by RichardK » Tue Aug 28, 2012 9:10 am
I like Campbell/Esselstyn/McDougall for the fact that these guys have based their dietary recommendation on very simple observations such as:
1) "As to the risk factors in predominantly rural African populations in southern Africa, the principal dietary sources of energy were in the past and still are to an extent cereals (maize and kaffir corn or sorghum) and their products, wild spinaches, and a variety of legumes (cowpeas, sugar beans, Jugo beans), along with relatively low intakes of most vegetables and fruits and infrequent consumption of small quantities of milk and meat".
"Serum cholesterol levels of rural Africans in the past ranged from about 3.0 to 3.5 mmol/l and remain low" (116-135mg/dl)
2) The epidemiology of coronary heart disease in South Africa
"Numerous reviews, past and present, have emphasised the rarity of coronary heart disease (CHD) in Africa. In 1960 in Uganda, CHD was considered to be 'extremely rare'.I In 1977, black Africans were described as being 'virtually free of hypertension and CHD'.' In the same year, at Enugu, Nigeria, over a 4-year period, not one patient out of 348 with cardiac disorders had the disease. In 1983, in the UK, a leading article entitled 'British and African hearts' underlined the tremendous contrast between the experience of CHD in the two population groups: From 1988 to 1993 in Zimbabwe, at Parirenyatwa Hospital, the main referral centre for the country, there was an annual average of 6 black patients with acute myocardial infarction.' Even at present, as concluded in a comprehensive review compiled in Nigeria,6 'CHD is still rare ... despite its increased incidence in recent years.' This rarity applies particularly to rural dwellers, as recently noted in Tanzania.'"
".....Soweto (which now has a population of 3 - 4 million), according to records of the Department of Cardiology at Baragwanath Hospital (3 200 beds), 35 blacks were diagnosed with CHD in 1992,51 in 1993, and 62 in 1994. However, of the latter number only 36 were Sowetans; the rest lived elsewhere.I' Clearly CHD remains very uncommon in urban blacks in South Africa. To afford perspective, it could be asked how uncommon CHD is in urban blacks, compared with its occurrence in Western populations? Of the population of Soweto, almost all attend Baragwanath Hospital when serious illness occurs. If it is assumed that all the 36 patients with CHD mentioned ultimately died from the disease, CHD would be responsible for only about 0.2% of the roughly 20000 deaths occurring annually in Soweto, an extremely low proportion even allowing for uncertainties. In Europe, in the Seven Countries Study,16 for those in the Mediterranean countries and inland the age-standardised 25-year CHD mortality percentages were 4.7% and 7.7%, respectively. The proportions reported for countries in Northern Europe and for the USA were far higher, namely 16.0% and 20.3%, respectively. These comparisons with Western populations underline the very low occurrence of CHD in urban blacks".
The epidemiology of coronary heart disease in South Africa
CARDIOVASCULAR JOURNAL OF SOUTHERN AFRICA (SAMJ Supplement 1 February 1999) C12
Fuhrman comes from wholly different tradition, natural hygiene, whereas Campbell/Esselstyn/McDougall come from the evidence-based science that relies on scientific method. Essentially Fuhrman acts no differently from the clerks working in health stores and pushing their sales pitch. He must compensate the lack of science in his alternative dietary philosophy with a display of messianic self-confidence along with the typical guru attitude.