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Background |
While I was in medical school, I proposed that abnormalities of essential fat metabolism and EFAD cause alterations of cell membrane fluidity and other biochemical changes that contribute to disease. These alterations in turn cause abnormal levels of cholesterol, triglycerides, insulin, and appetite. I developed a method to measure essential fat deficiency which is about 10 times more sensitive than methods used by previous researchers. In the 1980’s, I published several studies with my new methods. I proposed that EFA deficiencies were highly prevalent in the US.
My results supported the hypothesis of Hugh Sinclair that the ratio of PUFA/NoPUFA, that is, the ratio of all polyunsaturated fat to other types of fat, is "the most important factor in atherosclerotic disease and in coronary thrombosis." Like Sinclair and Ahrens, I proposed that a diet low in fat, which is likely to be deficient in essential fats, may not lead to a reduced risk of CAD, but may actually increase the risk. This increased risk occurs because excess carbohydrates and protein are converted by the body to saturated fat.
In 1994, Time magazine published one whole page about my research and the dangers of low fat diets, characterizing my findings as "controversial". At that time, many scientists disputed my findings. It seems that I was one of the few physicians willing to say that eating according to the USDA Food Pyramid and following a very low fat diet was potentially harmful.
Today my views are quite common. In 1998, the American Heart Association endorsed a new policy warning about potential risks of very low fat diet. Unfortunately, many people still misunderstand what I wrote or misinterpret the results of fatty acid profiles.
I have found that EF abnormalities are quite prevalent in the USA. According to my research, EFA deficiencies are the most significant nutritional factor in abnormal levels of cholesterol, in CAD, and in high blood pressure. Other researchers are finding that EFA abnormalities are a major factor in the complications of diabetes, brain function, arthritis, child growth and development, PMS, immune system function, and a wide range of body functions in health and disease.
It takes more than 10 hours for us to calculate the amounts of > 30 different types of fat in the blood for the fatty acid profile EFA-SRä. The test identifies what kinds of fat people have been eating and what kinds of fat they need to eat to correct their conditions. The technology requires the use of computers and expertise in physics, chemistry, mathematics, and medicine. Several hours are required to interpret each test result.
Using my sophisticated blood tests, expert nutritionists can identify and correct for many diseases and mild disorders. Unfortunately, in spite of the value of nutritional studies for the health of the patient, it is difficult to get insurance companies to reimburse patients for nutritional evaluation, or to pay physicians a fair value for time spent analyzing biochemical results, which are frequently more complicated than NMR or CAT scans. Patients, professionals, and lay people must work to educate legislatures and insurance companies, so that prevention and nutritional therapy is placed on at least equal footing with heart transplants and kidney dialysis.
Based on my clinical experience and research, it is my opinion that an assessment of fatty acid abnormalities and EFA status provides useful and practical information in the evaluation and monitoring of patients likely to suffer from fatty acid abnormalities. For the past several years, I have been evaluating fatty acid profiles in TPN patients and patients with chronic intestinal disorders, obesity, neurological disease, cystic fibrosis, and other conditions (for a brief description of our results, see Siguel EN, Lerman RH. Trans fatty acid patterns in patients with angiographically documented coronary artery disease. Am. J. Cardiology 1993; 71:916-920; and Siguel EN, Lerman RH. Fatty acid patterns in patients with angiographically documented CAD. Metabolism, Aug 1994.) I found that significant abnormalities of fatty acid metabolism in many patients have been overlooked by traditional methods of laboratory testing. As many patients with gastrointestinal disease have difficulties in absorbing or tolerating lipids enterally, and some cannot tolerate lipids parenterally, I find that fatty acid analysis allows me to determine the smallest quantity of fatty acids necessary to maintain EFA status and adequate overall nutrition.
Edward Siguel, MD, PhD
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© 1998 Edward
Siguel. All rights reserved |
modified 1/15/00 |