Kowalski refused to resign himself to his fate. "I adored my very young children," he explains. "Jenny was 3 and Ross was 6 at the time. They needed me. Never before had I wanted so badly to live."
A free-lance science writer based in Venice, Calif., Kowalski, who holds master's degrees in communications and physiology from Iowa State University, began consuming scientific literature like a binge eater at a Shriners' picnic. When low-fat diets failed to lower his cholesterol appreciably, he got busy on a self-devised survival plan based largely on oat bran and niacin. The regimen not only restored him to apparent good health, but has also made him a publishing phenomenon.
Kowalski describes his experiences in The 8-Week Cholesterol Cure, which, even without aggressive promotion, has stayed rooted on the New York Times best-seller list for a full year. With 882,000 copies already in print, 8-Week has spawned nine foreign-language editions, video and audio cassettes, a computer program to help readers measure their progress, a quarterly newsletter with 4,000 subscribers and a follow-up volume entitled Cholesterol & Children, which recently arrived in bookstores.
While cholesterol is but one component in a complex equation, its link to heart disease is hardly in doubt. A waxy substance in the blood that is manufactured by the liver as well as ingested through the consumption of animal fats, cholesterol is essential to life. Problems arise when too much builds up and blocks the arteries, leading to stroke, heart disease and other life-threatening problems. Cholesterol counts are expressed in milligrams-per-deciliter, and last year new federal standards were established, coupled with a warning that desirable cholesterol levels probably shouldn't exceed 200 mg/dl. Kowalski's level had reached a dangerous 284 by the time of his second bypass operation.
Ordinarily, the way out of the cholesterol trap is through fat-controlled diets and, sometimes, drugs. But Kowalski says that dieting alone had little impact in his case, and that cholesterol-lowering drugs were not only expensive, but so unpalatable that they made him ill. From his reading, Kowalski had learned that cereal fibers, particularly oat bran, and niacin, which is a B vitamin, both help purge the body of cholesterol. Experimenting on himself, he worked out a low-fat regimen featuring three oat-bran muffins and a maximum of three grams of niacin daily. He is quick to caution that no one should follow his example without first consulting a physician because an excess of niacin may produce side effects like gastric upset and even heart arrhythmia. Children, and anyone with liver damage or gout, shouldn't take niacin at all.
In Kowalski's case the combination of diet, oat bran and niacin reduced his cholesterol count 115 points in only eight weeks. He admits that neither he nor anyone else can yet explain precisely why. Somehow, he claims, "the whole of the combination has an effect greater than the sum of its three parts."
To confirm his results, Kowalski enlisted the aid of his own physician, Dr. Albert A. Kattus, director of cardiac rehabilitation at the Santa Monica Hospital Medical Center. Kattus recruited 25 volunteers, including two physicians, with high cholesterol levels and found that all of them benefited from the program.
Still, many doctors are concerned about the niacin dosage he suggests. At those levels, warns Dr. David Blankenhorn, director of the Atherosclerosis Research Institute at the University of Southern California, "niacin has to be considered a drug and must positively only be taken under a doctor's supervision." Although Kowalski credits the late low-fat-diet pioneer Nathan Pritikin as one of his major inspirations ("His contributions broke new ground; I have nothing but admiration for the man"), Pritikin's son, Robert, urges caution with Kowalski's approach. Robert, who now heads his father's Longevity Centers empire, says that Kowalski "is advocating in effect that the nation go on drugs. The majority of people can and should lower their cholesterol level through diet alone."
Whatever their medical value, niacin and oat bran have turned Kowalski's professional life around. Not that his routine has changed much; he shares a modest home with his wife, Dawn, a high school English teacher, and their children, and he has just completed his third book, this time on weight loss. He works out each morning at a nearby gym ("I have a resting pulse of 48," he boasts), eats his three oat-bran muffins in the car coming home, then sits down to write by 9:30. A student from nearby Loyola University helps with the shopping, chores and cooking, while another tends to the 80 letters that Kowalski receives each week from appreciative readers. No health-food fanatic, Kowalski drinks wine with dinner, eats meat when he wants and refuses to castigate salt even for people with normal blood pressure. As for those who find fault with his program, he calmly dismisses them. With a million copies of 8-Week due in print by year's end, says Kowalski: "The scientist in me is very proud of the fact that I've apparently made a medical contribution. I am an exceedingly happy and satisfied man."
—By Dan Chu, with Eleanor Hoover in Venice, Calif.
By his 41st birthday four years ago, Robert E. Kowalski might have suspected that his number was up. The danger was a high cholesterol count that had already brought on a heart attack and forced him to undergo coronary surgery twice within six years—first a triple-bypass operation and then, in 1984, a quadruple. Although he made a rapid recovery on each occasion, there was every prospect that his problem would recur and that the next attack could be fatal.