Dr. McCully thoroughly studied a case of an eight year-old boy who died of a stroke in 1933 and a case of a two month-old infant who also died of homocystinuria (homocysteine in the urine) in 1965. He discovered the two children died of arterial damage similar to damages seen in the elderly. The arteries were abnormal with hardening and loss of elasticity of the artery walls. These children, however, did not have cholesterol abnormalities.
Homocysteine, discovered in 1932, is a sulfurated non- essential amino acid formed from methionine, which can also be converted, back to methionine or cystathionine. It is a regular constituent in the blood but at elevated levels, it affects our coagulation system. The enzyme cofactors needed to metabolize homocysteine and to keep its levels low, are folic acid, vitamin B12 and vitamin B6. McCully believed that an overprocessing of whole grains caused a deficiency in folic acid and vitamin B6. An estimated 85-90% of the water-soluble vitamins, folic acid and B6 are lost in refining. These deficiencies along with a deficiency in vitamin B12 and protein excesses (methionine is derived mostly from animal protein) was also responsible for elevated homocysteine levels. McCully hypothesized that elevated homocysteine levels may have damaged the arteries by a direct effect on the arterial cells and tissue of children with homocystinuria. McCully knew that if his hypothesis were true, it would have a far-reaching positive impact on human health. McCully performed a variety of animal experiments to confirm his hypothesis.
This promising insight did not generate much interest in the scientific community for several reasons. There were not enough scientific studies to support his theory. Secondly, the medical profession did not have as thorough an understanding of biochemistry and metabolism as McCully. Some did not accept his theory because the cholesterol-CVD (cardio vascular disease) connection was prevalent. Since there was no cholesterol or fat metabolism abnormalities in the arteries of these children, the question as to how homocysteine could cause vascular disease went unanswered. Some medical professionals believed the homocysteine theory might even undermine the conventional treatment for arteriosclerosis. Dr McCully was denied a grant and thrown out of Harvard. The idea that the stripping of whole grains would increase the risk of CVD was not acceptable. The American diet, after all, was revered throughout the world. The downplay on the cholesterol theory and the lost of revenue for the pharmaceutical industry also played an important part in not recognizing McCully's work.
Some researchers now believe that the elevated homocysteine levels connection to CVD may be the most important medical breakthrough of the twentieth century. Studies are showing that elevated homocysteine levels increase the risk of cardiovascular disease as well as other diseases. More than 75 clinical and epidemiological studies have shown a relationship between elevated total homocysteine levels and coronary artery disease, peripheral artery disease and stroke. Homocysteine also has an effect on cancer, alzheimers, pulmonary embolism, and neural tube defects of the brain and spine.
It is estimated that 280ug of folic acid intake per day for women and 350 ug per day for men has the potential of preventing 50,000 deaths a year from coronary heart disease alone. An estimated 88% to 90% of the population have low dietary folate intake. Foods rich in folic acid are beans, liver; dark green leafy vegetables, potatoes and whole grains.
The American Heart Association (AHA) currently recommends their Step 1 and Step 2 diet to reduce the risk of coronary heart disease. AHA also recommends a balanced diet that includes five servings of fruits and vegetables a day and whole grains or enriched cereal that, if consumed, will provide the needed folic acid (Since 1998 wheat flour has been fortified with folic acid.) and B6 to metabolize homocysteine. They also recommend substituting beans for meat at least three times a week. The lower consumption of meat will also lower methionine, which is needed to convert to homocysteine.
The food guide pyramid encourages whole grains, and they do so because they understand what McCully's underlying message is, stripping away a wholesome food, any food, can have dire consequences. Take a look at whole grains, a carbohydrate food. For you to digest and metabolize this carbohydrate your body needs many different nutrients, for example, the body needs B vitamins, especially B6, niacin and thiamine and minerals, like chromium. You also need fiber, to slow down the blood sugar rise. All of these nutrients are contained in the whole grain. Strip the grain and you have nothing left. Where will the body obtain the nutrients to digest and metabolize these foods? It will take them from your body's reserves. That's why some people call white flour, white sugar, anti-nutrients. Like borrowing from Peter to pay Paul, it can result in disaster. Yes, they add back some nutrients, but they can't add back all the nutrients, and they can't add back what they haven't discovered. What are the consequences of refining out these undiscovered nutrients?
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