The causes of coronary heart disease

The causes of coronary heart disease, according to many doctors and nutritionists, are saturated fats and cholesterol. And so they tell us to avoid such foods.

In short, plagues are the causes of coronary heart disease. This seems to make sense. What's more, this theory is suppposedly supported by some 60 years of scientific research. The only problem with this lipid hypothesis, however, is that it does not explain what happens in real life.

Many distinguished scientists have pointed to serious flaws in this theory. For example, studies of different populations show that most older people have build up of plaque in the artery, whether or not they had heart disease.

Koreans, who eat substantial amounts of saturated fats, were found in a 1955 study to have significant plaque build up. The Japanese, who eat little meat compared to the Koreans, were also found to have significant plaque build up in their arteries. Both studies were done at about the same. The Korean study made front page headlines, the Japanese study did not. The Bantu, a South African tribe whose diet was largely vegetarian, were found to have as much plaque buildup in the arteries as other South African tribes who ate more meat. Blacks in Jamaica had as much plague in the arteries as Americans - but they had lower rates of heart disease. The Masai, an African tribe, eats only meat, blood and milk and have extremely high levels of saturated fats in their diet. They have practically zero heart disease. They also have one of the world's lowest levels of blood cholesterol.

One of the biggest studies to establish saturated fats as the causes of coronary heart disease was the 1968 International Atherosclerosis Project, in which over 22,000 corpses in 14 nations were cut open and examined for plaques in the arteries.

The study found roughly the same degree of plaque in all parts of the world – among people who ate a lot of meat and saturated fats, as well as those who ate little or no meat; among people with high rates of heart disease as well as those with little or no heart disease.

Saturated fats are not the causes of
coronary heart disease!

The lipid hypothesis fails to explain other real-life observations as well.

• In America, the rate of heart disease soared during a period when saturated fats consumption fell sharply.

Before 1900, heart disease was rare in America, affecting about 8 percent of the population. By 1950, heart disease caused 30 percent of all deaths in America. Today, it causes about 45 percent of all deaths.

During the period, consumption of butter, which is high in saturated fats, fell from over 18 lbs per person per year at the turn of the century, to about 10 lbs per person per year by 1950. Today it is even lower, yet the rate of heart disease continues to escalate.

In the same period, margarine consupmption rose from about 2 lbs per person to 8 lbs per person.

If saturated fats are the causes of coronary heart disease, one would expect the rate of heart disease in America to fall over the past 100 years, rather than to increase so dramatically.

The same heart disease patterns have taken place throughout the world in more recent decades. Everywhere, whenever the population reduces its consumption of saturated fats and switched to polyunsaturated vegetable cooking oils, the rate of heart disease started soaring.

"The diet-heart idea is the greatest scam in the history of medicine." – Dr George V Mann, author Coronary Heart Disease: The Dietary Sense and Nonsense

• In India, a 1968 study found that North Indians, who ate more meat and used mainly ghee (clarified butter) for cooking, had 17 times more saturated fats in their diets than South Indians, who were more vegetarians. However, North Indians had seven times less heart disease than Indians in the South.

This was because, by the late 60s, South Indians had started the switch from coconut oil, which contains about 90 percent saturated fats, to margarine and other polyunsaturated vegetable oils. More recent studies show that North Indians are finally begin to catch up with the South in heart disease rates – because North Indians have started to use less ghee and more margarine and vegetable oils.

Causes of coronary heart disease in modern times

I began my practice as a cardiologist in 1921 and I never saw a myocardial infraction patient until 1928. - Dr. Paul Dudley White, the man who introduced the electrocardiograph (ECG) machine to America during the 1920s. Back then, heart disease was so rare that Dr Paul Dudley White's medical colleagues advised him to find better ways to earn a living.

Another very important point to note is this: Modern heart disease is a new form of heart disease that did not exist before 1900.

Most people who die from heart disease nowadays die from myocardial infraction, or what is commonly called a heart attack. It happens when a massive blood clot causes obstruction of a coronary artery. Another common cause of death today is stroke. In a stroke, the same thing happens – a massive blood clot blocks the flow of blood, except that it occurs in the brain!

Myocardial infarction, or heart attack, almost never occurred before the 1920s. By 1930, it caused about 3,000 deaths in America. Today, it causes more than 500,000 deaths in America each year.

The true causes of coronary heart disease

This background about myocardial infraction is important for it tells us that at least two conditions must be present before a heart attack or a stroke can take place:

1. The build-up of abnormal plaque in the arteries. This abnormal plaque gradually hardens through calcification and it occurs most often in the large arteries feeding the heart or the brain.
   
   
2. The blood clot – which doctors call thrombus – that blocks blood flow to the heart or brain.

The build-up of ABNORMAL plaque is therefore just one of at least two causes of coronary heart disease. Yet the majority of doctors and scientist focus on this one factor, ignoring or paying scant attention to other causes.

The word ABNORMAL has to be emphasised. Earlier, we saw that people all over the world have plaque build-up in their arteries no matter whether they:

• ate plenty of meat products of were largely vegetarian
• lived in traditional or industrialised societies
• had high rates of heart disease or little / no heart disease.

Thus, plaque build-up, on its own, is not one of the causes of coronary heart disease.

This NATURAL plaque build-up is a protective factor. It occurs mostly in areas where the arteries might come under stress, such as places where they branch out or make a turn. Without this protective plaque build up, our arteries would weaken as we grow older. They might rupture.

With normal plaque build up, the blood vessels usually widen to accommodate the change. So blood continues to flow smoothly, unobstructed.

This natural plaque build-up is due to saturated fats and cholesterol. It is not a problem. It is not a symptom of heart disease. Saturated fats and cholesterol are not causes of coronary heart disease.

Heart disease starts to develop only when the plaque build-up is ABNORMAL – meaning it is thicker and harder than normal, and it deposits in areas where normal plaque do not usually occur.

Why does this happen? No one knows for sure and there are many theories to explain this abnormal plaque build-up. These various theories give us a better idea about the true causes of coronary heart disease.

The predominant theory is that abnormal plaque build-up occurs due to damage or injury to the arteries. To repair the damage or injury, the body deposits saturated fat and cholesterol to patch up the area.

Blood clots

To discover the true causes of coronary heart disease, scientists must also understand what causes blood clots inside the arteries.

This aspect has not received adequate attention from researchers. But it is equally important. Because heart attack due to a blood clot can occur when the arteries are not blocked by abnormal plaque build-up.

Here again, there are many theories and possible explanations:

• Inflammation is one of the possible causes of coronary heart disease. Normally, inflammation is a natural process that helps the body heal from injury. But with dmage and injury occurs too often inside the arteries, inflammation might cause plaques to rupture and blood clots to form.
  
  
• The integrity of artery walls is another factor. When the vessel walls are weak, they might break or tear. This will not only cause blood clots, but also rapid loss of blood.

So what causes damage or injury to the blood vessels – which lead to abnormal plaque build-up, inflammation, ruptures, blood clots... and finally to a heart attack?

Here is where the many different theories come in. Among many possible causes of coronary heart disease, they could be due to:

• trans fats
• free radicals
• polyunsaturated oils that have turned rancid and oxidised - due to high heat or exposure to oxygen and light
• sugar and other refined carbohydrates
• excess omega-6 from refined vegetable oils
• viral or bacteria infection
• nutritional deficiency, including deficiencies of vitamins A, C and E, folic acid, vitamins B6 and B12, selenium, magnesium, etc
• pasteurised and UHT treated milk
• thyroid malfunction
• coffee consumption
• lack of exercise
• exposure to carbon monoxide

Most of these theories provide better explanations – and have stronger supporting evidence – than the popular lips theory that blames saturated fats and cholesterol as the causes of coronary heart disease.

Is smoking one of the causes of coronary heart disease?

In a long-term British study involving several thousand men, half of them were asked to reduce saturated fat and cholesterol, stop smoking and increase the amounts of unsaturated oils such as margarine and vegetable oils. The rest continued to eat their usual amounts of saturated fats and cholesterol, and also continued to smoke. The study results, reported in The Lancet in 1968, were startling: After one year, those following the ‘healthy’ diet and lifetyle had 100 percent more deaths than those on the supposedly unhealthy diet and lifestyle. A study of Indians from Bombay and Punjab found that those from Punjab had one-fifth the number of heart attacks even though they smoked eight times more cigarettes!

Smoking, too, is often cited as one of the major causes of coronary heart disease. But this idea, too, needs to be seriously examined.

Most signficant is the fact that smoking was widespread – just as saturated fats were widely consumed – at the turn of last century, when heart attacks were non-existent. There are several possible explanations for this:

• Factors in traditional diets – including possibly saturated fats – could have protected against the negative effects of smoking.
  
  
• Chemical additives in modern cigarettes – in the tobacco as well as in the paper – make them more harmful.
  
  
• Both heart disease and the desire to smoke are caused by some other factors, such as stress, nutritional deficiency, etc.

Lack of physical activity

This discussion can go on and on... But let's end off for now with one of the more straight forward causes of coronary heart disease – lack of exercise or physical activity.

When we exercise or perform physical activity, our heart beats more rapidly and the arteries widen to facilitate blood flow and provide more oxygen to the cells.

Lack of exercise may also point to other factors that may be the true causes of coronary heart disease. For example, people who are overweight tend to dislike exercise. Or, certain foods may make people feel lethargic and less inclined to exercise.

The causes of coronary heart disease are therefore not as straight forward as most doctors and health authorities make it out to be. But whatever the causes, saturated fats and cholesterol are not among them!

Visit my Stop Trans Fats website to learn more about the causes of coronary heart disease.