CHD is the leading cause of death on the planet, whether it is Nigeria or the so called affluent world. The prevalence and pathological behviour of CHD is influenced by risk factors that are universal and some unique.Why do Indigenous Australians die prematurely from CHD and have a prevalence significantly higher than the caucasian population?They live in the same country, under the same Laws.Do Indigenous peoples of the affluent world such as Australia and the Central and North America’s suffer most?Has the early and extensive exposure to processed CHO, flour, sucrose sugar, vegetable oil, tobacco and alcohol been responsible?These are the staples of damaged Colonial peoples, who were invaded by European nations, treated as ‘inferior’because they did not read, write or have a religion, inspite of tribe members able to name and identify over 2000 of their kind, family, tell their ‘stories’, history.European Laws demanded the loss of land, waterways, their source of energy-nutrition, survival, because they did not document their ‘Ownership’. I have wondered often about neurotoxins from fungi in the old horse hair wigs of the Colonial Law Lords and early dementia!!All these populations sedimented to forms of poverty, which continues today with different guises.
The ‘superior’ invaders did not have the skills or knowledge to recognise the biological ‘superiority’ of these Indigenous people. While on British expeditions to explore natural forna and flora, incidently comments were made regarding Indigenous phenotypy, activity, strength, talent. Comments like they seem intelligent enough when with their own kind. The Austrian School of Psycho-analysis was a century away! But this psychological sophistication was unnecessary. A Maori Chief was reported to have described Cook’s men as small, pale, bent, sickly, white men, which they were. The gestated progeny of the life practice and nutrition of semi-industrial, post Neolithic Britain, where the life expectancy for those working in factories was 20-25 years!
I suspect the devastation by European introduced viruses,bacteria, their morbidity, mortality emitted an aroma of ‘poor health’, and gave a perception of biological weakness amongst the Indigenous populations. Recovery was protracted because their culture, ways of living, sources of nutrition were persistently damaged by a controlling European fraternity, that believed they were God’s chosen people, superior. All indigenous people have had a similar fate.We know in medicine that the Indigenous cohorts studied before assimilation were free of CHD, DM, OWOB and hypertension. Medicine in Africa did not see these diseases in the Indigenous, until late in the 19th century, when they increasingly adopted European type nutrition as of necessity, as their land and waterways were taken over.This phase of nutrition change and disease was documented in British and European medical journals of the late 19th century and early 20th century.Early studies of Indigenous Australians in small cohorts before assimilation, by some enlightened medico’s documented a well, lean, active people with BMI’s 15-19, low SBP at 80-90mm Hg, normal blood biochemistry and Hb. Their hunter gatherer nutrition was extensive, known as ‘bush tucker’, with more animal saturated, mono-saturated and PUFA content than their ‘assimilated’ food! Some later studies suggested early insulin resistance, before exposure to processed CHO and sugar.
This drift into European type poverty was ‘colour blind’, because there was no such thing as an ethnic weakness.However a very senior Australian cardiologist on discussing a Aboriginal CV study I had completed, seemed still to believe the Indigenous were innately susceptible! Neel had retracted his ‘stingy gene’ hypothesis. If you were caucasian and used the same ‘staples’ of CHO, sugar, tabacco and alcohol, your biological future was similar and still is. Indigenous poverty is wrapped in extensive loss of culture, status, land,damaged ways of survival and reproduction, that caucasian poverty does not usually experience. Using the term poverty in medicine is too often misleading. The longest living males in the world in the 7 Countries Study in Crete and Okinawa would by affluent definition, be living in poverty.Similarly Indigenous hunter gatherer societies studied with no CHD, DM or OWOB. These populations were living with nutrition that was definitely not impoverished. The range of food items, micronutrients, minerals, protein, all fats and fibrous CHO in these populations was extensive. The Aboriginal increasingly abandoned their extensive range of nutrients consumed over 70,000 years, as they were removed from their lands and flour, sugar, water, tea, a billy and matches had to do too often, to survive.
The observations, comments, documentation of the medical fraternities in Africa during the 19th century were interesting and I believe reliable. They came from many medical sources and were consistent.They experienced an early long period where the common European pathologies, like dyspepsia, reflux oesophagitis, gastritis, ‘indigestion’, gall bladder disease, gastric and duodenal ulceration, OWOB, hypertension,chronic pulmonary disease, inflammatory bowel disease, appendicitis, were absent,with virtually no cancer of any kind in the Indigenous. They died principally of infection of all types and organs, with trauma and a high maternal and infant mortality. This pathological picture changed similarly as these European diseases emerged in the Indigenous populations of Africa.There were no scientific studies done, but these practitioners easily and reliably recognised the relationship of these diseases, to European nutrition and life practices like tobacco and alcohol use.Later sugar came on the scene, but was absent in Africa, until early 20th century.An American professor of surgery, Burkitt gave a lecture to medical students in Auckland in 1972, where he stated that bowel cancer did not arise in Southern Africa where his team were researching. We knew that was the case with CHD, DM and OWOB.The distribution of the latter diseases was patchy in the affluent world.
The nutrition and life practice changes did not involve an increase in animal fat, cholesterol because as omnivores they had a history of animal fat consumption over millions of years, starting with our fore-bears. It was recently introduced processed CHO as flour and sugar by our ‘mother’ countries, they now were consuming. Tobacco and alcohol mood changers, followed.No the European mother countries as gestures of colonial good will, did not subsidise all red meats, with copious fat( saturated and mono-sat) a full range of cheeses, cream, dairy butter, FC milk and yoghurt.If these items were available, they were scarce and expensive and would have changed the Indigenous disease load for the better.
My first Aboriginal heart attack victum was a 28 year old male representative Rugby League player, who on nutrition review, was not consuming excessively animal fat and had a normal LDL cholesterol, but his TG’s were elevated and HDL depressed. He had an angiographically demonstrated, single obstructive lesion in the anterior descending coronary artery. At this time cardiology did not understand the significance of this lipid profile and we could not measure small dense or oxidised LDL, that we now know is produced by TG’s. This lipid profile is produced by CHO excess seen also commonly in diabetes.The Germans in the ProCam study linked TG’s with CHD, but the US Lipid Hypothesis was too ‘powerful’ in US cardiology, medicine and like too much evidence there questioning the Lipid Hypothesis, it was ignored.
Since Prior and Hunter revealed the results of the TIMS amongst Tokelau Pacific Islanders during a fifth year tutorial, no study has persuaded me and many others in medicine and cardiology, that saturated fat and cholesterol plays any part in atheromatous vascular disease and CHD. Billions have been spent studying, researching and treating this pandemic, but the simple sensible observations of a small cohort of human biologists, early, mid 20th century, then science with the TIMS was ignored and the story is frightening for modern medical science.The story is being told slowly now, but public confusion remains.
When I went to work amongst the Aboriginal populations of North Qld, Central Qld. West Qld, NW and central Australia, I quickly realised they consumed little food with saturated fat and cholesterol, they could not afford it. The source of income was almost universally ‘sit down money’ from a benefit. Their lipid profiles did not have elevated cholesterol, total or LDL. Yes OWOB, hypertension, DM, smoking and boozing were obvious and many diabetes studies showed this.They had ample other risk factors for CHD. The Aboriginal was told to reduce saturated fat!! They did not need to, they were consuming little currently.Analysis of ‘Bush Tucker’ any where in Australia, shows the consumption of animal fat was much higher as hunter gatherers!!! Many studies, largely of diabetes and others have shown consistently the lipid profile of excess CHO, where TG’s are elevated and HDL is depressed, now known as CHO Dyslipidemia or Athrogenic Dyslipidemia or evidence of Insulin Resistance. This is the source of small dense LDL that contributes to atheroma.Yudkin in early 1960’s knew that, and demonstrated the same from the 7 Countries data. Keys the lead researcher accepted his analysis and conclusion, then this critical data went to the USA and disappeared in mountains of non medical, political, commercial, food, agriculture, pressure groups and arguably fraud. If you read the history of fat, cholesterol, sugar, grains, and vegetable oils in the US at this time, you will understand why ‘medicine’ in NZ and Australia vigorously opposes ‘corporate’ management of medicine in any capacity. We have had 25 years of it and good evidence reveals its a dud.
Its recently been reported over 40 Aboriginal studies,predominantly diabetic, showed CHO Dyslipidemia but its cardiology significance was not recognised! The obsession with the consumption of animal fat and cholesterol has been weird and distracting. I will say it again. For the 20th century up until now, US consumption of animal saturated fat has stayed as a median ‘flat line’ on all US recording graphs. Vegetable oils have grown markedly since the 1930’s and by far are the major source of ‘fats’, mono unsaturated and polyunsaturated. Keys confused vegetable oil fats and animal fats in data up to 1950 as part of his ‘Lipid Hypothesis’, indicating an increase. This was entirely wrong and can be argued as just one of Keys important errors. Actually, if the US consumption of manufactured vegetable oils, since 1900 are graphed against the prevalence of CHD until 2000, they shadow one another. Saturated fat and cholesterol mean data tracks almost horizontally and falls slightly in the last five decades!!I believe Keys could have reviewed this data in 1950’s and realised his thesis was seriously weakened. He reportedly was advised and knew the increase in ‘fats’ from 1900-1950, was due to vegetable oils, not saturated fat!!Here is the puzzle for me.Keys believed initially that ‘fat’was the culprit and before the 7 Countries Study, amended that to saturated animal fat!! When aware of the fat data mistake from 1900-1950, that I believe as do others, that his lipid hypothesis evaporated, he should have officially accepted such.Its not clear at this distance what he believed, because nothing was proven satisfactorily.
Its reported that he finally accepted Yudkins analysis of the 7 Countries Study, that processed CHO was the culprit. I believe Keys faulted because he did not train in medicine.But it gets worse!! From the mid-late 1970’s the Lipid Hypothesis was made ‘official’ by the US government via the McGovern Committee and all ‘Health’ agencies, Dept., of Agriculture, Processed food industry, and finally a gullible AHA and FDA!!! Keys had his photo on the front page of Time magazine!!! This story needs to be told by a wordsmith.
In 1994-5 I completed an Aboriginal CV risk factor study amongst 875 adults and children, with the aid of Indigenous helpers from Woorabinda and Bidgerdii, Aboriginal cohorts in Central Queensland.Dr. Tom Lynch generously provided the laboratory work. The four editors at “Circulation’ praised the study and commented the findings were ‘interesting’, but wanted us to spend another $150,000 on the study which was not possible.The results of the different aspects of the study have been presented by me at eight Physician and Cardiology Meetings in WA, NT,Qld., NSW and NZ. I intend to present the completed study on this blog soon, as I recognise features of value from the study, were ignored largely by medicine then. I believed then and now, they are important in the diagnosis and management of Indigenous CHD.
Mean total cholesterol and LDL were with in the normal limits in the study. Near 50% of the adults, 376, of the 803 had raised TG’s and abnormal ratios with HDL, the CHO or Atherogenic Syndrome. Most of this group satisfied the criteria for the Metabolic Syndrome. The Indigenous Australian then died prematurely of CHD, near 20 years earlier than the caucasian. I convinced Parke Davis to supply 376 of these patients with Benzfibrate for three months, hoping I could get Qld., Health to finance the drug further. They refused. I had the Rockhampton hospital dietician ‘illegally’asses the nutrition at both centres and it was clear they were not eating much animal fat. Qld., Health refused to have her offer a service to these centres. This is the sort of ‘institutional’ racism that operates in Australia at all levels.So we changed their name to Queensland Unhealthy.
All adults and children were CMV IGg antibody positive to high dilution levels and microalbuminuria was present in 39% of adults and 22% of children. A sepperate cohort of 236 adults were CRP checked, but the results although surprisingly positive were confounded by gut, skin and chest infections with periodontal disease. In other blogs I have discussed the nutritional means of correcting Atherogenic Dyslipidemia and the possible future vaccination against CMV infection, for congenital infection, that may help reduce the large cohort with CHD. That has not been proven yet.
A serious effort to effect a nutrition that eliminated processed CHO and sugar from Indigenous nutrition and beverages, introduced by the Colonial invaders, is required now. The cost effectiveness of continuing as we have is deplorable. A subsidy system using food stamps or ration books for food that excluded flour, processed food, sugar, bread, vegetable oils, beverages and alcohol would be a start. This can be seen as an emergency for all individuals and families earning a minimum either at work or from the state.Distributing money has too many flaws. Hunger can be a universal leveler. Most nations have used these systems during war successfully. We are at war now. As an example, depending on age, each child to 18 years has access to milk, cheese, fish, poultry, red meat, all vegetables and fruit in season up to an amount. Yes there will be cheats selling and purchasing, and it will be argued their ‘human rights’ will be interfered with. Its a state of emergency. Let us start with children, then adults.The cost to do so, will be less than the cost to not do so.
Dr.Lindsay. A Green. FRACP. FCSANZ.