The Real Culprits in Heart Disease
                    — by Cynthia Cechota

In the last issue of CR, this column tackled the role of cholesterol in the human body and the myth that cholesterol causes heart disease. If, as I argued, cholesterol is a necessary substance in our bodies and is not a culprit in heart disease, then what is?

Prior to 1920, heart disease was a rare phenomenon. In fact, when a young doctor named Paul Dudley White presented the German electrocardiograph to his Harvard colleagues, they encouraged him to concentrate on a more profitable venture. The new machine revealed blocked arteries, an infrequent condition in patients at the time. However, by the mid-1950s, heart disease was the leading cause of death in the U.S. What could be the cause of such a dramatic change? How could heart disease be rare in 1920, and commonplace less than 40 years later?

Food du Jour: 1880

To answer these questions, we first must explore what was being served in kitchens and dining rooms across America pre-1920. Historian Harvey Levenstein contends in his book, Revolution at the Table: The Transformation of the American Diet, that the most dramatic changes in the U.S. diet occurred between 1880 and 1930. These changes were a result of many sociological factors and technological advances, including the development of the modern cooking range; the rise of a low-cost, efficient transportation system; the advent of new ways to preserve food; and the birth of our modern processed food industry (Pillsbury, 1998, p. 54). Another factor was the greatly expanded food supply that resulted from the settling of the American West (Levenstein, p.29).

In 1880, the dinner tables of the various classes looked something like this:

Notice the heavy reliance on a variety of meats and the many courses included in the upper class diet. The men were often rotund and it was fashionable in 1880 for women to be fleshy. However, their portliness was attributed to an overabundance of food. (Yet they did not suffer from heart disease!) Paradoxically the poor southern tenant farmers of the time were often malnourished. It is interesting to note that Northern farmers, although poor, were healthier than those in the South. They were not tied to tyrannical landowners, as were their Southern counterparts. Northerners could raise and process their own food, while the Southern poor relied upon the monopolies of their employers to sell them the small selection that made up their diet at every meal. Only those who could afford them consumed eggs, butter, and milk on a regular basis. Of course, these are considered staples in a 21st Century diet.

As a result of the costly refining process, white flour and white sugar were more expensive. Therefore, sorghum, molasses, and brown sugar were more common in the middle and lower income families. The rich obviously imbibed on plenty of refined confections. However, the ingestion of plenty of animal products provided fat-soluble activators, which encouraged absorption of vitamins, minerals, and other nutrients.

The Birth of Processed Foods

Americans living in the thirty-four years between 1880 and World War I experienced radical changes in the food industry. The Midwest was producing great quantities of wheat and dairy that were being shipped via railroad to the East. More food meant the need for new technology to enhance preservation. And who rose to the occasion? The giant food corporations that began extolling the virtues of such products as Kellogg’s Corn Flakes and Post’s Grape-Nuts and Toasties. These products were touted as health foods to the middle class who were quick to embrace this new, modern thinking. Nabisco, Heinz, Van Camp, and Campbell soon became household names and their products were accepted as equivalent to traditional foods in all respects.

Around 1900, the American Sugar Refining Company (a giant sugar corporation that marketed its well known “Domino” brand) mounted a successful campaign to denigrate brown sugar. This is another example of the public accepting the “wisdom” of the food industry, as cookbooks began warning cooks about microbe infestations in brown sugar. Unfortunately, consumers were already convinced that white products were superior to brown ones. Even poor farmers gave up their consumption of molasses and homemade sorghum, while workers abandoned their intake of molasses and brown sugar. In the thirty-five years between 1880 and 1915, the per capita consumption of white refined sugar doubled.

In 1911, the first trans fat, “Crisco,” was mass marketed to housewives as a healthier, more modern alternative to strong-smelling lard. Crisco was originally developed as a lard substitute for candles ad soap, but with electrification, the new product needed a new market. The Story of Crisco, published by Proctor and Gamble in 1913, brilliantly but subtly convinced wives and mothers across the U.S. that they would be better wives and mothers if they used Crisco. One chapter is entitled, “The Importance of Giving Children Crisco Foods.” The book contained 615 recipes, each including Crisco as an ingredient. As a result, butter and lard were suddenly condemned as “old-fashioned.”

In 1915, the pasteurization of milk became mandatory by law. This was an unfortunate response to the high infant mortality of the day and unsanitary city dairies and milk outlets. There was much controversy and speculation about the true cause of the 50 percent mortality rate of children five and younger. The champions of breast-feeding claimed it was the result of artificial feeding, or the lack of breast milk. The artificial feeding proponents claimed it was the unsanitary dairy and citywide milk outlets. Although babies from all classes who were not breast-fed suffered a three to five times higher mortality rate than those who were breast-fed, the studies were not able to pinpoint artificial feeding as the main correlation. Instead, a relationship between declining family income and infant mortality was finally made in 1924. Declining income resulted in poor maternal nutrition, which meant smaller babies and more susceptibility to disease. Nevertheless, the decline in infant mortality after 1915 was credited to pasteurization.

Food du Jour: 1930

By 1930, America had been “dry” for ten years. Most of us are probably unaware that the policies of Prohibition had a profound effect on the American diet. The French chefs hired by the upper class and elegant restaurants were either living on the streets or buying their tickets to return home. Prohibition, therefore, closed down many fine restaurants whose liquor sales provided the majority of their revenue. In their absence, small diners catering to the lunch hour market quickly sprang up. These luncheonettes and self-service cafeterias served canned foods, soft drinks, salads, cold dishes, and sandwiches on toast. A 1924 study shows the great changes that took place in American restaurants since Prohibition:

“[F]irst a recognition of the rise of calorie-consciousness, exemplified
by calorie-counting menus which ‘capitalized on and furthered the growing
public interest in scientific eating’; second, they reflected the great increases in vegetable consumption, particularly by men; and third, ‘the menu with unpronounceable French names in giving way to the Americanized menu’” (Levenstein, p. 191).

Another survey conducted the next year showed that people were eating half the meat they were eating five years earlier while consumption of vegetables, nuts, fruit, cereals, and nuts had soared. Classically trained chefs were fired and replaced by unskilled labor who could easily open a can and heat its contents. These changes in restaurant consumption mirrored those taking place in American homes.

Food du Jour: A Simple Comparison

In comparing the consumption of food in 1880 to that of 1930, it is easy to see that the primary differences were twofold. First, in 1880, people were eating authentic food that was prepared from scratch. In 1930, people were eating more processed food, including canned and fresh vegetables that were unavailable or cost prohibitive in 1880. The post-WWI consumer was looking for lighter fare (since being “pleasingly plump” was no longer in vogue), which consisted of more fruits (especially citrus), more green vegetables, more milk and cheese, and fewer starches. As a result, the average height of boys and girls increased substantially, most likely because of the wider variety of nutrients available. Secondly, they were consuming less meat, much more sugar, pasteurized milk and cheeses, Crisco instead of butter and lard, Campbell’s soup over homemade stocks and soups, and processed cereals over traditional egg and meat breakfasts. The rich, satisfying, made-from-scratch French food high in cream and butter was all but history.

In other words, contrary to their forefathers in the 1880s, people in 1930 were ingesting less vitamin A and vitamin D (found in butter, cream, lard, fish, meat), which are critical for strong blood vessel walls. They were also receiving fewer minerals important to a healthy diet (including calcium and magnesium found in meat, homemade stocks, and unpasteurized milk). Less meat equates to the unfortunate loss of good, protective fat, and vitamins B6 and B12. Interestingly, deficiencies in both B6 and B12 are linked to nervous disorders, such as Alzheimer’s, Parkinson’s, and Lou Gherig’s (ALS) diseases—currently considered commonplace in the U.S. Conversely, the increase use of Crisco, a hydrogenated trans fat, as well as, an increasingly excessive consumption of polyunsaturated vegetable oils, such as safflower, corn, sunflower, soybean, and cottonseed oils (from which Crisco was made), form free radicals in the body, interfering with healthy cell production. The replacement of traditional breakfasts with highly processed white flour, corn, and white sugar cold cereals that are difficult to digest also deprive the body of important nutrients.

The medical industry is now looking at high levels of homocysteine in the blood as an indicator of heart disease. This substance has been correlated with plaque buildup and clot formation, and therefore foster ideal heart attack conditions. Nutrients that lower serum homocysteine levels include vitamins B6 and B12, folic acid, and choline—all found mostly in animal foods.

Heart disease is a 20th Century affliction derived from the use of modern, convenience foods, that has led to malnutrition and stress on the system.

According to Sally Fallon, author of a cookbook entitled Nourishing Traditions, and founder of the Weston A. Price Foundation, “[p]revention of heart disease will not be achieved with the current focus on lowering cholesterol–either by drugs or diet–but by consuming a diet that provides animal foods rich in protective fats and vitamins B6 and B12; by bolstering thyroid function through daily use of natural sea salt, a good source of iodine; by avoiding vitamin and mineral deficiencies that make the artery walls more prone to ruptures and the buildup of plaque; by including antimicrobial fats in the diet; and by eliminating processed foods containing refined carbohydrates, oxidized cholesterol and free-radical containing vegetable oils that cause the body to need constant repair”(Fallon, p. 13).

So bring on the butter! Bring on the milk and cream (fresh from the farm if possible). The higher the “good” fats the better. Bring on the organic meats, homemade stocks, plenty of free-range eggs, lots of unrefined, cold-pressed coconut oil, and fresh vegetables. This type of diet is much more satisfying, and therefore, cravings for bad fats—bags of potato chips, fast food, and sweets—will vanish. Eat nutrient-dense, whole foods for a contented, healthy heart, and Bon Appetit!

© 2004 Cynthia Cechota, M.S.

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For fascinating reading on the transformation of the American diet and related topics, Cynthia recommends the following resources:
Revolution at the Table, by Harvey Levenstein (provides an extensive bibliography for further research)
No Foreign Food, by Richard Pillsbury
The American Kitchen • 1700 to Present, by Ellen M. Plante
What’s Cooking, by Sylvia Whitman
The American History Cookbook, by Mark H. Zanger
American Home Cooking, by Cheryl Alters Jamison & Bill Jamison
The Untold Story of Milk, by Ron Schmid, ND
The Sugar Blues, by William Dufty
Nourishing Traditions, by Sally Fallon
Nutrition and Physical Degeneration, by Weston A. Price