Health Facts Important to You

There are certain health considerations of more immediate concern to us than others. Generally speaking, the more important causes of death might be classified under three principal groups: (1) acute and contagious or infectious diseases, (2) cancer, (3) cardiovas­cular diseases.

The Epidemic or Contagious Diseases

The first group includes those epidemic dis­eases that in time past have been great killers, such as smallpox, cholera, typhoid, diphtheria, scarlet fever, measles, plague, polio, dysentery, influenza, meningitis, also tuberculosis, leprosy, pneumonia, and many other diseases caused by specific organisms or viruses. It will be rec­ognized that most of these contagious or in­fectious diseases are well under control in many parts of the world. Since the first of this century the most dangerous of these diseases have been brought under control by public health meas­ures, sanitation, inoculation, and education on health matters. Malaria, tuberculosis, leprosy, and certain tropical diseases still remain serious problems in some of the less-developed parts of the world. However, with the newer antima­larial medications and the widespread mosquito control, malaria is losing its reputation as the world's first killer. In the treatment of tuber­culosis the newer medications, with appropri­ate use of surgery, are making such progress as to make it possible to dispense with some of our tuberculosis hospitals in Western countries. Even leprosy, whose bacilli can scarcely be distinguished from those of tuberculosis, is like­wise yielding to the newer treatment. For the first time since the healing of lepers by the Saviour nineteen centuries ago, the pathetic victims of this loathsome disease have the pros­pect of restoration to family and society, thanks to modern medicine.

The Degenerative Diseases

As the proportionate number of those dying as a result of this first group of diseases diminishes, it becomes inevitable that certain other causes of death will become more significant. And thus cancer and arteriosclerosis, the de­generative diseases, are coming into the lime­light as the cause of the great majority of deaths in most of the countries with the highest stand­ards of living.

We hear much discussion concerning this spectacular increase in cancer and heart fail­ure. It is true, of course, that when people sur­vive the hazards of childhood, youth, and mid­dle age, they are inevitably brought into that period of life when cancer and other degener­ative diseases are naturally more frequent.

The question that comes to many in the face of these facts is whether anything can be done to eliminate or delay the approach of these hazards in the experience of each individual. Many feel that since these diseases are the re­sult of advancing age, they are therefore in­evitable and must be accepted with fatalistic resignation.

Perhaps this acceptance of the supposedly inevitable is one of the reasons for the tragi­cally high incidence of these diseases among those of middle age. Those who believe that heredity and other factors beyond our control are the cause of these conditions are inclined to neglect their responsibility in facing these haz­ards. If, for example, cancer is thought to be hereditary, or is accepted as inevitable in certain people at a certain age, and if it is an incurable disease, then why be concerned before the time?

Cancer

Cancer in the body might be compared to a dangerous fire in a building. If the fire is not detected till it has spread beyond control in inflammable material, the chances are the building cannot be saved. The fire extinguish­ers and water hoses will be of little effect. If the fire is detected early while the flame is local­ized to an area where available means of fight­ing will be effective, the blaze will be elimi­nated and the building saved. Cancer is frequently not detected till it has advanced be­yond certain defensive barriers, where available forms of treatment are not effective. As in the case of the fire, early and adequate treatment is our only defense.

Let us notice one of the more common forms of cancer—cancer of the breast. Unlike cancer of some other parts of the body, this facin is so located as to be easily detected at an early stage of its development. If a woman observes a lump in the breast, however small, or if she notices the skin drawn in, or the nipple re­tracted or depressed, it is cause for consultation with a competent physician. If taken early, sur­gical removal of such cancer is a life-saving pro­cedure. Neglected, the cancer, like the fire, will spread and become destructive.

Regular physical examinations will often re­veal these cancers sufficiently early to make ef­fective treatment possible. Cancer that has spread beyond a certain point ultimately takes the life of its victim. There are certain well-publicized "cures" for cancer. These have in many cases led people to refuse surgical treat­ment till such was too late, and thus their very trust in the "cure" has become the cause of their death. There are some forms of cancer that may yield temporarily to certain medical treatment or that may be retarded in growth, but any sure remedy for cancer is not now in sight. Regular physical examination is our first and most effective line of defense against can­cer.

Cardiovascular Diseases

Coronary heart attacks and strokes are bas­ically manifestations of the same disease in different parts of the body. The underlying disease is usually arteriosclerosis, or more ac­curately in the early stages, atherosclerosis.

To understand what happens in this condi­tion it is necessary to take a look at the struc­ture of the arteries, which are the immediate tissues involved in this disease. Our arteries range in size from the very small ones—in fact, smaller than a hair—to the large blood vessel carrying the blood from the left ventricle of the heart, the aorta. This largest artery is the size of the middle finger. Some of the more critical arteries of the heart and the brain, which may by their failure cause death, are approximately the size of a matchstick or smaller. The coronary arteries of the heart, which are so frequently in the news as the cause of the death of important, busy people, are of matchstick size and branch into smaller and still smaller sizes as they spread into the muscular wall of the heart to supply the fresh blood necessary to the continued function of this vital organ. The meningeal and cerebral arteries of the brain also are a little larger than matchstick size and branch out into the meningeal coverings and into the various sec­tors of the brain through smaller and still smaller vessels to carry the life-giving blood to every one of the millions of cells of these struc­tures.

Disease Changes Arteries

In our study of arteriosclerosis—literally, hardening of the arteries—our interest is in the inner or lining layer. It is this inner layer that undergoes changes that are potentially so dan­gerous. When certain nutritional and meta­bolic conditions exist within the body, there begins to be laid down between this lining and the rest of the artery wall a fatty material called cholesterol. This material, at first only in slight amounts and perhaps in scattered areas increases in extent and in thickness till considerable areas may be affected. The separation of this lining from its natural base removes its principal source of support and strength. Gradually it becomes weakened and may now be easily torn.

Possibly in the natural flow of the blood, or perhaps with a sudden exertion, such as run­ning to catch a bus, or in a moment of unusual emotional stress, such as anger or fright, the extra flow of blood may loosen a portion of this fatty material, cholesterol, which then moves along the blood channel freely so long as the channel is large enough to permit its passage. This clump of matter, called an embolus, may be in a part of the body where the blocking of a blood vessel is not a serious matter. But if it is channeled into the coronary artery or into an important artery of the brain, there may be serious trouble ahead. All arteries become smaller farther from the main aorta. If the coronary is involved, this embolus may go to the point where the vessel divides into right and left branches and be small enough to pass on into one of these branches, ultimately lodg­ing firmly in a point where a comparatively limited portion of the heart wall is involved. In this case the result will likely be a critical illness, but the patient will probably survive. If, how­ever, the area supplied by the vessel is extensive or if the embolus lodges at the point where the artery divides into right and left main branches, the result is immediate stoppage of the heart action with instant death. If the artery involved is in the brain, the occlusion will result in de­struction of the function of a portion of the brain, with accompanying paralysis or death. In many cases the fatty or cheesy matter in these blood vessels may not be loosed from its place of formation in the artery, and the body defense mechanism sets about the replace­ment of the cholesterol, which is soft, with calcium (lime), which is hard and brittle. This is a process comparable to the calcification of the scars of tuberculosis in the lungs. This calci­fication, when well advanced, gives to the artery a hard, resistant feeling and the condition known as hardening of the arteries, or the true arteriosclerosis.

Related High Blood Pressure

In addition to hardening the arteries this process of laying down cholesterol and later cal­cium under the lining of the vessel may tend to cut down the size or caliber of the passage­  way. This recInction of size may continue till the tube is but a fraction of its original size. As the flow of blood through certain organs of the body must be kept fairly constant, the heart is impelled by stimulus from the brain to work harder and raise the pressure of the blood flow through these smaller caliber blood vessels, thus bringing about higher blood pressure, or hypertension. This higher blood pressure work­ing against these damaged blood vessel walls constitutes an increased hazard both from the standpoint of breaking loose an embolus and also from the possibility of bursting some weak spot, possibly in the brain, where the accident may result in death. It will be apparent that these serious accidents—the heart attacks and the strokes—result directly from the changes in the blood vessels, the formation of the cho­lesterol under the lining membrane of the arter­ies.

Sources of Cholesterol

We have now observed that the cholesterol is usually the immediate cause of these tragic accidents. The source of this strange fatlike substance now is a matter of special concern. Is this blood vessel change something mysteri­ously inevitable at a certain age, or is it the result of conditions known and controllable?

Free cholesterol is found in certain foods. It is found in highest concentration in egg yolk, 3 per cent; animal fat, 1 per cent or more; and milk fat and butter, 6 per cent. These foods—eggs, fat meat, fish, fowl, and game, also dairy products, except those from which the butterfat is removed—contribute this choles­terol directly.

Research now indicates that any fat, animal or vegetable, is a source from which the body synthesizes cholesterol, if this fat is in excess of the body needs. Just how significant the free cholesterol of animal origin is in the degener­ative changes of the blood vessel, as compared with the fats in general, or even with vege­table fat, is not fully known. It is, however, fully accepted by recognized medical authorities that animal fats are a major consideration in the development of blood vessel change. It is ob­served statistically that in areas and in circum­stances where the standard of living is high and the diet contains liberal amounts of fats in general, and specifically, large amounts of fat of animal origin, cardiovascular disease (heart attacks and strokes) are of higher fre­quency.

During the recent war when the British peo­ple were greatly restricted in all animal prod­ucts, including eggs and dairy products as well as fats in general, coronary disease was of much less frequency. So, also, the people of Holland suffered practically no heart attacks or strokes when their animal produce and much of their other food was being shipped to Ger­many. This was also true of the people of Len­ingrad when for eighteen months the siege of the city cut off food supplies from the outside. With the return of normal supplies of all foods after the war, the incidence of this disease re­turned to the former average.

From observable facts it becomes evident that this blood vessel disease, now responsible for more than two thirds of the deaths in lands and among people with a high standard of liv­ing, is directly related to eating habits. We would not claim that diet alone is responsible. Stresses of high-pressure work, serious emotional stress, lack of exercise in sedentary work­ers, heredity, and doubtless other factors are concerned. As the great majority of profes­sional workers today die with either heart at­tack or stroke, and in most cases at an un­necessarily early age, it is evidence of dangerous neglect or ignorance when such people con­tinue to disregard known precautions in this matter.

Specific Suggestions

What are some of the practical precautions that could well be observed in guarding this phase of our health? Accepting generally ap­proved interpretations of our present knowl­edge, the following suggestions will be benefi­cial:

1. If past the age of forty, sharply limit the use of eggs and, of course, meat, and use only in limited quantities dairy products containing butterfat.
2. Particularly those in the upper-age groups limit the use of fats of either animal or vege­table origin.
3. Use only a limited amount of fried foods, rich gravies, pastries, and desserts.
4. Restrict total food intake to required cal­ories according to age and occupation.
5. Develop habit of free use of fresh fruit, fresh vegetables, leafy vegetables, and salads in place of starches, fried foods, heavy or rich roasts, heavy desserts.
6. Generally avoid the use of sweetened bot­tled drinks and candy bars.
7. Develop the habit of some vigorous ex­ercise daily. Walking or hiking is one of the best exercises and probably the most available.
8. If you know you are working beyond your legitimate physical capacity, change your gait or, if necessary, your job.
9. Do not neglect your regular recreation or your vacation. Self-inflicted martyrdom confers no great halo.
10. Relate yourself to your moral obligations and your conscience in such a manner that there will be no just cause for worry; then refuse to worry.

In the practical application of these sugges­tions, success is much more likely to accompany the efforts of those who apply them with intel­ligence and reason. Under the first suggestion the person who feels that if a little limitation is good, complete avoidance is better, will prob­ably find the plan burdensome and soon be back to his unrestricted earlier diet. The occasional use of eggs or the use of some eggs in cooking is probably a reasonable interpretation of this caution. Any person who has a poor heredity in the matter of cardiovascular disease should, however, after fifty years of age be very cau­tious in the use of eggs as well as fat meats. In the average diet, milk is desirable. Those in the upper-age group will be well advised to use skimmed milk, cottage cheese, and other protein of low fat content. Butter or margarine will be used sparingly. The fond housewife who drops large chunks of butter in the peas, car­rots, spinach, and the soup, or who prepares other foods such as fried potatoes and hot cakes with liberal quantities of butter or other fats, is not serving her family well, partic­ularly her fifty- or sixty-year-old husband. These foods can be made attractive with much less cooking fat than is used in the average house­hold.

Under caution number three, if one makes a general practice of moderation, or of gener­ally avoiding these foods, it is obvious that on occasion deviation from the general rule is not going to be of serious significance. There are those who have taken a most rigid stand against any use of ice cream, cake, or sweets for either themselves or their children. It is doubtful that either the physical or moral merit attained in such an extreme course is adequate justification. Children held to such restrictions will only wel­come the time when they are old enough to throw off not only the objectionable don'ts of diet, but also the religion to which these pro­hibitions have been related.

Under sections four and five, the burden of those suggestions is that the total nutrition of the body be held down to the point where the weight is slightly below the average for build and height, yet without neglecting the proper nutrition of the body as to minerals and vita­mins. Those who find this a difficult matter will be helped by the practice of a larger use of salads made of the low-calorie vegetables and the use of salad dressing rather than may­onnaise.

The exercise mentioned in number seven should not be initiated too suddenly if it has not been a habit in the past. If you are over fifty years of age, somewhat overweight, and accustomed to go even short distances by car rather than by walking, your blood vessels are probably in no condition to take any vigorous exertion. The muscles, including the muscle wall of the heart, are probably flabby and weak. The arteries are developing plaques of the cheesy cholesterol ready to slough off under undue exertion and form a possible fatal em­bolism. This is why physicians advise against very much exertion by people over fifty. If you are in this class, it is highly desirable that you immediately adopt the general program here suggested and gradually over a period of six months to a year return to a program of health­ful exercise appropriate to your age and physi­cal condition. There is no better exercise than walking. Get plenty of it; it is not expensive.

The observations under eight and nine are too obvious to require much comment. Why should you insist on making your wife a widow before the time? By going on day after day and month after month with no recreation, and year after year without vacation, you will surely accomplish this earlier than you think. In doing this your motives may be good, but your judgment is bad and your prognosis worse.

The question is frequently asked, "When these blood vessel changes are well advanced, perhaps to the point of danger, is there any prospect of a return to normal?" Yes, there is a good prospect, and in this fact lies the ex­planation for the return to good health by some who have had near-fatal heart attacks. Experi­mentally, laboratory animals have been placed on a high cholesterol diet—a diet rich in fat and excess calories. After a period of six months, examination reveals advanced blood vessel changes similar to those causing heart attacks.

Now after returning the surviving animals to their noimal diet it is found at the end of another six months that the blood vessel damage is cleared up and not all circulation is restored. Even though through careless dietetic habits one has developed fairly advanced atheromatons changes in his blood vessels, by returning to an abstemious diet and wholesome adequate exercise he may reasonably hope that within six months or a year the dangerous condition will have receded and he will be well along on the road to recovery.

From these observations it becomes evident that among the most significant health counsels ever given to our people is that recom­mending an abstemious diet. See Counsels on Diet and Foods, p. 189.

Most of the diseases of the digestive system including the stomach, liver, and related organs, are the direct result of the wrong food and too much food. Liver and gall-bladder trouble is usually the product of too much "good food"—rich food, fried food, pastries, highly shortened and highly seasoned food. While these dietary indiscretions are the cause of most organic disorders of the digestive system, they more signif­icantly contribute to the far more dangerous blood vessel disease, which may take the life suddenly and without notice through heart at­tack or stroke.

Paul has aptly observed that "every man that striveth for the mastery is temperate in all things" (1 Cor. 9:25). He goes on to point out:

"Know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God's" (1 Cor. 6:19, 20).

In the light of this newer information on diet, how very appropriate his conclusion to this discussion: "Whether therefore ye eat, or drink, or whatsoever ye do, do all to the glory of God" (1 Cor. 10:31).