Transcript: Cavities and Coronaries: Our Choice
Many of today's lifestyle medicine doctors, myself included, were greatly influenced by Nathan Pritikin, the nutrition pioneer who started reversing heart disease with a plant-based diet and exercise, opening up arteries without drugs and without surgery, effectively curing our number 1 killer disease. But where did he come up with it? We tend to think of rural China as a place with a fraction of our disease rates, forgetting about Africa.
Pritikin was 43 when he was told by his cardiologist that he was at great risk of death from heart attack, so he began to live on a diet patterned after the black population in Uganda. This was a population living off plants that was essentially free from death from heart attacks. After curing his own heart disease with a plant-based diet he went on to save the lives of thousands of others. What was the data that so convinced him?
Last year, the International Journal of Epidemiology reprinted this landmark article from the 50's that started out with a shocking statement: "In the African population of Uganda, coronary heart disease is almost non-existent." Our number one cause of death, almost nonexistent? What were they eating? Plantains and sweet potatoes, other vegetables, corn, millet, pumpkins, tomatoes and, "green leafy vegetables are taken by all." Their protein was almost entirely from plant sources, and they had the cholesterol levels to prove it, similar to modern-day plant-eaters. Apart from the effects of diet and of the blood cholesterol levels the researchers couldn't figure out any other reasons for their freedom from heart disease.
50-year-old findings just as relevant today. They showed dietary intake to be a key, modifiable, established and well-recognized risk factor for heart attacks…without needing to invoke novel, as yet undiscovered, risk factors. This contrasts with the rather desperate search in recent decades for even newer cardiovascular risk factors. We have all the risk factor we need, cholesterol, we've had it for 50 years, and we can do something about it.
According to the Editor-in-Chief of the American Journal of Cardiology this year, the only risk factor required for these atherosclerotic plaques, our #1 killer, is cholesterol. Elevated LDL or "bad" cholesterol in our blood. To drop our LDL cholesterol, we need to drop our intake of three things: trans fat, found in junk food and animal foods; saturated fat, found mostly in animal foods; and dietary cholesterol, found exclusively in animal foods.
The epidemiology journal actually went back and located Dr. Shaper, now 97 years old, and asked him to personally reflect on this groundbreaking study he performed a half-century before. It would be cheering to think that his article actually helped, and attitudes to diet have been changing in recent years, however to his personal surprise and disappointment we still lack a deep commitment to the diet–heart hypothesis, and it is likely that atherosclerosis and its complications will follow us throughout the next half century.
What he discovered is that heart disease may be a choice. Like cavities…
If you look at the teeth of people who lived over 10,000 years before the invention of the toothbrush, they pretty much had no cavities. Didn't brush a day in their lives, never flossed, no Listerine, no water pik… yet no cavities. That's because candy bars hadn't been invented yet. Why do people continue to get cavities when we know they're preventable though diet? Simple. Because the pleasure people derive from dessert may outweigh, the cost and discomfort of the dentist… And that's fine!
Look, as long as people understand the consequences of their actions, as a physician what more can I do? If you're an adult and decide the benefits outweigh the risks for you and your family, then go for it—I certainly enjoy the occasional indulgence (I've got a good dental plan). But what if instead of the plaque on your teeth we're talking about the plaque building up in your arteries? Another disease that can be prevented by changing your diet.
Then what are the consequences for you and your family? Now we're not just talking about scraping tarter. Now we're talking life and death. The most likely reason most of our loved ones will die is heart disease. It's still up to each of us to make our own decisions as to what to eat and how to live, but we should make our choices consciously, educating ourselves about the predictable consequences of our actions.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.
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