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Seven Countries Study

Coronary Heart Disease Mortality and Blood Cholesterol

In the Seven Countries study, there were great differences in coronary heart disease (CHD) mortality at similar blood cholesterol levels.

In this study Dr. Keys pointed to a correlation between deaths from coronary heart disease and serum cholesterol in 15 populations in seven countries.

Dr Ravnskov plotted his original data which was not available in the research summaries. Particularly interesting were differences between two localities within the same country or nearby islands in each of 4 of the seven countries.

West Finland had about 45 CHD (coronary heart disease) deaths at a median cholesterol level of 250 mg/dl. However North Karelia, also in Finland, had over 200 CHD deaths at about 260 mg/dl.

The island of Crete had only 20 CHD deaths at cholesterol levels of about 200. The nearby island of Corfu had about 85 CHD deaths at a cholesterol level of about 190 mg/dl.

Montegiorgio in Italy had about 40 CHD deaths at about 190 mg/dl cholesterol, while Crevalcore in Italy had nearly 100 CHD deaths at nearly the same cholesterol level.

In Croatia, Slavonia had about 120 CHD deaths occurring at a cholesterol level of about 200, while Dalmatia had about 40 CHD deaths that occurred at about 180 mg/dl.

All known risks for CHD were similar in all these districts of the Seven Country Studies.

The above is summarized somewhat differently immediately below.

• North Karelia had 5 times the number of deaths as West Finland at the same cholesterol level.
• Crevalcore had 2.5 times as many deaths as Montegiorgio at the same cholesterol level.
• Corfu inhabitants had 5 times as many CHD deaths as nearby Crete inhabitants, even though mean cholesterol levels on Corfu were slightly lower.
• Crevalcore had 2 ˝ times more deaths than people in Montegorgio at the same mean cholesterol level.
• Slavonia had 3 times as many CHD deaths as Dalmatia.at a slightly higher mean cholesterol level.

Electrocardiographs and Diet Correlation

Electrocardiographs of all patients in the Seven Countries Study were recorded at the beginning of the study. The interpretation of all ECG’s were done by specialists at the American study center. There was no correlation between a diet of saturated fat or cholesterol and the major electrocardiographic findings.

Dr. Ravnskoff said the ECG data should have more relevance than clinical diagnosis or diagnosis on a death certificate. Many deaths are certified by physicians of varying persuasions, experience, and competence.

The conclusion is that the Seven Countries study flatly contradicts the saturated fat-cholesterol in the diet as a cause of heart disease, says Dr. Ravnskov.

It is hard to understand how the proponents can say the study is proof of the connection between cholesterol and heart disease.

Focusing on closely related areas in these countries with great differences in CHD death rates may have yielded something helpful for mankind. Because of blind devotion to cholesterol in the diet-heart disease idea, these striking differences were ignored.

Dr. Keys and the diet-heart proponents claimed there is a direct connection between blood cholesterol and the occurrence of coronary heart disease in various populations.

This is just not true.

As we have examined above, at any given blood cholesterol concentration, there can be a great variation in CHD deaths per 100,000 population.

At the time of the Seven Countries study, data from 27 countries was available. Heart disease deaths varied from 100 CHD deaths in France to 450 CHD deaths in Finland. The cholesterol level was 250 mg/dl in the six areas from 8 countries.

At 230 mg cholesterol per deciliter, 13 areas from the 27 countries reported about 70 CHD deaths per 100,000 population. In an area in France there were 425 CHD deaths per 100,000 population at the same 230 mg/dl blood cholesterol.

Again there is no correlation between blood cholesterol levels and CHD deaths.

Dr. Keys stressed the low cholesterol and low CHD deaths in Japan versus the opposite findings in Finland.

Unique Japanese Society Traits

In Japan it was regarded shameful to die of a heart attack, but honorable to die of a stroke. Could this attitude have had a pronounced effect on death certificates in Japan?

The Japanese placed great emphasis on group cohesion, group achievement, and social stability. They were protected from emotional and social stress in more highly industrialized countries some say is an important cause of heart attacks.

American society placed more emphasis on social and geographic mobility, individualism and striving ambition.

Dr. Keys found that Japanese immigrants to the US had high blood cholesterol and died from heart attacks almost as often as Americans. But Dr. Keys failed to mention that while CHD deaths increased among immigrants, stroke mortality decreased by the same amount, and total mortality decreased much more.

Study of Japanese Immigrants to the US

Dr. Michael Marmot, a British physician, studied Japanese who emigrated to the US during this time period. He reported that Japanese who preferred their cultural traditions, but adopted the high fat American food raised their cholesterol as high as their American counterparts.

But they had 50% fewer heart attacks than Japanese who adopted the striving ambition of Americans, but who preferred Japanese cuisine.

If Dr. Marmot’s observations about Japanese immigrants to the US are true then the diet-heart connection held tenaciously by Dr. Keys and his supporters cannot be true. But any study results that threatened Dr. Keys and his supporters views is rejected or explained away.

Despite the problems with their many studies over several years, the cholesterol-saturated fat cause of heart disease continues today. The official statements of the AHA, and the NHLBI of the National Institutes of Health all claim that cholesterol is the cause of heart disease. These statements are not based on an objective review of the scientific research.

They all insist today nearly everyone will benefit from lowering blood cholesterol, which has not been proven.

And some studies indicate lowering cholesterol below normal levels for an individual can be dangerous.
Seven Countries Study and other data as well confirm that cholesterol is unimportant in heart disease. Return to the Home Page.

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