How to Prevent Heart Disease

What You Need to Know About Preventing Heart Disease

Image Credit: Knar Bedian / Flickr. This image has been modified.

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 back in the 70s. (More on Nathan Pritikin in Engineering a Cure,  Our Number One Killer Can Be Stopped, and The Answer to the Pritikin Puzzle.) But how did he come up with the idea of opening up arteries without drugs or surgery? We tend to think of rural China as a place with a fraction of our disease rates, but we may forget about Africa.

Pritikin was 43 when he was told by his cardiologist that he was going to die from a heart attack, so he began to live on a diet patterned after the black population in Uganda, 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 a landmark article from the ‘50s 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.

These fifty-year-old findings are still relevant today. They showed “dietary intake to be a key, modifiable, established and well-recognized risk factor for heart attacks. This contrasts with the rather desperate search in recent decades for even newer cardiovascular risk factors.” We have the only risk factor we need—cholesterol. We’ve known it for 50 years, and we can do something about it. See One in a Thousand: Ending the Heart Disease Epidemic.

As you can see in the video Cavities and Coronaries: Our Choice, according to the Editor-in-Chief of the American Journal of Cardiology, the only risk factor required for atherosclerotic plaques to form is elevated LDL, or “bad” cholesterol in our blood. Dr. William Clifford Roberts is the distinguished cardiac pathologist who doubles as the Editor-in-Chief of the American Journal of Cardiology. More from him in Eliminating the #1 Cause of Death and Heart Attacks and Cholesterol: Purely a Question of Diet.

To drop our LDL cholesterol, we need to drop our intake of three things: trans fat (found in junk food and animal foods – See Trans Fat in Meat and Dairy); saturated fat (found in mostly animal foods); and dietary cholesterol (found exclusively in animal foods). More on lowering LDL in Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What Dr. Shaper discovered is that heart disease may be a choice.

Like cavities.

People who lived over 10,000 years before the invention of the toothbrush pretty much had no cavities. Didn’t brush a day in their lives, never flossed, no Listerine, no Waterpik—and yet, no cavities. Why? Because candy bars hadn’t been invented yet! So 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.

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 that 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 our teeth, we’re talking about the plaque building up in our arteries? Then we’re no longer just talking about scraping tarter. We’re talking life and death.

The most likely reason 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.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

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