Fats - What they are and what they do to you. The outstanding fats eaten daily in the United States and Europe are butter, eggs, whole milk, cream, meat, fish and poultry fats, and cheese in various combinations. These fats, at 9 calories per gram, contain more than twice the amount of calories than protein or carbohydrate does at four calories each per gram. As we have noted and shall describe in later chapters, excessive intake of fats leads to the shortening of life, premature death by heart attacks and strokes, obesity, and numerous crippling illnesses. Fats (or lipids) contain the elements of carbon, hydrogen, and oxygen in various combinations of animal and vegetable fats. Examples of animal fats are butter, lard, cream, milk, eggs, and the fat in meats. Vegetable fats are soyabean oil, olive oil, cottonseed and corn oils, and peanut oils; these are found in nuts, coconuts, avocados, margarines and other vegetable fats used in cooking. Fats do not dissolve in water, and when pure they are odorless and tasteless. They are found in most bodily tissues, particularly in combination with other elements, proteins, or minerals. Fats or lipids act as vehicles for the absorption of the natural fat-soluble vitamins such as vitamins A, D, and E. In order for fats to be utilized by the body, they must first be digested and broken down into constituent parts before being absorbed. They are absorbed in the following manner: After the food is masticated and enters the stomach, the digestive system supplies its first fat enzyme called lipase, to begin the digestion of the fat. Enzymes or ferments are unique chemical compounds manufactured by the cells of the tissues. In the digestive tract they are vital for the chemical breakdown of all foods before they can be absorbed.
How are fats digested? The fat enzyme of the stomach, lipase, begins its job on the fats eaten. However, it is a rather weak enzyme, leaving most of its work to be carried out by steapsin, the fat enzyme manufactured by the pancreas, and by bile manufactured by the liver. In the bile are found bile acids and salts which, together with steapsin, split the fats ingested into the smallest molecules and particles possible. These can then be absorbed through the lining of the small intestine and pass either into the liver or directly into the blood stream as chyle, a milky or creamy serum.
How fats are absorbed. When the fat particles are brought to the liver, they undergo further chemical breakdown and metabolic changes before they enter the blood stream in the form of cholesterol, phospholipids, fatty acids, neutral fats (which are neither acid nor alkaline), lecithin, and other fat derivatives. Much of the fat is broken down by the liver cells into cholesterol, which is excreted into the bile and goes back again into the intestine in various chemical forms. Once in the intestine, some of the cholesterol is reabsorbed again along with other fats and some is excreted from the body in the bowel movement. If the proportion of the cholesterol in the bile becomes too high, then it precipitates out of the bile and forms gallstones, which can produce attacks of pain and indigestion, and so often keep the surgeon busy.
Now that the fats or lipids have entered the blood stream, they circulate and are deposited in the various bodily tissues and in the great body storehouses called fat depots. These are located in the abdomen, on the hips, the chest, around muscles, under the skin, in the liver, and elsewhere. The fats consumed in the diet are called exogenous fats. The liver and other tissues, however, manufacture equally important quantities of fats or lipids normally found in the blood stream. These are called endogenous lipids. These lipids are manufactured from proteins and carbohydrates through certain remarkable processes inherent in vital bodily tissues and glands such as the liver or the adrenal glands. Energy and vital cellular constituents for the body result from these lipids. When present to excess, their effects become devastating to humans, as shown in the chapters on overweight and atherosclerosis. (See Chapters 7 and 3.) We now come to the fats circulating freely in the blood stream. Let's see how they get into the artery walls to actually damage or destroy the artery with atherosclerosis.
How fats damage or destroy your arteries. Extensive research in experimental animals has been able to demonstrate how these lipids can leave the bloodstream and enter the artery wall within 24 hours. The atherosclerosis produced in these animals becomes indistinguishable from the atherosclerosis seen in human arteries. However, the exact details of the mechanism whereby fats actually enter into the wall of the artery are not yet known. What is known and what is important is that there is a definite ratio or relation between the amount of fats in the blood stream and in the artery wall, and this is surprisingly predictable in most cases. Also, the relationship of the fats in the artery wall itself is very close to that in the bloodstream. This direct relationship between the two seems to be in fairly constant balance. As described in the first chapter, the artery wall consists of three different layers. If the reader can picture a garden hose as representing the artery, it presents an innermost layer called the intima, a middle layer called the media, and an outer layer called the serosa.
The fats circulating in the blood stream are of course closest to the innermost layer of the artery, with which they are in direct contact. When conditions are right for atherosclerosis, the fats attach themselves and enter the inner or intima layer of the artery. A kind of wart or excrescence on the artery is then formed, called a plaque of lat. When the plaque grows larger, it encroaches upon the passageway of the artery. As it grows larger and larger, it may finally block or obstruct it partly or completely. When this clogging or obstruction of the artery takes place in the vital coronary arteries of the heart, then a coronary thrombosis or heart attack assails the victim. If the blockage from these fatty or atheromatous plaques occurs in the brain, then a stroke strikes down the victim.
However, if the artery is only partly blocked by this accumulation of fatty plaques, then the vital organs supplied by the arteries suffer from a lack of the necessary amount of blood and nutriments contained in it to sustain normal function and health. Along with the fatty deposits of cholesterol, fatty acids, neutral fats, etc., which make up these atheromatous plaques, calcium and other minerals are also deposited. These make the artery feel hard, giving rise to the term commonly in use - "hardening of the arteries." Actually we see a softening of the arteries which takes place first because of these fatty deposits. It is often noticed in many individuals that this free fat will be floating in the blood stream for hours after a meal containing fat has been eaten. The blood is then called lipemic, which means loaded with fats. When these fats are easily visible to the naked eye, scientists speak of such neutral fats as chylo-microns. These fats in the blood are regarded by many scientists to be as dangerous as is cholesterol, in entering the artery wall.
