What Causes Heart Disease?

In a mental exercise I posted yesterday, I asked readers to speculate as to the order of most likely cause of heart disease and death from myocardial infarction.

The facts are that death by MI was unheard of in 1910 (about 100 years ago), had risen to 3,000 deaths per year by 1930, and to 500,000 by 1960. Then I provided eight food group categories, A – H, and indicated how much each had changed over the last 100 years, but without telling you which group was which. So here we go:

  • A; sugar and sweeteners: 100% increase
  • B; eggs, fruit (excl. citrus), vegetables, whole grain: Moderate decrease
  • C; lowfat milk: 100% increase 
  • D; whole (full fat) milk: 50% decrease
  • E; butter, lard, tallow: 70% decrease (30 lbs. per person per year to under 10)
  • F; vegetable oils (incl. hydrogenated): 437% increase (11 lbs. pppy to 59) 
  • G; poultry: 280% increase (18 lbs. pppy to 70)
  • H; beef; 46% increase (54 lbs. pppy to 79) 

So, if one were to simply line it up by the numbers, the order would be like this:

  1. Massive increase in vegetable oil consumption.
  2. Huge increase in poultry consumption. 
  3. Large increase in sugar and sweeteners.
  4. Large increase in low fat milk consumption. 
  5. Large decrease in animal fat consumption (butter, lard, tallow).
  6. Moderate decrease in whole, full fat milk consumption.
  7. Moderate increase in beef consumption.
  8. Moderate decrease in eggs, fruit, vegetables and whole grains. 

Of course, this is missing junk and highly processed foods.

Now, I agree with the commenter on the previous post. This does not establish causality. And yet, how many decades has it been now that the "health" establishment has been telling you, as though it was certain, that meat and saturated fat are the causes of heart disease? If they even mention junk food, pastries, and all manner of stuff loaded with flour and sugar, it's not those: It's the fat.

It's absurd.

So here's the article with associated references from whence I culled this little exercise. That's Sally Fallon and Mary Enig: It's the Beef. This is an excellent source for all manner of mythbusting with regard to meat and other animal products. Here's another good one.

There was another question posed on my original post speculating that perhaps there weren't heart attacks in 1910 because people didn't live long enough to have them. Average longevity was way lower. The firs thing to note about that is infant and child mortality is what brings the averages way down. There are still people living to 80, 90, 100 and beyond — plenty of them — and they weren't dying of heart attacks. Stephan had a good post last July concerning this exact issue, vis-a-vis the Inuit.


  1. Stephan on October 27, 2008 at 17:00

    Except for the poultry and beef changes, I'd say that pretty much sums up the nature of the problem!

  2. Erik on October 28, 2008 at 00:20

    Are you linking this to the Alexander's post?: https://freetheanimal.com/root/2008/10/alexanders-steakhouse.html


  3. Jeff on October 28, 2008 at 16:49

    Hey Richard,

    Do you have any idea what the increase/decrease of refined wheat flour intake was during that period? I would bet that it increased dramatically.


  4. Richard Nikoley on October 29, 2008 at 08:15

    Jeff, not really sure. I suspect that people may have eaten more bread, perhaps pastries of various sort, but those were generally home made or purchased from a bakery.

    Now, the processed stuff is literally all over and has been for decades, and it's full of white flour, HFCS, and concentrated vegetable oils.

    And people still eat a lot of bread, too.

  5. Pete on November 1, 2008 at 12:59

    In 1910, people ate more whole grains and death from MI was unheard of. I'm gonna take a guess that the diseases of civilization such as diabetes and obesity were also less prevalent. Does this not exonerate unprocessed grains, at least in the context of the pre-1910 diet?

  6. Richard Nikoley on November 1, 2008 at 13:52

    "In 1910, people ate more whole grains…"

    What's your source fort that? Seems unlikely, at least without making a distinction concerning type of grain (whole, refined, level of processing).

    Grains products are in just about everything, as is HFCS and some sort of processed and concentrated vegetable oil of the sorts that require solvents to extract (corn, canola, safflower, etc.), and used to be used as junk oil, to lubricate machinery — bow called "heart healthy."

  7. Pete on November 2, 2008 at 13:31

    My source is the post above in which you note a
    "Moderate decrease in eggs, fruit, vegetables and (**)whole grains(**)." I specifically mentioned unprocessed grains in my previous comment. I'm aware that any type of processing probably makes grains unhealthy. The point is that if one assumes the information in this post to be accurate, and wants to change their diet to a pre-1910 way of eating that apparently prevents death by heart-attack, then that would involve moderately increasing their intake of whole, unprocessed grain. To me, that suggests that as long as I optimize all other factors of my diet I can probably eat some unprocessed oatmeal, unprocessed rice, and sprouted-wheat bread without risking heart-disease (I don't know about the diabetes or obesity risks, although I'd guess that these were also much lower in 1910)

  8. Richard Nikoley on November 2, 2008 at 13:54


    Yea, the problem is that, for one, my source didn't list any specific number:

    "Consumption of eggs, fresh fruits (excluding citrus), fresh vegetables, fresh potatoes and whole grain products has declined…"

    I said "moderate decrease" under the assumption that if it was a decline of real importance (the lowest with an actual number is 46%) there would have been a number attached, as with all the others.

    Another problem, of course, is that it's a group of foods, so it's conceivable that even with a total decline, some may have increased while others decreased. And then also, note the qualifications "fresh" and "whole."

    All that said, my point was that with three categories at 100% change or more, we ought to sooner be looking to those, not meat and saturated fat.

  9. Pete on November 3, 2008 at 17:17

    Your fundamental point is a good one, and well made. Let's look at the things that have really, drastically changed in our diet, rather than disproportionately focusing on variables that have only changed to a minor degree. Seen from that vantage point, the data in this post suggest that whole, fresh, unprocessed grains eaten in the right context don't cause fatal heart disease. That distinction seems to fall to HFCS, sugar, vegetable oils, low-fat diets, and….chicken? (Damn those omega-6's). And if eating more of the right kind of grain is part of an overall picture that includes less heart-disease, could it also be part of a picture that includes less of the other diseases of civilization that often clump with it, i.e. diabetes, obesity, and cancer? I wonder what the rates of these diseases were in 1910 compared to their rates today. You're right that it would be more useful if we knew exactly which grains the statistics refer to, and exactly how much more or less of each we eat today. But to me, the data suggests that it's important to not be ideologically opposed to the idea that unprocessed grain could be healthy or neutral just because our species hasn't eaten it for very long.

  10. Richard Nikoley on November 3, 2008 at 17:38


    Certainly. Even Weston Price, a particular hero of mine, whose work in "Nutrition and Physical Degeneration" heralded whole grains — but these were whole grains cultivated, harvested, and ground all by a single village's own means, on their own stone.

    I've made the point before that mechanization and processing is a double-edge sword. In some ways it's beneficial. We can get high concentrations of important nutrients, which, might be a good thing from time to time — kinda analogous to taking a supplement. We can also get high concentrations of natural allergens, anti-nutrients, and toxins.

    This is relevant, and I'll likely blog it soon.


    Nobody loves great bread more than me. I can easily down a whole bagette. Yet, I managed to mostly keep away for the better part of a year, and the results were…fucking obvious, excuse the language. Whereas, I might have said, that's cool, and I'll moderate, it simply have to be far more infrequent that that. For me.

    I fully understand that some people don't have a bad reaction. On the other hand, lots of people — including myself — have no idea until they spend months free of grains.

  11. Eric on September 1, 2010 at 04:57

    If you call the department of agriculture they might share the data. They did for me a few years ago but at that time I worked for the government. They broke it down over the whole period they had data.

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