The 10% Solution For A Healthy Life, Chapter 12: The Ten-Minute Guide to the 10% Solution

March 6, 2002

This chapter gathers together in a single concise guide all of the principles of the 10% solution. While much of this material has been presented earlier in this book, it is organized here for the purpose of providing a brief yet thorough reference.

1. What It Is

The 10% solution is a nutrition, exercise, and life-style program designed to maximize both the enjoyment of life and longevity. Through extensive medical and health research, the dietary and health principles have been shown to dramatically reduce the likelihood of developing major diseases that account for at least two-thirds of all deaths in the United States and other Western societies. The 10% solution also addresses the principal health risks of the Japanese diet and life-style. Other benefits include an immediate beneficial impact on health and well-being.

The words ten percent refer to the most important guideline: limiting fat consumption to 10 percent of caloric intake. This guideline is emphasized both because of its central importance and because it is the least well understood of the principles. Other guidelines concerning the intake of cholesterol and salt, moderation of alcohol consumption, restriction of smoking and other forms of drug abuse, exercise, and stress management are more widely understood. While some level of fat consumption is necessary to maintain health, the level of fat consumed in Western societies is far in excess of what the human species evolved to tolerate. The major thesis of this book is the central contribution of the vastly excessive consumption of fat in the diet to the development of the principal degenerative diseases of the Western world, including heart disease, stroke, hypertension, diabetes, and cancer. The 10% solution refers, however, not just to the fat guideline, but to the entire program of dietary and lifestyle modification.

2. Benefits

In most individuals following the 10% solution, atherosclerosis is halted and even reversed. Since atherosclerosis is the principal cause of virtually all heart attacks, the risk of developing coronary heart disease is dramatically reduced. The risks for contracting other diseases and life-threatening conditions caused by atherosclerosis are also dramatically reduced-including thrombotic and embolic strokes (the most common forms of stroke in the United States), claudication (blockage of blood to the legs), impotence in men, aneurysms, and other conditions.

The 10% solution is an ideal program for controlling hypertension without medication (many of these medications have been shown to increase the risk of heart disease) and, thus, for avoiding intracerebral hemorrhage (another principal form of stroke). It also has been shown to be effective in controlling or preventing type II diabetes (usually without medication) and hypoglycemia.

Studies of societies that eat a diet following these principles, as well as studies of American populations, have shown these dietary and lifestyle principles lead to dramatically reduced incidences of breast cancer, ovarian cancer, colon-rectal cancer, uterine cancer, prostate cancer, lung cancer, and other cancers.

The 10% solution also significantly reduces the risk of glaucoma, cataracts, hearing loss, arthritis, gallstones, and gout.

It strengthens the immune system, which is effective in combating diseases ranging from cancer to minor viral infections.

High-fat diets clog the capillaries within hours of a typical high-fat meal as a result of red blood cell aggregation. The 10% solution prevents this condition, thus improving capillary circulation, which improves energy level, alertness, and sleep patterns.

The 10% solution is the ideal program for sustained and permanent weight loss. It also prevents the cycle of food cravings that result from the common high-fat, high-sugar diet.

The high-fiber content of the 10% solution encourages better digestion and regularity in elimination. A low-fat diet also significantly improves complexion problems.

Overall, it improves the sense of well-being.

3. Who This Is For

The 10% solution is for all adults except for pregnant women and those who are chronically too thin and have great difficulty maintaining adequate weight. See section 6, below, for the guideline exceptions for pregnant women, chronically thin adults, and children.

4. Nutritional Principles

The most important principle is to reduce fat intake to 10 percent of calories, as opposed to the 35 to 40 percent (or more) that is typical of the Western diet. In addition to avoiding saturated fat, it is important to dramatically reduce the intake of polyunsaturated fat. Consumption of polyunsaturated fat reduces HDL levels (the good cholesterol), increases the risk of cancer (even more than saturated fat), suppresses the immune system, and increases red blood cell aggregation which blocks the capillaries. While monounsaturated fat (found in most vegetables) and omega-3 fat (found in fish such as salmon and swordfish) are regarded as “less bad” fats, they should nonetheless be included in the fat total. If a person eats 2,000 calories per day, then 22 grams of fat would represent 10 percent of calories.

Cholesterol intake is to be reduced to 100 milligrams a day or less, compared to the 500 milligrams or more consumed in the typical Western diet.

Studies have suggested that an average or higher blood iron level is a risk factor for heart disease, particularly when combined with an elevated level of LDL cholesterol. The source of iron in the blood is iron in the diet. Avoiding sources of fat and cholesterol in the diet, particularly meat and other foods of animal origin, will automatically avoid concentrated sources of iron. It would also be a good idea to avoid iron supplements (unless you have a significant deficiency), vitamin and mineral supplements that include iron, and “fortified” foods

Menstruating or giving three units of blood per year will also significantly lower blood iron levels and may help lower the risk of atherosclerosis and heart disease.

Protein is to be limited to less than 15 percent of calories per day. The Western diet is typically excessive in protein as well.

Complex carbohydrates (vegetables, grains, legumes, cereals, pastas, breads) are encouraged as the primary constituent of the diet. They should comprise 70 to 80 percent of the calories consumed. Fruits, which contain both complex and simple carbohydrates, are also encouraged.

Sugar is seen as empty calories, and excessive sugar consumption can lead to high insulin-low blood sugar cycles. However, minimal inclusion of sugar and its equivalents (glucose, sucrose, dextrose, molasses, maple syrup, honey, etc.) is not particularly harmful.

Sodium, found principally in salt, is to be restricted to less than 2,000 milligrams per day. This is particularly important for anyone with increased risk of hypertension. Sodium consumption in the Western diet is typically more than 6,000 milligrams per day, with the Japanese diet being 10,000 to 15,000 milligrams per day or more. This is a principal factor in the Japanese tendency toward hypertension and intracerebral hemorrhage (one of the leading causes of death in Japan).

A diet high in complex carbohydrates will necessarily be high in fiber, which aids in digestion and the healthy functioning of the gastrointestinal tract. Fiber should be 40 grams per day or more, compared to less than one-third that amount in the typical Western diet. Soluble fiber, found in beans and peas, is particularly desirable and may reduce cholesterol. Insoluble fiber found in most fruits and vegetables is the most effective in inhibiting the promotion, or growth, phase of cancer.

It is important to eat a variety of foods to obtain necessary vitamins and minerals. If the diet is sufficiently varied, then vitamin and mineral supplements are not necessary. Adequate calcium to prevent osteoporosis can be obtained from non-fat milk products, although women may wish to consider calcium supplements.

5. Caloric Restriction

There is a recent body of evidence that indicates the potential for a significant extension of longevity and delay of morbidity through caloric restriction. Animal experiments have found an extension of life span by approximately 50 percent as a result of reducing caloric intake by 33 percent. Interestingly, the normal-eating animals and the low-calorie animals ate the same number of calories in their lifetimes. The low-calorie animals not only extended their life spans by approximately 50 percent, but also extended youthfulness and avoided the feebleness, poor health, sluggishness, and grizzled appearance of old age, even as they neared the end of their extended lives. Some of the mechanisms identified that can account for the extended longevity include a lower blood glucose level, significantly reduced levels of oxygen free radicals, and improved levels of free-radical detoxifying enzymes and DNA-repairing enzymes. The key to this approach is obtaining an adequate intake of nutrients (vitamins, minerals, protein, essential fatty acids) when reducing calories.

The evidence for the other guidelines of the 10% solution (10 percent calories from fat, low cholesterol and sodium, aerobic exercise, etc.) represent a rich mosaic of evidence gathered for more than fifty years. It includes conclusive and extensive human intervention and population studies. The evidence for the benefits of caloric restriction are more preliminary and are based on extensive animal studies but no human studies to date. However, the animal studies are consistent across experimenters and across species.

Because of the lack of human studies, the importance of obtaining adequate levels of all nutrients, and the importance of avoiding feelings of hunger, it is suggested that a more moderate guideline be followed than has been suggested by the animal studies. One’s weight should be maintained at approximately 95 percent of the ideal weight specified by tables l and 2 of chapter 5, “Your Weight,” but not significantly lower than this level. Caloric intake should be at the level necessary to maintain this weight.

6. Exceptions

Chronically thin adults may wish to increase the percentage of calories from fat to 20 or 25 percent. Otherwise, 10 percent is strongly recommended.

The guidelines are also appropriate for children, except here, also, a higher percentage of calories from fat is recommended, again for greater caloric density to allow for optimal growth. The recommended guideline for children is 20 to 25 percent calories from fat, which is still considerably lower than the 40 to 50 percent typical of Western societies. There should be no restriction on fat intake for children under 2 years of age.

Pregnant women should take care to eat sufficient calories, protein, iron, and calcium. Skim milk and 1 percent fat milk products are good sources of all of these nutritional categories. Pregnant women may also wish to increase somewhat their intake of lean meat and fish to obtain sufficient calories and protein. I recommend that pregnant women increase their fat intake to around 20 percent of calories to help avoid nutritional deficiencies.

A woman should gain approximately 10 pounds of weight during the second trimester of pregnancy and 24 to 30 pounds overall to avoid the risk of low birth weight in her newborn.

Persons without any major risk factors:

· Who do not have diabetes or hypertension

· Who have never had coronary heart disease, cardiovascular diseases (such as stroke), angina, cancer, or indications of these diseases

· Who have no immediate (nuclear) family members who have had these diseases

· Whose total serum cholesterol level is less than 160

· Whose cholesterol-to-HDL ratio (on their higher-fat diet) is less than 3.5

· Whose weight is less than 105 percent of their ideal weight

· Who exercise regularly

· Who do not smoke, or abuse alcohol or other drugs and who would prefer to eat 15 percent calories from fat rather than 10 percent may do so.

Persons without any indication of hypertension and who have never had diabetes, hypertension, coronary heart disease, cardiovascular diseases, or angina may eat 3,000 milligrams of sodium a day

7. Other Substances

Smoking is damaging to one’s health, dramatically increasing the risks for atherosclerosis, heart disease, hypertension and stroke, cancer, emphysema, and other diseases. People should not smoke and should avoid cigarette smoke in the air.

Low to moderate alcohol usage (preferably less than two glasses of wine, beer, or spirits per day) is acceptable, although the calories are “empty.” Excessive use of alcohol is damaging to one’s health and behavior. Moderate alcohol usage may provide a modest protective effect against heart disease for those who eat the “normal” high-fat diet, although the evidence is still not entirely clear. Moderate use of alcohol may, however, increase the likelihood of certain cancers. For persons following the guidelines of the 10% solution, there is no benefit in moderate use of alcohol, although moderate use is not restricted.

Caffeine is to be avoided. It increases the risk of heart disease and hypertension. Anyone who suffers from anxiety or panic disorders or has difficulty sleeping should not consume any caffeine.

Abuse of any drugs, legal or illegal, is to be avoided.

Additives and chemicals in food are to be avoided to the extent possible. Some may be safe, but many are found not to be.

8. Exercise

Aerobic exercise has been found to lower the risk for heart disease, cancer, and other diseases. Together with a low-fat diet, it is a necessary component of any weight-loss program. It is effective in lowering high blood pressure. It improves one’s mood and sense of well-being. The dietary recommendations, above, and regular aerobic exercise work synergistically to provide the maximum health benefit

Aerobic exercise is any exercise that increases the heart rate into the training heart-rate range for a sustained period of time (at least twenty to forty minutes). Ideal is walking or cycling. Running is effective aerobic exercise, but does have a high risk of injury. Swimming, rowing, and cross-country skiing are other forms of aerobic exercise. Stop-and-go activities such as tennis are not ideal, although they do provide some aerobic benefit. The training heart-rate range is 65 percent to 85 percent of one’s maximum heart rate, which is roughly computed as 220 less one’s age.

Exercise should proceed in five phases: a few minutes of stretching (to prepare one’s muscles for exertion), a few minutes of warm-up (start slow), aerobic exercise (at least thirty to forty minutes), a few minutes of cool-down (slow down again), and, finally, a few more minutes of stretching.

An exercise period of at least forty-five minutes four to seven times per week is recommended.

People starting an exercise program should consult their doctor. Persons (1) 45 years of age or older, or (2) between 35 and 44 who have at least one risk factor for coronary artery disease (such as an immediate family member who developed coronary artery disease before age 50, obesity, smoking, high blood pressure, or high cholesterol level), or (3) at any age who have cardiovascular disease, lung disease, diabetes, or hyperthyroidism, should have an exercise stress test (an electrocardiogram test administered while exercising on a treadmill or stationary bike) before starting a regular exercise program.

9. Stress

Chronic stress can aggravate existing conditions. In particular, it can accelerate atherosclerosis and lead to coronary heart disease. If one’s atherosclerosis is already in the 70 percent-plus (percentage of blockage of the coronary arteries) danger zone, then a stressful event can trigger the coup de grace of a complete blockage by a blood clot (a heart attack, stroke, aneurysm, or other incident).

The behavior of the so-called type A individual (hard driving, relentlessly committed to work) is detrimental to health if the behavior pattern includes chronic hostility and anger. Negative chronic stress is distinguished from more constructive forms of sustained effort which are characterized by the four Cs: commitment, challenge, curiosity, and creativity.

Chronic stress can be managed short term through relaxation techniques and long term by reassessment of life and work patterns.

Stress is characterized by activation of the fight-or-flight mechanism, a chain reaction of neuronal and hormonal changes, which include the sudden production of epinephrine (adrenaline) and norepinephrine (noradrenaline) by the adrenal glands, the disruption of the digestive process, and increases in blood pressure, blood sugar levels, cholesterol levels, and breathing and heart rates. It is also manifested in the dilation of the pupils, the activation of blood clotting mechanisms, and the mobilization of internal energy stores. The fight-or-flight mechanism is necessary for survival because it provides the capacity to respond appropriately to danger. Chronic stress is characterized by excessive activation of this mechanism, which can result in permanently raised levels of blood pressure and cholesterol and other changes that are detrimental to physical and mental health.

Physical symptoms of chronic stress can include high blood pressure, headaches, rapid heartbeat, aches and pains, muscle tension, and gastrointestinal discomfort. Behavioral indications include difficulty sleeping, compulsive use of food, drugs, alcohol, sex, or gambling, or any other compulsive behavior; problems in concentration; accident proneness, and social withdrawal. Emotional signs include nightmares, crying spells, feelings of worthlessness, excessive or compulsive worrying, mood swings, restlessness, and anxiety. Spiritual signals would include a sense of emptiness, loss of life’s meaning, excessive confusion, and doubt about one’s direction in life.

False stress relievers are substances or behaviors that appear to relieve stress in the short term but lead to greater levels of chronic stress and anxiety in the long term and are dangerous to one’s health and well-being. These include abuse of tobacco, alcohol, caffeine, benzodiazepines (which comprise the bulk of prescription tranquilizers and sleeping pills), cocaine, heroin, and other legal and illegal substances. Abuse of food and other compulsive behaviors can also be regarded as false stress relievers.

A ten-point program for effectively managing stress:

1. Follow the nutritional guidelines of the 10% solution.

2. Do not use tobacco. Do not use cocaine and other illegal drugs. Consume as little alcohol as possible, not to exceed the equivalent of one or two glasses of wine or beer a day. Consume as little caffeine as possible. Persons with anxiety or panic or sleep disorders should avoid caffeine completely.

3. Follow the guidelines of the 10% solution for aerobic exercise.

4. Give a high priority to obtaining a sufficient quantity and quality of sleep.

5. Balance the three poles of life: work, family/friends, and self.

6. Take periodic time off from your regular routine (i.e., take vacations).

7. Share your innermost feelings (fears, worries, hopes, delights) with someone on a regular basis.

8. Listen empathetically to others.

9. Manage your time. Set an approximate schedule so that you consciously set your priorities. Learn when to say no to commitments. Do not overschedule; allow sufficient time for problems, opportunities, and spontaneity

10. Evoke the relaxation response-a physiological mechanism that is essentially the opposite of the stress (fight-or-flight) mechanism. It can be evoked through techniques such as yoga, biofeedback, and certain forms of meditation. A meditation technique that has been thoroughly researched at Boston’s Beth Israel Hospital is described in chapter 8.

10. Target Weight and Serum Lipid and Glucose Levels

Weight should be within 5 percent of ideal weight. See tables 1 and 2 in chapter 5, “Your Weight,” to determine ideal weight.

Total serum (blood) cholesterol should not exceed 160mg/dl. Ideally, it should be 150 or less.

There have been misleading reports of correlations between very low serum cholesterol levels and the incidence of cancer, alcoholism, and other conditions. A very low serum cholesterol level does not cause cancer or alcoholism. Rather, the casualty runs in the opposite direction. Certain cancers (including preclinical cancer) and in some cases abuse of alcohol can cause very low cholesterol levels. Abuse of alcohol in turn is linked to a variety of other conditions including increased rates of suicide. A low serum cholesterol level that results from eating a low fat, low-cholesterol diet is not a risk factor for these conditions.

The ratio of total cholesterol to HDL (the good cholesterol) should be less than 4, ideally as close to 2.5 as possible. However, if your total serum cholesterol level is 150 mg/dl or less, then the level of HDL and the ratio of total cholesterol to HDL are less important.

Triglycerides should be 100 or less.

Fasting (i.e., before breakfast) glucose should be less than 120. An elevated glucose may indicate diabetes.

11. Weight Loss

The nutrition and exercise guidelines of the 10% solution are ideal for weight loss. While losing weight, daily calorie consumption should equal at least ten times your ideal weight. This will provide steady and sustainable weight loss. Once the weight is lost, continue all of the guidelines, but increase the calorie level until weight is sustained. Eating less then 1,000 calories per day for a female or 1,200 calories per day for a male is not recommended, as it may lead to nutritional insufficiencies.

12. Review of Foods

Foods to Emphasize

· Breads made without added oils, butter, and margarine. Breads made from natural unprocessed grains are preferable.

· Pastas made without oil or eggs. Whole-wheat pastas are ideal. Cereals without added fats, salt, and sugar.

· Any whole grains or grain products.

· All vegetables except avocados and olives (which are high in fat).

· All fruits and fruit juices.

· Legumes such as peas, beans, lentils, etc., are ideal and good sources of soluble fiber.

· The only nuts encouraged are chestnuts, which are low in fat

· Air-popped popcorn.

· All dairy products that are non-fat (i.e., made from skim milk), including skim milk, non-fat yogurt, skim-milk cheese. Cottage cheese made from l percent fat milk is acceptable.

· Soybean products, including tofu, while relatively high in fat, are acceptable in moderation.

· Egg whites.

· Up to 4 ounces per day of fish or lean white meat of chicken or turkey (cooked without the skin), although it is possible to eat up to 8 ounces if necessary. Very lean red meat (flank steak or round steak) is also acceptable, although fish or lean fowl is preferable.

· Clams, oysters, mussels, and scallops are acceptable (up to the total of 4 to 8 ounces per day for fish or lean meat).

Foods That Can Be Eaten Occasionally

· Sugar and its equivalent (sucrose, glucose, dextrose, honey, maple syrup, corn syrup, molasses, brown sugar, etc.).

· Grain products (breads, cereals) made with small amounts of added fat (such as oil).

· Pastas made with small amounts of egg.

· Avocados and olives are high in monounsaturated fat and should only be eaten in moderation (but count the fat grams toward your limit).

· Mild (low-sodium) soy sauce.

· Alcohol, up to one or two drinks per day (preferably less).

· Low-fat milk products (1 percent milk fat).

· If you must use an oil, use olive oil or canola oil, which are high in monounsaturated fat, but use very limited amounts, if any.

· Coffee and caffeinated teas should be avoided, but if you must consume caffeine, limit yourself to one or two cups of coffee (or the equivalent) per day or drink decaffeinated coffee or tea.

· Lobster, crab, and shrimp contain moderate amounts of cholesterol (although low in fat) and may be eaten in moderation.

· Smoked foods and charbroiled foods contain a powerful carcinogen, which is largely responsible for the high rate of stomach cancer in Japan, and should be eaten in very limited quantifies.

Foods You Should Never Eat

· Any meat that is not very low in fat. Avoid chicken or turkey cooked with the skin. The skin itself is 100 percent fat and should never be eaten. Most forms of red meat are very high in fat and should not be eaten. Organ meats are very high in cholesterol and should never be eaten. Deli meats are usually very high in fat and sodium as well and should not be eaten.

· Animal fats, butter, hydrogenated vegetable oils, lard, margarine. Coconut oil and palm oil, which are high in saturated fat.

· Mayonnaise (avoid all salads made with mayonnaise, such as tuna salad, etc.), unless it is non-fat.

· Oils high in polyunsaturated fat, such as corn oil and most vegetable oils.

· Whole dairy products, including milk, cream, sour cream, whole milk, yogurt, ice cream, cream cheese, all cheeses (unless made with skim milk). Cheeses made from partially skimmed milk are still too high in fat.

· Nuts (except chestnuts).

· Never use the saltshaker.

· Egg yolks.

· All fried foods.

· Non-dairy creamers.

· Highly salted foods.

13. Tips

· Eat a variety of foods. This will assure you of getting adequate levels of all nutrients, including vitamins and minerals. This will also avoid taste fatigue.

· When you start out, count your fat grams. This is more important than counting calories. The fat content of foods is not always intuitive, until you get some experience. Counting fat grams is the best way to learn the implications of the most important guideline. For example, if you are eating 2,000 calories per day, then limit yourself to 22 grams of fat per day. Count all sources, even small ones, as they add up. Even an apple has half a gram of fat.

You can determine fat grams in several ways. The easiest is to look them up on the nutritional labels, found on many food products. Appendix 2 of this book, “Nutritional Content of Food,” has additional information on the fat content of different foods.

· Eat at least three meals a day. Do not skip breakfast or lunch.

· Use spices rather than salt to flavor foods.

· Never fry foods. Steaming and poaching are useful cooking techniques. You can sauté foods (but not in oil!) using wine, defatted chicken stock, mild (low-sodium) soy sauce, or water. If you sauté in wine, 85 percent of the calories and all of the alcohol are gone within one minute.

· Another alternative is to broil foods. I recommend use of stove-top grills.

· Plan ahead.

· When traveling by airplane, call ahead (at least twenty-four hours) and order a low-fat, low-cholesterol meal.

· If you travel to Europe or another place where low-fat milk products may not be readily available, take non-fat milk powder with you. You can carry it in a small container and then use it (with bottled water) to make skim milk for your cereal or as a beverage.

· If you are invited to a function, call ahead and explain your dietary needs; they will usually be readily accommodated.

· If you are invited to a party by a friend, call ahead and explain your dietary needs to the host or hostess. Usually, they can be accommodated easily without requiring a lot of effort. For example, your hosts may put your baked potato aside before filling it with a cheese filling or put your vegetables aside before putting on a butter sauce. This is preferable (both for you and your host or hostess) to not eating most of what is served.

· It is important to have a good source for low-fat foods and cooking condiments. A good health-food store is ideal. Not everything in a health-food store is low in fat, but these stores do tend to be good sources of low-fat products. They are also excellent sources of organic and whole-grain products that are hard to find in a regular supermarket.

· Look for the increasing variety of no-fat and low-fat (as well as low sodium) foods that are becoming commercially available due to increasing public demand.

· Be wary of “low cholesterol” or “no cholesterol” labels. While reducing cholesterol intake is certainly important, it is not sufficient. Many of these products are very high in fat.

· Read food labels. The ingredients list will tell you if there are added fats, such as oil. The nutritional breakdown will tell you the amount of fat, cholesterol, sodium, and (sometimes) fiber. If a product has l or 2 grams of fat per 100 calories, then it is okay from a fat standpoint (but count the grams because they add up). If a product has 5 or 6 grams of fat (per 100 calories), then you immediately know it’s not for you.

· Be wary of labels such as “low in fat” without reading just what that means. For example, “2 percent low-fat milk” has 5 grams of fat per serving, which is too high and represents 38 percent calories from fat. One percent low-fat milk has 2 grams of fat per serving and is acceptable, although skim milk is better.

· The essential fatty acids come primarily from whole grains, beans, vegetables, fruits, and fish. Meat is not a good source of essential fatty acids, so there is no danger of any deficiency in essential fatty acids from eliminating or restricting meat from the diet. There is no RDA (Recommended Daily Allowance) of essential fatty acids, but experts suggest that at least 3 percent of calories come from essential fatty acids. The diet described here will provide in excess of that amount.

· Intestinal gas and flatulence are common when people make significant changes in their diet Some intestinal gas is normal and a natural consequence of changing your diet, as well as of the high-fiber content of a diet that is high in complex carbohydrates. People vary in their reactions, but most people will find that this experience diminishes as your digestive tract adjusts to the dietary change. If you are troubled by flatulence, then limit bran, legumes, and other foods particularly high in fiber. Also choose cooked vegetables over raw vegetables.

· Have your cholesterol tested. Make sure it is a “fasting” test (a test taken in the morning before you have had anything to eat). Make sure they measure your HDL, triglycerides, and glucose levels. These are not automatically tested for. Very often a cholesterol test will measure only total serum cholesterol. Everyone should know their serum cholesterol, HDL, triglyceride, and glucose levels.

· Keep in mind that your tastes will change. High-fat foods that may appeal to you before making this type of modification are likely to appear greasy and unappealing once you have become used to the nutritional principles of the 10% solution. Conversely, foods that may initially seem bland will become quite tasty as you get used to a diet in which foods are not drenched in fat, salt, and sugar.

· Occasionally you may backslide and make an exception to the 10% solution. You shouldn’t let that discourage you. On the other hand, making regular exceptions, even once or twice a week, will prevent the process of your tastes changing. Then the 10% solution will remain a discipline forever, which ultimately will cause it to fail. Being strict about these changes initially is important for the phenomenon of taste change to occur. The first month requires discipline, the second is easier, then your desires are likely to become consistent with the principles of the diet.

· Most important, keep an open mind!