‘Man is an omnivore, best adapted to fat and protein. Just as man’s basic mental drives which determine much of his behaviour have not changed in millions of years…so his physical adaptation to his food has remained unchanged and there is ample evidence to show that he can avoid obesity and keep his nervous system intact by sticking to the food which helped to determine the change from ape to intelligent man: fat meat.’
Born in 1916 in India, Mackarness interestingly began his career as an artist training under Mervyn Peake at Westminster Art School. After moving on to study at the Westminster School of Medicine, he served as an army medical officer and then took various hospital posts. General practice followed, with Mackarness moving into hospital psychiatry in 1965 and later setting up an allergy clinic to treat mental illness. Richard Mackarness died in 1996 and you can read an obituary for him here.
Eat and Grow Slim
His first book Eat Fat and Grow Slim (1958) was a best seller and advocated a high fat, low carbohydrate diet based upon pre-cereal, hunter gatherer diets which is described as the ‘Stone Age Diet’. Dr Mackarness discusses the history of high fat, low carbohydrate diets including the story of William Banting (I first read about Mr Banting in Good Calories, Bad Calories by Gary Taubes). He also looks at the work of his (then) contemporary physicians such as Professor Kekwick and Dr G.L.S. Pawan at the Middlesex Hospital in London. Their research studied Banting’s diet and concluded that reduction of carbohydrate rather than fat was the key to treating obesity (their work was also an influence on Dr Atkins).
Dr Mackarness disputes the calorie hypothesis with some wonderful arguments. He stresses the importance of eating food that we have evolved to eat over millions of years, with an emphasis on fat and meat together with a reduction in carbohydrates.
The work of several pioneering physicians who warned against the excessive consumption of carbohydrates is discussed (some of whom were also mentioned by Gary Taubes in GCBC). These physicians linked a high carbohydrate, low fat diet to many diseases – diseases that we are still struggling with in the 21st Century.
Interestingly, Dr Mackarness recounts an interview with Dr Blake Donaldson, a Scottish cardiologist who moved to New York in the 1920s and who treated 17,000 people over 40 years. In 1919, faced with a growing number of patients suffering from heart disease and other assorted ailments Dr Donaldson went to the American Museum of Natural History and studied the teeth of ancient skulls. He was particularly fascinated with their apparent lack of caries and the excellent condition of their teeth:
‘Donaldson thought that the cells of which we are made might have common nutritional needs. The same food that keeps teeth healthy might prevent cataracts from developing in the eyes, and might also be good for the cells involved in the mysterious diseases like duodenal ulcer, migraine, high blood pressure and obesity…’
Dr Donaldson went on to treat many patients using a diet based around pre-agricultural foods and Dr Mackarness interviewed him in 1964:
‘Dr D: ‘I now have a group of about 1500 patients over the age of 75, who from five to forty years have avoided flour and have kept primitive food as their basic way of maintaining health.
Dr M: This is what I call a Stone Age diet. Would you agree with that description? It is a pre-cereal diet.
Dr D: Well, I should say that it is perhaps 6000 years old and twenty years ahead of its time. I think this will be a popular idea in twenty years; that flour is a bad thing for about 80% of the population.’
Dr Donaldson wrote Strong Medicine in 1963 and I would be very interested to read it.
Another notable pioneer that Dr Mackarness discusses is the cardiologist Dr Alfred Pennington. Dr Pennington placed executives of the US Chemical company Du Pont on a diet that eliminated starch and sugar and increased fats and protein, with excellent results. The work of Dr Wolfgang Lutz, author of Life without Bread is also mentioned and Dr Mackarness quotes the following observation from Dr Lutz:
‘I arrived at the conclusion that only by returning to the nutritional habits of our ancestors would people be able to overcome the diseases of civilization.’
Towards the end of the book, Mackarness makes the following very interesting observations on why the medical industry continues to promote a low fat, high carbohydrate diet in the treatment of disease.
1. ‘the medical education is still, in spite of attempted reforms, among the most authoritarian and hierarchical in the world, partly because of the mass of facts that have to be crammed into the unfortunate medical student’s head in a short space of time.’
2. ‘…because of the ladder structure of advancement in hospital medicine, the junior who questions the dogmas of his teachers and seniors is branded as a trouble-maker and his progress to consultant status made that much more difficult.’
3. ‘Textbooks take a long time to write and publish, and bringing them up to date is a formidable task.’
4. ‘Finally, more perhaps than people in any other profession, doctors are conventional and hate changing their ideas. Also, in common with the rest of humanity, they are lazy and nothing is such hard work as constructive thinking. But to be fair, there are shining examples to this rule and it has been my good fortune to know and work with some of them. It is really the middle-echelon consultants who are stuffy. The real big boys are not.’
I wonder if this still holds true today? Why is it that the work of Dr Mackarness and others like him has seemingly no influence on mainstream dietary advice? Why is the myth that saturated fat causes heart disease still pushed by many nutritionists and doctors?
Not All in the Mind
The second book that Dr Mackarness wrote Not All in the Mind followed 17 years after Eat Fat, Grow Slim. It proposes a connection between diet and mental illness due to allergic reactions to certain foods. Again, Dr Mackarness advocated a return to the foods that we have evolved to eat – the Stone Age diet – as a way of treating many of the neurological problems presented in the modern world.
‘If wrong food can make people fat and rot their teeth, why should it not, in some susceptible people, injure their brains as well and make them appear mad?’
Dr Mackarness was particularly influenced by the work of Dr Theron Randolph, a Chicago physician who pioneered the study of allergies and is considered as the godfather of environmental medicine, as well as Dr Albert Rowe of San Francisco, who created the concept of the elimination diet in the 1920’s.
In Not All in the Mind we learn about some of the patients that Mackarness has successfully treated by removing certain foods from their diet. The case of Joanna, a 27 year old woman who had tried to slash her wrists and was subsequently been treated with ECT is particularly striking. She is placed on an elimination diet with dramatic results and is able to live a normal life at last. The foods that she particularly reacted to were bacon, egg, porridge, veal, tongue and instant coffee.
We also hear of ‘Mrs A’ whose story Dr Mackarness reported in his article ‘Stone-Age Diet for Functional Disorders’ in Medical World July 1959*. Displaying an array of symptoms and after undergoing many tests including barium follow-throughs and x-rays (rather like myself!) she approached the doctor for help. Upon testing, Dr Mackarness found that cereal foods caused the most extreme reaction and after removing these from her diet, Mrs A was able to live a symptom-free life. Dr Mackarness notes that it is not always the foods themselves that cause trouble, but their chemical contaminants such as monosodium glutamate.
What is particularly interesting is the way in which Dr Mackarness talks of adaptation, evolution and stress. Here are some fantastic quotes:
‘It is a rule of ecology that living creatures show better adaptation to those things to which they have been exposed the longest: it is very much rarer to find a patient disabled by eating meat or by normal exposure to sunlight (I am not talking about sunburn), than it is to find one made ill be eating wheat or inhaling the petro-chemicals in the air on a street full of heavy motor traffic.’
‘Man’s diet has evolved over millions of years, from the monkey-type vegetarian diet of the forest-dwelling gatherers to a carnivorous one. Meat has been man’s main food for over nine-tenths of the time since he learned to walk upright and use his hands as tools. Starches and sugars as a basis for nutrition are a very recent introduction: they have been part of our diet for 10,000 years at most, as against 2-3 million years on meat, fat and protein.’
‘The primitive hunter in pursuit of food uses exactly the same nerve signals as the NASA scientist programming the computers which guide a landing on the moon. The difference is only in complexity. In both cases the work is done by the same sort of nervous system built of the same basic materials, chiefly animal fats. No nervous system has ever been built of starch and sugar and to base a diet on carbohydrates, as millions do today, is to invite the problems of inadequately constructed and malfunctioning brain and nerves.’
Adaptation in relation to the rate of change is clearly a concern:
‘The adaptation of a species can fail in two different ways: the organism may not be able to reproduce quickly enough to evolve in the face of new stress; or it may be subjected to unrelieved exposure to too much stress over too long a period’
This theory of stress was heavily influenced by Professor Hans Selye who defined stress as ‘the struggle to adapt to a noxious agent’. Read more about professor Selye here. Stress was not just a mental manifestation but a wider disease defined as ‘the rate at which wear and tear is induced in the body by the process of living.’ Certain foods are one of the many potential stressors and the struggle of the body to adapt to these causes an array of symptoms, of which psychological factors may be only a part of the whole story.
The stress response is divided into distinct stages; that of alarm, apparent adaptation, exhaustion and death. Dr Mackarness notes that patients do not contact their doctor until entering into the stage of exhaustion and herein lies the problem. This leads to diagnosing the symptoms as the cause for the illness (as in the case of the patient Joanna) rather than dealing with the exhaustion brought about by constant exposure to allergic foods.
‘Many, if not all typically ‘Western diseases’ derive from cultural trends that have changed our environment and by which we have voluntarily pushed the conditions of existence beyond our evolutionary-established flexibility to adapt’
Dr Mackarness develops the theory of a ‘masked’ (delayed or chronic) allergy as put forward by Dr Herbert Rinkel. The victim actually feels better after exposure to the allergen and consequently continues to – in the case of food – ingest the offending substance on a regular basis (perhaps with every meal) over many years, believing it to be beneficial. Symptoms of any allergic reaction are reduced or eradicated to such an extent that the person never suspects that the allergy exists until they reach a stage of exhaustion.
Dr Theron Randolph was influenced by both Selye and Rinkel and adapted Seyle’s three stages to the problem of addiction. This included food addiction, such as carbohydrates. The victim resorts to increasing amounts of the offending substance in order to remain ‘normal’ before eventually succumbing to exhaustion.
Believing that allergy (after infection), is the number one cause of illness in Western society, Dr Mackarness quotes Sir James Mackenzie in his call for the ‘simplification of medicine.’ He admits that he does not know why the allergic ‘target organ’ is ‘in the gut in one patient and the nervous system in another’, but current research into the human biome would suggest that there is a direct relationship between the two and that problems in the nervous system may have direct causation in the gut. This reminded me of the extremely interesting passage in The Wahls Protocol by Dr Terry Wahls, in which she discusses the possibility that there may be a single underlying cause to many of the diseases we face in the 21st Century. Currently, we treat the myriad of symptoms classified as separate diseases but not this primary cause. She states: ‘In a very real sense, we all have the same disease…’
The work of Dr F. Curtis Dohan of Pennsylvannia University and his research into the possible causes of schizophrenia is also discussed by Dr Mackarness. You can read more about Dr Dohan’s work here.
Towards the end of the book, Dr Mackarness gives a warning:
‘We are not infinitely adaptable animals, and there is mounting evidence that many of us have already adapted as much as we can to today’s increasingly sophisticated and chemically contaminated diet. It is time to call a halt to this appallingly risky experiment in human nutrition and to look again at the relationship between the food we eat and the changing pattern of disease in industrialized countries.’
He notes with amazement that everything that he has talked about in his book has been written in medical books and journals dating back to the 1920s, yet only a handful of doctors have used these methods. Reading this book 38 years later, (and 56 years on from the first edition of Eat Fat, Grow Slim) I wonder if anything has changed much. Are we finally recognising the critical importance of food (and gut health) in dealing with a myriad of conditions, including neurological diseases? Is nutrition given the status it deserves in medical education? Have we realised that returning to eating the real food that has sustained us for the majority of the time on this planet will not cause diseases such as cancer and atherosclerosis? Are we closer to successfully preventing the diseases of Western civilization, rather than treating symptoms? These are all questions that Dr Mackarness may have pondered decades ago and still we go round and around in circles. If we were losing the ability to adapt in the era of Dr Mackarness, what is happening now? In 2014, his books are a wonder to read but did his call for action fall on deaf ears? Let’s hope not.
‘Time is running out for us; a complete reappraisal of environmental and dietary politics in Europe and Americais literally a matter of life and death, and long overdue.’
*I have tried to locate the article by Dr Mackarness entitled ‘Stone-Age Diet for Functional Disorders’ but cannot get access to it. If anyone has a copy – do let me know.