the medical profession call familial hypercholesterolemia. These
words are a term referring to persons who have inherited
abnormally high levels of blood cholesterol. These are the
unfortunate ones throughout whose families runs the devasta -
tion of heart attacks and strokes, usually coming in the prime
of life.
Such a condition is often discovered accidentally during a
routine checkup by an able physician. He may note such signs
as cholesterol deposits in the form of whitish plaques under the
eye (called xanthalasma); or as a crescent along the periphery
of the pupil in the eye (called an arcus senilis). Such indications
may also be observed by the alert physician in various other
parts of the body, including the elbows, arms, legs, heels, and
hands. Many times the condition may reveal itself in the
arteries inside the eyes, when they are checked by a competent
eye doctor.
Whether such danger signals exist or not, however, if you are
a man over 20 or a woman over 40, a diet comprising not more
than 10 to 20 per cent of fat in calories can offer some measure of
protection against heart and blood vessel disease. Such a low -
HOW TO BE REALLY WELL, THE LOW-FAT WAY
47
fat diet can, in fact, help you to enjoy the kind of over-all good
health that makes life worth living. So, for your health's sake,
follow the recommendations found in the rest of this chapter
and avoid those foods that may destroy your health and your
heart.
The low-fat, low-cholesterol program:
FOODS PERMITTED
Soups
Emphasize bouillons and consommes, as they are nutritious,
filling, and low in calories and fats. They are ideal for relieving
that hungry feeling quickly and picking you up in the process.
Soups are great to warm you up instantly in cold weather and,
in the jellied form, to cool you off in hot weather. Soups stim-
ulate the digestive juices, start the stomach and intestinal muscles
churning and "warmed up" for the job ahead, while "flushing
out" the stomach and getting it ready to stoke the digestive
furnace.
Use fat-free vegetable soups, vegetable broths, and soups
prepared with skimmed milk.
It is imperative to remove all visible fat and grease from
the soup. Here are some good ways to do this:
1. Refrigerate or chill the soup first: then carefully remove
the fat and grease that has caked on the top with a knife,
spoon, or other suitable utensil.
2. If there is not time for refrigerating or chilling the soup
first, use bread slices by direct application to the top
layer of the soup, in order to blot up or absorb the grease.
3. Place some lettuce leaves on top of the heated soup. When
you see the fat absorbed onto the leaf or leaves, remove
them. The lettuce leaf may also impart a slight flavor to
the soup, helping to lend a little zest.
4. Blot up the top layer of grease by floating one or more
paper towels on the surface of the soup. When it is fat-
48
HOW TO BE REALLY WELL, THE LOW-FAT WAY
saturated, discard the towel; it is a greasy reminder of
escape from unhealthy calories.
Dry soup mixes are quite low in fat and are very enjoyable.
Some soup manufacturers prepare canned soups that have
about a half-teaspoonful of fat per serving of soup when diluted
equally with water. Vegetable and vegetable-beef canned soups,
however, are very low in fat content and are thus highly desirable
for the low-fat diet.
Meats
Beef, veal, and lamb are naturally high in both visible and
"invisible" fat and cholesterol. However, since their protein con-
tent is most desirable for energy and palatability, and because
of custom, they are basic ingredients in the low-fat diet. Much
of the dietary fat allowance is contained in meat, which has
its greatest amount of calories predominantly in fat. It must
be kept in mind that the butcher will at all times allow a max -
imum of fat to remain on every cut of meat for reasons of added
price and the presumption of "quality." This visible fat must
be carefully cut away and trimmed while raw, before cooking.
During the cooking, baking, or broiling of the meat, the fat
should be drained off by keeping the meat or roast on racks.
One ideal way of removing most of the fat content of meat and
making it almost fat free is to partially cook it on the day before
it is to be eaten. Refrigerate the meat and the broth. On the
following day it is now easy to remove the layer of grease that
has floated to the top and hardened.
Buy and eat lean meats. If you are having ground meat,
specify to the butcher that it is to be made from trimmed, lean
meat. Bear in mind that the highest fat content is present in the
prime and choice grades of beef, lamb, and veal (which are
more expensive too), since they originate from fattened animals.
Less fat and good quality is contained in meats that bear the
stamp "U.S. Good."
Do not fry meats. Pan-cook or brown without fat or grease,
HOW TO BE REALLY WELL, THE LOW-FAT WAY
49
if desired, by using a dry skillet; heat and salt it first before the meat
is placed in it, while turning the meat repeatedly. After it is as
brown as desired, cook slowly until well done or rare, whichever
you wish.
A preparation called "Pantastic" (manufactured by G. N.
Coughlan Company, West Orange, New Jersey) is one method of
cooking with pans and reducing fat to a minimum. It prevents
meats and other foods from sticking to the pan so that grease and
fat-free cooking is possible.
Remember that among meats pork, bacon, and ham are highest in
fat and cholesterol content. They should not be eaten on the
low-fat diet other than occasionally, if permitted by your doctor or
by the virtual absence of other fat-containing foods in your
menus for the day. The same is generally true of sausages, and
organ foods like brains, sweatbreads, and kidneys. Liver is an
exception, however, as we will see later.
If gravy is desired for the flavoring of meats, it must be
prepared free of its usual very high fat content. The regular brown
drippings found at the bottom of the pan after meat is cooked must
have the meat juices separated from the exceptionally high melted
fats. Separate the fat in this gravy by chilling or refrigeration.
Remove the thick layer of caked grease as described above by spoon
and by blotting with bread or absorbent paper. Fat-free gravies can
also be made by consulting various low-fat cookbooks.
Instead of gravies, meats can be flavored and made to look
appetizing by the following garnishes: watercress, parsley, celery,
carrots, radishes, pimento, pickles, paprika, green peppers,
cucumbers, mushrooms, and onions in various shapes and com-
binations. Also helpful are spiced peaches, pears, prunes,
apricots, cinnamon apples, spiced watermelon rind, applesauce,
cinnamon pears, pineapple pieces, broiled bananas, seasoned
tomatoes, herbs, and the various relishes such as mint jellies and
sauces, chili, catsup, cranberry jellies, chutney, and many others.
50
HOW TO BE REALLY WELL, THE LOW-FAT WAY
Also appealing are some of the following seasonings: garlic
cloves, thyme, marjoram, basil, oregano, bay, and peppermint.
Fish
As a. rule, fish are often excellent low-fat food sources. Un-
like meats, very little fats will be cooked out of the fish, so
attempting to drain off fish fats in cooking is unnecessary.
Some fish are especially low in fat, such as perch, haddock,
flounder, sturgeon, smelts, scallops. Others like brook trout,
porgy, cod, and croakers are somewhat higher in fat content,
but are still quite low in fat content when compared with meats.
Shell-fish are outstandingly low in fat and cholesterol con -
tent. Lobster, shrimps, and crabs are ideal examples. Clams
are next in line; oysters are a bit higher in fat content, but are
still low in comparison with beef, lamb, or veal. For the con-
noisseurs, frogs-legs are also low in fat content.
Tuna is now packed in dietetic form called "Chicken-of-the-
Sea Brand" and is particularly low in fat. Many canned fish
when not packed in oil are very low in fat.
Poultry
Chicken and turkey are excellent sources of animal proteins
for low-fat, low-cholesterol content, provided lean poultry is
used. The dark meat of poultry is higher in fat content than
white meat. Skin should be discarded. Giblets are very high in
fat content.
Guinea hen and squab are also comparatively low in fat
content. However, duck and goose are extremely high in fat
and should not be included unless the fat is drained off and
removed by the methods recommended in the section under
meats. As a matter of fact, the fat from chicken and turkey,
even though much less quantitatively than that in meat, is best
drained off and removed in the same manner as in the prepara-
tion and cooking of all meats.
HOW TO BE REALLY WELL, THE LOW-FAT WAY
51
Eggs
Egg whites, which are proteins, may be eaten and used for
cooking as much as desired. The yellow portion of the egg,
or the yolk, contains one of the most concentrated forms of
fat available—namely cholesterol—and therefore should be
avoided.
Milk and Milk Products
One pint or more daily of non-fat or skim milk should be
taken. Use fortified milk with added amounts of vitamin A and
D, as now commonly in use. Buttermilk is also a refreshing
source of milk with an exceedingly low-fat content.
As an added source of fat-free or low-fat protein, skim or
fat-free milk can be fortified by adding to each glass of milk one
or more tablespoonsful of dried, skim milk. This "fortified"
milk also has a thick creamy taste and can be flavored to suit
the individual taste with various flavoring agents. Yogurt made
from non-fat milk can also be used for nutritious variety.
Cheeses
The majority of cheeses are very high in butterfat content
and so cannot be used in the low-fat diet. There are several
important exceptions, however. First is cottage cheese made
from dry curd and non-fat milk, as specified by federal law.
Cottage cheese must contain a minimum amount of butterfat
to meet legal requirements.
One of the most frequent pitfalls in the use of cottage cheese
is the user's failure to notice that often she is using or buying
creamed cottage cheese, which of course does contain fat. Res-
taurants in particular use creamed cottage cheese in their menus,
and this should be borne in mind when eating out. This creamed
cottage cheese can be corrected by washing it out with cold water
through a strainer. Various brands of cottage cheese that taste
like creamed cottage cheese are available, such as "Slim Cheez"
52
HOW TO BE REALLY WELL, THE LOW-FAT WAY
or Ricotta Cheese made from milk whey and a favorite of Italian
cooks. There are also other foreign brands of cheeses low or
negligible in fat content, which are processed from non-fat milk
or whey, such as the Geska type of Sapsago cheese (Swiss green
cheese), certain Scandinavian cheeses, and in the United States
brands of jack cheese made from skim milk or whey. Cheese
spreads or dips made from non-fat or cottage cheeses are also
widely used for low-fat menus.
Vegetables
Vegetables are virtually fat free and contain no cholesterol.
Certainly the acid test or taste ( ! ) of the good cook is in
the preparation of vegetables. To prepare vegetables without
butter or fat means that a little originality is required by the
cook, such as by the use of herbs or seasoning. Since many of
the vital vitamins and minerals in vegetables may be destroyed
by cooking, the ideal use of raw vegetables is the most desirable
for any menu, and especially for the low-fat menus. However,
because many vegetables are cooked, it is best not to soak them,
and to save and use in other dishes the water used for the
cooking, to avoid using soda and to avoid overcooking or re-
heating of the vegetables.
The addition of bouillon cubes as a substitute for butter in the
cooking of vegetables is very helpful and palatable. The sub-
sequent addition of herbs before serving the vegetables adds
further to the natural flavor.
Fruits
Fruits also contain virtually no fat and are entirely free of
any cholesterol. Two notable exceptions, however, are the
avocado and the coconut, which are both very high in fat content
and thus should be avoided. Otherwise there is no restriction
on the use of fruits, which are also certainly ideal for desserts.
HOW TO BE REALLY WELL, THE LOW-FAT WAY
53
Salads and Salad Dressings
Use raw vegetables almost exclusively, since the vitamin
value is at peak this way, and the crispness of the vegetables
is most appetizing. No fat or cholesterol is concerned unless
specifically added. Fruit salads are in the same category and
are
particularly
refreshing
and
nutritious.
Various
combinations can be used with vegetables, cottage cheese, or
gelatin recipes. When fresh fruits are not in season, use
dried, canned, or frozen fruits. Gelatin salads are special
favorites to many, especially when made with fruit juices
instead of water. Aspic salads are excellent when prepared
with vegetables or vegetable juices. If cottage cheese is
added to gelatin and aspic salads, more protein and "body"
results.
Salad dressings low in fat content are readily available
from various manufacturers under such trade names as Mar-
se Diet Rite (Lo-Calorie Mayonnaise Substitute), Diamel
Diet Whip, and others. These do contain a relatively small
degree of fat, however, so it is best to prepare your own fat -
free dressings whenever possible, such as t he one described
in the recipe, page 72. Small amounts of mineral oil are
preferred by some for salads, but if used more than
occasionally this is not desirable, since mineral oil tends to
interfere with absorption of vitamin A in the food. If
allowance is made for the caloric content of the vegetable
oils described in Chapter 5, soya-oil, cornseed oil, and
cottonseed oil are valuable for use in salad dressings. As
explained in Chapter 5, these vegetable oils are excep tions to
other fatty foods in that they contain large amounts of
unsaturated fatty acids. These fatty acids are very effective in
reducing the fats and the cholesterol present in the blood
stream. They are thus "protective" against the harmful effects
upon the arteries of other fats, such as c ontained in butter,
milk, eggs, and cream.
Don't forget eye-appeal in preparing an appetizing salad.
The
54
HOW TO BE REALLY WELL, THE LOW-FAT WAY
following garnishes are particularly nutritious and appealing:
watercress, croutons, garlic, chives, pimiento, lemon, lime,
orange or tangerine and other fruits, mint, carrots, beets, green
onions, celery, radishes, cottage cheese, parsley, pickles and
peppers, ketchup, vinegar, non-fat yogurt, herbs, and spices.
Cereals
These are nutritious, energy producing, and virtually fat free.
Therefore, all cooked or dry cereals are excellent carbohydrate
foods, if served with non-fat milk. The taste is enormously en-
hanced by the addition of stewed or fresh fruits such as bananas,
prunes, peaches, pears, apricots, berries, dates and figs, raisins,
or baked apple.
Whole wheat and whole grain cereals are also an important
source of vitamin B complex and protein in the low-fat diet.
Their cooking can be done with skim milk if it is not boiled or
burned. The addition of one-to-four tablespoonsful of wheat
germ to the cereal is a most desirable nutritional supplement
and is an ideal daily food when added to the cereal.
For those who work and feel best beginning the day with a
substantial breakfast, the inclusion of the above cereal, skim
milk, fruit, and wheat germ "combo" is excellent for energy,
proteins, vitamins, and minerals.
Breads
Both white and whole wheat breads contain only a negligible
amount of fat (approximately 5 per cent by weight) a minority
quantity of protein (about 20 per cent) ; the rest is carbohydrate.
Whole wheat bread is the healthiest, most nutritious form of
the "staff of life." Bakeries customarily incorporate some lard,
butter, or egg yolk in most yeast loaf bread, sweet rolls, rolls,
muffins, buns, and coffee cake. Various enriched breads now on
the market are also nutritious as far as vitamin B complex is
concerned, and often may match 100 per cent whole wheat, rye,
or pumpernickel breads in this regard.
HOW TO BE REALLY WELL, THE LOW-FAT WAY
55
Desserts
Fat-free sweets are great energy producers as well as com-
forting for that "sweet-tooth." Excellent, but high in calories
because of sugar content, are jams, jellies, marmalade, honey,
molasses, maple syrup, and sugar; hard candies and candies
without nuts, creams, or chocolate are also fat-free.
Beverages
A wide choice of fat-free drinks is available to all, such as
tea, coffee, coffee substitutes, skim, fat-free milk, non-fat milk
cocoa, skim milk powder shakes, and egg white eggnogs. Where
desired for additional nutriments, flavoring can be added to
these flavored skim milk drinks in between meals or at bedtime.
Fruit and vegetable juices are also appealing and nutritious,
as is fat-free yogurt. Carbonated drinks such as ginger ale,
Coca-Cola, 7-Up, and others are also fat-free and popular.
FOODS TO AVOID
Soups
All creamed soups are high in fat content. The commercially
prepared ones are particularly fat-heavy, and since the fat can-
not be readily removed from them, they should not be used. It
is always a good idea to read the label carefully on any packaged
product from which soup is being made. The law pertaining
to the labelling of foods requires a description of any fat con-
tained in the product, so undesirable sources of fat can be
avoided.
Meats
Glandular organs such as sweetbreads, brains, kidneys, caviar, fish
roe, and giblets are high in cholesterol and fat content, so
should be avoided. Pork and pork products, bacon, and ham
are also high in fat and cholesterol and should not be eaten,
except at an occasional meal.
56
HOW TO BE REALLY WELL, THE LOW-FAT WAY
As already mentioned, liver is an exception to the list of
glandular organs to be avoided. It is quite desirable as a
valuable nutritional source of essential vitamins and minerals,
and because of the "protective" content of phospholipids that
counteract the action of fat and cholesterol, it is not harmful.
Fish
Certain fish are high in fat content and are best avoided.
These are: bass, bluefish, butterfish, deviled crab, eel, herring,
mackerel, scalloped or fried oysters, pompano, salmon, sardines,
shad, and trout.
Poultry
Both duck and goose are very high in fat and cholesterol con-
tent and so should be avoided unless prepared in the fat-free way
described under the section of "Meats Permitt ed," page 48.
Dairy Products
Whole milk, cream, butter, and cheeses such as American
cheddar, Swiss, cream, creamed cottage, cheese spreads, Gruy-
ere, Edam, Limberger, Liederkranz, Parmesan, Roquefort, and
Yogurt made from whole milk are all high in fats a nd should
be eliminated from your diet.
Eggs
Egg yolks are exceptionally high in cholesterol and fat con-
tent. They are often used by medical investigators and re -
searchers to produce atherosclerosis and "hardening of the
arteries" in experimental animals.
Breads
Hot breads, pancakes, waffles, coffee cakes, muffins, buns,
doughnuts, Danish pastry, sweet rolls—all contain some appre-
HOW TO BE REALLY WELL, THE LOW-FAT WAY
57
ciable amount of lard, butter, or egg yolk. Those especially
interested in home baking can find recipes for these fat-free
breads and pastries in low-fat cook books, if desired.
Desserts
All those made with butter, egg-yolks, or cream, such as
pies, cakes, pastries, cookies, custards, eclairs, gingerbread,
shortcake, and puddings. Notoriously high in fat and cholesterol
are ice-cream, parfaits, and frozen creams.
Miscellaneous Foods
Avocados, coconuts, nuts, cholocate, cocoa, fat contained in
the usual salad dressings, gravies, and sauces are all very fatty.
Animal fats, including lard and suet, should particularly be
avoided in cooking.
Frying should be completely eliminated in the preparation
of foods, not only because of its high fat production, but also
because of its unhealthy way of interfering with the normal
digestion of foods and essential nutriments and vitamins, the
irritating character and effect on the digestive tract of the fried
fats, and the destruction of vitamins and essential foodstuffs
in the food that is fried. Even vegetable fats are best not used.
An exception can be made for vegetable oils such as soya oil,
cornseed oil, and cottonseed oils as described on page 66.
Alcohol has no fat content, so there are no restrictions on its
use other than by the dictates of common sen