Essay on Health

Despite every effort, medicine can neither prevent nor cure heart disease. The same goes for cancer, diabetes, dementia and even arthritis. As a result, we suffer horribly as we age. Medicine pays lip service to nutrition, yet public policy allows foods depleted of essential nutrients to reach the marketplace. Examples include trans-fats, refined vegetable oils and sugar. Societies which do not eat these foods do not deteriorate as we do! Ironically, the healthy people in these societies have almost no knowledge of nutrition. While we have a great deal, we don’t use what we know because the food industry and the pharmaceutical companies with the complicity of government distort this knowledge for their own purposes.

I have insulin-dependent diabetes, a disease notorious for accelerating heart disease. When I was diagnosed at age 37, I saw the devastation wreaked by the disease in my doctor’s waiting room and was driven by sheer terror to search for a solution. For years, my wife and I experimented with diets. We learned that raw vegetables are kinder to the insulin-dependent diabetic than cooked vegetables, but I wasn’t out of the woods. In fact, I was at my wit’s end because I couldn’t keep my blood sugar in the normal range, and the harder I tried, the worse the hypoglycemic episodes I suffered. Then Dr Richard Bernstein published his low-carbohydrate approach, which is the opposite of the medical prescription. I found that the combination of my raw vegetables and his approach of avoiding starchy foods like bread and potatoes worked like a charm. I eat meat and fish with (mostly) raw vegetables and almost no refined foods, and eating this way keeps my blood sugar stable and in the normal range. I never gave a thought to heart disease, yet after fifteen years of eating this way, my wife and I both have calcium scores in the aorta of zero, which is unusual and implies a low risk of heart disease (Pletcher 2004). I’ve researched the phenomenon and I’m convinced I’ve found a reason why: people who have no heart disease eat unrefined foods. Explore the evidence with me and conclude for yourself if this is coincidence.

Kitava Islanders have no Coronary Heart Disease

Near Papua, New Guinea, there is an island called Kitava among the Trobriand Islands, which were made famous by Margaret Mead in her 1928 book about their freewheeling sexual practices, Coming of Age in Samoa. Later researchers have suggested that the islanders were pulling her leg, and that fear of sorcery is actually far more widespread than promiscuity. However, there is a truly remarkable thing about Kitava: there is today a complete absence of heart disease, and also of stroke, high blood pressure, cancer and dementia besides! Whole foods are eaten almost exclusively, and this suggests to me that a benefit of whole-food nutrition really is zero risk of CHD.

The Kitavans are by all accounts a charming people with a rich culture. They have a long history of sailing their ornate, hand-carved outrigger canoes to neighboring islands and trading necklaces and carved shells in an intricate, competitive exchange of gifts. The anthropologist Bronislaw Malinowski was exiled to the island during WWI, and published his ground-breaking cultural investigation into this so-called Kula exchange in his book, Argonauts of the Western Pacific.

In spite of an abundance of food, the Kitavan Islanders are lean and their blood pressure does not rise with age. The common causes of death are infections, accidents, complications of pregnancy and senescence. Senescence means old age: the Kitavans die of old age. You can hear the cholesterol chorus chime in with “It’s their genes!”, but a visiting emigrant islander who had lived on a Western diet for many years gave the lie to this notion. He had the typical Western health pattern of high blood pressure and abdominal obesity. And besides, the researchers noted that “compared with [Westerners] … Pacific Islanders seem more prone, not less, to develop diabetes after adopting a Western lifestyle” (Lindeberg 1999).

The Kitavans eat taro, sweet potatoes, yams, fruit, fish and coconuts, and eat very little Western food such as sugar, alcohol, grains, refined vegetable oils, and trans-fats. Almost all of them smoke (78%!), all chew the betel nut, and they exercise only at the level of a moderately active Westerner. Their cholesterol levels are said to be “unfavorable.” The reason for this is that 60-year-old males average a “bad” LDL-cholesterol level of 120, and the average 60-year-old female scores even higher at 148, while a “desirable” level is less than 100. The researchers thought this was “probably due to a high intake of saturated fat from coconut”, albeit in a diet with only a low 21% calories from fat. This seems to me to be a truly awesome failure of the imagination: whatever their cholesterol picture, it must be entirely favorable since they have no heart disease whatsoever! And this is not a fluke. Interestingly, the Tokelau Islanders (among the Cook Islands in the South Pacific) eat no less than 47% of their calories as saturated (coconut) fat, and males aged 55 to 64 have cholesterol levels averaging 245, yet they, too, enjoy robust vascular health (Prior 1981).

So far, the Kitavans have lots of supposed Western risk factors but no heart disease. This suggests that cholesterol is not actually a cause of heart disease, and that saturated fat is not, in itself, dangerous! It cannot be their low-fat diet is protecting them, because this is inconsistent with the experience of the Tokelau islanders, and with that of traditional-living Eskimos who were free of heart disease while eating the most fat of any diet ever investigated. What the diets of the Kitava Islanders, the Tokelau Islanders and the Eskimo have in common is a very small amount of refined food, unlike the Western diet.

The surviving hunter-gatherer tribes are also without heart disease:

Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). … In this review we have analyzed the 13 known quantitative dietary studies of HG and demonstrate that animal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). … and a lower omega-6/omega-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD. (Cordain 2002)

Polynesian horticulturalists, East African nomads, Eskimos and Cretans have also been studied and found to have negligible heart disease. All ate predominantly unrefined foods, and some (especially the Cretans) had characteristics such as smoking and “high” cholesterol which, were they Westerners, would put them in the high-risk category.

Significantly, the insulin levels of the Kitava Islanders are half those of Swedes living in Sweden (Lindeberg 1999), meaning that the Kitavans are not insulin-resistant and do not develop insulin resistance with age as Westerners do.

The Kitavans demonstrate that our conception of the cause of the diseases which kill us is mistaken.

US Healthcare: Caveat emptor!

I’m a psychotherapist. Nutrition is not my field, but I started out as an engineer so I applied my engineering skills to this new problem when I developed diabetes at 37 years of age. I knew I had to make careful study of how to avoid the complications this malady. I gained a PhD in Health Principles, and eventually published a book, Food for Vitality, on essential fatty acid disturbances in disease. The low-carbohydrate solution I found through my researches turned out to be amazingly simple and effective, yet it is diametrically opposite to the prescription of the diabetes healthcare system. The price of the diabetologists’ bad advice is complications which eventually kill most of the diabetic population. And yet the conventional diabetes diet was adopted directly from the American Heart Association diet, on the principle that since diabetics suffer accelerated heart disease, they need a heart-healthy diet. Unfortunately, the flaws in this diet accelerate both diabetic complications and heart disease.

When the measures my doctor prescribed made things worse, I researched the question and what I discovered from the scientific literature left me shocked and appalled. For example, I learned that the commonly-accepted idea that cholesterol causes heart disease must be wrong because lowering cholesterol fails to prevent heart disease. This is crystal clear. However, cholesterol is very good business for food manufacturers, drug makers, cholesterol testers, cardiologists, surgeons, hospitals and so on. I also learned that nutritional measures which do alleviate heart disease have been discovered, and rediscovered, over the years, but are simply ignored if they contradict the cholesterol idea. The healthcare system neglects nutrition, and therefore fails those who depend on it.

Most of us believe that America has the most advanced healthcare system in the world, and that we have the best care money can buy. In the narrow arena of the repair of coronary arteries and the removal of cancerous tumors, advances are nothing short of miraculous but elsewhere there is much cause for concern.

Let us look at what we spend, and what we actually get. Mirabile dictu – incredible to relate – America spent 1.5 trillion dollars on healthcare in 2001. That’s $4,887 on each man, woman and child in America, which adds up to 14% of the Gross National Product. To put this figure in perspective, consider that it=s by far the highest in the 10 industrialized nations, yet our life expectancy is near the bottom, our infant mortality is the worst, and we have the fewest Aquality-adjusted life-years.@ This means that while the life expectancy of a 65-year-old increased by about 3% in the decade, the expected years of life with "core activity restriction" increased by 34% for women, and by 51% for men. We’re getting sicker younger with each passing generation, in spite of spending more on healthcare than anyone else on Earth.

The popular perception that we=re living a great deal longer than we did a century ago is quite wrong, a figment of statistics. It is true to say, statistically speaking, that life expectancy at birth was 47 years in 1900 and 75 years in the year 2000, but the telling statistic is that the life expectancy of a 65 year old male in 1900 was 12 years (i.e. he’d live to 77), and the life expectancy of a 65 year old male in 2000 was 16 years, an increase of but four years. The key to the puzzle is that infant mortality was 216 per 1,000 births in 1900, and only 6.3 in 2000:

Infant mortality has fallen. (Click on images for large view)

Running water, indoor plumbing and refrigeration controlled the infectious diseases and permitted more babies to survive, but medical advances have improved our circumstances towards the ends of our lives hardly at all. We used to die of infectious diseases, and now we die of heart disease and cancer, so it’s really only the manner of our passing that has changed:

Deaths from infections disease have fallen dramatically. Interestingly, the introduction of antibiotics and vaccines did not steepen the fall: in other words, measures such as the chlorination of water, refrigeration and improved sanitation did far more than medicine.

As deaths from infectious diseases fell, deaths from heart disease and cancer have risen. Mortality from heart disease is deceptively low because the figures are age-adjusted to the 1940 population, in which there were far fewer older people. There were 1.7 times the number of people aged 65-84 years in 2000 than there were in 1940, which means that the heart-death rate in 2000 was 1.7 times what the graph shows (because most heart deaths take place in this age group.) The 1940 point is accurate at about 300,000 deaths, and the 2000 point would be about 1,400,000 were the graph not age-adjusted. That there has actually been an increase in the incidence of angina corroborates this: angina almost doubled between 1978 and 1995 in a sample of British men aged 55-59 (Lampe 2005).

We know that heart disease is not caused by a cholesterol-lowering drug deficiency, and that cancer is not caused by neglecting to take chemotherapeutic agents. But the truth is that we don’t really know what causes heart disease or cancer, and today’s ideas don’t suggest preventive strategies or effective treatments. Healthcare is virtually helpless to prevent these epidemics.

Medical care itself is estimated to have caused 783,936 deaths in 2001. Among other things, there were adverse reactions to drugs (106,000), medical errors (98,000), infections acquired in hospitals (88,000), botched surgeries (32,000), unnecessary procedures (37,136), even malnutrition (108,800) and, amazingly, bedsores (115,000), making the healthcare industry itself the third leading cause of death in America.

To add insult to injury, according to a Harvard University study of 2001 data, half of all personal bankruptcies in the U.S. were caused at least in part by medical bills, and most of these people had health insurance!

Yet in more Aprimitive@ cultures eating their traditional diets, people who survive childhood infections and accidents die of old age with their faculties intact at pretty much the same age we do. The health surveys are unequivocal, the facts inarguable. Perhaps their immunity from our degenerative diseases is because of the higher nutrient content of their traditional, unrefined diets. This seems to me to be self-evident, but are we using this information to improve our health? We don’t use this information to improve our health because we mostly don=t know about it, and, what=s worse, we don=t know we don=t know!

There are known knowns ... but there are also unknown unknowns.

The ones we don=t know we don=t know.