We Can End the Heart Disease Epidemic
Many of the diseases that are common in United States are rare or even nonexistent in populations eating mainly whole plant foods.
These so-called Western Diseases are some of our most common conditions:
- obesity, the most important nutritional disease
- hiatal hernia, one of the most common stomach problems
- hemorrhoids and varicose veins, the most common venous disorders
- colorectal cancer, the number two cause of cancer death
- diverticulosis, the number one disease of the intestine
- appendicitis, the number one cause for emergency abdominal surgery
- gallbladder disease, the number one cause for nonemergency abdominal surgery
- ischemic heart disease, the most common cause of death
These diseases are common in the West, but are rarities among plant-based populations.
A landmark study in 1959 I profiled in my video Cavities and Coronaries: Our Choice, for example, suggested that coronary heart disease was practically non-existent among those eating traditional plant-based diets in Uganda. “Doctors in sub-Saharan Africa during the ‘30s and ‘40s recognized that certain diseases commonly seen in Western communities were rare in rural African peasants. This hearsay talk greeted any new doctor on arrival in Africa. Even the teaching manuals stated that diabetes, coronary heart disease, appendicitis, peptic ulcer, gallstones, hemorrhoids, and constipation were rare in African blacks who eat foods that contain many skins and fibers, such as beans and corn, and pass a bulky stool two or three times a day.” Surgeons noticed that the common acute abdominal emergencies in Western communities were virtually absent in rural African peasants. But did they have hard data to back it up?
Major autopsy series were performed. In one thousand Kenyan autopsies, there were no cases of appendicitis, not a single heart attack, only three cases of diabetes, one peptic ulcer, no gallstones, and no evidence of high blood pressure (which alone affects one out of three Americans).
Maybe the Africans were just dying early of other diseases and so never lived long enough to get heart disease? No, in the above video we can see the age-matched heart attack rates in Uganda versus St. Louis. Out of 632 autopsies in Uganda, only one myocardial infarction. Out of 632 Missourians—with the same age and gender distribution—there were 136 myocardial infarctions. More than 100 times the rate of our number one killer. In fact, researchers were so blown away that they decided to do another 800 autopsies in Uganda. Still, just that one small healed infarct (meaning it wasn’t even the cause of death) out of 1,427 patients. Less than one in a thousand, whereas in the U.S., it’s an epidemic.
If heart disease is so rare in rural Africa, how do the local doctors even know what to look for? Though practically unheard of among the native population, the physicians are quite familiar with heart disease because of all the people that immigrate to the country.
The famous surgeon, Dr. Denis Burkitt, insisted that modern medicine is treating disease all wrong. “A highly unacceptable fact—that is rarely considered yet indisputable—is that, with rare exceptions, there is no evidence that the incidence of any disease was ever reduced by treatment. Improved therapies may reduce mortality but may not reduce the incidence of the disease.” Take cancer, for example, where the vast majority of effort is devoted to advances in treatment, and second priority is given to screening programs attempting early diagnosis. Is there any evidence that the incidence of any form of cancer has been reduced by improved treatment or by early detection? Early diagnosis may reduce mortality rates, and medical services can have a profoundly beneficial effect on sick people, but neither have little (if any) effect on the number of people becoming ill. No matter how fancy heart disease surgery gets, it’s never going to reduce the number of people falling victim to the disease.
Dr. Burkitt compared the situation to an engine left out in the rain. “If an engine repeatedly stops as a consequence of being exposed to the elements, it is of limited value to rely on the aid of mechanics to detect and remedy the fault. Examination of all engines would reveal that those out in the rain were stopping, but those under cover were running well. The correct approach would then be to provide protection from the offending environment. However, considering the failing engine as the ailing patient, this is seldom the priority of modern medicine.”
Dr. Burkitt sums it up with the analogy of The Cliff or The Ambulance: “If people are falling over the edge of a cliff and sustaining injuries, the problem could be dealt with by stationing ambulances at the bottom or erecting a fence at the top. Unfortunately, we put far too much effort into the provision of ambulances and far too little into the simple approach of erecting fences.” And of course there are all the industries enticing people to the edge, and profiting from pushing people off.
If all plant-based diets could do is reverse our number one killer, then shouldn’t that be the default diet until proven otherwise? The fact that it also appears to reverse other leading killers like diabetes and hypertension appears to make the case for plant-based eating overwhelming. So why doesn’t the medical profession embrace it? It may be because of The Tomato Effect. Why don’t many individual doctors do it? It may be because lifestyle medicine hurts the bottom line (see Lifestyle Medicine: Treating the Causes of Disease). Why doesn’t the federal government recommend it? It may be because of the self-interest of powerful industries (see The McGovern Report). But you can take your destiny into your own hands (mouth?) and work with your doctor to clean up your diet and maximize your chances of living happily ever after.
Michael Greger, M.D.