The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them

7. THE CHEMIST IN THE KITCHEN

SEVEN THE CHEMIST IN THE KITCHEN Thy food shall be thy remedy. ATTRIBUTED TO HIPPOCRATES, CA. 400 B.C.E. NO ONE KNOWS MORE ABOUT THE DIVERSITY OF FATTY ACIDS IN FAT than Ralph Holman. He spent years, decades, teasing out alpha linolenic acid (or eicosapentaenoic acid or DHA) from the messy mixture of triglycerides that make up any one fat. In the process, he acquired an appreciation for those messy mixtures. There must be some reason for them, though neither scientist nor cook understood it as yet. This appreciation kept him from jumping on the prostaglandin bandwagon as so many scientists did in the 1960s and ’70s. Holman heard through the grapevine about his good friend Sune Bergström’s success in isolating these powerful new biological messengers. And when Bergström and David van Dorp published their papers in 1964, he learned, along with the rest of the scientific world, that fatty acids were the starting material of prostaglandins. But Holman did not think, as many did, that the role of essential fatty acids was now completely understood and that it was only to provide the starting material of prostaglandins. With his intimate knowledge of the behavior of different fats, he suspected 76 that polyunsaturates play other important roles in the body: in transporting cholesterol, as he had been suggesting since the 1950s, and in creating the optimal environment of membranes, which are involved in most metabolic processes. “While Bergström would be looking for ways to increase his yield of prostaglandins,” Holman told me in a recent telephone conversation, “I’d be looking for ways to prevent fatty acids from turning into prostaglandins. Bergström was only interested in prostaglandins and threw everything else away. I was interested in everything that came before the prostaglandins.” Ever since his collaboration with the pediatrician Arild Hansen on the problem of eczema in bottle-fed infants (changing the once-common practice of feeding babies sweetened skim milk), Holman had been intrigued by the connection between essential fatty acids and disease. At first, this meant examining only linoleic acid and arachidonic acid, since those were the only fats that could correct the symptoms seen by the Burrs. And at first, the only animals shown to have an absolute requirement for these fats were rats; then, because of his work with Hansen, human infants. The essentialness of linoleic acid for adults was an unresolved question, as I noted in chapter 3, until the 1960s, when hospitals became capable of maintaining patients on intravenous feeding, or total parenteral nutrition (TPN), for longer and longer periods of time. Because of the difficulties of delivering lipids intravenously (fat being insoluble in an aqueous solution), the first TPN preparations were fat-free. Patients who were sustained on them for long periods developed many of the same symptoms that the Burrs’ rats had displayed thirty years before: dry scaly skin, weight loss, and an increase in water consumption. Tragically, Ralph Holman’s mother was one of these patients. She was put on TPN after a mesenteric infarction destroyed the THE CHEMIST IN THE KITCHEN 77 use of her bowels, and Holman watched helplessly as she died of the very kind of deficiency that he was working to prevent. His mother’s doctor was receptive to what Holman was telling him about essential fatty acids (as many doctors at the time were not), but neither of them could figure out how to safely provide her with the nutrients she was missing. Unmodified fat given intravenously could itself cause death. Rubbing her body with corn oil, which they tried, was somewhat effective but couldn’t entirely correct the deficiency. A nontoxic fat emulsion was developed in Sweden in 1961, but it was not yet available in the United States. In 1962, Holman’s mother died. “Why would this happen to my mother of all people?” Holman remembers asking himself, and he redoubled his efforts to convince the medical profession of the importance of fats. Not knowing what he would find, he asked physicians who specialized in diseases of the nervous system for blood samples from their patients. That was when he got his first hint that a deficiency of omega-3 fats was a much more widespread problem in human health than a lack of omega-6s. By that time it was known that brains and nerves are very rich in...