Real Food Part 5

I Try the Winston Churchill Diet.

Hannah Bantry, In the pantry, Gnawing at a mutton bone; How she gnawed it, How she clawed it, When she found herself alone.

- Mother Goose.

A MAN OF APPEt.i.tES, with the const.i.tution of an ox, Winston Churchill lived to ninety smoking cigars, drinking champagne, and relis.h.i.+ng bone marrow. The English have long considered unctuous bone marrow on toast a delicacy as well as a tonic for the malnourished. In London today, the signature dish at St. John- the celebrated restaurant near Smithfield, the wholesale meat market that clatters with butcher hooks in the small hours- is Roast Bone Marrow and Parsley Salad. Chef Fergus Henderson, dedicated to elemental, frugal, and traditional English food, made "nose to tail" eating fas.h.i.+onable.

Marrow may be the oldest and simplest dish ever. Stone Age hunters devoured it even before they went for the raw meat. In Latvia, successful hunters still celebrate by eating the raw bone marrow on bread with salt, pepper, and onion before they divvy up the kill. Organ meats- also called offal or variety meats- have a similar poor-relation reputation, coming in second to more glamorous cuts of pure muscle, such as a T-bone. Yet this distinction between cla.s.sy steak and down-market liver and bones- not to mention beyond-the-pale parts, like brain and thymus glands- is recent. Dishes built on bones and variety meats fill old American and European cookbooks, and our taste for these foods goes back long before that.

"Since prehistoric times, man and other primates have killed for the valuable fats present in brain, tongue, and marrow," writes the food historian Nichola Fletcher.21 "Red meat, although prized, was once secondary." Native Americans sometimes returned from buffalo hunts with nothing but tongue. Loren Cordain, the expert on Stone Age nutrition, writes, "There is absolutely no doubt that hunter-gatherers favored the fattiest part of the animals they hunted and killed."

One reason our ancestors preferred organ meats and bone marrow is the sheer desire for fat. Fat is tasty for a host of reasons: because fat kept us alive during long winters, because without fat a woman cannot get pregnant, because fats are essential for digestion. But the particular fats in the oddball cuts are perhaps even more important. They are not, as many people believe, mostly saturated. "Brain is extremely high in polyunsaturated fats including . . . omega-3 fatty acids," writes Cordain. "The dominant fats in tongue and marrow are the cholesterol-lowering monounsaturated fats."

Eating bone marrow had a profound effect: it separated us from our ape cousins and helped make us uniquely human. The human brain grew very large relatively quickly on a diet of long-chain polyunsaturated fats found in bone marrow (and fish, as I describe in chapter 4). Polyunsaturated fats, so vital to brain and visual development, are considered the main factor in our astonis.h.i.+ng leap ahead, brain-wise, over other primates. They were still eating mostly fruit, leaves, and insects, while early humans went for fat.

It's too bad that bone marrow is underappreciated. I like to roast beef or lamb shanks and scatter the hot meat on a watercress salad before tossing the bones in the stock pot. Tearing thin shreds of meat off the bone like Hannah Bantry is the fun part; it feels so primitive. Perhaps you don't fancy the role of the clawing, gnawing Hannah- who, let's admit, is cast as slightly uncivilized. Another way to get at the nutrients in marrow is by making broth from bones. A staple of most cuisines, stock adds flavor to starches, richness to soups, and depth to sauces. Fresh stock, which lasts several days in the fridge and freezes well, is also convenient; a bowl of hot consomme with bread makes a quick meal. "Stock is everything in cooking," said Escoffier. "Without it, nothing can be done."

It's also affordable. If you would like to eat well on not very much money, buy soup bones. Broth made from the lesser cuts- necks, knuckles, wings, feet- is rich in minerals including calcium, magnesium, and phosphorus, all in a form that's easily absorbed. Joints are particularly rich in gelatin, called a "protein sparer" because it helps the body use the smaller amounts of incomplete and low-quality protein found in plants. That's why stock is a staple of protein-poor cuisines. Wartime ads for Bovril bouillon cubes in Britain featured a cow made of vegetables because a bit of Bovril ( essentially, reduced beef stock) could stretch even vegetables into the nutritional near-equivalent of meat. Stock is also famously good for convalescents. A South American proverb says, "Good broth will resurrect the dead."

I Am Skeptical That Red Meat Causes Cancer.

CANCER is ON THE RISE, and, like heart disease, it has many causes. Damage to DNA increases with age, for example, so our long lives may be one reason for higher cancer rates. Is our diet killing us? My guess probably won't surprise you: I doubt that foods we've eaten for millions of years cause cancer. Indeed, cancer is rare in groups where wild meat is eaten liberally. I tend to suspect industrial foods and chemicals.

The suggestion that animal foods cause cancer took root in 1965, when Dr. Ernst Wynder of the American Health Foundation said that animal fat and colon cancer were linked in the United States and elsewhere. "Unfortunately," said the lipids expert Mary Enig, the consumption data Wynder cited for the United States were "mostly processed vegetable fat," not animal fat. 22. If Enig is right, Wynder's conclusions were unfounded. Enig says that other data undermining the link between animal fat and cancer were neglected or ignored over the years. In 1973, for example, National Inst.i.tutes of Health researchers looked at diet and cancer in j.a.panese Hawaiians. "They actually found that the highest risk relations.h.i.+p came from macaroni, green peas, green beans, and soy," writes Enig. Yet the authors concluded colon cancer was linked to beef.

Because cancer is on the rise and red meat is a regular part of diets in most of the industrial world, many researchers have examined a possible link between eating red meat and cancer. Lately, it looks rather weak. In the 1990s, three studies with rats found no relations.h.i.+p between red meat and cancer, but two called for more study on fat itself, as opposed to lean meat. The first study concluded that lean beef did not cause colon cancer.23 In the second, researchers who fed cancerous rats lard, olive oil, beef, chicken with the skin, or bacon found that beef did not promote tumors.24 A third group reported that their data "do not support the belief that red meat consumption increases the risk for colon carcinogenesis."25 They, too, fed rats with cancer various fats (corn oil versus beef fat) and various proteins (lean beef versus milk protein). Rats who ate beef had significantly fewer colon tumors.

Recent human studies don't seem to support the link either. In the 1998 Australian Journal of Nutrition and Dietetics, researchers reviewed many published studies, asking "Does Red Meat Cause Cancer?" They concluded that "any true effect of meat is likely to be small, or even an artifact of a decreased consumption of fruit, vegetables, and cereals among high meat consumers."26 Other researchers reviewed five studies including eighty-three hundred deaths among seventy-six thousand people. The subjects included a large number of vegetarians. There were no differences between the vegetarians and omnivores in death rates from stomach, colon, lung, breast, or prostate cancer.27 In 2003, a team led by Dr. Walter Willett, the prestigious epidemiologist at the Harvard School of Public Health, followed more than eighty-eight thousand women for eighteen years and found no evidence that eating meat was a.s.sociated with breast cancer.28 Other studies, however, have shown a link between meat and cancer. Some researchers suspect that cured meat, not meat itself, is responsible. One of the world's largest studies on diet and health is the European Prospective Investigation into Cancer and Nutrition (EPIC). For cancers of the colon, r.e.c.t.u.m, stomach, and upper digestive tract, EPIC found fish was beneficial, red meat harmless, and preserved meat harmful.29 Two studies in Argentina, where people eat a lot of red meat, linked cured meat and colon cancer. Others reported that preserved meats (cold cuts) were linked to cancer, while lean meat was beneficial.30 Yet another study found that total meat intake was unrelated to colon cancer and large amounts of cold cuts increased the risk.31 If cured meat is to blame, the actual culprit may be nitrite, which improves the flavor of cured meat, preserves its pink color, and prevents bacterial growth. Nitrite in various forms has been used to preserve meat since the Middle Ages. Scientists say that nitrites are harmless at the levels we eat them, but at high temperatures nitrites are converted to nitrosamines, which may cause cancer. Nitrosamines are "powerful DNA-damaging chemicals," writes Harold McGee in On Food and Cooking. "Yet at present there's no clear evidence that the nitrites in cured meats increase the risk of developing cancer." The use of nitrite has fallen drastically since the 1970s, and fairly small amounts are used now.

McGee is a scientific man, an accomplished cook- and a moderate on meat. "To the extent that meat displaces . . . vegetables and fruits that help fight heart disease and cancer, it increases our vulnerability to both," he says. In addition to nitrosamines, two other carcinogens are formed when meat is cooked at high temperatures.32 . McGee suggests that we eat vegetables liberally and and cook meat gently.

To that good advice, I would add: never burn the fat (if it's smoking, it's burning) and cook meat rare. Even better- if you have a taste for it- make steak tartare and eat it raw. After all, our ancestors ate everything, even fish and red meat, uncooked for about three million years before they first used fire, only 250,000 to 350,000 years ago. For raw meat dishes, Sally Fallon recommends using frozen beef as a precaution against parasites. For steak tartare, I only use gra.s.s-fed beef from a farm I trust. I also buy nitrite-free bacon and salami.

If not meat, what dietary factors might account for the rise in cancer? For me, the simplest approach is to ask what's new in the diet, and fats are key. Industrial food contain too many omega-6 fats and too few omega-3 fats, an imbalance that promotes cancer, according to omega-3 experts, including Dr. Andrew Stoll and Dr. Artemis Simopoulos.33 Wild game, gra.s.s-fed meat, and gra.s.s-fed b.u.t.ter- until recently, the only kind- contain omega-3 fats and CLA, the powerful anticancer fat.

Another major factor in cancer is lack of antioxidants, including vitamins C and E and the hundreds of compounds in fruits and vegetables. The interactions of foods are mightily complex. Here's a curious one, again from McGee: fruit, vegetables, and acidophilus bacteria in yogurt appear to diminish the effect of the carcinogenic compounds formed when meat is burned. Anyone- vegetarian or omnivore- who eats a lot of fruits and vegetables is doing the right thing.

One other hypothesis about cancer and fat deserves more study- especially because some research exonerates lean meat. Modern life is rife with carcinogens, from plastics to pesticides. Stone Age humans certainly had their worries, but persistent environmental toxins weren't among them. Some believe that cancer comes not from animal fat itself but from the "bioacc.u.mulation" of carcinogens in the fat. As toxins travel up the food chain, they become more concentrated, and they lodge in fat. A feedlot steer contains a great deal of grain, most of it grown with chemicals, which means you ingest more chemicals from a steak than from a slice of bread. Any toxins in the beef fat, in turn, acc.u.mulate in your fat, which might explain the rise in fat-related cancers. As ever, the sensible thing is to avoid foods laden with chemicals.

Buying and Cooking Real Meat.

ONCE YOU GET THE hang of it, buying and cooking gra.s.s-fed and pastured meat and poultry is easy. Here are the essential facts about the labels gra.s.s-fed, pastured, and organic, and some kitchen tips.

Gra.s.s-fed applies to ruminants: cattle, sheep, goats, and game. It means animals were raised on gra.s.s and hay, but how much varies widely; the term is not legally defined. Ideally, fresh pasture makes up the bulk of the diet, and when there's no gra.s.s, animals eat hay. Some farmers add a dollop of sorghum silage, which many would regard as a gra.s.s-based diet, or corn silage. However, silage is fermented- sort of like sauerkraut for cows- and fermented foods, like grain, give cattle an acid stomach. Purists never feed silage, grain, corn, or soybeans to ruminants.

Grain-finished beef was raised on gra.s.s and fattened with grain. I can live with a little silage or grain in my beef- even a wild steer would have eaten a few seed heads- but if you're a purist, look for the label 100 percent gra.s.s-fed.

Pastured applies to pork, poultry, and eggs when animals are raised on pasture. "Gra.s.s-fed" bacon and eggs is not correct, because a diet of gra.s.s isn't enough for these omnivores. Like humans, pigs and chicken need complete protein. Pastured chickens eat corn, insects, and sour milk as well as gra.s.s. On eggs or poultry, the label vegetarian feed is misleading. It means chickens were not fed other ground-up chickens- and that's good. But chickens are not natural vegetarians. What it does mean is the birds never went outside; if they had, they might have eaten a grub or two. Free-range poultry and eggs says nothing about gra.s.s. It means the birds aren't in cages, but they may be in barns or on bare dirt. Gra.s.s is the key source of beta-carotene, CLA, and omega-3 fats in pastured poultry and eggs.

As I've mentioned, there is no single diet for the not-picky, omnivorous pig. Swine will eat different foods on every farm: acorns and apples here, coconut and corn there. Whey-fed pork is popular on dairies because farmers have plenty of protein-rich whey to spare after cheese making. Pigs are sometimes raised in barns on deep straw; this is better than industrial pork, but ideally pigs root outside in meadows or woodland, usually with huts for shelter. Good fencing is the key; it is not easy to keep pigs from running riot. If a local farmer raises pastured pork, count yourself lucky and eat up.

LETTING PIGS GO HOG WILD.

Beverley Eggleston of EcoFriendly Foods in Moneta, Virginia, explains how pigs like to live: "Wild hogs are foragers with a great sense of smell; they root with strong snouts. Pig and plow come from the same root word. You will never find a happier pig than one up to his shoulders in dirt, chewing on wild potatoes or other roots. I've seen pigs flip big rocks over with their noses, just for fun. Our farmers raise hogs in a setting that allows them to run around and dig. Because pigs literally tear up the landscape, it's important to use that to the advantage of the farm, not the destruction. The industry's solution is to put the pigs on concrete; this makes a boring and hard life for the pig. On the other hand, you can't really put them on pasture and expect the gra.s.s to last. The obvious solution is to put the pigs in a place that you want to dig up anyway."

Organic is legally defined. It means the food was produced without synthetic fertilizer, antibiotics, hormones, pesticides, genetically engineered ingredients, and irradiation. Organic does not mean animals were gra.s.s-fed or pastured. Organic beef, pork, and poultry eat organic grain, but most commercial versions are not raised on gra.s.s, or their access to pasture is minimal.

Conversely, gra.s.s-fed and pastured don't mean animals were raised to organic standards, but the gra.s.s farmer who uses antibiotics, hormones, pesticides, or genetically engineered foods is rare. The label natural says nothing about the animal's diet. It means the product contains no artificial flavor or color, chemical preservative, or any other artificial ingredient. This weasley term is widely used. According to the USD A, "all fresh meat" qualifies as "natural."

In the 1950s, when corn-fed beef became trendy, good cooks adjusted their recipes- or so I imagine. Similarly, you may need to tweak things a bit for lean gra.s.s-fed beef. Many people believe that lean meat is bound to be tough, but the gra.s.s-farming expert Jo Robinson says that fat marbling accounts for only 10 percent of variation in tenderness. Other factors are breed, cut, age, and s.e.x of the animal, calcium levels in the soil (and thus the meat) whether it was stressed before slaughter, how it was chilled (too cold and it toughens), how long it was hung, and, of course, how you cook it.

"We would no sooner cook salad bar beef like fat beef than we would cook venison like fish," says Mr. Gra.s.s himself, Joel Salatin. The chief risk with gra.s.s-fed beef and bison is overcooking. At high temperatures, the proteins in meat contract and toughen. Gra.s.s-fed steaks cook in half the time of a grain-fed steak. Other things being equal, the lower the final temperature of the meat, the more tender it will be.

That said, there are two approaches: cook it very quickly and keep it rare; or cook it slowly, with moisture. For steak, the food writer Betty Fussell, an expert on beef, favors quick cooking over high heat. "Rare should be really rare," she says. "If you like a b.u.t.tery texture, add a pat of herbed b.u.t.ter to the cooked steak, French-style." Some cooks marinate steak first. With other cuts, cook it low and slow, with moisture. As with any meat, the less tender cuts, such as chuck steak, benefit from braising.

You may need to make other minor adjustments with gra.s.s-fed meat. When you calculate how many people a roast will feed, you don't need to allow for shrinkage- gra.s.s-fed tenderloin, for example, is so lean that very little fat is lost- but the temperature should be lower and the cooking time shorter. When browning gra.s.s-fed ground beef for chili or spaghetti sauce, I find it helpful to use a fair bit of olive oil.

Industrial beef is fattier than traditional beef, but with pork, the opposite is true. Commercial pork has been bred very lean- that's why kitchen tricks to prevent dry meat are often called for- and traditional pork is richer. The industrial pig is typically 56 percent lean, while Bill Niman, founder of Niman Ranch, favors 48 to 51 percent lean pork. A fatter and moderately muscled pig has more flavor.

Many small farmers raise a standard commercial breed like the Large White. A Yorks.h.i.+re native, the Large White has been a registered breed in England since 1884, and it has proved adaptable on modern farms. It does well in confinement and produces a great deal of bacon and other cuts from its straight back and large loin. Other farmers favor rare traditional breeds like Gloucester Old Spot, Large Blacks, and Tamworths, which are often richer than conventional breeds. A loin of pastured Gloucester Old Spot requires very little doctoring. A little olive oil, salt, rosemary, and a very hot oven will do nicely.

Pastured chicken has a rich flavor and firm texture compared with flabby and insipid factory chicken. Stock made from pastured chicken is superior, too. I suspect that's because a chicken that gets exercise on well-managed pasture and grows slowly has more gelatin in its joints, more amino acids (protein) in its meat, and more minerals in its bones. In other words, a pastured chicken is a more complex and dense creature, and that makes for richer, tastier, and more nutritious stock.

Recently, poultry breeds have won more attention from farmers and chefs. The typical commercial chicken is a large-breasted Cornish cross, and many small farmers raise it on pasture. Other farmers raise traditional, slow-growing breeds such as Redbro, Mastergris, or GrisBarre, which tend to be leaner, with darker meat and rich flavor. Traditional turkey breeds, once endangered, are also making a comeback. Look for Standard Bronze, Narragansett, Royal Palm, Bourbon Red, and Black Slate.

Cooking pastured poultry is simple: just watch the leaner breeds to avoid dry meat. They benefit from shorter roasting times and the sort of tricks used on wild fowl, such as wrapping with bacon. I'm a fan of traditional turkey breeds, but for roast chicken, I find some of the older breeds a bit too skinny, so I tend to buy a commercial breed, like a Cornish cross. When raised on pasture, they seem to have the right combination of meat, juice, flavor, and tenderness.

4.

Real Fish.

How Our Brains Grew Fat on Fish.

WHAT WOULD YOU SAY to a six-year-old who asked you: where do farmers come from? Perhaps you would tell a bedtime story like this: Back in the Stone Age, our ancestors were skillful hunter-gatherers. They gnawed on marrow bones, dug tubers, gathered seeds, cracked nuts, and speared fish. Life was good. Over time, however, the smarter ones perceived that a little planning and organization would yield a more reliable food supply, one that could be more easily stored for a rainy day and shared with others. These innovative deer hunters and berry pickers began to tame smaller wild cows and plant larger seeds of wild gra.s.s. Eventually, the tribes who were best at these new tricks put aside their restless ways and settled down in villages to harvest grain and herd animals for milk and meat. They became farmers.

Richard Manning has a subtly different take on what he calls the "just so" story of the rise of agriculture. He believes fis.h.i.+ng was the second-oldest profession, not farming. In Against the Grain, Manning imagines early humans were keen to be near a steady supply of eels, salmon, and other migrating fish. They looked for neighborhoods with good water and rested there to wait for hordes of fat seasonal fish; only then did they start to tend, guide, herd, and harvest wildlife in the backyard. While REAL FISH 123 waiting for the river mouth to disgorge fish, the Cro-Magnon had time to paint the mighty salmon on cave walls, a sure sign of its importance.

Fis.h.i.+ng man- call him h.o.m.o piscator - fills in part of the story Fis.h.i.+ng of the transition from swinging in the trees (like our fruit-loving primate cousins) to becoming hunter-gatherers and, eventually, farmers. Paleoanthropologists have long puzzled over the "missing link"- the ancestor we share with chimpanzees and gorillas, whose bones (mysteriously) are not found in the fossil record. Where did they live, how did they move about, what did they eat? No one knows.

In 1960, the marine biologist Alister Hardy offered a novel theory about the era after we came down from the trees and before we settled on the plains. Suppose we spent a few million years living in the shallow waters of the sea, like aquatic mammals including the dolphin, hippo, and sea cow? According to Elaine Morgan in The Descent of Woman, the quasi-aquatic ape hypothesis could explain a number of downright peculiar human features: nude skin, subcutaneous fat, always plump b.r.e.a.s.t.s, how newborns love to swim, why we have s.e.x face-to-face . . . I could go on about the ways we are unusual among primates. But for our purposes, the most compelling thing about the idea that our ancestors once lived in the water is our dramatic and indisputable dependence on fish.

If you've glanced at a biology text recently, you'll know that the river ape idea is not widely accepted. However, the experts do agree our taste for fish is ancient. Many fossils tell us that some two million years ago, at least three hominid species lived near the huge freshwater lakes of the East African Rift Valley. Each had its niche. The ones with broad, flat molars apparently ate a plant-based, high-fiber diet; another group, with smaller teeth, ate mostly small fruit, berries, and the occasional egg or rodent. The third species, of course, was our very own h.o.m.o habilis. Dubbed "handy man" for the tools he used, including fis.h.i.+ng gear like spears and nets, he was an omnivore- and loved fish.

Whether we lived in it or near it, water offered easy access to DHA and EPA, omega-3 fats essential to visual, mental, metabolic, and hormonal function found only in fish. The body can make its own DHA and EPA from another omega-3 fat found in plants, Alpha-linolenic acid (ALA), but the conversion of ALA to DHA and EPA is inefficient. Making DHA and EPA requires vitamin B6, magnesium, calcium, and zinc; it is hindered by trans fats, cortisol, alcohol, and sugar.1 Moreover, the plant sources of ALA- walnut, flaxseed, and canola oil, and a weed called purslane- were not abundant in the Stone Age. Then, as now, the best source of these vital fats is fish. This is a dilemma for vegetarians; in the future, DHA and EPA supplements made from algae may solve it.

DHA and EPA are vital to the brain. Like bone marrow, which helped our brains grow much bigger and faster than the brains of leaf eaters, fish was brain food. Recall that the brain is 60 percent fat; half the fat is DHA.2 Dr. Andrew Stoll puts it bluntly in The Omega-3 Connection, "Without large amounts of DHA . . . we might not have evolved at all." No wonder the search for fish and seafood is universal. The overwhelming bulk of the human family has settled near sea sh.o.r.es and river mouths. The exceptions- landlocked and mountain people- go to great lengths to trade with fis.h.i.+ng groups for seafood.3 Like the bon.o.bo- our closest relative, a playful creature that likes to catch shrimp with its hands- h.o.m.o sapiens is a water-loving ape.

Life After Salmon: Obesity, Diabetes, and Heart Disease.

THE KLAMATH RIVER RUNS through the mountains of northwest California, pa.s.sing through the town of Happy Camp, home of REAL FISH 125 the Karuk tribe. Once the Klamath River ran thick with salmon, which the Karuks devoured at every meal, each one putting away more than one pound of fish daily. Then, in the 1960s and '70s, hydroelectric dams stopped the water, the salmon disappeared, and the Karuks turned to industrial foods.4 When wild salmon were plentiful, diabetes and heart disease were rare. Not now. The percentage of tribe members with diabetes has risen from near zero to 12 percent, almost twice the national average. Forty percent of the tribe has heart disease- three times the national rate. "You name them, I got them all," Harold Tripp, a Karuk fisherman, told the Was.h.i.+ngton Post. "I got heart problems. I got the diabetes. I got high cholesterol. I need to lose weight."

That's what can happen when people lose access, almost overnight, to traditional foods and then resort to poor-quality foods. Like the Karuks, many indigenous Americans have swapped a wholesome diet for cheap, ubiquitous industrial foods. Health takes a double hit; the new industrial diet causes the very health problems traditional foods can ward off. In this case, the nutritional mechanisms are well understood. Omega-3 fats in wild salmon prevent the trio of modern diseases- obesity, diabetes, and heart disease- in multiple ways.

Let's look first at the effects on metabolism, because metabolic disturbances are in many ways the root of all three conditions. Omega-3 fats regulate blood sugar levels and fat burning. DHA and EPA in particular are directly involved in activating the expression of genes controlling fat metabolism. For example, mice fed the same number of calories from fish oil are leaner than those fed corn oil, which is rich in omega-6 fats. People whose muscles are low in omega-3 fats are more likely to be obese.

Obesity, in turn, leads to diabetes. In the United States today, diabetes and metabolic syndrome- or prediabetes- are epidemic. "In medical school, I was taught that if you can understand diabetes, you will understand all of medicine," says Dr. Andrew Stoll, author of The Omega-3 Connection, "because those with diabetes fall prey to many other disorders, from cardiac disease to kidney failure to stroke."

What is diabetes? When blood sugar rises, the pancreas secretes the hormone insulin, which signals the muscles to take sugar from the blood to muscles. Once in the muscle, the sugar has two uses: as immediate energy or as short-term, stored energy, in the form of glycogen, which marathon runners draw on. In type 1 diabetes, the pancreas does not produce insulin at all. In type 2 diabetes, which accounts for 90 to 95 percent of cases, the pancreas does produce insulin, but the muscles don't respond; they are "insulin resistant." When the muscles are deaf to insulin, sugar, which is toxic at high levels, gathers in the blood. Until recently, type 2 diabetes was viewed as an adult disease, and it is still most common in overweight people over fifty-five, but the rising number of cases in children is a distressing trend. Diabetes, it seems, is not a disease of age, but of diet. Fish is important, because omega-3 fats decrease insulin resistance.

EAT FISH TO BEAT INFLAMMATION.

In type 1 diabetes, the body attacks its own pancreatic cells. Other autoimmune diseases include arthritis, psoriasis, Crohn's, lupus, colitis, and asthma. A common symptom is chronic excessive inflammation. Omega-3 fats prevent inflammation, and omega-6 fats promote it. Dr. Artemis Simopoulos (The Omega Diet) says the protective effect of omega-3 fats on autoimmune kidney disease is "one of the most dramatic effects of omega-3 fats on any pathology."5 Diabetes, in turn, leads to heart disease. According to the cardiologist Dr. Arthur Agatston, author of The South Beach Diet, half of heart disease patients have metabolic syndrome first. The evidence that omega-3 fats prevent heart disease is robust and growing. Omega-3 fats reduce the risk of a first heart attack and reduce the risk of sudden death during a heart attack by 20 to 40 percent.6 The Physician's Health Study, which followed twenty thousand doctors, found those eating fish as little as once a week were half as likely to have a fatal heart attack as those who ate fish less than once a month.7 If you've survived one heart attack, eating fish can prevent another. The Lancet reported a study of more than two thousand men who had recovered from a heart attack and were given various instructions on diet. Advice to reduce fat made no difference in mortality, but men told to eat fatty fish two or three times a week had 29 percent fewer deaths from all causes- the most important measure in epidemiology. Researchers called the effect " significant," even after adjusting for ten potentially confounding factors.8, Such studies always cheer me up. All too often, nutritional research is ambiguous, the results are modest, and the advice is . . . well, confounding. Happily, the news on fish is good and getting better. If you're lucky enough- as the Karuks once were- to live near a source of wild salmon, take advantage of it. Not so lucky? See "Where to Find Real Food".

HOW OMEGA-3 FATS PREVENT HEART DISEASE.

* Raise HDL.

* Reduce LDL and VLDL (very low density lipoprotein)9.

* Reduce blood pressure by dilating the blood vessels.

* Reduce clotting, inflammation, and triglycerides.

* Reduce lipoprotein (a),(Lp(a)) which promotes atherosclerosis and blood clots10.

* Reduce risk of death during and after heart attack by reducing irregular heartbeat (arrhythmia) through the actions of sodium, calcium, and pota.s.sium ions in heart muscle Are.

You Depressed? Try Eating More Fish.

MUSCLE AND BONE ARE made of protein and minerals, but the brain is the house that fat built. Our brain is particularly hungry for the omega-3 fats found in fish. While other organs can manage (if not ideally) on a ratio of four parts omega-6 to one part omega-3 fats, the brain appears to require equal amounts of each.11 Why? Unlike other body tissues, the brain can't make DHA and EPA from plant oils like walnuts and flaxseed. In nutrition jargon, the brain has an "absolute need"- as opposed to a conditional one- for DHA and EPA, which, as we've seen, are found only in fish. Without adequate DHA and EPA, brain cell membranes don't function properly. Abundant research, much of it recent, confirms that fish is food for thinking. In 2005, for example, the Archives of Neurology reported that older men and women who eat more fish have sharper minds and better memory.

Mental health is one of the most exciting therapeutic applications of fish oil. Omega-3 fats may be as powerful as the drugs a psychiatrist prescribes, even for serious depression. Population studies, lab work, and clinical experience with depressed patients all suggest that fish oil can prevent and treat depression. The omega-3 expert Dr. Joseph Hibbeln has found that differences in depression rates across countries can be predicted by the quant.i.ty of fish in the diet. Lab a.n.a.lysis shows that the brains of depressed people have less omega-3 and more omega-6 fats. Finally, clinical evidence is mounting: doctors have prescribed omega-3 fats for major depression, postnatal depression, bipolar disorder, and schizophrenia, with impressive results.

The risk to mental health of omega-3 deficiency starts in the womb and continues throughout life. The baby has ma.s.sive needs for DHA and EPA, especially in the second half of pregnancy, when growth is mostly due to fat.12, Formula-fed babies and those nursed by omega3-deficient mothers fail to develop proper visual and mental function. Premature babies are particularly vulnerable because they are poor converters of ALA to DHA and EPA. In one study, premature babies fed corn oil had underdeveloped eyes and poor vision, while premature babies fed fish oil were virtually identical to full-term, breast-fed infants. Thus, even when the situation is not ideal- preterm infants are at greater risk in many ways- fish oil can make a difference.

QUALITY OF BREAST MILK IN SAMPLE POPULATIONS.

In addition to mental and visual problems in the baby, lack of omega3 fats causes preeclampsia, eclampsia, premature birth, low birth weight, difficult labor, and postnatal depression. Note how much the quality of breast milk varies, presumably with fish consumption.

*Two studies were conducted in the United States.

Source: Andrew Stoll, The Omega-3 Connection.

In children, omega-3 fat deficiency is linked to dyslexia, poor motor skills, and attention deficit hyperactivity disorder.13 Deficient teenagers and adults are p.r.o.ne to anger, hostility, and violence. Pregnant and nursing women who don't replenish omega-3 stores face serious risk of postnatal depression.14 (Omega-3 fat depletion is c.u.mulative; that is, if the mother's diet lacks these essential fats, deficiency grows with each pregnancy and each generation.) In older people, lack of omega-3 fats is linked to Alzheimer's disease and dementia.

Fish oil prevents depression in several ways. Omega-3 fats make up nerve cell membranes, which affect the transmission of nervous system signals. ALA, DHA, and EPA regulate calcium, sodium, and pota.s.sium ions, which control electrical activity in the brain. Omega-3 fats directly activate receptors for neurotransmitters including dopamine and serotonin, chemical messengers for mood, sleep, appet.i.te, and libido- symptoms altered or crippled by depression. Finally, eicosanoids have a vital (though poorly understood) effect on mood.

Schizophrenia is one of the more distressing and intractable mental illnesses. The traditional treatment, which is more than fifty years old, employs drugs to alter levels of dopamine and serotonin. This works for about 30 percent of patients- not impressive. Moreover, the drugs are costly and cause side effects. A radical new approach begins with the observation- first suggested by Dr. David Horrobin in the 1970s- that the brain is made of fat.15 Neurotransmitters are carried in pouches made of fats called phospholipids, which the body can make from plant-based sources of omega-3 fats or (ideally) obtain directly from fish. In the schizophrenic brain, however, the complex metabolism of fatty acids is damaged, so that neurons and neurotransmitters don't work properly. Early clinical trials suggest that fish oil supplements might be as effective as drugs, without the side effects.16 If fish oil can prevent or treat obesity, diabetes, heart disease, and depression, the muscular salmon immortalized by CroMagnon artists begins to look like a delicacy, superfood, and wonder drug, all wrapped up in one speckled silver package. Clearly, eating fish is a good thing. If only deciding which fish to eat were as simple.

The Truth About Fish Farming.

FIs.h.i.+NG is FUN, but- famously- it involves a fair bit of waiting around for the fish to fall into the trap, whether it's a net, basket, or hook. If you fish for fun, simply watching the water rush by is pleasant enough, but it would quickly seem inefficient if dinner depended on it. One day, a clever h.o.m.o piscator (his brain swollen by omega-3 fats) began to wonder whether there wasn't a quicker, more reliable way to gather the tasty protein he was now accustomed to eating every day. His idea was to trap, feed, and breed fish. In Asia, carp farming is an ancient form of agriculture; the book Fish Culture Cla.s.sics was printed in 460 BC.

Alas, traditional fish farming is all but forgotten. The marine equivalent of cattle feedlots, confinement dairies, and battery egg farms, fish feedlots present the all-too-familiar problems of intensive food production: crowding, disease, parasites, pesticides, antibiotics, excess manure, environmental damage, and- did you guess?- less nutritious food. Just as beef, milk, and eggs raised on gra.s.s contain more omega-3 fats than those fed grain and soybeans, wild fish contains more omega-3 fats than farmed fish.