The term heart disease refers to several types of conditions affecting the heart. The most common type of heart disease in the United States is coronary artery disease (CAD), which is often the precursor to a heart attack. Heart disease kills more men and women in the United States than any other disease. It claims the lives of around 610,000 Americans every year.
But the fatalities of heart disease, though tragic, are the smallest statistic. Much larger numbers are those suffering from one of several types of heart conditions. For instance, over 5 million U.S. adults suffer from heart failure, and an estimated 15 million have coronary artery disease (narrowing of the arteries that can lead to heart attack). Meanwhile, the American Heart Association (AHA) conducts research in hopes of one saying finding a cure for heart disease.
But instead of searching for a cure, the AHA should investigate how heart disease became such a major killer. The answer to that question will cure this disease once enough people understand it and put specific principles into action. Such an investigation is outside of the AHA’s scope, of course, so it is left to others to put the pieces together. It is left to us to shine some SANEity on the subject.
So here goes.
Heart disease became a major killer because of the U.S. government’s actions (or inaction). Here’s how it happened.
The big heart disease scare
Americans rarely died of heart disease at the beginning of the 20th century. It was the fourth most common cause of death in 1900, right behind such infectious diseases as tuberculosis. By 1930, heart disease had become the most common cause of death, and the death rate kept climbing through the mid-1960s.
Health experts noted the growing heart disease rates and endlessly debated the possible causes. But there was no real urgency to find the cause — at least, not until the President of the United States became a victim. In 1955, then-President Dwight Eisenhower suffered a heart attack. Though he survived to live into a healthy old age, his heart attack set in motion a desperate search to find a scientific cause for heart disease.
Ancel Keys to the rescue
Minnesota physiologist Ancel Keys had been searching for the cause of heart disease even before Eisenhower became president. While reading obituary columns in the newspaper shortly after the war, Keys noticed an increasing number of heart attack fatalities.
Determined to find a reason for this, Keys noticed that well-fed Americans had high rates of heart disease, while Europeans, whose food had been rationed during World War II, did not. Since Americans ate high amounts of saturated fat, Keys theorized this caused heart disease.
In 1947, Keys tested his thesis on 283 businessmen from St. Paul and Minneapolis. He examined them and took blood samples over several years, and concluded that high blood pressure, high cholesterol, and smoking were linked to the development of heart disease.
The Seven Countries Study blasts fat consumption
In the 1950s, Keys began his most ambitious project with the Seven Countries Study (SCS for short), the first large-scale study to examine nutrition and lifestyle in addition to other cardiovascular disease risk factors over a lengthy period of time, spanning diverse countries and cultures.
For the Seven Countries Study, Keys compiled the heart disease rates of seven countries and compared them with the level of saturated fat consumption. The results were amazing. They showed a correlation between higher fat consumption and higher rates of heart disease.
Keys published his study in 1958 and became a vocal advocate of his theory that saturated fat causes heart disease. He attacked any researcher who questioned his theory. He made the cover of Time Magazine in 1961 (thanks to his famous study and his theory.) Keys was everywhere. Everyone was listening, even the American Heart Association.
He finally persuaded the AHA to issue its first-ever dietary guidelines making sure Americans knew the dangers of saturated fats. It seems Keys was on a mission. He drowned out all contrary opinions so that, eventually, nobody was left to question his theory.
Turns out there was a lot to question.
Heart disease and saturated fat: the big hole in Ancel Keys theory
The Seven Countries Study, once so praised, is now controversial. Critics accuse Keys of including only the countries that gave him the results he wanted. They accuse him of manipulating the results to fit his theory, and they have evidence to support this view.
For instance, Keys studied 22 countries but chose only seven to include in his study. The seven he included, critics say, were the ones most likely to conform to his hypothesis. He excluded countries, such as France, whose citizens were known to have low rates of heart disease while regularly enjoying high-fat diets.
But even the seven countries Keys included don’t prove his hypothesis, say the critics. Researchers who have reviewed his study say it is sugar, not fat, that correlates most closely with heart disease.
In the 1950s and 1960s, sugar and fat were two food items that were most debated by doctors and researchers as probable causes of heart disease. Several scientific articles have even been published indicating a link between sugar consumption and heart disease.
Heart disease: the sugar industry’s cover-up
And sugar wasn’t going to stand for that! Recently discovered internal documents show just how far the sugar industry would go to protect its interests.
These documents detail how, in the 1960s, the Sugar Research Foundation hired three Harvard researchers to conduct a literature review of studies examining what roles fat and sugar may play in heart disease. The Sugar Research Foundation selected all the studies the researchers reviewed.
Not surprisingly, the review found major weaknesses in every study that implicated sugar’s role in heart disease. But it found every study that implicated fat, no matter how flimsy the evidence, to be rock solid. Not surprisingly, the review concluded that the best way to lower heart disease risk is to reduce fat consumption.
The review was published in the prestigious New England Journal of Medicine in 1967, and the Sugar Research Foundation did not disclose it had funded the research. This shaped the scientific discussion, and from then on, dietary fat was THE cause of heart disease. Period.
But Ancel Keys had already paved the way with his Seven Countries study, and that’s probably not a coincidence. Keys and the sugar industry had collaborated once before, so to speak.
Ancel Keys and the sugar industry: partners?
In 1942, sugar was the first food to be rationed during World War II. The government cut sugar consumption from 4 pounds a month per person to 2 pounds a month while launching a PR campaign that sugar was not a necessity in the diet.
The sugar industry got scared, and in 1943, it established the Sugar Research Foundation to study the role of sugar in food and publish its finding. Its first research grant — for $36,000 — was awarded to Dr. Ancel Keys at the University of Minnesota to “study the metabolism in man of sugar.”
Years later, Keys’ Seven Countries Study gave the sugar industry what it wanted — free reign to add its product to food without restriction. For the next few decades, there would never be a serious debate about sugar’s role in heart disease. They made sure everybody blamed fat.
The real cause
There has never been any scientific proof that fat– saturated or otherwise — causes heart disease. But there is a lot of scientific proof that sugar causes or contributes to it.
One study published in the April 2014 edition of JAMA: Internal Medicine found a link between added sugar in the diet and increased risk of heart disease death. Researchers discovered that if 17-21 percent of your calories come from added sugars, you have a 38 percent higher risk of dying from cardiovascular disease compared to someone who consumes just 8 percent of their calories from added sugars.
Many studies also show excess sugar consumption causes chronic inflammation, a known risk factor for heart disease.
But the government has always ignored every study linking sugar and heart disease — then and now — wholeheartedly endorsing the findings of Ancel Keys. The government also took many steps that condemned fat, giving sugar a free pass that made heart disease worse. Let’s take a look at some of them.
Condemning fat, embracing sugar: a brief timeline of how the government made heart disease worse
1977 – the Senate Committee on Nutrition and Human Needs releases Dietary Goals for the United States, a report advising Americans to reduce fat in their diets while increasing carbohydrates. Low-fat, high-carb diets became the norm.
1992 – the United States Department of Agriculture introduces the Food Pyramid, which advises Americans to eat more servings of whole grains and starches than any other food group, 6-11 servings of bread, rice, pasta, and cereal a day!
2011 – The United States Department of Agriculture replaces the Food Pyramid with MyPlate. It is just a slight improvement, as it still recommends low fat, which almost always leads to high carb/sugar consumption.
1970s – Intense debate among researchers about the effects of sugar on heart disease heats up.
1975- The Sugar Foundation launches a PR campaign, publishing ads in newspapers and magazines praising the health benefits of sugar. The debate puts pressure on the FDA to review the health effects of sugar.
1976 – The FDA declares sugar GRAS (generally recognized as safe.) The department received its info from the sugar industry, not from sugar researchers! When a chemical or substance added to food is GRAS, it is not subject to regulation or food additive tolerance requirements by the FDA.
The sugar industry can now put any amount of sugar in anything it wants. And it does.
Sugar, sugar everywhere
More than 70 percent of processed foods have added sugar, and many of these foods don’t taste sweet. Manufacturers add sugar to soups, frozen dinners, protein powders, and much more. They add sugar to almost everything to improve the flavor and extend the shelf-life of the product. (Like salt, sugar is a preservative.) At least, those are the reasons manufacturers give. However, researchers have found evidence that manufacturers rigorously test what quantities of sugar to add to their products, looking for the “sweet spot” of addiction that keeps the customer coming back for more.
And they do. The United States Department of Agriculture reports that the average American consumes 150 to 170 pounds of refined sugar per year! That’s not hard to do when you consider one 12-ounce can of soda contains 32 grams of added sugar, a whopping 8 teaspoons. And many people drink multiple cans of soda per day.
The American Heart Association recommends a maximum daily added sugar consumption of 9 teaspoons for men and 6 teaspoons for women. If the majority of the foods you eat are processed, one soda puts you way over your daily limit.
Heart disease mortality rates: Are they decreasing?
The number of heart disease deaths in the U.S. peaked in the mid-1960s, and they’ve been steadily declining since then. The decrease is likely because of better detection and treatment methods. There were no real treatment options for heart disease in the 1960s, and no drugs to treat heart arrhythmias or high blood pressure. There was no coronary angioplasty and stents. Doctors didn’t even know blood clots caused heart attacks.
The National Institutes of Health say the decline in heart disease deaths is a victory, and it is a good sign. But while fewer people die of this disease than they did in the 1950s and 1960, the death toll is still staggering. And still, the government is doing nothing to decrease sugar consumption.
The SANE way to prevent diseases of the heart
There is an easy way to prevent heart disease. On the SANE Diet, you’ll decrease your sugar intake will enjoying filling foods scientifically proven to heal your hormones, lower your setpoint weight, and reduce your sugar cravings.
You’ll choose foods as close to their natural states as possible. (You’ll find these foods in the perimeter of the grocery store, where the produce and meats are displayed.) This will reduce your consumption of processed foods, automatically slashing your added sugar intake.
The four basic SANE food groups are non-starchy vegetables; nutrient-dense proteins; whole-food fats; and low-fructose fruits. Eating the first three food groups at every meal will lower your setpoint weight, reduce your risk of heart disease, and wean you off sugar. (Protein, especially, has been shown to decrease or eliminate sugar cravings.)
The foods you’ll eat won’t be bland and boring, either. Here is just a sampling of the tasty foods you’ll enjoy.
10+ servings per day
- Bell peppers
3-5 serving per day (30-50 grams per meal)
- Egg whites
- Grass-fed beef
- Lean meats
- Low-fat Greek yogurt
3-5 servings per day
- Flax Seeds
0-3 servings per day
- Acai berries
Simple steps lead to big changes
If the thought of drastically changing your diet scares you, calm down. True SANEity comes from progress, not perfection. Start out slowly, making simple substitutions at a time. Slowly remove processed foods from your diet, replacing them with yummy home-cooked meals containing non-starchy vegetables, savory meats, and satisfying whole-food fats.
Instead of soda, drink green tea sweetened with Stevia or another natural sweetener. Or drink water with a twist of lemon for healthy and natural flavoring.
Make just a few changes at a time, and before you know it, you’ll be almost totally free of added sugars in your diet. You’ll lower your heart disease risk, too!
Next step: Prevent heart disease by going SANE
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