Fat & Stress

As the usual stream of brass moved through the Pentagon concourse last week, top Air Force men occasionally broke formation and glided unobtrusively into a suite of neat, quiet rooms. Their object: a thorough hangar check for heart disease. Since 1950, more than 50 middle-aged Air Force executives--from the Secretary down--have undergone regular scrutiny by a team of Air Force specialists under Colonel Marshall E. Groover. The medicos can point to a fair record for the group: only 19 heart attacks, including six deaths (among men who did not follow recommendations). But the Air Force program may prove most important for significant findings about the functions of diet and stress in heart disease.

Doctors have long believed that coronary heart disease is more prevalent among people subject to strong emotional stress, but just how stress does its damage has always been a mystery. With the discovery of large amounts of cholesterol in the blood of heart victims, many doctors switched the blame from stress to diet, since some fats are known to raise the blood's cholesterol level. Colonel Groover's findings interrelate both stress and diet.

Canapes & Cholesterol. Whenever Groover found cholesterol danger signs in a patient, he put him on strict diet and exercise. Of nearly 100 men in this category, 75% were thus restored to normal cholesterol levels. But some of the men developed high levels of cholesterol and lipoproteins (fat compounds containing cholesterol) even under the strict regimen.

At first, this was put down to laboratory errors or diet infractions (one big executive temptation: the plentiful, high-calorie canapes at Washington cocktail parties)..Then it was found that in some men cholesterol and lipoprotein levels were highest during periods of great emotional stress. Investigation showed that lipoprotein levels were the first to rise when stress appeared, followed by a general rise in cholesterol level if it persisted. A check of the men turned up many cases in which stress seemed to be the only explanation for such fluctuations, and Dr. Groover believes that other cases may have gone undetected. To Groover and his aides the implication was clear: stress may contribute to heart disease by causing the body itself to produce extra cholesterol--entirely apart from foods that augment the body's natural cholesterol supply.

Among Groover's case histories was the story of Colonel M.B., who worked for an unreasonable, hostile boss. His cholesterol level was high, but diet and exercise failed to help. When the boss was taken to the hospital (with cerebral arteriosclerosis), Colonel M.B.'s cholesterol level showed a remarkable drop. Brigadier General F.R.'s cholesterol level was normal when he was assigned to Washington, but it shot up when he took over a demanding job in which he constantly had to meet deadlines; a change of duty brought him down to normal.

Prescription and Prevention. In similar cases, Groover recommended changes (transfers to new assignments, hospitalization) that were likely to remove the stress; since this was the Air Force, transfers were easy. But improvement lasted only as long as the men avoided new stressful situations. Groover is not yet prepared to say that success in restoring fat levels to normal means that potential heart attacks have been prevented. Such high levels may be a major factor contributing to the attack, "like the oily-rag-in-the-attic fire," he says, "but they aren't necessarily the cause of heart attacks." Still, Groover is sure that somewhere in the area of diet and stress, the answer will be found.

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