Lifestyle Changes Proven To Save Lives

i want to give a shout out to david katz i was in honolulu two weeks ago lecturing for the vegetarian society of hawaii and i spoke about the neo-sand study and i thought it was a japanese word event great sushi and i realized now it’s honolulu san francisco and i thought it was hiroshima but nagasaki you know everything and i said at the feet of david katz um anyways i will uh happily tackle finland you heard if you were at walter will dr will’s talk he mentioned the venerable name of ansel keys phd phd because they had two of them and studies he did called the seven country study and that launched in 1958 one of the sites picked to compare dietary patterns versus other societies like okinawa like um crete like some american communities was east finland called north korea he’s filling the north korea it’s confusing but it was known to be a pocket of potential heart disease and a very high fat diet specifically as they evolved to study high saturated fat diet and it turned out by the late 60s about 10 years after the seven country study was launched that it was pretty clear that the highest heart attack rate in the western world was in east finland a budding russia and their diet was very heavy in sausage and very heavy in butter and had a saturated fat rate that approached 30 percent of calories were from saturated fat to the point that 40 45 50 year old men were having heart attacks that are rate unprecedented and when men have heart attacks they often just drop dead it’s a special thing we do better than women um many gifts we have to end up dying earlier than women so there was this massive public health study they found this guy with the cutest name of pukapeska uh an md in the public health sector young man who took on the uh the onus of going to food companies can we sneak beans in the sausage let the women know god forbid don’t tell the men when they go out in the fields can we you know change the butter to margarine on the store shells they did recommend quitting smoking that sometimes gets brought up as a criticism it wasn’t just a food it was a comprehensive lifestyle change and within five years the heart attack rate had dropped 80 to 85 percent well if you live in west finland you say i want to be part of it so they extended the study to the entire country and they ultimately showed and it continues to this day you know major and significant reductions in heart attack rates but it’s extended to overall lifespan and certainly cancer cases too not 80 to 85 percent but cancer is somewhere in the 50 percent or so range so you know many of us point to it as one of the most um you know instructive of public health measures by changing diet to really change measurable and important lifestyle measures there’s this beautiful graph of just drop drop drop drop drop and heart attack rates over five years so north korea david perhaps the anals of internal medicine has sabotaged i don’t know

all right so just to just a great answer by joel just to append something so the north korea study is currently run by pukapeshka’s successor irkee vartiya and we were privileged i met erke in lithuania we were privileged to actually have him come over and speak at the american college of lifestyle medicine meeting so the story is beautiful and it lasts a very long time over a span of almost half a century rates of heart disease in north korea dropped 82 percent average life expectancy went up a full decade one of the more stunning examples of community-wide effective public health intervention in the world but alas this age of alternative truth social media echo chambers misinformation and the well-funded machinations of the beef industry have caused the finish to begin doubting all the things that americans are doubting so you know maybe meat is really better for me right big fat surprise and all of that so irkey reported that actually after all those many years of stunning and luminous benefit from their intervention that young finns were starting to increase their intake of meat and their intake of saturated fat and for the first time in half a century they saw the mortality curve going back up we have to be very careful never to take for granted the gains that we’ve achieved because famously familiarity breeds contempt we’re seeing that by the way i don’t know how this audience is going to feel about this comment i will take my chances just the same it’s clearly off topic but we’re seeing that with vaccines vaccines are one of the more stunning advances in all of public health history and yet when you get comfortable with the fact that you don’t have to worry that your kids are going to get polio myelitis every spring when nobody gets smallpox you start to worry more about vaccines than the dreaded diseases that vaccines prevent until you get a new dread disease like the coronavirus and then everybody’s wondering when there’ll be a vaccine but we tend to do that we get complacent about our gains and then we start to shift our perspective until we’re imperiled again so sadly some of those gains in north korea are in peril

can i can i ask you i was at that lecture where they where they talked i was interested and maybe you could or wanted you to comment they were so it seemed like they thought that the margarine shift was the biggest part of that i was very impressed at the acl meaning that they were all into how the margarine seemed to shift and the other thing i wanted in this uh in this change that i knew was happening they seemed to say that there was an abutting uh area in finland that was eating mainly meat and doing better than north korea that’s how it started do you know if there’s any truth to that

so i i just have the benefit joe of having been at the lecture so as joel mentioned they did a lot of things carso they focused on reducing smoking they focused on reducing sodium intake they focused on reducing saturated fat and then much of the replacement was with polyunsaturated fat from plant sources honestly i think if they had reduced saturated fat with any healthy alternative they would have witnessed much the same benefit but i think irky and others were kind of subscribed to the mediterranean diet notion so you know i think ansel keys also ansel keys by the way you know everybody associates his name with a low-fat diet he actually he practiced a mediterranean diet he advocated for a mediterranean diet he really was focused on reducing saturated fats and we outlived all of his critics yeah absolutely yeah but um bukapeshka and irkey vartana were sort of disciples of ancel keys so i think they may have had an early focus joel maybe you can speak more to this on benefits of replacing saturated fat with unsaturated fat that was the purpose of the margin and obviously this was not trans fat containing margarine

right i remember them saying that but they were very proud of their parents but they they did achieve multiple changes in lifestyle i i think i agree with joel i think that’s a good thing at the end of that you’re not able to say okay how much exactly of this benefit was related to salt versus saturated fat versus tobacco

yeah but you know they sort of lined up all the bad stuff knocked it all down and added 10 years to life expectancy you sort of say after that who cares who cares that’s right it was all bad they fixed it all