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The Coronary Heart Disease Epidemic: Possible Culprits Part II

In the last post, I reviewed some of the factors that I believe could have contributed to the epidemic of heart attacks that began in the 1920s and 1930s in the U.S. and U.K., and continues today. I ended on smoking, which appears to be a major player. But even smoking is clearly trumped by another factor or combination of factors, judging by the unusually low incidence of heart attacks in France, Japan and on Kitava.

One of the major changes in diet that I didn't mention in the last post was the rise of industrial liquid vegetable oils over the course of the 20th century. In the U.S. in 1900, the primary cooking fats were lard, beef tallow and butter. The following data only include cooking fats and spreads, because the USDA does not track the fats that naturally occur in milk and meat (source):

Animal fat is off the hook. This is the type of information that makes mainstream nutrition advice ring hollow. Let's see what happened to industrial vegetable oils in the early 1900s:

I do believe we're getting warmer. Now let's consider the composition of traditional American animal fats and industrial vegetable oils:

It's not hard to see that the two classes of fats (animal and industrial vegetable) are quite different. Animal fats are more saturated (blue). However, the biggest difference is that industrial vegetable oils contain a massive amount of omega-6 (yellow), far more than animal fats. If you accept that humans evolved eating primarily animal fats, which is well supported by the archaeological and anthropological literature, then you can begin to see the nature of the problem.

Omega-6 and omega-3 fats are polyunsaturated fatty acids that are precursors to a very important class of signaling molecules called eicosanoids, which have a hand in virtually every bodily process. Omega-6 and omega-3 fats compete with one another for the enzymes (desaturases and elongases) that convert them into eicosanoid precursors. Omega-6-derived eicosanoids and omega-3-derived eicosanoids have different functions. Therefore, the balance of omega-6 to omega-3 fats in the diet influences the function of the body on virtually every level. Omega-6 eicosanoids tend to be more inflammatory, although the eicosanoid system is extraordinarily complex and poorly understood.

What's better understood is the fact that our current omega-6 consumption is well outside of our ecological niche. In other words, we evolved in an environment that did not provide large amounts of omega-6 all year round. Industrial vegetable oils are a product of food processing techniques that have been widespread for about 100 years, not enough time for even the slightest genetic adaptation. Our current level of omega-6 intake, and our current balance between omega-6 and omega-3, are therefore unnatural.

The ideal ratio is probably very roughly 2:1 omega-6:omega-3. Leaf lard is 6.8, beef tallow is 2.4, good quality butter is 1.4, corn oil is 45, cottonseed oil is 260. It's clear that a large qualitative change in our fat consumption occurred over the course of the 20th century.

I believe this was a major factor in the rise of heart attacks from an obscure condition to the primary cause of death. I'll be reviewing the data that convinced me in the next few posts.

The Coronary Heart Disease Epidemic
The Coronary Heart Disease Epidemic: Possible Culprits Part I
The Omega Ratio
A Practical Approach to Omega Fats
Polyunsaturated Fat Intake: Effects on the Heart and Brain
Polyunsaturated Fat Intake: What About Humans?
Vegetable Oil and Homicide

The Coronary Heart Disease Epidemic: Possible Culprits Part I

In the last post, I reviewed two studies that suggested heart attacks were rare in the U.K. until the 1920s -1930s. In this post, I'll be discussing some of the diet and lifestyle factors that preceded and associated with the coronary heart disease epidemic in the U.K and U.S. I've cherry picked factors that I believe could have played a causal role. Many things changed during that time period, and I don't want to give the impression that I have "the answer". I'm simply presenting ideas for thought and discussion.

First on the list: sugar. Here's a graph of refined sugar consumption in the U.K. from 1815 to 1955, from the book The Saccharine Disease, by Dr. T. L. Cleave. Sugar consumption increased dramatically in the U.K. over this time period, reaching near-modern levels by the turn of the century, and continuing to increase after that except during the wars:

Here's a graph of total sweetener consumption in the U.S. from 1909 to 2005 (source: USDA food supply database). Between 1909 and 1922, sweetener consumption increased by 40%:

If we assume a 10 to 20 year lag period, sugar is well placed to play a role in the CHD epidemic. Sugar is easy to pick on. An excess causes a number of detrimental changes in animal models and human subjects, including fatty liver, the metabolic syndrome, and small, oxidized low-density lipoprotein particles (LDL). Small and oxidized LDL associate strongly with cardiovascular disease risk and may be involved in causing it. These effects seem to be mostly attributable to the fructose portion of sugar, which is 50% of table sugar (sucrose), about 50% of most naturally sweet foods, and 55% of the most common form of high-fructose corn syrup. That explains why starches, which break down into glucose (another type of sugar), don't have the same negative effects as table sugar and HFCS.

Hydrogenated fat is the next suspect. I don't have any graphs to present, because no one has systematically tracked hydrogenated fat consumption in the U.S. or U.K. to my knowledge. However, it was first marketed in the U.S. by Procter & Gamble under the brand name Crisco in 1911. Crisco stands for "crystallized cottonseed oil", and involves taking an industrial waste oil (from cotton seeds) and chemically treating it using high temperature, a nickel catalyst and hydrogen gas (see this post for more information). Hydrogenated fats for human consumption hit markets in the U.K. around 1920. Here's what Dr. Robert Finlayson had to say about margarine in his paper "Ischaemic Heart Disease, Aortic Aneurysms, and Atherosclerosis in the City of London, 1868-1982":

...between 1909-13 and 1924-28, margarine consumption showed the highest percentage increase, whilst that of eggs only increased slightly and that of butter remained unchanged. Between 1928 and 1934, margarine consumption fell by one-third, while butter consumption increased by 57 percent: and increase that coincided with a fall of 48 percent in its price. Subsequently, margarine sales have burgeoned, and if one is correct in stating that the coronary heart disease epidemic started in the second decade of this century, then the concept of hydrogenated margarines as an important aetiological factor, so strongly advocated by Martin, may merit more consideration than hitherto.

Partially hydrogenated oils contain trans fat, which is truly new to the human diet, with the exception of small amounts found in ruminant fats including butter. But for the most part, natural trans fats are not the same as industrial trans fats, and in fact some of them, such as conjugated linoleic acid (CLA), may be beneficial. To my knowledge, no one has discovered health benefits of industrial trans fats. To the contrary, compared to butter, they shrink LDL size. They also inhibit enzymes that the body uses to make a diverse class of signaling compounds known as eicosanoids. Trans fat consumption associates very strongly with the risk of heart attack in observational studies. Which is ironic, because hydrogenated fats were originally marketed as a healthier alternative to animal fats. The Center for Science in the Public Interest shamed McDonald's into switching the beef tallow in their deep friers for hydrogenated vegetable fats in the 1990s. In 2009, even the staunchest opponents of animal fats have to admit that they're healthier than hydrogenated fat.

The next factor is vitamin D. When the industrial revolution became widespread in the late 19th century, people moved into crowded, polluted cities and vitamin D deficiency became rampant. Rickets was a scourge that affected more than half of children in some places. Dr. Edward Mellanby discovered that it's caused by severe vitamin D deficiency, milk was fortified with vitamin D2, and rickets was all but eliminated. However, it only takes a very small amount of vitamin D to avoid rickets, an amount that will not contribute significantly to optimum vitamin D status. Vitamin D modulates the body's inflammatory response, it's ability to resist calcium deposition in the arteries, and seems to be important for so many things I had to include it.

The rise of cigarettes was a major change that probably contributed massively to the CHD epidemic. They were introduced just after the turn of the century in the U.S. and U.K., and rapidly became fashionable (source):

If you look at the second to last graph from the previous post, you can see that there's a striking correspondence between cigarette consumption and CHD deaths in the U.K. In fact, if you moved the line representing cigarette consumption to the right by about 20 years, it would overlap almost perfectly with CHD deaths. The risk of heart attack is so strongly associated with smoking in observational studies that even I believe it probably represents a causal relationship. There's no doubt in my mind that smoking cigarettes contributes to the risk of heart attack and various other health problems.

Smoking is a powerful factor, but it doesn't explain everything. How is it that the Kitavans of Papua New Guinea, more than 3/4 of whom smoke cigarettes, have an undetectable incidence of heart attack and stroke? Why do the French and the Japanese, who smoke like chimneys (at least until recently), have the two lowest heart attack death rates of all the affluent nations? There's clearly another factor involved that trumps cigarette smoke. I have a guess, which I'll expand on in the next few posts.

What are you going to do with your week?

If your actions inspire others to dream more, learn more, do more and become more, you are a leader." - John Quincy Adams

Patricia Gray writes about 'WHAT'S HOT 'in the world of Interior Design, new and emerging trends, modern design,
architecture, and travel, as well as how your surroundings can influence the world around you.
© 2007-2009 Patricia Gray Interior Design Blog

Earth Hour 2009

This year, Earth Hour 2009 has been transformed into the world’s first global election, between Earth and global warming.

For the first time in history, people of all ages, nationalities, race and background have the opportunity to use their light switch as their vote – Switching off your lights is a vote for Earth Hour 2009 or leaving them on is a vote for global warming. WWF are urging the world to VOTE EARTH HOUR 2009 and reach the target of 1 billion votes, which will be presented to world leaders at the Global Climate Change Conference in Copenhagen 2009.

This meeting will determine official government policies to take action against global warming, which will replace the Kyoto Protocol. It is the chance for the people of the world to make their voice heard.
Earth Hour 2009 is aiming to reach more than one billion people in 1000 cities around the world

VOTE EARTH Hour 2009 by simply switching off your lights for one hour, and join the world for Earth Hour 2009
8:30PM local time, wherever you live on planet earth. Saturday 28 March 2009
Sign-up to for Earth Hour 2009!!!
Earth Hour 2009 in Canada
Earth Hour 2009 YouTube
Earth Hour 2009 USA
Earth Hour 2009 India

All Art by Belgium Artist Patrick Desmet used with Artist's permission
Bottom Photo Titled: THE LAST FOREST

Ice-Bag Wine Chiller

The Ice-Bag Wine Chiller is a new product that has just hit the North American Market. It is a clear plastic wine tote and chiller that is reusable. It is completely water tight and portable. With it's sleek design and trend-setting appeal the Ice Bag Wine Chiller is an alternative to the ice bucket. And talking about trend setting, this Ice-Bag Wine Cooler has been used at venues such as the Ascot Racetrack, to high profile concerts (Madonna, Elton John, George Michael). How fun to display your wine or champagne in this Ice Bag Wine Chiller. I think that it would be great to use for weddings, special events, or your next party. It is even customizable with your own logo.

For the coolest drinks in town, re-usable Ice-Bag Wine Chiller. My friend Joyce is distributing these. Please contact Joyce for ordering information for Canada, South America, and the Americas here.

Ibiza Interior Design and Architecture

Ibiza. Even the word has magic. One thinks of beautiful Interior Design and Architecture; of nightclubs that open at dawn; of a night life and a daytime so tightly integrated, one can’t see where the one ends and the other begins. One thinks of royal high-jinks and celebrities avoiding the pesky paparazzi and people so beautiful, when the rest of us look at them, it hurts the eyes. Ibiza is an island and town located in the Mediterranean Sea about 80 km off the coast of Spain. A reader of my blog, recently sent me photos of a house in Ibiza that I fell in love with as soon as I set my eyes on it. I posted the picture of the living room painted a beautiful pink in my post: Benjamin Moore Virtual Fan Deck. This house is designed by the German architect ERWIEN WACHTER in the architectural style of Mies van der Rohe. It is a 'secret place' not on the public market and is available for rental for 'friends and friends from friends'. If you are interested Contact MONIKA BORCHERT. Enjoy the pictures.

Ibiza Interior Design and Architecture
I think that this is an amazing design for a front door...and look at the view you have when you enter this home.

Ibiza Interior Design and Architecture
The picture on the right is looking towards the staircase with the front door to the left.

Ibiza Interior Design and Architecture

Ibiza Interior Design and Architecture

Ibiza Interior Design and Architecture

You might be interested in these books on Ibiza Interior Design and Architecture

Related Post: Benjamin Moore Virtual Fan Deck

Benjamin Moore Virtual Fan Deck

As this week marks the beginning of Spring and pink is a color I associate with spring as the cherry trees are starting to blossom

, I have two favourite Benjamin Moore Paint colors to share with you that are season appropriate: 1. Benjamin Moore Spring Azalea & 2. Benjamin Moore Springtime Bloom. The color Spring Azalea has a little more of a purple cast to it than the Springtime Bloom and is a closer match to the color on the wall of this beautiful room. Benjamin Moore has a neat product on their web-site that you can see color samples on line. This living room is in a house is located on the island of IBIZA and has been designed by the German architect ERWIEN WACHTER in the style of Mies van der Rohe. It is available for rental. If you are interested Contact MONIKA BORCHERT for information. I will be posting more photos of this house, but for now this is just a little teaser. Be sure to check out Benjamin Moore Virtual Fan Deck

Happy Happy Spring

Here is another post on Pink you might be interested in:
Think Pink

Patricia Gray writes about 'WHAT'S HOT 'in the world of Interior Design, new and emerging trends, modern design and travel,
as well as how your surroundings can influence the world around you.
©Patricia Gray | Interior Design Blog

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