Almost everyone in America now appears to have abnormal fatty substances - of which part is cholesterol-deposited in the walls of the arteries, a condition known as atherosclerosis. These deposits, may narrow the channels through which blood passes to the point that circulation is markedly decreased. Such a partial blockage, limiting the blood supply in the eyes, hastens the onset of cataract and other abnormalities; in the legs, feet, or hands, it causes coldness, discomfort, cramps, pain, and sometimes gangrene, making amputation necessary; in the brain it may cause confusion, forgetfulness, premature senility, or strokes; and in the heart, angina or attacks known as coronary occlusion.

These fatty deposits seriously complicate such diseases as diabetes and nephrosis and delay recovery from almost every illness. They may be localized as tumors, or atheromas, on the skin or be so generalized that they clog all arteries uniformly, the space left for the blood so decreased that high blood pressure results and becomes progressively more elevated as the atherosclerosis advances. High blood pressure from other causes, however, makes atherosclerosis worse.

Atherosclerosis Is Reversible

Deposits containing cholesterol can be seen in the skin around the eyes as fatty accumulations; these tiny tumors quickly disappear after the diet is improved. Countless experiments with, survivors of heart attacks, healthy volunteers, persons in prisons and mental institutions, and innumerable animals show that when fatty substances are being deposited in the arterial walls, the blood cholesterol is invariably high ; and that the fat in the blood which is combined with phosphorus, known as the phospholipids, or lecithin, is too low. Yet these abnormalities are corrected as soon as all nutrients needed to utilize fats are supplied.

Atherosclerosis and much obesity appear to be caused by a combined undersupply of many nutrients essential before fats can be used normally. All tissues synthesize cholesterol but only that produced in the liver reaches the blood. Some of it is made into pituitary, adrenal, and sex hormones; some into bile acids which aid the absorption of foods; and some into vitamin D if the skin is exposed to summer sunshine. Cholesterol, however, which is particularly concentrated in the brain, appears to have functions not yet understood. It enters the small intestine with bile, passes into the blood, and, if all nutrients are generously supplied, is eventually broken down by the cells into carbon dioxide and water.

Saturated And Unsaturated Fats

In an attempt to correct atherosclerosis, much attention has been focused on fats, which, during digestion, are broken down into fatty acids. The chemical terms saturated and unsaturated (or polyunsaturated) refer, to the hydrogen content of these acids; and most fats are a combination of both varieties. Fats that are solid are predominantly saturated: margarines, hydrogenated cooking fats, tallow, butter, lard, and fats from all meats. The unsaturated fats are liquids such as fish oils and vegetable oils. The body and blood fat of persons with atherosclerosis is made up largely of saturated fatty acids, whereas the storage and blood fat of individuals free from the disease contain a high percentage of unsaturated fatty acids.

Three fatty acids, linoleic, linolenic, and arachidonic (a fancy word referring to peanuts), which can be obtained from vegetable oils, are essential before cholesterol and saturated fats can be utilized. If the diet furnishes sufficient linoleic acid, the other two essential acids can be synthesized from it provided a bevy of vitamins and minerals are also present, but several of these nutrients may be undersupplied. Though many factors are involved, when fats cannot be burned readily by the tissues, they are dammed up in the blood.

The Importance Of Lecithin, Or Phospholipids

Like cholesterol, lecithin-the phospholipids-is continuously produced by the liver, passes into the intestine with bile, and is absorbed into the blood. It aids in the transportation of fats; helps the cells to remove fats and cholesterol from the blood and to utilize them; and increases the production of bile acids made from cholesterol, thereby reducing the amount in the blood. Lecithin also serves as structural material for every cell in the body, particularly those of the brain and nerves. In a healthy person, it forms 30 per cent of the dry weight of the brain and 73 per cent of the total liver fat, both of which are greatly decreased in persons dying of heart disease.

Lecithin is a powerful emulsifying agent and for this very reason is particularly important in preventing and correcting atherosclerosis .Although blood is essentially water into which fats cannot dissolve, lecithin, if present in normal amounts, causes cholesterol and neutral fats to be broken into miscroscopic particles which can be held in suspension, pass readily through arterial walls, and be utilized by the tissues.

All atherosclerosis is characterized by an increase of the blood cholesterol and a decrease in ecithin. As early as 1935 it was shown that experimental heart disease, produced by feeding cholesterol, could be prevented merely by giving a small amount of lecithin; and atherosclerosis has since been repeatedly produced in various species either by decreasing the blood lecithin or increasing the cholesterol.lf enough lecithin is given, the disease does not occur regardless of how much cholesterol is fed. Even when atherosclerosis is far advanced, health is restored after lecithin is supplied in the diet. Furthermore, animals most resistant to experimental atherosclerosis are those with the greatest ability to produce lecithin.

Cholesterol can be made from fat, sugar, or indirectly from protein. Lecithin, however, consists of several substances (cephalin, sphingomyeliI, etc.) which require essential fatty acids and the B vitamins cholin and inositol for their structure and numerous other nutrients to synthesize them. Because lecithin is essential to every cell in the body, the demand for these raw materials is tremendous and an undersupply of anyone limits its production.

Fortunately the identical lecithin occurs in all unrefined foods containing oil. The lecithin in vegetable oil destined to be used for paints is removed because it makes the paint smear; hence it is available in a mild flavored, granular form which can be added to foods. This lecithin is used commercially as an emulsifying agent in the candy and baking industries and in heavy industry where oil must be broken into minute particles.

Many physicians have successfully reduced blood cholsterol with lecithin.For example, 4 to 6 tablespoons has been given daily to patients who had suffered heart attacks and been consistently resistant to many cholesterol lowering medications, some for as long as ten years. Although no other dietary change was made, within three months the level of blood cholesterol dropped markedly, in one case from 1,012 to 186 milligrams. These patients felt more energetic, had an increased capacity for work, and were relieved of pain and other symptoms. After the blood cholesterol has once decreased, 1 or 2 tablespoons of lecithin daily have kept the blood fats at normal levels, though larger amounts have been taken over long periods with good results. Supplements of lecithin have also caused the pain of angina to disappear and have been especially beneficial to elderly persons who have suffered strokes or have cerebral atherosclerosis.