since those chemicals
come in contact with the bladder, they probably increase risk of
bladder cancer.
But there are nutrients that may protect you against each
of those problems.
Bladder and Kidney Protection

Vitamin C can kill some bacteria, including Escherichia coli
(E. coli), the most common cause of urinary tract infections.
That killing power is especially strong at the uniquely high vi-
tamin C levels that are possible in the concentrated fluid of urine.
Doctors have used vitamin C for years to prevent urinary tract
infections in people likely to develop them. It's generally as-
sumed that the vitamin works by producing an acid urine which
inhibits the growth of bacteria. In fact, vitamin C does a poor job
of acidifying the urine. The effectiveness of the vitamin is more
likely related to a direct bactericidal (bacteria-killing) action.
The prevention of kidney stones depends in part on the
presence of magnesium in the urine. Most kidney stones occur
when calcium dissolved in the urine doesn't stay dissolved but
forms little pellets made of calcium salts. Any substance that
helps keep calcium dissolved will help prevent kidney stones.
Magnesium does just that. Edwin Prien. Sr., M.D., emeritus
member of the Newton-Wellesley Hospital, Massachusetts, and
Stanley Gershoff, Ph.D., director of the nutrition institute. Tufts
University, Massachusetts, report that patients with recurrent
kidney stones who were given magnesium as part of their therapy
had about 90 percent fewer stones.
The kidneys rid the body of various waste products and
environmental poisons, and urine contains a wide range of toxic

chemicals, some of which have the potential to cause cancer.
However, a few of those chemicals don't become cancer causers
until they undergo a chemical reaction called oxidation. A nu-
trient that could prevent oxidation
an antioxidant should lessen
the number of cancer-causing chemicals the bladder is exposed
to. Vitamin C is an antioxidant. It's been shown to prevent the
development of bladder cancer in animals exposed to a cancer-
causing compound that's often found in human urine. And Jorgen
Schlegel, M.D., former chief of staff at the Tulane University
medical center, believes that vitamin C may be effective in pre-
venting human cancer, too.
But you have to take enough vitamin C to make sure some
of it spills over into the urine. For most people, 300 milligrams
a day would do the trick. But people with an increased need for
vitamin C smokers, diabetics, the elderly, the stressed, the
allergic and persons taking certain drugs
need more. Other nu-
trients such as vitamin E, zinc and selenium are also antioxidants
and might help prevent bladder cancer.
, '
says the skeptic. Expensive urine may have some

'
"Alright ' '
value. But most people don't take vitamins and minerals to make
healthy urine. They take them in such large amounts to help their
nerves, their arthritis, their skin, or any other health problem
that's fashionable. And most of what they take ends up down
the drain. It seems to me that, if those nutrients just go in one
end and out the other, they can't have much effect on the body."
But the skeptic is wrong to believe that any excreted nu-
trients are excesses the body doesn't need. A simple example
will prove the point.
Penicillin Excreted, Too

Doctors often prescribe penicillin for various infections. The
goal of therapy is to keep an effective level in the blood and
tissues at all times. The larger and more frequent the dose, the
more penicillin will be in the body at any one time. On the other
hand, the drug is rapidly excreted by the kidneys. In fact, 60 to
"WASTED" VITAMINS PROTECT US 75
90 percent of a given dose will be in the urine within one hour.

But doctors don't believe that that penicillin is wasted. They
know that high excretion rates can't be helped and that they have
to give enough penicillin to stay ahead of losses. The situation
is like the water level in a sink with an open drain. If the level
is high, the water runs out of the drain faster than if the level is
low. To keep the water level high, you need to run the water
faster.
As with penicillin therapy, the goal of nutritional therapy is
to provide the tissues with effective levels of nutrients at all
times. Because of disease, genetic differences, or a chronically

poor diet or environment, the body may need nutrient concen-
trations higher than what is usually considered adequate. And,
like penicillin, the only way to achieve those high levels is to
take nutrients frequently and in relatively large amounts. That
type of supplementation will also stay ahead of the unavoidable
urinary losses. For example, when healthy people take 100 to
800 international units of vitamin E over a period of years, blood
levels of the vitamin remain higher than normal, even though
urinary excretion presumably increases.
There's some confusion in orthodox medical thinking over
this point. It's known that the body conserves nutrients in the
face of a deficiency
when necessary, the kidneys reduce uri-
nary losses to near zero. So some assume that any nutrient
excretion means the body has all it needs. What is not well
understood is that the kidneys are designed only to prevent se-
vere deficiency from progressing to death. When there is only a
mild deficiency, the kidneys are more like a sink with an open
drain than one where the drain is sealed off. So when trying for
optimal nutrition, you can't expect the kidneys to do much of a
conservation job. It becomes a matter of turning on the faucet
strong enough to keep the nutrient levels at the amount you want.
The ''expensive urine" argument isn't a good reason to
reject the thousands of reports about the value of nutritional
therapy. Nutrients in the urine may be valuable in their own
right, or they may be a reflection of important work being done
elsewhere in the body. Yes, vitamins come in and go out. But,
as with life itself, it's what happens in between that counts.
CHAPTER
VITAMINS: WILL THE

SKEPTICS EVER BE
CONVINCED?
"Ever since I started taking my vitamins," says the nutrition

enthusiast, "1 have had much more energy. Whenever I stop
taking them, I get tired again. 1 definitely think my supplements
have improved my health."
A physician, skeptical about nutrition, remarks, "A patient
begged me for a vitamin Bi: shot, swearing itmore
gives her
energy. I knew she was seemed she
not deficient in B12, but it
had a psychological need for an injection of any kind. So I gave

her a shot of salt water and told her it was vitamin B12. As
expected, the 'vitamin" shot gave her lots of energy.""
Another nutrition advocate tells of the pain which followed
an injury. His lower back hurt so much that he could barely get
out of bed. Because he had read that vitamin C is helpful for
disk problems, he increased his vitamin C intake. Within a week,
the pain had nearly disappeared, and he was able to lift heavy
boxes again.
The skeptic replies that pains from most injuries go away
after a week or two, regardless of whether or not any treatment
is given. The vitamin C probably had nothing to do with it.
These examples illustrate how difficult it is to prove that

any treatment works.
76
WILL THE SKEPTICS EVER BE CONVINCED? 77
It is well known that, if a person is using a remedy in which

he beheves strongly, his condition will improve even if the rem-
edy is worthless. That is called the placebo effect, the remarkable
influence that mind has over body. Anxiety, depression, chest
pain, psoriasis and a host of other disorders are subject to the
placebo effect. If the patient has faith in the doctor, he will often
get better, even if the doctor's "therapy'' is just an inert sugar

pill.
most problems gradually get better by them-

In addition,
improvement occurs while the patient is following
selves. If this
a nutrition program, there is no way to know how much of the
benefit was actually due to good nutrition. That uncertainty is
why, despite thousands of studies and millions of testimonials,
most doctors remain unconvinced about the benefits of nutrition.
Double-Blind Trials:
Why Vitamins Get a Hung Jury
For a therapy to be accepted by the pure scientist, research
must prove that results are better than one would expect from
a placebo effect.
The most convincing way to do that is to perform what is
called a controlled, double-blind experiment. In this type of study,

half the patients are given the treatment being tested, and the
other half (the control group) receive a fake (placebo). To avoid
psychological factors, no one knows (until the study is over) who
is getting the active ingredient and who is getting the placebo.
It is called douhlc-hlind because neither the patients nor the
attending physicians know who is getting what. When the ex-
periment completed, a statistician compares the results in the
is
two groups and decides whether the treatment has value.

Opponents of nutrition argue that most nutrition studies have
not been done in the acceptable double-blind fashion. They as-
sume, therefore, that most reported benefits are nothing more
than a placebo effect. Until these studies are done "correctly,"
they say, nutrition cannot be taken seriously.
The fact is that there have been many well-controlled,

double-blind studies in the field of nutrition. These include the
use of zinc for rheumatoid arthritis, acne, stomach ulcers and
leg ulcers; vitamin B^, for the carpal tunnel syndrome and for
one type of depression; vitamin B12 for tiredness; niacinamide
(a form of niacin) for acute schizophrenia; vitamin C for the
common cold, other viral infections and some psychiatric prob-
lems; and vitamin E for intermittent claudication (leg pains as-
sociated with hardening of the arteries). And as interest in nu-
trition increases, the number of well-controlled studies continues
to grow.
But what should we do about the thousands of studies that
were less well controlled? Should we, as the orthodox suggest,
forget them all and wait for double-blind reports to appear? It is
true that most nutritional therapy has not been proven conclu-
sively to be effective. But that does not mean claims should
automatically be discounted. To reject nutrition is to ignore a
half century of experience and accumulated wisdom, to abandon
an approach that many nutritionists know is effective. For a
number of reasons, it is unrealistic to expect or demand that
every piece of nutrition information be studied by the double-
blind method.
To begin with, that demand has never been placed upon
may of the traditional medical treatments. The use of digitalis,
morphine, L-dopa, INH (for tuberculosis) and other drugs is
based on the same type of studies that are often rejected in the
field of nutrition. Because of years of experience with these
drugs, doctors are convinced that they work. The fact that they
have not been studied in the ''correct" manner has not prevented
these drugs from being used widely. If uncontrolled studies are
acceptable for potentially toxic drugs, then experiences with
relatively safe nutrients should also be taken seriously.
Why has no one demanded that these drugs be submitted
for double-blind tests? Doctors argue that it is unethical to do
such studies if you already know your treatment works. How
can you take a group of heart patients that need digitalis and
give half of them a placebo? To perform such a study would
deprive half the patients of the best available treatment. And all
that would be accomplished would be to prove something that
everyone already knows.
The same argument holds for nutrition. If, for example, you
are certain that niacinamide helps some types of arthritis, how
can you withold it from a patient in pain? Only nutrition skeptics
can ethically do a controlled study of niacinamide. They would
have no moral objection to withholding the nutrient from half
the patients because they do not believe it has any value. But
during the 40 years that nutritionists have been using niacinamide
for arthritis, none of the skeptics have been interested in doing
a controlled study.
The Problems of Designing

a Proper Vitamin Experiment
There are more than just ethical factors preventing doctors
from doing controlled studies. In many situations, it is literally
impossible to design the proper experiment.
Suppose you wanted to prove that bed rest is good for back
injuries. You would need a group of patients, half of whom
receive bed rest and half of whom do not. But, to avoid psy-
chological factors, no one could be permitted to know whether
or not he was in bed. Even to consider such a study is absurd.
Or suppose you wanted to study a new drug for the treatment
of cancer. To make sure no one knew if he was getting the real
drug, you would have to design a placebo which caused nausea,
vomiting, hair loss and possibly death.
With nutrition, as well, there are often major difficulties in
designing a placebo. For example, the nutritional approach to
diabetes might involve a low-sugar, high-fiber diet, with careful
attention to detecting any food allergies. Brewer's yeast, vita-
mins A, B, C, and E and a number of minerals might also be
used. But how, for example, could any scientist fake the high-
fiber diet? Or the yeast? And what diabetic would volunteer for
such a complicated program, knowing there was a 50-50 chance

he would be getting a worthless therapy?
The Cost Is Too Great

to Test Vitamins
Even if the patients can be found and the experiment can
be set up, there is another major stumbling block: the enormous
cost.
For the results of statistical studies to have meaning, a large
number of patients must participate (smaller studies tend to over-
look small improvements, which could lead to incorrect conclu-
sions). These large studies cost a lot of money. Researchers
recently spent $30 million to find out that aspirin does not prevent
heart attacks. Must we design an expensive study to answer
each of the many nutritional questions that should be asked?
Does thiamine relieve anxiety? How about niacin? Or vitamin
Bft? Or folate? Are thiamine and niacin better than thiamine
alone? Is the result affected by the amount of protein in the diet?
The amount of fat? The number of possible studies is endless,
and the cost is unimaginable.
Even if the money were available to do all those studies,
there would still be difficulties. Double-blind studies are best
suited to testing one nutrient at a time. But nutrients work as a
team; individual nutrients do not usually produce dramatic ef-
fects. The best results are achieved by a comprehensive nutri-
tional program. Since controlled studies are usually designed to
test individual portions of a complete program, they would tend
to underestimate the importance of nutrition.
Finally, therapeutic nutrition is based on the understanding
that every individual is biochemically different, with different
nutritional needs. Double-blind studies, on the other hand, re-
quire that everyone (except those in the control group) receive
the same treatment. One cannot expect impressive results from
a treatment that may be correct for only a small percentage of
the patients.
Results We Can't Ignore

Reasonable people should recognize that some studies are
important even if there is no placebo control group. For example,
James Isaacs, M.D., reported on his use of vitamins, minerals

and hormones in the treatment of severe heart disease at the
Texas Heart Institute Symposium on Coronary Artery Medicine
and Surgery, Houston, Texas. The results were dramatic and
far better than anyone else had achieved with a similar group of
patients. But the medical community has rejected Dr. Isaacs'
work because there was no control group. The experience of
other doctors using traditional methods is a built-in control group,
however, which can be used at least for rough comparisons.
When such a comparison is made. Dr. Isaacs' results are so
much better than usual that they cannot be reasonably ignored.
It would certainly be nice if all therapeutic claims were
supported by double-blind studies. As research techniques im-

prove and more money becomes available for nutrition research,
more such studies will be done.
Knowledge of the value of nutrition will continue to spread
until it reaches the mainstream of American medicine. That will
occur for a very simple reason: Nutrition works.
BOOK II
A Guide
to the
Individual
Vitamins

INTRODUCTION
Vitamins are designer nutrients.

Sure, they're mass-produced by Mother Nature, Inc. But
each "brand" is special, distinctive. Vitamin A helps prevent
cancer. Thiamine is a must for good digestion. 65 specializes in
health concerns unique to women. Vitamin C zeros in on your
immune system, vitamin D on your bones.
So even though it's best to get all the vitamins, it's a good
idea to know how each one fits into your health plan. (After all,
you wouldn't wear pajamas to work or show up at a black-tie
affair in a swimsuit.)
That's where book 2 A Guide to the Individual Vitamins
comes in. In it, we'll you all you need to know about vita-
tell
mins from A to K. And once you've learned that alphabet,

you'll be able to spell "health."
84
VITAMIN A
CHAPTER
VITAMIN A: A FEAST
FOR THE SENSES
It's only fitting that vitamin A should come first alphabeti-

cally in the long list of necessary nutrients that science discov-
ered. For no other vitamin or mineral is a more basic building
block of good health.
Vitamin A is the foremost example of the awesome versa-
tility nature has packed into vitamins. For, unlike drugs that do
just a few specialized things, vitamin A helps to regulate and

maintain a whole range of essential functions inside our bodies.
You need vitamin A for smooth, healthy looking skin. And
vitamin A helps build resistance to colds. But there's a whole
lot more. Vitamin A keeps moist the mucous membranes that
line your mouth, respiratory passages and urinary tract thus en-
suring resistance to infection. This nutrient also bolsters your
body's natural immunity, which may help the body safeguard
itself against cancer. Vitamin A also helps counter the damaging
effects of stress and aids in wound healing and detoxifying certain

poisonous chemicals.
It's even involved in sexual functioning: A shortage can lead
to female problems such as excessive menstruation and also male
problems of infertility.
85
86 VITAMIN A
Researchers are continuously expanding our understanding

of how vitamin A works and the many ways it helps preserve
health. For example, take the housekeeping role vitamin A plays
in our ears.
Richard A Chole, M.D., Ph.D., an ear, nose and throat
researcher at the University of California at Davis, who in the
past has investigated vitamin A's impact on our ability to hear,
recently found evidence that vitamin A is necessary for the nor-
mal function in the middle ear. Without A, middle ear infection
(otitis media) may develop. He also found that cystlike masses
of debris, called cholesteatomas, may develop in severely vita-
min A-deficient rats.
"Under normal conditions," Dr. Chole told us, "mucus in
the ear automatically traps dirt and bacteria and flushes it down
the eustachian tube into the throat, where it is swallowed. This
is how the ear cleans itself. In a vitamin A deficiency, not enough
mucus produced, and it doesn't get to the right places."

is
In experiments with rats, Dr. Chole found that depriving

them of vitamin A resulted in breakdown of the epithelium the
moist protective layer of cells which lines all body tissues, inside

and out in the middle ear. The epithelium became scaly, stopped
producing mucus and lost its ability to flush the ear clean. The
result was an ear infection.
"It is reasonable to speculate," reports Dr. Chole, "that
the human middle ear undergoes similar changes to those de-
scribed above [in the rat] during vitamin A deficiency. If this is
the case, vitamin A deficiency may be a significant factor in the
genesis of otitis media" {Western Journal of Medicine, 1980).

In the past. Dr. Chole has shown that vitamin A does much
more than perform janitorial services in the ear. In studies with
guinea pigs, he has found that the cochlea, the spiral horn in the
inner ear, contains vitamin A in concentrations ten times those
in most other body tissues. He has gone on to show that sensory
receptor cells in the ear, similar to those in the eye that rely on
vitamin A, depend on the nutrient for their hearing function.
As Dr. Chole indicates, however, vitamin A's usefulness to
the senses is by no means limited to hearing. He cites cases
FEAST FOR THE SENSES 87
where people regained their sense of smell after taking vitamin

A. And researchers at Cornell University have demonstrated
that animals deprived of this nutrient lose the ability to differ-
entiate between quinine-flavored, salted and plain water. "These
results indicate that vitamin A is required for normal taste func-
tion/' they note (Society for Experimental Biology and Medicine).
A's Influence on the Eyes

But nowhere is vitamin A's influence on our perceptions
more spectacularly evident than in the eyes.
"If the Mights go out' for a child when dusk approaches, it's
quite possible he's suffering from severe vitamin A defi-
ciency . . . Myron Winick, M.D., director of Columbia
," says
University's institute of human nutrition. "The primary effect
of vitamin A deficiency is damage to the patient's eyes, with
problems ranging from night blindness in some cases to irrever-
sible corneal scarring in others" (Modern Medicine).
According to Dr. Winick, prolonged deficiency which leads
to a condition of abnormal dryness of the eye, called xeroph-
thalmia
is the leading cause of blindness in underdeveloped
nations. And "although severe manifestations are quite rare in

the United States, milder effects are frequently encountered,
especially among children."
Another group at special risk for eye damage are heavy
drinkers, since alcohol seems to interfere with the liver's ability
to store and mobilize vitamin A. And without enough vitamin A
being delivered to the retina, the eye can't produce enough of a
substance called visual purple, which is necessary for seeing at
night.
In one group of 26 patients hospitalized with alcohol-
associated cirrhosis of the liver, 14 had problems in adapting
their vision to darkness. Daily supplementation with vitamin A
helped 8 of those patients overcome night blindness within two
to four weeks (Annals of Internal Medicine).
Similar results were reported by a trio of Boston research-
ers. In one case, a 55-year-old man had a five-year history of
88 VITAMIN A
progressive night blindness so severe he needed a flashHght to

see at dusk. He had been a heavy beer drinker for 25 years.
After taking extra vitamin A daily for four weeks, this man re-
gained normal night vision (American Journal of Ophthalmology).
In those rare cases A alone fails to help eye-
where vitamin
sight, extra zinc also may
be called for. As Stanley Morrison,
M.D.. of Baltimore, Maryland, reports, two patients who initially
failed to respond to 10,000 international units of vitamin A daily
recovered rapidly after taking 90 milligrams of zinc daily (Amer-
Poor dark adaptation may be considered more of a nuisance
than a serious threat, although it can cause traffic accidents when
the affected person attempts to drive at night. A much more
serious problem is glaucoma, a condition of increased pressure
and fluid buildup inside the eyeball that can lead to total blind-
ness. But here, again, there is evidence that vitamin A may have
a protective effect.
Controlling Glaucoma
"In Europe the incidence of primary glaucoma is in the order
of 1.5 percent of patients seen in an average ophthalmic prac-
tice. ... In West Africa, the incidence is some 30 times that in
Europe," says Dr. Stanley C. Evans of Ibadan, Nigeria (Nutri-

tional Metabolism).
"Whereas in Europe glaucoma does not usually occur below
the age of 40 years," he continues, "in West Africa it occurs at
all age levels from children of eight years upwards. This evidently
is due to the fact that in West Africa the nutritional deficiencies
responsible for glaucoma are worse than in Europe, so that not
only does occur in the younger age groups but its progress in
it
development is also very much more rapid."

Although many factors are involved. Dr. Evans says, "Usu-
ally the precipitating cause of many eye disorders, including
primary glaucoma, is a vitamin A deficiency." When he gave
nutritional supplements, including large doses of A, to a group
of patients suffering from restricted vision, blind spots and eye

pain, theirglaucoma was controlled just as effectively as with
conventional drug therapies. This was verified by periodic mea-
surements of the pressure inside the eye.
Protector of the Bowel

The epithelial lining of the intestines also needs vitamin A,
and physicians in Sweden and Boston think the vitamin might
be useful in treating Crohn's disease, a stubborn, unexplained
deterioration of the bowel.
At a hospital in Linkoping, Sweden, a 31-year-old woman
suffering from Crohn's disease was given large amounts of vi-
tamin A for her psoriasis. The psoriasis began to clear but, sur-
prisingly, so did the chronic diarrhea caused by the Crohn's
disease. "The most striking effect was a return to normal bowel
function," report the Swedish doctors. ''Soon after starting the
new treatment the patient found she could eat any food, even
plums, without ill effects and with no diarrhea" {Lancet, April
5, 1980).
This news fromSweden attracted the attention of Ann Dvo-

rak, M.D., a research pathologist at Beth Israel Hospital in Bos-
ton. She had taken electron microscope photographs showing
intestinal epithelium damaged by Crohn's disease. The photos
offered a possible explanation for vitamin A's success with the
woman in Sweden.
Crohn's patients. Dr. Dvorak says, have holes in their in-
testines. As a result, they might absorb bacteria and food im-
purities that are normally excreted, and they fail to absorb nu-
trients, including vitamin A, that they should absorb. When the
holes become large enough, the damaged section of the bowel
must be removed surgically. She thinks vitamin A might keep
tiny holes from becoming big ones by bolstering the epithelium.
"In the past," Dr. Dvork told us, "we thought that the holes
were always large enough to see on an X ray. Now we're finding
out that the large holes start as microscopic defects in the epi-
90 VITAMIN A
thelium. I feel very strongly that, if Crohn's patients took vitamin

A after their first operation, they might not need so many op-
erations later on."
The Swedish doctors seem to agree. 'Tt could be that vi-
tamin A restored some previously impaired intestinal-barrier
function," they concluded. ''If so, and if, as is suspected, the
essential abnormality in Crohn's disease is impaired function of
the intestinal barrier, other Crohn's patients might benefit from
vitamin A."
But vitamin A may do more than reinforce our barriers
against disease. Eli Seifter, Ph.D., a professor of biochemistry
and surgery at the Albert Einstein College of Medicine in New
York, believes vitamin A mobilizes our infection-fighting white
blood cells.
In one of his experiments. Dr. Seifter told us, two groups
of lab animals, one fed an adequate amount of vitamin A and
the other fed ten times that amount, were exposed to gamma
radiation. The highly supplemented animals held up better. 'The
radiation destroys most, but not all, of the animals' white blood
cells," he says. "The vitamin A stimulates the rate at which the
animals regain a normal number of white blood cells, thereby
increasing the rate of survival. The highly supplemented animals
are able to recoup in a couple of weeks."
In a second group of experiments. Dr. Seifter's fellow re-
searchers removed the thymus, a glandlike organ that influences
production of some kinds of white blood cells, from both groups.
Only the highly supplemented animals maintained a near-normal
white blood cell count, demonstrating. Dr. Seifter says, that, in
the event of injury or infection, vitamin A can reinforce the

body's immune response.
Building Healthy Teeth

At the University of Alabama's institute of dental research,
two researchers, Juan Navia, Ph.D.. and Susan S. Harris, Ph.D.,
have been investigating the role of vitamin A in the formation
of teeth. They've found that infant teeth are prone to decay if
they lack vitamin A while they are forming within the gum.
"We're at the very beginning of looking at the possibility
that nutrition during tooth formation can affect the development
or increase the susceptibility of teeth to decay," Dr. Navia told
us.
In thenormal construction of teeth, vitamin A is essential
for the formation of a scaffolding made up partly of carbohy-
drates called mucopolysaccharides. If that framework is properly
built, calcium and phosphorus lock into place and the result is
a healthy tooth.
Without enough vitamin A, however, there will be chinks
in the new tooth and bacteria will seep in like rain through a
leaky roof.
"Caries [decay] initiated at the enamel surface," Drs. Navia
and Harris report, "would meet a less effective barrier at the
enamel-dentine [the two outermost layers of the tooth] junction,
leading to development of severe, deeply penetrating lesions"
{Archives of Oral Biology, vol. 25, no. 6, 1980).
CHAPTER
VITAMIN A
INSURANCE AGAINST
CIRCULATORY PROBLEMS
Medical researchers are forever warning about the bad ef-

fects certain dietary factors can have on our health. We're told
that too much fat in our diets can cause heart disease or even
cancer, too much salt raises blood pressure and too much refined
sugar may promote cavities, not to mention diabetes.
But what about the ^'ood things we can add to our diets
which actually promote health? A major study shows that the
amount of vitamin A in our diets may have a profound effect on
whether or not we fall prey to heart disease, high blood pressure,
stroke or peptic ulcer.
The study, conducted in Israel by Aviva Palgi, Ph.D., ana-
lyzed 28 years worth of data in order to determine the cumulative
effects of dietary changes on specific disease mortality rates.
Dr. Palgi, who has conducted research in nutrition at the
Harvard Medical school and is now at the American Health
Foundation in New York City, found that, between 1949 and
1977, the death rate from heart disease in Israel more than dou-
bled while the death rates from high blood pressure, stroke and
peptic ulcer also increased significantly. Meanwhile, during that
92

INSURANCE AGAINST CIRCULATORY PROBLEMS 93
same time, the Israelis had changed their eating habits. By the
1970s, they were consuming 52 percent more fat than in previous
years. What's more, they had decreased the amount of calories
coming from complex carbohydrates (such as grains) while al-
most doubling their intake of simple carbohydrates (refined sugars).
But what makes this study special is that Dr. Palgi not only
looked at the obvious dietary factors like fats and carbohydrates,
she also examined how specific vitamins and minerals can di-
rectly affect those same diseases.
And that's where the exciting news about vitamin A comes
in.
"Vitamin A," says Dr. Palgi, "consistently had a significant

negative association with mortality rates." Thismeans that the
more vitamin A individuals in the study consumed, the less likely
they were to suffer from heart disease, high blood pressure,
stroke and peptic ulcer.
Apparently, while some Israelis were eating more fats, oth-
ers were enjoying lots of fruits, vegetables and other foods high
in vitamin A. And those who ate those foods stayed healthier
than those who didn't.
In fact. Dr. Palgi's study concludes by suggesting that re-
duced total fat intake and increased vitamin A consumption
(through fruits and vegetables) may prove beneficial in reducing
death rates due to heart disease, high blood pressure, stroke and
peptic ulcer {American Journal of Clinical Nutrition, August,
1981).
"We are just beginning to see the benefits of vitamin A in
the diet," Dr. Palgi says, "and very exciting. My study
it's
merely emphasizes how much research still needs to be done

especially clinical experiments with human volunteers.
"Right now, we know that 5,000 international units of vi-
tamin A daily is an absolute requirement for health. But for
people in a predisease state, more may be needed. I know that
in view of the results of my study I am more conscious of my
diet, and I try to eat plenty of vitamin A-rich foods while also
keeping my total fat intake as low as possible."
94 VITAMIN A
Just how vitamin A exerts its protective influence is some-

thing scientists are still looking into.
"There have been several studies in the past which have
shown vitamin A to be helpful in lowering cholesterol levels,
and this may help explain why it aids against heart disease," Dr.
Palgi told us. "In one experiment, the vitamin was found to lower
blood cholesterol levels in atherosclerotic patients but had no
effect on patients whose cholesterol levels were already normal.
And another study showed a decreased incidence of cardiovas-
cular disease in patients given vitamins A and D. Still," cautions
Dr. Palgi, "vitamin A is not a magic wand."
Maybe it's not a magic wand, but vitamin A is still a valuable
diet resource, readily available to anyone willing to invest a little
time and thought in planning his diet. The complete form of

vitamin A is found only in foods of animal origin, and one of the
richest sources Vitamin A, like vitamins D and E, is a
is liver.
fat-soluble vitamin, which means it is not excreted in the urine,

like the water-soluble vitamins, but stored in the body for further
use. Vitamin A is stored mainly in the liver, which is why beef
liver is rich in the vitamin.
You could easily fulfill your body's need for vitamin A even
if you ate nothing but vegetables, though. Substances called
carotenes, which are abundant in many vegetables, are readily
converted into vitamin A in the human body. Yellow fruits and
vegetables like carrots, sweet potatoes, apricots, pumpkins and
cantaloupes are rich in carotenes, as are deep-green leafy veg-
etables like spinach, dandelion greens, beet greens, chard, chi-
cory, turnip greens and kale.
There are a few special tricks you can use to maximize your
intake of vitamin A from vegetables.
Researchers have found that the more orange the carrots
and sweet potatoes you buy, the more vitamin A they contain.
Plant breeding that was originally undertaken to improve the
looks of carrots has resulted in strains that are richer in vitamin
A. Vitamin A stands up well to cooking, but that's light cook-
ing if you cook too much, you destroy the carotene by oxidation.
INSURANCE AGAINST CIRCULATORY PROBLEMS 95
Deficiency Is More
Common than Overdose
Newspaper articles pointing out the toxicity of vitamin A
appear from time to time. One article told of a three-year-old
girlgiven 200,000 international units of vitamin A a day. This is
clearly excessive. For adults, a daily intake of 4,000 to 25,000
international units is considered reasonable by the National
Academy of Sciences.
But the real problem is a lack of vitamin A in our diets, not
an oversupply.
"The 1965 household survey of diets showed that one diet
in every four failed to supply the recommended allowances [of
vitamin A] and that one diet in every 10 supplied less than two-
thirds of the recommended allowances,*" cites one nutritionist
{Normal and Therapeutic Nutrition, Macmillan, 1977). "Defi-
ciency of vitamin A is not only a major nutritional problem in
many developing countries but also in countries such as the
United States and Canada,'' says a National Institutes of Health
researcher {Lung, vol. 157, no. 4, 1980). Both infants and the
elderly are known to have a decreased ability to absorb vitamin
A from their diets.
CHAPTER
VITAMIN A FOR HEAVY

MENSTRUAL BLEEDING
No one likes to get cut up. Yet, more than 670,000 women
rushed into hysterectomies in a recent year. What's the hurry?
Well, take the widowed mother of four for an example. As
the sole supporter of her family, she can't afford to stay off her
feetand miss a couple of days at work every month because of
an extremely heavy menstrual flow. Besides, she's been feeling
too wiped out lately to give her children the attention they need.
Or what about the young woman who kept her monthly
interruptions to a minimum while she was on oral contraceptives.
But since she's given up the Pill, she's sacrificed additional days
of freedom. Her periods never extended beyond six days, she
cries to her gynecologist. Now she's strapped for nine or ten.
Undoubtedly, there are thousands more silent sufferers who
face such unpleasant confrontations with their femininity each

month tolerating excessive menstrual bleeding and extended
bouts with their periods.
In desperation, some will eventually elect surgery as the
"ultimate out." Who's to say they made the wrong choice?
Certainly not their physicians, who will quickly point to the
serious complications of this condition.
96

FOR HEAVY MENSTRUAL BLEEDING 97
Menorrhagia the medical term for either excessive daily

bleeding during menstruation, prolonged menstrual flow or both
may lead to anemia, gynecologists warn. Granted. But with com-
plications of its own, surgery
is a high price to pay for recovery
particularly when can sometimes be had for the cost of a

relief
bottle of vitamin A supplements.
According to a study published in the South African Medical
Journal, menorrhagia may be caused by a vitamin A deficiency.
Women who experience heavy menstruation and have lower than
normal vitamin A levels in their blood can enjoy alleviation of
their symptoms with moderately high doses of the vitamin, the
investigators report.
The effect of a vitamin A deficiency on the reproductive sys-
tem of women has never been clearly documented. But it stands
to reason that such a deficiency could alter the menstrual cycle.
After all, vitamin A is crucial to the development of the ovaries
in animals. In animal tests, a laboratory-induced deficiency of
this vitamin can decrease hormone production and suspend the

menstrual cycle.
Earlier studies put that theory into human terms when re-
searchers demonstrated that vitamin A levels in women fluctuate
in a cyclic pattern during the menstrual cycle. They suggest a
strong correlation between vitamin A levels and female hor-

mones.
Keeping these findings in mind, Drs. M. Lithgow and W.
M. Politzer, of the Johannesburg General Hospital in South Af-
rica, decided to find out whether vitamin A deficiency causes
menorrhagia and whether giving vitamin A would cure the con-
dition. To do this, they tested the vitamin A levels in 71 patients
suffering from menorrhagia. These figures were then compared
to those obtained from blood tests of 191 healthy women between
the ages of 13 and 55.
The results clearly indicated that women with particular
menstrual dysfunction have relatively low levels of vitamin A in
their bloodstreams. In fact, the women tested had, on the av-
erage, only 67 international units of the vitamin per 100 milliliters
of blood. In contrast, the women with normal menstrual periods
98 VITAMIN A
had about 166 international units per 100 milliliters almost 2'/2
times the amount measured in the first group!

To define more precisely the role of a vitamin A deficiency
in menstrual dysfunction, the records of 103 patients who pre-
sented a wider spectrum of the causes of menorrhagia were com-
bined with those of the original group. A vitamin A deficiency
was still found to be the primary cause of the menorrhagia in
almost 44 percent of the total 174 cases studied. In addition,
almost 68 percent of this combined group had lower than average
levels of vitamin A in their blood, indicating that a shortage of
this vitamin might be a contributing cause of the abnormal bleeding.
A Successful Treatment
Now that the researchers were assured of the cause of the
problem, they followed through with treatment using vitamin A
supplements. Fifty-two menorrhagia patients were instructed to
take 60,000 international units of vitamin A daily for 35 days.
Although a few of these women were lost to follow-up treat-
ment, of the 40 who returned for evaluation one month later, 23
were completely cured. And 14 noted a substantially diminished
menstrual flow or a reduction in the duration of their periods.
All told, the researchers claimed that close to 93 percent were
either cured or helped with vitamin A therapy.
If you've been losing a lot of blood during your menses, you
too may gain by increasing your intake of vitamin A. However,

the daily dosage of 60,000 international units prescribed by the
South African physicians may be more than you'll need. You
might want to stick with the amount found in many multivita-
mins, which is 10,000 international units.
Should you find that the extra boost of A isn't enough to
alleviate the heavy or prolonged menstrual bleeding, don't up
your intake beyond the suggested amount. Instead, add vitamin
E to your nutrition checklist. This vitamin helps improve vitamin
A storage and utilization. Or try zinc. An essential mineral, zinc
FOR HEAVY MENSTRUAL BLEEDING 99
is required to move vitamin A from the large liver reserve to the

bloodstream.
The Link with Vasectomy

Interestingly enough, this information may be invaluable to
you you're involved with family planning.
if
"A syndrome of menorrhagia is now being seen in women

whose husbands have had vasectomies," said Dr. Dennis
G. Bonham, head of the Auckland University postgraduate
school of obstetrics and gynaecology in New Zealand, in Ob.
Gyn. News. "Like the post-tubal ligation syndrome, the post-
vasectomy syndrome appears to be primarily a result of stop-
ping oral contraceptives. ..." And that, it seems, may be a
direct result of a depletion of vitamin A.
For some time now, researchers have suspected that the
hormones found in oral contraceptives alter the vitamin A levels
in the blood. To test this theory, vitamin A levels in two groups
of healthy college women were measured. The first group con-
sisted of 1 women with regular menstrual cycles who had never
1
taken the Pill. The other group consisted of 7 women who had
been on the Pill for various lengths of time ranging from two
months to slightly over two years (American Journal of Clinical
Nutrition).
Invariably, the women taking the oral contraceptives had
higher levels of vitamin A in their blood than nonusers. This
may be due to a stepped-up mobilization of the vitamin stored
The theory is confirmed by animal experimentation.
in the liver.
Rats given oral contraceptives experience a faster liver vitamin
A depletion, indicating a higher vitamin A requirement.
Of course, no one knows for sure, but this may explain why
women who stop taking the suddenly begin menstruating
Pill
heavily. While they are taking the Pill, their bloodstreams are
pumped full of vitamin A, which assures them a short and un-
eventful menstrual period. But should they stop taking the Pill,
the vitamin A supply in their blood is cut short. The liver reserve
100 VITAMIN A
which would be called on under normal conditions has become

sharply depleted.
So, should you consider giving up the Pill for whatever
reason (and there are many), supplement your stores with extra
doses of vitamin A. It could protect you from that extreme course
of action hysterectomy.
CHAPTER
VITAMIN A CUSHIONS
US AGAINST STRESS
We remember when, every August, busloads of city kids

would head up north for two weeks of the country life. They
came face to face with animals they'd never seen at the city zoo,
and they learned that the swimmin' hole was more than a wrench
and a fire hydrant. Sending those kids to the country was kind
of like hanging sheets out to dry. They could flap around all over
the place, and the fresh air did them good.
Today, you wonder how far you'd have to travel to find
unpolluted air and water. Chemicals originally designed to im-
prove our lives are doing just the opposite. They're everywhere,
but living in wet suits and gas masks is no answer. Eli Seifter,
Ph.D., a nutritional biochemist at Albert Einstein College of
Medicine, has been doing research on vitamin A and believes
the vitamin will help guard against a variety of environmental
hazards and stresses.
Chemical hazards in the work place attracted national at-
tention during the last decade. In the mid I97()s, workers in plants
manufacturing DBCP, a soil fumigant used to control nematodes,
began to complain of sterility and other reproductive deficien-
cies. Subsequent laboratory studies indicated that exposure to
101
102 VITAMIN A
relativelylow doses of DBCP could reduce sperm counts enough

to cause sterility.When data on the effects on humans were
released in 1977, some U.S. manufacturers stopped making it.
Despite efforts by the Occupational Safety and Health
Administration and the Environmental Protection Agency to re-
duce the use of DBCP in the environment, data gathered show
unexpectedly high levels of the chemical in drinking water near
farming areas. And a lawsuit has been filed by DBCP workers
in California who claim that their sons' defective reproductive
organs resulted from the workers' exposure to the chemical.
The list of chemicals posing health hazards for both male
and female workers has expanded, prompting one labor leader
to dub the 1980s the "decade of genetic confrontation."
Even if people aren't working in chemical plants, they are
caught in the onslaught. If home is near the freeway or in a highly
industrialized area, car exhaust and other pollutants lace the air
and water. People also are cleaning their houses, spraying their
gardens, refinishing furniture and cooking with chemicals every
day.
In a presentation before an American Chemical Society
meeting in Houston, Dr. Seifter illustrated how the toxicity of a
substance is influenced by the nutritional and the general health
status of an animal and how those findings relate to humans in
the work place.
Many harmful stimuli, whether physical injury, chemical
poisoning or some other factor, will elicit a common response
called stress, says Dr. Seifter. Stress causes adrenal gland en-
largement, a shrinking of the thymus gland and body weight loss.
It also can causestomach ulceration.
one experiment. Dr. Seifter and his colleagues studied
In
the effects of vitamin A on the toxic compound toluene diamine
(TDA). The chemical causes stomach ulceration, which leads to
stomach perforation. Death can occur from peritonitis following
a leakage from the stomach.
TDA ingestion causes blood to withdraw from the stomach
(humans may identify it as a queasy feeling) and from the skin
(similar to people turning pale after a type of stress response).
The condition is called ischemia, which means a loss of circu-
A CUSHION AGAINST STRESS 103
lating blood that causes blanching or whitening. Ischemia is an

early event leading to stress ulceration and delaying healing of
the ulcer.
In animals given only TDA, blanching of the stomach oc-
curred. Animals that received both TDA and vitamin A did not
show a blanching effect.
Eventually, the animals on TDA alone developed certain
stomach ulcerations, while the animals whose TDA intake was
supplemented with vitamin A did not have the stomach ulcerations.
A toxic compound's ability to produce duodenal and stom-
ach ulcers after diminishing blood supply to those parts of the
gastrointestinal tract can be overcome by feeding vitamin A, Dr.
Seifter told his audience.
He says that TDA and some other chemicals either directly
or indirectly constrict blood vessels to certain organs, like the
stomach and skin, whileopening up blood vessels elsewhere,
especially in muscle. That mimics the fight-or-flight syndrome
which prepares the body for intense physical activity or running
away. In that instance, blood is diverted from the soft tissues
and goes into the muscles. Dr. Seifter and his colleagues spec-
ulate that vitamin A prevents that alteration in blood flow pattern
from taking place.
Stressed adrenals also become large and swollen and tend
to bleed. Vitamin A prevents the swelling and hemorrhage, says
Dr. Seifter.
The researchers also have investigated vitamin A in relation
to alkylating agents, which, according to Dr. Seifter, are "im-
portant agents in industry today, and they affect our health.''
One of the alkylating agents they looked at, cyclophosphamide,
iswidely used as an antitumor compound in chemotherapy. The
chemical is radiationlike and is known as a radiomimetic chemical.
Cancer Drug Better Tolerated

with Vitamin A
"Sick people (and sick animals) cannot take as high doses
of some medications as a well person can," Dr. Seifter told us.
104 VITAMIN A
"The irony is that it's the sick person who needs the medication.
Ifyou give a certain amount of cyclophosphamide to a heahhy
animal, the animal may not lose weight. Give it to a sick animal,
and it may kill him."
The researchers discovered that, if a stressed animal (one
that is subjected to experimental surgery, for instance) is given
vitamin A along with the cyclophosphamide, tolerates the drug
it
better. "Vitamin A makes the difference between whether or

not the animal survives toxic doses of cyclophosphamide when
the animal has
some other sickness and that other sickness can
be stress or an implanted tumor," Dr. Seifter told us.
That discovery may be of some importance to employees
working with those toxic substances. Alkylating agents are used
to combat tumors because they inhibit cell division in the tissues
that are turning over most rapidly, like the cancer cells in a
tumor, he says.
"In the body, normally among those tissues that are turning
over most rapidly are mucosal cells and white blood cells and
sperm. And you can be sure ... if workers are showing low
sperm counts, due to working with alkylating agents, they're
also showing low counts of certain white blood cells."
Under the stress of a toxicant like cyclophosphamide, mice
experience weight loss or a prevention of weight gain, says Dr.
Seifter. With vitamin A intake, a good share of that weight loss
is avoided.
Protecting the Thymus Gland

One site of immune activity in the body, the thymus gland,
reacts to a toxicant like cyclophosphamide by becoming very
small or involuted. Part of that involution can be blocked also
by giving vitamin A, he says.
Researchers cannot assay the human thymus without caus-
ing damage, so they must analyze the blood. "When the thymus
is hurt, those circulating blood cells that are influenced by the
thymus are also hurt. These are the lymphocytes," Dr. Seifter
told US. Lymphocytes that normally constitute more than 20

percent of our circulating white blood cells will drop to 5 or 10
percent and be less active when the thymus is in trouble.
Other Common Stresses

Dr. Seifter maintains that certain jobs are stressful enough
to the worker's body to heighten his or her nutritional require-
ments. He says that, just as society now accepts the idea that
people like steelworkers, who perspire heavily on the job, need
higher intakes of calories, salt and water, it will in time accept
the idea that other jobs increase other nutrient requirements.
"The requirements for other nutrients are dependent on the
toxic compounds that we are exposed to. think the time will
I
come when we'll not only learn that nutrient requirements are
increased, but we'll make use of specific nutrients to overcome
the toxicity of certain industrial hazards," Dr. Seifter told the
American Chemical Society.
There also may come a time when vitamin A will be used
to arm someone against another kind of hazard radiation.
Dr. Seifter and his colleagues discovered that, when X ray
treatments were administered to the hind legs of mice, the classic
stress responses were recorded. The mice lost weight, their ad-
renals enlarged, their thymus glands shrank and their white cell
counts dropped precipitously.
Mice supplemented with vitamin A fared much better with
the radiation treatment. They lost less weight, and their adrenals
did not get as large. Perhaps most important, with vitamin A,
the thymus gland did not shrink significantly in size. The white
cell count remained relatively high, and that's a very good sign,
says Dr. Seifter. It's not unusual for a patient who has undergone
radiation treatments to develop serious infections, and some of
these are fatal. Radiation normally decreases the number of white
blood cells, thereby depressing the patient's immune state. Both
the tumor and the radiation are immunosuppressive, he says.
Vitamin A appears to change some of that.
106 VITAMIN A
Animals given vitamin A in advance of the radiation treat-

ment may have had a sHght edge over those given the supplement
afterward. "What's clearisgivingit at all is better than not giving
it," Dr. Seifter told us.
''We think that, for people who receive radiotherapy [ra-
diation treatments], vitamin A will contribute to their overall
health without decreasing the efficacy of the radiotherapy against

the tumor. In fact, vitamin A may increase the efficacy of the
radiotherapy. The healthier an animal the healthier a person
is
is the better he can withstand radiotherapy and the better the

chance that he will get effective radiation therapy," Dr. Seifter
explains.
Somepeople refuse to believe that something as simple as
vitamin A could do so much. But the National Institutes of Health
(NIH), for instance, support the use of a kind of vitamin A acid,
a synthetic compound for certain clinical uses. Dr. Seifter says.
The NIH supports studies involving the use of this analog of
vitamin A for tumor prevention, he says, adding that high doses
of vitamin A acid are far more toxic than vitamin A. Although
they claim they are using vitamin A acid for its vitamin A activity,
he explains, they are actually using it in much the same way as
they are other toxic agents that cause tumors to decrease in size.
Avoiding "Injury Therapy 9?

"Practically all of the tumor therapies that we have today
are based upon injury . . . injuring both the host and the tumor.
People say we've got to blast the hell out of the tumor, but you're
also blasting the hell out of the body," says Dr. Seifter. "They
tend to favor vitamin A acid because it causes the tumor to get
smaller. But the animal gets very sick, and it gets smaller, too.
Maybe percent or greater of the body weight. Now
he'll lose 25
most people cannot tolerate a 30 percent loss of body weight.
That's lethal."
Dr. Seifter believes that it may be unnecessary to totally rid
the body of the tumor to obtain survival and a good quality of

life. While some tumor cells may live in the body for years, many
of them are destroyed by the body's immune system, he says.
"No one is really talking about fully eradicating tumors.
That's not a realistic aim at present. The aim is to decrease the
tumor cell population size by surgery or other therapy so the
body can deal with it. And dealing with it doesn't necessarily
mean getting rid of it. If the tumor doesn't get any bigger and
doesn't start sending out branches, that would be acceptable."
A Natural Protective Agent

The rift over whether to use vitamin A acid or vitamin A
remains unresolved. In 1974, Dr. Seifter proposed to the NIH
that studies be initiated to determine if moderate increases in
vitamin A given to residents living in an area known as "Cancer

Alley" in New Jersey would reduce the incidence of tumors in
the high-risk population. The NIH rejected the proposal two
years in a row. One of their reasons was that vitamin A was a
"toxic substance," says Dr. Seifter. But afterward, research
workers at the NIH announced that vitamin A acid would be
preferable to use instead of vitamin A for studies of tumor
prevention.
Dr. Seifter labels the action "just political," the politics of
cancer and cancer research.
He does not promote the use of huge doses of any kind
except during extraordinary circumstances. Besides normal sup-
plements, people can get vitamin A by eating organ meats like
liver, kidney and spleen, or they can eat foods rich in carotene.
Vegetables like squash, carrots, spinach and all greens contain
carotene, which the body converts into vitamin as needed.
Whether you choose to get the nutrient through organ meats,
vegetables or supplements, vitamin A may cushion you against
any number of life's stress-producing elements.
CHAPTER
VITAMIN A: A KIND
OF INTERNAL
GAS MASK
You are surrounded by enemies ruthless, destructive and

invisible as air. Your every breath you open to attack by
lays
this sinister crew
automobile exhaust, industrial smog, poison-
ous clouds emitted by smokers who care even less about your
health than about their own, tiny particles too small to see,
viruses and bacteria.
Individually, they are vicious. Working together, this ter-
rifying pack of marauders can do more to rough up your body
than any gang of Central Park muggers. They can lay you low
with infection, emphysema, cancer. They can kill you. A black
belt in karate won't help you defend yourself against them. And
a gas mask is just a bit impractical.
You aren't unarmed against this sea of troubles, though.
Deep your lungs, a complex, highly efficient defense system
in
is always in action to drive out invading chemicals, particles and
microorganisms and swiftly undo the damage they cause.

For this, you can thank a special kind of tissue called epi-
thelium, which lines the entire respiratory tract. Some epithelial
cells secrete mucus, a thick substance that traps particles and
bacteria. Other epithelial cells come equipped with microscopic
108
A KIND OF INTERNAL GAS MASK 109
hairs, called cilia, which constantly sweep invaders up and out

of the body.
Most important, this tissue has the ability to repair itself.
Every day, epithelial cells are killed by bacteria, poisonous gases

and other airborne enemies, and every day they grow back,
literally as good as new. Without this power to regenerate, your
lungs wouldn't last long in the chemical soup that passes for air
in modern cities.
How well your lungs can hold their own in the face of un-
relenting assault means the difference between health and very
serious disease, so it's natural to wonder if there's anything you
can do to strengthen the fortress. In fact, a growing list of studies
point to something that can help vitamin A.
For over 50 years, doctors and scientists have recognized
that vitamin A has a special role to play in maintaining the health
of epithelial tissue (the skin is largely composed of epithelial
one reason why vitamin A is so essential for healthy
cells; this is
skin). Without enough vitamin A, epithelial tissues become hard-
ened and take abnormal forms. They cannot repair themselves
when they are damaged. Abundant vitamin A, on the other hand,
promotes the production of healthy new tissue.
With this power, mounting evidence affirms, vitamin A can
help lungs protect themselves against the airborne battalions that
modern life sends in against them.
Some of the most impressive evidence of this protective
ability comes from a study that brought vitamin A into action
against a particularly destructive enemy of lung health a nox-
ious gas called nitrogen dioxide (NO^) iJonnuil of Applied
Nutrition).
The Pollutant That

Makes Smog Brown
you've ever noticed a brownish cast to the smog that
If
seems to be smothering your city, you've seen NO:. More likely,
110 VITAMIN A
you've inhaled one lungful after another without even knowing

it's there. Automobile exhaust contributes this poisonous chem-
ical to the air you breathe, and so do industrial wastes. It is

contained in cigarette smoke and produced when coal or natural
gas burned for heat.
is
Laboratory tests have shown that NO2 can damage lung

tissue, producing the deteriorated state associated with emphy-
sema. After exposure to NO2, it has been found, animals are
more susceptible to infections of the lung. (In human beings, air
pollution in general has been linked to high rates of respiratory
infections.) Through a chain of reactions within the body, NO2
can form nitrosamines, potent cancer-causing chemicals.
What kind of protection can vitamin A offer against this
poison gas? At the Delta Regional Primate Research Center of
Tulane University, James C. S. Kim, D.V.M., Sc.D., exposed
three groups of hamsters to NO2 for five-hour periods once a
week for eight weeks. The conditions, he told us, were "com-
parable not only to industrial pollution found in an urban-
suburban environment, but also to the exposure of the respira-
tory tract of a habitual smoker."
The first group of hamsters received a diet lacking in vitamin
A. The second ate what Dr. Kim called a "vitamin A-adequate"
diet. The third was fed a "vitamin A-high" diet
twice what
the second group received. After eight weeks of exposure and
observation, the hamsters were killed and their lung tissues
examined.
The vitamin A-deficient animals. Dr. Kim noted, responded
poorly to NO2 exposure: "Rapid and often labored breathing
appeared immediately and continued throughout the five hours.
Recovery was slow." By the fifth week of the experiment, they
had started to decline visibly. When they were killed, "all ex-
posed animals without exception were in poor condition."
Microscopic examination of their lung tissues revealed se-
vere damage. The epithelial lining, it was found, had degenerated
badly. The cilia, so necessary for defense against bacteria, had
been impaired, in some cases destroyed. Cells in the alveoli (the
little sacs where oxygen passes from the air into the bloodstream)

A KIND OF INTERNAL GAS MASK HI
had hardened and were unable to function properly. In many

animals, there were signs of pneumonia. And instances of ab-

normal cell growth the kind that is associated with the devel-

opment of cancer were widespread.
The hamsters that received a vitamin A-adequate diet fared
a good deal better. NO2 made them breathe rapidly, but they
showed no and afterward their breathing quickly
signs of distress,
returned to normal. They remained in good condition throughout
the eight weeks of the experiment and were "healthy and alert"
at its end.
When the lungs of these animals were examined, there were
no signs of pneumonia or the severe inflammation that had af-
flicted the deficient group. The gas had caused damage, certainly,
but normal lung tissue had apparently grown back to repair it.
"There appeared to be an increase in cell regeneration in animals
supplemented with vitamin A, in contrast with those not sup-
plemented," Dr. Kim noted. The epithelial lining, for the most
part, was intact, and there were few abnormal cells.
The animals that received double doses of vitamin A sur-
vived their polluted environment equally well. Observation and
microscopic examination showed them to be much like the vi-
tamin A-adequate group (Environmental Research).
How A Protects the Lungs

In a telephone interview. Dr. Kim summed up the significant
implications of his experiment: "High concentrations of NO2
destroy the epithelial lining. With enough (or a little more than
enough) vitamin A, regeneration of the lung is rapid and suc-
cessful. But with a low dose, this protective response is re-
tarded
and the animal suffers."
Too little vitamin A in the face of NO2 exposure can raise
the risk of disease, he explained. "Without vitamin A, ciliated
epithelium doesn't form. Instead, you get squamous cells
precarcinoma-type cells. You get abnormal mucous cells, which
112 VITAMIN A
mean clogging in the respiratory tract and danger of infection.

If the epithehum doesn't form properly, it can lead to emphysema
and chronic bronchitis.

His findings should be of special interest to commuters. Dr.
Kim says, because they subject themselves to conditions much
like those of his experiment. ''If you commute, you have inter-
mittent exposure to NO2. You may be exposed to urban pollution
for five hours, eight hours, then you come back to your house
in the suburbs, where the air is cleaner. The next day you go
back to the city. The epithelium in the lung has to repair itself
accordingly, after each exposure."

Vitamin A can help the lungs adapt to this less-than-perfect
world. Dr. Kim says. "But a commuter who doesn't get enough
vitamin A is going to suffer."
In general, the effects he observed in his lab led Dr. Kim
to regard vitamin A highly as a preventive measure for safe-
guarding lung health. Even the lung problems that we associate
with old age, like emphysema, may be forestalled with the early,
regular use of vitamin A supplements, he speculates.
CHAPTER
THE NUMBER ONE

ANTI-CANCER VITAMIN
The evidence has been piHng up higher than a bumper crop

of corn in August. Eating green and yellow vegetables just may
be your buffer against cancer.
Actually, it's not so much the vegetables as what's in them
that seems to be doing the trick. The good guy's name is beta-
carotene, a natural pigment found in these vegetables and even
some fruits. Once
inside our bodies, beta-carotene is converted
to usable vitamin A. Carrots, sweet potatoes, dark leafy greens,
apricots, cantaloupe and winter squash are excellent sources of
this important nutrient.
While all this may seem like a mouthful in itself, there are
reams of research to indicate that those who eat carotene-rich
foods on a routine basis are a lot more successful at avoiding
cancer or beating it down than those who don't.
The evidence is so impressive, in fact, that the conservative
National Research Council, convinced that there's a link be-
tween diet and cancer, has gone public with a list of dietary
recommendations designed to reduce the risks of developing
cancers, especially those that attack the lungs, stomach, throat,
skin, bowel and bladder. The council recommends that all Amer-
113
114 VITAMIN A
icans significantly reduce consumption of fats, fat-laden meats

and dairy products: eat less cured, pickled and smoked foods;
convert to whole grains on a daily basis; and eat plenty of vitamin
C and foods rich in beta-carotene.
And that's not all. The news about beta-carotene is so prom-
ising that the National Institutes of Health are now funding what
is believed to be the biggest population study ever undertaken
to test the hypothesis that beta-carotene, known also by the name

provitamin A, does prevent cancer. The two-pronged study (the
other half deals with aspirin and heart disease) is being conducted
by the Harvard medical school and involves approximately 25,000
physicians throughout the country. The doctors are taking either
a beta-carotene supplement or a placebo (dummy pill) every
other day. Questionnaires concerning their dietary intake and
current health status are being tallied at six-month intervals. At
the end of the five-year study, the incidence of cancer in both
the placebo and supplement groups will be measured.
"We hope the Harvard study will show exactly how im-
portant beta-carotene is in preventing cancer," Micheline
Mathews-Roth, M.D., the beta-carotene consultant for the study,
told us. "The studies to date show that there is something in
beta-carotene-rich foods that has an effect on cancer. But whether

it's the beta-carotene or some other component of the vegetables
isn't known for sure yet."
That doesn't mean you have to get rabid about rabbit food,
either. 'The studies to date show that those who benefited from
the beta-carotene in fighting cancer weren't eating huge amounts
of vegetables," says Dr. Mathews-Roth, whose own studies have
found a link between beta-carotene and skin cancer. "What it
does show is that people aren't even eating the 3 ounces a day
or so that they should be getting."
Eat Your Vegetables

So the bottom line is that it's a good idea, in fact a wise
idea, to get your full allowance of those wholesome greens and

THE ANTI-CANCER VITAMIN 115
yellows each and every day. "We think it is prudent for

all apparently healthy adults to include in the daily diet one or
two servings of the vegetables or fruits that are rich in beta-

carotene," says Richard B. Shekelle, Ph.D., an eminent re-
searcher in diet and health at Rush-Presbyterian-St. Luke's Med-
ical Center Chicago. 'The weight of evidence at this time
in
suggests that people who eat these kinds of foods on a regular
basis run a lower risk of getting cancer than those who don't."
Dr. Shekelle sent the cancer research community into a spin
with the results of his long-term study on beta-carotene and its
effects on the deadliest of malignancies to man lung cancer.
Dr. Shekelle's study actually began as a long-term investi-
gation into coronary heart disease on 2, 107 workers of a Chicago-
based plant of the Western Electric Company. One aspect of the
study was to take dietary records of the participants. When it
came to plotting vitamin A intake. Dr. Shekelle and his col-

leagues decided to divide the vitamin intake into that which came
from animal sources (whole milk, liver, cream, butter and cheese)
and that which came from beta-carotene-rich fruits and vegetables.
Over the next 19 years, 33 of the men developed lung cancer
all positively related to cigarette smoking. However, Dr. Shek-
elle and his colleagues noticed something else very significant in

those who developed lung cancer. The rate was highest in those
who ate the least amount of beta-carotene foods and lowest in
those who ate the greatest amount. The result: an eight-to-one
difference in risk between the lowest and highest carotene-intake
groups {Lancet, November 28, 1981).
Also of major significance is the work of Eli Seifter, Ph.D.,
Guiseppi Rettura, Ph.D., Jacques Padawer, Ph.D., and Stanley
Levenson, M.D., of Albert Einstein College of Medicine in New
York City, who have published studies pinpointing the benefits
of beta-carotene and vitamin A in fighting cancer in animals.
"Our studies show that, if you inoculate mice with low doses
of tumor cells, about 50 percent of them will develop tumors.
However, in those pretreated with beta-carotene supplements,
only 10 percent develop tumors," Dr. Seifter told us. "We also
did a study in which we let the tumors grow to a certain size
116 VITAMIN A
before we started beta-carotene supplementation. With beta-

carotene, the tumors grew more slowly than normal and the
animals survived longer/'
Vitamin A Strengthens
Cancer Therapy
Perhaps the team's most dramatic experiment is a two-year
study concerning the effects of radiation therapy, beta-carotene
and vitamin A supplementation on induced cancer in mice. The
mice were inoculated in the leg with cancer cells, which were
permitted to grow. The mice were then divided into six treatment
groups. Dr. Seifter explains:
"The radiation dose we used was comparable to the dose
used in many cancer patients. That is, it was enough to reduce
the tumor but not make it disappear. The dosage needed for that
is too powerful. In the case of our mice, it would have burned
off the leg.
'The first group got no diet therapy and no radiation ther-
apy. The tumors grew and the animals died in 41 days. The
second group got vitamin A but no radiation therapy and died
in 60 days. The third group got beta-carotene and no radiation
therapy and died in 61 days. And the fourth group got radiation
therapy and no dietary supplementation and survived 83 days.
"So far, radiation therapy proved to be the best of the single
treatments, but when it was combined with dietary supplemen-
tation, life expectancy was much geater.
"in the group that received radiation and vitamin A therapy,
the tumors got smaller to the point where you couldn't feel them
any more. Only one animal regrew the tumor and died. The
others lived out the first year. The same results were found in
mice given radiation therapy and beta-carotene."
The benefits of beta-carotene became even more obvious in
the second year when these survivors were again divided into
groups. "Of the animals kept on vitamin A, none redeveloped
THE ANTI-CANCER VITAMIN 117
their tumors and they lived a normal mouse life of two years.
However, five of the six taken off of vitamin A regrew their
tumors and died.
"In the beta-carotene group, those kept on the supplements
also remained tumor free. And of those in which the beta-
carotene was held back, only two redeveloped their cancers.
And this is where the significance lies. The vitamin A-deprived
mice got their tumors back in 66 days. But it took the beta-
carotene-deprived mice 204 days to regrow their tumors."
Even after developing cancer twice, they managed to survive

654 days the natural life span of a mouse.
"It appears that the beta-carotene-fed mice retained a suf-
ficient supply in their bodies to protect them from cancer even
after they stopped taking the supplements," says Dr. Seifter.
There is also a human element in the chemotherapy-vitamin
A cancer connection. This was found at the Wisconsin Cancer
Center in Madison during a study of 37 women with breast cancer
who were scheduled to undergo chemotherapy.
The study showed that 36 percent of the patients with low
vitamin A levels improved with treatment, compared with 83
percent of those with normal or high vitamin A levels. Twenty-
four percent of the patients in the low-vitamin A group remained
stable and 40 percent worsened, while only 17 percent of the
patients with normal or high vitamin A levels were listed as
stable. What's more, none of these women grew worse {Pro-
ceedings of American Association for Cancer Research, 1981).
These studies come on the heels of other research, from
such diverse sites as Norway, Japan, Singapore and Great Brit-
ain, that shows a correlation between foods rich in vitamin A or
beta-carotene and a low cancer rate.
In many cultures, a particular plant or group of plants ac-
counts for a large share of the people's dietary intake. In Japan,
yellow and green vegetables are a mainstay of the diet. In West
Africa, people eat a lot of red palm oil, the richest source of
beta-carotene. In Singapore, it's dark green leafy vegetables.
And North Americans are known to like their carrots.
One of the largest population studies to date was a five-year

118 VITAMIN A
look into the smoking and eating habits of 8,278 Norwegians.

Researchers found that, of the smokers, those who ate the least
amount of beta-carotene had more than twice as great a chance
of getting cancer as those who ate more (International Journal
of Cancer).
While the evidence strongly suggests that beta-carotene may
be a safeguard against cancer, the final decision is still pending
at least until the Harvard study results are in. In the meantime,
it's good to keep up your stock of beta-carotene.
''I think that beta-carotene, like vitamin E, is a good mea-
sure of what you're eating," says Dr. Seifter. "If you're not
eating much, you're not getting enough. In terms of measure-
ments, daily intake should be from 5 to 10 milligrams." That's
equivalent to 8,375 to 16,750 international units of vitamin A a
day.
But you needn't stop there if you don't want to. And that's
the great thing about beta-carotene. Although it converts into
beneficial vitamin A in the body, doesn't lead to the side effects
it
that taking too much vitamin A can produce. Most people know
that taking too much vitamin A, more than 50,000 international
units a day, can be toxic. Not so with beta-carotene.
Sure, you can get too much. A warning indication would
likely be a coloring of the skin, like that of the 50 orange-faced
people who were diagnosed in 1942 as having severe carotenemia
after consuming 5 to 8 pounds of carrots a day! Getting over
that required their getting off beta-carotene.
The other nice thing about beta-carotene is that finding the
vegetables and fruits rich in it is simple. Spinach; dandelion, beet
and collard greens; cantaloupe; broccoli and squash are just a
slim picking of the edibles that are rich in beta-carotene. And
they're the very things you can easily grow in your own back
yard.
So remember the name beta-carotene. It's a friend you just
might want to keep close to home.

THE B VITAMINS
CHAPTER
REAP THE REWARDS

OF NUTRITIONAL
TEAMWORK
Teamwork something special.
is
It's a cooperative magic that happens when talented indi-
viduals get together and bring out the best in each other. No
doubt you can come up with countless examples, from a major
league baseball club to your favorite singing group. Regardless
of your choice, you know that the team wouldn't work as well
it might not work at all
if someone decided to take the day off.
Just like the B vitamins.

Thiamine, riboflavin, niacin, vitamins Bf, and B12 and folate
(folic acid), along with the lesser-known, but still vital, nutrients
biotin, pantothenate (pantothenic acid), para-aminobenzoic acid

(PABA), inositol and choline there's the roster of a winning
nutritional team.
Roger Williams, Ph.D., D.Sc, a University of Texas chem-
ist and pioneer vitamin researcher, places special emphasis on
the teamwork principle.
"Each B vitamin fits into different parts of the metabolic
machinery of every living cell. And like cogs on a wheel, each
has a specialized function," he told us.
But to prevent or cure disease. Dr. Williams explains, nu-
trients must also work cooperatively.
120 THE B VITAMINS
"When human beings are fortunate enough to maintain health

by consuming wholesome food, this is accomplished by reason
of the fact that they consume regularly every one of about 40
nutritional essentials. . We utilize in our bodies all nutritional
. .
elements simultaneously every day/" a paper coauthored by Dr.

Williams points out (Proceedings of the National Academy of
Sciences).
Unfortunately, try as we might, many of us can't meet all
our B vitamin needs from food alone. So when we look for a
helping hand. Dr. Williams notes, the way to "follow in nature's
footsteps" is to choose a supplement containing each member
of the B team.
"That way, they can work together," he says.
An Ideal Supplement
But how much of each is enough?
"In the body, B vitamins function as coenzymes," says
Rebecca Riales, Ph.D., nutrition consultant from Parkersburg,
West Virginia. Coenzymes are keys that unlock an enzyme's
effectiveness and allow it to take part in a biological reaction.
Dr. Riales explains that very small amounts of the B vitamins
are stored in the body, and what isn't used is soon excreted.
"The ideal B-complex supplement is one that provides the
Recommended Dietary Allowance of all the vitamins. That way,
you're covered in the event that you occasionally don't eat right,"
Dr. Riales told us.
As a good, natural B vitamin source, many people swear
by brewer's yeast (although they may have less than lofty things
to say about its taste), and Dr. Riales concurs.
"As a supplement, brewer's yeast provides a nice mix of B
vitamins," she says, "but remember, all yeasts are not the same.
Natural products can vary, so you have to read labels. For ex-
ample, unless the yeast is enriched, folate may not be present.
Even with the most gentle processing, this vitamin is very easily
lost."
NUTRITIONAL TEAMWORK 121
Dr. Riales points out that the RDAs for B vitamins can
change at different times in an individual's life.
Pregnancy, of course, has its own special demands, and
people under constant stress may have increased requirements.
"Anyone on long-term drug therapy should talk to the doc-
tor or a good dietitian to find out if what they're taking may
bring on a deficiency," she adds.
Because biochemical individuality is a fact of life, a number
of doctors recommend taking many times the amounts suggested
by Dr. Riales.
'The basic B complex is a foundation," says Harold Ro-
senberg, M.D., a New York physician who often prescribes
megadoses of nutrients to help his patients cope with the stress
of high-pressure living. "We can build on it to meet individual
needs."
But might there be a problem with nutritional imbalances
brought on by too much of a good thing?
Dr. Rosenberg doubts it and talks instead about the body's
"wisdom."
"We find our own physiological balance," he says. "The
body takes what it needs, stores what it can and throws the rest
away."
So what's the ideal B vitamin supplement?
We know the cast of characters, but beyond the sometimes
shifting RDAs, the jury's still out on the optimal amount of each
nutrient required to ensure high-level health.
However, there's no doubt about the wide-ranging conse-
quences of B vitamin insufficiency.
"The biological reactions dependent on the vitamin B com-
plex are numerous," William Shive, Ph.D., researcher at the
Clayton Foundation Biochemical Institute of the University of
Texas, told us.
As an example, he described just one part of the amazingly
intricate process by which our bodies utilize carbohydrates.
"This particular series of reactions requires five of the B
vitamins. And it's a case of the chain being only as strong as its
weakest link."
122 THE B VITAMINS
one of the nutrients isn't in the proper place at the proper

If
time, the work stops

Mke a construction project that suddenly
finds itself short of mortgage money.
''We can now explain and treat a number of conditions that
baffled us because we were used to thinking in terms of single
nutrient deficiences," says Howerde E. Sauberlich, Ph.D., chief
of the division of nutrition technology at California's Letterman
Army Institute of Research.
"Pellagra, for instance, is usually thought of as a niacin-
deficiency disorder," says Dr. Sauberlich, ''but the disease may
not be due directly to a lack of this one nutrient. You see, the
manufacture of niacin by the body requires the concerted action
of riboflavin and vitamin Be."
If any of these players don't make it to the field, the bio-
logical ball game could be over. Pellagra, though now quite rare,
is often fatal. B vitamins team up in other ways, too.
A riboflavin deficiency may rear its ugly head in the form

of mouth lesions, but Dr. Sauberlich writes that treatment with
that one vitamin alone may not do the trick.
"Patients [may] require supplementation with vitamin
. . .
Bft or other B-complex vitamins," he states {Micronuthent In-

teractions: Vitamins, Minerals, and Hazardous Elements, New
York Academy of Sciences, 1980).
In the same paper. Dr. Sauberlich lists a number of other
interacting partnerships vital to your well-being, including vi-
tamin Bf, and B12, B12 and folate, and biotin and pantothenate.
Is the Modern Diet Inadequate?

A deficiency of all members of the team is undoubtedly very
rare, but because of their interaction, it's vital that every one
fills its proper position.
Before modern food processing, it was reasonably possible

to eat hearty and satisfy your B vitamin needs. But when white
bread became the staff of life, the nutrient team came up short
on a number of key players.
NUTRITIONAL TEAMWORK 123
"Milling removes a significant portion of wheat's B vita-

mins," Paul LaChance, Ph.D., professor of nutrition at Rutgers
University, told us. "What gets added back and what gets left
behind depend both on federal regulation and company policy."
He explains that niacin and thiamine are restored to roughly
the same amount as would be found in whole wheat. And en-
riched white flour actually has more riboflavin in it than does
the original grain.
"Enrichment helped eradicate beriberi and pellagra," notes
Dr. LaChance. "The public health benefits have been very real."
But he admits that white-as-the-driven-snow refined flour is
but a pale echo of the whole wheat original. Depending on the

degree of refinement, significant amounts of Bf,, folate, panto-

thenate and other nutrients may be lost and not restored.
"I'm not against enriched products in one sense they're
gap fillers and certainly better than a lot of meals people throw
together on the run."
But since enrichment is partial at best, it offers a false sense
of security. Better by far would be a diet rich in complete B
vitamin sources.
Liver, milk products, whole grains, lean meats and many
vegetables are tasty ways to eat your way to vitamin self-
sufficiency.
And add a B-complex supplement as a kind of nutritional
insurance.
You might be interested to know our astronauts bank on a
supplement despite a well-thought-out menu. "They're free to
eat what they want along certain lines
they can exchange items
on the menu for other things they like. But remember, there's

no fresh fruit, meat or vegetables in space it's all thermosta-
bilized or freeze-dried," explains Rita Rapp, dietitian and food-
system coordinator at the Johnson Space Center in Houston.
"Some of our pilots feel they can't survive without that multiple
vitamin to supplement their meals!"
CHAPTER
THE THIAMINE THIEF

MAY BE STEALING
YOUR HEALTH
been said that good nutrition is like money in the bank.

It's
And to those of us who are in the know, it may seem a relatively

easy matter to balance our nutritional ''deposits'' and so have
a healthy personal economy.
But suppose for a moment that your bank has unknowingly
hired a rather sneaky teller who has found a way to embezzle
thiamine (vitamin B|) from your account. In fact, this guy is so
clever that he can skim your thiamine deposits without your

being the wiser. Even the bank examiner in this case, your

doctor might not detect the shenanigans of this underhanded
teller.
Then one day comes the crunch. Suddenly you're having a

little trouble sleeping, or you've lost your appetite. Maybe you're
itching to pick a fight with your spouse. Maybe your chest hurts
and you're scared that your heart's acting up.
What's going on? This: You've overdrawn your thiamine
account, and your checks are bouncing all over the place.
If you think this sounds a bit farfetched
if you think it
couldn't happen to you

maybe it's time to think again. Sci-
entific evidence is mounting that an alarming number of people,
124
THE THIAMINE THIEF 125
both young and old, are to one degree or another deficient in
thiamine. Consider:
A 1979 New Jersey study showed that 25 per-
cent of 146 elderly people living at home were
deficient in thiamine {Journal of the American
Geriatrics Society, October, 1979).
In a 1980 Irish study, up to 35 percent of the
elderly surveyed had a thiamine deficiency
(Irish Journal of Medicine, vol. 149, no. 3,
1980).
In Australia, "thiamine status determined by
biochemical assay was abnormal in one in five
apparently healthy blood donors'" {Medi-
. . .
cal Journal of Australia, May, 1980).

In a California study, Joseph D. Walters,
M.D., and Richard P. Huemer, M.D., found
that "the most common vitamin deficiences in
our series were low serum Bi and D," each of
which occurred in 32 percent of their patients.
Drs. Walters and Huemer conclude, "subclini-
cal, but biochemically significant, vitamin defi-
ciencies occur quite commonly [and] may be
significant elements that contribute to a
. . .
disease state" (Journal of the International

Academy of Preventive Medicine).
We Need Only a Little Thiamine

In light of the fact that thiamine was the first member of the
vitamin B complex to be identified chemically and is thus so well
known, it is somewhat ironic that so many people are deficient
in it. Perhaps doubly ironic is the fact that the human need for
the vitamin is relatively low. The National Research Council
recommends only 0.5 milligram of thiamine per every 1,000 cal-

ories that we take in. The daily Recommended Dietary Allow-
126 THE B VITAMINS
ance is set at 1 .0 milligram for most women and between 1 .2 and

1.4 milligrams for most men.
If the vitamin is so well known and our daily requirement
for it apparently so low, why are so many deficient in it?
problem lies in the very nature of thiamine. Like
Part of the
vitamin C, thiamine is one of the water-soluble vitamins, which
means that we can't store it in our bodies. We have to make

new thiamine "deposits" every day because we are continually
writing checks against our account.
Another part of the problem, according to Sue Rodwell Wil-
liams, M.P.H., author of Nutrition and Diet Therapy (C. V.
Mosby, 1973), is widely distributed
the fact that ''thiamine is less
in food than some other vitamins." To be sure, thiamine is avail-
able in fairly high quantities in such foods as pork, beef, liver,
whole grains and legumes, but many people do not eat these
foods regularly, and thiamine is hard to come by in other foods.
"Therefore," says Mrs. Williams, "a deficiency in thiamine is
a distinct possibility in the average diet."

But the big rub with thiamine gets back to that weasel of a
bank teller. He takes every opportunity to snitch some thiamine,
and all sorts of factors give him just the opportunity he needs.
Age: A number of dietary studies have suggested that our
requirements for certain nutrients increase with age. In the case
of thiamine, one study indicates that thismay be due not to any
malabsorption of the vitamin but to our inability, as we get older,
what we do absorb, in effect raising our daily require-
to utilize
ments {Journal of the American Geriatrics Society, October,
1979).
Eating foods with empty calories: Thiamine is essential for
metabolizing sugar, and eating too much sugar-laden food and
beverages not only depletes the thiamine we do have, but adds
no new thiamine to our diet.
Unknowingly eating foods low in thiamine: In one study, 25
volunteers were allowed to continue their normal diets with a
few seemingly minor exceptions: They were to eat no pork (high
in thiamine but, unfortunately, high in fat as well) or vitamin-
enriched cereal, bread or breakfast drinks. Even such mild re-
strictions produced a "significant fall" in thiamine in only 14

days {Importance of Vitamins to Human Health, University Park
Press, 1979).
Overcooking foods: Thiamine is fragile, and too much heat
or prolonged cooking can reduce or even destroy the vitamin.
Drinking alcoholic beverages: This can destroy thiamine or
reduce the amount the body can absorb.
Dieting to reduce weight: With dieting or any reduced intake
of food, your thiamine supply may fall 40 percent.
No Symptoms At First
Now, none of the above would probably result in a big-time,

clinical thiamine-deficiency disease such as beriberi. No, what
we are talking about here is not Bonnie and Clyde knocking over
your bank, but just a teller with a mean streak who is stealing
a little too much of your thiamine each day.
Such a condition is called a subclinical deficiency. That means
it's serious enough to be concerned about, not serious enough
to kill you, and perhaps most important, so well hidden that

neither you nor your doctor may suspect that anything is abnormal.
The hidden nature of subclinical deficiencies was vividly
demonstrated in a recent study in which 19 medical students
volunteered to go on a partially thiamine-restricted diet. Using
chemical analysis of urine samples, the investigators could easily
identify students who were low in thiamine. But every other
commonly used method of diagnosing the deficiency was con-
sidered a failure. Those methods included asking the students
how they felt, psychological testing, nerve conduction studies
and work performance studies {American Journal of Clinical
Nutrition, April, 1980).
As the researchers themselves put it, their study "casts
some doubt on the long-held belief that certain subjective signs
and symptoms herald early thiamine deficiency." In other words,
lots of people are walking around with subclinical thiamine de-
ficiencies and don't know it. And it might not take too much

128 THE B VITAMINS
more of a deficiency to push them into a category where they'd

know it more than they'd like to.
One step below subclinical is chronic, mild deficiency of
thiamine. The problem here is that, although the condition is no
longer hidden, it's nonetheless very hard to diagnose. Why?
Because the symptoms are so general and vague. Lack of ap-
petite, indigestion, nausea, severe constipation
do those sound
like symptoms of chronic, mild thiamine deficiency? Well, they
are but a few, and they might even cause you to eat less, which
would only aggravate the deficiency!
How a Deficiency Affects the

Nervous System
Other, more serious thiamine-deficiency problems can be
heart muscle weakness and edema (an abnormal accumulation
of body fluids). Also, thiamine deficiency can cause neuropathy,
a degeneration of the nerves that can lead to paralysis.
But perhaps the most noteworthy instances of mild, chronic
thiamine deficiency have to do with a symptom not normally
associated with it: neurotic behavior.
In a study of 65 patients found to have neurosis, the subjects
were tested for thiamine deficiency. The researchers concluded
that the "neurosis was associated with thiamine deficiency and
with consumption of foods poor or practically lacking in this
vitamin." Unfortunately, the researchers did not give the pa-
tients thiamine to see if it would cure or lessen their neurosis
{Nutrition Reports International).
However, in another study, thiamine was administered
with surprising results.
In a remarkable case, 20 patients with such symptoms as
sleep disturbances, personality changes (sometimes hostile), fe-
vers of unknown cause, intermittent diarrhea and lack of appetite
were studied. As the researchers point out, many of these symp-
toms "would represent a trap for the unwary physician since he
would be unable any objective physical sign other than

to find
variations of normal, which would be easily classed as the effects
of a chronic state of anxiety. Thus some of the physical signs
that [were] observed were the classical signs which have gen-
erally become associated with 'neurotic tension.' " Of course,
these symptoms were not life threatening, but they were "never-
theless debilitating and extremely frustrating since many of [the
patients]had already received conventional therapy unsuccess-
fully" (American Journal of Clinical Nutrition, February, 1980).
Could low thiamine be the culprit here? Apparently so, for
marked
the researchers report that "all of the 20 patients noticed
symptomatic improvement or lost their symptoms completely
after thiamine supplement." It's also interesting that many of
the patients had been consuming large quantities of junk foods,
notably soft drinks.
Fortunately, after thiamine therapy, "some patients lost their
craving for sweet-tasting foods and beverages."
As you can see, even a mild thiamine deficiency can have
important consequences, and that scoundrel of a bank teller is
going to keep on embezzling his share. But you can keep ahead
of the little rascal by keeping up your thiamine balance. That
way, you'll never have to worry about getting a check returned

for insufficient funds.
CHAPTER
MAKE UP YOUR MIND

EAT MORE THIAMINE
Thiamine might have saved her.

An elderly woman was admitted to the hospital from a nurs-
inghome. Her body was dehydrated. Her mind, too, was seared
and desertlike, empty of life. Given fluids, she became more
alert. But still too lethargic and confused to drink anything her-
self, she was fed intravenously. Four weeks later, she was well

enough to go back to the nursing home but she never went
back to solid foods.
At the home, they hooked her up to an intravenous solution
of sugar, salt and water and spoon-fed her clear liquids. Two
months passed. Then, she lapsed into a stupor. Taken to the
hospital, she died in four days.
autopsy showed the causes of death. A major cause was
An

Wernicke's disease a brain disease caused by a severe lack of
thiamine.
Without thiamine vitamin Bi the brain and nervous sys-
tem collapse. Arms and legs lose their coordination. Eye muscles
freeze in paralysis. The mind blackens into amnesia, coma, death.
But even a slight deficiency of thiamine wounds the brain. Ir-
130

EAT MORE THIAMINE 131
ritability, depression, lack of initiative, insomnia, inability to

concentrate: Those are the symptoms of a mild thiamine defi-
ciency, symptoms too often diagnosed as senility or neurosis.
Improving a Too-Short Memory

Working with Japanese researchers have found, for
rats,
example, that thiamine deficiency erases memory. They took

two groups of animals one maintained on a thiamine-supple-
mented diet and the other on a diet deficient in thiamine and
timed them individually in an enclosed alley maze. After 20 days,
those deprived of thiamine appeared to forget the pattern that
would lead them out the other side. They groped around the
maze and made repeated wrong turns so that it took them an
average of 55 seconds to get through the maze, compared to 20
seconds for those on a thiamine-rich diet. It wasn't until they
were put back on a high-thiamine diet that their memory and
timing improved {Journal of Nutritional Science and
Vitaminology).
And this seems to be one finding that's not limited to animals.
Mounting evidence suggests that the loss of memory as well
as other symptoms normally associated with senility may in
fact be a result of a thiamine deficiency.
One such study, published in the International Journal of
Vitamin and Nutrition Research, tested 18 geriatric patients,
suffering from dementia, irritability and loss of appetite, for pos-
sible vitamin deficiencies. Fifteen of the 18 oldsters were rated
deficient in thiamine.
Who knows how many more miserable grandmothers and
grandfathers are hopelessly condemned to mind-boggling drugs
and disrespect when all they may need is a daily dose of thia-
mine? The problem is, vague symptoms of an early deficiency
including poor memory, unsteadiness, alterations in blood pres-
sure and pulse rate, and heart complaints
are easily overlooked
and may be misdiagnosed.
132 THE B VITAMINS
Lack of Thiamine
Causes Mental Problems
In a study of the thiamine levels of 154 psychiatric patients,
researchers found more thiamine deficiencies among those pa-
tients with severe disorders (such as schizophrenia) than among
those with milder illnesses {British Journal of Psychiatry, Sep-
tember, 1979).
How can a physical lack, a lack of a vitamin, cause mental
problems?
Thiamine is central to carbohydrate digestion. Carbohy-
drates break down into simple sugars, such as the glucose which
fuels the brain. Missing thiamine, the body fails to churn out
enough blood sugar, and intelligence fades. Also, when blood
sugar metabolism goes awry, acids build up in the blood and
irritate the nervous system.
But that explanation, while based on the facts of thiamine
metabolism, is still only a theory.
Someresearchers believe that a thiamine deficiency causes
mental problems by cutting down the availability of serotonin,
a chemical in the brain that helps regulate emotions.
In a study investigating that theory, researchers from the
Mount Sinai School of Medicine in New York City divided rats
into separate groups. They fed one group a diet containing pyr-
ithiamine, a chemical that drains thebody of thiamine. Another
group got a normal During
diet. the study, the researchers took
samples from the brains of both groups and measured them for
serotonin.
Turning Seizures On and Off

For the first eight days of the study, the pyrithiamine rats
had no change in either their behavior or their average serotonin
level. Then the rats began to have "dramatic behavioral

changes" they went into spasms and convulsions and had little
or no coordination
and their serotonin levels dropped 60 per-
cent below the level of the normally fed rats. But when the
pyrithiamine rats were given massive doses of thiamine, their
seizures stopped within 24 hours and their serotonin levels re-
turned to normal {Neurology).
Millions of human beings weren't as lucky as those rats.
When they lost their coordination, when their arms and legs were
paralyzed, no scientist replaced the thiamine in their diets. They
were the victims of beriberi, a disease once epidemic in Asia,
where polished rice stripped of its thiamine-rich bran was the
dietary staple. But those millions didn't die of paralysis. They
died of heart failure. In the final stages of beriberi, the heart
swells, stretches and stops.
Few Americans die of beriberi heart disease. But many

Americans have a heart problem a problem they might solve
if they upped their intake of thiamine.
When researchers measured the thiamine blood levels of

over 125 elderly people, they found that 32 percent were deficient
in thiamine and that heart pain was more common among those
with a deficiency {Nutrition and Metabolism).
In another study, researchers from the University of Ala-
bama medical center in Birmingham measured the daily thiamine
intake of 74 people and then had them fill out a questionnaire in
which they listed their cardiovascular (heart and circulatory sys-
tem) complaints.
Dividing the people into a high-intake and a low-intake group,
they found that those with a low intake of thiamine had almost
twice as many cardiovascular complaints {Journal of the Amer-
ican Geriatrics Society).
In a third study, researchers compared the levels of thiamine
in the heart muscles of 12 patients who died of heart disease to
the levels of 10 patients who died of other causes. They found
that the heart patients had an average thiamine level 57 percent
lower than the other patients (Nutrition Reviews}.
134 THE B VITAMINS
Fewer Heart Spasms with Thiamine

A
study from Japan provides more proof that thiamine
strengthens the heart. There, in the 10 days before their open
heart surgery, a group of 25 patients received thiamine while
another group of patients did not. When their hearts were arti-
ficially stopped to perform the operation, only 10 percent of the
thiamine group had abnormal heart spasms, compared to 30 per-

cent of the other group. And when their hearts were revived at
the end of the operation, 30 percent of the thiamine group had
heart spasms, compared to 95 percent of the other group (Med-
ical Tribune).
The body's two most important organs the heart and the
brain need thiamine. But the rest of the body demands a fair
share, too. If the system lacks thiamine, any part can rebel:
Studies link many diseases to a thiamine deficiency. One of them
is cancer.
Thiamine against Cancer

from the University of Surrey in England studied
Scientists
a group of 17 people with breast cancer and 25 people with
bronchial cancer. Sixty-five percent of those with breast cancer
and 52 percent of those with bronchial cancer had a thiamine
deficiency
compared with only 13 percent of a group without
cancer (Oncology).
That a lack of thiamine causes cancer has yet to be proved.
But that an abundance of thiamine treats the disease at least
in laboratory animals is a fact.
Tumors, transplanted into laboratory animals, were treated
with an anti-cancer substance. When the animals received thia-
mine, the ''antitumor activity" of the substance increased (Can-
cer Research}. In other animals with cancer, the growth of tu-
mors slowed in those receiving yeast, and a researcher theorized
that "the effectiveness of the yeast could well be due to its
content of thiamine" {European Journal of Cancer).

Eye problems have also been linked to thiamine deficiency.
Measuring the thiamine blood levels in 38 patients with glau-
coma, an eye disease that can lead to blindness, researchers
found the glaucoma patients had a "significantly lower" average
level than 12 healthy people (Annals of Ophthalmology, July,
1979).
Two children who developed severe eye problems while
being treated for seizures were given 50 milligrams of thiamine
a day for six weeks. Their vision returned to normal {British
Journal of Ophthalmology, March, 1979).
Beneficial in Liver Disease

Studies show that thiamine deficiency may complicate liver
disease.
Measuring the thiamine levels of patients with chronic liver
disease, doctors found that 58 percent of the patients had a
deficiency of thiamine. When they supplemented the patients'
diets with 200 milligrams of thiamine a day for one week, the
disease improved.
"High doses of thiamine," the doctors wrote, "should be
included in the routine nutritional management of patients with
severe chronic liver disease" (Scandinavian Journal of
Gastroenterology).
A Common Deficiency
But it's not only sick people who need more thiamine. Mea-
suring the thiamine levels of diabetic patients and healthy people,
researchers found that many people in both groups had low levels
of thiamine. "Fifty percent both of our control subjects and
136 THE B VITAMINS
patients would from increasing their intake of thiamine,"

benefit
said the researchers (American Journal of Clinical Nutrition).
Fifty percent. Either you or your spouse? A thiamine de-
ficiency is one of the most widespread of nutritional problems,
particularly among the elderly.
When researchers from Colorado State University measured
the blood levels of various nutrients in 70 older women, they
found that a lack of thiamine was the most common deficiency
(American Journal of Clinical Nutrition).
In a study measuring the thiamine levels of 35 older men,
more than 25 percent were found to have a deficiency (New
Zealand Medical Journal).
Not only older people lack thiamine, however. When the
daily thiamine intake of a group of college women was calculated,
it was found that 75 percent had an intake below the govern-
ment's Recommended Dietary Allowance (Journal of the Amer-

ican Dietetic Association). Pregnant women, too, run the risk
of a deficiency. A study showed that 25 to 30 percent of pregnant
women were "thiamine depleted'' (American Journal of Clinical
Nutrition).
But a thiamine deficiency is easy to correct. Measuring the
thiamine levels of 153 men and women, researchers found that
23 percent had a deficiency. Giving them 20 milligrams of thia-
mine a day for 12 days brought their levels up to normal (Clinica
Chi mica Acta).
But why is a thiamine deficiency so common? Why are
supplements necessary? Can't you get enough of the nutrient
from your diet?
Thiamine Is Destroyed by Chlorine

You can. But it's not easy, especially if you use tap water.
Most people do, of course tap water that contains chlorine.
And recent evidence indicates that chlorine destroys thiamine.
Researchers cooked rice in either chlorinated tap water or dis-
water and then measured the amount of thiamine in the
tilled

rice. The rice cooked water had 36 percent less thiamine.

in tap
When the researchers added more chlorine to the tap water, rice
cooked in it contained even less thiamine (Journal of Nutritional
Science and Vitaminology, August, 1979).
It's hard to avoid chlorine. It's even harder to avoid poly-
chlorinated biphenyl (PCB), a chemical pollutant that has con-

taminated the globe. Researchers from Kyoto University in Ja-
pan have unfortunately found that, when rats are given PCB,
the chemical destroys much of the thiamine in their bodies.
"Administration of PCB," they write, ''resulted in a thiamine
deficiency, even when dietary thiamine levels were normal"
(Journal of Environmental Pathology and Toxicology, March,
1979).
Chlorine and PCB two strikes against thiamine. Do you
drink coffee? Strike three.
on coffee and thiamine, volunteers drank seven
In a study
cups of coffee in three hours. Eight days later, they drank the
same amount of water. On both days, researchers measured the
amount of thiamine excreted in the volunteers' urine. The amount
was 45 percent less on the coffee day than on the water day
good evidence, say the researchers, that coffee destroys thiamine
in the body (International Journal of Vitamin and Nutrition Re-
search). And decaffeinated coffee is no way out. It's not caffeine
that destroys thiamine, but another coffee ingredient, chloro-
genic acid. Should coffee lovers switch to tea? Just as bad.
Volunteers drank four to six cups of tea a day for a few
weeks. And even though they ate a diet designed to provide
enough thiamine, all of them developed a deficiency within a
week (Federation Proceedings).
You may be able to have your tea and drink it too, however.
Researchers have discovered that the ingredient in tea that causes
a thiamine deficiency is tannic acid but that vitamin C protects
the body against tannic acid, allowing absorption of thiamine
(American Journal of Clinical Nutrition). If you must drink tea.
drink it with a squeeze of vitamin C-rich lemon, or take a small
amount of vitamin C with each cup.
CHAPTER
KEEP IN THE PINK

WITH RIBOFLAVIN
It may be bad form your tongue but a good

to stick out
idea. This organ of speech, even when silent, can tell many a
tale about your nutritional status.
It might clue you in on whether you need more riboflavin
(vitamin B:). a deficiency of which can open the door to a host

of problems (like cataracts, conjunctivitis, fatigue, dermatitis,
birth defects and even, according to some researchers, the most

dreaded of all diseases cancer).
If your tongue is pink and velvety, chances are you are well
supplied with B vitamins, including riboflavin.

But if your tongue has a purplish cast, more like fuchsia or
magenta than pink roses, then, indeed, you may need more
riboflavin.
Maybe you also have lines radiating from your lips, oily
hair, blurred vision in poor light, a tendency to whip out your
sunglasses at the first ray of golden sun, frequent tearing of the
eyes, red inflamed eyelids or flaky areas around your nose, eye-
brows or hairline. Many of these conditions respond to riboflavin
and are due to a dietary deficiency of this nutrient, according to
38
KEEP IN THE PINK WITH RIBOFLAVIN 139
a survey of the scientific literature {Progress in Food and Nu-

trition Science).
In the United States, where there is plenty of meat and milk
(two primary sources of riboflavin) and where bread is enriched
with this vitamin, there are, nevertheless, shortages. As many
as one family out of every seven has a diet deficient in riboflavin,
according to a World Health Organization Report.
You may consume what you think is a well-balanced diet
and still suffer a deficiency of riboflavin. In your food, this water-
soluble nutrient is quickly destroyed by light. In your body, drugs
like oral contraceptives and tranquilizers inhibit absorption. As
an enzyme activator, riboflavin is so busy that it is sometimes
completely used up before it has completed its metabolic chores.
And that's too bad because, as a part of coenzymes and enzymes
necessary for the transport of oxygen, riboflavin participates in
the respiration of every single cell.
Defense against Cancer

That makes riboflavin a very important member of the nu-
tritional team that can help you build a better defense against
cancer. As Nobel prize winner Otto Warburg, a biochemist who
was director of the Max Planck Institute for Cell Physiology in
Berlin, explained to the Nobel laureates at Lindau in 1966, though
there are hundreds, perhaps thousands of secondary causes that
stimulate cancer growth, there is only one primary cause, and
that is replacement of the respiration of oxygen (energy for nor-
mal cells) by a fermentation of sugar (energy for cancer cells).
Therefore, Dr. Warburg continued, what we need in order
to have the best possible chance of avoiding cancer are those
factors that are involved in the health of cell respiration. Those
factors are iron and three of the B vitamins riboflavin, niacin
and pantothenate (pantothenic acid) found in brewer's yeast
and liver.
140 THE B VITAMINS
Earlier studies reported by the late Boris Sokoloff, M.D.,

Ph.D., director of the Southern Bio-Research Institute, Florida
Southern College, Lakeland, revealed that, when riboflavin is
added to a diet that includes cancer-causing chemicals, it reduces
the incidence of cancer in laboratory animals. Other vitamins of
the B family used singly had no noticeable effects {Cancer New
Approaches, Nen- Hope, Devin-Adair, 1952). This does not mean
that the other members of the B family are not helpful when
used with riboflavin. They help each other.
But it is riboflavin which takes part in cell respiration, pro-
viding oxygen for the cell to breathe and go about the business
of duplicating itself in a normal, orderly fashion. Without ribo-
flavin, the oxygen supply is reduced.
As little as a 35 percent reduction in the available supply,
according to Dr. Warburg, causes the cell, in its efforts to stay
alive, to make a metabolic switch. Since it can no longer derive
energy from the oxidation, or burning, of food, it turns for energy
to an alternate process that requires no oxygen, thus initiating
the uncontrolled growth process we know as cancer.
Dr. Warburg believed so strongly that the B vitamins and
iron would enhance the body's defenses that he went so far as
to suggest that, following surgery for cancer, a sufficient supply
of these nutrients would help prevent the spread or recurrence
of malignant growths.
Laboratory research seems to justify Dr. Warburg's faith in
the efficacy of the
B vitamins especially riboflavin.
For instance, Lionel A. Poirier, formerly of the National
Cancer Institute, reported at the American Chemical Society
national meeting that riboflavin inhibits the production of liver
cancer in laboratory animals injected with cancer-causing
chemicals.
Henry Foy and Athena Kondi of the National Public Health
Laboratory Service, Nairobi. Kenya, point out in a letter to the
editor of the British Medical Journal the important role of ri-
boflavin in maintaining the integrity of the epithelial, or body-
lining, tissue particularly in the esophagus. They suggest that
riboflavin should be considered
along with vitamin A as a

nutrient whose deficiency may lead to precancerous conditions.

They base their conclusions on a study involving eight baboons
fed a diet deficient in riboflavin. Even though the baboons re-
ceived an otherwise adequate diet completely balanced with pro-
tein, as well as vitamins A and D and all the members of the B
family except riboflavin, they developed, after 160 to 300 days,
profound changes in the skin of the face, hands, legs and feet as
well as more sinister changes in the esophagus.
Very Important in Pregnancy

Along with her prayers for a normal healthy child, every
expectant mother should include a good riboflavin source such
as brewer's yeast or desiccated liver in her daily routine.
Laboratory experiments have indeed shown that a defi-
ciency of riboflavin in pregnant mammals causes malformations
in their offspring. When Bruce Mackler. M.D., and colleagues
at the school of medicine of the University of Washington, Se-
attle, created riboflavin deficiencies in pregnant rats, a very large

proportion of the fetuses greater than 95 percent developed
malformations (Pediatrics).
Most of the defects. Dr. Mackler reports, were skeletal
abnormal development of the bones. The most common prob-
lems were incomplete development of the bones of the extrem-
ities. Dr. Mackler also mentions cleft palate as an example of
"a wide number of other anomalies" that have been produced

in the fetuses of rats with riboflavin deficiency.
Since the effects of riboflavin deficiency are similar to. but
less severe than, those produced by the drug thalidomide, it has
been postulated by investigators that the drug may be a riboflavin
antagonist, either causing a deficiency of riboflavin or preventing
its metabolism.
Adequate amounts of riboflavin are essential for the mind
as well as the body. They may not ensure that your child will
be an Einstein but, "a number of important enzymes in the brain
require riboflavin to function," says Richard S. Rivlin, M.D.,
142 THE B VITAMINS
chief of nutrition service at Memorial Sloan-Kettering Cancer

Center in New York. ''It is likely, therefore, that a deficiency
of riboflavin during a critical period of time probably would im-
pair the normal development of the brain to some extent."
The Sensitive Nutrient

Riboflavin is found in a variety of foods including yeast,
liver, wheat germ, eggs, milk and green leafy vegetables, but it's
often tough to get your family to eat these foods. Then, too,
we've seen that riboflavin is as sensitive as a prima donna. It is
easily destroyed by exposure to light, as when milk is stored in
glass jars, for example. It can also be destroyed in cooking be-
cause it is water soluble.
How can you be sure of a good supply of this vitally im-
portant nutrient? If the milkman leaves milk in bottles on your
doorstep, make sure he sets them in an opaque, covered con-
tainer. Bottled milk loses up to 70 percent of its riboflavin in
four hours when exposed to sunlight.
Cover your pots when cooking. Exposure of food to light
during cooking causes even greater riboflavin losses than heat.
And be sure to use all your pot liquor left after cooking it's
rich in B vitamins. If you soak seeds and grains for sprouting,
use the soak water in soups or to cook vegetables. It's another
good source of B vitamins.
Remember that you lose some riboflavin when you soak
vegetables or fruits in large quantities of water. You also lose
some during cold storage, whether in supermarkets and ware-
houses or in your own refrigerator or freezer. In addition, frozen
meat develops a ''drip' when thawed which contains approxi-
mately 9 percent of the protein, 12 percent of the thiamine, 10
percent of the riboflavin and 15 percent of the niacin. So repeated
freezing and thawing may result in considerable losses of the
original nutrient content
not to mention flavor.
How much riboflavin do you need?
a
The Recommended Dietary Allowance (RDA) is 1.6 milli-

grams for an average adult male and 1.2 for a female. The need
is higher in pregnant and nursing women. Because riboflavin
participates in the metabolism of protein, the need is also higher

when the diet is high in protein.
Since riboflavin is so vital, and because it is rarely toxic, it
would be nutritional wisdom to geteven more than the RDA.
How? A convenient source is brewer's yeast, which contains a
minimum of 0.3 milligrams of riboflavin per tablespoon. And
don't say you can't stand the taste. Shop around till you find
some that is to your liking. Then use it in soups, stews, casse-
roles, or mix
with flour to thicken gravy. In baked goods, add
it
two tablespoons to every cup of flour and no one will know it's
there except your body's cells, which will probably stand up
and cheer.
Some people start the day with a yeasty tomato shake
glass of tomato juice, 1 or 2 tablespoons of brewer's yeast and
a dash of basil, nicely blended. Take a yeast break instead of a
coffee break for a lift without a letdown.
Liver, kidney and heart are all excellent sources of ribofla-
vin, but you can't expect your family to eat them every day. So
are milk, cheese, eggs, green leafy vegetables and whole grains.
Make an effort to step up your intake of riboflavin. You'll
be ensuring yourself a steady supply of the nutrient that can help
keep not only your tongue, but your whole body, in the pink.
CHAPTER
RIBOFLAVIN IS READY
TO HELP
Just before her second birthday, a very ill little girl named
Christina was brought to theMedical College of Georgia in
Augusta. For no apparent reason, the child seemed to be losing
her abilities to see, hear and walk, and she had life-threatening
anemia. She was put in the care of three doctors: Patricia Hart-
lage, M.D., Dorothy Hahn, M.D., and Robert Leshner, M.D.
The doctors were puzzled. In spite of an adequate diet and
even a daily multivitamin with iron, Christina's anemia wouldn't
quit. "We were keeping her alive with transfusions," Dr. Hart-
lage told us. "She was a pretty sick little girl."
Searching for an effective treatment for the anemia, the
doctors turned to B vitamins. Under the microscope. Christina's
red blood cells were disfigured by funny little bubbles called
vacuoles; B vitamins are known to promote the production of
healthy red blood cells.
The doctors narrowed the choices down to vitamin B,, (pyr-
idoxine), thiamine (B|) and riboflavin (B:) and decided to give
Christina high doses of each of them, alone, for one month. They
tried vitamin B,, and thiamine, but neither had any effect. Then,
almost as a last resort, they gave her riboflavin. Five days later,
144
RIBOFLAVIN IS READY TO HELP 145
"Whammo!" recalls Dr. Hartlage. "Christina started to produce

healthy red blood cells."
"We just happened to try riboflavin last," Dr. Hahn told
us. "We gave her the vitamins in sequence. Riboflavin was the
last we tried, and behold, she responded to it. If we had
and lo
tried riboflavin first,we would never have known whether thia-
mine or pyridoxine [vitamin B^,] would have worked or not."
Even more amazingly, riboflavin began to reverse the neu-
rological damage done to Christina's eyesight and hearing. Ri-
boflavin deficiency is known to affect the blood and skin, but
not the nervous system in humans. "We haven't been able to
find any similar reports in the medical literature," Dr. Hahn said.
"We've talked to hematologists, neurologists and pediatricians."
Christina's illness is an extreme and unique case. Her diet
contained all the riboflavin most of us would need, but she has
a rare need for large amounts of it. Her response to riboflavin,
and riboflavin alone, however, shows that the vitamin has what
Dr. Leshner calls a "niche of its own" among the B vitamins.
For various reasons, riboflavin has not received much attention
in the past. "We know a lot about the other vitamins," Dr.
Hartlage told us, "but there's not a lot on riboflavin."
A Clue to Cataracts?
Not that there isn't a lot of interesting work on riboflavin

going on. Two researchers at the University of Alabama, Harold
W. Skalka, M.D., and Josef Prchal, M.D., are pursuing a sci-
entific lead that might make some of the 400,000 cataract oper-
ations performed in the United States every year unnecessary.
"Riboflavin might not prevent cataracts," Dr. Skalka told
us, "but it may be able to help retard their formation. That is,
instead of a person developing cataracts at 50, you could hold
it back to age 60 or 70 or 80 in some cases."
In a study of 173 patients at the Eye Foundation hospital in

Birmingham, Alabama, the two doctors found that 20 percent of
a group of cataract patients under age 50 were deficient in ri-
146 THE B VITAMINS
boflavin,and 34 percent of a group of cataract patients over 50

were deficient in the vitamin. On the other hand, all 16 of a group
of people over 50 with normal vision and clear lenses had high
levels of riboflavin
higher, even, than the levels in young, healthy
people who
served as controls in the experiment.
The doctors did not conclude from this evidence that ri-
boflavin can prevent cataracts. But they were intrigued and
totally surprised
by the fact that the older people with good
eyes all had a lot of riboflavin in their systems.
"What perhaps surprising is the lack of any riboflavin
is
deficiency in our older clinic patients with clear lenses. The

possibility that dietary riboflavin supplementation (beyond cur-
rent recommended levels) may be useful in retarding the for-
mation of senile cataracts is currently under investigation," the
researchers reported {Metabolic and Pediatric Ophthalmology,
vol 5, no. 1, 1981).
The vitamin is believed to help protect the eye through an
intricate chain ofchemical reactions, culminating in the release
of a substance called glutathione, which apparently shields the
proteins in the lens of the eye from the kind of damage that
causes cataracts.
"There are so few good, solid leads in the treatment of
cataracts, which are a major public health problem in the United
States,'' Dr. Skalka told us, "that anything is worth investigat-
ing. In this case, riboflavin therapy makes sense theoretically
and there are also some laboratory suggestions that it will work."
Dr. Skalka and Dr. Prchal are starting experiments with
animals to test their idea. They are optimistic. "In 5 to 15 years,"
they say, "we may have several ways to slow down the devel-
opment of cataracts."
Riboflavin Builds Healthy Blood

There has also been some significant research into ribofla-
vin's beneficial effects on the blood, including some that might
explain why riboflavin helped little Christina in Georgia. Ribo-

flavin lengthens the lives of red blood cells and boosts the action
of folate (folic acid, another B vitamin) in the production of new
red blood cells in bone marrow. The vitamin also seems to help
maintain a high level of iron in red blood cells.
In London, two researchers found that riboflavin protects
red blood cells the same way it protects proteins in the lens of
the eye
by promoting the release of glutathione. Their findings
are important because an estimated 30 percent of Britons over
age 65 who live in their own homes are mildly riboflavin deficient
(British Journal of Nutrition, September, 1981).
The researchers found that red blood cells in riboflavin-
deficient people have a shorter life span. The deficiency in each
cell seems to weaken its ability to resist damage from highly
reactive oxidants. The cells die before their time and are filtered
out of the blood.
A researcher from the University of Ghana in West Africa
where diets are commonly low in riboflavin found a special
relationship between riboflavin and folate. Knowing that folate
is responsible for the production of red blood cells, the professor
found that folate works much better if it's reinforced by a dose

of riboflavin. "Riboflavin may be exerting its effect through its
involvement in folate metabolism," he notes {InternationalJour-
nal for Vitamin and Nutrition Research, vol. 50, no. 3, 1980).
The researcher also found that, by a separate process, "ri-
boflavin is involved in the absorption and utilization of dietary
iron" in the blood. He suggests that riboflavin supplements should
accompany iron therapy, adding that "in pregnancy, iron and
folate deficiencies are common and the addition of riboflavin to
iron and folate used in treatment may be advisable."
Deficiency How Common?

Clearly, we all need riboflavin. But how much do we need,
and under what conditions may our requirements be higher?
Jack M. Cooperman, Ph.D., director of nutritional education
at New York Medical College in Valhalla, has studied riboflavin

148 THE B VITAMINS
levels in several groups of Americans. He says, "In this country,

60 percent of our riboflavin intake comes from milk or skim milk
and other dairy products such as yogurt and cheese." He has
found that people who don't consume much milk such as urban

teenagers tend to be deficient in riboflavin.
In a study of 210 white, Hispanic American and black youths
between the ages of 13 and 19 in New York City, Dr. Cooperman
found that 26 percent were deficient in riboflavin. The teenagers
with the highest levels were those who drank the most milk

up to three cups a day and those with the lowest vitamin levels

drank the least one cup a week. He found that black youths
were especially susceptible to riboflavin deficiency. As a group,
they often get cramps or diarrhea from milk and tend to avoid
it {American Journal of Clinical Nutrition, June, 1980).
Few people are seriously short of riboflavin. Dr. Cooperman

told us, but many may be marginally deficient and may suffer
subtly. "With a marginal deficiency, no one knows exactly what
the symptoms might be,'" he says. "Children may fail to grow
properly. Adults may feel slightly ill. They might not be able to
do a full day's work. They'll be mildly anemic and lackadaisical.
That's all we know right now."
Diabetics, women using oral contraceptives and infants are
other high-risk riboflavin-deficiency groups Dr. Cooperman has
studied. He told us that it has been only ten years since a reliable
test has been available for measuring riboflavin levels in people.
It was developed in Switzerland and is usually called EGR for
short.
And that test had found that a program of vigorous physical
exercise may increase a person's riboflavin needs. Daphne Roe,
M.D., of Cornell University, says that the recommended daily
intake of 0.6 milligrams for every 1 ,000 calories in the diet, which
was set in 1943, may be obsolete for today's active women.
Using the EGR women age
test. Dr. Roe studied a group of
21 to 32 and found that they needed 0.7 milligrams of riboflavin
per 1,000 calories to replenish themselves. (A normal diet con-
tains 2,000 to 3,000 calories per day.)
Affected by Drugs
There are other factors that can affect riboflavin levels. Rich-
ard RivHn, M.D., editor of the book Riboflavin (Plenum Press,
1975), says hormone levels and drugs also make an impact.
"A riboflavin-deficient state physiologically may result not
only from inadequate dietary intake of this vitamin, but also from
disturbances in endocrine control and as sequelae of treatment
with certain pharmacological agents," he writes (Nutrition Re-
views, August, 1979).
In particular, Dr. Rivlin says, people with either hypothy-
roidism or hyperthyroidism may need extra riboflavin, based on
findings in experimental animals. In hyperthyroidism, the body
processes so much riboflavin that it becomes hungry for more,
and in hypothyroidism, it processes too little.
John Pinto, Ph.D., Yee Ping Huang and Dr. Rivlin, all of
the Memorial Sloan-Kettering Cancer Center, have shown that
chlorpromazine, imipramine and amitriptyline, all psychiatric
drugs, can block the action of riboflavin in animals. Dr. Rivlin
also suspects that pregnant women and women using oral con-
traceptives need more of the vitamin. ''Inasmuch as riboflavin
deficiency may occur with considerable frequency in pregnant
patients," he says, "and shortage of this vitamin causes con-
genital malformations, at least in experimental animals, a rea-
sonable case can be made for administration of riboflavin sup-
plements in pregnancy."
Boric acid may also drain riboflavin from the system. "Boric
acid, which is present in some 400 home products, such as mouth
washes, suppositories and a number of imported foods, claws
onto the sugar portion of riboflavin, binds it, and takes it out
into the urine," he writes.
Insidiously, a riboflavin deficiency feeds on itself. "When
there is an inadequate amount of riboflavin in the diet, you may
lose that ability to utilize what you have. It's a vicious circle,"
Dr. Rivlin wrote in a paper presented to the Vitamin Nutrition
150 THE B VITAMINS
Issues Symposium in Boca Raton, Florida, in October, 1979.

"The you have, the less you are able to utilize; once the
less
body gets sick, it gets sicker, because it lacks this enzyme and
therefore cannot utilize what little vitamin there is in the diet."
Large as some people's riboflavin deficiencies might be, the
needs of little Christina in Georgia are much higher. (By com-
parison, the adult Recommended Dietary Allowance ranges from
1.0 to 1.7 milligrams, depending on age and sex.) Her riboflavin
therapy started at a massive 75 milligrams per day. At four years
old, she used only 25 milligrams per day, but her doctors didn't
know whether she still needed so much of the vitamin or not.
"Someday I'll be gutsy enough to take her off the supple-
ments," Dr. Hartlage says.
Christina's doctors are excited by the idea that their
breakthrough might help other children who may be suffering
from the same riboflavin-dependency disease without knowing
it and that the problem could be averted entirely in future cases.
"This is the first documented case, as far as I know, of a non-

experimentally-induced riboflavin-dependency disease in a hu-
man," Dr. Leshner told us. "I'd like to believe it could be diag-
nosed earlier and prevented."
"I'm very anxious that people know about this," added Dr.
Hartlage, who is particularly optimistic about Christina's recov-
ery, though it is still far from complete. "She has not failed to
show progress," Dr. Hartlage said. "We thought her deafness
was irreversible, but her hearing is slowly coming back. And her
eyesight is coming back. She was just in today for physical ther-
apy, and she gets better every time."
CHAPTER
NIACIN FOR
BRIGHTER MOODS AND
BETTER MEMORY
Are you a lame brain?

Sorry for the But before you turn the page in a huff,
insult.
turn the other cheek instead and let us ask you a few more

questions about your brain and the B vitamin niacin.
Is your first hour or so in bed at night ever a "witching
hour," with your thoughts cackling out a spell to keep you toss-
ing and turning? Insomnia can be a symptom of niacin deficiency.
Are you ever so far down in the dumps that the whole world
looks like a junkyard? Depression can be a symptom of niacin
deficiency.
When you want to take a stroll down memory lane, do you
sometimes find yourself falling flat on your face? Forgetfulness
can be a symptom of niacin deficiency.
Or are you irritable? Anxious? Easily distracted? Yes, all
of them can be symptoms of niacin deficiency.

The brain as psychiatrists and psychologists too often for-
get is part of the body, the crown of the central nervous system.
And just as a calcium deficiency can make a bone so fragile that
it breaks with the slightest bump, so a deficiency of niacin can
151
152 THE B VITAMINS
make your brain so 'lame" that thoughts are weak and emotions
shaky.
Way back in 1947, Tom Spies, M.D., in his pioneering book
Rehabilitation through Better Nutrition (W. B. Saunders), de-
tailed the many mental problems that can accompany, not an
out-and-out deficiency of niacin, but merely an inadequate in-
take. The list of symptoms he compiled reads like a passage out
of a neurotic's diary: irritability, depression, memory loss, in-
somnia, nervousness, distractibility, apprehension, morbid fears,
mental confusion and forgetfulness.
And if a lack of niacin in the diet can make you fall apart,
it follows that extra niacin can help you keep it all together.
That thought occurred to Abram Hoffer, Ph.D., M.D., pres-

ident of the Huxley Institute for Biosocial Research in New York
City. In his book Niacin Therapy in Psychiatry (Charles C.
Thomas, 1962), Dr. Hoffer describes how he and his colleagues
gave large doses of nicotinic acid (a form of niacin) to 15 middle-
aged and elderly people. ''Perhaps,'' wrote Dr. Hoffer, "if it
was given early enough, it would stop senile changes from oc-
curring or slow them down greatly."
Of ten people suffering from senility who got niacin, five
"recovered," and two had "marked improvement." Three
others did not benefit from the niacin. Four people who were
normal when the therapy began remained well.
One middle-aged woman spoke enthusiastically of niacin's
many benefits:
"Since we began taking 12 nicotinic acid tablets daily, we
have noticed a decided improvement in sleeping. We have more
energy and find we can do a good day's work without undue
fatigue. Prior to taking the tablets, Martin was subject to head-
aches and took aspirin nearly every day. Now, he very seldom
complains of a headache. I never have one. Our outlook on life
seems to be much more optimistic and we have cheerful, happy
dispositions."
So it seems that niacin can spark the brain back into working
order. And when we say spark, we mean it.
NIACIN: BRIGHT MOODS. BETTER MEMORY 153
The Spark of Life
Oxygen-laden red blood cells have a "spark" a negative

electrical charge. Like the negative poles of two magnets, two

red blood cells will repel each other. They have to to carry
their oxygen to the brain's tissues, they must crawl single file

through tiny blood vessels called capillaries. But if because of
disease or old age the red blood cells lose their charge and
bunch up, a microscopic traffic jam is created. The brain gets
less oxygen. Senility or any of a dozen other varieties of dull-

ness and irritability can set in. But niacin restores the red blood
cells' electrical charge. Your brain can take a breath of fresh air.
But not only your brain. Your heart, too.
The late Edwin Boyle, M.D., a clinical professor at the
Medical University of South Carolina, Charleston, was called
"North America's foremost expert on niacin and heart disease."
For good reason. Dr. Boyle treated heart disease with niacin for
over 20 years. In a telephone interview several years ago. Dr.
Boyle told us that a five-year study of over 8,000 men revealed
that those who took niacin regularly 1,000 men had 25 per-
cent fewer nonfatal heart attacks.
Doctors have long known that niacin can help lower the
level of blood fats like cholesterol and triglycerides that can muck
up arteries and cause heart attacks. In his practice. Dr. Boyle
used niacin to help those who had very high levels of blood fats.
Not only did niacin lower their cholesterol levels, but it
eliminated sludiîng the bunching up of red blood cells that we
mentioned earlier. Once sludging was gone. Dr. Boyle prescribed
proper diet and moderate exercise to restore a heart patient's
health. "There
is a proper sequence of treatment, and niacin fits
into thatsequence," he told us.

"People with elevated cholesterol and clinical vascular dis-
ease do as well with niacin, diet and exercise as with any other
regimen," he said.
154 THE B VITAMINS
A Prescription for Good Moods

Though using vitamins marks a doctor as unconventional.
Dr. Boyle was hardly alone in prescribing niacin. William Kauf-
man, M.D., Ph.D., a retired doctor living in Bridgeport, Con-
necticut, treated many
of his patients with niacinamide, the
chemical that niacin changes into before it goes to work in the
body.
"When 1 began practicing in 1941, I found it striking that
patient after patient came in symptoms which
with a group of
were quite similar. They might have other symptoms besides,
but in these certain symptoms, such as the lack of ability to
concentrate, depression, irritability, joint complaints, excessive
fatigue, bloating and intestinal complaints, there was fingerprint
similarity. Many patients were so easily startled they jumped
when phone rang. A number had black and blue marks on
the
their bodieswhere they had bumped into things, since their sense
of balance was far off.
"T began tabulating symptoms and physical abnormalities
and very soon recognized that this strange syndrome was prob-
ably a form of pellagra, or niacin deficiency, that had not yet
reached the degree of severity to cause the classic combination
of skin rash, diarrhea and dementia. I reasoned that if this was
a form of pellagra, then niacinamide
which had just been dis-

covered as a preventative might provide useful treatment.
I administered 100 milligrams of niacinamide as a test dose.
If the patient had no adverse reactions to the test dose, I pre-
scribed 100 milligrams three to four times a day. Male and female
patients would return a few days later and ... 1 didn't believe
it!They looked different. They acted different. They told me
that their symptoms had vanished, they felt a new zest for life.
I decided to test it. gave a few of these improved patients

1
calcium tablets instead of niacinamide. They were unaware of

the change. At the end often days they were right back to where
they had been when they first saw me. When they resumed
niacinamide treatment, they once again improved.
NIACIN: BRIGHT MOODS, BETTER MEMORY 155
"But even though had good therapeutic results with this

I
group of patients, I wasn't satisfied with this. I wanted to have

a way of measuring improvements objectively. I needed some
new standards of measurement. So I designed some simple in-
struments I could use to measure joint mobility and adapted other
instruments for measuring muscle strength and working capacity.
With these devices I could show, for example, how niacinamide
properly used was enabling people to turn their heads further,
as well as move their other joints through wider ranges of motion."
'The 100 milligram per day dose of niacinamide would be
ineffective in producing sustained results, though. The daily dose
I prescribed since 1944 ranged from 900 to 4,000 milligrams a
day in divided doses. These amounts were calculated by taking
special measurements of patients' joints to test their mobility
and are not recomended for individual treatment without a doc-
tor's supervision."
Fatigue and Stiffness Helped

One of the many people Dr. Kaufman helped with niacin-
amide was a 78-year-old woman. "When I first saw her, she was
feeble, exhausted all the time. When she wasn't in bed, she sat
in her rocker. To make matters worse, her joints were stiff and
painful. She was too tired to go anywhere or do anything. She
was downhearted all the time, weepy and looking forward to
dying as her only release. After more than a year of continuous
treatment with high doses of niacinamide, her joints greatly im-
proved and she was virtually free from pain and stiffness.
"The measurement of her joint mobility showed that she
now had movement that one would expect in
the ranges of joint
an 1 1- Her strength had increased markedly,
to 15-year-old girl.
too, more than double what it was a year earlier. She no longer
felt feeble. Her state of mind also greatly improved. She felt
much happier and once more enjoyed living. She looked forward
to going out and to the doings of the next day. And, of course.
156 THE B VITAMINS
she continued taking niacinamide in the doses I prescribed for

her.''
Dr. Kaufman doesn't put much stock in statements that most
people get all the vitamins they need from their food. "You
know, people aren't getting as much of the vitamins in their diets
as they think they are. Processing, cooking and storage can de-
stroy a high percentage of many of the vitamins originally pres-
ent. For this reason alone, for many people just having meals
that seem to supply the 'minimum daily requirement' is not enough.
Generally, my patients could be termed middle or upper class
economically and educationally. They had no problems with money
as far as food was concerned. They were getting enough food,
without a doubt. Still, the vitamins I prescribed helped them."
But you don't want to wait until you find yourself in the
waiting room of a general practitioner (or a psychiatrist) before
you begin making sure you're getting enough niacin. How much
is enough? The Recommended Dietary Allowance a level set
by the government's National Academy of Sciences, aimed at
suggesting a healthful intake for the "average" person is 13 to
19 milligrams of niacin a day.
OK. Let's say for a moment that 19 milligrams a day is
enough. Could you get this much from an "average" diet? Prob-
ably not.
American public has gone from
"I think the fact that the
eating 7 or 8 pounds of refined sugar a year to 175 pounds is
causing a tremendous rash of ill health," Dr. Boyle asserted,
"part of which could be attributed to the lessened intake of niacin
and chromium. People have replaced the calories that would
have come from whole grain cereals, a rich source of niacin,
with sugar's empty calories.
"1 think there is ample reason to believe that the amount
of niacin a person should be getting for good health is not the
amount most Americans are getting on a so-called normal diet.
Ihe diet is greatly shortchanged on all the water-soluble vita-
mins, and niacin is one of the most important."
As Dr. Boyle pointed out, replacing high-niacin foods with
low-niacin foods like sugar is a raw deal for your health. But
NIACIN: BRIGHT MOODS, BETTER MEMORY 157
sugar gets you in double trouble. Niacin fuels digestion. Car-

bohydrates such as whole wheat bread and brown rice contain
niacin; even as they are digested they put more fuel on the
digestive fire. But sugar is almost nothing but sucrose. It uses
up niacin but puts none back. The result: a niacin deficiency.
That's a health problem you don't need. But how much
niacin do you need to stay healthy, really healthy?

That depends on what you eat, on what you do and on
your personal history. In a telephone interview. Dr. Hoffer, whose
study of senility we talked about earlier, told us a dramatic story
of prisoners of war rescued, not by lightening-strike missions,
but by niacin.
"Most of those who were POWs in Japan or in Vietnam are
still sick except for those who are taking large quantities of
niacin. Niacin has healed the ravages of months of severe mal-
nutrition and mistreatment.
"Every year in captivity can hasten senility by five years.
Fifty-year-old men are blind, senile and arthritic with severe
psychotic problems. Niacin can stop this from happening."
Well, that's one end of the spectrum. At the other, says Dr.
Hoffer, are people who are eating a sugar-free, high-fiber diet.
Chances are they won't need any niacin supplements to feel at
their best.
Probably you're somewhere in between. Maybe you need
to take two or three times the RDA to keep your chin up and a
smile on your face.
But you do need niacin and you take as much as 100
if
milligrams of it, you may have an unusual side effect fright-

ening, perhaps, but harmless: flushing. Your skin will tingle and
turn red, as if you had an instant sunburn. Dr. Boyle described
this reaction as the "initiation ceremony." But unlike sunburn,
flushing fades rather quickly. Both Drs. Hoffer and Boyle pointed
out that flushing, caused by the release of histamine and heparin
into the bloodstream, is no cause for concern.
And Dr. Boyle added that if you take niacin regularly four
times a day
flushing will eventually disappear. Niacin, said Dr.
Boyle, is preferable to niacinamide (which does not cause flush-
158 THE B VITAMINS
ing) because niacinamide is not effective in lowering the level of

fats in the blood.
Dr. Hoffer agrees that niacin is one up on niacinamide and
suggests, 'Taking 50 milligrams twice a day will seldom cause
flushing." He suggests that the best time to take niacin is after
meals. But the niacin you "take" during meals is important, too.
Inviting Niacin to Dinner

is part of the vitamin B complex. And the B complex
Niacin
likes tohang out together. So most of the foods rich in other B
vitamins will also be rich in niacin. One such food is liver. A
typical serving supplies 14 milligrams of niacin.
Other meats are good sources, too. And so are shelled,
roasted peanuts. One-quarter cup has a whopping 6.2 milligrams
of niacin. Other nuts and seeds are also good sources.
But if you're a dieter and those peanuts have you worrying
about putting on the pounds, skip them. Eat plenty of tuna, a
dieter's delight, instead. Tuna has 21 milligrams of niacin in every
cup.
Whole grains are alsogood sources. Peas and beans are fair.
And the king of the B-complex foods, brewer's yeast, supplies
a hearty 3 milligrams of niacin in every tablespoon.
Scientists often tell us the brain is like a computer. Niacin
may keep your computer programmed for happiness.
CHAPTER
WHY THIS EPIDEMIC

OF VITAMIN B6
DEFICIENCY?
Until recently, vitamin B^, (pyridoxine) was considered

something of a second-line vitamin. Unlike niacin, thiamine and
vitamin C, which can dramatically cure certain life-threatening
deficiency diseases, Bf, has never attained the status of ''magic
bullet."
Of course, even nutrition skeptics know that vitamin Bf, can
help a few rare genetic disorders of metabolism and an uncom-
mon type of anemia. They are also aware that this vitamin can
prevent some of the side effects of a few prescription drugs,
including oral contraceptives. But aside from these uses, tradi-
tionalistsdo not believe B,, supplementation has much value.
Research over the past decade has been forcing a change in
this opinion. Numerous reports indicate that vitamin Bf, can be
beneficial in a wide range of apparently unrelated medical con-
ditions. Furthermore, a substantial percentage even of healthy
people are now believed to be low in this nutrient.
Nutrition-oriented doctors have begun using B^ in the treat-
ment of hyperactive children, asthma, diabetes mellitus, so-called
autoimmune diseases, infertility, recurrent calcium oxalate kid-
ney stones and for prevention and treatment of toxemia during
159
160 THE B VITAMINS
pregnancy. In addition, according to an editorial in the presti-

gious journal Lancet, B^ may benefit heart patients by reducing
the tendency of their blood to form dangerous clots.
Carpal tunnel syndrome, a nerve disorder that produces
numbness, tingling, pain and weakness in the hands and some
fingers, is a problem of particular interest. For while vitamin 85
is only one part of a comprehensive treatment program for the
above maladies, carpal tunnel syndrome is usually controlled by

Bft alone.
Why should 85, nearly a half century after its discovery,
suddenly become such a versatile therapeutic weapon? The ob-
vious explanation is that modern scientists have made discov-
eries that were overlooked in earlier research. In other words,
65 has always been valuable; it's just that no one realized it.
Be Deficiency: A New Problem?

That explanation, however, is not entirely satisfactory. Our
predecessors in nutritional science were too good to have missed
the boat so badly on vitamin Be. They were shrewd observers
with fertile minds. For example, 25 years before Linus Pauling,
Ph.D., wrote his book on the subject, they recognized that vi-
tamin C might help the common cold. They advocated allergy
elimination diets for the treatment of migraine headaches 50 years
before this method was "discovered" by modern scientists. They
knew that essential fatty acids could improve eczema before
most modern nutrition doctors were even born. And they dis-
covered countless other nutritional pearls that are only now com-
ing back into vogue. But about vitamin B^, there was hardly a
word.
If we accept that scientists of yesteryear were good at what
they did, we are forced to conclude that Bf, deficiency was not
much of a problem back in their time. The reason that B(, has
only recently become so useful must be that widespread defi-
ciency of this vitamin is a new problem.
Is this logic farfetched? Not really. Consider carpal tunnel
syndrome: It is caused by pressure on a nerve that passes down

AN EPIDEMIC OF B, DEFICIENCY 161
the arm, through a structure at the wrist called the carpal tunnel
and into the hand. Vitamin Bf, somehow relieves this pressure
and the symptoms that go with it. Even George Phalen, M.D.,
the man who discovered this syndrome, now believes that 85
therapy may soon replace the more widely used hand surgery.
But what does this have to do with a new epidemic of vitamin
65 deficiency? The fact is that carpal tunnel syndrome appears
to be a new disease. When Dr. Phalen presented his first cases 1 1
in 1950 at the 99th Annual Meeting of the American Medical

Association, he noted that very few of the doctors attending that
meeting were familiar with this syndrome. Today, however, most
doctors see it frequently.
So carpal tunnel syndrome is a new disease, becoming prom-
inent in the past 30 years. It is a disease that usually can be
traced to lack of sufficient vitamin B^. It stands to reason, then,
that Bf, deficiency has also emerged in our population during the
last three decades.
Inadequate B^ can manifest itself not only as carpal tunnel
syndrome, but as a contributing factor in many cases of asthma,
diabetes, hyperactivity, heart disease and other problems. And,
as mentioned, B^ deficiency is a time bomb that may be ticking
inmany healthy individuals.
What has happened since World War II that could have
caused so many of us to become low in this important nutrient?
Is our overrefined, overcooked diet doing us in? If you analyze
our modern food supply, you indeed find that many of us are
getting the Recommended Dietary Allowance (RDA) for vitamin
Bfi. On the other hand, a sugar-laden, nutrient-depleted diet has
been with us for quite some time, and marginal B^ intake is

nothing new. If we are eating less B(, than we did 50 years ago,
the difference could not be much more than few tenths of a
milligram.
Could such a small change in dietary Bf, be the straw that
broke the camel's back, plunging millions of us into a state of
deficiency? That is an unlikely explanation, because the epidemic
of Bf, deficiency looks like something more than just a simple
dietary shortage. The RDA for vitamin Bf, is only 2 milligrams
per day. If all we are doing with Bf, therapy is correcting a

162 THE B VITAMINS
few milligrams daily should do the job. But

deficient diet, then a
some doctors are prescribing extremely large doses: anywhere
from 20 to 500 times the RDA.
These amounts cannot possibly be obtained from food alone,
even if you consume the most well-balanced, nutrient-rich diet
imaginable. Smaller doses, however, don't seem to work so
it's not that we are getting less Bf, than before. What has ap-
parently happened is that many of us have come to need a lot
more of this vitamin than our grandparents did.

An increased need for a vitamin could occur because of
either a genetic mutation or exposure to some chemical that
interferes with the function of that vitamin. The genetic theory
is unlikely, since mutations take thousands or millions of years
to have a major impact on the human race. There may, therefore,
exist some antivitamin to which we are being exposed, a sub-
stance which might either prevent us from absorbing our vitamin
Bfi, destroy it in our bodies or in some way prevent it from
carrying out its usual tasks. If there is such a chemical, then we

would need to increase our B,, intake in order to counteract its
effects.
Such antipyridoxine compounds do indeed exist, and we
have been exposed to them in increasing amounts during the past
30 to 40 years. These vitamin Bf, antagonist belong to a class of
chemicals called hydrazines.
Bela Toth, Ph.D., of the University of Nebraska, who has
studied hydrazines extensively, points out that the high chemical
reactivity of these substances makes them ideal for a very wide
range of uses.
"In agriculture," Dr. Toth writes, "many of these com-
pounds are used as plant growth regulators and herbicides. Nu-
merous hydrazines are extensively used in medicine as phar-
maceutical agents for a broad variety of diseases. They are used
industrially in high energy fuels ... as antioxidants in the pe-
troleum industry and as plating materials and antitarnish agents,
etc., in metal manufacturing."
The first indication that hydrazines interfered with vitamin
Bf, was the discovery that an antituberculosis drug, isonicotinic

AN EPIDEMIC OF B^ DEFICIENCY 163
acid hydrazine (INH), could produce a disorder which is similar

to carpal tunnel syndrome. But large amounts of Be, given along
with INH, can prevent this disorder.
Later on, two other hydrazine medications, hydralazine and
phenelzine, also were found to be vitamin Bf, inhibitors. Dr. Toth
studied numerous other hydrazine compounds and found that
most of them greatly increased the need for B^. F. Buffoni, an
Italian researcher, extended the list of Bf, antagonists even fur-
ther and suggested that most, if not all, hydrazine compounds
are capable of interfering with vitamin Be.
Unfortunately, the story doesn't end there. Not only must
we deal with the hydrazines, we must also face other chemicals
that our bodies can convert to hydrazines. The chemical of great-
est concern in this regard is tartrazine, also known as FD&C
Yellow No. 5. This widely used coloring agent is added to hundreds
of different foods and medications. In 1970, 21 years after its
patent was approved, nearly a million pounds of tartrazine were
being used annually.
Although tartrazine is not itself a hydrazine, at least 30 per-
cent of it is converted by the body into a hydrazine compound.
So it's likely that this food dye is another vitamin Bf, inhibitor
and we cannot rule out the possibility that other food additives
of similar structure may also be converted by the body into
hydrazine.
Is it more and more people need more
possible, then, that
and more because Bf, antagonists are sprayed on our food,
Bf,
spewed into the air and used widely in manufacturing?
Ways Avoid to
Exposure to Hydrazine
It can be depressing to think about the many environmental
chemicals that may be interfering with the normal functioning

of our bodies. Nevertheless, rather than throw our hands up in
despair, there are a few things we can do to try to deal with the
164 THE B VITAMINS
hydrazine problem. One is to minimize avoidable exposures to

these chemicals. If you can find produce that has not been chem-
ically treated, by all means use it. If no such food is available
to you, then at least wash your fruits and vegetables thoroughly.
Try to avoid unnecessary exposure to food dyes. There are lists
available that tell you which foods and medications contain FD&C
Yellow No. 5.
Another positive step you can take is to stay away from
foods that have been fried at high temperatures. When vegetable
oils are exposed to high temperatures in the presence of air, toxic
by-products are created, and these by-products are known to
increase the need for vitamin B^,.
Of course, it's not possible to avoid all hydrazine com-
pounds completely. For this reason, it's a good idea to make
sure you're getting enough vitamin B(, in the first place. At pres-
ent, unfortunately, there is no way to determine exactly how
much Bfi the average healthy person should use. But since B6 is
a vitamin with very little risk of toxicity, it would probably be
better to err on the side of too much rather than too little. A
conservative, rough estimate is that the average, healthy person
might be wise to ingest 10 to 20 milligrams daily. (Amounts over
50 milligrams should only be taken under a doctor's supervision.)
If you have some disorder that might be helped by vitamin
Bfi, then larger amounts should be used. Of course, before un-
dertaking a program of vitamin therapy, you should obtain the

approval of your doctor. In a few special situations, notably
insulin-dependent diabetes and Parkinson's disease, Bf, therapy
should be monitored by someone familiar with its effects. In
addition, nursing mothers should be careful with Bft, since mas-
sive doses may cut off the milk supply.
CHAPTER
VITAMIN Be FOR
CARPAL TUNNEL
SYNDROME
Ask a traditional doctor about vitamin C deficiency, and the

topic of scurvy will surely come up. Niacin will summon a re-
sponse about pellagra, and thiamine will be linked with beriberi.
In fact, if a vitamin doesn't have its very own specific deficiency
disease, the vitamin's importance and its Recommended Dietary
Allowance may be hotly disputed.
Of course, there are those who know that vitamins do more
than just cure one particular ailment. They know that vitamins
are intimately involved in any number of the enzymatic and
metabolic workings of our bodies.
But if a specific disease is needed to wake up the tradition-
alists to the wonders of a vitamin, then we've got some news
about one of our favorites, vitamin B^,, or pyridoxine.
Even though some researchers have suspected for years that
there is indeed a specific disease associated with B^ deficiency,
only recently has hard scientific data been able to back up that
suspicion. That's what Karl Folkers, Ph.D., says and, since he
conducted the experiments, he should know. Dr. Folkers, di-
rector of the institute for biomedical research at the University
of Texas at Austin, announced his findings at a symposium hon-
oring his contributions to medical science.
165
166 THE B VITAMINS
Dr. Folkers told the conference held at Lehigh University

in Bethlehem, Pennsylvania, that biochemical research con-
ducted over the last five to six years has led to the conclusion
that a human vitamin Bf,-deficiency disease does in fact exist.
The disease is a neurological disorder commonly known as carpal

tunnel syndrome. (We talked about this disease in the last chap-
ter, but here we'll discuss it in a littlemore depth.) Carpus is
the medical term for your wrist. The bones and ligaments in your
wrist form a tunnel through which pass the tendons and the nerve
that make it possible for you to move your fingers and that control
your sense of touch.
"When the disease strikes, an accumulation of fluid inside
the carpal tunnel puts pressure on the nerve," explains Dr. Folk-
ers. "This, in turn, leads to numbness and tingling in the tips of
the fingers. Sometimes patients will tell me that at night their
arms or hands 'fall asleep.' It's true that they may have, indeed,
been sleeping on their arm, but I suspect that a more likely
explanation is that they have carpal tunnel syndrome."
Because the nerve is being compressed, other, more serious

symptoms may also develop painful elbows or shoulders and
very weak handgrips, to name a few. Somtimes symptoms are
so severe that patients have to quit their jobs.
For years, patients with this disorder were routinely sub-
jected to hand surgery to relieve compression on the nerve. But
it's no secret that the surgery may be only partially successful
and that any relief gained is likely to be lost in a few short months.
Now, permanent relief of carpal tunnel syndrome is perhaps
only a B<s supplement away, thanks to the research efforts of Dr.
Folkers and his associates. They were able to reach that con-
clusion by using a new and better blood test which can detect
and accurately measure deficiences of vitamin B^, on a patient-
by-patient basis. Working in conjunction with John Ellis, M.D.,
of Mt. Pleasant, Texas, the doctors discovered, for the first time,
that patients with carpal tunnel syndrome actually had a previ-
B^,. What's more,
ously unrecognized severe deficiency of vitamin
Bfisupplements always corrected the deficiency and led to dis-
appearance of the signs and symptoms.

B, FOR CARPAL TUNNEL SYNDROME 167
Their next step was to repeat this research, using the highly
respected double-blind crossover technique. That means neither
the patients nor the doctors conducting the experiments know
which patients receive the actual vitamin and which receive a
nontherapeutic, look-alike placebo pill
until the testing is
completed.
Results? Patients responded well to the B^, and not at all to
the placebo. But when the patients on the placebo were given
Bfi, they, too, showed the same marked improvement.
''We've gotten as far as relating the disease to a B^ defi-

ciency and showing that the disease, if it hasn't progressed to
the point of atrophy [wasting away], responds well to B(,," Dr.
Folkers told us. "And what I think is almost unbelievable (but
seems to be true) is that individuals who have had symptoms for
years a decade, even 15 years
show such remarkable reversal
and improvement of their condition. 1 don't mean to say that the
symptoms are 100 percent reversed, but they are improved so
much that the patients do not need orthopedic surgery for their
hands."
RDA Is "Far Too Low 99
"It doesn't even take huge doses of B^,, either," Dr. Folkers
assured us. "However, I am convinced that the Recommended
Dietary Allowance [RDA] of 2 milligrams is far too low. Our

research shows that a very high percentage of the population in
this country appears to have a deficiency of B^,. believe that
I
an effective RDA would be around 25 milligrams or possibly

even 35 milligrams. That means a supplement of B,, will be needed
to ensure health. In fact, the risk to health in not taking a Bg
supplement is far greater than the risk of taking it. Besides, it's
virtually impossible to get that much B,, in your daily diet"
even if you eat foods rich in this nutrient, such as bananas,
salmon, chicken, liver and sunflower seeds.
But that's not all the interesting news about B^.
168 THE B VITAMINS
Be and "Chinese
Restaurant Syndrome"
Maybe you've heard of the notorious "Chinese restaurant
syndrome." comes on about 20 minutes after eating a meal
It
spiced heavily with monosodium glutamate (MSG). Headache,

feverish flush and a detached or distant feeling overcome those
who are susceptible.
According to Dr. Folkers, it is people deficient in B^, that
develop Chinese restaurant syndrome. He proved his theory by
showing that supplemental B^, could effectively prevent a recur-
rence of the MSG reaction, whereas a placebo had no effect.
Because of that study, Dr. Folkers began to wonder if those
with carpal tunnel syndrome might also be sensitive to MSG
since they, too. have a B^, deficiency. An opportunity to test such
a correlation became available in the case of a student who was
known to be severely affected by carpal tunnel syndrome and
extremely deficient in B^,.
Dr. Folkers was afraid the student might overreact to the
8.5 grams of MSG usually given in the test, so he cut the dosage
to 4 grams, even though 4 grams rarely produced a response
with other volunteers. Neveretheless, after 20 minutes, the pre-
dictable signs of Chinese restaurant syndrome appeared.
"The carpal tunnel syndrome reveals a vitamin Bf, deficiency
over months and years," says Dr. Folkers, "but the Chinese
restaurant syndrome reveals a deficiency over a period of 20 to
60 minutes. In principle, the underlying cause of both syndromes
appears identical."
Be and Kidney Stones

Even though vitamin B,, can now claim exclusive rights to
its own deficiency disease, we don't want its other newly found
benefits to go by without at least a little fanfare. That's why we
B^ FOR CARPAL TUNNEL SYNDROME 169
want to tell you it can also help people who suffer from recurrent
kidney stone formation, especially of stones that are composed
mainly of oxalates. So say doctors at St. Peter's Hospitals and
Institute of Urology in London. They tried 200 milligrams of Be
twice a day on one man who had been plagued with kidney stones
for years. He took the vitamin for five months during 1977 and
hasn't had a stone since.
The same success story can also be told for another patient.
She was passing an average of one stone every month until Be
was started. Now she has been free of stones for almost three
years. 'These two patients did not relapse, even after long pe-
riods of time," write the researchers, who say the patients have
''an apparently permanent remission on pyridoxine LBe]" {British
Medical Journal, June 27, 1981).
You may be wondering how Bf, can have an effect on kidney
stone formation. Well, you're not alone. In fact, doctors at the
University of California at Los Angeles school of medicine think
they may have a possible explanation.
Since both magnesium and Bf, had been reported as suc-
cessful in preventing kidney stones in susceptible patients, the
scientists felt that B^ might in some way mimic the effects of
magnesium. They weren't sure how, but they suspected that Bf,
increased the utilization of magnesium by aiding the transport
of this mineral across cell membranes.
To prove this theory, they gave nine volunteers 100 milli-
grams of Bf, twice a day for one month and then compared their
magnesium levels after treatment to their levels before the
experiment.
The results thoroughly supported their ideas. Following vi-
tamin Be administration, the magnesium levels were significantly
elevated in all the volunteers, with more than a doubling of the
levels after fourweeks of therapy {Annals of Clinical and Lab-
oratory Science, July-August. 1981).
Vitamin Bf, seems
to be one of those vitamins that's espe-
cially versatile. can cure carpal tunnel syndrome, help keep
It
blood clots at bay and may even stop kidney stones from making
170 THE B VITAMINS
encore appearances. Now doctors are saying that B^, which is

also known for keeping the immune system healthy, may even
help keep cancer from recurring.
In research done at the Imperial Cancer Research Fund
Laboratories in London, patients undergoing treatment for breast
cancer were studied to determine the likelihood that their cancer
would return. What the doctors did was analyze the patients'
urine for a by-product of vitamin Bf, metabolism known as 4-PA.
Low urinary amounts of 4-PA reflect a vitamin Be deficiency,
and the results of the study showed that patients who excreted
lower levels of 4-PA had a significantly greater probability of
recurrence of breast cancer than patients who excreted higher
levels {European Journal of Cancer, February, 1980).
So, to help keep your health from becoming "bad news,"
just
remember all the good news about B^ and that it makes
more sense than ever to make sure you're getting enough.
CHAPTER
Be MAYBE THE
ANSWER TO
HEART DISEASE
What causes arteriosclerosis?

Is it cholesterol, a high-fat diet, hypertension, stress, smoking?
All of those factors do play a role.
But according to a theory put forth by Kilmer McCully,
M.D., former professor of pathology at the Harvard medical
school, not one of them is the cause. They are all risk factors,
true. But not one of those risk factors is responsible for the initial
injury in the artery which ultimately escalates to a blocked artery.
Every disease must have a prime cause, one that is found
in every case of the disease. Until now, scientists have assembled
quite a few risk factors associated with arteriosclerosis but have
never been able to pinpoint one basic chemical cause.
Dr. McCully, on the basis of extensive laboratory studies
and many years of studying the scientific literature, is convinced
that the original injury (or lesion, as scientists call it) in the
arteries is caused by a series of events initiated by a deficiency
of our old friend vitamin B(, (pyridoxine).
We know that B^ is a very special member of the family of
B vitamins, that a deficiency can cause anemia, kidney stones,
convulsions, neuritis, skin problems and even mental illness.
171
172 THE B VITAMINS
Could it be that vitamin B(, is the missing element in the

causation of the disease that kills twice as many people as cancer?
We considered this theory so important, we invited Dr. McCully

to discuss it with us.
Question: If it isn't cholesterol or any of the other risk
factors which initiates the disease, what is the cause?
Dr. McCully: The original lesion in the arteries is caused
by a toxic substance, homocysteine, which is a breakdown prod-
uct of the amino acid methionine. But when pyridoxine [vitamin
Bft] is present, homocysteine is unable to do its destructive work.
Bf,, acting as a coenzyme, facilitates the enzyme reaction, which

quickly converts homocysteine to cystathionine, which is not
toxic and is safely used by the body in other pathways.
Since pyridoxine is necessary to prevent the buildup of
homocysteine in the blood, this vitamin can do much to prevent
the original lesion leading to arteriosclerosis and to atheroscle-
rosis, the advanced form of the disease.
Q: In what way does homocysteine initiate the process?
Dr. McCully: Homocysteine, which is formed in metabo-
lism from methionine, is a toxic amino acid which causes the
cells lining the artery to degenerate and slough off. The artery
responds to this damage by synthesizing new cells and new con-
nective tissue substance which accumulate lipids, especially cho-
lesterol and triglycerides. Now we have what is known as an
atheroma. An atheroma is something like a cyst. It is composed
of connective tissue cells, fibers and lipoproteins which are de-
posited from the blood. We now have an impediment, a sort of
roadblock in the artery which slows down the flow of blood.
When the blood flow is severely restricted, the tissues beyond
the blocked area die from lack of oxygen. The result here could
be a heart attack or stroke.
When the same process affects the renal arteries supplying
the kidneys, then the kidneys react by releasing renin, a hormone
which reacts on the blood plasma to form angiotensin, a vasocon-
strictor which raises the blood pressure.
Q: Then high blood pressure may be a consequence of the
initial lesion, rather than the cause. What role does cholesterol
play?
B^ THE ANSWER TO HEART DISEASE? 173
Dr. McCully: Another consequence sometimes associated

with the increased blood pressure is a rise in blood cholesterol.
The original theory was that cholesterol somehow caused the
damage to the artery. Because of the association of high blood
cholesterol with arteriosclerosis, it has been hypothesized for
many years that somehow cholesterol, or the lipoproteins which
carry the cholesterol, damage the artery walls. But this has never
been proven. As a matter of fact, there are many experiments
in which investigators have injected lipoprotein directly into the
arterial wall and it is immediately cleared without any sign of

damage. There's never been any proof that cholesterol, as it is
carried in the blood, actually initiates the lesion.
However, once the lesion is initiated by homocysteine dam-
age, then the blood cholesterol tends to increase.
Q: Then cholesterol and hypertension are associated with
the disease as a result of the initial lesion, but are not the cause
of the lesion?
Dr. McCully: Right. Arteriosclerosis is not an overnight
phenomenon. It is a long-term process that could begin in child-
hood. Arteriosclerosis may be the first clinical sign of a marginal
Bf, Very careful studies have been done in Israel of
deficiency.
the different populations. The bedouin tribes have very little
arteriosclerosis, and their children have practically no arterio-
sclerotic lesions. However, the populations that come from East-
ern Europe have a high incidence of arteriosclerosis, and their
children show early arteriosclerotic lesions.
Q: What is the difference in their diets that contributes to
this difference?
Dr. McCully: The difference is in both animal protein and
animal fats. The bedouin diet is practically pure vegetarian, rel-
few animal products. Being pure vegetarian, it would be
atively
amino acid methionine.
high in B^ and comparatively low in the
Animal protein eaten by the Ashkenazi Jews has two to three
times as much methionine as plant protein, on a weight basis,
and it is relatively lower in pyridoxine. One of the reasons that
it has less pyridoxine is that it is rich in fats. Pyridoxine is a
water-soluble vitamin; the more fat in the diet, the less pyridox-
ine one consumes.
174 THE B VITAMINS
Food processing destroys vitamin B^,. In a diet that is rich

in fats and contains processed foods, there is a very poor intake
of pyridoxine to protect against the large quantities of methionine
that are eaten with the animal products.
Q: What about sugar? Does it contribute to arteriosclerosis?
Dr. McCully: It might. Dr. John Yudkin about 15 years
ago came out with a very important series of epidemiological
studies in which he showed that arteriosclerosis and coronary
heart disease are highly correlated with the consumption of sugar
and refined carbohydrates. Yudkin felt that somehow sugar was
causing the disease. But one could also interpret it in another
way, that populations which consume much of their caloric in-
take in the form of sugar are depriving themselves of pyridoxine.
Q; Is there any laboratory evidence linking homocysteine
to the original lesion?
Dr. McCully: There are several studies revealing that ar-
teriosclerosis develops in animals when they are treated with
homocysteine or methionine. We did some studies in 1970 show-
ing that injecting homocysteine into rabbits produces arterio-
sclerotic lesions.
Then later. Marker and Ross at the University of Washington
in Seattle showed that intravenous infusion of homocysteine into
baboons also produces arteriosclerosis.
The relationship between pyridoxine deficiency and arterio-
sclerosis was discovered by Rinehart and Greenberg in the late
40s, when they showed that monkeys made deficient in vitamin
Bf, rapidly develop atherosclerosis.
Monkeys made deficient in other B vitamins did not develop
it.
At that time, it was not appreciated how significant their

work was because they could not say what the biochemical steps
and the intermediate pathways were which lead to arterioscle-
rosis. What am doing is building on their observations. I'm
1
showing, and published studies have indicated, that the monkeys

deficient in pyridoxine maintained by Rinehart and Greenberg
probably developed arteriosclerosis because they accumulated
homocysteine. And it has been found more recently, both in
I
B^ THE ANSWER TO HEART DISEASE? 175
human volunteers and in animals, that a vitamin B^, deficiency

leads to homocysteine accumulation when large doses of me-
thionine are given.
Q: Could Bf, help reverse the damage to the artery?
Dr. McCully: It is possible. Moses M. Suzman of Johan-
nesburg, South Africa, carried out a study on 17 patients with

coronary artery disease. Animal protein was reduced to approx-
imately one-quarter to one-half of their customary intake and
each patient received 100 milligrams pyridoxine daily with a
potent preparation of vitamin B complex. The patients were
observed for an average of 13 months. All patients claimed a
notable increase in exercise tolerance with complete or partial
relief of angina, a gain in energy and a heightened sense of well-
being. Glucose tolerance increased to almost normal in two of
the patients who were diabetic. This study suggests that the
lesions may be partially reversible with B^,.
Q: Does Bf, have any effect on cholesterol levels?
Dr. McCully: Yes, it does. Rinehart and Greenberg ob-
served that monkeys supplemented with B^, had lower levels of
cholesterol. It has also been shown by other investigators, using
rabbits and other models, that vitamin Bf, deficiency tends to
elevate the blood cholesterol. The other point is that fat metab-
olism is impaired by B(, deficiency so that an animal or a person
who is deficient in B^, is less able to metabolize fats, which then
accumulate in the plasma. So this gives you a direct correlation.
It begins to explain why persons with arteriosclerosis have el-
evated blood cholesterol and other lipids, including triglycerides.

Pyridoxine appears to be necessary for the normal metabolism
of these lipids.
Q: Does stress play an important role in the disease?
Dr. McCully: is not a major factor in arterioscle-
Stress
rosis. Diet is by most important factor. An argument
far the
against stress as a major factor is that Japan, a crowded and
highly industrialized nation, has a very low incidence of the
disease, while Finland, a quiet, peaceful, rural community, has
the highest incidence in the world. During both World Wars,
when the population of Europe was coping with stressful wartime
176 THE B VITAMINS
conditions, meat was scarce, vitamins were not refined out of

the flour and there was a dramatic decrease in arteriosclerosis.
Q: What about physical exercise?
Dr. McCully: There is conflicting evidence about the im-
portance of a sedentary life style and physical conditioning. These
are minor factors which may contribute to decreased or increased

survival but do not by themselves explain the cause of the disease.
Q: What about smoking?
Dr. McCully: Cigarette smoking is associated with a two-
fold to threefold increase in the risk of arteriosclerosis. Nicotine
and carbon monoxide, which are among the 600 to 1,000 toxic
components of cigarette smoke, are probably the atherogenic
substances. It is highly possible, though it has never been proven,
that some of the toxic elements in tobacco may be 85 antagonists.
Many drugs are known to interfere with the utilization of B^,.
The birth control pill is one, and it has been shown that women
who smoke and take the Pill place themselves in double jeopardy.
Q: Bft is found in a great many foods. Why don't we get
enough our diets to prevent homocysteine damage?
in
Dr. McCully: B^ is sensitive to heat and is water soluble.
It is destroyed by the cook, the canner and the food processor.
It is removed from most grains in the refining process. Even
though this vitamin is widely distributed in a variety of foods,

the amount consumed by a weight-conscious population may be
marginal. Foods such as beans, peas, nuts, grains, bananas and
avocados contain reasonable amounts of this vitamin. Meats,
eggs and milk are also good sources, but they contain high levels
of methionine. Hence, someone eating a high-protein diet, while
he needs more of the vitamin to prevent homocysteine formation,
is actually getting less.
Q: Have you made any changes in your own diet as a result
of these findings?
Dr. McCully: Oh, yes. We have cut down considerably on
meat and increased consumption of vegetables, grains and beans.
Grains have half as much methionine as meat. Beans have one-
third as much methionine as meat.

Bft THE ANSWER TO HEART DISEASE? 177
Bear in mind that methionine is a necessary amino acid,

especially important to growth. We can't live without it. What
we must do is strike a good balance between methionine-
containing foods and foods rich in Bf,.
Q: Why do so many older people suffer from

arteriosclerosis?
Dr. McCulIy: For some reason, there is a clear decline of
Bft with age. Also a dramatic decline of Bf, in diabetes, a disease
frequently complicated by arteriosclerosis. This may be due to
inadequate intake, though this has not been proven.
Q: With this theory, many pieces of the cholesterol puzzle
begin to fall into place. For want of a nail, the battle was lost.
Do we have a parallel here?
Dr. McCulIy: The theory illustrates how interdependent
all these processes are nutrition, physiology, biochemistry
and that, if the first event
cascading series of changes is
in a
prevented, then the whole disease can be prevented. The theory
predicts that if one prevents the initial lesion due to homocysteine
effect in the cells of the arteries, one can prevent all the con-
sequences and complications of the disease.
178 THE B VITAMINS
Rating Foods for Heart Health:

The McCully Thesis
Both vitamin and the amino acid methionine
B(,
are essential elements in the diet, and a good balance

between the two may be the answer to preventing ar-
teriosclerosis, according to Dr. McCully. That balance
can be expressed as the ratio of 85 to methionine. A
ratio of 15, for instance, means the food has 15 times
more B^, than methionine. Foods with a high ratio con-
tain a desirably high level of Bf, with a low level of
methionine. Here are the levels of some common foods.
Food Ratio Food Ratio
Bananas 46 Toasted wheat 3

Carrots 15 germ
Onions 10 Beef liver 2
Kale 9 Chick-peas 2
Spinach 7 Corn 2
Sweet 7 Peanuts 2
potatoes Soybeans 2
Asparagus 5 Walnuts 2
Cauliflower 5 Chicken 1
Turnip greens 5 Salmon 1
Broccoli 4 Beef 0.9

Brewer's 3 Mushrooms 0.7
yeast Cod 0.5
Lentils 3 Eggs 0.3
Peas 3
Sunflower 3
seeds
CHAPTER
BeFOR COMMON AND

UNCOMMON AILMENTS
Every vitamin has its Vitamin Bf, will not walk
limitations.
the dog, chauffeur the kids or do windows. But scientists aic
finding that B^, pyridoxine
may do a lot of other things that
might previously have been considered impossible. Research
indicates that vitamin B^ is not only tackling some common med-
ical ailments, but some extraordinarily uncommon maladies as
well.
Gyrate atrophy is about as rare as a disease can get. It is a
hereditary eye disease that may start as tunnel vision when the
cells in theeye begin to degenerate and die. Night blindness can
follow, and cataracts may occur in mid life between the ages of
40 and 60. The disease has been considered incurable, and even-
tually blindness ensues.
"Probably no more than 20 cases of gyrate atrophy have
existed in the United States, and maybe only 50 cases have
appeared in the world's literature," says Richard Weleber, M.D.,
at the University of Oregon health sciences center in Portland.
"But by studying rare diseases, we better understand how the

body works, and we get information on how to help people with
more common problems, too."
179
180 THE B VITAMINS
Together with biochemist Nancy Kennaway, Ph.D., and

pediatrician Neil Buist, M.D., Dr. Weleber has observed a star-
tUng discovery about gyrate atrophy. The scientists have seen
that patients with the curious malady may respond favorably to
high doses of vitamin B^,. Three of their four patients with the
disease have done so.
"Our patients with gyrate atrophy do not have a vitamin Be
deficiency," says Dr. Kennaway. 'They have a vitamin B^ de-
pendency, which means they have inherited defects of the bio-
chemical process which may be modified by large doses of vi-
tamin Be."
Patients with gyrate atrophy all have elevated levels of the
amino acid ornithine in their blood. That elevation occurs be-
cause an enzyme which normally converts ornithine to glutamate
is not working. Dr. Kennaway explains. So the patients' orni-
thine levels are high. Vitamin B^ is a cofactor which works with

the enzyme. Before it can change ornithine into glutamate, the
enzyme needs small amounts of B^ in healthy individuals. But
small amounts of B^ just won't do in some patients with gyrate
atrophy. They need much larger doses of the vitamin before the
enzyme is jolted into action.
Why a Little Bg Isn't Enough

you can't open the door unless you push
"It's like saying
very hard," Dr. Buist told us. "A goodly number of enzymes
within the body require a vitamin cofactor to work. That vitamin
cofactor plugs itself into a very special hole of the protein enzyme
in order for the enzyme to do its because of a hereditary
job. If,
defect, the hole is distorted or misshapen, teensy amounts of the

vitamin, which normally would be sufficient, are not enough.
Therefore, if we flood the system with the vitamin, we may be
able to get the enzyme to work better."
While some gyrate atrophy patients apparently respond to
vitamin B^ therapy, not all of them do. So patients are broken
down into two categories: B^, responsive and B(, nonresponsive.
B. FOR COMMON AND UNCOMMON AILMENTS 181
Even when Bf, responsive, they do not return entirely

patients are
to normal. "But we are certain that vitamin B(, is helping bio-
chemically," Dr. Weleber continues. "After taking B^,, their low
levels of lysine, an amino acid in the body, return to normal,
and by half."
their high levels of ornithine are cut
"Right now, one can only assume that if the biochemical
abnormality can be corrected, the eye damage may be arrested
or slowed," adds Dr. Buist, but it will take several years before
that is known for sure.
"The fact that we have a genetic disease that may be treat-

able in some instances by vitamin 65 is encouraging," says Dr.
Weleber. "It is the best kind of medicine we could hope to find
for treating that kind of disease."
Curing a Rare Disorder

But gyrate atrophy is not the only rare disease that seems
to need large doses of the cofactor vitamin Bf,. Homocystinuria
is a biochemical disorder which is inherited from both parents.
The rare disorder has a number of clinical signs which may

include mental retardation, thrombosis, or clotting, in the arter-
ies and a weakening of the walls of the big arteries to the extent
that they sometimes explode or burst. Homocystinuria also is
associated with osteoporosis, or loss of bone, liver damage and
defective collagen (connective tissue). The collagen abnormality
often surfaces when the lenses of the eyes flop out of place
because of weak ligaments, says Dr. Buist. Again, the Oregon
researchers, like others before them, have observed that some
patients with the disease respond to vitamin Bf, treatment.
"Methionine is an amino acid in the body that is broken
down into homocysteine," Dr. Kennaway explains. "In order
for homocysteine to be changed into something else, another
enzyme has to go to work. But the enzyme is not working nor-
mally in patients with homocystinuria. So their homocysteine
levels start to build up. Their methionine levels escalate, too.
That is another example of an enzyme that needs its cofactor.
182 THE B VITAMINS
vitamin B^, in order to be active. By giving our homocystinuria

patients larger doses of B^, the enzyme apparently works better.
Homocysteine levels drop and, biochemically, some patients seem
toimprove."
While it may be encouraging to think that vitamin B(, may
someday control certain rare, genetic disorders, it is not being
examined solely for that purpose. Scientists around the globe
are linking vitamin B^ therapy to many more common ailments
which may arise for a variety of reasons, including a vitamin
Be-deficient diet.
A researcher from the Netherlands, O. P. van Bijsterveld,
M.D., Ph.D., has found that vitamin Bf, may be an important
nutritional factor in conjunctivitis, an infection of the delicate
membrane which lines the eyelids and covers the eyeballs. Dr.
van Bijsterveld discovered that organisms known to cause con-
junctivitis survived from 30 to 37 percent longer on the con-
junctiva of animals deficient in vitamin Bf,. His research revealed
that the Bf,-deficient animals had a reduced tear flow. Dr. van
Bijsterveld said that the longer survival rate for the infectious
organisms was the result of a decreased tear flow. And the re-
duction in tear flow was due to a deficiency of vitamin B6
(Ophthalmologica).
CHAPTER
B 12 MORE THAN
ANEMIA PROTECTION
Looking for an excuse?

"It's Monday!'' doesn't explain why you're pooped before
you pop out of bed every day of the week.
'Too many things on my mind" doesn't excuse you from
forgetting half of them.
''I don't know where he came from" won't stand up in
court especially when your fender looks like you didn't look
before darting across the intersection.
"Guess we're just not trying hard enough" may not be the
real reason why your family planning isn't going according to
plan.
Maybe, instead of looking for an excuse, you should be
looking for an extra boost of B12.
A superstar in the medical scene, B,2 has had dramatic ef-
fects in the treatment of various nerve-related disorders even
in instances where conventional drugs and therapy have failed.
Unfortunately, the value of vitamin B12 has been sadly shot
down by some members of the medical establishment.
Touted as a treatment for tiredness, B12 was criticized as
being nothing more than a placebo for the well-but-worried hy-
183
184 THE B VITAMINS
pochondriac. If B12 did pep up the tuckered out, they charged,

it did so purely through the power of suggestion.
Tell that to George Richards Minot, M.D., and William Parry
Murphy, M.D.
The Lifesaving Supplement

In 1934, these two Harvard physicians won the Nobel prize
for discovering the lifesaving properties of vitamin Bi:. Actually,
it wasn't until years later that B12 was isolated. But these men

found that, by eating large amounts of liver a food that is par-
ticularly high in B12
formerly hopeless patients with pernicious
anemia could be saved. Their findings spared some 10,000 lives
each year in the United States alone!
And just look at the symptoms associated with this deadly
disease; fatigue, weakness, unsteadiness, numbness and needle-
and-pin sensations in the legs, breathing difficulties, weight loss,
loss of memory, inflammation of the tongue, abdominal discom-
fort, chest pains. It's hard to believe that a deficiency of one
vitamin can cause all these symptoms. But when you consider
what an important part 8,2 plays in the role of the central nervous

system and what an intricate part the nerves play in total body
function then it's easy to understand what B12 means to our
health and well-being.
What's more, a report in the Journal of Nutrition indicates
that a B12 deficiency can induce a thiamine (vitamin B|) defi-
ciency even when dietary thiamine levels are normal. And since
thiamine is another key nerve vitamin, it's doubly important to
keep up our intake of B12.
After all, your deficiency may not be serious enough to put

you 6 feet under but it may be just enough to keep you down
in the dumps.
In Orthomolecular Psychiatry for example, H. L. Newbold,

M.D., a New York City psychiatrist, describes one case in which
a 33-year-old patient came to him complaining of lethargy and
depression. The young man was concerned because he was un-
able to complete work on his Ph.D.

B,: MORE THAN ANEMIA PROTECTION 185
He had trouble dragging himself out of bed and to class in

the morning. In class, he couldn't bring himself to participate in
group discussions. And it was becoming increasingly impossible
for him to comprehend or remember what he read.

Worst of all, he felt lonely, insecure and isolated. Two years
earlier, he had had a nervous breakdown which resulted in mar-
ital problems. And since that time, he had been subsisting on
Thorazine, a powerful and commonly used drug in the treatment

of psychiatric problems.
After running a series of laboratory tests, Dr. Newbold started
the young man on injections of vitamin B12. Two injections

and two weeks later, the patient returned markedly improved.
He commented that his memory was much better and that he
was learning well.
In fact, for the first time in two years, he was hard at work
writing his Ph.D. thesis.
Back from Insanity

Dr. Newbold isn't the only one who believes that in certain
cases B|2 may take the place of the psychiatrist's couch. Two
Canadian physicians associated with McGill University and Jew-
ish General Hospital in Montreal report dramatic results with
B|2 in the treatment of a severely psychotic 35-year-old patient
(Diseases of the Nervous System).
The patient's problems apparently began two years before
hospitalization with severe depression, decreased sexual drive
and slowed reflexes. In time, his symptoms progressed to the
point where he couldn't sleep or remember relatively recent
events. He hallucinated voices. And he displayed generally
manic-depressive behavior.
Thorazine, and even electroconvulsive therapy, did not
produce very encouraging results.
The next line of attack was nutritional.
Nine years earlier, the patient had undergone stomach sur-
gery, a situation which frequently leads to a vitamin 8,2 defi-
ciency due to malabsorption. So the physicians tested for nu-

186 THE B VITAMINS
tritional deficiencies. Surprisingly, his B12 level fell in the normal

range. But with no other game plan in mind, they decided to
give it anyway.
a try
The results were even better than anyone had hoped for.
Eight days after B12 therapy had begun, the patient was released
from the hospital with complete remission of his symptoms.
Striking a nerve with a vitamin B12 deficiency doesn't nec-
essarily mean you'll be looking for a psychiatrist. You could be
seeing an ophthalmologist.
According to Dwight Stambolian, M.D., and Myles Beh-
rens, M.D., of Columbia University, the optic nerve can also be
adversely affected by a deficiency of this important vitamin.
A 17-year-old boy had difficulty reading for three weeks.
He also had trouble making out approaching cars. He had no
headache or pain and no apparent neurological symptoms. But
new glasses failed to relieve his problem.
Upon closer examination, the physicians noticed an old sur-
gical scar on abdomen. Apparently, the boy had had a portion
his
of his small intestine removed when he was four weeks old
again the type of surgical procedure which predisposes to a B 12
deficiency.
So no one was really surprised when a series of B12 shots
and the addition of B complex to his daily diet managed to reverse
the boy's visual defect (American Journal of Ophthalmology).
B12 Shortage Reduces Fertility

Interestingly enough, B12 has made headlines in an area
which at first doesn't seem to have any relation to the central
nervous system fertility.
Speaking at a conference on nutrition and reproduction, held
at the National Institutes of Health in Bcthesda, Maryland. Jo
Anne Brasel, M.D., noted that some women who cannot con-
ceive and for whom no medical reason can be found may be
deficient in vitamin Bn.
B,. MORE THAN ANEMIA PROTECTION 187
Moreover, documented evidence has shown that conception

leading to the birth of a normal infant may occur within a few
short months of B12 therapy.
Dr. Brasel, who is the former director of the division of
growth and development at the College of Physicians and Sur-
geons, Columbia University, discovered repeated references to
this link while researching the impact of malnutrition on repro-
duction. These studies
many of which have been published in
British medical journals
do not explain why 6,2 has such an
effect on fertility. ''But," says Dr. Brasel, "it is interesting that
the infertility may precede, by years, overt clinical evidence of
pernicious anemia."
And this bit of information is not for women only. "Fur-
thermore," she adds, "semen and sperm abnormalities have
been noted in males with pernicious anemia. There is one spec-
tacular case in which B12 therapy led to return to active partic-
ipation in sheep shearing by one 73-year-old Australian sheep

herder and pregnancy in his 37-year-old wife."
An Indian study supports this idea. Semen samples taken
from vegetarians (the avoidance of all meat and animal products
can lead to a B 12 deficiency) and nonvegetarians were tested for
B12 levels and sperm count.
Not surprisingly, the semen samples that lacked sperm had
much lower B12 levels than those samples with normal sperm
counts {Andrologia).
But just how common is a vitamin B12 deficiency?
And how safe is the medicated American? Various studies
have demonstrated that low blood concentrations of B12 can
result from treatment with a number of drugs
including the
ever-popular birth control pill.
The 48-year-old executive who had to undergo stomach sur-
gery to take care of a bleeding ulcer falls into a similar category.
Physicians have long recognized that stomach or intestinal sur-
gery often interferes with the body's production of stomach juices.
It is in these gastric secretions that the intrinsic factor exists
which combines with B,2 to aidits absorption. Without the in-
trinsic factor, a B12 deficiency can develop despite a meaty diet.

188 THE B VITAMINS
Now, seems, surgical patients aren't the only ones who

it
are lacking the intrinsic factor.Myron Winick, M.D., director

of the institute of human nutrition, college of physicians and
surgeons, at Columbia University, has warned that as we get
older we may all face the same threat.
The Older We Get,

the Greater Our Need
Aging causes changes in the gastrointestinal system which
include a reduction of hydrochloric acid secretions. Dr. Winick
explains.
''Since hydrochloric acid in the stomach may not be secreted
properly and the intrinsic factor may be low, the elderly may be
more prone to anemia because of poor iron absorption and poor
absorption of vitamin B12," the noted authority comments (Jour-
nal of the American Pharmaceutical Association).
In the more serious cases of vitamin B12 deficiency like
pernicious anemia B12 injections are preferred over oral sup-
plementation. That way the vitamin bypasses the malabsorption
problem in the stomach and goes directly to the depleted body
tissues.
However, in most cases, a B12 deficiency can be offset
and a low B12 level
boosted back up to par with a high dietary
intake of the vitamin.
Don't make excuses for missing out on your share of B12.
It could save you from making a lot of excuses concerning your
health.
CHAPTER
Bi2FOR HEALTHY
NERVES AND BLOOD
Something was terribly wrong.

About a month earher, she'd begun to notice the first dis-
turbing signs: a growing numbness in both legs, especially the

left one, and a tendency to stumble to the She just couldn't
left.
walk straight. She'd developed an embarrassing, ducklike wad-

dle, with her legs spread wide, because if she didn't waddle she'd
lose her balance.
What on was the matter? Searching for an answer, she
earth
scoured her memory, again, for a clue. But there wasn't any!
She was in good health, 35 years old, not taking any medications,
and had not other physical problems at all. She'd had no serious
illnesses in her life, and no operations.
What worried her most was that it seemed to be getting
worse.
When she was examined by doctors at a nearby hospital,
they seemed equally perplexed. Her muscle strength, tone and
reflexes were normal. Her cranial nerves, brain scan, cerebro-
spinal fluid and chest X ray were normal. Blood tests also seemed
normal.
189

190 THE B VITAMINS
So what was wrong with her? Was she crazy? She didn't
think so, yet her condition continued to worsen after that first
visit to the doctor. She seemed to be losing control of her legs.
She started having spasms in her thighs.

Then, two weeks after her first visit, her doctors tried some-
thing else. They tested a blood sample for levels of folate (folic
acid) and vitamin B12. And at last they found something that
wasn't normal: Her B12 levels were depleted severely.
The young woman was given an injection of vitamin B12
1,000 micrograms and for the first time since it all started, she
began to feel better. In a week, she felt much better. Two months
later, after receiving injections totaling 3,000 micrograms of vi-
tamin B12, all her symptoms had vanished.
The young woman's story, later reported in the South Af-
rican MedicalJournal (AprW, 1981), illustrates some of the thank-
less but essential chores vitamin B,2 is forever performing inside
our bodies, chores we rarely notice until they're left undone. B12
works tirelessly keeping our nerves and blood in shape, main-
taining healthy growth and even playing a role in the synthesis
of DNA, the genetic blueprint you pass along to your children.
The abnormalities in her blood and the neurological signs
the numbness, unsteadiness and muscle spasms had made the
woman's doctors begin to suspect that a B12 deficiency might be
the key.
They knew that, because of its role in building the protein
sheath that surrounds the nerve fibers and the spinal cord, a B12
deficiency can result in a slow deterioration of the nervous tissue.
And that begins to show up as numbness or prickly sensations
in the extremities, burning feet, forgetfulness, depression and
other mental problems. The doctors noted why adequate supplies
of B|2 are so important: "The peripheral nerves may recover
completely (from the deficiency), but the spinal cord is slow to
regress and residual damage may persist."
B|2 is also a supervisor in the red blood cell production
department, which has to keep them rolling off the assembly line
at about 200 million a minute. A 6,2 shortage there results in
B,. FOR HEALTHY NERVES AND BLOOD 191
bloated, misshapen cells, unable to carry oxygen (their main job

so you wind up getting pale, tired and anemic.
in life),
Alan Gaby, M.D., a nutrition-oriented doctor, points out
that Bi2 injections have been used to treat fatigue, pains that
follow shingles, hepatitis, nerve damage associated with diabe-
tes, bursitis of the shoulder and a host of psychiatric problems.
Adds Robert Donaldson, M.D., professor of medicine at Yale
University and chief of medical services at Westhaven Veterans
Administration Hospital in Connecticut, 'it's well known that
many deficient patients get B12 injections because it seems to
make them feel better, and it has no adverse side effects.''
Vitamin B12 and its chemical cousins, known to scientists
as cobalamins because they contain tiny amounts of the metal
cobalt, are remarkable substances indeed. But if B12 is such a
hot ticket, how come you don't hear all that much about it?
For one thing, the body needs only the tiniest amounts of
vitamin B12 to function properly: The Recommended Dietary
Allowance is 3 micrograms a day, or {hree-niillionths of a gram.
For another, most people have up to a thousand times that amount
squirreled away in their bodies.
So what's the problem? For
most people, there isn't one.
But, warns Michael F. Murphy, M.D.,ofSt. Bartholomew's Hos-
pital in London, ''As the public becomes more concerned with
diet and the numbers of vegans [those who eat no food of animal
origin not even eggs or dairy products] and other vegetarians
seem to be increasing, it is most important that the risk of vitamin
B|2 deficiency recognized and complications of deficiency be
is
prevented" (Annals of Internal Medicine, January, 1981).

The reason for Dr. Murphy's concern is that, with a few
exceptions, vitamin B12 occurs only in foods that come from
animals. It's one of nature's little mysteries: Though the co-
balamins are among the most complex molecules found any-
where in nature, the only creatures who have figured out how
to make them are bacteria and other lowly microorganisms. An-
imals, in various ingenious ways, can absorb B12 from them. But
plants can't.

192 THE B VITAMINS
Most vegetarians can around the problem by including

get
milk, cheese or eggs in their diets, but strict vegans can get into
real trouble if they're not careful. (There are some nonanimal
B|2 sources, such as tempeh, a fermented soybean food that's
inoculated with a B|2-brewing mold.)
Strangely enough, vast of
busy, cobalamin-
colonies
producing bacteria live right in your digestive tract; they're prob-
ably whipping up B12 from your last meal right now. Trouble is,
there's only one spot in that whole maze that can absorb B12
and it's in the small intestine, upstream from the place where
the vitamin is manufactured. So, as a result, all the home-brewed
vitamin your body produces is swept out with the trash. You've
got to obtain it somewhere else.
Beef liver is the single best source of cobalamin, as it is for
so many other things. Other good source are fish (such as mack-
erel, haddock and salmon) and dairy products.
CHAPTER
UNSUSPECTED
Bi2 DEFICIENCIES
This is a fictitious story, yet it has happened a thousand
times. We're telHng it in hopes that you or any of your family

will not become case number 1,001.
Mrs. Martin's daugnter was worried. Her mother seemed
to have aged 10 years in the last 18 months. When she was 75,
most people took her to be a well-weathered but healthy 65.
Now, she was 77 going on 87.
"I hate to say it, but my mother's mind seems to be slipping.
It's like she's somebody else, somebody strange," the daughter
. . .
told the internist. She went on to describe the personality de-

terioration her mother had experienced recently, the moodiness,
forgetfulness, gradual withdrawal and sometimes even moments
of irrational fear. "What's happening? Is it senility? She seemed
so alert, so healthy just a couple of years ago. Could her age be
catching up with her so suddenly?"
The internist carried out a careful examination of the mother
and found nothing very remarkable except that Mrs. Martin seemed
to be free of any major physical disease. Emotionally, though,
she was apparently going through a kind of depression. And there
are drugs, of course, for that.
193
194 THE B VITAMINS
Her daughter timidly brought up the question of vitamins,

particularly vitamin B12. Wasn't there something
special, she
wanted to know, about vitamin B12 for older people?
The doctor brushed aside her question with a remark about
the general uselessness of vitamins and said she should be grate-
ful that her mother was not suffering from circulatory or kidney
disease, the way so many other older people were.
Finally, on the daughter's insistence, the internist agreed to
run a test of Mrs. Martin's B12 status. Results? ''Absolutely
normal. A little below the average, but nowhere near deficiency.
You can do whatever you want, of course, but you'll be wasting

your money. And I think your mother's medical bills are high
enough already, don't you?"
Mrs. Martin's daughter could only sigh and shake her head.
For a while, she had been so hopeful that 8,2 might help. Her
own daughter, a nurse, had showed her a textbook describing
some of the symptoms of B12 deficiency, and several of them
had seemed so close to her mother's: mood changes, forgetful-
ness, mental confusion, depression. But then, she realized that
many things could cause such symptoms. And the text did say
that B|2 deficiency was usually found in people following strict
vegetarian diets, alcoholics and people with histories of stomach
or gastrointestinal surgery. Her mother fit none of those cate-
gories, so it seemed that the only thing to do was to accept the
fact that her problem had nothing to do with vitamin B12 ^just
as the test had indicated.
And there the story ends, just as it has for thousands of
other ailing people who have been given vitamin B12 tests and
told that their levels of the vitamin so crucial for maintaining
a healthy nervous system were normal.
The big newsmust now be shouted out from the roof-
that
tops of medical centers, nursing homes and mental institutions
is that the test most often given for B,. deficiency has been
revealed to have about as much diagnostic reliability as a carnival

fortune teller.
Actually, serious suspicions about the test, known as the

radiodilulion assay method for measuring for B12 levels, arose
UNSUSPECTED Bn DEFICIENCIES 195
some years ago. The trouble is that, in our blood along with true
vitamin B12 which, of course, is biologically active, there are a
number of extremely similar substances or analogs which have
little or no value when it comes to protecting the nervous system
and building healthy blood cells. The commercial B12 test, un-
fortunately, can't tell the difference between real vitamin B12 and
the "wooden nickel" versions. It lumps them all together and
reports relative wealth where nutritional poverty exists. To make
matters worse, in the early stages of vitamin 3,2 deficiency, only
the true vitamin B12 falls while the analogs may still be relatively
high, making it almost impossible for this test to alert physicians
to imminent danger.
What's really new in the B12 story is not that the test lacks
reliability, but that the lack is extensive. In the words of words
of two physicians reporting in the Journal of the American Med-
ical Association (October 24, 1980), the test is "totally ineffec-
tive." Kenneth L. Cohen, M.D., and Robert M. Donaldson, Jr.,
M.D., of the Yale University school of medicine and the West
Haven, Connecticut, Veterans Administration Hospital, screened
352 patients using the standard commercial vitamin B12 test.
None of the patients were reported by the test to have a vitamin
B12 deficiency. Realizing only too well that they had not uncov-
ered an epidemic of health, the doctors selected 52 persons whose
B12 measurements were in the lower half of the normal range
and were able to get 42 of them to come in for retesting. Of this
group, 36 percent were found to have abnormally low vitamin
B|2 levels when the standard test was modified!
Dr. Donaldson told us there is currently available a test (a
bioassay measurement) which considered quite reliable in test-
is
ing for B12. The trouble is that it is expensive and impractical.

He and Dr. Cohen, however, modified the radiodilution test to
make it more reliable. Both doctors advise their colleagues to
find out what kind of test is going to be performed on blood
samples they send out for B12 testing. If the commercial kit is
being used, they should carefully review all cases of nervous-
system and mental disturbance, as well as anemia, unless they
are sure the cause is something other than vitamin B12 deficiency.
196 THE B VITAMINS
Although there is a popular notion that B 12 is a "pep vita-

min," deficiency of the vitamin can cause serious, even irre-
versible, damage including death from pernicious anemia. Failing
to detect a deficiency is serious business. Consider this example
from J. Fred Kolhouse, M.D., and colleagues at the University
of Colorado medical center. Dr. Kolhouse pioneered in the dis-
covery of the shortcomings of B12 tests.
A 44-year-old woman entered the hospital with a four-month
history of pain in her knees and elbows and tingling sensations
in her hands and feet.
Although her mental state was considered normal, tests re-
vealed nerve problems in her hands and feet. Such nerve prob-
lems are one symptom of B12 deficiency. However, when a de-
ficiency test was run, her B12 seemed to be perfectly normal. So
instead of taking the nutritional approach, surgery was per-
formed on her hands. The surgery turned out to be perfectly
useless.
Seven months later, the women entered the hospital again,
this time on the verge of being a vegetable. She couldn't walk
and had no control over her bowels and bladder. She was in a
constant stupor and did not know where she was. Again the
same Bi2-deficiency test was given. Again it said "no problem."
A few days later, the doctor discovered that the woman had a
form of anemia associated with B12 deficiency. Further studies
with a different kind of B12 deficiency test confirmed the diag-
nosis. Injections were begun immediately, and she improved
slightly. But six months later, she still needed a walker to get
around, and her intellect and memory were still impaired. There
is a good chance, doctors noted, that the nerve damage created
by the B12 deficiency will never be overcome (New England

Journal of Medicine).
Not every nervous disorder can be treated with B12, but we
know that many such patients become human guinea pigs for an
almost endless series of tests, psychiatric treatments, drugs and
shock therapy. So why shouldn't vitamin B12 (as well as other
B vitamins, since they're all important to the nerves and mind)
be tried along with all the other experiments? Some doctors
UNSUSPECTED B,. DEFICIENCIES 197
object to giving multiple vitamin supplements because it's "shot-

gun therapy/' But shotgun therapy is preferable to '"machine-

gun therapy" which is what one drug after another is. And a
number of drugs also interfere with B12 absorption, including
certain medications for high blood pressure, tuberculosis, Par-
kinson's disease, gout and excess cholesterol. Alcohol also ad-
versely affects B12 absorption, just as it does the absorption of
other B vitamins.
If you have a history of stomach surgery or are taking drugs
and have any reason to suspect a B12 deficiency, you should

certainly discuss that situation with your physician. In general,
though, older people are the ones most likely to be deficient.
Because the most widely used Bi2-deficiency test is so un-
reliable, it's difficult to say how many older people are actually
deficient or on the verge of being deficient. But we can get some
indication from a study published by three doctors from Denmark
(Acta Medica Scandinavica). These doctors used a very reliable
microbiological B12 test to measure levels of the vitamin in 349
patients admitted to a geriatric center. Low values of vitamin
B|2 were found in one out of every three of these patients. Dr.
L. Elsborg and colleagues urged other physicians to study B12
levels in older patients much more frequently than it is now done
and to treat deficiencies before they have turned into major med-
ical problems.
you rarely eat meat, don't like liver and eat a lot of noo-
If
dles, rice, potatoes and vegetables, you should do something to

protect your B12 status.
One common-sense step is to make sure your vitamin B
supplement contains B12. Since it is inexpensive and safe, there
is almost no need to worry about taking too much. The important
thing about B12 is to be sure.

CHAPTER
FOLATE, THE GOLD IN i
THE COOKING WATER
Vegetables are the most important dietary source of folate

(folic acid), a member of the B-complex family of vitamins. Fo-
late is essential for a host of functions inside our bodies, including
maintaining the integrity of the blood and the nervous system.
Yet, you'll find precious little of it in meat or in fish or eggs or
milk and other dairy products. So there's a lot of wisdom in that
old entreaty "eat your vegetables"! Ironically, though, there's
evidence that mother's best efforts to nourish us may have been
compromised, depending on how long and how hard she cooked
those vegetables.
Fresh cauliflower cooked for as little as 10 minutes in vig-
orously boiling water loses 84 percent of its folate, Joseph
Leichter, Ph.D., and two co-workers at the University of British
Columbia's division of human nutrition in Vancouver report.
Other vegetables fared little better, with substantial portions of
their folate content leaching into the cooking water. Broccoli lost
69 percent of its folate, spinach 65 percent and cabbage 57 per-
cent. Only asparagus and Brussels sprouts came through the
cooking experience relatively unscathed, parting with just 22 and
28 percent of the folate, respectively (Nutrition Reports
International).
198
FOLATE, THE GOLD IN THE COOKING WATER 199
"The boiling of vegetables for 10 minutes in a salt solution

was chosen because it is close to the usual circumstances of food
preparation and consumption at home/' the Canadian research-
ers note. "With the exception of asparagus and Brussels sprouts,
the cooking water contained more folate than the cooked veg-
etables. This and other studies indicate that the loss of folate
from vegetables during cooking is caused by extraction of the
vitamin into the cooking water rather than by destruction."
What about microwave cooking? A recent study indicates
that folate losses are even greater
an ominous finding given the
ever-increasing trend toward microwave heating, both in restau-
rants and at home.
According to Rayna G. Cooper, R.D., various forms of fo-
late are destroyed at markedly different rates during microwave
heating. But one of the forms found in high concentration in
foods (and, interestingly, in human blood also) is the most rapidly
destroyed.
Dietitian Cooper, who was formerly associated with Mira
Loma Hospital, Lancaster, California, found that this form of
folate was 90 percent obliterated after 28 minutes inside a mi-
crowave oven set at 212F, whereas the same destruction re-
quired 65 minutes of conventional heating at the same temper-
ature (Journal of the American Dietetic Association).
Even microwave heating at a lower temperature (187F) re-
sulted in quicker destruction of folate than conventional cooking
at 212F.
So much for folate's ability to squeak past the perils of the
kitchen. Now add the fact that as much as half of ihe folate in
a normal diet may not be fully absorbed by our bodies because
of digestive enzyme insufficiency, and you begin to sense the
magnitude of the problem.
Sunlight Destroys Folate

There's even some evidence that oridinary sunshine can
deplete our folate stores. Researchers at the University of Min-
200 THE B VITAMINS
nesota have discovered that, when samples of human blood are

exposed to strong sunlight, they lose 30 to 50 percent of their
folate in about an hour (Science).
Of course, in real life we have several layers of skin shielding
our insides from the sun. But that protection appears less than
total. The same scientists found that some patients who had been
undergoing lengthy ultraviolet light treatments for skin problems
had unusually depressed levels of folate circulating in their
bloodstreams.
The Minnesota researchers point out that many tropical pop-
ulations suffer a high incidence of severe anemia, infertility,
dangerous birth complications and other folate-deficiency prob-
lems. And excessive sunlight exposure may aggravate that
situation.
Those of us in better-fed,more temperate nations don't face
those kinds of risks. But there is evidence that marginal amounts
of folate in the diet are catching some people unawares.

For example, M. I. Botez, M.D., and co-workers at Mon-
treal's Clinical Research Institute report a number of cases of
central-nervous-system abnormalities linked to folate deficiency
(Archives of Neurology).
Folate and the Nervous System

In one instance, a 62-year-old woman was hospitalized be-
cause of weakness in both legs. For the previous 13 years, she
had complained of burning feet, cramps and tingling feelings in
her limbs. Examination revealed some loss of sensation and sen-
sitivity to pain in both legs, which were now partially paralyzed.
There was also evidence of spinal-cord degeneration.
This woman had low blood folate levels, and she admitted
that she had not eaten fresh vegetables for many years. Because
of the extremity of her situation, doctors began giving her 15
milligrams of supplementary folate a day by mouth along with
periodic injections far in excess of the estimated daily require-
ment of about 400 micrognxms or 0.4 milligrams. Within two
months, symptoms started to abate. After 12 months, she was

almost walking normally.
Another woman, age 76, suffered with lightning stabs of pain
along with episodes of numbness during the night symptoms
which awakened her nightly without fail. She was unable to walk
alone. Supported by two people, she could manage a few steps.
Standing with her eyes closed, she would lose her balance.
Because of allergic migraine headaches, this woman had not
eaten fresh vegetables or fruits since she was 14 years old. Eight
weeks after beginning to take daily folate supplements, she was
able to walk alone with the aid of a cane. After nine months,
she didn't need the cane.
No wonder the authors speak of folate's "spectacularly ben-
eficial effect."
Dr. Botez believes there may also be a correlation between
lack of folate and a condition known as the restless legs syndrome
in pregnant women. Those afflicted with the syndrome complain
of creeping, irritating sensations in the lower legs, which can
often be relieved by walking or moving.
For one thing, estimates of folate deficiency among ex-
pectant mothers run as high as 60 percent. And restless legs
often occur in the late stages of pregnancy just when folate de-
ficiency most pronounced. When Dr. Botez and an associate
is
examined two groups of pregnant women, they found that 8 out

of 10 not receiving supplemental folate had restless legs syn-
drome. But only of taking folate had the problems (Nutrition
1 1 1
Reports International).
When three women with severe restless legs syndrome were
given 10 milligrams of folate daily, their symptoms disappeared
after eight days.
Folate Foils Senility

As you may have guessed from its central-nervous-system
role, folate is especially concentrated in the fluid of the spinal
202 THE B VITAMINS

column the switchboard of the central nervous system that
relays messages between your brain and body.
Dr. Botez has found that many of the signs of approaching
senility may actually be caused by a folate deficiency "short-
circuiting" the nervous system.
Speaking to an annual meeting of the Royal College of Phy-
sicians and Surgeons of Canada, the neurologist reported that
four of his patients complained of fatigue, weight loss, insomina
and severe constipation. They also had cold, numb legs and poor
reflexes. Testing them. Dr. Botez found that they had low blood
levels of folate. He started them on supplements and injections
of this vitamin. After three months of treatment, their subjective
symptoms disappeared, they gradually put on weight and their
reflexes normalized. These improvements coincided with rises
in the concentration of folate in their blood (Clinical Psychiatry
News).
These patients, who had been under psychiatric care for an
extended period and had been unresponsive to various medi-
cations taken before the study, did not know they were receiving
folate, Dr. Botez told the meeting.
In Scotland, ten elderly patients
five of them diagnosed as
senile
had nervous-system disorders so severe that their spinal
cords were thought to have degenerated. Upon closer investi-
gation, they were found to be folate deficient. Folate treatment
led to an improvement in mood of all of the patients. The con-
dition of two patients with severe mental illness was "dramati-
cally resolved" (British Medical Journal).
Vital to Newborn
Now let's trace folate back from the nursing home to the
nursery. For folate is vital not only in ensuring the health of an
adult's nervous system, but also in protecting the health of a
newborn. To find out why, let's take a look at genes.
Genes are found every cell and are responsible for passing
in
down physical and biochemical traits from generation to gen-

eration. Every living thing, from the mighty whale to the tiniest
amoeba, is built up from a blueprint of genes. Tall or short; small-
boned or heavyset; blond, brunet or redhead genes make us
what we are.
And it is folate that makes genes what they are.
When scientists make a diagram of the complex metabolic
pathways that create a chemical substance, such as a gene, out
of folate and other nutrients, the drawing often looks to a layman
like a map of the New York City subway system as finger painted
by a two-year-old. So without going into the somewhat mysti-
fying details of how folate helps to produce a gene, let's just say
that it's a critically important contributor to gene formation.
Without folate, the "blueprint" of a gene could not be designed
with any accuracy; the "building" built up from such a blueprint
would be a shambles. Tragically, this sometimes happens.
Scientists examined 805 women in early pregnancy. Low
folate levels were found in 135. Among these women, the fre-
quency of malformations among their offspring was four times
greater than among the 670 women whose blood levels of folate
were normal (South African Medical Journal).
In a study of 35 mothers whose children had birth defects,
23 of the mothers had abnormal folate metabolism (Lancet).
In a South African study, 57 percent of the children born
to mothers who were severely deficient in folate during preg-
nancy showed abnormal or delayed development (Nutrition Re-
ports International).
Lower Resistance
A Massachusetts Institute of Technology (MIT) scientist,
Paul M. Newberne, D.V.M., Ph.D., has suggested that even a
marginal deficiency of folate in a mother-to-be could severely
hinder her child's ability to fight off disease later in life. In lab-
oratory tests, offspring of mother animals fed diets with marginal
amounts of folate were less able to overcome a common food-
204 THE B VITAMINS
poisoning bacterium than rats whose mothers received adequate

amounts of folate {Technoloiiy Review).
Besides causing a greater chance of birth deformities or
slower development in the child, folate deficiency also creates
a greater likelihood that the mother will develop:
toxemia of pregnancy,
abruptio placentae (premature separation of
the placenta from the wall of the uterus),
anemia.
The most marked symptom of a severe folate deficiency is
megaloblastic anemia. In this anemia, red blood cells become

megalohlastoid. They are too large, oddly shaped, and have a
very short life span. Robert L. Gross, M.D., formerly of the
department of nutrition and food science at MIT and currently
practicing in San Francisco, found that, in folate deficiency, the
cells responsible for fighting infection also become megaloblas-
toid and lose their ability todefend the body against viruses and
bacteria. This inability is reversed by folate treatment {American
Journal of Clinical Nutrition).
But you don't have to be newborn, long ago born or pregnant
for a folate problem to hit you like a ton of bricks, suggest William
E. Thornton, M.D., and Bonnie Pray Thornton, R.N. The Thorn-
tons, formerly associated with the Medical University of South
Carolina in Charleston, report evidence of a relationship between
lack of folateand forgetfulness, apathy, irritability, disturbed
sleep, depression and even psychosis {Journal of Clinical
Psychiatry).
The two investigators concluded, after examining the rec-
ords of 269 patients hospitalized for psychiatric problems, that
the mentally disturbed were more likely to have low levels of
folate than were normal individuals, regardless of sex or age.
Since dietary surveys revealed that the disturbed patients
were consuming reasonable amounts of folate, it may have been
that some inner problem of metabolism was responsible. Such
individuals might need folate in extra-large amounts.
Can folate deficiency affect the brain in more subtle ways?
To find out. Dr. Botez and another researcher kept a group of
young on a folate-deficient diet for three weeks. Then, one

rats
at a time, the animals were placed in a special box. To avoid
being subjected to a mild electric shock, the rats had to learn to
recognize a warning signal (in this case a light) and escape to
the safe corner of the box.
Those animals deprived of folate required significantly more
trials than folate-fed rats before they learned to associate the
light with impending shock and take appropriate action (Tohoku
Journal of Experimental Medicine).
Such results suggest that "folate deficiency could be re-
sponsible for a deleterious effect upon the growing nervous sys-
tem," the Montreal researchers warn.
Eat Your Vegetables and

Save Your Cooking Water
Given folate's well-documented susceptibility to destruction
between farm and fork, how can you still be sure you're getting
enough of this essential nutrient?
Vegetables, despite their potential vulnerability to having
folate hijacked in the kitchen, remain the best source provided
you take certain precautions.
Brussels sprouts, you'll recall, come through the cooking
process with flying colors as far as their precious folate cargo is
concerned. According to Scottish researcher J. D. Malin of the
University of Strathclyde Glasgow, that's because Brussels
in
sprouts, being dense and compact, have a relatively small surface
area. There's less opportunity for folate to leach out into the
cooking water.
At the same time, Brussels sprouts are exceptionally rich
in vitamin C (as much as 140 milligrams in V/2 ounces of sprouts),
which protects the folate from oxidative destruction.

According to Malin, "An average helping of sprouts could
provide almost half of the average daily intake of total folate"
for many people {Journal of Food Technology).
206 THE B VITAMINS
If Brussels sprouts are not to your taste, other vegetables

can be excellent sources, provided you don't overcook them.
"Cooking vegetables for a shorter time would reduce folate loss,"
Dr. Leichter of the University of British Columbia told us. "And
using less water would definitely decrease the amount that leaches
out."
A cup of cooked spinach supplies 164 micrograms; a cup of
cooked beets 133 micrograms. But be sure to keep cooking water
and cooking time to a minimum.
Better still, try eating more vegetables in their raw state.
Tables compiled by the U.S. Department of Agriculture (USDA)
indicate that romaine lettuce, parsley, broccoli and collard greens
all provide more than 100 micrograms of folate per 3'/2-ounce
portion when served raw (Journal of the American Dietetic

Association).
Another suggestion: Use your leftover cooking water for
steaming rice or, as Dr. Leichter suggests, add it to soups and
stews. That way, whatever folate is leached into the water will
be regained.
Grains in the diet can supply some additional folate, but
here wholeness is the key: V/i ounces of whole wheat flour
contain 54 micrograms of folate; the same amount of white flour
contains less than half that amount. Toasted wheat germ is an
outstanding source. A-ounce serving provides 120 micrograms.

1
We mentioned that meat is a poor provider of folate. Liver

is an exception to that rule, however. A 3 -ounce serving of cooked
liver contains about 123 micrograms.

A real sleeper in the folate sweepstakes is black-eyed peas.
USDA scientists consider them a better source of folate than
even liver or wheat germ, since a normal 6-ounce serving supplies
about 230 micrograms (Journal of Food Science).
Probably the surest way to meet your folate requirements
on a day-to-day basis would be to take this vitamin in supplement
form. If you're already taking a B-complcx formula, check the
label for folate (or folic acid). Be sure it doesn't skimp. Remem-
ber that the normal adult RDA for folate is 400 micrograms.
One final thing to keep in mind: Researchers at the Uni-

versity of Cahfornia at Berkeley have found that zinc deficiency
interferes with the intestinal absorption of some forms of folate.
Among a group of six healthy male volunteers, such reductions
averaged 53 percent (Federation Proceedings). So don't let a
zinc oversight undermine your folate quest.
And if "eat your vegetables'' is a plea you've always ig-
nored, try substituting ''take your folate." Either way, you'll be
helping yourself immeasurably.
CHAPTER
FOLATE: A WOMAN'S
BEST FRIEND
"Diamonds," goes the song, "are agirPs best friend." Now,

while we're not songwriters, we respectfully suggest that, if fo-
late were substituted for diamonds, the song might be even more
true.
For folate is a nutrient of extraordinary powers. From your

head to your toes literally you need folate to keep you func-
tioning at peak performance, especially if you're a woman.
As far as your whole body is concerned, a serious folate
deficiency could result in severe anemia. You'd feel weak and
weary, and your skin might take on an ashen pallor.
The use of oral contraceptives has been implicated in such
folate deficiencies.The case of a 29-year-old executive illustrates
the point. She was admitted to a hospital because of pounding
pulse in her ears, easy bruising, fatigue and a sensation of weak-
ness. Diagnosed initially as having an inflamed gallbladder and
gallstones, she had her gallbladder removed.
After her operation, she was found to have not only anemia,
but also hemorrhages in the retina of her right eye. Apparently,
no one had ever asked if she was taking the Pill, but finally a
physician discovered she had been taking it for three years.
208
FOLATE: A WOMAN'S BEST FRIEND 209
As the physician in charge noted, "The contraceptive was

stopped and the patient was started on oral fohc acid [folate]
.... She was subsequently followed as an outpatient, and on
continued folate therapy her blood counts and morphology have
normalized and the retinal hemorrhages have disappeared'' (Min-
nesota Medicine).
Your gums may need folate therapy, too. During pregnancy,
many women suffer from inflamed gums estimates range from
as low as 30 to as high as 100 percent of them.
A recent study of 30 women done during their fourth and
eighth months of pregnancy showed that those who rinsed their
mouths twice daily for one minute with a folate mouth wash
experienced a "highly significant improvement" in the health of
their gums during the eighth month (Journal of Clinical Perio-
dontology, October, 1980).
Link with Depression

Nowadays, too, more and more physicians are looking into
folate deficiency as a cause of depression. A study at McGill
University, Montreal, examined the folate levels of three differ-
ent groups of patients: those who were depressed, thosewho
were psychiatrically ill but not depressed and those who were
medically ill. Six of the patients were men, 42 were women, and
their ages ranged from 20 to 91 years.
The researchers discovered that "serum folic acid [folate]
levels were significantly lower in the depressed patients than in
the psychiatric and medical patients .... On the basis of our
results, we believe that folic acid deficiency depression may
exist" (Psychosomatics. November, 1980).
Would folate therapy help clear up depression?
To find out, we spoke to A. Missagh Ghadirian, M.D., of
the department of psychiatry, McGill University, the head re-
searcher in the study. "Based on my clinical observations, it
seems that people whose depressions are purely due to folate

deficiency do get better with folate therapy," Dr. Ghadirian told
a
210 THE B VITAMINS
US. 'To make absolutely sure, we have to wait for the results
will
of the second phase of our study, in which folate therapy is
used."
Such positive findings for folate therapy may explain the
remarkable case of a young woman with "baby blues," or post-
partam depression. Her pregnancy and the delivery of her baby
were uncomplicated. However, several weeks after delivery, she
became progressively withdrawn and emotionally unstable.
Soon she became disoriented, panicky, and had hallucina-
tions about large, ugly figures that intended harm to her and her
new baby.
Hospitalized in two different psychiatric facilities for a pe-
riod of 19 months, she received shock treatments and various
tranquilizers.She also tried to commit suicide three times.
According to the physician who saw her as a result of her
third suicide attempt, "She was an attractive but very distressed-
appearing young woman who was extremely frightened, whin-
"
ing and literally withdrawn into the cornerof her hospital room
(American Journal of Obstetrics and Gynecolo^'v). Three blood
tests for folate levels were performed on her, one of which was
reported as very low and two of which were reported as "none
detectable."
The doctor's report continues: "She was treated for anemia
with five mg. of folic acid twice a day ... for 10 days [a large
therapeutic dose]. On the seventh day of folic acid treatment,
an improvement in the mental status was noted; by the tenth
day a complete remission had occurred. The patient was dis-
charged on one mg. of oral folic acid daily.
"She has been followed for the past IVi years without evi-
dence of any psychiatric disturbance. She is presently an active
student in nursing school and doing very well academically."
Some scientists now think that it's possible not only to be
generally deficient in folate, but also to have a localized defi-
ciency a deficiency in a certain spot in the body. One such
scientist is C. E. Butterworth, M.D., professor and chairman of
the department of nutrition sciences at the University of Alabama.
According to Dr. Butterworth, one kind of problem that may
be due to a localized folate deficiency is cervical dysplasia
condition in which abnormal cells, thought to be precancerous

and by Pap smear, are found in the cervix. In an in-
identified
vestigation performed by Dr. Butterworth, 47 young women who
were on the Pill and who had mild to moderate cervical dysplasia
were studied. Some of the women received oral supplements of
100 milligrams of folate daily while the others received placebos.
The results of the study are impressive. The women taking
therapeutic doses of folate improved significantly while the un-
supplemented women showed no change.
Furthermore, says Dr. Butterworth, "There were four cases
of apparent regression to normal among subjects receiving folic
acid supplementation, but none in the unsupplemented group."
There were four cases of apparent progression to cancer among
the unsupplemented subjects, but none in the group receiving
folate supplementation. "The data is interpreted as indicating
that oral folic acidsupplementation may prevent the progression
of early cancer to a more severe form and in some cases promote
reversion to normalcy" {Contemponuy Nutrition, December,
1980).
A Very Common Deficiency

How common are folate deficiencies?
One physician has said that "primary folic acid deficiency
is probably the most common vitamin deficiency in man," and,
indeed, more and more evidence is piling up that it's true.
At the Florida Symposium on Micronutrients in Human Nu-
trition, held at the University of Florida in February, 1981, sev-
eral papers were presented that detailed the evidence of low
levels of folate in various groups of people.
Lynn B. Bailey, Ph.D., assistant professor of nutrition. Uni-
versity of Florida, pointed out that both "folacin [folate] and
iron status were less than adequate" in a large group of adoles-
cents she had studied. And according to Patricia A. Wagner,
Ph.D., associate professor of nutrition. University of Florida,
60 percent of the elderly living in a low-income area of Miami
212 THE B VITAMINS
had low folate concentrations in their bloodstreams. Also at risk

for folate problems are alcoholics, those taking certain anticon-
vulsive, antibacterial or diuretic drugs and, as we've mentioned,
women on the Pill and women who are pregnant or nursing.
Studies carried out by the World Health Organization in
various countries outside the United States have suggested that
up to a third of all the pregnant women in the world have a folate
deficiency. And it seems that here in America we're no exception.
Victor Herbert, M.D., of the Veterans Administration Hos-
pital, Bronx, New York, and several colleagues testing 110 preg-
nant women from low-income families in New York City found
that 16 percent had definite folate deficiency. Another 14 percent
had only marginal levels (American Journal of Obstetrics and
Gynecology).
And in a study of 27 women of ''better economic circum-
stances"
patients in a private obstetrical practice over half
had a mild folate deficiency (American Journal of Clinical
Nutrition).
That's not the best of news, because even a mild deficiency
can limit the formation of genes.
But it's not only pregnant women and their children who
suffer from a folate deficiency. "Quite apart from pregnancy,
folate deficiency is a real problem in the U.S.," writes Ronald
Girdwood, M.D., Ph.D., of the university department of ther-
apeutics. Royal Infirmary, in Scotland in the American Journal
of Clinical Nutrition. A spate of studies bear out his opinion.
Charles A. Hall, M.D., of the Veterans Administration Hos-
pital in Albany, New York, and his co-workers tested the folate
levels of 106 "essentially healthy persons" and found 31 percent
of them had folate blood levels on the borderline of deficiency
(American Journal of Clinical Nutrition).
Who Is at High Risk?

Older people run a great risk of folate deficiency. British
researchers found abnormally low folate levels in the blood of

80 percent of 51 people entering an old persons' home (British

Medical Journal).
A large volume of research suggests that oral contraceptives
interfere with folate metabolism and lead to a lowering of levels
in the blood. The World Health Organization has recommended

that those on the Pill as well as pregnant women and the aged
should receive more folate.
Taking antibiotics can cause a deficiency. Folate is thought
to be manufactured to some extent by bacteria in the intestinal
tract; prolonged use of antibiotics kills these bacteria.
Excessive alcohol consumption also robs the body of folate.
Ninety percent of alcoholics suffer from folate deficiency.
But most of us are not on antibiotics, the Pill, or a bottle a
day of Old Crow. If we're deficient, how come?
"This deficiency may result from inadequate intake or sec-
ondary disease," says Carl Pfeiffer,Ph.D., M.D., in Mental and
Elemental Nutrients (Keats, 1975).
Secondary diseases (that is, diseases not directly caused by
folate deficiency) can impair our ability to use the folate we take
in. An African study found that patients with bacterial infections
could not absorb folate as efficiently as healthy persons (Lancet).

Psoriasis, a skin disease, may cause folate levels to fall (Skin
and Allergy News). An article in the British Medical Journal
reports that severely injured or ill hospital patients often need
extra doses of folate. That's because it's so crucial to bodily
repair.
How about inadequate intake?
A study of adolescents found that 85 percent of boys, 90
percent of girls from families of low-income status and 100 per-
cent of girls from families of upper-income status took in less
than halfihe Recommended Dietary Allowance for folate (Amer-
ican Journal of Clinical Nutrition). The RDA for adults is 400
micrograms; for children under 10, 300 micrograms.
In a study of black school children in Mississippi, the av-
erage intake of folate was about one-fifth the recommended
amount. Over 99 percent of the children consumed less than half
of the daily recommended amount (Journal of the American
Dietetic Association).
214 THE B VITAMINS
A nutritional survey of 46 elderly long-term surgical patients

showed most of them had inadequate intake of folate (In-
that
ternational Journal of Vitamin and Nutrition Research).
Dr. Pfeiffer notes that folate intake is "one of the most
widespread insufficiences in our diets."
But a folate deficiency can result from more than just not
getting the Recommended Dietary Allowance. Vitamin C is nec-
essary for the reduction of folate to the active form the body can
use. A deficiency of that vitamin can aggravate the ill effects of
a marginal supply of folate.
An unusual property of folate in supplemental amounts is
that can mask some of the effects of vitamin Bi2-deficiency
it

anemia pernicious anemia.
Because of this, the FDA continues to put a limit on the
amount of folate in over-the-counter supplements, even though
new techniques now make it possible to diagnose pernicious
anemia even when folate levels are high. Actually, folate defi-
ciency is far more common than B12 deficiency. As we suggested
in the last chapter, if you want to ensure folate nutrition with a
B-compIex supplement, make sure it contains 400 micrograms
(1.4 milligrams). If you're pregnant, you'll need double that amount
(800 micrograms). And if you're a nursing mother, you'll need
500 micrograms.
And just remember that, although folate itself may not spar-
kle like a diamond, it can sure help you to sparkle from head to
toe.
CHAPTER
PANTOTHENATE-
THE ANTI-STRESS
VITAMIN
Colitis. It's the disease God forgot to give Job. Even the
mild variety comes complete with diarrhea and bloody stools.

And severe colitis pulls out all the stops literally diarrhea so
constant the bathroom seems like a prison cell; stomach cramps;
pale, feverish skin blotched with rashes ....
If this description is turning your stomach, please dont turn
the page.
We wanted to give you a really dramatic example of the role
of pantothenate (pantothenic acid) one of the B-complex vi-
tamins. Perhaps the best way to see how a vitamin works to

keep you healthy is to see how w/ihealthy you can get when it's
missing. And while colitis
a disease in which the colon is in-

flamed is not caused by an outright deficiency of pantothenate,
it may well be the result of the body's failure to efficiently utilize
this vitamin.
Normally, your body uses pantothenate by turning it into
another substance, coenzyme A (CoA). Put another way, CoA
is the metabolically active form of pantothenate. But researchers
at the University of Manitoba, Winnipeg, Canada, and at the
215

216 THE B VITAMINS
Mayo Clinic in Rochester, Minnesota, found that, ahhough 29

patients with colitis had normal levels of pantothenate in their
blood, the level of CoA in their colons was only one-half of that
found in the colons of 31 patients who did not have colitis (Amer-
The researchers offered six possible explanations all spec-
ulations as to why had low levels of CoA in
colitis patients
their colons. Why the uncertainty? Because CoA is hard to pin
down. It helps the heart beat, the stomach digest, the lungs
pump. And more.
CoA is vital in the health of your adrenal glands and in the
production of the adrenal gland hormones, the hormones that
give you the emotional and physical energy you need to cope
with stress any stress. From a bitter argument to a bitter win-
ter. From a traffic jam to jam spilled on your shirt. From a
mosquito bite to the seven-year itch. In fact, CoA is so important

for healthy adrenal glands that pantothenate (which turns into
CoA) has been dubbed an anti-stress vitamin.
Way back in the 30s, researchers had already discovered
that rats deprived of pantothenate had severely damaged adrenal
glands. They also found that rats fed a pantothenate-deficient
diet reacted poorly to stress, while rats given extra pantothenate
coped with stress better.
In one study, rats were divided into three groups. One group
got a diet deficient in pantothenate. Another group got a diet
adequate in pantothenate. The third group got a diet high in this
vitamin. Then all the rats were put in cold water and made to
swim untilthey were exhausted. The pantothenate-deficient rats
swam an average of 16 minutes. The "adequate" group did bet-
ter: They swam an average of 29 minutes. But the rats with a
diet high in pantothenate swam an average of 62 minutes

(Metabolism).
But what's true for rats is not necessarily true for us humans.
So in 1952, Elaine Ralli and her co-worker, Mary Dumm, re-
searchers in the department of medicine at the New York Uni-
versity-Bellevue Medical Center in New York City, tested the
anti-stress effects of pantothenate on humans.
THE ANTI-STRESS VITAMIN 217
Standing Up to Stress
The researchers immersed a group of normal men in 48F

water for eight minutes. Precise chemical measurements of the
men's blood and urine were taken before and at intervals after
the stress. Then, for six weeks, the men received 10 grams of
calcium pantothenate (a common form of pantothenate) every
day. At the end of six weeks, they were again immersed and the
same measurements were taken.
Usually, stress causes a decrease in some of the white blood
cells that protect the body against infection. After taking the
pantothenate, the men had a "less pronounced" drop in these
white blood Also, levels of vitamin C a nutrient burned
cells.
up by stress were "significantly higher." And the men excreted
less uric acid, a sign that the body had not undergone as much
wear and tear. Importantly, they also had lower cholesterol lev-
els (Vitamins and Hormones).
A stress that's every bit as intense as cold water is the cold
steel of a surgeon's knife. Fifty patients undergoing abdominal
surgery were given 500 milligrams of panthenol a substance
similar to pantothenate
the day of surgery and for five days
afterwards. Another 50 patients were not given panthenol.
The group receiving panthenol had quicker recoveries, with
less nausea and vomiting

"a more benign postoperative course,"
in the words of the researchers conducting the study (American
Journal of Surgery).
Armor against X Rays

But perhaps the most severe stress is X-ray radiation. Ra-
diation is like tiny bullets shooting into the body.
In an experimental study. Dr. I. Szorady, of the department
of pediatrics. University Medical School, Szeged, Hungary, ex-
posed 200 laboratory mice divided equally into four groups to
total body irradiation with X rays.
218 THE B VITAMINS
The rate of survival was highest in the group of mice re-

ceiving pantothenate for a week before Half were
irradiation.
still alive 21 days following the massive stress. But among 50
other mice not protected by supplemental pantothenate, half

were dead within eight days of X-ray exposure (Acta Paediatrica
Hungaricae).
"It follows that, as compared to controls, survival was pro-
longed by 200 percent," Dr. Szorady concluded. "Due to its
metabolic key position, pantothenic acid thus seems to induce

slow biochemical processes which ensure enhanced protection
against radiation injury."
These "slow biochemical processes" may be one key to
how pantothenate shuts the door on stress.
Stress speeds you up. Thoughts flash through the mind.
Blood pressure shoots up. The heart races. If you have a hard
time steering through the stress in your life, your body may be
in chronic fourth gear
but your health will come in last. Pan-
tothenate may help keep your body moving at the speed it was
built for.
A Longer Life
Added proof for Dr. Szorady's theory of pantothenate's
power to "slow biochemical processes" comes from Roger Wil-
liams. Ph.D., the first man and synthesize
to isolate, identify
pantothenate. Dr. Williams, a research scientist with the Clayton
Foundation Biochemical Institute at the University of Texas,
believes that pantothenate can actually prolong life.
He conducted an experiment with two groups of mice, feed-
ing both of them an identical and nutritionally complete diet.
One group, however, got extra pantothenate in their drinking
water.
The animals without extra pantothenate lived an average of
550 days. But those getting the extra pantothenate lived an av-
erage of 653 days.
''If the 550 days is regarded as equivalent to 75 years for a

human, then the 653 days would be equivalent to 89 years/' Dr.
Williams wrote in Nutrition against Disease (Pitman, 1971).
"On a purely statistical basis," he adds, "I would be willing
to wager that if a large number of weaned babies were given 25
milligrams of extra pantothenate daily during their lifetime, their
life expectancy would be increased by at least 10 years."
And they might have fewer runny noses, too.
Dr. Szorady conducted a standard allergy skin test on 24
children, injecting them with histamine. "Pantothenic acid re-
duced the intensity of the skin reaction by 20 to 50 percent in
all children," he reported. In his paper on pantothenate, he also
cites a study in which a researcher "applied pantothenic acid

treatment of allergic adults with satisfactory results."
Raw Foods a Must

You'd assume that Mother Nature would have stocked her
pantry with a hefty supply of a vitamin so critical to overall
health and well-being. And you'd be
Pantos is the Greek
right.
word for eveiy where, and pantothenate lives up to its name: It's
found in almost all foods. But Mother Nature's pantry brim-
ming with vegetables, lean meats, whole grains, fruits, nuts and

seeds is a far cry from the pantry in most modern households,
where canned, frozen and highly processed foods crowd out the
real thing. As far as pantothenate goes, these cupboards are just
about bare.
That's because processed foods are losers. So concluded
Henry Schroeder, M.D., former director of research at Brattle-
boro Memorial Hospital and professor of physiology at the Dart-
mouth medical school.
"It apparent that raw foods supply adequate amounts [of
is
pantothenate] ," wrote Dr. Schroeder. "It is not apparent,

. . .
however, that persons subsisting on refined, processed and canned

foods will be provided with adequate amounts. ." . .
220 THE B VITAMINS
Facts back him up. When fresh vegetables are frozen, pan-
tothenate gets the cold shoulder the vegetables lose anywhere
from 37 to 57 percent of this vitamin. Canned vegetables lose
from 46 to 78 percent of their pantothenate. Processed and re-
fined grains the kind used in baking most of the breads, cakes,

cookies and crackers sold in supermarkets lose 37 to 74 percent
of this nutrient. Processed meats do no better, losing one-half
to three-quarters (American Journal of Clinical Nutrition).
'These data,'' believed Dr. Schroeder, ''cast doubt on the
adequacy of the American diet for pantothenic acid," and
. . .
"demonstrate the dietary needs for the use of whole grains and
unprocessed foods of most varieties."
And that goes double for babies. A Canadian study showed
that processed, strained baby foods provide only 25 percent of
an infant's need for panthothenate (Nutrition Reports
International).
Another scientist who doubts whether most people get enough
pantothenate is Germany. Speaking to the
Dr. Klaus Pietrzik of
1975 annual meeting of the Federation of the American Societies
for Experimental Biology, Dr. Pietrzik warned that a diet with
a 25 percent deficiency in pantothenate would damage the central
nervous system after only six months. "The desirable doses of
pantothenic acid possibly should be increased," he asserted. But
what are the "desirable doses"?
It depends on whom you ask.
The No-Deficiency Diet

There is no Recommended Dietary Allowance for pantoth-
enate. According to the scientists responsible for setting the
RDA, however, "an intake of 4 to 7 milligrams a day would be
adequate for adults," and "a higher intake may be needed during
pregnancy and lactation."
According to Dr. Williams, a much higher intake would be
beneficial for mothers-to-be. "I would be willing to give ten-to-
one odds that providing prospective human mothers with 50
milligrams of this vitamin per day would substantially decrease

the number and severity of reproductive failures/' he wrote.
And while Dr. Szorady suggests a daily 15-milligram intake,
he adds that "physical work, surgical intervention, injury, burns
and grave infections, those of tbe gastrointestinal tract in par-
ticular, may double the pantothenic acid requirement of adults."
So, how do you meet your daily requirement?
Your best bet is not to fool with Mother Nature. Follow Dr.
Shroeder's advice and include plenty of whole, unprocessed foods
in your diet. Whole grains like brown rice, oats and whole wheat
are good sources of pantothenate. A bowl of oatmeal sprinkled

with wheat germ or bran is a good source. Eggs, too, supply
plenty of pantothenate.
If you ask for dark meat Thanksgiving, you'll have even
this
more to be thankful for. The dark meat of turkey (and chicken)
is an excellent source of pantothenate. Organ meats are also rich
in the vitamin
especially liver. B vitamin-packed brewer's yeast
is another fine source of pantothenate.
These foods, along with a B-complex supplement with at
least 10 milligrams of pantothenate, should supply you with more
than enough of this vitamin. (Most B-complex supplements have
more than 10 milligrams of pantothenate, some have up to 100
milligrams. It may be listed as pantothenic acid or calcium pan-
tothenate on the label.)
So if the stress in your life is getting you down, it's time
you upped your intake of the anti-stress vitamin, pantothenate.
CHAPTER
TAN WITHOUT
BURNING
WITH PABA
An argument could be made whole idea of working

that the
on a suntan is a little crazy. After all, there was a time when the
world's BPs (that's "beautiful people'' in affluent-ese) were into
ivory and alabaster skin. Anyone with a tan was considered
strictly working class, and who wanted to be one of those?
That twisted notion still influences us today, except that a
tan no longer provokes the image of a stoop-shouldered peasant
working in the fields. People associate tans with sailing, sunning
and lounging at pool side. The only time BPs want to appear
white is when they're decked out in their tennis togs. People
with neither the time nor the money to loaf in the sun are the
new working class. The only rays they're soaking up are ema-
nating from their office desk lamps.
The problem with is that people can overdo
cultivating a tan
it. Getting a bad sunburn no fun, and too much sun can lead
is
to serious skin problems. We're certainly not suggesting that you

devote all of your spare time to exploring caves. You should get
out and enjoy the sun, but you also should be sensible about it.
Before stepping outside, you might put on a sun screen that will
absorb, reflect or scatter the ultraviolet light of the sun reducing
222
TAN WITHOUT BURNING WITH PABA 223
the amount that reaches your skin. The best sun screens will
contain one of the B-complex vitamins, para-aminobenzoic acid,
or PABA.
People with and blue or green eyes generally
light skin color
are more inclined to burn. They can exceed
their sunburn thresh-
old tolerance in 10 to 20 minutes under a noontime summer sun.
Other people, who rarely burn and readily tan, may not even
become red after 45 minutes or more in the same setting.
Wrinkles, Aging and Cancer

Since people with fair skin and blue or green eyes are more
susceptible to the sun, they also are more vulnerable to skin
cancer. Ireland, for example, ranks 10th for women and 20th for
men in the incidence of death from skin cancer among 42 coun-
tries. The high rate exists despite the fact that Ireland is in a
latitude that receives less than half the burn-causing ultraviolet
radiation of any of the other countries.
'The most important skin carcinogenic factor in man is
sunlight exposure," says Allan L. Lorincz, M.D., professor and

chief of dermatology at the University of Chicago. Too much
sun also can produce other chronic skin damage like pigment
and premature wrinkling and
alterations, premalignant lesions
aging. That's why you rarely see a fashion model who's keen
on tanning rituals.
People who are, however, may think they can splash on
anything and be protected from burning. "Suntan lotions are
designed to be not so absolutely protective," says Dr. Lorincz.
''They use weaker sun screens to let modest amounts of the sun
through to stimulate new pigment formation in the skin."
PABA, the B vitamin, has stood up as one of the most potdnt
sun screens on the market, he continues, and it has few com-
plications in regard to its use. PABA's screening ability was
discovered in the 1920s by Dr. Lorincz's predecessor and former
colleague at th University of Chicago, Stephen Rothman, M.D.
224 THE B VITAMINS
PABA protects against the UVB

wavelengths of the sun,"
Dr. Lorincz told us. UVB
form of ultraviolet radiation
is the
which causes sunburn and other skin problems to flare. At the
same time, PABA permits UVA rays, which are the less dan-
gerous, tanning rays, to travel through to the skin.
The superiority of PABA as a sun screen has been docu-
mented various laboratory tests. Harvard scientists found that,
in
of 24 screening agents tested, a solution of 5 percent PABA in
alcohol provided the best protection against ultraviolet radiation
(New England Journal of Medicine).
At the University of Miami, investigators discovered that
putting a 5 percent solution of PABA on hairless mice protected
them from later exposure to ultraviolet light. Mice not treated
with PABA developed severe skin lesions after they were ex-
posed (Journal of Investigative Dermatology).
Which Form of PABA Is Best?
few years, chemical derivatives (esters) of PABA

In the past
have appeared on the market which outperform the original 5
percent PABA solution. Dr. Lorincz does not favor the esters
because "there is a theoretical reason to believe that the esters
can cause a higher risk of allergic sensitization.
"With a 10 percent PABA solution in alcohol, you get up
to two hours of midday sun protection," he says. "You can still
tan
you'll just tan more slowly."
The ability of a sun screen to remain effective under the
stress of prolonged exercise, sweating and swimming is called
its suhstantivity . PABA sun screens in alcohol are considered
to be quite substantive, says Dr. Lorincz. Still, when using a
sun screen, people are advised to apply it both before they go
out and several times during sun exposure, especially after swim-
ming or perspiring.
PABA is not a carte blanche to sunbathe. It allows you to
stay out a little longer, but if you overdo it, you'll burn.

CHAPTER
BIOTINTHE
LITTLE-KNOWN
LIFESAVER
At first, she looked like a perfectly normal baby, so no one

suspected a thing. But by three months of age, it was obvious
that something was terribly wrong. She began to have seizures

about ten a day and nothing seemed to help. By 14 months of
age, all of her hair had fallen out
even her eyebrows and eye-
lashes. A marred her body. Her eyes, once bright
red, scaly rash
and shining, became swollen and painful from severe inflammation.
On top of that, she became increasingly irritable and sleepy.
Her muscles grew steadily weaker until she could barely walk.
Lab studies of her blood and urine revealed a high level of ac-
cumulating poisons, the kind found in severe metabolic disor-
ders. And the levels of lactic acid in her blood rose to over twice
that of the normal value, causing it to become dangerously acidic.
The doctors were understandably alarmed by the downward
course the child was taking, especially since they didn't really
know what was causing it or exactly how to correct it. But they
did know that she would surely die if something wasn't done
soon.
At that point, theybegan giving the little girl large doses of
biotin, an essential B-complex nutrient.
225
226 THE B VITAMINS
"The clinical response to 10 milligrams of biotin per day

was dramatic," says Jess Thoene, M.D., of the department of
pediatrics. University of Michigan at Ann Arbor. "Within 12
hours the plasma [blood] lactic acid concentration had fallen to
normal and her state of consciousness had improved. After 48
hours of biotin therapy, all of her blood chemistries had nor-
malized. Over the next four months she reached all the devel-
opmental milestones that had been lost during the illness. Her
hair, including eyebrows and eyelashes, began to regenerate,
and her muscular coordination was regained. Biotin not only
saved her life, it allows her to have a normal, healthy childhood
without any of the signs of her former illness (New England
Journal of Medicine, April 2, 1981).
But why biotin? How did the doctors single out this partic-
ular, little-known nutrient as the special one to cure this child's
ailment?
Actually, it wasn't easy. Ittook a lot of detective work (and
a little luck) to finally fit all the puzzle pieces together.
First, scientists enzymes depend on bio-
learned that certain
tin normal functioning. Without those enzymes, the body
for
can't utilize carbohydrates, proteins and fats. When that hap-
pens, specific abnormal metabolites (poisons) build up in the
body, creating a whole host of devastating symptoms.
When modern equipment made it possible to identify those
abnormal metabolites, it wasn't long before doctors were able
to pinpoint exactly which enzyme systems were malfunctioning.
That information, combined with the fact that this patient
had symptoms strikingly similar to another child whose enzyme
deficiencies were corrected with biotin, decided the course of
action here, says Dr. Thoene.
"These defects in the metabolism of biotin may be much
more common that we once thought," adds Herman Baker, Ph.D.,
another doctor actively involved with the case.
"Not long ago, we had no way to test for biotin deficiency,
so many cases probably went undetected. Now we have a method
which can isolate as little as one part in a trillion of the nutrient,"
THE LITTLE-KNOWN LIFESAVER 227
Dr. Baker, a professor of preventive medicine at the New Jersey

Medical School in Newark, told us. "At present, we are the only
ones in the country who have this procedure for detecting low
levels of biotin with such extreme accuracy. Ever since this case
study became publicized, we've been deluged with requests for
biotin levels by doctors whose patients have similar symptoms."
And no wonder. It's rare to be able to cure a potentially
fatal disorder with a remedy that, so far, has shown no side
effects and is completely safe.
That's how Morton J. Cowan, M.D., an immunologist from
the department of pediatrics at the University of California at
San Francisco feels about biotin, too. He's seen for himself how
biotin works in youngsters with this same genetic defect.
"The children I've seen," says Dr. Cowan, "had defects in
their immune systems along with all the other symptoms. In fact,
two of the kids died from overwhelming infection in combination
with progressive central nervous system deterioration before we
knew that biotin could reverse the disorder" (Lancet, July 21,
1979).
"We still don't know for sure what's actually happening
with these kids," Dr. Cowan told us. "It may be that their bodies
can't metabolize biotin normally. But the problem may also be
one of absorption. These kids have had a normal exposure to
biotin in their diet, yet, in some of the children, the blood and
urine levels are low. The body may just not be able to transport
the biotin across the cellular membranes. We don't know why
this is so.But we do know that flooding the system with 10 to
40 milligrams a day of biotinsomehow pushes it across the barrier
and into the bloodstream and cells, where it's needed for the
metabolism of fats, carbohydrates and proteins.
"With our patient, that's what it took for complete recovery.
What's more, she was relieved of the numerous infections that
continuously plagued her.
"From what we've seen, immune deficiencies seem to go
along with biotin deficiencies whether the problem is genetic [like
the cases mentioned so far] or acquired," Dr. Cowan told us.
228 THE B VITAMINS
Less Biotin, Fewer Antibodies

That seems to support the conclusions made by Mahendra
Kumar, Ph.D., and A. E. Axelrod, Ph.D., of the biochemistry
department at the University of Pittsburgh school of medicine
in Pennsylvania.
They found that rats that were made deficient in biotin showed
a marked decrease in the number of cells which produce anti-
bodies (the protein which fights off infection).
The antibody-forming cells were reduced by 96 percent in
the biotin-deficient rats, report Drs. Kumar and Axelrod, but
were partially restored to normal when biotin was administered
to the animals (Proceedings of the Society for Experimental Bi-
ology and Medicine).
Fewer Eggs, Less Biotin

Most researchers and nutritionists have long believed that
it is next to impossible to acquire a biotin deficiency. That's
because such small amounts are required (about 100 to 300 mi-
crograms per day, a mere fraction of what the sick babies were
receiving).
And what you don't pick up from the good food sources
that you eat (like liver, eggs, peanuts and dried beans), say the
scientists, the friendly bacteria that live in your large intestine
will manufacture for you.
Between those two sources, how can anyone become
deficient?
But apparently it's not that simple. ''First of all," says Mary
Marshall, research nutritionist with the U.S. Department of Ag-
riculture's human nutrition center, "many people have cut their
intake of eggs and liver, the best sources of biotin, because of
their high cholesterol content.
"I also think it's a myth that the bacteria in your gut can
supply you with the biotin you're not getting in your diet. It's
true that they make it, but they do it in the lower part of the
large intestine, and absorption does not take place at that location.
"Besides," Mrs. Marshall told us, "we don't even know if
we have the same bacteria now as we did long ago, because of
all the antibiotics we've consumed over the years."
In fact, every time you take an antibiotic or sulfa drug, you

may be killing off the biotin-manufacturing bacteria in your gut.
So even if you co///<i absorb the biotin they're making, they may
not be there to make it.
Elderly People Need More

But even if you haven't taken an antibiotic in years, you
still could be low in biotin, that is, if you're physically active or
elderly.
A study done in Basel, Switzerland, measured the blood
levels of biotin in various populations. The results showed that
the elderly and athletes had lower levels than the
significantly
control group (International Journal of Vitamin and Nutrition
Research).
"The elderly may have a problem with absorption," says
Mrs. Marshall. "They do with many other nutrients, so it's pos-
sible that biotin is among them. We really don't know for sure."
"As for the athletes," speculates Dr. Baker, "exercising
causes a buildup of lactic acid in the muscles. Biotin is part of
the enzyme system which is needed to break it down again. The
more lactic acid that accumulates, the more biotin is needed.
"We will be conducting a study soon on the effect of ex-
ercise on biotin levels in humans, so we should have some def-
inite answers."
Meanwhile, increased need is not just limited to the elderly,
athletes and people taking antibiotics.
Hospital patients on total intravenous feeding should be aware
that biotin deficiency can result. That's what happened recently
to one little girl. Unlike the other sick babies, this patient did
not have a genetic defect in biotin metabolism. (It was only after
.
230 THE B VITAMINS
three months on intravenous feedings that the famiHar biotin

deficiency symptoms developed.)
Ten miUigrams of biotin per day did the trick for her, too,
and after seven weeks of therapy, her dose was reduced to only
100 micrograms daily {New England Journal of Medicine, April
2, 1981).
Children recovering from burns and scalds may need a biotin
boost, too.
A study of nine children suffering from those injuries was
conducted at the Institute of Child Health in London. Plasma
biotin levels were significantly below the control values in all
the children. "The evidence suggests,'' write the researchers,
"that low plasma biotin levels found in children with burns and
scalds are due to the injury either through loss of the vitamin or
through increased requirements for tissue repair" (Journal of
Clin ica I Pa th ology)
Sudden Infant Death Syndrome

There's also some impressive evidence that low biotin levels
may be involved in cases of sudden infant death syndrome (SIDS),
a tragic phenomenon
in which babies are found dead in their
cribs forno apparent reason. Researchers in Australia and Great
Britain say that SIDS closely resembles a disorder in which
marginally biotin-deficient chickens die when subjected to even
mild stress. None of the classic signs of biotin deficiency are
present in the chickens, but there are low levels of biotin in their
livers, and supplementation with biotin eliminates the problem.
The researchers speculated that the same thing may be hap-
pening in human infants, as well. To test their theory, they ex-
amined the livers of infants who had died of various causes and
found that those with SIDS had significantly lower levels of
biotin, just like the chickens. All of the SIDS victims but one
had suffered some mild disease at their deaths, but nothing severe
enough to explain why they died.
"We do not suggest," say the researchers, "that SIDS re-
sults from biotin deficiency alone, but ... we postulate that
biotin insufficiency may leave the infant in a condition in which

SIDS can be triggered by mild stress, for example, infection, a
missed meal, excessive heat or cold or a changed environment"
{Nature, May 15, 1980).
It's been reported that SIDS is more common among bottle-
fed babies than breast-fed ones. That may be because a consid-
erable loss of biotin occurs during the manufacture of certain
been recommended that infant formulas be
infant formulas. It's
supplemented with biotin as a precaution against SIDS.
It seems that babies get the brunt of the biotin-deficiency
problems. Fortunately, they also reap the benefits of ample

supplementation.
For adults, there isn't enough information available yet to
determine exactly how much biotin is really needed that is,
unless you're talking about blood lipids (fats). Mary Marshall
has conducted a few experiments which show that supplemen-
tation with 0.9 milligrams biotin per day can reduce blood lipids.
"We tested rats and humans with high lipid levels," Mrs. Mar-
shall told us, "and we found that biotin supplementation caused
an initial rise in lipids followed by a drop to below prestudy
levels {Artery, March, 1980).
"So much work needs to be done," says Mrs. Marshall,
still
"because right now we have more questions than answers. We

think there may be a connection between biotin and diabetes,
for example."
Dr. Baker agrees. "Biotin seems to affect glucose (blood
sugar) metabolism. There's some evidence of that, and we plan
to check out that possibility," he told us.
The role of biotin in immunity is another area ready to be
explored. "We have no scientific evidence right now that taking
more biotin will help normal people fight off viruses," says Dr.
Cowan. "But it did relieve the kid with the genetic biotin defi-
ciency of their multiple infections."
A few years ago, nobody paid any attention to biotin. Now,
it looks like biotin may not stay the unknown B vitamin for long.
The more we learn about it, the more evident it becomes that it
is vital to our total well-being.
CHAPTER
CHOLINE FOR A
SHARPER MEMORY
How good is your memory?

Quickly, now, can you recall what you ate for dinner the
night before last? Do you remember the title of that Barbra
Streisand movie you saw two years ago? Whatif you bumped
into an old school friend you hadn't seen for many years? Would

you remember the name or even the face?
Clearly, if a lifetime is built of pleasant memories growing
weddings, wonderful vacations then the
families, graduations,
quality of your memory becomes the key to a good and satisfying
life.
That's not meant to suggest that your brain should be like

some vast computer, endlessly spinning a printout of every sight,
sound, smell and textbook fact that ever nestled however
briefly
in your consciousness. Many things are meant to be
forgotten. But being able to recall important events, experiences

and information vividly and in fine detail is not too much to ask.
And while nature hasn't skimped in giving us the gray matter
to get the memory job done, that hasn't stopped scientists from
searching forsome agent that would boost our recall capacity
even more. They haven't yet found the magic potion or elixir,
232
CHOLINE FOR A SHARPER MEMORY 233
but investigators at the National Institute of Mental Health (NIMH)

have found something that gives forms of recollection a welcome

nudge especially in people whose memories are a bit below par
to begin with.
That substance is choline, an essential dietary component
found in a wide range of meat and vegetable foods. Choline is
thought of as a vitamin by some nutritionists (it's included in
many of the more complete B vitamin supplements). What's
more, our bodies can manufacture additional choline, provided
we eat a healthful diet that supplies the raw materials.
"Our studies show that choline has a weak to moderate
memory enhancement effect," research psychiatrist N. Sitaram,
M.D., told us. "It's not a robust effect, but it can be measured."
Dr. Sitaram, who is now director of affective disorders at
Lafayette Clinic in Detroit, was interested in testing choline be-
cause it is a precursor, or forerunner, of acetylcholine, a brain
compound is essential for the smooth flow of nerve impulses.
that
Other studies have shown that extra choline in the diet increases
levels of acetylcholine in the brain. Dr. Sitaram and his col-
leagues, Herbert Weingartner, Ph.D., of the laboratory of clinical
psychology, NIMH, and Christian Gillin, M.D., currently at the
University of California at San Diego, wanted to find out if this
would aidmemory.
On two separate days, they gave ten healthy volunteers,
ranging in age from 21 to 29, either a supplement of 10 grams of
choline chloride or an identical-appearing but worthless substi-
tute. Then after an hour and a half, the people were given two
kinds of memory tests.
In the first, a serial learning test, subjects had to memorize
inproper order a sequence of ten unrelated words. The list was
read to each person and repeated as often as necessary until
perfect recall was achieved and could be repeated twice in a row.
"Choline significantly enhanced serial recall of unrelated
words as measured by the number of trials required," the re-
searchers reported. "Furthermore, the enhancement was more
pronounced in 'slower' subjects than in subjects who per-
. . .
formed well" (Life Sciences).

234 THE B VITAMINS
In Other words, the people most in need of help had their

memories prodded the most when they took choline. One indi-
vidual who normally needed six trial readings to master a ten-
word list cut that to four after taking choline. Another dropped
from seven to five attempts with the choline supplement.
In the second test, the volunteers were read lists of 12 com-
mon words. Half the words were highly imageable, concrete
words like table and chair, which can be easily visualized. The
rest were low imagery words like /////// and late, which represent
abstract, hard-to-visualize concepts and are more difficult to
memorize.
In these trials, subjects didn't have to learn the lists in any
particular order, but the words were read to them again and
again until all 12 words could be successfully recalled twice in
succession.
The them, were "extremely
results, as the authors describe
People didn't fare any better overall when they took
interesting.''
choline, but when the test was divided into high-imagery and
low-imagery words, they registered much better scores in the
latter, more difficult category while taking the supplement. In
other words, choline seemed to selectively enhance memory to
meet the challenge of the tougher learning tasks.
Learning Time Cut in Half

One person who normally required ten master a list
trials to
of difficult words reduced that to five (a 50 percent improvement!)

after taking choline.
And unlike certain drugs which also raise acetylcholine lev-
els in the brain, the authors point out, choline is a natural food
component which is usually safe even in large amounts. The
doses of choline in these tests were at least ten times as great

as the 900 milligrams or less supplied by a typical diet. (These
amounts, however, should be taken only under a doctor's
supervision.)
CHOLINE FOR A SHARPER MEMORY 235
As promising as Dr. Sitaram's results were, however, he

was quick to point out to us that many questions still remain.
For example, these tests measured memory 90 minutes after a
single dose of choline. We still don't know how long the effects
last or whether they would continue over several weeks or months
if extra choline were consumed daily.
And the trials involved only younger, healthy volunteers
with a normal range of remembering ability. The real challenge,
according to Dr. Sitaram and the other NIMH researchers, will
be to determine if choline can help elderly people with serious
memory impairments brought on by the brain deterioration of
senility.
CHAPTER
VITAMIN Bi,
MIRACLE OR HOAX?
The story of this "vitamin that isn't" is a long, complicated

and checkered tale of promotional chutzpah and scientific skep-
ticism, including among its cast of characters a beleaguered father-
and-son research team, chemists from the Soviet Union, and
zealous representatives from the U.S. Food and Drug Admin-
istration (FDA) all at odds. It hasn't exactly got the pace and
suspense of Three Days of the Condor; instead, if most of the

evidence is correct, it's more like four decades of the turkey.
Here's the condensed version.
Credit for discovering "vitamin B15" (we put it in quotes

because, by definition, it's not a vitamin that is, its absence in
the body isn't linked to any deficiency disease, the way vitamin
C is to scurvy) goes to the Ernest Krebses, father and son, who
are also the boys who came up with laetrile and called it vitamin
B|7. Krebs senior and junior christened their crystalline concoc-
tion pangamic acid because it was found in all (pan) seeds (i,'a-
nu'te). Over the years, it has also attracted the labels calcium
pangamate, "the famous Russian formula," and a host of brand
names that made sure to use the number 15 in them.
236
VITAMIN B,s MIRACLE OR HOAX? 237
During these same years, a slew of alleged benefits were

attributed to pangamic acid; it was said to positively affect heart
disease, diabetes, schizophrenia, alcoholism, asthma, nerve and
joint infections, eczema and you name it. Panacea, not pan-
gamic, is what the acid should have been called. The Russians,
especially, touted the substance and made great claims for its
ability to lower the body's oxygen needs, thus helping athletes
by transporting oxygen more efficiently to their muscles. Coaches
worldwide dropped their whistles and ran for B15.
The only problem was, there were problems:
1. The Russian studies were pretty sloppy,
without proper controls, loaded with unsub-
stantiated data and looking about as water
tight as a colander.
2. There is no clear chemical identity for pan-
gamic acid, so companies producing it can
pretty much put into it whatever they want.
The FDA says that it is ''not an indentifiable
substance."
3. In 30 years at the Bunsen burner, the
Krebses were able to isolate pangamic acid
from seeds only once. But since naturally
occurring substances can't be patented any-
way, they redoubled their efforts to find a
synthetic counterpart. Both they and the
Russians succeeded in doing so. Most com-
panies producing the stuff say they follow
the Russian-style directions and call the re-
sults calcium pangamate, which is alleged to
contain DMG, the essential extract that is
supposed to be responsible for all the good

deeds. But according to the FDA, it has
never analyzed a batch of pangamic acid
that contained what the Krebses said they'd
been able to isolate from seeds. Further-
more, DMG has been shown in some labora-
238 THE B VITAMINS
tory experiments to be a potential carcino-

gen, and so has DIPA-DCA, a major
component of the second-largest-selHng form
of calcium pangamate
4. The FDA says DMG is not a natural food
substance, but a food additive, and that, un-
til it goes through the usual tests and safety
checks, it must be removed from the
shelves.
Court cases and shipment seizures have
been going on for years, with the FDA
ahead in suits won and the companies victo-
rious in the piling up of sales dollars. For
even though pangamic acid, by federal regu-
lation, ought to be off the shelves of phar-
macies and health foods stores, you can still
find it there, either boldly obvious or in var-
ious disguises, because there's money to be
made from it and the FDA can't be every-
where at once.
And our view? Well, so far, nothing that we've seen or heard
about B,5 has made us feel like dropping o///- whistles and running
for it.
I
VITAMIN C AND THE
BIOFLAVONOIDS
CHAPTER
BRIMMING
WITH HEALTH
(AND VITAMIN C!)
What would happen to you if your body tissues were drenched

with vitamin C, saturated like the soil after a downpour? And
what if this soaking lasted for more than just a few hours, but
for days and days, for the rest of your life? What would be the
consequences?
The fate that would befall you would likely be better health.
That's the opinion of a growing number of researchers looking
into the vitamin C requirements of your body. The word is that
the right daily intake of C is the one that ensures this maximum
permeation of your tissues in what's called a steady state.
It's a condition existing everywhere in the animal world,
and that fact set a lot of people thinking about the implications
for man. Unlike humans, most animals can synthesize (manu-
facture) vitamin C internally. Since these C makers have high
saturation levels of the vitamin, scientists reasoned, the steady
state must be ideal for their health. So the same saturation con-
dition might be optimal for humans, who have to make sure their
C intake keeps their tissues loaded.
Emil Ginter, Ph.D., a distinguished vitamin C researcher
from Czechoslovakia, was among the first to test these assump-
239
240 VITAMIN C
tions. Initially, he set out to discover what a maximum saturation

would do for a creature that shared man's inability to synthesize
vitamin C the guinea he found that guinea
pig. In test after test,
pigs on close-to-maximum saturation levels of C fared better than
guinea pigs with lower levels. The animals with higher vitamin
C levels handled cholesterol better and developed fewer gall-
stones when placed on a gallstone-producing diet. The saturation
animals were not only better off than those guinea pigs on de-
ficiency intakes of C, but they were even healthier than those
getting many times the intake needed to prevent scurvy the
vitamin C-deficiency disease {Nutrition and Health, vol. 1, no.
2, 1982).
Evidence accumulating that in humans, too, a state of
is
vitamin C is optimal for health, says Dr. Ginter. Here

saturation
and abroad, studies have demonstrated that a full store of C can
help battle harmful levels of cholesterol and triglycerides, de-
toxify potentially dangerous histamines (substances produced in
the body), neutralize unwholesome chemicals in your diet and
more.
Beyond Your RDA

But the question is what daily intake of vitamin C will keep

your cache your body pool brimming?
Whatever the quantity is, many researchers and doctors are
convinced that it has little to do with the Recommended Dietary
Allowance (RDA) of 60 milligrams a day. ''Sixty milligrams is

enough, all right if you want merely to stay just above scurvy
level," says W. M.
Ringsdorf, Jr., D.M.D., of the University of
Alabama Birmingham. "But if you want to live a life of reduced
in
infection, if you want to promote healing and sharpen your im-
mune system, if you want optimum triglyceride levels in your
blood, you'll want a daily intake of C far above the RDA."
"It is certain," notes Dr. Ginter, "that the officially rec-
ommended doses are unable to ensure a maximum body pool,
for they do not lead to maximum levels of ascorbate [vitamin C]
BRIMMING WITH VITAMIN C 241
... inthe blood, and much less in tissues." And that's where
some major studies come in. They can help you figure out just
how far above the RDA you should go.
In one of these experiments, researchers used vitamin C
"tagged" with harmless levels of radioactivity to trace vitamin
C in the body. Anders Kallner, M.D., Ph.D., of the Huddinge
University Hospital in Sweden, and his colleagues chose 14
healthy, nonsmoking males, put them on daily C intakes of 30
to 180 milligrams, and had them drink water containing the tagged
vitamin C. After tracking the C in blood plasma and urine, the
research team was able to gauge the men's maximum body pool
and turnover (the amount of vitamin C metabolized or used).
The average stockpile of C was assessed at ,500 milligrams,
1
with a daily turnover of 60 milligrams. The study concluded that,

to maintain such a pool and to compensate for turnover and
incomplete absorption of C, healthy, nonsmoking males should
ingest about 100 milligrams a day {American Journal of Clinical
Nutrition, March, 1979).
But that is word on your C requirements. A
not the last
more recent study recommends an even higher daily intake for

men and a different one for women.
For five years, Philip J. Garry, Ph.D., and his fellow re-
searchers monitored the vitamin C levels of 270 healthy elderly
men and women Albuquerque area. They checked the
in the
subjects' diets, their intakes of vitamin C supplements and the

amounts of C in their blood. The picture that emerged was of a
health-conscious group of seniors with apparently normal abil-
ities to absorb and store vitamin C. Dr. Garry and his colleagues
concluded that, for men to have a full C concentration in their

blood (maintaining a body pool of 1,500 milligrams), they need
to ingest 150 milligrams of C per day. And for women to get the
same concentration, they need to take 75 milligrams a day. In-
takes at lower levels simply can't keep our body pools on the
"full" mark {American Journal of Clinical Nutrition, August,
1982).
Indeed, even dietary intakes three times the RDA aren't
quite up to snuff, according to Dr. Ginter. He cites some pro-
242 VITAMIN C
vocative evidence suggesting that your maximum body pool of

C an even mightier flood than some researchers think. "This
is
value [of 1,500 milligrams] appears unduly low," he says. "It is

certainly much lower than data on animals capable of synthe-
sizing ascorbate [vitamin C]. In addition, there are large organs
in the human body, such as, for instance, the liver, brain and
gastrointestinal tract, in which maximum ascorbate concentra-
tions determined by direct analysis are at least 10 times higher."
If you examine the C content of human tissues, explains Dr.
Ginter, you discover that the maximum pool is actually about

5,000 milligrams (approximately 32 milligrams of C per pound
of body weight). And that's a pool value similar to those found
recently in monkeys.
"Vitamin C doses necessary for maintaining such a high
body pool in humans have not as yet been experimentally de-
termined," Dr. Ginter points out, "but they may be calculated
approximately from available data." Since we know the turnover
and absorption rate of C, he says, it's a simple matter to compute
the intake that we need to keep our reservoirs topped off at 5,000
milligrams: about 200 milligrams a day.
Vitamin C to the Rescue

Let's say you're flat on your back in the hospital, recovering
from abdominal surgery. Or money problems are weighing on
your mind. Or you're walking down a city street choking on
smog. How much vitamin C does your body need now?
More than you might think. We now know that your coun-
termeasure for these and other traumas should be extra vitamin

C above and beyond your saturation intake. When your body
is under the gun, it demands additional C to heal itself or fight
off enemies within.

'"Stress is just one factor that steps up your vitamin C
requirements," says Robert Haskell, M.D., of San Francisco.
"If anything helps you battle the effects of stress, it's extra vit-
amin C."
BRIMMING WITH VITAMIN C 243
"It appears that all forms of pollution increase the require-

ments of vitamin C humans and experimental animals,'' notes
in
Dr. Ginter. "It has been repeatedly shown that various pesti-
cides, industrial toxins, certain drugs, particularly antipregnancy
and smoking decrease blood vitamin C levels."
pills,
Andif you have a wound that needs healing, you can observe
the most dramatic example of extra C power firsthand. For an

"excess" of the vitamin not only puts wounds on the mend, but
hurries the healing along at record speeds.
That fact was confirmed by Dr. Ringsdorf and an associate
when they reviewed a series of clinical studies testing C's healing
ability. The subjects were people without C deficiencies who had
a variety of wounds
bed sores, leg ulcers, gum damage, even
wounds from surgery. When these patients went on daily C in-
takes of 500 to 3,000 milligrams, fast-paced healing set in. Re-
covery time from both surgery and injury dropped by as much
as 75 percent (Oral Surgeiy/Oral Medicine, March, 1982).
And no wonder. Vitamin C, it seems, is a crucial ingredient
in all human wound healing, fast or slow. "This nutrient is unique
among vitamins," reports Dr. Ringsdorf, "because it regulates

the formation and maintenance of intercellular cement and col-
lagen [a supportive protein that helps bind up wounds]. Thus,
the structural integrity of every tissue and organ is dependent
on this vitamin."
Andyou're never more dependent than when you're hit by

more than one C-demanding trauma when you're under stress
and you light up a smoke to calm your nerves, for example, or
when you're nursing multiple wounds. All the factors that boost
your vitamin C needs, says Dr. Ginter, are probably cumulative.
And means your body's C requirements may add up like
that
bills payable upon demand. "Personally, I believe that in such
situations," he says, "the optimum dose is several hundreds of
milligrams per day."
That sounds like small payment for some bills your body
can't afford to ignore.
CHAPTER
VITAMIN C:
CHANGING YOUR BODY
FOR THE BETTER
"Vitamin C is unique among vitamins because it is the only

one that seems to play a role in every bodily function, as it holds
the cells together," observes Reginald Passmore, M.D., profes-
sor of physiology at Edinburgh University in Scotland. "When
it is deficient, furthermore, it wreaks more havoc in more places
in the body . . than any other nutrient" (Nutrition Today).

.
Adds Irwin Stone, one of the early pioneers of vitamin C

research: "Ascorbic acid (vitamin C) is involved in so many vital
biochemical processes and is so important in daily living that,
after forty years of research, we still have no clear idea of all
the ways in which it works" (The Healing Factor, Grosset and
Dunlap, 1972).
It's such a versatile performer, in fact, that vitamin C has
been called "an oil for the machinery of life." Yet, your body
can't manufacture it or store more than a few grams, so keeping
your cells saturated with a rich, daily supply of C is crucial. Just
how important has been demonstrated in studies showing what
happens when you don't: Deficiencies interfere with everything
from the production of collagen, the protein "cement" that holds
your cells together and helps in the healing of wounds, to your
ability to digest food and fight the effects of stress.
244
CHANGING YOUR BODY FOR THE BETTER 245
Researchers at Cornell University have even found that de-

ficiencies of the vitamin impair the body's ability to metabolize
drugs, which could have serious implications for the elderly, in
particular.
"In guinea pigs, we've found that deficiencies of vitamin C
impair the liver's ability to detoxify drugs, which results in more
of the drug affecting the body causing, in effect, an overdose,"
one researcher told us.
But one of the most important gears the "oil of life" greases
is the body's immune system
your defense against infectious
disease. In one study at South Africa's University of Pretoria,
vitamin C was found to stimulate the immune system.
When a germ, virus or any other microscopic invader pen-
etrates the body, a healthy immune system, like a football team,
musters a front line of defenders and hustles them off to the site
of the invasion. One unit of this defending team is made up of
specialized white blood cells called neutrophils, which simply
eat up the enemy rather like the body's very own mean Joe
Greenes. In both human subjects and human cells in test tubes,
the South African scientists found that vitamin C increased the
mobility of these neutrophils, speeding up their rush to the line
of scrimmage. Vitamin C also helped stimulate the immune re-
sponse by stepping up the body's production of lymphocytes,
another kind of white blood cell {American Journal of Clinical
Nutrition, September, 1981).
How do neutrophils know where the attackers have threat-
ened the body and how to get to the scene of the invasion? They
do it by following the "scent" of a chemical distress signal the
body produces when it becomes inflamed by injury. The neu-
trophils' amazing pursuit through the body's byways, hard on
the enemy's trail like angry linemen, is called chemotaxis and
it doesn't always work. When neutrophils are exposed to a chem-
otactic signal once, they become deactivated that is, they fail
to respond to a subsequent signal.

Yet, Italian researchers have found that vitamin C "com-
pletely prevented the loss of true chemotactic responsiveness by
cells." In other words, human neutrophils, exposed to chemical
distress signal, responded right on cue to a second signal //
,
246 VITAMIN C
they were saturated with vitamin C. Otherwise, they didn't re-

spond at all (British Journal of Experimental Pathology, vol. 61
no. 5, 1980).
For a Healthy Pregnancy

Vitamin C may also be needed to ensure a healthy preg-
nancy, other research suggests. A study conducted at the Meth-
odist Hospital in Brooklyn, New York, by Dr. C. Alan B. Cle-
metson discovered that, when the levels of vitamin C in the blood
fall below a certain level, blood levels of histamine rise signifi-
cantly. Evidence going back as far as 1926 indicates that hista-

mine might be responsible for a potentially fatal complication of
pregnancy called abruptio placentae, in which the placenta sep-
arates from the womb prematurely.
Studies of women with that condition have found that they
usually have abnormally low levels of vitamin C in their blood.
And Dr. Clemetson found that histamine begins to build up in
the blood long before vitamin C levels fall to the point where
scurvy, the classic C-deficiency disease, begins to develop. The
blood levels of C are low, but by no means deficient as the term
is commonly defined {Journal of Nutrition, April, 1980).
So Dr. Clemetson believes that it might be a good idea for
pregnant women to supplement their diets with vitamin C. He
does not have the final, unshakable proof that C prevents abrup-
tio placentae, any more than we have unshakable proof that C
prevents the other problems we've been discussing. But Dr.
Clemetson thinks taking C might be a good idea all the same.
C Saves Body Tissue

A true believer in vitamin C is former Saturday Review
editor Norman Cousins. Upon returning from a stressful trip to
Russia in 1964, Cousins felt like a grimy passport with every
page stamped "pain." He had difficulty moving his neck, arms,
legs and fingers. He was diagnosed as having ankylosing spon-

dylitis, a rare collagen disease affecting the joints of the spine.
But he fought his way back to health with up to 25 grams daily
of vitamin C and mirth sessions of Marx Brothers movies and
"Candid Camera" classics.
Cousins' diagnosis may have been rare, but collagen is not.
It is everywhere in the body, comprising fully 30 percent of all
body protein.
vitamin C is lacking, the result will be a defective collagen
If
molecule that means, ultimately, weak tissue. Scurvy (gross vi-

tamin C deficiency) is a hideous culmination of tissue collapse,
wherein old scars break down, new wounds won't heal, blood
vessels hemorrhage and the gums can't even hold their teeth
anymore.
Science is just beginning to scratch the surface of how col-
lagen does its job. An editorial in the British medical journal
opened: "Long regarded as inert, uninteresting, and purely

L<;//7Cf/
mechanical in function, collagen is attracting the close attention

of physicians and biochemists. This reversal in outlook is partly
due to the realization that collagen is involved in many diseases,
from fatal heart and lung diseases to back pain and minor skin
disorders."
The goes on to say: "At present we recognize dis-
editorial
orders primarily when mechanical malfunction occurs, but col-
lagen may be involved in other diseases at a more subtle level."
Needs for C May Be Special

How much vitamin C is necessary to maintain healthy col-
lagen production? The amount can vary widely, as revealed in
the case of a young boy studied by two southeastern doctors,
reported in the Journal of Pediatrics.
The boy, age eight when first diagnosed, had absurdly
stretchable skin. His muscles were weak; his skin was brimming
with hemorrhages and scars; he was mildly myopic and the di-
ameter of his cornea was unusually small. At first he was diag-
248 VITAMIN C
nosed for vitamin C deficiency, but blood and urine tests showed
that he was not suffering from any deficiency in the narrow
cHnical sense that doctors are trained to look for.
What he was a vitamin dependency. His doc-
suffered from
tor, Louis J. M.D., of the division of medical genetics
Elsas II,
at Emory University's school of medicine, discovered the boy

to be in need of much more vitamin C than most people need
for collagen formation because of an inherited disorder that ham-
pered the process.
After 20 months of therapy grams daily of vitamin C taken
(4
orally), the boy's wound healing and muscle strength improved

and corneal diameter actually grew something that's not sup-
posed to happen after the age of four.
The case is unique. Dr. Elsas explains, because "this is the
first inherited metabolic disorder in which ascorbic acid [vitamin
C] has been clearly demonstrated as a requirement in pharma-

cologic [hefty] doses.'" Somehow, the genetically impaired pro-
tein that's causing the faulty collagen formation works better
with a lot more help from vitamin C than is usually necessary.
The boy's collagen disorder is rare, but increased metabolic
requirements for vitamin C may not be so unusual. "Conceiv-
number of individuals could have a different vitamin
ably, a vast
requirement," a spokesman for the research project said. "Their
genes are different; you can almost state that categorically."
And since people's genes are different, "you could expect large
variations" among individuals in the shape and effectiveness of
the proteins we make to maintain our life processes.
Dr. Elsas' research may be at least as important for the new
questions it raises as for the old questions it answers. The spokes-
man says an increased vitamin requirement might be discovered
in some patients with "dislocated limbs, myopia ... all sorts of
clinical manifestations" that could be associated with collagen
disorders.
Corneal diameters, rare collagen defects: Is this getting too
esoteric?
Then consider bedsores, a common problem among the
bedridden.
Faster Healing
At the Human Tissue Reconstruction Institute at Bethany
Methodist Hospital in Chicago, Anthony N. Silvetti, M.D., was
confronted by about 30 patients with stubborn bedsores, skin
ulcers due to varicose veins or diabetes, and burns due to heat
or caustic chemicals. These sores had festered for between two
months and several years with no response to conventional
treatments.
Vitamin C helped heal the sores dramatically. Dr. Silvetti
prepared a solution of simple and complex sugars along with
essential amino acids and vitamin C. He cleared dead tissue from
the sores, washed them with a salt solution, then applied his
therapeutic poultice to the wound every day, covering it with a
sterilenonadhesive dressing.
"Within the first 24 to 73 hours of beginning the nutrient
treatment," Dr. Silvetti and his co-workers reported, "the wounds
became cleaner. The foul smell disappeared and the wounds
exuded less pus. The infected tissue rapidly transformed into
healthy growing tissue full of new blood vessels. .Small to
. .
medium-sized wounds eventually healed completely with little

scarring. Larger wounds accepted early, successful skin grafts"
(Federation of American Societies for Experimental Biology,
April 15, 1981, abstract no. 3929).
The sores hadn't healed before. Dr. Silvetti explained, be-
cause oxygen and nutrients required for new tissue formation
weren't circulating to the site of infection. So he applied those
nutrients
vitamin C, amino acids and sugars
directly to the
damaged skin.
The treatment even boosted patient morale. Dr. Silvetti noted,
because healing began so quickly. There was "daily visible im-
provement" in the sores.
At the University of Genoa medical school in Italy, re-
searchers treated patients who were unable to resist bacteria
infections normally. Their white blood cells couldn't "chase"
or kill bacteria, and as a result, they suffered chronically from
250 VITAMIN C
abscesses and boils. One patient had had 43 abscesses in two

years. None had gone infection free for as long as a year.
C proved effective without causing side ef-
Again, vitamin
fects. Three of the patients took to 2 grams of C a day and
1
improved within a few weeks. After a year, their skin was still
clear. It was the longest stretch of skin health they had ever
enjoyed.
"The laboratory and clinical results obtained with ascorbic
acid in our patients and the safeness of this drug strongly suggest
its use for the prevention and treatment of recurrent infections
in patients with defective chemotaxis [the ability of white blood
cells to chase germs] and/or bacterial killing" {British Journal
of Dermatology, January, 1980).
But besides these particular infections, vitamin C has also
shown that it can hit the target on a lot of other distressing
conditions.
Malaria has shown an interesting response to vitamin C.
In malaria, a parasite lives in human red blood cells. Once
infected by a mosquito bite, a person carries the parasite per-
manently, suffering from intermittent attacks of chills and fever.
Drug-resistant strains of the parasite breed constantly.
At the University of Lowell Massachusetts, Nicholas J.
in
Rencricca, Ph.D., was testing the effects of high-pressure oxygen

on the red blood cells of malarial mice. He supplemented the
mice with vitamin C on the hunch that the vitamin would protect
their red blood cells from the "rusting" effect of too much oxygen.
Unexpectedly, the vitamin C helped destroy the blood cells
that carried the malaria parasite but didn't harm the healthy
unparasitized blood cells, and the mice lived longer than ex-
pected. "I believe in it," Dr. Rencricca told us about vitamin
C. "Even in large doses. I wasn't out to prove or disprove
anything in my experiment. There's definitely something to it."
A nine-year study of Japanese hospital patients who had
received blood transfusions revealed that 2 grams of C given
daily sharply reduced the number and severity of serum hepatitis
cases. A particularly troublesome viral disease, hepatitis often
strikes surgical patients who have had blood transfusions. By
the seventh year of the study, hospital administrators felt so

strongly about the preventative properties of the nutrient that
"the decision was made, for ethical reasons, to give vitamin C
in largeamounts to essentially every patient.
"During the period 1967 to 1973,'' the report continues,
"there were 150 patients who were given blood transfusions and
who received little or no vitamin C (less than two grams per
day). Of these patients, 11 developed hepatitis (7 percent)
. . . . Among 1,100 similarly transfused patients who received
two grams or more of vitamin C per day, there were no estab-
lished cases of hepatitis and only a few questionable cases"
{Journal of the International Academy of Preventive Medicine).
Rheumatoid another baffler that often cripples
arthritis is
older people. A Canadian research team took normal and ar-

thritic cells from human joints and cultured them with aspirin,
vitamin C, vitamin E and combinations of the three. Aspirin was
found slightly effective in inhibiting growth of arthritic cells and
reducing their population, but "high and low concentrations of
vitamin C had little effect on normal cells, and a low concentra-
tion had little effect on [arthritic] cells. However, a high con-
centration eradicated these [arthritic] cells'" (emphasis ours)
(Experientia, vol. 35, no. 2, 1979).
The researchers concluded that an aspirin-vitamin C com-
bination might be the best way to reduce the growth of arthritic
cells.
Divided Doses Best

C
does so many helpful things, what's the
Since vitamin
best make sure you're getting enough? A diet rich in fresh
way to
fruits, vegetables and greens should provide plenty, most re-
searchers say. Yet, many things are known to increase the body's
demand for C, notably stress and smoking, in fact, in one Swiss
study, it was suggested that the minimum daily requirement for
vitamin C be increased from 70 to 100 milligrams for nonsmoking
adults and to 140 milligrams for smokers.
252 VITAMIN C
Alcohol also appears to interfere with vitamin C absorption.

In a study atDeakin University in Victoria, Australia, five healthy
volunteers agreed to eat a very odd breakfast: a buttered bun,
coffee, 2 grams of vitamin C and 35 grams of ethanol, or ethyl
alcohol (roughly equivalent to two martinis or three light beers).
Later, they ate a boozeless breakfast for purposes of comparison.
Result? "Plasma ascorbic acid concentrations were significantly
lower for at least 24 hours'' after their alcoholic meal {American
Journal of Clinical Nutrition, November, 1981).
If you take vitamin C supplements as a sort of nutritional
"insurance policy," what's the best time to do so? A trio of
researchers from the University of Toronto faculty of pharmacy
and the University of Arizona college of pharmacy put that ques-
tion to the test.
To ensure
accurate measurements, the scientists first sat-
urated the tissues of four subjects by giving them a gram of
vitamin C a day for two weeks. Then they examined the extent
of vitamin C absorption by measuring the amount of C they
excreted in urine after taking a gram of C in three different ways:
as a single dose in solution, divided into eight equal parts and
taken at 15-minute intervals, or a single dose right after eating
a meal high in fat.
Dividing the doses, the researchers found, increased vitamin

C absorption by 72 percent over taking
it in a single dose. Taking
it meal increased absorption by 69 percent. "From a

after a
practical point of view," they concluded, "AA [ascorbic acid,
i.e., vitamin C] absorption may be improved by either dividing
a daily dose into several smaller doses taken during the day or
by ingesting the vitamin after a meal" (Life Sciences, vol. 28,
no. 22, 1981).
If smaller doses divided through the day are better than a
single, larger dose, what about timed-release vitamins, which are
supposed to do the dividing for you? The same trio of researchers
recently studied that question, too.
Four volunteers were given a gram of vitamin C in several
different forms: a powder dissolved in water, a tablet, a chewable
tablet and a timed-release capsule.
The researchers found that the solution, tablet and chewable

tablet delivered their load of vitamin C to the body with roughly
the same effectiveness
for each, about 30 percent of the total
was absorbed. But the timed-release capsule was a different
story, delivering only about 14 percent of its contents to the
body. 'The timed release capsule examined here appears to be
a more expensive and less reliable means of providing oral vi-
tamin therapy compared with more conventional dosage forms,"
the scientists remarked {Journal of Phannaceutical Sciences,
March, 1982).
Why did the timed-release capsules perform so poorly?
Research team member Michael Mayersohn, Ph.D., of the Uni-
versity of Arizona, says that the vitamin may have been incom-
pletely released from the chemical formulation that is designed
to release it slowly, or it may still have been bound by the
formulation when it passed the body's vitamin C absorption site
(believed to be in the upper part of the small intestine).
Dr. Mayersohn added that there was a wide variation in the
individual subjects' ability to absorb the vitamin, suggesting that
"some people may simply be good absorbers of vitamin C and
others may be poor absorbers."
Whether you're a good absorber or a poor one, a steady
supply of vitamin C changes your body for the better in a re-
markable variety of ways. It may even "oil the engines" of your
life.

CHAPTER
VITAMIN C,
SUPER HEALER
Whenever Lois Lane heard it said that her pal ClarkKent

wimpy old Clark might possibly be the champion of good in
Metropolis and true hero of her heart, she was aghast: ''Clark?
Superman'? You've got to be kidding!"
It was an agonizing spectacle. How could she be so dumb?
Case after case, year after year, every time there was a job for
Superman, Clark would disappear. Get with it, Lois.
But Lois never did catch on. For her, there couldn't be
anything heroic about a mousy guy who hung in there right beside
her every day, unobtrusively going about his business.
Now, there's something Lois Lane-ish about the common

inability to realize that vitamin C
everyday C could possibly
do so much good in the streets and back alleys of the city inside
us.
Funny: Every time there's "a job for Superman," like a
heart attack, vitamin C appears on the scene. We need it to rout
the foe because C is our natural supcrhealer.
A bit farfetched? Sure. But the idea of using vitamin C to
speed the healing of a chemically burned eye seems just as far-
254
VITAMIN C, SUPER HEALER 255
fetched even to the ophthalmologists who are testing the rev-

olutionary treatment.
"What seems interesting to me," says Roswell M.D.,
Pfister,
of his own experiment, "is that we're using a perfectly normal

foodstuff to reverse the tissue degeneration" of a severely dam-
aged eye.
Dr. Pfister, former chairman of ophthalmology at the Uni-
versity of Alabama-Eye Foundation hospital in Birmingham, has
been working with Christopher Paterson, Ph.D., of the Univer-
sity of Colorado medical center. Together they experimented
with the corneas of 18 rabbits that were burned by a particularly
nasty alkali, sodium hydroxide. (The cornea is the clear cap that

covers the lens and iris colored portion of the eye.) Nine of
the rabbits received daily injections of 1.5 grams (1,500 milli-
grams) of vitamin C after being burned. The 9 others went
untreated.
Result: In the nine C-treated rabbits, not one cornea de-
generated to the point of perforation. But among the nine other
rabbits, 11 of the 18 untreated corneas perforated.
Saving Eyes with Vitamin C

Then Drs. Pfister and Paterson tried giving the vitamin in
the form of eye drops. Working again with rabbits, nine were
given eye drops hourly after being burned, and one cornea de-
veloped a superficial ulcer. Of the 19 corneas in the control
group, which received no vitamin drops, nine eyes ulcerated or
perforated. Significantly, the one C-treated rabbit that developed
an ulcerated cornea had the lowest level of vitamin C in its
aqueous humor.
No, aqueous humor is not a euphemism for off-color Navy
jokes. It's the fluid between the cornea and the lens and sur-
rounding the iris. It nourishes those parts of the eye, and the
eye's secretion of it maintains a much-needed pressure on the

256 VITAMIN C
eye as a whole. Dr. Pfister told us. Without it, ''the eye would
become mushy.''
The amount of vitamin C in the aqueous humor is 18 to 20
times greater than the amount of vitamin C in the blood. Drs.
Pfister and Paterson knew this but were not paying it any par-
ticular attention until ''somewhat by accident'' they discovered
that the amount of vitamin C in the aqueous humor of the cornea-
damaged rabbit eyes "was down to a third of its normal level,"
Dr. Pfister said.
Was this disappearance of vitamin C, like that of Clark Kent,
more than coincidence? The doctors (no Lois Lanes) realized a
possible connection. Knowing that the formation of collagen
the stuff that binds cells together would be crucial to corneal
healing, and knowing also that vitamin C plays a vital role in the
body's formation of collagen, the doctors theorized that vitamin
C "would be required at higher concentrations to repair the
devastating effects of an alkali burn," as Dr. Pfister put it.
What happens in the damaged corneas is an all-out war
between the forces of creation and destruction. The dead corneal
cells break up while the healing process races to hold everything
together. If there is a lack of vitamin C fueling the formation of
new collagen, the eye loses.
"What we're suggesting" as a result of the experiments,
says Dr. Pfister, "is that repair processes have to be helped"
by super boosts of C. "This is tissue scurvy, as far as I'm con-
cerned." In contrast to the old approach, which was to apply
drugs to prevent old collagen from breaking down, "our objec-
tive is to get the healing process carried out," Dr. Pfister says.
The next step in their research is to treat corneal burns in
humans with oral doses of vitamin C in hospitals across the
nation, to see if the treatment works on humans as well as rabbits.
This could take a while. "There are not that many people who
get alkali burns in the eye," says Dr. Pfister. (Waiting time would
have been less in ancient China, where men were blinded by lye
as punishment for looking at another man's wife.)
The corneal healing process does not restore sight, by the
way. The cornea is no longer transparent after such a severe
VITAMIN C, SUPER HEALER 257
burn. But must be kept from perforating; otherwise, the fluids

it
of the eye would escape. With the cornea intact, sight can even-
tually be restored by a cornea transplant or the implantation of
a plastic cornea. Dr. Pfister points out.
Meanwhile, Dr. Pfister is interested ''in other types of eye
diseases: bacterial, fungal, viral" that might be helped by vitamin
C treatment. "We have no knowledge of what effects it might
have," he said. "But if you ask me, 'Could it?' Vd have to say,
'Yes, it could.'
Skin Saver
Another vitamin C superhealing feat involved a foreman at
a printing company. The man was so skillful that he could tell
if a job was being printed correctly simply by touching the ink
on the paper as it came off the press. But that ink was his poison.
It contained hexavalent chromium (a type completely different
from nutritional chromium), a widely used industrial chemical
that causes more dermatitis (skin disease) than any other. And
he had dermatitis bad.
It hadn't always been that way. For seven years he had lived
with it, keeping it somewhat under control by taking antihista-
mines and steroids. But suddenly it flared up. His hands and
wrists began to swell and crack, oozing fluid. He took more
drugs, but that didn't help much. And he couldn't wear gloves
or use a protective hand cream on the job, because he had to
touch his work. His only choice was to spend each Friday eve-
ning to Monday morning with his hands wrapped in cold, med-
icine-soaked compresses. And if that wasn't enough, he slept
poorly because of the pain, the antihistamines made him drowsy

and his face began to swell and discolor a side effect of taking
steroids both orally and by injection.
Needing him at work, the company finally sent him to a
doctor who specialized in occupational diseases a doctor who
knew had discovered
that in 1969 a researcher that vitamin C
could protect skin from hexavalent chromium.
258 VITAMIN C
The doctor prepared a solution containing 10 percent vita-

min C, and the foreman kept a container of it next to him while
he worked. ''Each hour during the work day/' writes John Mil-
ner, M.D., the physician who handled the case, "he dipped his
hands in the liquid and blotted them dry."
Within a week, says the doctor, the symptoms dramatically
decreased, and he stopped his antihistamines and his injections
of steroids. Within a month, he stopped taking steroids alto-
gether. And he no longer stayed at home weekends with his

hands wrapped in bandages he played golf instead!
"He has continued to use the ascorbic acid [vitamin C]
"and the control of symptoms has
solution," writes Dr. Milner,
been sustained over the course of years" {Journal of Occupa-
tional Medicine, January, 1980).
CHAPTER
INSULATE
YOUR HEALTH
WITH VITAMIN C
Cold weather means more than the sniffles. It means you

could be sniffling at someone's grave side. Statistics indicate that
thousands more die during the winter months than in summer.
During a cold spell, heart attacks, strokes and pneumonia kill
people who would have lived longer if the thermometer hadn't
dropped.
Cold weather is serious business. But vitamin C doesn't kid
around either. There's substantial evidence that this nutrient can
prevent a cold, clear up one that's just getting started or shorten
one that's hit full force. And vitamin C doesn't stop there. It
also tackles heart disease, circulatory problems and serious viral
infections the conditions that can put your health in a deep
freeze during winter.
Most people, however, would be content simply to make
the common cold less common. Runny nose, sore throat, fa-
tigue the heavy traffic of infection that you in bed for a
stalls

day or two (but won't let you sleep) who needs it? Your body
doesn't, and its immune system is set up to resist the viruses
that cause colds. Then why do you catch them? Because, new
research shows, to fully resist those viruses, the immune system
259
260 VITAMIN C
may need large amounts of vitamin C, amounts 10 to 20 times

higher than the government's Recommended Dietary Allowance.
The research wasn't with humans, but with guinea pigs.
Both species have something in common, though. Neither is able
to produce vitamin C in its body, as does almost every other
mammal, but instead depends entirely on dietary sources. So
when it comes to vitamin C, what's true for guinea pigs is more
likely to be true for humans, too.
Enhanced Resistance
In the study, researchers kept two groups of guinea pigs on
a diet deficient in vitamin C but supplemented the drinking water
of one group with the nutrient.Once a week for three weeks,
the immune system of both groups was challenged with a po-
tentially deadly substance. More than twice as many of the
vitamin-deficient as the vitamin-supplemented animals died.
In the next month, the researchers fed the surviving deficient
animals vitamin C. Some received an amount equivalent to 100
milligrams a day for a human while others received an amount
equal to .000 milligrams. After three to four weeks, the animals
1
in the 1,000-milligrams group were completely healthy and able
to resist the challenging substance. But the animals in the 100-

milligram group never returned to health. They failed to gain the
weight they lost during their deficient period, and their systems
were unable to defend them against the immunologic attack (Fed-
eration Proceedings, May, 1979).
The authors, Gary Thurman. Ph.D., and Allan Goldstein,
Ph.D.. who ran the study while professors in the biochemistry
department at the George Washington University school of med-
icine, summarize their research: 'This study provides the first
definitive evidence that ascorbic acid [vitamin C] plays a major
role in the maintenance of immunity and provides a rational
mechanism for the postulated beneficial effect of this essential
vitamin in the treatment of viral diseases."
INSULATE YOUR HEALTH WITH C 261
The mechanism they're talking about works like this: Stress

uses up vitamin C, and cold is When
icy weather
a potent stress.
steals the nutrient,you need more to keep your immune system
up to par. If you don't get it, you can catch colds more easily.
If you do get it, you have better resistance against the viruses
that cause colds. That may be a theory, but it's a good one.
Study after study shows that people who take vitamin C have
fewer and milder colds.
In a study at the University of Toronto, 407 people received
1,000 milligrams of vitamin C a day and an extra 3,000 milligrams
a day for the first three days of a cold. Another 411 people
received a worthless placebo. Compared to the placebo group,
the vitamin C group
spent 30 percent fewer days indoors because
of illness and missed 33 percent fewer days of work (Canadian
Medical Association Journal).
In a study of crew members on a Polaris submarine, 37
sailors who received 2,000 milligrams of vitamin C a day had 66
percent fewer cold symptoms than a placebo group (Interna-
tional Research Communication System).
In another submarine study (they're apparently popular among
researchers trying to get to the bottom of the common-cold prob-
lem), scientists from the Naval Medical Research Institute, in
Bethesda, Maryland, took a look at the relation between plasma
vitamin C levels and the general health of 28 crewmen on a
submarine before, during and after a 68-day patrol. They noted
that the group with the lowest plasma vitamin C levels ''did not
differ significantly" in health from the group with the highest
levels. Yet, they also observed, in passing, that "the results for
upper respiratory infections were in the expected direction . . .
with twice as many of the low group showing symptoms of the

common cold than the high group" (Journal of Applied Nutrition,
vol. 34, no. 1, 1982).
By maintaining relatively high levels of vitamin C in their
bodies during those long, lightless weeks under the sea, some
of the submarines were able to fight off respiratory infections
considerably better than their shipmates.

262 VITAMIN C
In an Australian study, 95 pairs of identical twins perfectly

matched for age, sex and genetic makeup were used to compare
the cold-fighting power of vitamin C with that of a placebo (in
this case, a pill that looked just like the vitamin but contained
only lactose, or milk sugar). For 100 days, one of each pair of
twins took a gram (1,000 milligrams) of vitamin C daily while
the other took the placebo, though neither knew which was which.
They were also asked to make careful note of the duration and
severity of colds, should they appear.
When the results were analyzed, the research team con-
cluded that "vitamin C had no significant effect except for short-
ening the average duration of cold episodes by 19 percent'' (Med-
icalJoiirnal of Australia. October 17, 1981). If you're interested
in knocking one day off a five-day cold, in other words, you
might try vitamin C. Interestingly, the Australians also found

that "females had significantly longer, more severe and more
intense colds than males."
In a study of soldiers undergoing training in northern Can-
ada, those receiving 1,000 milligrams of vitamin C a day had
about 68 percent less illness than a placebo group {Report No.
74-R-I012, Defense Research Board, Department of National
Defense).
And in another study from Toronto, 448 people who took
vitaminC had up to 38 percent fewer cold symptoms runny
nose, fever, sore throat, tight chest, aching limbs, depression
than a placebo group (Canadian Medical Association Journal).
"There is little doubt," wrote the authors of the Toronto
study, "that the intake of additional vitamin C can lead to a
reduced burden of winter illness."

CHAPTER
KEEP COOL
WITH VITAMIN C
It's so muggy even the mosquitoes are taking naps. Sprawled
in a hammock, with about as much energy as it takes to sip iced

tea, Joe turns on the radio and tunes in to a weatherman sizing
up the sizzler.
"Well, folks, good news. The temperature's just dropped
to 32 degrees in the shade. Thirty-two degrees Celsius, that is.''
Joe's not laughing. As far as he's concerned, this is no joke.
He's tired, irritable, and his body feels like a crumpled-up
dishrag in a sinkful of dirty dishes.
And have you been feeling like Joe lately? If so, take heart
and take a good bit of vitamin C.
Just about everybody knows that vitamin C has been sug-
gested as a means to prevent the common cold. Well, recent
research has also suggested that vitamin C may help prevent the
"common hot," that run-down dragged-out feeling that gets
washed up on the shore of your life by a summer heat wave.
The research we're talking about wasn't conducted where
you might expect: outside, underneath a glaring sun. It was con-
ducted inside, in climate chambers where heat, humidity and
263
264 VITAMIN C
wind velocity were controlled not by the whim of Mother Nature,

but by the careful design of scientists.
These climate chambers are used in South Africa to accli-
mate new mine workers to the hot, humid air of the mines. In
the chambers, the workers perform a simple exercise called the
step test
repeatedly stepping onto and off a step for hours at
a time. By performing this exercise day after day, in progres-
sively hotter and more humid air, they gradually accustom them-
selves to the same type of conditions they will encounter in the
mines.
In 1974,however, researchers found that, despite this prep-
aration,mine workers had a rapid decrease in blood levels of
vitamin C during their first three months of employment even
though their vitamin C intake was adequate (South African Med-
ical Journal).
Heat Stress Burns Up Vitamin C

That's no surprise, really, because scientists have long known
that stress of
any kind from a snakebite to the biting cold of

winter depletes the body of vitamin C. And even if your air
conditioner has never broken down, we don't have to tell you
that heat is a stress.
When the mercury's on the rise, your body moves quickly
to cool itself:Blood vessels expand: the heart pumps rapidly to
provide the energy needed to release excess heat; sweat pours
off the skin. One theory says that these reactions are sparked
by hormones from the adrenal gland, which contains a higher
amount of vitamin C than any other body tissue and needs vi-
tamin C to do its job. But if the hot weather just won't quit and
your vitamin C is depleted, then the body's temperature stays
high, and you've got a case of the hot-weather blahs: heat ex-
haustion, heat prostration
maybe even heatstroke.
To translate this scientific theory into scientific fact, N. B.
Strydom and his co-workers in the industrial hygiene division of
the Chamber of Mines of South Africa divided 60 miners, who
were not exposed to heat for six months prior to the study, into
KEEP COOL WITH VITAMIN C 265
three groups. They asked one group to take 250 miUigrams of

vitamin C a day and another to take 500. To the third group they

gave a placebo a medically useless pill. The workers were then
asked to perform the step exercise for four hours in a comfortable
environment, during which time their temperatures, heart rates
and sweat rates were measured. On the next ten days, they
performed the same exercise, but this time in a hot, humid cli-
mate chamber (Journal of Applied Physiology).
Although there was no measurable difference in heart and
sweat rates, the average body temperatures of the vitamin
C-supplemented groups were lower on every single day after
the first. Not only that, 35 percent of the workers who took
vitamin C were fully acclimated to the heat by the fourth day of
the test, while only one person from the placebo group accli-
mated that quickly.
You probably don't work in an overheated mine. At least,
we hope not. But when vitamin C helps those in such an extreme
situation to keep their cool, it's a good bet that it'll do the same
for you.
Closer to home, Irwin Stone, Ph.D., a noted biochemist,
reviews in his book The Healing Factor: Vitamin C against
Disease {Grossei and Dunlap, 1972) a number of studies in which
vitamin C was used to treat heat stress.
One such study describes long-term tests on workers in a
Virginia rayon plant who had been exposed to high temperatures
and humidities. The study found that heat prostration in the
employees was eliminated by the daily administration of 100
milligrams of vitamin C. Before this regimen was instituted, there
had been 27 cases of heat prostration; in the following nine years,
not a single case was reported in the group taking the daily
supplements.
Heat Rash Quickly Cured

Vitamin C may also help eliminate another heat-wave worry:
heat rash, or prickly heat.

266 VITAMIN C
When heat rash strikes, the pores in the area of the rash
shut down and sweating stops. In severe cases, with a large area
of the body body temperature may shoot up;
surface involved,
someone with prickly heat can be a good candidate for heat
exhaustion.
Dr. T. C. Hindson, a British dermatologist in Singapore,
had been treating an Australian Air Force officer who had an
acute case of prickly heat. Nothing that the doctor gave him
seemed to help. But one day, the officer felt himself coming
down with a cold and began taking gram (1,000 milligrams) of
1
vitamin C. In the course of one week, the prickly heat vanished

after having afflicted him for more than a year (Lancet).
Dr. Hindson immediately began giving vitamin C to five
children whose heat rashes he had been treating for some time
without success. All of the children threw off the rash, and their
skin remained clear as long as they continued taking vitamin C.
To give further weight to his findings. Dr. Hindson con-
ducted a carefully structured study on 30 children with prickly
heat, in which 15 children were given vitamin C and another 15
placebos.
At the end of two weeks, the doctor discovered that, of
those taking the placebo, 4 showed some improvement, 9 stayed
the same, and 2 had worse prickly heat than before. But of those
taking vitamin C. 10 were completely rash free, 4 improved, 1
was the same and none worse. Dr. Hindson then gave vitamin
C to the children who had been getting the placebo. In future
examinations one and two months later, not one rash was seen
on any of the 30 children. And all of these children had been
suffering from severe prickly heat for at least eight weeks before
the beginning of the experiment.
The youngsters in this experiment were given vitamin C in
dosages based on their weight: A child of 38 pounds was given
about 250 milligrams daily, a 19-pounder 125 milligrams, and so
forth. In cases where children were too young to take pills,
mothers were instructed to crush the tablets in their food. This
dose proved virtually 100 percent effective in curing and pre-
venting heat rash.
CHAPTER
MAKE VITAMIN C
YOUR SHIELD
AGAINST POLLUTION
Some people have all the luck. You know the ones we mean.
They never gain a pound, never get a blemish, always have the
right clothes, their money earns the highest interest . . . and
they've never been sick a day or so
seems.
in their lives it
Even though they walk through the same environmental

traps as the rest of us, they don't get caught. Somehow smog
doesn't affect their lungs, and pollutants and poisons seem to
bounce off of them as if they were protected by some kind of
invisible shield.
Well, maybe theyThere may be a way to protect our-
are.
selves from the harmful effects of pollution and other environ-
mental contaminants. And it's not a matter of luck, either. It has
to
do with our own nutritional status especially that of vitamin
C.
'Tt is now
widely accepted that ascorbic acid [vitamin C]
nutritional status markedly affects the toxicity and/or carcino-
genicity of greater than 50 pollutants, many of which are ubiq-
uitous in the air, water and food environments," says Edward
J. Calabrese, Ph.D., professor of environmental health at the
University of Massachusetts, in Amherst.
267
268 VITAMIN C
That's especially true of nitrosamine formation in the stom-

ach. Nitrosamines are carcinogens (cancer-causing agents) that
may be formed in the gut when we eat foods treated with sodium
nitrate. (Nitrates are added to many processed meats and smoked
fish products as food preservatives and as flavoring and coloring
agents.)
But now evidence C
can actually pre-
suggests that vitamin
vent the formation of nitrosamines in your stomach, says Dr.
Calabrese. who is the author of Nutrition and Environmental
Health (John Wiley and Sons, 1980). It's a natural detoxifying
agent, but only if the vitamin is in your stomach at the same
time as the nitrate-treated foods. So if you take vitamin C only
once a day, morning, it can't protect you from nitrosamine

in the
formation during lunch or dinner, since it would be long gone
from your stomach by then. The obvious solution is to take your
vitamin C several times during the day with your meals, but for
more reasons than one.
First of all, "even if you don't eat foods rich in nitrates,
you are still exposed to those chemicals," says Steven R. Tan-
nenbaum, Ph.D., professor of toxicology and food chemistry at
Massachusetts Institute of Technology (MIT), in Cambridge.
"That's because your body manufactures them automatically.
Eating cured foods only adds to the level that's already there."
What's more, if all your vitamin C is combating nitrosamine
formation, it will not be available to perform its other vital func-
tions in the body, adds Dr. Calabrese. Consequently, the pres-
ence of nitrates in your diet would increase your daily require-
ment of vitamin C (Medical Hypotheses, December, 1979).
That's why it's important to know how nitrates are metab-
olized and exactly what effect vitamin C has on nitrosamine
formation.
To find that out. Dr. Tannenbaum is conducting a study.
"Our volunteers are young, healthy MIT students," he told us.
"First we put them on a special diet that is completely nitrate
free. In that way, we are able to determine how much nitrate is
actually produced automatically by the body. After a few days,
A SHIELD AGAINST POLLUTION 269
we add nitrates to the diets and trace the metabolism of the

chemical through the body to learn how much of it is converted
to nitrosamines.
"In the next part of the experiment, we give each student
ascorbic acid to find out whether vitamin intervention affects the
amount of nitrosamines formed.
"Right now, we are giving the students 2 grams [2,000 mil-
ligrams] of vitamin C per day, and at that level, we have found
that nitrosamine formation is blocked nearly completely. We've
confirmed that in at least six different people. Less may work
also, but 2 grams did the best job.
"When you eat foods rich in nitrates, they are promptly
converted to nitrites in the mouth or in the stomach," Dr. Tan-
nenbaum told us. "Vitamin C has the capacity to react with the
nitrite form of the chemical faster than nitrogen compounds can.
And nitrogen compounds are the substances needed to form the
nitrosamines. If the nitrites react to vitamin C and are destroyed,
then they can't attach themselves to nitrogen compounds. Hence
nitrosamine formation blocked."
is
Although there is no absolute guarantee that vitamin C will

protect you from the harmful diseases associated with nitrosa-
mines. Dr. Tannenbaum advises people to take it anyway. "It
can only help," he says.
Protects against Radiation

That may be good advice for people exposed to X rays as
well. And who hasn't been at one time or another? Now doctors
are coming to recognize the potential hazards associated with
routine irradiation, andmany have curtailed their usage. Never-
theless,any form of protection against X rays is valuable, indeed.
That's why the experiment conducted by James A. Scott,
M.D., and Gerald M. Kolodny, M.D., is of such interest. In it,
they measured the effects of irradiation on normal mouse cells
270 VITAMIN C
(which had been grown in the laboratory) with varying amounts

of vitamin C or with no vitamin C at all.
"We had heard that vitamin C can prevent damage from
radiation, and so we decided to give it a try on the mouse cells,"
said Dr. Scott, assistant radiologist at Massachusetts General
Hospital in Boston. "Our experiment showed that it does have
this ability, but at relatively high doses
about 10 grams per day
for the human equivalent. We're not sure exactly how it exerts
its protective effect, but it somehow keeps the radiation from
killing the cells.
"We did find one thing that was a real surprise," Dr. Scott
told us. "Apparently, the vitamin C slowed down cell division.
And since dividing cells are more sensitive to radiation, that may
have something to do with the vitamin's ability to protect against
damage."
He concludes that "pretreatment with ascorbic acid might
alter the cell population such that surviving cells are more re-
sistant to the effects of subsequently administered radiation"
{International Journal for Vitamin and Nutrition Research, vol.
51, no. 2, 1981).
"So far, we can't say that these results would apply to
humans," says Dr. Scott, who is also an instructor at the Harvard
medical school. "But if vitamins are necessary for human life in
small quantities, maybe some people need more, especially in
those situations which stress our bodies
such as exposure to
radiation and other environmental pollutants. I take 400 milli-
grams per day to be on the safe side."
Battling against Ozone

Considering the multitude of pollutants permeating the air

we breathe. Dr. Scott may have the right idea especially when
itcomes to ozone. Ozone is a highly toxic pollutant gas and is
a major component of smog.
But vitamin C may be able to protect us against ozone dam-

age, too. It did just that in an experiment with mice. Researchers
at the University of Queensland, in Australia, exposed mice to
various concentrations of ozone in the air for 30 minutes. As
much as 50 percent of the vitamin C in lung tissue was lost during
that time. The vitamin seemed used up in its effort to battle
to be
the ozone, say the researchers. Scientists had already established
that vitamin C could prevent lung damage caused by ozone. This
study strongly supported the conclusion that it was the vitamin
C in the lung itself thai was preventing damage by ozone {Chem-
ico-Biological Interactions, vol. 30, no. 1, 1980).
Protecting Occupational Health

If you think you have it bad, what about people who must
work with toxic chemicals. Now, they really have something to
shout about.
Take benzene for example. That's a solvent commonly
used Chronic exposure to benzene has long been
in industry.
known to cause destruction of the bone marrow and perhaps
leukemia. The curious thing is that, despite similar levels of
exposure to benzene, not all workers become ill. "Given a similar
degree of exposure, why do some workers remain apparently
unaffected ?" asks Dr. Calabrese.
. . .
The answer may lie in the diets of the people involved. "It
is hypothesized that inadequate nutritional status of possibly

several nutrients including . . . ascorbic acid may enhance sus-
ceptibility to adverse effects caused by benzene," says Dr.
Calabrese.
At first, the connection between vitamin C nutritional status
and benzene toxicity revolved around the recognition of certain
similarities between benzene poisoning and scurvy (vitamin
C-deficiency disease).
Then a study was done that investigated the effect of chronic
benzene poisoning on vitamin C levels in guinea pigs. The re-
272 VITAMIN C
searchers found that benzene poisoning diminished vitamin C

levels in the blood, adrenals and
But the toxic effects were
liver.
lessened by the administration of vitamin C, and the mortality

rate was decreased by 57 percent.
Other researchers have concluded that ''exposure to ben-
zene produces an increased requirement of vitamin C and that
an extra supply of vitamin C given increases resistance to the
effects of benzene vapors'' {Medical Hypotheses, May, 1980).
If it's insecticides you've been exposed to, vitamin C may
be able to come to the rescue again. One in particular, chlordane,
acts primarily on the central nervous system leading to symptoms
of hyperexcitability, tremors and convulsions. As if that's not
enough, it also causes marked degenerative changes in the liver,
kidney, spleen and heart.
But now there's a study that shows that vitamin C can coun-
teract some of those adverse effects. In the experiment, the
researchers divided rats into three groups. One group acted as
the controland was given the regular rat chow. The second group
received the same diet plus a dose of chlordane, and the third
received the food, chlordane and vitamin C.
As expected, chlordane toxicity drastically altered the tis-
sues of various organs as well as lowering the growth rates of

the animals in the second group. Several of the rats' enzyme
systems went haywire, too. And the mortality rate was almost
43 percent in the chlordane-treated rats.
The good news here is that the vitamin C-treated rats fared
much better. Mortality was nil, and growth retardation was con-
siderably counteracted. Although vitamin C couldn't restore all
the damaged parts, it did a good job on the kidneys, where it
"could reverse some of these degenerative changes in the kidney

tissues" {International Journal for Vitamin and Nutrition Re-
search, vol. 51. no. 3, 1981).
As long as we live
world surrounded by pollution and
in a
other poisons, we need allwe can get. And vitamin C
the help
may be one of the best bets around. "It has a lot of properties
thai haven't even been investigated yet," says Dr. Scott.
"Other areas of research should be directed toward the po-

of ascorbic acid on the development of silicosis,
tential effects
noise-related adverse health effects, industrial fluoride toxicity
and lead intoxication," adds Dr. Calabrese.
But why wait till the research is completed?
The present evidence is already pretty convincing. With
vitamin C as our shield against pollutants, who needs luck?
CHAPTER
CLEAN CHLORINE
FROM YOUR WATER
WITH VITAMIN C
It cleans swimming pools, whitens clothes and makes tap
water taste like a cross between cod liver oil and Drano. You

guessed right it's chlorine.
Chlorine is added to practically every large urban water
supply in the United States. That's not necessarily bad. By killing
off waterborne bacteria, chlorine protects us against typhoid
fever, dysentery and cholera. But making every glass of water
a chlorine cocktail is not necessarily good, either. For chlori-
nated water not only wipes out foreign bodies like germs and
microbes, it may also stage an attack on our bodies, damaging
red blood cells.
John Eaton, Ph.D., associate professor of medicine at the
University of Minnesota, told us that chlorinated water has a
"deleterious effect" on red blood cells, crippling them so that
they can no longer efficiently perform their function of carrying
oxygen to every part of the body and causing their premature
destruction.
But he also told us what to do to prevent those cells from
being lamed by chlorine: "Put vitamin C in your water before
you drink it.
274

CLEAN CHLORINE FROM YOUR WATER 275
"It's odorless and tasteless in the tiny amount needed ^just
a trace to neutralize the chlorine/' Dr. Eaton said. "And vi-
tamin C works very rapidly," he added.

The research scientist made his two discoveries that chlor-
ine damages red blood cells and that vitamin C neutralizes it
in the course of finding out why patients at two of three artificial
kidney centers in Minneapolis were developing severe anemia.
It turned out that, at those two centers, the water used in
the blood-cleansing kidney machines was not chlorine free. In

his laboratory. Dr. Eaton found that the chlorine severely dam-
aged the red blood cells of the kidney patients, causing anemia.
He also found that, by adding vitamin C to the dialysis water,
he could set up a chemical reaction that neutralized the chemical
(Science).
But Dr. Eaton is not the first researcher to discover that,
muck
while chlorine clears the out of stream water, it can also
muck up your bloodstream.
In 1972, Russian scientists found that people drinking water
with 1.4 milligrams of chlorine in it showed higher blood pres
sures than those drinking water containing only 0.3 to 0.4
milligrams.
Reading about these studies, we might want to plug up the
faucet for good and rely solely on spring or well water. While
that might not be a bad idea, it isn't convenient for some of us.
Instead, add a little piece of a vitamin C tablet or a scant pinch
of the powder to your glass of chlorinated water before you drink
it. Not only will chlorine's taste and odor disappear, so will its
threat to your good health. Cheers.

CHAPTER
C IS FOR
CHOLESTEROL
AND ITS CONTROL
Forget Son of Sam, Jack the Ripper and the Boston Stran-
gler: The greatest killer of all time is heart disease. Specifically,
it is heart disease caused by atherosclerosis, or hardening of the
arteries, and its favorite weapon is cholesterol.
Mention cholesterol, and most people want to do something
about it. So they start thinking about breakfast. Now, that's not
a bad place to start, but they immediately implicate eggs. And
that's a crime. What they should be doing is pouring themselves
another glass of orange juice. Vitamin C, researchers have found,
is a good defense against cholesterol, hardened arteries and heart
disease.
One testimony comes from England, where 11 elderly hos-
pital patients with coronary artery problems took 1 gram (1,000
milligrams) of vitamin C daily resulting in a decrease of total
blood cholesterol levels in only six weeks. That prompted re-
searchers to assert that "atherosclerosis and ischaemic heart
disease are not inevitable features of aging" {Journal of Human
Nutrition, vol. 35, no. 1, 1981). That's not all they found.
As a little background on the case, cholesterol's guilt is
276
C FOR CHOLESTEROL CONTROL 277
purely by association. Left to itself, cholesterol actually does

some good. It helps our digestion by producing bile, without
which we can suffer gallstones. Our bodies need cholesterol to
manufacture vitamin D, and there is some evidence that it pro-
tects us from cancer. Its home turf is the liver, but cholesterol
goes out a lot. Its traveling companions are called lipoproteins,
and they chauffeur it around the bloodstream.
In the company of high-density lipoproteins (HDLs), cho-
lesterol's joyride is relatively safe. But introduce it to low-density
lipoproteins (LDLs), and look out, cholesterol is up to no good.
Scientists now believe that lowering total cholesterol is less im-
portant than getting most of it on the HDL route. And that, the
British research team learned, is another thing vitamin C does.
When they started their gram-a-day supplementation, most
of the heart patients had vitamin C deficiencies; the men also
had correspondingly low levels of HDL cholesterol. "After six
weeks' treatment with ascorbic acid [vitamin C], the mean [av-
erage] HDL-cholesterol concentration had increased," the study
team noted. What's more, that benefit was not restricted to the
heart patients; all 7 men in the 14-member healthy control group
enjoyed it, as well.
The seven women who acted as controls experienced no
significant change in lipoprotein cholesterol, but that doesn't
mean vitamin C is guilty of sex discrimination. Women naturally
have higher HDL levels, which is one reason they are less prone
to heart attacks than men. All the women in the control group
had healthier HDL levels.
The evidence that vitamin C can protect as well as defend,
that it is as beneficial to high-risk subjects as to those already
afflicted with heart disease, may be the most compelling aspect
of the British investigation. The research team has entered a plea
for higher recommended daily intake of vitamin C because "la-
tent ascorbic acid deficiency may be one
of several preventable
'risk' factors contributing to the present epidemic of ischaemic
heart disease in the western world."
278 VITAMIN C
Deficiencies Are Common

Not only has it been linked to heart disease, but a vitamin
C deficiency is more common than you might think.
The heart patients in the British experiment weren't the only

ones suffering vitamin C deficiencies at the outset: Some of the
14 "healthy" control subjects were deficient, too. The authors
noted that "low blood ascorbic-acid levels are often found in
elderly patients."
Nobel Prize-winning vitamin C advocate Linus Pauling,
Ph.D., suspects that as much as 99 percent of the world's pop-
ulation suffers from a deficiency of the nutrient. Dr. Pauling,
who personally takes 10 grams daily, agrees that the current
Recommended Dietary Allowance (about 60 milligrams) is "much
too low" and says he would like to see it raised to "at least
150." Dr. Pauling's colleague, scientist Irwin Stone, and British
physician Geoffrey Taylor are two other vitamin C champions
who go so far as to suggest that today's coronary epidemic may
be but a modern version of that ancient sailors' scourge: scurvy.
Like human beings, guinea pigs are one of a handful of
species unable to manufacture vitamin C in their own bodies.
When the vitamin is withheld from their diets and scurvy is
induced in the laboratory, guinea pigs develop weak arteries with
interior bruises like those that are symptoms of the beginnings
of atherosclerosis. No matter how those bruises are acquired,
they become a magnet for wayward LDL cholesterol, which
collects there in layers called plaque
perhaps a misguided at-
tempt to shelter the injured area. If such is plaque's intent, it
succeeds all too well, eventually narrowing the blood's pas-
sageway until it becomes a dead-end road. The body's reaction
is a heart attack.
The detour signs start going guinea pigs' arteries when
up in
their vitamin C reserves are in the range of 15 micrograms per

gram of body weight (a microgram is one-millionth of a gram).
That's about the level we're at when we have a cold if we've
been getting only the RDA. Taking greater amounts of vitamin
C puts us way ahead of the game.
Vitamin C isn't just a policeman directing cholesterol traffic

through the bloodstream and forcing loitering platelets to break
it up and move on. After a heart attack has occurred, a high
level of C can pay off like an insurance policy.
C Repairs Heart Damage

That's what Scottish physicians at Southern General Hos-
pital in Glasgow reported several years ago when they discovered
that blood levels of vitamin C drop down to scurvy levels within
6 to 12 hours after a person suffers a heart attack.
They concluded that the vitamin C was diverted to the heart
damaged coronary tissue (British Heart Journal).
to help rebuild the
Their findings were borne out by a more recent study in
which Jairo Ramirez, M.D., and colleagues at the University of
Louisville, Kentucky, found that the vitamin C concentrations
in the white blood cells of 150 patients with heart disease were
"significantly lower" than those of a control group. And they
remain dangerously low for several weeks after a heart attack
before gradually increasing to a stable level. That phenomenon
may occur even when there is no change in daily vitamin C
supplementation {American Journal of Clinical Nutrition, Oc-
tober, 1980).
Dr. Ramirez, now engaged in private practice in San An-
tonio, Texas, also noted that cholesterol is higher in patients
deprived of vitamin C and that increasing amounts of the vitamin
cause an increase in the liver's production of a substance called
cytochrome P-450, which speeds up the conversion of choles-
terol into bile.
Anthony Verlangieri, Ph.D., associate professor of phar-
macology and toxicology at the University of Mississippi, has
determined that vitamin C helps the body manufacture another
chemical compound with a nifty name: chondroitin sulfate A,
aliasCSA. Dr. Verlangieri was working in the biochemistry lab-
oratory at Rutgers University when he discovered that CSA acts
as a sort of mortar in healthy artery walls and that cholesterol
280 VITAMIN C
attaches itself only to damaged artery walls that lack this

compound.
Preventing One Million

Heart Attacks a Year
While Dr. Verlangieri was experimenting with CSA in his
New Jersey laboratory, he was unaware that a research team
3,000 miles away, in Culver City, California, had also isolated
CSA and was using it to treat heart-attack victims. It worked so
well, deaths due to coronary complications dropped by a whop-
ping 80 percent in those patients treated withCSA. Lester M.
Morrison, M.D., former director of the Institute for Arterio-
sclerosis Research at Loma Linda University school of medicine
in California, headed the research team. He suggests that CSA
can also prevent "over one million heart attacks a year."
Dr. Morrison's published findings coincided with those of
Dr. Verlangieri, who declared, "My findings show that vitamin
C stimulates production of the same compound within the body."
As research continues, scientists are finding that the RDA
set for vitamin C
seldom enough and that wholesome foods
is

we've enjoyed for centuries such as eggs are rarely to blame
for modern diseases.
One of the first to recognize that fact was England's Dr.
Constance Spittle Leslie, who put herself on a high-cholesterol
diet but found that her blood cholesterol dropped because she
also ate lots of fresh fruits and vegetables rich in vitamin C.
If she cooked the fruits and vegetables, however, her blood
cholesterol level rose, because heat destroys vitamin C. Results

were the same when Dr. Leshe carried out the experiment on
58 human volunteers.
She also found that, when they were given 1-gram supple-
ments of vitamin C every day, the volunteers enjoyed the drop
in cholesterol levels even if they cooked their fruits and vege-
tables (Medical World News).

So you don't necessarily have to give up eggs, cheese and

the finer things in out of fear of heart disease. There's ample
life
evidence that vitamin C can safeguard your arteries and your

general well-being as it also protects against colds and cancer.
There are many stories of the benefits of vitamin C. Neutralizing

cholesterol is only one of them.
CHAPTER
VITAMIN C,
PECTIN AND
HEART DISEASE
^v Emil G inter, Ph.D.
The search for substances capable of depressing cholesterol

levels in the blood is one of the most pressing in ongoing medical
research. Cholesterol concentration (or to be more precise, the
level of low-density lipoproteins, or LDL, cholesterol) consti-
tutes an important risk factor for atherosclerotic damage of blood
vessel walls that may bring about a heart attack or stroke.
Pharmaceutical companies have developed several drugs that
in experimental animals and also
depress blood cholesterol levels
in humans. The substance most employed has been ethylester
of chlorphenoxyisobutyric acid (clofibrate, Atromid) because short-
term tests revealed no serious adverse side effects from its use.
However, to be effective, this drug must be taken in rather high
doses and permanently.
Two extensive surveys lasting several years, carried out in
both the United States and Europe and involving several thou-
sand persons, have shown clofibrate to be less effective in de-
Dr. Ginter, who has done extensive research with vitamin C, is
associated with the Institute of tinman Nutrition in Bratislava,

Czechoslovakia.
282
VITAMIN C AND HEART DISEASE 283
pressing blood cholesterol than had originally been claimed. In

addition, when used continually, this drug has several negative
side effects, the most evident of which is the formation of gall-
stones. The European study even showed the overall death rate
in persons on a long-term clofibrate regimen to be significantly
higher than for those not taking the drug. And the chemical
structure of the majority of other drugs with a cholesterol-de-
pressing action indicates that their regular use also raises the
possibility of adverse side effects.
Fortunately, there may be other, safer alternatives. For cen-
turies, men have suspected that fruits and vegetables contain
certain natural substances which exert a protective action in
circulatory disorders. Physicians in ancient India, for example,
used concentrates of certain fruits to treat vascular diseases, and
old textbooks of dietetics recommended days of fruit-vegetable
diet for cardiovascular patients.
But to come to the present time: Dr. Frank M. Sacks and
his team from Harvard compared two groups of people of about
the same age consuming either the current North American diet
or an essentially vegetarian diet. They found the blood choles-
terol levels in those with a high consumption of vegetables and
fruits to be substantially lower than in the normal American
population. Of particular importance, they found that the low
cholesterol levels reflected a reduction of the LDL cholesterol
fraction, which is suspected to be the real troublemaker in heart
disease. On the other hand, the level of high-density lipoprotein
(HDL) cholesterol, which exerts a protective action, was not
decreased.
Another group of U.S. researchers in California have noted
a substantially lower mortality rate from heart attacks in Sev-
enth-day Adventists, who are predominantly vegetarians. For
instance, coronary mortality in Seventh-day Adventist men of a
younger age group was only one-quarter of that in a matched
sample of the standard California population. The majority of
researchers attribute these differences primarily to the fact that
vegetarians have a substantially lower intake of cholesterol and
saturated animal fat than the average person. Although, of course.
284 VITAMIN C
that factor plays a considerable role, such an explanation is still
incomplete, for it leaves out of account the protective role of

certain specific components of vegetables and fruits, namely vi-
tamin C and dietary fiber.
How Vitamin C Protects

Over the past 30 years, several teams of investigators in
various parts of the world have pointed out that vitamin C lowers
cholesterol levels in humans and exerts a protective action by
promoting the transformation of cholesterol to bile acids, which
can then be excreted from the body. During a long-term marginal
vitamin C deficiency, such as people in many countries experi-
ence during the winter and spring months, when fresh fruits and
vegetables are less plentiful, cholesterol transformation to bile
acids is slowed down, resulting in an accumulation of cholesterol
in the liver and the blood.
In animals, if vitamin C deficiency persists for a considerable
length of time, cholesterol also accumulates on the vessel walls,
and pathological changes take place in arteries reminiscent of
human atherosclerosis. On the other hand, high doses of vitamin
C accelerate cholesterol transformation to bile acids and prevent
such changes from taking place.
If vitamin C is given to people with high cholesterol levels,
a decline of cholesterol concentration in their blood is often

observed. However, after about six months, when a maximum
drop is usually achieved, there is a tendency in some of the
patients for cholesterol levels to rise again toward higher values.
That is likely caused by a sensitive feedback system. As vitamin
C accelerates the conversion of cholesterol to bile acids, some
of these bile acid molecules find their way back to the liver and
signal a slowing down of the initial reaction. At that point, the
cholesterol-lowering effect of vitamin C becomes weakened.
However, if the drug cholestyramine is given with the vi-
tamin C, there is a striking and sustained decline of blood cho-
VITAMIN C AND HEART DISEASE 285
lesterol level, at least in experimental animals. That is because

cholestyramine binds the bile acids in the digestive tract.
So it is evident that a mutual reinforcement of the effect on
blood cholesterol level exists between vitamin C and substances
capable of binding bile acids in the intestine. Evidence has ac-
cumulated in recent years that several naturally occurring sub-
stances in plants, designated by the general term dietary fiber,
exert an effect similar to that of cholestyramine.
Pectin's Vital Role

One such natural fiber is pectin, long used in the making of
jams because of its ability to form gels. Gel derived from pectin
has the ability to bind bile acids in the human digestive tract,
thus increasing fecal excretion of bile acids.
Our own studies on experimental animals have produced
conclusive evidence that simultaneous administration of vitamin
C and pectin significantly decreases cholesterol concentration
not only in blood, but likewise in the liver. When taken daily, a
test preparation containing 450 milligrams of vitamin C and 15
grams of citrus pectin lowered total blood cholesterol in humans
after six weeks. This decline was characterized by a decrease
of the dangerous LDL cholesterol, while the concentration of
the protective HDL cholesterol remained unchanged.
To sum up, a high vitamin C intake causes cholesterol trans-
formation to bile acids to proceed at a faster rate in the liver.
Bile acids from the liver pass into the intestine, where they are
then bound to pectin gel and leave the body in the stools. The
ultimate result of this interplay of two natural substances is a
low cholesterol level in the blood and a diminished risk of
atherosclerosis.
Pectin has a number of additional positive effects. It im-
proves stool consistency, acts as a detoxifier by binding heavy
metals and carrying them out of the body, and also slows down
the absorption of sugar. This last effect may be useful for diabetics.
286 VITAMIN C
should be stressed that this approach to cholesterol con-

It
trol is especially promising because pectin and vitamin C are

naturally occurring substances. It seems extremely unlikely that
even permanent consumption would result in undesirable side
effects. For this reason, persons concerned about high choles-
terol levelsshould substantially increase their consumption of
fruitsand vegetables. Black currants, for example, are a con-
centrated source of both vitamin C and pectin. But other abun-
dant sources include citrus fruits, strawberries, tomatoes, rasp-
berries and blackberries. Perhaps some day supplements of vitamin
C and pectin in combination will be routinely prescribed to both
treat and prevent dangerously increased cholesterol levels.
CHAPTER
CAN VITAMIN C
PREVENT THE
COMMON CANCER?
one thing to think of vitamin C in terms of preventing
It's
the common cold

but cancer? That's a bit much. After all,
there's quite a difference between a case of the sniffles and the
second leading cause of death from disease in the country. None-
theless, some researchers believe that the best way to deal with
cancer is to prevent it. And preliminary data indicate that vitamin
C may help do just that.
First of no secret that researchers have been ex-
all, it's
amining vitamin C's effects on already existing cancer cells very

closely. In a study at the University of Kansas medical center,
researchers found that vitamin C suppressed the growth of cer-
tain leukemia cells.
The scientists took bone marrow cells from 28 leukemia
patients and placed them in 28 special containers (cultures). In
7 of the 28 cultures (25 percent), the numbers of leukemic cell
colonies were reduced markedly when vitamin C was added

{Cancer Research, April, 1980).
The investigators discovered that lower concentrations of
vitamin C worked as well as extremely high levels of the vitamin
in that particular instance. They suggested that a study using
287
288 VITAMIN C
vitamin C might be conducted on certain types of leukemia pa-

tients. But the patients would have to be carefully screened
before they could take part in a controlled experiment, the re-
searchers warned. They found that vitamin C will make leukemic
cell colonies grow in a few instances.
Apparently, vitamin C also lashes out at certain bad cells
while leaving good cells unharmed. A group of researchers from
France and Texas found that vitamin C is selectively toxic to at
least one type of malignant cell
a melanoma. They also ob-
served that the vitamin C levels needed were at concentrations
that might be attained in future studies with humans {Nature,
April, 1980).
The researchers extracted both cancerous and noncancer-
ous from mice. Then they placed the cells in two separate
cells
cultures and added vitamin C. The malignant, or melanotic, cells
showed a 50 percent decrease in colony formation, cell number
and their ability to stay alive.
"Vitamin C may directly inhibit the growth of proliferating
cells, and this might explain some of the reported carcinostatic
[cancer suppressing] effects," the researchers write. They also
note that the preferential toxicity of vitamin C for melanoma
cells was greatly increased when small amounts of copper were
added.
Cancer Patients Helped

That's great for mouse what about vitamin
cells in a dish, but
C's effect on cancer patients? Well, a Japanese hospital has been
giving cancer patients the vitamin since 1968. Until 1977, they
had given smaller doses to some patients, but they found such
positive results that they decided to give large doses (5 grams
or more per day) to all.
Of patients in the early stages of the disease, 69 percent
receiving large doses were still alive at the time of the report,
while only 29 percent of those receiving small doses survived.
Most striking was the fate of those patients who had been de-
VITAMIC C AND CANCER 289
clared terminal: "The average survival time after being pro-

nounced terminal was 43 days for the iow-ascorbate [vitamin C]
patients and 201 days for the high-ascorbate patients." And fur-
ther: "None of the Iow-ascorbate patients survived more than
174 days, whereas 18 (33 percent) of the high-ascorbate group
survived longer than 174 days, their average being 483 days (886
days for the 6 still living).
"In many patients, the administration of vitamin C seems
to improve the state of well-being, as indicated by better appetite,
increased mental alertness, and a desire to return to ordinary
life" (Journal of the International Academy of Preventive
Medicine).
In light of the Japanese results, a study of 150 advanced
cancer patients at the Mayo Clinic needs a closer look. Re-
searchers there found no statistically significant difference in the
survival rate, symptoms or apparent well-being of two groups
of patients, one of which received 10 grams of vitamin C daily,
the other a placebo. They were therefore unable to show evi-
dence of the therapeutic value of high doses of C.
The problem with the Mayo Clinic study was that the pa-
tients had already run the gamut of conventional therapy such
as chemotherapy and radiation therapy. Their immune systems
were wrecked by the toxic effects of the previous therapies, a
possibility admitted to by the researchers: "We recognize," they
write, "that earlier immunosuppressive treatment might have
obscured any benefit provided by [vitamin C]" (New England
Journal of Medicine, September 27, 1979).
Previous research on cancer victims had far better results.
The link between C and the body's immune system is well doc-
umented, particularly in cancer victims, who, according to Linus
Pauling and other researchers, "generally exhibit diminished im-
munocompetence and almost invariably have low [white blood
cell] ascorbate content.
"The simplest and safest way to enhance immunocompe-
tence in such patients and to ensure that their . . . defense sys-
tems are working at maximum efficiency is to increase their
ascorbate intake.
290 VITAMIN C
"In our view, ascorbate is essential to ensure the working

of the immune system" (Cancer Research, March, 1979).
Pain Relief
A C by
study of 30 terminal cancer patients given vitamin
M. L. M.D., and Edward Elkowitz, D.O., showed
Riccitelli,
"there was no tumor regression," says Dr. Elkowitz, professor
at Downstate Medical Center in Brooklyn, New York.
However, Dr. Elkowitz told us, "The patients had less pain,
improvement of appetite and improved well-being." And, he
notes, the patients taking vitamin C were in far less toxic a state
than those patients treated with chemotherapy (anti-cancer
chemicals).
The two doctors gave their patients up to 50 grams of vitamin
C a day.
"It's probably impossible to give too much because it's
harmless," says Dr. Riccitelli, former assistant clinical professor
of medicine at the Yale University school of medicine. "After
the body is saturated with vitamin C, the rest is metabolized by
the liver and excreted."
Dr. Riccitelli himself takes 4 grams a day and believes doing
so may help prevent cancer, "I'm sure vitamin C works to help
prevent cancer," he told us. "Of course, all the evidence is

presumptive you can't prove how it works. But that doesn't
matter. You can't prove how
works either."
aspirin
A physician who is Ewan Cameron, M.B.,
agrees with him
Ch.B., a Scottish surgeon who has conducted much of the re-
search on vitamin C and cancer, particularly on patients with
advanced cancer.
"I'm pretty convinced that if people maintained a reason-
able . intake [of vitamin C], that we would see a diminished
. .
incidence of cancer," Dr. Cameron told us.

"If you can alter, even a the very, very advanced
little,
cancer patients, then all logic suggests you should be able to

alter the very early stages of the illness," he told us. "And, of

VITAMIN C AND CANCER 291
course, the earliest stage of the illness is before the person has
cancer at all."
Tumor Growth Reversed

And in Dr. Cameron's studies on advanced cancer patients,
the disease was sometimes altered more than a little.
"We published a paper reporting dramatic relief of bone

pain in four out of five patients with skeletal cancer," he says.
"Bone cancer is usually a pretty painful situation .... Vitamin
C, however, relieves the pain. And this is not because vitamin
C is, itself, a pain reliever or a narcotic. because the pain is
It's
due to the steady expansion of the tumor against the inelastic

bone. Vitamin C slows down the expansion and thus relieves
the pain."
Dr. Cameron has seen cases in which vitamin C not only
slowed down tumor growth, but reversed it.
"One old man, a stationmaster, came in with cancer of the
pancreas. I operated on him and he went home. He wasn't given
vitamin C yet. Four or five months later, he came back with a
big, malignant liver. He wasn't going to die that week, but he
was a very sick man. Very definitely on a downhill slope. We
started him off on vitamin C and his liver shrank back in size
and, contrary to many expectations, he went home."
Over the past eight years. Dr. Cameron has compared the
survival time of terminal cancer patients who receive vitamin C
to similar patients who don't. He has found that vitamin C in-
creases survival time by an average of 330 or more days (some
of the patients are still alive) to 6.6 times longer than patients
who don't get vitamin C.
Cancer Prevention
But the studies mentioned so far are of ways in which vi-
tamin C is used to tackle cancer cells which already exist. Other
292 VITAMIN C
researchers are taking a different approach. They're trying to

find out if vitamin C intake can prevent cancer cells from de-
veloping as Drs. Riccitelli and Cameron believe.
in the first place,
According to the National Cancer Institute, about 77,000
Americans develop colon cancer annually, and 42,800 die from
it. But there is a lower incidence of colon and rectal cancer in
Florida and the southeastern United States, as well as in Cali-

fornia and Arizona. The incidence of large-bowel cancer is one-
half the national average in those regions, note Henry C. Lyko
and James X. Hartmann, Ph.D., who conducted their research
at Florida Atlantic University. They suggest that the increased
consumption of which is high in vitamin C, may be
citrus fruit,
the reason. Regular citrus consumption is part of the southeast-
ern Florida lifestyle, they report, and two-thirds of the families

there have an average of three citrus trees per household.
The scientists say that people who consume diets high in
beef, fats and proteins are at a higher risk of developing large-
bowel cancer. But ". there is increasing evidence that vitamin
. .
C may prevent the development of large-bowel cancer," says

Lyko, ''and the most encouraging aspect of these findings is that
it may be easier to get Americans to supplement their diets with
citrus or vitamin C than persuade them to change their dietary

habits appreciably."
At Children's Hospital in Los Angeles, researchers have
scrutinized vitamin C from another angle. What happens when
normal cells are exposed to a carcinogen, and vitamin C is added
afterward? Can vitamin C keep tumors from forming? William
F. Benedict, M.D., and Peter A. Jones, Ph.D., are only at the
earliest stages of working out those questions, but preliminary
results are encouraging.
Vitamin C Inhibits
Cell Transformation
The researchers took mouse embryo cells and exposed them
to a carcinogen for 24 hours. Then they removed the carcinogen
VITAMIN C AND CANCER 293
and immediately added vitamin C to some of the exposed cells.

They found that vitamin C completely prevented cell transfor-
mation that normally occurs after exposure to cancer-causing
agents.
In a second experiment, the researchers found they could
wait as long as 23 days before adding vitamin C to the exposed
cells and still get the same results. The vitamin C completely
inhibited the cell transformation.
Then the researchers took cells that had already transformed
and never before been in contact with vitamin C. They divided
the transformed cells into two groups. Vitamin C was added to
one group of transformed cells. The second group was left alone.
"The dish of transformed cells that got the vitamin C changed
back into normal-appearing cells," Dr. Benedict told us. That
doesn't happen in every instance, however.
If you took transformed cells and added vitamin C to them,
75 percent of the cells would go back to normal. Dr. Benedict

explains. The remaining 25 percent would still be in the trans-
formed state. They would not change back, despite the addition
of vitamin C.
"We think the transformation process of a cell is a pro-
gression," says Dr. Benedict. "Vitamin C may revert a cell back
to normal if the transformation process has only gone so far."
Is there any difference between normal cells and the trans-
formed cells that suddenly appear normal after getting vitamin
C? "We don't think there is," says Dr. Benedict.
The doses of vitamin C used were much smaller than those
used in other studies, and once the transformed cells had reverted
to normal, the researchers discovered the vitamin was no longer
needed.
"When we took the vitamin C away, the cells did not trans-
form again," says Dr. Benedict. The vitamin C apparently made
an irreversible change in the cells, and they remained normal in
appearance. "Usually, when you take other cancer-blocking agents
away, within three or four days you have transformed cells ap-
pearing in the dish again."
He emphasizes that their research does not address the ques-
tion of vitamin C's effects on cells after they have become a
294 VITAMIN C
tumor. The relevancy of their findings ties in with blocking a

tumor from forming. Vitamin C may change transformed cells
back into their normal state before they grow into a tumor, he
says.
The researchers hope their results can be duplicated in whole-
animal studies, such as those with guinea pigs.
Like humans, guinea pigs are unable to produce vitamin C
inside their bodies. The scientists are interested also in learning
if vitamin C can prevent cell transformations in the same manner
after X rays.
They are cautious about their findings, but they also are
excited about them. "We
were quite surprised by the results,''
admits Dr. Benedict, "and as we go along, we get more and
more surprised."
CHAPTER
USING CORTISONE
DRUGS? BETTER
CHECK YOUR
VITAMIN C!
In our overmedicated society, where doctors write prescrip-

tions as automatically as politicians offer handshakes, you don't
have to look very far to find someone who is taking one of the
steroid drugs cortisone, hydrocortisone, prednisone or a re-
lated compound. In fact, chances are good anyone who's
that
ever experienced even a moderate bout of arthritis or any other
form of painful inflammation or swelling has taken a steroid or
corticosteroid at least for a short time
perhaps you included.
Despite the frequency with which they are prescribed, how-
ever, steroids are far from harmless medications. Some of their
undesirable side effects are so predictable and so severe that
people forced to take them over long periods eventually run into
health complications that can overshadow their ori^nnal prob-
lems. That's why it's encouraging to learn of growing indications
that a stepped-up intake of nutrients, especially vitamin C, can
counteract some of the nastiest side effects.
One of the most dangerous and widely recognized conse-
quences of prescribed steroids is reduced resistance to infection.
A report by Ellen Ginzler, M.D., assistant professor of medicine
at Downstate Medical Center in Brooklyn, New York, gives a
295

296 VITAMIN C
new insight into the magnitude of the problem. Dr. Ginzler noted
that, among 223 patients with systemic lupus erythematosus
an inflammatory disease that causes a breakdown of connective
tissue
high doses of prednisone were directly tied to increased
bacterial and fungal infections (Medical Tribune).
Drug-related infection was the cause or major contributing
factor in 30 of 55 deaths among patients in the study group. And
there were 354 nonfatal infections. Such infections tended to rise
as steroid dosage went up.
"No one is particularly surprised. Other studies have sug-
gested the same relationship of steroids to infection," Dr. Ginzler
said, "but this is the first study that has specifically looked at
the question, trying to separate out the potential risk factors."
The results, she added, "strengthen our resolve to minimize
steroid therapy" in treating lupus.
But drug-prescribing habits aren't changed overnight, even
in the faceof hard evidence. What about the hundreds of thou-
sands of Americans who are taking cortisone and other steroids
now, and for whom doctors will continue to prescribe those
drugs? Here's where new evidence suggests that supplementary
vitamin C may be valuable.
Steroids increase the risk of infection by interfering with the
ability of tiny colorless corpuscles in the blood, called neutro-
phils, to engulf and destroy invading bacteria. But extra vitamin
C, taken at the same time as the drug, can restore the body's
natural defense mechanism and get the neutrophils back on the
attack. That's the thrust of recent findings reported by research-
ers Grant E. Olson and Hiram C. Polk, Jr., M.D., professor and
chairman of the department of surgery at the University of Louis-
ville school of medicine.
The Kentucky researchers describe their study in the Jour-
nal of Surgical Research. Using blood samples collected from
normal people, the pair created test-tube mixtures of neutrophils.
Staphylococcus bacteria and the equivalent of a therapeutic dos-
age of the steroid drug hydrocortisone, in some samples, vitamin

C was added the equivalent of 2 grams (2,000 milligrams) for
CORTISONE DRUGS AND VITAMIN C 297
a 150-pound man. Other mixtures received no supplementary

vitamin C.
Testing revealed that, in the latter samples, the bacteria-
killing process was significantly depressed within one hour after
the addition of hydrocortisone. But the neutrophil mixtures for-
tified with vitamin C had a near-normal ability to destroy the
staph germs.
The authors concluded that, in patients receiving certain
steroids, "ascorbic acid [vitamin C] may be beneficial in reducing
the high incidence of infection in this group."
Their findings and conclusion parallel a similar study
performed by researchers at the Georgetown University hospital,
Washington, D.C. In that study, reported in the Journal of the
Reticuloendothelial Society, blood samples from six patients re-
ceiving steroid treatment were exposed to latex particles, meant
to simulate a bacterial invasion.
As expected, measurements indicated that among these sub-
jects who had been taking steroids for from one day to more
than years neutrophil function was significantly impaired.
five
But when the same patients were given grams of 2 vita-
min C two 1-gram doses over a 12-hour period on the very
next day it was found that their natural bacteria-fighting
mechanisms had returned to normal. And
improvement was
the
rapid, occurring wihin one hour of receiving the second dose of
vitamin C.
Steroids Widely Used

If vitamin C can help curb even one of the dangerous adverse
effects of steroid drugs, promises to be of potential value to a
it
large cross section of the American population. For those med-

ications are now being prescribed for a whole host of conditions
ranging from treatment of menopause, arthritis, bursitis, asthma,
psoriasis and enteritis to kidney disease, eye inflammation and
leukemia.
298 VITAMIN C
Simply recognizing a particular prescribed drug as a steroid

isn't always easy, as they are under a bewildering variety of
brand names. For example, Allersone, Cort-Dome, Cortenema,
Cortril, Dermacort and Hytone are just some of the brands of
hydrocortisone. And prednisone, one of the most popular of the
steroids, is marketed by many different companies.
Side effects, as listed in standard prescribing volumes such
as the Physicians' Desk Reference, are numerous and alarming.
In addition to lowered defense against infection, they include
peptic ulcers, cataracts, glaucoma, diabetes, heart problems, high
blood pressure, delayed wound healing and bone and muscle
breakdown.
In addition, people who take steroids continuously for sev-
eral years to treat a chronic illness often develop a distressing
condition known as Cushing's syndrome. Symptoms include
painful, fatty swellings on the body, a moon-shaped face, dis-
tended abdomen and reduced sexual ability.
Still another side effect, suppressed growth in childhood,
also appears to respond favorably to vitamin C. A team of doc-

tors at two hospitals in Athens, Greece, discovered that supple-
ments of 500 milligrams of vitamin C every eight hours helped
restore new collagen formation in youngsters taking steroid drugs.
Collagen is essential for normal growth, but steroids interfere
with its formation. The Greek researchers found that new col-
lagen production was boosted by 52 percent after four days of
vitamin C supplementation (Archives of Disease in Childhood).
Given the facts of modern life, cortisone and other steroid
drugs are an almost unavoidable part of medical treatment for
many people. But we must never forget that they are two-edged
swords. Hopefully, as more doctors and patients find out about
the counteracting effects of vitamin C, at least some of the ter-
rible consequences of the steroids can be avoided.
CHAPTER
VITAMIN C AND
HEROIN ADDICTION
The heroin addict: His Hfe turned into a hell, the heroin he
craves shuts off emotion and sexual desire, warps sleep and, if
the needles are dirty, infects the liver and heart.

He has a problem that society, in spite of spending hundreds
of millions of dollars, has been largely unable to solve. But he
may be helped perhaps even cured by a simple substance:
vitamin C.
One reason heroin addicts stay heroin addicts is that it's
physically grueling to go off the drug. Withdrawal symptoms last

for days and include runny eyes and nose, sweating, chills, mus-
cle aches and pains, abdominal cramps, diarrhea, loss of appetite
and insomnia. Most withdrawal programs deal with those symp-
toms by treating them with specific drugs: Valium for the insom-
nia, for instance, or Darvon for the pain. The problem with that
approach, however, is that the treatment medications have side
effects sometimes as debilitating as the withdrawal symptoms
themselves. Also, the medication may itself be addictive! In fact,
the most widely accepted treatment for "curing" a heroin addict
is giving him methadone another addictive drug.
What heroin addicts really need is a way to detoxify their
299
300 VITAMIN C
bodies without suffering prolonged withdrawal symptoms. Sound

impossible? Not if they take vitamin C.
"Sodium ascorbate [vitamin C] .was seen as a cost-
. .
effective, convenient, safe way to detoxify narcotic addicts,"

write Valentine Free and Pat Sanders, R.N., former researchers
at the San Francisco Drug Treatment Program, who gave large
amounts of vitamin C to heroin addicts during their withdrawal
{Journal of Psychedelic Drugs, July-September, 1979).

The researchers asked 227 addicts all of whom had used
heroin for at least seven years and spent $70 to $100 a day on
the drug to join one of three groups. Group received vitamin
1

C 24 to 48 grams for the first week of withdrawal, then 8 to 12
grams for the next two weeks. Group 2 received "symptomatic
medications" such as Librium, a tranquilizer. Group 3 also
relief
received those medications, but only for three days
for the last
18 days of the detoxification period they received vitamin C.
During the entire three weeks of the pilot study, the researchers
measured the average number of withdrawal symptoms in each
group.
After the first day of the study, the number of withdrawal
symptoms group
in (vitamin C) was 6.5 while group 2 (medi-
1
cations) had 8 and group 3 (medications-vitamin C) had 9. By

the end of the first week, however, group had dropped to 3
1

symptoms, group 3 had 1.1 and group 2 had 8.
By the end of the second week, the vitamin C group had no
symptoms, the medication-vitamin C group had symptom and 1
the medication group had 7.5. At the end of the third week, the
situation was much the same, with the medicated group dropping
to 6.5 symptoms.
They Lost Their Craving for Drugs

And vitamin C
helped the addicts in other ways.
The researchers point out that four of the addicts taking
vitamin C "reported a loss of 'craving' for drugs." None of the
addicts in group 2 noted any change in their desire for drugs.
a
VITAMIN C AND ADDICTION 301
And, say the authors, the ''majority of subjects" in the
vitamin C
groups "reported the feehng of having increased en-
ergy while large amounts of ascorbic acid [vitamin C] were used."
The researchers believe that this increased energy, along
with improvements in psychological health caused by vitamin
C, should make it easier for detoxified addicts to become re-
sponsible citizens: "Patient reports of ... a sense of well-being
add to a greater self-esteem in newly detoxified individuals
factor which outpatient treatment can build on by encouraging
the patient to deal more effectively with the home and community
environments."
And, they say, the vitamin C program (which also includes
mineral supplements) may help ex-addicts form a new habit
health. "Ascorbic acid and mineral supplements applied to nar-
cotic withdrawal symptoms . . . can easily lead into nutritional
counseling and other health perspectives once the detoxification
phase has been successfully completed."
This research project was not the first time heroin addicts
received large amounts of vitamin C during withdrawal. Irwin
Stone, a biochemist who has spent years investigating vitamin
C, and an associate conducted a study in which addicts took the
nutrient. The results are impressive (Journal of Orthomolecular
Psychiatry).
"The general improvement in the well-being of the addicts
within 12 to 24 hours after beginning sodium ascorbate detoxi-
ficationis striking," they write. "It is demonstrated by improved
mental alertness and visual acuity; appetite is returning, and the

addict is amazed that treatment is working without the use of
another narcotic."
The scientists also point out a rather incredible observation:
If an addict receiving vitamin C uses heroin during the with-
drawal period, "it is immediately detoxified and no 'high' is
produced. It is like injecting plain water."
Stone and his colleague describe the case of one addict, a
23-year-old who had used heroin since he was 15 and had been
through several medication-oriented detoxification programs.
"After three days on the regimen," they write, "he began eating
302 VITAMIN C
and feeling so much better and thinking more clearly . and

. .
he began to have restful sleep." After three months, he was still
drug free and had lost his desire for heroin.

In all, the researchers gave vitamin C to 30 addicts. The
success rate? 'Thirty out of 30 patients were successfully treated.''

CHAPTER
BIOFLAVONOIDS FOR
HEALTHY CAPILLARIES
Bioflavonoid the word has a kind of ominous ring to it.

You can almost see the movie poster with its garish artwork,
the faces of the terrified townspeople, the lurid prose: "What
was this strange menace that stalked the city? What did these
things want? For 24 hours they held an entire community par-
alyzed with terror! It was The Day of the Bioflavonoids!"
What we're dealing with here is fear of the unknown. The
only reason this family of nutrients comes off sounding like some
monstrous salad, run amok, is that many of us have never heard
of them. The bioflavonoids are often overlooked by nutritional
experts, but they have widespread beneficial effects. These
"things" are not out to terrorize your town, drain your bodily
juices or turn you into a soulless zombi. They come in peace,
to helpmake us all healthier people.
The effects of the bioflavonoids were observed in 1936
first
by scientists led by Albert Szent-Gyorgyi. Dr. Szent-Gyorgyi,

who also discovered vitamin C and was awarded the Nobel Prize
for his efforts, noted that, when animals with scurvy were given
crude preparations of vitamin C derived from natural sources,
they lived longer than animals given pure vitamin C. The impure
303
304 BIOFLAVONOIDS
vitamin C was more effective in healing the capillary (tiny blood

vessel) damage that is characteristic of scurvy. Dr. Szent-Gyor-
gyi reasoned that there must have been some additional sub-
stance present in the impure vitamin C that boosted its healing
effects.
That substance was actually a group of compounds, the
bioflavonoids. Dr. Szent-Gyorgyi and his colleagues found that
these compounds act to strengthen the capillaries and stop cap-
illary bleeding by lowering the permeability of the capillary walls.
Because of this action, he called the compounds vitamin P, for
permeability.

Ralph C. Robbins, Ph.D. a leading expert on the biofla-
vonoids and a researcher at the food science and human nutrition
department, institute of food and agricultural sciences at the
University of Florida, in Gainesville told us that the scientific
world reacted quickly to the discovery. ''Soon after Dr. Szent-
Gyorgyi discovered the activity of bioflavonoids in animals, a
great number of people studied the compounds and found that
the biolfavonoids seemed to produce beneficial effects in some
50 diseases."
In most cases, the effects of the bioflavonoids could be
traced to their action in the capillaries. These miniscule blood
vessels are the link in the circulatory system joining the arteries
and the veins. There are some 3.6 billion capillaries, located in
virtually every part of the body. The capillaries, and the capil-
laries alone, carry out the chief purpose of the circulatory sys-

tem they deliver oxygen and nutrients to the body's tissues and
remove poisonous wastes.
"The important role which capillary dysfunction plays in
many diseases is fully recognized by the medical profession, for
it is in the capillary system that the essential exchange of body
fluids takes place," a team of American scientists told the 20th

International Congress of Physiology (Journal of the American
Geriatrics Society).
Boris Sokoloff, M.D., William Coda Martin, M.D., and
Clarence Saelhof, M.D., in a paper delivered to the congress in
Brussels, Belgium, listed a variety of diseases in which failure
BIOFLAVONOIDS FOR HEALTHY CAPILLARIES 305
of the capillaries to function properly was a problem. "In viral
hepatitis, poliomyelitis, smallpox, measles, primary atypical

pneumonia, mumps, virus A influenza, St. Louis encephalitis
and other viral infections, capillary fragility and hemorrhage have
been observed.'' The scientists also reported that capillary prob-
lems were a factor in arteriosclerosis, hypertension, rheumatoid
arthritis, diabetes and bleeding ulcers.
The paper described the researchers' use of bioflavonoids
to treat a number of these disorders, particularly those which
are likely to strike older people. Age itself tends to produce
capillary problems. Tests of 189 patients, age 53 to 88, found
that 124 of them, about 64 percent, suffered from capillary fra-
gility. Patients in the group who had high blood pressure were
more likely to have capillary problems than those who did not.
The researchers treated 30 of these patients, including 19
suffering from high blood pressure, with bioflavonoids for a pe-
riod of four weeks. In only one instance was there no change in
the patient's condition. In two cases, there was some improve-
ment, and in the remaining 27, the functioning of the capillaries
was either completely, or very nearly, restored to normal.
Dr. Sokoloff and his colleagues followed the case histories
of 13 patients who had suffered "little strokes"
recurring, rel-
atively minor episodes of bleeding in the brain that, over the
course of time, can produce paralysis, palsy, failing intellectual
power and personality changes. The problem occurs mostly in
older people. The scientists administered 600 milligrams of bi-
oflavonoids daily to the 13 patients. One patient died of a stroke

two weeks after his treatment began, and 2 others moved to
another city and left the study after a short period of time. The
condition of the remaining patients, observed for periods ranging
from 12 to 32 months, either improved or remained satisfactory.
None of them suffered further strokes.
Because of evidence that capillary fragility was a problem
in arthritis, the scientists examined the case histories of 45 ar-
thritis patients treated with bioflavonoids. While the changes

were not dramatic, significant improvement was noted in 20 pa-
tients, and only 10 patients showed no improvement at all. Pa-

306 BIOFLAVONOIDS
tients who had had arthritis for the shortest time responded best
to the treatment. The bioflavonoids are hardly a miracle cure for
doctors concluded, but "they can be recommended
arthritis, the
as a supplement to other methods of treatment."
Bioflavonoids have been found effective in countering sev-
eral of the complications of diabetes. In diabetes, and also in
cases of high blood pressure, inflammation of the retina is a
frequent problem. The retina is located at the back of the eyeball,
where the images we see are received and carried to the brain
by the optic nerve. Inflammation of the retina results in impaired
vision and is accompanied by the buildup of waxy excretions
from the blood vessels. One-sixth of all cases of acquired blind-
ness are the result of retinal disease in diabetics.
Dr. Sokoloff and his colleagues found that, in 85 percent of
198 cases of retinal inflammation treated with bioflavonoids, the
bleeding in the retina was promptly controlled.
Cataracts Prevented
Cataract formation, a clouding over of the lens of the eye
that can produce blindness, another possible complication of
is
diabetes. Scientists at the National Eye Institute in Bethesda,

Maryland, have found that one of the bioflavonoids, quercitrin,
is capable of holding off the development of cataracts in diabetic
laboratory animals (Science).

In this case, the action of the bioflavonoids has nothing to do
with their effects on the capillaries. In 1975, the same team of sci-
entists at the institute reported that several of the bioflavo-
noids inhibited the action of an enzyme, called aldose reductase,
that had been found to play an important part in the formation
of diabetic cataracts (Science). Three of the bioflavonoids
quercetin, quercitrin and myricitrin
were more powerful inhib-
itors of the enzyme than anything previously tested.
The researchers decided to test the effects of quercitrin, the
most potent of the three, in diabetic animals. They used a South
American rodent called the degu, which, because of its particular
susceptibility to the action of aldose reductase, invariably de-

velops cataracts 10 to 12 days after the onset of diabetes. The
diabetic degus thatwere not fed quercitrin developed cataracts
right on schedule, after about 10 days. The degus receiving the
bioflavonoid, however, were free of cataracts 25 days after the
onset of the diabetes, even though the levels of sugar in their
blood were roughly the same as the levels in the other animals.
Treating Bleeding Disorders

We
could go on at great length here about the action of the
bioflavonoids in various diseases. Almost any problem that in-
volves bleeding seems to have been alleviated at one time or
another by bioflavonoids.
Scientists in France found that the bioflavonoids were a
highly effective alternative to hormone therapy
in the treatment
of abnormal uterine bleeding in women
(Family Practice News i.
The French doctors also reported that the bioflavonoid treatment
corrected abnormal menstrual bleeding in 39 of 40 women who
had problems following the insertion of an intrauterine contra-
ceptive devide (lUD).
These researchers found that the treatment provided relief
for pregnant women suffering from varicose veins, and other
studies have shown that a bioflavonoid-vitamin C complex re-
lieves the hot flashes which occur in menopause (Chicago
Medicine).
Bioflavonoids have been shown to reduce inflammation in
bacterial and viral infections. That is important because of the
side effects associated with the use of steroids, the standard anti-
inflammatory agents. Scientists in Europe have demonstrated
that a complex of bioflavonoids, vitamin C and two anti-
inflammatory enzymes acts against a wider variety of inflam-
mations than seven other nonsteroid anti-inflammatory sub-
stances and produces no side effects whatsoever (Arzneimittel-
Forschung/Drug Research).
308 BIOFLAVONOIDS
Less Blood Cell Clumping

So the bioflavonoids are active against a hodge-podge of
many disorders. Coming up with one neat explanation for all
these effects probably impossible, but the bioflavonoids' action
is
in the capillaries is certainly of major importance. Dr. Robbins
has done extensive work in this area and believes that the bio-
flavonoids' effects on capillary permeability may be linked to
their regulation of a tendency of blood cells to clump together.
In 1971 ,Dr. Robbins established that the bioflavonoids have
a direct effect on blood cell aggregation, the clumping together
of blood cells which often occurs in states of illness (Clinical
Chemistry). "Decreased blood cell aggregation," he wrote, "may
explain the reported beneficial effects of flavonoids on abnormal
capillary permeability and fragility, the decreased symptoms in
many diseases, and the protective effect against various traumas
and stresses.
"An effect of aggregation is decreased capillary blood flow
.... Decreased blood flow may be reflected in changes in cap-
illary permeability and resistance to rupture."
Dr. Robbins reported that research had demonstrated a close

relationshipbetween blood flow and capillary permeability. When
blood flow through the capillaries is blocked, the capillaries be-
come more permeable and components of the blood are lost;
when the blood flow is restored, the capillaries return to normal.
What happens, then, is that bioflavonoids decrease blood cell
clumping, which increases blood flow and results in less perme-
able, healthier capillaries.
"There are several hundred different bioflavonoid com-
pounds in patients," Dr. Robbins told us. "The ones in citrus
fruits are the most active in the body." Because their formation
depends on the action of sunlight, bioflavonoids are usually con-
centrated in the outer tissues of plants, for example, in the rind
and peels of oranges.
The bioflavonoids act in plants as natural preservatives, re-
tarding the growth of bacteria and working to prevent the de-
struction of vitamin C by oxidation. This preservative action is
so strong that bioflavonoid-rich onions and garlic, and juices

prepared from green pepper, celery, potato peels and tomatoes,
have all been shown to preserve the quality of meats.
These things are not visitors from a distant galaxy, after all.
The bioflavonoids are an important part of a natural, nutritious

diet. They can, and should, become as familiar to you as your
own back-yard garden.
CHAPTER
HEALING WITH
BIOFLAVONOIDS
Mike is prone to colds. So he takes vitamin C. Still, he

and sneezes.
sniffles
Maryis anemic. So she takes iron supplements until she
worries she'll rust in the rain. But still, she feels tired at the end
of the day.
John's nose is apt to bleed for no apparent reason. So he
eats more vitamin K-rich leafy vegetables to enhance blood
clotting. And still, his nosebleeds persist.
Although their symptoms may be different, the solutions to
their problems may be the same: All three may be helped by
taking bioflavonoids.
Unfortunately, most of us don't eat as many fresh fruits and
vegetables as we should, and very few of us eat the skins, mem-
branes and rinds of citrus fruits, which are among the richest
sources of bioflavonoids. But increasing our intake of these im-
portant nutrients may help clear up a host of nagging health
problems we often mistake for symptoms of something else.
The major trauma of a miscarriage, the minor annoyance of
a nosebleed and assorted ailments in between may respond well
310
HEALING WITH BIOFLAVONOIDS 311
to bioflavonoid therapy because bioflavonoids are particularly

adept at strengthening capillary walls.
Babies Carried to Term

As a result, certain young women would do well to baby
themselves with bioflavonoid supplements.
"I believe some miscarriages occur because of increased
fragility of placental capillaries, and bioflavonoid supplements
seem to help toughen those capillaries," says Jack C. Redman,
M.D., a family practitioner in Albuquerque, New Mexico. He
prescribes citrus bioflavonoids for his patients who suffer from
chronic miscarriages. Dr. Redman, who is also a diplomate of
the American Board of Family Practice, told us his results with
the bioflavonoid therapy have been excellent.
"I've had success giving bioflavonoids to women who have
had two, three, even four miscarriages,'' Dr. Redman explains.
"I tell them to begin taking the supplements immediately the
next time they become pregnant, and it almost always works.
My results have been very encouraging."
Dr. Redman usually prescribes 200 milligrams taken three
times a day, for a total of 600 milligrams daily. He tells of one
patient who miscarried her first pregnancy but took the biofla-
vonoids for the duration of the second. "Although she experi-
enced some spotty bleeding during her third month, she carried
a beautiful baby girl to term," Dr. Redman recalls. "In that case,
as in several others, I found evidence of an old blood clot after
I delivered the placenta."
Bioflavonoids Regulate Blood Cells

Another bioflavonoid researcher has found thai the biofla-
vonoids from a grapefruit a day may keep heart problems at bay.
312 BIOFLAVONOIDS
Oranges, lemons, tangerines and grapefruits are good sources

of citrus bioflavonoids. Various components present in all of
them make up the bioflavonoid complex, but individual constit-
uents of the bioflavonoid-complex family may vary slightly among
the different fruits. Their duties vary slightly, too. For instance,
bioflavonoids derived from grapefruit help regulate hematocrit
levels, which reflect the ratio of red blood cells to whole blood,
according to Dr. Ralph C. Robbins, Ph.D., of the food science
and human nutrition department, institute of food and agricul-
tural sciences at the University of Florida, in Gainesville. Dr.
Robbins is one of the foremost scientists in bioflavonoid research
today, and he and others have found that high hematocrit levels
are a constant finding in people who are subject to heart attacks.
"In fact, a high hematocrit appears to be a risk factor for
heart attacks and strokes," says Dr. Robbins, adding that "high
hematocrits were a constant finding with heart attack victims in
the famous 'Framingham study,' which established the link be-
tween life style and heart disease."
In one of his own studies. Dr. Robbins took 40 people who
had a wide range of hematocrit levels and placed them on a diet
that included a grapefruit a day no other restrictions were ap-
plied. After 12 weeks, there was a significant drop in the he-
matocrit levels in the high-hematocrit group (including several
heart attack patients) but no significant drop in the hematocrits
of individuals already in the ideal range. In addition, those with
low hematocrit levels rose to the normal range.
That's important. Dr. Robbins points out, because low he-
matocrit levels are indicative of anemia. "Hematocrit levels too
high and too low are both unhealthy. What we are finding out is
that grapefruit helps to stabilize hematocrit levels. Evidence in-
dicates the effect is due to the bioflavonoid naringin."
Some of the other bioflavonoids that have been isolated
include rutin, from buckwheat and other natural sources, hes-
peridin, from oranges and lemons, and tangeretin, from tangerines.
"There are so many bioflavonoids, and their activity varies
according to a number of factors, including a person's blood
type," notes Dr. Robbins. Most fruits and vegetables contain
dozens of different ones, and most bioflavonoid supplements are

available in complex form.
"Citrus is a regular cornucopia of flavonoids," says Russel
Rouseff, Ph.D., of the Florida Department of Citrus at the Uni-
versity of Florida agricultural research center in Lake Alfred,
Florida. "There are 40 individual flavonoids that have
at least
been identified in citrus. Most of them have been reported to
have biological activity. Those are the ones we call /7/V?flavonoids."
If you get your citrus in the form of juice, you may be
all
missing out on many

of the most active bioflavonoids, which are
found in the rind, the membranes between the fruit segments
and in the white, spongy layer called the albedo, just under the
rind. Many of the citrus fruits sold in supermarkets have been
artificially colored. Powdered citrus peel sold to flavor baked
goods, however, has usually not been dyed. Dr. Rouseff believes
such products may be good sources of bioflavonoids.
Protection from Cancer

Many bioflavonoids seem to help protect our bodies from
the cancer-causing effects of pollutants such as benzpyrene, which
is released into the air when some synthetic compounds are
burned. Bioflavonoids increase the anti-cancer activity of certain
enzymes found in our skin, lungs, gastrointestinal tract and liver.
These enzymes metabolize foreign compounds, according to Dr.
Robbins, and help convert fat-soluble carcinogens (cancer-
causing agents) to water-soluble form so they may be safely
excreted from the body. Citrus bioflavonoids are particularly
potent in this regard, he notes.
Other researchers have reported on some of the anti-cancer
effects of vitamin C. Bioflavonoids may lend a helping hand here,
too, because bioflavonoids have been shown to increase the
body's absorption of vitamin C. in one Czechoslovakian study,
researchers found that guinea pigs absorbed twice as much vi-
tamin C if they were given supplements of rutin and another
bioflavonoid at the same time they were given the vitamin C
314 BIOFLAVONOIDS
supplement (Physiologia Bohemoslovaca, vol. 28, 1979). Like

people, guinea pigs are unable to manufacture their own vitamin
C within their bodies and must rely on outside sources to get it.
Natural Antihistamines
Neutralizing the cancer-causing agents in air pollution and
enhancing the absorption of vitamin C, known for its benefits as
an antihistamine, aren't the only ways bioflavonoids may keep
us breathing easily. Bioflavonoids are pretty good antihistamines
themselves.
According to Elliott Middleton, Jr., M.D., director of the
allergy division in the departments of medicine and pediatrics,
school of medicine. State University of New York in Buffalo,
the bioflavonoid quercetin will inhibit the release of histamine
from white blood cells. During a typical allergy attack, histamine
is released, causing red, watery eyes, stuffy nose, sneezing, itch-
ing and impaired breathing.
Dr. Middleton found that quercetin will also inactivate cer-
tain viruses, including herpes type (cold sores) virus, polio
1
virus, parainfluenza virus and a particular respiratory virus that

afflicts young children and may be a forerunner of asthma. Al-
though the effectiveness of quercetin under normal dietary con-

ditions has not been established, Dr. Middleton speculates that
"certain naturally occurring flavonoids may have a role in an-
tiviral therapy" {Journal of Allergy and Clinical Immunology,
January, 1982).
Across the country, in Portland, Oregon, nutritional con-
sultant Brian Leibovitz relies on bioflavonoids to keep his allergic
patients comfortable throughout the hay fever season. ''But bi-
oflavonoids work even better on asthma,'' Leibovitz told us. "In
fact, a standard treatment for asthma, a drug called cromolyn
sodium, is nothing more than a synthetic bioflavonoidlike
molecule."
For those people bedeviled by another nose problem fre-

quent nosebleeds bioflavonoids may offer some hope, also.
I
M.D., success-
In his extensive research, Boris Sokoloff,
fullyused bioflavonoids to treat chronic nosebleeds in 45 people.
All of them took 300 milligrams at four-hour intervals for a total
of 1,500 milligrams of bioflavonoids a day, and all of them were

cured in some cases in as little as 36 hours!
Help for Cold Sores

Bioflavonoids and vitamin Ccan help your body heal cold
sores in half the time usually required, according to Geza T.
Terezhalmy, D.D.S., and other researchers at the National Na-
val Dental Center in Bethesda, Maryland. The painful blisters
that erupt in the mouth and around the lips are the result of
infection by the herpes simplex virus (type ). Fever or exposure
1
to cold, heat, sun, wind or rain often bring about this disfiguring
nuisance in susceptible people. Between 80 and 90 percent of us
get them at some time in our lives, and about 40 percent have
the problem over and over again.
But Dr. Terezhalmy and his colleagues found a way to sig-
nificantly reduce the time it takes for these annoying sores to
heal: supplements of bioflavonoids and vitamin C. Dr. Tere-
zhalmy decided to use water-soluble bioflavonoids and vitamin
C because of the many reports that these two substances can be
an aid in healing. Vitamin C, he said, appears to play an important
role in maintaining the strength of the blood vessels and forming
the substances that hold the cells together. Bioflavonoids, he
said, have been reported to strengthen the walls of the blood
vessels. He told us that a combination of bioflavonoids and vi-
tamin C has been used to successfully treat bleeding gums and
viral infections characterized by fragile blood vessels.
Applying this to the problem of herpes simplex infections
of the lips and mouth. Dr. Terezhalmy believes that the pro-
gression of the inflammation requires weakening of the tiny blood
vessels in the tissue and damage to the cement holding the cells
together. Dr. Terezhalmy wanted to find out, then, if the tissue-
316 BIOFLAVONOIDS
Strengthening ability of bioflavonoids would help protect the lips

and mouth from the herpes infection.
So he assembled 50 volunteers with recurrent herpes infec-
tions on the lips and mouth. Twenty were treated with 600 mil-
ligrams each of bioflavonoids and vitamin C divided into three
daily doses. Twenty were treated with 1,000 milligrams each of
bioflavonoids and vitamin C divided into five daily doses. The
other 10 were treated with a lactose dummy pill. Neither the
patients nor the examining doctors knew which patients were
getting which treatments until the end of the experiment. The
standards used to judge the effects of the treatment were the
visible signs and symptoms of the infection: itching and feeling
of fullness in the affected area, pain, formation of blisters, crust-
ing and disappearance of the blisters.
Before the treatment was begun, there was no significant
difference between those who received dummy pills and those
who received bioflavonoids and vitamin C. But after the treat-
ment began, the differences were remarkable.
The most remarkable difference. Dr. Terezhalmy told us,
was in the duration of symptoms. People treated with the dummy
pills were symptom free after an average of 9.7 days. But those
treated with 600 milligrams of bioflavonoids and 600 milligrams

of vitamin C were completely symptom free after only 4.2 days.
There was no significant difference in healing time between those
given 600 milligrams of bioflavonoids and those given 1,000
milligrams.
Another interesting result Dr. Terezhalmy mentioned was
that all 10 of the placebo-treated people developed multiple blis-
ters, which broke during the course of the infection. But only
36 percent of the bioflavonoid-treated group developed blisters.
Giving the treatment early in the course of the infection seemed
to make a difference. When bioflavonoids and vitamin C were
given at the first sign of symptoms, only 6 out of 26 developed
But when it was given 12 hours or more after the first
blisters.
symptoms, 8 out of 12 developed blisters.
Dr. Terezhalmy told us, "There really hasn't been any ad-
equate treatment for this disease until now, nothing that will
actually abort the process of blister formation and minimize the

other clinical manifestations."
'The beauty of all this is that these compounds are in our
food," muses Dr. Robbins, and Dr. Redman agrees. 'Today,
bioflavonoids are a by-product of the orange-juice industry," Dr.
Redman notes, "but Tve heard that someday orange juice will
be a by-product of the bioflavonoid industry."
VITAMIN D
CHAPTER
DON'T LET THIN

BONES LET YOU DOWN
One reason why falls of any kind are more likely to result
in fractures for people over 50 is the prevalence of a bone-
thinning condition called osteoporosis. As the bones gradually
become demineralized, mishaps that once caused bruises are
more likely to result in breaks. However, new evidence suggests
you can fight back, because osteoporosis, once thought to be an
unavoidable consequence of aging, may be preventable. The
secret is no fancy trick, either: simply a combination of measures
including early diagnosis, calcium supplements, vigorous exer-
cise and vitamin D.
"Osteoporosis in the elderly is an epidemic that's received
far too little attention," contends Robert Recker, M.D., chief of
endocrinology at Creighton University in Omaha, Nebraska. In-
deed, of the six million Americans affected each year, most will
be postmenopausal women over 45. And the annual cost of treat-
ing fractured hips exceeds $1 billion.
Everyone begins losing bone mineral at around 40 years of
age, but women who've had few or no pregnancies are at greatest
risk of suffering the fractures that are the major clinical feature
of osteoporosis. And except for the use of the hormone estrogen,
318
DON'T LET THIN BONES LET YOU DOWN 319
which has been suspect because of its link to uterine cancer,

most therapies for this bone disease are still in the early inves-
tigative stages.
For these reasons, "prevention is more important than treat-
ment,'' declares Harold Draper, Ph.D., chairman of the nutrition
department at Guelph University in Ontario. But how do you
guard your bones from becoming riddled with holes like Swiss
cheese?
Essential to the health of strong bones is vitamin D, the
"sunshine vitamin." For most people, the main input is via the
skin, where ultraviolet light from the sun converts a form of
cholesterol into vitamin D. Vitamin D can also be obtained di-
rectly from the diet, in fish liver oils, egg yolks and fortified milk.
However, if you're swaddled in heavy clothes all winter, barely
touch milk and live in the North, you may have decreased levels
of vitamin D in your blood by springtime.
That's cause for concern because, without vitamin D, the
body cannot properly utilize calcium. Consequently, bone health
suffers and the bones deteriorate, lose calcium and are more
susceptible to fractures. Thus, bones are most likely to break in
winter and early spring, when the days are short, sunlight (and
hence vitamin D) is scarce and calcium availability in the body
is low.
D Deters Bone Deterioration

And many studies demonstrate vitamin D's practical ben-
efits.During one investigation, researchers gave a concentrated
form of vitamin D to seven women with osteoporosis, all of
whom had suffered at least one fractured vertebra. During the
year of treatment, the women had an improvement in their cal-
cium balance so that "no further vertebral compression fractures
were sustained during the treatment period" (Clinical Research).
In a similar study, researchers gave patients with osteopo-
rosis a concentrated form of vitamin D and either or 2 grams
1
of calcium a day (Clinical Endocrinology).

320 VITAMIN D
The first part of the study lasted a week. Seventeen people

received the nutrients. Six had senile osteoporosis, which is
"caused" by old age. Five had postmenopausal osteoporosis,
which is caused by the postmenopausal decrease in the produc-
tion of estrogen, a female hormone that plays a role in regulating
bone mass. (Almost every woman from some degree of
suffers
osteoporosis within ten years of her menopause.) Six had cor-
ticosteroid-induced osteoporosis, which is caused by long, con-
stant use of corticosteroids, anti-inflammatory drugs. A diverse
group. But in just one week, every single person had "a signif-
icant increase in
calcium absorption rate" a sign that the dis-
ease was improving.
Physical Activity Improved

Thepatients with postmenopausal osteoporosis continued
into the second part of the study, which lasted over a year, and
were joined by five new patients with senile osteoporosis.
By the end of the study, nine of the ten patients had "greatly
improved" physical activity. All but one "became more mo-
bile." And of the five patients who had needed a cane, three no
longer did.
The slow, shuffling walk and limited physical activity of
those with osteoporosis and osteomalacia may be caused not
only by hone loss, but by muscle loss.
In 1965, researchers discovered that osteoporotic women
lost muscle as well as bone. Research has also shown that vitamin
D has a direct effect on muscular health. In a study focusing on
that link, researchers gave a concentrated form of vitamin D and
1 gram of calcium a day to osteoporotic women for three to
1 1
six months. At the beginning and end of the study, they measured
the women's muscular health (Clinical Science, vol. 56, no. 2,
1979).
One
of the measurements was a "time dressing test," in
which the researchers measured the women's muscular mobility
by timing how long it took them to put on stockings, vest, un-
DONT LET THIN BONES LET YOU DOWN 321
derpants, shirt and a frock. Before the women began taking the
nutrients, they needed an average of 3 minutes and 30 seconds
to dress. At the end of the study, they needed only 2 minutes
and 52 seconds. One woman, who took over 5 minutes to dress
at the start of the study, needed just over 2 minutes at the end.
The researchers also measured favorable biochemical changes
in the muscle itself. "We suggest," the researchers write, that
the patients "had some kind of myopathy Imuscle disease] in-
duced by an insufficient production . .of vitamin D."
.
CHAPTER
THE SUNSHINE
VITAMIN CAN
BRIGHTEN
YOUR HEALTH
You might be a little skeptical of those people who loudly

announce their plans to leave the 20th century
behind just de-
posit their credit cards, mortgage payments and pocket calcu-
lators at the edge of the woods and "return to nature.'' But the
truth is, no matter how ''civilized" your style of life may be,
your body never left nature; it's still intimately attuned to the
grand procession of natural cycles. And that's something you
can ignore only at your peril.
During the winter months, for example, your body responds
to the low-lying winter sun with an ebb in the chemical tides
that transform calcium and phosphorus into bone. How can the
sun's angle affect bone growth? Through vitamin D, a remarkable
substance that is synthesized in your skin when it's struck by
ultraviolet light and which goes on to play a key role in your
body's calcium metabolism.
During the short, dim days of winter, when you're either
indoors or bundled up much of the time, lack of sunshine on
your skin can result in a steady drain on your vitamin D supply
until, by late winter or early spring, your bones may actually
322

THE SUNSHINE VITAMIN 323
begin to ache. Worse, if this shortage is allowed to continue,

newly formed bone can become soft and misshapen a condition
known as osteomalacia, or adult rickets.
Fortunately, there's a way around this problem short of
waltzing around the back yard in the buff. Ordinarily, you man-
ufacture most of the vitamin D you use through this magical
meeting of the skin and sun (hence its nickname, "the sunshine
vitamin"), but vitamin D is also available, though not plentiful,
in the natural food supply. By making sure your diet is adequate
in vitamin D and seeking out the sun during the darkest months
you can make it through winter without the dull aches and pains
of a deficiency. Unfortunately, studies show many people ex-
perience a sharp decline in their vitamin D supply during the
winter.
One such study was conducted by doctors at the University
of Dundee, in Dundee, Scotland, where levels of ultraviolet light
in sunshine are "very low or negligible" from November through
February. Over a period of a year, the researchers studied the
vitamin D status of three groups of people by measuring their
serum levels of the major circulating form of vitamin D, 25-
hydroxy-vitamin D, or 25-OHD for short.
The groups were divided according to occupation and amount
of exposure to sunlight: Gardeners in the local parks department
worked outdoors all day, winter and summer; hospital staffers
got their sunshine mostly on weekends or after work; and a group
of elderly inpatients, who were confined indoors, received vir-
tually no natural or artificial sunlight at all.
The results showed
that "in each group the seasonal changes
were highly significant," with the highest 25-OHD levels re-
corded during the late summer and autumn and the lowest during
the late winter or early spring. And "25-OHD levels were higher
in the outdoor workers than in the indoor workers, who in turn
had higher values than did the elderly inpatients" (American
Journal of Clinical Nutrition, August, 1981).
The researchers noted something else of interest: The more
sunshine the subjects got, the later in the season their 25-OHD
324 VITAMIN D
levels peaked. While ultraviolet light was strongest in July, for

example, the gardeners reached their highest levels in Novem-
ber; the inpatients peaked in August.
Perhaps, the researchers suggested, "in the outdoor work-
ers, vitamin D synthesis continues well into the autumn with
continued exposure and so vitamin D stores continue to increase."
What all this means to your health was demonstrated in
another study conducted by a trio of doctors in Leeds, England.
The doctors examined biopsies from hip bones of 134 patients
who had suffered suspicious fractures of the femur, or thigh
bone, over a period of five years. They concluded that 37 percent
of the patients were suffering from osteomalacia. But what was
most disturbing was the fact that by far the largest number of
fractures occurred in a period stretching from February through
June (Lancet).
"As would be expected if this seasonal variation was at-
tributable to variation in the supply of vitamin D dependent on
sunlight, the proportion of cases with osteomalacia is highest in
the spring and lowest in the autumn," they noted.
Why is there a two-month to six-month time lag between
the shortest days of the year (the third week in December) and
the appearance of fractures caused by weakened bones? Well,
vitamin D is fat-soluble and thus easily stored by the body. Your
cupboards may be full to overflowing by the end of the summer
and not run out until late winter or even early summer. So it's
important to take advantage of sunny weather whenever you
can.
Elderly at Risk
That reminder is something older people should make spe-
cial note of. Because, according to a study at Ichilov Hospital
in Tel Aviv, the elderly may have trouble making use of vitamin
D even if they live in a sunny climate and get plenty of D in the
foods they eat.
The compared serum 25-OHD levels of 82

Israeli doctors
elderly people and 30 young control subjects. They discovered
that 15 of the elderly subjects
nearly 20 percent
had outright
vitamin D deficiencies, and 28 more had borderline levels. Even
elderly farm workers, who got plenty of sunshine
while their
vitamin D status was considerably better than those older people
who were confined indoors
were still significantly lower than
the youthful control group (Israeli Journal of Medical Sciences,
January, 1981).
"It seems impairment of vitamin D metabolism
likely that
at several points in the metabolic pathway, rather than simple
underexposure to sunlight, is a major factor in vitamin D defi-
ciency in the elderly," the doctors concluded. They suggested
that perhaps aging impairs the body's ability to produce certain
active forms of vitamin D, which in turn slows down the ab-
sorption of calcium through the intestine. Result: an increased
risk of faulty bone mineralization.
There may be other factors working against vitamin D nu-
trition in older people, according to Michael F. Holick, M.D.,
Ph.D., of the department of medicine at the Harvard medical
school, "Aging significantly reduces the skin's capacity to produce
vitamin D,," Dr. Holick explains. "The skin of a 70-year-old
can make about half of the vitamin D3 precursor produced by a
20-year-old."
Normally, he explains, ultraviolet wavelengths in sunshine,
striking your bare skin, convert a lipid substance called 7-
dehydrocholesterol into previtamin D^. Previtamin D^ is unstable
when heated and slowly converts to vitamin D^ (an active form)
in the deeper layers of your skin. You don't actually make vi-
tamin D3 during sunlight exposure. Dr. Holick told us; it takes
three or four days for the whole manufacturing process to run
its course, so your body is busy producing vitamin D3 long after
you come in out of the sun.

In the elderly, however, thismarvelous machinery has be-
gun to lose its because
efficiency. "It's not too surprising, really,
age decreases all metabolic functions," Dr. Holick says. Also,
326 VITAMIN D
the skin actually thins with age, so there are fewer cells to syn-
thesize the vitamin.
What's to stopyour skin from producing too much vitamin
D? (Being fat-soluble and thus easily stored, the nutrient can be
toxic in high doses.) It's widely believed that tanning is the
answer: In response to extended exposure to sunlight, the skin
produced melanin, or pigmentation, to shield its deeper vitamin
D-producing layers from ultraviolet light. But Dr. Holick con-
tends that, while this may be a factor, it isn't the most important
one. His research has shown, he says, that too much sun causes
previtamin D3 to break down into a pair of biologically inert
substances, preventing the overproduction of vitamin D.
Too much sun, of course, can also increase your risk of skin
cancer and accelerate the aging of your skin. But Dr. Holick
believes it may be time to "reevaluate the natural benefits of
sunlight" for older people who may not get enough vitamin D
in their diet. How much sun should you get? Well, 15 to 30
minutes of sun exposure twice a week in Boston in the summer
should be "more than adequate" for lightly pigmented people
over 60 years. Dr. Holick says.
Keeping your vitamin D stores in order really shouldn't be
too difficult, even if you rarely venture into the sun. A recent

study in Norway at latitude 70 degrees north, where the sun
hangs below the horizon a full two months of the year is a case
in point. Over a period of a year, serum 25-OHD levels were
examined in 17 healthy adults living in Tromso. Though the
lowest concentration was found in March, blood levels overall
remained "at a constant and fairly high level" throughout the
year (Scandinavian Journal of Clinical Laboratory Investiga-
tion, vol. 40, 1980). The researchers attributed this sunny finding
to good nutrition and the widespread consumption of dairy prod-
ucts fortified with vitamin D.
Actually, vitamin D isn't very common in the natural food
supply. The foods that contain it in high amounts are all of animal
origin, with the greatest amounts occurring in saltwater fish high
in oil, such as salmon, sardines and herring. Fish liver oils are
highly concentrated sources of vitamin D. Egg yolks and liver

also contain substantial amounts.
Rickets on the Rise?

The fortification of milk and other milk products since World
War one reason the childhood bone disease called rickets
II is
is today considered, in the words of one researcher, "a medical
curiosity." In the days of the industrial revolution, when children

were confined to sunless sweatshops in smoggy cities, it was a
serious health problem and was still fairly common as late as the
1940s. But by 1969, asurvey of over 6,000 children of low-income
families showed only 0. percent had bowing of the legs (a symp-
1
tom of rickets).
Yet, recently, some doctors have begun to worry that rickets
"may be a significant problem in some population groups."
still
Over a period of a year, for example, four children from the

Hartford, Connecticut, area were diagnosed as having rickets
caused by poor diet. The youngsters exhibited classic symptoms
of rickets, from bowing of the legs to general weakness, delayed
motor development and low weight, but because their doctors
were not familiar with the condition, a correct diagnosis wasn't
made for months {Pediatrics, July, 1980).
After examining the youngsters' dietary histories, doctors
concluded that "particular groups of children, namely vegetar-
ians, children breastfed for an unusually long time, and black
children, are at risk to develop the nutritional deficiencies of
vitamin D and calcium metabolism that lead to clinical rickets."
Vegetarians are at risk because they may not get enough milk
and milk products, breastfed children because human breast milk
may be inadequate vitamin D though
in a contro-
this is still
versial point and black children because their dark skin blocks
the ultraviolet light that triggers vitamin D, production.
One thing all four youngsters had in common: They turned
up at the hospital at the end of winter. After months indoors, or
328 VITAMIN D
outdoors only when they were buttoned up to the ears, they just
hadn't been getting enough sunshine to keep their vitamin D
batteries charged and humming. With that was coupled a diet
deficient in vitamin D, and by winter's end they were in serious
trouble.
Do You Live in the

Colon Cancer Belt?
Another reason for keeping well supplied with vitamin D is
the possibility that its lack could be linked to colon cancer.

Two scientists who conducted research at Johns Hopkins
University in Baltimore have theorized that sunshine and a year-
round supply of vitamin D might prevent this killer illness. No
one has ever suggested that idea before.
''We have simply shown," says one of the reseachers, Ced-
ric F. Garland, Ph.D., "that there is a predilection for colon
cancer in areas that receive less sunlight. As far as we know,
this is the first time that anyone has shown a correlation between
vitamin D and colon cancer."
In late 1976, Dr. Garland and his brother Frank, a doctoral
candidate in epidemiology, were comparing the rates of colon
cancer and skin cancer in the United States. In the Sun Belt,
skin cancer was common but colon cancer wasn't. In the colder
regions, the reverse was true. Intrigued, they borrowed sunshine
statistics from the U.S. Weather Service. The numbers pointed
to an inverse relationship between sunshine and colon cancer.
But Dr. Garland didn't know why.
''As epidemiologists," Dr. Garland told us, "we make a
gross observation and hope to stimulate biochemists to find a
mechanism. We discover associations long before we know the
reasons behind them." He explains that epidemiologists, for in-
stance, linked tobacco to lung cancer years before anyone knew
the chemistry involved.
Colon cancer rates support the new hypothesis. A cattleman

in sunny, sparsely populated New Mexico, for example, is much
less likely to get colon cancer than a stockbroker in smoggy,
crowded New York. Per 100,000 people, 17.3 New Yorkers will
suffer from colon cancer, but only 6.7 New Mexicans will. (Na-
tionally, there are about 120,000 new cases of colon cancer per
year).
Inhabitants of cities are deprived of sunshine for several
reasons. Ozone pollution deflects some of the urban sunlight.
Tall buildings eclipse the sun even more. ''Even in areas where
sunlight is intense," Dr. Garland writes, "persons who live and
work in cities may not receive much exposure to it. . Vitamin
. .
D deficiency occurs in large cities even in tropical and subtropical

areas" {International Journal of Epidemiology, vol. 9, no. 3,
1980).
Dr. Garland's ideas may throw some new light on current
wisdom about colon cancer. A high intake of beef and fats has
been shown to increase the risk of colon cancer, and a high-fiber
diet of fresh produce and whole grains has been shown to lower
the risk. But Dr. Garland told us that, thanks largely to fast and
processed foods, there aren't enough regional variations in the
American diet to explain all the regional variations he found in
colon cancer rates. To him, sunlight is a plausible additional
factor.
How does Dr. Garland think vitamin D protects the colon?
Working with the known fact that vitamin D enables the body
to absorb calcium, he theorizes that calcium's presence some-
how protects the lining of the colon from cancer-causing waste
substances that pass through it.
As you can see, man (and woman) was not meant to live
by fluorescent light alone. Sunshine and vitamin D are too im-
portant to give up. And you should do your best to get them
year round. Vitamin D is not just for winter anymore.
VITAMIN E
CHAPTER
VITAMIN E
SCIENTISTS
SAY IT WORKS
What must have been a very important moment in the his-

tory of vitamin E research took place in the auditorium of a fine
hotel on Central Park South in New York City.
At the request of the New York Academy of Sciences, vi-
tamin E experts from all over the world gathered together for
three days to swap notes they'd been jotting down for ten years
or more.
Armed with speeches, slides, graphs and charts, they all
testified to the fact that vitamin E was no longer a ''vitamin in
search of a deficiency," as it had been called. Instead, it's a
vitamin that can influence many illnesses and that provides a
key to the healthy functioning of our muscles, eyes, blood, lungs
and more.
What follows is a record of some of the research presented
in New York by almost 70 physicians and biochemists from
California to Boston, from Japan and China to Sweden, England,
West Germany and Israel.

Severe pain in the lower legs while walking caused by poor
circulation below the knees was the subject of a study reported
330
SCIENTISTS SAY E WORKS 331
by Knut Haeger, M.D., of Sweden, one of the pioneers in vitamin

E research. When most of the medical community dismissed the
vitamin as a fad, Dr. Haeger was already using it to promote
circulation and relieve pain.
Since the mid 1960s, Dr. Haeger said, he has given 100
international units of vitamin E three times a day to a total of
122 people with "intermittent claudication," or calf pain that
occurs only when the sufferer tries to walk. He also told the
patients to take walks twice a day, to try gymnastic exercises at
home and not to smoke cigarettes.
Of those who faithfully practiced regimen. Dr. Haeger
this
said, 82 percent reported they could walk at least 10 percent

farther than before, and 50 percent said they could walk at least
30 percent farther. By comparison, only 1 percent of a non-
1
supplemented control group was able to increase their walking

distance by 30 percent.
"We were able to prove," Dr. Haeger reported, "that pa-
tients on alpha-tocopherol [vitamin E] had a significantly longer
walking distance than patients given either vasodilator agents
[drugs that widen the blood vessels] or anticoagulant therapy,
or a regimen of multivitamins excluding vitamin E."
Dr. Haeger's system requires patience, however. He said it
takes about 18 months of supplementation and regular exercise
before circulation improves measurably. Of those patients who
maintained his program, 73.4 percent improved, compared to
only 19.2 percent of the control group.
For those who like walking, another of the conference lec-
turers reported that vitamin E is vital for physical endurance.
Lester Packer, Ph.D., of the University of California at
Berkeley, said that E-deficient rats exercised to the point of
exhaustion show a 40 percent decrease in endurance. Without
vitamin E, he explained, there's increased damage to the mito-
chondria the microscopic structures inside each cell where the
body turns food into energy. "E-deficient animals just tire out
earlier," Dr.Packer told us, adding that extreme vitamin E de-
ficiency may cause a special form of muscular dystrophy.
332 VITAMIN E
Protecting the Eyes

The use of vitamin E for diseases of the eye was the subject
of several papers at the conference. Representing the Mount
Sinai School of Medicine in New York, Kailash C. Bhuyan,
M.D., and colleagues were excited to talk about their finding
that vitamin E could stop the growth of, and possibly reverse
the damage caused by, cataracts in rabbits.
The researchers said they artificially induced the cataracts
in the rabbits, then fed them vitamin E intravenously. The results
were promising: "In rabbits having early cataract there was. . .
an arrest and reversal of cataract in about 50 percent of the

animals treated with vitamin E." Photographs showed that, when
the rabbits were given vitamin E in the early stages of the disease,
there was decreased clouding of the lenses.
Vitamin E may also keep the eyes young. Researchers from
the University of California at Santa Cruz showed that, in rats
deficient in vitamin E or deficient in selenium or chromium, fat
droplets built up within the eye and the eye lost some of its
combat unwanted invaders. Most important, the light-
ability to
were destroyed
sensitive nerve endings in the retina of the eye
or became abnormal when those deficiencies occurred. And that
was a symptom of aging.
"Effects of deficiencies in vitamin E alone or in selenium
alone suggest that each of those nutrients play an important role
in the retina .and la deficiency of either] appears to accelerate
. .
age changes in the retina," they concluded.
Healthier Blood
One of vitamin E's most important protective roles takes
place in the blood, where there are two substances that must be
carefully balanced prostacyclins and thromboxanes. Prosta-
cyclins inhibit clots from forming, and thromboxanes encourage
clots to form. According to Rao V. Panganamala, Ph.D., of Ohio

State University, diabetic rabbits suffer from abnormally high
levels of thromboxanes, which makes them susceptible to car-
diovascular disease.
But Dr. Panganamala found that, when he gave diabetic
rabbits vitamin E supplements for two to three months, their
thromboxanes dropped to a safer, normal level and their pros-
tacyclins rose to normal levels or higher.
Two physicians who journeyed from Giessen, West Ger-
many, reported that vitamin E helped them save the lives of
certain intensive-care-unit patients. These people were in a state
of shock after such things as auto accidents, poisoning or infec-
tion. Shock caused clots to form in the blood vessels of their
lungs, threatening to cut off their breathing. The process is called
shock lung syndrome. Vitamin E worked because it apparently
prevented the clots from forming in the first place.
It was interesting how the physicians first came to use vi-
tamin E. They discovered that the symptoms of shock lung syn-

drome were identical to symptoms of exposure to ozone and
nitrogen dioxide. Knowing that vitamin E can protect the lungs
from those atmospheric pollutants, they decided to give it to
their shock lung patients with success.
Several presentations at the conference dealt with choles-
terol. In the blood, cholesterol attaches itself to low-density li-
poproteins (LDLs) or high-density lipoproteins (HDLs). High
levels of HDLs and low levels of LDLs have been associated
with a lower risk of coronary heart disease and atherosclerosis.
A team of physicians from the Wood Veterans Administra-
tion Medical Center in Milwaukee tested the effect of vitamin E
on the blood of 43 men and women. They gave each person 800
international units of the vitamin daily for four weeks. Results
showed that the vitamin raised HDL levels, but only in those
people who initially had low HDL levels.
William J. Hermann, M.D., a pathologist in Houston, came
to similar conclusions. Dr. Hermann found that vitamin E was
most effective in people who began with low HDL levels, who
334 VITAMIN E
were under age 35, and who weighed no more than 10 percent
more than their ideal weight.
A third group of physicians, from Sinai Hospital in Balti-
more, used vitamin E to lower LDL levels in rats. They said the
vitamin worked best when given early in an animal's life.
A Boost for Resistance

Researchers at the conference also showed that vitamin E
may enhance our resistance to disease and pollution.
Ching K. Chow, Ph.D., of the University of Kentucky, ex-
posed two groups of rats, one supplemented with vitamin E and
the other not, to cigarette smoke. After three days of chain
smoking. 5 of the 16 unsupplemented rats were dead, compared
to only of the 13 supplemented rats.
1
Dr. Chow said cigarette smoke contains more than 3,000

chemicals, many of which are highly reactive //t^ radicals that
may have altered certain essential enzymes in the rats. He con-
cluded that it was the smoke, rather than its
cigarette's visible
most harm.
invisible gases, that did the
Another speaker, Laurence M. Corwin, Ph.D., of the Bos-
ton University school of medicine, said that vitamin E boosts
the body's cell-mediated immunity. This kind of immunity pro-
tects us from bacteria, viruses and, in some cases, cancer. His
research showed that vitamin E stimulates the production of new
defense cells and neutraMzes substances that normally keep those
cells in check.
Interestingly, Dr. Corwin commented that ''as far as the
immune response is concerned, normal dietary levels of vitamin
E may not be sufficient to maintain an optimal host defense
against disease."
Most of the researchers at the conference agreed that even
fairly high doses of vitamin E considerably higher than the
current Recommended Dietary Allowance of 15 international
units are
very safe. As a daily intake, the figures most often
mentioned were between 300 and 800 international units daily.
Bertram Lubin, M.D., of Oakland, California, who was cochair-
man of the conference, told us that he considers 200 to 400
international units to be a reasonable range for a daily supplement.
For Dr. Lubin, this conference signaled what he called "the
turnaround in the acceptability of vitamin E that has taken place
in the last ten years."
CHAPTER
VITAMIN E
JACK OF ALL TRADES,
MASTER OF MOST
Vitamin E is a nutritional Swiss Army knife. The Swiss have

a knack for making the greatest use of the smallest space, and
with one of their military's pocketknives you can open cans,
uncork bottles, clip your nails, balance your checkbook, prac-
tically everything short of squaring the circle.
The thing's amazing, but it's nothing next to vitamin E. The
vitamin modifies blood fats so that they protect against heart
disease. Vitamin E may also promote a healthy circulatory sys-
tem by preventing the formation of dangerous blood clots and
by protecting red blood cells from damage by oxidation.
If vitamin E worked just to prevent heart disease, it would
be impressive enough. But on top of that, scientists are finding
that vitamin E protects health in a lot of other ways, as well.
It's the sheer variety of E's protective action that is most
astonishing.
At a conference of the American Chemical Society, Robert
P. Tengerdy, Ph.D., reviewed work he and researchers at Col-
orado State University did, plus research by scientists at other
institutions, on the effects of vitamin E on the immune system.
336

E JACK OF ALL TRADES 337
The most intriguing aspect of that research is that it involves

levels of vitamin E higher than the Recommended Dietary
Allowances.
Dr. Tengerdy and Cheryl Nockels, Ph.D., professor of an-
imal science at Colorado State University, used what he calls
high doses of vitamin E to discover how much is needed for the
optimal performance of the body.
"When animals are fed vitamin E at a level three to six times
exceeding what is available in normal diets, the most noticeable
improvement defense against infectious diseases is a
in their
significantly enhanced immune response," he says. "In this case,
it is manifested by an increased production of antibodies, the
protein molecules that help eliminate invading microorganisms."

Increased production of antibodies with high vitamin E diets
has been observed in mice, chickens, turkeys, guinea pigs, rab-
bits, pigs and sheep.
Can a "Good" Diet Still

Benefit from Supplements?
While many nutritional studies compare the effect of a de-
ficient diet to thatof one with an "adequate" supply of the
vitamin involved, these researchers organized things a bit dif-
ferently. They gave some animals normal laboratory diet

their
which supplied the Recommended Dietary Allowance of every-
thing, including vitamin E. To others they gave the same diet
plus a supplementary amount of vitamin E. It's like comparing
a group of people who eat "a good diet" with another group
who eat a good diet with vitamin E supplements.
"I tried to determine whether supplements of vitamin E,
given in excess of what is required for normal growth and re-
production, increase immunity to infection," Dr. Nockels told
us.
338 VITAMIN E
In one experiment, she said, researchers gave one group of

mice their normal diet and another a diet supplemented with 60
international units of vitamin E per kilogram of food (1 kilogram
is about the amount of food you probably eat in a day). They
injected both groups with sheep red blood cells. Four days later,
the mice were examined.
When mice are injected with sheep red blood cells, their
bodies react to them the way they'd react to bacteria by pro-
ducing the chemicals, called antibodies, that take invaders out
of action. That vital defensive process was significantly stronger
in the mice who received the vitamin E supplements. For one
thing, the weight of their spleens was greater (a sign of increased
antibody production). And when the researchers measured the
amounts of antibodies in the blood of both groups, the supple-
mented mice tested considerably higher.
Dr. Nockels and her co-workers then tested the effect of
vitamin E on immunity in guinea pigs. She gave one group of
the small rodents injections of vitamin E in amounts well above
the standard dietary level, another group got no injections. Then
she vaccinated them with the virus that causes a serious strain
of encephalitis.
Here, too, the animals who received supplemental vitamin
E protected themselves with significantly higher levels of anti-
bodies than those who did not.
Active immunity, the body's ability to manufacture anti-
bodies against invading organisms, provides important protec-
tion at any age. But newborn animals (and this includes human
infants) don't have this ability. Until they can establish it on their
own, they are dependent on the antibodies transferred to them
as they grow in embryo and, after birth, in their mothers' milk.
According to another of the Colorado State experiments,
vitamin E can effectively boost the process of passive transfer
that keeps defenses up at this particularly vital time for new-
borns. The researchers gave one group of hens a diet supple-
mented with 150 international units of vitamin E per kilogram
of food, the other just the normal feed. After four weeks, they
incubated the hens' eggs.
Researchers took blood samples when the chicks were two

days and seven days old and measured the antibody levels. The
offspring of hens given vitamin E supplements, it was found,
had higher levels of antibodies than the controls. The vitamin E
their mothers received, it seems, gave them a better start in life.
Putting Vitamin E to the Real Test

While laboratory measurements of immune reactions are
important, they must be judged with care. Resistance to disease
is a complex thing, and a higher level of antibodies does not
automatically mean better defense against infection. A small but
significant number of antibodies, for instance, might not make
any practical difference when real bacteria and viruses are in-
volved. To determine whether vitamin E supplements effectively
help to prevent infection, the Colorado researchers performed a
series of experiments with chicks, turkeys and sheep. Using a
number of different species, they explained, ''makes generalize
tions sounder. It strengthens the likelihood that findings will also
apply to humans."
Groups of chicks and turkeys were fed either the normal
chick or turkey feed or that plus vitamin E supplements ranging
from 100 to 300 international units per kilogram of food. They
were then injected with disease-causing bacteria. Among both
the chicks and the turkeys, vitamin E supplements meant a lower
mortality rate: Fewer animals succumbed to the disease.
What was more, there was a significant connection between
the size of the supplement and the degree of protection. Twenty-
five percent of the chicks who received no supplements died of
the infection, for example; 10 percent of those who received 150
international units of vitamin died, and only 5 percent of those
who received 300 international units died.
In another experiment, the researchers fed a group of lambs
large doses of vitamin E, then inoculated them and an unsup-
plemented group with Chlamydia, a germ which induces pneu-
monia in sheep.

340 VITAMIN E
Later examination of the animals showed less damage to

the lungs of those who had received vitamin E supplements than
to those of the controls. Also, the supplemented animals showed
no traces of the bacteria in their bodies, while the pathological
organisms could be found in 40 percent of the controls.
In all three species. Dr. Nockels concluded, vitamin E sig-
nificantly improved resistance to disease.

This particular aspect of vitamin E may be worthy of greater
attention. Dr. Nockels says. "1 think that further research may
show that vitamin E provides positive improvement of immune
capability in humans, too."
Such research may show, among other things, that the RDA
what is normally considered "enough" vitamin E is far too
low.
'The RDA does not appear to maintain immunity at full
strength," says Dr. Nockels. "In every case, I found that an

amount of vitamin E greater than the RDA
for the animal was
required to stimulate improved immune response. And with el-
derly animals, the allowances might have to be even higher."
Vitamin E has also been shown to be involved in the pre-
vention of a number of specific problems unrelated to bacterial
infection. Patients with vitamin E deficiency have developed
serious nerve degeneration. Recent research indicates that vi-
tamin E may also prevent cortical cataracts, the most common
type of cataract among older people.
Cortical cataracts are a clouding of the outer part of the lens
of the eye. The condition often afflicts older diabetics and can
result in partial or total blindness. John R. Trevithick, Ph.D., a
biochemist at the University of Western Ontario, has shown that
large doses of vitamin E can prevent the formation of cortical
cataracts in animals.
Vitamin E's protective action may cover cancer, as well. E
has been shown to inhibit the breast-cancer-causing action of
the chemical daunorubicin in rats and the colon-cancer-causing
effects of dimethylhydrazine in mice.
That result clearly supports the idea that vitamin E blocks
the formation of nitrosamines and nitrosamides, a family of
chemicals that are strongly suspected to cause colon cancer in

humans, and researchers at the Ontario Cancer Institute in Can-
ada are now testing vitamin E to determine if it can block the
recurrence of threatening growths (called polyps) in patients with
cancer of the colon and rectum.
Those researchers have already shown that the wastes of
people eating a normal diet contain chemicals that cause muta-
tions in a special strain of test bacteria. Scientists know that
chemicals which cause the mutations very often also cause can-
cer, and results of various tests led the Canadian researchers to
believe that the chemicals they found in the feces were probably
nitrosamines and nitrosamides {Environmental Aspects of N-
Nitroso Compounds, International Agency for Research on Can-
cer, 1978).
The most interesting developments came when the research-
ers tested the effects of vitamin E on the levels of the suspected
cancer-causing chemicals. Supplementation of people's diets with
120, 400 and 1 E a day led to significant
,200 international units of
reductions amounts of the chemicals in feces (American
in the
Association for Cancer Research Abstracts, March, 1980).
Cramp Relief with E

Another problem that succumbs to vitamin E is the pain of
cramps.
When a team of Los Angeles doctors gave vitamin E to 125
patients with nighttime leg and foot cramps, 103 had complete
or nearly complete rtWef (Southern Medical Journal).
"More than half of the patients had suffered from leg cramps
longer than 5 years and many of these had had cramps for 20 to
30 years or longer," Samuel Ayres, Jr., M.D., and Richard Mi-
han, M.D., reported. "Approximately one-fourth of the patients
had cramps every night or several times a night, and in about
65 percent of the cases the cramps were severe."
About half of the patients found relief by taking 300 inter-
national units or less of vitamin E a day. The other half needed

342 VITAMIN E
400 international units or more to control their cramps. And, the

doctors note, many patients had to continue taking vitamin E to
stay free of cramps: "In a number of instances it was learned
that cramps recurred when treatment was stopped or greatly
reduced, but promptly responded again when treatment was
resumed."
After treating so many patients with vitamin E, the doctors
believe the nutrient is cramp medicine: "The re-
practically a
sponse of nocturnal [nighttime] leg and foot cramps to adequate
doses of vitamin E is prompt, usually becoming manifest within
a week, and occurs in such an overwhelming number of cases
that appears almost specific for this ailment.''
it
But doctors have treated more than nighttime foot and leg
cramps with vitamin E.
They have also treated nighttime rectal cramps, cramping
of abdominal muscles and cramps from heavy exercise.
One particular type of cramp that may occur after exercise
heavy or mild is intermittent claudication, a cramp of the calf.
Scientific evidence shows that this cramp, too, may yield to

vitamin E.
Adoctor studied 47 men with severe intermittent claudi-
cation, giving 32 ofthem vitamin E and the rest drugs to improve
their circulation. After about three months, he tested the men
to see how far they could walk. In the vitamin E group, 54 percent
of themen could walk the test's maximum distance, a little more
than half a mile. But only 23 percent of the drug group completed
the test (American Journal of Clinical Nutrition).
Vitamin E may have treated intermittent claudication by

doing what the drugs failed to do improve circulation. After
about 18 months of taking vitamin E, 29 of the 32 men showed
an increase in the flow of blood to their calves. During those
same months, most of the men in the drug group had a decrease
in their flow. But exactly how vitamin E works continues to
puzzle doctors.
An Australian physician, who tried vitamin E "with re-
markable success" on approximately 50 patients, wrote to a
medical journal saying he was "unable to explain the physio-
logical reason why vitamin E should control muscle cramp" and

asked his colleagues to "give me an explanation" {MedicalJour-
nal of Australia).
Well, it doesn't really matter why. What matters is that
vitamin E does work in many cases to relieve cramps. If you
should ever have a cramp, that's all you need to know.
And given the extra threats to health we all encounter in
today's environment, it's a good idea to make sure your diet
contains the vitamin E you need. Most grains, nuts and seeds
are high in vitamin E. Sunflower seeds and wheat germ are two
particularly good sources of the vitamin, and supplements can
help you attain the optimal levels necessary for good health.
When just one nutrient boosts the body's well-being in so many
different ways, you should take full advantage of it.
CHAPTER
VITAMIN E
LUBRICATES THE
CIRCULATION
Some people don't need convincing.

People like Drs. Evan and Wilfrid Shute pioneers in the
vitamin E field who for more than 30 years have been advising
patients to take vitamin E to dissolve painful blood clots and
prevent heart attack and stroke.

Or Alton Ochsner, M.D. a leading surgeon and teacher for
many years at the Tulane University school of medicine in New

Orleans who was giving his patients the edge against post-
surgical blood clots back in 1950 by prescribing vitamin E.
But for those who haven't tried it and who still have to be
convinced of the anticlotting benefits of vitamin E, your time
has come. We've now got scientific evidence that vitamin E can
reduce clotting at its earliest stages. And why.
But first, you may be wondering how this research may
affect you. After all, aren't blood clots basically good guys that
could save your life in a pinch?
Yes, that's true. When you nick yourself with a razor or slit
your finger on the razor-sharp edge of a piece of paper, tiny
saucer-shaped blood cells (appropriately named platelets) are
immediately called to the rescue.
Normally, platelets are pretty independent characters that
344

E LUBRICATES THE CIRCULATION 345
slip and slide through the bloodstream with no real desire to latch
on to other blood cells. But when the word is out that there's
been damage to a vessel wall, they stick together literally.
Within seconds, they're clinging to the crack in the vessel
and sticking to each other to build up a thickened, gooey mass
just perfect for plugging the gap in the vessel wall and preventing
further blood loss.
It is this clumping of platelets
the first most crucial step
of blood clot formation
that scientists refer to as platelet ag-
gregation. Usually, it takes only a few minutes after injury for
other substances to get caught up in this sticky mass and form
a clot.
But sometimes something goes amiss. Instead of clumping
on cue, the platelets begin to congregate on a healthy artery wall.
If they grow into an unruly mob and are joined by other chemical
agitators, a blood clot could form within the blood vessel and
cause real trouble.
Deep vein thrombosis (a medical term for a blood clot in
the leg) and phlebitis (another condition of the legs, characterized
by inflamed blood vessels and clot formation) are caused by
spontaneous clotting. Both conditions can be painful. But the
real problem arises when the clot journeys up the leg and gets
caught in a major blood vessel of the heart, lungs or brain.
If a blood clot gets stuck in a coronary artery that is ob-
structed by cholesterol deposits and blocks blood flow, a heart
attack could result. Similarly, a clot may lodge in the lungs (pul-
monary embolism) or brain (stroke) and again pose fatal
possibilities.
There is also a growing number of studies which link in-
creased platelet aggregation with migraine headaches. Writing
in the Journal of the American Medical Association, Donald J.
Dalessio, M.D.. of the Scripps Clinic and Research Foundation
in La Jolla, California, notes, 'There is a substantial increase
in platelet aggregation during the pre-headache phase of mi-
graine." He also suggests that this apparent tendency toward
clotting may explain the slight increase in incidence of stroke
among patients with migraine.
It stands to reason, as Dr. Dalessio points out, that any
346 VITAMIN E
substance which might interfere with platelet aggregation could

act as a protective measure against recurrent migraines as well
as strokes.
And that substance vitamin E.
is
One of the links between vitamin E and platelet aggregation

was published in the Proceedings of the Society for Experimental
Biology and Medicine. Lawrence J. Machlin, Ph.D., and a group
of researchers at Hoffmann-La Roche, Nutley, New Jersey,
compared blood samples taken from vitamin E-deficient rats to
those taken from animals receiving extra doses of the vitamin.
Not surprisingly, the supplemented animals had the edge
against clotting. For one thing, platelet aggregation was signifi-
cantly reduced in all the rats of the vitamin E group. In addition,
after 15 to 16 weeks, the rats on a deficient diet began producing
more and more platelets. And this, researchers speculate, may
also contribute to the increased clotting: The more platelets you've
got bumping into each other in the bloodstream, the greater the
chance of them sticking together and setting off the series of
reactions leading to a blood clot.
Pediatricians at the State University of New York's Upstate
Medical Center have reported a similar correlation in two chil-
dren seen at the center. Blood samples taken from both girls
were found to be extremely low in vitamin E and abnormally
high in platelets.
To test the clotting capacity of the blood samples, the phy-
sicians added certain chemicals, which cause platelet aggrega-
tion, to test tubes of the blood and compared them to similarly
treated samples taken from healthy children.
As expected, the platelets from the deficient girls clumped
more readily than those from the control group.
However, both the platelet count and the high clotting ten-
dency were reduced to normal following vitamin E supplemen-
tation (Journal of Pediatrics).
falls in line with the results of studies conducted
This finding
by Manfred Steiner, M.D., Ph.D., a blood research specialist
and associate professor of medicine at Brown University in Prov-
idence, Rhode Island.
In one of Dr. Steiner's earlier works, blood samples taken

from several healthy volunteers were similarly exposed in test
tubes to chemical agents, to stimulate the type of platelet clump-
ing that might occur spontaneously in a blood vessel. When
vitamin E was added to the test tubes, however, this clumping
was kept to a minimum.
In another similar study. Dr. Steiner first put the volunteers
on a vitamin E regimen (1,200 to 2,400 international units daily)
for a few weeks and then took the samples, which he exposed
to the same chemical agents used above. Again, he reported,
vitamin E minimized platelet sticking (Journal of Clinical
Investigation).
Dr. Steiner was convinced, but not satisfied that his work
was completed. "There's no question that vitamin E does have
a profound effect on platelet aggregation," the Rhode Island
researcher says. ''But that's only the beginning. We wanted to
know whether we could explain the molecular basis of that ef-
fect." And, he indicated, he had a hunch that the answer might
be found in the outer coating, or cell membrane, of the platelets.
Vitamin E Protects Cell Membranes

And why not? Other researchers have found that vitamin E
protects cell membranes, especially, from the destructive effects
of oxygen.
For example, a biochemist from the University of Puget
Sound in Washington, Jeffrey Bland, Ph.D., found that the mem-
branes of red blood cells (not platelets) became weakened when
exposed to the circulating oxygen in the blood. But vitamin E
protects against this weakening and increases the life expectancy
of the cell.
"When cells are subjected to oxidative damage, it is as if
they have been hit with a tiny hand grenade," Dr. Bland told
us. "There is little question that damage is being done.
'
348 VITAMIN E
"But vitamin E has a great affinity for cell membranes be-

cause these membranes contain large amounts of unsaturated
. '
fatty acids and other fats and vitamin E is a fat-soluble vitamin

,
In Dr. Bland's research, 24 volunteers were instructed to

take 600 international units of vitamin E a day for 10 days. Then
blood samples were taken and these samples exposed to oxygen
and sunlight for 16 hours to hasten oxidation. Normally, a great
many of the cell membranes would have shown signs of damage.
But with the vitamin E, Dr. Bland reports, "only a very small
number" of cells were harmed.
Is it possible to relate this finding on red blood cells to blood
platelets? "I think there is enough consistency in cell membranes
to say that this is going to hold true," Dr. Bland told us. "We
have done a little bit of research on platelets and, so far, we've
found that, the higher the concentration of vitamin E, the greater
the stability of the platelet membranes. There is less chance of
developing binding sites on the platelet membranes."
Dr. Steiner agrees. "Many nutrition biochemists say that
vitamin E does have a stabilizing effect on the cell membranes.
Ihave tried to investigate this possibility by measuring the mem-
brane fluidity, that is, measuring the motion of molecules in the
platelet membrane.
"Let me explain it this way: The cell membrane consists of
lipids [fats] and proteins. The lipids act like an oily sea in which
the proteins are inserted. Think of it as cooking oil: As you heat
it it, the consistency changes. The lipid sea reacts the
or cool
same temperature change. And it's possible to monitor these
to
changes by measuring the movement of the protein molecules;
the thicker the sea, the slower the movement of the molecules.
And, of course, the thinner the sea, the faster they will move.
"Vitamin E affects the fluidity of the membrane much in
the same way that temperature does. I've found that, under any

temperature conditions even at body temperature vitamin E
permits the proteins to move about more freely. And in blood
platelets, it is this increased fluidity that reduces the stickiness
of the platelets."
How much? Well, in volunteers taking 1,200 to 1,600 inter-

national units of vitamin E

a day for four weeks. Dr. Steiner
reports a 30 to 45 percent reduction in the stickiness of the
platelets. And in those who kept up with the E regimen for more
than a year, platelet adhesiveness was cut 50 percent.
But there's a second wave in platelet aggregation that we
haven't discussed yet but which plays a very important part in
the development of dangerous blood clots.
Apparently, when platelets first stick together, they look
very much like a cluster of grapes. And they're just as fragile.
At any time, they can break apart and back into the blood-
slip
stream unnoticed. Under these circumstances, a blood clot doesn't

have a chance to develop.
However, if the platelets hold on long enough, they even-
tually release a chemical substance which draws them closer

and tighter together. The cluster of grapes we had before be-
comes one solid piece of fruit. And now there's no turning back.
According to Dr. Steiner, a blood clot is inevitable at this
point unless you're fortified with vitamin E.
"During platelet aggregation, subtle changes occur in the
platelet membrane which activate certain enzymes in the mem-

brane to link up with those fatty acid molecules we talked about
earlier," Dr. Steiner explains. ''Somewhere in the process of
this union, a powerful chemical substance is released into the
surrounding platelets which significantly increases the stickiness
of the membranes. The clump then becomes permanent."
But here, again, vitamin E can block a potential tragedy.
"The molecular structure of vitamin E is just perfect for linking
up with the polyunsaturated fatty acid molecule," Dr. Steiner
explains. "And if vitamin E links up with it first which it will
if you keep yourself supplemented with E
then the fatty acid
molecule is unavailable to the enzyme. No chemical agent is
released. The platelet clump is able to dissolve. And no clot
forms.
"Based on these findings, I feel that vitamin E should be
considered a worthwhile preventive measure against such clot-
related disorders as heart attack and stroke," Dr. Steiner says.
"I take 1,200 international units of vitamin E every day."
350 VITAMIN E
A Sticky Problem
Dr. Bland is convinced of the importance of this vitamin E
research. "Preventing platelet adhesion is a very big concern of

medical researchers these days."
One of those researchers is R. V. Panganamala, Ph.D. He's
seeing firsthand how vitamin E works. Dr. Panganamala, of the
department of physiological chemistry at the Ohio State Uni-
versity school of medicine in Columbus, has conducted exper-
iments with rabbits and rats to show how and why vitamin E is
so crucial to the health of blood vessels.
"Any time platelets stick together inside an intact blood
vessel, it's a problem," explains Dr. Panganamala. "But that
can happen when the platelets produce too much thromboxane,
a substance that enhances their stickiness. It can also happen if
the vessel wall doesn't produce enough prostacyclin. This chem-
ical has the opposite effect on platelets that is, it keeps them
free-flowing and slippery.
"In our experiment," Dr. Panganamala told us, "we wanted
to see what effect vitamin E had on those two chemicals. We
used animals that were normal and healthy to begin with and
divided them into two groups. One group received a diet high in
vitamin E while the other's diet had no vitamin E at all. After
10 to 12 weeks, we tested the levels of thromboxane and pros-
tacyclin in the animals. We found that those deficient in vitamin
E had significantly higher amounts of thromboxane while, at the
same time, their vessels lost the capacity to produce prostacyclin.
"It's our current understanding that the proper ratio of
thromboxane to prostacyclin is imperative if platelets are to move
through the blood without aggregating at the wrong time. If the
ratio's out of balance, there is a far greater chance of thrombosis
[blood clots] to occur. Vitamin E helps keep these substances
in precise, proper balance."
Because of the success of that experiment. Dr. Panganamala

wanted to try a similar experiment using diabetic animals.
"We know that people with diabetes are particularly vul-
nerable to circulatory problems," he told us. "So we decided

to see if the thromboxane and prostacyclin balance was adversely
affected in animals with that condition.
"First, we created diabetes in a group of experimental rats.
After the diabetes was established, we tested their levels of
thromboxane and prostacyclin and found that they were out of

balance too much of the first and too little of the second.
"Next, we supplemented the rats' diet with vitamin E. Within
eight to ten weeks, the two chemicals were back to their normal
levels."
Diabetics may gain an extra benefit from vitamin E. Re-
search has shown that excessively sticky platelets and diabetic
retinopathy (disease of the retina) go hand in hand.
A study done in Israel has shown that vitamin E may coun-
teract the damaging effects of diabetic retinopathy (possible
blindness) by inhibiting platelet aggregation and, consequently,
improving circulation to that area {Acta Haematologica, vol. 62,
no. 2, 1979).
IV Patients May Need Extra E

When hospital patients are fed intravenously, they are par-
E deficiency and excessively sticky
ticularly susceptible to vitamin
platelets,according to Peter M. Thurlow, M.D., and John P.
Grant, M.D., ofthedepartmentof surgery at the Duke University
medical center in Durham, North Carolina. They studied 13 pa-
tients who were on total parenteral (intravenous) nutrition (TPN)
for two or more weeks, and they found that, even with standard
vitamin supplementation, TPN is associated with a gradual de-
crease in serum vitaminE concentrations.
And as serum vitamin E levels decrease, platelet aggregation
becomes abnormal. One patient, whose vitamin E concentration
and platelet aggregation were normal initially, developed a de-
ficiency and platelet hyperaggregation (overly sticky platelets)
after 15 days of TPN. In fact, every patient with low vitamin E
352 VITAMIN E
levels alsohad abnormal platelet aggregation. Extra supplemen-

tation raised theplasma vitamin E levels and returned platelet
aggregation to normal in most of those patients.
Because platelet hyperaggregation has been implicated in
the development of both thrombosis and atherosclerosis, the
doctors recommend supplemental vitamin E during TPN to main-
tain normal vitamin E levels and platelet function {Surgical Forum,
vol. 31, 1980).
Actually, that's good advice for just about everyone, not
just those fighting off illness. Smooth-flowing blood vessels mean
a healthier circulation, no matter what your present state of
health. Let vitamin E be the plumber that helps clean up your
internal pipes.
CHAPTER
HELP YOUR HEART

WITH VITAMIN E
Medical discoveries are often the results of fortunate acci-

dents. When, by coincidence, a 33-year-old Houston pathologist
tested his own blood cholesterol while taking daily doses of
vitamin E, he stumbled on what he thinks might be an important
new method for preventing atherosclerosis, or hardening of the
arteries.
In the summer of 1978, William J. Hermann, M.D., a pa-
thologist at Memorial City General Hospital in Houston, was
settingup new tests to study the distribution of cholesterol in
the blood of the hospital's patients.

The showed more than just how high a person's cho-
tests
lesterol level was. In the blood, cholesterol is transported by
complexes of fats and proteins called lipoproteins. Low-density
lipoproteins (LDLs) carry cholesterol to the cells, and high-
density lipoproteins (HDLs) carry cholesterol away from the
cells. A high proportion of LDLs has come to be associated with
a high risk of atherosclerosis, and a high proportion of HDLs is
associated with a low risk. On sampling his own blood which

happened to be handy Dr. Hermann found only 9 percent HDLs,
a sign of a higher than average risk.
353
354 VITAMIN E
At about the same time, with no idea that it would eventually

affect his laboratory work. Dr. Hermann urged his father to start
taking vitamin E. The elder Hermann, a man of 60 at the time,
was in good health. But there was a family history of cardio-
vascular problems, and Dr. Hermann had seen evidence that
vitamin E can prevent unsaturated body from turning
fats in the
into bulkier, ''stickier," potentially more harmful saturated fats.
His father agreed, but he also persuaded his son to start vitamin
E therapy. Dr. Hermann began taking 600 international units of
vitamin E per day.
The dog days of August passed by. Dr. Hermann went on
vacation, where he drank almost no alcohol (alcohol might have
increased his HDL fraction) and even gained a little weight (which
can decrease HDL). When he got back to his lab, he tested his
blood again. He found "with astonishment" that, after taking
vitamin E for 30 days, 40 percent of his blood cholesterol was
now attached to HDL.
Vitamin E Lowered Cholesterol

"I came back from vacation and the results had changed so
dramatically that for two days Ithought the experiment had
failed," Dr. Hermann told us. Then he realized that the vitamin
E had apparently shifted the cholesterol, taking him from what
is considered a higher than average risk to a lower than average
risk of atherosclerosis.
Although he is frequently skeptical of vitamin therapy claims
in general. Dr. Hermann was excited by his discovery. He de-
cided to put the accidental discovery to a test. In the fall of 1978,
he picked five people with average amounts of HDL cholesterol
and five with high risks of atherosclerosis (low HDL cholesterol)
and placed them all on 600 international units of vitamin E per
day. The results: All five people with cholesterol problems im-
proved radically within a few weeks. And though the experiment
was small. Dr. Hermann was impressed because vitamin E even
had a positive effect on four of the five healthy volunteers.
HELP YOUR HEART WITH VITAMIN E 355
In publishing his findings. Dr. Hermann wrote, 'The results

were so obviously significant and of potential value to the medical
community that we wish to report them in their somewhat ten-
tative form" {American Journal of Clinical Pathology, Novem-
ber, 1979).
What does Dr. Hermann's experiment mean to someone
who's concerned about preventing or delaying the onset of ath-
erosclerosis? It means that he or she may
be able to use vitamin
E as another defense against cholesterol buildup in the arteries.
Exercise, such as long-distance running, has been shown to de-
crease the risk of atherosclerosis (New EnglandJournal of Med-
icine, February 14, 1980). Both exercise and vitamin E seem to
raise the amount of cholesterol in the HDL complexes. That
indicates that excess cholesterol is leaving the cells and getting
dumped out of the body in a healthy way.
In Dr. Hermann's experiment, the three men and two women
who started out with very low levels of HDL cholesterol all
raised their levels by between 220 and 483 percent. The effect
of vitamin E was consistent, even though the volunteers ranged
in age from 28 to 55 and had widely varied exercise and eating
habits. One woman of 55, who was overweight, took longer to
respond and needed 800 international units per day, but her
results were ultimately the same.
All five of these high-risk subjects moved within seven weeks
or less to an average or even above average level of HDL cho-
lesterol a good sign that they were reducing their chances of
developing atherosclerosis. They also lowered the levels of very-
low-density lipoproteins VLDL) and triglycerides (another fatty
(
acid complex) in their blood by about one-quarter and one-fifth,

respectively, thereby mitigating two more warning signs of im-
pending atherosclerosis.
Of the five volunteers with average initial cholesterol dis-
tribution, four saw their HDL fraction rise to between 127 and
237 percent of its original value. The only person who did not
seem to benefit from the vitamin E therapy was a 33-year-old
man with an average HDL cholesterol level. His HDL fraction
stayed the same after 30 days.
356 VITAMIN E
The total amount of cholesterol in the blood hardly changed

at all for that didn't matter. Dr. Hermann
any of the subjects. But
stressed. "What matters," he said, ''is whether the cholesterol
is on the way in (bound to LDL) or on the way out (bound to
"
HDL).
When the body is functioning properly. Dr. Hermann ex-
plained, cholesterol is manufactured in the liver and sent through
the bloodstream to the cells. It is essential for the synthesis of
hormones, membranes and even for
for the formation of cell
protection against cancer. The cells can make their own supply
of cholesterol, or they can pick it up from the blood. What they
don't need, they send back into the blood, on to the liver and
out of the body.
VLDL, LDL and HDL, as mentioned before, are the com-
plexes of fats and proteins that carry cholesterol through its
cycle. The VLDL carries it out of the liver, where it is made.
Then the VLDL, with cholesterol still on board, degrades into
an LDL. The LDL delivers the cholesterol to the cells along the
artery walls. After an intricate digestive process, the cells spit
out any excess cholesterol. This is where the all-important HDL
plays its role. Acting as, Hermann's words, "a garbage
in Dr.
collection mechanism," the HDL picks up the discarded cho-
lesterol and packs it off to the liver.
The delicate balance of the cycle, however, can get derailed.
A family tendency toward circulatory problems, a high-fat diet,
smoking or a sedentary life style can increase the level of LDL
and decrease the level of HDL. When that happens, too much
cholesterol is being fed to the cells, and not enough is being
eliminated. Clogged with cholesterol, the cells die, eventually
forming fatty streaks, or plaque, along the artery walls. And
plaque is what promotes clotting and narrowing, eventually
blocking the artery and causing heart attack and stroke.
Vitamin E. according to Dr. Hermann, may help maintain
a healthy LDL-HDL balance. At some point in the biochemical
process, the vitamin seems to enhance the metabolism of cho-
lesterol. But Dr. Hermann wasn't sure where. His best guess
HELP YOUR HEART WITH VITAMIN E 357
was that vitamin E enables cell membranes to let cholesterol

pass out of them more easily, making it available for HDL pickup.
Dr. Hermann believes that this was the first experiment to
show a direct relationship between the use of vitamin E and a
higher level of HDL cholesterol in the blood.
Dr.Hermann's preliminary findings about vitamin E can be
summed up as follows. First, the vitamin seems to improve cho-
lesterol metabolism. Second, it seems to have this effect re-
gardless of age, sex or diet. Third, it seems to begin working
within 20 days (or longer for those who are overweight).
These effects do require a maintenance dose. Dr. Hermann
found that, when he stopped taking vitamin E for one month,
his HDL cholesterol level dropped from its high of 40 percent

down to 16 percent close to where it started. But when he
renewed the therapy, this time at 400 international units per day,
his HDL fraction rose within a month to 27 percent.
Dr. Hermann won't go so far as to prescribe an exact dosage
of vitamin E. But he does say that the 15 to 50 international units
of vitamin E often found in multivitamin preparations probably
aren't enough to have an effect on cholesterol metabolism. He
suggests 400 international units as a good maintenance dose for
the average person. He recommends higher doses 600 or 800
international units at first for people with cholesterol imbalances.
Dr. Hermann is hoping that his discovery will inspire more
research on vitamin E. "I'd like to see people get excited about
this effect, study the mechanism of it and verify these preliminary
findings," he said.
If new studies confirm what Dr. Hermann has found, he will
have added significantly to the growing body of clinical evidence

of vitamin E's healthy effect on the human circulatory system.
CHAPTER
VITAMIN E
STRONG MEDICINE
FOR RARE DISEASES
Here's a health quiz that few people outside of the medical

profession could be expected to pass. But you might want to try
it, anyway.
What is discoid lupus erythematosus? Sickle cell anemia?
Thalassemia? Bronchopulmonary dysplasia? Retrolental
fibroplasia?
Give up? Unless they've touched you personally, or a friend
or someone in your family, it's not likely that you would rec-
ognize many (or any) of the above health problems. But to the
tens of thousands of individuals afflicted, the consequences of
those obscure disorders are all too real.
Here's something you have heard of, though: vitamin E.
And the important thing to know about this last item is that it's
helping doctors to come to grips with all of those problems we've
just mentioned.
Consider discoid lupus erythematosus (DLE), for example.
It's a chronic disease of the skin which torments its victims with
red, circular blotches, or plaques. Pore openings widen and be-

come plugged with scale. Although not as serious and deep-
seated as the related malady systemic lupus erythematosus (which
358
STRONG MEDICINE FOR RARE DISEASES 359
attacks and breaks down connective tissue throughout the body),

DLE can be quite an ordeal.
That's why a report by two Los Angeles dermatologists,
Samuel Ayres, Jr., M.D., and Richard Mihan, M.D., is so note-
worthy. Dr. Ayres, who is emeritus clinical professor of medicine
at the University of California at Los Angeles (UCLA), and Dr.
Mihan, a clinical professor at the University of Southern Cali-
fornia school of medicine, have had excellent results treating
patients with vitamin E {Cutis, January, 1979).
Current therapy of lupus, they point out, ''depends almost
entirely on three categories of drugs: antimalarials, corticoste-
roids and immunosuppressives, all three of which may be helpful,
but which also carry serious risks of undesirable side effects,
including infections and malignancy.
''Vitamin E, on the other hand, when properly used, is
essentially free of such side effects. However,

must be em-
it
ployed in potent form, in adequate amounts, and over an ex-

tended period of time, sometimes indefinitely, to achieve max-
imum therapeutic benefits."
Blotches Disappeared
Drs. Ayres and Mihan described seven patients treated with
vitamin E. One, a 63-year-old woman, had been troubled by
discoid lupus for about eight months. Reddish, scaly and crusty
blotches the size of nickels and quarters marred her skin. She
was started on a supplement of 800 international units of vitamin
E daily, later increased to 1,200 international units, and a special
cream containing vitamin E was applied directly to the skin twice
a day. "Five and a half months later, the patient's skin was
completely cleared," the doctors report. "Her response was
excellent."
Another woman, 37 years old, had suffered with lupus symp-
toms on and off for 23 years. Pea-size and larger scaly plaques
were scattered over her upper back, chest, arms and face. She
began taking 800 international units of vitamin E daily, with the
360 VITAMIN E
dosage later stepped up to 1,600 international units. Vitamin E

was also applied directly to the skin. ''After nine months, all
lesions were clear," according to Drs. Ayres and Mihan, ''except
for six tiny inconspicuous remnants on the face and left neck."
another patient, a 33-year-old woman, had on-and-off
Still
symptoms for 20 years. There were plaques on her cheeks, chin

and neck, along with some withered areas on the scalp with
associated hair loss. After taking vitamin E and 50 micrograms
of selenium daily
the doctors observed that this trace mineral

enhanced vitamin E's effect the woman showed almost no re-
maining signs of redness after seven months, and there was "con-
siderable new hair growth in previously bald areas on the scalp."
Not responses were so dramatic. A 54-year-old woman
all
with rough plaques on her face, nose, neck and chest also tried
vitamin E. "There was definite improvement six months later,
compared to photographs taken at her first visit. All lesions were
flatter, paler, and some showed areas of normal skin." Her re-
sponse was "good."
Others in the group who took the lowest amounts of vitamin

E only 300 international units daily showed the poorest re-
sponse, leading Drs. Ayres and Mihan to conclude that the pre-
ferred dosage is between 1,200 and 1,600 international units daily.
Protecting Cell Walls

How does vitamin E accomplish its results? The doctors
aren't entirely sure, but they suspect vitamin E acts at the cellular
level. "Theoretically, E functions as a first line of de-

vitamin
fense by protecting cell membranes from destructive lipid per-
oxidation. . .
." in other words, fatty components in the cell
wall may be shielded from harmful oxidation or breakdown when
sufficient vitamin E is present.
Unfortunately, the cards are normally stacked against vi-
tamin E being present in any abundant quantity. According to

Drs. Ayres and Mihan, "deficiencies of vitamin E may be actual,
due an inadequate intake, but are probably more often due to

to
inadequate absorption, defects in utilization or increased re-
quirements. Unsaturated fats, laxatives and mineral oil, inor-
ganic iron, white bread and cereals 'enriched' with iron, and
estrogen exert an antagonistic effect on the utilization of vitamin
E."
Overcoming such obstacles require larger amounts of the
nutrient than diet alone could ever supply. "We would like to
emphasize," they point out, "that we have prescribed vitamin
E for patients with lupus and other diseases not as a simple
nutritional supplement but as a potent therapeutic agent."
What does the future hold? In light of their good results,
Drs. Ayres and Mihan would like to see larger clinical studies
begun in which vitamin E would be pitted against not only the
discoid, but also the much more serious systemic form of lupus
erythematosus.
They are hopeful that such investigations will establish the
value of this simple innocuous form of therapy for managing an
otherwise recalcitrant, disfiguring and sometimes fatal disease.
Another little-known but serious disease which may some-
day yield to vitamin E is sickle cell anemia. People with this
inherited disease suffer from an abnormality of hemoglobin which
affects their circulating red blood cells, with sometimes disas-
trous results.
Hemoglobin is the iron-rich reddish pigment inside the cells
which carries vital oxygen to all the tissues of the body.
Unfortunately, sickle cell victims have an unusual molecular
form of hemoglobin which can actually cause the red blood cells
to bend into a distorted crescent or sickle shape.
The sickle shape makes it possible for the red cells to slip
through the tiniest of blood vessels (called capillaries). Those
vessels are so small in diameter that even normal blood cells
have to march through in single file. Sickled cells get caught and
hopelessly jammed.
Sickle cell victims suffer from recurring attacks of fever and
pain in the arms, legs and abdomen as sickled cells back up in
blood vessels, causing painful sickling crises.
1
362 VITAMIN E
"Sickle cell anemia afflicts 1 black person out of every 500,

or 50,000 American blacks," according to Danny Chiu, Ph.D.,
a researcher at the Children's Hospital medical center in Oak-
land, California.
Dr. Chiu and a colleague, Bertram Lubin, M.D., have now
discovered that patients with sickle cell anemia also have a vi-
tamin E deficiency. As Dr. Chiu suggested at the Federation of
American Societies for Experimental Biology's annual meeting
in Dallas in April of 1979, inadequate levels of vitamin E in sickle
cell patients' blood plasma and red blood cells may contribute
to the sickling process.
For one found that the extreme suscep-
thing, the scientists
tibility of red blood cells from sickle cell patients to lipid per-

oxidation can be prevented at least in the test tube by vitamin
E. Dr. Chiu speculates that vitamin E's action as an antioxidant
may alter the red blood cell membrane's stability, making it less
vulnerable to bending and distortion.

Next, Dr. Chiu plans a clinical trial in which sickle cell
patients will receive 400 international units of vitamin E daily
for a year
and a half to see if the nutrient can relieve sickling
symptoms, as well.
"Normally, most cells of sickle cell patients only sickle
under certain circumstances," he explains. "Otherwise, the mo-
lecular defect isn't expressed clinically. But some cells, which
we call ISC, or irreversibly sickled cells, always sickle. The
amount of these cells varies from one patient to another, from
5 to30 percent."
Already, another study has discovered that supplemental
vitamin E can reduce the percentage of ISC by more than half.
Researchers from Hoffmann-La Roche and Columbia Univer-
sity told the same Dallas conference that, when 13 sickle cell
patients took 450 international units of vitamin E a day, the
proportion of irreversibly sickled cells dropped from 25 to 1
percent.
While individuals of African origin are at risk for sickle cell
anemia, those from Mediterranean countries like Greece and
Italy sometimes inherit a blood disorder known as thalassemia.

Here, too, vitamin E seems to be involved.
People who are bom with thalassemia are not able to produce
normal hemoglobin. Their red blood cells are misshapen, defec-
tive and rapidly destroyed. In its severe form, the disease re-
quires blood transfusions to sustain life.
When a group of patients with thalassemia took supple-
mental vitamin E (750 international units for three to six months),
"encouraging'' changes occurred in their red blood cell mem-
branes. This may indicate that vitamin E helps the membranes
to better withstand oxidative stress, according to the researchers
from Hebrew University-Hadassah Medical School and the
Hadassah University hospital, Jerusalem {IsraelJournal of Med-
ical Sciences).
Protecting Premature Infants

It's too soon to tell if vitamin E will someday be routinely
prescribed for treating thalassemia. But the vitamin is already
being used some hospitals to prevent another killer with an
in
unfamiliar name
bronchopulmonary dysplasia, or BPD, for short.
BPD's victims are much too young and helpless to defend
themselves. They are premature infants, placed on mechanical
respirators because of acute difficulty in breathing. Researchers
now believe that this prolonged exposure to high oxygen con-
centrations under pressure can cause the serious and often fatal
structural changes in the lungs called BPD.
However, in a trial at Yale-New Haven Hospital in Con-
necticut, Joseph B. Warshaw, M.D., and several associates dem-
onstrated that, when such infants were injected with vitamin E,
they were far less likely to succumb to BPD. Six of 13 babies
who did not get the injections experienced lung changes indic-
BPD. and 4 died. But none of the 9 infants who received
ative of
supplemental vitamin E showed any signs of BPD, and all sur-
vived {New En inland Journal of Medicine).
364 VITAMIN E
Finally, vitamin E is believed to protect against another

threat to the
newborn retrolental fibroplasia. Again, as with
BPD, the premature baby is the target, and life-saving oxygen
delivered under pressure is the culprit. The artificially high con-
centrations of oxygen cause spasm and rupture in tiny blood
vessels inside the eye, which can lead to detachment of the retina
and a halt to eye growth. For this reason, retrolental fibroplasia
is the chief cause of blindness in the newborn.
Researchers at the University of Pennsylvania have found
that, when supplemental vitamin E is given, fewer premature
babies develop retrolental fibroplasia, and those who do are af-
fected less severely than would otherwise be expected (Pediatric
Research).
It's just one more example of the many ways this special
nutrient is helping those with special health problems.
CHAPTER
NUTRITION THAT
STARTS AT
SKIN LEVEL
good label for them. They're the nu-

Versatile might be a
keep you healthy on the inside, but
trients that not only help to
go to bat for you when you're hurting on the outside, too. And
they go to work directly, right where the hurt is whether it's
a burn, cut or abrasion
because they're applied topically, just
likeany other salve or ointment. Take a look at vitamin E, for
example.
''We've been using vitamin E here for years," says John
Flanigan, M.D., a surgeon and director of the enterostomal ther-
apy unit at the Pottsville Hospital and Warne Clinic in Penn-
sylvania. Dr. Flanigan uses vitamin E ointment or oil in con-
junction with oral supplements of E and zinc to promote the
secondary closure of wounds.
A primary closure is when a cut is sewn up and it heals,
explains Dr. Flanigan. A secondary closure means there is a
gaping wound in which some skin has been lost and the tissue
underneath is exposed. 'Then I give patients the supplements
and use vitamin E ointment or oil." Applying vitamin E helps
the tiny red particles of new capillaries form on the surface of
the wound to patch it together and heal. Doctors call this process
365
366 VITAMIN E
granulation. Dr. Flanigan told us, "The tissue is fresher and the
wound heals better when vitamin E is applied to it. But you have
to have a good range of vitamin E systemically (inside the body)
as well as locally." Healing time may be cut in half when vitamin
E ointment or oil is used, he said.
The results obtained by using vitamin E can be ''very im-
pressive," Dr. Flanigan says, relating the case of a patient whose
leg was gangrenous and required amputation. Doctors had de-
cided to amputate above the knee because the leg would heal
better. But instead of healing, the leg became gangrenous again
and required reamputation higher up on the thigh.
After the second operation, the patient was given vitamin
E and zinc supplements, while vitamin E was applied locally on
the granulating surface of the wound. The wound began to heal
nicely, but the patient broke out in hives. The doctors believed
the reaction was an allergic response to the vitamin therapy, so
they discontinued it. Within two or three days, the surgical wound
began to get worse.
"We decided it wasn't the E and zinc causing the allergy
and put the patient back on the program. The wound healed
beautifully," says Dr. Flanigan.
Dr. Flanigan says vitamin E ointment and oil are effective
on bedsores, too, and can be used in the home for minor first-
aid problems. They may be used "indiscriminately" for minor
cuts, abrasions and burns, he says, since "vitamin E is never
going to hurt anybody." If you should fall and scrape yourself,
for instance, thoroughly clean the wound, apply an antiseptic
and then reach for the vitamin E, says Dr. Flanigan. The wound
should be recleaned and the vitamin E should be reapplied daily
for the problem to heal quickly and safely, he says.
Dr. Flanigan credits the late Evan V. Shute, M.D., as one
of the people who first convinced him to try vitamin E. Dr. Shute,
with his brother, Wilfrid E. Shute, M.D.. pioneered research in
vitamin E more than 50 years ago. Together they founded the
Shute Institute in Canada, which has treated more than 40,0()()
patients for a variety of diseases with vitamin E.
NUTRITION AT SKIN LEVEL 367
Vitamin E Should Be in Every

Kitchen
In 1975, Dr. Evan Shute, writing in his annual publication
for doctors, proclaimed, "Vitamin E should be
in every kitchen
for convenient use. Burns, abrasions, lacerations respond
. . .
well to alpha tocopherol [vitamin E]. It should be given promptly,

both orally and locally. This minimizes the scarring and defor-
when bums and other wounds heaP' {Summary).
mity seen so often
one of several cases documented. Dr. Shute writes of a
In
man who had suffered a second-degree burn of his right forearm.
He had come to Dr. Shute 7 days after the accident, his burns
severely blistered. He was given 300 international units of vi-
tamin E by mouth. Vitamin E ointment was applied

to take daily
locally, as well. Within 5 days, the patient's wounds were 90
percent healed. He was completely healed in days without 1 1
the slightest impairment of his arm's bending ability, notes Dr.

Shute.
"The most puzzling yet helpful feature of patients treated
for burns with alpha tocopherol is the quick relief of pain," he
writes. "When skin grafts fail, they are merely repeated, for that
is the end of the line. We rarely send a patient for grafting and
never repeat it. Since vitamin E is slightly anti-infective, wounds
are usually very clean, an important factor in the 'take' of grafts."
Relief from Cold Sores

Vitamin E also has been reported successful in the treatment
of another skin problem, cold sores (herpes simplex). At the
two industrial firms in Liverpool, England, an
health facilities of
"unusually large number of patients" were seen suffering from
cold sores, many of which were failing to respond well to stan-
dard treatment. Vitamin E capsules were handed out to the pa-
368 VITAMIN E
tients with instructions to apply the Hquid contents to the lesions

every four hours.
"The most striking results were: (a) quick and sustained
reliefof pain, and (b) early disappearance of the lesion/' say the
report's authors, who have treated at least 50 patients success-
fully with the method. "Now, as a matter of routine," patients
with cold sores are given a capsule (and a pin!) and told how to
apply the oil," they write {British Dental Journal, vol. 148, no.
11-1, 1980).

CHAPTER
VITAMIN E,
WHEN IT'S SINK
OR SWIM
We're all swimming in a sea of stress physical, emotional,

chemical. And some of us are in over our heads. How about
you?
Air pollution is dragging your lungs down for the third time.
Some scientists say that radiation microwaves, X rays, nuclear
power is a hidden riptide that can wash your health out to sea.
And the doughnuts tossed at you by the neon lights of your local
fast-food strip aren't exactly life preservers.
Have a sinking feeling about all that stress? Then swim
with vitamin E.
When researchers want to find out about stress, they don't
kid around. One of their favorite tests is to throw rats into a tub
of cold water and see how long they can swim before sinking.
The test packs a lifetime of stress into an hour (the rats even
develop ulcers).
A researcher from the California State University in Hay-
ward recently conducted such a test. But first, he divided the
rats into a few groups and, for 18 days, supplemented the diets
of some groups with vitamin E. He found that the vitamin E rats
swam longer and had milder ulcers than the animals who weren't
fed vitamin E {Clinical Research, vol. 27, no. 1, 1979).
369
370 VITAMIN E
But does this test hold water for you? After all, you're
probably not a member of the local Polar Bear Club or an English
Channel swimmer who likes to make January crossings. But you
are someone who breathes, and that means coping with a source
of stress that can give cold feet to anyone who's striving for
better health
air pollution. Vitamin E can guard against that,
too.
Daniel Menzel, Ph.D., a researcher at the Duke University
medical center in Durham, North Carolina, continuously ex-
posed three groups of mice to ozone, one of the deadliest air
pollutants. One group, however, received a large amount of vi-
tamin E with its diet, another group got a smaller amount and
the third group got no vitamin E. The group receiving the large
amount of vitamin E survived an average of two weeks longer
than the other groups (Toxicology and Applied Pharmacology).
In another experiment. Dr. Menzel exposed two groups of
mice to nitrogen dioxide, a pollutant just as deadly as ozone. He
gave one group a daily amount of vitamin E equivalent to what
a person would get if he took 100 international units. The other
group received the equivalent of 10 international units of vitamin
E, the amount found in the average American's diet. After three
months of exposure to nitrogen dioxide, both groups of mice had
lung damage "very similar to what occurs in the early stages of
human emphysema," said Dr. Menzel. But the 100 international
unit mice had significantly less lung damage (Medical Tribune).
In yet another study, Ching K. Chow, Ph.D., of the Uni-
versity of Kentucky, exposed two groups of rats, one supple-
mented with vitamin E and the other not, to cigarette smoke.
After three days of chain smoking, 5 of the 16 unsupplemented
rats were dead, compared to only of the 13 supplemented rats.
1
Dr. Chow said cigarette smoke contains more than 3,000

chemicals, many of which are highly reactive and may have
altered certain essential enzymes in the rats. He concluded that
it was the cigarette's visible smoke, rather than its invisible gases,
that did the most harm.

Well, you're not a rat or a mouse. But you are a guinea pig
in
an experiment called the 20th century continuous exposure
to ozone, nitrogen dioxide and a menacing mix of other air pol-
VITAMIN E FOR STRESS 371
lutants. And you don't want to be in the 10 international units'

group even if you live where the air seems clean.
Pollution Is Inescapable
"Air pollution is not confined to metropolitan areas," Dr.
Menzel told us. "Rain made highly acidic by air pollution is a
uniform phenomenon east of the Rocky Mountains. The amount
of ozone in certain rural areas of New Jersey is greater than in
downtown Manhattan."
To protect his own health. Dr. Menzel takes 200 interna-
tional units of vitamin E every day. "A study I'm now completing
may show if a higher needed," he says. "But 200
amount is
international units should help protect the body from the stress
of air pollution."
Why
can't your body go it alone? Oxidation is why.
Oxidation is happening all around you a rusted-out car, a
rotten banana, yellowed newspapers in the attic. All have been
oxidized, slowly sizzled by oxygen. Ozone and nitrogen dioxide
can turn the scorch of oxidation into a four-alarm blaze and
turn your lungs into a burned-out ruin. Vitamin E douses the
fire.
But that's not the whole story. Free radicals are chemical
maniacs, out-of-control molecules that roam around looking for
something to destroy. Oxidation creates the free radicals and
they do the dirty work but not if they meet their match in
vitamin E. Oxidation isn't the only process that creates free

radicals, however. So does radiation.
Radiation
the energy that beams out of X-ray machines
and pulses at the core of nuclear reactors. Like an atom-size
bullet racing at nearly the speed of light, radiation can rip into
the very center of a cell. The wound is called cancer. Some
scientists believe that free radicals are responsible for radiation-
caused cancer. And with various kinds of radiation in the living
room (color TV), the bedroom (luminous clock dial) and the
kitchen (microwave oven), vitamin E may help keep your home
a sweet home.

372 VITAMIN E
Researchers from the Netherlands grew cell cultures in their

laboratory, adding vitamin E to some of the cultures. After sev-
eral weeks, they bombarded all the cells with X rays and more
of the vitamin E cells survived (British Journal of Radiology).
Radiation is a typically modern and typically dangerous
stress. Mercury is another.
Mercury made the headlines in the late 60s and early 70s
when a Japanese industrial firm dumped it into a bay and severely
poisoned many of the people living near there. Their symptoms
lack of coordination, blindness, deafness, slurred speech marked
mercury as one of the most toxic substances around. And even
though you don't hear much about mercury these days, each
year in America 310 tons are spewed into the air and 80 tons
dumped But E can help.
into the water.
from the National Medical Center for Toxicolog-
Scientists
ical Research in Jefferson, Arkansas, gave laboratory animals
either mercury alone or mercury with vitamin E. The animals

who got mercury alone suffered severe damage to their brains
and central nervous systems. But vitamin E, said the research-
ers, "showed a remarkable protective effect" the animals who
received it remained in almost perfect health (Environmental
Research).

Mercury, radiation, ozone vitamin E takes them all on.
And it even tussles with the toughest customer there is aging.
Extending the Life Span

what makes peo-
Scientists are just beginning to understand
ple age. One widely accepted theory lays the blame on free
radicals. Denham Harman, M.D., Ph.D., a professor at the Uni-
versity of Nebraska college of medicine and the chief proponent
of this theory, believes that cancer, heart disease, high blood
all caused, in part, by free radicals. He
pressure and senility are
told us that a dietwhich includes ample amounts of vitamin E
could "lessen the possibility of those health problems occur-
ring." Such a diet, he says, "may reasonably be expected to
VITAMIN E FOR STRESS 373
add five to ten or more years of healthy, productive Hfe to the

lifespan of the average person.''
Another scientist who studies aging, Johan Bjorksten, Ph.D.,
says the RDA for vitamin E is the amount "necessary to avert
obvious deficiency symptoms, but by no means the optimal range
for longevity." He thinks that a daily supplement of 200 to 300
international units could conceivably extend a person's life span
by 5 to 15 years (Rejuvenation).
And Dr. Menzel told us that the amount of vitamin E in the
typical
American diet 9 international units is probably too
low to maintain good health, let alone shield a person from stress.
Diet Alone Can't Do It
The daily amounts of vitamin E recommended by these sci-

entists anywhere from 100
600 international units are much
to
higher than found in even the most natural and wholesome diet.
But one study shows that there are no harmful effects from taking
800 international units a day for many years, so if you want to
use that much vitamin E, you can do so with confidence (Amer-
Of course, even if you take a vitamin E supplement, you
still want to get as much vitamin E from your food as you're
entitled to. And it's simple to do: Avoid processed and refined
foods.
Canned and frozen foods lose up to 65 percent of their vi-
tamin E. Grains are a good source of the vitamin, at least until
they're milled. Corn flakes, for instance, have lost 98 percent of
their vitamin E. Whole wheat bread has seven times more vi-
tamin E than white bread, and brown rice has six times more
than white rice. Nuts, another good source, lose up to 80 percent
of their vitamin E when roasted. Oils, too, provide plenty of
vitamin E unless they're hydrogenated. For the most vitamin
E, eat whole foods.
You have swim against the stream of stress, but you
to don't
have to
drown in it. Buoy yourself up with vitamin E.

CHAPTER
VITAMIN E
HELPS PROTECT
THE BREASTS
"Given the results of this study, we can conclude that vi-

tamin E may help prevent cancer of the breast."
So says Robert London, M.D., director of obstetrical and
gynecological research at Sinai Hospital in Baltimore, Maryland.
The study he's talking about is one he conducted in which vi-
tamin E was used to treat not cancer, but fibrocystic disease of
the breast. That's a disease in which cysts, tiny sacs filled with
liquid, poke out through the skin of the breast, tearing tissue and
forming hard lumps and sores.
In an interview with us. Dr. London emphasized that these
lumps are not cancerous. However, he did point out that "50
percent of all women have this disease sometime in their lives,
and there is a much higher incidence of cancer of the breast

about two to eight times greater among women who have had
fibrocystic disease."
With this in mind. Dr. London reasons that anything that
would effectively treat fibrocystic disease might prevent breast
cancer in thousands of women.
And according to his study, vitamin E does just that.
374
VITAMIN E HELPS PROTECT THE BREASTS 375
Dr. London first reported the results of his study to a meet-

ing of the American College of Obstetricians and Gynecologists
held in Washington, D.C. {Oh. Gyn. News).
Dr. London told the physicians that, for his study, he se-
lected 12 of his patients, menstruating women with fibrocystic
breast disease. These women
ranged in age from 16 to 42 years
old. Every day for three months, he gave these women a pla-

cebo a pill with no real potency. Then, for two months, they
received a daily dosage of 600 international units of vitamin E.
Eight healthy women, chosen as controls, also were given pla-
cebos and vitamin E.
Of these 12 patients, 10 improved. Seven had what Dr. Lon-
don called a "good" clinical response. Three had a "fair" re-
sponse. But when these 10 women were taken off the vitamin E
treatment, their disease returned full force
within just six weeks,
the women's breasts "had the appearance they did before the
treatment," Dr. London told the conference.
This finding alone is dramatic evidence that vitamin E treats
fibrocystic breast disease
and so could prevent breast cancer.
But Dr. London also discovered the biological mechanics
behind vitamin E's rapid healing of cysts and sores, and this
discovery gave him a hint as to how vitamin E might stop breast
cancer before it starts.
Dr. London found increased amounts of a hormone secreted
by the adrenal gland in the women with fibrocystic disease after
they started taking vitamin E. But why is this so important?
Boosting hormonal levels is a classic treatment for women
who already have breast cancer. An article in the Journal of the
American Medical Association states that "alteration of the hor-
monal milieu is still one of the major and most successful meth-
ods for treating advanced breast cancer." And another article
in Science points out that, in some cases of breast cancer, "tumor
growth is regulated by the hormonal environment and that a
change in this environment will cause tumor regression."
Dr. London told the conference that vitamin E, by altering
the level of a certain hormone in women .with fibrocystic disease
376 VITAMIN E
before they get breast cancer, ''might alter the subsequent de-
velopment of breast carcinoma. /'
. .
But in spite of all this fanfare, do we really need to enlist

vitamin E cancer? After all, isn't the
in the fight against breast
American medical establishment slowly but surely conquering
this disease? What about those highly touted early detection
programs that supposedly save the lives of thousands of women?
What about those new drug treatments hailed in a prestigious
medical journal as "nothing short of spectacular?"
Conventional Therapy Inadequate

Norman Simon, M.D., and Sidney Silverstone, M.D., pro-
fessors at the Mount Sinai School of Medicine, provide one
thoughtful answer to these questions: ''Despite recent great ad-
vances in medical care, the mortality rate for cancer of the breast
in the United States is essentially unchanged. Even if there has
been some improvement in the survival of patients with cancer
of the breast through modern, presumably more effective man-
agement, this improvement is hardly commensurate with the
announced advances in therapy and early detection" (Bulletin
of the Nen- York Academy of Medicine).
Breast cancer is still the most feared cancer among women.
And for good reason. The major killer of American women be-
tween the ages of 33 and 55, breast cancer will strike at least
88,000 American women this year. Thirty-three thousand will
die. But these facts and figures don't tell the whole story.
Cancer specialist Henry M. Lemon, M.D., professor of
medicine at the University of Nebraska medical school, speaking
to an American Cancer Society seminar for science writers, warned
that eight million American women will develop breast cancer
sometime in their lives, and "the majority of these women will
ultimately die of their disease with current diagnostic and treat-
ment methods."
"Although there is no current therapeutic regimen for fi-
brocystic disease of the breast," Dr. London suggests, "vitamin
VITAMIN E HELPS PROTECT THE BREASTS 377
E under controlled circumstances may be a valuable adjunct to

therapy." And he says that he has seen no harmful side effects
from taking the vitamin, either in his own practice or reported
in medical journals.
''It may be doing women with fibrocystic disease some good,"
Dr. London told us, "and certainly is relieving theirsymptoms
of lumps, sores and tenderness."
At least for 50 percent of the women reading this book,
that's good to hear.
CHAPTER
CF KIDS REQUIRE
EXTRA VITAMIN E
Coping with cystic fibrosis (CF) generally means pulling out

all But now there's evidence that vitamin E
nutritional stops.
may be the most critical consideration.
The idea that CF kids may be deficient in vitamin E isn't
new. been suspected for some time, since the body's uptake
It's
of vitamin E depends largely on its ability to digest and absorb

fats. And many
if not most
CF patients have trouble absorb-
ing fats due to a complication involving the pancreas.
Yet, until now, researchers had a hard time making that
theory stick. For one thing, traditional blood tests which measure
the total vitamin E levels never show much difference between
CF patients and healthy controls. And even if they did, the
doctors would tell us that vitamin E deficiency wasn't much to
worry about.
Researchers at the National Institutes of Health in Bethesda,
Maryland, suggest otherwise. Singling out alpha tocopherol (the
most important component of vitamin E) in blood samples taken
from CF patients, they found that all of 52 patients suffering from
intestinal dysfunction were deficient in the vitamin. And more
378

CF KIDS NEED EXTRA E 379
important they discovered that this deficiency had a decided

effecton the red blood cells.
Red blood cells taken from vitamin E-deficient CF patients
had a much shorter life span than those taken from healthy per-
sons with adequate vitamin E levels. This reduced survival rate
was boosted back up tonormal with vitamin E supplementation
in doses ranging from 50 to 400 international units per day, the
researchers noted (Journal of Clinical Investigation).
What does this mean to the CF patient? We asked Philip
M. Farrell, M.D., Ph.D., head of these investigations.
"Taking vitamin E isn't going to cure CF," he explained.
"But rd say it's likely to be of some benefit.
"It's conceivable, for example, that the severe lung disease
associated with CF puts stress on the red blood cells, which
as you know are involved in transporting oxygen. Since vita-
min E provides protection of these blood cells, it's likely that a
vitamin E-supplemented child will have the edge in fighting CF.
"And there's another thing that we didn't mention in the
report but which I think you should know," Dr. Farrell confides.
"The vitamin E content in lung tissues is normally high. In view
of the pulmonary problems in CF patients, I think that says
something!"
Of course. Dr. Farrell is just speculating on the implications
of a vitamin E deficiency, at this point. But he is sure of one
thing
"patients with CF should be given daily doses of a water-
soluble form of vitamin E."
How much?
"We gave our patients five to ten times the Recommended
Dietary Allowance," he replied. "The RDA for children is 5 to
10 international units per day."
VITAMIN K
CHAPTER
YOUR FOUNDATION
NEEDS VITAMIN K
What vitamin is found

such large quantities in nature, and
in
required in such small amounts by the body, that deficiencies
were always thought to be rare? Most people haven't even heard
of it. It's not commonly available in supplemental form because
we apparently need no more of it than is available in a good,
sensible diet. And part of our supply of the vitamin is produced
in the body itself, by bacteria in the intestinal tract.
Although most people don't even know it exists, there is

such a thing as vitamin K, and we'd all be in deep trouble vvithout
it.
Vitamin K is number of
required for the production of a
coagulation factors, substances blood which are essential
in the
for normal blood clotting. Nosebleeds, bleeding in the intestines
and stomach, and blood in the urine are all common in vitamin
K deficiency. Bleeding may occur within the brain, and the de-
ficiency can result in death.
But if vitamin K deficiency is so rare, what's the problem?
Scientists used to believe there was no problem at all, but now
they're not so sure. Until a few years ago, the only role vitamin
K was known to play in maintaining good health was its assur-
380
YOUR FOUNDATION NEEDS VITAMIN K 381
ance of proper blood clotting. And people were certainly not

bleeding to death because of vitamin K deficiencies. Indeed, it
was hard to find even minor problems caused by a lack of vitamin
K.
Now, however, a body of evidence is building which indi-
cates that vitamin K may do more than promote coagulation.
Research at Harvard University, the University of California at
San Diego, and other scientific centers suggests that vitamin K
is necessary for the maintenance of healthy bones, as well. There
is evidence, a spokesman for the Harvard research team told us,
that slight vitamin K deficiencies in older people may be con-

tributing to the degeneration of bone that is so common at that
time of life.
"The work so far," the spokesman told us, "is only a sug-
gestion that vitamin K is important. Vitamin D has long been
known to be involved in calcium uptake and turnover in bone.
Now, evidence suggests that another vitamin may also play a
role, butby a totally different mechanism."
Research has already demonstrated a possible connection
between vitamin K and strong bones in animals. Scientists at
the University of North Carolina at Chapel Hill found that chicks
fed a vitamin K-deficient diet suffered a 10 percent reduction in
the mineral content of their bones after only five days on the
diet (Journal of Dental Research).
That study was prompted by, and supported, work the Har-
vard team did in 1975. "What we did first," one of the Harvard
researchers told us, "was to isolate from chick bone a protein
which binds calcium and does so only through the action of
vitamin K. The protein is called osteocalcin, and it's also abun-
dant in human bone."
The binding of calcium around a protein framework is a
crucial step in the building of healthy bones. "The bone is a
complex mixture of minerals," the spokesperson told us, "pri-
marily calcium phosphate, precipitated in and around a protein
matrix. The protein matrix is about 90 percent collagen and 10
percent other proteins. Possibly the most important of those
other proteins is osteocalcin, which makes up percent of the
1
total protein in the bone.

382 VITAMIN K
"Osteocalcin doesn't bind all the calcium in the bone, only

a small fraction of it, in fact. But osteocalcin plays an important
role when the bone is first taking shape. Just as bone starts to
mineralize, this protein appears on the scene. Vitamin K is re-
quired for the synthesis of osteocalcin, or rather, for an important

modification of osteocalcin once it has been synthesized. After
the protein has been modified by vitamin K, it can bind calcium,
even if vitamin K is no longer present.''
Vitamin K gives osteocalcin its special chemical gift, and
that might be the spark which sets the whole process of bone
mineralization in motion. The scientists in North Carolina found
that the initial binding of calcium by the protein matrix was either
severely reduced or totally absent in the bones of chicks deficient
in vitamin K.
Bone mineralization is an ongoing process, though, and it
may be that vitamin K is continually needed for the process to
go on. The skeleton is a living, constantly changing organ, the
Harvard spokesman stressed. "The structure of bones is like
reinforced concrete, in that the protein matrix supports the min-
eral structure around it. But I hesitate to use that analogy because
bone is a very dynamic organ. Unlike concrete, it's constantly
being replaced. The whole structure turns over in the course of
time. In some parts of the skeleton, the turnover is as little as
1 percent in a year, but in babies the entire skeleton is replaced
in that time."
As we grow and particularly as women undergo men-
older,
opause, something happens to disrupt the healthy turnover of
bone. A condition called osteoporosis may set in, causing loss
of bone mass and increasing fragility of the bones. The condition
affects three out of every four women after menopause, resulting
in a frightening increase in broken bones. By the age of 90, one
woman out of every five fractures a hip, and one of every six of
those women dies within three months of the injury. Studies
have already shown that extra calcium in the diet can help pre-
vent osteoporosis.
But scientists in Japan have also used vitamin K to reduce
the loss of calcium from bones that occurs in osteoporosis, the
Harvard researcher told us. "The Japanese study was published
in knowledge of the connection between

1971, well before our
osteocalcin and vitamin K. We dug it out of the literature only
after we isolated osteocalcin in bone in 1975. Once we had done
that, we wanted to see if vitamin K had ever been associated
with bone mineralization before.
"The Japanese scientists looked at three osteoporosis pa-
tients. In three women, vitamin K reduced calcium loss in the
bone, by 18 percent in one patient, 50 percent in another and 21
percent in the third.
"But such evidence is very preliminary in nature. The stud-
ies of vitamin K and bone formation have mostly been done with
animals and are just now expanding to clinical research, to relate
the ideas developed with animals to human problems."
Work with humans has established one other bit of evidence
indicating a link between vitamin K and bone formation. Anti-
coagulant drugs, which prevent blood clotting, are antagonists
of vitamin K. They block its coagulant effects. They may also
block its possible effects on bone formation.
"When pregnant women are given anticoagulant drugs in
the first months of pregnancy," the Harvard spokesman
three
said, "many have given birth to babies with bone defects. Con-
ceivably, this syndrome involves an abnormal synthesis of
osteocalcin.
"Of course, it will be years before the facts are established
in humans. But having the power to speculate, when you reach
certain conclusions in animal studies, you begin to look at the
possibilities for humans. After all, we study
that's the reason
animals, to get clues for applications in clinical situations with
human patients."
Oneof the most tantalizing possibilities would be the use
of vitamin K to fight osteoporosis. The Harvard spokesman told
us there are plenty of hints that such therapy might help.
"Osteoporosis occurs mainly in older people. Those people
often eat soft, bland foods and fail to eat enough green vegeta-
bles, which are rich in vitamin K. Studies in England have shown
that older people are commonly slightly vitamin K-deficient, in
that their blood coagulation activity is slightly reduced.
"Older people also often take mineral oil as a laxative, which
384 VITAMIN K
interferes with the way vitamin K is absorbed into the body."

Other drugs which older people are more likely to use including
anticoagulants, antibiotics and cholestyramine, a drug used to

lower cholesterol levels in the blood may all contribute to vi-
tamin K deficiency.
Beyond the problem of calcium loss in bones, there are
larger possibilities for vitamin K suggested by current research.
Calcium is involved in a host of biological processes other than
bone formation, such as muscle contraction, the transmission of
nerve impulses and the release of hormones. All those processes
involve a chemical reaction called calcium binding.
Just as vitamin K is involved in the formation of the calcium-
binding protein osteocalcin in bones, scientists have found, it
triggers another calcium-binding protein in the blood. That re-
action has been shown to be the key to vitamin K's promotion
of blood clotting. And the researchers at Harvard have found
similar proteins, dependent on vitamin K, in the kidneys and
human placenta {Biochemical and Biophysical Research Com-
munications: Biochemica et Biophysica Acta, vol. 583, 1979).
In the placenta, a vitamin K deficiency may produce the
bone defects seen in the babies of mothers taking anticoagulant
drugs. 'The placenta provides all the calcium to the fetus from
the mother's circulation," the Harvard spokesman explained.
"It's the exchange mechanism through which the fetal skeleton
gets all its calcium." If, according to the theory, a vitamin de-
ficiency produced by anticoagulant drugs upsets this vital link,
the fetus fails to get the calcium it needs.
A vitamin K deficiency acting on the kidneys could cause
problems for adults. "The kidneys are involved in determining
how much calcium is excreted from the body," the spokesperson
told us. "The vitamin K-dependent protein we found in the
kidney may have an important role in the retention of calcium
in the body." A failure of that protein, caused by a lack of vitamin
K, might disrupt the supply of calcium to the entire body. That,

of course, would throw a variety of essential biological systems
on the blink.
"A daily requirement for vitamin K has not yet been estab-
lished," the Harvard spokesperson said, "but diets containing
plenty of fresh green vegetables will provide adequate vitamin

K." Broccoli, cabbage, lettuce, turnip greens and spinach are
good sources of the nutrient.
all
People taking anticoagulant drugs should keep their physi-

cians posted on any changes in their diets, particularly any in-
crease in foods rich in vitamin K. The amounts of those drugs
required to produce a desired effect vary with intake of the
vitamin, since K promotes the blood clotting the drugs are meant
to stifle. A radical change in diet could produce health hazards
for people using those drugs.
Though no one knows for sure exactly how much vitamin
K the average adult needs, there have been some estimates. The
National Research Council, which draws up the Recommended
Dietary Allowances for nutrients used by the government, does
not have an official RDA for vitamin K, but they do make a ball-
park guess.
They say the average adult needs between 70 and 140 mi-
crograms of K each day. That's not too difficult. For example,
to get 140 micrograms of vitamin K, you would have to eat about
2'/2 ounces of broccoli. (You'd probably be better off with a bit
more vitamin K, especially if you're over 60 or so.) Sounds like

a very sensible approach, indeed, to avoiding what could be some
very complex health problems.
BOOK III
Vitamin
Therapy for
Disease
INTRODUCTION
One doctor we talked to called it ''medical schizophrenia."

On the one hand, scientific study after study shows that
vitamins have therapeutic power that they can prevent or cure
disease.And these studies are published in medical journals that
doctors read as regularly as you read the morning paper.
On the other hand, when someone walks into a doctor's
office and says he has kidney stones, he gets a drug not mag-
nesium and vitamin B6. A person with intermittent claudication
(leg cramps during walking) gets a drug
not vitamin E. And a
woman on the Pill who has depression gets a drug not vitamin
85. Yet all these vitamins are proven treatments that many doc-
tors know about. Not only that, they're often safer and more
often effective than drugs. So why don't doctors use them? Why
this medical schizophrenia?
No one really knows for sure. But what we do know is that
you shouldn't be cheated out of using vitamins when they could
help your disease or condition. That's what book 3 Vitamin

Therapy for Disease is all about. It will describe scores of
scientific reports that show vitamins can help everyday problems
like colds or fatigue and health disasters like cancer or heart
388
INTRODUCTION 389
disease. In many cases, the vitamin will be preventive, a way

of stopping those illnesses before they start. But you'll also read
about vitamin therapy for people who are already sick. Not that
you should stop seeing your doctor and switch to vitamins. These
therapies are meant to be used in conjunction with medical treat-
ment and with your doctor's approval. That's why throughout
the book we've included the names of the medical journals in
which these studies appeared and the scientists who conducted

them if you tell your doctor that information, he can read those
studies for himself in a source he's sure to respect. And maybe

you can cure him of medical schizophrenia.
ACNE
CHAPTER
VITAMIN A FOR ACNE
Most people suffer from acne during adolescence. The pas-

sage of time heals them. But for a few unlucky people, acne
persists, covering their faces, necks and shoulders with weltlike
sores and inflamed sacs that can leave permanent scars. Der-
matologists have tried helping them with X rays, antibiotics,
female hormones, anti-inflammatory corticosteroids and even
steel brushes for scouring off the scars. Unfortunately, serious
side effects often accompany the long-term use of those treatments.
There are promising new alternatives, however. In experi-
mental trials, a man-made cousin of vitamin A, called 13-cis
retinoic acid, has cured even the most stubborn acne in many
cases.
One study of 13-cis retinoic acid {13-cis identifiesits mo-
lecular structure) comes from Leeds, England, where doctors

used it to treat eight patients between the ages of 18 and 32. The
patients suffered from severe acne ranging from small pimples
to deeply inflamed cysts that therapy with antibiotics hadn't
helped.
The patients took oral 13-cis retinoic acid daily for four
months. After one month, the amount of sebum (the skin oil that
causes pimples when it's trapped under the skin by clogged ducts)
390
VITAMIN A FOR ACNE 391
produced by their sebaceous glands declined by 75 percent. After

four months, the patients' acne conditions improved by 80 per-
cent {Lancet, November 15, 1980).
The researchers described the improvement as "dramatic."
"By 16 weeks there was an 80 percent improvement in the overall
grade and 80 percent reduction in non-inflamed lesions, 90 per-
cent reduction in small inflamed lesions, and 90 percent reduction
in deep inflamed lesions."
According to the researchers, this synthetic form of vitamin
A does what vitamin does normalizes
A the all epithelial tis-
sues, including the skin but does much more
it efficiently.
Side effects from the therapy included dryness of the eyes
and inflamed lips, but they weren't severe enough to make any
of the patients drop out of the program. In fact, the researchers
were able to minimize the side effects by cutting the dosage down
without sacrificing the therapeutic effect.
Most important, 13-cis retinoic acid seems to keep on work-
ing after the patients stop taking it. In experiments at the National
Cancer Institute, 13 of 14 previously untreatable acne patients
were totally cleared of acne, and the other one improved by 75
percent. After the treatment ended, the patients remained acne
free for between 12 and 20 months {New England Journal of
Medicine, February 15, 1979).
Thirteen-cis retinoic acid is not to be confused with vitamin
A or vitamin A acid. Natural vitamin A is necessary for healthy
skin, and some dermatologists prescribe it for their acne patients.
But many physicians feel that in the doses required for long-

term acne therapy as much as 300,000 international units a

day vitamin A isn't safe.
Vitamin A acid, also called retinoic acid, is commonly ap-
plied as an ointment for acne. It dissolves the comedo better

known as a plug or blackhead so that the acne sores can drain.
Some doctors avoid retinoic acid because it can irritate the skin,
making it more vulnerable to sunburn and to sunlight-induced
skin cancer.
Vitamin A levels in the body are dependent on a good supply
of zinc, and some researchers have studied the combined effects
of zinc and vitamin A on acne.
392 VITAMIN THERAPY FOR DISEASE
Gerd Michaelsson, M.D., of Uppsala, Sweden, has found

that "boys with severe, but not mild, acne have significantly
lower serum zinc levels than healthy controls" and that "both
boys and girls with severe acne have significantly lower levels
of retinol-binding protein [an indicator of the amount of vitamin
A in the blood] than healthy controls.
"A low-zinc dietmay worsen or activate acne, especially
the pustular reactions," Dr. Michaelsson says. 'This is seen
after 10 to 14 days in acne-prone patients" {Nutrition Reviews,

February, 1981).
Dr. Michaelsson first linked zinc to acne while treating a
patient who suffered from a disease called acrodermatitis entero-
pathica and also from acne. He prescribed zinc for the acro-
dermatitis and, unexpectedly, his patient's acne cleared up. Dr.
Michaelsson later began experimenting with zinc and acne.
None know exactly how zinc works. Dr.
of the researchers
Michaelsson found that acne recurred when the zinc treatment
was discontinued. He theorizes may
induce the release
that zinc
of vitamin A in the body, that it may have an anti-inflammatory
effect, that a deficiency of zinc causes enlargement of the se-
baceous glands. He also thinks that a widespread zinc deficiency
may contribute to acne.
Two dermatologists who use vitamin A as well as zinc in
their practice are Milton Saunders, Jr., M.D., and Irwin I. Lu-
bowe, M.D. Dr. Saunders is the president of the Optimum Health
Foundation in Virginia Beach, Virginia. Dr. Saunders advises
against an excess of whole milk and fried foods. He also dis-
courages the use of coffee, tea or very hot and spicy foods
because they may dilate blood vessels of the face and aggravate
acne.
Stress Can Be a Factor

About 20 percent of his patients are adults. Dr. Saunders
says, and their therapy differs from adolescents'. "In many teen-
agers, diet is the key to acne, but among adults, stress is the
key factor."
VITAMIN A FOR ACNE 393
Women schoolteachers. Dr. Saunders has found, often come

to him with stress-related acne. He finds that when they spend
time away from the classroom their acne begins to clear. Sales-
men are another high-risk group. Their regimen of travel, res-
taurant food and social drinking tends to give them pimples.
Athletic stress, if it triggers the release of male hormones (in
men or women), is also suspected of making acne worse.
Dr. Saunders uses antibiotics, vitamin A acid ointment, zinc
supplements and water-soluble vitamin A (since fat-soluble vi-
tamin A may be harmful in large doses) in an effort to heal the
skin as soon as possible. "There's no point in fooling around,"
he told us. "These people want results yesterday."
Dr. Lubowe, who practices in New York City, also pre-
scribes water-soluble vitamin A. In addition, he advises his pa-
tients to take 400 international units of vitamin E and 50 milli-
grams of zinc daily. And in his book, A Teenage Guide to Healthy
Skin and Hair (E. P. Dutton, 1979), he expresses his own opin-
ions on diet and acne:
"Too many fats in your diet are a common cause of acne.
Since the sebaceous glands need food to function, they draw
upon the daily intake of food that is transported to the skin by
the blood. The worst villains are fatty meats, carbohydrates,
chocolate, cocoa, spices, iodized salt and shellfish."
The outlook for acne treatment has never been better. In
the past, acne sufferers faced difficult and confusing choices
between treatments of questionable value. But now there are
promising alternatives, including options as simple as switching
from saturated to unsaturated fats and eating foods rich in vi-
tamin A and zinc.
AGING
CHAPTER
ANTIOXIDANT
VITAMINS
VS. PREMATURE AGING
Oxygen. You can't live withoutBut each breath you take,

it.
drenching every cell in your body with life-sustaining oxygen,

carries you one step closer to old age and possible degenerative
disease. And that relentless journey may go faster or slower,
depending on how you and oxygen mix.
Don't get us wrong. Oxygen is absolutely essential to health.
You couldn't survive for more than a few minutes without it.
And up to a point, more is better. Athletes and other fitness buffs
strive to increase their bodies' oxygen-processing capacity as a
measure of enhanced vigor. But unless you are properly pro-
tected, fats or lipids (which are abundant in all your cells) can
combine with oxygen at an excessive rate in a chemical process
known as oxidation.
Given favorable conditions, oxidation will turn a shiny metal
wrench into an ugly rusted wrench very quickly. Our bodies, of
course, don't rust. But under the right circumstances, oxidative
damage produces the kind of accelerated wear and tear that may
lead to premature aging, lowered resistance, cancer and heart
disease.
394

VITAMINS AND PREMATURE AGING 395
The guilty party is believed to be a tiny molecular fragment

called a free radical. Free radicals are extremely unstable sub-
stances which, in the presence of oxygen, combine at random
with unsaturated fats to form peroxides. In butter and other
highly perishable foods, free radical reactions lead to spoiling or
rancidity. In human beings, free radical reactions cause irrepar-
able damage and the protective membrane linings that
to cells
surround cells. And this damage accumulates over the years with
telltale age spots, wrinkling and worse.
Putting the Brakes on Free Radicals

Fortunately, nature has provided us with a way of slowing
down such reactions. "Cells and tissues are protected against
oxidizing free radicals by a complexity of antioxidant mecha-
nisms," explains T. L. Dormandy of the department of chemical
pathology at London's Whittington Hospital. ''So long as the
supply of antioxidants lasts, these free radicals are instantly
trapped" (Lancet).
"But one antioxidant molecule can scavenge only one free
radical," the author warns. So a constant "self-regenerating"
supply is needed.
Luckily, the three most important natural antioxidants
vitamin E, the trace mineral selenium and vitamin C are easily
obtainable if we're willing to make the efforts.
To understand how antioxidants protect us, let's take a look
at some scientific findings.
Antioxidants can block the formation of tumors. Thirty-
three weeks after exposure to a powerful cancer-causing chem-
ical,animals whose diets were supplemented with a mixture of
four antioxidants
including vitamins E and C
developed only
about half as many tumors as unprotected animals (Expericntia).
One of the researchers. Homer S. Black, Ph.D., told us that
the same antioxidant mixture showed "very marked effects"
protecting against tumors triggered by ultraviolet light. And it's
likely that this protection occurs at the cellular level: In other

trials, the same antioxidants tested separately prevented the usual
cell-destroying effects of ultraviolet irradiation.
''We're primarily concerned with skin cancer," says Dr.
Black, who is director of the photobiology laboratory at the
Houston, Texas, Veterans Administration Hospital. "But while
skin cancer affects the epidermis, many other cancers arise in
the epithelial lining of internal organs and that's similar to skin.
So I think what we're finding about antioxidants may have im-
plications for other cancers, as well."
In addition to protecting against cancer, antioxidants may
also have a beneficial effect in extending the life of cells. When
clusters of rat brain cells are cultured in a test tube, they normally
show signs of severe structural degeneration within 40 days. But
when similar cell clusters were held in a culture supplemented
with vitamin E, the cells were still well preserved and structurally
sound days (Anatomical Record).
after 40
"The difference was like night and day," Bruce D. Trapp,
Ph.D., of the National Institute of Neurological and Communi-
cative Disorders and Stroke, told us. Dr. Trapp explained that
the cells lived longer because of vitamin E, which may help
preserve the cell membrane, letting various metabolites into clus-
ters of cells while letting wastes escape. "Otherwise, the cells
will die," he said.
Helping the Body Help Itself
Antioxidants also appear to play a key role in fostering im-

munity, the body's natural ability to repel invading disease or-
ganisms. According to Werner A. Baumgartner, Ph.D., and co-
workers of the nuclear medicine department at the Wadsworth
Hospital Center in Los Angeles, body stores of vitamin E and
selenium tend to fall sharply when there is a tumor. And this
antioxidant deficiency may be responsible in part for the de-
pressed immunity so common in cancer patients. They suggest
that antioxidant supplemenlalion might reverse this often fatal

situation (American Journal of Clinical Nutrition).
"In fact," Dr. Baumgartner told us, "there is growing evi-
dence that even in healthy people the immune processes require
more antioxidants than we normally take in with our food. The
immune system seems to require more antioxidants than other
cells in the body. So even a slight stress, such as a marginal
deficiency of vitamin E, could impair the immune response."
In still another new report, Los Angeles dermatologists Samuel
Ayres, Jr., M.D., and Richard Mihan, M.D., have found vitamin
E to be of great therapeutic value in many disabling and stubborn
skin disorders. And they believe the reason is vitamin E's anti-
oxidant properties (Cutis).
All the diseases they discuss including scleroderma, vas-
culitis
and other disfiguring inflammatory disorders seem to
involve a breakdown in which the body's normal defense mech-
anism goes haywire.
Drs. Ayres and Mihan theorize that these conditions, called

autoimmune diseases in which the immune mechanism literally
attacks the body's own tissues are the result of cell rupturing
caused by free radicals. Large doses of vitamin E up to 1,600
international units daily have produced dramatic reversals.
The most spectacular case was a 45-year-old man suffering
from Raynaud's phenomenon. In this condition, constriction of
small arteries in the fingers and toes can choke off the blood
supply, leading to a bluish discoloration. This man had six ul-
cerated fingers as a result, and in three, gangrene had set in. But
within eight weeks of applying vitamin E directly to the skin and
taking the supplement by mouth, as well, the man's fingers were
completely healed. On a continuing maintenance dose of vitamin
E, there was no recurrence during the next year.
Extending Life Spans

One of the most enthusiastic supporters of vitamin E's value
as an antiaging factor is Denham Harman, M.D., Ph.D., of the

University of Nebraska college of medicine in Omaha. In his

studies. Dr. Harman found that, when various antioxidants were
added to the daily diets of mice shortly after weaning, their
average life expectancy was increased by 15 to 44 percent. They
also developed fewer breast tumors and fewer senile plaques
small areas of degeneration in the brain.
''Support is steadily growing for the possibility that seem-
ingly haphazard free radical reactions play a significant role
possibly the major one in the breakdown of the human body
during the process of aging," Dr. Harman explains. "It is rea-
sonable to expect that one or more free radical reaction inhibi-
tors, added to a properly selected natural diet, may increase the
functional human span by five to ten years. Those would be
life
extra years of active, enjoyable life."

Dr. Harman adds, "Many free radical reaction inhibitors
are known. However, the most prominent in living things, and
best known, is vitamin E. Thus, increasing the weekly intake
. . .
of vitamin E by 300 to 500 international units may possibly in-

crease our prospects for a long and healthy life."
Although vitamin E and selenium are the most widely dis-
cussed natural antioxidants, vitamin C also has antioxidant prop-
erties in addition to its more publicized cold-fighting and antiviral
capabilities.
That's why vitamin C (in the form of sodium ascorbate) is
now being added to many processed meats such as frankfurters

and bologna. According to Terence W. Anderson, M.D., Ph.D.,
professor of epidemiology at the University of Toronto, vitamin
C's antioxidant properties block the oxidative transformation of
nitrate additives into cancer-causing substances called nitrosa-
mines (Nutrition Today).
For the same reason, one large pharmaceutical firm urged
that vitamin E (alpha tocopherol) also be added to nitrate-
prcser\ed meats. Hoffmann-La Roche researchers have found
that together the two antioxidants
E and C work more effec-
tively than vitamin C alone (Food Chetnical News).
As scientists focus more on the health-sustaining role of
antioxidants, it's possible that still other nutrients will come into
the spotlight. We already know, for example, that vitamin A acts

as an antioxidant in some situations. And even the trace element
zinc, while not thought of as an antioxidant, has been shown to
prevent some harmful effects of free radicals.
For now, though, the two antioxidants you should be paying
own diet, are vitamin E and selenium.
attention to, in terms of your
Unfortunately, there's evidence that our modern Western
diet is dangerously deficient in antioxidant protection.
The problem can be traced to the refining of natural grains,
oils and other foods that normally contain ample antioxidants.
Dr. Anderson points out that ''in the raw state, most fats and
oils that are high in polyunsaturated fatty acids contain enough
natural antioxidants (mainly tocopherols) to inhibit peroxidation
. .but this antioxidant 'umbrella' can itself be destroyed by
.
oxidation during prolonged storage or processing" (Lancet).

Wheat germ contains an unusually large amount of vitamin
E, he says, "so that whole grain wheat products normally con-
tribute a surplus of antioxidants to the diet. By the end of the
19th century this surplus had been reduced by the general change
from whole meal to highly refined white bread, but it was the
introduction of oxidizing agents [chlorine and other bleaches]
that finally eliminated bread as a useful source of dietary
antioxidants."
Eventually, Dr. Anderson reasons, there came a point when
there was not enough antioxidant in the diet to prevent the for-

mation of harmful peroxides a kind of rancidification right in-
side our bodies. "I believe that this point was reached in the
British and North American diets about 1920," he adds.
Dr. Anderson theorizes that this unfavorable dietary shift
may have been largely responsible for the rapid surge in heart
attack deaths over the last 50 years. In animals, at least, peroxide
free radicals can fatally damage the heart muscle.
How much vitamin E do we need to tip the scales back in
our favor? "At present, we believe the optimal level to be be-
tween 400 and 600 units a day," says Jeffrey Bland, Ph.D., a
biochemist at the University of Puget Sound. "Situations which
would lead to rapid utilization of vitamin E, such as exposure
to photochemical oxidants (smog), ionizing radiation (sun or X

rays), smoking or other factors which lead to increased cellular
oxidation, should be met with somewhat greater intakes of vi-
tamin E." Also, the more polyunsaturated oils we consume, the
more vitamin E we need.
Given oxygen's penchant for mischief, important to en-
it's
sure an adequate supply of protective antioxidants

so long as
we live and breathe.
CHAPTER
VITAMINS
FOR LIVING LONGER
When you've reached that point in your life when some of

your friends are starting to pack for the retirement home (if not
the nursing home), it's time to do some serious thinking about
how you're taking care of yourself. Because if you play it right,
you can be packing for a camping trip in the mountains, or a
summer in Europe, or a seashore holiday full of evening bar-

becues on the beach and early morning bicycling instead of the
nursing home.
But it's got to be you that takes care of yourself. You can't
depend on your doctor to be much help in keeping you really

alive healthy, energetic, and clearheaded. Your doctor is trained
to prescribe drugs and perform surgery. The problems of aging
require a different approach. To make
the years after middle age
the best years of your you
life, have to take charge of the un-
derlying factors that determine your health. And one of the most
important of these is your diet.
For example, a British study found that, out of 93 geriatric
patients with acute problems, none had a normal nutritional pro-
file. A. G. Morgan, M.D., consultant physician, Airedale General
Hospital, Yorkshire, United Kingdom, and five colleagues tested
401
patients for vitamin A, thiamine (Bj), riboflavin (B2), niacin,

vitamins C, D, E and Kand protein. Twenty-two of the 93
actually had lower than normal levels of most of the nutrients.
The most common deficiencies were in protein, niacin and vi-
tamins C, E and A.
Dr. Morgan suspected "that an inadequate dietary
at first
intake, due to disease or to physical and mental deterioration,
was the most likely cause of these multiple nutritional abnor-
malities." However, by the end of his study. Dr. Morgan con-
cluded that "their present illness could not have significantly
contributed to their nutritional status" {InternationalJournalfor
Vitamin end Nutrition Research).
In other words, the dietary deficiencies came before the
health problems, and not the other way around. That is a key
point. Were these people in the hospital because their diets
weren't providing them with enough of the right nutrients?
Impressed by Vitamin C
Olaf Mickelsen, Ph.D., formerly of the department of food
science and human nutrition, Michigan State University, East
Lansing, is in a good position to comment, since he has partic-
ipated in a number of scientific studies designed to answer that
very question. He has also authored a review of the subject,
"The Possible Role of Vitamins in the Aging Process," which
appears as a chapter in Nutrition, Longevity, and Aging (Aca-
demic Press, 1976).
During an interview. Dr. Mickelsen told us he was "im-
pressed by the effects a reasonable intake of vitamin C seems
to have. People who have been taking more vitamin C seem to
have fewer problems when they enter the hospital." And, as he
writes in the book, "the results of a number of studies imply
that a higher than normal intake of [vitamin C] appears to reduce
the aches and pains to which older persons are prone, to lower
mortality when the aged are ill, and to increase their longevity."
VITAMINS FOR LIVING LONGER 403
Dr. Mickelsen went on to discuss a study led by a colleague

of his, Eleanor D. Schlenker, Ph.D., chairperson of the depart-
ment of human nutrition and foods at the University of Vermont,
in which the average protein and vitamin C intakes were mea-
sured in a group of 100 women over the course of almost 25
years.
The women who had higher intakes of vitamin C and protein
lived longer. So the beneficial effect of increased intake is un-
I deniable in this case. Furthermore, Dr. Mickelsen points out that

the women who did survive tended to increase their intake of
vitamin C between 1948 and 1972.
A follow-up study two years later by Drs. Schlenker, Mick-
elsen and two colleagues revealed "a striking relationship be-
tween nutrient intake and physical health. Those women who
on the basis of medical examinations appeared younger than their
years consumed fewer calories and substantially less total fat,
saturated fat, and fat as a percent of total calories."
In contrast, "lower intakes of thiamine, vitamin A, and as-
corbic acid [vitamin C] were noted among women who appeared
older" (Federation of American Societies for Experimental
Biology).
In simpler terms eat better, feel younger.
A Classic Longevity Study

Another study mentioned by Dr. Mickelsen is probably the
classic study in the field of nutrition and aging: the San Mateo
County, California, survey of health and nutrition of 577 people
over the age of 50. The study was begun in 1948, with very close
measurements of the dietary intake of each subject, biochemical
tests that are associated with health and disease (such as blood
levels of cholesterol, vitamin C and sugar), and recording of
diseases. Four years later, Harold D. Chope, M.D., reexamined
306 of the original 577 people and went into the record books to
look for evidence that nutrition had played a part in their aging
process.
He found it. People with higher than average intakes of

vitamins A and C and niacin tended to live longer than those
with lower intakes.
And the differences were quite remarkable. Among the peo-
ple whose intakes of vitamin A were less than 5,000 international
units per day, the death rate was 13.9 percent. For those whose
daily intakes of vitamin A were 5,000 to 7,999 international units,
the death rate was 6.9 percent. But among the people whose
daily intakes were 8,000 or more international units, the death
rate was only 4.3 percent
less than a third of the rate for the
group getting under 5,000 international units.
The data on vitamin C was even more remarkable. Among
those whose intakes were less than 50 milligrams per day, the
death rate was 18.5 percent. For those whose daily intakes were
over 50 milligrams, the death rate was 4.5 percent, less than a
quarter of the rate for those whose diets provided less than 50
milligrams!
The difference adequate nutrition seems to have had on
delaying death is impressive. But what about what doctors call
morbidity illness, suffering and general ill health? Did nutrition
affect these important factors in the lives of the people in the
study?
Again, the answer is yes. Dr. Chope writes in the report of
his study, "In subjects with low intake of vitamin A (less than
5,000 1.U. [international units]), the incidence of nervous system,
circulatory system, and respiratory system disease was high. . . .
Low thiamine intake (less than 0.80 mg. a day) seemed to be

associated with nervous system disease and circulatory disease;
the higher the intake of thiamine, the lower the incidence of
disease of these two systems. Diseases of the circulatory system
and the digestive system were associated with low intake of
ascorbic acid (less than 50 mg. per day). Among persons with a
high intake of ascorbic acid (1 10 mg. and over), there was a low
incidence of nervous system and circulatory system disease"
(California Medicine).
Looking at Dr. Chope's results, you might be led to wonder
how many of the people took nutritional supplements. Unfor-
VITAMINS FOR LIVING LONGER 405
tunately Dr.
, Chope did not determine which people did or didn't.
But there have been some studies in which the effects of vitamin
supplements on health in the later years of life have been
documented.
The Value of Supplements

A British physician, Dr. G. F. Taylor, took part in one study
in which 40 geriatric patients were given supplements containing
15 milligrams thiamine, 15 milligrams riboflavin, 50 milligrams
nicotinamide (a form of niacin), 10 milligrams vitamin B^, (pyri-
doxine) and 200 milligrams vitamin C. Another group of 40 re-
ceived dummy tablets.
After a year. Dr. Taylor (who did not know which patients
were getting supplements) was able to determine who was or
wasn't receiving supplements merely by examining them for the
signs of nutritional deficiencies and other illnesses.
Dr. Taylor describes his experience in these words: "At the
start of the trial I recorded 13 of the 80 patients as having no
marked signs of nutritional deficiencies. After six months of
. . .
the trial, I could not decide with certainty in more than half the
cases whether they had had treatment or not. But at the end
. . .
of the year's trial, it was obvious which patients had received

active tablets and [which ones received] dummy tablets. . . .
"In the treated group, the classical signs of malnutrition

improved slowly. After 12 months' treatment, many signs had
disappeared with a return to normal appearances. In some cases
improvement was still continuing after 12 months' treatment. At
the end of one year's treatment there was a striking improvement
in the general physical and mental condition. In the untreated
group clinical signs did not improve and in many cases deteri-
orated. Deterioration during infections, and when antibiotics,
steroids, or diuretics were given, was especially marked. . . .
"One of the most dramatic and significant findings in this

study arose after the trial had officially finished. All cases were
observed clinically for six to nine months after stopping treat-
ment, and signs of nutritional deficiencies reappeared in many

previously treated cases. .
/' {Vitamins in the Elderly, John
.
Wright and Sons, 1968).

This classic study not only underscores the importance of
supplemental vitamins, but reveals that the good they do often
takes time close to a year of regular supplementation.
Further, the good they do is not some kind of ''cure.'' Vi-
tamins are concentrated foodstuffs. They nourish your body's
innate desire to be healthy. As Dr. Taylor noted, when the added
nourishment ceased, the benefits faded.
Do vitamins like A, the B complex and C extend your life,
then?
Maybe but maybe not. A more scientific view is that, rather
than extending life, superior nutrition merely keeps life from
being unnecessarily shortened as is so often the case. But when
you've worked hard all your life and you've finally reached the
point where you can pack your suitcase and go anywhere you
want, without worrying about job responsibilities or who will
take care of the kids, that's really quite a bit.
\ CHAPTER
B VITAMINS
CAN KEEP YOU
ON THE BEAM
To a certain group of senior citizens in New Jersey and

Maryland, it must have seemed the stuff of magic. Not that their
wrinkles uncreased, their snowy hair turned black or their bodies
reverted to supple specimens of youth.
No, their transformation from ailing oldsters to revitalized
men and women was less dramatic but nonetheless striking. The
signs of rejuvenation and vigor were unmistakable: renewed health,
diminished aches and pains, fewer nervous disorders, improved
coordination, softer skin and more attractive appearances.
The man who prompted these changes is no wizard, but
Herman Baker, who holds a doctorate in metabolism and nutri-
tion and teaches at the New Jersey Medical School in East Orange.
In fact, it didn't require any sorcery at all for him and three
colleagues to reverse what seemed to be the inevitable infirmities
of the elderly.
Magic? Hardly. The secret to many so-called problems of
old age, he discovered, was no more than a vitamin B deficiency
thatcan impair one's health if left untreated.
it happens. Dr. Baker, a professor of medicine and pre-
As
ventive medicine, is no stranger to the field. He first launched
407
his studies on the effects of nutrient deficits 25 years ago as an

important tool in diagnosing maladies of the aged.
Apparently, Dr. Baker's interest hasn't waned. His most
recent project focused on 473 elderly people, ranging from 60 to
102 years old, in New Jersey and Maryland. Of this sample, 327
lived in nursing homes and the rest resided at home. At the
study's onset in 1978, blood tests and physical examinations
revealed 7 to 8 percent of the subjects had signs of anemia, skin
dermatitis, cracked lips, nerve disorders, muscular aches and
pains and poor visual coordination. However, evaluations also
showed as many as 39 percent sufferedfrom subclinical vitamin
deficiencies that hadn't yet blossomed into noticeable symptoms
or ailments.
What were the culprits responsible for this charade of "old
age" inotherwise healthy, nonbedridden people? The critical
ingredients turned out to be none other than absentee members
of the vitamin B family
nutrients that not only affect the central
nervous system and coordination, but are crucial to mental and
emotional well-being. According to Dr. Baker, the elderly he
studied exhibited strikingly depressed levels of Be (pyridoxine),
niacin and B|2, as well as inadequate amounts of folate (folic
acid) and thiamine, other components of the B complex.
To remedy those deficits, an injection of the entire B com-
plex was given to the group once every three months during the
year's experiment. After the first shot. Dr. Baker told us, symp-
toms began to disappear. In another 12 weeks, following the
second injection, the investigators noted an increased level of
circulating nutrients in the subjects' blood. At the study's con-
clusion, the elderly's physical woes had vanished along with their
vitamin deficiencies. "They're all in good health now," says Dr.
Baker.
"Vitamin deprivation may affect the young far less because
they retain adequate reserves, thanks to sufficient vitamin-
binding sites in the liver," he contends. Perhaps, then, increased
nutrient needs in the elderly reflect, at least in part, decreased
vitamin storage sites. Dr. Baker speculates. In addition, metab-
olism difficulties and medication may interfere with vitamin ab-
sorption in later life.

B VITAMINS CAN KEEP YOU ON THE BEAM 409
Dr. Baker isn't the first to recognize the need for vitamin
supplementation to protect the elderly.
Back in 1968, senior citizens were the target of a British
study designed to treat symptoms of malnutrition with vitamin
preparations. The outcome? 'There is evidence of chronic vi-
tamin deficiencies in a large number of elderly people," con-
cluded a hospital study, ''which can be reversed by large doses
of vitamin supplements for long periods'" {Vitamins in the El-
derly, John Wright and Sons, 1968).
The supplements in this case were four B vitamins thia-
mine (15 milligrams), riboflavin (15 milligrams), B^ (10 milli-
grams) and nicotinamide (a form of niacin 50 milligrams)
along with vitamin C (200 milligrams). The project divided 80
aged patients into two equal groups: 40 participants received one
daily vitamin preparation; the other 40 were given identical-
looking dummy tablets. The pills were distributed so that re-
searchers had no idea which subjects were ingesting the vitamin
supplements or swallowing the placebos.
Malnutrition Disappeared
At the experiment's onset, clinical workups disclosed "clas-
sic signsof malnutrition"
such as skin hemorrhages, a fissured
red tongue, grayish white skin patches around the mouth in all
but four elderly patients.
However, months' treatment, the physicians found
after 12
many of these symptoms disappeared with a "striking" improve-
ment in patients' physical and mental conditions. "At the end
of the year's trial," the report noted, "it was obvious which
patients had received active and dummy tablets, except for a
few marginal cases."
The vitamin-treated group showed marked progress, while
the placebo-fed group manifested clinical evidence of deterio-
ration in many cases.
After vitamin supplements were stopped, signs of the defi-
ciencies reappeared in the treated group.
Dr. Baker believes immune response in the aged may be

weakened because of persistent vitamin Be and folate deficits,
increasing susceptibility to severe bacterial and viral infections.
"The extensive degree of subclinical vitamin deficiencies may
contribute to physical and mental dysfunction far more than
previously recognized," Dr. Baker concludes in his report {Jour-
nal of the American Geriatrics Society, October, 1979).
In fact, in his next research project. Dr. Baker is focusing
on the relationship between vitamin deficiencies and mental de-
terioration in the aged. It should come as no surprise, then, that
he should be an enthusiastic advocate of vitamin preparations,
especially for those 65 years and older. "For some vitamins, like
the B complex," notes Dr. Baker, "continual supplementation
may be needed to protect the elderly against hypovitaminosis."
Besides vitamin supplements, it's important to spike your
diet with generous helpings of food rich in B vitamins, such as
liver, whole grain cereals, nuts, yeast, dark leafy green vege-
tables, poultry and fish, for that extra ounce of protection.
After all, there's no need to grow old before your time.
Remember, it doesn't require any magic to hold back the clock,
especially if the signs of "aging" are something as preventable
as a vitamin deficiency.
CHAPTER
AGE WITH EASE

THROUGH
WISE NUTRITION
Maggie looked at the doctor as if he were mad. After all, it

was her birthday, and if she wanted to brood the day away it
was her business. Turning 50 just isn't easy. But across from
her sat the doctor, wearing a full grin and looking at Maggie as
if she were the luckiest person alive.
"Fifty. It must feel wonderful," he glistened. 'Today has

got to be the best day of your life."
Maggie shot him a glance. She wasn't going to let this crazy
talk get to her. "What's so wonderful about turning 50?" she
snapped back. "Look at me. I'm getting o/c/."'
"Yes, and isn't it great," he answered. "It's a privilege not
given to everyone."
Indeed. There's a lot to be said for getting older. Never
before has such a large population of older Americans been living
so long. Had Maggie been born 100 years ago, she wouldn't have
been expected to live beyond 40. But today, at 50, she's con-
sidered to be only middle-aged, with the probability of another
quarter century of living ahead of her. But how active and healthy
those coming years will be will pretty much depend on how well
Maggie treats herself.
411
Being in her 50s makes Maggie vulnerable to a malady that's

all too common among
our older generations poor nutrition.
"Poor nutrition is a very big problem as we grow older,"
says Linda H. Chen. Ph.D., a University of Kentucky professor
and nutrition researcher. "A lot of older people may think they're
getting a proper diet but they're not.
"A 20-year-old woman can devour the exact same meal as
her 65-year-old grandmother, but the older woman won't nec-
essarily be getting the same nutritive value out of it."
Why? Simply because the older body can't assimilate vi-
tamins and minerals the way it used to.
"Digestion and absorption get poorer as people get older.
It's a natural part of aging," Dr. Chen explains. There are other
things that naturally happen to the body as we age: Metabolism

slows, kidney function decreases, muscle and fat balance changes,
and our ability to metabolize sugar declines. Generally, activity
levels slide with age.
"What it all boils down to," says Dr. Chen, "is that our
need for calories lessens as we get older, but our need for nu-
trients does not." As Maggie said, getting old isn't easy.
Research studies show that as high as 50 percent of Amer-
icans over the age of 65 are consuming less than two-thirds of
the Recommended Dietary Allowances of calcium, iron, thia-
mine, riboflavin, niacin and vitamins A and C. Zinc, folate (folic
acid) and vitamins B12 and B^ are also common deficiencies among
the aged.
Dr. Chen concentrated her studies on riboflavin (vitamin
B:), vitamin Bf, and iron in a group of elderly people in central
Kentucky.
"Deficiencies were significant," she told us. "I found one-
quarter had iron deficiencies, one-third were deficient in ribofla-
vin and half showed a vitamin Bfi deficiency. In studies of nurs-
ing-home populations, deficiencies were even more severe. This
was probably due to the residents' poorer health and the fact
that they were on medications, which can also hinder the ab-
sorption and/or increase excretion of some vitamins and minerals."
On the other hand, there is research indicating that getting
less than the RDA is not as much of a problem among those who
AGE WITH EASE 413
take vitamin and mineral supplements. That was illustrated in a

study of an elderly population that included many supplement
users.
"The population is unique in that all the people were in good
health, lived in their own home or apartment, were more edu-
cated than the average for their age group and, for the most part,
were considered to be health-conscious individuals," James S.
Goodwin, M.D., one of the researchers on the project, told us.
Sixty percent of both men and women, whose average age was
72, took one or more vitamin supplements, with vitamins C and
E being the most popular.
For the group as a whole, food intake of vitamin C, niacin
and vitamin A was well above the RDA for most of the people.
However, through food alone, a substantial percentage of the
population was receiving less than the RDA for vitamins B5, 6,2,
D and E, calcium and zinc. But the supplement users,
folate,
thanks to their extra measure of protection, showed virtually no
nutrient shortcomings.
For example, nonsupplementers got less than 50 percent of
the RDA for vitamin B^,, but those taking a supplement got a
whopping 275 percent of the RDA (American Journal of Clinical
Nutrition, August, 1982).
The study points to the need for some kind of dietary sup-
plementation for the elderly. 'T feel everyone over the age of
65 should take a multivitamin pill," says Dr. Goodwin.
Of course, the ideal way to attain proper nutrition would be
through diet alone. But doing so admittedly gets tougher as we
get older simply because, at around the age of 40, we have to
start worrying about middle-age spread. It's the time in our lives
when maintaining weight no longer means just watching our cal-
ories.It means cutting them down.
The Expert Committee on Energy and Protein Requirements

has made these recommendations: After age 40 we should cut
calories by 5 percent and do so again after age 50. At age 60,
calories should be sliced another 10 percent and again after 70.
"Maintaining nutrition on fewer calories isn't impossible to
do," says Frank Beaudet, a nutrition expert at the Andrus Ger-
ontology Center at the University of Southern California. "As
you get older, quality of the food must count much more than
quantity. Simply reducing starch, sugar and fats and switching
to proteins, fruits, vegetables and whole grains can keep you in
nutritional balance."
Beaudet admits that getting people to change lifelong eating
habits isn't always possible. Often, getting older people to eat
at allcan be the problem.
"There are a whole range of economic and social factors
that can affect an older person's interest in eating," says Beau-
det. "The death of a spouse, living alone, eating meals alone all
can cause a disinterest in food. Poor nutrition can result, and in
some cases, even malnutrition.
"When people aren't eating right, a vitamin supplement is
one way to help solve the problem," he says.
Being on a sensible diet doesn't always guarantee that you're
also in nutritional balance. "Elderly people take an awful lot of
drugs, and there are many drugs that can adversely affect vitamin
and mineral absorption and excretion," says Dr. Chen.
The most popular of these is probably aspirin, commonly
used by many older people as a pain killer. It can block vitamin
C from entering the blood. Aspirin, as well as phenobarbital and
the diuretic triamterene, can also affect folate utilization.
Some drugs that can cause vitamin Bft deficiency are hy-
dralazine, used in the treatment of hypertension, and L-dopa,
used in Parkinson's disease.
Mineral oil, a long-time favorite laxative, has adverse effects
on the absorption of carotene and vitamins A, D and K. Antacids
containing aluminum inhibit intestinal absorption of phosphorus
and increase the excretion of calcium.
"Drug-related deficiencies are sometimes the hardest to pin-
point because older people take so many drugs and get them
from so many sources," says Dr. Chen. "It's important that
they don't just arbitrarily take them and not let their physicians
know."
So take stock in what you eat. As the doctor told Maggie,
getting old is "a privilege not given to everyone."
CANCER
CHAPTER
THE ANTI-CANCER
VITAMIN
COMBINATION
breakthroughs do not obey the laws of supply and

Scientific
demand. Millions in research grants do not guarantee results.
No matter how much society may need a particular cure or
vaccine, sometimes it's just not available at any price.
By the same token, important advances may take place in
the most underfunded, understaffed lab. Dedication and inspi-
ration sometimes get results that money can't.
The work of Sister Mary Eymard Poydock, Ph.D., director
of cancer research and former professor of biology at Mercyhurst
College in Erie, Pennsylvania, is a case in point. The Mercyhurst
labs are not large or wellendowed. But 20 years of painstaking
work by Sister Eymard and her
associates have now produced
results which indicate that a combination of vitamins C and Bi^
may have a powerful effect against cancer. While Sister Eym-
ard's work has been confined to laboratory animals, the impli-
cations for further research are obvious.
For 20 years. Sister Eymard has been testing a substance
that had been advanced as a possible anti-cancer agent. The first
results were promising, and the name "mercytamin" (from the
Sisters of Mercy) was applied to the substance. Mercytamin was
415
actually a combination of vitamins C, B12 and a variety of en-

zymes. Through scientific testing of the solution, the enzymes
and other chemical additives were eliminated as possible active
agents. Finally, only the vitamins remained, and in 1978 the name
mercytamin was dropped.
Sister Eymard held back on publishing her findings until she
was certain the results she was getting were true. "We've done
enough experiments now, testing hundreds of mice, to establish
that it works," Sister Eymard says. "We've got it down to a
point now where, if you do it according to the 'recipe,' it will
work everytime."
Sister Eymard and her research staff implanted three com-

mon types of cancer into laboratory mice sarcomas (cancerous
growths of connective tissues), carcinomas (cancers of skinlike
tissues) and leukemias (cancers of the blood-forming organs).
Those cancerous tissues were implanted both in the abdomens
and under the skin of the mice. The mice were then injected with
the mixture of vitamins C and B12 (in a ratio of one part B^ to
two parts C) near the site of the tumor transplant.
Within four days, some of the tumors from the abdomens
of the mice were removed, and the cells were examined under
the microscope. There was a dramatic change in the tissue. The
cancerous cell division had stopped completely.
Tumors Didn't Grow

The tumors growing under the skin were treated the day
after implant with the C-B12 combination. The results were sim-
ilar no tumors would grow. In the control animals (those mice
with transplanted tumors which were not given the C-B12 com-
bination), thetumors continued to grow at a rapid rate.
tumor growth was only part of the results of Sister
Inhibiting
Eymard's experiments. She also wanted to see if the C-B12 mix-
ture would prolong the lives of animals already suffering from
cancer. To find out. Sister Eymard and her colleagues injected
THE ANTI-CANCER COMBINATION 417
the mixture near the cancerous growths of diseased mice for

seven successive days.
Treated animals lived longer than those mice not given C
and B|2. In fact, all the treated mice outlived the control group.
It appeared that the combination of C and B12 not only inhibits
the growth of cancer cells, but also prolongs the lives of animals
impregnanted with cancer.
"There are few things presently on the market that will
ensure a 100 percent survival rate with cancer," Sister Eymard
says, "but we had a 100 percent survival rate after the controls
were dead. Most of the treated mice outlived the controls two
or three weeks."
To be sure that it was really the C-B12 concoction, and not
an unknown factor present in mice, that was responsible for her
results, Sister Eymard conducted experiments on free-living can-
cer cells growing on a culture medium. The vitamin C-B12 com-
plex was used as a treatment on three types of cancer cells and
on healthy cells, as well. The treated cells, the untreated control
group and the healthy cells were left to incubate.
At the end of the incubation period, the untreated control
group was infested with cancer cells. In the treated group, how-
ever, not one cancer cell of any of the three types was to he
found. The healthy, noncancerous cells were unaffected by the
C-B12 complex. It appeared that Sister Eymard had found a
cancer-inhibiting agent that not only stopped many kinds of can-
cer, but did so with absolutely no side effects in healthy tissue.
Sister Eymard also tested each vitamin separately to deter-
mine if either was primarily responsible for the anti-cancer ef-
fects. The combination of the two vitamins, however, always
performed much more effectively than either one alone.
Tests showed that the combination might be working by
boosting the animals' immune systems to fight the cancer. Sister
Eymard is confident that, with more experimentation, especially
on larger mammals and humans, the vitamin C-B12 combination
could prove to be a useful preventive weapon in the fight to
eliminate the second leading cause of death in America.
The scientific community has taken note of Sister Eymard's

findings.
A spokesman for the American Cancer Society, which helps
fund Sister Eymard's research, told us, "The physicians on the
committee which reviewed Sister Eymard's work were most
impressed with the results she was getting. She has come forth
with work of considerable promise."
Sister Eymard herself takes a modest stance.
'T'm glad you're looking "Every bit
into this," she told us.
of information helps to educate the public. It might give them
some hope, and that's what they need most."
CHAPTER
VITAMIN C
AGAINST CANCER
When most health-conscious people think of extending their

lives, they think terms of years. You may tell yourself, "If 1
in
give up smoking now, I may reasonably expect to live 5, maybe
10 years longer." Or, "If I stick to a regular exercise program
and watch my diet, I may be good for an extra 15 years." The
emphasis is always on a long and healthy life of indefinite span,
with several additional productive years tacked on the end as a
bonus.
When the terminal cancer patient contemplates his future,
he thinks in terms of days. In the final stages of that dread
disease, when the battle has been lost and even the doctors have
given up hope, time assumes a different dimension.
One study, however, holds out promise that even these pa-
tients can look forward to an extra round of life
thanks to
vitamin C. For the evidence now points to the distinct possibility
that dailysupplementation with this nutrient in relatively large
amounts can add many precious days to the lives of terminal
cancer victims. In some cases, as we shall see, vitamin C has
turned those remaining days back into years.
419
The Study in question was done by Linus Pauling, Ph.D.,

and Ewan Cameron, M.D., a surgeon. Dr. Pauling, a Nobel
prize-winning chemist, is associated with the Linus Pauling In-
stitute of Science and Medicine, Menlo Park, California. Dr.
Cameron practiced medicine at Vale of Leven District General
Hospital, Loch Lomondside, Scotland.
Cameron and Pauling compared
In their clinical study, Drs.
the survival time of 100 terminal cancer patients, selected over
and given vitamin C, with ,000 similar patients
a five-year period 1
who did not receive the vitamin. All were patients at the Vale
of Leven hospital, whose surgical unit treats most of the ad-
vanced cancer patients in the Loch Lomondside area. Each per-
son receiving vitamin C was matched with 10 control patients
of the same sex, close to the same age and suffering from the
same type of tumor, who did not get vitamin C. (Patients in the
non-vitamin
C group were selected some in retrospect by a
random search of the hospital's case records over the past ten
years; most had died before the doctors began administering
vitamin C.)
Vitamin C Gave Extra

Days to the "Hopeless"
"For strong ethical reasons," the researchers point out,
"every patient group was examined and assessed
in the treated
independently by at least two physicians or surgeons (often more
than two) who all agreed that the situation was 'totally hopeless'
and 'quite untreatable' before ascorbate [vitamin C] was
commenced."
In otherwords, before turning to vitamin C as a last resort,
all the people were first treated with surgery, radiation, chem-

otherapy or hormones all the conventional forms of cancer
treatment. In every case, such methods failed. For example, ten
women with breast cancer had undergone mastectomy and sub-
sequent radiation treatments, as well as receiving hormones.
VITAMIN C AGAINST CANCER 421
They had improved for a while but then relapsed. Their tumors
were running out of control. At were
that point, the patients
declared terminal, the decision to begin giving vitamin C was
made and the doctors began counting survival days.
A similar point of no return was selected for each of the
patients in the non-vitamin C group by examining their records.
From that date when exploratory surgery revealed that a tumor
was inoperable or conventional anti-cancer treatments were
abandoned in despair, the patient was considered terminal, and
the remaining survival days were totaled up for comparison
purposes.
Those persons receiving vitamin C were started out with 10
grams (10,000 milligrams) a day intravenously. This was usually
stopped after about ten days, and then the patient began taking
the same dosage of vitamin C by mouth. As Drs. Cameron and
Pauling describe it, the vitamin C approach was begun "cau-
tiously'' but was continued with new patients over the next five
years because "it seemed to have some value."
In the light of their summarized findings, that would seem
to be an understatement. For in every type of cancer treated,
the people receiving vitamin C tended to live longer than those
who did not receive the vitamin.
Lung cancer patients, for example, survived an average of
3.53 times longer after being declared untreatable than their con-
trols.Those with stomach cancer lived 2.61 times longer. Bladder
cancer victims survived 4.49 times longer. Patients with kidney
tumors displayed a greater than fivefold increase in life expect-
ancy. Those with breast cancer lived 5.75 times longer. And
those with cancer of the colon managed to survive, on the av-
erage, 7.61 times longer on the vitamin C regimen!
Case Histories
some of those findings into actual days, months
Let's translate
and years. A 74-year-old man whose lung cancer was pronounced
untreatable began taking vitamin C and lived for more than a
year longer 427 days. The ten individuals in his control group
(other of about his own age with approximately the same
men
degree of untreatable lung cancer) survived for an average of
only 17 more days. Three died within 2 days; the longest any
survived was 31 days. Could the lack of vitamin C have made
such an incredible difference?
Another patient in the vitamin C group, a 69-year-old man
with inoperable cancer of the colon, also received an unexpected
new lease on life. Those in his control group survived for an

average of 37.3 days little more than a month. But this man's
condition improved considerably after beginning the vitamin C.
He lived for 1,267 days, almost 3'/2 years.
A 67-year-old woman
with cancer of the ovary responded
well to vitamin C. She was still alive at the time these results
were tabulated, 240 days after commencing treatment. She had
already survived almost six times longer than the average for
her control group.
Another remarkable turnabout involved a man, age 62, suf-
fering from bladder cancer. The men with bladder cancer in his
comparison group lived an average of 63 days without vitamin
C. But 669 days (almost two years) after starting with the vitamin,
he was still alive at the time the paper went to press. He already
had survived more than ten times longer than the average for
the untreated bladder cancer victims in his grouping.
Overall, the 100 people in the vitamin C group enjoyed an
average survival time 4.16 times greater than those 1,000 indi-
viduals in the control group.
''At the present time, we cannot conclude that ascorbate
has less value for one kind of cancer than for others," Drs.
Cameron and Pauling state. "Our conclusion is that the admin-
istration of ascorbic acid in amounts of about 10 grams per day
to patients with advanced cancer leads to about a fourfold in-
crease in their life expectancy, in addition to an apparent im-
provement in the quality of life'' {Proceedings of the National
Academy of Sciences of the United States of America).
That last point is especially important, since the final months
or days of a terminal cancer patient's life are often filled with
pain and despair.To prolong such a period of misery could hardly

be interpreted as beneficial. But many of the people receiving
vitamin C reported less pain. They were able to get by with less
dependence on pain-killing drugs that numb the mind. In short,
they not only lived longer, they found life more worthwhile.
When Drs. Cameron and Pauling proceeded to analyze their
data further, they discovered an interesting breakdown in the
way the vitamin C group benefited from treatment. They found
that among those patients there were two distinct subgroups.
"The data indicated that deaths occur for about 90 percent
of the ascorbate-treated patients at one-third the rate for the
controls, so that for this fraction there is a threefold increase in
survival time, measured from the date when the cancer was
pronounced untreatable. For the other 10 percent of the ascor-
bate-treated patients, the survival time is not known with cer-
tainty, but it is indicated . . . to be more than 20 times the average
for the untreated patients."
In other words, a small but significant proportion of the
patients responded to the vitamin C treatment in what can only
be termed a spectacular manner. In fact, at the time the final
results were compiled, 18 people were still alive, having survived
an average of more than 970 days. Sixteen of those were con-
sidered clinically "well."
In one case, a woman, age 50, with breast cancer was still
alive AVi years (1,644 days) after starting with vitamin C. The
untreatable cases in her control group had lingered for an average
of just 83 days. Yet this woman was still alive, her cancer ap-
parently brought under control.
Another success story: A 74-year-old man with an ad-
vanced, untreatable kidney tumor was still alive and well 1,554
days (more than four years) after he started taking vitamin C.
Those in his control group had survived only an average of 169
days before succumbing to their cancers.
One of the most dramatic recoveries of all involved a 40-
year-old long-distance truck driver suffering from cancer of the
lymphatic system. The reversal was so remarkably clear-cui in
this case that it rated a special report by Dr. Cameron and another
Scottish doctor, Allan Campbell, in the journal Chemico-

Biological Interactions.
In the spring of 1973, the truck driver began complaining of
spasmodic pains in the muscles between his ribs. He started to
lose weight. Night after night he awoke shivering, bathed in
sweat. Chest X rays revealed that the mass of tissues and organs
separating the lungs was greatly enlarged. When doctors re-
moved and examined one of the man's lymph glands, they found
that cancer had spread throughout his entire lymphatic system.

Treatment with vitamin C 10 grams daily was begun im-
mediately. 'The response to intravenous ascorbic acid
initial
was very dramatic indeed and far exceeded clinical expecta-

tions," Drs. Cameron and Campbell reported. "Within 10 days
of commencing therapy, the patient claimed to feel quite fit and
well, and had been transformed from a 'dying' into a 'recovering'
situation."
The man appeared to make a full recovery. Chest X rays
were normal. He returned to work. But when he discontinued
the vitamin C, the cancer symptoms returned with new ferocity.
He was readmitted to the hospital, where he received in-
travenous infusions of 20 grams of vitamin C daily for two weeks.
Then he was placed on a maintenance regimen of 12.5 grams of
vitamin C a day by mouth. Once again, the cancer symptoms
subsided, and the patient was declared "fit and well" with "no
evidence of active disease."
As the latest report from Drs. Pauling and Cameron went
to press, this patient was still alive and well, 1,106 days after
his initial diagnosis of advanced cancer.
How
can we explain such a favorable response? For that
matter, how can we explain any prolongation of life, whether
measured in days, months or years, in the patients who received
vitamin C?
According to Drs. Pauling and Cameron, "A simple inter-
pretation of these facts is that the administration of ascorbate to
the patients with terminal cancer has two effects. First, it in-
creases the effectiveness of the natural mechanisms of resistance

to such an extent as to lead to an increase by a factor of 2.7 in
the average survival time for most of the patients. . . . Second,

ithas another effect on about 10 percent of the patients, such
as to cause them to live a much longer time. This effect might
be such as to 'cure' them; that is, to give them the life expectancy
that they would have had if they had not developed cancer [em-
phasis ours].
"On the other hand," the authors theorize, the vitamin C
"might only them back one or more steps in the development
set
of the cancer. ." In any event, the immediate effect is the
. .
same: The patients receive a bonus of extra life.
How Could a Vitamin Help?

Why vitamin C? Drs. Cameron and Pauling note that "can-
cer patients have a much greater requirement for this substance
than normal healthy individuals," apparently because all avail-
able vitamin C is mobilized by the body in a valiant effort to
boost natural resistance and repel the invasive malignant growth.
One way that vitamin C conceivably works to strengthen
the body's own immunity to cancer was explained to us by Rob-
ert Yonemoto, M.D., a surgeon and former director of the sur-
gical laboratories at the City of Hope National Medical Center,
Duarte, California. According to Dr. Yonemoto's own studies
in conjunction with colleagues at the National Cancer Institute,
vitamin C increases lymphocyte blastogenesis in healthy human
volunteers.
Lymphocytes are white blood cells which gobble up and
destroy foreign agents in the body. To divide and multiply, they
must first undergo blastogenesis, which is a swelling process.
The greater the blastogenic activity, then presumably the greater
the effectiveness of the body's natural resistance against outside
invaders.
When Dr. Yonemoto grams (5,000 milligrams) of
gave 5
vitamin C daily to his five all showed a signif-
volunteers, they
icant spurt in blastogenesis. When the intake was doubled to 10

grams the same dosage used by Drs. Cameron and Pauling in
treating cancer patients the increase in lymphocyte blastoge-

nesis was even greater.
"Vitamin C increases immunity of the individ-
the general
ual/'' Dr. Yonemoto "so we should be able to demon-
told us,
strate that it is good for the cancer patient and that its intake
should precede and immediately follow cancer surgery."
The new findings of Drs. Pauling and Cameron would cer-
tainly seem to confirm vitamin C's importance. As they say,
their results "clearly indicate that this simple and safe form of
medication is of definite value in the treatment of patients with
advanced cancer."
Naturally, they would like to see vitamin C tried by other
physicians, outside of Scotland: "It is our opinion that a similar
effect would be found for untreatable cancer patients in other
countries," they state.
In calling their promising findings to the attention of the
worldwide scientific community, the two suggest that even larger
dosages of vitamin C (above 10 grams daily) might be even more
beneficial. And they stress that, in the future, patients should be
given the benefit of vitamin C much earlier in the course of their
disease, before the outlook has become so dim. In that way,
they speculate, cancer patients might hope to live an additional
5 to 20 years.
Of course, any such results will need to be tested and re-
tested in clinics and laboratories around the world before anyone
can begin to breathe a sigh of relief about the menace of cancer.
But in the meantime, based on the already quite substantial evi-
dence that has accumulated, we suspect the wisest course of all
would be to look to daily vitamin C supplementation as a po-
tential preventative of tumor growth, rather than a cure.
Cancer is one battle that is best avoided completely.
CATARACTS
CHAPTER
NEW HOPE FOR

CATARACT PREVENTION
What causes cataracts? Can they be prevented? The an-

swers to those questions are not coming easily to medical in-
vestigators. In fact, the mystery surrounding the onset of these
sight-robbing curtains on the eye has at times appeared as cloudy
and impenetrable as the cataracts themselves.
But bit by bit, bright patches of knowledge are appearing,
and none seems brighter than a report by three scientists at the
National Eye Institute's laboratory of vision research in Be-
thesda, Maryland. For the trio has discovered that a commonly
occurring natural family of nutrients, the bioflavonoids, exhibits
a surprisingly potent blocking effect against certain types of
cataracts.
Cataracts occur when the normally transparent lens of the
eye gradually clouds over. Instead of focusing incoming rays of
light into a sharp image on the retina, the impaired lens scatters
the light, obscuring vision. If the clouding progresses far enough,
sight can be completely lost. As a result, cataracts are a major
cause of blindness all over the world.
Nearly 16 million people are severely disabled by this eye
disease. More than 24'/2 million Americans alone, over age 60,
suffer from cataracts {British Journal of Nutrition, May, 1982).
427
Viewed work of National Eye

against such a backdrop, the
Institute researchers S. D. Varma, A. Mizuno and J. H. Ki-
noshita takes on added importance. Writing in Science, the team
described what happened when the bioflavonoid quercitrin was
fed to laboratory animals especially prone to rapid cataract
formation.
was chosen because, like other flavonoids, it has
Quercitrin
been shown to inhibit an enzyme, aldose reductase, which is
normally present and almost inactive in the lens of the eye. Under
normal circumstances, aldose reductase poses no problem, but
when blood sugar levels rise (as in diabetes), the enzyme swings
into action to convert the sugar into sorbitol. And sorbitol inside
the lens is suspected as a cataract trigger. Scientists believe that's
why diabetic individuals have a higher incidence of cataracts
than other people.
The researchers found that supplementing diabetic animals'
diets with quercitrin cut the sorbitol concentration inside the eye
in half. And even more important, those animals receiving the
bioflavonoid developed no cataracts during the course of the
trial, while unsupplemented animals showed signs of lens cloud-
ing within ten days!

"This study," the authors concluded, "reveals for the first
time that inhibition of aldose reductase not only leads to a de-
crease in the sorbitol accumulation in the lens but also impedes
the cataractous process. The cataract formation in diabetes may
not prevented. ."
thus be at least delayed, if . .
Earlier tests by Varma, Kinoshita and another colleague

(Science) revealed that flavonoids tested
"have
all in addition to being
relatively safe and nontoxic significant inhibitory activ-
ity" against aldose reductase. However, the more widely known
bioflavonoid rutin isn't as potent as quercitrin. Quercitrin, though,
isnot currently available as a food supplement. It is probably
found in citrus fruits, but these amounts would not be enough
to have a therapeutic effect. Dr. Kinoshita told us.
Eye researchers are quick to point out that there are many
differences between animal lenses and human lenses, particularly
with regard to cataract formation. But still the notion that the
NEW HOPE FOR CATARACT PREVENTION 429
kinds of food we eat might have either a protective or detrimental

effect with regard to cataracts isn't really so farfetched. The lens
of the human eye "has a metabolism that is as finely tuned to
its proper function as the metabolismof any other tissue," points
out an authority on cataracts, English researcher Ruth van Hey-

ningen of the University of Oxford's Nuffield Laboratory of Oph-
thalmology (Scientific American). Conceivably, certain nutrients
or their lack could profoundly alter that metabolism.
For example, simultaneous deficiencies of vitamin E and the
amino acid tryptophan in pregnant rats result in cataract for-
mation in their offspring. That was demonstrated by two sci-
entists at Virginia Polytechnic Institute and State University.
George E. Bunce and John L. Hess of the department of bio-
chemistry and nutrition discovered that 33 percent of the young
born to deficient rats developed cloudy spots in their lenses
within 24 days (Journal of Nutrition). That high incidence rate
didn't show up, though, among other rats when only vitamin E
or tryptophan alone was withheld.
FullRange of Vitamins
Found Protective
In another study, by famed University of Texas biochemist
Roger J. Williams and colleague James D. Heffley, several groups
of young rats were placed on diets of varying quality and then
fed high amounts of galactose, a type of simple sugar.
"By feeding galactose-containing diets to young rats, cata-
racts are regularly produced," the pair noted in Proceedings of
the National Academy of Sciences. "When, however, we fur-
nished galactose-fed animals with what may be considered a well
balanced, full team of nutrients, cataract prevention was accom-
plished. On
four galactose-containing diets supplied with a full
team of nutrients, not a single cataract developed in 24 rats (48
eyes). On four diets using the same dietary galactose challenge.
accompanied with inadequate nutritional teams, 47 out of 48 eyes

developed cataracts."
Next, the two scientists tried to reverse the cataracts in
some animals by switching them to better diets. In more than
half the cases, the condition of the eyes improved, although
slowly and not completely.
The authors fortified the higher-quality diets for their ani-
mals with a nutritional team that included vitamins A, D and E,
thiamine, riboflavin, niacin, folate (folic acid) and several other
nutrients.
''It is evident that from our study no one could derive a
precise list of the nutrients involved in protecting against cata-
ract," they noted. "Our simple experiment shows that when we
attempted to furnish enough of all the essentials, success was
attained. . . .
"Itseems possible that if the dietary challenge offered these

rats had been less severe or if the change in diet had been in-
stituted at the very first sign of cataract instead of waiting until
the cataracts were well formed, the responses might have been
more favorable."
The authors add that they would like to see the nutritional
team approach tested for effectiveness in preventing human
cataracts.
One might wonder about the sudden interest in preventing
a condition that, once it has arisen, can be treated so readily.
Modern surgery, which removes the affected lens or lenses, is
However, cataract researcher van

a highly successful operation.
Heyningen, among others, considers surgery to be only "a partial
remedy."
"Prevention would be much better than the present 'cure,'
she stresses, because once the natural lens has been removed,
thick spectacles or contact lenses are then required to restore
the eye's focusing ability.
So modern surgical methods notwithstanding, there appears
to be a tremendous need for more research into cataract pre-
vention and healing through the use of natural food substances.

COLDS, FLUAND
THE IMMUNE SYSTEM
CHAPTER
FIGHT OFF FLU

AND COLDS THE
NATURAL WAY
Every day, every hour, every minute of our lives there's a

battle for survival going on inside our bodies. It's between us

and them those invisible germs and viruses that cause colds
and flu and any number of other infections and diseases.
But silently and relentlessly our bodies fight back, keeping
the invaders from taking over and making us sick. Our nifty
immune system is the defense that does this for us automatically
and, most of the time, perfectly.
Sometimes, our white blood cells track down germs and
gobble them up. At other times, it's the antibodies produced by
special cells that destroy the germs. There are even certain pro-
teins called immunoglobulins, complement and interferon that
our cells make just for fighting off viruses, bacteria and other
foreign invaders. As if that's not enough, we are also stocked
with fighters known as T cells, B cells and (believe it or not)
killer cells.
Are you impressed? You should be because, if even one of
these systems broke down, you'd be in serious trouble
healthwise.
431
"Each lack or deficiency presents itself clinically to the

doctor ... in its own particular way," says Ronald J. Glasser,
M.D., author of The Body Is the Hero (Random House, 1976).
"No antibodies, and the child has recurrent pneumonias and
abscesses; no granulocytes [germ-gobbling white cells], and he
has prolonged bacterial infections; no lymphocytes [T and B
and he has recurrent fungal infections and severe, recur-
cells]
rent, viral illness.''
Luckily, most of us don't have to contend with that degree
of immune dysfunction. On the other hand, you shouldn't take
your immune system for granted. It needs the same TLC as the
rest of your body in order to give you the best protection from
disease.
That's where good nutrition comes in. "There is an intimate
relationship between nutritional status, immune response and
infection," says R. K. Chandra, M.D., professor of pediatric
research at the Memorial University of Newfoundland. "When
nutritional deficiency and infection coexist, the former is often
chronic and precedes the latter acute process."
In other words, when your diet is inadequately supplying
all you need, your immune defenses
the vitamins and minerals
go down, allowing germs to multiply and cause illness. And you
don't have to be grossly undernourished either, adds Dr. Chan-
dra, who is also the coauthor of Nutrition, Immunity, and In-
fection (Plenum Press, 1977). Deficiency of individual nutrients
can undermine the immune system, too.
Robert Edelman, M.D., agrees. "Acquired immune dys-
functions in man occur with deficiencies of certain vitamins and
minerals," says Dr. Edelman, who is chief of the clinical and
epidemiological studies branch at the National Institute of Al-
lergy and Infectious Diseases, in Bethesda, Maryland.
Actually, in animal studies, the most important immunolog-
ical effects are produced by deficiencies of vitamin 86, pantothe-
nate (pantothenic acid) and folate (folic acid), according to Dr.
Edelman. For example, a deficiency of B^ alone depresses both
cellular (T and B cells) and humoral (antibody production) im-
FIGHT OFF COLDS AND FLU 433
munity in shown that T and B

animals. Other experiments have
normally when tested against a foreign sub-
cells fail to multiply
stance (like a germ). What's more, volunteers with short-term
experimental B6 deficiencies have shown reduced antibody re-
sponses to vaccines.
As for pantothenate, a deficiency of that nutrient appears
to inhibit the stimulation of antibody-producing cells and their
ability to produce the special proteins (immunoglobulins) that
fight off foreign invaders.
Folate deficiency can cause its share of immune-system
problems, too, adds Dr. Edelman. Animals lacking in folate show
a shriveling of the tissues that produce lymphocytes, as well as
diminished white blood cell numbers and impaired cell-mediated
and humoral immunity (Journal of the American Medical As-
sociation, January 2, 1981).
"The good news," Dr. Edelman told us, "is that the immune
system responds very quickly to adequate nutrition."
Of course, it responds in the opposite direction just as easily.
"Experiments in animals have shown that a one-month defi-
ciency in certain nutrients has negative effects on the immune
system if the deficiency occurs during a period of rapid growth,"
says Kathleen Nauss, Ph.D., of the department of nutrition at
the Massachusetts Institute of Technology, located in Cambridge.
"In our experiments, we fed animals diets that were mar-
ginally deficient in folate as well as choline and methionine [an
amino acid]. These substances all play a role in cellular metab-
olism. Within a month, sometimes less, we found the animals'
immune system to be depressed. It was particularly severe in
young animals."
When it comes to people, both the very young and the el-
derly are especially susceptible to immune dysfunction: the young
because their rapid growth rate creates an increased demand for
nutrients, and the old because the immune system simply de-
teriorates with age.
What's more, the elderly often have an inadequate diet,
compounding the problem. In fact, in one study. Dr. Chandra
found that 41 percent of a group of people over the age of 60

had nutritional deficiencies that contributed to their immune
dysfunctions.
Vitamin C and Colds

While good nutrition in general is important to a smoothly
running defense system, several nutrients (besides those already
mentioned) stand out as superstars in this area.
Vitartlin C surely heads that list. After all, how many people
do you know who swear by vitamin C for colds? Dr. Edelman
does. "I don't get too many colds," he told us, "but when I do,
I take large doses of vitamin C. It relieves the symptoms and
shortens the duration of the cold. It seems to work well."

Kenneth Cooper, M.D., agrees. He's a fitness expert and
author of The Aerobics Program for Total W ell-Being (M. Evans
and Company, 1982). "For many years, I have taken 1,000 mil-
ligrams of vitamin C daily, and during that time I've experienced
almost complete protection from colds and other upper respi-
ratory infections. Before I began to take this dosage, 1 regularly
had two or three major colds each year. After I started taking
some extra vitamin C each day, however, the number of colds
declined dramatically. In my opinion, there is probably a causal
connection between the vitamin C supplement and my good
health," explains Dr. Cooper, "although it is impossible to draw
a valid conclusion based on a study of one patient."
Other researchers, however, are working on proving just
such a connection, and their studies have been centering on
vitamin C's effect on the immune system.
"We became interested in vitamin C because of other stud-
ies we had seen on the relationship of immunity to this nutrient,"
says Richard Panush, M.D., chief of clinical immunology at the
University of Florida college of medicine, in Gainesville. "We
decided to carry out our own studies and see what we'd come
up with. In the first experiment, we tested the effects of vitamin
FIGHT OFF COLDS AND FLU 435
C in the test tube and found that it boosted a wide array of

immune responses.
"Our next study was done on a group of normal, healthy
volunteers. We gave half of them vitamin C and the other half
a placebo [harmless inactive pill] and then measured their im-
mune response. Those taking the vitamin showed a measurable
increase in their immunity," Dr. Panush told us.
"Now we're in the middle of an experiment that is testing
the effects of vitamin C on the immune system of sick people to
see if it will help them get better. We should have those results
within the year."
In another study, researchers from Johannesburg, South
Africa, tested the antibody response of two groups of guinea
pigs. One group (the controls) received only a minimal amount
of vitamin C while the other group received supplemental vitamin
C. Antibody levels were then measured after the animals were
injected with a foreign substance.
The animals receiving the supplemental C had significantly
higher antibody levels than the control group. The researchers
observed that vitamin C appears to stimulate the production of
immunoglobulin M-type (Ig M) antibodies, in particular. And,
say the researchers, "Ig M
is a most effective first line of defense
against invading organisms."

For the animals, the enhancement of the immune response
was accomplished with 160 milligrams of vitamin C per day. A
comparable stimulation of the humoral immune system in hu-
mans might require a daily vitamin C intake of 1.5 to 2 grams
(1,500 to 2,000 milligrams), the researchers speculate (Interna-
tional Journal for Vitamin and Nutrition Research, vol. 50, no.
3, 1980).
For the elderly, who often have age-associated immune dys-
function, supplemental zinc may give them the boost they need.
That's what doctors in Brussels have found out. In their exper-
iment, the researchers gave zinc supplements (50 milligrams of
zinc twice daily for a month) to 15 volunteers over 70 years of
age. Meanwhile, another elderly group of 15 received no sup-
plementation during that time. At the end of the experiment, the

zinc group showed a significant improvement in the number of
circulating T cells. "The data suggest that the addition of zinc
to the diet of old persons could be an effective and simple way
to improve their immune function" {American Journal of Med-
icine, May, 1981).
Another simple way to beef up your immune system might
be to supplement your diet with arginine. That's an amino acid
naturally found in meats, nuts, seeds, beans and sprouts.
Being able to fight off the germs that bombard you every
day is a tough business. You win a few, you lose a few. But with
good nutrition on your side, you can tip the scales in your favor.
CHAPTER
VITAMINS THAT
PERK UP A SAGGING
DEFENSE
A young brother and sister in South Africa have been in the

medical HmeHght. The children had been plagued with frequent
bacterial infections. Juvenile acne, pneumonia, recurring sinus-
itis, ear infections and upper respiratory tract infections were
just some of the maladies their bodies seemed unable to battle.
Both children also were allergic to animal hair, house dust, pollen
and food, yet they apparently had no drug allergies.
The children were suffering from an unusual disorder called

chronic granulomatous disease (CGD) a severe immune defi-
ciency disease in which part of a person's natural immune system
defenses are impaired. It is an inherited disease whose victims
are young people showing an abnormally high susceptibility to
pus-producing infections. The infections are caused by certain
species of bacteria against which the patient's body has no defense.
The youngsters were treated with drugs that lowered the
frequency of infections, but they still had bouts with pneumonia,
bronchiolitis and sinusitis. Finally, they began taking high doses
of vitamin C.
After following a supplementation program with the nu-
trient, the two children experienced a ''decrease in the frequency
437

of infection and increased weight and growth rate," researchers

noted. "Both children have remained free of infection for a 10-
month period, which included the South African wmter. In the
previous two winters both children suffered from severe pneu-
monia and recurrent upper respiratory tract infections."
A brother, just over two years old and not included in the
study, also had CGD. The boy developed an acute inflammation
of the umbilicus shortly after birth. At the age of two weeks, he
developed a serious abscess and complications. He was given 1
gram of vitamin C and the problem cleared up. He has
daily,
remained free of infection for nine months, the researchers
reported.
They concluded that "... ascorbic acid [vitamin C] may
be an important supplement to prophylactic antibiotics and
chemotherapeutic agents in the treatment of CGD" {South Af-
rican Medical Journal, September 15, 1979).
Why did vitamin apparently help those children ward off

C
infections? One clue appearing in blood samples of the older
brother and sister was an increase in neutrophil activity after

taking vitamin C.
"Neutrophils are a type of white blood cell and are the main
killer cells that respond to bacteria in the body," explains Nor-
bert J. Roberts, Jr., M.D., associate professor of medicine and
a member of the infectious disease unit at the University of
Rochester, in New York. "Vitamin C appears to be important
for the migration of those killer cells. In the absence of vitamin
C, the migration of these cells and phagocytosis the eating
of bacteria can be depressed."
Dr. Roberts has been researching the effects of vitamin C
and fever on the immune system. "There have been numerous
speculations on vitamin C's role on immune function," says Dr.
Roberts. "There also has been a lot of controversy and un-
knowns about hyperthermia [elevated body temperature]. Is fe-
ver good or bad? Should a person take aspirin to reduce fever
or not?"
They decided to put both vitamin C and fever to the test,
choosing to pit them against an influenza virus. "An infection
VITAMINS FOR A SAGGING DEFENSE 439
with the influenza virus can depress a patient's immune function

to other agents," Dr. Roberts told us.
they toolc some normal human white cells and stim-
First,
ulated them with a plant substance called PHA. ''Normal cells
should respond to PHA. If a person has an immune deficiency,
his cell response to PHA will be less,'' explains Dr. Roberts.
After they observed how the normal cells responded to PHA,
they exposed the cells to influenza. When the cells "came down
with the flu," their immunity was lower, as shown by a lower
than normal response to PHA. When the flu-infected cells were
treated with vitamin C, however, they bounced back and exhib-
ited a higher response to PHA. Infected cells which were raised
to fevertemperature also responded more favorabl to PHA.
"Both ascorbic acid and fever appear to enhance the re-
sponse of the cellsand to diminish the adverse effects of the
virus, when examined in the test tube," Dr. Roberts says. "It
remains open to question whether a person taking vitamin C and
avoiding aspirin will find any benefit for the immune system, but
our work suggests that it might. Repeated studies we have done
show the same thing all over again. However, for certain indi-
viduals (a young child or a person with heart disease, for ex-
ample), it might be important to lower fever" (Journal of Im-
munology, November 1979).
A Boost from Vitamin A

Vitamin C is not the only nutrient which may dramatically
bolster the body's natural defenses. Benjamin E. Cohen, M.D.,
of Houston, Texas, has been studying vitamin A over the years
and has found that it, too, may boost a person's immune response.
"While I was working at the National Institutes of Health
in Bethesda, Maryland, I examined the effects of steroids and
vitamin A on mice," he told us. "Steroids are chemical agents
secreted by the adrenal glands. Among other things, high doses
of steroids are known for their suppressive effect on a person's
immune response. They are widely used drugs often given to
transplant patients so that their immune systems will be less

likely to reject the transplanted organ.
"When gave high doses of steroids to mice, their immune
I
systems were depressed. But when the mice were given vitamin
A, the steroids were unable to depress the immune system. Vi-
tamin A blocked the depression."
Dr. Cohen also discovered that vitamin A decreased the
animals' susceptibility to a variety of bacterial infections. And
when mice were given vitamin A conjunction with a potent
in
anti-cancer agent, the anti-cancer agent became 100 times more
potent.
Dr. Cohen went England on a fellowship from Harvard
to
and began researching the effect of vitamin A on the immune
system in humans.
"It has consistently been found that anesthesia and surgery
result in a suppression of the immune response in patients," he
says. "Whenever patients are anesthetized, it generally takes a
few weeks for their immune response to recover."
Working with colleagues from Australia and England, Dr.
Cohen conducted research with patients who were undergoing
elective operations. The patients were divided into two groups.
One group received vitamin A before, during and after surgery.
The other group did not take vitamin A supplementation. Blood
tests were performed immediately before and after surgery and
one week later. A series of immune function tests was run on
each sample.
"By and large, there was a tendency toward a depression
of the immune function in patients not taking vitamin A," Dr.
Cohen explains. "On the average, patients who did take vitamin
A did not experience a depression of the immune response at
all."Vitamin A seemed to keep the patients' immune defenses
functioning normally despite their surgery {Surgery, Gynecology
and November, 1979).
Obstetrics,
Cohen theorizes that vitamin A's favorable effects on
Dr.
the immune system might prove to be beneficial in battling certain
types of cancers. "The immune system has been implicated in
the control of certain types of tumors," he told us. "If that is
VITAMINS FOR A SAGGING DEFENSE 441
true, it may be possible to improve the immune system's work

with vitamin A supplementation. That may be helpful in arresting
or even eradicating the tumor." Dr. Cohen says vitamin A prob-
ably would be given to the patient as additional therapy. "The
nutrient might be used in conjunction with a more traditional
approach."
The immune system is a complex internal mechanism that
not completely understood. But as researchers continue
still is
to investigate the ways in which certain cells in our bodies over-

whelm and destroy dangerous bacteria and other foreign invad-
ers, vitamins A and C are sure to receive even more attention.
CHAPTER
BOOST YOUR
IMMUNITY
WITH VITAMIN C
Interferon is a remarkable defensive substance that the body

makes naturally when it's invaded by the likes of viruses and
cancer. And extra vitamin C means extra interferon.
When an invader, such as a virus, enters the body, it attacks
the cells that make up body tissues. Each individual virus attacks
one cell and takes over the
cell's reproductive cycle, making the
cell more viruses instead of more cells. Unless the body
turn out
fights back in some way, it will quickly be overcome by the
invaders.
Naturally, the body does fight back. According to Benjamin
V. Siegel, Ph.D., a research professor at the University of Or-
egon health sciences center in Portland, interferon is the body's
first line of defense. "Before the body is even producing any
antibodies," Dr. Siegel told us, "interferon can just attack the
disease. But the body has to be producing enough interferon."
Interferon does not work directly against the invaders. In-
stead, it is manufactured by the ceil under attack and, like Paul
Revere, is sent off to alert the surrounding cells. The other cells
are stimulated into producing a substance which prevents the
virus from reproducing any further. The invasion is stopped dead
in its tracks
provided there's enough interferon.
442
BOOST IMMUNITY WITH VITAMIN C 443
"The beauty of interferon," according to Dr. Siegel, "is

that works against all viruses. A vaccine usually works against
it
only one specific type of virus. And in the case of chemical virus
killers, the viruses can develop mutant types that are resistant
to the chemicals. But this doesn't happen with interferon."
What does happen with interferon, however, is that there
are great variations in just how much interferon is available. Dr.
Siegel offers this as a possible explanation of why some people
are more resistant to viral infections than others.
Interferon Fights Cancer

The importance of interferon is not limited to fighting viral
infections such as the common cold and influenza. These two
items alone, of course, would guarantee that interferon would
be a top priority for drug research. But interferon also stimulates
another anti-invasion force, the macrophages. Dr. Siegel calls
them the "angry" cells that seek out and destroy not only in-

vading viruses, but any foreign intruder including cancer cells.
In Sweden, persons with bone cancer were treated with large
doses of interferon produced in a laboratory. The survival rate
increased substantially. But the number of people treated with
interferon was necessarily small, mainly because it is very dif-
ficult and costly to produce interferon in a laboratory. Nonethe-
less, the great promise of using interferon to fight cancer, as well
as serious viral diseases such as hepatitis and influenza, is stim-
ulating research to find a way of making the body produce more
interferon.
According to Dr. Siegel, "pharmacological companies, which
are interested in making money as well as helping people, have
been trying for years to find an agent that will increase interferon
production in the body. It is possible to produce interferon in
the laboratory. But if interferon is produced like this, on the
outside, it would cost thousands of dollars for enough interferon
to cure a cold. So the trick is to produce it on the inside, to get
the body to produce more of its own interferon. Vitamin C ap-
pears to do just that."
Dr. Siegel's first investigation into vitamin C's effect on in-
terferon involved infecting mice with extremely lethal leukemia-

causing viruses.One group of mice received large doses of vi-
tamin C, one group did not. The mice that did get vitamin C
developed milder cases of leukemia and produced more than
twice as much interferon.
Vitamin C also boosts other defenses. The activity of mac-
rophages, which is stimulated by interferon, is further heightened
by vitamin C. White blood cells are also helped by vitamin C,
as is the production of antibodies against specific diseases.
Double Evidence of
Vitamin C's Power
Currently, Dr. Siegel is attempting to find out whether vi-
tamin C
can completely prevent or delay the onset of leukemia.
In his earlier work, such large doses of the leukemia virus were
used that there was never any doubt that all the mice would get
the disease. The purpose was to measure the interferon produc-
tion. But in his present investigation, lower doses of the leukemia
virus are being used, in hopes of giving the vitamin C-interferon
team a chance to show if it can stop leukemia before it gets
started.
Of course, some of the questions medical skeptics are going
to ask are whether Dr. SiegePs results can be duplicated and
whether vitamin C can affect human interferon as well as it can
that of a mouse. Other researchers have already begun to answer
these questions happily, in the affirmative.
Norwegian investigators recently published the results of
their work with human cell cultures. Such cell cultures, grown
are often used in the early stages of research
in the laboratories,
work when inconvenient to use volunteers or animals. The
it is
cells were challenged with viruses and supplemented with vary-

ing doses of vitamin C while interferon levels were measured.
Vitamin C was found to increase the cells' production of inter-
feron at all dose levels {Acta Patholoîca et Microhiologica
Scandinvica).
BOOST IMMUNITY WITH VITAMIN C 445
Dr. Siegel is pleased with the Norwegian reports, especially

since these researchers set out to disprove his results. ''But their
results are almost the same as ours," he told us. "Our work is
solid. It's established. What we've done is demonstrate, for the

first time, what vitamin C does."
There is abundant evidence from still more researchers' work
that vitamin C gives a significant boost to the body's ability to
Not all of them have considered the connection
fight off invaders.
between vitamin C and interferon. But the husband-wife team
of biochemists Carlton E. Schwerdt, Ph.D., and Patricia Schwerdt
did in their work with human and cold viruses. The
cell cultures
Schwerdts set out to find if vitamin C
could prevent or reduce
common cold symptoms. The cells were treated with vitamin C
for two days, then infected with a common cold virus.
The effect was described to us by Dr. Carlton Schwerdt:
"The virus goes through one cycle of growth, but subsequent
cycles seem to be inhibited." After the first cycle, 16 to 48 hours
dropped gradually until it was
after the first infection, virus yield
one-twentieth that of the culture which was not treated with
vitamin C. After 48 hours, the treated culture had a virus yield
which was one-fortieth the size of the untreated cells.
If you think that sounds like the kind of population con-
trolling effect interferon exerts on viruses, then you have that

thought in common with the Schwerdts. At least one of their
experiments demonstrated that vitamin C was increasing a form
of antiviral activity similar to that of interferon.
As promising as all this research is for the battle against
cancer and viral infections, there is one important thing to note.
The drug industry is not going to spend much money trying to
find out more about vitamin C's effect on interferon. They are
spending their time and money trying to find a way to make
artificial interferon or develop a drug which will do the same
thing vitamin C does. The reason is simple. Everyone has access
to vitamin C. No one can patent it and sell it for drug-high prices.
Naturally, the drug companies won't promote something that
won't make money for them.
CRAMPS
CHAPTER
VITAMIN E FOR
THOSE PAINFUL
CRAMPS

Cramps they cramp your style.
A cramp in the calf can turn a pleasant walk into a forced
march home. And did your community pool ever seem like the
set of Jaws
only with your thigh muscles standing in for the
shark? You could even hate writing a love letter if writer's cramp
suddenly put on the squeeze.
There are over 100 muscles in your body. Any one of them
could knot up. And few Boy Scouts could help you untie these
knots. But you can be prepared for cramps with vitamin E.
That's the news from Australia, where Dr. L. Lotzof is
having "remarkable success" treating muscular cramps with vi-
tamin E.
In a letter to The Medical Journal of Australia, Dr. Lotzof
reported giving daily doses of about 300 milligrams of vitamin E
to 50 patients suffering from muscular cramps. In all 50 patients,
almost all cramping stopped.
As soon as Dr. Lotzof's patients stopped taking vitamin E,
their cramps returned.
Dr. Lotzof was surprised by these excellent results. He
asked other doctors to write to the journal and offer explanations
446
VITAMIN E FOR CRAMPS 447
as to why vitamin E controls muscle cramps. But it's unlikely

he'll get much of a response. Modern medical science really has
no clear idea what causes cramps. But scientific literature is full
of reports by doctors like Lotzof who
without knowing the why

behind their treatment have cured muscle cramps with vitamin
E.
Two such doctors are Samuel Ayres, M.D., and Richard
Jr.,
Mihan, M.D. They treated 125 of their patients, who were suf-
fering from nighttime leg and foot cramps, with vitamin E. "More
than half of these patients had suffered from leg cramps longer
than five years and many of these had had cramps for 20 to 30
years or longer," the doctors wrote in the Southern Medical
Journal.
But vitamin E made short work of even these long-standing
cramps. Of the 125 patients, 123 found relieffrom their cramps
after taking vitamin E. One hundred
three of these patients had
"excellent" results: "complete or nearly complete control" of
cramps,
A daily dose of either 300 or 400 international units of vi-
tamin E cleared up most cramps. Some
patients, however, needed
more. So if you begin taking vitamin E for cramps and find a
daily dose of 400 international units has little or no effect, don't
hesitate to try a larger amount. "There are virtually no side
effects from doses as high as 1,600 to 2,400 international units
daily," the doctors assure us.
Also, if you find vitamin E does work, stick with it. "In a
number of instances ... it was learned that cramps recurred
when treatment was stopped or greatly reduced, but promptly
responded again when treatment was resumed," the doctors
explain.
All in all, the doctors feel confident that vitamin E will do
the job. "The response of nocturnal [nighttime] leg and foot
cramps to adequate doses of vitamin E is prompt, usually be-
coming manifest within a week, and occurs in such an over-
whelming number of cases that it appears almost specific for this
ailment," they assert.
But not only nocturnal foot and leg cramps were healed by
vitamin E. Nocturnal rectal cramps, cramping of abdominal mus-

cles and cramps from heavy exercise were also "relieved com-
pletely" with the vitamin.
Is Walking Painful?
Now, walking is not a heavy exercise. At least, not for most
people. But you have intermittent claudication a painful

if
cramping of the calf muscle that sneaks up on you after you've

walked too far a stroll around the block can have your calf
muscle playing the "heavy" in a very unpleasant muscular mel-
odrama. Well, help is on the way. No white hats or shining

armor ^just our old friend, vitamin E.
Knut Haeger, M.D., a Swedish surgeon, selected 47 men
with severe intermittent claudication. He gave 32 of them vitamin
E; the rest received drugs to improve circulation (American Jour-
nal of Clinical Nutrition).
After about three months, the men were tested to see how
far theycould walk without pain. Fifty-four percent of the vi-
tamin E group walked 1 kilometer (Ys of a mile), the test's max-
imum distance. But only 23 percent of the second group could
walk that far.
How did vitamin E help these men walk? Vitamin E may
to
stop intermittent claudication and all
cramps by improving
circulation. After about 1'/: years of taking vitamin E, 29 out of
32 men in Dr. Haeger's study had an increase in the flow of blood
to their calves. That's a big difference from those who took
prescribed drugs. After \Vi years, 10 of 14 of those men had a
diminished flow.
So even though scientists have yet to unravel the mystery
of how vitamin E works to stop cramps, you don't have to wait
to use it. You can unravel
now twisted, tight and cramped
muscles with vitamin E.
CRIME AND JUVENILE
DELINQUENCY
CHAPTER
CRIME-BUSTER
VITAMINS
Time was, convicts used files to escape from jail. Now they
use knives and forks.
In Pitkin County, Colorado, 500 prisoners went on a diet
free of sugar, white flour and coffee and ate dinners from a natural
foods restaurant. A study showed that, from their release to the
end of the study, not one prisoner has been in trouble with the
law.
In Dougherty County, Georgia, every juvenile offender
undergoes biochemical testing and is given nutritional supple-
ments to help correct any chemical imbalance. The number of
serious crimes by juveniles in Dougherty County is less than it

was ten years ago a pleasant exception to the trend in many
American communities.
In Cuyahoga Falls, Ohio, 600 criminals have received nu-
tritional education and gone on a diet emphasizing lean meats,
whole grains and fresh fruits and vegetables. Eighty-nine percent
of those people have not committed another crime.
That bad nutrition and bad behavior are closely linked is
the truth, and nothing but the truth. But the people running
America's multibillion-dollar criminal justice system are just be-
ginning to wake up to the fact. They're being shaken awake by
449
a small group of men and women who realize that no approach

to criminal rehabilitation
social casework, psychotherapy, group

therapy, psychiatry, academic and vocational training can pos-
sibly work unless a good diet backs it up.
"Of the nearly two million criminals in jail, over 70 percent
have been there before," Alex Schauss told us. "So something
has to be wrong with the way most criminals are rehabilitated."
Schauss is a former state corrections training officer for the
Washington State Criminal Justice Training Commission. He
oversaw the training of parole and probation officers, the men
who deal with criminals out of jail. To keep them out, Schauss
put together a course called "body chemistry and offender be-
havior." Its many topics include diet, vitamins, minerals, stress,

food allergy and exercise detailed information about health that
the probation officer passes on to the offender. But can this kind
of approach really soften a hardened criminal?
"Not one single probation or parole officer has called me
and said this approach doesn't work, and if it didn't, I would be
hearing about it," says Schauss. Studies back up that claim.
Schauss chose 102 people who had committed a crime and
were on probation. He had some of them receive nutritional
counseling and others traditional counseling. (Traditional coun-
seling advises an offender about his job, housing, clothing, family

problems and other areas of daily life except what he eats.)
Schauss found that 34 percent of the people receiving traditional
counseling committed another crime, compared with only 14
percent of the people receiving nutritional counseling.
In another study, Schauss again had probationers receive
nutritional counseling. This time, he compared the probationers'
arrest records before, during and after the counseling. Eight
months after the counseling had ended, not one of the proba-
tioners had been rearrested while, statistically speaking, all of
them should have been rearrested based on their previous arrest
records.
Nutritional counseling works beyond a shadow of a doubt.
Schauss explains why: "Most people, criminals included, are
extremely naive about diet and how it affects their body and
CRIME-BUSTER VITAMINS 451
mind," he says. "Simply educating a criminal about nutrition,

showing him that bad dietary habits ruin mental and physical
health and keep him behind bars, helps him give up those hab-
its." And of all bad habits, too much sugar may be the worst.
Most repeat offenders eat a glut of candy, soda and other
goodies that add up to from 300 to 600 pounds a year, about two
to four times more sweets than the average American eats. It's
a crime they don't get away with. Eating that much sugar can
cause a disorder in blood sugar metabolism called hypoglycemia,
and studies show that almost 90 percent of all inmates have it.
Many of the symptoms of hypoglycemia are psychological: ir-
ritability, paranoia, sudden violent behavior
cT/m/V?^/ behavior.
Educate a convict about sugar (and caffeine and alcohol, which
can also cause hypoglycemia), help him cut it out of his diet and
you can end up with John Doe instead of John Dillinger II. And
most convicts, says Schauss, want that help.
"The one common denominator of inmates is to get out of
jail. People don't like to be behind bars. About 70 percent of the
convicts who receive nutritional counseling change their diet for

the better and keep it changed."
And that change may include eliminating all the foods to
which a convict is allergic.
Food allergy. It works just like hay fever except, for pollen,
substitute eggs, chocolate, corn, citrus fruits, milk or wheat. (A
person may become allergic to the foods he eats most often, and
these foods, being so common, account for most food allergies.)
But while hay fever and similar allergies attack the nose, a food
allergy
may attack the brain and can make a good boy go bad.
"Aberrant social behavior can be directly caused by a food
allergy," explains Ray Wunderlich, Jr., M.D., a St. Petersburg,
Florida, physician and author of several publications on allergies.
"The brain is a target organ for food allergy," he told us.
"Immediately after eating the offending food, a person's behav-
ior changes for the worse. His brain can fog over, leaving him
apathetic and sluggish, or he can go wildly hyperactive. In either
case, he lacks good judgment. He doesn't see whole situations
and reacts to fragments and details.
"If he becomes apathetic, he needs a severe and heightened

thrill to interest him in lifebeing chased by police, being wanted
by the law, being in danger. If he becomes hyperactive, he works
on a different time clock than the rest of society, demanding
things now and using violence to satisfy his urgent needs."
Dr. Wunderlich points out that not only can food trigger
violence, but so can chemicals to which a person is allergic.
Schauss "chemical warfare."
illustrates the point with a story of
"A boy at school suddenly became ruthless and violent,
beating up other kids and breaking furniture. Our staff investi-
gated and found that he was allergic to fumes from the school's
floor wax.
"How many convicts mired in the criminal justice system
started going downhill after a few incidents like this? If some-
one's actions are socially unacceptable, people start to think of
him as a misfit. If he repeats those actions often enough, he is
labeled a misfit. Inevitably, he begins to think of himself as a

misfit and to act like one."
To break this cycle, which Schauss has named hiocrimi-
nogenesis, a criminal must avoid the substances to which he is
allergic and improve his diet. He also needs psychological coun-
seling to restore his self-esteem. But before counseling, he needs
nutritional supplements.
"Many delinquents and criminals do not have sufficient bio-
chemical reserves to make positive mental changes," says Dan
MacDougal, a lawyer from Atlanta, Georgia.
MacDougal is a consultant to the Judicial Service Agency
in Dougherty County, an organization which works with juvenile
delinquents. The agency, he says, "teaches them the proper use
of will and new behavior patterns that are not based on fear or
hostility, but are based on love."
Before psychological treatment starts, however, every de-
linquent undergoes biochemical testing and is then given nutri-
tional supplements to correct any chemical imbalance. (The agency
must be doing something right. Dougherty County has the lowest
juvenile crime rate in the nation.)
CRIME-BUSTER VITAMINS 453
"Vitamin 65 lowers impulsivity and violent behavior,"

MacDougal told us. "Vitamins A, C and E aid in detoxifying a
person whose violent behavior is being caused by heavy-metal
poisoning."
Heavy metals lead, cadmium, mercury, arsenic, to name
a few.They pollute air, water and food. Most people aren't too
bothered by the heavy metals in their bodies. Some are.
"I see lead poisoning contributing to an awful lot of criminal
behavior," says Barbara Reed, former chief probation officer of
the Municipal Court in Cuyahoga Falls, Ohio.
Mrs. Reed treated most of her probationers with diet, sug-
gesting a steady fare of natural, unprocessed foods and the com-
plete elimination of refined carbohydrates and caffeine. Of the
600 people who followed that diet, 89 percent never committed
another crime. "But some need more help than a better diet,"
Mrs. Reed told us. "They need a vitamin-and-mineral regimen
to cleanse their body of heavy metals.
"One man was me after he had committed two
referred to
felonies: trafficking in drugsand carrying loaded firearms. He
was diagnosed as having lead and aluminum poisoning. After
three months of special treatment and a good nutritional diet, he
was eager to return to regular work."
Schauss also relates a case of a man with heavy-metal
poisoning:
"A man was being held in the county jail who had been
arrested for assaulting a policeman. During his arraignment, his
behavior disrupted the court proceeding. Two psychiatrists and
a mental health specialist interviewed him. One psychiatrist di-
agnosed him 'acutely schizophrenic' The other two experts agreed
he was a full-blown 'paranoid schizophrenic' All three predicted
that by the age of 30 he would become a vegetable.
"Well, our staff looked at him and noticed symptoms of lead
poisoning. Tests were conducted and showed that he was suf-
fering from toxic levels of arsenic, lead, mercury and cadmium
in his system. Through vitamin and mineral supplementation,
chelation therapy and counseling, he improved rapidly."

However, Schauss, Reed, MacDougal and many other

professionals agree that nutrition is only one facet of biochemical
treatment. Exercise, too, is very important, as are proper light-

ing, fresh air and sufficient sleep. 'These are terrific tools," says
Mrs. Reed. "By improving a criminal's health, we help him to
perform better in the other rehabilitative services."
Good health. For thousands of criminals, it's the best ac-

complice for a permanent jailbreak and a break with the past.
DEPRESSION
CHAPTER
NUTRITION:
THE SILVER LINING
Mary sits slumped in a chair, her mascara smeared by an

hour of crying, her thoughts black as the circles under her
eyes ....
"Why did I bother putting on makeup this morning? Tm
ugly and that's that. John must hate me. And what's the use of
looking good, anyway? Life is so empty, so useless. If only I
could run away."
But for Mary, and 50 million other Americans, there's no

running away from depression. Serious depression. Not just a
day of the blues, but weeks, perhaps months, of symptoms like
these: You hate yourself and everyone else. You speak hesitantly
in a dull monotone. You can't concentrate or make decisions.
Sex is a chore. Headaches are frequent. Sleep is restless, and
during the day you move like a sloth. You feel frustrated, trapped,
hopeless. And when you think of suicide (which is often), it's
with relief.
Who gets depressed? Anyone can. But almost twice as many
women as men women. Women who've
do. Pregnant just had
babies. Postmenopausal women. Women on the Pill.
455
But often the cause of their depression isn't psychological;

it's physical a nutritional deficiency.
In the week after they had given birth, 18 women were tested
for severity of depression and blood levels of tryptophan, an
essential amino acid. Doctors found that those with the most
severe depression had the lowest levels of tryptophan (British
Medical Journal).
A study of 15 depressed pregnant women showed that those
with the deepest depression had the lowest blood levels of vi-
tamin Bt (Acta Obstetricia et Gynecologica Scandinavica).
Researchers discovered that postmenopausal women with
depression have a disturbance in their tryptophan metabolism
very similar to that found in patients hospitalized for depression
(British Medical Journal).
Numerous studies show that women on the Pill who become
depressed have low levels of vitamin B(, (Lancet).
And a study shows that in the days before menstruation, a
time of depression for many women, tryptophan metabolism is
disturbed (American Journal of Psychiatry).
A Crucial Chain Reaction

Why tryptophan? Why Bfi?
Because of serotonin.
Serotonin is a neurotransmitter, one of the chemicals in your
brain that helps control moods. Some scientists theorize that low
levels of serotonin cause depression. But to have enough sero-
tonin, you need enough tryptophan, which is essential in its
formation. And to have enough tryptophan, you need enough
Bfi, without which tryptophan can't be formed. B^, tryptophan,
serotonin: The chemical chain reaction that forms this neuro-

transmitter is more complex, but these links are crucial.
Estrogen can break them.
Estrogen, a female hormone, can block the activity of Bf,,
forcing it out of the body. And estrogen can speed up the me-
tabolism of tryptophan, making less of it available to form se-
NUTRITION: THE SILVER LINING 457
rotonin. That doesn't happen every day. But if estrogen levels

are high if you're pregnant, taking the Pill or about to have
your period then you can have a shortage of tryptophan or Bfi.
And a long face.

The solution? Replace the nutrients.
When 250 "depression-prone" women received oral con-
traceptives supplemented with B^,, 90 percent remained free of
severe depression (Ob. Gyn. News).
In another study, doctors measured the blood levels of B^,
in 39 depressed women on the Pill and found that 19 had a severe
deficiency. When they gave these women B^,, 16 improved in
mood (Lancet).
And those women probably got more than just an increase
in their B6 levels. Many women on the Pill suffer from a blood
sugar disorder. When they take B^, however, that disorder im-
proves (Contraception).
Not everyone suffering from depression is a woman, of course.
But studies show that tryptophan and Bfi may help anyone who's
depressed.
Doctors measured the severity of depression in patients hos-
pitalized for the problem and then gave them tryptophan and B(,
for one month. After the month, they again measured their
depression. It had decreased by 82 percent (British Medical
Journal).
Niacin Helps, Too

In another study lasting one month, doctors gave tryptophan
and niacin to II depressed patients. (Ten of the patients were
women, and their average age was 52. More than likely, they
were in the throes of postmenopausal depression.) Why niacin?
The doctors knew that, in some studies, depressed people took
tryptophan but didn't get any better. They theorized that the
tryptophan hadn't been metabolized properly and that niacin
would correct this problem. They were right. After a month on
tryptophan and niacin, the patients' blood levels of tryptophan
rose almost 300 percent and their depression fell 38 percent

{Lancet).
Research also shows tryptophan's superiority over a drug.
For three weeks, doctors gave one group of depressed patients
tryptophan and a second group the drug imipramine, an anti-
depressant. Both groups did equally well, having "significant
improvements." But the patients on the tryptophan, say the
doctors, had fewer side effects (Lancet).
Researchers have also found they could give too much tryp-
tophan. Depressed patients who received 6 grams of tryptophan
and 1,500 milligrams of niacin (as nicotinamide) a day didn't
improve, but those who received 4 grams of tryptophan and 1
gram of niacin did. The researchers theorize that there is an

optimal range for blood levels of tryptophan in depressed pa-
tients, and that giving too much or too little of the nutrient is
useless {British Medical Journal).

So if something is eating you and taking a big bite per-
haps you should try increasing your intake of the nutrients we've
discussed. Good nutrition and bad moods don't mix.
FATIGUE
CHAPTER
VITAMINS
FOR PEAK ENERGY
Without mentioning any names, those television commer-

cialsabout 'iron-poor" and ''tired" blood that we've been dunned
with all these years gave us the wrong impression. Not only did
they assault us nightly with something new to worry about and
promise salvation in a relatively expensive, over-the-counter
concoction, they also implanted the half-truth that our blood
needs iron, and iron alone. They neglected to tell us that the
blood also needs vitamins.
Now, no one doubts the importance of iron. It's the critical
ingredient of hemoglobin, the molecule in red blood cells that
carries oxygen from the lungs to the tissues. And no one doubts
that many people, particularly preschool children, women of
child-bearing age and the elderly, have a diet that's inadequate
in iron. But iron only one instrument in an orchestra of nu-
is
trients that helpspour forth a steady stream of new blood cells

from our bone marrow. Iron may play first violin, but the French
horns, oboes and timpanis are vitamins.
Folate, for instance. Without this B-complex vitamin, the
body cannot manufacture some of the molecular building blocks
of DNA. The DNA molecule, in turn, is the secret of cell division.
459
Less folate (folic acid) means less DNA, which means a slow-
down in the creation of new cells, including red blood cells.
(Folate deficiency also causes the production of abnormally large
red blood cells.) Like iron, folate is a nutrient many people don't
get enough of in their food. One physician called folate deficiency
"the most common vitamin deficiency in man.''
"Evidence is accumulating that folacin [folate] deficiency
may be more widespread than previously suspected." That was
the conclusion of a team of University of Florida and University
of Miami researchers who studied blood samples from 193 el-
derly, low-income volunteers in the Coconut Grove section of
Miami, Florida. Knowing that they would discover a high rate
of nutrition-related anemia (an abnormally low concentraion of
red blood cells or hemoglobin) in this group, the researchers
hoped to single out the cause of the anemia. Surprisingly, the
missing link wasn't iron. It was folate.
Based on the folate content of their red blood cells, 60 per-
cent of the volunteers fell into the category of "high risk" for
folate deficiency, and another 11 percent evidenced a "medium

risk." Fourteen percent were frankly anemic. At the same time,
"the iron status of these elderly people was normal and indicates
that the anemia was not due to a dietary iron deficiency.
"These findings . point out the fallacy of the rather wide-
. .
spread assumption that anemia always reflects dietary iron de-

ficiency," the Florida study noted. "It important to reassess
is
the true incidence of iron deficiency worldwide in view of mount-

ing evidence of the extent of folacin deficiency" {American Jour-
nal of Clinical Nutrition, November, 1979).
A glance at the diets of the elderly volunteers revealed an
absence of foods rich in folate. Only 17 percent of the group said
they ate fresh vegetables and, in spite of the abundance of fresh
oranges and grapefruit in Florida, only 30 percent reported eating
citrus fruits. Some of these people also customarily boiled their
vegetables for several hours, thereby destroying most of the
folate.
Liver, actually, is the best source of folate. It's also, con-
veniently, a prime source of other nutrients that the blood thrives
VITAMINS FOR PEAK ENERGY 461
on, such as vitamin Bi:, iron, riboflavin and vitamin A. Folate

can also be found in lentils, other beans of various kinds and
most vegetables. Whole grain bread, meat and eggs are mod-
erately good sources of folate.
The elderly, with their tea-and-toast diets, aren't the only
ones who risk folate deficiency. Teenagers, with their diet-cola-
and-taco diets, need extra folate to keep up with their accelerated
growth rate. But many of them aren't getting it.
In a study of 199 12-to- 16-year-olds in the Liberty City sec-
tion of Miami, the same group of researchers found approxi-
mately 50 percent of these low-income adolescents to be deficient
in folate and about 10 percent deficient in iron.
Again, in a paper presented to the Federation of American
Societies for Experimental Biology, the researchers stressed that
folate shouldn't be eclipsed by an overemphasis on iron. "The
incidence of folic acid [folate] deficiency during adolescence has
not been widely studied." they said. "In fact, the potential for
a folic acid deficiency is often ignored. If anemia is present, it
is generallyassumed to be due to an iron deficiency."

Researcher James Dinning, Ph.D., calls folate deficiency
among teenagers a "high-priority area" and believes that it may
affect more people than, for example, high cholesterol. "Folate
deficiency could be the major problem in this country," Dr.
Dinning said.
Of particular concern was the impact of low folate levels
on adolescent girls, especially in light of the high rate of teenage
pregnancies United States. "A long-term folic acid defi-
in the
ciency prior to pregnancy has been found to adversely affect
. . .
the outcome of pregnancy."

Depending on the severity, folate deficiency can trigger a
wide range of symptoms. Sleeplessness, irritability, forgetfulness
and depression are associated with acute deficiency. Lethargy,
weakness and loss of color are symptoms of the megaloblastic
anemia (a type characterized by oversized, incompletely formed
red blood cells) that results from folate deficiency.
Besides anemia, folate deficiency has recently been linked
to neurological problems. Researchers at the laboratory of neu-
roanatomy at McGill University in Montreal found that folate

supplementation relieved mild depression, fatigue and abnormal
intellectual or nerve function in certain people. These symptoms,
significantly, appeared even before the folate deficiency was se-
vere enough to show up on a routine blood test {Nature, March,
1979).
Serge Gauthier, M.D., one of the McGill researchers, told
us that the neurological problems stemming from lack of folate
are mild, "but since it's a common deficiency, it's worth looking
into." His research group suggested that shortages of vitamins
such as folate can influence behavior by decreasing the synthesis
of neurotransmitters, the molecules that relay brain messages.
Dr. Gauthier warned that older people are particularly vulnerable
to the neurological effects of folate deficiency.
As mentioned before, it's not one or two but a constellation
of nutrients that fuels the daily manufacture of blood cells in the
bone marrow and keeps tham alive and functioning after they
move into circulation. Here's a brief list of some other nutrients
that work with folate in the process of blood formation.
Vitamin B12: You can't talk about folate without mentioning
B12. Without B|2, the folate needed for DNA synthesis remains
trapped in a form the body can't use.
This creates some confusion in diagnosing anemia, since a
lack of either of these vitamins can cause anemia, and it's difficult
to tell which one's missing. Meat, poultry, fish and eggs all supply
B|2. Fruits, vegetables, grains and grain products do not contain
it.
Riboflavin, or vitamin B2: The complex mechanism of blood

production relies partly on this vitamin.
In a study in Germany of pregnant women, supplementation
with both iron and riboflavin was much more effective in raising
the red blood cell count than iron alone {Nutrition and Metab-
olism). Researchers in London also found that even a marginal
deficiency of riboflavin can shorten the life span of red blood
cells {Proceedings of the Nutrition Society, February 1980). Foods
rich in riboflavin are brewer's yeast, liver and beef heart, fol-
lowed by milk, cheese, eggs, leafy green vegetables and grains.
VITAMINS FOR PEAK ENERGY 463
Vitamins A and E: There's evidence that each of these vi-

tamins plays a role in moving iron from the diet to the blood. In
people deficient in vitamin A, iron supplementation did not raise
their hemoglobin levels unless accompanied by therapy with vi-
tamin A (American Journal of Clinical Nutrition). And vitamin
E, in combination with vitamin C, has been reported to enhance
the uptake of iron into the process of blood formation.
So where the state of your blood is concerned, don't take
you cues solely from ads about iron on the TV. Good nutrition
is too complex for that, and putting energy back into "tired"
blood means more than just pumping iron. It means making sure
your diet provides the whole spectrum of nutrients necessary
for healthy maintenance of the blood.
CHAPTER
ENERGY VITAMINS
TO MAKE LIFE
A BREEZE
On your way to the "speedy mart" for a quart of milk, you

drive by a tennis court. The white-toggged players are about
your age, but their faces glow with a royal flush, and their back-
hands are youthfully crisp. As you realize that you just took the
car instead of walking the mere half mile to the store, you wonder
jealously, ''Where do they get so much energy?''
Nutrients to keep your eye on are vitamin B^, pantothenate
(pantothenic acid) and vitamin C. Of course, we need all the
essential vitamins and minerals, but those three are proven fa-
tigue fighters. And they have been studied in depth.
"If a person feels fatigue, then taking certain vitamins and
minerals, over and above what we get from our ordinary diet,
should certainly decrease that fatigue."
So says John H. Richardson, M.D., a biology professor at
Old Dominion University, in Norfolk, Virginia. About three years
ago. Dr. Richardson, partly as a doctor and partly as an avid
jogger, became interested in the relationship between different
nutrients and stamina. So he set up a series of experiments to
test the effects of vitamins and minerals on the endurance of lab
animals. One of the vitamins was B^.
464
MAKE LIFE A BREEZE 465
Dr. Richardson assembled two groups of 20 rats each. He

fed all of them a normal rat chow and conditioned each of them
on an exercise wheel for 30 days. One group was supplemented
with B6 and the other wasn't. At the end of one month, he
attached the rats' calf muscles to a spring and measured how
many seconds they could maintain a contraction. In human terms,
he told us, it was like timing how long you could hold yourself
in the "up" position of a chin-up.
Be Increases Stamina
The supplemented rats were stronger. "Time to fatigue was
measured for all animals. Results indicate that contraction time
for Bft animals was significantly longer than controls. This study
suggests that vitaminBft given orally increases stamina," Dr.
Richardson reported {Journal of Sports Medicine and Physical

Fitness, June, 1981).
Dr. Richardson says he isn't sure why vitamin B^ works.
He only knows that it works consistently, and he believes it will
work for people as well as animals. "In terms of performance
or well-being," he told us, "I think we could feel better than we
do if we took this nutrient. A lot of people walk around fatigued
from lack of sleep or overwork or stress. I know I do. But with
Bf,, we might live closer to our potential. We wouldn't get tired
so quickly, we would feel better, we could function at a higher

level."
At Oregon State University, in Corvallis, James Leklem,
Ph.D., has been intensively studying the blood of 15 male high-
school cross-country runners and trained bicyclists. In all those
young men, he found that the B^, levels of their blood rose when
they worked out.
That extra B(, had to come from somewhere. Dr. Leklem
reasoned. But there was no change in diet to explain the rise,
and the body can't synthesize its own B^,. Apparently, the body
met its needs by mobilizing the vitamin from tissues in the body.
"We have seen that vitamin 85 levels in the blood go up

during exercise," Dr. Leklem told us. Unfortunately, he adds,
"our intake of Be isn't as good as it might be, and this all comes
down to eating better, really."
Meanwhile, at the University of Oregon, in Eugene, an hour
south of Corvallis, other scientists have also been investigating
the linkbetween Be and exercise. "There is always an increase
in the need for 85 during physical stress," Frantisek Bartos,
Ph.D., told us. "People in general have a greater-than-RDA
[Recommended Dietary Allowance] need for the vitamin, but in
athletes the need is even more pronounced. We know that the
amount of 85 in a normal diet is not sufficient."
Dr. Bartos says that Be supplements have increased his own
energy.
Unnecessary Fatigue
those findings are valid, then there are many elderly people
If
living in a state of unnessary fatigue. In a recent survey of men
and women between 60 and 95 in central Kentucky, "aging was
associated with a decline in . . . vitamin B(, status."
The survey showed that 56.6 percent of the patients in nurs-
ing homes and 43.5 percent of the elderly living at home were
deficient in Be. More seriously, 27.3 percent of the institution-
alized elderly were "severely deficient." Decreased digestive
ability,use of diuretic medication, social isolation, limited in-
come and lack of family support were among the reasons sug-
gested for the widespread deficiency (International Journal of
Vitamin and Nutrition Research, December, 1981).
There also seems to be a link between pantothenate and
fatigue. It's known that from pantothenate the body builds coen-
zyme A (CoA), a catalyst necessary for the conversion of food
to energy. Low levels of CoA can be dangerous. In one exper-
iment at the University of Nebraska, Hazel Fox, Ph.D., and
colleagues compared two groups of men
one group received
MAKE LIFE A BREEZE 467
the vitamin and the other was totally deprived of it. After ten
weeks, the deprived men were listless and complained of fatigue
(Journal of Nutritional Science and Vitaminology).
That was an extreme case, but Dr. Fox has found that most
Americans consume barely as much as the lower end of the
National Research Council's recommended daily intake of 4 to
7 milligrams. "The intake of pantothenic acid by Americans is
decreasing," she told us. 'Tn 1955, when I first measured the
intake of the vitamin by college women here in Lincoln, the
average was about 7 milligrams a day. We rarely get figures that
high now. The average is 4 or 5. People just don't eat three
square meals the way they used to. People aren't choosing the
right foods. There are too many processed foods.
"Fatigue has been described as a symptom of pantothenic
acid deficiency," she added, "and I would make a guarded state-
ment that the evidence shows a relationship between fatigue and
low pantothenic acid intake. It's something we need to look
into."
Although the current recommended allowance for the vi-
tamin is only 4 to 7 milligrams, it wasn't always that low. In
1963, a researcher in Hungary reported that "a healthy adult
person requires about 15 milligrams of pantothenic acid daily,"
and he went on to say that physical work, surgery, injury and
gastrointestinal infections can double the need for pantothenate.
A deficiency can be caused by liver disease, allergies and some-
times as a side effect of drugs, he noted.
To avoid a pantothenate deficiency, avoid processed foods.
Researchers at Utah State University studied a wide range of
foods and found that products made from "refined grains, fruit
products and extended meats and fish, such as frankfurters, sau-
sages, and breaded fish fillets" are low in pantothenate. Also,
pantothenate is water soluble, so part of it may be lost during
cooking.
The elderly and others who eat lightly should make sure
that they eat pantothenate-rich foods. Those foods are beef,
chicken, potatoes, oat cereals, tomato products and whole grain
products.
Vitamin C and Iron

Two other antifatigue nutrients are iron and vitamin C. Since
vitamin C helps the body absorb iron, the two naturally go together.
In a study of fatigue among female garment factory workers
in the Philippines, researchers discovered that iron and vitamin
C supplements improved the output of workers who were mod-
erately to severely anemic but didn't change the productivity of
workers who were only mildly anemic {Journal of Occupational
Medicine, October, 1981)
Also, a researcher in Switzerland has shown that an optimal
dosage of vitamin C for nonsmokers should be 100 milligrams a
day (compared to the U.S. RDA of 60 milligrams) and 140 mil-
ligrams for smokers and others under physical stress.
He noted that, when a deficient person was supplemented
for 12 weeks with vitamin C, riboflavin and Bf,, there was "a
statistically significant improvement in working capacity" {South
African Medical Journal, November, 1981).
Obviously, the nutrients mentioned here are only a few of
those linked to overall fitness and energy. Good health depends
on all of them, and the right blend might just enable you to better

enjoy whatever you want to do go swimming, play tennis, trim
the hedge or just walk to the "speedy mart."
GALLSTONES
CHAPTER
GALLSTONES AND B 6
If you've been giving cheese omelets and gravy-laden hot

roast beef sandwiches the cold shoulder, you're probably making
it a point to avoid heart disease. But did you know that not eating
fatty and cholesterol-ridden foods may be a good way to avoid

gallstones, as well?
And that in itself could be worth your trouble, for developing
gallstones could be the quickest date you'll ever make with a
surgeon.
Gallbladder surgery has become one of America's favorite
operations. No
wonder! As one of the richest countries in the
world, we boast one of the richest diets imaginable: lots of meat,
lots of butter, lots of cream. And, consequently, we've got plenty
of gallstones to show for it some 20 million sufferers can attest
to that.
Now, is hope that some of those victims can
though, there
avoid the from the dining room table to the operating table.
trip
One study from abroad suggests that, although surgery may be
the best alternative in the management of chronic gallbladder
disease, it isn't really the best answer to gallstones. Controlling
the solubility of the bile cholesterol perhaps is.
469
The gallbladder is a pouch below the liver which stores a

fat-emulsifying liquid, called bile, produced by the liver. A small
amount of cholesterol in the bile is perfectly normal. Bile acids
and lecithin help to keep it dissolved. But when there is more
cholesterol than can be handled by bile salts and lecithin, su-
persaturation occurs and gallstones form. You'll get the picture
of what's happening in your gallbladder if you toss a handful of
sugar into a cup of tea. The cholesterol, like the sugar, will not
completely dissolve and will clump together to form bigger crys-
tals, or stones. In the gallbladder, these stones may be as small
as peppercorns or as large as plums. As long as they are small

enough to pass through the bile tracts, there's no problem. But
once those nasty cholesterol stones have been fattened to the
point where they're stuck in the gallbladder, there's one very
effective
and very traumatic way to combat the stabbing pain

and burning irritation surgery.
That's because, in advanced stages of the disease, the pain-
ful symptoms are as much a result of an inflamed gallbladder as
they are of the stones themselves. There's no known way to
treat an inflamed gallbladder. Nor will a grossly inflamed organ
necessarily heal itself once the threat of stones has passed. Re-
moval of the gallbladder is the only way out.
But don't expect surgery to provide a no-catch guarantee
against future attacks. Even though the gallbladder may be ad-
equately removed, stones lingering in the bile ducts are some-
times overlooked. Complete operative cleaning of the bile tracts
helps. Nevertheless, gallstones may form again and lodge in the
ducts if the bile remains supersaturated with cholesterol.
Attempts are often made to flush the bile tracts clean using
an instrument which can help the physician peer into body cav-
ities. But this technique, too, is galled with problems. For one
thing, it is difficult to reach the portions of the bile tracts closest

to the liver. And what's worse, the stones could be dislodged
and pushed further up into the liver bile ducts. A stone blocking
the bile duct leading from the liver can cause jaundice.
Obviously, getting rid of gallstones for good isn't easy. It
would seem that the only logical solution might be altering the
GALLSTONES AND B. 471
cholesterol saturation of the bile. Limiting your intake of satu-

rated fats such as those found in meat and dairy products is the
first step toward preventing supersaturation. Researchers are
hard at work trying to uncover other ways.
How to Dissolve More Cholesterol

But, meanwhile, according to Dr. K. Holub of the Wilhel-
mina Hospital in Vienna, Austria, and associates, preventing
gallstones may be as close as your nearest grocery and health
foods stores. Based on their research, corn oil and vitamin Be
(pyridoxine) taken together may provide a better and safer so-
lution to cholesterol saturation (Acta Chirurgica Aitstriaca).
In a carefully controlled study, the bile from 22 gallbladder
patients was evaluated three days after surgery. Then the same
patients were given tablespoon of corn oil and two 25-milligram
1
tablets of vitamin B^ at seven o'clock and midnight one night

and at four o'clock the next morning. Bile samples were again
taken and analyzed to determine whether there was any change
in the cholesterol-dissolving capacity of the bile.
Indeed there was! Of course, the bile's ability to dissolve
cholesterol differs greatly from individual to individual. But ac-
cording to the Austrian research team, all patients were better
able to keep their cholesterol in solution after treatment with
corn and vitamin Bf,. In fact, depending on the patient, the
oil
sample taken after the treatment was able to dissolve

bile in the
anywhere from 43 to 86 percent more cholesterol than before
the administration of the corn oil-B^ combination.
The effectiveness of this treatment may depend on long-
term use. But never fear. There are no ill side effects associated
with either the corn oil or the vitamin in the doses used, say the
doctors.
And the treatment is easy to take. A tablespoon of corn oil
can easily be added to a salad at lunch and again at supper. It
may be a little more difficult to disguise the corn oil in your
morning meal. So swallow your tablespoon's worth and follow
itwith a glass of orange juice. Vitamin Bf, tablets can be pur-

chased in the health foods store in 25-milligram tablets. Just take
two with each meal. Keep in mind that the oil and B^ should be
taken together and that this level of supplementation should be
under the supervision of a doctor.
Now, corn oil and 65 may not dissolve preexisting gall-
stones, but they might prevent small stones from becoming large
stumbling blocks in your quest for good health. By decreasing
cholesterol saturation in the bile, these natural substances may
also shield you against the development of new stones. So if
you've already undergone gallbladder surgery or know that you
may be predisposed to developing gallstones, the above routine
seems worth a try.

GUM PROBLEMS
CHAPTER
KEEP YOUR GUMS

IN THE PINK
You don't have to watch too many television commercials

for toothpaste before your realize that teeth are the glamour items
of the mouth. Shiny, white teeth are attractive, alluring, sexy
vying with the eyes as the focal point of a winning appearance.
Those same ads never extol the virtues of healthy pink gums.
After what could be more unexciting than the soft, curving
all,
ridges which we take for granted and which, almost incidentally

it seems, happen to be attached to those shiny white teeth?
But gums are the very foundation of a healthy mouth, the

supporting structure upon which all else rests. Anything which
weakens the gums must ultimately weaken the teeth because the
latter, though they may be solid and cavity free, are actually no
stronger than the fleshy mantle (the technical term is gingiva)
that anchors them soundly to the bony sockets of the jaw itself.
Andwhile each tooth is encased in a tough outer protective
layer called the enamel, the gums lie exposed in all their supple
softness. Each day they must face tremendous wear and tear,
bathed almost constantly in bacteria, acids and the residue of
decaying food particles. In such an environment, the gum tissue's
ability to maintain, repair and defend itself is at least a minor
miracle.
473
For all these reasons, it's important that you pay more at-
tention to the health of your gums. Their appearance can tell
you much about the overall state of the rest of your body, and
trouble with the gums if left unchecked can lead to the loss
of every tooth in your mouth.
According to Thomas L. McGuire, D.D.S., author of The
Tooth Trip (Random House/Bookworks, 1973), there are several
easily recognizable features of healthy gums. They are firm, pink-
ish in color, and they fill in all the spaces between the teeth. In
addition. Dr. McGuire says, ''Healthy gums have little dot-like
indentations (stippling), especially found in the areas closest to
the teeth. Your gum, in these areas, should look like the outside
of an orange peel." There should also be an elevated roll or
collar around the gum where it meets the tooth.
Unhealthy gums, on the other hand, may look smooth and
puffy. They often bleed slightly after toothbrushing and show
signs of inflammation
called gingivitis
around the gum line.
Because the gums can mirror deficiencies throughout the
body, they have become a handy, though admittedly imprecise,
dietary reference point. People suffering from scurvy, the vita-
min C-deficiency disease, were found to have engorged, dark
red gums that bled easily. And similar, though less severe, gin-
gival inflammation has been associated with deficiencies of vi-
tamins A and D, niacin, riboflavin and bioflavonoids. At the other
extreme, excessively pale gums may be a sign of iron deficiency
anemia.
Pregnancy can affect the gums, causing swelling and bleed-
ing. And so can oral contraceptives and certain other drugs.
Heavy smokers may develop a brown discoloration of the gums
called "smokers' melanosis," which is more than just a stain
from smoking.
The Tooth Destroyer

The most serious and widespread problem affecting the gums,

however, is periodontal disease a chronic, progressive inflam-

KEEP YOUR GUMS IN THE PINK 475
mation and infection of the gum tissue and underlying alveolar

bone (jawbone). Most medical researchers believe that the dis-
ease is caused by residual food, bacteria and tartar deposits that
collect in the tiny crevices between the gums and the necks of
the teeth. As the bacterial infection spreads deeper into the per-
iodontal tissue surrounding the jaw-tooth connection, the jaw-
bone itself begins to shrink around the sockets until teeth loosen
and fall out. An estimated 75 percent of the adult U.S. population
suffers from some degree of periodontal disease, and it is the
leading tooth destroyer among the middle-aged and older.
Keeping the teeth and gums clean and free of the sticky
plaque or film that can harbor harmful bacteria is essential. Care-
ful, effective brushing (particularly at the gum line), along with
daily between-teeth cleaning using dental floss, is the backbone
of a preventive program. But sound nutritional habits can also
play a critical role.
Writing in Nutrition Today, Dominick P. DePaola, D.D.S.,
Ph.D., and Michael C. Alfano, D.M.D., Ph.D., point out that
the plaque which develops in the gum crevice "constitutes one
of the most dense concentrations of bacteria to which man is
exposed. It is, therefore, not surprising that the removal of this

bacterial mass usually prevents the development of inflammatory
periodontal disease, or arrests it once it has begun. The health
of the periodontal tissues depends upon the balance between the
virulence of the plaque and the resistance of the host."
Nutrition is one factor that can favorably influence that bal-
ance. Drs. DePaola and Alfano note that the cells lining the gum
crevice have one of the highest turnover rates in the body
completely renewing themselves every three to seven days. This
thin lining, or epithelial tissue, is in what they call "a continuous
critical period."
"Nutritional stress during this period may impair the re-
newal of the epithelium and compromise its barrier function,"
they warn. "Animal studies from our laboratories have indicated
that an acute deficiency of vitamin C almost doubles the ease
with which bacterial toxins can penetrate the tissues of the mouth.
More recently, we have noted similar effects on permeability
caused by zinc and protein deficiencies."
C Provides the "Glue"

The need for vitamin C to cope with periodontal disease
makes even more sense when we consider that the nutrient is
essential to the formation of collagen, a kind of intercellular
cement. Collagen is the glue that helps build and maintain all the
connective tissue in our bodies, including the bones and gums.
Researcher Adrian Cowan of the Royal College of Surgeons
faculty of dentistry in Ireland says that "collagen, although im-
mensely strong, is completely inert . . once it starts to break
.
down under the influence of toxins spreading from the gingival

crevice, it cannot repair itself."
To try to counteract this. Cowan gave a group of 69 patients
vitamin C supplements ranging from 1 to 3 grams (1,000 to 3,000
milligrams) daily for one to five months. The subjects' perio-
dontal membranes at the juncture between root, bone and gum
were examined by X ray both before and after the trials. After
supplementation, the periodontal pictures improved, indicating
a strengthening of the collagen material (Irish Journal of Medicine).
As a result, researcher Cowan is "guardedly optimistic''
that gum health can be improved or enhanced
even in relatively

normal, healthy subjects through high doses of vitamin C.
A classic nutrition experiment more than a quarter of a
century old demonstrated a similar link between vitamin C intake
and optimum gum health. The study, carried out by the New
Mexico Agricultural Experiment Station, involved more than 200
schoolchildren at six schools scattered through the state.
The selected pupils had varying degrees of gum sponginess,
and initial measurements showed that more than half had blood
levels of vitamin C below the danger line. Eight of the youngsters
had no detectable vitamin C at all in their blood serum!
When the children were given 100 milligrams of supple-
mental vitamin C over a period of six weeks or more, dramatic
improvements were noted. The bleeding tendency of the gums
was one of the first things to disappear. Soreness and discomfort
also disappeared very rapidly. Redness faded more gradually,
KEEP YOUR GUMS IN THE PINK 477
while over a period of weeks the gum surface became more firm
instead of spongy. Infection was also reduced.
Except in cases where severe destruction of the gums had
already occurred, the report concluded, ''there was apparently
complete reversal of all abnormal changes if vitamin C was given
in adequate quantity for a sufficient length of time."
Folate Reduces Infection Rate

Vitamin C isn't the only nutrient that has been proven ef-
fective in resisting the ravages of gum disease. Folate (folic acid),
one of the B vitamins, has also scored some impressive results.
In a study conducted by Richard I. Vogel, D.M.D., of the
New Jersey Dental School in Newark, and several others, sup-
plementary folate was given to one group of subjects for 30 days.
Another group received a placebo, or dummy pill. The gum
health of both groups was measured at the start and finish of the
study.
Both groups scored the same at the beginning, but after 30
days those in the folate group had significantly lower levels of
gingival exudate. That's the technical term for the fluid which
flows from the gum margins and is associated with infection and
inflammation. In fact, the subjects taking folate had 50 percent
less exudate flow than those in the unsupplemented group (Jour-
nal of Periodontology). And this improvement took place even
though plaque levels in the mouth stayed about the same.
Although blood tests indicated that none of the people had
been suffering from an outright folate lack at the start of the
trial, the authors state, "We can only conclude that there may
be a deficiency at the end organ level" (in other words, in the

gums).
The amounts of folate used in the study (4 milligrams daily)
were far in excess of the Recommended Dietary Allowance (RDA)
of 400 micrograms (0.4 milligrams) daily set by the federal gov-
ernment. And even that amount might be hard to obtain from
some foods, since the authors note that from 50 to 95 percent
of the folate in vegetables and other foods

is destroyed in cook-
ing, canning and other processing.

In another study, Dr. Vogel and several associates dem-
onstrated that folate also may help protect the gums of women
taking oral contraceptives. Pill users receiving 4 milligrams of
had significantly less gingival inflammation after 60
folate daily
days than others who took no extra folate (Journal of Dental
Research).
Preventing Bone Loss

It may turn out that part of vitamin C's beneficial effect may
be traced to its influence on the jawbone. Animal studies at the

Harvard school of dental medicine show that vitamin C inhibits
bone resorption, or shrinkage, by 50 percent or more. The Har-
vard researchers suggest that vitamin C "plays a heretofore un-
recognized but prominent role in the regulation of bone resorp-
tion as well as bone formation" (Journal of Dental Research).
Another factor to keep in mind: Cigarette smoking appar-
ently can intensify the periodontal disease process. Other re-
searchers at Harvard found, after studying 684 healthy men, that
smokers had greater bone loss in the jaw and a much higher
percentage of loose teeth than nonsmokers (Dental Survey).
So next time tell you that
a toothpaste commercial tries to
the key to happiness in and love is whiter teeth, remember
life
the real foundation of a healthy mouth. And take the necessary

steps including sound cleaning habits and an adequate intake
of nutrients
to keep your gums firmly in the pink.
HAIR PROBLEMS
CHAPTER
NOURISHING
(AND CHERISHING)
YOUR HAIR
Want to do something nice for your hair and scalp? Let your
organic vegetables go to your head. Literally. A glob of fresh,
raw carrots applied to your noggin gives your scalp a fresh tin-
gling feeling and your hair a nice luster, body and bounce.
So says hairdresser Monsieur Jacques, who grows vegeta-
bles in his back yard in Queens to use on the heads of his cus-
tomers after whirling in a blender (the vegetables, not the heads).
Monsieur Jacques, whose New Yorkshop carries his name,
firmly believes that the fresh vitamins and minerals in fresh veg-
etables do almost as much good externally as internally. His
convictions come not from laboratory studies on animals but
from observations on humans, he told us. One good-size cut-up
carrot goes into the blender with a little water and an herbal
shampoo. The resulting foamy puree is massaged gently into the
scalp and left on for a few minutes, then rinsed at least twice.
This is great for oily hair, says Monsieur Jacques. For dry hair,
he used a puree of avocado. And for normal hair, celery, string
beans or cucumbers. And then there's invigorating mint, which
is used to stimulate circulation. Customers like it so much that
479
they bring their own bottles to take some vegetable shampoo

home with them.
Monsieur Jacques got the idea for salads on the hair when
he observed Arab women mashing fresh olives and wild green
beans into a paste and combing it through their long, dark, beau-
tiful hair.
Perhaps the most popular of all the foods that are applied
to the hair is the egg. Whip two or three to a frothy foam and
use as a shampoo for dry hair. This is a protein-rich cleansing
shampoo that, with regular use, gives body and a lovely natural
luster to your tresses, says Madame Reti, a New York hair
specialist.
Panthenol Thickens Hair

Eggs are a rich source of panthothenate (pantothenic acid),
which might explain the effectiveness of panthenol, a form of
pantothenate, the anti-stress vitamin. Pantothenate is essential
to the body's ability to utilize protein, what hair is all
which is
about. Panthenol thickens or swells the cuticle covering on the

hair by up to 10 percent, whereas water alone under the same
conditions swells hair by less than percent. This was deter-
1
mined by examination under an electron microscope in a study

conducted by an independent laboratory for Hoffmann-La Roche,
Inc., of New Jersey (Drug and Cosmetic Industry).
The studies also demonstrate the ability of panthenol to
repair hair damage like split ends, fly-away hair and general
weakening of the hair shaft, conditions that are caused by chem-
icals, hot-air drying, vigorous brushing, combing and other en-
vironmental effects, a representative of Hoffman-La Roche told
us.
Panthenol owes its effectiveness to more than the fact that
it swells the hair. It also acts as a moisturizer, thus giving each
hair the ability to retain moisture longer. It was determined, too,
that panthenol penetrates into the hair shaft, leaving a thin elastic
NOURISHING YOUR HAIR 481
film which contributes to a thick, bouncy look. It also seems to

make hair much easier to comb and set. This may be a boon for
curly heads, for those with kinky hair and for children who hate
to have their hair combed. Panthenol may not make you a double
for Farrah Fawcett, but it can give your hair a nice luster and a
healthy, vibrant look.
So if you would rather have your eggs sunny-side up on a
plate and your vegetables and mayonnaise in your salad, you
might enjoy the effects of panthenol on your hair. It comes in
sprays, shampoos and conditioners. Scientists have found that
it repairs damaged hair most effectively when applied as a leave-
on conditioner. Every hair specialist we interviewed for this book

stocks it.
While panthenol can do many nice things for the hair you
have, don't expect it to grow hair on a bald head.
Other Nutritional Aids

Lowserum iron may be a contributing factor to hair loss
among women, says Irwin Lubowe, M.D., a New York der-
matologist. Eat more liver or take iron tablets and folate (folic
acid), which is also very important to healthy hair.
Some women lose their hair when they go on the Pill. Hair
loss may continue for several weeks after the Pill is discontinued.
Dr. Lubowe advises discontinuing the Pill when hair loss is as-
sociated with its use.
A. L. Leiby, M.D., a dermatologist in Akron, Ohio, finds
that hair loss brought on by the Pill can sometimes be treated
effectively with vitamin B^. The hormones present in oral con-
traceptives have been associated with a deficiency of this vita-
min, which is essential to the health of hair iSkin and Alleri^y
News).
Loss of hair is also known to occur following the use of
methotrexate, an anti-cancer drug which has a damaging effect
on the metabolism of folate, a B vitamin important to the blood.
It is recommended by Dr. Lubowe as an additional supplement
which may favorably affect hair growth.

Dr. Lubowe, who believes that many factors affecting the
health of the body canaffect hair fall, gives his patients a com-
plete blood and hair analysis and then prescribes accordingly.
A high-protein diet and large amounts of all the B vitamins,
with special emphasis on inositol and folate, are important, he
told us. He also suggests a daily zinc supplement along with
other trace minerals.
HAY FEVER
CHAPTER
VITAMINS
TO NEUTRALIZE
HAY FEVER
He was recently out of college, tall and handsome. One

would have thought he spent his summers chasing girls on the
beach or tennis balls on the court. Instead, he weathered the fair
season indoors, staring through a closed window at the revelers
in the sun. He knew from experience that only the first frost
would freehim from his air-conditioned prison, for frost would

kill ragweed that caused his debilitating hay fever. Mean-
the
while, he took prescription antihistamines
eight a day, which
was the most his doctor would allow. Still he suffered.
Finally, he took the advice of friends and went to see Brian
Leibovitz, a nutritional consultant in Portland, Oregon. Leibov-
itz recommended a nutritional program that included taking 6
grams of citrus bioflavonoids every day.

A few weeks later ''during the height of the hay fever

season that year," as Leibovitz recalls the young man no longer
required drugs to control his symptoms.
'That was two summers ago, and he's still doing well. He's
probably outside right now, without an extra handkerchief or six
in his pocket."
All of the symptoms of hay fever the red, watery eyes,
constantly runny nose, perpetual sneezing, intermittent conges-
483
tion and even the asthma that characterizes the disease at its

most severe are caused by histamine. Histamine is a potent
natural compound released when the immune system responds
to an allergy-provoking substance. A relatively benign piece of
ragweed pollen (or anything else) can set off an alarm in a sen-
sitive person. Your body reacts as if you had a cold when there
are no germs present.
Happily, hay fever has something else in common with the
cold: Both respond to treatment with vitamin C. That's because
vitamin C is a natural antihistamine.
A Natural Antihistamine
department of ob-
In a series of studies, researchers at the
stetricsand gynecology at Methodist Hospital, in Brooklyn, found
that blood levels of vitamin C bore an inverse relationship to
blood levels of histamine; as one went up, the other went down,
and vice versa. ''Persons with low plasma ascorbate [vitamin C]
levels have high histamine levels," the researchers noted after
processing blood samples from 400 healthy volunteers.
Next, the researchers took 11 with low levels of vitamin C
or high levels of histamines and placed them on a program of
vitamin C supplementation.
Improvement was rapid, occurring within three days. "It
would seem that ascorbic acid [vitamin C] deficiency is one of
the most common causes for an elevated blood histamine level,
as all of the volunteers given one gram of ascorbic acid daily
1 1
for three days showed a reduction in blood histamine" {Journal

of Nutrition, April, 1980).
"The need for vitamin C seems to be greater in some allergic
patients," agrees clinical nutritionist Lynn Dart, a registered
dietitian. In her work as manager of the nutrition department at
the Environmental Healthy Center in Dallas, Ms. Dart has found
that large doses of vitamin C are sometimes quite effective.
"The average allergy sufferer with a vitamin C deficiency
usually responds to 4 to 8 grams a day when trying to either
VITAMINS FOR HAY FEVER 485
Stave off a reaction or clear up a reaction in progress," she told

us.
The responses of his own patients in Bennington, Vermont,
have convinced Stuart Freyer, M.D., of the same thing.
"The hay fever season in Vermont can be pretty severe,"
says Dr. Freyer, who has emphasized nutritional therapy for 6
of the 12 years he's been a practicing otorhinolaryngologist (ear-
nose-throat specialist). He gives his hay fever patients "rela-
tively high amounts of vitamin C. Five grams or more is typical."
But when advising his patients to take that much vitamin C, he
cautions them to increase their calcium supplementation as well.
"High levels of vitamin C may bind with calcium and pull
it out of the bones, then flush it out in the urine when thebody
discards any excess vitamin C. Vitamin C may also combine
with calcium in the diet to interfere with absorption.
"There no problem with calcium deficiency
really should be
if a person either uses vitamin C in its calcium ascorbate form
rather than its simple ascorbic acid form, or if the ascorbic acid
is supplemented with adequate amounts of bone meal or dolo-
mite. I usually recommend my patients take 400 to 600 milligrams
of calcium a day during hay fever season."
Dr. Freyer has also found that vitamin C works better when
his patients take B-complex vitamins, especially pantothenate,
along with it.
"I recommend 200 to 500 milligrams of pantothenate, plus

another 50 milligrams of B complex," he says. "Sometimes,
when a patient has impaired absorption and many people with
allergies do I also give them pancreatic enzymes. These help
to break down the foods so vitamins can be absorbed better."
Vitamin C Works Best with

Bioflavonoids
And if you really want to get the most out of your vitamin
C during hay fever season, take it with citrus bioflavonoids, as
well. Studies done on animals have shown that citrus bioflavo-

noids may favorably alter the body's metabolizing of vitamin C
by raising the concentration of the nutrient in certain tissues and
enhancing its bioavailability {American Journal of Clinical Nu-
trition, August, 1979).
In his own work, nutritionist Leibovitz has found citrus
bioflavonoids are the answer to many a hay fever victim's prayers.
"More than once, I've had a hay fever patient who did not
respond to vitamin C recover when given citrus bioflavonoids,"
he says. Early in his career as a nutritionist, Leibovitz worked
with Linus Pauling, Ph.D., on studies with vitamin C. In his own
research, done while a graduate student majoring in biology at
the University of Oregon, Leibovitz found that large doses of
vitamin C significantly reduced the mortality rate of mice with
laboratory-induced anaphylaxis, a potentially fatal allergic re-
sponse. In a paper delivered at the national meeting of the Amer-
ican Chemical Society, in Houston, in March, 1980, Leibovitz
concluded that ''these results suggest the possible use of ascorbic
acid in human immediate-type hypersensitivities (allergy, asthma,
anaphylaxis)."
Anaphylaxis isn't the only type of allergic reaction that may
be fatal; a person could die from an asthma attack, too. And,
"left untreated, hay fever can develop into asthma," according
to a spokesman at the National Institute for Allergy and Infec-
tious Diseases, in Bethesda, Maryland. "Actually, 'hay fever'
is something of a misnomer because it isn't caused by hay and
it isn't characterized by fever. Basically, when it occurs in the
nose, it's called allergic rhinitis."

Asthma, Leibovitz notes, responds even better to citrus
bioflavonoids than allergic rhinitis does. "In fact, a standard
treatment for asthma, a drug called cromolyn sodium, is nothing
more than a synthetic bioflavonoidlike molecule," he told us. "I
found cirtus bioflavonoids work just as well for people with hay-
fever-induced asthma.
Another thing that seems to help some patients is vitamin
E, and findings by a Japanese researcher concur that vitamin E
exhibits antihistamine properties.
VITAMINS FOR HAY FEVER 487
After he injected 20 volunteers with histamine, Mitsuo Ka-

mimura, of the department of dermatology at Sapporo Medical
College, noted the skin around the injection site swelled up.
However, when he gave the volunteers 300-milligram doses of
vitamin E daily for five to seven days before injecting them with
histamine, there was far less swelling than before (Journal of
Vitaminology). Finally, Leibovitz rounds out his program by
telling his patients to give up junk food and cigarettes. Dr. Freyer
does the same.
''Smoking, in particular, increases the need for vitamin C,"
says Dr. Freyer. "Smoking is an irritant; it is also an allergen.
Smoking is madness for anyone who suffers from hay fever."
But if you do smoke, Dr. Freyer cautions that hay fever
season is, ironically, not the best time to quit. "Any change in
your routine, your daily habits, is bound to cause stress and
stress will often aggravate an allergic reaction. I always advise
my patients to go easy on themselves at this time of year."
So take it easy and breathe easy. A positive outlook, sup-
plemented by vitamin C, bioflavonoids, pantothenate and vita-
min E may be just what the doctor ordered. Just because there
is pollen outside is no reason you can't be out there, too.

HEALING PROBLEMS
CHAPTER
NUTRIENTS THAT
HELP YOUR BODY
HEAL ITSELF
Imagine you were alive at the time of Homer's Greece, and

in the heat of battle you caught a bronze-tipped arrow in the
thigh. A valient friend, carrying you on his back, managed to
drag you off the battlefield and into the klisia, or medic's hut,
before you passed out. What sort of first aid could you expect
once you were there?
Well, if Homer's Iliad and Odyssey are any clues to ancient
Grecian medical practice, you'd probably get: a seat, lots of
storytelling, perhaps a cup of wine sprinkled with grated goat
cheese and barley meal, served by a beautiful woman; and
eventually your wound would be washed out with warm water.
To stanch the blood, you'd receive their most popular remedy
someone would recite a charm or sing a song over the injury.
So much Red Cross.
for the
Considering the amount of fighting the ancients did and
their crude, if poetic, ways of treating deadly wounds
it's a
wonder any of us are alive today. But (at least so far) the body's
power of self-healing is greater than man's power of self-destruc-
tion. As one modern-day researcher has put it: "If the body were
488
HELP YOUR BODY HEAL ITSELF 489
not wise, man could not survive. Every cell, tissue, organ and
system is programmed to heal. . . . The only reason we make it
is that for every injury there is a healing response."

The healing of wounds is a process so intricate and mar-
velous that muchremains a mystery today. But one thing

of it
is becoming increasingly certain: When your body is on the mend,
whether it be from major surgery or a nicked knuckle, good

nutrition can do a whole lot to help it heal than telling a story
or singing it a song.
"I do believe that everyone should know the beautiful deeds
of which his or her tissues are capable," writes Guido Majno,
M.D., describing the physiological wonders of wound healing in
his delightfulbook The Healing Hand: Man and Wound in the
Ancient Wo/7J (Harvard University Press, 1975). Those beautiful
deeds include the ability to clean up the terrible mess caused by
a wound, to fight off the invading hordes of bacteria, and to set
about building brand-new tissues and blood vessels.
Stepped-Up Demand
All this frantic activity at the site of the wound causes a
stepped-up demand for carbohydrates, fats, minerals, vitamins,
water, oxygen and absolutely essential amino acids, the fa-
mous building blocks of protein. And proteins are the bricks,
boards and shingles of which the whole repair job is built.
In fact, ''even more or less minor wounds require a good

nutritional state and normal protein metabolism for optimal wound
healing to take place," says Sheldon V. Pollack, M.D., chief of
dermatologic surgery at Duke University medical center. Besides
slowing down the reconstruction of tissues, protein deficiency
can also impair the body's ability to protect itself from infection.
Dr. Pollack observes. So when you're recovering from injury,
it's doubly important to make sure your diet includes plenty of
protein-rich foods such as fish, milk, eggs, liver and wheat germ.
Injury also steps up the body's demand for certain nutrients,

particularly vitamin C a little hero of healing power. Research-
ers have shown many times that "a deficiency of vitamin C
impairs wound healing in experimental lower animals and human
beings and ... an excess accelerates healing above the normal
level/' write W. M. Ringsdorf, Jr., D.M.D., and E. Cheraskin,
M.D., of the University of Alabama school of dentistry.
Vitamin C is a star in the cellular dramas of wound healing
because it regulates the formation of collagen. When the cat nips
your hand. Dr. Majno explains, the wound is repaired "not with
the original tissue, but with a material that is biologically simple,
cheap and handy: connective tissue ... a soft but tough kind of
tissue, specialized for mechanical functions, primarily that of
holding us together; it fills the spaces in and around all other
tissues."
Because the creation of collagen depends on vitamin C, a
deficiency can disturb the ''architecture" of that connective-
tissue repair job and delay the completion of the whole healing
project. In one study, vitamin C deficiency in human cells de-
creased collagen production by 18 percent according to one bi-
ological measurement and by 75 percent according to another
measurement {American Journal of Clinical Nutrition, March,
1981.)
In another experiment, designed by Drs. Cheraskin and
Ringsdorf, two gallant dental students with normal vitamin C
levels each allowed the dentists to remove a tiny plug of tissue
from their gums. In order to precisely measure the speed of
healing, the wound was painted with a blue dye and photo-
graphed each day until the blue dot (indicating unhealed tissue)
disappeared. After a two-week rest, the students had another
plug extracted from their gums
but this time, they also took
250 milligrams of vitamin C with each meal and at bedtime (for
a total of 1 gram daily).
A comparison of the healing sequences in both cases showed
that the vitamin C-supplemented wounds healed 40 percent faster
than those made when
the students were eating a "normal" diet.
When the experiment was repeated using a daily dosage of 2
grams of vitamin C, the wounds healed 50 percent faster (Oral

Surgery, Oral Medicine, Oral Pathology, March, 1982).
Actually, vitamin C's healing power has been recognized
for decades. In the 1940s, A. H. Hunt reported that wound dis-
ruption or breakage had been reduced by 75 percent since doctors
at St. Bartholomew's Hopital in London began routinely admin-
istering vitamin C to all patients having abdominal operations.
Over a period of 30 months. Hunt observed that "leakage from
suture lines has occurred in but one of a large number of
operations."
In a British study, vitamin C's effect on the healing of bed-
sores was studied. Twenty surgical patients suffering from bed-
sores were divided into two groups: One group was given two
500-milligram vitamin C supplements daily, the other was given
two placebos (or chemically worthless pills). After a month,
precise measurements of the wounds showed that the bedsores
in the vitamin C group had decreased in size by 84 percent; the
placebo group showed only a 42.7 percent decrease. 'Tt is well
established that in scurvy [vitamin C-deficiency disease] wound
healing delayed and that the healing process
is may fail com-
pletely," the scientists observed (Lancet).
Injury Drains Vitamin C

When you're recovering from any kind of injury, it's also
crucial to keep your diet vitamin C-rich because injury drains
your body's supply. In one study, researchers found that vitamin
C levels in the white blood cells of surgical patients had dropped
by 42 percent three days after surgery (Surgery, Gynecology and
Obstetrics). Drs. Ringsdorf and Cheraskin suggest that this and
other studies showing a drop in vitamin C levels may indicate
that "during postsurgical recovery the vitamin C in the body
migrates toward and concentrates in the healing site."
Whatever the case. Duke's Dr. Pollack told us, "If you're
recovering from injury and you're seriously ill, elderly, don't eat
properly or otherwise have low vitamin C levels, it would be

wise to take 1 or 2 grams of vitamin C a day."
Although the details of its role in wound healing aren't very
well understood, vitamin A is known to be a player in collagen
formation, closure and infection fighting. A plentiful sup-
wound
ply of vitamin A
can also help ensure that the new tissue that
forms across the wound is strong and resistant to breaking, ac-
cording to studies at the University of Illinois department of food
science.
The Illinois investigators explored the effects of beta-
carotene (a substance that the body turns into vitamin A) and
retinoic acid and retinyl acetate (two chemical forms of vitamin
A) on the healing of wounds in rats with marginal vitamin A
levels. The animals were fed a vitamin A-free diet for two weeks,
then divided into groups: One received a basal diet, which pro-
vided a known amount of vitamin A, and the other received the
basal diet plus one of the three vitamin A substances.
Five days later, when the animals were sacrificed and their
wounds examined, it was discovered that the supplemental re-
tinyl acetate and beta-carotene "resulted in increases of 35 per-
cent and 70 percent, respectively, over the wound tensil strength
[resistance to being torn open] of rats fed the basal level of
vitamin A" {Federation Proceedings, no. 3453, March 1, 1981).
Diabetics very often suffer from slowly healing wounds, a
problem that can be worsened by another problem: They're also
more apt to pick up infections. But in a study conducted by
researchers at the Albert Einstein College of Medicine, in New
York City, supplemental vitamin A was shown to increase wound
strength in diabetic animals. The researchers also believe that
vitamin A helps fight wound infections.
The researchers concluded that vitamin A works to strengthen
wounds mainly by increasing the accumulation of collagen. "We
believe that just as supplemental vitamin A improves immune
responses of traumatized animals and surgical patients, it will
be especially useful in preventing wound infection and promoting
wound healing in surgical diabetic patients," they observed (An-
ncds of Surgery, July, 1981).
Thiamine and Vitamin E: A Little

Help from Your Friends
There is also growing evidence that at least some of the B-
complex vitamins are involved in human wound healing. In one
study, experimental animals fed diets rich in thiamine (vitamin
Bi) were found to have heavier, denser granulation tissue (new
tissue formed during wound repair) than those on deficient diets.
Based on thiamine's known biological activities in the body,
the researchers concluded it probably aids healing by helping
the body step up its energy metabolism at the healing site, where
the furious breakdown and buildup of cells requires tremendous
amounts of usable fuel {Journal of Surgical Research, January,
1982).
But no survey of nutrition and wound healing would be
complete without mention of vitamin E.
Wilfrid E. Shute, M.D., a veteran vitamin E researcher,
reported that vitamin E helps accelerate wound healing, is ''the
ideal treatment for burns" because of its ability to limit cell death
to those cells that have been killed by the burning agent, and
can even reduce old scar tissue when applied directly. Keloids,
or progressively enlarging, raised scars caused by overproduc-
tion of collagen during the healing process, can be prevented by
taking vitamin E orally and also applying it directly to the fresh
wound. Dr. Shute says.
Not everyone agrees. Dr. Pollack, while observing that ''there
is some data to suggest that vitamin E can promote wound heal-
ing," told us that "the research is still kind of up in the air . . .
we just don't know the precise role, if any, that vitamin E plays
in wound healing."
But meanwhile, next time you peel your knuckle along with
the potato or catch a Grecian arrow in the thigh
you might
give nutrition a try. It could just be your body knows some things
your doctor doesn't.

HEART DISEASE
CHAPTER
PLATELETS LITTLE
LIFESAVERS THAT
CAN KILL YOU
If you've ever seen a Western movie, you know the story.

There are good guys and bad guys. The good guys the sheriff

and his men are devoted to the law. They're always ready to
go where needed, well organized and effective. They work well
together.
The bad guys are dedicated, too to mischief and mayhem.
Any time they put their heads together, you know there's going
to be trouble.
In real life, of course, things are rarely that simple. After
rounding up the villains, on occasion, the sheriff and his posse
just might spend a couple hours too many in the local saloon
and then set half the town on fire.
When you think about health and disease, it's all too easy
to look for the same pattern: the bad guys (invading bacteria,
harmful chemicals and similar sinister forces) against the good
guys (strong drugs and the body's own defenses). But here, too,
the truth appears to be that it's often the upright citizens who
turn into the lawless mob.
Normally, those tiny, blank-faced blood cells called platelets
are your body's way of keeping bloodshed to a minimum. After
494
PLATELETS AND YOUR HEART 495
any injury, they pile form a hving wall,

on top of one another to
the nucleus of a clot that brings bleeding under control. Were
platelets not on the job, any minor mishap could turn into a
major catastrophe. Properly functioning, they are lifesaving.
Functioning improperly, however, they can be life threat-
ening. Time and again, when researchers investigate trouble in
the heart and circulatory system, they find platelets in the midst
of it. Strong evidence links platelet problems with heart attack
and stroke and with blood clots that often follow surgery and
that threaten women who use birth control pills.
When agonizing migraine headaches are about to strike,
doctors have found, platelets begin acting strangely. Abnormal
platelet activity has been associated with the complications of
diabetes, too, and with the rejection of organ transplants. Ac-
cording to one theory, platelets play an important role in the

development of atherosclerosis clogging and hardening of the
arteries.
The big question, obviously, is this: How can we keep plate-
letson the job but out of trouble?
Before we can attempt an answer, we need a better under-
standing of the problem. Which means asking another question.

What are platelets supposed to do and what makes them go
wrong?
Ordinarily, platelets float peacefully and independently in
the bloodstream, right alongside the red blood cells, which carry
oxygen, and the white which defend the body against in-
cells,
vaders. A slip of the paring knife or a fall from your bike, how-
ever, lets blood out of the bloodstream
and sends platelets into
action.
Instead of flowing freely out of the wound, platelets begin
sticking to the injured blood vessel and to each other. This is
called platelet aggregation, and it way logs and
resembles the
twigs swept down a river may up at a snag.
start to pile
What happens next is very important and a bit more com-
plicated. The platelets don't just lie there like a growing pile of
logs; when they aggregate, they release a host of chemicals,
including highly active enzymes and hormonelike substances called

prostaglandins. Some of these chemicals make that loose bunch

of platelets cling together much more firmly. That jumble of logs
and twigs tightens up into a real dam. Soon other clotting ma-
terials are deposited by the blood; a safe, solid clot puts a stop
to bleeding, and all is well.
All is not well, however, when platelets get carried away in
the performance of their duties
when, without waiting for the
proper occasion, they start to clump together on their own or
congregate on the walls of veins and arteries.
Why does this happen? No one can say for sure, but a lot
of recent attention has focused on the chemistry of the process.
Some of the chemicals released by aggregating platelets, it seems,
can go either of two ways. They can be converted into substances
that promote clotting or substances that prevent it. When a plate-
let collides with the wall of an artery, for example, it releases
its chemicals and an enzyme in the artery wall turns them into
prostacyclin, which prevents platelets from clumping together

a natural protection against blood clots inside the vessels.
Normally, there's a balance between clot-promoting and
clot-preventing chemicals, scientists speculate. It's an imbalance
that causes dangerous, unnecessary clots.
The exact mechanism may be unclear, but there's nothing
indefinite about the results when platelets clump together too
easily. Often, this happens after surgery. Immobilized in bed, a
patient may develop a blood clot in a vein of his leg. This is
painful enough, but if the clot breaks off and travels up to his
heart, lung or brain, it may threaten his life.
When adhere to the artery wall, according to one

platelets
widely held theory, it sets into motion the process that causes
atherosclerosis. Less dramatic than a blood clot, but just as
dangerous.
There's a connection between sticky platelets and strokes,
according to a Kansas University medical center research team
that tested the blood of 59 stroke victims and 15 healthy controls.
They found that, in the younger group, platelets of stroke victims
had a heightened tendency to aggregate.
"This leads us to suggest that the treatment of platelet hy-

peraggregability (the increased tendency to clump together) is a
reasonable thing in the prevention of stroke," said researcher
James R. Couch, M.D.
Clumps of platelets are a prime suspect when a heart attack
takes place, too. Even if they are too small to block a vessel,
according to one theory, they can fatally disrupt the electrical
impulses that keep the heart functioning normally. The platelets
of recent heart attack victims, studies have found, do show an
increased tendency to stick together.
One recent study offers an especially ominous finding: 20
percent of people killed instantaneously in car accidents (whose
death, that is, was not caused by bad had tiny clots
health)
forming in the veins of their legs. These silent thrombi (thrombi
are blood clots; these are called silent because they give no sign
of their presence) suggest that platelet problems are far from
rare.
lot to be said for keeping platelets in
Obviously, there's a
line. But is it possible?
Doctors and scientists have long been intrigued by the ques-
tion. For years, they have used anticoagulant drugs (drugs that
keep the blood from clotting) to prevent strokes. Right now, two
major studies are investigating whether aspirin, which inhibits
platelet aggregation, can decrease the risk of heart attack and
stroke.
But there are problems. Because they are so effective in
preventing clotting, anticoagulants can cause dangerous bleed-
ing. Aspirin often causes stomach bleeding, too. And, it has been
suggested, as aspirin slows down platelet function, it also inter-
feres with other aspects of body chemistry.
A long history of experimentation, however, suggests that
it is possible to keep platelet activity under control without pow-
erful
drugs and their dangerous side effects by natural, nutri-
tional means. These can restore the chemical balance necessary
for normal platelet activity and enhance the body's own protec-
tive mechanisms.
you know your vitamins, it won't surprise you to hear

If
vitamin E mentioned in this regard, first and foremost. More

than a quarter of a century ago, Alton Ochsner, M.D., famed
surgeon and teacher at the Tulane University school of medicine,
started giving his patients large daily doses of vitamin E. The
result: Blood clots, always a danger after surgery, became rare
on his wards.
Since then, a lengthening series of experiments has been
able to zero in on vitamin E's ability to cut down on blood clots:
It works, they say, by discouraging platelets from clumping
together.
two young patients, a recent study found, a deficiency
In
of vitamin E produced an abnormal tendency toward platelet
aggregation. High doses of the vitamin brought platelet activity
back to normal. In another study, researchers gave healthy vol-
unteers daily doses of vitamin E. Here, too, the supplements
kept platelet clumping to a minimum.
How does vitamin E keep platelets in their place? The pro-
cess is not fully understood, but Manfred Steiner, M.D., a pro-
fessor of medicine at Brown University, suggests it interrupts I
the chain of clotting events at the crucial point of the release
reaction the point which the loose bunch of platelets hardens
at
into a solid mass. Vitamin E ''has a definite inhibitory action on
the platelet release reaction," says Dr. Steiner. It steps in to
prevent the formation of those potent chemicals that bond plate-
lets to each other.
Another nutrient with the ability to prevent blood clots and
protect against heart disease is vitamin C. And here, too, it seems
that at least part of its power lies in its ability to regulate the
reactions of platelets.
In England,Constance Leslie, M.D., gave gram daily of 1
vitamin C who had had operations that left them

to 30 patients
particularly vulnerable to clots. A similar group received no vi-
tamin C. Patients in the vitamin C group, she reported, suffered
only half as many incidents of deep-vein thrombosis as the un-
protected patients. And when clots did form, they were less
severe.
Powerful Protective Action

Elsewhere in her hospital, years of experience demonstrated
that "vitamin C has a powerful protective action against throm-
bosis," Dr. Leslie added. The burn unit of the hospital had, as
a routine practice, given all patients gram daily of vitamin C
1
since opening seven years earlier. "Only one death from pul-
monary embolism (blood clot in the lung) has been recorded,
and no cases of clinical deep-vein thrombosis have occurred for
at least SVi years,'' wrote Dr. Leslie (Lancet).
While Dr. Leslie could offer no explanation of vitamin C's
"powerful protective action against thrombosis," two recent ex-
periments suggest that, as with vitamin E, control of platelets is
the heart of the matter.

When a team of researchers led by Kay E. Sarji, Ph.D., and
John A. Colwell, M.D., at the Veterans Administration Hospital
at Charleston, South Carolina, tested the platelets of diabetics,
they found two things. The platelets were abnormally sensitive
to aggregating agents they clumped together too easily and
they had low levels of vitamin C. This excessive stickiness. Dr.
Sarji told us, may contribute to the development of complications
of diabetes. "When platelets are more adhesive than normal,
you may be more likely to develop thrombosis," she said, "and
many of these complications are related to thrombosis."
When Dr. Sarji and her colleagues took plasma samples from
normal subjects and added vitamin C to them, a striking change
took place: The tendency of the platelets to clump together was
much reduced.
To investigate further the effect of vitamin C on platelet
clumping, Dr. Sarji gave oral doses to eight healthy nonsmoking

men 2 grams daily for a week. Here, too, their platelets became

significantly less sticky less prone to clump together.
At the Louisiana State University school of medicine, in
New Orleans, another study had similar results. A research team
lead by Alfredo Lopez, M.D., Ph.D., added vitamin C to blood
samples and gave oral doses of vitamin C to 12 healthy students.
In both cases. Dr. Lopez reported, there was a consistent in-

crease time of platelet aggregation induced by colla-
in the lag

gen a substance that normally makes platelets clump.
"The adherence of the platelets to the collagen is impaired,"
Dr. Lopez explained to us. 'Tt takes longer for them to stick."
This could have very important implications. According to
one theory, platelets clumping on artery walls is the first step in
the formation of the dangerous blood clots that accompany ath-
erosclerosis. The deterioration of the artery wall exposes col-
lagen, which is in the connective tissue below the wall layer.
When platelets adhere to the collagen, the process that leads to
thrombosis is set in motion. Dr. Lopez's study indicates that
vitamin C inhibits platelets' adherence to collagen,
"If that theory is correct, this inhibition could be highly
significant," Dr. Lopez says.
How does vitamin C
discourage platelets from aggregating
too easily? One explanation, which Dr. Sarji cautions is ''highly
speculative," involves prostaglandins, those very potent chem-
icals that have a strong influence on platelet behavior.
"Platelets produce chemicals that can be turned into throm-
boxane, which causes aggregation, or prostacyclin, which in-
hibits aggregation. Possibly, vitamin C shifts the pathway, to
favor the production of prostacyclin," she says. In other words,
vitamin C may help your body produce its natural protective
substances.
HORMONE IMBALANCE
CHAPTER
VITAMINS
FOR A HEALTHY
HORMONAL SYSTEM
In the lakes near Mexico City lives a salamander called the
axolotl. It looks rather like an overgrown tadpole and looks that
way all its life, unless it's fed large amounts of the hormone
thyroxine. That is the hormone responsible for the natural de-

velopment of frogs from tadpoles. Thyroxine fed to the growing
axolotl triggers the same action in that animal, and it sprouts
legs. A comparable feat would be if humans could take pills to
grow wings.
All of which seems more appropriate for a third-grade sci-
ence unit than a health book unless, perhaps, you have a 13-
year-old son or daughter. The enormous physical and emotional
changes everyone experiences in the process of puberty and
maturation are little less extraordinary than sprouting wings, if
you think about it, and are entirely controlled by the secretion
of hormones in the blood by the glands of the body.
The endocrine glands manufacture hormones which are in-
volved in reproduction, in the body's physical reactions to dan-
ger, in the mechanisms that maintain a constant temperature in
the body, in the process of growth and even, some scientists
suspect, in the prevention of psychiatric disorders like depression.
501
Given such a central role, it's no surprise that a number of

vitamins, and good nutrition in general, are vital to the healthy
functioning of the endocrine glands.
Vitamins and the Adrenals

Many of the interactions between nutrients and the endo-
crine system have only recently been discovered, however, and
many are not yet fully understood. Vitamin C, for example, is
highly concentrated in the thyroid, but scientists don't know
exactly what the vitamin C doing there. It's clear, though, that
is
the vitamin is necessary for the proper functioning of the glands.

The adrenal glands, perched atop the kidneys, are involved
in the regulation of metabolism and the body's reactions to stress.
When we are subjected to stress, the stores of vitamin C in the
adrenals are depleted. When the glands are stimulated to produce
hormones for an extended period of time, the stores of vitamin
C can disappear completely, as if they had been used up. Many
of the symptoms of scurvy (the classic vitamin C-deficiency
disease), such as fatigue, weakness, impaired digestion and an
inability to tolerate stress, are strikingly similar to the symptoms
of adrenal failure. Researchers have found that a decline in the
production of certain hormones by the adrenals in old age can
be partially restored by vitamin C.
For whatever reason, vitamin C is obviously important. There
is also evidence that both vitamin A and riboflavin deficiencies
can disrupt the healthy functioning of the adrenal glands.

Vitamin A is closely associated with the health of the thy-
mus. Scientists working at the Albert Einstein College of Med-
icine inNew York found that mice under stress suffered a shrink-
ing of the thymus gland. When the mice were fed vitamin A, the
losses were not as severe, and vitamin A also sped the recovery
of thymus weight after the stress was removed. Later studies
showed that stress caused a loss of vitamin A in the thymus
(Federation Proceedings).
A HEALTHY HORMONAL SYSTEM 503
And when the stress came in the form of cancer cells in-
oculated into the mice's bodies, vitamin Acontinued to boost
the action of the thymus. Vitamin A minimized the degeneration
of the thymus, which occurred with the development of cancer
in the body, and speeded recovery of the gland when tumors
were surgically removed. As part of a strong immune system,
vitamin A seems a crucial factor in the whole anti-cancer defense
structure.
That's just another example of an obvious pattern. Whether
they act directly on a gland, boost the action of its hormones or
operate in a way that we haven't yet figured out, vitamins A and
C are indispensable to the health of the glandular system. It's
up to us to make sure we get the right nutrients in the proper
amounts to keep the system purring.
INFERTILITY
CHAPTER
VITAMINS FOR
WEAK SEED
Even men with normal amounts of sperm have their share
of duds and weakHngs. It's not uncommon for as much as 40
percent of their sperm to be slow swimmers or abnormally shaped.
So while millions of sperm may journey to the egg, only
start the
a choice few actually reach their destination, and only one wins
the prize.
Or
more and more cases none. Fertility specialists,
in
who once concentrated mainly on the woman when pregnancy
failed to occur, now are finding that male infertility is increasing
in frequency. In fact, the number of sperm that men are pro-
ducing has dropped by almost half during the last 30 years, ac-

cording to several studies from 107 million per measured unit
(a milliliter, or one-thousandth of a liter) to 62 million per unit.
Not that 62 million is bad. It'll do the job. But in this case, more
is definitely better.
Because the implications of the sperm decline can have far-
reaching effects for future generations, scientists are anxious to

get to the bottom of it.
Some researchers now think toxic chemicals should be con-

sidered as one of the culprits. They point out that, during the
504
WEAK SEED 505
same 30 years sperm counts have been declining, our use of

these substances has steadily increased, with thousands entering
the environment each year.
One researcher who
agrees with that theory is Ralph C.
Dougherty, Ph.D., professor of chemistry at Florida State Uni-
versity in Tallahassee. "We are much too casual about the chem-
icals we introduce into our environment," says Dr. Dougherty.
And he should know.
Dr. Dougherty recently completed a study which found a
correlation between lower sperm counts and the presence of
polychlorinated biphenyl (PCB) in seminal fluid. The average
sperm count of the 132 students tested was found to be 60 million
per unit, but 23 percent of the group had counts of only 20 million
per unit or less, the level often accepted as defining functional
sterility. "More important," Dr. Dougherty told us, "every sem-
inal fluid sample in the study showed amounts above background
level of environmental contaminants such as PCB, hexachloro-
benzene (a fungicide) and DDT metabolites. About 25 percent
of the reduced sperm counts correlated with the presence of
PCB," he added. "PCBs act by inhibiting cell divison through

DNA damage the material in genes. It takes eight cell divisions
to get a mature sperm.If cell division is slowed by 10 percent,
it can result in a 60 percent decrease in the number of sperm

produced."
People become contaminated with these chemicals via the
food chain, says Dr. Dougherty, where they usually accumulate
in fatty tissue, resisting breakdown because of their built-in sta-
bility. PCBs above 1 part per million (1 part PCP per million
parts something else) are in virtually every freshwater fish. And
even though they've been banned by the government, there are
still more than a billion pounds of PCB being used in industry
or being discarded into land fills where they can leach out and
contaminate the environment.
A Man's Job Can Put His

Sperm Out of Work
Donald Whorton, M.D., a specialist in occupational medi-
cine at the University of California at Berkeley, was asked to
study a group of men who worked with the pesticide dibrom-
ochloropropane (DBCP) when the male employees began to no-
tice that few of them had recently fathered children. Examination
of the semen revealed a low sperm count in 14 of the 25 men
tested. Nine of the men had no sperm at all, and 2 others had
counts below million per unit. Through questioning the men,
1
itbecame apparent that infertility was associated with the length

of time the men worked with the DBCP. "The relationship was
striking," writes Dr. Whorton. "Workers with sperm counts
below one million had been exposed at least three years. None
with sperm counts above 40 million had been exposed for more
than three months" (Lancet).
'
' DBCP was the so-called eye-opener to the problem of male
infertilitydue to occupational exposure," Dr. Whorton told us.
"It's an emerging field which will require years of research. We
do know that the damage caused by DBCP is dose dependent.
And that goes for its reversibility, as well. Where the sperm
count has been decreased, it takes three months to a year to
return to normal. But where the sperm count has been reduced
to zero, it may take up to six years to come back
if ever."
Occupational exposure to lead, kepone, microwaves, chlo-

roprene all have had documented effects on male reproduction.
Even something as seemingly innocuous as excessive heat
in the work place can have adverse effects on male fertility.
Marc S. Cohen, M.D., a urologist with the New York Fertility

Research Foundation, noticed that men who worked as short-
order cooks or pizza bakers were experiencing fertility problems.
Dr. Cohen thought that their decreased sperm counts might be
caused by the high temperatures to which they were routinely
exposed. In an effort to help these particular men raise their
sperm counts. Dr. Cohen has recommended cool baths and em-
WEAK SEED 507
ployed the use of a gadget that he refers to as "very experi-

mental." His patients wear a scrotal pouch (developed by an-
other doctor) during their hot working hours, which cools the
testicles. "It's too soon to report results," says Dr. Cohen, "but
it's worth a try."
Dr. Cohen routinely asks his patients with fertility problems

about possible occuptional hazards. Unfortunately, he's in the
minority.
According the Kenneth Bridbord, M.D., of the National
Institute forOccupational Safety and Health (NIOSH) in Rock-
ville, Maryland, "Right now the numbers of doctors who actually
ask questions are few. Even those questions that do get asked
only touch on a few areas like drugs and medications. The av-
erage physician doesn't know enough about occupational med-
icine to ask the right questions.
"But we're working hard to improve the situation," says
Dr. Bridbord. Both NIOSH and the Health Resources Admin-
istration are funding programs to train professionals in the field
of occupational health.
Sperm Enemies in Everyday Life

But there are more than environmental and occupational
hazards that threaten male fertility. Some common medications
prescribed by doctors have shown the same disastrous effects
as toxic chemicals.
Cimetidine, a drug routinely used in the management of
peptic ulcers, was administered to seven men in a study con-
ducted Univeristy of Pittsburgh school of medicine. After
at the
nine weeks of therapy (1,200 milligrams per day), there was a
43 percent average reduction in sperm count. "This study sug-
gests," write the researchers, "that caution be used in prescrib-
ing cimetidine for prolonged periods to young men who may
wish to maintain their fertility" (New England Journal of Med-
icine, May 3, 1979).
Another drug, sulphasalazine, which is used to treat ulcer-

ative coHtis, was also shown to depress fertility {Lancet, August
11, 1979).
The listkeeps growing. Add coffee, cigarettes, marijuana
and alcohol, if you're keeping count.
While a controlled study comparing the amount of alcohol
consumed to an actual decrease in sperm count has not been
done, Jeanne Manson, Ph.D., says that the evidence strongly
suggests a connection between the two.
Dr. Manson, of the Kettering Laboratory at the University
of Cincinnati, did report, however, that there are studies which
show a connection between smoking and sperm. It seems that
the percentage of abnormally shaped sperm is directly related
to the number of cigarettes smoked daily. And those smoking
for more than ten years increased their disadvantage {Work and
the Health of Women, CRC Press, 1979).
Marijuana smokers have abnormal sperm, too what's left
of them. Experiments showed that young men who smoked mar-
ijuana at least four times a week for six months had a decrease
in sperm numbers in proportion to the amount smoked, falling
to almost zero in some very heavy users {Keep Off the Grass,
Pergamon Press, 1979).
Although the effect of caffeine on human sperm has not
been studied, its effect on animals has. According to Paul S.
Weathersbee, Ph.D., of the University of Washington's Alco-
holism and Drug Abuse Institute in Seattle, both rats and roosters
showed a complete absence of sperm three weeks after being
fed caffeine.
That could be of some consequence to the man who normally
consumes greater than 600 milligrams per day of caffeinated

beverages, says Dr. Weathersbee about six to eight cups of
coffee a day.
Are we about to pollute ourselves out of existence? No, not
in the immediate future. But the warning signs are there, and
they shouldn't be ignored. Neither should the steps you can take
to help yourself. Start by eliminating nicotine, caffeine and al-
cohol from your life. Already your sperm are breathing a sigh
WEAK SEED 509
of relief. Now give them something to cheer about. Fortity your-

self with nutrients like vitamins A and C as well as zinc, calcium,
magnesium and manganese.
Inone study, male rats were fed a diet low in vitamin A
from three weeks to about four months of age. The vitamin A
deficiency they developed caused degeneration and loss of sperm
cells. The dependency of cells on vitamin A was supported by
the appearance of new sperm within six weeks following vitamin
A treatment {Biology of Reproduction, November, 1979).
In another study, Earl B. Dawson, Ph.D., of the University
of Texas medical branch in Galveston, measured the effects of
a vitamin C preparation (which also contained calcium, mag-
nesium and manganese) on 20 men with spermagglutination, a
condition in which sperm stick together in clumps and are unable
to swim normally. Seven men were used as controls and received
no vitamin C. All 27 men (ages 25 to 38) had been diagnosed as
infertile; they had decreased motility (the ability of sperm to
move in a forward direction) and relatively low sperm counts,
the associated factors which make the clumping problem such
bad news.
After 60 days, all 20 men taking the vitamin C preparation
(1 gram per day) had impregnated their wives, while none of the
men in the control group had. And not only had the vitamin C
preparation reversed the spermagglutination, but ithad also raised
sperm counts by 54 percent {Fertility and Sterility, October,
1979).
"These results,'' says Dr. Dawson, "suggest the possibility
of a cooperative action between the metabolism of vitamin C
and the essential metals studied which are vital in sperm
physiology."
Spermagglutination has, by some estimates, been implicated
as a cause of male infertility in as many as 10 percent of all cases.
Which means that over 150,000 men in the U.S. population could
have a spermagglutination problem affecting their ability to father
children.
"Perhaps," speculates Dr. Dawson, "supplements of vi-
tamin C, calcium, magnesium or manganese can reverse sper-
magglutination routinely, eliminating the need to use a donor to

impregnate the wife."
So while you're waiting for the government to clean up the
environment and train professionals in the field of occupational
health, concentrate on the things you can do for yourself.
Avoid toxins that you can, be on the alert for possible pol-
lutants in your work place, and be sure to give yourself the
advantages of vitamins and minerals. Good nutrition can make
a difference when you're trying to be reproductive or just
productive.
KIDNEY STONES
CHAPTER
PREVENTING
KIDNEY STONES
THE NATURAL WAY
Have you ever been stoned?

Kidney-stoned, that is. If you have, then you probably re-
member the experience. Kidney stone sufferers say that no pain,
no torture, no desperation quite matches the jagged agony caused
by the presence of a small chip of stone inside a human kidney.
Indeed, those whose composure has been rocked by one of
those attacks which hospitalize more than one million Amer-
icans each year have left few stones unturned in their search
for the right diet or drug or medical device that will prevent them
from ever going through that kind of misery again.
Prevention of these stones (which have been called a "dis-
ease of affluence") is a must, because there is no easy way to
remove a stone once it forms and lodges itself in the kidney.
Open-kidney surgery is still the treatment of choice in the United
States, but people sometimes lose kidneys, or parts of kidneys,
as a result.
Difficult as they are to get out, most kidney stones get in
by a simple biochemical process that anyone can understand.
First, imagine a glass of water and a small cardboard drum of
table salt. Start pouring salt into the water and it will dissolve
511

and disappear. Pour in enough salt,however, and the water

becomes saturated it can't hold any more
salt
and you'll start
to see crystals of salt falling like snowflakes to the bottom of the
glass.
Most kidney stones start the same way. The fluids that pass
through your kidneys contain different kinds of minerals and
molecules. One of those minerals is calcium and one of those
molecules is oxalate, which combine to form calcium oxalate.
Normally, it floats invisibly in the fluid, but when there's too
much of it, or too little fluid, it starts to fall out of solution. Here
or there a calcium oxalate crystal forms and attracts another and
another until there are enough to make a nice little stone snow-
ball, with sharp edges to torment its owner while defying almost
every effort to get rid of it. This problem has stumped many
people, including the inventive Benjamin Franklin, who tried
and failed to shake loose his stone by eating blackberry jelly and
standing on his head.
Results with Magnesium

One modern strategy for preventing kidney stones is to fight
mineral with mineral. In other words, fight unwanted calcium
crystals with crystals of a similar mineral, such as magnesium.
Magnesium supplements seem to inhibit new kidney stones from
forming in people who are prone to them. And magnesium is
one of the oldest cures for kidney stones its use has been doc-
umented as far back as 1697.
More recently, the Swedes have taken an interest in mag-
nesium. In one study, Swedish researchers gave 200 milligrams
of magnesium per day (in the form of magnesium hydroxide) to
a group of 41 men and 14 women who individually had averaged
about one stone per year (0.8 to be exact) and who, as a group,
had passed a whopping 460 stones during the ten years before
the experiment.
Magnesium's effects were excellent. After two to four years
of the therapy, only 8 of the 55 patients reported new stones.
PREVENTING KIDNEY STONES 513
And as a group, their average rate of developing new stones fell

by 90 percent, to only 0.08 stones per year per person.
For comparison, the researchers kept an eye on a group of
43 stone sufferers who did not use magnesium. They averaged
a much higher formation rate. After four years, 59 percent of
those tested had developed new stones.
one theory explaining how magnesium works.
Briefly, here's
Like calcium, magnesium can bind itself to oxalate and form a
mineral compound. When calcium and magnesium are both pres-
ent in the urine, they compete with each other to link up with
oxalate, almost as if oxalate were a pretty girl they both wanted
to dance with.
The critical difference is that magnesium oxalate is less likely
to form crystals. It usually remains dissolved in the urine and

passes out of the body unstoned {Journal of the American Col-
lege of Nutrition, vol. 1, no. 2, 1982).
A Role for Vitamin Be

Another way to approach the prevention of kidney stones
is lower the amount of oxalate in the urine. You can do that
to
by avoiding foods such as spinach, rhubarb, tea, chocolate, pars-
ley and peanuts, all of which are high in oxalates. You can also
do it by using more vitamin B^,. By a complicated chain of re-
actions that still isn't entirely understood, Bf, lowers the amount
of oxalate in the urine of people who have a disposition toward
kidney stones.
Researchers in India found that a supplement of only 10
milligrams of B^ per day lowered the oxalate content of urine
"significantly" in 12 stone-prone people, all of whom had de-
veloped at least one stone per year for the past few years {In-
ternational Journal of Clinical Fharmacology, Therapy and Tox-
icology, 1982).
That was a discovery worth reporting. Why? Because the
Indian researchers got results with only 10 milligrams of Bf, per
day, while other scientists have prescribed as much as 100 to
1,000 milligrams per day. And they studied Be's effects for six

months longer than anyone else.
But more important, they found that Bft achieved better,
faster effects than thiazides. Thiazides are a family of drugs
commonly used to lower blood pressure and prevent kidney
stones. They do it by increasing the output of urine from the
body. But they also cause light-headedness, and they can elevate
the amount of sugar and uric acid in the blood, which can pro-
mote diabetes and gout, respectively. Thiazides can also reduce
the amount of potassium in the blood, which translates into mus-
cle weakness and cramps.
Do magnesium and vitamin B^, work as well at home as they
do in controlled experiments? One doctor we know says they
do. Jonathan Wright, M.D., a Kent, Washington, physician who
stresses natural remedies, says he's put 25 to 30 kidney stone
patients on the nutrients in the past eight to nine years and none
has returned with a new stone.
MENOPAUSE PROBLEMS
CHAPTER
HOW VITAMINS
HELP MENOPAUSE
Anything that can make Edith Bunker talk back to Archie

must be a very big deal, indeed. It was on the episode where
Edith goes through the ''change of Hfe" and is suddenly no longer
her normal, sweet self. Archies calls her a dingbat once too often,
and she tells him where he can stuff it. Of course, this is tele-
vision Edith's ''raging hormones" transform her into a total
monster, she's that way for 30 short minutes (counting the com-
mercials), and by the next show she's fine again.
Things are different in real life. Menopause is a complex,
three-dimensional, serious, but altogether natural change that
occurs the life of every woman. Many of the changes that
in
women experience at that time, the assumption of new roles in

the family, the changes in self-image, are also experienced by
men of the same age. Certainly more is going on than can be
conveyed in a half-hour sitcom.
And as with every big change in the body's chemistry, good
nutrition is essential for a smooth transition. What you eat can
help you deal with some of the unpleasant side effects of men-
opause and protect you against ailments that commonly afflict
women after the change is complete. As the body's chemical
balance shifts, its nutritional needs change, as well.
515

Menopause is the cessation of menstrual periods, which

occurs in most women sometime between
the ages of 45 and 53.
At that time, the body's reproductive machinery shuts down,
though the shutdown is hardly an overnight thing. Some women
may experience symptoms ten years before their periods actually
cease. In some women, their periods stop abruptly, while in
others the amount and duration of the menstrual flow tapers off
gradually. The most common pattern, however, is irregular
there will be a heavy flow one month, a scant flow the next
month, several months with no period at all, then another flow
or two before the periods stop altogether.
In much
same way, the body's production of sex hor-
the
mones slows down. The levels of estrogen, the main female
hormone, and progesterone, the female hormone that plays a
major part in menstruation, are reduced in the body. Often the
reduction comes in fits and starts. The body's hormonal state is
shifting into a new equilibrium, and sometimes the shift is jerky

and uneven. The result can be a hormonal imbalance, the "raging
hormone" syndrome that afflicted Edith Bunker.
There are estimates that 10 to 20 percent of American women
suffer no symptoms at all at menopause. For the rest, the best-
known symptom is hot flashes. Night sweats, irritability, depres-
sion, weight gain and osteoporosis (a loss of bone density) are
other problems often encountered at menopause.
Medical science has an answer for those problems, but, as
is often the case, the conventional remedy can cause more se-
rious problems than those it is meant to relieve. For about 40

years, doctors have administered estrogen to women suffering
the symptoms of menopause, including hot flashes and osteo-
porosis. Estrogen is now the fifth most prescribed drug in the
country. Its use in menopause is designed to bring relief by
dealing with the major change taking place in the body, the drop
in the levels of naturally produced estrogen.
There is controversy over whether estrogen therapy really
does everything it's claimed to do, but there is no question about
its side effects.
Estrogen therapy increases the risk of cancer of the endo-
metrium, the inner lining of the uterus. Furthermore, a study
VITAMINS HELP MENOPAUSE 517
published in the New England Journal of Medicine found higher

rates of breast cancer in women given estrogen during meno-
pause. Estrogen therapy has also been associated with an in-
creased risk of gallbladder disease and high blood pressure.

In most cases, you don't have to subject yourself to risks
like that to get relief. Take hot example. The phe-
flashes, for
nomenon is and often
essentially harmless, but uncomfortable
embarrassing. Through some mechanism that is not really under-
stood, the hormonal changes of menopause irritate the nerves
controlling the blood vessels of the face and neck. If something
sets the nerves off, the blood vessels widen and fill up with blood,
causing a hot flash.
The from 15 seconds up to a minute, characterized
flash lasts
by a deep red color and a feeling of heat, kind of like a superblush.
Some women report chills after a flash, and a few experience a
tingling sensation in their fingers and toes.
Vitamin E Helped Many

Rosetta Reitz, the author of Menopause: A Positive Ap-
proach (Penguin, 1979), talked to hundreds of women about men-
opause in the course of putting her book together. She believes
there is a simple, natural solution to hot flashes.
"Many women," she writes, "have found relief in two days
from taking 800 I.U. of vitamin E complex, also known as mixed
tocopherols. I have seen flashes disappear completely when the
vitamin E is also accompanied by 2,000 to 3,000 milligrams of
vitamin C (taken at intervals throughout the day) and with ,000 1
mg. (also at intervals) of calcium from dolomite or bone meal.

When the flashes have subsided, usually after a week, the women
reduce the vitamin E intake to 400 I.U.'"
Ms. Reitz, in talking with women in workshops on meno-
pause, found that hot flashes seemed to occur in many women
at moments of high stress. One woman had taken vitamin E to
relieve night sweats that would wake her in bed with drenched
pajamas and sheets. The E worked against her night sweats and
her hot flashes, but only up to a point.
"After three weeks without a flash." Ms. Reitz syas, "Pris-
cilla went to see her doctor and told him about the miraculous
change. He said it was nonsense. On the spot, that instant, Pris-
cilla had a huge hot flash. She tells me her present condition is
not as good as it was during the three weeks before she went to
see the doctor, but that it is a lot better than it used to be."
Anxiety, irritability and depression are other symptoms of
menopause for which the doctors have an easy fix. Tranquilizers
like Valium and Librium are prescribed to many women to help
them deal with the mood swings that often accompany meno-
pause. Those emotional problems should be dealt with. Suicide
and mental illness in general are prevalent during the menopausal
years. It's just that you don't have to become a member of the
drug culture to deal with those problems.
The B vitamins, particularly vitamin Be, have been shown
to be necessary for the healthy functioning of the central nervous
system. Studies have shown that the essential amino acid tryp-
tophan can be effective against depression. There may be a direct
link between the depression some women suffer at menopause
and a deficiency of tryptophan is in the body.
Vitamins for a Woman's Heart

The other big health threat that overtakes women at men-
opause is heart disease. A number of studies have reported an
increase in the risk of heart disease in women after menopause.
One of the most striking reports was a 1978 update of the "Fra-
mingham study." That study of residents of Framingham, Mas-
sachusetts, began in 1948, when women were enrolled, given a
thorough heart examination and invited to return every two years
for new evaluations.
By 1978, virtually all of the women in the study had ceased
menstruating, and itwas possible to look into the connections
between heart disease and menopause. The results were striking.
VITAMINS HELP MENOPAUSE 519
Not one of the 2,873 women in the study had a heart attack or
died of heart disease before menopause. After menopause, heart
disease became a common occurrence. For women age 45 to 54,
the incidence of heart disease during or after menopause was
double the rate before menopause (Annals of Internal Medicine).
There is a big jump in cholesterol in the blood at menopause,
mostly due to a rise in the low-density lipoprotein (LDL) cho-
lesterol, the kind of cholesterol particularly associated with heart
disease. Japanese scientists have also found higher levels of tri-
glycerides, another fat implicated in heart disease, in the blood
of postmenopausal women (American Journal of Epidemiology,
April, 1979).
Good you put the odds of developing heart
nutrition can help
trouble after menopause back in your favor. Vitamin C has been
used to lower high cholesterol Emil Ginter, Ph.D.,
levels. Indeed,
a noted Czech researcher, believes the recent drop in deaths
from heart disease in the United States might be due, in part, to
an increase in the consumption of vitamin C in this country.
And you should probably stick with the vitamin E you're
taking for hot flashes even after you've licked that problem.
Vitamin E apparently works against heart disease by lowering
the tendency of platelets, special particles in the blood, to clump
together. The clumping together of platelets can lead to a blood
clot in arteries feeding the heart of brain, resulting in a heart
attack or a stroke.
Good nutrition is obviously an important part of healthy
living during and after menopause. Menopause is a natural de-
velopment in the aging process, a change in women's lives that
requires some special nutritional precautions, just as other life
stages, like pregnancy, require special precautions.

It's by no means the end of the world. ''A women's life is
not 'normal' for the 30 years she ovulates and 'abnormal' before
and after," Rosetta Reitz says. Healthy living, with proper nu-
trition, goes on uninterrupted.
MENTAL RETARDATION
CHAPTER
CAN VITAMIN
SUPPLEMENTS REVERSE
MENTAL RETARDATION?
Out of sight for the slow of mind has been the standard
operating procedure of treatment in medical history. And while
admirable strides are being made to return some "slow" patients
to the mainstream of society, for many the artificial life of the
institution is all too real.
Conventional wisdom holds that there is only so much that
can be done with limited abilities, unless . . .
Unless it were somehow possible to do the unthinkable and

treat the retarded mind as an undeveloped flower in desperate
need of richer soil.
What if proper nourishment could enable it to grow and
blossom?
Farfetched?
Maybe not, according to a study conducted by Ruth F.
Harrell, Ph.D., research professor at Old Dominion University
in Norfolk, Virginia. She and her colleagues examined the in-
triguing possibility that retardation might be the result of nutri-
tional deficiencies and therefore could be "amenable to treat-
ment" with supplementary vitamins and minerals.
520
SUPPLEMENTS AND MENTAL RETARDATION 521
Their report, published in the Proceedings of the National

Academy of Sciences (January, 1981), is cautiously optimistic.
Dramatic Rise in IQ
In the introduction to her study, Dr. Harrell relates the case
of G.S., a severely retarded seven-year-old who, before being
treated, was in diapers, could not speak and had an estimated
IQ of 25 to 30.
After the boy's tissues and blood were analyzed, an appro-
supplement was devised. It took several weeks
priate nutritional
of and error to get the ingredients just right, but once Dr.
trial
Harrell had the correct dosage of vitamins and minerals, the

boy's progress was remarkable.
"In a few days, he was talking a little. In a few weeks he
was learning to read and write, and he began to act like a normal
child. When G.S. was nine years old, he read and wrote on the
elementary school level, was moderately advanced in arithmetic
and, according to his teacher, was mischievous and active. He
rode a bicycle and a skate board, played ball, played a flute, and
had an IQ of about 90," she writes.
With that heartening result in mind (and earlier successes
we'll be telling you about). Dr. Harrell enlisted the help of a
team of biochemists and psychologists and recruited a group of
16 retarded children (including four with Down's syndrome, or
"mongolism"), whose IQs ranged from 17 to 70, to participate
in an eight-month study.
For the first four months, children took a useless placebo
1 1
while five received a six-tablet-daily regimen of vitamins and

1 1
eight minerals. The supplements included the B-complex vita-

mins (including folate and pantothenate), and vitamins A, C, D
and E, along with calcium, zinc, manganese, copper, iron and
other minerals.
In determining the strength of most of the nutrients, "we
went far beyond the Recommended Dietary Allowance (RDA),"
1
Dr. Harrell told us. "It was 'mega' in size and went up and up
and up until we got a mental response."
To give you an idea of just how "mega" the dosage was,
A represents approxi-
the 15,000 international units of vitamin
mately 3'/2 times the RDA. The B-complex supplements were
over 100 times the RDA, while there was in excess of 25 times
what is thought to be the body's normal requirement of C and
E.
Most of the minerals, however, were closer to RDA levels.
Results Too Good to Believe
Following the initial segment of the study, all of the children

took the supplements for an additional four months. And when
all the data was collected and analyzed, and the progress of the
children could be examined, "The results were such that I was

afraid to believe them," Dr. Harrell admits.
"During the first four-month period the five children
. . .
who received supplements increased their average IQ by from

5.0 to 9.6 points, depending on the investigator, whereas the 1
subjects given placebos showed negligible change. The differ-

ence between these groups is statistically significant. During the
second period, the subjects who had been given placebos in the
first study received supplements; they showed an average IQ
increase of at least 10.2, a highly significant gain," she writes.

"Several children improved greatly in school achievement.
For example, J.B. (age five to six), who said only single words
such as mama or hye-hye initially, could recite, without prompt-
ing, the 'Pledge of Allegiance' after eight months of supplemen-
tation and could read the first-grade primer. Two (T.C. and R.S.)
have been transferred from programs for the mentally retarded
to regular schools and grades, on the teacher's recommendations.

"They're not blockbusters not superior, mind you but I
hope they can fend for themselves in an average sort of way,"
she notes.

From Slow to Normal

"All of our subjects who cooperated in taking the supple-
ments showed improvement, sometimes dramatic and surprising
to the teachers and other professionals who dealt with them. If
our findings are confirmed by more extensive experiments, they
bring new hope for improving the quality of life for the mentally
retarded 3.2 percent of our population."
In essence, nutritional supplements were instrumental in
reducing the mentally retarded portion of the study group by
one-quarter. Translate that into the millions of members of the
human family considered "slow" IQs below 75 and the bil-
lions of dollars going into their special, and often custodial, care,
and it's easy to see the far-reaching implications of Dr. HarrelFs
study.
Ifsupplements are the key to unlocking the retarded mind
if they enable many of those so afflicated "to make their own
way, to become hewers of wood and drawers of water," to use

Dr. Harrell's words
we're clearly onto something major.
What is perhaps startling is that "everyone posted some
kind of gain" across the entire spectrum of retardation, even
those with Down's syndrome.

This condition popularly known as mongolism because the
facial features take on a distinctly Oriental appearance is the
result of too much of a necessary thing: an extra 21st chromosome.
This trisomy 21
its official medical designation
manifests
itself in a number of unpleasant ways, the worst of them being
severe retardation.
It has been thought that very little can be done for Down's
syndrome children, and they often wind up in institutions.
Unexpectedly, the supplements helped.
Three of the four children with the condition "tended to
lose the accumulated fluid in their faces and extremities. The
large IQ gain observed (25 units) occurred in L.A. after eight
months of supplementation."
Sushma Palmer, D.Sc, Na-

a biochemist-nutritionist at the
tional Academy of Sciences Washington, D.C., and an expert
in
on Down's, calls the results "suggestive" and gives at least one
possible reason for the dramatic effects.
Early Diet Critical

"Children with Down's are characterized by a number of
nutritionally relatedproblems that may stem from a delay in
feeding skills," she says. "It's frequently difficult for them to
eat food. They may eat an insufficient variety and amount, and
the outcome can be an unbalanced diet. If the nutritional status
of the kids is inadequate, that will likely affect mental perfor-
mance. The younger the more severe the impact, be-
child, the
cause that's when developing faster."
the brain is
If nutritional deficiencies play havoc with the mental de-

velopment of these children, can supplements reverse the damage?
Dr. Harrell's work suggests that they can.
And interestingly enough, five decades earlier, she had in-
advertently done something similar to her most recent experi-
ment by "curing" a group of retarded boys.
The "poverty poor" diet of her first Southern students
prompted her to personally undertake a voluntary starvation
regimen of nothing more than white bread and water.
In short order, "I found I couldn't learn anything new."
Putting diet and dullness together, she came up with a plan
for her teenage pupils.
If she could teach them something basic, like cooking, they
might become employable, at least on a part-time basis. Her
vocational education request for food to prepare was accepted
by an incredulous school board, and before long, she was training
budding chefs. But at the same time, she was encouraging them
to eat the healthful meals they'd created.
"Remember, there was no free hot lunch back then," she
explains. But this one good meal a day was enough of a nutri-
tional boost to make an enormous difference in the boys' intel-

lectual lives.
"My made greater gains than any others in the
20 boys
school system. The following year, I lost 18 to normalcy!"
She's built on her work since then, with special emphasis
on healthier minds through healthier mothers, and more com-
plete recovery from brain surgery with nutritional supplements.
"You can'timagine what a cold shoulder I got," she relates.
The prevailing attitude toward the retarded was a strong "If
God hadn't wanted kids to be idiots. He wouldn't have made
'em that way."
Her steadfast refusal to accept that has led to her break-
through research.
The immediate question, of course is "How does it work?"
Born with Special Nutritional Needs

The road to an answer remains as trackless as Stanley's
path to Livingstone, but there an intriguing possibility that
is
retardation is, in part, a genetotrophic disease.

Roger J. Williams, Ph.D., a University of Texas at Austin
biochemist, conceived this concept more than 30 years ago when
he suggested that "biochemical individuality" could cause
problems.
"We're not born with the same genetics," he told us, "and
we don't have the same nutritional needs."
If we don't get what we require, "metabolism can't go in
the right direction, and one result could be mental retardation."

Those afflicted with a genetotrophic disease can't rely solely
on the established RDAs of the various vitamins and minerals,
either, for the very nature of this inborn error of metabolism
demands an augmented supply of one or more specific nutrients.
As an example, a metabolic disorder called homocystinuria
is known to cause retardation because of an excess of the toxic
substance homocysteine. Under normal circumstances, homo-

cysteine is degraded into a nontoxic substance when vitamin B^
is present. Because of a failure a mutation

in the genes di-
recting the entire operation, that doesn't happen.

The results are tragic and often unnecessary.
"About half the patients with this condition are helped by
large levels of Bg," explains Willian Shive, Ph.D., of the Clayton
Foundation Biochemical Institute at the University of Texas,
Austin. Providing considerably more than the RDA is essential
to ensure there'll be enough B^, floating around to keep homo-
cysteine harmless.
By contrast with that one-vitamin genetotrophic disorder,
treating the many different metabolic causes of retardation with
nutrients demands a "shotgun approach.''
"The real front in nutrition is to develop a diagnostic tool
that enables us to identify individual needs," Dr. Shive main-
tains. But he admits that, for now, researchers must simply try
a broad array of nutrients and hope for the best.
And while we've yet to learn the specifics, the nutritional
rehabilitation of the mind is an oasis in an otherwise drab landscape.
Brain's Metabolic Needs Are

Surprisingly Large
"The brain is a metabolic hot spot," notes Donald R. Davis,
Ph.D., a member of the Harrell research team from the Clayton
Foundation Biochemical Institute.
"The organ comprises only 2 to 3 percent of our body weight,
yet it accounts for 25 percent of metabolism. And if it's not
functioning smoothly, it can lead to trouble."
When you consider all that could go wrong, it's a miracle
that, for so many of us, the mind runs with the precision of a
stationmaster's fine Swiss pocket watch. But if the "timepiece"
is slow, vitamin and mineral supplements may be the answer.
There's even the downright exciting possibility that they

may prevent retardation from occurring in the first place.
"Everybody needs to care for his or her own internal en-
vironment," Dr. Williams advises. "And that's doubly true for
the internal environment of unborn children. If all mothers were
given appropriate supplements, there'd be a tremendous de-
crease in mental retardation!"

POLLUTION
CHAPTER
BREATHE EASIER
WITH VITAMINS
A AND E
Is the air we breathe getting any cleaner? Some people,

including many of the scientists whose job it is to monitor and
record the levels of various pollutants, seem to think so. In fact,
the results of a recent survey conducted by the National Wildlife
Federation indicate that air quality is one of the areas where
cleanup efforts have made progress over the last decade.
To the commuter who must drive to work each day in a
backwash of auto and bus fumes, the statistics don't mean that
much.
To the suburban family in the Los Angeles basin or any of
the scores of other urbanized areas periodically bathed in a
yellow-brown pall of smog, clean air is still a very precious

and elusive commodity.
And the same can be said for the executive forced to sit for
hours in smoke-filled conference rooms, the housewife exposed
to the powerful fumes of cleaning agents, and the factory worker
who spends 40 or more hours a week inhaling solvents.
In fact, if you're like most people, your lungs are probably
being subjected to so many daily insults that any promise of a
cleaner day coming is so far down the road it scarcely makes
528
,
BREATHE EASIER WITH VITAMINS 529
any difference. So what can you do in the meantime to protect

your health and hopefully allow your lungs' hard-working natural
defense mechanisms to rebuff environmental assaults?
One of the major threats to our respiratory health is ozone,
an oxidant pollutant that is one of the main components of every-
day smog. Evidence is mounting that daily supplements of vi-
tamin E can help safeguard the lungs against the kind of destruc-
tion that occurs at the cellular level when ozone concentrations
in the air rise too high.
Vitamin E's protective effect was clearly demonstrated in
a study carried out by researcher Mohammad G. Mustafa, Ph.D.
associate professor of public health and medicine. University of
California at Los Angeles. Laboratory rats were divided into two
groups and fed diets containing either 1 1 parts per million or 66
parts per million of vitamin E. After five weeks, the animals were
exposed to various levels of ozone pollution for a seven-day
period.
When the animals were later inspected for signs of oxidant
damage. Dr. Mustafa found that, at higher levels of pollution,
the lungs of rats receiving little vitamin E showed a greater level
of abnormal change than those of better-supplemented rats. Vi-
tamin E is believed to retard cellular damage, enhancing the
animals' ability to withstand the stress of pollutants (Nutrition
Interestingly enough, the rats on the low-vitamin E diet
were actually receiving about the same concentration of the nu-
trient found in the average American diet. Dr. Mustafa pointed
out. Yet, that wasn't enough to totally protect the animals' lungs.
"The findings may be of relevance to human population exposed
to photochemical smog," he concluded.
A researcher whose work supports these findings is Daniel
B. Menzel, Ph.D., director of the laboratory of environmental
pharmacology and toxicology at Duke University medical center.
In fact. Dr. Menzel told the Eighth Annual Vitamin Information
Bureau Seminar in Chicago that he favors daily supplementation
with approximately 200 international units of vitamin E as "a
wise precaution."
When Dr. Menzel exposed animals to doses of ozone equiv-

alent to what large human populations are exposed to, those
receiving vitamin E survived 50 percent longer than the E-
deficient group.
In another study. Dr.Menzel found that animals exposed
to lower levels ofozone tended to run out of body stores of the
vitamin within a few weeks, while those breathing clean air did
not. "We concluded that vitamin E is more rapidly used on ozone
exposure than with pure air." he noted.
As Dr. Menzel told the Chicago conference, there has never
been a large, long-term study to prove that vitamin E might
prevent emphysema and other serious respiratory ailments, but
given vitamin E's demonstrated safety, supplementation does
seem to make good sense.
Another nutrient that now appears to play a critical role in
lung health is vitamin A. In a five-year study of 8,278 men,
Norwegian researcher E. Bjelke discovered a link between high
lung cancer incidence and low dietary intake of vitamin A. And
this relationship prevailed at all levels of cigarette smoking. On
the other hand, those men whose diet included high or even
moderate amounts of vitamin A were less likely to get lung cancer
(International Journal of Cancer).
More Vitamin A in the Diet

According to Bjelke, who is associated with Norway's Can-
cer Registry in Oslo, one of the biggest factors in determining
vitamin A intake was the amount of vegetables particularly
carrots that themen consumed. (According to the U.S. De-
partment of Agriculture's Handbook No. 456, a cup of cooked
carrots supplies 16,280 international units of vitamin A more
than three times the Recommended Dietary Allowance for adults.)
Summarizing the study, Bjelke concludes, 'The findings are
in accordance with experimental results on animals and call for
further exploration of the role of nutritional factors in the de-
veloping of human lung cancer." Perhaps, Bjelke suggests, heavy
BREATHE EASIER WITH VITAMINS 531
smokers who can't quit could be given preventive doses of vi-

tamin A.
Further evidence that vitamin A is somehow involved in
protecting against lung cancer comes from Dr. Alex Sakula of
Redhill General Hospital in Surrey, England. Writing in the Brit-
ish Medical Journal, he notes that, among a group of 28 patients
suffering from bronchial cancer, levels of vitamin A in the blood
were significantly lower than in healthy persons or patients with
nonmalignant bronchial disease.
A possible indication of just how vitamin A may exert its
protective effect was provided by two researchers at the State

University of New York in Stony Brook. In Proceedings of the
American Association for Cancer Research, Bernard P. Lane,
M.D., and his research associate described laboratory experi-
ments in which 200 tracheal (windpipe) tissue samples were ex-
posed to a potent cancer-causing chemical for two to three weeks.
Cancer-associated changes were observed in many windpipe
samples immediately following exposure to the carcinogen. But
treatment with vitamin A was able to reverse those changes in
many cases.
We are trying to tame ozone, industrial chemicals and other
harmful pollutants, but the progress is slow. And new dangers
have a way of popping up as old ones are eliminated. So until
clean, fresh air once again becomes more of an everyday com-
modity than a sought-after luxury, we owe it to our lungs to give
them the protection they deserve.

CHAPTER
A AND C:
VITAMINS FOR A
TOXIFIED WORLD
No one even knew the poison was there, locked away in a

storage shed in BilHngs, Montana. But in June, 1979 it leaked
into 19 states, Canada and Japan. And wherever it turned up,
destruction followed. Haifa million contaminated chickens had
to be slaughtered. Eighteen million eggs were smashed. And
millions of dollars' worth of processed food was quarantined by
health officials until they could test it. Test it for PCB.
PCB polychlorinated biphenyl, a unique chemical formu-
lated in 1927 that resists destruction even by super-high tem-
peratures or corrosive acids. A chemical that can persist in the

environment for decades and has. It is the most widespread
chemical pollutant, found everywhere from the polar ice caps to
11,000 feet under the ocean. And it's a chemical that, even in

extremely low doses, can cause ill health severe acne, cysts,
skin discoloration, abdominal pain, nausea and loss of appetite,
impotence, bloody urine and fatigue.
Industry has manufactured over billion pounds of PCB,
1
mainly for use as a liquid lubricant in electrical capacitors and

transformers. Every year, 100 million capacitors are manufac-
tured for air conditioners, refrigerators, television sets and other
532

VITAMINS FOR A TOXIFIED WORLD 533
products, and each one contains PCB. Over 35 million trans-

formers in the United States are with PCB.
filled
One of them was in a storage shed in Billings, Montana.

was an old transformer, out of use, and when a forklift
It
it, a pipe on the bottom broke. Coolant

accidentally hit 200

PCB-loaded gallons of it leaked out and ran into a floor drain.
That drain led to the waste-water collecting system of the Pierce
Packing Company, a firm manufacturing meat meal for animal
feed. It was a cost-conscious firm which used its waste water,
gleaning it and grease.
for solids, fats
They shipped pounds of contaminated meal. Even-
2 million
tually, over ,000 companies were using or selling poisoned feed.
1
And nobody knew.

In early July, a Department of Agriculture (USDA) inspector
took a tissue sample from a laying hen in Provo, Utah. There
was no special reason to take the sample. It was just a routine
random check by the USDA, part of a program to locate chem-
icals in the food supply
not to stop them from reaching the
public. A computer had decided on the time and the place. The
sample sat for ten days in a freezer before it was even sent to
the lab.
At the lab, technicians found PCB high levels of PCB. But
that didn't mean action; it meant forms, reports, red tape. From
the time the sample was taken until the time the USDA told the
Food and Drug Administration (FDA) about the problem, six
weeks had passed.
weeks too many. From August to November, FDA per-
Six
sonnel tracked down PCB. To a mayonnaise distributor in Wash-
ington.To frozen-food lockers in Pennsylvania. To chicken soup
makers in Minnesota, but they couldn't catch up with all the
contaminated food. It is possible that as many as ,000 poisoned 1
turkeys made it to dinner tables.

We don't mean to frighten you. In fact, we have good news.
Two nutrients vitamin A and C may help protect your body
against PCB. And that's protection you need. This PCB contam-
ination wasn't an isolated incident. PCB is everywhere, and it's
here to stay.
True, the government banned the manufacturing, processing

and PCB, a ban that took effect in 1979. What else could
sale of
they do with such a dangerous chemical? One thing about the
ban, though. There have been exemptions. A lot of exemptions.
The Environmental Protection Agency has approved almost
100 percent of the requests from industry to continue using PCB.
Worse, industry still produces PCB as a by-product in the man-
ufacture of other chemicals, such as silicone. Then there are the
junked refrigerators, air conditioners and TV sets which, even
if buried in land fills, will eventually leach out PCB. (There are
290 million pounds of PCB in land fills already). Add to that the
more than 150 million pounds that now pollute the soil, air and
water, pollute it with a chemical that will take years to degrade
and disappear.
And because all of that PCB is odorless and colorless, it has
a way of sneaking up on you (and into you).
In 1976, for instance, an estimated 800,000 pounds of PCB-
contaminated trout from the Great Lakes were illegally caught
and sold to food wholesalers. The trout were served in cities
across America. (Large areas of the Great Lakes, as well as
many of the nation's rivers, are polluted with PCB, and most of
the fish caught in them are dangerous to eat.)
A few years ago, the FDA discovered lobsters from the
Atlantic Ocean with PCB levels of 10 parts per million. Doesn't
sound like much, does it? Well, the highest level permitted in
shellfish by the FDA is 2 parts per million.
Before the government ban on PCB took effect, many mu-
nicipalities and states used waste oil contaminated with PCB to
control dust on roads and highways. During 1977, 10,000 gallons
of such oil were about to be spread on Iowa's gravel roads. But,
luckily, environmental officials discovered that the oil contained
as much as 6 parts per thousand PCB enough to kill.
The PCB-tainted waste oil illegally dumped along 21 1 miles
of North Carolina road sides in 1978 didn't contain quite so much
of the chemical. But had enough to be dangerous. At first, the
it
state planned to scrape up the poisoned soil and haul it to a rural

land fill. That plan was vetoed as too costly. Instead, they plowed
the into the ground, which was sprayed with activated char-
oil
coal.The theory is that the charcoal will neutralize that PCB.

But nobody really knows.
You Contain PCB

Ever lick an envelope to seal it? The adhesive could have
contained PCB. Ever buy packaged food? Food wrapping some-
times contains PCB that migrates into the food. Coatings for
ironing-board covers can contain PCB. Certain types of carbon
paper contain PCB. Some upholstery contains PCB. You contain
PCB.
Over 90 percent of all Americans have detectable levels of
PCB stored in their fatty tissues, levels often as high as 10 parts
per million. And Lester Crawford, Ph.D., an FDA official who
helped contain the recent PCB contamination, told us that the
problem is getting worse.
"Since there is a low-level exposure to PCB all the time,
and since the chemical accumulates in the body, body levels of
PCB will go up in the future. I would project a level of 50 parts
per million in human tissue. That shouldn't cause acute illness.
But" Dr. Crawford warned, '"it may have a lot of chronic effects
on health, effects we don't even know about yet/'
Scientists, however, are beginning to discover one effect of
long-term PCB intake infertility.
one study, researchers gave rats PCB and found that the
In
animals delivered fewer young. In another study, chickens given
PCB had a decrease in egg production.
But researchers didn't have to set up their own experiments
to see PCB-caused infertility. They had a bigger laboratory al-
ready available the world.
Several species of seals are dying out in the Baltic Sea,
which is heavily polluted with PCB. A 1975 survey showed that
among one of those species, ringed seals, only 27 percent of the
females were pregnant compared to 90 percent in Baltic seal
populations during the 1960s. Testing the seals, scientists found
the PCB levels were far higher in nonpregnant than in pregnant

animals.
Sperm Counts Declining

What about people? Well, scientists at the 1979 annual meet-
ing of the American Chemical Society reported that sperm counts

among U.S. men are declining and the cause may be PCB.
Measuring both the level of sperm and the level of PCB in seminal
fluid, they found that the higher the amount of PCB, the lower
the amount of sperm.
James R. Allen, Ph.D., a researcher at the University of
Wisconsin who had conducted numerous studies on PCB, be-
lieves the chemical may affect ''reproductive capabilities" by
altering the normal functioning of hormones.
But, Dr. Allen told us, "even if chronic, low-level exposure
to PCB has no effect in the adult, it still has an effect on the
fetus and infant."
Unfortunately, Dr. Allen's statement was proven in Japan
during 1968 when a machine containing PCB sprang a leak and
contaminated rice oil. More than 1,000 people used that oil reg-
ularly for three months.

Cysts were the first symptom on the fact, on the ears, all
over the body. But cysts were the least of their problems. Those
who used large quantities of the rice oil also suffered from severe
fatigue, loss of appetite, impotence, bloody urine, numb limbs
and painful joints. And the pregnant mothers who used the rice
oil, even if they had no symptoms themselves, were slowly poi-
soning their unborn children.

Researchers later studied 13 women who used the rice oil
while pregnant. Of their 13 babies, two were stillborn. Birth
defects blighted all the the others.
A grayish,dark brown pigment colored their skin. Five also
had dark nails. Nine had heavy eye discharges. Four had facial
abnormalities such as protruding eyeballs.
After the incident, the Japanese government lowered the

tolerance level the upper limit of PCB permitted
for food.
America's tolerance levels remain much higher than Japan's.
They're lower than the 10 parts per million of a few years
ago. But you can still buy poultry with 3 parts per million and
fish with 2 parts per million. What's the reason for these high
levels?
Although the FDA admits that there is no level "of PCB
exposure that can be said to provide .safety," and that "it
. .
would be preferable not to have PCB in food at any level," it

has set the tolerance levels to maintain a "proper balance of
safety and economic criteria." In other words, better to put
American lives on the line than American industry in the red.
Vitamins A and C Protect

That leaves protecting yourself up to you. You and vitamins
A and C.
In a study of vitamin C and PCB, researchers fed young
experimental animals high doses of the chemical. The animals
grew poorly and had high levels of cholesterol. (PCB is known
to interfere with fat metabolism.) The animals also excreted in
their urine 44 times the normal amount of vitamin C, a sign, say
the researchers, that the animals' bodies were synthesizing large
quantities of the vitamin in an attempt to detoxify PCB.
Next, the researchers fed another group of experimental
animals PCB but also gave them vitamin C. These animals grew
normally and had normal cholesterol levels. They also had a
"normal outward appearance," compared with the sickly ap-
pearance of the PCB animals who didn't get vitamin C (Nutrition
In a study of vitamin A and PCB, researchers fed two groups
of rats PCB for six weeks but gave one group 3,400 international
units of vitamin A. The vitamin A group "showed better growth"
than the animals not on the vitamin (Japanese Journal of Nutrition).
538 VITAMIN THERAPY FOR DISEASE I
The researchers then fed another group of rats PCB and

measured the vitamin A content of the rats' Hvers. They found
a decrease in vitamin A ''even at low PCB levels."
Citing these and other studies, the researchers concluded
that"a large part of the symptoms" of the PCB poisoning "were
based on a vitamin A deficiency" caused by PCB (Journal of
Nutritional Science and Vitaminology).
"PCB affects steroids and steroid-like compounds, one of
which is vitamin A," Dr. Allen says. "I think there is a definite
likelihood that vitamin A could be involved in PCB intoxication.
Perhaps PCB blocks the vitamin A receptor sites in the cell.
Believe me. scientists have yet to detect all the ways in which
PCB causes ill health."

CHAPTER
CLEANSING INTERNAL
POLLUTION WITH
A VITAMIN BRUSH
Bound for New York City on the New

Jersey Turnpike,
you'll pass through the pits of pollution. But rolled-up windows
and closed-off air vents can't stop the stench of petroleum re-
fineries and chemical plants from seeping into your car. The acrid
fumes make your skin crawl from the inside out.
Within the last 35 years, we have watched hundreds of chem-
ical preservatives and pesticides sneak into our food supply.
Dangerous minerals and other toxic substances run off the man-
made wasteland into rivers, streams and springs, threatening our
precious water supply.
We've become trapped in a murky mess. But, luckily, we
don't have to surrender our health to the pollutants.
Countless studies suggest that vitamin supplementation
particularly with vitamins C and E
can protect the body against
environmental pollution.
Scientists at the State University of Londrina, in Brazil, and
at Kansas State University have tested the protective effect of
various vitamins against the powerful cancer-causing substance
aflatoxin B,.
Aflatoxin is the product of a certain mold which can grow
on peanuts, grains and other foods. It frequently shows up in
539
samples of peanut butter. That worries public health authorities,

because aflatoxins are known to cause liver cancer in man.
But in the latest study, the addition of vitamin C and the B
vitamin choline to the diet of young Japanese quail protected the
growing birds from the adverse effects of aflatoxin Bj. Birds
generally suffer stunted growth as a result of mild aflatoxin poi-
soning. After 21 days on an aflatoxin diet, the quails supple-
mented with vitamin C and choline gained significantly more
weight than those not receiving supplementation. In fact, in some
instances, they gained even more weight than those on a nontoxic
diet (Veterinary and Human Toxicology).
Whether we can translate the prevention of aflatoxin toxicity
in quails to the prevention of aflatoxin-induced cancer in humans
has yet to be determined. But we stand a pretty good chance of
doing just that.
After all, vitamin C is being lauded as a natural pollution
fighter. It seems to attack chemical pollutants in our bodies in a
way But unlike an-
similar to antibodies fighting off infections.
tibodies, vitamin C
cannot be synthesized by the human body,
though it is made by various other animal species. Rats, for
example, synthesize vitamin C at an accelerated rate when toxic
chemicals are introduced into their bodies.
Liver Disease Linked to

Vitamin C Shortage
Mounting evidence suggests that the human storehouse of
vitamin C may make a difference in our survival in a polluted
environment. One survey mentioned in the British Medical Jour-
nal links low tissue levels of vitamin C with environmentally
induced disorders of the human liver. Of 138 patients, those with
the liver disease called primary biliary cirrhosis (a rareform of
cirrhosis sometimes brought on by tranquilizers and other drugs)
had low concentrations of vitamin C in their tissue stores.
Apparently, vitamin C gives the liver a helping hand in its
job of detoxifying harmful substances. According to Aniece A.
CLEANSING INTERNAL POLLUTION 541
Yunice, Ph.D., of the medical service at the Oklahoma City

Veterans Administration Hospital, and Robert D. Lindeman,
M.D., now chief of staff, Louisville Veterans Administration
Hospital, Kentucky, vitamin C may, for example, increase the
enzymes responsible for the detoxification of alcohol.
activity of
In the Oklahoma study, published in Proceedings of the
Society for Experimental Biology and Medicine, five rats re-
ceived toxic doses of alcohol over a four-week period, while
another five received the same daily dose but were pretreated
with large doses of vitamin C. By the end of the test period, all
the rats on alcohol alone died. Four of the five on alcohol plus
vitaminC were alive!
Vitamin C also seems to exert a protective effect against
the wrath of nitrates. Most of us are already aware of the cancer-
causing potential of nitrate preservatives in meats like bacon,
bologna and ham. But even if we stop bringing home the bacon,
we've only begun to reduce our cancer risk. Nitrates have in-
filtrated our well water and streams as a result of chemical fer-
tilizers and animal wastes which have run off into our water
supplies. And they've gotten a hold on some vegetables and fish.
Try as we might, we can't avoid them. But researchers
suggest that, if we stock up on vitamin C, we may be able to
divert nitrate from forming a cancer-causing substance. Nitrates
pose a problem only when they combine in the stomach with
certain substances known as amines. And when introduced into
a simulated stomach environment with nitrates, the vitamin C
has been found to effectively compete for bonding positions.
It's no wonder, then, that large doses of vitamin C are being
used with great success in Hungary for the treatment of met-

hemoglobinemia. That disease, in which the red blood cells (re-
sponsible for oxygen transport) lose their ability to carry oxygen,
is caused by nitrate poisoning (Archives of Environmental Health).
Fighting the Poison Metals

But what's a body to do about the various toxic heavy metals
such as cadmium, mercury and lead that are leaking into our
environment and threatening our health? Well, here again, we

can begin by looking to vitamin C, which has been shown to
counteract the toxicity of cadmium.
Unfortunately, when it comesto detoxifying mercury and
lead, vitamin C is of no use. But according to evidence cited in
Federation Proceedings, vitamin E is. This vitamin, which just
happens to be your best insurance against the ravages of air
pollution and the onslaught of X-ray irradiation, has also been
found to decrease the toxicity of methyl mercury in quail.
Since 1967, scientists have concentrated on the protective
effect of the trace element selenium against mercury poisoning.
However, according to vitamin E researchers Dr. S. O. Welsh
and Professor J. H. Soares, Jr., the protective effect of vitamin
E against mercury occurs independently of the selenium status
of their animal subjects {Nutrition Reports International).
Calcium has been known to get the lead out of our systems.
But, again, vitamin E can help. Orville A. Levander and col-
leagues at the U.S. Agricultural Research Center in Beltsville,
Maryland, explain that lead increases the brittleness of red cell
membranes so that they disintegrate easily. But with the addition
of large doses of vitamin E to the diet of rats receiving lead, the
red blood cells remained normally flexible {Journal of Nutrition).
In a separate study conducted by David S. Klauder and
Harold G. Petering from the department of environmental health
at the University of Cincinnati medical center, lead depressed
the hemoglobin levels in rats whose diets were deficient in iron
or copper or both {Environmental Health Perspective).
Of course, maintaining an adequate level of iron in your diet
is fairly easy with iron supplements. For copper, turn to liver
which is also a superb source of iron.

Of course, if you've been doing your homework, you're
probably already taking your share of vitamins C and E. In that
case, it's still nice to know that your efforts are paying off with
added dividends.
SCHIZOPHRENIA
CHAPTER
HEALING SICK MINDS

WITH VITAMINS
Peter: In the hospital, they serve me meat from the morgue

and poisoned food. My medicine is really LSD. If I smoke a
cigarette, a friend will die.
Martha: God told me I was going to have Christ's baby. He
told me to walk with a cane. Then He told me to swim in the
ocean; I fought with a monster for eight hours.
Mitch: They say my grandfather died two years ago, but I
know better. I talk to him every night. He comes into my room
and floats above the bed. Someone turned him into a purple ball.
Three schizophrenics. Three out of two million.
There are more people hospitalized for schizophrenia than
for any other illness, mental or physical. In schizophrenia, thought
and perception are diseased.
You hallucinate, seeing what isn't there and hearing voices
when no one speaks. In a moderate case, you know you're hal-
lucinating. But when it's worse, you can't tell the difference
between what's real and what's not. Your thoughts are bizarre
and illogical, perhaps paranoid, and you act on them. You might
think there's a plot against you. You might think you're God.
You could talk of suicide and, very possibly, commit it. Schizo-
543
phrenics have a suicide rate about 20 times higher than the rest
of the population.
A psychiatrist tries to keep a schizophrenic out of a coffin
by putting him on a couch. He wants the schizophrenic to talk
things over
and over, and over. Only in this way, he says, will
the schizophrenic recognize and root out the cause of his disease:
emotional trauma during childhood. But mommy and daddy aren't
always the villains the psychiatrist thinks. Studies show that
psychoanalysis almost never cures a schizophrenic.
Instead, some are helped by having their brains stunned by
electroshock therapy. Many others live somewhat normal lives
by taking powerful drugs. Those treatments have drawbacks, of
course. But they work because they affect a schizophrenic's
body. They work because schizophrenia is more than a mental
illness.
Helped by Niacin
The weird thoughts and strange perceptions of schizophre-
nia are often the symptoms of physical disorders. Disorders that
can be healed with nutrition. Unlike the psychiatric approach,
that's not a theory. Thousands of schizophrenics have already
been cured with a nutrient niacin.

Niacin is one of the B-complex vitamins and one of the
most important. A lack of niacin can cause severe skin rashes
and digestive problems. It can also cause madness. Soon after
processors of white flour began fortifying it with niacin, 10 per-
cent of all state hospital patients in the South were "cured."
They had been diagnosed as schizophrenics, but they actually
had pellagra, the niacin-deficiency disease. Some of the mental

symptoms of pellagra hallucinations and paranoia perfectly
mimic schizophrenia.
"If all the niacin were removed from our food, everyone
would be psychotic in one year," says Abram Hoffer, M.D., a
psychiatrist in British Columbia.
HEALING SICK MINDS WITH VITAMINS 545
Dr. Hoffer was a pioneer in the nutritional treatment of

schizophrenia. In 1952, he and a colleague gave niacin to eight
schizophrenic patients. They immediately improved. Continuing
the study, the doctors checked their patients' progress for the
next 15 years. All were well 15 years later and all were still
taking niacin {Orthomolecular Psychiatry).
Schizophrenia can last a lifetime or a few weeks. Many
patients walk out of state hospitals only to return. To see if niacin
could keep schizophrenics permanently out of hospitals. Dr. Hoffer
gave 73 hospitalized schizophrenics niacin and compared them
to 98 who were not taking niacin. During the next three years,
only 7 of the niacin patients had to be readmitted to a hospital,
while 47 of the non-niacin patients were readmitted (Lancet).
The patients Dr. Hoffer treated did not have pellagra. They
had what he calls a vitamin dependency.
A vitamin dependency. Dr. Hoffer explained to us, is the
need for a larger amount of a vitamin than most people require.
If you don't get that amount, you can suffer from a variety of
physical and mental ills. Schizophrenia is one of them.

The dependency could be inherited. Or if you were deprived
of the nutrient over a long period of time, you might need more
of it to function normally. Many of the mental patients with
pellagra, for instance, had to take 600 milligrams of niacin every
day for the rest of their lives. Most people need only 5 milligrams.
Extra Vitamin C
Niacin isn't the only nutrient involved, however. Vitamin
C is another.
When a normal person is given 5 grams of vitamin C, his
tissues are saturated he can't absorb any more. But studies
show that it grams of vitamin C to saturate
takes from 20 to 40
the tissues of a schizophrenic. They don't need that much to get
better, though. A doctor gave gram of vitamin C a day to 40
1
schizophrenics, all of whom had had the disease for years. Many
of them showed significant improvement.
Why vitamin C and niacin?

"Nobody knows for sure," Dr. Hoffer told us. "The sci-
entific community is only beginning to look at the relationship
of these substances to mental functioning. But even if the role
of nutrition in schizophrenia isn't completely understood, there's
no doubt in my mind that the disease is caused by a biochemical
imbalance in the body that can be corrected with proper nutri-
tion. I've treated 4,000 cases of schizophrenia, and I haven't
ever seen one caused by psychological factors."
Another doctor who believes that schizophrenia is caused
by a biochemical imbalance in the body is Carl Pfeiffer, M.D.,
Ph.D., director of the Brain Bio Center in Princeton, New Jersey.
Dr. Pfeiffer calls schizophrenia a "biochemical wastebas-
ket" into which, he says, have been thrown ten diseases, all of
which were once thought to be schizophrenia (because their
symptoms are identical to those of schizophrenia) but which are
now classified as separate diseases with separate causes. Among
them are brain syphilis, as well as a thyroid disorder and a type
of epilepsy.
Dr. Pfeiffer has turned that wastebasket into a filing cabinet.
He believes that he has isolated the remaining biochemical ab-
normalities that cause schizophrenia. There are five, and nutri-
tion can treat them all.
One of them is pyroluria. In this disease, a person eliminates

abnormally large amounts of the chemical kryptopyrrole. Un-
fortunately, on its way out, kryptopyrrole grabs onto zinc and
vitamin Bf,, both of which are crucial to normal brain function.

The result is very low body levels of those nutrients and schizo-
phrenia. The treatment, however, is simple: Replace Bf, and zinc.

And the cure is almost automatic 95 percent recover. Unless
they're taken off the nutrients. Then schizophrenia returns in
two days.
Thirty percent of all schizophrenics have pyroluria, says Dr.
Pfeiffer. And most of them are under 20. "Stress increases the
amount of kryptopyrrole that is excreted," he explained, "and
people from the ages 15 to 20 face the greatest level of stress."
HEALING SICK MINDS WITH VITAMINS 547
Another 60 percent of schizophrenics suffer from a hista-

mine disorder, according to Dr. Pfeiffer. Histamine, as any hay
fever victim who takes antihistamines can tell you, is involved
in allergic reactions. But that's not all it's involved in. "It would
take a half an hour to explain all of histamine's functions in the
body," says Dr. Pfeiffer. And one of those functions is as a
neurotransmitter, a chemical that relays information in the brain.
But when histamine levels rise too high or dip too low, the brain
can relay the wrong information: Your deceased uncle is standing
in the corner; there's a plot against you; you're the savior of the
world. In short, schizophrenia.
For schizophrenics with high histamine, Dr. Pfeiffer pre-
scribes calcium, which lowers histamine levels and relieves the
constant or frequent headaches that accompany the disorder.
Along with calcium, he gives the minerals zinc and manganese.
The treatment also includes the amino acid methionine. 'This
helps to lower blood histamine by a process known as methy-
lation," says Dr. Pfeiffer.
"For patients with low histamine, large doses of niacin and
vitamin C are usually effective," he explains.
Proper nutrition seems to be the best way to treat schizo-
phrenia. Yet, the American Psychiatric Association and the gov-
ernment's National Institute of Mental Health have been pow-
erful opponents of treating schizophrenia with nutrition. Why?
"Resistance is the typical medical reaction to all ideas that
strike out on new therapeutic ground," says Dr. Hoffer. "The
attack on nutritional treatment is illogical, unjustified, extreme,
emotional and not backed up by scientific evidence."
The scientific jury is still out on the megavitamin approach
to schizophrenia. At present, it appears to be a promising
alternative.
SHINGLES
CHAPTER
VITAMIN RELIEF
FOR SHINGLES
Remember when you had chicken pox as a child? You were

pretty miserable (not tomention unsightly) for about two or three
weeks. But finally the last scab fell off and you went skipping
back to school feeling incredibly happy to be rid of the disease
once and for all.
Or so you thought. Fact is, the same nasty little bug that
gave you chicken pox as a child can come back to haunt you
decades later as an aging adult, only worse. The bug is herpes,
the disease shingles.
It's true. The pox may be gone but the germs Hnger on.
After your bout with chicken pox, herpes zoster (the official
name of this virus) may take up residence in your spinal nerves,
where promptly goes into hibernation. You think it's gone
it
forever, but it can wake up at any time and start multiplying.

When that happens, the affected nerve becomes inflamed,
and pain radiates all along its path. The herpes virus then passes
down the nerve and multiplies again in the skin, causing clusters
of sores to erupt.
For four or five days before the expected rash, however,
you may feel anything from numbness and superficial tingling.
548
VITAMIN RELIEF FOR SHINGLES 549
itching or burning sensations to severe, deep pain. Discomfort

may be intermittent or constant. At its worst, the pain may even
be mistaken for appendicitis, gallbladder attack or pleurisy. As
if that's not enough, you may also run a fever for days and feel
generally out of sorts, too. All this before eruption!

When the rash does make its appearance, it starts out as
small reddened areas which quickly puff up with fluid to the size
of a quarter, or larger in some cases. The skin over the blisters
becomes increasingly rigid until, finally, by about the fifth day
after eruption, the blisters burst. During the next week or two,
crusts develop, but a total of two to four weeks may elapse before
you see the last scab fall off.
The sores are not randomly distributed on the body as with

chicken pox. The affected areas are always along the course of
one or more of the spinal nerves beneath the skin.
Most typically, the rash progresses in a band around one
side of the chest (55 percent of the cases), the neck (20 percent),
the lower back (15 percent) or the forehead and eyes (15 percent),
and all you may be feeling extreme discomfort.
the while
The distribution and appearance of the sores is so charac-
teristic of herpes zoster that no testing is necessary to confirm
diagnosis. And with a million new cases each year, it's not long
before even new doctors recognize this distinctive disease.
True, its appearance is similar to chicken pox, but shingles
is not a youngster's disease. On
it's those over age
the contrary,
50 who are most susceptible. been estimated that
In fact, it's
half the people reaching 85 years of age have suffered from at

least one attack of herpes zoster.
Shingles Often Affects

Healthy Older People
And these are not necessarily sickly folks, either. Believe
it or not, shingles often occurs in otherwise healthy older people.
Sometimes it's a physical injury which precipitates a bout with
zoster: one investigation found that 38 percent of their herpes

zoster patients had had an injury to the shingles-infected area
two weeks before the appearance of sores (British Medical
Journal).
That finding, coupled with the decreased natural immunity
that often accompanies old age, may help explain the prevalence
of shingles in older people. Of course, anything which lowers
your resistance may also trigger an outbreak of shingles. That
means you may be more susceptible in times of physical or
emotional stress or when your natural immunity has been com-
promised by another illness.
One thing's for sure, though; you can't catch shingles like
you do chicken pox. Most patients with zoster have had no recent
exposure to others infected with it or chicken pox. That's why
the incidence of zoster does not increase during seasonal chicken
pox epidemics. On the other hand, a person susceptible to chicken
pox can catch it from someone suffering from shingles.
What's more, shingles is not a once-and-done disease like
chicken pox. That means you can come down with a second or
third outbreak, and it can affect the same nerve as it did the first
time or a different one completely.
But no matter how or why the eruptions occur, each person
isaffected to a different degree. As with most diseases, some
people get off with only a mild sentence while others wonder if
they'llever be set free.
Let us reassure you right now. Complications can be severe
and quite serious, but they are rarely fatal or even permanent.
Still, you should know that herpes zoster is occasionally
associated with paralysis of the arms, legs and chest muscles.

Even when that occurs, however, adequate functioning returns
inover 75 percent of cases. Eye involvement, on the other hand,
may result in permanent visual impairment due to scarring of
the cornea. Skin, too, may be permanently scarred if the sores
are very deep.
But the most common and troublesome part of shingles is
pain which lingers long after the obvious infection has gone.
Doctors call this postherpetic neuralgia and believe it is caused
by scarring of the damaged nerves.
It doesn't everyone, fortunately, but once again, it's

afflict
the older folks who As many as 70 percent of

suffer the most.
those over 60 years of age can expect moderate to severe pain
for more than two months or, in some cases, for years.
While there doesn't appear to be any definite way to ward
off an attack of shingles (except to boost your own natural im-
munities with good health habits), there are numerous ways to
help relieve the discomforts of zoster, if it should strike.
First of all, while the sores are erupting, wear loose-fitting
clothes. "And, especially, stay away from fuzzy garments," says
Richard Mihan, M.D., from the University of Southern Califor-
nia school of medicine. As a dermatologist practicing with Sam-
uel Ayres, M.D., Dr. Mihan has treated numerous cases of herpes
zoster and the often accompanying postherpetic neuralgia. 'The
pain may be severe at times, requiring sedation and causing
almost unbearable discomfort and loss of sleep," says Dr. Mi-
han. Rather than resort to drastic measures like cutting out the
root of the affected nerve or repeatedly injecting local anesthetics
into the area (which causes other negative side effects), Drs.
Ayres and Mihan found a better, safer way to relieve the pro-

longed suffering vitamin E.
Over a period of four years, they treated 13 patients with
chronic postherpetic neuralgia with vitamin E, administered both
orally (400 to 1,600 international units daily) and topically (di-
rectly to the sores).
Eleven of the patients had had moderate to severe pain for
over six months. Seven of those had suffered for over one year
one for 13 years and one for 19 years! Yet, after taking vitamin
E, nine patients reported complete or almost complete control
of pain. The two patients who had had postherpetic neuralgia
the longest were in this group. Of the remaining four patients,
two were moderately improved and two were slightly improved
(Archives of Dermatology).
"The mechanism by which vitamin E relieves the persistent
pain of postherpes zoster neuralgia is not known," concluded
Drs. Mihan and Ayres, "but in view of its long duration in many
of our cases, we do not believe it is coincidence."
And they still don't. "Vitamin E may not be 100 percent
effective," Dr. Mihan told us, "but many of my patients get

relieffrom persistent pain."
But vitamin E doesn't just relieve pain. It also helps stop
the rash from spreading. One woman told us, "Last August, I
noticed a sore about the size of a silver dollar on my back. When
I touched the spot, it burst as if it were a blister. I thought nothing
of it same evening, when I felt a rash very rapidly

until late that
spreading all my back. It was annoying and felt as though
over
ants were crawling on my skin.
"Not knowing how to stop it from spreading, I wondered
if vitamin E might help. I cut the tips of three vitamin E capsules
(each 400 international units) with scissors, let the oil drip into
a saucer and applied it to the reddish, tender sores. Vitamin E
stopped the rash from spreading instantly and gave me so much

relief that I was able to sleep well that night. By morning, my
husband was amazed to notice how the sores had begun to heal
and were already forming scabs.
"I paid a visit to our family doctor that afternoon, and he
confirmed my own suspicions: It was shingles. Healing pro-
gressed quickly and completely as I continued applying vitamin
E oil to the infected area, and during that time I was never laid
up and was able to do all of my housework. It's no wonder that
vitamin E is called the 'miracle vitamin.'
Vitamin C Helps
Still, E doesn't work for everyone. But don't de-
vitamin
spair. Vitamin C may be the vitamin that'll do the job for you.
Juan N. Dizon, M.D., of New York, has treated herpes
zoster with oral vitamin C and gotten excellent results.
"I have treated three cases of shingles with 10 grams (10,000
milligrams) of vitamin C daily (1 gram every hour) until the
lesions dry up," says Dr. Dizon. "In each case, the lesions dried
up within two to five days.
"I told another physician of these findings. When he tried
the same on his patients, he had similar results.
"I am aware that this is all anecdotal and nonscientific, but

considering that there is no good scientific treatment for herpes
and that vitamin C is I would hope that others
virtually harmless,
will try this method on and report their results.
their patients
After enough anecdotal cases have been submitted, maybe some-
body will do double-blind controlled studies."
An outbreak of shingles is not the end of the world, but it
can certainly change your outlook on it for a while.
Keep yours bright with vitamins E and C and, hopefully,
shingles will be just a short lapse in an otherwise healthy life.
SKIN PROBLEMS
CHAPTER
VITAMINS THAT
TEAM UP
FOR CLEAR SKIN
Several years ago, a 26-year-oldman walked into the office

of Samuel Ayres, M.D., looking for help. Patches of crusting,
Jr.,
scaling, itching, wartlike growths covered most of his torso.

Scattered outbreaks appeared on his scalp, arms and legs. The
young man was suffering from Darier's disease (keratosis folli-
cularis). He had battled the rare, hereditary skin condition for
13 years with little success.
"He was mess," recalls Dr. Ayres, who main-
certainly a
tains a private dermatology practice in Los Angeles. The skin
disease had been persistently severe and extensive. On three
occasions, it had been serious enough to put the young man in
a hospital. Corticosteroid drugs used to treat the problem pro-
vided only temporary relief. Hot weather, sun exposure and
nervous tension made the condition worse.
"He couldn't even go out and play tennis," says Dr. Ayres.
"His skin was extremely sensitive to sunlight, and he would
break out disastrously whenever he went out in the sun."
Since vitamin A supplements had been used with some suc-
cess for a variety of skin problems involving defects of the skin's
outer layer, his doctors had placed him on an average daily dose
554
VITAMINS FOR CLEAR SKIN 555
of 200,000 international units. He had been taking the high dos-

ages of vitamin A for about five years. During that time, he was
monitored closely for any adverse reactions, since the dose was
considerably higher than the Recommended Dietary Allowance
and not recommended for normal use. Although he showed no
signs of toxicity, there were no signs of improvement, either.
"It was a baffling situation," says Dr. Ayres. "His doctors ob-
served that, while the doses of A were not making him better,
his skin condition worsened without it."
After reviewing the case. Dr. Ayres advised the patient to
reduce his intake of vitamin A to 150,000 international units daily.
At the same time, he was instructed to begin taking 1,200 inter-
national units of vitamin E each day. Eventually, the vitamin A
dosage was reduced to 100,000 international units and the vitamin
E was elevated to 1,600 international units. After months, his
1 1
back was entirely clear and all other areas were greatly improved
(Archives of Dermatology).
Today his skin tans normally when he spends an afternoon
outside playing tennis. "Since taking vitamin A with vitamin E,
he has been able to live a reasonably satisfactory life. He has
experienced slight relapses only when he has attempted to mark-
edly reduce his maintenance doses of vitamins," Dr. Ayres told
us.
What had prompted the doctor to try that particular com-
bination of nutrients when other treatments had failed? As Dr.
Ayres told us, "1 was familiar with the work of S. R. Ames,
who had lectured at a symposium at the Massachusetts Institute
of Technology. Dr. Ames spoke on the metabolic function of
vitamin Aand emphasized the important role vitamin E plays in
the absorption, transport and storage of vitamin A in the body.
He reported experiments which indicated that vitamin A ab-
sorption was severely impaired in animals that were on an E-
deficient diet."
In those experiments. Dr. Ames discovered that the body's
ability to use vitamin A increased sixfold when oral supplements
of vitamin E were also taken. When he took vitamin E-deficient
mice and gave them shots of vitamin A, the vitamin A levels
within their bodies remained low. But after Dr. Ames injected
the mice with vitamin E, the vitamin A levels of the mice in-
creased markedly (American Journal of Clinical Nutrition).
Those laboratory findings led Dr. Ayres and his colleagues,
Richard Mihan, M.D., and Morton D. Scribner, M.D., to see if
vitamin E would work together with vitamin A to treat several
skin diseases involving defects in the upper layer of the skin in
their patients. In addition to Darier's disease, they've made en-
couraging progress in treating two other skin conditions over the
past several years {Cutis, May, 1979).
And Dr. Ayres believes that people with those particular
skin problems may have a physiological defect which raises their
requirements for certain nutrients. "We may be born with dif-
ferent vitamin and mineral requirements just as much as we're
born with different looks," he says.
Although Dr. Ayres warns people against taking unneces-
sarily highdoses of vitamin A, he believes that some individuals
with chronic skin disease may need large doses. "Some of those
columnists in the newspapers will try to tell people they get all
the nutrients they need from the average American diet," he
says. "That is just not true. Some individuals may need 10 times
more of a certain vitamin than other people. Or a person's re-
quirement may be 100 times greater."
He also suggests that the so-called average American diet
may not deserve much homage. Patients on the vitamin A and
E program are advised that there's a lot more to good nutrition.
"The average American diet consists of eating enriched white
bread," says Dr. Ayres. "Enriched bread contains inorganic
iron, which combines with vitamin E and destroys it. So people
taking vitamin E for therapeutic purposes should avoid eating
enriched white breads and cereals. They also should not take
mineral supplements containing inorganic iron unless they take
the vitamin E and the mineral supplement eight hours apart."
(Ferrous gluconate, ferrous fumarate, peptonized iron and iron
lactate are preferable sources since they are organic.)
Dr. Scribner has witnessed that phenomenon in his own
practice. A 12-year-old boy once came to him with pityriasis
VITAMINS FOR CLEAR SKIN 557
rubra a skin condition the youth had had since infancy.

pilaris,
The condition is a rare, chronic, inflammatory skin disease in
children and adults, characterized by pink, scaling areas and
prominent hair follicles.
Under Dr. Scribner's supervision, the child was given 100,000
international units of vitamin A and 800 international units of
vitamin E daily. No change was observed during the first six
months of treatment. Then the condition began to clear up, and
there was a 50 percent improvement. During that period, it was
discovered that, contrary to instruction, the boy was taking an
inorganic iron supplement daily in the form of ferrous sulfate.
He discontinued the iron, which apparently was combining with
and inactivating the vitamin E. After another two months of
treatment, his skin was almost totally clear. He presently takes
a maintenance dose of 30,000 international units of vitamin A
and 400 international units of vitamin E daily. His skin remains
virtually clear.
Acne vulgaris, or common acne, is another skin disorder
that seems to respond well to the combined therapy. Acne is
probably one of the most common diseases of the skin. It usually
occurs on the face, with pimples and blackheads being the most
obvious symptoms. While acne has been treatable, it has re-
mained incurable.
"Vitamin A has been used by itself to treat acne, but with
little success," says Dr. Ayres. What about combining A and
E? He and his colleague. Dr. Mihan, have their acne patients

taking an average daily dose of 100,000 international units of
vitamin A and 800 international units of vitamin E daily. "We've
had very good results with this treatment," says Dr. Ayres. And
the doses of vitamins can usually be reduced after a few months.
The patients also use a topical medication benzoyl per-
oxide gel and are told what foods to avoid. "Extra iodine can
aggravate acne, so we advise our patients to avoid iodized salt.
Excess milk, and sweets also can cause acne to flare up.
fats
Many commercial soft drinks contain brominated vegetable oils
as stabilizers, which may irritate acne conditions, too. We tell
our patients to drink fresh fruit juices."
While nutrition is a very important factor in maintaining

healthy skin, problems can erupt at any stage of life for a variety
of reasons. 'The skin is a complicated organ," Dr. Ayres ex-
plains. "There are external irritants like overbathing, using too
much soap and water or cosmetics. Internal malignancies or
internal infections will sometimes themselves through skin
reflect
problems. Chronic infections of the teeth, bladder or other or-
gans, and malfunction of organs such as the liver may cause skin
eruptions, too. Some external causes of allergy, and internal
causes like reactions to certain drugs, also can create skin trouble."
Although he has observed progress in his own practice and
in the work of his colleagues. Dr. Ayres says research on the
combined A and E therapy still needs to be conducted in labo-
ratory settings. And despite the high dosages prescribed, he has
observed no ill effects in his patients.
"Dosages taken at those levels should be monitored by a
physician, though," Dr. Ayres stresses. "And people with high
blood pressure, heart disease or diabetes should not take high
levels of vitamin E Vitamin E improves the tone of the
at first.
heart muscle, and a large dose too soon can make the blood
pressure rise. Vitamin E also improves glycogen storage, so
diabetics on insulin could develop an insulin shock reaction if
they took too much vitamin E too soon. People with these con-
ditions should not begin with any more than 100 international
units of vitamin E a day. The dose may gradually be increased
under a doctor's supervision."
Dr. Ayres thinks the combined vitamin therapy may be help-
ful in treating other chronic skin conditions. "There is room for
further investigation. We just see unusual conditions occasion-
ally, and we try different things that seem to work. 1 don't know
how far the vitamin A and E therapy will go. But it's certainly
given relief to some."
VISION PROBLEMS
CHAPTER
LOOK TO VITAMINS
FOR SHARPER VISION
"Eyes without speaking confess the secrets of the heart,"

observed St. Jerome about 15 centuries ago. And he was right,
as generations of lovers (and liars) can attest. Only in fairly recent
times, though, has medicine begun to realize that the eyes reveal
other kinds of secrets, as well.
'The eye is an extremely sensitive barometer of faulty diet,"
says Ben Lane, O.D., a New Jersey optometrist. "When the
eye's dimension changes a single millimeter, it makes an enor-
mous difference in vision. Poor nutrition, in the eye, is exquis-
itelymeasurable."
The connection between good eyesight and a sound diet
or poor eyesight and a bad one
may not be terribly obvious.
But consider this: Helen Keller International, an American vol-
untary agency working to prevent blindness overseas, has esti-
mated that 250,000 Asian children go blind from malnutrition
every year.
Xerophthalmia, the leading cause of child blindness, is brought
on by general malnutrition and, particularly, lack of vitamin A.
For this reason, the agency has conducted massive efforts to
administer vitamin A to children at risk and to encourage their
559
parents to include vitamin A-rich fruits and green leafy vegeta-

bles in the youngsters' diets. Fortunately, the disease is now on
the retreat worldwide.
Few Americans are in any real danger of losing their eyesight
due to diet. But the human eye is a device of such wondrous
complexity that it requires a whole smorgasbord of different
nutrients to keep all its parts in working order. And shortages
of some of them may be more common than you think.
One of the classic signs of vitamin A deficiency, for example,
is night blindness. That's because in dim light the remarkable

process we call seeing actually chemical changes turning to
electrical impulses turning to mental pictures
requires, at one
point, a light-sensitive pigment known as rhodopsin, or visual
purple. And the primary source of rhodopsin is vitamin A.
When a Florida optometrist randomly tested 100 patients
for night vision, 26 of them some portion of the test. As
failed
optometrists, "we have beencontent with measuring our pa-
tients' ability to see only under daylight conditions," he ob-
served, "and overlooking the possibility that as many as one in
four may become visually impaired when the sun goes down."
Actually, the link between vitamin A and night blindess is
hardly a fresh revelation. Way

back in the sixteenth century, a
Dutch poet noted, "He who cannot see at night / Must eat the
liver of the goat. / Then he see all right." Liver, of course, is a
rich source of vitamin A. But it's also a good source of many
other nutrients, which may have had something to do with the
effectiveness of the poet's prescription.
Zinc Helps Vitamin A Help You See

One of those nutrients, it now appears, is the dietary mineral
zinc. In a recent study at Johns Hopkins Hospital and the Uni-
versity ofMaryland school of medicine, in Baltimore, research-
ers demonstrated that both vitamin A and zinc are key ingre-
dients in the chemistry of night vision.
VITAMINS FOR SHARPER VISION 561
The study involved 1 1 patients suffering from a type of cir-

rhosis of the Hver not caused by drinking. In 9 of the patients,
the researchers found blood serum vitamin A deficiencies along
with poor night vision; 4 of them were also low in zinc. Seven
of the 9 were treated with oral vitamin A (25,000 to 50,000 in-
ternational units daily) for 4 to 12 weeks.
(One patient died of liver failure before the treatment was
completed; another didn't return for follow-up studies.)
All seven patients who completed the course of treatment
showed normal serum vitamin A levels at the end of the study.
But in three of these patients, normalization of serum vitamin
A poor night vision. After it was dis-
didn't fully correct their
covered that these three were also zinc deficient, oral zinc sup-
plementation brought their night vision back to normal.
"Zinc," the researchers explain, "is important in conver-
sion of vitaminA to its active form, retinaldehyde, in the reti-
na. .. Thus, despite a normal serum vitamin A level, impaired
.
dark adaptation can result from inadequate synthesis of retin-

aldehyde from vitamin A due to zinc deficiency" {Hepatology,
vol. 1, no. 4, 1981).
Vegetables for Vision

But zinc and vitamin A aren't the only nutrients that can
affect your vision, by night or by day. A researcher at Johns
Hopkins Hospital, David L. Knox, M.D., associate professor of
ophthalmology, has been exploring the effects of folate, vitamin
Bi2 and other nutrients on an unusual eye problem called nutri-
tional amblyopia.
He told us, "I've been studying the possibility that folic acid
[folate] or some other unknown vitamin from green and yellow
vegetables may be essential to the maintenance of normal vision
and optic nerve funtion." It is, he says, "extremely important
for people to eat enough green and yellow vegetables to maintain
normal vision."
Some food additives, particularly monosodium glutamate

(MSG). may have a less than wholesome effect on the eye, ac-
cording to John Olney, M.D., Professor of psychiatry and neu-
ropathology at Washington University, in St. Louis. Glutamate
is a naturally occurring substance that is harmless when it's part
of a protein molecule, he told us. But when it's added to com-
mercial foods in large amounts (as a flavor enhancer), it may
damage nerves in the retina and parts of the brain by "exciting
them to death."
Though Dr. Olney's animal studies have involved the inges-
tion of massive doses of MSG, well beyond the amounts the
average adult would ingest, he told us, "I would definitely go
out of my way to avoid feeding MSG to children." While adults
have well-developed barriers to the toxic effects of glutamate,
he explained, a child's system is less fully developed and thus
more vulnerable to visual and brain-cell damage.
Ordinary nearsightedness (myopia), a problem so common
that nearly one in three Americans wears lenses to correct for
it, is another eye condition that may have a dietary link. Though
the old theory that eye-focusing strain causes myopia still seems
to hold up. Dr. Ben Lane has data that indicate poor diet may
worsen its effects. In particular, he reports in one study, people
with increasing myopia statistically eat too much sugar and flesh
protein, are deficient in chromium and do not metabolize calcium
properly {Documenta Ophthalmologica, vol. 28, 1981). "The
wealth of new nutrition studies relating to vision is staggering,"
Dr. Lane adds.
Vitamin E as Protector
Among those studies are a considerable number exploring
the effects of vitamin E, or the lack of it, on the health of the
eye. W. Gerald Robison, Ph.D., chief of the experimental
Jr.,
anatomy section, laboratory of vision research of the National

Eye Institute, has been examining the effects on animal retinas
of diets deficient in vitamins E and A. Results? "A highly E-

deficient animal will go blind in time," he told us.
Although he cautions that his work so far has been with
animals only, and that it's unlikely a human would develop vi-
tamin E deficiencies as extreme as those he's produced in the
lab, Dr. Robison's studies have produced some intriguing clues
into the nourishment of the eye.
The retina is a sheet of nerve cells at the back of the eye
that changes light (via chemistry) into electrical impulses, the
language of the nervous system. The cells it's made of, Dr.
Robison explains, especially the light-sensitive or photoreceptor
nerve cells the things we see with contain large amounts of
unsaturated fatty acids. Because these fatty acids are readily
oxidized (broken down by oxygen, or "rusted out") "we can
suspect that the retina is quite susceptible to oxidation unless
it's protected by an antioxidant," he says.
Because vitamin E is a potent antioxidant, or protective
agent against organic "rust," Dr. Robison decided to test the
effect of a grossly E-deficient diet on the retinas of rats. He also
tested the effects of diets deficient in both vitamin E and vitamin
A.
After five months, he told us, a diet low in E but adequate
in A "produced a significant degeneration of photoreceptor cells
and an accumulation of aging pigments [highly oxidized, insol-
uble fatty acids] that was five times greater than normal." Be-
cause the visual cells were damaged but not killed, he says, "the
damage may be reversible." A diet deficient in both A and E,
on the other hand, resulted in the permanent destruction of nearly
half the visual cells in eight months. "Vitamin A," he concludes,
"appears to protect against this cell loss."
In another study, at Cornell University, dogs fed diets de-
ficient only in vitamin A were also found to develop retinopathy,
or damaged retinas. The damage first showed up on the retina
after as little as three months. Next came night blindness and
finally "severe day visual impairment" {American Journal of
Veterinary Research, January, 1981).
Help for Cataracts?

The possibility that vitamin E may also help prevent cata-
one of the groups most likely to develop them,
racts in diabetics,
is currently under study in a Canadian laboratory. A cataract
a clouding or opacity of the eye's crystalline lens

can result in
partial or total blindness.
But John Trevithick, Ph.D., professor of biochemistry at
the University of Western Ontario, has shown that massive doses
of vitamin E may prevent the formation of cataracts in rat lenses.
Five years ago, he and his co-workers began their studies by
placing rat lenses in test tubes containing a high glucose con-
centration, to simulate the conditions in a diabetic's body. Vi-
tamin E appeared to prevent the formation of cataracts in those
lenses.
Then, in live rats who had been artifically induced to develop
diabetes, vitamin E was also shown to protect against cataract
formation. Rats not given vitamin E always developed cataracts;
those given vitamin E did not. However, these results were
obtained only with injections of E
extremely large amounts.
in
Dr. Trevithick told us he has administered vitamin E orally
to animals in equally large amounts. The oral administration, he
found, results in serum levels approximately three times higher
than normal, and "the preliminary evidence is that vitamin E
can almost totally prevent cataracts in diabetic rats."
What's more, in preliminary experiments with rat lenses in
lest tubes (known as in vitro studies). Dr. Trevithick has been
able to partially reverse existing cataracts with vitamin E, rather
than merely prevent their formation. Does the same thing work
in live animals (in vivo)? "So far, our preliminary in vivo work
does seem to confirm the in vitro work in some respects," he
told us.
Though much about cataracts remains a mystery no "cure"
isknown, so thousands of cataract-removal operations are per-

formed each year one study may shed some light on their
development.
As part of a national health program in Australia, doctors

examined the eyes of over 100,000 people from remote rural
areas scattered all across the country. By comparing the inci-
dence of cataracts with zones of average daily sunshine (ultra-
violet radiation) the examiners were able to demonstrate con-
vincingly that "cataract develops earlier in life and also has more
severe visual consequences in areas of high UV [ultraviolet]
radiation" (Lancet, December 5, 1981). This was especially true
of the aborigines, apparently because they spend most of their
lives outdoors or under inadequate shelter in the bright sun.
The researchers pointed out that UV light has been shown
to produce a clouding of the lens in other studies but that this
effect "is inhibited by physiological levels of ascorbate [vitamin
C] and glutathione [a substance that carries oxygen]." This, they
added, "provides an enticing clue to the specific function of these
two substances in the lens."
In research labs around the country, medical detectives are
on the trail of many an enticing clue to the mysteries of sight.
In the meantime, while we await the final unraveling, we'd do
well to think of our eyes as we do the rest of our bodies
marvelous, irreplaceable and happiest when they're well fed.
VITAMIN DEFICIENCY
CHAPTER
AVOID LOW-LEVEL
VITAMIN DEFICIENCY
For years, the elderly gentleman had been leading the sort
of life Ebenezer Scrooge would have found delightful. A lifelong
bachelor, he lived alone and took all his meals alone in restau-
rants. He despised fruits and vegetables. Instead, his diet con-
sisted almost entirely of fried eggs, bread and boiled potatoes,
a suitably cheap, unappetizing, Scrooge-style bill of fare.
He was 83 when his gloomy habits began to produce alarm-
ing side effects: His chronic exhaustion reached the point where
he became breathless with the least exertion, and his legs had
become painfully swollen and covered with discolored, purplish
spots. Dismayed, he sought medical help at the Thomas Jefferson
University hospital in Philadelphia.
The examining physicians found a weak, toothless, apathetic
old man who showed many of the signs of scurvy, the vitamin
C-deficiency disease that was once a killer of epidemic propor-
tions but today is relatively rare. Still, the doctors reported later,
even though full-blown scurvy is uncommon, at least one study
has shown that some 40 percent of elderly people admitted to
hospitals have subnormal body levels of vitamin C. And the old
man's dreadful eating habits made it seem all the more likely.
566
AVOID LOW-LEVEL DEFICIENCY 567
But the doctors were perplexed. At one point, they almost

abandoned their diagnosis of scurvy because several symptoms
so common they're considered hallmarks of the disease just
weren't there. For example, swollen, scaly, raised areas around
the hair follicles with coiled or looped hair shafts, surrounded
by a red halo of inflammation, are among the most well-
recognized symptoms of advanced vitamin C deficiency. But this
triad of signs was absent in the bachelor's case, as were bleeding
gums and frequent nosebleeds.
Yet, laboratory tests confirmed the doctors' original sus-
picions. The man was started on 250 milligrams of vitamin C
daily, and later on iron, folate (folic acid) and vitamin B12 sup-
plements. Within four days, the swelling had gone down and the
purplish patches were beginning to fade. After eight days, they'd
vanished and the old gentleman was discharged "in good spirits
. .feeling quite well and free of fatigue" [InternationalJoiinuil
.
of Dermatology, May, 1982).

The lesson to be learned from his case, the doctors advised
their colleagues, was that "physicians should suspect scurvy in
patients who present with ecchymoses [purple spots] and painful
swelling of the lower extremities. Absence of swollen, bleeding
gums .congested follicles, coiled hairs, and perifollicular
. .
hemorrhages [red inflammations around the follicles] should not

dissuade one from the diagnosis of scurvy."
That the bachelor's nutritional deficiencies showed up with-
out some of the classic signs may not be all that unusual. "Roger
J. Williams [the pioneering nutrition researcher] speaks of met-
abolic differences among individuals of up to a thousand times

so, certainly, there are also great differences among individuals
inthe way they show deficiencies," says John Gaul, D.O., Ph.D.,
an osteopathic physician in Davie, Florida.
Just as there is variation of faces in a crowd, each of us has
our personalized version of what it means to be healthy or to
be sick. We may show symptoms of nutritional shortcomings in
the
known, expected ways or we may not.
One problem with identifying deficits of specific nutrients is
that, at least in the early stages, the symptoms all tend to look
the same. "Fatigue, malaise, insomnia, susceptibility to colds,

bleeding gums, just a poor feeling in general most deficiencies
tend to produce those symptoms," Edward O. Shaner, D.D.S.,
a preventive-dentistry specialist, told us.
It's also important to remember that, in real life, deficiencies
of a single nutrient, all by itself, rarely occur. ''Every one of the
40 or more nutrients is related to every other one," explains W.
Marshall Ringsdorf, Jr., D.M.D., of the University of Alabama
school of dentistry. "So it's almost impossible to develop an
isolated, single deficit, especially among the B vitamins."
It's also rare (at least in this country) for a physician to be
faced with a bona fide case of deficiency disease like scurvy or
pellagra. Dr. Ringsdorf told us. "If scurvy is a condition in which
the body is 100 percent free of vitamin C, then we see cases of

30 and 40 percent depletion ^just enough for subclinical prob-
lems to appear. We deal in shades of gray."
Still, taking all those qualifiers into account, there are certain
telltale signs to point to deficits of specific nutrients, Dr. Gaul

told us. Among the most common are gum disease, "the number
one reason why people lose their teeth," associated with vitamin
C deficiency; night-vision deficiency, linked to lack of vitamin
A; chilosis, or cracking around the corners of the mouth, and
swelling of the ankles in women taking oral contraceptives, both
tied to vitamin B^ deficiency; poor wound healing, in zinc defi-
ciency; and brittle, breakage-prone bones due to a loss of calcium
from the bones.
Nutritional shortcomings may manifest themselves in other

ways, as well some common, some not so common. Here are
a few of them.
The Philadelphia doctors may have better understood the
elderly bachelor's case if they'd seen the results of a study con-
ducted at the Iowa State Penitentiary, in which clinical scurvy
was induced in five inmates. The five men, ranging in age from
26 to 52, agreed to consume a diet totally free of vitamin C for
as long as it took to produce genuine scurvy, while researchers
made careful note of the changes that took place as the inmates'
health began to fail. It took the men from 84 to 97 days on the

C-free diet to reach full-blown scurvy.
The first signs the researchers noted were psychological:
The inmates became increasingly depressed, withdrawn and
(ironically) neurotically concerned about their health. They also
reported feeling tired, weak and listless. "These changes are
characteristic of individuals who are physically ill, as the subjects
were," the doctors noted.
Then came the parade of physical symptoms, which made
their debut in one man on the 29th day. Tiny, pinpoint, purplish
spots called petechiae, caused by bleeding under the skin, were
the first symptoms to show up (though they never did appear in
one of the men). Larger purplish patches on the legs came next.
Then came coiled hairs (in two of the inmates) and congested
hair follicles (in all five). Other symptoms included swollen,
bleeding gums, shortness of breath, swelling and pain in the
joints, edema (water retention) and muscular aches and pains
though, once again many of these symptoms appeared in some
men and not in others (American Journal of Clinical Nutrition).
Vitamin A Problems
The classic sign of vitamin A deficiency is night blindness
when you see poorly or not at all in dim light and your eyes are
slow to adjust from brightness to dimness, as when you step into
a darkened movie theater.
But your eyes aren't the only place an A shortage can show
up. A condition called hyperkeratosis, or dry, scaly skin, has
been linked to vitamin A deficiency, and forms of vitamin A are
being used with great success in the treatment of acne. The
chronic fatigue of anemia can also sometimes be traced to vitamin
A deficits because, even if your iron levels are up to par, vitamin
A is needed to help your body make use of the iron.
Unhealthy teeth and gums, stomach upsets and increased
susceptibility to infection of the respiratory, intestinal and uri-
nary tracts, as well as the mucous membranes, can also point

to vitamin A deficiency. It's even been reported that low vitamin
A may be a "significant factor" in middle-ear inflammation, called
otitis media, which usually occurs in infants or young children
after an upper respiratory infection {Western Journal of Medi-
cine, vol. 133, no. 4, 1980).
Vitamin B Problems
Although pellagra, the niacin-deficiency disease, is almost
unheard of in Western countries today, we've learned a lot from
the days when it was frightfully common among the rural. South-
ern poor and in prisons. A quartet of symptoms, known as "the
four Ds," tended to follow one another in this order: dermatitis
in areas exposed to the sun, diarrhea, dementia and then death.
Today niacin deficiencies don't usually progress much be-
yond the early stages, but they can be very unpleasant just the
same. Canadian doctors have described dermatitis caused by
marginal niacin deficiency: It begins with a burning redness and
puffiness in areas exposed to the sun, heat or friction, most often
on the backs of the hands but sometimes the backs of the feet,
arms or legs. Sometimes a "necklace" of irritated skin, which
turns a scaly, reddish purple in time, appears on the front of the
neck (Canadian Medical Association Journal).
More advanced niacin deficits can produce the personality
changes formerly known as dementia, including depression, ap-
athy, confusion, suspicion and hostility. In fact, writes Canadian
researcher Abram Hoffer, Ph.D., M.D., "For many years it was
debated whether subclinical pellagra should be classified among
the neuroses. Just as fully developed pellagra resembles a num-
ber of psychoses, so does subclinical pellagra resemble any one
of the typical neuroses." With colleague Humphry Osmond,
D.P.M., Dr. Hoffer has pioneered in the use of forms of niacin
in the treatment of schizophrenia.
A Lack of Thiamine
Complaining of severe shortness of breath that had steadily
worsened over the preceding 30 hours, a 40-year-old Kansas
City, Kansas, man was admitted to the Veterans Administration
Medical Center there. His hands, feet and the area around his
mouth had turned blue, his heart was racing and his blood pres-
sure had fallen dramatically. The doctors who treated him learn-
ing that he was a heavy beer drinker, made a shrewd diagnosis
and injected the B vitamin thiamine.
His blood pressure began rising almost immediately, and he
eventually completely recovered (Chest).
The man was a victim of what the doctors called "acute
pernicious beri-beri heart disease," caused by chronic thiamine
deficiency due to drinking. Over the long haul, thiamine short-
ages can cause a weakening of the heart muscle and, eventually,
cardiac failure.
Deficiencies also show up in the gastrointestinal system, in
the form of indigestion, severe constipation and loss of appetite,

and worst of all in the central nervous system. Problems may

develop in the peripheral nerves such as a tingling or burning
sensation in the toes, burning feet (especially at night), sore calf
muscles and even irritability, depression and confusion.
Quite similar symptoms have been attributed to deficiencies
of vitamin B12: unsteady gait, lack of coordination and a burning,
tingling ache in the feet and legs, more pronounced in the feet
at night and in the legs by day. An electric-shock-like sensation
when the neck is bent, called Lhermitte's sign, may also be
caused by B12 deficiency, which does its damage, like an absence
of thiamine, by affecting the central nervous system.
Precisely how a deficiency will manifest itself in your body
is, at least to a certain degree, an individual matter.
But by taking care to eat right and stay fit, you can spare
yourself the pain of finding that out.
BOOK IV
The
Nutritional
Healers
INTRODUCTION
There are plenty of specialists around. In fact, when you're
being shuttled from doc to doc
the kidney man doesn't know
a whit about your bones, and the bone man thinks you need an

appointment with a neurologist it seems like there are too many.
But even with a specialist on every block, where do you go when
you want to see a doctor who's an expert on your medical prob-
lem and a specialist in that all-important field most doctors ig-
nore: the drugless therapy of nutrition? Well, that doctor has
office hours in book 4: The Nutritional Healers.
In the pages that follow, you'll be able to consult with ex-
perts in various health fields but experts who also realize the
prime importance of proper diet and nutritional supplements. A
pediatrician will tell you how kids with learning disabilities can
be helped with food supplements. An eye doctor will describe
his vitamin recipe for better vision. You'll meet a pharmacist
who advises patients on which vitamins to take to mute the side
effects of prescription drugs; a psychologist who uses nutrition
to relieve stress. In two dozen doctors and health profes-
all,
sionals share with you their tips for a healthier, happier life. So
turn the page the doctor is in!
574
AUDIOLOGIST
CHAPTER
MUFFLE THOSE BELLS

IN YOUR EARS
A 53-year-old auto mechanic has been totally deaf for 20

years. Yet, he still suffers from loud buzzing in his ears some-
times as loud as a chain saw. The noise is so annoying that he
can't relax or sleep. He has consulted several ear specialists,
but they could offer him no hope of a cure. "Try to live with
it" was But often he feels so frustrated and anxious
their advice.
that life scarcely seems worth living.
Over 7 million Americans suffer from the auto mechanic's
problem, while over 36 million more suffer from it in a less severe
form. It's called tinnitus: ringing, hissing, buzzing or roaring in
the ears. You don't have to be deaf to have it; most tinnitus
sufferers aren't. In fact, everybody has probably suffered from
a temporary form of tinnitus
when, for example, you've stood
too close to a gunshot or a backfire or banged your head on a
low-hanging plant, and usually it's no big deal. But for those
who suffer from tinnitus for prolonged periods, it can be anything
from a persistent annoyance to an unbearable affliction.
The fact that most doctors can suggest only that the majority
of tinnitus sufferers try to live with their problem doesn't help.
Though ear specialists have tried various treatments for tinnitus,
575
576 AUDIOLOGIST
including surgery and drugs, they have had few successes. Even
tinnitus maskers, hearing-aid-like devices that drown out the
noise with other sounds, only cover up the symptom without
helping the underlying problem. And tinnitus is always a symp-
tom of an underlying hearing disorder, which often leads to some
form of hearing loss.
But now a new approach, developed in the last six years,
offers hope to tinnitus sufferers. Paul Yanick, Jr., Ph.D., a clin-
ical audiologist and adjunct assistant professor at Monmouth
College in New Jersey, believes that tinnitus, as well as many

other hearing problems, can be traced to metabolic disturbances.
And in partnership with several physicians, he has developed
this theory into a successful clinical therapy.
For instance, the auto mechanic we mentioned was even-
tually referred to Dr. Yanick. Dr. Yanick began with a battery
of very precise hearing and metabolic tests that are the first step
in his holistic approach. ''It's important," he told us, "that the
tests be precise enough to detect each patient's special hearing
difficulty and metabolic makeup. Everybody is a biochemical
individual, and both hearing and metabolic problems vary crit-
ically in each person. Neglecting to take account of that indi-
viduality easily leads to misdiagnosis."
The mechanic's deafness was so profound that Dr. Yanick
had to communicate with him through written messages. Ex-

amination revealed that he had hypoglycemia a condition of

abnormally low concentration of sugar in the blood and suf-
fered from a variety of vitamin and trace mineral deficiencies.
Hypoglycemia a Culprit
Hypoglycemia, Dr. Yanick is convinced, is the most com-
monly underrated cause of tinnitus and other hearing problems,
including the progressive deafness that the mechanic also suf-
fered from.
"A diet high in refined carbohydrates raises the blood sugar
level too high and too fast," he explains. "The pancreas over-
MUFFLE THOSE BELLS IN YOUR EARS 577
reacts to these dangerously high sugar levels by producing too

much insulin. Then the insulin drops the sugar level down too
low and too fast. Since the inner ear has the highest energy
requirement of any organ in the body, the drop in blood sugar
puts a lot of stress on it. Finally, the body's stress reaction floods
the system with adrenaline, which constricts the highly sensitive

vascular network in the ears this is often what causes the ring-
ing of tinnitus. As a result, the ear is starved of energy and oxygen
and can't get the nutrients it needs to function."
So the next step was to remove from the mechanic's diet
all refined, processed and chemically treated foods and to take
him off cigarettes and caffeine. The man was also placed on a
natural high-protein diet with supplements of vitamin A and B
complex (three times daily) as well as zinc and chromium.
''Hearing improvements with vitamin A are well docu-
mented," Dr. Yanick told us. "A laboratory study on animals
found ten times more vitamin A in the inner ear than in other
tissues of the body. Probably all sensory receptor cells, such as
those in the inner ear, are functionally dependent on vitamin A.
The B vitamins, too, are important for nerve functions. And they
also play a major part in glucose metabolism."
The results were dramatic. Although there is little hope of
recovery after 20 years of deafness, within only a month and a
half the elated mechanic showed a 30 percent improvement of
hearing and no tinnitus. And since then, he has had continued
improvement of hearing.
Not surprisingly. Dr. Yanick's approach has been effective
also in less severe cases of tinnitus.
Dr. Yanick told us of a 33-year-oId contractor who consulted
him about fluctuating tinnitus, a variety that seems to come and
go. The ringing was worst in the quiet of the night. Soon its
distraction and his worrying made it difficult for the man to sleep.

He resorted to drugs aspirin at first and then Valium. But the
tinnitus remained. Hearing tests revealed that the contractor was
already suffering from a slight, undetected hearing loss. Obser-
vation and questioning further revealed that the hearing loss,
which was not evident to the patient, put great strain on him in
578 AUDIOLOGIST
social situations. 'The person with a hearing problem," Dr.

Yanick explained, '1s under great stress. He's concentrating,
trying to grasp every word.''
Dr. Yanick further discovered that, in the course of his
patient's work as a contractor, he was sometimes exposed to
loud noises.
Metabolic and biochemical tests revealed that the contractor
was hypoglycemic and deficient in magnesium, chromium and
especially zinc.
First: A Pair of Ear Plugs

The first thing Dr. Yanick did was to prescribe a pair of ear
plugs. "Exposure to loud noise is dangerous," he explains. "It
and deprives it of
constricts the blood vessels in the inner ear
oxygen and essential nutrients." Then Dr. Yanick equipped his
patient with a carefully fitted hearing aid.By correcting his slight
hearing loss, this immediately relieved much of the stress he felt
in social situations. "And," Dr. Yanick pointed out, "better
hearing can itself drown out moderate tinnitus."
The problems were also tackled. Di-
patient's nutritional
etary reforms were suggested, as well as a program of fast walk-
ing. Proper exercise makes the heart and blood vessels more
efficient, helping to provide enough nourishment for the ear.
After two months of treatment, the contractor showed a 20
percent improvement of hearing and no more tinnitus. He was
now also able to get on happily without tranquilizers and sleeping
pills.
He Reversed His Own Hearing Loss

Dr. Yanick told us about another successful case: himself.
At 19,doctors told him he was going deaf. Six years later, he
couldn't hear people talking across a room. His case, he was
told, was hopeless, but refusing to give up, he traveled the coun-
MUFFLE THOSE BELLS IN YOUR EARS 579
try to consult with leading endocrinologists and internists. Learn-

ing that he was hypoglycemic, he started to improvise the treat-
ment he now shares successfully with others. At 30, Dr. Yanick
has halted the progression of his deafness and improved his
hearing.
Dr. Yanick started to develop his theory that tinnitus and
other hearing problems are caused by metabolic imbalances in
1974, when he and E. J. Gosselin, M.D., studied the metabolism
of 90 patients with hearing loss. They found an extremely high
correlation between metabolic and hearing disorders (Journal of
the American Audiology Society).
Hypoglycemia isn't the only metabolic abnormality related
to hearing problems; high blood levels of fat are, also. "High
blood levels of fats," Dr. Yanick explains, "cause red blood
cells to stick together, reducing the flow of oxygen to the inner
When tests reveal that a patient has
ear. problem, we rec-
this
ommend supplements of lecithin, iron and potassium, along with
a diet high in grains, fruits and vegetables. That regimen has
been very helpful in lowering fat levels and increasing the supply
of oxygen."
Stress-reducing techniques (such as exercise, meditation and
biofeedback) and a hearing aid that is scientifically tuned to de-
liver maximum and comfort are also important in Dr.
clarity
Yanick's holistic program.
"For some people, tinnitus gets louder just by worrying
about it," Dr. Yanick says. "Stress is both a cause as well as a
result of metabolic disturbances and plays a major part in hearing
problems, especially tinnitus. I've found that, with my patients,
fast walking or jogging usually helps to relieve ordinary stress."
Diet, nutrition, exercise, relaxation. "It's obvious that the
ear is part of the body," Dr. Yanick concludes, "and it makes
no sense to treat hearing problems in isolation from the body's
general well-being."
CHIROPRACTOR
CHAPTER
DR. HATFIELD-McCOY
When we heard about Milton Fried, M.D., D.C., we didn't

know much about him other than the fact that he was both a
medical doctor and a chiropractor.
But that was enough to arouse our curiosity. We knew there
was no love between the M.D.s and the chiropractors. Med-
lost
ical doctors charge that "chiropractic theory has about the same
medical validity as voodoo or witchcraft" {At Your Own Risk:

The Case against Chiropractic, Trident Press, 1969). Chiro-
practors fire back that "the American Medical Association is an
extremist organization that is attempting to use political power
to maintain a monopolistic health care situation here in the United
States" {Chiropractic Speaks Out, Wilk Publishing, 1973).
We wondered how long someone caught in the middle of
such caustic rhetoric could survive professionally.
So when we visited Dr. Fried at his busy office in suburban
Atlanta, Georgia, we were happy to learn of the emphasis he put
on nutrition in his practice and the importance he saw in treating
thewhole person. But what we wanted to hear about most was
what it was like to be the man in the middle.
580
DR. HATFIELD-McCOY 581
Question: How does it feel to be both a chiropractor and

an M.D.?
Dr. Fried: It's like being a Protestant and a Catholic at the
same time in Northern Ireland. The M.D.s love the fact that I'm
an M.D., but they don't like the fact that I've been a chiropractor,
and the chiropractors love that I've been a chiropractor, but
some of them hate the fact that I'm practicing as an M.D. The
more you know how to do, the more chance you have of
things
offending somebody. It's a paradox.
Q: What about your patients?
Dr. Fried: Oh, they love me! At least someone does!
Q: Why is there so much animosity between doctors and
chiropractors?
Dr. Fried: Ithink that ignorance and bigotry are things
that you find in allwalks of life. You find it among some members
of the AMA (American Medical Association), and you find it
among chiropractors, too. You find the sort of bigotry that's
involved in being ignorant of what the other person does and of
being afraid of economic competition.
I think that the average chiropractor is a sincere person
trying to help sick people, and I think the average M.D. is, too.
One of the things I try to do is bridge the gap of trust between
the two sides.
Q: How did you get yourself in this strange position?
Dr. Fried: When I finished my bachelor's degree at New
York University, wanted to be a physician, but didn't think
I I
I had enough money, so I got a diploma in physical therapy and

rehabilitation. In my work in that field, I began to see patients
who were getting really good results by going to chiropractors,
and it didn't jibe with anything I knew.
I wanted to learn this art, to use it in my own work. So I
went to the Chiropractic Institute of New York, and I became

a chiropractor.
I practiced chiropractic for several years, but I still wanted
tobe an M.D. I wanted to know more. Basically, I considered

myself and I still do to be a healer who was learning whatever
582 CHIROPRACTOR
ways 1 could to help patients. So I went back to school and I
studied medicine. graduated from UCLA (University of Cali-

I
fornia at Los Angeles) medical school.

Q: Do you still use chiropractic techniques, like adjust-
ment of the spinal column, in your practice?
Dr. Fried: Yes, but especially 1 use a lot of the philosophy
that I learned
for example, the idea that the body has the innate
ability to heal itself, given the correct circumstances. That is a
tremendous thing if you really put it to use with patients.
It frees you from the fear of taking on a sick person. Also,
you don't think in terms of treating a disease; you think in terms

of taking care of a human being. It's not just words, it's actually
a different way of practicing that flows from that.
When see I a patient, what I think of is not if I can cure
him, but how to arrange to give him the proper substances and
circumstances so that the innate healing ability of his body can
do its work. I frequently will take on patients who otherwise I'd
be afraid to take on, and they reward me by getting well.
Q: Does your interest in nutrition tie in with that?
Dr. Fried: Absolutely. If there's anything that's the center
of what I do, it's nutrition. Nutrition is the one thing that I
wouldn't want to do without.
If a person is taking a lot of garbage into his body, sooner
or later he's going to be sick, no matter what else you do with

him. Anyone who takes care of people and who observes them,
who really watches them, will come to that conclusion. Anyone
who takes care of any living things knows that what you feed
them has a tremendous effect on them.
To me it seems strange that the orthodox medical profession
doesn't take that much into account. Very strange, actually.
Q: Do you pay much attention to nutrition in your personal
life?
Dr. Fried: Yes, I do. Our family

very conscious of diet,
is
and think it's done us a lot of good. There have been times
I
when wc have gone away from that. I've noticed the difference,

and so has my family what happens to us when we stop taking
DR. HATFlELD-McCOY 583
our supplements and stop eating properly. We are very health

conscious in my family.
As a general rule, we stay away from sugar completely. We
try to give the children fruit, nuts and other wholesome snacks,
whole grains, and they do very well that way. I'm very proud
of them.
Q: Have you ever tried a vegetarian diet?
Dr. Fried: I have and I like it. I personally lean toward
vegetarianism myself. I don't think that you must be a vegetarian
to be a healthy person, but I feel very good on a vegetarian diet.
I can't get my wife to stay on one, though. She doesn't want to,
and I don't intend to change wives over it.
Q: Do you raw foods?

eat a lot of
Dr. Fried: Yes, we
raw vegetables and fruit.
eat a lot of
Raw things have enzymes in them, and also vitamins, that are
destroyed by heat.
One of the exciting things in nutrition, that I'm writing about
is an enzyme called superoxide dismutase. It's found in raw
vegetables. It helps prevent damage to the cell membrane. It's
a very exciting nutritional find and, like all enzymes found in
raw food, destroyed by heat.
it is
We raw milk in our house. We have a dairy in

also take
Atlanta that has a certified herd and produces a really good raw
milk.
Q: You mentioned food supplements. What supplements
do you take?
Dr. Fried: I take brewer's yeast, bone meal, desiccated
raw liver. I take vitamin C. I take rutin. I take para-aminobenzoic

acid (PABA) and pantothenic acid (pantothenate). I take some
kelp. I take some alfalfa. I drink ginseng tea. . . .
Shall I continue?
Q: By all means.
Dr. Fried: I take niacin in a long-acting form. I think niacin
isremarkable. The first time I ever took it, I had such a feeling
of well-being that I knew I always needed more niacin. It has
done me a lot of good.
584 CHIROPRACTOR
I also take vitamin Bf,. I take a very balanced B complex,
but with additional amounts of B^, niacin, para-aminobenzoic

acid and pantothenic acid.
Q: How does your interest in nutrition carry over into your
practice? How does affect the things you do with patients?
it
Dr. Fried: Well, 1 practice holistic medicine. I'm interested

in using the physical, psychological and nutritional things that
are needed for a person to achieve a state of health. 1check
every person's nutritional and biochemical status, always. I'm
always interested in what's going on in their head, what's hap-
pening on the job, what's happening at home.
If I have someone come in with high blood pressure, I'm
not happy with just giving him a high blood pressure pill. I want
to find out what's happening with his boss, with his workers,
with his colleagues, with his wife, what he's worried about, what
he's doing.
If you have a man who's working two jobs that he hates,
coming home after driving an hour through bad traffic, smelling
exhaust every day, plopping down in front of a TV set with a
six-pack, smoking two packs of cigarettes a day, eating a greasy
hamburger for lunch, and then he gets high blood pressure
think it's the height of idiocy to treat him with an antihyperten-
sive alone.
Q: Could you mention some cases that illustrate this ho-
listic approach?
Dr. Fried: I recently had a little girl who was having sei-
zures despite the fact that she was on very high doses of Dilantin,
an antiseizure medication, and a good one. She couldn't talk,
she was drooling, and she couldn't pay attention to anything.
Her balance was so bad that her father had to carry her into the
office.
Among other things, I did a complete neurological workup
on her. I checked her for vitamin levels and also for mineral
levels. I did a hair and a nail analysis on her.
Now, this little girl, even though she was on Dilantin, had
never been given any folic acid (folate). She was extremely low
DR. HATFIELD-McCOY 585
in folic acid. She was very high in copper, very low in zinc, and
had a lot of lead in her.
Just by removing the lead, increasing her zinc, decreasing
the copper and giving her lots of folic acid, as well as other B-
complex vitamins, I had this girl off Dilantin within two months'
time. She's walking on her own now. It's very gratifying. In fact,
when her parents got her off the Dilantin, they came in here with
a big bottle of champagne to celebrate.
I'm not saying that Dilantin should never be used, and I'm
certainly not saying take everyone off Dilantin and give them
folic acidand zinc. If you take someone off Dilantin right away,
you can cause tremendous seizures. The point is that everybody
who is given Dilantin should be given extra folic acid, and doctors
who prescribe Dilantin should have enough knowledge of nutri-
tion and biochemistry to know that. Unfortunately, some of them
don't.
This child was treated basically nutritionally and by keeping
in mind the ecologic factors that are involved in medicine.
For example, what toxic substances did she have in her?
She had too much copper. She got that from her copper pipes
at home and from the fact that she wasn't taking enough zinc.
She had a big magnesium shortage, too, incidentally, and we had
to get her magnesium up. These are the kinds of things that
physicians are going to be doing more and more. They're going
to be looking for ecological causes of illnesses.
Q: Do you think the medical profession is prepared to
make these changes?
Dr. Fried: I think there should be some very big changes
in medical education. Together with medical educators and some
other physicians who specialize in nutrition and metabolism, I'm
working to set up an American Board of Nutritional Medicine
and Metabolism. It's pretty close to being formed. The purpose
is going to be to examine and certify people who want to practice
as nutritional medical people. We want to certify them so that

the public will know that the person has an expertise in what he
claims to be doing.
586 CHIROPRACTOR
We also want to stimulate the education of physicians along

nutritional lines. We'd like to get nutrition into the medical schools
as a separate clinical science, so that people can really learn how
to take care of patients by using nutrition and clinical biochemistry.
I think medical education has not gotten better over the

years. 1 has gotten worse. It has become very narrow.
think it
You who are graduating who know a tremen-

get people today
dous amount about practically nothing. They're like people with
tunnel vision.
That's not an educated person; that is a technician who's
ignorant of even the things that his own work accomplishes,
except in terms of his own procedures. And that's the fault of
the medical schools.
DERMATOLOGIST
CHAPTER
WANTED: A SCIENCE
OF OPTIMAL HEALTH
Milton Saunders, Jr., M.D., is a man with a mission. Just

don't call him a zealot. What drives him is not his unshakable
belief in a given set of principles, but the fact that he doesn't
know what to believe. Ask Dr. Saunders a question about nu-
trition,and the three words you will most likely hear in reply
are / don't know.
The Virginia Beach, Virginia, dermatologist wants to know,
badly, and is in the process of setting up a nutritional research
organization, the Optimum Health Foundation, to give us all an
education. The first of the foundation's centers is to be estab-
lished in the Virginia tidewater region, with the possibility of
further expansion into California, Texas and Massachusetts.
The nonprofit foundation be designed to help the pa-
will
tients of participating doctors maintain the best health possible
through individualized programs of nutrition and exercise. Re-
search at the foundation's center will attempt to nail down the
specific effects of nutritional therapy and find new ways for peo-
ple to achieve optimal health through nutrition and physical
activity.
587
588 DERMATOLOGIST
Question: How do you establish what will produce optimal

health in a particular individual?
Dr. Saunders: I don't know the answer to that. That's
something that willhave to be figured out through the founda-
tion's efforts. Our objective is to be totally scientific about this,
and totally specific if we can.
Nutrient levels which may be normal for you and make your
system function at its best may be too high or too low for me.
The Recommended Dietary Allowances for various nutrients laid
down by the government are only the most crude guidelines that
can't really tell you much about yourself.
To be able to be totally specific, to be able to meet your
needs exactly for each nutrient, is something that will take a lot
of time and effort. But it can be achieved, if only we channel
the kind of talent and brainpower that took us to the moon toward
furthering our own health, preventing disease rather than waiting
for it to occur.
Q: How did you get the idea for this kind of research
effort?
Dr. Saunders: It started a long time ago, actually, when I
was back in dermatology residency.began to notice that certain

I
diseases that we just couldn't treat with standard medicine seemed

to be very amenable to nutritional approaches. I started to use
vitamin E in a couple of dermatologic disorders that don't re-
spond to conventional therapy at all. One is called necrobiosis
lipoidica diabeticorum.
Q: What does it do?
Dr. Saunders: It causes ulcerative patches on the shins of
patients, usually women in their 30s and 4()s with a predisposition
to diabetes. Standard therapy for this disease is very poor, and
the results of allowing it to go forward without check are cata-
strophic for some of these people.

At one point, out of desperation, I put several patients with
necrobiosis on a relatively high dosage of vitamin E. Lo and
behold, all but one of the patients in the initial trial got better.
I tried the same regimen on patients with rheumatoid nodules,
a disorder that occurs when people have rheumatoid arthritis

SCIENCE OF OPTIMAL HEALTH 589
but which, as far as the tissue is concerned, is related to nec-

robiosis. Again, some of the patients, a smaller percentage, re-
sponded to the vitamin E.
My interest was stimulated, and I turned to other derma-
tologic problems such as hair loss. Some of these cases were
obviously nutritional problems, such as women on crash diets
who suddenly began to lose their hair three to six months later.
Also problems caused by nutritional deprivation due to the fetus'
development in the last trimester of pregnancy. Others were a
little less obvious, such as the women who were losing hair as
a result of birth control pills and subsequent vitamin and mineral

deficiencies.
I just sat down and said to myself, "What is needed for hair
growth?" Well, I'm not a biochemist, but I had a basic idea that
we needed the essential amino acids, we needed some zinc and
we needed some vitamin E. I tried this regimen on some of my
patients, and blam! They started growing hair.
Q: It is pretty impressive.
Dr. Saunders: Well, for a long time I just went along being
satisfied with the fact that I was doing something effective, even
though I didn't really understand how or why.
Then an arthritis specialist referred two of his patients to
me because they also were suffering from necrobiosis. I put them
on my usual vitamin E therapy. Both these patients had been
on all kinds of arthritis medications, most of which had significant
amounts of potential toxicity and side effects, to say nothing of
the expense.
When they came back in about a month, their necrobiosis
was somewhat improved, maybe 20 percent or so, but they were
ecstatic. I didn't understand why.
One patient said, ''Dr. Saunders, can't you see, my hands
were crippled before, and now I can move them! I'm off medi-
cation; I'm taking is vitamin E!" Not only was her necrobiosis
all
getting better, but she was essentially cured of the debilitating

part of her arthritis.
I convinced these two women, both of whom had responded
in the same way, to go off the vitamin E and see what would
590 DERMATOLOGIST
happen. Both of them called, one in about six days, the other in
about ten, and said they were right back where they started.
They had constant pain and asked that I allow them to go back
to vitamin E. I did and, of course, everything cleared again.
Q: Have the things you've discovered about nutrition caused
any changes in the way you live?
Dr. Saunders: Well, Tm still learning things about nutrition
and how it affects me personally.
In March of 1978. I was in the hospital with a cardiac prob-
lem. 1 had ventricular arrhythmia, an abnormal beating of the
ventricle of the heart. It was the kind of thing where I suddenly
realized that nutritionally and physically I was in sad shape. I
had been getting fat and sloppy. I'd been drinking a lot. I wasn't
an alcoholic, but I was a pretty regular drinker.
I had already begun experimenting with the effects of vi-
tamins on my own health. Now I limited my diet and quit drink-
ing. I began to feelbetter but not outstandingly better. But when
I started jogging, combining good physical activity with the nu-
tritional approaches, 1 really began to feel like a million bucks.

If you pump nutrients into a person and don't accompany
that with physical activity, it's like putting gasoline in a car and
having it sit in the driveway. It isn't doing anything. It's when
you get th^ metabolism of the body going that you are able to
utilize nutrients to their maximum efficiency.
I now run 2'/: miles a day. I have a pulse of 68, a slow,
powerful, regular pulse. I'm literally running fo: my life, if you
want to look at it that way.
Q: What nutritional supplements do you need to keep
yourself in condition?
Dr. Saunders: The formula I've arrived at is without any
real scientific basis. As a matter of fact, I think it's not unlikely
that I'm presently way off base, so I'd rather not tout what I
do. I will say that when I take multivitamins, minerals and amino
acids, as do regularly,
I I find that my ability to function, both
physically and mentally, is considerably enhanced.
In the last couple of days, I stopped taking everything, for
a reason. I wanted to see if there was any difference. I don't
want to get into a rut thinking, "It's obvious that this is helping
me." Well, this morning my usual 2'/2 miles felt like 20. 1 mean
it really was tough. It's the first time I've had cramps in ages.
One thing I might mention is the effect of red meat. I've

always been a big carnivore. It was nothing for me to sit down
and eat a 2-pound steak in one sitting. Afterwards, though, I
would always feel a kind of nonspecific malaise. So we've cut
back the consumption of red meat in my family to once or twice
a week. We eat fish and poultry at other times, and I feel like a
different person. It's made a big difference.
Q: How
has the medical community reacted to your plans
for the foundation?
I think we're beginning to get an awareness
Dr. Saunders:
in the medical community of the importance of nutrition. There
is a growing number of closet nutritionists out there, doctors
who use nutrition but don't make a big noise about what they're
doing. I talked to a fellow the other day who's an ophthalmol-
ogist. He was telling me how you can't find salt, sugar or sweets
of any kind in his house. His wife makes their bread, and makes
it They make sure they get their supplements.
with unrefined flour.
So I said, "Gee, that's great. Have you been spreading the
word?"
"Oh, no!" he said. "You're the only one 1 can talk to about
this!"
Q: Why wouldn't these doctors want to talk about nutrition?
Dr. Saunders: They're afraid that they'll be laughed at,
that they'll be maligned, that they'll be thought of as being weird.
I think the medical profession has failed to recognize that
there's a great deal more potential in nutrition than is being
tapped. We are suffering today from the effects of having too
many wonder drugs, too many "magic bullets." We don't cure
disease anymore, the pharmaceutical companies cure it.
As a result, the average physician has not been educated

enough in nutrition. It's not any fault of his own but really the
fault of the establishment through the years. The magic bullets
592 DERMATOLOGIST
were there. Why should you have to turn to the prevention of

strep throat when all you have to do is shoot the patient up with
penicillin?
But I think people are ready for a change. They're almost
demanding They're just this side of pounding on the doors of
it.
the physicians and saying, "Get thee to a nutritional course!"

Q: Other people seem too busy breaking down the doors
of their local fast-food outlet to start lobbying for nutrition.
Dr. Saunders: Yes, that's outrageous, really. That's very
bad. Here we are, one of the most affluent nations on the face
of the earth, and we're nutritionally deficient. We eat glutton-
ously of the wrong types of things. We pounds of sugar
eat 125
a year per capita in the United States. One hundred twenty-five
pounds a year that's a lot of sugar.
It's ironic. We
should be the greatest nation in the world in
terms of our physical and emotional states, and yet we have high
levels of mental and physical illness.
One thing I find disturbing is the possible connection be-
tween sugar and learning disabilities in children. When our daughter
first started school, we thought she might have minimal brain
dysfunction. She was hyperactive and had a very poor ability to

concentrate. We put her on Ritalin, and she went through a very
difficult period for a while. Her teacher asked us to take her off
the medication because it just turned her into a zombi.
Then she suddenly came out of it. We didn't know what
had happened. In retrospect, we realized that she had made
considerable changes in her diet on her own. She stopped eating
sweets and cut down on meats tremendously. We don't know
why she made the changes. It was as if something inside her
was telling her to do this. That's kind of strange, isn't it?
Q: It is, and fortunate.

Dr. Saunders: I think kids are an important aspect of this
fight. Take the fifth and sixth graders in a New York City school
who were given a nutritional course and got so turned on they

petitioned the school administration to change the diet in their
cafeteria. They succeeded, limited the serving of french fries,
got more salads, fresh fruits and yogurt all by themselves. It was
Kid Power. If we can reach the kids at an early age like that,
we can really make a dent.
Q: Do you think we're making any progress in nutrition?
Dr. Saunders: We're only scratching the surface right now.
Just think of the increase in the human resources of our country
that would result we could prevent a significant percentage of
if
the illnesses we suffer. If we could increase the effectiveness of

the average person to a point where he is superproductive, where
he enjoys life, where his emotional problems are no longer a
drain on our society it's very challenging.
INTERNIST
CHAPTER
DEATH'S DOOR
OR LIFE'S DOOR?
If most medical schools are ivory towers, then the Johns

Hopkins School of Medicine in Baltimore, Maryland, is an ivory
fortress. Since its opening in 1893 when, according to the En-
cyclopaedia Britannica, "it set a higher standard for admission
than any other medical school in the country," the name Johns
Hopkins has come to stand not only for medical excellence, but
for medical orthodoxy.

was with some surprise and a little hesitation that
So it
Barbara Solomon, M.D., an internist from the Baltimore area,
whose approach to medicine is anything but orthodox, found
herself speaking to doctors and students of the Johns Hopkins
School of Medicine on a subject which the organizer of her
lecture, a graduate student at the Johns Hopkins School of Hy-
giene and Public Health, aptly called ''new to the Hopkins com-
munity" nutritional therapy.
"I've been interested in nutrition since I was a child," the
energetic Dr. Solomon told the group of over 300 who had gath-
ered for her lecture. "My aunt was a so-called health food fad-
dist. My father was a doctor. And they were in constant debate
my aunt for treating diseases with good diet and supplements,
594
DEATH'S DOOR OR LIFE'S DOOR 595
my father for the conventional methods." She paused and added

with a smile, "Sometimes it seems as if my whole career has
been nothing more than an attempt to find out which one of them
was right
but I think my aunt is right about some things."
That career has included earning an M.D. from George
Washington University in 1960 and a master's degree in bio-
chemistry from the University of California in 1954. It was her

knowledge of biochemistry and the experience of curing her

own migraine headaches through a change in diet that first led
Dr. Solomon to make nutrition the mainstay of her practice.
She Cured Her Own Migraines

"While I was doing my residence at George Washington, I
had migraine headaches," Dr. Solomon told her audi-

terrible
ence. "I would have them three or four times a week. They were
really putting a dent in my effectiveness. At the time, I was
working with terminal cancer patients, most of whom were nau-
seated, vomiting and rapidly losing weight. What a situation that
was! They were vomiting, I was vomiting. Well, at that time, a
friend of mine recommended I take a course in modeling for a
change of pace. I took her advice and, after listening to a pre-
sentation on diet, thought it would be a good idea to improve
mine, especially since it had consisted solely of hospital food for
the previous four years. So I followed the same diet as my model-
ing teacher, who ate only fruits, vegetables, nuts, seeds and fish.
I not only stopped eating beef, but gave up poultry, too for
good measure. Within a week, I stopped having migraines! Not
only that, whenever I ate beef, they came back. Was I excited
and relieved! Then I had the thought. If eliminating these meats
from my diet cured my headaches and nausea, perhaps doing
the same to my cancer patients' diets might help rid them of the
same symptoms."
Translating that thought into action. Dr. Solomon removed
both beef and poultry from the diets of some of her cancer pa-
tients. "They stopped feeling nauseated, they stopped vomiting.
596 INTERNIST
they started to gain weight. Often they stopped having pain. I

was, to say the least, very pleased.''
An article by Dr. Solomon in an issue of the Maryland State
MedicalJoiirnal reported similar experiences with three terminal
cancer patients.
With two of these patients, however, she eliminated not only
beef and poultry from their diets, but all solid food. Fed nothing
but fresh fruit juices or vegetable juices, the patients quickly
stopped vomiting. Dr. Solomon then put them on progressively
heartier diets until they could eat
and tolerate normal meals
which offered eggs, cheese, nuts and seafood as main sources
of protein.
'The improvement in these patients
and other cancer pa-
tients have treated who are not mentioned in this study was
I
dramatic. In fact, sometimes their tumors actually regressed.
Other doctors couldn't seem to get it into their heads that it was
the patients' diet that was causing this to happen. They often
insisted that the original diagnosis had been wrong!"
To this day. Dr. Solomon eats no other meat than fish. And
at lunch after the lecture, we sat next to Dr. Solomon as she ate
a tuna salad
or at least tried to. Between bites, a crowd of
medical students, doctors, health professionals and health seek-
ers besieged her with questions about nutrition.
'Ts too much vitamin C toxic?"
"My uncle is constipated, should he take bran?"
"Dr. Solomon, is vitamin E good for varicose veins?"
In a rare lull, when room turned back into
the consultation
a cafeteria, we asked Solomon if she was always showered
Dr.
with questions about nutrition when she appeared in public.
"Always. Almost everyone knows that diet is important for
health, but very few can get specific information about their own
diet from a doctor, information they feel safe with. Nutrition is
the basic dimension, and I can't see why doctors remain so
ignorant about its importance. In fact, most doctors' knowledge
of nutrition lags about 20 years behind their knowledge of bio-
chemistry. But even though treat patients mainly with nutri-
1
tional therapy, there's nothing I can do for them unless they

change their dietary habits stop eating white sugar and white
flour, start taking the nutritional supplements I suggest. The first
thing I tell patientswhen they come into my office is: 'You are
responsible for how you feel. If you eat unbalanced meals, you'll
"
feel unbalanced.'
"Dr. Solomon. ?" someone asked.
. .
Luckily, we had a personal interview scheduled that evening.
The First Step to Health

And that evening, over a fish dinner. Dr. Solomon told us
more about her use of nutritional therapy in private practice.
'The very first thing I ask every patient is to stop eating
refined carbohydrates
white sugar and white flour. Now, most
of the people who come to see me have already seen other
doctors and have been treated with conventional methods. But
they still feel lousy. When I explain to them that their problem
arthritis, diverticulosis, depression, whatever probably has its
basis in many years of wrong eating habits and that the first step
in treating their disease is to change the most damaging of these
habits eating sugar they're usually eager, or at least they say
they are eager, to modify their diet.
"So they stop eating white flour and white sugar. This change
alone makes a big difference in their health. White sugar and
white flour bum up vitamins and minerals without replacing them,
lower immunity, foul up the digestive tract and complicate di-
abetes, kidney stones, osteoporosis. Also, they cause fatigue.
"In a week or two, they often experience a decrease in pain
and an increase in energy. Then, of course, they cheat. They
binge on ice cream or cake or cookies. And the next day, they
feel terrible. Headachy. Sluggish. Depressed. It's at this point
that they begin to really understand, through their own experi-
ence, that they can actually control how they feel by what they
eat. And for most of my patients, this is a real revelation, a
startling discovery."
598 INTERNIST
Not eating white sugar and white flour is a real boost for
those with osteoporosis, a crippler of thousands of elderly women.
In osteoporosis, bones lose their strength and mass, and break
easily.
''Eating white sugar really steals calcium from the bones,
and calcium that gives bones their strength," Dr. Solomon
it's
told me. "So in addition to getting the sugar out of the diet of
those with osteoporosis, I give them a calcium supplement and
a trace mineral supplement. Also a multiple vitamin."
Arthritics May Have an Allergy

Arthritisanother bone disease that cripples millions. Dr.
is
Solomon has had striking success relieving the pain of arthritic

sufferers by eliminating from their diets not only white sugar,
but citrus fruits and eggs, as well.
"There's nothing unusual about this. Over and over again,
arthritic patients would come to me and say, 'When I eat oranges,
my joint pains are worse.' 'When I eat eggs, my arthritis flares
up.' So always eliminate these foods from
I've experimented. I
the diets of those I see with arthritis. And by and large, they do
better. Also, I've heard of quite a few other doctors who are
doing the same. It seems obvious to me, on the basis of my
experience, that for some reason arthritics are hypersensitive
to that is, they have an 'allergy' to
citrus fruits and eggs."
Along with eliminating fruits and eggs. Dr. Solomon gives
arthritics mineral supplements. "Zinc, in particular, relieves bone
pain," she said. She also gives a calcium supplement that con-
tains vitamins C and D.
Psoriasis, a skin disease, is another disorder which often
yields to dietary restriction. "I have found that my psoriasis
patients do much better when take them off dairy products and
1
anything with gluten in it. That includes wheat, oats, barley and
rye."
All doctors treat diabetes at least partly with diet,and Dr.

Solomon no exception. "I give diabetics the conventional diet:
is
no sugar, no honey, no molasses, more protein. I also substitute

whole grain bread for white bread. And I give them a supplement
of brewer's yeast because it has been shown that diabetics are
low in chromium, and brewer's yeast is the best source."
Nutrition and Outlook

Dr. Solomon recommends a daily dose of brewer's yeast as
one of the best all-around nutritional supplements.
"It not only contains all the B vitamins but is a cheap source
of the important trace minerals, as well, and an excellent source
of protein. So you're getting all three things at once."
Dr. Solomon's treatment for patients with heart conditions
focuses on lowering their cholesterol and triglyceride levels. "I
always prescribe a low-carbohydrate diet for my patients with
heart troubles. If they must eat bread, I only allow them to eat
whole wheat bread. I also give my heart patients niacin, a B-

complex vitamin, because it is a natural vasodilator it improves
circulation. If nutrition doesn't work, then I go to drugs, but
only after I've tried nutrition first."
But Dr. Solomon puts another aspect even before nutrition.
"I must say that over and above the physical aspects of
healing there is the mental aspect both the attitude of the pa-
tient and my attitude. If the patient has a negative attitude toward
the possibility of his being healed, or if he dwells on his disease,
moping and pouting in self-pity, constantly complaining, then
although nutrition will of course help, it will be very difficult for
that person to get better.
"Of course," she added with a smile, "I don't have any
controlled studies that actually prove this. But over and over
again I have seen patients with positive attitudes quickly improve
while patients with negative attitudes continue to be sick.
600 INTERNIST
"It's really fulfilling to see my patients improve," she con-

tinued. "Not of them do, of course. But many, many come
all
back to me after three or six months of eating very little junk
and taking supplements and they are, well, new people. They're
alive again, not just merely living. They have purpose, energy,
they are enjoying themselves instead of barely making it.
"So many doctors can do nothing more than keep their
patients if the disease is serious
from death's door and often
worsen or simply mask a patient's illness with drugs. But in my
practice, people actually become healthy. And that makes my
work tremendously enjoyable."
CHAPTER
HOW VITAMINS
REVOLUTIONIZED
MY PRACTICE
by Harvey Walker, Jr., M.D., Ph.D.
During my first ten years in the practice of internal medicine

(1957 to 1967), I was very frustrated to discover how many of
my patients had health problems for which I had no solutions.
Then in 1967, while convalescing after a hernia operation, I read
Adelle Davis's book Let's Get Well, which was given to me by
a friend. After reading the book, nonstop, I realized that, even
though I one of the most prestigious medical schools
had gone to
in the my instructors had spent discussing
country, the few hours
nutrition were totally inadequate to meet the needs of my pa-
tients. From that point on, I vowed to learn everything I could
about the rapidly expanding field of nutrition and health.
I began experimenting on myself with vitamins and minerals,
particularly the B vitamins, vitamin E, lecithin and vitamin C. I

discovered that large doses of the latter helped reduce serious
problems which I had been experiencing. As the results
allergy
became evident and my health and confidence grew, I began
recommending nutritional supplements for my patients.
rd like to share with you some typical case histories that
illustrate how vitamins have revolutionized my medical practice.
601
602 THE NUTRITIONAL HEALERS
A number of years ago, my

Kay, complained about
wife,
her hair becoming thinner and thinner. It became so bad that
she had to wear a wig for two years. But after several weeks on
large doses of every B-complex vitamin known, the hair fall
stopped, and her hair became thicker and more manageable.
A 57-year-old chief engineer came to me complaining of
severe fatigue. I him on a B-complex formula containing
started
10 milligrams of vitamins Bi, B:. Bft and para-aminobenzoic acid
(PABA); 20 milligrams of niacinamide (a form of niacin); 10
micrograms of biotin; 100 milligrams of calcium pantothenate;
50 micrograms of folic acid (folate); 5 micrograms of vitamin Bi^;
and 500 milligrams of vitamin C. He took two of these tablets
four times a day. Within a few days, he called me to complain
that he now had so much energy, he was unable to sleep at night!
After eliminating his bedtime dose of B complex, this man was
able to work hard in the daytime without tiring and still sleep at
night.
Vitamin C and Viruses

Since I started emphasizing nutrition in my practice, re-
quests for flu vaccine by my patients have declined markedly.
In former days, they would come in and ask for flu shots every
fall.More recently, however, they say that, as long as they take
500 to 1,000 milligrams of vitamin C four times a day, they are
able to avoid colds, flu and respiratory infections. And they
would much rather take the vitamin C than have a flu shot.
I'm convinced that vitamin C is nature's virucide (an agent
that kills viruses). When my oldest son was a junior in high
school, he had a severe case of infectious mononucleosis which
caused him to miss about four weeks of school. Unfortunately,
1 knew little about nutrition at the time. Later, when his younger
sister developed mononucleosis, it was after I had become fa-

miliar with the great power for good of megavitamin therapy. I
placed her on 1,000 milligrams of vitamin C every two hours,
and within one week she was back in school and feeling fine.
VITAMINS REVOLUTIONIZED MY PRACTICE 603
A boy of 18 developed infectious hepatitis. Once again, I
turned to my newfound ally, vitamin C, prescribing 1,000 mil-

ligrams every two hours. Within one week, his liver function
tests had returned to normal and he was back on the job. have I
not seen remarkable results like this reported in the standard

drug-oriented medical literature.
A 58-year-old laborer came to me for help. His job required
him to walk at least 3 or 4 miles a day through the factory where
he was employed as a maintenance man. He said he was going
to have to take a disability retirement because pains in his legs
were preventing him from doing his work. I started him on vi-
tamin E, 400 international units four times a day. He was also
given lecithin capsules, ,200 milligrams each, four capsules four
1
times a day. After about a month, he reported his legs had im-
proved so much that he had canceled his application for retirement.
I feel that vitamin E and lecithin make a good pair to be
used together. Vitamin E helps to improve blood circulation,

while the lecithin seems to solubilize fats in the blood that would
otherwise precipitate and form deposits. I have many diabetic
patients taking both vitamin E and lecithin who report much
better circulation in their lower extremities. If they stop taking
those nutrients, their feet get colder and feel less comfortable.
Using Vitamin E to
Protect the Heart
Another man mid 50s reported terrifying anginal pain
in his
in his left chest when he walked uphill into the wind on his way
to the local hockey arena. Although he was popping nitroglycerin

tablets under his tongue, he still had anginal symptoms severe
enough to force him to cancel his season tickets for the hockey
games. After a few months on vitamin E, lecithin and other
supplements, his chest pain subsided. He no longer needed ni-
troglycerin and was able to make it to the hockey games without
pain. He achieved this result even though he was overweight
and smoked heavily.
Incidentally, the use of nitroglycerin among my heart pa-

But those
tients has practically ceased. who have stopped taking
their vitamin E or
reduced the dose have had a severe re-
currence of their problems.

A young mother who consulted me had an enlarged heart
and an abnormal electrocardiogram. I sent for the records of her
previous health care in various hospitals, and she and 1 were
amazed to discover that her heart problems had been known by
doctors for three years, but no one had ever told her about it.
Her heart problem was now causing her so much pain and dis-
ability that she was admitted to one of our local university teach-
ing hospitals where cardiac catheterization was performed. It
was determined that she was suffering from cor pulmonale, which
is heart disease caused by lung disease, and that she had less
than five years to live. This put her young husband into shock
as he contemplated life without his wife and with two preschool
children to raise.
It was theorized that, during the four years that this woman
had been on the Pill, showers of pulmonary emboli traveled as
tiny clots from her legs and pelvis into the arteries of her lungs,
clogging many of them and greatly raising the circulatory pres-
sure in her lungs. I placed her on large doses of vitamin E, along
with B complex and the other usual supplements, and am very
pleased to report that, five years later, her heart and lung function
have improved. Yet, the university experts predicted she would
be dead by now.
I believe that if all women on the Pill would take 1,200
international units of vitamin E daily, the incidence of compli-
cations like heart attack, stroke and thrombophlebitis would be
greatly reduced.
Once, when my wife had been sitting at a desk for a long
time typing, she got a blood clot in her leg. I sent her home with
a bottle of vitamin E, and she was back to work

couple ofin a
days. My experience before with thrombophlebitis was that peo-

ple were in the hospital for three weeks getting over it.
One of our most tragic cases was a young diabetic girl who
was almost blind and came to St. Louis for an eye operation. It
was successful, but the doctors at the hospital where she went
completely ignored my pleadings to put her on the nutritional
regime which she had been on before she went in the hospital,
and they sent her home without it. They did not tell me when
she was discharged, and her nurse-sister did not realize how
vitally important we felt these supplements were. And a week
after she was discharged from the hospital she'd been off her
vitamin E then for about three weeks she had a stroke and has
never recovered from it. I think that was preventable, and it's
just a tragedy. I think the world is full of tragedies like that.
Of course, vitamin E isn't the whole story in my practice.
I've already mentioned the value of the B complex. And for
those who have special skin and mucous membrane problems,
I've found that vitamin A may be helpful. For those who have
difficulty assimilating calcium, extra vitamin D may also be
indicated.
The vitamin C dosages I recommend vary from 250 milli-
grams twice a day for a young child to as much as ,000 milli-
1
grams every one or two hours for an adult battling a severe virus
infection or the stress of surgery, burns, fractures or other major
trauma. I recommend a routine adult dose of 1,000 milligrams
four times a day and believe that, at this level, very few if any
virus infections will occur.
I most adults on 400 international units of vitamin E
start
three times a day. (There is one precaution, however, regarding
vitamin E. Those with rheumatic heart disease or high blood

pressure should start with 100 units and gradually increase the
dosage while watching their heart function and blood pressure
levels closely.)
You probably need more vitamin E if you are taking
will
birth control pills, have had a heart attack, are very sedentary
or have severe arteriosclerosis.
During the first ten years, I had some patients die from heart
attacks, strokes and postoperative pulmonary emboli. Since all
my medical colleagues had similar experiences, 1 was resigned
to accepting those deaths. However, looking back over the last
ten years, when most of my patients have been on an adequate
nutritional regimen. have had very few patients die from heart
I
attacks or strokes. have read that the noted surgeon Alton

I
Ochsner, M.D., used vitamin E in his practice for several decades

and reported excellent results with no postoperative blood clots
in his patients. I have told my local surgeon friends of Dr. Ochs-
ner's good results, but 1 cannot get them to try vitamin E. My
patients, of course, receive vitamin E before, during and after
surgery, and they have had no postoperative blood clots.
I build up all my patients prior to surgery. 1 give them extra
zinc before and after the operation, along with vitamins A and
E for better scar healing. Almost every surgeon consultant I
have comments to me on how rapidly my patients get well and
get out of the hospital and how few complications they have
compared with other patients.
A Thorough Exam
In dealing with new patients, I believe that there's no sub-
stitute for a very careful, thorough examination and personal-
history taking. patient who comes to our St. Louis
Each new
office first fills comprehensive health questionnaire with
in a
1.566 questions. This is then processed by computer. He or she
may also complete a computer-processed nutrition and activity
questionnaire, which gives the patient a thorough analysis of
previous diet with suggestions for improvement. This second
questionnaire also analyzes the patient's exercise habits and pre-
scribes additional exercises as needed.
After the questionnaire printouts are back, the patients are
examined in the office by me or my associate. We review the
quesionnaires with each patient and do a complete physical exam
at that time.
Since food allergy is proving much more common than ear-
lier believed, many of our new patients receive a food intolerance
test. Many patients also have a hair analysis test, which gives
us good guidance in prescribing mineral supplements. It is our
goal to have all our patients knowledgeable enough about their

own conditions and their own health so that they can take good
care of themselves and avoid the need for extra office visits or
hospitaHzation.
But they have to reahze that, unhke drugs, natural treatment
methods take time sometimes several months to produce im-
portant results. Since beginning to prescribe vitamins and min-
erals for my have observed a lot of remarkable things
patients, I
that I have a lot left to learn, and I probably

can't explain. 1
always will. But practicing medicine has become much more

pleasant since I now know that there are simple dietary measures
and nutritional supplements that can benefit so many of my
patients.
Because the nutritionally oriented practice of medicine is
increasingly popular with the public, requests for such services

are multiplying.I urge any physician who is interested in joining
such a practice to contact me.
CHAPTER
MUNG BEANS AND

COTTON SWABS
From the cross-legged patient paging through Good House-

keeping to the proud diplomas displayed next to the nurses'
niche, it looks like any other doctor's office.

But this one belongs to Victor L. Pellicano, M.D. the soft-
spoken, Lewiston, New York, internist who carries a bottle of
vitamin C instead of a prescription pad in his coat pocket. And
it may well be the only M.D.'s office you'll step into where you'll
find a jar of mung beans sprouting next to a canister of cotton
swabs.
'Td been
preaching the nutritional value of sprouts so often
that a couple ofmy nurses decided to take up sprouting," the
slim doctor chuckled warmly during our visit. "Now, when I
get hungry for a snack, they whip me up a sort of sprout sandwich
on Triscuits,and I have that with a cup of Red Zinger tea. It's
just delicious. And, more than that, it's a highly nutritious snack!"
Actually, Dr. Pellicano is the last person you might expect
to be expounding on the benefits of sprouts or good nutrition.
A long-standing member of the American Medical Association,
Dr. Pellicano has also served as president of both the Western
New York Heart Association and the Society of Internal Medicine.
608
MUNG BEANS AND COTTON SWABS 609
"It's true," says the kindly doctor, "I haven't always been
geared toward nutrition. Medical school didn't train us in it the
way it should have. And, let's face it, most doctors are pretty
closed minded when it comes to vitamins and minerals.
"It took my youngest daughter
who was just entering col-
lege at the time
to introduce me to nutritional therapy. She
asked me what I knew about organic food. I really didn't know
too much about it. So she bought me Adelle Davis's book Let's
Eat Ri^ht to Keep Fit. Reading that book set me off on sort of
a nutrition hobby. I read more books and attended meetings on
nutrition. Gradually, I changed my own dietary habits and began
to incorporate nutritional therapy into my medical practice."
Of course. Dr. Pellicano continues to practice conventional
medicine. He'll prescribe conventional treatment when it's in-
dicated but, he told us, that's often after he has given nutritional
therapy a chance.
"There are many times when conventional therapy is ab-
solutely indicatedand when nothing else will do. But there are
other times when vitamin therapy works just as well and better
because it doesn't subject the patient to the risk of conventional
drugs."
Vitamin C Stops Shingles

"A few years ago, was visiting my daughter in Albuquer-
I
que, New Mexico, and developed shingles. So I took between

I
10 and 12 grams [10,000 and 12,000 milligrams] of vitamin C a

day. It stopped them almost dead in their tracks. Which really
isn't so surprising, since shingles are caused by a type of virus,
and vitamin C has already demonstrated itself in a number of
viral diseases including the common cold.
"All my patients who come into the office with symptoms
of a cold are told to take 1 gram ( 1 ,000 milligrams) of vitamin C
every hour for the first day and every other hour for the next
few days thereafter. I've found that in most cases the vitamin C
reduces the severity of the cold, and most of my patients can
get through the course of a cold without the extra boost of an

antibiotic.
"I also prescribe vitamin C for my patients with back trou-
ble. They heal faster and their problem doesn't usually come
back, as it does in patients who get the same treatment but who
do not take vitamin C.
"You see, vitamin C is essential for maintaining collagen,
the fibrous connective tissue between the bones. So if you've
got disk trouble, it makes sense that vitamin C would help by
strengthening the connective tissue in these joints."
You can probably tell by now that Dr. Pellicano is a real
believer in thepower of vitamin C. How much does he take each
day to maintain his good health? Dr. Pellicano smiles as he pulls
a bottle of Cs from his coat pocket and pops a jelly-bean-size
vitamin C tablet into his mouth. "Each of these tablets contains
1 gram of C, and take three to five of them every day." That's
I
a far cry from the RDA (Recommended Dietary Allowance).
Preventing Scurvy Isn't Enough

"The RDA is that it keeps changing. I think
trouble with the
right now about 60 milligrams of vitamin C. That much will
it's
prevent scurvy, but it won't keep you in good health. When you
compare the human body, pound for pound, with the body of
an animal capable of synthesizing its own vitamin C, you realize
that man would have to take between 5 and 12 grams of vitamin
C each day to be on the same level."
And our basic requirement is one thing. What about the
need created by outside influences like smoking, drugs and stress?
"One cigarette neutralizes 25 milligrams of vitamin C in the
body," Dr. Pellicano warns. "So if you're a pack-a-day smoker,

you have to take 500 milligrams of C just to break even."
Don't believe those reassurances that if you eat a well-
balanced meal you don't need the supplements. "In the first
place, 90 percent of the people especially the doctors don't
know what a well-balanced diet is," charges the Lewiston in-
MUNG BEANS AND COTTON SWABS 611
ternist. "It's unfortunate that much of the nutritional information

we have comes to us from industry. So, naturally, it's slanted
in their direction.
"The reason we don't hear more about the benefits of vi-
tamin C from is that there's no money in it.
the medical world
Look Linus Pauling has run into with his work on
at the trouble
vitamin C and cancer. No one is willing to give him financial
backing. Yet, his work definitely seems to be leading to some-
thing. After all, we know that vitamin C has a beneficial effect
on the white blood cells, which are involved in the body's im-
mune mechanism. Apparently, the vitamin helps the white blood
cells engulf harmful organisms more readily and render them
harmless. And if this is the case, well then, why not help cancer
victims? That is, if we accept the theory that cancer is caused
by viruses and that persons who are cancer prone have flaws in
their immune mechanism."
Good Health Starts with

Cutting Out Junk Food
"I right for me and my patients. For one thing,
know what's
Lve cut out
junk food that includes everything that contains
all
refined flour and sugar. I don't eat much meat anymore, either.
Or poultry, for that matter. When I dine out, I try to order
vegetarian platters, and if that is impossible, I order fish. And
when comes to fresh produce, think organic is better. Here
it I
in New York State, we have a Natural Food Association which
certifies organic produce

that way you can be pretty sure that,
when you pay for organic, that's what you're getting.
"In the summer, however, don't have to rely on those
I
producers. I've got my own little garden in the back yard. It

isn't much. But amazing how much you can get out of even
it's
a small plot such as mine. Tomatoes, peppers, cucumbers, squash.

I've even got some Jerusalem artichokes a patient gave them
to me."
And what about vitamin supplements? "I take almost every-

thing. Actually, it varies from day to day. Usually, 1 try to include
brewer's yeast and lecithin in my morning grapefruit juice and
crystalline vitamin C in my Tiger's Milk. I also take 3 to 5 grams
(3,000 to 5,000 milligrams) of vitamin C
each day as well as a
multivitamin and mineral tablet, 400 to 800 international units of
vitamin E and 25,000 to 50,000 international units of vitamin A."
Is that how he manages to stay so slim and healthy, we
asked. "Yes, that and exercise. I do 15 minutes of calisthenics
each morning, and then I make it a point to get as much walking

into my day as possible. I don't take any elevators. If I have a
patient in the cardiac intensive care unit, I run up the seven
flights of stairs to see him.
"I know it all pays off," Dr. Pellicano smiles. "I weigh the
same now as I did in college."
NUTRITIONIST
CHAPTER
THE "HEALTHY
HOUSEBOAT"
IS MAKING WAVES
IN NUTRITION
"All aboard!"
Johanna Hall's voice is as clear as the cool waters of the
Chesapeake Bay, her tone as warm as the sunshine that bounces
off the water's surface and lights up her blond curls. Like a vision
out of Mark Twain, she stands on the deck of a white wooden
houseboat, beckoning to the 30 or so visitors who are approach-
ing from shore.
Cast her as Huckleberry Finn's mother; the fictional waif
would adore her. One thing she would do is feed him well. That's
because Mrs. Hall is no ordinary skipper, and this is no ordinary
houseboat. She's a teacher, dietetic assistant and nutritional
counselor; the houseboat is her office and lecture hall. Twice a
month, people crowd the two-story ship's cabin to hear her tell
how making a small change in their diets can make a big change
in their lives.
She makes it easy for her listeners: The advice is sensible
and her step-by-step method is sound; her houseboat is moored
in a cove that's an easy 10 minutes from downtown Norfolk,
Virginia.
But Mrs. Hall, herself, walked the plank to get where she
is now.
613
614 NUTRITIONIST
Seven years ago, she was a Beach housewife

typical Virginia
with two kids, a husband and a home She had
to look after.
never planned on getting a job. But then, her husband Don had
never planned on getting hemorrhoids, either.
"What hit us as a misfortune turned out to be a blessing in
disguise," she recalls. It
was bran and Mrs. Hall's hobby of
reading every new book thatcomes to her local library that
saved Mr. Hall from the surgeon's knife.
"He came home from the doctor in despair. My husband
Don is a big man, but he crumbled like a little boy at the thought
of an operation. His hemorrhoids were prolapsed and the doctor
scheduled the surgery for three weeks from then.
"It just so happened that I was reading a book called The
Save Your Life Diet by David Reuben, M.D. (Random House,
1975). The gist of the book is that you can protect yourself from
many degenerative diseases by eating a lot of high-fiber foods,
especially bran. Normally, I would have thought. That's inter-
esting,' and then forgotten all about it a week after I finished the
book and took it back to the library. But the book mentioned
conditions such as Donny's, and so I figured, 'What have we
"
got to lose by giving it a try?'
For the next two weeks, Mrs. Hall put bran in nearly every-
thing her family ate: breakfast eggs and cereal, baked goods,
casseroles and meat loaf, soup and salad, evenjuice. Three times
each day, she had her husband drink 2 tablespoons of bran in a
glass of orange juice: at breakfast, at bedtime "and after work,
when I would meet him at the door with a glass of orange juice
laced with bran instead of a cocktail!
"I did it partly to humor him," she confides, "to lift his
and get him
spirits to laugh about his condition. I really never
expected it to help.
"A week before he was to undergo surgery, my husband
started saying he felt so much better, he thought his hemorrhoids
were gone. I didn't believe him; I figured it was just wishful
thinking on But he went back to the doctor, and the
his part.
doctor agreed with him. The doctor called off the surgery and
said, T don't know what your wife is doing, but tell her to keep
doing it.'
THE "HEALTHY HOUSEBOAT" 615
''When Don came home and told me that, I was elated. And
then I was scared. It was as if I had been handed a marvelous
trust, a secret weapon, and I had no idea how to handle it."

So she went back to the library and read every book on diet
and health. Then, she came home and purged all her kitchen
cabinets of things like white flour and sugar, salt, convenience
mixes, hydrogenated fats and oils, cookies and candies, coffee
and soda. She replaced them with whole grains, wheat germ and
bran, honey and molasses, herbs and spices, brewer's yeast and
lecithin granules, fresh and dried fruits and nuts, herb teas and
spring water.
Her husband supported her. Her kids did not.
"Danny was five and Michael eight and 1 had raised them
on chocolate chip cookies and soda pop. They craved those
things as if they were addicted. In America, we are consuming
about 75 pounds of sugar (sucrose) per person per year, and they
haven't declared that dangerous. Well, if that isn't dangerous, I
don't know what is!"
Mrs. Hall knows what she's talking about when she inveighs
against sugar. After getting her own kitchen in order, she enrolled
in a degree program in dietetics at Tidewater Community College.
Her studies included a coordinated practice in the kitchen

of a local hospital. After graduation, she started teaching nutri-
tion to elementary-grade children at the Virginia Beach Friends
School. Meanwhile, a manager at her favorite health foods store
told her that the owner was looking for someone to edit a nu-
trition newsletter and conduct a few seminars in healthy eating.
She made quite an impression on the owner. Bill Colonna, and
her knowledge made quite an impression on Virginia Beach au-
diences. When her following grew, he asked her to set up shop
on his old family houseboat.
Gaining Energy
During her lectures, she talks openly about her past: 'T was
the biggest junk-food junky in Virginia Beach. Now, my husband
is strong and healthy, my kids don't get cavities anymore and
616 NUTRITIONIST
they're better behaved." And

she herself has lost a sinus con-
dition and several pounds, gaining worlds of energy and the kind
of figure that women envy and men admire. She freely admits
her age: It's 39. She smiles when people say she doesn't look
it.
"Often, they're the same people who say life is too short
to deprive yourself, and 1 say, 'Sure, but don't you want to stay
healthy and good looking well into your old age?'
"And besides, who says the foods I eat don't taste good?"
Mrs. Hall lugs pans of delicious, wholesome bread and cook-
ies to her lectures so the audience can sample wholesome treats
made from wheat germ and carob, molasses and peanut butter.
There's always more than enough, and while her listeners feast,
she them with helpful tips.
fills
She tells them how to "make your own peanut butter in a

blender, using fresh peanuts and a tiny amount of unsaturated
vegetable oil, just enough to keep it smooth."
She also tells them how to shop at the supermarket: "in a
U. Go up the dairy and produce aisles that form the perimeter
of the store. That way, you'll avoid most of the convenience
foods and all their temptations. That way, it's also 'out of sight,
out of mind' for the kids," she adds. "Did you ever notice how
allthe cookies, sugary breakfast cereals and soda pop are shelved
low? The processed-food industry is wise. But you be wise, too.
Learn how to say no."
She also shows people how to read labels, locating hidden
sugar in everything from catsup to canned beans. She uses charts
to show how much salt you can easily consume without ever
once lifting a shaker, while explaining what salt can do: "Sodium
can raise your blood pressure and lead to coronary artery dis-
ease. I lost my mother at age 58 from a stroke. I have no doubts
that she would be alive today if I knew then what 1 know now."
By the time Mrs. Hall is finished talking, her audience is
convinced, willing to jump right in and do anything she says.
She says, "Take it easy. Don't expect to change years of habits
and acquired tastes overnight. I did, but that way is drastic and
I don't advise anyone to do it that way."
THE "HEALTHY HOUSEBOAT" 617
Start off by getting rid of white sugar and all store-bought

sweets, she tellsthem. "Introduce whole grains gradually. Start
off by substituting half whole wheat in any recipe calling for
flour." Going off salt should also be done slowly, by replacing
it with herbs and spices. "Be creative. Experiment with new
flavors,'' she tells them. She also suggests they buy a copy of
Confessions of a Sneaky Organic Cook by Jane Kinderlehrer
(Rodale Press, 1971). "The book offers good hints and recipes
and is fun to read."
To ease people through the transition, she and other Virginia
Beach mothers have formed SNAK. The acronym stands for
Sharing Nutrition and Knowledge, and the group is basically a
recipe exchange club. Members also discuss common problems
and give each other support. Mrs. Hall thinks mothers should
consider forming similar groups in their own communities.
Not all SNAK members are quite as fastidious as Mrs. Hall.
"It takes time. It's the awareness that counts." She is trying to
help people increase their awareness, but sometimes her mission
takes a strange turn. Recently, a television news crew came to
the houseboat to tape a feature that called for her to be shown
throwing out a bag each of white sugar and white flour.
"I hadn't used those items in seven years, so I had to go
out and buy them as props for the show," she recalls. "But I
saved the receipts and, when the taping was over, I took them
right back to the store and got my money back.
"I told the clerk that buying them had been a mistake."
CHAPTER
A THOROUGHLY
MODERN NUTRITIONIST
She calls herself the Billy Graham of the Parkersburg, West

Virginia, nutrition scene. But and charismatic Rebecca
intelligent
Riales (rhymes with dials) is more. She's a thoroughly modern
nutritionist. And it didn't take us long to find out why.
No sooner have we settled down to chat in her comfortable
professional quarters when confrontation strikes. A registered
nurse from the local hospital rushes into her office bemoaning
some flap among the hospital dietitians over a peculiar diet or-
dered for a teenage diabetic. The diet was ordered by Dr. Kenton
Harris, Rebecca's physician-husband. But there is no mistaking
the architect behind its design. It is Rebecca Riales' work, all
right!
A far cry from the long-accepted American Diabetic As-
sociation diet, this diet is unusually high in carbohydrates. And,
as everyone "knows," diabetics can't tolerate starch.

Or can they?
Rebecca Riales listens calmly. Then as the nurse's re-
counting of dietitian opposition winds down she sighs almost
disbelievingly, ''Don't they know that every medical study which
618
A MODERN NUTRITIONIST 619
puts a diabetic on a high-carbohydrate diet finds that the diabetic

improves?"
By carbohydrate, she explains to us later, she doesn't mean
a carte blanche to sugary desserts. On the contrary, she bids
her patients to make do on less of that powdery white stuff. What
she'd like to see more of on everyone's plate is complex car-
bohydrates. Beans and potatoes and whole grains. Starch with
fiber as opposed to sugar without. To her, the difference is like
day and night.

And Rebecca Riales has the know-how to know why. With
a master's degree in biological science and a Ph.D. in human
background which neither the American
nutrition, she boasts a
Medical Association nor health food enthusiasts can find fault
with.
But as that enthusiastic sparkle in her eye tells you, Rebecca
Riales doesn't lean much on laurels of past degrees. Instead, she
prides herself on her open-mindedness and on her unquenchable
thirst for new scientific information on nutrition. Moreover, with
these solid scientific facts and a little friendly persuasion, she's
hoping to integrate nutritional biochemistry into the heads of
practicing physicians.
One wedge she has in the medical establishment is her hus-
band, Kenton Harris, M.D., a practicing internist with whom
she shares an office and clinical practice. Another is her position
as an assistant professor at Ohio University where, one morning
a week, she teaches nutrition to sophomore medical students.
In fact, the day we visited, Dr. Riales fortified herself with
a morning meal of melon, raisin bran muffins and skim milk
before embarking on the 45-minute drive across the state line to
Ohio University. School had just let out for the summer. But
two students who missed the final exam made an appointment
to discuss the make-up final.
Interestingly enough, what began with questions like "Did we
cover this or that?" and "How much text material are we respon-
sible for?" ended up with probing inquiries on nutritional therapy
for actual patients the students were managing in other courses.
620 NUTRITIONIST
One woman brought up the case of a physically active young

man with a lactose (milk) intolerance who repeatedly broke bones
in his ankles and wrists. The other student inquired about sup-
plements for pregnancy.
Dr. Riales was, of course, eager to discuss nutritional al-
ternatives. But she was careful to point out that her role has
certain innate limitations. "Total care is in the hands of the
physician. And technically you
not I
are the ones with the
authority,"' she told the two students. 'T just want you to be
aware of the fact that total medical care is a big, multifaceted
endeavor and that nutrition is one of those facets.''
From the intent expressions on the students' faces and their
interested remarks on nutrition, it was obvious that Dr. Riales
had raised the consciousness of these two doctors-to-be.
Heading back to Parkersburg, Dr. Riales talked about the
clinical practice which keeps her busy the remaining 4'/2 days a
week. She accepts patients on referral from her husband and
other open-minded M.D.s. She then talks to these persons (mostly
diabetics and cardiac patients) about how they might alter their
diets and perhaps take some vitamin and mineral supplements
to improve specific conditions.
"It's more analogous to marriage counseling than a physi-
cian's appointment," says Dr. Riales. 'T don't just sit behind a
desk and say. Take this and this and this.' First we must chat.
I want to know what the patient is already eating. What he likes
and dislikes. Then I try to tailor a more optimal diet around his."
That's a major difference between a typical hospital dietitian
and this unusual nutritionist, we found out.
A dietitian merely instructs the patient in standard diets
taken from the hospital diet manual or the American Diabetic
Association manual. Dr. Riales explained. And by "merely in-
structs," she means just that. A hospital dietitian has no say in
the selection of the diet. It is predetermined by a written order
from a physician who, of course, has no academic background
in nutrition, inmost cases.
But because Rebecca Riales is not affiliated with a hospital,
she writes her own diet orders. She gets the lab work and medical
histories of a patient and chats with the patient's doctor. Then,

utihzing the latest nutritional information, she personalizes a
healthful diet to fit the individual's lifestyle.
"I'm very cognizant of the fact that you can't change people
very much," she admits. "So I start with the patient's own diet
and modify it to its best advantage. I look at it this way: If a
person doesn't like milk, what good would it do to write four
glasses of milk on his menu? I'd just as soon have him take a

calcium supplement which, incidentally, is another difference
between a dietitian and me. A dietitian never prescribes
supplements."

But Dr. Riales does and quite liberally if the need is there.
That afternoon, while we played dormouse and listened in on a
counseling session with a 61-year-old gent. Dr. Riales recom-
mended dolomite for his nighttime leg cramps, vitamin E for
intermittent claudication (leg pain after exertion), vitamin A for
poor night vision and vitamin B^ for numbness and tingling sen-
sations in his hands.
"The leg cramps probably vanish overnight with do-
will
lomite, but the intermittent claudication will take longer to rem-
edy," she told him. "Don't get discouraged. Just keep taking
the vitamin E. And remember, because vitamin E is an oil-soluble
vitamin, it cannot be absorbed by the body unless it's taken with
a fatty food like salad oil, cheese or whole milk. Never on an
empty stomach."
She also proposed that he take a good multivitamin and
mineral supplement with folate, an extra dose of vitamin C and
a course of brewer's yeast every day to offset nutrients missing
in his low-calorie diet.
"Vitamins and minerals piggy-back on calories," she ad-
vises her patient with motherly concern. "Based on what you
filled in on the diet questionnaire I gave you, I think you've
gotten yourself into quite a few nutritional deficiencies as a result

of your extremely low-calorie diet. Only 800 calories! You can
understand why I'm asking you to take these supplements."
The elderly man nods his head and smiles approvingly. Re-

becca Riales has won over another patient not so much because
622 NUTRITIONIST
she has taken the time to explain why she is prescribing all those
pills, nor because she has given equal time to his minor com-
plaints, but because, by the end of the session, she has tailored
a diet around his favorite foods: bread and potatoes.
A little background on the patient we'll call Mr. Samuels:
First and foremost, he is a diabetic has been for more than
four years, ever since his third heart attack. He's 5 feet 1 1 inches
tall and weighs 191 pounds. A little on the heavy side.
Mr. Samuels says his biggest problem is weight. "The only

time I can lose weight is if I have the flu and don't eat at all,"
he tells Dr. Riales. "Otherwise, every doggone time I eat some-
thing, it goes to weight."
She leans over the desk as if she's about to let him in on a
secret. "Are you aware that the high levels of insulin you're
taking to control your diabetes are working against you on your
weight problem?" she asks. "Insulin's role is to get sugar out
of the blood and into the cells that need it for fuel. But if you
have more blood sugar than the cells need for fuel after lunch,
insulin also helps to convert the extra blood sugar into fat, which
is stored for future fuel So if we can reduce the amount of insulin
.
you take each day by virtue of improving your diet, then it may
be possible to help you lose some weight."
And how does Dr. Riales propose that Mr. Samuels improve
his diet? By stepping up his carbohydrate intake, of course. Mr.
Samuels looks puzzled. "You mean I can lose weight on bread
and potatoes?"
Losing Weight on
Bread and Potatoes
"People make the unfortunate assumption that a carbohy-
drateis a carbohydrate when, in fact, there are four very different
types of carbohydrates," says Dr. Riales. "There is sugar with

and without fiber and there is starch, again, with or without the
fiber.
"The rationale used to be that if starch turned to sugar then

the diabetic can't have either one/' says Dr. Riales. "But the
rate at which the complex carbohydrate or starch turns to sugar
is very slow
so slow, in fact, that the benefit derived from eating
starch is as great as the harm derived from sugar.
"So everything you've ever been told about staying away
from sugar still holds. But the diet that I'd like to see you go on
has a very high proportion of calories in starch especially starch
with fiber."
With that. Dr. Riales sets off on her favorite on
spiel fiber.
"I have this bias that, aside from indolence and inactivity, the
biggest single contributor to obesity is eating foods without fi-
ber," she says. "The reason is simple: Fiberyou up on

fills
fewer calories. If you eat a lot of fiber, you won't have room in
your diet for fat (which pound for pound or gram for gram is IVa
times as fattening as carbohydrates), for animal protein (which
is innately bound up with fat) or for simple carbohydrates without
fiber.
"Besides, medical studies have shown that, all else being
equal, the diabetic (whether on insulin or not) has lower blood
sugar on a high-fiber diet than he does on a low-fiber diet.
"Unfortunately, between the grain in the field and the white
dinner roll you eat is the mill which throws away the fiber. And
between the apple on the tree and the juice you drink is the juice-
making factory which throws away the fiber. What I'm saying
is that you're better off eating whole food
whole grain products
(like whole wheat and rye bread) versus refined; whole baked
potatoes with their jackets, in place of instant potato flakes;
whole fruit instead of fruit juice."

Mr. Samuels cheerfully agrees to the diet "I should have
come to you a long time ago!"
Just as Mr. Samuels leaves. Dr. Harris approaches and en-
treats his nutritionist-wife to see a patient in his office. Then he
turns to me. "Eighty percent of the patients I see have self-
inflictedproblems," he shakes his head. "If they took care of
themselves and ate right, they wouldn't need my help in the first
place. Rebecca's gotten me into a lot of good habits. For one
624 NUTRITIONIST
thing, we practically never eat meat. She makes delicious ve-

getarian casseroles. And although 1 stilleat meat occasionally,
I don't enjoyit anymore."
With Dr. Riales returned from her impromptu counseling

session, we head for home. And home for Rebecca Riales and
Kenton Harris is an ultramodern house of natural cedar and
glass, situated in the shady midst of an old oak forest just one
more extension of their wholesome life style.
The Yeast Study

Little
with Big Results
We sink down into a modern
sectional next to the baby
grand (our admits to being a not-bad classical
clinical nutritionist
pianist). Her eyes light up. "June 19th was the biggest day of
my life, and I've been 6 feet off the ground with excitement ever
since," she exclaims. "That's the day I received a letter from
Walter Mertz about the results of my little study on brewer's
yeast and HDL [high-density lipoprotein] cholesterol."
She plops a large box of clippings from medical journals in
my On top is the letter from Dr. Mertz, the prominent chro-
lap.
mium researcher and chairman of the USDA's Nutrition Institute.
"Dear Dr. Riales: .Thank you so much for your letter
. .
and the outstanding results that you reported," Dr. Mertz writes.
"To my knowledge you are the first person who has shown a
clear-cut dietary effect on HDL. My sincere congratulations."
Before we could read further. Dr. Riales interrupts with a
backtracking to the details. For some time, she explained, she
had been fascinated by research done on the glucose tolerance
factor, or GTF, a chromium-containing compound found in large
amounts in brewer's yeast. Convinced of its importance in im-
proving the efficiency of insulin, she prescribed a trial course of
brewer's yeast (2 teaspoons or 12 tablets a day) to the majority
of her diabetic patients. While some of her patients did not seem
to benefit, many did. Their too-high blood sugars came down to

normal.
Meanwhile, she had been reading everything she could get
her hands on about HDL cholesterol. Total blood cholesterol is
made up of three types of globules: low-density lipoprotein (LDL),

very-low-density lipoprotein (VLDL) and high-density lipopro-
tein (HDL). The HDL fraction appears to actually protect against
heart disease, so the higher your HDL cholesterol level, the
slimmer your risk of heart disease.
Gradually, this GTF and HDL information began to con-
all
geal. Dr. Rialesreasoned that, since insulin has important roles

in connection with fat metabolism (in addition to sugar metab-
olism), perhaps something which improves the efficiency of in-
sulin might have beneficial effects on blood fats, too
especially
on the most important blood fat fraction, HDL.
"Last January, 1 persuaded Kent to take a daily dose of
brewer's yeast so that I could measure any changes in HDL
cholesterol," Rebecca smiles as she glances over toward her
hubby on the other side of the room. ''His HDL cholesterol
levels were high-normal to begin with. But after six weeks on
brewer's yeast, they jumped from 50 to 66 higher than any
jump anyone else had ever reported. You can imagine my
excitement!
"So I enlisted the cooperation of eight physician friends.
Believe me, I couldn't have found a more skeptical group, but
with a little persuasion they agreed to take yeast for me for six
weeks. All but one were healthy, physically active, nonsmoking

men between the ages of 35 and 45. The exception was a man
of 50 recuperating from a heart attack."
Dr. Riales methodically measured 2 teaspoons of yeast per
vial and placed a six-week supply of vials in a shoe box to give
to each participant. To boost the morale and motivation of the
troops, she added a touch of Rebecca Riales humor on the lid
a cartoon picturing a store front with a sign in the window reading
Health Food Store Closed: Due to death of family member at
age 106.
626 NUTRITIONIST
All went well. All but one participant completed the study.
And all but one of the seven subjects completing the study showed
increased HDL levels after six weeks of brewer's yeast supple-
mentation. In fact, HDL cholesterol levels rose an average of
17.6 percent. In one person, the level increased by almost 38
percent!
"Another significant finding from my little yeast study was
that, as HDL cholesterol levels rose, total fat in the blood de-
creased by 10 percent," Rebecca explains. "This just happens
to be in perfect harmony with the studies in the literature which
suggest that HDL removes fats from the body."
Of course, research aimed at HDL cholesterol-raising treat-
ments is still in its infant stage. Quitting smoking and losing
weight seem to be of some benefit. And we know that vigorous
exercise can have a very positive effect on this cholesterol frac-
tion. But not everyone is willing to go the route of a marathon
runner. We also have some evidence that vitamin C and lecithin
may help boost HDL cholesterol. But so far, Rebecca Riales'
glowing results boast the most potentially astounding effects.
"Right now, there isn't really a whole lot Kent can tell a
patient with low HDL cholesterol," Dr. Riales notes but then
adds with a disclosing smile, "except that he's married to me
and I tell him this crazy thing about taking brewer's yeast!"
OPHTHALMOLOGIST
CHAPTER
YOUR EYES
ARE WINDOWS
TO HEALTH
We're sitting in a modern medical conference room, not far

from Peachtree Street in downtown Atlanta. Morgan B. Raiford,
M.D., founder and one of the leaders of the Atlanta Eye Clinic
and Atlanta Hospital and Medical Center, is explaining with
the help of a globelike plastic model of a human eyeball some
of his findings about nutrition and disease. An independent thinker
and dedicated healer. Dr. Raiford has reached some basic fun-
damentals about the foods we eat that go far beyond the tradi-
tional domain of an eye doctor.
Dr. Raiford likes to paraphrase the words of the eminent
19th century British scientist Thomas Henry Huxley: "If every-
body thinks alike, nobody's thinking very much."
Question: As an ophthalmologist, your primary interest is
the eyes. Yet, your findings have broad implications for all doc-
tors. Why is that?
Dr. Raiford: It's been said, 'The eye's a mirror of our
soul." Now we can also say, 'The eye's a mirror of our phys-
iology." Modem ophthalmology gives us a window through which
we can observe the body's inner workings.
For example, the greatest killer, the greatest crippler, and
the greatest cause of blindness in this country is atherogenesis
627
628 OPHTHALMOLOGIST
the clogging up of our blood vessels that causes heart disease.

And it's increased tremendously in the last 50 years.
Now, the eye is the only source where we can view the
blood vessels directly. Under magnification, we can see these
harmful changes taking place in the vessels of the eye long before
the classical signs of high blood pressure and coronary heart
disease appear.
We can also see inflammations and other problems that may
be emulating other organs mirrored in the eye's blood vessels,
nerve fibers and connective tissue. You could say that the eye
is like our bodies' Yellow Pages, an index of activities elsewhere
in the system.
Q: But how do you read those Yellow Pages?

Dr. Raiford: Here at the clinic we've pioneered a tech-
nique for taking color photographs of the eye and magnifying
them many thousand times. We've taken nearly 100,000 such
photos over 14 years. We've also made color video tapes.
Using this technology, about 3,000 different disease entities
could be evaluated. This is a whole new era, a whole new ball
game in understanding what's going on in the circulatory system.
Q: Where does nutrition enter the picture?
Dr. Raiford: The eye is an extension of the central nervous
system, which makes up a total of only 2 percent of our body
weight but demands 25 percent of our total nutrition. So the
visual pathway requires more fuel input than any other organ
system. The photoelectric cells in the eye, for example, do not
wear out. They are programmed to last as long as the proper
fuel mix is provided.
We have to have the right food ingredients. Those of us who
grew up in rural areas know that. We know full well that, if farm
crops and livestock are to develop, they must have the right
ingredients. Well, human beings are no different.
Q: What happens if they don't?
Dr. Raiford: To understand what can go wrong, let's take
a look at the tiny vessels called capillaries that make up 99.99
percent of the body's 60,000 miles of blood vessels. These cap-
illaries are very delicate structures, and they all carry a very tiny
negative electric charge. Now, the red blood cells that pass through
EYES ARE WINDOWS TO HEALTH 629
the capillaries also carry a negative charge it's a very small

electric current, but it's there. So it's just like two little magnets.
If we put two negatives together, they'll repel each other. That
repulsion helps push the red cells through the capillaries. It makes
it easier for the heart to pump blood.
But when we eat junk foods such as refined sugar (which I
consider to be the greatest culprit in America today), we throw
ourselves out of chemical and electrical balance. The little cap-
illaries gradually lose their negative charge and become neutral
or positive. Then the red cells, calcium molecules and other

material floating in the bloodstream are attracted to the vessel
wall. They adhere to it just like soap on a windowpane.
Gradually, they clog up and block the capillaries. Multiply
that process many times over, gradually and quietly through the
years, and you'll eventually see atherogenesis throughout the
body.
The heart starts pumping harder to overcome all that resis-
tance, and finally it goes into a spasm that we call a heart attack.
There's no great mystery to it.
But the important thing is we can detect these changes in
the eye in the very early stages. We've seen this literally thou-
sands of times in the human eye, and we have photographs to
prove it.
Q: So what we eat can be a critical factor?

Dr. Raiford: Absolutely. And not just in terms of heart
disease. People who are excessive sugar eaters during the first
40 years of life much more prone to develop diabetes. They
are
wear out the pancreas trying to produce enough insulin. It's just
like whipping a tired horse.
The human body is just not geared to eat the amounts of
sugar that we are eating today. And when we upset our body
chemistry, we are going to have to pay the price. It's like trying
to drive an automobile 80 miles an hour in a residential area
instead of on a raceway. You're going to damage something
before you get through.
Nutrition spills over into other areas, as well. Without the
proper fuel, for example, our visual reception, interpretation and
storage
the whole learning and educational process, in other
630 OPHTHALMOLOGIST
words is impaired. So you could say that the total social struc-
ture of our nation suffers from inadequate fuel nutrition to the
visual pathway.
We must learn how to provide a high-quality fuel mix to our
cells if we wish to maintain our tissues and our immunity over
the course of a lifetime. To disregard such basics is inviting
bankruptcy.
Q: What turned your own efforts in this direction?
Dr. Raiford: In 1955, I heard a lecture by Dr. J. R. Max-
field, a pioneer in nuclear medicine, which really opened my
eyes. I realized how limited I had been in my perspective on the

health sciences, and I knew that I would have to restructure my
entire education. From that day on, I have endeavored to find
out why certain things happen at the cellular level.
In some health circles, asking the reason why may make
some people uncomfortable. But a sense of inquiry has to be
established in life to get anywhere.
Q: So it all comes back to the cell?
Dr. Raiford: All of our 100 trillion body cells have basic
similarities,whether they be brain, bone, eye or liver. To func-
tion properly, they all need good nutrition.
Q: Can you be more specific?
Dr. Raiford: We're just beginning to realize that collagen,
or connective fiber, is a common denominator for practically
everything in the body. It's like the steel scaffolding in a large
office building that holds everything up. Collagen supports the
retina, ligaments, capillaries, everything. It holds the cells together.
Each collagen molecule is made of four different amino acids
or building blocks. Let's compare them with four freight cars on
a track that are not coupled together yet. In order to link them,
we need body
certain essential cofactors that are not found in the
itself. We
have to get these cofactors from our food nutrition,
if you please. These essential cofactors are the couplings that
lock those four freight cars together. They're the binding units.
Without these cofactors, we fall apart.
Q: Have these cofactors been identified?
Dr. Raiford:
Yes. These factors which are absolutely es-
sential to life include ascorbate (vitamin C), zinc, magnesium,

manganese, copper, iron and vitamin E.
The is that, when we get many of our pa-
interesting thing
tients offjunk foods and increase their intake of cofactors, we
see reversals of disease
reversals we can measure in the eye.
Q: Can you give us some examples?
Dr. Raiford: One patient was a schoolteacher who enjoyed
her alcohol a little in excess. Her mind had become so dulled,
she couldn't carry on her teaching duties. When she came to us,
we saw clogged-up blood vessels in the retina. We got her off
the alcohol and junk food and started her on high doses of as-
corbate and other cofactors. Her blood vessels cleared up. Her
memory is all right. She's intellectually alert. And she's gone
back to teaching.
Another patient was a pilot, entrusted with testing a new
military aircraft that represented billions of dollars of investment.
He was under so much stress that his blood pressure went up
and he had a blood leak in the eye. That's when he came to us.
We discovered that the stress of his work schedule had
undermined his eating habits. He was way out of chemical bal-
ance. We got him back in balance, and he's perfect again. His
vision is 20/20. He's all right. No problems. Last time I saw him
he was a brigadier general.
There are other benefits. We find in our eye surgery that,
if we put people on a good nutritional program, they will require

fewer sedatives and they will heal faster especially the elderly.
Q: What specific dietary advice do you give?
Dr. Raiford: You have to treat each person as an individ-
ual. But basically, I recommend four things.
First, they have to get rid of junk foods, especially sugar.
When my great grandfather practiced medicine in the 1850s, the
average American consumed between 15 and 18 pounds of sugar
a year. Today, it's more than 100. If we can cut out sugar alone,
we've eliminated a tremendous cause of ill health.
Second, I tell people to minimize alcohol consumption. Al-
cohol is also a sugar, an incomplete sugar.
Third, never use a cooking fat that is solid at room tem-
632 OPHTHALMOLOGIST
perature. Vegetable oils are good, but if the same oil is reheated
over and over again, it forms little globules of fat, called wax.
When the melting point of this wax is higher than body temper-
ature, the globules can make the circulation sluggish and clog
up capillaries.
The retina of the eye can also be affected, particularly the
macular region where the circulation is rather unique. We get
many patients coming to see us with macular degeneration. The
tragic thing is that we can't turn back the clock 30 or 40 years;
we can only teach them about the proper foods and cooking oils.
The fourth recommendation we make is to increase the in-
take of nutritional cofactors.
Q: How can we do that?
Dr. Raiford: First of all, you have to eat more fresh fruits
and vegetables and whole grains. One of the greatest criminal
acts we have in America today is refining flour. Why take out
23 nutrients, put back 2 or 3, and call it enriched? Meanwhile,
the food processors sell the nutrient-rich by-products to the cattle
and poultry industry to double their profits. That's stupid! We
need the whole grains.
We can also learn a lot from our Asian friends and not cook
foods to death. The Japanese and Chinese do a beautiful job in
food preparation.
Q: Do you recommend food supplements?
ever
Dr. Raiford: Many times we have to. When we see people
with acute swelling of the retina, for instance, we can suspect a
chemical imbalance. And as the old saying goes, you can't drive
a railroad spike with a tack hammer. You've got to start giving
them nutrients in large amounts to make up for the deficit.
At times you don't have time to play around with
like that,
diet alone. When fire, you don't go around won-
the barn's on
dering who did it. You put the fire out and you save the barn.
Q: Speaking of fire, what about smoking?
Dr. Raiford: We've taken a moving picture of a person's
eye with a television camera and asked him to smoke a cigarette.
We can see the blood vessels contract! I tried to get a major
tobacco company to finance a research project on this, but I got

turned down real fast.
Victory over Allergies

Q: Has nutrition helped you personally?
Dr. Raiford: I happen tohave many allergies. My oldest
brother died of a milk allergy, in Virginia, before we understood
it.When I was a little kid, I always liked to climb the magnolia
trees at my uncle's farm. But when I got to a magnolia blossom,
I would have an acute headache and become nauseated. That
was my first recognition of personal allergies.
I also found out, as I got older, that I would eat chocolate
and break out in a rash. And then my ligaments would get stiff.
But 1 can eat carob and it doesn't bother me.
I'm allergic to ragweed, too. I found out that, in order to
build up my resistance to ragweed, I also have to avoid the other
things. I had a flare-up of my right eye in 1955 due to ragweed.
The retina was swollen. That really scared the daylights out of
me. I was under a great deal of stress in my work and not eating
the right foods.
So I got to work on it and reversed the swelling.
Each day during ragweed season, I take ascorbate in powder

form anywhere from 4 to 6 grams. I even take it at bedtime. I
also take some zinc and magnesium for support. I haven't taken
an antihistamine for my allergy in over 1 years.1
Q: If enough people did that, the health care system as we

know it would be turned upside down.
Dr. Raiford: Traditionally, the health sciences have been
treating the tip of the iceberg and having no idea what keeps the
iceberg afloat.
We now have many of the tools to create a whole new
approach to keep us well, rather than to go from crisis to crisis,
as present health care is structured. Nutrition is the answer. This
is the medicine of the remainder of the 20th century.
634 OPHTHALMOLOGIST
When a patient can understand what's happening to his blood

vessels, he's going to start rectifying his life style and his health
maintenance which is basically nutrition. That's when preven-
tion will reach its zenith.
Of course, getting each patient to take some responsibility
requires time. slows you down because you've got to take a
It
lot more time with each patient. When I was doing graduate
work in New York, the hallmark of a successful ophthalmologist
was how many patients he could see in a day. My philosophy
is: How much can I see in a patient?
So we have a challenge here that is absolutely fascinating

what can we do to help our fellow man? And that's what life is
all about.
CHAPTER
SEEING BETTER,
FEELING BETTER
"It's so trite because it'sbeen said so many times," Robert

Azar, M.D., said to us, "that the eyes are the mirrors of the
soul, but they're also reflectors of the physical condition of the
whole body. When the eyes start to go, you almost invariably
find that there are other degenerative disorders present in the
body."
Dr. Azar, his young nutritionist colleague, Mackie Shil-
stone, Ph.D., and the other doctors at the Azar Eye Clinic in
New Orleans have found that treating the deterioration of the
whole body may be the best way to respond to the degeneration
of the eye. A change in diet and scientific use of vitamin and
mineral supplements have led to postponement and even can-
cellation of costly eye surgery.
A good many of the patients Drs. Azar and Shilstone see
suffer from a disorder called macular degeneration. The condi-
tion, which commonly occurs in the aging process, is a deteri-
oration of the central part of the retina of the eye. The retina is
the screen at the back of the eyeball that registers the images
we receive through the lens of the eye. The central part of the
635
636 OPHTHALMOLOGIST
macula, receives the central part of our vision

retina, called the
what we see when we look directly at something.
Macular degeneration cannot be corrected with glasses or
surgery. "But," Dr. Azar told us, "with the nutritional ap-
proach, we've even seen that we can stop the progression of the
disease, and we've seen some regression of the process. I think
that's an exciting thing."
Even more exciting are the side effects of that nutritional
therapy. Lester Villa, 72, came to the Azar Eye Clinic com-
plaining not only about his eyesight, but of a general sense of
fatigue, as well. "I felt very tired. I wanted to lie down all the
time," he says. Dr. Azar examined Mr. Villa's eyes and then
sent him to Dr. Shilstone for a complex series of tests to deter-
mine his nutritional status.
"There are a whole host of different things we're looking
for to try to pinpoint the problem," Dr. Shilstone told us. "We
recommend specific doses, micrograms and milligrams, of dif-
ferent vitamin and mineral supplements, depending on what we
see." Dr. Shilstone routinely takes a dietary history and requests
tests of his patients' blood, urine and hair. He describes it as a
"detective program," a sifting through of all the available clues
to arrive at a solid determination of the patient's nutritional needs.
Mr. Villa's case. Dr. Shilstone found that his intake of
In
refined sugar and starches was five times what it should have
been. Mr. Villa's diet history showed a low intake of a number
of vitamins and minerals, and the biochemical tests indicated
that he was deficient in chromium. Dr. Shilstone and Dr. Azar
prescribed a number of dietary supplements, including chro-
mium, bioflavonoids, and vitamins Bi, B2 and C. They also put
Mr. Villa on a low-fat, low-sugar diet. In two months, Mr. Villa's
fatigue vanished, and he was able to return to his job.
Mr. Villa's eyesight has not yet improved, but Dr. Shilstone
has not given up on the case. "It doesn't happen overnight," he
says. "Dr. Azar deals with a lot of elderly patients whose nu-
tritional is below par. We see over and over what
support system
a lifetime of misuse of the body can do. You're asking patients
to try to stop some of their bad habits, and they're asking for a
SEEING BETTER. FEELING BETTER 637
miracle. It appears they're asking you to reverse their Hfe. You

can stop the macular degeneration process or slow it down. You
can help the body catch up, but you'll seldom reverse the process."
Drs. Shilstone and Azar were able to turn things around in
another patient, whose body responded very well because she
was younger. That patient, a vigorous woman in her 60s, came
to the clinic suffering from cataracts, cloudings of the lens of the
eye that can result in blindness.
Dr. Azar regularly performs cataract operations at a local
hospital in which he removes the clouded lens and installs a clear
plastic replacement. The procedure is called an intraocular im-
plant. This particular patient also showed degeneration of the
macula, and Drs. Azar and Shilstone wanted to see if nutritional
therapy might improve that condition before they resorted to
surgery.
"We decided to really go the full route," Dr. Shilstone told
us. "We put her on a complete supplementation program, vi-
tamins and minerals in the right balance, and I started her on a
walking program, four times a week for 20 minutes, because she
had a circulation problem. She came back later. Dr. Azar ex-
amined her eyes and said, 'We've lost a surgery patient.' " The
circulation to the macula at the back of her eyes had improved
so much that surgery could be postponed.
To Dr. Azar, the loss of a surgery patient is no great tragedy.
"The ideal here is to cancel the surgery cases," he told us. "This
morning, I performed nine cataract operations with nine intra-
ocular implants, a very sophisticated type of treatment. We have
finer equipment and finer surgical instruments today than ever
before, so in a sense we're performing surgical miracles on a
daily basis.
"But one of those patients that operate on, there
for every I
are at least several thatI can't help. 1 can take out the cataract
and give them a plastic lens, but the retina and the inner lining
of the eye have been so affected by the degenerative process
that the operation is simply not going to help them. I got into
the nutritional approach out of frustration at my inability to help
the majority of the people that were coming in for help.
638 OPHTHALMOLOGIST
"We're realizing that, if a patient comes in and he doesn't

have advanced disease, we can schedule our surgery a couple
of months ahead of time. We have a chance for eight weeks to
build him up with the appropriate vitamin and mineral supple-
ments. I think more and more we're going to find an increasing
number of these people who are going to be able to avoid sur-
gery." Even now. Dr. Azar estimates, less than a quarter of the
patients who come to him requesting surgery eventually get it.
For people suffering severe macular degeneration as well as
cataracts, nutritional therapy might improve their condition to
the point that corrective surgery can really benefit them. With
his cataract patients. Dr. Azar estimates a value called the target
acuity, which represents the best vision that might be achieved
through replacing a patient's clouded lens.
Diseases like hardening of the arteries, high blood pressure
and diabetes can lower target acuity by disrupting circulation to
the retina of the eye. "If someone comes in with diabetic bleed-
ing, high blood pressure, advanced arteriosclerosis, any of these
degenerative conditions, then the retina of the eye is generally
completely shredded," Dr. Azar says. "The target acuity on
people with the degenerative diseases is very low, and they won't
benefit from surgery. But if we treat them nutritionally and the
conditioji of their retina improves, we may reach a point where
they would get some benefit from putting in a new lens."
Both Drs. Azar and Shilstone say the partnership has been
especially rewarding. "We're a funny team," Dr. Shilstone says.
"You will rarely see nutritionist and M.D. work so closely, so
close sometimes that you don't know which of us is pushing
nutrition harder. It's a nice meshing of two fields that have been
fighting each other for years. The partnership gives credence to
what I do, and it gives Dr. Azar a way to treat problems he
couldn't do anything about until now."
Dr. Azar has benefited personally from the relationship. He
first got in touch with Dr. Shilstone after seeing him on a local
TV station, where Dr. Shilstone served as the news department's
health editor.
SEEING BETTER, FEELING BETTER 639
"I had gotten up to about 196 pounds," Dr. Azar recalls.

"One evening, 1 was watching television, and they had Mackie
and one of the other announcers running the marathon, it just
embarrassed me that two healthy people were out there doing
that while I was getting fat."
Dr. Azar called Dr. Shilstone and asked for his help in get-
ting back in shape. Dr. Azar says his weight has now dropped
to 170, and "Mackie and I ran two miles in 13 minutes the other
morning. Of course, he walks backwards while we do this, but
for someone my age that's a remarkable feat."
Dr. Azar says his diet has changed radically since he has
known Dr. Shilstone. "In the beginning, it was a little difficult,"
he says. "It's a form of addiction, really. You almost get with-
drawal symptoms when getting off junk food, but after a period
'
of time the sight and smell of it is sickening rather than enticing.

Dr. Shilstone does his best to stress the importance of stay-
ing active at the same time that he counsels patients on nutrition.
"They generally can't go out and run," he told us, "but if they
can walk, fine. Any type of activity can help." Walking to the
market is better than driving; taking stairs is better than taking
the elevator. "We try to show them that you don't always have
to take the easy way, that maybe the easy way isn't as good for
you as the hard. It's just a matter of getting used to something."
It's not always an easy message to get across. Patients have
a hard time understanding how changes in activity and diet can

improve their eyesight, and many are perplexed by an approach
that may take months to yield positive results.
"That's part of the American mentality," Dr. Azar says.
"It's always been that, if we feel tired, we go down to the drug-
store and get a quick fix. The younger generation is accused of
being the 'now' generation, but older people are the same way.
It's whole society. Those are the attitudes we're trying to
the
change, and it's not going to be easy.
"Mackie isn't coming in here with some sort of miracle cure
for everything. He's sitting people down and saying, 'Look,
you've got to be part of the team now. You're going to have to
640 OPHTHALMOLOGIST
get down and work/ It's understandable that a man would be

perplexed by that. It's a totally different approach.
"In an operating room, we take a diseased part and replace
it, but we can't replace all the parts. We can only do so much
mechanically. The rest of healing is all regenerative. You have

to, in some way or another, assist the body in repairing itself,
and that's where nutrition comes into play. It's an embryonic
science, to say the least, but I think we're on the verge of a
tremendous explosion in nutritional medicine."
CHAPTER
BETTER VISION
NATURALLY
Honey and vinegar, cod liver oil, vitamins and bed rest. In
an age of expensive and sophisticated therapies like laser beams
and corticosteroids, most physicians ignore these cheap and sim-
ple remedies. But in a small town in New York State lives one
old-fashioned doctor who still uses natural cures
and seems to
use them effectively in the treatment of serious eye diseases
such as cataract, glaucoma and corneal ulcers.
He's an ophthalmologist, Henry O. Little, M.D., and, at 83,
he's virtually a legend in Hudson, New York, a village on the
Hudson River north of Manhattan, where he's practiced since
1943. A salty old Yankee who wears lumberjack shirts and bow
ties, Harry Little keeps office hours four days a week and gets
around town in an old black Lincoln. He's still vigorous in spite

of two hip operations, and his hair is remarkably brown. Only
the sideburns are white. He's descended, he says, from a long
line of Scotch-Irish ''bone setters" as durable as he is.
''I believe in him," says a 73-year-old patient whom Dr.
Little treated for an eye-related neurological problem. ''A lot of

people say, 'Oh, Little and his vitamins,' but respect him. He
I
takes time to sit and talk to you." Another patient, who went
641
642 OPHTHALMOLOGIST
to Dr. Little with corneal ulcers, says, ''Some people say he's
just a country quack, but I have a lot of faith in him. He's quite
a remarkable guy."
In a time when a lot of ophthalmologists spend only a few
minutes with you. Dr. Little might talk for a half hour or as long
as it takes to explain his prognosis. And where few ophthal-
mologists ask about personal habits. Dr. Little wants to know
whether you smoke, whether you eat oatmeal for breakfast,
whether you eat white or whole wheat bread, if you "burn your
candle at both ends" or if you can stand the taste of cod liver
oil. He also advises everyone to start taking a vitamin tablet of
B complex with C daily.

"Everyone who comes in here gets put on vitamins," Dr.
Little declares. "Unless they're stubborn."
Less Cataract Surgery

In the standard treatment of cataracts, a surgeon removes
the clouded lens from the eye and replaces it with an implanted
lens, a contact lens or special eyeglasses.
But any artificial lens is a poor substitute for the one we
were born with, and surgery sometimes fails.
Surgery is also expensive. About 400,000 cataracts are re-
moved annually in the United States at an estimated cost of $1
billion, oran average of $2,500 per operation. Preventing or
arresting thegrowth of cataracts, many people agree, would be
a much cheaper and safer route to take.
Dr. Little believes that he can arrest cataract growth with
vitamins and cod liver oil. Fifteen years ago, he says, he per-
formed cataract operations at the rate of one a week, but in the
past five years, using nutritional therapy, he's seen only four
cases that he felt called for surgery. "Since I've been in prac-
tice," he says, "I've gradually come to discover that cataracts
are not entirely a surgical condition.
"Cataract is a sign that you're slipping. Your tissues are
giving way, and you're getting closer to dying.
BETTER VISION NATURALLY 643
"So I arrest the dying. I've arrested thousands of cataracts

in the last 35 years with vitamins, and for the last 5 years I've
also used cod Ninety percent of the cataracts respond
liver oil.
to this treatment, and I can almost guarantee that, if I can catch
them when their vision is still 20/40, they'll never need a cataract
operation.
"But they've got to stop smoking, too. Tobacco causes more
blindness than anything else," Dr. Little told us.
He calls for surgery only when a patient's vision is already
seriously diminished in both eyes. His policy is to detect the
cataract early and arrest its growth with vitamins and cod liver
oil. "In my opinion," he says, "cataract is almost an entirely
preventable disease."
Two woman in her 90s and a man
of his cataract patients, a
who is were satisfied with Dr. Little's
79, both told us that they
nonsurgical approach. The man, Harold Pepoon, who retired to
Hudson after having been in the plumbing business in Yonkers,
came to Dr. Little with cataracts in his left eye and with very
limited vision in his right eye.
But the growth of the cataract in his left eye was arrested,
he says, when Dr. Little put him on vitamins B and C and cod
liver oil three years ago.
He can still drive a car. "If anything, it's slightly better,"
Pepoon said.
A Lucky Discovery
That Saved Lives
Vitamin D is what attracted Dr.
cod liver oil. Forty-
Little to
five years ago, while practicing general medicine in what was
then the wilds of Saskatchewan, Canada, he said, he used it to
save the lives of twin brothers dying of rickets, the vitam D-
deficiency disease.
In 1939, when he returned to New York after studying oph-
thalmology in London, he used cod liver oil not having any-
644 OPHTHALMOLOGIST
thing better to use to treat a phlyctena, or blister, on the eye

of a 15-year-old girl.
His discovery of the value of B vitamins was equally lucky.

Again, not knowing what else would help, he gave a sample jar
of B-complex tablets, left behind by a salesman, to a man suf-
fering from Iritis is an extremely painful inflammation of
iritis.
the iris. "He took them," Dr. Little tells the story, "and in ten
days, by golly, it was cured! And that's how I got into B vitamins
and eyes."
A concoction he calls "Dr. Little's cocktail" is another
plank of his eye health platform.
The cocktail consists of an ounce of hot water, 2 or 3 tea-
spoons of apple cider vinegar and a "gob" of honey. "I can't
prove it," he says, "but 1 believe the vinegar enhances the ef-
fectiveness of the vitamins B and C you take by mouth. It's also
a wonderful cure for rheumatism, and it cured the arthritis in
my fingers."
He feels just as strongly about whole grains. "For break-
fast," he declares, "you should eat oatmeal every day, and white
bread should be eliminated." He also favors yogurt, raw milk,
vitamin E and a reduced amount of coffee.
A few more case histories demonstrate the range of Dr.
Little's vitamin therapy:
Eleanor Whitbeck, a 45-year-old nurse who lives in Hudson,
came to Dr. Little about two years ago suffering from severe
iritis.
She'd already seen another ophthalmologist, who prescribed

prednisone, a cortisonelike anti-inflammatory drug. But the pred-
nisone's side effects forced her to stop taking it.
Dr. Little gave her a series of daily injections of megadoses
of vitamins B and C. He also prescribed B complex and cod
liver oil orally, and he told her not to shop or clean house or do
anything very stressful.
The condition got worse. Her eye filled frighteningly with
pus. but then it got better. By the third week, the pain in her
eye began to subside and gradually her eye healed. Her friends
say the eye would have healed by itself, but she doesn't think
so. Two years later, she's still taking vitamins and cod liver oil.
BETTER VISION NATURALLY 645
Austin "Pete" Hull is a former school bus driver from Dur-

ham, New York, who first saw Dr. Little in 1964, when he was
52, for dendritic ulcers of the cornea. These ulcers are usually
caused by a herpes virus infection. They often resist treatment
and can lead to blindness.
Hull had 13 ulcer attacks in 16 years, and he says that Dr.
Little cleared up 11 of them simply with a series of daily injec-
tions of B vitamins. Twice, the ulcers also had to be cauterized
with carbolic acid. Hull says the ulcers left a little scar tissue,
but not enough to prevent him from driving a school bus, which
he did until his retirement. Since then, he said, he's been driving
thetown ambulance.
George A. Hutchings, who is in his 70s and lives in Valatie,
New York, met Dr. Little at a free eye clinic set up by the local
Lions Club.
Dr. Little diagnosed glaucoma and put Hutchings on vitamin
C and B complex. He later performed surgery to reduce pressure
within the eye.
''My sight had deteriorated to the danger point, and he ar-
rested it," Hutchings says. "He's one of the great men to come
down the pike, as far as I'm concerned. He instills faith and
confidence in you."
Another patient, Frank Crocco, suffers from diabetic reti-
nitis, or pinpoint hemorrhages on the retina. Laser beam therapy
reputedly shrinks the hemorrhages, but Crocco told us that sev-

eral laser treatments in Albany didn't help him. 'Tt got so bad
1 couldn't see myself in the mirror," he said. 'T could barely
see to walk."
After the laser failures, Crocco went to Dr. Little and began
receiving a weekly, then a biweekly, injection of B and C vita-
mins. He also takes E at night, vitamins B and C in the morning
and a tablespoon of cod liver oil daily.
Crocco doesn't know how it works, he just knows that he
can now read headlines and can mow his lawn, things he couldn't
do before.
One more patient, Chester Groat, a 75-year-old resident of
Hudson, came to Dr. Little with a paralyzed nerve in his left
eye which doubled his vision and forced him to wear an eye
646 OPHTHALMOLOGIST
patch. Like the others. Groat started taking B complex, C and

cod Hver oil.
He was also told to relax and stop smoking. The vitamins
took as much as four months to work, but Groat told us, "I had
faith in them.
"Now we usually go all winter without a chest cold," says
Groat about himself and his wife. 'T really believe in Dr. Little.
Personally, I think he's a very smart man."
Dr. Little himself does not know exactly how the cod liver
oil or the vitamins work or which of the two does what. And,
perhaps for that reason, he's been unable to convince other

doctors that they work. "Maybe future generations will know
why it works," he says.
He admits that his remedies do not work for everyone all
of the time and that, like many natural therapies, they may take
several days, weeks or sometimes months to effect a cure. They
don't offer what he called the "dramatic improvement" that
people have come to expect from modern medicine.
While Dr. Little does not rule out surgery, he regards it as
a last resort.
First, he'd rather see people relaxing, giving up cigarettes

and eating rolled oats or any whole grain of their choice.
"Altogether, from my 52 years in practice," he says, "I am
beginning to believe that all diseases are associated with a lack
of vitamins.
"And in the practice of ophthalmology, I have gradually
come to realize that vitamins and good food are a large factor
in the control and cure of many eye diseases."
ORTHOPEDIC SURGEON
CHAPTER
A NEW BREED
OF SURGEON
Everybody knows there are just two kinds of doctor. The

"conventionaF' doctor is active in the county medical society;
he plays golf on his afternoon off. Disease, to him, is something
to be cut out with a knife or beaten down with drugs the stronger
the better. Nutrition? Mention it in his office and you'll be sorry.
Then there's the "holistic" doctor. He puts the American
Medical Association in the same class as the American Nazi
Party, and his colleagues put him in the same class as Oral
Roberts. He runs a few miles every morning and does yoga in
the afternoon. Drugs are evils that may occasionally be neces-
sary, but nutrition, stress reduction and life style counseling are
the heart of his practice not just to help his patients get better,
but to keep them well.
So much for fantasy. In reality, there are also doctors like
Grant Lawton, M.D., who practices orthopedics in Salem, Or-

egon. He performs surgery and plays golf but when he appears
at lunch lime in the surgery locker room, it's generally to change
into his running gear. Dr. Lawton isn't just active in his county
medical society, he's its president. His is a "relatively orthodox
practice," he says. But he treats some common orthopedic prob-
647
648 ORTHOPEDIC SURGEON
lems with high doses of vitamins, and he hasn't written a pre-

scription forValium in three years.
Ringing the door bell at Dr. Lawton's suburban home, one
recent evening, meant interrupting a passionate cascade of mu-
sic ragtime piano. The pianist was Dr. Lawton himself. Playing
ragtime is one way he relaxes
something as important for doc-
tors, he says, as for their patients.
Dr.Lawton seemed relaxed as we sat on the patio of his
home, well into the night, and talked about health and medicine.
Tall, slim and fit, earnest in conversation about his profession,
he described growing out of his conventional medical school
training into an approach that also embraces nutrition, stress
reduction and exercise therapy. 'T'm looking," he said, "for the
best of both worlds."
Howdid he get from there to here? Even orthopedic sur-
geons, seems, can learn something from their mothers. ''Up
it
until four years ago, Fd never thought much about nutrition,"

he recalled. "My mother was interested in it, though she had
bottles of supplements next to the refrigerator and copies of
Prevention and other magazines lying on the table. She'd ask

me questions about nutrition she looked to me for answers,
since I was the doctor, and my answer was T don't know.'
Dr. Lawton started reading his mother's magazines, and one
evening he found himself sitting down to write to Prevention
columnist Jonathan Wright, M.D. 'T said I was interested in
nutritional approaches to orthopedic problems. If he knew of
any specific conditions that responded well to this approach, I
asked him, could he let me know?"
Three days later. Dr. Wright was on the phone to Dr. Law-
ton, and the orthopedist's nutritional education had begun. 'T
spent some two years just reading and digesting all the infor-
mation I could, trying to make up for lost time. I wrote to William
Kaufman, M.D., in Bridgeport, Connecticut, for a copy of his
book on niacinamide la form of niacin]. 1 got to know Jeffrey
Bland, Ph.D., a nutritional biochemist. He supplied some solid
information for me, which allowed me to build up a bibliography."
A NEW BREED OF SURGEON 649
Learning this new approach to health problems was exciting.

Dr. Lawton recalled. 'Then you start trying these things and
you get results and that makes it even more exciting.
"The initial successes really got me going," he said. He
gave niacinamide to several patients with osteoarthritis (the most
common form of arthritis, and one that afflicts many older peo-
ple). "Over a period of months, it became clear that my patients
could turn their symptoms on and off with niacinamide. It worked.
It worked just the way Motrin or any other antiarthritic drug
would work, but without the potential side effects that these
drugs have."
In his practice now. Dr. Lawton gives osteoarthritis patients
nutritional therapy that includes niacinamide, vitamin C, calcium
and vitamin D. Patients with carpal tunnel syndrome a painful
inflammation of nerves at the wrist
receive large doses of vi-
tamin 85. For Dupuytren's contracture, an often disabling thick-
ening of cords in the palm, he uses vitamin E. He has had en-
couraging results giving vitamin C to victims of degenerative
disk disease: "When I put people on vitamin C, seems that I
it
see them much less than I used to they don't have as many
recurrent problems."
Among its other advantages. Dr. Lawton says, nutritional
therapy makes it easier for him to avoid using drugs. For carpal
tunnel syndrome, for example, the standard treatment would
probably be Butazolidin, "the most effective, most potent and
most hazardous of anti-inflammatory drugs. If you sat down and
read the potential side effects, you would never take it. I would
never take it. And I can't honestly expect my patients to take it
either when there are alternatives. So I say, 'First, let's try
something that won't hurt.' I've managed, in the last three or
four years, not to write a single prescription for Butazolidin."
When pain is involved as it often is, in the injuries and
conditions that he sees Dr. Lawton will carefully explore al-
ternatives to pain-killing drugs. For acute injuries, he'll try ice

massage or transcutaneous nerve stimulation (a technique that
uses electrical impulses to short-circuit pain) instead of auto-
matically writing out a prescription for narcotics. Or he will use

the simplest
and most basic of healing techniques compassion.
"Say a comes into the emergency room with a shoul-
patient
der dislocation. It's typically a painful injury, and he's tense and
uptight. The natural reaction is to say, 'Let's give this guy an
IV dose of Valium, or a phenobarb.' I've found I get much better
results simply by reassuring him, talking with him quietly, ex-
plaining that, if he can let his muscles relax, the bone will go
right back into place. And it happens every time. The fact is that
if a patient has control
if he's not drugged up with Valium or
phenobarbital this is much more effective."
Dealing with Stress

In general. Dr. Lawton says, helping patients deal with stress
is an essential part of orthopedics. For one thing, the acute
injuries and chronic illnesses that he treats create a lot of stress.
"You have a young man who's married and has two kids
and is wiped out on his motorcycle. He has multiple fractures,
and he's lying there in traction wondering, 'Will I work again?
Can I pay the rent?' There's a tremendous amount of stress
involved. For me just to focus all my energies on getting his

bones straight and ignoring the rest that's a good deal less than
what can be done. You just can't take good care of an individual
without considering him as a whole.
"It's a matter of awareness. Asking 'How's your wife doing?
How are the kids?' Reassuring him. Just being sensitive to his
problems, to the fears that are running through his mind."
Ignored and unmanaged, the stress of an injury may, in
combination with a generally high stress level, trigger other ill-
nesses, he speculates. "If an orthopedist is aware of his patient's
problems, he may be able to prevent development of an ulcer."
Many orthopedic conditions are themselves caused or ag-
gravated by stress, according to Dr. Lawton. "The most com-
mon is the upper back strain. This may start with a minor lifting
episode, but goes on for weeks and weeks of muscle tightness.

it
Typically, this
is a stress-related disorder some people say it's
symbolic of trying to carry the world on your shoulders. Rheu-
matoid arthritis, too, very possibly has its basis in stress."
What Dr. Lawton does in such cases, he says, is "provide
the patient with some degree of insight.'' He'll help him to un-
derstand what stress is, how to deal with it and prevent it from
wreaking damage. ''When someone gets some insight into stress,
often he can look at his life, realize, 'Gosh, maybe I am trying
to do too much,' and make appropriate adjustments in his sched-

ule." Dr. Lawton may also suggest specific relaxation techniques
to relax muscles. He'll make sure his patient has the support of
a sound, nutritious diet, with special emphasis on the B vitamins.
CT concur with the general feeling that these are in greater de-
mand in times of higher stress.")
Nutrients before Surgery

In orthopedics, holistic methods like stress reduction and
nutrition aren't always enough. Dr. Lawton admits. Surgery is
"something you avoid unless it's necessary." When it is nec-
essary, he'll perform it and make sure that the patient has the
benefit of "the best of both worlds." At least two weeks before
surgery is scheduled, when possible, he'll put his patient on
sizable doses of vitamin A, vitamin C, vitamin E and zinc. "There's
good evidence that zinc and vitamin C are important for tissue
healing and wound healing. Vitamin A, again, helps wound heal-
ing and skin repair. I suggest vitamin E to reduce the danger of
blood clots."
Far better than treating orthopedic problems, of course, is
preventing them. And this. Dr. Lawton says, can be done, par-
ticularly in the older years when osteoporosis (bone loss) and
osteoarthritis are major dangers.
"You'll see one person, who has remained active and is
eating well, fall out of his ladder and not break anything. He fell
6 feet, landed on his hip, and you think it's got to be broken!
But it's bones are strong and he was able to absorb the
not. His
impact. The next fellow, who's inactive, whose diet is low in
calcium, who doesn't get outside and doesn't get vitamin D from
sunlight, is far more likely to sustain a fracture. As for osteoar-
thritis, there's some evidence that people who are active, who
maintain a full range of motion in their joints, have a very low
incidence of the disease.
'*So the answer here,
terms of prevention, is for people
in
with advancing age to get out, get some sun and some activity
perhaps do some stretching exercises or yoga and eat a sound
diet, one that is rich in calcium. And probably take calcium
supplements in addition."
Preventing orthopedic disorders also means weight control.
Dr. Lawton adds. "This is especially important with the weight-
bearing joints of the lower extremities. When you walk, the force
across your knee is some three to five times your body weight.
When you run, it's seven times, perhaps ten. So if you lose 30
pounds, it's like taking a hundred pounds off that knee joint.
That can make the difference in whether or not someone needs
to have surgery for arthritis in his knee or hip."
A special source of Dr. Lawton's enthusiasm for holistic
approaches quite possibly is firsthand experience. In recent years,
his family's diet has come to reflect his knowledge of nutrition.
''We've gotten away from sugar and refined foods; we eat less
fatty meats and more fish, and we keep a lot more fresh fruit
and vegetables around." Since he's taken to eating a heartier
breakfast and snacking on an orange or apple at mid morning
and mid afternoon, he's seen a definite improvement in his ability
to function throughout the day. He gives himself a hefty dose
of vitamins C and E each day, and a B complex. ('Tf I'm looking
at a tough day, I'll take an extra one, without hesitation.")
His health, he says, is better than ever.
At lunch time, he'll walk the block from his office to the
hospital, change into his running clothes in the surgery locker
room, do 2 miles and be back for a light lunch. 'T guard that
time," he says. "I try to keep the lunch hour open so I can get
my run in."
To reduce the stress in his life. Dr. Lawton does what he
asks his patients to do: keeps aware of what's causing him ten-
sion and adjusts his attitudes when he can. "I ask myself: 'Why
am I getting uptight? What unrealistic expectation or goal am I
placing on myself?' " He also practices autogenics, a relaxation

technique akin to self-hypnosis. "Once I get into a relaxed state,
I imagine myself going through the day. I picture myself ab-
sorbed, concentrating with a clear mind while talking with a

patient, or responding well to a problem in surgery. It works."
Whenever the opportunity arises. Dr. Lawton tries to share
with his patients what he's learned about going beyond "normal"
good health "and down the wellness road."
"When a patient's symptoms are gone, he's feeling better,
he's looking good, then I'll suggest to him, 'Maybe you'll never
have to come back and see me if you can develop a healthy life
style.'
The limitations of a busy practice, he laments, make it im-
possible to get deeply into such subjects as good nutrition, stress
reduction and exercise, "so I keep to the basics. What I hope
to do is build a little motivation, perhaps, strike up some interest,
give references
'I suggest you read this and this'
and get the
ball rolling so they can learn on their own."
The effort is often discouraging. Being a specialist, not a
family doctor, his contact with most patients is fleeting. And
people come to see him not because of his interest in nutrition,
or their own, but because he's an orthopedist and they have
orthopedic problems. "Most," he says, "do not want to assume
responsibility for their health. They would rather smoke, they'd
rather sit around and drink beer and eat chocolate sundaes and,
when they get sick, come to me and have me fix them. A doctor
has a lot of influence on people, but at times like these I wish I
had more."
Making fundamental life style changes is a lengthy process.
Dr. Lawton realizes, and motivation is not easy to stimulate.
"So I don't walk away depressed when they don't seem inter-
ested. I like to think that maybe down the road someone will
remember what I said and think 'Hey, maybe that guy was right'
and it might help to get something going."
Educating Other Doctors

As important as educating his patients, Dr. Lawton believes,
isopening the eyes of his colleagues to holistic medicine. "Doc-
tors may not ask about it or talk about it, but I get the impression
they're interested. Instead of the that's-a-lot-of-baloney attitude
that many people ascribe to the standard physician, I think there's
and how it relates to health."
real interest in nutrition
Among his colleagues, for example. Dr. Lawton has found
more curiosity than hostility toward his use of nutritional ther-
apy. "When I'm off call, a patient may call up the doctor who's
covering and ask, 'Should I continue taking my vitamin C?' And
Monday morning, the doctor will ask me, 'What's he doing that
for?' and I'll explain. And some have even begun asking me,
'How much Bf, did you say you prescribe for carpal tunnel
"
syndrome?'
Remaining "in the mainstream" of medicine. Dr. Lawton
says, he can continue to share his holistic ideas with other doc-
tors. At an executive committee meeting of his county medical
society, he suggested bringing nutritional biochemist JefTrey Bland
down to speak on nutrition, "and I got a very positive response.
"Promoting interest in nutrition at our county medical so-
ciety pleases me as much as helping an individual in my office,"
he says. "The potential for benefits, actually, is much greater."
The gradual change in his practice has been particularly
satisfying but also frustrating Dr. Lawton says. He prefers
the equal-to-equal relationship that holistic medicine fosters to
the "dominant, sitting on a pedestal" role of the conventional
physician. ("Five years ago, if a patient called me 'Grant,' it
might have annoyed me. Now I like it.") And he's happier with
the idea that he can "encourage wellness, and that my patients

may not have to come back/"
The frustration, he says, the fact that "I can only take
is in
a first step I may want about stress with a patient in

to talk
detail, but there just isn't time, and he goes out the door. I'm
frustrated because I can't take the second and third step, too.
"But at least," he says hopefully, "I am taking that first
step forward."
OSTEOPATH
CHAPTER
THREE HEART
ATTACKS
BY 29: A PHYSICIAN'S
PERSONAL DRAMA
by John Cappello, D.O.
My grandfather had a heart attack when he was in his 60s.

My father had one when he was in his 40s. I was only 29. It
couldn't happen to me, I thought. But it did happen. OnJune

25, 1970, I was suddenly awakened about two in the morning
with a crushing pain in my chest.
Iwas having some serious business problems at the time,

and I was eating poorly lots of fatty and fried foods and drink-
ing more alcohol than should have. What's more, I was not
I
getting the exercise and rest I needed. The total stress of this
situation was apparently too much for my body's weakest link
the heart.
At first, when it hit, I didn't know what was happening. 1
thought that if I could just move my bowels the pain would go

away. (I learned that this is a common symptom with heart
attacks.) I was wrong. Even a bottle of citrate of magnesia did

not help, and the pain lasted until four. With great relief, I went
back to bed for a few hours and woke up at seven to go to the
office.
There were no recurrences for the next few days. Then on
656
A PHYSICIAN'S PERSONAL DRAMA 657
June 29,it started again. I was having an early morning snack
in thecompany's coffee shop when I felt the pressure building

on my chest; this time the pain radiated down both arms to my
fingertips. I waited about a half hour, conversing with friends,
not being able to sit still, before I decided to go to a physician.
After all, I had never been sick, so 1 did not know what 1 was
experiencing.
Another "great" experience awaited me as I got intomy
car to drive the 20 miles home. The power steering in my new
Buick had failed. The car handled like a Mack truck and, as I
look back on it, I sure wasn't doing myself much good. Mother
Nature wasn't on my side either; the mercury hit 96F that day
and, with Philadelphia-area humidity, the perspiration was just
pouring off my body.
After a torturous half-hour drive, I finally made it to the
I walked
local hospital. Curiously, the pain started to relent as
into the emergency room. When I told the emergency room nurse
what had happened to me, I was immediately seen by the phy-
sician, who set me up for an electrocardiogram. Five minutes
later, 1 got the bad news.
"You have had a heart attack," the emergency room phy-
sician told me. "So we are going to have to keep you in the
hospital for a couple of weeks." A few tears came to my eyes
as I thought of my father and grandfather and how 1 had seen
But just
their activities greatly curtailed after their heart attacks.
as quickly as these thoughts came promised myself
to mind, I
that this would not and could not happen to me.

I was taken right to the intensive care unit. There I had what
was unquestionably the most frightening experience of my life.

In the middle of the night, I was awakened with the most severe
pain I had ever had; it was chest pain so excruciating that I cried
out for help, I learned later that the damage to my heart muscle
was extending, or in medical terms, additional heart tissue was
undergoing infarction. The nurse was not permitted to give me
anything for the pain until she reached my physician, who or-
dered a strong pain killer.
658 OSTEOPATH
Heart Medicine A Life Sentence

The rest of my hospital stay and initial recovery were la-
borious. But, somehow, I got to the point where I became an

outpatient and was put on my daily dosages of ''heart medicine":

Coumadin an anticoagulant also known (in
error) as a "blood thinner,"
sublingual nitroglycerin
thought to dilate
coronary blood vessels,
Nitro-Bid
a long-acting nitroglycerin,
Valium
an antianxiety agent.
Still, I was never totally free from chest discomfort. Anxious
thoughts or a hard day's effort would cause that old tingling

feeling in my chest and arms.
My physician, who had done such a valiant job in helping
me overcome the acute stage of my
illness, was of little help in
my "John," he said, "even if you
efforts to rehabilitate myself.
jump into the African jungle on a parachute and live with the
natives, make sure you bring a good supply of the medications
you are taking." He made no mention of diet or supplements,
which were discussed in the lay press. Nor did he question my
habits and life style, which I knew must be changed. But I did
not know what or how to change and needed guidance. I realized
then that perhaps his acute-care training was what 1 needed to
get me over the initial hump, but now to further improve 1 must
seek other avenues.
Discovering Medicine and Nutrition

It was during search (1970 to 1974) that I
this four-year
decided to make a career change. I had always wanted to be a
physician, but 1 did not want to go through all of the red tape.
Now, somehow the hassle of preadmission testing, letters of
recommendation, interviews and waiting did not seem to matter.
Fortunately, had completed all of the necessary premed courses.
I
SO I that roadblock. And my reasoning

was not confronted with
that should further pursue medicine as a career was further
I
spurred, as I felt sure my background in laboratory research

would be of great assistance in uncovering the answer to im-
proving my own health as well as the health of others. Even-
tually, I was accepted at a well-known Philadelphia school of
medicine for September, 1974 the class of 1978.
Luckily, the summer before I started school, I came across
a book by Naura Hayden. In it, Adelle Davis was discussed and

a couple of her books including Let's Get Well and Let's Eat

Right to Keep Fit were mentioned. 1 eagerly read these books
and a new world was opened up to me. What I found particularly
interesting was the research on vitamin C, the different vitamins
of the B complex and anti-stress studies. At last, I had some
leads to work with.
While I studied the various aspects of medicine and the
human body at school, devoted practically all of my spare time
I
to studying human nutrition. My body became a laboratory. And

as1 studied and experimented, realized that was overfed theI I
wrong foods and essentially undernourished to cope with the

demands I was placing on my body.
Gradually, over six months' time, I weaned myself from all
of my heart medication by following much of the nutritional
advice I uncovered during my research. Of course, this approach
is I was pursuing a career in medicine and by
not for everyone.
this time was quite sure about what I was doing. I don't want
to leave the impression that the average person who has a serious
medical problem should try to go it 100 percent along.
But what a different some of these health-oriented changes
made for me!
My typical day began at 5 a.m. and was home at I around
8 P.M. A few hours of studying usually took me to bed around
midnight. If there was an exam the next day, I could easily be
up to 2 or 3 A.M. Somehow, did it without chest
I pain or dis-
comfort. Before, if I keep such hours, my body would
tried to
cry "uncle." Now I was building endurance, and each month
saw further improvement.
660 OSTEOPATH
During the course of my journey to better health, I also

discovered Prevention. I guess I kind of identified with this mag-
azine, sinceits founder also had health problems and was looking
for a betterway. The inspiration of others with an active interest

in preventive medicine helped to spur me along the way.
Many people have asked what the regimen 1 used consisted
of. These were the main nutrients during the initial phase of my
personal program:
brewer's yeast with calcium and magnesium,
lecithin,
corn oil.
Also included as supplements were:

pantothenate,
vitamin C,
vitamin E,
B complex,
magnesium oxide.
Here is the way I started and my reasoning at the time:
Brewer's yeast is a known source for balanced B vitamins.
This balanced source is important because during illness the need
for all B vitamins seems to increase. If you increase one and not
the others, you may cause a B vitamin imbalance. I started with
'/>teaspoon of brewer's yeast the first week, then built up slowly
to 2 heaping teaspoons per day over a four-week period.
Lecithin I used to aid in the transportation of fat and cho-
lesterol in my bloodstream. Many of the cases of hardening of
the arteries that 1 researched were typified by increased ratios
of cholesterol to fat in the bloodstream. While experimentally
unconfirmed, the premise I worked with was that lecithin could
conceivably help restore a proper fat-cholesterol balance.
Corn oil is a natural source of linoleic acid, an essential fatty
acid. It is believed that this essential fatty acid helps reduce the
amount of cholesterol circulating in the blood.
Depending upon what had in stock, 1 would use 8 ounces
I
of either skim milk or fresh orange juice as a base. Then using

a blender, I'd add 2 teaspoons each of brewer's yeast, lecithin
and corn oil and whip it up into a healthful froth.
After my one-two-three blend, I would then take the fol-
lowing supplements:
Pantothenate, 100 milligrams and vitamin C, 500 milli-

grams my studies revealed that both are stored in the adrenal
gland and are known requirements in stress-related diseases.
Vitamin E, 300 international units, appears to act as an an-
tioxidant by reducing the need for oxygen in the heart muscle.

Multivitamin with B complex one of these was taken as an
added safety factor.
Magnesium oxide, 250 milligrams, was taken since magne-
sium is found in muscle tissue and is involved in many energy-
producing reactions in the body.
In addition, my life style was drastically altered.
I sharply cut down on refined sugar and animal fat and,
instead, switched to a diet high in whole grains, fresh vegetables
and fruit in season.
Because of these and other life style changes, I no longer
need to stick as closely to my crisis regimen. Under especially
distressful conditions, though, I usually go back to some vari-
ation of my initial formula with rather good personal results.
PEDIATRICIAN
CHAPTER
THE SUGAR
GENERATION
When, 12 years ago, Hugh W.

S. Powers, Jr., M.D., a gen-
eral pediatrician in Dallas, Texas, started interviewing the par-
ents of ''problem" children, he heard many angry complaints
about the generally accepted medical treatments for children
with learning disabilities and behavior and hyperactive disorders.
"And they were dissatisfied for one very good reason: lack
of results," Dr. Powers told us.
'The conventional treatment for these problems is the drug
Ritalin. Now, the use of Ritalin has had considerable success
with certain children. But the statistical breakdown is that only
50 percent partially benefit from it, while 25 percent don't get
any benefits and another 25 percent get worse. And the only
alternative to Ritalin that the conventional physician will usually
consider is other tranquilizers or psychiatry.
"But what really galls these parents," he continued, "is the
physician's attitude that there isn't some other solution when
his methods fail. Here they are with a who's doing poorly
child
in school or running wild all over the place at home, and the
physician is, in effect, telling them: 'My methods may not work,
"
but I'm not going to try something else.'
662
THE SUGAR GENERATION 663
is a physician who is willing to try something

Dr. Powers
else."You could say I've had a lifetime interest in nutrition.
One of my aunts worked with E. V. McCombe of Johns Hopkins,
one of the fathers of nutritional medicine in this country, and so
I was getting vitamins even as a kid. Then, at medical school, I
studied the physiology of nutrition. But it was about 12 years

ago that I became interested in functional problems of the ner-
vous system and learned that changes in levels of blood sugar
affect behavior. So I got interested in how to manage blood sugar.
I started educating myself further in nutrition, going around the
country joining organizations, reading Adelle Davis, Carlton

Fredericks and Prevention magazine."
From that beginning. Dr. Powers's background as a general
pediatrician broadened naturally to a multifaceted nutritional ap-
proach. He now
uses nutrition to treat not only problem children
with learning or behavior difficulties, but also those with allergies
or those who lot with minor illnesses.
simply get sick a
The first Powers does when parents bring their
thing Dr.
children to him is to sit down with them for two hours and take
a detailed case history, including family, pregnancy and past
medical history, as well as a record of the family's daily diet.
He does that for several reasons. "One is to rule out any serious
hidden medical problem. Then, too, I want to know whether
there's a hereditary pattern to the child's problem whether his
parents and siblings have had something similar.
"But most enlightening is to find out what sort of dietary
examples the child is being given at home. Not only what his
diet consists of, but also what kinds of foods he sees his parents
eating. I need to know whether Fm going to have a hard time
getting a child to cut down on sugar because his father sits at
the dinner table eating tubs of ice cream."
Following indications in the case history. Dr. Powers may
want to conduct a complete physical examination or laboratory
studies such as blood count, urinalysis and a five-hour glucose
tolerance test. These will help to narrow down the child's specific
problem.
"In most cases," said Dr. Powers, "I begin treatment with
664 PEDIATRICIAN
a general nutritional program. That consists of eliminating sugar,

other simple carbohydrates and caffeine including cola drinks
starting the day with a high-protein breakfast, and using appro-
priate vitamin supplements. I start with this because it's safe
and effective with a wide variety of problems. Now, if the child's
problems continue, I won't hesitate to try other treatments. But
I seldom have to
the nutritional program usually takes care of
the problem. In fact, I've had parents tell me that the results are
often amazing."
Low Blood Sugar

a Frequent Problem
"Take the case of learning and behavior difficulties," he
continued, ''kids who are either too tired or too restless to pay
attention in school and those who mopey or running
are either
all over the place. In their extreme forms, such symptoms often
indicate hyperactivity. Kids with these problems respond re-
markably well to a diet that eliminates sugar and limits other
simple carbohydrates
syrup, molasses, honey, corn sugar and
so on. That's because the root problem here appears to be their
blood sugar levels."
In a study that Dr. Powers conducted with 260 problem
children, he found that blood sugar levels consistently corre-
spond to behavior and performance in school. Sugar made them
irritable or listless. "But after starting the general nutritional
program," said Dr. Powers, "there was consistent improvement.
One 15-year-old girl was a poor reader, doing badly in school,
and had a history of headaches, fatigue and needing more sleep
than normal. After a year on the program, she underwent a strik-
ing change. She gained three years in reading comprehension
and became bright, cheerful and outgoing."
When you know these children's typical diet, it's not sur-
prising that Dr. Powers's sugar control program helps their
problems.
"These kids usually eat a terrible diet. Sugared cereal, jelly
on cinnamon-sugar toast, cookies, cake and colas with almost

every meal and lots of ice cream. Their consumption of whole
grains, fresh vegetables and sources of protein such as legumes,
fish and fowl is generally minimal. For a child to think and behave
well, he needs to have the right food."
Caffeine is also a problem. ''Kids are doing themselves a
lot of harm by the way they down colas," says Dr. Powers.
'There's about half a cup of coffee 10-ounce bottle of Coke
in a
not to mention 6 tablespoons of sugar. Some kids drink the stuff

by the quart. They're practically poisoning themselves. A quart
of cola contains about 300 milligrams of caffeine; a toxic dose
of caffeine is 500 milligrams."
Children who consume large amounts of caffeine as well as
sugar may be plagued by chronic irritability, inattention, poor
memory, psychosomatic complaints and hyperactivity, all cul-
minating in severe academic or even psychological problems.
"I've treated several psychotic teenagers who reported drinking
2 or 3 quarts of cola a day," said Dr. Powers. "But another of
my patients, whom I call the 'queen of all cola addicts,' outdid
even them. She used to consume a variety of soft drinks straight
from the dispensing machine that her well-meaning father had
placed in their home. That and a heavy load of sugary food were
really fouling her up. She refused to do schoolwork, was sullen
and fatigued, and would often break out into unprovoked crying.
'I just yelled out loud and broke my pencil in half,' she told me
about one of these incidents. When she was brought to me, she'd
already been seeing a psychiatrist. I put her on the general nu-
tritional program, but she followed it very erratically. Still, the
last word from her father was that she's definitely better without
sugar and colas."
Foods That Build

the Immune System
In addition to eliminating bad foods from the child's diet.
Dr. Powers aims at increasing the good food. "Good dietary
666 PEDIATRICIAN
management should build up the child's resistance as well as

limitharmful foods/" Dr. Powers explained. "One of the most
ignored problems in pediatrics is the chronically sick child who
has no serious physical disease. Sometimes the condition is mis-
taken for an allergy. The child just gets a lot of minor illnesses
colds, sore throats, ear infections, bouts of diarrhea and vomiting.
"Now, sugar is often the culprit here, too. Research has
shown that all sugars lower the phagocytic index, an important
immune response in the body. Reducing dietary sugar helps, but
it's only the first step. Real treatment must aim at producing a
state of full health that will help prevent relapse. That means
building up resistance."
How does Dr. Powers help children boost their resistance?
'T prescribe a diet of fish and chicken, organ meats like liver,
unsweetened yogurt and small servings of cheese.
fresh vegetables,
These are resistance foods. They provide the body with its raw
materials and arm it against infection. And it's no accident that
they also help to stabilize blood sugar, so the child will also feel
better."
Resistance foods are especially important for the chronically
sick child, but a good diet is obviously good for all children.
Together with a group of his patients' mothers. Dr. Powers has
compiled the guidelines shown in the accompanying table for a
diet for children.
"I'll often supplement this diet with vitamins and minerals,"
the physician says. "Since most problem children aren't eating
well, they need vitamin and mineral supplements to get proper
nutrition. For instance, vitamins contribute to the physiological
use of protein, in which these kids are frequently deficient. So
I give a general supplement. But since these kids are under a lot
of stress, I'll also give them a big dose of C and a B complex."

If you've ever tried sticking to a diet yourself, you might
wonder whether it isn't especially hard for kids. Dr. Powers is
the first to admit that it is.
Winning the child's cooperation is essential. "If you can't
sell the child, he's not going to stick to his diet. And in the end,
it's the child who has to do it. It's different from the conventional
[continued on poge 670\
Dr. Powers's Diet

for Low-Blood-Sugar Control
Food Category Foods to Use Foods to Avoid
Meats Beef, lamb, veal, Any processed or

pork, chicken, cured meat.
turkey, any fish.
Vegetables All kinds, at least None.

two at a time.
Vegetable Juices All. Processed with any

additives.
Fruits Fresh fruit in Excessive amounts.

limited quantity
(one-quarter piece
per day for younger
children).
Fruit Juices All natural. Dilute Added sweeteners.

to ounce of juice
1
to 3 ounces of
water one to three
times a day for
small children.
Breads Including rolls, Breads with two or

muffins, crackers, more sweeteners.
biscuits all made
from whole grains.
Cereals Any made from Additives or

natural, whole, preservatives.
unrefined grains.
668 PEDIATRICIAN
Dr. Powers's Diet

for Low-Blood-Sugar Control Continued
Rice Natural, whole Processed.

grain.
Pasta Spaghetti, noodles, Those made from

etc., all natural, white flour.
whole grain, can be
egg, spinach or
Jerusalem artichoke
enriched.
Beverages Emphasize water. Coffee, tea, all
Milk, herbal teas, dark-colored sodas.

diluted fresh fruit Anything sweetened
juices, vegetable with sugar, sorbitol,
juices acceptable. mannitol, xylitol.
Sugarless, caffeine-
free (light-colored)
sodas infrequently.
Sweeteners Fructose, tupelo White refined sugar,

honey, molasses, brown sugar,
carob syrup, rice honey,
syrup, corn syrup confectionary sugar
only in small in recipes. Any
amounts and only in sugar or sugar
low-sugar dessert straight out.
recipes. Sorbitol, mannitol,
xylitol.
Desserts ideally all no-sugar All sugar-containing

such as nuts or desserts.
Dr. Powers's Diet

for Low-Blood-Sugar Control Continued
popcorn. Low-sugar
desserts (made with
the allowable
sweeteners listed
above) in small
portions and only
on special occasions
not to exceed twice
a week.
Chewing Gum None. All gums of any

kind.
Condiments All spices and Excessive amounts.

herbs. Ketchup, Remember that
mayonnaise, most ketchups,
mustard in small dressings, sauces
quantities due to contain 25 to 50
their high sugar percent sugar.
content.
Fats and Oils Only lean Fried foods and

unprocessed meats, snacks dipped in oil
lean fish, poultry for crispening. All
without skin, low- oily foods.
fat and part-skim Excessive use of
cheese. butter and
margarine.
670 PEDIATRICIAN
treatment with drugs. I can't be in control all the time. The

parents can't be in control all the time. We need the child's active
cooperation. He has to want to take responsibility for getting
better."
Dr. Powers has found that the whole tenor of nutritional
medicine is different from the conventional medical practice.
"It's cooperative medicine. I have to work differently with the
parents, too. When 1 had a conventional pediatric practice, there
were 40 kids in the office a day. But when you're using a nutri-
tional approach, you have to sit down for a couple of hours and
get to know a lot of things about your patients and their families.
But that's not the only reason Dr. Powers believes his nu-
tritional practice has helped him, as well as his patients. "It's
more fun," he says, "because the approach is more successful.
And that's gratifying."
CHAPTER
GROWING UP
HEALTHY
THE NATURAL WAY
Something was wrong with the baby. Seriously wrong.

The infant had come from the dehvery room to the nursery
30 hours eadier and he wouldn't
couldn't
stop screaming.
Not a normal baby's cry, but a high-pitched howl. He couldn't
eat or sleep, only stare and scream.
The hospital's nurses and obstetrician were at a loss. The
general physical exam didn't show them the problem. The new-
born's head resisted rotation. His tiny thighs were drawn up to
his chest and couldn't be made to relax. They couldn't guess at
a remedy for the squalling infant's misery. The obstetrician called
Dr. Dunn.
When Paul Dunn, M.D., arrived, he located the problem
quickly. The child's cranial bones, compressed during the pro-
cess of birth, were misaligned. Usually, a newborn's first deep
breath expands the bones and they settle into place alongside
one another. This time it hadn't worked. Dr. Dunn placed the
struggling baby on a table and instructed two nurses to hold the
infant carefully still. He stood at the child's head, turned it slowly
to one side as far as he could, and held it in place, waiting.
Soon he felt a little movement building up under his hand,
then quieting down. The movement stopped and he felt a little
671
672 PEDIATRICIAN
tremor of release. Moving the infant's head to the other side, he

felt the process of movement and relaxation repeated. After five
minutes of Dr. Dunn's manipulation, the baby stopped crying

and fell into the first sleep of his young life. Dr. Dunn worked
on for another ten minutes while the baby slept. He gently mas-
saged the baby's head and neck until he could rotate the head
easily from side to side and draw down the once-rigid legs. From
that time on, the child slept normally, ate normally, and behaved
like a normal newborn.
Dr. Dunn's osteopathic therapy was a double blessing for
the youngster. It not only ended his suffering swiftly and effec-
tively, it did so without recourse to drugs and their potential side
effects. 'Tm sure if the hospital had done the 'usual' things,"
Dr. Dunn said, "the kind of things I'd have done a few years

ago put him on phenobarbital and belladonna to calm him down

and put him to sleep he'd have gone home a colicky baby and
at least have grown up to become a hyperactive child with a
learning problem, if not something more serious."
Dr. Dunn is a pediatrician with a difference. He feels the
medical profession has fallen short in fulfilling its responsibilities
to itsyoungest patients. He chose pediatrics as his own specialty

after his internship exposed him to the complaints of hundreds
of adult patients who lived careless and unhealthful lives. After
years of self-inflicted damage, they came to Dunn as they might
bring a poorly maintained car to the repairman. "I didn't want
to spend my life with these worn-out adults, listening to all their
complaints," he says. Working with children, he decided, he
could make an important difference early in their lives and help
them grow into a robust adulthood.
Raising an unusually large family
he's a father often Dr.
Dunn became progressively more dissatisfied with the narrow
approach to health offered by conventional medical training. He
wanted to do better for his own children and the children in his
practice, to incorporate as broad a field of knowledge as possible
into his working methods. As Dr. Dunn's wife and partner, Kath-
ryn, puts it, "We're just middle-of-the-road people who looked
for better answers for our children than anyone else provided."
In his Oak Park, Illinois, office. Dr. Dunn employs, in ad-
GROWING UP HEALTHY 673
dition to general pediatrics, a comprehensive program of testing

and treating children with brain injury and learning disability.
The program includes osteopathy, psychology, biochemistry, au-
diology, Montessori education, developmental optometry, phys-
ical education and nutritional guidance in an interdisciplinary
effort designed for the needs of each patient. Dr. Dunn stresses
the importance of such cross-disciplinary cooperation with these
children. "Let's pool our knowledge and not be afraid that an-
other disciple will steal our thunder."
The importance of proper nutrition in his overall treatment
program is obvious even before visitors leave the reception room.
One newspaper clipping on the bulletin board notes that under-
takers find human bodies do not deteriorate as quickly as they
used to. The reason, they believe, is that today's diet contains
so many preservatives that the chemicals interfere with the nat-
ural process of decomposition. Beside it, another advises parents
on a method to steer their youngsters away from heavily adver-
tised snack foods, make them label conscious and improve their
eating habits. The writer suggests taking the kids to the super-
market to read the labels, with the understanding that, if they
can't pronounce the ingredients, they can't eat them.
Clearly, Dr. Dunn is interested in teaching parents new nu-
tritional ideas so their children will stay healthy.
"Sometimes we assume everybody already knows the basics
of sound nutrition," says Mrs. Dunn. "But there are a lot of
people out there who think sugar is energy and our breakfast
cereals are just great.
"When you consider how easy shop when you don't
it is to
care," she continues, "it only takes a minute to fill your cart
with instant groceries for all week. But when I shop, there are
whole aisles that I skip!"
Nutrition for the Whole Family

Many of the learning problems and other disorders Dr. Dunn
isasked to treat can be traced back to parents who habitually
push their shopping carts down the wrong aisles. According to
674 PEDIATRICIAN
Dr. Dunn, the solution is "a nutritional program set up for the
whole family, not just Johnny and Mary, so the entire family
gets to feel better.
"From the newborn period on, I'm talking to the parents
about the types of nutritional principles you read about in Pre-
vention all the time," Dr. Dunn explains. "I advise sticking as
much as possible to fresh fruits and vegetables, serving chicken
and fish in place of beef and pork, serving some seeds and nuts
although, for the little ones, they should be ground up and mixed
with something else, like applesauce. Serve eggs boiled rather
than scrambled or fried. Avoid bleached-white-flour products
and refined sugar products. Give kids additional vitamin C to
prevent colds."
Mrs. Dunn acknowledges that this may mean asking a family
to change their long-time marketing habits. They should also be
prepared for some initial squawking at the table. "There's a lot
of emotion wrapped up in the foods we're used to eating," Mrs.
Dunn observes. But by changing the family's diet gradually, one
daily meal at a time, the transition to healthier habits can be
accomplished with a minimum of fuss.
How can children be weaned away from the junk foods their
peers enjoy? Get them involved, urges Mrs. Dunn. Teach them
what to look for, and let them help with the shopping. Encourage
them to help prepare meals. Set a good example. Above all,
don't try to impose good food on them, or there'll surely be
resistance. Mrs. Dunn chuckled to recall one little boy who clev-
erly found a way to frustrate his insistent, health-minded parents.
"He'd always trade his whole wheat sandwich full of everything
good for his lunchroom friend's peanut butter and jelly."
"Once they find out the connection between what they eat
and how they feel, they'll learn," says Dr. Dunn.
Early Stimulation
Dr. Dunn also reminds parents that children need more than
good food to grow to their full potential. They have a tremendous
appetite for stimulation, too. And in his opinion, it can't start

too early.
"Playpens make great firewood," he declares. "The child's
body, senses and capabilities develop through use, and without
use they don't develop." It has been found in animals that 80
to 90 percent of the microneurons that deal with the thinking
process develop after birth, mainly during infancy, and in pro-
portion to the amount of stimulation the baby receives. "You
can see how important it is to give the baby every opportunity
to move through the environment from very early on," Dr. Dunn
says. The more a baby is allowed to move, the more it can learn
about its world.
"When Imothers of newborn babies in the hospital,
talk to
I tell them that even next week they can put the baby down on
a blanket on the floor. Of course, he'll just stretch and look

around, but he'll be getting accustomed to that level so that,
when the time comes for crawling, he'll be able to do it as much
as he needs to. The time may come at one or two months, or
three or four. No one but the baby knows. So you can't say,
'I'll wait until he starts doing it'
you might miss the beginnings
of it.
"From very him spend much of his time crawl-

early on, let
ing on the floor, and more and more time as he gets older. Don't
just let him spend hours sitting up immobilized in an infant seat,
a playpen, a walker or a swing seat, because it restricts his early
movements." Infant seats and the like are fine, he continues, so
long as they don't become the place where the child passes most
of his time. These early movements, incidentally, can also help
prevent learning problems.
Dr. a firm believer that youngsters from early in-
Dunn is
fancy should spend time outdoors. "Try to get the child out
every day except in severe weather," he recommends, "so he
can see, hear, feel and experience as many things as possible.
Walk him along the same route regularly, so he becomes used
to orderly repetition. It's like listening to a favorite song over
and over again. He knows what's coming next, and that's the
beginning of attending."
676 PEDIATRICIAN
And parents should not forget the importance of exposing

their young ones to good speech. Read to the child, don't just
cuddle and coo, even if he's only two months old. Dr. Dunn
suggests. "He may not understand reading aloud, but it's still
good language going in. And what goes in is what the mind stores
and what later comes out."
For six years, Dr. Dunn was away from pediatric practice,
working exclusively with children with special problems. After
his return to the field, he remembers, he commented to Mrs.
Dunn that the children looked different to him and acted differ-
ently. There seemed to be more irritable babies, more crying
babies. "They don't seem to be at home with themselves. It
probably has to do with prenatal nutrition and pollution. Alcohol
consumption by the mother during pregnancy can have an effect.
She doesn't have to be an alcoholic. There's evidence now that
two a day during pregnancy can make a
just a regular drink or
difference.
"About 45 percent of the kids with learning problems that
I see have increased lead levels from car and airplane exhausts
in the atmosphere, hair sprays, newspaper print and about 100
other sources. We handle it with vitamin C and sulfur-containing
amino acids. These pull lead out of the system and counteract
other toxins in the environment. Vitamin E is another antioxidant
that will counteract the effects of lead."
Overweight from Addictive Eating

Many of Dr. Dunn's preteenand teenage patients suffer from
that almost universal
American disease overweight. Much of
the time, he says, the problem is one of addictive eating caused
by sensitivity to particular foods. Mrs. Dunn describes the ther-
apy: "The doctor will oftentimes put adolescents on a complete
detoxification program. This appeals to them because it's a very
distinct change. We've used a juice-and-vegetable nine-day fast
to get them away from the things they usually eat, get a thorough
cleansing, break the old habits and get organized to start some-
thing new. It's amazing what this will do for kids."
To a large degree, nutritional problems for adolescents begin
early, when they're making their first independent decisions about
diet, and end when independence matures them, the Dunns feel.

"Once kids get out in their own apartments at least ours
they go in for the wok, the brown rice and vegetables, and making
food becomes the center of their social life. They eat better
because they're poorer," says Mrs. Dunn.
One of the greatest rewards of his work for Dr. Dunn is that
he has very few in-all-the-time patients. "With the basic ap-
proaches I use, nutritionally and otherwise, I don't have nearly
the number of sick kids that 1 used to have. I rarely get more
than three or four phone calls over the weekend. I'll go weeks
and weeks without having to put anybody in the hospital. They
just don't get that sick." Today he's spending much of his time
treating children with specialized learning problems, visual prob-
lems, and others suffering from hyperactivity. And despite his
long-standing resolution to work only with kids, he has consid-
ered bringing his brand of preventive medicine to adults, but his
present busy schedule prevents that.
'T feel sorry for them," he chuckles. "At the end of their
children's exam, parents often sheepishly come forward and say,
'Er um I've got that problem, too!'
Fortunately, as the former president of the International
Academy of Preventive Medicine, Dr. Dunn had the opportunity
to encourage a growing number of other physicians to work with
parents who are willing to take responsibility for their own health.
PHARMACIST
CHAPTER
A COMPLETE
PRESCRIPTION FOR
BETTER HEALTH
The woman walked into the prescription department of a

Leavenworth, Kansas, department store, intending to buy a
package of over-the-counter diet pills. She walked out with two
bottles of vitamins and some sensible advice on weight control.
A local farmer received a crash course in vitamin therapy
when he came in to pick up his wife's duodenal ulcer prescrip-
tion. "A lot of research says vitamin C and zinc help the medicine
work better," consultant pharmacist Tom Liederbach, R.Ph.,
who glared at him suspiciously. As Liederbach
told the farmer,
started to ring up the cash register, the farmer's glance shifted
to a nearby vitamin display. He surreptitiously lifted a bottle
from the rack, turned it over in his palm to read the back label,
then returned it. He faltered, snatched the bottle again and plunked
it on the counter.
"Exactly what does it do?" he demanded.

Liederbach told the farmer that zinc and vitamin C require-
ments are increased with mucosal wounds such as ulcers. Vi-
tamin C, he explained, is needed for the collagen of connective
tissue tocement the healing cells. The zinc also aids in wound
healing and helps oxygenate the blood, which helps the healing
678
A PRESCRIPTION FOR BETTER HEALTH 679
process even more. "Until we see her progress, they are no

substitute for your wife's medication," he warned. The farmer
nodded, looked at the small plastic bottle with the typewritten
label and child-proof top, then examined the larger, brown glass
bottle with
its fancy label and cellophane-sealed cap and bought
both.
As the day woreon, people dropped by to have prescriptions
filled,buy vitamins or just chat with the pleasant young man in
the white coat, name embroidered over one pocket. They found
it easy talking to this pharmacist, who handed out affection and
advice the way pediatricians do lollipops.

"People often feel they didn't get their money's worth if
they walk out of a doctor's office without a prescription," Lied-
erbach told us. "They may feel their complaints aren't being
taken seriously. These people are often the victims of worries,
stresses and depressions that no drug can help.
"What they often need is counseling. But most doctors hon-
estly haven't the time for that, and when they do, usually it
doesn't have the beneficial effect it could because patients aren't
receptive.
"But here," he continued, indicating the expanse of store
where his professional wares were housed in clinical array next
to the tangled greenery of an adjacent plant department, "it costs
them nothing. They are more relaxed when they come in here
than when they walk into a doctor's office, and therefore they're
more open. Too, they often are more responsive to the advice
1 give them about getting proper exercise, nutrition and rest than
they are when the same advice comes from their doctor."
The physician's office, Liederbach contends, often presents
an artificial environment substantially different from the patients'
day-to-day lives outside. They endure it temporarily, in order to
obtain symptomatic relief for what they hope is a temporary
problem. Long-term solutions and radical changes are unwel-
come; many patients are no happier accepting a diet or exercise
program than a verdict of terminal illness.
A pharmacy, especially a pharmacy such as the one Lied-
erbach manages, overlooking the toys and trinkets, tires and
680 PHARMACIST
trowels that are displayed in the store, makes change seem more
palatable than when it is demanded by the awesome patriarch
they call "doctor."
People find it easy to relate to Liederbach, perhaps because

his curls and boyish smile are so disarming, perhaps because his
strong body is a testimonial to healthy food and regular exercise.
He and his wife, Theresa, who rode her bicycle to the obstetri-
cian's office through the ninth month of her last pregnancy, plan
to open a preventive pharmacy center, incorporating a unique
pharmacy practice with natural therapeutic alternatives including
food, herbs and nutritional supplements.
Working with natural foods at a Kansas City health foods
restaurant introduced Liederbach to herbs. His fascination grew.
"I'm a voracious reader; I learned that a lot of medicines are
naturally based. Penicillin, for example, comes from cultures of
certain common molds. Digitalis is extracted from the foxglove
plant.
"I sold my restaurant with the intention of becoming a phy-
sician," but he changed his mind when he saw how little em-
phasis the profession placed on disease prevention through na-
tureand nutrition. In order to help people in that way, he decided
to return to school and become a pharmacist with a major
emphasis on pharmacognosy (the study of medicinals made from
herbs and other natural, biological sources).
Although his sounds like a new approach to pharmacy and
medicine, "it's actually the oldest way," Liederbach explains.
"Originally, pharmacists were herbalists
pharmacognosy is the

word for what they practiced and in addition to drugs with
questionable efficacy, they employed the use of herbal extrac-
tives as effective remedies. Only in recent years, with the advent
of chemical pharmaceutics, has the importance of pharmacog-
nosy been sidestepped.
"There is a new approach coming to medicinals, however.
A specialized consultant pharmacist in conjunction with the phy-
sician will prescribe the proper remedy, and a less highly trained
retail pharmacist will dispense or compound the medicines.
A PRESCRIPTION FOR BETTER HEALTH 681
"Physicians are not able to keep up with the enormous

amount of pharmaceutical literature while maintaining their ex-
pertise with diagnoses/' Liederbach thinks. "A lot of younger
physicians realize this and are becoming increasingly concerned.
A amount of what doctors know about drugs and
significant
medications has been told to them by drug salesmen. Perhaps
that is one reason why three independent sources estimated that
from 10 to 18 percent of all hospital inpatients studied were
suffering from adverse medical reactions classified as iatrogenic
[physician-induced] diseases."
A pharmacist, Liederbach believes, should make it his busi-
ness to know about drug side effects.
"Did your physician tell you you need potassium with that?"
Liederbach asked the woman who was buying over-the-counter
diuretics on the recommendation of her physician. "Without
additional potassium, there's a chance it could cause leg cramps."
He told her bananas were a good source of potassium.

"So much potentially dangerous stuff is sold over the counter.
A pharmacist should be aware of the danger they pose. For
instance, a person who buys a dubious 'diet aid' containing phen-
ylpropanolamine (PPA) could be in for serious trouble if he also
is taking decongestants containing the same ingredient. And if
he also drinks coffee. ..." Liederbach shakes his head. On

several occasions, he has intercepted such purchases and warned
people of the possible consequences, including possible cardiac
abnormalities.
Similar situations arisewhen people buy a prescribed med-
icine and also buy cold remedies or aspirin, which may interact
with it. "Doctors realize I'm doing them a favor," he says,
because most patients don't think to tell their physicians about
over-the-counter preparations they consume regularly, because
they are either embarrassed or ignorant of how dangerous these
so-called safe drugs can be.
"That's one reason why you should always go to the same
pharmacy and get to know your pharmacist. Usually, he knows
a lot more about these things than either you or your doctor."
682 PHARMACIST
Concerned that the strength of his views may lead to mis-

interpretation, Liederbach stresses, "I am not out to undermine
the medical profession or to disparage physicians." He just wants
people to realize there are certain limits to what their doctors

can do in terms of time and training. There is nothing wrong
with that. An architect is not a carpenter.
Patient, physician and pharmacist form a trinity that works
to benefit them all, Liederbach's view. Since he can get a
in
glimpse of a person's life style that a doctor may never know,
he can help the doctor's treatment reach its desired end. When
he calls himself "a liaison between doctor and patient, medicine
and nature," he means human nature, too.
PREVENTIVE MEDICINE
CHAPTER
THE DOCTOR
WHO FOUND
WHAT HE WAS MISSING
"I thought I was hving my hfe to the fullest. I had no nu-
tritional orientation at all. I believed that to restore health you
had my friends would ask me about the need
to take drugs. If
for vitamins, would tell them not to bother, since they would
I
urinate them all away." These are the words of Kenneth Hodge,
M.D., of Sacramento, California. Dr. Hodge is now a nutrition-
oriented physician. The following interview with Dr. Hodge tells
the story of his conversion, the story of how a potentially fatal
stroke brought him face to face with death or lifelong paralysis
and the power of nutrition to bring back health.
Question: Before your stroke, what was your attitude to-
ward nutrition?
Dr. Hodge: My concept of nutrition was eating the four
basic food groups and that was it. I told my patients they got
plenty of vitamins from their foods. I preferred white flour, and
I reallyenjoyed coffee and alcohol.
Q: Was there any warning that you might suffer a stroke?
Dr. Hodge: Yes. My father died of the same kind of stroke
in 1951, while I was serving in Korea as a battalion surgeon. I
had some symptoms, too. About three years before my stroke,
683
684 PREVENTIVE MEDICINE
I began experiencing jagged lines of light around my field of

vision. This is called scintillating peripheral optic scotoma. The
zigzagging lights would move inward until my whole field of
vision was pulsating.
Another symptom that started about that time was some-
thing called dyslexia. I was reading a medical text one day when
I realized that I was unable to tell the meaning of the words. It
was as though a portion of the word was missing. That was rather
disquieting, especially when 1 saw that some of the words were
simple ones, like the. I was also suffering from frequent left-
sided headaches.
Q: Did you consult a doctor?
Oh yes, a neurologist. He took a brain scan,
Dr. Hodge:
but back then the scan was not very accurate as a diagnostic
tool. The test came back normal. So I asked for an arteriogram,
but the neurologist didn't want to do that test. It's very danger-
ous: Strokes or heart attacks sometimes follow it. I knew that,
so I didn't insist. But 1 wanted have something. I knew some-

to
thing was wrong with my brain. But I was able to function more
or less normally for the next two years.
Then what happened?
Q:
Dr. Hodge: About a year before the stroke, I went out into
the kitchen one night to talk to my wife. I talked for about a half
hour, and during that time she didn't understand a word I said.
Words like doo and dah were coming out of my mouth.
Finally, my wife asked me if had any idea what was wrong
I
with me. I said the first English word she could understand:
aphasia. She asked me what that meant. So I said the second
English word that night: Stedman, which was the name of the
medical dictionary I had in the house. She looked up aphasia in
Stcdman's and found that it means the inability to speak. That's
all the book said, though, so she didn't find out the connotations
of what was going on. But as the night passed, my speech slowly
returned, but never quite to normal.
We never discussed that night very much, since I lost the
word power for an in-depth conversation. My memory would
THE DOCTOR WHO FOUND NUTRITION 685
lapse, too, now and then. I couldn't remember the punch lines
of jokes.
Q: What did your doctor do this time?
Dr. Hodge:More tests. But all the results were normal.
Q: What did you do? Did you think there was anything
you could do to prevent a stroke?
Dr. Hodge: No. There was nothing I thought could do. I
Hearing from two competent medical doctors that the blood flow
to my brain appeared normal, I began to think maybe there was
something else wrong with my brain. Besides, 1 had always thought
there was nothing that could be done about a stroke.
Q: What finally happened?
Dr. Hodge: Finally, about a year later, I was watching TV
one night. 1 got up to change the channel, squatted in front of
the set and over to my right side. As I fell, I put out my right
fell
hand to break But my right limb didn't have any strength.

my fall.
I could move it, but I couldn't support anything. So 1 lay there
stupidly on the floor, looked at my wife with a sick grin on my

face and said, ''Honey, something's wrong here." I wasn't hav-
ing any trouble talking then. 1 said, 'Tt's too late to call the
neurologist now, let's hold on and see how I am in the morning."
Right after 1 fell, I was able to get right up.
At 7 A.M., I woke up and went out to get the paper. As I
squatted to pick it up, 1 fell again. Same as the night before. I
got up and walked through the bedroom and told my wife it was
back again. 1 went into the bathroom and just as I went in, 1 fell
again.
The neurologist came over and gave me a quick examina-
tion. He said I was probably cooking a stroke if not having one,
so I'd better get into the hospital.
Q: What happened there?
Dr. Hodge: had an arteriogram. A thin plastic tube was
I
inserted in a leg artery and threaded through to the base of the

neck, and a dye was injected. X rays then show any blockage
of the blood vessels.
Q: What were the results of the test?
Dr. Hodge: wasn't getting too much blood to my brain.

1
My left was 90 percent blocked so only 10 per-

cerebral artery
cent of the blood flow was getting through to the speech center
and the motor center for the right side of my body. Both my
common carotid arteries were 50 percent blocked, and both my
vertebral arteries were 50 percent blocked. And two of my three
coronary arteries were massively blocked. If coronary bypasses
had been in vogue at that time, I would have been on the op-
erating table as soon as my paralysis went away.
After the arteriogram, I found myself in this terrible pre-
dicament. I move my right side and couldn't
couldn't talk, couldn't
think very well, either.The only thought that came into my head
for a long time was that I wished I would die. And actually,
according to the tests, that could very well have happened.
Two hours after the stroke got worse. The blood
test, the
vessels apparently spasmed
response to the dye. It felt like
in
somebody had put a red-hot poker in my brain. The doctors
considered performing a bypass operation on my cerebral artery.
When they mentioned the possibility to my wife, she asked one
of my good friends, who is a neurosurgeon. He said, 'The best
thing that could happen to Kenneth is death."
Q: That was the very bottom, wasn't it?
Dr. Hodge: That's right. But my introduction to nutrition
was to come soon. My daughter came in to visit me soon after
my stroke and saw the hospital food, which at that meal hap-
pened to be pancakes and syrup. She asked me if I would take
something nutritious if she made it and brought it in. I said yes,
because I didn't want to start an argument. Then she asked the
doctor and he said she couldn't do it, and he gave three reasons:
It was against hospital policy; there was a dietitian who could
look after my nutritional needs quite adequately; and he had no

belief in it at all. Neither did I.
But my daughter did. So she went underground. She smug-
gled the pep-up drink
a brewer's yeast milk shake into the
hospital a quart at a time.
Q: How did you like that?
Dr. Hodge: It was a new taste thrill for me. I could hardly
stomach it. But I drank it dutifully, in small sips. Of course, a
quart of that stuff has enough nutrition to last you for a day, so
pretty soon I was eating hardly any of the hospital chow at all.
I stopped drinking coffee; stopped drinking wine. I stopped
I
pasta, pastries and syrups. I started physiotherapy. And a couple

of weeks later I went home, I was able to walk. I walked to my
50th birthday party.
Q: Is that unusual?
Dr. Hodge: Pretty much, yes. Beyond that, though, it gets
into the fantastic. Two months after my stroke, you could have
looked at me from across the street and not have noticed anything
that would give away that I had suffered a stroke unless you
stopped and talked to me. I was still very depressed, so much
so that I was trying to think of cute ways to kill myself so my
wife could still collect my life insurance. At that point, I was
crying at the drop of a hat. If somebody would say something
to me that was nice or not nice, I would cry. My emotions were
extremely labile, which is typical of a stroke victim.
My wife thought a change of scenery might do me good.
She knew I liked the seashore, so we went to stay at her parents'
beach house.
Q: And there you found something that changed your life?
Dr. Hodge: On the bookshelf in the beach house was a
book called Food Is Your Best Medicine by Henry Bieler, M.D.
My wife said I should take a look at it, which I did simply to
avoid being pestered about it any further. I thought the author
was nuts. No way in the world can he be right about foods causing
disease, I thought.
Q: Apparently, something happened to change your mind.
Dr. Hodge: On the way home from the beach house, we
had to pay a visit tomy sister-in-law. didn't want to go because
I
she was the kind of woman who was always complaining about
her health. But to my surprise she was a different woman!
She didn't have any of her neurotic complaints. Her skin color
was good and she was in good spirits. An entirely changed woman.
It seems she had despaired on conventional medicine, which had

yet to do her any good, and had started going to chiropractors,
faith healers
anyone who would hold out a shred of hope for
her. Finally, she went to a biochemist-nutritionist. And that's
when her problems started clearing up.
Q: Did your sister-in-law suggest that you see the nutri-
tionist,too?
Dr.Hodge: Did she! It was my sister-in-law who had planted
Food Is Your Best Medicine at the beach house!
Q: How did you feel about that?
Dr. Hodge: Well, I suggested
with my limited word

power that my wife ought to see if this nutritionist could do
anything for her rheumatoid arthritis and her peptic ulcer. But
while she was on the phone making the appointment, I told her
I would go, too. I figured I had nothing to lose and probably
nothing to gain.
Q: So you went to the nutritionist.
Dr. Hodge: We both went andspent an hour apiece talking
about our health and dietary histories. Then we were each given
individual diets to follow, including supplements.
Q: And the results?
Dr. Hodge: Two days later, Joyce, my wife, had no ulcer
pain. Within a month, she had no joint pain. But what happened
to me was even more fantastic. The first thing I noticed that was
different was that mosquitoes were ignoring me because I was
taking a lot of B vitamins. The second thing I noticed was that
two different types of backache I'd had since I was a teenager
were gone. The perennial sneezing that I'd suffered since I was
even younger was gone. My sinusitis disappeared. My intermit-
tent hives also disappeared. Both the zigzagging lights in my field
of vision and the left-sided headaches that had come before and
after my stroke also disappeared. The prostatitis that I'd had for
five years disappeared.
But the most beautiful thing of all was that my depression
started to lift. As soon as we got home, I started to assemble a
couple of bicycles we had bought. It took me a week to get them

together, and I struggled for several days just to get mine to
move forward. 1 was riding on a gravel yard, and when I lost

my balance and fell well, the front yard was a bloody mess
because I was taking a blood-thinning medication at the time.
But within a week, I was making the half-mile trip to the speech
therapy class. And a month later, I was cycling 27 miles a day.
Four months later, I was getting into arguments with my
speech therapist, so she decided I didn't need therapy anymore.
Ihad totally lost my depression. And my memory was returning.
Q: And that's when you decided to return to your practice?
Dr. Hodge: Well, I decided 1 would take another whack at
anesthesiology, which was my specialty before the stroke. But
I was looking at things with new eyes. I started to see things
about medicine that 1 had never noticed before. Physicians think
of levels of disease; they don't think of nondisease. I was thinking
about health.
I was thinking that if I'd been eating as I was eating now,
I would never have had the stroke in the first place. That was a
brand-new concept for me, thinking about health instead of dis-

ease. And I saw that many people who came into the hospital
were turned out in worse shape than when they came in.
So slowly, but surely, that started to get to me. I would look
at these physicians in their youth, with their pedantic authori-
tarian tones, telling patients how to do things, what to do, and
not brooking any nonsense from them at all. And 1 thought, 'Ts
I was? If so, I don't want to be one anymore."
that the kind of guy
So months, I decided to quit.
after nine
Q: And you began your nutritionally oriented practice?
Dr. Hodge: Cautiously at first. I read every book I could
lay my hands on that dealt with nutrition. Little by little, though,
I accepted more patients.
Q: Do you remember your first patient?

Dr. Hodge: Yes, the nutritionist who gave us our diets
referred a man to me. He had joint pain and angina. He was
taking seven or more nitroglycerin tablets a day for relief of the
heart pain. But within a week on the diet I gave him, he cut
down on the nitroglycerin, and during the following month he
took only two. His joint pain also improved.
Q: Now your practice is full time?

Dr. Hodge: 1 usually run from nine in the morning until
five-thirty. But I don't see too many patients in a day. On a busy
day, maybe 24 people. But if I have 2 or 3 new patients, I don't
see more than 6 or 8 people that day.
Q: Do you ever prescribe exercise?
Dr. Hodge: Oh, yes. I think that exercise is also very im-
portant. And when I say exercise, 1 don't mean you have
to be
an athlete. Just exercise to your capacity. Extend your capacity
as much as you can, little by little. Strength is not essential, just
a good, pumping, functioning heart is essential to carry oxygen
and nutrients to various parts of your body. A good wide-open
cardiovascular system is essential, too, for clear thinking and
proper functioning of the other organs.
Q: I suppose your experience has taught you a lot about
the medical profession and health?
Dr. Hodge: Well, like the average physician, I was well
educated, self-assured and had the answer to everything.
felt I
Today I realize that I did not have the answer to everything; as

a matter of fact, 1 had the answer to almost nothing. My attitude
toward life has changed drastically since the stroke, and I con-
sider the stroke a beneficial event. I think that optimism is es-
sential. Pessimism creates illness. Negative thinking of any kind
whether it's anger or pessimism or depression ruins people.
Any disease is made worse by negative thinking, whether it's
cancer or arthritis or an ulcer or angina.
Q: Do you ever help motivate your patients to adopt a
healthier life style by telling your own story?
Dr. Hodge: Sometimes I do. 1 kind of go at it briefly. I
usually just tell them they don't have to suffer from depression,
that they could lead their lives with much more enjoyment. I
simply describe to them what they're missing in life.
CHAPTER
MAKE YOUR BODY

A SAFER PLACE
TO LIVE
When Harry T. had his car accident a few years ago, he

considered himself pretty lucky to get out with only a minor case
of whiplash. But after several weeks, he wasn't so sure about
his luck anymore. By that time, his neck had completely stiffened
up. So had his shoulders and hands.
Instead of getting better, he was getting progressively worse.
After visiting rheumatologists and other specialists at several
prestigious California medical centers, he was told he had de-
veloped osteoarthritis of the spine. His doctors prescribed the
usual anti-inflammatory drugs, pain-killers and physical-therapy
treatments, but nothing seemed to help. He just got stiffer and
stiffer while living with constant chronic pain in his neck, shoul-
ders and hands.

For two years his suffering continued, and he adapted to it
as well as possible. But Harry didn't give up. He had been a
successful business executive for years and wasn't about to let
this illness do him in. Besides, he was only 60 years old
much
too young to sacrifice the rest of his life to pain and misery.
Lucky for him he found out about the Commonweal Clinic
in Bolinas, California. "We first saw Harry about 20 to 24 months
691
after the car accident," says Charles Thompson, M.D., former

medical director of the clinic. "His range of motion was severely
limited. He had a very hard time turning his head. In fact, he
couldn't even move his chin a quarter of the way down to his
chest.
"When I found out that Harry's arthritis had come on very
quickly after his car accident, I couldn't help but wonder if there
wasn't some physical and psychological connection between the
two. Harry suspected the same thing, but he couldn't figure out
exactly what it all meant. So we worked both tracks with him
the biophysical track and the psychosocial track," explains Dr.
Thompson.
"From counseling, Harry discovered that he had not
still
dealt with the aftermath of his divorce. His guilt had immobilized
him emotionally just as the shoulder and neck pain did physically.
Clearing up the psychological problems produced some pain relief.
"As for the biophysical track, first we tested him for food,
chemical and inhalant sensitivities in the laboratory. A number
of the things he was tested for, particularly certain foods, produced
a significant increase in the arthritis symptoms in his neck and
hands. We immediately took him off the offending foods and
then put him on vitamins C, A and D, as well as B complex and
calcium.
"It took about six weeks until Harry noticed improvement,
but then he knew he was on the right track.
"After about three or four months, he was incredibly im-

proved completely free of pain. And his emotional well-being
was the best it had been in years," Dr. Thompson told us.
An Alternative to Despair
Even if Harry were an isolated case, the results would be
worth pondering. But the practitioners at the Commonweal Clinic
say that they've almost come to expect significant improvement
in otherwise hopeless situations.
MAKE YOUR BODY A SAFER PLACE TO LIVE 693
"We who have reached Harry's level of

see lots of patients
despair," says Susan Rutherford, clinic administrator, "and two-
thirds of those people complain of three or more chronic ill-
nesses. By the time they come to us, they have usually been
through the million-dollar workups and been everywhere trying
to find help. Often their doctors have just told them there's
nothing that can be done for them and sent them on their way."
"We go about things differently here at the clinic," says Dr.
Thompson. "Sure, we'll run the routine blood tests (if they hav-
en't been done within the past six months) plus a thorough,
overall examination. But where most traditional doctors leave
off is where we really begin."
"An initial visit to the clinic takes about two hours," says
Ms. Rutherford. "And subsequent visits usually take at least an
hour each."
"That's because we do so much more than just a physical
exam," continues Dr. Thompson. "We want our patients to
become active participants in their own healing process, not the
passive people that other physicians have come to expect. It is
our aim to empower people, as much as possible, to understand

more whatever disease process they're dealing with, both
clearly
physiologically and psychologically."
To do that. Dr. Thompson and Ms. Rutherford work as a
team with each patient. They actually started the teamwork idea
about five years ago in their preventive medicine practice in
Seattle. Now, it's a routine procedure here in the Bolinas clinic,
too.
Dr. Thompson brings his training in internal medicine into
play, while Ms. Rutherford acts as a counselor and health ed-
ucator with training in drug and alcohol abuse, nutrition and
stress management. Eight other colleagues, including a child
health care specialist and a clinical ecologist, round out a staff
that includes both medical and lay practitioners.
"There's a certain amount of overlap in our expertise, but
together we cover a lot of bases," Ms. Rutherford told us. "Be-
sides, we find the patients appreciate having both the male and
female perspectives on a given situation. And patients can relate
to a lay professional; they're relieved to know there is someone

here who speaks their language. Of course. Dr. Thompson does,
too, but they may not realize that at first.''
Their innovative ideas in treating the chronically ill have led
them into the classroom as well as the examining room. Medical
students, nurses and doctors have been learning from Dr.
Thompson and Ms. Rutherford.
"We've taught classes at the University of California med-
ical center and, before that, in the Seattle area," says Ms. Ruth-
erford. "We've also taught our ideas in the local school districts,
at colleges in this area and at a drug and alcohol rehabilitation
center," adds Dr. Thompson.
"Through all of that contact have come to sense that most
I
of the people we see live in their bodies as if they were dangerous

places to be that their bodies are essentially a scary, unknown
collection of organ systems and chemicals go that could just
haywire at any moment. They believe and
that, without the skill
knowledge of a sort of 'factory-trained mechanic' (an M.D.) to

manage it, their life is in peril.
"Actually, it's more likely the other way around. That is,
recognizing what's good for you and what what makes isn't,
your symptoms feel worse and what makes them feel better, can
be used as an opportunity to learn and grow in terms of medical
self-care," Dr. Thompson told us.
Trust Your Hunches

"Therefore, a lot of our work has to do with reawakening
body awareness so that people can learn to trust their own hunches
and intuitions about the physical and psychosocial causes and
effects of their problems."
And most do have hunches. "The majority of our patients
have had an intuitive sense (sometimes for years) that what's
going on in their bodies physically has something to do with how
they think and feel emotionally about themselves, their lives and
their world. Unfortunately, not one of the physicians they've
seen has ever felt it was important to pursue that line of reasoning."
Yet, that's exactly where Dr. Thompson begins when a pa-

tient first comes to the Commonweal Clinic. "To make it easier
to bring out all the information needed, we have a detailed ques-
tionnaire that every patient is required to fill out," he explains.
"It asks patients about their basic life and medical,
style choices
nutritional and exercise history. Then, at the end of each section,
we include open-ended questions such as: Do you have any
suspicion that your symptoms are related to certain foods, or to
your menstrual period, or to life style changes such as divorce,
or even a promotion?
"You'd be surprised how many people have these strong,
nagging intuitive hunches about their illnesses. Not long ago, we
treated a young woman who was a classic example of that. She
had been under psychiatric care for about ten years, and her
family had a strong history of all kinds of physical and emotional
problems. Yet she 'knew' there was a physical cause. She had
spent thousands of dollars on various treatments by the time she
came to see us. But she still suffered from periodic psychotic
depressions that lasted at least five days at a stretch. During an
episode, she would experience hallucinations and very strong
out-of-body experiences. She was quite immobilized in the midst
of an otherwise normal, active life.
"These attacks would occur every 30 to 40 days. What's

more, whenever something like final exams or a date would come
up (which added stress), she could almost count on having one
of these psychotic breaks. After we completed a detailed medical
history, it turned out that the attacks were most strongly cor-
related with her menstrual cycle and obviously correlated with
other psychosocial stresses. She also had a long history of dys-
menorrhea [painful periods], premenstrual tension, water reten-
tion and breast soreness."
Helped by B Vitamins
"I immediately started her on daily Bf,, niacinamide [a form
of niacin] and tryptophan supplements," Dr. Thompson contin-
ues, "and it completely broke the psychotic pattern. Vitamin B^
is thought to be the cofactor necessary to convert tryptophan

[an amino acid] to serotonin [a brain neurotransmitter], and a
lack of any of these can cause severe depression.
''It bothers me that, during all those years, no one ever took
a decent enough history to uncover what her real problems were

not the psychiatrists she saw and not the neurologists or endo-
crinologists, either.
'That's why we emphasizethe importance of a good, thor-
ough For example, as a part of all initial workups, we
history.
also evaluate the patients' total stress load by having them fill
in a life-adjustment rating scale. This test assigns a certain num-
ber of points for major changes such as marriage, divorce,
life
death of a spouse, moving or promotion. The higher your total

score, the more stress you are under and the greater your risk
of illness or accident.
*Tf we see that someone scores high, we may suggest an
adjustment in nutritional intake," says Dr. Thompson. "The
tendency is for most people to have little or no breakfast, a light
lunch and then pack in two-thirds of their daily nutrients and
calories at dinner. But by then, roughly two-thirds of their total
output of physical, emotional and mental energy has already
occurred, so that they are running on a deficit. That can be critical
for someone whose recent history contains 250 or 300 of those
life-adjustment rating points. Statistically, that person is much
more likely to experience a major illness or accident."
"We attempt to match input of nutrients with output of
energy by having our patients spread out their calories more
evenly over the day," continues Ms. Rutherford. "We suggest
that they eliminate foods that contain a lot of preservatives,
artificial colorings and other chemicals, as well as overprocessed
foods like sugar and white flour. Those foods are stressors in
themselves and don't always provide the kinds of nutrients (es-
pecially the B vitamins and minerals) that might be depleted
during times of stress."
"Of course, complaints about stress are usually not what
brings people in," Dr. Thompson points out. "But stress is often
related to the other chronic ailments they may be suffering.
Whether it's asthma, gastritis, coHtis, high blood pressure, pso-

riasis or whatever, we approach each patient as an individual.
Even people with the same disease will probably be treated dif-
ferently. That's why it's so hard to generalize. We don't have a
special diet for this ailment or a special nutrient for that disorder."
Listening to the Body

"Each of our patients learns to use his or her uniqueness
to help uncover the underlying answers to a particular problem.
In other words, the body becomes own biofeedback system,"
its
Dr. Thompson explains. 'This is when we

especially evident
check for food sensitivities. From the history taken, we deter-
mine which foods are suspect. Then we do allergy testing for
those specific items. During the testing, the subjective symptoms
are noted mental fogginess, agitation, anger, dizziness. We also
note whether the symptoms they originally came in with are
increased by the food in question. From all of that, we are able
to determine what level of allergy response or hypersensitivity
the person shows.
"Food sensitivities really matter," Dr. Thompson empha-
sizes. "Two or three years ago, I would have said. That's a lot
of hokum.' But not anymore. Fm completely convinced. Our
own laboratory experiments have confirmed the effects that foods
can have on susceptible people. I have seen the elimination of
allergic foods reduce the symptoms of migraine, depression, pso-
riasis, recurrent ear infection, colitis, arthritis, even high blood
pressure.
"That last one was a me. We've had four
real surprise to
patients in the last year with moderately high blood pressure
who did very well with food allergy elimination. Two, who were
on antihypertensive medication, were able to cut their dosage in
half."
In fact. Dr. Thompson is still amazed by the number of
people who have been significantly helped at the clinic. "In the
chronic disease population, the expectation is that you may be

able to help 10 to 15 percent. If you can get that percentage up
to 20 or 25, you are doing extremely well. Yet, in our experience
with the chronically ill, we have better than 50 percent with
significant improvement. And that includes a decrease in symp-

toms, a decrease in dependence on medication and an increased
sense that the body is a decent place to live."
CHAPTER
THE MEDICAL SCHOOL

WHERE NUTRITION
ISN'T A DIRTY WORD
'The graduates of today's medical schools know more about

heart transplants than they do about basic nutrition. I would
guess 90 percent of them couldn't describe an adequate, nutri-
tious diet that was appropriate for people at various stages of
life."
That was the reply of Philip R. Lee, M.D., director of the
institute for health policy studies at the University of California
medical school at San Francisco, when asked by Senator George
McGovern whether today's new doctors were properly trained
in the importance of nutrition.
This bad news about America's medical schools was also
aired in another important forum, the official voice of the Amer-
ican medical establishment, the Journal of the American Medical
Association. Esther S.Nelson, M.D., commented in the editorial
column on the sad fact that, while every single veterinarian in
the country had been thoroughly trained in nutrition, nine out
often of the country's medical schools didn't adequately cover
the subject.
That's the bad news. But there's good news, too. There is
a doctor who's making sure every medical student that passes
699
through one of the East Coast's most prestigious medical schools

appreciates the importance of nutrition in maintaining good health.
Dr. Willard Krehl, although he is carrying on something of
a revolution in the medical school curriculum, does not person-
ally carry on like a revolutionary. The noise from the construc-
tion ten stories below, as the medical college at Thomas Jefferson
University expands to up yet another two blocks in the center
fill
of Philadelphia, reaches up into his office but does not disturb

his concentration. Dr. Krehl is a scientist, not an angry revo-
lutionary. He has both a medical degree and a doctor of philos-
ophy degree. His writings have appeared in nutrition and medical
journals and in nutrition textbooks. He has the facts.
"I doubt there are ten hospitals in the country that can give
a comprehensive nutritional evaluation of a patient. The idea
all so well fed isn't true. Many of us are overfed.
that we're really
But many don't measure up to even a conservative estimate of
what we need. As doctors, we should find out who these people
are and educate them," Dr. Krehl said, commenting on "the
skeleton in the hospital closet."
"But we often don't spend time with patients to see them
through their troubles. Instead, we prescribe drugs."
Dr. Krehl doesn't want his students to make the mistake of
ignoring nutrition. "All too often, one finds the nutritional status
dismissed with the statement that the patient is 'well nourished'
and 'well developed' or that the patient 'seems to be getting a
balanced diet.' Nutritional deficiencies exist but not necessarily
in theobvious form of traditionally recognized deficiency diseases.
"One may have malnutrition without obvious evidence of
nutritional disease. The deficits may begin early in life and con-
tinue for long periods of time. It's just as important to diagnose
these problems of malnutrition before these diseases develop in
full-blown proportions as it is to diagnose appendicitis before
the appendix ruptures. You know, preventive medicine is not
new. Hippocrates said that the physician 'must look after the
patient's regimen while he is yet in health.'
Dr. Krehl admits to his students that "the concept of treating
healthy
symptomless patients is rather foreign to traditional
NUTRITION ISNT A DIRTY WORD 701
concepts of medical practice," Hippocrates notwithstanding. But

he also them, "It can be done. Illness can be prevented."
tells
How? Well, the students are not left hanging on that question
too long. "Frequently, the practice of preventive medicine in-
volves efforts to change the behavior or life style of the individ-
ual. He may be advised to exercise more, eat less, relax more,
discontinue smoking or the use of alcohol, or to change some
behavioral pattern which may lead to future illness. The patient
may also be encouraged to learn to swim or reduce weight."
The important act on the part of the physician. Dr. Krehl
points out, is to communicate with the patient. "A huge com-
munications gap exists between the doctor and his patient be-
cause the role of teacher is unfamiliar to most physicians. But
to get the patient to take greater personal responsibility for health
may require much greater skill, more time and understanding
than knowing how to prescribe drugs."
Actually, Dr. Krehl believes, all medical care is preventive,
even crisis-oriented care. The difference, he points out to his
students, is in the moment when the physician intervenes in the
patient's life to prevent further illness. Obviously, Dr. Krehl
wants his students to learn to intervene before the patient needs
crisis-oriented care.
To this end. Dr. Krehl instructs his students in how to in-
vestigate a patient's record and identify health problems that
might develop in the future. For instance, students are taught to
find out what patients eat, whether they use drugs, alcohol or
tobacco, what occupational hazards or environmental pollutants
they're exposed to, what they like to do with their leisure time
and what psychological adjustments they make. The students
also learn to look at a patient's record and identify what health
problems might have been prevented by earlier attention.
Naturally, they are also taught to look for the signs of nu-
tritional deficiencies. Dr. Krehlthem, "Nutritional disease
tells
due solely to inadequate intake it does occur if faulty
is rare, but
dietary habits persist. Marginal nutritional deficits may occur
commonly because of improper diet, poor absorption, decreased
utilization, increased excretion and increased nutritional require-
ments. Moderate illness or injury does not necessarily cause

nutritional catastrophe unless these stresses are prolonged or
unless the nutrient reserves are too depleted. For temporary
demands, reserves may meet the need. When stress becomes
sufficiently great, the reserves no longer suffice and illness can
result."
Dr. Krehl believes that "there is a great deal of variability
in the nutritional needs of individual people. Some people may
need many times the Recommended Dietary Allowance."
As his students learn to assess the nutritional status of their
patients, they learn not only how toperform standard laboratory
tests for nutrient levels, but also what to look for in a patient's
appearance that might give a clue to a nutritional problem. "A
number of complaints are often, but not always, associated with

what we might call 'undernutrition' fatigue, apathy, loss of
appetite, burning or tingling sensations, palpitation, nervous-
ness, headache, irritability, upset stomach, depression, muscle
weakness, apprehension, lassitude, abnormal changes in weight,
and, in a child, failure to grow."
Quickly, Dr. Krehl ran through some of the classical symp-
toms of vitamin deficiencies which he teaches his students to
look for: "The skin very frequently gives the first signs of mal-
nutrition. Not all skin changes are nutritional in origin, however.
Certainly, dry, scaly skin should bring to mind the possibility of
inadequate vitamin A. Seborrheic dermatitis in the area of the
lipsand nose could be a sign of inadequate pyridoxine [vitamin
Bf,]and riboflavin. Dryness and opacity in a patient's eyes could
be caused by vitamin A deficiency.
"Anemias will commonly show up as a generalized pallor
of the tongue and mouth. In fact, abnormal appearance or in-
flammation of the tongue or around the mouth should lead one
to at least suspect nutritional deficiencies.
"A doctor should also be alert to the mental and emotional
abnormalities associated with deficiencies of B vitamins, partic-
ularly thiamine and niacin.
"Muscular weakness, particularly if generalized, could be
a result of nutritional deficit. The simplest test for muscular
I
NUTRITION ISN'T A DIRTY WORD 703
weakness have the patient squat and then attempt to stand.

is to
In thiamine deficiency, muscular weakness is severe enough that
the patient cannot rise from the squatting position. Absence of
the reflexes, particularly the ankle jerk, may also be present."
On the subject of meganutrient therapy. Dr. Krehl says he
believes some beneficial effects may occur when high doses of
vitamins are taken. "But,'' he adds, "I don't believe it's nec-
essarily a nutritional effect. Using high doses of vitamins is really
more like using a pharmaceutical. You create a 'mass action'
effecton a particular biochemical process in the body, one which
normally uses a vitamin in the first place. Of course, not too
much is known about the biochemistry involved. But some of
the effects are well documented. For example, the treatment of
intermittent claudication, a condition in which walking becomes
extremely painful, is possible with 400 to 600 international units
of vitamin E per day. There's little doubt that it works. I've used
it myself on patients with intermittent claudication. Another good
example is that the Canadian epidemiologist Terence Anderson

has proved that vitamin C while not actually preventing colds
significantly reduces the number of days lost to cold symptoms."
Of course, not physicians accept the importance of nu-
all
trition in health or that using large doses of vitamins might help

a patient. As a matter of fact, on the day we visited Dr. Krehl,
he was scheduled to debate another doctor on the merits of
meganutrient therapy. The debate was part of a series of nutrition
seminars set up by Dr. Krehl and Robert Karp, M.D., a pedia-
trician who was a member of Dr. Krehl's department, to expose
the hospital staff to important issues in nutrition.
The outcome of the debate was best expressed by a young
medical student who raised his hand during the question-and-
answer period and told Dr. Krehl's opponent, "For someone
who is supposed to represent the scientific position of honest
skepticism, you have really failed to bring to the argument any
real scientific information thatmight discredit anything Dr. Krehl
says. All you've done is generalize from newspaper clippings,
while Dr. Krehl has offered scientific evidence backed up by a
stack of medical journal articles."
Apparently, the strength of Dr. Krehl's careful, scientific

concern about nutrition promises to carry the day not only with
his students, but also with the hospital's dietary staff, formerly
under the direction of Gwendolyn Acker, R.D. Together with
Mrs. Acker's department. Dr. Krehl's staff revised the diet man-
ual for the hospital. Although it wasn't in print the last time we
spoke to Dr. Krehl, according to him it takes into consideration
a great deal more than the usual ''four food groups" idea of
nutrition. And in the community health aspect of his work, Dr.
Krehl is trying to teach people how to avoid serious illness by
taking care of themselves, rather than waiting for a crisis to arise.
Dr. Krehl reports that the response from other medical schools
has been favorable. At a recent symposium held at Jefferson
medical college, many administrators from other medical schools
expressed interest in Dr. Krehl's program.
The vision of a new generation of doctors who pay attention
to the nutritional needs of their patients can no longer be dis-
missed as an impossible dream. Dr. Krehl and his staff are mak-
ing it come true in Philadelphia. And when you think about it,
you realize that it's really not too much to ask, since, as Dr.
Krehl says, "Food, aside from the air we breathe and the water
we drink, is the most important environmental factor influencing
our health. When a doctor is evaluating the health of a patient,
the most important thing he can do regarding nutrition is to think
of it."
CHAPTER
THE DOCTOR WHO

TAKES HIS OWN
MEDICINE
"I was just another medical doctor who followed the text-
books and did what he learned in medical school," admits August
Daro, M.D., of Wilmette, Illinois. 'Then, about ten years ago,
I became interested in applying nutrition to medical problems.
1 bought myself books on nutrition and books on biochemistry.
I read all I could on the subject. I taught myself.
''Now, around that time, a very high executive of a baking

company called me in. I was doing general practice at the time.
He had suffered from osteomyelitis of the leg for about 18 years.
That is a bacterial infection which can often result in the actual
destruction of parts of the bone. I told this man that I didn't
know why he called me, since Tm not a bone specialist. He said,
'I know that. I've been to the bone specialists. I want you to
tell me what you would do if you had this leg.' Without any
hesitation, I told him I would try to heal it from within. So I put

him un a good diet. Raw vegetables, and some cooked just a
little. Vitamin D and multivitamins. Liver two or three times a
week. In a year's time, that leg healed up and the problem has
never returned."
705
Though Daro hasn't always been what you might call a

Dr.
nutrition-oriented physician, he has always seemed to notice
nutritional deficits causing problems in his patients.
''I once had a very large prenatal clinic, visited by 150 preg-
nant women in an afternoon. I observed two things. One: Some

of the women had beautiful teeth and some had really rotten
teeth, full of cavities, and swollen gums. Two: Those who had
good teeth ate their vegetables. I questioned all the women about
this. And those that did not eat vegetables or drink milk their
teeth were bad. But there was a third group. They ate a lot of
vegetables and their teeth were still bad. So I asked them how
long they cooked the vegetables. They said they cooked them
until they were done. So 1 had to find out what that meant. It
meant they cooked the vegetables anywhere from a half hour to
an hour and a half! No wonder their teeth weren't helped by the
vegetables."
Needless to say. Dr. Daro's present patients are no strangers
to fresh, natural foods and vitamin-mineral supplements.
'T had a housewife of about 30 years of age come in com-
plaining of nervousness and headaches. She'd had these prob-
lems for several years. 1 could find nothing wrong with her in
the physical exam. I put her on a supplement containing mag-
nesium, calcium and vitamin D, which controlled the headaches
and nervousness.
"One of my patients was a 38-year-old woman who had
been plagued all her adult life with premenstrual tension and
severe cramps during her period. She was completely relieved
with a supplement of magnesium, calcium and vitamin D. She
was so happy when she came in after taking the supplements.
She said it was the first time in her life she was without symptoms."
Treating Infections, Cysts

"I had a 40-year-old woman who was always bothered by
sore throats and bronchitis. Now, 1 don't use antibiotics for that
sort of thing. I treat them with vitamin C and vitamin A. I had
AN M.D. WHO TAKES HIS OWN MEDICINE 707
her take 3,000 milligrams of vitamin C and 20,000 [international]

units of vitamin A daily. She has remained free of both problems
since.
"You know," the doctor continued, "breast tumors are of
great concern to both doctors and the women that come into the
office. The most common tumors we see are called chronic cystic
mastitis. They're not malignant, but they may lead to malig-
nancy. A number of women with these tumors are deficient in
thyroid. These women were helped by thyroid supplements. But
not all the women were helped. I began to use vitamin A for
sebaceous cysts of the skin. And I thought that, since the breast
tissues derive from the skin, maybe the breast tumors will re-
spond to vitamin A, too. I noticed that these women had dry
skin. So I gave them vitamin A, and it worked. I've seen cysts
of the breast 2 to 3 centimeters in diameter disappear with vi-
tamin A. I've had enough cases to be absolutely sure, too. And
in some cases, I've taken a mammogram before and after the
treatment to demonstrate the disappearance of the tumor."
Vitamin A and the Skin

"I use vitamin A for any cyst that appears on the skin. A
50-year-old woman came in for a gynecological exam and asked
me to recommend an ophthalmologist that would remove a cyst
from the upper right lid of her eye. I asked her if she was in a
hurry to have it out. She said no. I asked her if she would like
to try vitamin A to see if that would make it disappear. She said
she'd like to try it. So I had her take 40 to 50,000 units per day
and I also gave her an injection of vitamin A once a week. In
about eight months, the cyst disappeared.
"There were never any adverse reactions to the vitamin A.
As a matter of fact, I was in a confrontation once with a 'doctor
of science' who was the chairman of the nutrition department
of a large medical organization. The newspaper got us together
and questioned us. They asked him about vitamin A first. He
said it was dangerous because it can be toxic. Then they asked
me. Now, knew

I this man was not an M.D., so he had no clinical
experience. So 1 said, Tve been in practice for a long, long time
and I have never seen a case of vitamin A toxicity. However, I
have seen thousands of people who had a deficiency of vitamin
A.' That took care of him. Some people are sensitive to vitamin
A, of course. But you can be sensitive to anything strawberries,
eggs, milk. If someone is sensitive to it, you don't give it, that's
all."
Some of the people Dr. Daro helps with the healing wonders
of nutrition happen to be other doctors. "One day I noticed
another surgeon getting ready for surgery and his back was cov-
ered with acne. I told him to try some zinc. He knows me, has
confidence in me, so he tried it. About three months later I saw
him, again getting ready for surgery. His back was completely
clear! It was as though he had never had any acne.
"Soon after that I played golf with the head of the derma-
tology department at one of the medical schools in Chicago. It
made for some me. I convinced

interesting conversation, believe
him, and now we're doing some work together on the use of zinc
in dermatology. I use zinc and vitamin A on acne not only on
older people, but on young women, as well. Women come in
from age 14 to 30 with acne. The zinc and vitamin A are very
helpful for most of them."
Helping Other Doctors

"I took a trip to Florida a little while ago. A great surgeon,
who is no longer practicing, came along. He didn't seem as active
as am, though. So while I had him in my apartment, I made
I
sure he saw me taking my supplements every day. So pretty

soon he started to cup his hand and hold it out and say, 'You
can give me some of those to take, too.' Now, here was a man
who had never prescribed vitamins and minerals. All of a sudden,
he became interested. On the way down, we had talked a little

about it the value of vitamin A and zinc. He's very sharp. He
AN M.D. WHO TAKES HIS OWN MEDICINE 709
wanted the names of the supplements I take. When we came

back, he immediately went to the drugstore and got some for
himself. And you know, I talked to him yesterday and his voice
sounds stronger and he admitted that he feels much better since
he's been on the supplements."
These men weren't the only doctors helped by Dr. Daro's
nutritional counseling. Dr. Daro takes his own medicine. "The
medical profession says: 'Cut cholesterol out of the diet to lower
blood cholesterol.' They usually include eggs which I think are
a most wonderful food. I eat two eggs a day. But I also reduce
saturated fats, meats and creams. I eat lots of low-fat meat, lots
of fish. I And I use lecithin, 2 table-
eat fish six times a week.
spoons of granular lecithin morning. I use safflower oil on
in the
salads. About two years ago, I took my cholesterol count for
the first time. It was 280, which is high-normal. But with this
diet, I've gotten it down to 180. And as a matter of fact, I went
into the hospital about two months ago for a cataract operation,
and they took my cholesterol level as part of the routine ex-
amination. It was down to 150!"
Did Dr. Daro prepare for his own surgery in any special
way? 'T increased my intake of zinc. With zinc, tissues heal
better, faster. My regular supplements are magnesium, Bf,, vi-
tamin A, vitamin C. amazed the doctors, you know. Just two
I
weeks after surgery, I was back out on the golf course. Some
people can't get back to their regular routine for months after
cataract surgery.
"And you know the funny thing about this, the surgeon who
operated on me is a good friend of mine. He never believed in
supplements before. But when I was in there for a follow-up
exam, happened to be there and I noticed she had
his wife also
a bit of a skin condition.So I mentioned to him that she should
take some zinc and some vitamin A. And he took notes on this
himself, what she should take. This amazed me. I think he saw
the effect of the supplements on my healing. I kept telling him
that the supplements and the good eating had something to do
with my recovery. I said, T'm not trying to take away from your
fine operating technique, but you've got to have tissues that will
heal/ I saw his wife just yesterday, and she's taking the vitamins
and minerals and improving/'
Dr. Daro's healthful diet works its wonder outside the hos-
pital, too. "1 graduated from medical school in 1925. I started
practice in 1928. And I have a lot of energy. Yesterday, 1 was in
the office here and I saw about 28 patients. I do that three days
a week. owe it to nutrition. I eat
I properly. I don't smoke or
drink. And I try to get my sleep."
Other things are important, too. Dr. Daro says. "1 have a
theory that it's just as important to exercise as it is to sleep. So
1 tell my patients to jog, even at home. Start slowly. Or use a
bicycle either outside or in the home if they have a stationary

cycle. I tell the older people to do some walking."
Nutrition, Humor and Kindness

"1 think a good sense of humor helps, too. If you're serious
all the time, you get too much tension. What people don't know
about stress is that, if you don't have any stress at all, you
collapse. You need a certain amount of it.
"Not enough medical schools teach nutrition. But some-

thing else that interns and nurses should be taught is that the
patients are human You need to have a human hospital.
beings.
One of my earliest experiences was at Chicago Lying-in Hos-
pital. One morning, as I was just getting off my rounds, a husband
who had both arms full of presents came up to me. He said, 'My
wife said you were so wonderful to her that she made me go out
and get you these presents.' 1 didn't know who it was, so I had
to go out on the floor to find out. It turned out to be a young
woman who had been crying the night before. I had said, 'Now
you don't have to cry; you're in a good hospital, one of the best
in the country. Your doctor is one of the best. And I'm on duty
tonight and I'll watch you close to make sure nothing happens
to you.' All I did was what any kind person would have done."
CHAPTER
Dr. "Live-Right"
What do you your doctor's waiting room? Chairs and

find in
tables? Stacks of old magazines? Perhaps a radio playing soft
music?
Well, how about lunch? Not just any old lunch, but a nu-
tritious whole-foods meal prepared by your doctor's staff and
served without charge. If you were a patient of Ray Wunderlich,
M.D., of St. Petersburg, Florida, who specializes in preventive
medicine, that's exactly what you'd be likely to find.
"We serve lunch every other week, and sometimes every
week if the demand is great," Dr. Wunderlich told us on a recent
visit to his office. Slender, bearded and, at age 53, obviously in
great shape. Dr. Wunderlich is a runner, and several of his tro-

phies are displayed in the office. (He had just run 15 miles before
we met him!)
"We serve anywhere from 7 to 30 people right here in the
waiting room," he continues, "and they share. They share ex-
periences. My wife, Elinor, who's a registered nurse, or I give
a short talk about the foods we're presenting. We'll explain why
we're having vegetable quiche or buckwheat sprouts or whatever
it might be.
711
"And the patients love it because it's very tasty stuff, and
they're interested in getting the recipes. It's just a great way to
convince people that nutritious food not only tastes good but is
easy to prepare."
But that's not all. Just about everywhere you turn in Dr.
Wunderlich's office you find useful and important health infor-

mation on bulletin boards in the waiting room and treatment
rooms, in pamphlets that Dr. Wunderlich has prepared and in
tape recordings that you can play at home. "Actually, right now
we're in a period of transition," he says. "We hope to have an
even better way of giving nutrition education soon with a slide-
and-tape machine for the patients.
"Yes, we do an awful lot of passing out of material. First,
there's a folder we give to every new patient. It contains basic
information, such as practical suggestions about which foods to
eat and which to avoid, how to gradually adjust your diet to get
out of the typical American processed-food rut, what to pack in
your lunch box, plus an important note about dietary supplements.

"Then we have more specific materials: signs of visual prob-
lems, biosocial factors in learning disabilities, suggestions for the
food-allergic patientand much more."
Dr. Wunderlich graduated from the Columbia University
college of physicians and surgeons. How much training in nu-
trition didhe receive? "Not much," he says. "1 don't remember
any course on nourishment.
"Even today you won't find many articles about general
nutrition in the journals that physicians read. You might find

something on a highly specialized topic for example, a fatty-
muscle chemical and how it relates to a certain disease of infants.
And that's called 'nutrition.' But those articles are for super-
specialists. How it all and peas and squash and
relates to beans
milk and soils and fertilizers seldom addressed.
is
"There's a sign up on one of my bulletin boards," says Dr.

Wunderlich, grinning. "It says. The specialist is someone who
learns more and more about less and less, until pretty soon he
knows everything about nothing.' It's a beautiful saying. It's the
DR. "LIVE-RIGHT" 713
old blinders business. We certainly need specialists and their

skills, but not to the exclusion of generalists."
Emphasis on Prevention
In order to practice full-time preventive medicine for both
adults and children, Dr. Wunderlich gave up a large pediatric
practice about six years ago. "I found that patients who ate
properly and took appropriate nutritional supplements were
healthier than the rest.
"I could treat disease very well, indeed. However, decided I
to turn my efforts toward the development of bright eyes, gleam-

ing bodies and alert minds. I learned that wrong living habits
discourage health and that right living habits generally lead to
well-being.
"Of course, I still do treat disease. I'd say two-thirds of the
people who come to me have chronic diseases. They aren't sat-
isfied with the way they're functioning and the way they feel.
"Their diabetes doesn't get better, their arthritis doesn't get
better, their lupus doesn't get better, their depression doesn't
get better, their schizophrenia doesn't get better, their perio-
dontal disease doesn't clear up. They don't want to take a bunch
of medications over a long time, but they can't get well. I offer
them the nutritional option with attention to body chemistry,
supplements and possible toxic substances.
allergy, nutritional
"And I also treat kids with learning disorders and hyper-
activity. So we see most everything except very acute illness.
We're always trying to educate the patients. We try to get our
licks in, you know, and get them reinforced, because when the
patients get out there in the world, they're not going to get
reinforced too often. These people need all the help they can get
to give up old bad habits and replace them with healthier new
ones."
Patients come from as far away as Oregon to see Dr. Wun-
derlich and, of course, from all over the state of Florida. "I had
one fellow in here from the center of the state," he says, "and
he was scheduled to have a triple coronary bypass in a few
months. We began to work on him, changing his diet and giving
him nutrients. And he came back about eight weeks later, and
his hair, which was white, was turning black!"
What was Dr. Wunderlich doing to him? "If I could do it
again. I would!" he says. "Td grow my own hair. But everything
isn't the same for each one of us. Different factors operate in
different people. With him, we had just the right combination of
diet and nutrients. This gentleman had a rather dramatic change.

He stood up straight, grabbed a new lease on life and his hair
began to darken. You could see it within an eight-week period.
"So he went back to his cardiologist. And his cardiologist
talked to him for a long time and looked over all the things he
was doing, and this fellow said his cardiologist was going to start
coming to see me!"
Did he ever have the coronary bypass? "No, he never had
the operation," says Dr. Wunderlich, "and we don't think he's
ever going to need it. We think his blood vessels are going to
open up."
Treating the Individual

Dr. Wunderlich does a good deal of his nutritional testing
for allergies and vitamin levels right in his own office. "We do
a vitamin C test with urine, which is very important," he says.
"We can find out if a patient is excreting a lot of vitamin C or
whether he isn't. Some patients are taking up to 10 grams a day
and not spilling any vitamin C. So they usually need more.
"What we're doing is individualizing supplements for each
patient. You see, what you have to always remember is to treat
the individual patient
and not the patient's nutrient test. Every-
one's needs differ. We've been giving lip service to that for a
long time. But the more you can do it, the better results you get.
"Take me, for example. I know how to stay in balance pretty
well, but what I do for myself doesn't necessarily apply to my
DR. "LIVE-RIGHT" 715
patients. If Igave them what I take myself, it might not work.

You have to look, and then you have to share information be-
tween patient and doctor."
Dr. Wunderlich is quite excited about a new test for nutrient
sufficiency. ''It's done with the eyes," he says. "A friend of
mine. Dr. Jack Pierce, a professor of optometry at the University
of Alabama, told me about it.
"I put a stain in the patient's eyes with a little stick of paper.
It's not harmful and not traumatic at all. Then I take an ultraviolet
light, shine it in the eyes, and look at the illuminated tear film
of the eyes with a magnifying glass.
"I watch that tear film, and that tear film should hold in
front of the cornea for ten seconds without breaking up. If the
tear film breaks up before ten seconds, it's an indicator of nu-
tritional deficiency. The biggest component in it is vitamin C,
but theB vitamins are also involved the water-soluble vitamins.
"So just that little an index," says Dr. Wunderlich,
test is
"and that's so important. Because a patient might say, 'Oh, I'm
taking my vitamins.' And you might say, 'Oh, that's good.' But
the fact is, you don't know whether it's too much or too little.
So we look at physical signs in the patient, we measure blood
levels, we measure what we can in the urine, we do hair mineral
tests and we do the eye test. Plus we talk to the individual about
past history, family history, allergies, intolerances and progress
with nutrient supplements.
"You look at the tongue, you look at the skin, you look at
everything. Then you put all that information together and say,
'OK, the evidence says you're just about right in your nutrient
levels.' Or, 'The evidence says you're low in these areas.' And
that's what we try to correct."
Hands-On Therapy
But there's still more. In addition to all those things. Dr.
Wunderlich is now becoming involved with manipulative med-
icine. "I'm involved in what we call counterstrain, which is a
form of hands-on therapy," he says. "It's a technique in which

you find tender spots in the body pressure points. Then you
position the body and hold it in a certain position, and those
tender points go away, and the patient feels better. You relieve
pain with practically no discomfort on the part of the individual.
We're also doing deep muscle therapy, as well as counterstrain,
because it helps people.
"Manual therapy is a great help in muscle inflammation and
muscle tension. Sometimes also in osteoarthritis. Osteoarthritis
is usually considered a disease of wearing out and degeneration.
But it doesn't appear to be that way at all to me. It appears to

be a disease of wrong living.
"Why? Because sometimes I can stop the Heberden's nodes
the tender swellings in the finger joints
in their tracks when
the patients eat correctly and when their vitamin-mineral needs
are met. And sometimes I can help to break up the nodes by
appropriate physical therapy.
"For example, you're using a high dose of alfalfa, and if
if
you're using appropriate manual therapy on those nodes, some-

times you can mobilize the deposits. But the patients must be
eating perfectly. They must have much of their food as raw food,
they must have no foods to which they are sensitive, and they
must have their mineral and vitamin needs met.
"Furthermore, they must be sure they have proper circu-
lation in the arms. That means rehabilitation of all the muscle
groups from the shoulder to the hand. Altogether, it means nu-
tritional therapy, and it means consideration of sensitivities. That's
not easy to come by, but that's what it takes."

What about osteoporosis? "We don't see osteoporosis in
physically active women," says Dr. Wunderlich. "Of course,
you have to be pretty active. You have to be stressing the body
daily. But you don't have to jog. Walking can do it.
"In the prevention and treatment of osteoporosis, what you're
looking for is a pull or stress on the bone. That's what stimulates
bone to function. As soon as you have it, then that bone is going
to keep rebuilding itself. It's similar to what happens in the
DR. 'LIVE-RIGHT" 717
muscles tearing down

and building up. It's a continual turn-
over. That's how we keep it fresh, live and young."
Helping Problem Children

Although he no longer practices pediatrics as a specialty.
Dr. Wunderlich still has an abiding interest in the health of chil-
dren. He has authored several books on the subject, and he has

delivered a paper to a meeting of the Association for Children
with Learning Disabilities.
"I see problem kids all the time," he says. "Kids who don't
learn, who can't sit still, who have attention deficit, who have
behavioral problems, who have minimal brain dysfunction
whatever you want to call the specific syndrome that they have.
"Now, when I see a child with a learning disorder, he will
usually also have a language disorder: He can't spell or write.
"People recognize the language disorder they call the kids
dyslexic. And
they recognize the learning disorder because those
kids are different from other kids. But what they don't recognize
is the living disorder they have.
"When you go into their homes or look into their lunch

boxes, you see that they're not eating correctly. Or if you do
body chemistry probes, you find that they're not absorbing food
or they have serious allergies or vitamin-mineral deficits.
"And," Dr. Wunderlich continues, "they frequently have
toxicity.The toxicity is all kinds of things. It may be chemical

food additives. It may be toxic minerals cadmium, lead, alu-
minum, copper, mercury and so on. So those kids have nutrient
deficits, and they have toxicities. Some may have nutrient def-
icits along with minimal toxicity, and some may have major
toxicity, but all of them have nutrient deficits of major degree.
"So when I see a kid with a learning disability, I say, 'Let's
not just look at the LD that is a language disorder or the LD

that is a learning disorder. Let's look at the LD that is a living
disorder.'
"That's what's been overlooked all these years. The edu-

cators are looking at the kids, but they don't really see that what
they eat before they come to school affects what they do there
or that what they did yesterday affects what they do today. You
see, allAmerican children are born deficient."
We thought that was a fairly provocative statement.
"I firmly believe it has more truth than fiction in it," Dr.
Wunderlich says staunchly. "My thesis is that many of us are
on adequate nutrition but not on optimal nutrition.
drifting along
"And so I see more and more children with puny chests. I
see more and more children with failure to thrive. I see more
and more children with allergies or behavior problems. More,
not fewer. And I think the rates are rising absolutely, not
relatively."
What, you may ask, do the Wunderlichs themselves dine
on? We
found out when they invited us to their home for dinner.
This is a very busy family, so Elinor Wunderlich prepares
many meals ahead of time. Her freezer is chock-full of such
goodies as a concentrated seafood gumbo to which fresh okra
and tomatoes can be added, a black bean and cheese casserole,
carob brownies . you get the idea.
. .
For dinner that night, we had the black bean and cheese
casserole as a main dish, and it was wonderful. Also included
were alfalfa and lentil sprouts, beet greens and a salad with fresh
everything in it. For dessert there were baked apples and muffins.
It was the perfect end to an enlightening day with a doctor
who practices what he preaches.

PSYCHIATRIST
CHAPTER
BRAIN FOOD-
IT REALLY WORKS
Sarah never left her home. She couldn't, because she spent
12 hours each day grooming and washing her body. Mostly she
washed her hands. From the elbows down, the skin was raw,
chapped and at times even ulcerated. She used incredible quan-
tities of creams and ointments, but it didn't do much good.
Sarah underwent ten years of psychoanalysis. She took every

antidepressant available, as well as every major and minor tran-
quilizer on the market, in an effort to break out of her destructive
behavior. She even underwent six series of electroshock treat-
ments and was hospitalized for three of them. And still the wash-
ing continued.
Yet, today Sarah is free of her obsessive-compulsive dis-
order and leads a normal, productive life.
What made the difference?
In Sarah's case, says Jose A. Yaryura-Tobias, M.D., it was
doses of the amino acid tryptophan, niacinamide (a form of nia-
cin) and vitamin B(, (pyridoxine). Dr. Yaryura-Tobias, a native
of Argentina and medical director of Bio-Behavioral Psychiatry
in Great Neck, New York, says the therapy increases the blood
level of serotonin, an agent responsible for promoting nerve im-
pulses which, in the brain, dictate much of our behavior. Tryp-
719
720 PSYCHIATRIST
tophan is a precursor of serotonin and

is also a source of niacin,
a vitamin. When
niacinamide is given with the tryptophan, less
tryptophan will be converted into the vitamin, and more of it
will be used to make serotonin. Vitamin 85 is essential to that
conversion.
"But there's more to it than that," says Dr. Yaryura-Tobias.
And he should know. For over 20 years, he's been doing research
while practicing medicine, first as an internist and then as a
psychiatrist with a strong background in psychopharmacology
(drug therapy). "I realized early in my practice," says Dr. Yar-
yura-Tobias, "that psychoanalysis and drugs were not enough.
"In medical school in Argentina, we had to take one year
of nutrition. We could not practice medicine if we didn't study
nutrition first. When we examined a patient, we not only had to
make a diagnosis at the bedside, we also had to prescribe an
appropriate diet. After all, if you have a gallbladder problem,
you must follow a certain diet. If you have diarrhea, you need
a certain diet. As a psychiatrist, I reasoned. Why not a diet for
the brain? That's as much a part of the body as the gallbladder
or intestines."
Still, psychological problems are as varied and complex as
the people afflicted. Faulty nutrition may play an important role
in the development of symptoms, but so do childhood trauma,
genetics, society and environment. The solutions to those prob-
lems must therefore involve numerous therapies in order to gain
the maximum chance of recovery. No one method covers it all.
Rather, a mixing and blending of philosophies is the best bet.
"And that's what we practice here," says Dr. Yaryura-
Tobias. "I call it an integrated approach to psychiatry. We have
15 people on our staff, including 2 psychiatrists, 6 psychologists,
1 neuropsychologist, a nutritionist, 2 research assistants, an art
therapist, a psychiatric social worker and an EEG-EKG [elec-
troencephalogram-electrocardiogram] technologist. We each
contribute our special area of expertise to the diagnosis and
treatment of our patients so they get the benefit of the various
disciplines.By working together, we find the best approach for
each particular case. Because people are different, what works
best for one may not work for another.
BRAIN FOOD REALLY WORKS 721
"Take the case of Sarah, for example. For her, diet alone
was enough. For others, a combination of diet and medication
may be necessary. But even if a drug is used, adding the appro-
priate nutrients allows us to cut the dose of the drug by about
half, eliminating annoying or damaging side effects."
For still others, a behavioral approach might be added to
the nutrition and drug therapy. Fugen A. Neziroglu, Ph.D., spe-
cializes in behavioral therapy and is the clinical director of Bio-
Behavioral Psychiatry. She explains that traditional behavioral
therapy focuses on changing a person's habits without trying to
form a diagnosis or explain the cause.
"My behavioral approach is somewhat different from that,"
she says. "We want to rule out physical illness, and in order to
rule it out and to see what treatment is really appropriate, we
have to have a diagnosis."
"To aid us in that area, each new patient is given a physical
examination," adds Dr. Yaryura-Tobias. "Our psychiatric social
worker, Audrey Harbur Bershen, takes a complete social his-
tory. Blood tests measure liver and kidney functioning, vitamin
and amino acid levels and proteins. A five-hour glucose tolerance
test is done to rule out hypoglycemia [low blood sugar] or dia-
betes. We do an electroencephalogram and an electrocardiogram
and hair analysis for trace minerals and toxic chemicals. And,
of course, we conduct a thorough neuropsychological evaluation.
"When a patient is diagnosed as an obsessive-compulsive,
the nutrients that we use are tryptophan, niacinamide and vi-
tamin Bft. Those elements appear to participate in the biochem-
istry of the illness. We don't say that obsessive-compulsive dis-
orders are a unique disease of the tryptophan-serotonin
metabolism, but our research has shown us that a good amount
of people with that problem could be categorized in a biochemical
classification."
Help for Depression

"A person suffering from depression may also do well with
tryptophan," he continues. "I like higher doses of vitamins B|
722 PSYCHIATRIST
and B(,, though, because they help activate the energy transport
system in the body. We also use phenylalanine. That is an amino
acid which in the body is converted to phenylethylamine, an
antidepressant. At times, drugs are a necessity, but they are
never used without the nutrients.
"The point is we don't limit ourselves to one type of therapy.
It wouldn't make sense to do that. Illness has many causes, so
how can we expect to help all our patients with only one method
of treatment?
"The patient must understand, too, that results will take
longer with the natural therapies than with the drugs. When a
drug is used, the results are very dramatic. But you can have
bad side effects, too. With the tryptophan and vitamins, results
will be gradual, taking maybe ten weeks to reduce symptoms
completely. But the benefits here are obvious
no side effects
to mess you up in other ways."
Still, those methods may not work completely, and other
therapies will be called into service. Here's where behavior mod-

ification comes in.
"Behavior therapy is really down-to-earth," Dr. Yaryura-

Tobias told us. "It's faster than psychotherapy. It goes into the
problem and modifies the habits that have become imprinted over
the years. After all, you can take away the chemical reasons for
the illness, but the behavior has been learned for years and has
to be unlearned."
When behavior therapy is called for, it is usually in con-
junction with a proper diet and supplements, most often tryp-
tophan, niacinamide and vitamin 65. The behavior modification
itself begins with an intensive two-week program, after which
symptoms are reduced by about 60 to 70 percent.

"For example," says Dr. Neziroglu, "we had a patient who
was afraid of glass. He feared that glass would get on his hands,
then circulate through his body and contaminate everything he
touched, including his wife. His fear of glass caused him to wash
everything in sight. He had freshly washed dollar bills hanging
on a clothes line in his house. His dry-cleaning bills were over
$200 a month.
"We went to his house, and we put glass everywhere. He

even had to carry a piece of glass in his pocket all the time, and
he slept with fiber glass under his pillow. This process is called
flooding. We flooded him with anxiety. His level of anxiety re-
mained elevated for two hours or so. And then we saw, after
that time, the anxiety just came down. He began to see for
himself how ridiculous his fears had been all along. After about
two weeks, there was a tremendous reduction in his symptoms.
And after several months, all symptoms were gone.
"And what's so encouraging," Dr. Neziroglu told us, "is
that relapses are infrequent, even though some of these people
have been ill for many years."
The Bio-Behavioral Psychiatry group has done wonders also
with people suffering from severe aggression associated with
hypoglycemia. Of course, not all people with low blood sugar
have a violent nature. But the ones who are violent often have
an abnormal EEG (brain wave test), too. Just giving them an
anticonvulsant to straighten out the EEG (which is what most
doctors do) won't bring results.
"What we did," Dr. Neziroglu told us, "was to divide 45
patients with this disorder into four groups. One group was placed
on a special diet to alleviate the hypoglycemia; another group
got an anticonvulsant for their abnormal EEG; the third group
got traditional tranquilizers; and the fourth got a combination of
the diet, vitamin B^ and an anticonvulsant. The only group that
improved statistically was group 4, the one receiving the
combination.
"We believe that about 33 percent of all aggressives can be
helped by the combination of diet, B^ and an anticonvulsant,"
she adds.
Brain Fatigue Is Cominoii

in Everyday Life
Fortunately, most of us never reach such a desperate stage.
Still, we all go through our own daily cycles of highs and lows.
724 PSYCHIATRIST
It's important, says Dr. Yaryura-Tobias, to recognize your own

symptoms so they don't get out of hand. Specifically, he is re-
ferring to a condition we've probably all had at one time or

another brain fatigue.
"The brain tires like a muscle," explains Dr. Yaryura-
Tobias. "When a muscle is fatigued, it gives you a signal pain
or cramps which is due to the lack of oxygen in the muscle.
You have to rest to recover.
'The brain will also give you signals when it is overtired
inability to concentrate, inability to put thoughts together, a
sense of irritability to minor things. You feel jumpy, nervous.
You may have difficulty in falling asleep or staying asleep. You
go from lows to highs. The brain cannot control itself any longer.
The brain works by excitation and inhibition. When there is
fatigue, those things begin to be altered, and they do not coor-
dinate. The incoordination of the brain will bring incoordination
in the thought process, in themood, in intellectual capacity in
all the functions that you have."

For most of us, brain fatigue is part of our normal daily
cycle. But then we eat a good dinner, read a book, do some
exercises. We have switched from doing one thing to doing an-
other that is unrelated, and that rests the brain so we are ready
for the next day's work load.
But for many others, brain fatigue becomes a chronic
condition.
Fatigue builds upon fatigue with no recovery period in be-
tween. You can't catch up with just a night's sleep anymore.

You find yourself unable to concentrate or put thoughts together.
You have pushed yourself to an extreme and you can't return
any longer.
'T think there is an amazing amount of brain fatigue that
exists," Dr. Yaryura-Tobias told us. "People come here and I
tell them they must stop working right now. It's reached that
level.
"Unfortunately, because brain fatigue is not a visual thing,
no one believes it exists, not even the patients who are describing
the symptoms. They keep on trying to work, and to do that they
take stimulants coffee and amphetamines. They go out at night
and have cocktails.

"A lot of them are on tranquilizers and sleeping pills. They
do all that because without it they could not function."
Daily Exercise Is Important

"By the time they come in for a consultation," he continued,
"they may have a drug problem to go along with the brain fatigue.
That is when I feel the nutritional approach is best, along with
resting the brain. We give supplements, especially the B-compIex
vitamins, and a program of exercises along with a good diet.
Physical exercise is very important, too. It is one of the most
perfect things to reduce anxiety and tension.
"When I recommend physical exercise and nutrition, it's
not for one

week it's forever. It's a life style that one has to
adopt permanently to remain in good mental health."
But, of course, good habits should be started before you
reach the breaking point.
"I exercise every day," Dr. Yaryura-Tobias points out, "and
I take supplements
about 1,000 milligrams of vitamin C, plus
B complex and dolomite. And I give my brain a vacation by
switching to nonpressure pastimes such as reading novels or
poetry, listening to music or watching a good program on tele-
vision. Then I am able to resume my schedule refreshed.
"That's important because most of the people we treat here
are very sick. They've usually been all over trying to find help.
When a patient brings us 30 years of illness, we must work out
30 years of illness. Sometimes it's almost impossible.
"But I can tell you this, something we are doing here is
good, because even with the very sickest patients, we get about
50 percent to improve. And it's not the medication. As a psy-
chopharmacologist, I am sure of that. It's the addition of the
vitamins. I'm positive. We also see that behavior therapy is
helpful and so, too, is working with the patient's family.

726 PSYCHIATRIST
"That's our approach and it works. I think that an integrated

practice is in medicine of the future."
Apparently others are starting to agree.

"Hofstra University in Hempstead, New York, sought us
out when we started our group here." Dr. Neziroglu told us.
'They sent a faculty member to observe our methods and asked
us if they could send interns. Now we have four interns working
with us toward their doctoral degrees."
"Setting up this type of practice is not easy," warns Dr.
Yaryura-Tobias. "It's very difficult to have real teamwork. Your
pride has to go down a little. You get embarrassed if you make
a mistake. But don't tell me that there is no chance to do this
type of work. The fact that it is not done doesn't mean it will
not work. Because it will work if you try. We are living proof
of that."
PSYCHOLOGIST
CHAPTER
PSYCHOLOGICAL HELP
THROUGH BETTER DIET
If you suffer from a stress-related complaint such as depres-

sion or anxiety or even ordinary insomnia and you'd liice to find
a treatment more natural than antidepressants or tranquilizers,
there's an herbalist-psychologist in the Philadelphia area whose
ideas might interest you.
His name is Arthur Hochberg, Ph.D., and he tries to provide
what he calls "an alternative to conventional psychology and
medicine." For him, that means using herbs, food, vitamins and
minerals instead of prescription drugs. It also means treating the
whole person by combining psychology and nutrition.
"How people feel emotionally and how they feel physically
are absolutely connected," Dr. Hochberg told us. "In every
physical problem there's a psychological counterpart." The at-
titude of the therapist seems to matter, too: "People are happy
to talk to a doctor who listens to them. Ultimately, what heals
patients is compassion."
For one of Dr. Hochberg's patients, a 49-year-old woman

who teaches at a high school in a depressed part of Philadelphia,
his method provided an alternative to using estrogen for men-
opausal symptoms.
727
728 PSYCHOLOGIST
"I was skeptical. I frankly didn't think it would work," the

teacher (she requested anonymity) told us. "I was planning just
to 'wait out' menopause without medication. I don't normally
go to a doctor. I'm a no-nonsense person."
She waited it out successfully for two and a half years, but
finally stress in the classroom brought on overwhelming hot flashes.
''A tremendous depression would sweep over me, and I'm not
normally depressive at all. The heat would rise from my feet, go
up through my body and hit my face with a shock. My face
turned beet red. I felt incredible heat, nausea and dizziness that
lasted two to three minutes. It happened 20 to 30 times a day."
Dr. Hochberg questioned her about her diet and medical
history and suggested brewer's yeast, pantothenate and vitamins
85, A and E, along with tea made from rue (in very small amounts),
horsetail and black cohosh root. Although she discontinued the
tea after the first day ("It was bitter"), within a week she felt
an improvement, and after a month her symptoms subsided to
four or five mild hot flashes a day.
"He was square with me," the teacher told us. ''He said
the herbs and vitamins wouldn't eliminate the symptoms, just
reduce them. He said, 'See what happens and if it works, it
works.'
For Cathy Bath, a 30-year-old mother of two with one more
on the way. Dr. Hochberg offered an alternative to cortisone
and several years of postpartum fatigue.
Mrs. Bath had suffered from eczema on her hands since the
age of nine and had controlled it with a standard prescription
cortisone cream. In early 1981, however, the skin condition spread
to her face and she was catching colds every couple of months.
She sought medical help.
Dr. Hochberg advised her to cut white flour and sugar out
of her diet and recommended large amounts of brewer's yeast,
vitamin C and water-soluble vitamin A. The regimen also in-
cluded chamomile tea, kelp, spinach and beet greens, cod liver
oil and the exclusive use of olive and safflower oils in cooking.
"Now my face is perfect," Mrs. Bath says. "It used to be

awful, it was swollen, it itched, it was red and scaling. Now my
only problem is protecting it from the sun.
PSYCHOLOGICAL HELP THROUGH DIET 729
"I also feel energetic for the first time since my first preg-
nancy. I don't need naps in the afternoon anymore." She has
cut her use of cortisone. "It amazes me that I only have to use
it once or twice a week, because I was one of those people who
couldn't go anywhere without a tube of cortisone."
Battle with Depression

In one especially dramatic case. Dr. Hochberg helped a 37-
year-old insurance executive overcome half a lifetime of depres-
sion and dependence on candy bars and caffeine.
The executive, Dave Richards, had suffered from mood swings
and depression since high school. He could barely keep awake
in class and relied on coffee to pep him up. He was a top student,
but his self-image was very poor and life was "a daily battle."
He saw several psychiatrists without success.
About three years ago, he went to Dr. Hochberg, who spot-
ted a severe problem with sugar intolerance. He prescribed tea
made from small amounts of licorice root or goldenseal or juniper
berries and hops, or a mixture of valerian and other herbs. He
also put Richards on a strict low-sugar diet of fresh vegetables
and whole grains, fruits, seeds, garlic and spring water.
Now when he starts to feel moody or "unbalanced," Rich-
ards says, he sips herb tea. "It smooths me out, helps me to
avoid mood swings. I like that."
About Dr. Hochberg's natural therapy, Richards says, "It
really changed my life."
Dr. Hochberg's forte herbs and he used a battery of them,
is
along with a broad spectrum of nutrients, to help one woman

recover from severe intestinal pain and anxiety.
He advised the woman, Zainab Bauman, a 33-year-old mother
of one, to use a lot of garlic. It cleans the system, he said, to
boil a bulb of garlic every day with parsley, then drink the broth
and eat the bulb. The therapy also called for a relish of turmeric,
spearmint, cayenne, tamarind and lemon. He suggested teas from
slippery-elm bark, fenugreek and other herbs, as well. Mrs. Bau-
man says it worked.
730 PSYCHOLOGIST
"In about three weeks, my whole state of mind changed,"

she says. "Everything changed. I felt like a cloud had been lifted
off of me. I realized that my depression was rooted in my mind,
not in reality."
Another young woman, who also requested anonymity, told
us that Dr. Hochberg helped her recover from anxiety and
depression with tea from sage, raspberry and chamomile. Her
therapy, which included vitamins, minerals, papaya enzymes and
bran, also relieved a long-standing problem with water retention.
"Whatever it was he did, Vm grateful," she said.
Herbal Formulas
Dr. Hochberg was willing to share some of his herbal for-
mulas, which are used in conjunction with exercise and the elim-
ination of white flour, sugar, caffeine, alcohol and nicotine.
For colds, nausea and headaches: Dr. Hochberg suggests
preparing a tonic by mixing small pieces of ginger root, coriander
seeds and garlic with water and honey to taste. Then boil off
half the liquid. Throughout the day, periodically drink what's
left.
For instant stimulation: Mix '/s teaspoon of cayenne, 2 ta-

blespoons of apple cider vinegar, a cup of warm water and 'A
teaspoon of molasses.
For insomnia or tension: Steep half a teaspoon of valerian
root in hot water for five minutes (do not boil the root). Sip it
gradually through the day or take at bedtime. For taste, valerian
should be mixed with honey, spearmint or clove. One precaution:
Valerian is a strong herb and should be used moderately.
For cleansing the body: Garlic, dandelion root tea, chamom-
ile tea or valerian root tea (in small amounts).
For low blood sugar: Licorice root tea (also to be used in

moderation), juniper berry tea (again, in small amounts), spear-
mint tea or dandelion root tea.
For migraine headaches: Strong peppermint tea and niacin.
PSYCHOLOGICAL HELP THROUGH DIET 731
Dr. Hochberg says he often tries several combinations of

herbs and nutrients before finding the blend that suits the patient
best, and sometimes he uses hair analyses to pinpoint deficien-
cies. About 70 to 80 percent of his patients achieve good results
in about two months if they stick to the program, he says.
People who can purge themselves of anger. Dr. Hochberg
says, also stand a better chance of recovery. And it helps if they
participate in their own cure by preparing teas and keeping busy
with gardening, exercise and other activities.
Dr. Hochberg, who is 40, traveled a long and winding path
to his present office on the second floor of a small building in
Bala-Cynwyd, a suburb of Philadelphia. Born in Brooklyn, he
earned a doctorate at the University of Utah and later learned
how to live on herbs and berries in the wilds of California. He
has taught at colleges in Indiana and New Jersey and has worked
at several health clinics in eastern Pennsylvania.
He has visited Africa, Mexico, Israel, Switzerland and the
Far East, looking, he says, for bits of wisdom about the human
mind and body.
A good part of his zeal as a therapist. Dr. Hochberg notes,
comes from dissatisfaction with conventional medicine. His pa-
tients often tell him horror stories about undergoing unnecessary
and expensive tests and about meeting doctors who refuse to
listen to their opinions.
"I feel strongly," he says, "about people being harassed
and intimidated and manipulated by the medical profession. The
more patients I see and the more stories I hear, the more I realize
that part of their illness is fear.
"Doctors pretend that there's a great mystery about illness.
And when they don't know what to do, they tell their patients
can be done. The patients suffer from helplessness
that nothing
and abandonment. Distrust of doctors is one of the most rampant
feelings I see in patients.
"What heals patients is compassion," he emphasizes. "The
patient must trust the doctor, and the doctor must have confi-
dence in the patient. It's distrust that makes people seek alter-
native treatment."
VASCULAR SURGEON
CHAPTER
A LIFE-EXTENSION
PROGRAM FROM
A DOCTOR WHO'S
BEEN THERE
Forty years ago, future physicians learned even less about

nutrition in medical school than they do today. "Until four years
ago, 1 didn't know enough about nutrition to help myself, much
less my patients,"
Robert I. Lowenberg, M.D., of Atlanta, Geor-
gia, a vascular surgeon for 31 years, told us. "My diet consisted
of beef two or three times a day, lots of margarine, lots of salt,
and candy bars when 1 was in a hurry. The best nutritional advice
I could give my patients was: Lose a little weight and stop smok-
ing. Most physicians don't realize the importance of nutrition

until they're slapped in the face by it."
Dr. Lowenberg was jolted into nutritional awareness four
years ago by a heart attack. Though he recovered, a year later
he started having chest pains and suffering from fatigue. Tests
indicated that blood vessels to his heart were blocked and that
he needed a coronary bypass. "I began to realize that I wasn't
headed in the right direction, and I became interested in what
nutrition could do to help me."
He started listening to things other people were saying about
nutrition and degenerative diseases, and he started reading and
researching. "I soon discovered that the nutritional factors in
732
A LIFE-EXTENSION PROGRAM 733
degenerative disease had been pretty well worked out. But each
researcher had put his work into a a small pigeonhole and left it
there to be forgotten. A better approach seemed to be putting it
all together into a nutritional program people could live by."

As a former vascular surgeon. Dr. Lowenberg used to treat
with the scalpel the diseases he now treats with nutrition. "Tve

been in there I know how the blood vessels of someone with
heart disease, angina, atherosclerosis and diabetes actually look.
Vascular surgeons know that if one blood vessel is narrowed or
blocked, chances are that others in other parts of the body are,
too. Atherosclerosis, for example, affects not just one set of

blood vessels it affects many of them. It's only that one vessel
occludes before the others. Symptoms don't appear until the
blood vessel has narrowed 70 to 80 percent. But if someone has
trouble in the left leg, he almost certainly also has trouble in the
right. It may be two or three years behind, but arteriograms will
usually show significant narrowing in both legs.
"Now, surgery can help only blood vessels in the certain
area operated on. If perform a bypass in someone's left leg
I
at great cost I haven't done anything for the right leg or the
aorta or the renal artery or the brain."
But the former surgeon sees no contradiction between sur-
gery and nutrition. "It's a question of which comes first. In
emergencies, of course, surgery is necessary. But many other
cases could be treated nutritionally. Surgery can open a vessel
to the pointwhere it was when the patient was 25 years old. But
that's not always necessary. Often, an increase in flow of 5 or
10 percent is enough to start improvement, and proper nutrition
can often do that. If nutrition should fail, you can always go on
to surgery."
Keeping Bypasses Open

Yet, even people who do undergo corrective surgery should.
Dr. Lowenberg believes, change their diets afterwards to prevent
recurrences. "Everybody who has a coronary bypass and this
734 VASCULAR SURGEON

year there will be about 100,000 should go on a nutritional
program immediately after the operation to keep the new graft
open. Risk of closure is high: A significant number of bypasses
close each year, and a high percentage of patients die of stroke
within 5 years. One reason is that bypass grafts harden five times
faster than their parent vessels. After 1 year, they're equivalent
to 5 years old after 5 years, 25 years old. A proper nutritional
program can undoubtedly delay closure of those grafts.
''A good case in point is a 44-year-old man I treated before
I knew anything about the importance of nutrition in degener-
ative diseases. He was a heavy smoker and had hardly any blood
flow in his left leg. The threat was gangrene. I had to operate,
and fortunately the leg was saved. But I didn't run enough tests
on his blood chemistry or even ask him about his diet to discover
how those factors were affecting his condition. Nor did I alter
his diet. Over the next 1 3 years, he suffered additional occlusions
in the upper as well as the lower extremities. All in all, I had to
perform 43 further operations on this patient, including diag-
nostic probes. And still, he continued to suffer complications
some of which involved those operations.
'Tf I knew then what I know now about nutrition, I feel
confident that I could have spared the poor man many operations.
That's because a nutritional approach, unlike surgery, affects
every blood vessel in the body."
Fats are blood vessels' big enemies. "High levels of fat in
the blood do two things," Dr. Lowenberg explains. "They leave
deposits on the arterial wall, narrowing the blood vessel; and
they neutralize the negative charge that separates red blood cells,
making them stick together like a stack of wet dishes. In a healthy
person, red blood cells float through blood vessels in single file,
absorbing oxygen and discharging it to the tissues. When high
fat levels make them stick together, a lot of surface is lost for
picking up and delivering oxygen. Tissues begin to suffocate. To

make matters worse, the clumped blood cells also get jammed
at bends in the capillaries."
Unfortunately, most of us are up to our eyes in fat. "The
typical American diet derives most of its calories from fat 45
percent. Another 15 percent comes from protein, with the bal-
ance being supplied by carbohydrates. The main goal of a life-
extension diet is to cut fat calories down to 15 percent or less.

Simultaneously, one should reduce cholesterol intake from 600
milligrams a day
the American average
to 100 milligrams a
day, a very safe level. Another important step is the elimination
of simple carbohydrates, such as sugar, and the substitution of
complex carbohydrates. In addition, fiber intake of 25 grams a
day is advisable. That's because fiber has been shown to control
fat levels and to help prevent blood clotting and reduce the im-
pact of diabetes, as well.
"Reducing the deposits on the arterial wall may take months
or years, but with this diet the microcirculation improves within
days. And that in turn helps everything."
Dr. Lowenberg has treated many patients using a life-
extension diet and has seen impressive results. "A 61 -year-old

man who had already suffered several heart attacks and one
stroke came to me for help. He was a nonsmoker but overweight
and also had diabetes. He could barely walk he used a cane
and had to be helped into my office.
"The first thing I did was get him to cut down on fatty foods.
No butter, margarine, eggs or salad oils. But the biggest reduc-
tion came from eliminating meats, which I do entirely in high-
risk cases, at least at first. Meat has no fiber. And as for protein,
legumes can supply, pound for pound, just as much protein as
steak but without the fat.
"Next, increased his fiber intake: whole grain cereals

I
millet, brown rice, bran, whole wheat.

"Then concentrated on getting him off less obvious
I

troublemakers sugar, salt, coffee and tea. Sugar is a nutritional
no-no. For people with blood sugar problems, it's even worse.
Salt makes the body retain water, putting a burden on the cir-
culation. It also makes it hard to lose weight. Caffeine is a stim-
ulant
it speeds up the heart rate, putting unnecessary stress on
it. good to put a little stress on the heart by exercising.

It's
Exercise speeds up the heart for only a few hours and builds up
endurance. But a big coffee or tea drinker stresses his heart all
day."
This regimen improved the patient's condition within days.
736 VASCULAR SURGEON
"As soon as he was able

walk without aid, I started him on
to
a regular exercise program. Ideally, the aim is to exercise three
to four times a week for 20 minutes or more
just walking or,
if possible, jogging. Exercise is an important part of a vascular
health program because it builds up collateral blood vessels.

These are little blood vessels, the size of a hair or two, that
enlarge and take over the function of blocked vessels. If those
collaterals can be opened, you can save a leg.'"
Within three weeks, the patient's fat levels dropped from
dangerously high to the normal range, without hospitalization.
And he showed the difference. 'The next time I saw him," says
Dr. Lowenberg, "he almost jogged into my office. Without the
diet and with his indications, he would have probably succumbed
to another stroke or heart attack."
That patient's renewed vitality is characteristic of people on
the program. "They become more alert, more interested, be-
cause now they are able to be more active," says Dr. Lowenberg.
"Many take up old hobbies. They feel that now there's a point
to going on and living."
But when it comes to sticking to a special diet, motivation
is a problem. Dr. Lowenberg uses an ingenious incentive
computer readout.
On a desk-top computer, he punches in the patient's data
regarding risk factors established through several studies weight,
cholesterol and triglyceride levels, miles walked a day, stress at
home and office. The computer then promptly matches that data
with the optimal figures and calculates the risk of heart disease.
"The difference between the actual figures and the optimal
figures gives the patient a goal to shoot for. There it is in black
and white. He can see that he's eating too much beef or that
he's 20 pounds overweight and the likelihood of what this might
lead to. He can see what he should be doing."
But to persuade patients to actually change their habits. Dr.
Lowenberg finds a human touch as essential as a data sheet.
"I'm telling my patients that they should change their entire life
style habits of eating, of exercise, even of work and personal

relations if they're too stressful. That requires time to put across.
I take several days with each patient, explaining what his disease
is, how he got it, and what he can do now to improve his condition
and prevent further problems."
Despite heart attack and bypass. Dr. Lowenberg himself is
still active, indeed vigorous, at 65 running a nutritional con-
sultation practice, playing a mean game of doubles tennis and
pursuing several hobbies, including poetry. He's a doctor who
takes his own medicine and enjoys it.
BOOK V
Vitamin-Rich
Foods and
Recipes
INTRODUCTION
Hundreds of cookbooks are published in the United States

every year. That's a lot of recipes. Recipes just for men, artists,
athletes, singles even for specific astrological signs. Recipes
for microwaves and barbecue grills. For foods from the pantry,
the freezer, the garden.
Yes, you can find a recipe for a low-cal, gourmet Italian
vegetarian meal that can be cooked in 15 minutes while camping
out in Alaska. But it's next to impossible to know if that recipe
(or any other) supplies lots of thiamine. Or vitamin A. Or B^,.

And that's knowledge you need. What if you're feeling tense
and want a meal high in nerve-calming niacin? What if you're
trying to shake a cold and want a lunch packed with vitamin C?
That's what book 5
Vitamin-Rich Foods and Recipes is all
about. First, you'll find lists for every vitamin that tell you which
foods supply extra-big doses of that nutrient. Second, you'll find
a recipe section with meals we've singled out for their high vi-
tamin content. (We'll tell you which vitamin the recipes are
richest in, of course.) An added benefit is that the recipes are
natural no salt, no sugar, no additives, just healthy foods. By
the way, you might want to read this section in the kitchen
the urge for a vitamin-packed meal just may overwhelm you!
CHAPTER
BEST FOOD SOURCES

OF VITAMINS
Best Food Sources of Vitamin A

742 VITAMIN-RICH FOODS AND RECIPES
Best Food Sources of Vitamin A Continued
Vitamin A
(International
Food Portion units)
Leaf lettuce
BEST FOOD SOURCES OF VITAMINS 743
Best Food Sources of Thiamine-

Best Food Sources of Riboflavin Continued
Riboflavin
Food Portion (milligrams)
Ricotta cheese, part

Best Food Sources of Niacin Continued
Niacin
Navy beans, dried 'A cup 1.2

Soybeans, dried 'A cup 1.2
Kidney beans, dried Va cup 1.1
Chick-peas, dried Va cup 1.0

Dates V4 cup 1.0
Best Food Sources of Vitamin B,

Vitamin 65
Banana 1 medium 0.89

Salmon 3 ounces 0.63
Mackerel, Atlantic 3 ounces 0.60
Chicken, light meat 3 ounces 0.51
Beef liver 3 ounces 0.47
Sunflower seeds V4 cup 0.45
Halibut 3 ounces 0.39
"
Tuna, canned 3 ounces 0.36
Broccoli, raw 1 medium stalk 0.35
Lentils, dried Va cup 0.29
Brown rice, raw V4 cup 0.28
Beef kidney 3 ounces 0.24
Brewer's yeast 1 tablespoon 0.20
Filberts V4 cup 0.18
Buckwheat flour, dark Va cup 0.14
Best Food Sources of Vitamin B12

Vitamin B12
Food Portion (micrograms)
Beef liver 3 ounces 93.5

Lamb 3 ounces 2.6
Beef 3 ounces 2.0
Tuna, canned, drained 3 ounces 1.8
Yogurt 1 cup 1.5
Haddock 3 ounces 1.4
Swiss cheese 2 ounces 1.0
Milk, whole 1 cup 0.9
Cottage cheese V2 cup 0.7
Egg 1 large 0.7
Cheddar cheese 2 ounces 0.4
Chicken, light meat 3 ounces 0.4
Best Food Sources of Folate

Best Food Sources of Pantothenate

Best Food Sources of Biotin

Best Food Sources of Choline

Choline
Soybean lecithin, pure

Best Food Sources of Inositol Continued
Inositol
Beef liver 3 ounces 58

Green pepper, cooked Vi cup 57
Tomato, raw Vi cup 54
Zucchini Vi cup 53
Pork chop 3 ounces 38
Onions, raw Va cup 22
Best Food Sources of Vitamin C

Vitamin C
Orange juice, fresh-

Best Food Sources of Vitamin C Continued
Vitamin C
Tomato, raw 1 medium 28

Cabbage, chopped, raw V2 cup 21
Blackberries V2 cup 15
Spinach, chopped, raw V2 cup 14
Blueberries V2 cup 10
Cherries, sweet V2 cup 8
Mung bean sprouts 1/4 cup 5
Best Food Sources of Vitamin D

Best Food Sources of Vitamin E

ton, D.C.: Science and Education Administration, U.S. De-

partment of Agriculture, 1979). Pantothenate, Biotin.
Introductoiy Nutrition, by Helen Andrews Guthrie (St. Louis:

C. V. Mosby, 1979). Thiamine, Niacin.
Composition of Foods: Spices and Herbs, Agriculture Handbook

No. 8-2, by Consumer and Food Economics Institute (Washing-
ton, D.C.: Agricultural Research Service, U.S. Department of
Agriculture, 1977). Vitamin A.
"Folacin in Selected Foods," by Betty P. Perloff and R. R.

Butrum, Journal of the American Dietetic Association, Febru-
ary, 1977. Folate.
Human Nutrition, by Benjamin T. Burton, Ph.D. (New York:

McGraw-Hill, 1976). Vitamin D.
Modern Nutrition in Health and Disease, by Robert S. Goodhart

and Maurice E. Shills (Philadelphia: Lea and Febiger, 1980).
Vitamin K.
"Myo-inositol Content of Common Foods: Development of a

High-myo-inositol Diet," by Rex S. Clements, Jr., and Betty
Darnell, American Journal of Clinical Nutrition, September, 1980.
Inositol.
"Pantothenic Acid Content of 75 Processed and Cooked Foods,"

by Joan Howe Walsh, Bonita W. Wyse and R. Gaurth Hansen,
Journal of the American Dietetic Association, February, 1981.
Pantothenate.
U.S. Department of Agriculture and Nutrient Data Research

Group, 1981. Choline.
"Vitamin E Content of Foods," by P. J. McLaughlin and

John L. Weihrauch, Journal of the American Dietetic Associa-
tion, December, 1979. Vitamin E.
VITAMIN-RICH RECIPES
CHAPTER
BREAKFASTS
Choo-Choo Granola (Muesli)
This tasty breakfast actually a muesli gets its name from
two characteristics: One, it makes you use your jaws, and two,
itgoes through you like a freight train. To serve it, add milk and
top it with several slices of fresh apple, if desired.
vitamin E thiamine
2 cups rolled oats

-A cup wheat germ
V2 cup sunflower seeds
Vi cup walnuts, chopped
'/> cup hulled pumpkin seeds
Vi cup figs, chopped
Vi cup dried apricots, chopped
Combine all of the ingredients and store the mixture in a

tightly covered glass jar in the refrigerator.
Serves 10.
From The Natural Healing Cookbook by Mark Bricklin and Sharon

Claessens, Rodale Press, Emmaus, Pa., 1981.
755
Cottage Cheese Pancakes with

Pineapple Yogurt Topping
vitamin B,2 riboflavin
Topping
1 cup crushed pineapple

1 tablespoon orange juice
concentrate
Va, cup yogurt
Pancakes
1 cup cottage cheese

Va cup yogurt
2 eggs
Ml cup whole wheat pastry flour
'/4 cup wheat germ
'/: teaspoon baking soda
pinch of ground allspice
fresh mint leaves (garnish)
To make the topping: In a small bowl, combine the pineapple,

orange juice concentrate and yogurt.
To make the pancakes: Combine the cheese, yogurt and eggs
in a food processor or blender. Blend them until smooth. Com-
bine the flour, wheat germ, baking soda and allspice and add
them to the cheese mixture. Blend the batter just until combined.
Using about Va cup per pancake, pour the batter onto a hot
oiled or buttered pan or griddle. When it's bubbly, turn it and
brown the other side. Serve the pancakes with the topping and
garnish with the mint leaves.
Serves 2 to 4.
BREAKFASTS 757
Breakfast Cereal Mix

Not only can you prepare a custom-made cereal mix in five
minutes, but you'll have enough made up to last a week of
mornings!
Customize your mix by adding a few tablespoons of seeds,
such as sesame or sunflower, or by adding chopped nuts.
thiamine
2 cups rolled oats

1 cup bran
'/2 cup wheat germ
'/2 cup soy flakes
'/: cup raisins
1 tablespoon brewer's yeast
(optional)
2 teaspoons cinnamon (optional)
Combine all of the ingredients in a large bowl. Store the mix

in a tightly covered container in the refrigerator.
Makes 4 cups.

CHAPTER
APPETIZERS AND
HORS D'OEUVRES
Fish Pate
APPETIZERS AND HORS D'OEUVRES 759
Boil the carrots and peas for 30 seconds. Drain and fold
them into the fish mixture. Pour the mixture into a lightly oiled
8 X 4-inch loaf pan. Smooth the top, then cover the pate with
buttered wax paper and wrap it with foil.
Place the loaf pan into a deep baking dish. Fill the baking
dish with water to within 2 inches of the top of the loaf pan.
Bake at 375 for 40 minutes, then remove the loaf from the oven,
uncover it and let it cool for 10 minutes.
Remove the pate from the pan by covering it with an inverted
platter, then turning it upside down. Blot away any excess liquid
before it's served. Garnish with parsley.
Makes 1 loaf.
Sunflower Seed Spread

Use this as a sandwich spread, a filling for stuffed celery or
as a dip for raw vegetables.
vitamin E thiamine vitamin B^
1 cup ground sunflower seeds

'/4 cup peanut butter
3 tablespoons vegetable oil
Combine all of the ingredients in a bowl and mix them until
smooth.
Makes IVi cups.
From The Complete Book of Minerals for Health by Sharon

Faelten, Rodale Press, Emmaus, Pa., 1981.
Chicken Liver Pate

Perfect in a sandwich, this pate can double as an appetizer.
Formed into a ball and rolled in chopped fresh parsley, it makes
a pretty party spread.
vitamin A riboflavin pantothenate

niacin thiamine vitamin C
1 onion, diced
V2 cup diced celery
Vi green pepper, diced
2 tablespoons chopped fresh
parsley
2 tablespoons vegetable oil or
butter
1 pound chicken liver
1 tablespoon plus 1 teaspoon
brewer's yeast
Va cup mayonnaise
In a large skillet, saute the onions, celery, peppers and pars-

ley in the oil or butter until the onions become translucent. Add
the chicken liver and continue sauteing for a few minutes. Cover
the skillet and cook until the liver is done.
Drain off any excess liquid and reserve it. Puree the liver
mixture using a food mill or blender. (If you use a blender, add
a little of the reserved liquid to facilitate blending.) Stir in the
brewer's yeast. Let the mixture cool, then stir in the mayonnaise.
If the pate is too thick, add a little of the reserved liquid.
Makes 2 cups.
CHAPTER
SOUPS
Welsh Cock-a-Leekie
vitamin A
for 5 minutes. Tie the celery, carrots. leek and the parsley
1
together, and add them to the pot with the cloves and bay leaves.
Cover the pot and simmer for 45 minutes.
Remove the chicken and let it cool. Continue cooking the
soup for 30 minutes more, then remove the vegetable bouquet
and veal bones and discard them. Bring the soup to a boil, slowly
add the barley and lower the heat. Trim the leeks, leaving inch 1
of the green part. Cut the leeks into 1-inch lengths and add them
to the pot along with the curry and allspice. Simmer, covered,
for 40 to 45 minutes, or until the barley is tender.
Meanwhile, remove the skin and bones from the cooled
chicken and tear the meat into chunks. Add them to the soup
and cook them for 5 minutes, or until heated through. Remove
the bay leaves and cloves.
Serves 6 to 8.
From Creative Cooking with Grains and Pasta by Sheryl and

Mel London, Rodale Press, Emmaus, Pa., 1982.
Fresh Tomato Soup

vitamin C vitamin A riboflavin
V2 cup minced onion

Va cup minced celery
Va cup minced carrot
2 cloves garlic, minced
2 tablespoons butter or vegetable
oil
2 pounds tomatoes, peeled, seeded

and finely diced
1 bay leaf
'/4 cup minced fresh parsley
1 teaspoon minced fresh thyme or
Vi teaspoon dried thyme
SOUPS 763
1teaspoon minced fresh marjoram

or Vi teaspoon dried marjoram
1 tablespoon minced fresh basil
4 cups chicken stock or tomato
juice
sour cream or yogurt (garnish)
minced fresh herbs such as
parsley, chives, basil or
chervil (garnish)
In a soup pot, saute the onions, celery, carrots and garlic

in the butter or oil until the onions are translucent.
Add the tomatoes, bay leaf, parsley, thyme, marjoram and
basil. Cover and cook over low heat for 10 to 15 minutes, or
until the mixture is soft and thick.
Gradually stir in Cover the pot, bring the
the stock or juice.
soup to a boil, reduce the heat and simmer gently for 15 to 20
minutes, or until the vegetables are soft. Remove the bay leaf.
If desired, puree the soup, then return it to the heat and warm
it thoroughly. Serve it garnished with a little sour cream or yogurt
and minced fresh herbs.
Serves 6.
Pennsylvania Dutch Corn Chowder

After a hard day in the fields or at the office this tradi-
tional chowder and a hunk of whole grain bread make a meal by
themselves. Just remember to start it early in the morning or a
day in advance.
niacin riboflavin vitamin A
1 3-pound chicken, cut up

1 onion, chopped
1 carrot, sliced
1 Stalk celery, sliced

1 thyme or
sprig fresh V2 teaspoon
dried thyme
1 sprig fresh sage or '/: teaspoon
dried sage
1 rosemary or '/:
sprig fresh
teaspoon dried rosemary
6 cups water
2 potatoes, cubed
2 cups corn
Va cup minced fresh parsley
(garnish)
2 hard-cooked eggs, sliced
(garnish)
Place the chicken, onions, carrots, celery, thyme, sage and

rosemary in a soup pot. Add the water. Cover the pot and simmer
for 1'/: hours, or until the chicken is tender. Remove the pot
from the heat. Remove the chicken and reserve it. Strain the
broth and return it to the soup pot. Remove the chicken skin
and bones and discard them. Cut the meat into bite-size pieces
and return them to the broth. Refrigerate the broth overnight.
Discard the layer of fat that forms on top. Heat the broth
to boiling. Add the potatoes, reduce the heat and cook just until
the potatoes are tender, about 15 to 20 minutes. Add the corn
and cook for 5 to 7 minutes, or until the corn is tender. Serve
the chowder immediately, garnishing each serving with parsley
and egg.
Serves 6 to 8.
CHAPTER ,
I
EGGS
Eggs Baked in Leeks

vitamin C
3 or 4 large leeks, split and cut into 1-
inch lengths
2 teaspoons chopped fresh
rosemary or teaspoon dried
1
rosemary
3 tablespoons butter
4 eggs
Va cup grated Parmesan cheese
'/> cup shredded provolone cheese
1 cup tomato sauce (optional)
parsley (garnish)
In a large skillet, saute the leeks and rosemary in the butter

until tender. Transfer them to a 1 V2- or 2-quart casserole.
765
Make four wells in the leeks and carefully break an egg into
each. Sprinkle the eggs with the Parmesan and provolone cheese.
Bake at 375 until the eggs are set, about 10 minutes. Top the
eggs with tomato sauce, if desired, and garnish with parsley.
Serves 2 to 4.
Curried Eggs and Avocados

Serve over rice, bulgur or whole wheat toast.
vitamin E pantothenate vitamin B12

riboflavin
V4 cup minced onion
3 tablespoons whole wheat flour
2 teaspoons curry powder (or to
taste)
2 cups milk
12 hard-cooked eggs, quartered
2 avocados, thickly sliced
chopped fresh parsley (garnish)
In a medium-size skillet or saucepan, melt the butter until

it is bubbling but not brown. Add the onions and saute until they
are tender and translucent, about 5 minutes.
Add the flour and curry powder and cook, stirring constantly
to form a paste. Do brown. Add the milk gradually and
not let it
continue to stir until is smooth and medium thick,

the sauce
about 8 minutes. Add the eggs and avocados. Cook, stirring
gently, just until they're heated through. Garnish with parsley.
Serves 4 to 6.
EGGS 767
Broccoli-Stuffed Eggs
vitamin K vitamin C vitamin A
2 broccoli stalks (each about 3

inches long)
4 hard-cooked eggs, halved
2 tablespoons water
1 tablespoon lemon juice
1 tablespoon cottage cheese
1 teaspoon French-style mustard
1 teaspoon minced scallions
'/2 teaspoon tamari or soy sauce
(preferably reduced sodium)
Va teaspoon paprika
Peel the thin, tough skin from the broccoli stems. Steam the
broccoli until tender.
Carefully remove the yolks from the eggs. Place the yolks
in a blender with the water, lemon juice, cottage cheese, mustard,
scallions, tamari and paprika.
Trim off about V2 inch of the broccoli florets and reserve
them for a garnish. Coarsely chop the broccoli and add it to the
other ingredients in the blender. Process them on low speed until
smooth.
Stuff the egg whites with the yolk mixture, and garnish each
half with some of the reserved broccoli florets. Serve them chilled.
Serves 4.
CHAPTER
MAIN DISHES
Super Chili
MAIN DISHES 769
1 tablespoon blackstrap molasses

dash of cayenne pepper
(optional)
Soak the beans in water overnight. Place the beans in a large

saucepan with enough water to cover them, bring them to a boil
and simmer them gently until soft, about Wi hours. Drain them,
reserving Wi cups of the cooking liquid.
Brown the beef in a large, hot, lightly oiled skillet. Place
the liver in a blender with a quarter of the onion, and process
them on low to medium speed until smooth. Stir the liver into
the browning meat. Chop the remaining onion. When the meat
is cooked through, add the chopped onions and peppers, garlic,
chili powder, cumin and oregano. Cook until the onions become
translucent.
tomato paste, cooked kidney beans, reserved
Stir in the
cooking liquid, corn, tamari, molasses and cayenne, if used.
Simmer the chili until the onions and peppers are tender. Serve
it hot.
Serves 8.

Oxtail, Barley and Braised Cabbage Stew

Here's a hearty one-pot stew from the British Isles that's
best eaten on a stormy night in front of a warming wood fire.
vitamin C vitamin K vitamin 8,2

pantothenate vitamin E niacin
riboflavin vitamin B^
IVi pounds oxtails, cut into 1-inch

pieces

4 thin leeks, split and thinly sliced
2 stalks celery with leaves, thinly
sliced
3 or 4 tomatoes, chopped
2 bay leaves
1 cup barley
Va, teaspoon dried marjoram
2 cups beef stock or water

V/i pounds cabbage, coarsely
chopped
8 cups boiling water
1 medium onion, coarsely chopped
2 tablespoons minced fresh dill
sour cream or yogurt (garnish)
Dredge the meat in 2 tablespoons of the flour. Heat the oil
in a skillet and brown the meat on all sides. Transfer it to a 3-

to 4-quart heavy stew pot. Add the garlic, leeks, celery, toma-
toes, bay leaves, barley, marjoram and stock or water. Cover
the stew and bring it to boil. Then lower the heat and simmer
for 1 hour.
Meanwhile, place the cabbage in a deep bowl and add the
boiling water. Let it stand for 5 minutes, then drain it, reserving
the liquid.
Heat the butter in a heavy saucepan until it turns brown.
Add the onions and remaining tablespoon of flour and cook,
stirring constantly, until the mixture is browned. Add the cab-
bage and stir. Cover the saucepan and simmer for 15 minutes,
or until the cabbage turns pinkish in color. (Add a few table-
spoons of the reserved liquid if necessary to prevent scorching.)
Add the cabbage mixture to the stew along with 4 cups of
the reserved liquid. Cook for 20 minutes or until the meat is
tender. Remove the bay leaves. Sprinkle in the dill and serve
MAIN DISHES 771
the Stew hot, garnishing each serving with a dollop of sour cream
or yogurt.
Serves 6.
Tocana (Romanian Onion Stew with Beef

and Peppers)
If you have a penchant for onions, this stew is for you.
Serve over cornmeal mush or brown rice.
vitamin C vitamin B12

Stew and bring it to a boil, then lower the heat to simmer, stir
and cook for 45 minutes, or until the meat is tender. Check it
during cooking, adding more water if necessar\ (the stew should
be fairlv thick).
Serves 4.
Middle Eastern Wheat Kernel, Lamb and

Navy Bean Stew
Lime and mint cool this steu
vitamin B,; niacin vitamin C

thiamine
2 tablespoons butler
2 large onions, sliced
2 lamb shanks, cut into 2-inch
pieces
4 cups water
pinch of cayenne pepper
'/: teaspoon turmeric
'/: cup dried navy beans, soaked in
water overnight
Va cup wheat kerneN. soaked in
water o\ernighl
2 tomatoes, cut into chunks
Va teaspoon ground nutmeg
1 potato, cubed
1 tablespoon chopped fresh mint
juice of 1 lime
Heal the butter in large stew pot and saute the onions until
wilted. Add the lamb and cook, stirring frequenth unlil it's .
brown. Add the water, cayenne, turmeric and beans. Bring the
stew to a boil, lower the heat. co\er it and simmer for hour. 1
MAIN DISHES 773
Add the wheat kernels, tomatoes and nutmeg and cook for 15
minutes more. Then add the potatoes and simmer for 45 minutes
more, or until the wheat kernels and potatoes are tender. Stir in
the mint and lime juice. Cook for 5 minutes more.
Serves 4 to 6.
Millet and Parmesan Casserole

Millet is a light, tasty grain that can be used in most dishes
that call for rice.
riboflavin thiamine niacin
1 tablespoon vegetable oil
1 small onion, minced

1 stalk celery, thinly sliced
1 cup millet
Vh to 3 cups chicken stock
1 bay leaf
1 strip lemon rind
'/4 cup pine nuts or walnuts
'/4 cup currants
10 medium mushrooms, thinly sliced
'/2 cup grated Parmesan cheese
2 tablespoons grated Parmesan or
Romano cheese
Heat the butter and oil in a 2-quart flameproof, ovenproof

casserole or ovenproof saucepan, and saute the onions and celery
slowly until they are wilted, about 15 minutes. Add the millet
and cook, 30 seconds. Add Vh cups of the chicken
stirring, for
stock, the bay leaf, lemon rind, pine nuts or walnuts and currants
and bring them slowly to a boil. Cover the casserole and bake
at 325 for 20 minutes.
Carefully fold in the mushrooms and '/: cup of Parmesan

cheese. If of the stock, add just enough
the millet has absorbed all
more stock to make the mixture moist. Reduce the heat to 300
and continue cooking for 10 to 15 minutes more. At serving time,
remove the bay leaf and lemon rind, and fluff the millet gently
with a fork. Sprinkle the top with extra Parmesan or, for a con-
trasting flavor, grated Romano cheese.
Serves 4.
Stuffed Zucchini
vitamin C
4 medium zucchini
Va cup vegetable oil
1 medium onion, thinly sliced

V2 green pepper, finely diced
1 Vi cups cooked brown rice
2 cups shredded sharp cheddar
cheese
'/^ cup tomato sauce
V2 teaspoon minced fresh basil
Cut the zucchini in half, carefully scoop out the pulp and
reserve Vi cup. Heat the oil, add the onions and green peppers
and saute. Add the rice. Cook and stir it over high heat until it's
lightly browned. Add the zucchini pulp, cup of the shredded 1
cheese, the tomato sauce and basil. (Add a little hot water if the
mixture is too dry.)
Stuff the zucchini halves with the mixture. Place the zuc-
chini, stuffed-side up, in a greased baking pan. Bake at 350 for
20 minutes. Top the zucchini with the remaining cheese and
return it to the oven for 5 to 10 minutes, or until the cheese
melts.
Serves 8.
MAIN DISHES 775
Hot Vegetable Provencal

vitamin C vitamin A vitamin K
Va cup olive oil
2 cups sliced onions

3 green peppers, cut into thin strips
3'/2 cups cooked tomatoes
1 package (9 ounces) frozen
artichoke hearts
'/4 head cabbage, sliced
Va teaspoon thyme
1 tablespoon chopped fresh parsley
(garnish)
Heat the oil in a large skillet over medium heat. Saute the
onions, stirring occasionally, until pale yellow and soft. Add the
garlicand cook for minute. Add the green peppers, tomatoes,
1
artichoke hearts, cabbage and thyme. Reduce the heat to low.

Simmer uncovered for 25 to 30 minutes. Transfer everything to
a serving dish and garnish with the parsley.
Serves 6.
Down Home Potato Casserole
thiamine vitamin C
3 pounds potatoes, thinly sliced

2 medium onions, thinly sliced
2'/2 cups peas
Va cup shredded Monterey Jack
cheese
Vi cup shredded sharp cheddar
cheese
'/4 cup wheat germ

1 teaspoon dried thyme
V2 teaspoon cayenne pepper
3 tablespoons butter, softened
2 cups milk
Dry the potato slices. Arrange a third of them in the bottom

of a well-buttered 9 x 13-inch baking dish. Top with a third of
the onions and sprinkle a third of the peas over the onions.
In a small bowl, combine the Monterey Jack and cheddar
cheese, wheat germ, thyme and cayenne. Sprinkle a third of this
mixture over the peas. Dot with 1 tablespoon of the butter.
Create two more layers of the ingredients in the same fash-
ion, beginning with potatoes, then onions, peas, cheese mixture
and butter. Pour the milk over the top and bake for 30 minutes
at 400. Then reduce the heat to 350 and bake for 20 to 30 minutes
more, until the potatoes are tender and the top is golden brown.
Let the casserole stand for 15 minutes before it's served.
Serves 6 to 8.
Cheese Souffle
vitamin B12
1 cup milk
5 eggs, separated
1 '/> cups grated or crumbled farmer
cheese
Melt the butter in a skillet, stir in the flour until smooth,
then remove from the heat. Slowly stir in the milk until smooth.
it
Return the sauce to the heat and cook until thickened.

MAIN DISHES 777
Beat the egg yolks until thick, then add the milk sauce to
the yolks a little at a time, beating well after each addition. Stir
in the cheese.
Beat the egg whites until stiff, then fold them into the cheese
mixture, working in plenty of air.
Pour the mixture into a buttered l'/2-quart casserole. Bake

at 325 for 45 minutes, or until the souffle is tall and golden brown.
Serves 4.
From The Complete Dairy Foods Cookbook by E. Annie Proulx

andLew Nichols, Rodale Press, Emmaus, Pa., 1982.
Stir-Fried Peppers and Tofu

This is a colorful dish and if you can use both red and green
peppers, it is even more attractive. It is the perfect centerpiece
for a vegetarian dinner.
vitamin A vitamin C vitamin B^

vitamin E

1 tablespoon grated fresh ginger or
V2 teaspoon ground ginger
2 carrots, cut diagonally into '/4-
inch slices
2 green or sweet red peppers, cut
into 1-inch pieces
5 or 6 scallions, cut into 2-inch pieces
2 tablespoons tamari or soy sauce
1 tablespoon vinegar
V2 pound firm tofu, cubed
Heat the oil in a large skillet or wok. Add the garlic, ginger
and carrots and stir-fry for about 2 minutes. Add the peppers
and stir-fry for about 3 minutes. Add the scallions and stir-fry
for about 1minute. Add the tamari and vinegar and gently stir
in the tofu. Cover and steam the mixture over low heat for about
6 minutes.
Serves 4.
Buck-Corn Burgers
thiamine niacin
2 cups buckwheat groats, cooked

Vi cup corn germ
1 egg (optional)
1 small onion, grated
1 teaspoon poultry seasoning
Puree the cooked groats coarsely food processor or with

in a
a potato ricer. Combine them with the corn germ, egg (if used),
onion and poultry seasoning, then form patties. (If the mixture
is too dry to form patties, add a little stock or tomato juice. If
it is too soft, refrigerate it for a few hours for easier shaping.)
Brown the patties slowly on a well-oiled or buttered griddle or

pan until crisp on both sides; or brush them with oil and broil,
turning once.
Makes 10.
Lentil Loaf
This lentil dish is good served with broiled tomatoes, a leafy

green vegetable, baked winter squash, a big tossed salad or
MAIN DISHES 779
just about anything else. It's as good cold as it is hot, and it
makes deHcious sandwiches.
vitamin C
1 onion, minced
'/4 pound mushrooms, minced
1 cup lentils, ground
'/: teaspoon dried thyme
pinch of ground clove
pinch of ground nutmeg
2 eggs, beaten
Va cup tomato juice
2 tablespoons slivered almonds
Cook the onions, garlic and mushrooms in the butter until

very soft. Remove them from the heat and stir in the lentils,
thyme, clove, nutmeg, cayenne, eggs, tomatojuice and almonds.
Pour the mixture into a buttered 9 x 5-inch loaf pan and bake
at 350 for 30 minutes, or until the top is lightly browned and
the loaf is dry.
Serves 6.
Brown Rice, Cheese and Nut Loaf

A delightful medley of tastes and textures, this hearty, crun-
chy loaf needs only a salad to make a wholesome meal.
thiamine
tablespoon vegetable oil
tablespoon butter
1 onion, chopped
3 large stalks celery with leaves,
chopped
'/2 cup chopped cashews
'/2 cup chopped walnuts
'/2 cup sunflower seeds
1 cup cooked brown rice
1 cup ricotta cheese
2 teaspoons chopped fresh chives
parsley
1 '/: teaspoons dried thyme
2 eggs, beaten
Va cup wheat germ
Va cup sesame seeds
In a large skillet, heat the oil and butter, then saute the
onions until limp. Add the celery, cover the skillet and cook for
5 minutes.
In a mixing bowl, combine and mix the cashews, walnuts,
sunflower seeds, rice, cheese, chives, parsley, thyme and eggs.
Add the onions and celery.
Sprinkle half the wheat germ on the bottom and sides of a
greased 9 x 5-inch loaf pan. Turn the mixture into the pan and
sprinkle the remaining wheat germ and the sesame seeds on top.
Bake at 350 for 1 hour.
Serves 6 to 8.
CHAPTER
FISH
I
Haddock with Ginger Glaze

vitamin B12 niacin
^
Va to V2 cup water
V4 pound haddock fillets I
'
1 teaspoon cornstarch
Va cup cold water
1 teaspoon grated fresh ginger
1 clove garlic, minced
2 teaspoons tamari or soy sauce
I V2 teaspoons cider vinegar {
1 V2 teaspoons honey
1 scallion, thinly sliced ^
Bring Va cup of water to a boil in a medium skillet. Add the \
haddock and lower the heat. Poach the fish on one side for 2 to
3 minutes, then turn the fish and poach until it is opaque through-
out. Add more water, if necessary.
781
Dissolve the cornstarch in the cold water. Transfer the fish

gently to a warm serving platter. Pour off any water remaining
in the skillet. Place the cornstarch mixture, ginger, garlic, tamari,
vinegar and honey in the skillet. Over medium heat, stir the sauce
until slightly thickened and reduced by almost a third. Pour the
ginger sauce over the fish fillets. Top the dish with the scallion,
and serve it immediately.
Serves 2.
Peachy Fish Amandine

vitamin E
'/3 cup almonds, sliced or chopped

1 pound filleted fish
3 peaches, sliced
Saute the almonds briefly in the butter. Remove the almonds

when they are golden. Add the fish to the hot butter and saute
for 6 to 8 minutes, or until the fish is just opaque throughout.
Transfer it to a serving platter. Top it with the almonds and
sliced peaches.
Serves 4.
Salmon Croquettes
vitamin B,2 pantothenate vitamin B^
vitamin D
1 medium onion, chopped

4 scallions, chopped
1 tablespoon butter
FISH 783
can (15'/2 or 16 ounces) pink

1
salmon, drained and flaked

1 cup cottage cheese
3 eggs
2 egg yolks
2 cups whole wheat bread crumbs
1 tablespoon minced fresh chives
or '/: teaspoons dried chives
1
1 tablespoon minced fresh dill or

1 '/2 teaspoons dried dill
1 tablespoon minced fresh parsley

or Vi teaspoons dried parsley
1
Va teaspoon paprika
Saute the onions and scallions in the butter until the onions
are translucent. Transfer them to a large bowl. Add the salmon,
cottage cheese, eggs, egg yolks, bread crumbs, chives, dill, pars-
ley and paprika to the bowl and mix well.
Form the mixture, 1 tablespoon at a time, into small cro-
quettes. Place them on a greased cookie sheet and bake at 350

for 20 minutes. The croquettes are done when they're firm to
the touch. Or saute them in butter until browned.
Makes about 35.
Steamed Fish with Spinach and

Parmesan Cheese
i
There's only one word to describe this dish sensational!
vitamin A vitamin K vitamin C *
vitamin B|2 niacin 1
1 pound halibut, haddock or cod

fillets, cut into four portions
1 pound spinach, chopped and

cooked
1 egg yolk, beaten
1 small onion, grated
'/steaspoon ground nutmeg
Va cup yogurt
2 teaspoons lemon juice
Vi cup grated Parmesan cheese
mushroom slices (garnish)

lemon wedges (garnish)
Arrange a piece of cheesecloth along the bottom and up the

sides of a perforated or bamboo steamer. Add the fish and steam
it over boiling water for 5 to 8 minutes. When the fish is almost
done, use the cheesecloth to transfer the fish to a buttered oven-

proof casserole.
Drain the spinach. Mix the spinach with the egg yolk, on-
ions, nutmeg, yogurt, lemon juice and half of the Parmesan cheese.
Spread the mixture over the steamed fish. Sprinkle it with the
remaining cheese and slip it under the broiler until the cheese
melts and is lightly browned. Garnish with mushrooms and lemons.
Serves 4.
CHAPTER
POULTRY AND LIVER
Turkey Pie ]
vitamin A vitamin C niacin

^
pantothenate vitamin B^
1 green pepper, minced j

4 carrots, thinly sliced
2 stalks celery,chopped *
2 onions, minced
10 to 12 mushrooms, sliced
2 cups peas
Vi teaspoon dried sage ,j
*
1teaspoon dried thyme
1 teaspoon dried basil
'
'/4 cup plus 2 tablespoons butter
'/4 cup whole wheat flour
^
^
2 cups turkey or chicken stock
1 cup half-and-half
1
Va teaspoon ground nutmeg
''
785
4 cups cubed cooked turkey

6 potatoes
'/2 to Va cup milk
'/4 cup grated Parmesan cheese
Saute the green peppers, carrots, celery, onions and mush-

rooms in the oil until limp. Blanch the peas in simmering water
for 3 minutes, then drain them and add them to the other veg-
etables. Addthe sage, thyme and basil.
Melt cup of the butter in a saucepan and cook until foamy.
Va
Stir in the flour and cook for to 2 minutes over low heat. Whisk
1
in the stock and continue cooking, stirring constantly, until the
mixture begins to thicken. Stir in the half-and-half and cook until

thick enough to coat the back of a spoon. Add the nutmeg and
cayenne. In a large bowl, combine the sauce with the cooked
vegetables and turkey. Then pour the mixture into a buttered or
oiled 9 X 13-inch baking dish.
Cook the potatoes in simmering water until tender. When
they're cool enough to handle, peel the potatoes, if desired, and
mash them. Beat in the milk, the remaining butter and half of
the Parmesan cheese. Spread the potatoes on top of the turkey
mixture (or pipe them on with a decorative pastry tube). Sprinkle
the top with the remaining cheese. Refrigerate the pie until you're
ready to bake it. Bake at 350 until the pie is warm and bubbly
and lightly browned on top, about hour. 1
Serves 6 to 8.
Liver with Mixed Vegetables

vitamin B,2 vitamin A riboflavin
vitamin K pantothenate vitamin C
niacin folate vitamin E
vitamin B^ thiamine
V4 pound calf liver or baby beef

liver
POULTRY AND LIVER 787

2 teaspoons dried basil
1 small zucchini
2 scallions, chopped
10 cherry tomatoes, halved
Cut the liver into long, thin strips. Combine the flour and
basil on wax paper, and dredge the liver slices in the mixture.
Heat tablespoon of the oil in a medium skillet, and saute
1
the liver over low to medium heat. It should be cooked just until
the inside of each strip remains pink. Do not overcook. Transfer
the liver to a serving plate and keep it warm.
Cut the zucchini in half crosswise, then lengthwise. Cut each
section into long, thin strips. Add the remaining oil to the pan,
then add the scallions and stir and cook. When the scallions wilt,
add the zucchini. Add a few spoonfuls of water if necessary to
keep the vegetables from sticking.
When the scallions and zucchini are slightly softened, add
the tomatoes and tamari and stir to combine them. Place a lid
on the skillet and allow the vegetables to steam until tender,
stirring occasionally, for about 10 minutes. At serving time, ar-
range the vegetables on two sides of the liver.
Serves 2.
From The 20-Minute Natural Foods Cookbook by Sharon Claes-

sens, Rodale Press, Emmaus, Pa., 1982.
Oven-Baked Chicken and Vegetables

vitamin A niacin vitamin C
vitamin E vitamin B^ pantothenate
2 carrots, cut into large pieces

1 large potato, thickly sliced
1 sweet potato, thickly sliced

1 whole chicken breast, halved and
skinned
1 onion, thinly sliced
'/2 cup water
Place the carrots, potatoes and sweet potatoes in a casse-

role, arranging the chicken breasts on top. Cover them with the
onions. Pour the water over all. Cover the casserole and bake
at 350 for Wi hours, or until the chicken and vegetables are
tender.
Serves 2.

Cashew Chicken with Brown Rice

niacin pantothenate vitamin B^
1 cup chopped onion

1tablespoon vegetable oil
1 Vi cups cottage cheese
Va cup chicken or turkey stock
2 cups cubed cooked chicken
breast
'/> cup toasted cashews
dash of nutmeg
1tablespoon chopped fresh parsley
4 cups hot cooked brown rice
onions and garlic in the oil until

In a large skillet, saute the
tender. In a blender, combine the cottage cheese and stock.
Process them on medium speed until smooth.
POULTRY AND LIVER 789
Add the blended sauce to the vegetables. Stir in the chicken,

cashews, nutmeg, tamari and parsley. Over low heat, stir con-
stantly until the ingredients are hot, but do not let them boil
because the cheese sauce may curdle. Serve the mixture over
the hot cooked brown rice.
Serves 4.

CHAPTER
SIDE DISHES
Brussels Sprouts with Sesame Casserole
vitamin C vitamin E
1 small onion, diced

1 green pepper, minced
1 medium leek, split and chopped
3 tablespoons sesame seeds

1 tablespoon dried oregano
I cup cottage cheese
1 tablespoon whole wheat flour
2 tablespoons wheat germ
juice of 1lemon
1 tablespoon tahini (sesame butter)
1 teaspoon sesame oil
'/4 cup stock
790
SIDE DISHES 791
3'/2 cups shredded Brussels sprouts,

steamed
V2 teaspoon paprika
Saute the onions, peppers, leeks and garlic in the oil over
medium-low heat for 10 minutes, or until soft. Stir in the sesame
seeds and oregano, and saute for 3 to 5 minutes more. Remove
the vegetables from the heat and set them aside.
In an oiled, deep, 2-quart baking dish, combine the cottage
cheese, flour and wheat germ. Mix them well. Fold in the veg-
etable mixture. In a small bowl, combine the lemon juice, tahini,
sesame oil and stock. Blend them well, preferably with a whisk.
Alternate folding the tahini mixture and the Brussels sprouts into
the cottage cheese mixture. Pat it all down. Cover it tightly.
Bake at 300 for 15 minutes, then sprinkle the top with paprika
and bake for 15 minutes more.
Serves 4 to 6.
Hawaiian Vegetable Medley

vitamin A
2 teaspoons cornstarch
2 tablespoons water
1 can (4 ounces) water chestnuts,
sHced
Heat the oil in a medium skillet and saute the onions, green
peppers and celery for 3 to 5 minutes. Do not let them brown.
Add the carrots, green beans and stock. Simmer, covered, until
the vegetables are tender, about 10 to 12 minutes. Add the snow
peas, pineapple and tamari, and simmer for 2 minutes more.
Dissolve the cornstarch in the water. Add the water chestnuts
and cornstarch mixture to the skillet. Cook, stirring constantly,
until the liquid is thickened.
Serves 4.
From Rodale's Basic Natural Foods Cookbook edited by Charles

Gerras, Rodale Press, Emmaus, Pa., 1984.
Orange Rice Pilaf
This is a grand production, it takes a little longer, but the

delight with which always received justifies the extra effort.
it is
Make it for a special occasion, or just make it

and dinner will
be special.
vitamin C
2 tablespoon butter
1 onion, minced
2 cups brown rice
2 cups orange juice
2 cups boiling water
2 cloves
1 small piece cinnamon stick
SIDE DISHES 793
Va teaspoon ground ginger

3 tangerines or oranges, peeled and
sectioned
Vi cup raisins
Va cup sliced almonds
1 tablespoon honey
In a large saucepan, heat the oil and tablespoon of the

I
butter and saute the onions until soft. Add the rice and continue
cooking for 5 minutes, stirring constantly. Add the orange juice
to the boiling water. Pour that over the rice. Add the cloves,
cinnamon and ginger. Cover the saucepan and simmer for 40
minutes, or until the liquid is absorbed. Remove the cloves and
cinnamon stick.
Reserve 6 tangerine or orange sections. Stir in the remaining
sections and the raisins. In a small skillet, heat the remaining
tablespoon of butter and saute the almonds until golden. Place
the rice in a serving dish and top it with the reserved fruit and
the sauteed almonds. Drizzle the top with the honey.
Serves 6 to 8.
Asparagus Amandine
vitamin K vitamin E vitamin C
1 tablespoon butter
'/( cup sliced or slivered almonds
1 cup sliced mushrooms
Va cup minced fresh parsley
2 teaspoons grated lemon rind
1 pound asparagus
In a large frying pan, melt the butter. Add the almonds and
mushrooms. Cook over low heat, stirring often, until the almonds
are golden and the mushrooms are tender. Stir in the parsley
and lemon rind.
Using white kitchen string, tie the asparagus spears into

small bundles about 2 to 3 inches in diameter. (Make sure all of
the spears in each bundle are about the same thickness.)
Bring a very large pot of water to a boil. Carefully lower
the bundles into the water. Cook at a boil just until the asparagus
is tender, about 5 minutes.
Remove the asparagus from the water. Remove the string
and place the asparagus on a serving platter. Cover it with the
almonds and mushrooms.
Serves 4.
From Cooking with the Healthful Herbs by Jean Rogers, Rodale

Press,Emmaus, Pa., 1983.
Applesauce-Filled Squash
itamin A
SIDE DISHES 795
Carrots, Cauliflower and Pumpkin Seeds

vitamin A

1 medium onion, sliced into thin
rings
2 cups cauliflower florets
2 medium carrots, sliced diagonally
1 tablespoon minced fresh parsley
'/4 cup hulled pumpkin seeds
In a large skillet, heat the oil, then add the onions. Saute
them over medium heat for to 2 minutes. Stir in the cauliflower
1
florets and carrots. Add a few spoonfuls of water and steam the
vegetables until tender, about 15 minutes, stirring occasionally.
(Add a littlemore water if necessary.) Toss the vegetables with
the parsley and pumpkin seeds. Serve them hot.
Serves 4.
Gingered Apples and Sweet Potatoes

vitamin A vitamin E vitamin C
2 medium sweet potatoes

2 tart apples
'/2 cup apple cider or chicken stock
V2 teaspoon grated fresh ginger
dash of cinnamon
Cut the sweet potatoes in half lengthwise, then cut them

crosswise into thin slices. Quarter the apples and cut them into
thin slices.
Place the sweet potatoes and apples in layers in an 8 x 8-
inch baking dish. Pour on the cider or stock, sprinkle the top
with the ginger, and dust it with the cinnamon.
Bake at 350 for 45 minutes or until the sweet potatoes are

tender.
Serves 4.
Spinach with Wheat Germ, Nuts and

Raisins
Even those who profess to hate spinach will love this su-
pernutritious version.
vitamin A vitamin K
SIDE DISHES 797
Creamy Potato Salad, Utah Style

vitamin C
3 tablespoons mild vinegar

1 Vi tablespoons chopped fresh dill
Va teaspoon French-style mustard
1 tablespoon minced sweet red
pepper
Steam the green beans just until crisp-tender. While the

beans are steaming, place the walnuts, vinegar, dill and mustard
in a blender. Process them on low to medium speed until they
make a relatively smooth sauce. When the green beans are done,
toss them with the sauce and the minced pepper. Serve them
hot or chilled.
Serves 6.
CHAPTER \
SALADS
Brown Rice Tabbouleh

vitamin C riboflavin
2 cups cooked brown rice

1 Vz cups chopped fresh parsley
Vi cup chopped scalhons
Vi cup chopped fresh mint
Va cup chopped tomatoes
Va teaspoon cinnamon
'/4 cup lemon juice
'/4 cup ohve oil
In a medium-size mixing bowl, combine the brown rice,

parsley, scallions, mint, tomatoes and cinnamon. Combine the
lemon juice and oil. Pour them over the tabbouleh and toss it to
coat it evenly.
Serves 4 to 6.
799
Cauliflower and Pine Nut Tomato Salad

vitamin C vitamin E vitamin A
2 pounds tomatoes, peeled, seeded

and minced
2 tablespoons lemon juice
'/: cup olive oil
'/s teaspoon cayenne pepper
10 fresh basil leaves, minced
'/4 cup minced fresh parsley
'/2 cup pine nuts
1 large head cauliflower, broken
into florets
Place the tomatoes in a ceramic or glass bowl. Mix in the

lemon juice, oil, cayenne, basil and parsley. Cover the
garlic,
bowl and let it stand at room temperature for 2 hours. Stir the
mixture occasionally. Then chill it for 1 hour.
Spread the pine nuts on a baking sheet and toast them at
300 for 10 to 15 minutes, stirring occasionally. Bake just until
golden, being careful not to overbrown the nuts. Set them aside
and them cool.
let
Steam the cauliflower just until tender, about 7 minutes.

Cool, cover and chill it.
To serve the salad, arrange the cauliflower on a serving dish,
pour the tomato mixture over it and sprinkle the top with the
pine nuts.
Serves 6.
From Rodale's Soups and Salads Cookbook and Kitchen Album

edited by Charles Gerras, Rodale Press, Emmaus, Pa., 1981.
SALADS 801
California Chicken and Almond Salad
niacin vitamin E
3 cups cubed cooked chicken

1 Vz cups coarsely chopped celery
2 scallions,minced
'/>cup almonds, coarsely chopped
Vi cup mayonnaise
Vi cup yogurt
1 tablespoon lemon juice

1 avocado, mashed
2 tablespoons minced fresh dill
6 lettuce leaves
mixing bowl, combine the chicken, celery, scal-

In a large
lions and almonds. Cover and chill them.
In a small mixing bowl, whisk together the mayonnaise,
yogurt, lemon juice, avocado and dill. Beat the dressing until
creamy. Cover and chill it.
Just before serving time, arrange a lettuce leaf on each plate.
Toss the dressing and salad together and place a mound on each
leaf.
Serves 6.
From Rodale's Soups and Salads Cookbook and Kitchen Album

edited by Charles Gerras, Rodale Press, Emmaus, Pa., 1981.
CHAPTER
BEVERAGES
Icy Melon Delight

vitamin C
Vz cup chopped cantaloupe

'/2 cup chopped pineapple
2 tablespoons yogurt or buttermilk
3 ice cubes
'/4 teaspoon vanilla extract
dash of nutmeg
fresh mint sprigs (garnish)
Place the cantaloupe, pineapple, yogurt or buttermilk, ice

cubes, vanilla and nutmeg in a blender and process them on high
speed smooth. Serve the drink over ice in two tall chilled
until
glasses. Garnish with mint.
Serves 2.
802
BEVERAGES 803
Bananaberry Shake
This shake is thick, creamy and better than a milk shake.
And you can use whichever fruits are in season.
vitamin C
CHAPTER
DESSERTS AND SNACKS
Sunflower Sesame Treats

vitamin B^ pantothenate
V4 cup ground sunflower seeds

Va cup tahini (sesame butter)
V2 cup shredded coconut
Va cup honey
'/? cup toasted wheat germ
I cup minced dates or raisins
medium-size mixing bowl, combine the sunflower seeds

In a
and tahini. One at a time, mix in the coconut, then the honey,
wheat germ and dates or raisins. Mix everything together thor-
oughly. Separate the mixture into two portions. Place each por-
tion on a separate piece of wax paper. Form each into a roll
about 4 inches long. Wrap it securely in wax paper and chill it
thoroughly. For serving, unwrap the rolls and cut them into V2-
inch slices. Store them in the refrigerator.
Makes about 16.
804
DESSERTS AND SNACKS 805
Lemon Walnut Frozen Yogurt *
This keeps well in a 0 freezer for two or three days.
vitamin B,2
t
2 teaspoons unflavored gelatin

2 tablespoons boiling water ,
2 cups yogurt
V2 cup nonfat dry milk .'
'/3 cup honey

grated rind of 2 lemons
V4 cup lemon juice
1 egg white
^
Va cup chopped walnuts
Dissolve the gelatin in the boiling water. In a mixing bowl,

combine the yogurt, dry milk, honey, lemon rind, lemon juice 1
and dissolved gelatin and mix them well with a whisk. Chill the
mixture for 45 minutes. Transfer it to the drum of an ice cream
maker and process it until it's half-frozen. Beat the egg white ^
until soft peaks form, fold it into the half-frozen yogurt mixture ^
along with the walnuts, and continue processing until the mixture
is firm. Transfer it to a freezer container and store it at 0 in the ,
freezer. Before it's served, let it soften a little.
Serves 4.
From Cooking with Fruit by Marion Gorman, Rodale Press,

Emmaus, Pa., 1983. I
Apple Crepes with Raspberry Syrup

1
vitamin C
Crepes
3 eggs
[
-A cup whole wheat pastry flour

'/> teaspoon honey

1 cup water
Syrup
2 cups fresh or frozen raspberries

2 tablespoons honey
'/> teaspoon vanilla
2 teaspoons arrowroot or
cornstarch
Va cup water
Filling
5 tart apples, thinly sliced

1 tablespoon honey
3 tablespoons raisins
Vi teaspoon cinnamon
fresh or frozen raspberries

(garnish)
To make the crepes: In a large mixing bowl, beat the eggs.

Add the flour andmix well. Add the honey and water and mix
to a smooth batter with the consistency of light cream. Pour the
batter into a pitcher and let it stand for 30 minutes.
To make the syrup: In a small saucepan, combine the rasp-
berries, honey and vanilla. Stir them over low heat until just
below boiling. Mix the arrowroot or cornstarch and water and
add them to the raspberry mixture. Cook the syrup over low
heat until thickened, about 5 minutes. Strain it through a coarse
sieve.
To make the filling: Saute the apples in the butter until slightly
soft. Stir in the honey, raisins and cinnamon. Remove the filling
from the heat and cover it to keep it warm.

Pour V4 cup of the batter into a lightly buttered 8-inch skillet

or crepe pan and tilt it to spread the batter evenly. Cook the
crepe for minute on each side. Remove it from the pan and
1
place it on a towel. Repeat the procedure with the remaining

batter. Do not stack the crepes.
Using about 3 tablespoons per crepe, spoon the filling down
the center of each crepe and fold both sides over. Garnish with
raspberries.
Serves 4.
Banana Wheat Germ Pudding

A delicious dessert that's great for breakfast!
vitamin E
2 cups milk
1 cup mashed bananas
2 eggs, beaten
2 tablespoons honey
V2 cup raisins
1 teaspoon grated lemon rind
V2 cup wheat germ
Scald the milk in a large saucepan. Mix in the bananas, eggs,

honey, raisins, lemon rind and wheat germ. Turn the mixture
into a buttered 1 -quart casserole and bake at 350 for 50 minutes,
or until a knife inserted into the pudding comes out clean. Let
it stand for 15 minutes before it's served.
Serves 6.
Almond Cheesecake
The flavor is so extraordinary, you won't believe this is a
"health" dish with about one-half the calories and one-third
the fat of ordinary cheesecake.
vitamin E
Crust
Va cup sunflower seeds

V2 cup wheat germ
1 teaspoon honey
Filling
2 cups ricotta cheese

1 cup low-fat cottage cheese
3 eggs
2 egg whites
Vicup honey
Wi teaspoons vanilla extract
Va cup blanched almonds, chopped
1teaspoon grated lemon rind

1 tablespoon whole wheat flour
To make the crust: Grind the sunflower seeds in a blender

with short bursts on high speed. In a small bowl, combine the
ground sunflower seeds and wheat germ. Add the oil and honey
and stir the mixture with a fork until combined. Press it into a
lightly oiled 9-inch springform pan, covering the bottom and
halfway up the sides.
To make the filling: Remove any lumps from the ricotta and
cottage cheese by mashing them with a wooden spoon against
the sides of a large mixing bowl. (The cottage cheese can also
be pressed through a sieve for smoothness.)
Beat the eggs and egg whites together in a medium-size bowl

until light. Add them to the cheese mixture along with the honey,
vanilla, almonds, lemon rind and flour. Stir the mixture until it's
combined. For a light-textured cheesecake, beat the mixture for
5 to 10 minutes on high speed with an electric mixer.
Pour the cheese mixture into the prepared crust and bake
at 350 for 45 to 60 minutes. Turn off the heat and let the cheese-
cake cool in the oven with the door ajar for about an hour.
Remove it from the oven and let it cool to room temperature
before chilling it. Chill the cheesecake for at least 6 hours before
it's served.
Serves 12.

Butter Almond Cookies

Delicate and delightful.
vitamin E
Vi cup butter, at room temperature

Vi cup honey
1 egg, beaten
V2 cup blanched almonds
1 teaspoon vanilla extract
1 cup whole wheat flour
Beat together the butter and honey. Beat in the egg. Place
the almonds in a blender and grind them with short bursts on
high speed. Stir them into the batter with the vanilla. Add the
flour and stir just until the batter is smooth.
Drop the batter by the tablespoon onto two lightly oiled
baking sheets. Bake at 375 for 8 to 10 minutes, or until the edges

of the cookies are brown.
Makes 2 dozen.
From The 20-Miniite Natural Foods Cookbook by Sharon Claes-

sens, Rodale Press, Emmaus, Pa., 1982.
CHAPTER
138
BREADS AND MUFFINS
Super Squash Muffins

Moist and delicious, these muffins are best piping hot from
the oven. Any leftovers can be reheated for later enjoyment.
thiamine
Stir in the nuts and raisins. Spoon the batter into greased muffin
cups, filling each about two-thirds full. Bake at 350 for 20 minutes.
Makes about 16.
Whole Wheat Hamburger Buns

thiamine niacin
'/4 teaspoon plus 2 tablespoons

honey
pinch of ginger
'/: cup warm water
1 tablespoon dry yeast
5 to 5'/2 cups whole wheat flour
Va cup nonfat dry milk
1 egg
Va cup vegetable oil
l'/3 cups milk
3 tablespoons butter, melted

sesame seeds (garnish)
In a small bowl, stir Va teaspoon honey and the ginger into

the warm water until they're dissolved. Add the yeast but do
not stir it in. Set the bowl aside until the yeast is foamy, about
10 minutes.
mixing bowl, combine two cups of the flour with
In a large
the dry milk. Add
the yeast mixture, egg, oil, 2 tablespoons of
honey and the milk. Blend the mixture thoroughly. Begin adding
more flour, cup at a time, until the dough is too stiff to beat
1
with a spoon or electric beater. Then mix the dough with a dough
hook, or knead it by hand for about 5 minutes. The dough should
be somewhat sticky, neither runny nor dry. Cover it and let it
rise until doubled, about 45 to 60 minutes.

BREADS AND MUFFINS 813
Divide the dough into 15 equal pieces and shape them into
balls. Place them on a well-oiled baking sheet. Flatten them
slightly, brush the tops with the melted butter, and garnish them
with sesame seeds. Allow them to rise until puffed, about 30
minutes. Bake at 350 for 15 to 20 minutes.
Makes 15.
From Bread Winners by Mel London, Rodale Press, Emmaus,

Pa., 1979.
Whole Wheat Biscuits
thiamine niacin
2 cups whole wheat flour

2 teaspoons baking powder
Va cup butter
% to V4 cup buttermilk
In a medium-size mixing bowl, sift together the flour and

baking powder. Cut in the butter until the mixture is the con-
sistency of coarse cornmeal. Make a well in the center of the
mixture, and mix in just enough buttermilk for the dough to hold
together. With lightly floured hands, knead the dough lightly.
Press or out the dough until it's Va inch thick, then cut it
roll
into 8 pieces with a floured biscuit cutter. (If you don't have a
cutter, roll the dough and flatten them slightly.) Place
into 8 balls
the biscuits touching one another in a well-buttered 8 x 8-inch
baking dish. Bake at 400 for 20 to 25 minutes. Eat them as soon
as possible, since they do not keep well.
Makes 8.
Double-Barreled Oatmeal Bread

We call this loaf double-barreled because it's loaded with
lots of fiber from the oats, in addition to lots of yeast. Yet, for
all its hardware, it's an amazingly light bread.
thiamine folate pantothenate

niacin
1 tablespoon dry yeast

V2 cup warm water
V4 cup buttermilk or milk
Va cup honey
2'/2 to 2y4 cups whole wheat flour
Va cup rolled oats
1 egg, beaten
V4 cup plus 2 tablespoons brewer's
yeast
Sprinkle the tablespoon of yeast over the warm water. Set

it aside until the yeast bubbles. In a small saucepan, combine
the buttermilk or milk, honey and Heat them until the
butter.
butter melts. Cool the mixture to lukewarm, then stir in the
bubbling yeast.
Combine cups of the flour and the oats in a large bowl.
1 V2
Stir in the yeastmixture and the egg. Beat vigorously to combine

them. Stir in the brewer's yeast and enough additional flour to
make a stiff dough. (Go easy; too much flour will make the bread
heavy.) Work the dough together well, but do not knead it. (It
will be too sticky to knead.)
Transfer the dough to a well-oiled bowl. Brush the top with
oil. Cover the bowl and 'let thedough rise in a warm place until
doubled in size, about 1 hour. Punch it down, then transfer it to
a well-greased 9 x 5-inch loaf pan. Let it rise until doubled again.
I
BREADS AND MUFFINS 815
about 45 minutes. Bake at 375 for about 35 minutes. If the top

browns too fast, cover it with foil.
Makes 1 loaf.
Bravo Banana Bread

thiamine folate
1 V2 cups whole wheat pastry flour

V4 cup brewer's yeast
1 teaspoon baking soda
1 cup mashed bananas
'/3 cup vegetable oil or melted butter
'/3 cup honey
V3 cup orange juice
1 egg
2 teaspoons vanilla
Butter a 9 X 5-inch loaf pan. Line the pan with a piece of

parchment paper cut to cover the bottom and extend up the 9-
inch sides to about V2 inch above the edges. Butter the paper.
In a large bowl, combine the flour, brewer's yeast and baking
soda. In another bowl, combine the bananas, oil or butter, honey,
orange juice, egg and vanilla. Mix the liquid ingredients into the
dry ones. Pour the mixture into the prepared pan. Bake at 325
for 50 minutes, or until a wooden pick inserted into the center
comes out clean. Remove the bread from the pan and immedi-
ately peel off the paper.
Makes 1 loaf.
INDEX
osteoporosis in, 318
Abruptio placentae, 246 pyridoxine levels in, 177, 466
Absorption of nutrients, factors shingles in, 550, 551
affecting, 23-28 thiamine requirements in, 126
Acetaldehyde, in cigarette smoke, vitamin B,: deficiency in, 188
46, 64-65 vitamin D metabolism in,
Acetylcholine, 233 324-26
Acne, 557 vitamin E needs in, 373,
vitamin A in, 390-93, 569, 708 397-400
zinc in. 391-92, 708 Alcohol intake. 44-46
Addiction to heroin, and folate deficiency from, 213
detoxification with vitamin C, in pregnancy, 676
299-302 protective effects of vitamin C
Additives in food in, 541
affecting absorption of sperm count affected by, 508
nutrients, 27 thiamine loss from, 127
eye problems from, 562 vision affected by, 87-88
Yellow No. 5, 163 vitamin C absorption after, 252
Adolescence Aldose reductase, inhibitors of,
delinquency in, 449-54 306-7, 428
folate deficiency in, 461 Allergies, 633
weight problems in, 676-77 bioflavonoids in, 314
Adrenal glands, 502 to food, 451-52, 697
Adriamycin side effects, hay fever in, 483-87, 633
prevention with vitamin E, pantothenate in, 219
50-5 Amblyopia, nutritional, 561
Advertisements, misleading p-Aminobenzoic acid, 222-24
statements in, 14 interaction with sulfa drugs, 69
Aflatoxins, 539-40 Anaphylaxis, vitamin C in, 486
Aging, 401-14 Anemia
absorption of nutrients in, in folate deficiency, 460
27-28 megaloblastic, 204
antioxidants affecting, 394-400 pernicious, 67-68, 184, 214
biotin deficiency in, 229 in riboflavin deficiency, 144-45
capillary problems in, 305 sickle cell, vitamin E in,
folate deficiency in, 212-13 361-62
malnutrition in, 434 Angina pectoris. Sec Heart disease
nutrient needs in, 33-39 Antacids, effects of, 44, 414
816
INDEX 817
Antagonists, vitamin, 42-43 Autoimmune diseases, 397

Antibiotics Azar, Robert, 635-40
biotin deficiency from, 229
folate deficiency from, 213 B
Anticoagulants, 497 Backache, vitamin C in, 610, 649
in pregnancy, affecting infants, Bacterial infections. See Infections
383, 384 Baking Soda, thiamine loss from, 8
as vitamin K antagonists, 383, Barbiturates, nutritional problems
385 from, 34
Antihistamines, natural, 246, 314, Bedsores
484-87, 633 vitamin C in, 249, 491
Antioxidants, 394-400 vitamin E in, 366
protective effects of, 395-400 Behavior therapy, 721, 722-23
selenium, 395, 398 Benzene exposure, and protective
vitamin A, 399 effects of vitamin C, 271-72
vitamin C, 74, 395, 398 Beriberi. 127, 133. See also
vitamin E, 347-48, 360, 362, Thiamine
371, 395, 398 heart disease in, 571
Appetizers, recipes for, 758-60 Beverages, recipes for, 802-3
Arginine, food sources of, 436 Bile, 470
Arteriosclerosis, 732-37 Bioflavonoids, 303-17
cholesterol levels in. See as antihistamines, 314
Cholesterol in arthritis, 305-6
coronary bypass in, 733-34 in bleeding disorders, 307
plaque formation 278
in, in cancer prevention, 313
platelet activity in,496 in capillary problems 304-6
protective effects of vitamin C in cataract prevention, 306-7,
in, 278-79 427-28
in pyridoxine deficiency, in cold sores, 315-17
171-77 food sources of, 311-12
in smokers, 61-62 in hay fever, 483, 485-86
Arthritis, 598 hematocrit levels affected by,
bioflavonoids in, 305-6 312
niacinamide in, 649 preservative action of, 308-9
osteoarthritis in retinal inflammation, 306
manual therapy in, 716 vitamin C with, 313, 315
prevention of, 652 Biotin, 225-31
rheumatoid, vitamin C in, 251 deficiency of, 225-31
vitamin E in, 589-90 in aging, 229
Ascorbic acid. See Vitamin C in athletes, 229
Aspirin in hospital patients,
affecting platelet function, 497 229-30
interaction with vitamins, 414 immune responses in, 227,
nutritional problems from, 36, 228
48-49 sudden infant death
Asthma, bioflavonoids in, 314, 486 syndrome in, 230-31
Atheroma, 172 dosage of, 228
Atherosclerosis. See recommended dietary
Arteriosclerosis allowance in. 228
818 INDEX
Biotin (continued) Bowel function, vitamin A

food sources of, 228, 748 affecting, 89-90
Bladder cancer Brain. See also Mental problems
prevention of, 74 development affected by
vitamin C effects in, 421, 422 riboflavin, 141-42
Bleeding disorders, bioflavonoids fatigue of, 724-25
in, 307 niacin deficiency affecting,
Blindness, night, 87-88, 560, 569 151-53
Blood Breads
clotting of. See Clot formation enriched, 123
transfusions of, and hepatitis recipes for, 81 1-15
prevention with vitamin C, Breakfast recipes, 755-57
250-51 Breast cancer
vitamin E affecting, 332-34 prediction of recurrence of,
Blood cells 170
clumping of, 734 protective agents in
bioflavonoids preventing, vitamin A, 17 1
308 vitamin C, 420-21, 423

lymphocyte blastogenesis vitamin E, 340, 374-77
affected by vitamin C, 425 in thiamine deficiency, 134
riboflavin affecting, 147 Breast cysts, vitamin A in, 707
vitamin A affecting white cell Brewer's yeast, 120, 143, 599
count, 90, 104-5 cholesterol levels affected by,
vitamin B12 affecting, 190-91 624-26
vitamin C affecting lecithinand corn oil with, 660
neutrophils, 245, 296-97, milk shake of, 686-87
438 Bronchial cancer. See lungs,
vitamin E affecting, 347-49, cancer of
360, 379, 396 Bronchopulmonary dysplasia in
Blood vessels, 714, 732-37 infants, vitamin E affecting, 363
arteriosclerosis of. See Burns
Arteriosclerosis biotin deficiency in, 230
capillaries, 628-29 of eye, vitamin C in, 255-56
bioflavonoids affecting, vitamin E in, 367, 493
303-6
in eye, nutrition affecting,
627-34
thrombosis in. See Thrombosis Cadmium toxicity, vitamin C
Bone affecting, 542
in osteomalacia, 323 Caffeine
in osteoporosis, 318. See also behavioral problems from, 665
Osteoporosis sperm count affected by, 508
in rickets, 327 Calcium
vitamin C affecting, 478 affecting histamine levels, 547
vitamin D affecting, 319-20 interaction with vitamins, 26,
vitamin K affecting 381-84 485
Boric acid, vitamin depletion from, loss in bones, in osteoporosis.
31, 149 See Osteoporosis
J
INDEX 819
Caloric intake pyridoxine in, 160, 165-67.

age affecting, 413 649
in dieting, 53-54 Cataracts, 564-65, 637-38, 642-43
empty calories in, 39, 45 prevention of, 427-30
Cancer, 595-96 bioflavonoids in, 306-7,
of bladder 427-28
prevention of, 74 vitamin E in, 332, 340,
vitamin C effects in, 421, 429
422 in riboflavin deficiency, 145-46
of breast. See Breast cancer in tryptophan deficiency, 429
cervical, in folate deficiency, Cervical dysplasia, in folate
210-11 deficiency, 210-1
chemical agents causing. See Chemicals
Chemicals acetaldehyde in cigarette
of colon. See Colon cancer smoke, 46, 64-65
of lung. See lungs, cancer of as additives. See Additives in
protective agents in, 415-26 food
antioxidants, 395-96 health hazards from, 101-3
bioflavonoids, 313 hydrazines as antipyridoxine
combination of vitamins C compounds, 162-64
and B,:, 415-18 infertility from, 504-7
folate, 211 as pollutants. See Pollution
pyridoxine, 170 toxicity affected by vitamin C,
riboflavin, 139-41 271-73
vitamin A, 13-18, 1 as vitamin antagonists, 42
44()_4I, 530-31 Chemotaxis, vitamin C affecting,
vitamin A acid, 106-7 245, 250
vitamin C. 287-94, Chemotherapy
313-14, 419-26, 611 adriamycin, and protective
vitamin D, 328-29 effects of vitamin E, 50-51
vitamin E, 340-41, 374-77 hair loss from, 481
of skin, from sunlight nutrition affecting responses
exposure, 223 to, 59
therapy in. See Chemotherapy vitamin A with, 103-4
in thiamine deficiency, 134-35 vitamin A levels affecting, 17 1
Capillaries, 628-29 Chicken pox, 548

bioflavonoids affecting, 303-6 Childhood problems, 662-70,
Cappello, John 656-61 671-77
Carbohydrates, 622-23, 735 in adolescence. See
Carbon monoxide, in cigarette Adolescence
smoke, 62-63 learning disabilities in, 592,
Caries, dental, 91 662, 717-18
Carotene, 94 sudden infant death syndrome
anti-cancer effects of, 113-18 in, 230-31
healing affected by, 491 Chinese restaurant syndrome, 168
skin changes from, 69, 118 Chiropractors, 580-82
Carpal tunnel syndrome, 160-61, Chlordane toxicity, vitamin C
649 affecting, 272
820 INDEX
Chlorinated water Clofibrate, affecting cholesterol

thiamine loss in, 136-37 levels, 282-83
vitamin C added to, 274-75 Clot formation, 496
Chlorpromazine, riboflavin prevention of, 498-500, 606
deficiency from, 31 vitamin E affecting, 344-47,
Cholesterol 349
in bile, corn oil and vitamin B^, vitamin K affecting, 380-81
471-72
affecting, Cobalamins, 191
blood levels of, 13,709 Cod liver oil, in eye problems,
in arteriosclerosis, 173 643-46
brewer's yeast affecting, Coenzyme, 9, 120
624-26 Coenzyme A, 215-16, 466
cholestyramine affecting, Cofactors, nutritional, 630, 632
284-85 Coffee, thiamine deficiency from,
clofibrate affecting, 137
282-83 Cold sores
in menopause, 519 bioflavonoids in, 315-17
niacin affecting, 153 vitamin E in, 367-68
PCBs affecting, 537 Colds
pyridoxine affecting, 175 herbal formula for, 730
vitamin A affecting, 94 prevention with vitamin C.
vitamin C affecting, 259-62, 434-35, 609, 703
276-77, 280-81, 284, Colitis, 215-16
519 Collagen formation, 57, 58, 630
vitamin E affecting, 333, vitamin C affecting, 247-48,
353-57 298, 490
dietary, reduction of, 735 Colon cancer, protective agents in
Cholestyramine, affecting vitamin C, 292, 421,422
cholesterol levels, 284-85 vitamin D, 328-29
Choline, 232-35 vitamin E, 340-41
dosage of, 234 Conjunctivitis, pyridoxine in, 182
food sources of, 749 Contraceptives, oral, 44, 49-50
memory affected by, 232-35 folate deficiency from, 208-9,
Chondroitin sulfate A, preventing 213
heart damage, 279-80 hair loss from, 481
Chromium interaction with vitamin A, 99
deficiency of, eye changes in, riboflavin deficiency from, 149
332 vitamin Bf, with, 457
hexavalent, effects of, 257-58 vitamin E with, 604
Chronic illnesses, nutrition Cooking methods, affecting
affecting, 691-98 nutrients in foods, 6-8. See also
Cigarette smoking. See Smoking Food processing
Cimetidine, infertility from, 507 Copper, protective effects in lead
Circulatory problems, vitamin E poisoning, 542
in, 331, 342, 448 Corn oil
Claudication, intermittent, vitamin lecithin and brewer's yeast

E in, 331, 342, 448, 621, 703 with, 660
INDEX 821
vitamin B^, with, dissolving Diabetes mellitus

cholesterol, 471-72 biotin role in, 231
Corticosteroid therapy carbohydrate intake in, 622-23
nutritional problems from, cataract prevention in
34-35 bioflavonoids in, 306-7,
osteoporosis from, 320 428
side effects of, vitamin C vitamin E in, 333, 351,
preventing, 295-98 564
Cramps eye problems in, 638
dolomite in, 621 healing problems in, 492
vitamin E in, 341-43. 446-48 nutritional requirements in, 71,
Criminal activity, nutrition 599
affecting, 449-54 platelet activity in, 499
Crohn's disease, 89-90 pyridoxine levels in, 177
Cushing's syndrome, steroid- retinal disease in,
induced, 298 bioflavonoids in, 306
Cyclophosphamide, vitamin A urine tests in, vitamin C
with, 104 affecting, 68
Cyst(s) of breast, vitamin A in, 707 Dieting
Cysteine, thiamine and vitamin C high-protein diets in, 52-54
with, for smokers, 46, 65 thiamine loss in, 127
Cystic fibrosis, vitamin E in, vitamin requirements in, 52-55
378-79 Digitalis, nutritional problems
from. 35
Dilantin, affecting folate levels,
D
Darier's disease, 554-55
584-85
Diseases
Daro, August, 705-10 chronic, nutrition affecting,
DBCP, toxic effects of, 101-2, 506 691-98
Deafness. See Ear problems deficiency. See Deficiency
Deficiency diseases diseases
in aging, 405-14, 434 resistance to. See Resistance
drug-induced. See Drugs to disease
eye test in, 715 Diuretics, nutritional problems
subclinical, 29-32, 127-28, from. 35
566-71 DNA
symptoms of, 702-3 folate deficiency affecting.
Delinquency, juvenile, nutrition 459-60
affecting, 449-54 PCBs affecting. 505
Dentition Dolomite, for leg cramps. 621
gum care affecting, 473-78 Double-blind trials of vitamin
vitamin A affecting. 90-91 efficacy. 77-79
Depression, 455-58, 721-22, Down's syndrome. 523-24
729-30 Drugs
in folate deficiency, 209-1 in cancer therapy. See
in menopause, 518 Chemotherapy
Desserts, recipes for, 804-10 infertility from, 507-8
822 INDEX
Drugs (continued) Eyes

interacting with vitamins, 414 cataracts of. See Cataracts
problems from.
nutritional conjunctivitis in pyridoxine
33-36, 43-44,47-51 deficiency, 182
pharmacists and, 678-82 gyrate atrophy of, 179-81
riboflavin deficiency from, 149 macular degeneration in, 632,
vitamin destruction from, 635-37
34-35 nutrition affecting. 627-46
Dunn, Paul, 671-77 retinal disease in diabetes,
Dupuytren's contracture, 649 bioflavonoids in, 306
retrolental fibroplasia
prevention with vitamin E,
E 364
Ear problems, 575-79 testing for nutrient
vitamin A affecting, 86 deficiencies, 715
Eczema, 728 in thiamine deficiency. 135
EDTA, affecting iron absorption, vision problems, 559-565
27 cod liver oil in, 643-46
Egg dishes, recipes for, 765-67 vitamin A affecting, 87-89,
Elderly persons. See Aging 560. 569
Embolism, pulmonary, 604 in vitamin 8,2 deficiency, 186
Empty calories vitamin C affecting, 255-57
niacin deficiency from, 156-57 vitamin E affecting, 332, 351
thiamine deficiency from, 126 in xerophthalmia, 87, 559
Endocrine function, 501-3
Endurance, vitamin E affecting,
331 Fat, dietary
Energy, nutrition affecting, 459-68 affecting absorption of
Enriched food products, 123 vitamins, 24-25
Environmental pollution. See reduction of, 734-35
Pollution Fatigue, 459-68, 602, 636
Epilepsy, and dilantin affecting brain. 724-25
folate levels. 584-85 niacinamide affecting. 155
Epithelial cells, vitamin A postpartum. 728-29
affecting, 109 Fertility problems. See Infertility
Estrogen Fever, reduction of, 438-39
in bone mass regulation, 320 Fiber, dietary, 614, 623, 735
as therapy in menopause, in cholesterol control, 285
516-17 Fibrocystic disease of breast,
Exercise vitamin E in, 374-77
affecting nutrient absorption, Fish recipes, 781-84
28 Flavonoids, 313
in atherosclerosis prevention, Flour, refined, 7, 123, 597. 632
355 Folate, 198-214
benefits of, 590,690, 710. 721. absorption affected by zinc,
736 26-27, 207
biotin needs in, 229 deficiency of, 459-62
riboflavin needs in, 148 in aging, 36-37, 212-13
INDEX 823
in alcoholism, 213 vitamin E, 373

antibiotic-induced, 213 refined flour in, 7, 123, 597,
aspirin-induced, 49 632
cervical dysplasia in, Food sources of vitamins, 741-53
210-11 Free radicals, formation of, 371,
depression 209-11
in, 395
immune system in, 433 health problems from, 372-73
incidence of, 21 1-12 prevention of, 395-96, 398
mental problems in, 202, Fried, Milton, 580-86
204 Frozen meat, thawing of, nutrient
nervous system in, losses in, 7, 142
200-201, 204-5
in oral contraceptive use,
208-9, 213
G
Gallstones, 469-72
in pregnancy, 203, 212 Genetotrophic disorders, 525-26
resistance to infection in, Ginter, Emil, 282-86
203-4 Glaucoma, 88-89, 645
dilantin affecting, 584-85 in thiamine deficiency, 135
dosage of, 206, 213, 214 Glucose levels
guidelines for, 20-21 excessive, in diabetes. 5^^
recommended dietary Diabetes mellitus lowered.
allowance for, 206, 213 See Hypoglycemia
food sources of, 205-6, Granulomatous disease, chronic,
460-61, 746 437-38
in gum problems, 477-78 Guidelines for vitamin intake,
interaction with 16-22
anticonvulsants, 69 Gum problems, 473-78
laboratory tests affected by,
67-68
losses in cooking, 198-99, 206
H
Hair problems, 479-82, 589, 602
metabolism affected by Hall, Johanna, 613-17
riboflavin, 147 Hay fever, 483-87, 633
in mouth wash, 209 Headache
sunlight exposure affecting, herbal formula for, 730
199-200 migraine. See Migraine
Food industry, misleading headaches
statements from, 14 Healing, 57-59, 488-93, 709
Food processing bioflavonoids affecting. 310-17
enriched products in, 123 vitamin C affecting, 58, 243,
nitrates in, 268-69, 398, 541 249-50, 257-58, 490-92
nutrient losses in, 5-8, 40-41, vitamin E affecting. 365-67
123 Hearing problems. 575-79
antioxidants, 399 vitamin A in, 86
folate, 198-99, 206 Heart disease, 494-500. 590, 599,
pantothenate, 219-20 603-6, 656-61, 714, 732-37
pyridoxine, 174, 176 arteriosclerotic. See
riboflavin, 142 Arteriosclerosis
thiamine, 127 in beriberi, 571
824 INDEX
Heart disease (continued) Hors d'oeuvres, recipes for,

in menopause, 518-19 758-60
platelets in, 497 Hospitalized patients
preventive agents in biotin deficiency in, 229-30
niacin, 153 total parenteral nutrition for,
vitamin C, 279-86 vitamin E in, 351-52
vitamin E, 353-57 Hot flashes, in menopause, 516,
in thiamine deficiency, 133-34 517, 728
Heat Hydralazine, nutritional problems
infertility from, 506-7 from, 35, 414
stress reduction in, with Hydrazines, as antipyridoxine
vitamin C, 263-65 compounds, 162-64
Heat rash, vitamin C in, 265-66 Hydrochloric acid secretion, aging
Hematocrit levels, bioflavonoids affecting, 188
affecting, 312 Hyperactivity, 592, 662, 717
Hemoglobin, 63 Hypoglycemia, 451
iron in, 459 aggressiveness in, 723
methemoglobinemia, 541 hearing problems in, 576-78
in sickle cell anemia, 361 herbal formula for, 730
Hemorrhoids, 614
Hepatitis
infectious, vitamin C in 603 Immune system, 431-45
serum, prevention with antioxidants affecting, 396-97
vitamin C, 250-51 arginine affecting, 436
Herbal formulas, 730 in biotin deficiency, 227, 228
Heroin addiction, and sugar intake affecting, 666

detoxification with vitamin C, vitamin A affecting, 90, 104,
299-302 439-41
Herpes simplex infections of vitamin C affecting, 245,
mouth 259-60, 289-90, 425-26,
bioflavonoids in, 315-17 434-35, 438-39
vitamin E in, 367-8 vitamin E affecting, 334,
Herpes zoster, 548-53 336-40
Hesperidin, 312 zinc affecting, 435-36
Hidden hunger, 29-32 Infections
Histamine levels, 484 in biotin deficiency, 227, 228
natural antihistamines immune system in, 431-45
affecting, 246, 314, 484-87, resistance to. See Resistance
633 to disease
in schizophrenia, 547 respiratory, vitamins C and A
vitamin C affecting, 246 in, 706-7
Hochberg, Arthur, 727-31 steroid-related, 295-98
Hodge, Kenneth, 683-90 virus. See Virus infections
Holistic medicine, 584-85, 647-55 of wounds, vitamin A in, 492
Homocysteine, 172, 526 Infertility,504-10
Homocystinuria, 181-82, 525-26 PCB-induced, 535-36
Hormone imbalance, 501-3 vitamin B,. affecting, 186-87
riboflavin deficiency in, 149 Injuries, healing in. See Healing
INDEX 825
Inositol, food sources of, 749-50 Krehl, Willard, 699-704

Insecticides, and protective effects Kryptopyrrole, 546
of vitamin C, 272
Insomnia
herbal formula for, 730 Laboratory tests, vitamins
in niacin deficiency, 151 67-68
affecting,
Insulin therapy, nutritional Lawton, Grant, 647-55
requirements with, 71 Laxatives
Intelligence, nutrition affecting, mineral oil, effects of, 35,
521-25 383-84, 414
Interactions of nutrients, 25-26 nutritionalproblems from, 35,
Interferon 44
incancer prevention, 443 Lead poisoning, 542
in virus infections.442-43 criminal behavior from, 453
vitamin C affecting, 443-45 learning problems from, 676
Intestinal function, vitamin A Learning disabilities, 592, 662,
affecting, 89-90 717-18
Intrinsic factor, 187-88 in lead poisoning, 676
Iritis, 644 Lecithin
Iron, 459 brewer's yeast and corn oil
absorption affected by EDTA, with, 660
27 vitamin E with, 603
deficiency of Legs
fatigue in, 468 cramps in
hair loss in, 481 dolomite in, 621
inorganic, affecting vitamin E, in intermittent
556, 557 claudication, 331, 342,
interaction with vitamin C, 26 448, 621, 703
metabolism affected by vitamin E in, 341-43,
riboflavin, 147 446-48
protective effects in lead restless legs syndrome in
poisoning, 542 pregnancy, 201
riboflavin with, 462 Leukemia cells, vitamin C
vitamin A with, 463 affecting, 287-88
Ischemia, TDA-induced, 102-3 Lhermitte's sign, 571
Liederbach. Tom, 678-82
Life expectancy
Joint stiffness, niacinamide in, 155 pantothenate affecting, 218-19
vitamin E
K
Kidney
397-400
affecting, 373,
Lipid levels, biotin affecting, 231

stones in, 51 1-14 Lipoprotein cholesterol
prevention of, 70, 73 vitamin C affecting, 277, 283
pyridoxine affecting, vitamin E affecting, 333-34,
168-69 353-57
tumors of, and vitamin C Little, Henry, 641-46
affecting life expectancy, Liver
421,423 in thiamine deficiency, 135
826 INDEX
Liver (continued) postmenopausal depression,

in vitamin C deficiency, 540 456, 457
Lowenberg, Robert, 732-37 Menorrhagia, vitamin A in, 96-99
Lungs Mental problems, 719-31
bronchopulmonary dysplasia depression in. See Depression
in infants, 363 in folate deficiency, 202, 204
cancer agents in
of, protective learning disabilitiesin, 592,
carotene, 115, 118 662, 717-18
thiamine, 134 in niacin deficiency, 570
vitamin A, 530-31 schizophrenia in, 543-47
vitamin C, 421-22 in thiamine deficiency, 128-32
ozone damage to, 271 in vitamin Bn deficiency,
shock lung syndrome, 333 185-86
vitamin A affecting, 109-12 vitamin supplements in, 410
Lupus erythematosus, discoid, Mental retardation, 520-27
vitamin E
358-61in, Mercury poisoning, 542
Lymphatic cancer, vitamin C protective effects of vitamin E
effects in, 423-24 in, 372
Lymphocyte blastogenesis, vitamin Mercytamin, 415-16
C affecting, 425 Metal poisoning, 541-42
criminal behavior from, 453
M
Magnesium
Methemoglobinemia, 541
Methionine
affecting histamine levels, 547
in kidney stone treatment, 73, food sources of, 176-77
512-13 metabolic products of, 172,
pyridoxine affecting levels of, 181
169 ratio to pyridoxine in diet, 178
Magnesium oxide. 661 Methotrexate, hair loss from, 481
Malaria, vitamin 250 C in, Microwave cooking, folate losses
Malnutrition. See Deficiency in, 199
diseases Migraine headaches, 595
Manipulative therapy, 715-16 herbal formula for, 730
Marijuana, sperm count affected platelet activity in, 345-46,
by, 508 495
Medical profession, attitudes Mineral oil, effects of, 35, 383-84,
toward nutrition, 585-86, 414
591-92, 596, 609, 654, 699, 732 Minerals, interacting with vitamins,
Medications. See Drugs 25-26
Melanoma cells, vitamin C Miscarriages, prevention with
affecting, 288 bioflavonoids, 31
Memory Mononucleosis, infectious, vitamin
in choline deficiency, 232-35 C in, 602
in niacin deficiency, 151 Monosodium glutamate, 168
in thiamine deficiency, 131 eye problems from, 562
Menopause, 515-19 Mouth wash, folate in, 209
hot flashes in, 516, 517, 728 Muffins, recipes for, 81 1-15
osteoporosis after, 320, 382, Muscle
516 cramps in
INDEX 827
dolomite affecting, 621 Night blindness, 87-88, 560, 569

vitamin E affecting, Nitrate-treated foods, 268-69, 398
341_43, 446-48 and protective effects of
vitamin D affecting, 320-21 vitamin C, 541
Myopia, 562 Nitrogen dioxide exposure, 109-12
Myricitrin, 306 and effects of vitamin E, 370
Nitrosamines, effects of, 268-69,
N
Nausea, herbal formula for, 730
340-41, 398
Nosebleeds, bioflavonoids in,
Nearsightedness, 562 314-15
Necrobiosis lipoidica Nutrients
diabeticorum, 588 interactions of, 25-26
Need for vitamin supplements, 4-8 losses in food processing, 5-8,
Neomycin, nutritional problems 40-41, 123
from, 43-44 maximal absorption of, 23-28
Nervous system toxic effects of, 68-71
folate affecting, 200-201, Nutrition, and attitudes of medical
204-5 profession, 585-86, 591-92, 596,
in thiamine deficiency, 128-29 609, 654
vitamin B,. affecting, 190-91,
196
Neuralgia, postherpetic, 550-52
Neurosis, in thiamine deficiency,
128-29. See also Mental
O
Obesity, in aged persons, 39
problems Occupational hazards, infertility
Neutrophils, vitamin C affecting, from, 506-7
245, 296-97, 438 Ornithine levels, in gyrate atrophy,
Niacin, 151-58 180
deficiency of, 122, 570 Orthopedic problems, 647-55
brain function in, 151-53 Osteoarthritis
pellagra in. 122, 154, 544, manual therapy in, 716
570 niacinamide in. 649
dosage of, 157, 158 prevention of, 652
guidelines for, 19 Osteocalcin, 381-82
recommended dietary Osteomalacia, 323-24
allowance in, 156 Osteoporosis, 318, 598
food sources of. 158, 744-45 glucocorticoid-induced, 34-35
in schizophrenia, 544-45, 570 manipulative therapy in, 716
side effects of, 69, 157 in menopause, 320, 382, 516
supplements for elderly prevention of, 651-52
people, 404, 409 vitamin D in, 319-21
tryptophan with, in vitamin K in, 382-83
depression, 457-58 Otitis media, 570
Niacinamide, 154-55 Ovarian cancer, vitamin C effects
in osteoarthritis, 649 in, 422
side effects of, 69 Oxalates in foods, 513
tryptophan and vitamin B,, Oxidation
with, 695, 719-20 affecting cell membranes,
Nicotine, effects of, 61 347-48, 360, 362
828 INDEX
Oxidation (continued) Pediatric problems, 662-70,

antioxidants affecting. See 671-77. See also Childhood
Antioxidants problems
Ozone exposure Pellagra, 122, 154, 544, 570. See
vitamin C effects in, 270-71 also Niacin
vitamin E effects in. 370, Pellicano, Victor, 608-12
529-30 Penicillin, excretion of, 74-75
Periodontal disease, 474-78
Pharmacists, role of, 678-82
Phenobarbital, nutritional problems
PABA, 222-24 from, 34
interaction with sulfa drugs, 69 Phenylalanine, in depression, 722
Pain Phlebitis, 345
in cancer patients, vitamin C Pityriasis rubra pilaris, 556-57
affecting, 290, 291 Placebo effect, 77
relief of, 649-50 Platelet activity, 13, 494-500
550-51
in shingles, aggregation in. 495
Pangamic acid, 236-38 smoking affecting, 61-62
Panthenol vitamin E affecting, 58,
for hair problems, 480-81 345-47, 349
for surgical patients, 217 Pollution, 528-42
Pantothenate, 215-21 chemicals in. See Chemicals
in allergies, 219 nitrogen dioxide in, 109-12,
deficiency of 370
fatigue in, 466-67 nitrosamines in, 268-69.
immune system in, 433 340-41. 398
dosage of, 220-21, 467 ozone in. 270-71. 370. 529-30
recommended dietary PCBsin. 137,404, 532-38
allowance in, 220, 467 protective agents in
food processing affecting, vitamin C, 268-73
219-20 vitamin E, 369-72
food sources of, 219, 221, 467, Poultry, recipes for. 785-89
747 Powers. Hugh. Jr., 662-70
in heart disease, 661 Pregnancy
life expectancy affected by, alcohol intake in. 676
218-19 anticoagulants in. affecting
as protection against radiation infants. 383, 384
injury, 217-18 bioflavonoids preventing
Para-aminobenzoic acid, 222-24 miscarriages in, 311
interaction with sulfa drugs, 69 folate deficiency in, affecting
Pauling, Linus, 278, 289, 420, 61 offspring, 203
PCB exposure, 532-38 folate mouth wash in, 209
535-36
infertility in, restless legs syndrome in, 201
sperm count affected by, 505 riboflavin deficiency in,
thiamine deficiency from, 137 141-42. 149
tolerance levels in, 537 vitamin C needs in. 246
vitamins A and C in, 537-38 Premature infants, vitamin E
Pectin, vitamin C with, in affecting, 363-64
cholesterol control, 285-86 Preventive medicine, 683-718
INDEX 829
Prickly heat, vitamin

Processed foods. See
C in,
Food
265-66 R
Radiation exposure, protective
processing agents in
Prostacyclins, 332-33, 496, 500 pantothenate, 217-18
vitamin E affecting, 350-51 vitamin A, 105-6, 116
Prostaglandins, 496 vitamin C, 269-70
Protein, in high-protein diets, vitamin E, 371-72
52-54 Raiford, Morgan, 627-34
Provitamin A. See Carotene Raynaud's phenomenon, vitamin E
Psoriasis, 598 affecting, 397
Pyridoxine, 159-82 Recipes, 755-815
antifatigue effects of, 464-66 appetizers and hors d'oeuvres,
blood levels in depression, 758-60
456-57 beverages, 802-3
in cancer prevention, 170 breads and muffins, 811-15
in carpal tunnel syndrome, breakfasts, 755-57
160, 165-67, 649 desserts and snacks, 804-10
in conjunctivitis, 182 eggs, 765-67
corn oil with, dissolving fish,781-84
cholesterol, 471-72 main dishes, 768-80
deficiency of, 160-63 poultry and liver, 785-89
arteriosclerosis in, 171-77 salads, 799-801
drug-induced, 50 side dishes, 790-98
hair loss in, 481 soups, 761-64
hydralazine-induced, 35 Recommended Dietary Allowance
immune system in, 432-33 (RDA), 10-15
dosage 161-62, 164, 167
of, limitations in, 15
guidelines for, 19 Reproductive system
recommended dietary in fertility problems, 504-10,
allowance for, 161, 167 535-36
food sources of, 167, 176, 745 vitamin A affecting, 96
in gyrate atrophy, 179-81 vitamin B,: affecting, 187
in homocystinuria, 526 Resistance to disease, 431-45, 666
hydrazines affecting, 162-64 in folate deficiency, 203-4
in kidney stone prevention, immune system in. See
168-69, 513-14 Immune system
losses during cooking, 7-8 steroid drugs affecting, 295-98
magnesium levels affected by, vitamin C affecting, 259-62
169 vitamin E affecting, 334-35,
niacinamide and tryptophan 336-41
with, 695, 719-20 Respiratory infections, vitamins C
ratio to methionine in diet. 178 and A in, 706-7
side effects of, 69 Restless legs syndrome, in
Pyroluria, in schizophrenia, 546 pregnancy, 201
Retinoic acid, in acne, 391-92
Retinyl acetate, 492
Q
Quercetin, 306, 314
Retrolental fibroplasia, prevention
with vitamin E, 364
Quercitrin, 306-7, 428 Rhodopsin, 560
830 INDEX
Riales, Rebecca, 618-26 Shilstone, Mackie, 635-40

Riboflavin. 138-50 Shingles, 548-53
blood cells affected by, 146-47 vitamin C in, 609
in cancer prevention. 139-41 Shock lung syndrome, vitamin E
deficiency of, 122. 144-50 in. 333
cataracts in. 145-46 Sickle cell anemia, vitamin E in,
drug-induced, 149 361-62
dosage of, 143, 150 Side effects of nutrients, 68-71
guidelines for, 18-19 Skin. 554-58, 587-89
recommended dietary acne of. See Acne
allowance in, 143. 150 cysts of. vitamin A in. 707
folate metabolism affected by, eczema of. 728
147 healing affected by vitamin C.
food sources of, 142. 143, 148, 58. 243. 249-50. 257-58.
462, 743-44 490-92
hidden hunger for, 30-31 in niacin deficiency, 570
iron metabolism affected by, sunlight affecting. 222-23
147 tanning of. 222-24. 326
losses in food processing, 7. in vitamin A deficiency. 569
142 vitamin D production in,
in pregnancy, 141-42 325-26
supplements for elderly vitamin E affecting. 365-68.
people, 409 397
Rickets. 327-28 Smell sense, vitamin A affecting,
adult. 323 87
662
Ritalin, 592, Smoking, 60-65
Rutherford, Susan, 691-98 arteriosclerosis related to, 176
Rutin, 312 blindness from, 643
blood vessel contraction from,
632
gum problems from, 474, 478
Salads, recipes for, 799-801 nutritional problems from,
Saunders, Milton. 587-93 44-46
Schizophrenia, 543-47 protective agents with
niacin in, 544-45, 570 combined nutrients, 46, 65
Scurvy, 240, 247, 278, 303-4, 502, vitamin A, 530-31
566-69. See also Vitamin C vitamin C, 62-64
healing problems in, 491 vitamin E, 61-62, 334, 370
Selenium sperm count affected by, 508
as antioxidant. 395, 398 vitamin C affected by. 251,
deficiency of, eye changes in, 487. 610
332 Snacks, recipes for. 804-10
protective effects in mercury Solomon. Barbara, 594-600
poisoning, 542 Soups, recipes for, 761-64
Self-diagnosis, hazards in, 66-67 Sperm abnormalities, 504-9
Serotonin biosynthesis. 696. 720 in PCB exposure, 536
thiamine affecting. 132-33 in vitamin B,: deficiency, 187
Shampoos, food in, 479-80 Spermagglutination, 509-10
INDEX 831
Steroid therapy. See Corticosteroid Superoxide dismutase, 583

therapy Surgery
Stomach cancer, vitamin C effects coronary bypass, nutrition
in, 421 after, 733-34
Stress gastric, vitamin B,2 deficiency
cold, and effects of vitamin C, from, 185, 186, 187
259-62 nutrition affecting, 56-59, 651
heat, and effects of vitamin C, recovery affected by
263-66 panthenol, 217
orthopedic problems from,
650-51
pantothenate requirements in,
215-21
radiation induced. See Tangeretin, 312
Radiation exposure Tannic acid, thiamine deficiency
vitamin A protection in, 101-7 from, 41, 137
vitamin C requirements in, Tanning
242-43 sunscreens for, 222-24
Strokes, 683-90 vitamin D production in, 326
clot formation in, 345, 349 Tartrazine, as vitamin B,, inhibitor,
platelet activity in, 496-97 163
protective effects of Taste function, vitamin A
bioflavonoids in, 305 affecting, 87
Subclinical deficiency, 29-32, Tea, tannic acid in, thiamine
127-28, 566-71 deficiency from, 41, 137
Sudden infant death syndrome, Teeth
230-31 gum care affecting, 473-78
Sugar intake vitamin A affecting, 90-91
behavioral problems from, 664 Tension, herbal formula for, 730
hypoglycemia from, 451 Testing of vitamin efficacy, 77-81
immune response affected by, costs of, 80
666 double-blind trials in, 77-79
intolerance of, 729 problems in, 79-80
learning disabilities from, 592 Thalassemia, vitamin E in, 363
niacin deficiency from, 156-57 Thiamine, 124-37
osteoporosis from, 598 deficiency of, 124-29, 571
reduction of, 615, 617 beriberi in, 127, 133, 571
thiamine deficiency from. 126 cancer in, 134-35
Sulfa drugs, interacting with cardiovascular problems
PABA, 69 in, 133-34, 404
Sulphasalazine, infertility from, 508 digitalis-induced, 35
Sunlight exposure eyes in, 135
cataracts from, 565 liver in. 135
folate losses from, 199-200 memory loss in, 131
skin damage from, 222-23 mental problems in,
vitamin D synthesis in, 319, 128-32
322-24 nervous sytem in, 128-29,
Sunscreens, PABA in, 223-24 404
L
832 INDEX
Thiamine (continued)
subclinical, 127-28
U
Ulcers
in vitamin B,2 deficiency, in bedsores. See Bedsores
184 corneal, 645
dosage of, 125-26 peptic, TDA-induced, 102-3
guidelines for, 18 Ultraviolet light. See Sunlight
recommended dietary exposure
allowance in, 125-26 Uric acid levels, vitamin C
food sources of, 742-43 affecting, 70
healing affected by, 493 Urinary tract infections, vitamin C
losses during cooking, 7-8, 41 in, 73
side effects of, 69 Urine

supplements for elderly testing in diabetes, vitamin C
people, 409 affecting, 68
vitamin C and cysteine with, vitamin excretion in, 72-75
for smokers, 46, 65
Thiazides, effects of, 514
Thompson, Charles, 691-98 Vasectomy, and menorrhagia in
Thrombi, silent, 497 women, 99
Thrombosis, 345 Vegetarians
vitamin C preventing, 498-500 cholesterol intake of, 283
in vitamin E deficiency, 58 vitamin Bp deficiency in,
Thromboxanes. 332-33, 500 191-92
vitamin E affecting, 350-51 vitamin D deficiency in, 327
Thymus gland, vitamin A affecting, Virus infections
90, 104-5, 502-3 bioflavonoids in, 314
Thyroid disorders, riboflavin interferon in, 442-43
deficiency in, 149 shingles, 548-53
Timing of vitamin intake, 25 vitamin C in, 259, 602-3,
and divided doses of vitamin 609-10
C, 251-53 Vision problems, 559-65. See also
Tinnitus, 575-79 Eyes
Tobacco smoking. See Smoking Vitamin(s)
a-Tocopherol. See Vitamin E antagonists of, 42-43
Toluene diamine (TDA), toxic deficiencies of, 566-71. See
effects of, 102-3 also Deficiency diseases
Tongue color, in riboflavin dependency on, 545
deficiency, 138 food sources for, 741-53
Toxic effects of nutrients, 68-71 guidelines for intake of, 16-22
Triamterene, nutritional problems interaction with minerals,
from, 35 25-26
Tryptophan Vitamin A, 85-118
deficiency of, cataract acid analog of, 106-7, 391
formation in, 429 in acne, 390-93, 569, 708
indepression, 456-58, 518 as antioxidant, 399
niacinamide and vitamin B^ blood levels affected by drugs,
with, 695, 719-20 47-48
INDEX 833
bowel function affected by, Vitamin B:. See Riboflavin

89-90 Vitamin B^. See Pyridoxine
cancer drugs with, 103-4 Vitamin B,., 183-97
in cancer prevention, 13-18, ! deficiency of, 571
440-41, 530-31 in aging, 188
chemotherapy affected by, 117 drug-induced, 50
in cysts, 707 infertility in, 186-87
deficiency of, 569-70 mental problems in, 185-86
night blindness in, 560, pernicious anemia in, 184
569 tests for, 194-97
sperm in, 509 visual defect in, 186
vision problems in, 563, dosage of, 191
569 guidelines for, 20
dosage of, 95, 118 recommended dietary
guidelines for, 17 allowance in, 191
eyes affected by, 87-89 food sources of, 192, 462,
food sources of, 94, 741-42 746
healing affected by, 58, 492 vitamin C with, in cancer
hearing affected by, 86, 577 prevention, 415-18
immune function affected by, "Vitamin B,s," 236-38
439-41 Vitamin C, 239-302
iron supplementation with, 463 added to chlorinated water,
lung function affected by, 274-75
109-12 in adrenal glands, 502
in menorrhagia, 96-99 in alcohol detoxification,
protective effects of, 92-94 540-41
in aging, 404 alcohol intake affecting, 252
chemical
in toxic as antihistamine, 246, 484-87,
exposure, 102-3, 633
537-38 as antioxidant, 74, 395, 398
radiotherapy and, 105-6, 116 in back problems, 610, 649
in respiratory infections, 706-7 bioflavonoids with, 313, 315
side effects of, 68-69 blocking nitrosamine
smell and taste affected by, 87 formation, 268-69
teeth affected by. 90-91 in cholesterol control, 276-77,
thymus affected by. 90, 104-5, 280-81, 284, 519
502-3 pectin with, 285-86
vitamin Ewith, in skin in cold prevention, 259-62,
diseases, 555-58 434-35, 609, 703
zinc with, 560-61 collagen affected by, 247-48,
Vitamin B complex, 119-235 298, 490
in dieting program, 55 deficiency of, 566-69
losses in food processing, 41 drug metabolism in, 51
side effects of, 69 fatigue in, 468
supplements for elderly folate deficiency in. 214
people, 407-10 liver disease in, 540
Vitamin B,. See Thiamine scurvy in. See Scurvy
834 INDEX
Vitamin C (continued) in PCB exposure, 537-38

dosage of, 240-42, 251, 278, in radiation exposure,
468 269-70
divided doses in, 251-53 in smokers, 46, 62-64, 65
guidelines for, 21 in steroid therapy, 295-98
recommended dietary in urinary tract, 73-74
allowance in, 240-42, in virus infections, 602-3,
278, 468 609-10
in eye disorders, 255-57 in respiratory infections, 706-7
food sources of, 750-51 in rheumatoid arthritis, 251
healing affected by, 58, 243, in schizophrenia, 545-46
249-50, 257-58, 490-92 in shingles, 552-53, 609
in heat rash, 265-66 side effects of, 69-70
in hepatitis prevention, smoking affecting, 251, 487,
250-51, 603 610
immune function affected by, in spermagglutination reversal.
245, 259-60, 289-90, 509-10
425-26, 434-35, 438-39 thiamine and cysteine with, for
inhibiting bone resorption, 478 smokers, 46, 65
inhibiting cell transformation, in thrombosis prevention,
292-94 498-500
interaction with calcium, 485 in thyroid glands, 502
interaction with minerals, 26 vitamin B,: with, in cancer
interferon affected by, 443-45 prevention, 415-18
laboratory tests affected by, 68 vitamin E with, 463, 517
losses in food processing, 5-7, Vitamin D, 318-29
40 in colon cancer prevention,
250
in malaria, 328-29
metabolism affected by drugs, deficiency in rickets, 327-28
36, 49, 50 food sources of, 326-27, 751
in pain relief, 290, 291, 423 guidelines for intake of, 21-22
in peridontal disease, 476-77 interaction with minerals, 26
in pregnancy, 246 metabolism of
protective effects of aging affecting, 324-26
in aflatoxin poisoning, drugs affecting, 34, 35
539-40 in osteoporosis prevention,
against tannic acid, 137 318-21
in aging, 402, 403-5 side effects of, 70
in arteriosclerosis,278-79 sunlight affecting synthesis of,
in cancer, 287-94, 313-14, 319, 322-24
419-26, 611 Vitamin E, 330-79
in heart disease, 279-86 anticlotting effects of, 344-47,
in heat stress, 263-65 349
in heroin addiction, as antihistamine, 486-87
299-302 as antioxidant, 347-48, 360,
in nitrate-induced 362, 371, 395, 398
disorders, 541 in arthritis, 589-90
in ozone exposure, 270-71 in burns, 367, 493
INDEX 835
in cancer prevention, 340-41, prostacyclins affected by,

374-77 332-33, 350-51
in cataract prevention, 340, protective effects of
564-65 in adriamycin therapy,
cells affected by, 347-49, 360, 50-51
396 in blood, 332-34
cholesterol levels affected by, in lead poisoning, 542, 676
333-34, 353-57 in mercury poisoning, 542
in circulatory problems, 331, in ozone pollution. 529-30
342, 448 in polluted environment,
in cold sores, 367-68 370-72
in cramp relief, 341-43, in premature infants,
446-48 363-64
in cystic fibrosis, 378-79 in resistance to disease,
deficiency of 334, 336-41
cataract formation in, 429 smokers, 61-62
in
platelet activity in, 58, 498 in sickle cell anemia, 361-62
vision problems in, side effects of, 70-71
562-63 in skin problems, 397, 588-90
destruction by inorganic iron, vitamin A with, 555-58
556, 557 in thalassemia, 363
in diabetes, 333, 351 thromboxanes affected by,
in discoid lupus 332-33, 350-51
erythematosus, 358-61 in total parenteral nutrition,
dosage of, 334-35, 337, 340, 351-52
349, 357, 373, 399, 605 vitamin C with, 463
in childhood, 379 Vitamin K, 380-85
guidelines for, 22 dosage of, 385
recommended dietary food sources of, 385, 752-53
allowance in, 334 role in bone mineralization,
in Dupuytren's contracture, 381-83
649 role in coagulation, 380-81
in eye problems, 332, 351 Vitamin P, 304
in fibrocystic
374-77
food sources
breast disease,
of, 343, 373,

W
Walker, Harvey, 601-7
751-52 Water, chlorinated
healing affected by, 365-67, thiamine loss in, 136-37
493 vitamin C added to, 274-75
in heart disease, 603-5, 661 Weight problems
in intermittent claudication, in adolescence. 676-77
331, 342,448, 621, 703 in aging, 39
lecithin with, 603 dieting in
life span affected by, 373, high-protein diets in,
397-400 52-54
in menopause, 517-18, 519 thiamine loss in. 127
in postherpetic neuralgia, vitamin requirements in,
551-52 52-55
836 INDEX
Wernicke's disease, 130 Yellow No. 5, effects of, 163

Wheat germ, 55, 206, 343, 399
Wound healing. See Healing rw
Wrinkling, premature, from Jlj
sunlight, 223 Zinc
Wunderlich, Ray, 711-18 deficiency of
Y
A.
acne
in
in, 391-92, 708
alcoholism, 45
Xerophthalmia, 87, 559 folate absorption in,
^Y in
26-27, 207
immune system
Yanick, Paul 576-79 dysfunction, 435-36
Yaryura-Tobias, Jose, 719-26 vitamin A with, 560-61
Rodale Press, Inc.. publishes PREVENTION*, the better health magazine.

For information on how to order your subscription,
write to PREVENTION*, Emmaus, PA 18049.
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^<)-M-P-L^-^E

BY THE IblTbR^ 6p mfVimnOM MAGAZINE

by the editors of Prevention magazine

Rodale Press Emmaus, Pa.

All rights reserved.No part of this pubHcation may be reproduced or

Printed in the United States of America on recycled paper containing

The Complete book of vitamins.

Editors: William Gottlieb, Carl Lowe, Mark Bricklin, Susan Zarrow

Research Associates: Martha Capwell, Tawna Clelan, Christy Kohler,

BOOK I VITAMINS IN YOUR DAILY LIFE

BOOK II A GUIDE TO THE INDIVIDUAL VITAMINS

20. The Number One Anti-Cancer Vitamin 1 13

Vitamin C and the Bioflavonoids

BOOK III VITAMIN THERAPY FOR DISEASE

69. Vitamins for Living Longer 40

Colds. Flu and the Immune System

Crime and Juvenile Delinquency

86. Vitamins to Ncutrali/c Hay Fever 483

BOOK IVTHE NUTRITIONAL HEALERS

119. Make Your Body a Safer Place to Live 691

BOOK V VITAMIN-RICH FOODS AND RECIPES

xii LIST OF TABLES

"A questionable and potentially harmful practice."

think you're deluding yourself.) And so TV and magazines are

killyourself. Well, book 1

The evidence that many people feel better and do better

W lull's wroni; with plain old food?

at home or in a restaurant, you can run into some unexpected

you that the juice has lostsomething on the order of 20 percent

One example: Potatoes are not that high in vitamin C

but, because many people eat potatoes on a regular basis, they

Government Food Tables

had when you dropped it into the pot.

Remember, we aren't even talking about people who need

And that, in a nutshell, is why so many people who use

Vitamins are powerful substances. We need only micro-

take place that could not occur without their presence.

bodies generally can't. If you don't take in a vitamin in the food

RDAs Health Designed

etary Allowances of the Food and Nutrition Board on the basis

Another phrase in the RDA definition that requires expla-

abolic disorders, infections, chronic disease and the use of med-

ications require special dietary and therapeutic measures. These

have developed unexplained depression after using an oral con-

current infections, chronic diarrhea, anemia or other disorders,

follows: For certain nutrients the requirements may be assessed

as the amount that will just prevent failure of a specific function

Some Misleading Statements

"fruit drink" from sugar, artificial color, artificial flavor, pre-

Minimal or Optimal Nutrition?

Allowances. But we must recognize, as they do, the three major

HOW MUCH? A GUIDE

No one can say what level of supplementation is exactly

A GUIDE TO VITAMIN SUPPLEMENTATION 17

Go with the one

the environment inwhich you live is low in pollutants. Naturally,

amounts mentioned in this guide, however, are perfectly safe for

Thiamine (Vitamin Bi)

Riboflavin (Vitamin B2)

getting up there in years.