What about fish and chicken?

Most people know that red meats like beef, pork, and lamb are not the best for us. But what about white meat like fish and chicken that health authorities are recommending?

J. A. Scharffenberg, M.D., M.P.H., is medical director of the Pacific Health Education Center, Bakersfield, California, and an adjunct professor of nutrition at Loma Linda University.

Most people know that red meats like beef, pork, and lamb are not the best for us. But what about white meat like fish and chicken that health authorities are recommending?

When researchers discovered that saturated fats had a greater effect in elevating one's blood cholesterol than did dietary cholesterol, leading scientists did recommend leaving off the red meats and using fish and chicken. Fish and chicken contain a lot less fat and also much less saturated fat than do the red meats.

Now there is a slight swing of the pendulum back in the direction of avoiding cholesterol in the diet more than worrying about saturated fat. Cholesterol comes only from animal sources, but saturated fat can come from both plant and animal sources. However, 70 percent of the saturated fat comes from animal sources.

Dr. Jeremiah Stamler, noted authority in heart attack risk factors, reexamined four large population studies and discovered some interesting facts. Those who get 2,000 calories a day containing 200 milligrams of cholesterol (one large egg yolk provides 213 milligrams) and increase their cholesterol intake to 600 milligrams a day raise their heart attack risk by 30 percent. If they are used to 600 mg. a day of cholesterol intake and reduce that to 200 milligrams, they lower their risk of death from all causes combined (this includes cancer) by 37 percent. That is the equivalent of living 3.4 years longer.

Dr. Stamler states that if we can get rid of the cholesterol in the diet, then saturated fat would take care of itself. He points out that in animal studies, small amounts of cholesterol will cause hardening of the arteries even though it does not appreciably raise blood cholesterol levels. In other words, you need to eat properly, with little cholesterol in the diet, even if your blood cholesterol level is normal.

Dr. Blankenhom of the University of Southern California placed patients with clogged coronary arteries on the American Heart Association's phase II diet of less than 250 milligrams of cholesterol and less than 8 percent of daily calories as saturated fat. In fact, he was even stricter in that he allowed no more than 5 percent of fat to come from saturated fats. When rechecking these patients after one year, he found that their coronary arteries were more clogged than before. The American Heart Association phase II diet was not good enough to help these patients.

Dr. Ornish, on the other hand, had patients with clogged arteries go on a diet that was low in saturated fat and that allowed only 12 milligrams of cholesterol a day. (One cup of nonfat milk contains 5 milligrams of cholesterol.) A year after they were on this diet their coronary arteries showed improvement and began to open up. Dr. Omish also had his patients exercise and perform relaxation techniques. What really made the difference was the avoidance of much cholesterol in the diet.

Now, what does this have to do with chicken and fish? Chicken contains as much cholesterol, for all practical purposes, as does beef. There are 69 milligrams of cholesterol in a 3.5-ounce serving of chicken and 70 milligrams in that amount of beef. Chicken is a high-cholesterol food even though it is relatively low in saturated fat.

But what if one uses only the white meat, the young fryer, removing the skin and broiling it to let the fat drip off? That is better, since it reduces the fat content of the chicken but on an equal-weight basis it still contains as much cholesterol. Lean beef, for example, has slightly more cholesterol than does full fat beef on an equal-weight basis.

But wouldn't fish be better? Fish is not a low-cholesterol food either. Fish contains 40 to 60 milligrams of cholesterol per 3.5-ounce serving. Fish eaters have higher blood cholesterol levels than lacto-ovovegetarians and are therefore at higher risk of heart attack.

Studies show that fish will lower blood fat (triglyceride) levels but in the process elevate the bad cholesterol (LDL) in the blood. Then why the big push to use fish?

The EPA factor

In the Netherlands, researchers discovered that those who ate an ounce of fish a day had half the heart attack rate of those who didn't eat fish. Some suggested this was because the fatty acid EPA (eicosapentaenoic acid) kept the blood from clotting. Later, however, studies in Canada and Norway revealed that fish eaters and nonfish eaters have no difference in heart attack rate. Even the original Netherlands study showed that fish contains very little EPA. It was then suggested the selenium in the fish may have done some good.

The EPA in fish does reduce the ability of the blood to clot, and it is the clot that finally causes the heart attack in many patients. Since Eskimos consume so much EPA, they have fewer deaths from heart attacks. However, their death rate from strokes because of bleeding is 34-50 percent higher than the average person's.

EPA operates somewhat like aspirin by keeping the blood from clotting. When doctors who had one heart attack were then given aspirin, it reduced their risk of a second heart attack by about 50 percent. However, the risk of dying from a stroke because of hemorrhage increased by 15 percent. If a person who has had a heart attack is placed on aspirin (or some other medication to keep the blood from clot ting) and then consumes much fish, he or she is increasing the risk of brain hemorrhage even more.

If one uses Canola oil, flaxseed oil, or even some soy oil, he or she gets alphalinolenic acid, some of which in the body is converted to EPA. Usually when the body gets enough of what it needs it does not produce more. Therefore it is prob ably safer to get our EPA through these plant sources rather than from fish. That way it is unlikely we will get too great an anticlotting effect.

Cancer risk

What is the cancer risk among those who use fish? Because of industrial pollution, most species of fish in the Great Lakes now have cancers. The water in which those fish swim contains 900 chemicals. No wonder that when sediment from these lakes is painted on bullhead fish and on rats, they develop cancer.

There is another risk in eating fish. Physicians warn diabetics not to consume fish oils, because they inhibit insulin production. Some recent studies suggest that even nondiabetics are affected in a similar manner.

More and more nutrition authorities are saying that even the best of the meats should be used sparingly. For example, the World Health Organization now recommends fish and poultry in small amounts and less often as the main dish. The Physician's Committee for Responsible Medicine is recommending a basic four food group consisting of fruits, grains, vegetables, and beans. That is very close to the original diet recommended for humans in Genesis. The committee has forgotten to include nuts, which, according to recent studies, also help to reduce the risk of heart attacks.

Adventists have been counseled concerning the use of fish. "In many places fish become . . . contaminated. . .. Thus when used as food they bring disease and death on those who do not suspect the danger." * In accordance with both the light from the Spirit of Prophecy and science, the position of the General Conference Nutrition Council is that the best diet is one that is vegetarian one with out meat, poultry, or fish.

* Ellen G. White, The Ministry of Healing (Mountain View, Calif.: Pacific Press Pub. Assn., 1905), pp. 314, 315.

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J. A. Scharffenberg, M.D., M.P.H., is medical director of the Pacific Health Education Center, Bakersfield, California, and an adjunct professor of nutrition at Loma Linda University.

June 1992

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