Why is the epidemic of heart disease particularly strong in the U.S.A.? If you are a typical American, whether you know it or not you consume an unbalanced, obesity-producing diet. Drs. Louis Katz and J. Stamler, prominent researchers in this field, called it “a pernicious combination of over-nutrition and under-nutrition -excessive in calories, carbohydrates, lipids and salt; and frequently substandard in certain critically important amino acids, minerals and vitamins.” It is not surprising that this situation exists. The science of nutrition, a comparative newcomer to the medical field, has up until recently been concerned almost exclusively with under-nutrition. People have been urged to “eat the right foods” and to provide plenty of meat, eggs, milk, and cheese for their children. In most areas of the world, this problem of getting enough nourishing food to eat is still of primary importance. But it is not the problem in America. Our problem is somewhat the opposite: “living too high on the hog.” Our diet is too rich in fat as well as calories, refined sugars, starches, and oils. At the same time, it is low in essential nutriments, minerals and other vital requirements. The exact relationship between the amount of fat you eat and the production of cholesterol in your body is still a very complex question. Investigators differ on some points. Concerning one aspect of the problem, though, we are all agreed: the cholesterol found in the blood is made largely in the liver from fats in the diet. It is also believed that cholesterol is produced in the arterial walls themselves. But the main source and the one that we can to a great extent control is fat in our food.
What is the situation in other countries of the world? We have research that supports the big difference in the health of Americans and people in various other countries lies in their diet. For example, in Norway, during the war years of 1940-1945, the consumption of butter, milk, cheese and eggs (which are all high in fats) had to be decreased substantially. Did the reduction of fat content in the country’s diet prevent heart attack deaths? The Norwegian Ministry of Health, which kept accurate records, answered that question with an emphatic “yes.” With the reduction in fat consumption, the death rate from also coronary attacks was reduced. The Norwegians reported that deaths related to heart disease dropped by 31% each year among the urban population. In addition, there was a 22% decrease in heart disease-related deaths among the rural population. France, which also to ration high-fat content foods during the war years, had similar results. Mr. Marcel Moine, from the French Ministry of Health, reported to me that from 1941 to 1945, when the French population was on a low-fat diet, the death rate from heart disease was reduced to an average of 20.6 for each 100,000 persons. In the postwar years, when the diet returned to normal fat consumption, the death rate rose to 25.5 per 100,000, which was the death rate prior to the war. Italy is another example, in which they studied two neighboring provinces. In one neighborhood the daily diet included pork products (which are usually high in fat), the rate of heart disease ended up being much higher than in the neighboring town where the population followed the comparatively low-fat diet of the country as a whole. Related studies have been conducted in all across the world-countries such as Finland, Denmark, South Africa, China, and Japan. Statistically, the results all reveal the same conclusion: high-fat diet means a high rate of heart deaths. Famous celebrities, as Mark Twain and Marilyn Monroe have shown, sometimes have a way of giving us a false image, by misunderstanding cause and effect relationships where the health of whole populations is concerned. For example, you could claim, on the basis of statistics, that since the use of soap was also sharply reduced in some countries during the war, with a corresponding drop in death rate from heart disease, the soap (which is a fat) was the underlying cause of the disease. In a more scientific perspective, however, the evidence weighs heavily on the side of fat consumption as the primary factor in causing atherosclerosis.
Is the epidemic confined to older people? What has affected to our culture to the point that men between 30 and 45 are common victims of this “silent killer”? Why are increasingly more young women, thought to be practically immune to this disease until after menopause, are now joining men as common victims? We do not know the entire answer to this mystery, or even if there is a single answer to theses questions. However, the research that has been carried out by my colleagues across the globe, and by myself during the past 10 years, has provided some informative hints. Recently, we discovered to our amazement that over 90% of our adult population has, to a greater or less degree, a degenerative disease of the arteries that doctors call atherosclerosis. That, as you know, is the term meaning the thickening and narrowing of certain vital blood vessels, which is the leading cause of heart attacks and strokes. Doctors and physicians once believed that it was a result of growing old, but the disease is now being discovered in infants and children as well. As children, however, we have the ability of absorbing the fats that deposit themselves to the artery walls. As we age, we seem to lose this power of absorption, and thus real trouble begins. At what age does this happen? Much earlier than we might expect.
For example, my associates and I studied the arteries of 600 patients who had died from various diseases. Approximately 100 of them had met sudden death from accidents or acute illness. To our amazement we found that atherosclerosis, a disease of the arteries, was present in many of the young people before they had reached their thirtieth birthday. By the time they were near the mid-century mark, the fatty deposits and embedded crystals of cholesterol were already in the artery walls. Such thickening and narrowing of the blood vessels obstructed the nourishment and blood flow to the tissues in the heart, brain, or kidney. Similar evidence from autopsies also came from Korea, where Army doctors autopsied 300 American soldiers who had died while serving there. It was the first time such a study had been made of a cross section of the country’s youth; their average age was only 22. A report of the autopsies revealed shocking information: 77% of the young U.S. servicemen already had atherosclerosis! Furthermore, this data was weighed against the mere 11 incidence of the same disease among Koreans and Orientals who had lived and fought in the same environment under the same conditions.
Does heredity have anything to do with the problem? At this point you are probably wondering: why do some people have more cholesterol in their blood than others? At present we do not know the whole answer to that question. We do, however, know some of the predisposing factors. One of them is heredity. Some families are affected by what physicians call hereditary familial hyper-(excessive) cholesteremia. In such a family the tendency to high levels of cholesterol in the blood is passed on for several generations. Among members of such families we usually find a large number of individuals who suffer heart attack and strokes. If no heart attacks or strokes have occurred in your own family line, you have at least one protective factor in your favor from the beginning. The second factor is one that is pretty much up to you. It concerns what you eat and how much you eat. Unfortunately, it is too late for us to choose our parents.But it is not too late to choose our diet. By learning how to avoid food excessive in fat and cholesterol content, we can help minimize the effect of heredity.
Women have better natural protection against atherosclerosis. If you are a woman, you are less likely to suffer from a heart attack or stroke until well after you pass the half century mark. That is when your protective female hormones give out, and you become as susceptible to the disease as men.Can’t men take female hormones to protect themselves? They can, but if they do, they will “cross the border” and develop a high voice, full enlarged breasts, and other feminine characteristics. So that approach to the problem is not practical. Anything else? Yes, there is something everyone can do without great inconvenience, and with the added reward of improved health in general. It is this: select a diet that will keep your blood fats down to normal levels.
Can you reverse damage done to your arteries by excessive fat? Only recently have medical research teams produced dependable evidence supporting that excessive fat in our diets increases the risk of heart disease. If you are past the age of thirty, you have probably already started wonder whether the harm done to your arteries is permanent, or if it is reversible. Right now, as our current level of research, we doctors cannot answer the question with certainty. However, we can say with hope that experiments have shown that the condition is reversible in animals. We have data that verifies cholesterol in the arteries is absorbed in adolescents, as proposed by Dr. Russell Holman and others. However, this metabolic gift disappears as we age. There are many qualified experts in this field who hypothesize that since atherosclerosis is reversible in animals, the same can be true for humans as well. However, we should be careful when drawing conclusions from animal testing, as their metabolism is quite different from ours.
Another question that patients often ask me is: “Can you tell me whether I am already a victim of degenerative artery disease?” Unfortunately, we do not as yet have a test that can predict with certainty whether you are susceptible to coronary disease, or are likely to have a heart attack. One fact, however, is certain: if laboratory tests show that you have an excessive amount of cholesterol in your blood, your chances of avoiding heart and blood vessel disease, which can lead to heart attack or stroke, are much smaller. You are then much more susceptible. If you are over 30 years of age, you ought to have your physician include such a measurement of cholesterol level in your routine check-up. Too many men in the dangerous middle years are so busy playing for high stakes in the fast-moving game of life, that they forget that “hearts are trumps.”
What is the solution for us? The many studies that have been made do not prove conclusively that heart disease is caused solely by diet. But they do heavily underscore much of the information that I have gathered from my own quarter of a century of practice and laboratory research.Taken together, the evidence points strongly to this fact: If everyone in the United States would reduce his fat intake by 25 per cent, we would cut the number of heart deaths in half within another 20 years. Moreover, the low-fat diet will add immeasurably to your general health and well-being. “But,” you ask, “how can I go about reducing the fat in my diet? Where do I begin?” In the following pages you will find a safe guide; it includes low-fat menus and directions for using simple and inexpensive nutritional supplements that I employ in my own practice to help my patients forestall heart attack, and to treat those who have already had one or more. If you follow these directions carefully, you will not only add years to your life, but life to your years.
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