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From the Townsend Letter
June 2006

Letter to the Editor
Good Fats and Heart Disease

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Online publication only
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

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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