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What causes heart disease?

aturated fats and cholesterol are what causes heart disease - or so doctors and nutritionists claim. And so they tell us to avoid such foods.

The "experts" have been saying this for over 60 years. This idea is called the lipid hypothesis or diet-heart idea. It has dominated medical thinking about heart disease for the past 60 years.

The idea is so deeply entrenched that few people question it.

According to this idea about what causes heart disease, when we eat foods rich in saturated fat and cholesterol, these substances get deposited in our arteries in the form of plaque.

Over time, the plaque builds up, causing our arteries to get narrower until one day, little or no blood can pass through.

Or, a blood clot forms and cannot get past the narrow space created by the build-up of plague. Thus, a heart attack occurs. In short, plagues are what causes heart disease.

Not in real life

This seems to make sense. What's more, this belief is said to be supported by some 60 years of scientific research. Yet it does not explain what happens in real life.

Many distinguished scientists have pointed to serious flaws in this theory. For example, studies of different populations show that most older people have build up of plaque in the artery, whether or not they have heart disease.

Koreans, who eat substantial amounts of saturated fats, were found in a 1955 study to have significant plaque build up. The Japanese, who eat little meat compared to the Koreans, were also found to have significant plaque build up in their arteries. Both studies were done at about the same time. The Korean study made front page headlines, the Japanese study did not.

The Bantu, a South African tribe whose diet was largely vegetarian, were found to have as much plaque buildup in the arteries as other South African tribes who ate more meat.

Blacks in Jamaica had as much plague in the arteries as Americans - but they had lower rates of heart disease.

The Masai, an African tribe, eats only meat, blood and milk and have extremely high levels of saturated fats in their diet. They have practically zero heart disease. They also have one of the world's lowest levels of blood cholesterol.

One of the biggest studies to establish saturated fats as what causes heart disease was the 1968 International Atherosclerosis Project, in which over 22,000 corpses in 14 nations were cut open and examined for plaques in the arteries.

The study found roughly the same degree of plaque in all parts of the world – among people who ate a lot of meat and saturated fats, as well as those who ate little or no meat; among people with high rates of heart disease as well as those with little or no heart disease.

Historical patterns

The lipid hypothesis about what causes heart disease fails to explain other real-life observations as well.

  • In America, the rate of heart disease soared during a period when saturated fats consumption fell sharply.

Before 1900, heart disease was rare in America, affecting about 8 percent of the population. By 1950, heart disease caused 30 percent of all deaths in America. Today, it causes about 45 percent of all deaths.

During the period, consumption of butter, which is high in saturated fats, fell from over 18 lbs per person per year at the turn of the century, to about 10 lbs per person per year by 1950. Today it is even lower, yet the rate of heart disease continues to escalate.

In the same period, margarine consupmption rose from about 2 lbs per person to 8 lbs per person.

If saturated fats are what causes heart disease, one would expect the rate of heart disease in America to fall over the past 100 years, rather than to increase so dramatically.

The same heart disease patterns have taken place throughout the world in more recent decades. Everywhere, whenever the population reduces its consumption of saturated fats and switched to polyunsaturated vegetable cooking oils, the rate of heart disease started soaring.

"The diet-heart idea is the greatest scam in the history of medicine."
– Dr George V Mann
Coronary Heart Disease: The Dietary Sense and Nonsense

  • In India, a 1968 study found that North Indians, who ate more meat and used mainly ghee (clarified butter) for cooking, had 17 times more saturated fats in their diets than South Indians, who were more vegetarians. However, North Indians had seven times less heart disease than Indians in the South.

This was because, by the late 60s, South Indians had started the switch from coconut oil, which contains about 90 percent saturated fats, to margarine and other polyunsaturated vegetable oils. More recent studies show that North Indians are finally begin to catch up with the South in heart disease rates – because North Indians have started to use less ghee and more margarine and vegetable oils.

Modern heart disease

Another important point to note in understanding what causes heart disease is this: Modern heart disease is a new form of heart disease that did not exist before 1900.

I began my practice as a cardiologist in 1921 and I never saw a myocardial infraction patient until 1928.

- Dr. Paul Dudley White, who introduced the electrocardiograph (ECG) machine
to America during the 1920s. Back then, heart disease was so rare that
Dr White's medical colleagues advised him to find better ways to earn a living.

Most people who die from heart disease nowadays die from myocardial infraction, or what is commonly called a heart attack. It happens when a massive blood clot causes obstruction of a coronary artery. Another common cause of death today is stroke. In a stroke, the same thing happens – a massive blood clot blocks the flow of blood, except that it occurs in the brain!

Myocardial infarction, or heart attack, almost never occurred before the 1920s. By 1930, it caused about 3,000 deaths in America. Today, it causes more than 500,000 deaths in America each year.

Understanding this new form of heart disease is crucial. Click here for Part II of this article on what causes heart disease.

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