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This is being written following the reading of the
March issue of the Townsend
Letter, an issue that
had much about treatments for heart disease.
I find it hard to understand why the American Heart Association and
doctors in general seem not to know that the disease now called myocardial
infarction,
which is the cause of over 500,000 deaths in the US each year, is a new disease
of the heart discovered in 1926. They seem not to know that, prior to 1900,
there were only a very few deaths a year from this disease, they might care
to tell us to live as people lived prior to 1900, and this change in diet might
prevent heart attacks.
Let me review the steps leading up to the discovery in 1926 of what was then
the new and deadly disease of the heart, myocardial infarction. The first report,
from Scotland., was written by J.L. Stephens [The Lancet 1887;Vol
ii: 1205-9]. Stephens said that it was possible to have blood clots in one
or more coronary
arteries, which could result in death. His report was followed four years later
by another study by Sir William Osler, then at Johns Hopkins Hospital. In his
1892 book, The Principles and Practices of Medicine,
Osler added a new bit of information, reporting that the blood clot caused
a white infarction in
the myocardium, which was the cause of death. However, heart attacks of this
kind occurred so rarely in 1900 that no real attention was paid to Stevens
and Osler.
In 1910, machine-made cigarettes came on the market, and by 1920, nearly 80%
of US men were smoking cigarettes. Although cigarette smoking was causing myocardial
infarction-type heart attacks in 1920, death from this type of heart attack
was routinely incorrectly diagnosed. Often, a patient having a heart attack
will have severe stomach distress and, for a while, some doctors believed these
heart attacks were diseases of the stomach, and the name given to such an incidence
of heart attack was acute indigestion.
Then, in 1926, came two reports from England and one from the US.1-3 As Osler
had reported in 1892, these studies confirmed that there was a new disease
of the heart, in which a coronary blood clot was followed by an area of dead
heart muscle cells, an infarction, Doctors were slow to accept these findings.
In 1974, The Lancet published a letter entitled, "Myocardial Infarction
Then and Now," which said that many English doctors taking the examination
for the degree of MRCP in 1927 had no knowledge of this heart disease [The
Lancet, Mar. 9, 1974]. It was not until 1928 that
doctors in general agreed on the existence of this new heart disease, then
called coronary thrombus.
At the time, treatment for a heart attack involved putting the patient to bed
in an oxygen tent. In 1945, warfarin was discovered. Use of warfarin tended
to prevent the coronary blood clot, and for a while, warfarin was the standard
treatment for coronary thrombosis.
Then, in 1955, came a vast change in knowledge about this rather new disease
of the heart, which was publicized by the American Heart Association in a three-hour
program broadcast by all the television stations on a Sunday afternoon. According
to this program, coronary blood clots had nothing to do with this new heart
disease. This heart disease was caused by cholesterol in food, which affected
the blood, clogging the coronary arteries and thus causing a heart attack.
It had also been found that that the saturated fats in diet (like those present
in butter) would cause an increase in cholesterol in blood. People were advised
to avoid cholesterol in their diets. The new polyunsaturated fats from vegetable
oil, they were told, would tend to reduce the cholesterol in blood and should
replace the saturated fats in diet. Blood clots were no longer seen as the
cause of heart disease, and so the condition's name was changed from
coronary thrombosis to myocardial infarction.
In the 1955 television report, Katz of the University of Chicago and Kinsell
of the University of California talked in favor of a dietary change that would
restrict cholesterol and saturated fats in diet, replacing them with the new
polyunsaturated fats. Dr. Paul Dudley White, the cardiologist caring for President
Eisenhower, was the last speaker during that special report. Katz and Kinsell
should have talked to him first.
White declared that the cholesterol and saturated-fat connection was a lot
of nonsense. He cited a booklet, "Treatise on Sudden Death," written
by two doctors at Oxford University in 1855 that told of two patients who had
died suddenly of a mysterious cause. In 1955, it was clear to a doctor reading
that report that the two deaths had been caused by myocardial infarction. White
said this showed how very rare death from myocardial infarction was in England
in 1855. He said that the typical English diet in 1855 normally contained red
meat three times a day and was very high in cholesterol and saturated fats
from butter, cheese, and whole milk – all the things that the American
Heart Association in 1955 was saying must be avoided. White also said that
the polyunsaturated fats, which the American Heart Association approved, were
not to be had in the heart attack-free days of 1855 and had not come on the
market until after 1930.
In the past 200 years, there have been two pandemics of deaths from heart disease,
the first as a result of beriberi which started in about 1840. That disease
was caused indirectly by the steam engine. A steam engine could run a rice
mill, removing the rice bran from brown rice to make polished white rice. The
process also removed thiamine, the absence of which caused beriberi, which
instigated the heart failures. Millions in Asia died of beriberi in the hundred
years after 1840. Orthodox doctors would have nothing to say about the introduction
of polished white rice as the cause of the disaster. It has been suggested
that a process, similar to the one that lead to beriberi, has happened and
is the cause of millions of deaths from myocardial infarction. This is covered
in my report "The Beriberi Analogy to Myocardial Infarction" [Medical
Hypotheses. 1983;10:185-198].
All that was needed to save millions of death from beriberi was to add rice
bran back into the diet. It is suggested that a simple dietary answer to myocardial
infarction also exists. Professor Terence Anderson may have had this simple
answer to myocardial infarction. When he was with the School of Hygiene of
the University of Toronto, Anderson wrote "Nutritional Muscular Dystrophy
and Human Myocardial Infarction" [The Lancet.
Aug. 11, 1973;298-302]. Anderson and I became friends. He is now retired from
the Faculty of Medicine
at the University of British Columbia.
Anderson's answer to the causes of myocardial infarction is that too
much oxygen is going to the myocardium. Orthodox thinking is that myocardial
infarction results from too little oxygen to the heart. This assumption is
part of the problem. Anderson held that the formation of peroxide fats from
the polyunsaturated fats will cause small foci of degeneration to form in the
myocardium. He said these foci act like muscular dystrophy of the heart. This,
he said, makes the heart vulnerable to an attack when less blood flows in the
coronary arteries due to blood clots or plaques of atheroma. Anderson tested
this concept by studying the hearts of 20 men who had died. Half had died of
a heart attack, and half had died in accidents. All who died of heart attacks
had hearts showing these small foci of degeneration. Only one who had died
of an accident had one of these foci [The Lancet.1973;
ii: 912].
Here is Anderson's explanation of the rise of myocardial infarction.
Prior to 1900, whole-grain bread was the norm. Around 1900, bakers began selling
white bread made of bleached white flour, Just as making white rice caused
the pandemic of beriberi, so has the making of white bread had its part in
the pandemic of myocardial infarction. In the making of white bread, wheat
bran is discarded and, with it, most of the magnesium and selenium. James Landauer
wrote on the great benefit to the heart of magnesium [The New England
Journal of Medicine. 318 (14): 925]. Magnesium is
a powerful antagonist to platelet adhesion. It is an anticoagulant that prolongs
clotting time, stimulates fibrinolysis,
and increases prostcyclin and intracellular potassium levels. Magnesium is
also a powerful vasodilator and a potent arrhythmia agent. Selenium, a potent
antioxidant, is lost with the bran as well. In addition, powerful oxidizing
agent is used to bleach flour. This destroys the tocopherol antioxidants.
Wheat contains linoleic acid. This polyunsaturated fat is easily oxidized in
the body to a lipid peroxide fat, which is greatly harmful to the heart. The
selenium lost in the making of white bread and the tocopherols destroyed in
the bleaching process protect one from the making of the deadly lipid peroxide
fats. So, if one eats whole-grain bread, the protection is in place, but in
eating bleached white bread, one has the risk of the formation of these deadly
lipid peroxide fats.
Anderson cites Italy's experience. In 1925, Mussolini banned the making
of bleached white flour in order to reduce the importation of wheat from abroad,
So, from 1925 until the end of World War II, only whole-grain bread was eaten
in Italy. During these 20 years, there was no increase in death from myocardial
infarction, whereas in the US and in England, deaths from myocardial infarction
greatly increased.
Only one change in food processing brought about the beriberi pandemic: the
making of polished white rice. According to Anderson, two dramatic changes
in food possessing brought about the pandemic of myocardial infarction. The
first change was the replacing of whole-grain breads with bleached white bread.
The second change in food processing was the formation of the oil seed industry
around 1930. This industry took liquid fats from the seeds of certain grains
(like corn) and from beans (like soy). These fats were polyunsaturated. Much
of these new polyunsaturated fats were made into margarine, which sold at about
half the cost of butter. That low cost greatly helped the sale of margarine.
Then, in 1955, when the American Heart Association came out and said that polyunsaturated
fats prevented myocardial infarction, the sale of these products increased
even more. Today, Americans have about three times the amount of the polyunsaturated
fats in their diets as they had in the myocardial infarction-free days of 1900.
Nearly all tocopherol antioxidants are removed in the refining process that
occurs while making these polyunsaturated vegetable fats. Then, the double
bonds of the polyunsaturated fats make them about ten times as likely to form
peroxide fats as with the saturated fats. Anderson felt that the introduction
of great amounts of polyunsaturated vegetable oils and margarines after 1930
has been even more harmful in causing heart attacks than has been the introduction
of white bread.
It may be, too, that the addition of these polyunsaturated fats to our diet
is a cause of cancer. Dr. E.A, Newsholme of the University of Oxford reported
that polyunsaturated fats are highly immunosuppressive [The Lancet,
1977;i: 654]. I made contact with Newsholme and asked his opinion on saturated
fats.
He said that saturated fats are not immunosuppressive at all. He said that
the polyunsaturated fats should be used to treat autoimmune diseases, and he
told me of a case where polyunsaturated fats were used in the treatment of
children with Guillain-Barre' disease [The Lancet.
1978; March 18: 583-585]. I said that because polyunsaturated fats are so immunosuppressive,
they must
be causing cancer since, as we've seen with organ transplant patients,
immunosuppression will cause cancer. Newsholme was not about to say that the
polyunsaturated fats were causing cancer, but I reminded him of the history
of lung cancer. In 1930, when the fats in the typical diet were saturated fats,
almost no deaths from lung cancer occurred, even though 80% of men were smoking
cigarettes. At that time, there was only one death from lung cancer per 100,000
annual deaths in the US. By 1978, with less than 50% of men smoking cigarettes,
deaths from lung had reached pandemic proportions with 60 such deaths per 100,000 – this
at a time when polyunsaturated fats had increased in our diet by a factor of
three.
It is hard to understand how the American Heart Association can say that cholesterol
and saturated fats are causing heart attacks and that the polyunsaturated fats
are preventing them since, in 1855, when the average diet was rich in both
cholesterol and saturated fats and polyunsaturated fats were not to be had,
heart attacks were rare. Note should be taken also that M.W. Gillman of Harvard
Medical School et al. published a study not that long ago that concluded that
saturated fats in diet reduce the risk of ischemic stroke in men [JAMA.
December 24, 1997; 2144-2150].
It is time that we pay attention to Anderson and grant that the so-called good
polyunsaturated fats are causing both heart attacks and cancer. It is time
that we declare that the saturated fats are the good fats.
Wayne Martin, BS, ChE
25 Orchard CT
Fairhope, AL 36532
251-928-3975
Editor's Note: Wayne
Martin passed away in May 2006. Mr. Martin has been a longtime correspondent
and observer for the Townsend Letter.
He has been published in our print magazine for nearly 20 years.
Our indices cite many
of his contributing letters, some of which are available
online, but most
are available in the print magazine only. These
may be ordered from our offices.
Additional Notes
1. McNee JW. The clinical syndrome of thrombosis of the coronary arteries. Quarterly
Journal of Medicine. 1925; Vol XIX:44-52.
2. Gibbon AG. Ischemic necrosis of the heart. The Lancet.
1925;i:1270~1279.
3. Coombs C, Hadfield G. The Lancet.
Jan. 2, 1926.
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