66 the china study the most comprehensive phần 27

He started a study in 1946 two years before the Framingham Study to "determine the relationship of dietary fat intake to the inci-dence of atherosclerosis."22 In his study he instructed

Angeles He started a study in 1946 (two years before the Framingham Study) to "determine the relationship of dietary fat intake to the inci-dence of atherosclerosis."22 In his study he instructed fifty heart attack survivors to maintain their normal diet and fifty different heart attack survivors to consume an experimental diet

In the experimental diet group he reduced the consumption of fat and cholesterol One of his published sample menus allowed the patient to have only a small amount of meat two times a day: two ounces of "cold roast lamb, lean, with mint jelly" for lunch, and another two ounces of

"lean meats" for dinner.22 Even if you loved cold roast lamb with mint jelly, you weren't allowed to eat much of it In fact, the list of prohibited foods in the experimental diet was fairly long and included cream soups, pork, fat meats, animal fats, whole milk, cream, butter, egg yolks and breads and desserts made with butter, whole eggs and whole milk 22 Did this progressive diet accomplish anything? After eight years, only twelve of fifty people eating their normal American diet were alive (24%) In the diet group, twenty-eight people were still alive (56%), almost two and one-half times the amount of survivors in the control group After twelve years, every single patient in the control group was dead In the diet group, however, nineteen people were still alive, a survival rate of 38%.22 While it was unfortunate that so many people in the dietary group still died, it was clear that they were staving off their disease by eating moderately less animal foods and moderately more plant foods (see Chart 5.2)

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CHART 5.2: SURVIVAL RATE OF DR MORRISON'S PATIENTS

50

40

30

20

10

0

Time (years)

12 -+-Diet _Control

In 1946, when this study began, most scientists believed that heart disease was an inevitable part of aging, and nothing much could be done

some-thing as simple as diet could significantly alter its course, even when the disease is so advanced that it has already caused a heart attack

Another research group proved much the same thing at about that

patients with advanced heart disease and put them on a fat, cholesterol diet These doctors found that the patients who ate the

low-fat, low-cholesterol diet could significantly prolong his or her life This was a remarkable advance in our understanding of the number one killer in America Furthermore, this new understanding made diet and

-cussion of diet, however, was narrowly focused on fat and cholesterol

We now know that the attention paid to fat and cholesterol was mis-guided The possibility that no one wanted to consider was that fat and cholesterol were merely indicators of animal food intake For example, look at the relationship between animal protein consumption and heart disease death in men aged fifty-five to fifty-nine across twenty different

show that feeding rats, rabbits and pigs animal protein (e.g., casein)

only mirror these findings, but show that eating plant protein has even greater power to lower cholesterol levels than reducing fat or

While some of these studies implicating animal protein were con-ducted in the past thirty years, others were published well over fifty years ago when the health world was first beginning to discuss diet and heart disease Yet somehow animal protein has remained in the shadows while saturated fat and cholesterol have taken the brunt of the criticism These three nutrients (fat, animal protein and cholesterol) characterize

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CHART 5.3: HEART DISEASE DEATH RATES FOR MEN

AGED 55 TO 59 YEARS AND ANIMAL PROTEIN CONSUMPTION

ACROSS 20 COUNTRIESI6

800

•

400

200

Percent of total calories coming from animal protein

9

heart disease?

It would have led immediately to professional isolation and ridicule (for reasons discussed in Part IV) These were contentious times in the nutritional world A conceptual revolution was taking place, and

a lot of people didn't like it Even talking about diet was too much for many scientists Preventing heart disease by diet was a threatening idea because it implied that something about the good old meaty American

boys didn't like it

One status quo scientist had a good time making fun of people who

:

Thumbnail Sketch of the Man Least Likely

to Have Coronary Heart Disease:

in physical and mental alertness and without drive, ambition or competitive spirit who has never attempted to meet a deadline of any kind A man with poor appetite, subsisting on fruit and

ownership of radio, TV or motor car, with full head of hair and scrawny and un-athletic in appearance, yet constantly straining

blood sugar, uric acid and cholesterol, who has been taking

men have heart disease." Also notice how a diet of fruits and vegetables

is eaten by those people who are least likely to have heart disease The unfortunate association of meat with physical ability, general manliness, sexual identity and economic wealth all cloud how the status quo scien-tists viewed food, regardless of the health evidence This view had been passed down from the early protein pioneers described in chapter two Perhaps this author should have met a friend of mine, Chris Camp-bell (no relation) Chris is a two-time NCAA Division 1 wrestling

he became the oldest American ever to win an OlympiC medal in

man not likely to have heart disease, I think he might disagree with the characterization above

The battle between the status quo and the dietary prevention camp was intense I remember attending a lecture at Cornell University dur-ing the late 1950s when a famous researcher, Ancel Keys, came to talk about preventing heart disease by diet Some scientists in the audience

RECENT HISTORY

Today, this epic battle between defenders of the status quo and advo-cates of diet is as strong as ever But there have been significant changes

in the landscape of heart disease How far have we come, and how have

we proceeded to fight this disease? Mostly, the status quo has been

attention given to heart disease has been on mechanical and chemical

pushed aside Surgery, drugs, electronic devices and new diagnostic tools have stolen the spotlight

We now have coronary bypass surgery, where a healthy artery is

plaque on the artery The ultimate surgery, of course, is the heart

a procedure that doesn't require cracking the chest plate open, called coronary angioplasty, where a small balloon is inflated in a narrowed,

the passage for increased blood flow We have defibrillators to revive hearts, pacemakers and precise imaging techniques so that we can ob-serve individual arteries without having to expose the heart

The past fifty years have truly been a celebration of chemicals and

initial widespread research on heart disease, one doctor recently high-lighted the mechanical:

devel-oped after World War II could be applied to this battle [against

engineer-ing and electronics that had been stimulated by the war seemed to lend themselves particularly well to the study of the cardiovascu-lar system 4

Some great advances have been made, to be sure, which may account for the fact that our death rate from heart disease is a full 58% lower than what it was in 1950 2 A 58 % reduction in the death rate seems a great victory for chemicals and technology One of the greatest strides has come from better emergency room treatment of heart attack vic-tims In 1970 , if you were older than Sixty-five years, had a heart attack

chance of dying Today, if you make it to the hospital alive, you only

In addition, the number of people smoking has steadily been

hospital advances, mechanical devices, drug discoveries, lower smoking rates and more surgical options, there clearly seems to be much to cheer about We've made progress, so it seems

Or have we?