What a Small Mining Town Can Teach Us About Heart Disease

“Healing is impossible in loneliness; it is the opposite of loneliness.”
(Wendell Berry)

Coronary Artery Disease is the number one killer of both men and women in the industrialized world. It is followed closely by cancer. This may surprise you, but half the people who have a heart attack have normal cholesterol. Worse still, for almost half of the people with heart disease the very first symptom they ever have is a heart attack, and for a significant number of those people who have a heart attack, they die. That is a pretty grim scenario:  You can even have a heart attack when you have fought hard to lower your cholesterol, and it could kill you.

The efficacy of both prevention and treatment strategies has come under increasing attack by a wide variety of groups, perhaps the most academically-qualified being www.thincs.org and books such as Fat and Cholesterol Don’t Cause Heart Attacks and Statins Are Not the Solution, by Paul J Rosch. The story of cholesterol as a risk factor for heart disease is long, complex and far too in-depth for this post. However, there is no relationship curve between lowering cholesterol and lowering heart attack risk. And that doesn’t even begin to express the excess morbidity from statin use. This also includes an excess risk of diabetes which is, by the way, the leading cause of heart disease and other problems ranging from muscle pain to dementia.

There is a growing body of literature that supports the idea that the underlying causes of heart disease, from a biochemical view point is inflammation. But to me, an even more interesting question is what causes the inflammation in the first place? That brings us to a fascinating story of a small town in Pennsylvania. Roseto is situated in a mining community in Pennsylvania. Its heritage is rich and very interesting, but there is a sub-population of this town that emigrated from Italy. The local doctor began to realize that he was seeing almost no cardiovascular disease among those people. That led to conversations with various researchers and in turn led to a multi-decade research project within the community.

At first, the researchers assumed that the anomaly was due to diet, but this didn’t bear out because the subjects didn’t eat well. In fact, their diet consisted of all the things that main stream medicine would say causes heart disease. So, next the researchers looked at other lifestyle factors and they saw that smoking was also very prevalent. Basically, this was a community with all of the risk factors of heart disease, but no heart disease. This then led to a look at genetic factors and other considerations, and none of those avenues of research panned out either.

So, after population comparison studies between different communities local to these people, it was determined that their social connection was the major factor in the prevention of heart disease in their community. They tended to live in multi-generational homes, and they frequently sat down at the table together to have cohesive and communal meals.  Income disparity was minimal and those that had more income didn’t tend to flaunt it, but instead engaged within the larger community. This led to a sense of purpose, a sense of belonging, and a sense of place. This resulted in lower stress, which in turn meant lower cortisol, lower stress hormones, and fewer “alarm signals” being sent by the various organs. These “alarm signals” coming from the adrenal glands and the brain causing vasoconstriction, inflammation, and causing all the precursors to heart disease.

What the people of Roseto can teach us all is that integration with our families and wider communities is one of the bedrocks of our health, happiness and wellbeing.

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