Epidemic Of Atherosclerosis. Part 3

What is the situation in other countries of the world? We have evidence that a prime factor for the great difference between Americans and peoples in various other countries is diet. For example, let us see what happened in Norway during the war years of 1940-1945. Consumption of butter, milk, cheese and eggs (all of them high in fats) had to be sharply curtailed. Did the reduction of fat content in the national diet have any effect on the number of deaths from heart attack? The Norwegian Ministry of Health, which kept accurate records, answered that question with an emphatic "yes." With the reduction in fat consumption, the death rate from coronary attacks declined also. The Norwegians reported that heart deaths were reduced by 31 percent during each year among the urban population. At the same time, there was a 22 per cent drop in heart deaths among the rural population. France, which also had to tighten its belt during the war years, had similar evidence to offer. Mr. Marcel Moine, of the French Ministry of Health, reported to me that from 1941 to 1945, when Frenchmen were on a low-fat diet, the death rate from heart disease was reduced to 20.6 for each 100,000 persons. In the postwar years, when normal fat consumption was resumed, the death rate rose to 25.5 per 100,000 population, or a return to the old, prewar death rate.

Italy provides another example. There studies were made recently in two neighboring provinces. In one area, where the daily diet included pork products rich in fats, the incidence of coronary and generalized artery disease was found to be much higher than in the adjoining province where the population followed the comparatively low-fat pattern of the country as a whole. Similar studies have been made in various parts of the world - countries such as Finland, Denmark, South Africa, China, and Japan. Statistically the results all point in the same direction: high-fat diet means a high rate of heart deaths. Figures, as Mark Twain and Marilyn Monroe have shown, sometimes have a way of misleading us. This is admittedly true of interpreting cause and effect relationships where the health of whole populations are concerned. The long arm of coincidence can sometimes reach around corners or do a juggling act. For example, you might claim, an the basis of statistics, that since the use of soap was also sharply reduced in some countries during the war, with a corresponding drop in death rate from cardiovascular disease, it was the soap (which is a fat) that caused the disease. In a more scientific view, however, the evidence weighs heavily on the side of fat as a prime factor in causing atherosclerosis.

Is the epidemic confined to older people? What has happened to our way of life to make men between 30 and 45 the preferred victims of the "silent killer" that strikes without warning? And why are more and more young women, long believed to be virtually immune to this disease until after menopause, now falling prey to it? We do not know the entire answer to this enigma, or even whether there is a single answer. But research that has been carried on by my colleagues throughout the world, and by myself during the past 10 years, has provided some valuable clues. Only recently, we discovered to our amazement that over 90 per cent of our adult population has, to a greater or less degree, a degenerative disease of the arteries that doctors call atherosclerosis. That, as you know, is the term meaning the thickening and narrowing of certain vital blood vessels. It is the way in which the stage is set for heart attacks and strokes. Medical people once thought that it was a result of aging, but the disease is now being found in infants and children. As children, however, we have the power of absorbing the fatty deposits that attach themselves to the artery walls. As we grow older, we seem to lose this power of absorption. That is when the real trouble begins. At what age does this happen? Much earlier than we might expect. For example, my associates and I made a study of the arteries of 600 patients who had died of various diseases. About 100 of them had met sudden death from accidents or acute illness. To our amazement we found that atherosclerosis, a disease of the arteries, was present in many of the young people before they had reached their thirtieth year.

By the time they were 40 to 50 years of age, the fatty deposits and embedded crystals of cholesterol were inside the artery walls. Such thickening and narrowing of the blood vessels interfered with the nourishment and vitality of the tissues in the heart, brain, or kidney. Striking evidence of how widespread the disease is among our younger people today came also from Korea. There Army doctors autopsied 300 American soldiers who had died while serving in Korea. It was the first time such a study had been made of a cross section of the country's youth; their average age was only 22. A report of the mass autopsies contained startling information that 77 per cent of the young U.S. servicemen already had atherosclerosis! Balanced against this shocking total was a mere 11 per cent incidence of the same disease among Koreans and Orientals who had died on the same battlefield under the same conditions.

Does heredity have anything to do with the problem? At this point you are probably wondering: why do some people have more cholesterol in their blood than others? At present we do not know the whole answer to that question. We do, however, know some of the predisposing factors. One of them is heredity. Some families are affected by what physicians call hereditary familial hyper-(excessive) cholesteremia. In such a family the tendency to high levels of cholesterol in the blood is passed on for several generations. Among members of such families we usually find a large number of individuals who suffer heart attack and strokes. If no heart attacks or strokes have occurred in your own family line, you have at least one protective factor in your favor from the beginning. The second factor is one that is pretty much up to you. It concerns what you eat and how much you eat. Unfortunately, it is too late for us to choose our parents. But it is not too late to choose our diet. By learning how to avoid food excessive in fat and cholesterol content, we can help minimize the effect of heredity.