Mary G. Enig, PhDMary G. Enig, PhD is an expert of international renown in the field of lipid biochemistry. She has headed a number of studies on the content and effects of trans fatty acids in America and Israel, and has successfully challenged government assertions that dietary animal fat causes cancer and heart disease. Recent scientific and media attention on the possible adverse health effects of trans fatty acids has brought increased attention to her work. She is a licensed nutritionist, certified by the Certification Board for Nutrition Specialists, a qualified expert witness, nutrition consultant to individuals, industry and state and federal governments, contributing editor to a number of scientific publications, Fellow of the American College of Nutrition and President of the Maryland Nutritionists Association. She is the author of over 60 technical papers and presentations, as well as a popular lecturer. Dr. Enig is currently working on the exploratory development of an adjunct therapy for AIDS using complete medium chain saturated fatty acids from whole foods. She is Vice-President of the Weston A Price Foundation and Scientific Editor of Wise Traditions as well as the author of Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils, and Cholesterol, Bethesda Press, May 2000. She is the mother of three healthy children brought up on whole foods including butter, cream, eggs and meat. See her website at http://www.enig.com/trans.html.
Sally Fallon is the author of Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats (with Mary G. Enig, PhD), a well-researched, thought-provoking guide to traditional foods with a startling message: Animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper function of the brain and nervous system, protection from disease and optimum energy levels. She joined forces with Enig again to write Eat Fat, Lose Fat, and has authored numerous articles on the subject of diet and health. The President of the Weston A. Price Foundation and founder of A Campaign for Real Milk, Sally is also a journalist, chef, nutrition researcher, homemaker, and community activist. Her four healthy children were raised on whole foods including butter, cream, eggs and meat.
While the ongoing process of research into vitamin A and its effects is a boon to children and adults throughout the world, modern agriculture and food processing conglomerates gain nothing from this knowledge. Confinement farming practices effectively prevent vitamin A from incorporation into animal foods and the processing industry would rather use vegetable oils than animal fats. Some vegetable oils contain carotenes but they do not contain true vitamin A. Only animal fats contain vitamin A and vitamin A is present in large amounts only when the animals have a source of carotenes or vitamin A in the diet, such as green pasture, insects and fish meal.
Unfortunately, the vast majority of popular books on nutrition insist that humans can obtain vitamin A from fruits and vegetables. Even worse, FDA regulations allow food processors to label carotenes as vitamin A. The label for a can of tomatoes says that tomatoes contain vitamin A, even though the only source of true vitamin A in the tomatoes is the microscopic insect parts. The food industry, and the lowfat school of nutrition that the industry has spawned, benefit greatly from the fact that the public has only vague notions about vitamin A. In fact, most of the foods that provide large amounts of vitamin A—butter, egg yolks, liver, organ meats and shellfish—have been subject to intense demonization.
Under optimal conditions, humans can indeed convert carotenes to vitamin A. This occurs in the upper intestinal tract by the action of bile salts and fat-splitting enzymes. Of the entire family of carotenes, beta-carotene is most easily converted to vitamin A. Early studies indicated an equivalency of 4:1 of beta-carotene to retinol. In other words, four units of beta-carotene were needed to produce one unit of vitamin A. This ratio was later revised to 6:1 and recent research suggests an even higher ratio.5 This means that you have to eat an awful lot of vegetables and fruits to obtain even the daily minimal requirements of vitamin A, assuming optimal conversion.
But the transformation of carotene to retinol is rarely optimal. Diabetics and those with poor thyroid function, a group that could well include at least half the adult US population, cannot make the conversion. Children make the conversion very poorly and infants not at all — they must obtain their precious stores of vitamin A from animal fats6— yet the low-fat diet is often recommended for children. Strenuous physical exercise, excessive consumption of alcohol, excessive consumption of iron (especially from "fortified" white flour and breakfast cereal), use of a number of popular drugs, excessive consumption of polyunsaturated fatty acids, zinc deficiency and even cold weather can hinder the conversion of carotenes to vitamin A,7 as does the lowfat diet.
Carotenes are converted by the action of bile salts, and very little bile reaches the intestine when a meal is low in fat. The epicure who puts butter on his vegetables and adds cream to his vegetable soup is wiser than he knows. Butterfat stimulates the secretion of bile needed to convert carotenes from vegetables into vitamin A, and at the same time supplies very easily absorbed true vitamin A. Polyunsaturated oils also stimulate the secretion of bile salts but can cause rapid destruction of carotene unless antioxidants are present.
It is very unwise, therefore, to depend on plant sources for vitamin A. This vital nutrient is needed for the growth and repair of body tissues; it helps protect mucous membranes of the mouth, nose, throat and lungs; it prompts the secretion of gastric juices necessary for proper digestion of protein; it helps to build strong bones and teeth and rich blood; it is essential for good eyesight; it aids in the production of RNA; and contributes to the health of the immune system. Vitamin-A deficiency in pregnant mothers results in offspring with eye defects, displaced kidneys, harelip, cleft palate and abnormalities of the heart and larger blood vessels. Vitamin A stores are rapidly depleted during exercise, fever and periods of stress. Even people who can efficiently convert carotenes to vitamin A cannot quickly and adequately replenish vitamin A stores from plant foods.
Foods high in vitamin A are especially important for diabetics and those suffering from thyroid conditions. In fact, the thyroid gland requires more vitamin A than the other glands, and cannot function without it.8 And a diet rich in vitamin A will help protect the diabetic from the degenerative conditions associated with the disease, such as problems with the retina and with healing.
Weston Price considered the fat-soluble vitamins, especially vitamin A, to be the catalysts on which all other biological processes depend.9 Efficient mineral uptake and utilization of water-soluble vitamins require sufficient vitamin A in the diet. His research demonstrated that generous amounts of vitamin A insure healthy reproduction and offspring with attractive wide faces, straight teeth and strong sturdy bodies. He discovered that healthy primitives especially value vitamin-A-rich foods for growing children and pregnant mothers. The tenfold disparity that Price discovered between primitive diets and the American diet in the 1940s is almost certainly greater today as Americans have forsworn butter and cod liver oil for empty, processed polyunsaturates.
In Third World communities that have come into contact with the West, vitamin-A deficiencies are widespread and contribute to high infant mortality, blindness, stunting, bone deformities and susceptibility to infection.10 These occur even in communities that have access to plentiful carotenes in vegetables and fruits. Scarcity of good quality dairy products, a rejection of organ meats as old fashioned or unhealthful, and a substitution of vegetable oil for animal fat in cooking all contribute to the physical degeneration and suffering of Third World peoples.
Supplies of vitamin A are so vital to the human organism that mankind is able to store large quantities of it in the liver and other organs. Thus it is possible for an adult to subsist on a fat-free diet for a considerable period of time before overt symptoms of deficiency appear. But during times of stress, vitamin A stores are rapidly depleted. Strenuous physical exercise, periods of physical growth, pregnancy, lactation and infection are stresses that quickly deplete vitamin A stores. Children with measles rapidly use up vitamin A, which can result in irreversible blindness. An interval of three years between pregnancies allows mothers to rebuild vitamin A stores so that subsequent children will not suffer diminished vitality.
One aspect of vitamin A that deserves more emphasis is its role in protein utilization. Kwashiorkor is as much a disease of vitamin-A deficiency, leading to impaired protein absorption, as it is a result of absence of protein in the diet. High-protein, lowfat diets are especially dangerous because protein consumption rapidly depletes vitamin-A stores. Children brought up on high-protein, lowfat diets often experience rapid growth. The results—tall, myopic, lanky individuals with crowded teeth, and poor bone structure, a kind of Ichabod Crane syndrome—are a fixture in America. High-protein, lowfat diets can even cause blindness as occurred once in Guatemala where huge amounts of instant nonfat dry milk were donated in a food relief program.11 The people who consumed the dried milk went blind. Primitive peoples understood this principle instinctively, which is why they never ate lean meat and always consumed the organ meats of the animals that served them for food.
Growing children actually benefit from a diet that contains considerably more calories as fat than as protein.12 A high-fat diet that is rich in vitamin A will result in steady, even growth, a sturdy physique and high immunity to illness.
The great discrepancy between what science has discovered about vitamin A and what nutrition writers promote in the popular press contributes to awkward moments. The New York Times has been a strong advocate for lowfat diets, even for children, yet a recent NYT article noted that vitamin-A-rich foods like liver, egg yolk, cream and shellfish confer resistance to infectious diseases in children and prevent cancer in adults.13 A Washington Post article hailed vitamin A as "cheap and effective, with wonders still being (re)discovered," noting that recent studies have found that vitamin-A supplements help prevent infant mortality in Third World countries, protect measles victims from severe complications and prevent mother-to-child transmission of HIV virus.14 The article lists butter, egg yolk and liver as important sources of vitamin A, but claims, unfortunately, that carotenes from vegetables are "equally important."
Vitamin-A vagary confuses the public and contributes to continued acceptance of lowfat dogma, even among science writers.
Even worse than vitamin-A vagary is vitamin-A knavery in the form of concerns that vitamin A may be toxic in more than the minuscule RDA-recommended amounts. In fact, so great is the propaganda against the vitamin that obstetricians and pediatricians are now warning patients to avoid foods containing vitamin A!
Recently an "expert" panel recommended lowering the RDA (recommended daily allowance) for vitamin A from 5000 IU daily to about 2500 IU and has set an upper limit of about 10,000 IUs for women. The panel was headed by Dr. Robert Russell of Tufts University, who warned that intake over the "upper limit" may cause irreversible liver damage and birth defects—a ridiculous statement in view of the fact that just a few decades ago pregnant women were routinely advised to take cod liver oil daily and eat liver several times per week. One tablespoon of cod liver oil contains at least 15,000 IU and one serving of liver can contain up to 40,000 IU vitamin A. Russell epitomizes the establishment view when he insists that vitamin-A requirements can be met with one-half cup of carrots daily.
The anti-vitamin-A campaign began in 1995 with the publication of a Boston University School of Medicine study published in the New England Journal of Medicine.15 "Teratogenicity of High Vitamin A Intake," by Kenneth J. Rothman and his colleagues, correlates vitamin-A consumption among more than 22,000 pregnant women with birth defects occurring in subsequent offspring. The study received extensive press coverage in the same publications that had earlier extolled the benefits of vitamin A. "Study Links Excess Vitamin A and Birth Defects" by Jane Brody appeared on the front page of the New York Times on October 7, 1995; on November 24, 1995, the Washington Times reported: "High doses of vitamin A linked to babies' brain defects."
When a single study receives front-page coverage, it's important to take a closer look, especially as earlier research discovered the importance of vitamin A in preventing birth defects. In fact, the defects listed as increasing with increased vitamin A dosage—cleft lip, cleft palate, hydrocephalus and major heart malformations—are also defects of vitamin A deficiency.
In the study, researchers asked over 22,000 women to respond to questionnaires about their eating habits and supplement intake before and during pregnancy. Their responses were used to determine vitamin-A status. As reported in the newspapers, researchers found that cranial-neural-crest defects increased with increased dosages of vitamin A; what the papers did not report was the fact that neural tube defects decreased with increased vitamin A consumption, and that no trend was apparent with musculoskeletal, urogenital or other defects. The trend was much less pronounced, and less statistically significant, when cranial-neural-crest defects were correlated with vitamin-A consumption from food alone.
The study is compromised by a number of flaws. Vitamin-A status was assessed by the inaccurate method of recall and questionnaires; and no blood tests were taken to determine the actual usable vitamin-A status of the mothers. Researchers did not weight birth defects according to severity; thus we do not know whether the defects of babies born to mothers taking high doses of vitamin A were serious or minor compared to those of mothers taking lower amounts.
The most serious flaw was that researchers failed to distinguish between manufactured vitamin A in the form of retinol, found in supplements and added to fabricated foods, from natural vitamin-A complex, present with numerous co-factors, from vitamin-A-containing foods. It is well known that synthetic vitamins are less biologically active, hence less effective, than naturally occurring vitamins. This is especially true of the fat-soluble vitamins like vitamin A, because these tend to be more complex molecules, with numerous double bonds and a multiplicity of forms. Natural vitamin A occurs as a mixture of various isomers, aldehydes, esters, acids and alcohols. Pure retinoic acid, a metabolite of vitamin A used to treat adult acne, is well known to cause birth defects. Apparently pure retinol has teratogenic properties in high amounts as well.
Researchers found that cranial-neural-crest defects increased in proportion to the amount of retinol from supplements consumed during the first trimester of pregnancy (although the total number of defects remained stable up to 15,000 IU daily). Research into vitamin A has indicated that many factors interfere with its absorption and utilization. Inadequate fat in the diet, poor production of bile salts, low enzyme status, and compromised liver function can all interfere with the uptake and usage of vitamin A, especially when given as a supplement in the form of retinol, rather than as a component of whole foods. It may be that the teratogenic effects of commercial vitamin-A preparations are exacerbated in women whose dietary practices and general health status are poor. Some researchers believe that synthetic vitamin A interferes with the proper utilization of natural vitamin A from foods.
Pure retinol is added to many fabricated foods like margarine, breakfast cereals and pizza. The study made no distinction between those women whose vitamin A was supplied by whole animal foods and those who ingested retinol added to margarine, white flour and extruded breakfast cereals—foods which contain many other factors that can cause birth defects. Natural vitamin A provided by liver, eggs, butter, cream and cod liver oil is well recognized as providing excellent protection against birth defects.
Distinctions between synthetic and natural vitamin A have been absent in the extensive media coverage of this study—on the contrary, the newspaper reports contain implied warnings against pregnant women eating liver, dairy products, meat and eggs, but none against eating fabricated foods like margarine and breakfast cereals to which synthetic vitamin A is added. And there has been no media coverage for subsequent studies, which found that high levels of vitamin A did not increase the risk of birth defects. A study carried out in Rome, Italy found no congenital malformations among 120 infants exposed to more than 50,000 IU of vitamin A per day.16 A study from Switzerland looked at blood levels of vitamin A in pregnant women and found that a dose of 30,000 IU per day resulted in blood levels that had no association with birth defects.17
While scientists in America are creating confusion and fear about vitamin A, WHO and UNICEF vitamin-A-distribution programs in Africa and Asia have been extremely successful in reducing blindness and death among both children and adults. Vitamin A is more cost effective in saving lives and preventing suffering than immunizations and drugs and it can be administered with 2-cent capsules. The program does not undermine traditional cultures or foodways and is easily carried out on the village level.
But this kind of success doesn't sit well with the food and pharmaceutical industries because it strengthens village life and lessens the market for drugs and processed foods. Fulsome with praise, the "big guns of the international food supply system" have joined in a "public-private partnership" to get in on the program.18 Kellogg, Cargill, Monsanto and Procter & Gamble have pioneered the addition of vitamin A to margarine, vegetable oil, wheat flour, sugar and breakfast cereals—even to MSG! At a formal luncheon hosted by Hillary Clinton, the corporate executives and leaders of various relief groups announced their goal of showing "indigenous food companies. . . how to add vitamin A to foods that low-income people eat." In other words, vitamin A will be used to promote processed foods to villagers in Africa and Asia in the guise of humanitarian relief. Low income people in America eat margarine and other processed foods, but low-income people in the Third World eat foods grown by farmers and processed locally by artisans.
And when people refuse to eat processed foods, the "big guns" have devised another stratagem—genetically engineering rice to produce carotenes. Those who promote the so-called "golden" rice as a solution to the vitamin-A problem are either woefully ignorant or unabashedly corrupt. Golden rice containing carotenes can't provide true vitamin A to the world's children but it will further the trend of pushing their parents off the farm and into ghastly slums.
In the process of showing "indigenous food companies. . . how to add vitamin A to foods. . ." and of inserting genes for producing carotenes into rice, the multinational corporations will strengthen their grip on the world's food supply, leading to a disruption of village life and what Indian writer Vandana Shiva calls "food dictatorship." If the conglomerates have their way, programs to promote golden rice and "enriched" processed foods will replace programs to distribute vitamin-A capsules, increasing the suffering of children and worldwide economic slavery.
What can we in the west do to foil the nefarious plans of the food-and-pharmaceutical-complex in nations less prosperous than our own? The answer is simple: cut off their funding at the source by refusing to spend money on their products. Boycott processed foods; avoid pharmaceutical drugs. The better way to physical and economic health is through foods containing vitamin A.
1. Price, Weston A. Nutrition and Physical Degeneration. Price-Pottenger Nutrition Foundation, San Diego, CA, p 280.
2. The history outlined here has been expertly compiled by G Wolf. "A History of Vitamin A and Retinoids." The FASEB Journal, July 1996, 10:1102-1107.
3. Gerson, M., MD. A Cancer Therapy: Results of Fifty Cases. Totality Books, Del Mar, CA, 1958.
4. Griffin, G. E. World Without Cancer. American Media, Westlake Village, CA, 1974, pp 462-3.
5. Solomons, N. W. and J. Bulus. "Plant sources of provitamin A and human nutriture." Nutrition Review, Springer Verlag New York, Inc, July 1993, 51:1992-4.
6. Jennings, I. W. Vitamins in Endocrine Metabolism. Charles C. Thomas Publisher, Springfield, Illinois.
7. Dunne, L. J. Nutrition Almanac, Third Edition, McGraw-Hill Publishing Company, 1990.
8. Jennings, Op Cit.
9. Price, Op Cit.
10. Solomons, Op Cit.
11. Personal Communication, Ruth Rosevear
12. Protein calories should comprise about 15 percent of the diet. Fat calories in children's diets should be greater than 40 percent of total calories.
13. Angler, Natalie. "Vitamins Win Support as Potent Agents of Health," New York Times, March 10, 1992.
14. Brown, David. "It's Cheap and Effective, With Wonders Still Being (Re)discovered." The Washington Post, November 7,1994.
15. Rothman, K. J. and others. "Teratogenicity of high vitamin A intake." New England Journal of Medicine. November 23, 1995 333(21):1414-5.
16. Mastroiacovo, P. and others. "High vitamin A intake in early pregnancy and major malformations: a multicenter prospective controlled study." Teratology. January 1999 59(1):1-2.
17. Wiegand, U. W. and others. "Safety of vitamin A: recent results." International Journal of Vitamin and Nutrition Research. 1998, 68(6):411-6.
18. Mann, J. "Saving Young Lives With a 2-Cent Capsule." The Washington Post, March 17, 1999.