Transcript: One in a Thousand: Ending the Heart Disease Epidemic
This is a list of diseases commonly found here (and in populations that eat and live like the US), but were rare or even nonexistent in populations eating diets centered around whole plant foods.
These are among our most common diseases, like obesity. Hiatal hernia, one of the most common stomach problems; hemorrhoids and varicose veins, the most common venous disorders; colorectal cancer, the #2 cause of cancer death; diverticulosis, the #1 disease of the intestine; appendicitis, the #1 cause for emergency abdominal surgery; gallbladder disease, the #1 cause for nonemergency abdominal surgery; and ischemic heart disease, the commonest cause of death—here, but a rarity in plant-based populations.
This landmark study suggesting that coronary heart disease was practically non-existent among those eating traditional plant-based diets in Africa claimed that there was adequate autopsy evidence to confirm that fact. Let's look at it.
Doctors in sub-Saharan Africa during the 30s and 40s recognized that certain diseases commonly seen in Western communities were rare in rural African peasants. This hearsay talk greeted any new doctor on arrival in Africa. Even the teaching manuals stated that diabetes, coronary heart disease, appendicitis, peptic ulcer, gallstones, hemorrhoids, and constipation were rare in African blacks who "eat foods that contain many skins and fibres, such as beans and corn, and pass a bulky stool two or three times a day.” Surgeons noticed that the common acute abdominal emergencies like appendicitis in Western communities were virtually absent in rural African peasants.
But do we have hard data to back that up? Yes. Major autopsy series were performed. First thousand Kenyan autopsies—not a single case of appendicitis, not a single heart attack, 3 diabetics out of a thousand, one peptic ulcer, no gallstones, and no evidence of high blood pressure, which alone affects 1 out of 3 Americans.
Maybe the Africans were just dying early of other diseases and so never lived long enough to get heart disease? No, here are age-matched heart attack rates in Uganda versus St. Louis. Out of 632 autopsies in Uganda, one myocardial infarction. Out of 632 Missourans—same age and gender distribution—136 myocardial infarctions. More than 100 times the rate of our #1 killer. In fact they were so blown away they did another 800 autopsies in Uganda, and still, just that one small healed infarct (meaning it wasn't even the cause of death) out of 1,427 patients. Less than 1 in a thousand, whereas in the U.S. it's an epidemic.
How do the doctors even know what to look for over there then? Though practically unheard of among the native population, the physicians are quite familiar with heart disease because of all the folks that immigrate to the country.
The famous surgeon, Dr. Burkitt, insisted that modern medicine is going about it all wrong. A highly unacceptable fact that is rarely considered yet indisputable is that with rare exceptions there is no evidence that the incidence of any disease was ever reduced by treatment. Improved therapies may reduce mortality but may not reduce the incidence of the disease. Understand what he's saying? Take cancer, for example, the vast majority of effort is devoted to advances in treatment; the second priority given to screening programs attempting early diagnosis. Is there any evidence that the incidence of any form of cancer has ever been reduced by improved treatment or by early detection? Early diagnosis may reduce mortality rates and medical services can have a profoundly beneficial effect on sick people, but have little if any effect on the number of people becoming ill. No matter how fancy heart disease surgery gets, it's never going reduce the number of people falling victim to the disease.
He compares it to an engine left out in the rain. If an engine repeatedly stops as a consequence of being exposed to the elements, it is of limited value to rely on the aid of mechanics to detect and remedy the fault. Examination of all engines would reveal that those out in the rain were stopping, but those under cover were running well. The correct approach would then be to provide protection from the offending environment. However, considering the failing engine as the ailing patient, this is seldom the priority of modern medicine. He sums it up with the cliff or the ambulance.
If people are falling over the edge of a cliff and sustaining injuries, the problem could be dealt with by stationing ambulances at the bottom or erecting a fence at the top. Unfortunately, we put far too much effort into the provision of ambulances and far too little into the simple approach of erecting fences. And then of course there are all the industries enticing people to the edge, and profiting from pushing people off
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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