But here you see that heart disease kills about a third of Americans. Cancer kills about a quarter of us. Stroke kills about 7%. Diabetes has actually risen; it’s about 3.5% now. And I mark the red bars to indicate those diseases that are diet related. And clearly heart disease and cancer and stroke and diabetes are certainly diet related diseases. And remember I said that heart disease in some parts of the world is only like 1%. So again most of these diseases are indeed preventable.
Why is America getting fat?
Well, I call this the Hawaiian paradox. In Hawaii, we have the healthiest state in the U.S. because people live the longest here. But native Hawaiians have the worst cell in the nation and as you know I spent most of my career working with native Hawaiians in YNI. And this is the national rate that I just showed you. Well this is the mortality rate for pure Hawaiians. It’s more than double for heart disease, more than double for cancer, more than double for stroke. And if you look at diabetes, the quintessential nutrition-related disease, it’s actually 588% higher in terms of mortality and this is a hard end point; it’s deaths, it’s not just incidents which may be reported or not. These are hard endpoints. And obesity among native Hawaiians is double that of the national average but these figures are rising as well. So how many of you think Hawaiians are naturally overweight? You would think so, right? I mean if you ever came out to see my patients with me in YNI, I have 300 pound patients by the dozens. I’ve had 400, 500, 600, 700, 800 pound patients. My biggest patient was 890 pounds. And you know I have a practice in town and in town I never see people that large. But out in [YNI] we have the largest concentration of native Hawaiians. It’s actually all too common.
I’ve heard people say well it’s all in the genes. How many of you have heard, well it’s all in the genes? So if it’s all in the genes, then 200 years ago when Captain Cook arrived the genes were pure. Most of the people aren’t pure Hawaiian these days. So then if it was all in the genes, then they should have been even more obese back then, right? Well let’s see if that’s true. This is Captain Cook’s artist. How many obese individuals do you see here? Well I don’t see any frankly and today the rate is here at actually 64% and this was measured on the homestead, so the people had to be half Hawaiian or more but these are all pure Hawaiians and you don’t see any. And the question is why? And the answer to that may be the answer as to how we can avoid obesity and heart disease because of course heart disease comes along with obesity. And if you don’t believe a drawing, well his photographs from a hundred years ago, this in the 1800s,you know you don’t see overweight Hawaiians. It’s really stunning.
In 1823, world traveler [Ian Stewart] said that the common people are thin, I’m talking about Hawaiian people. When’s the last time you heard of Hawaiians referred to as thin? Maybe 1823 or so I suppose, right? When I first showed this statement in YNI I would get this kind of reaction. Aren’t you shocked? I mean when I saw it myself I said “Is this for real?” I mean somebody who travel around the world, who have seen people from all countries referred to Hawaiians as thin. And I thought that everyone should realize that, because there is an important lesson. The lesson is that here’s a population who today we have so much trouble keeping them from becoming obese, when in the old days there was no trouble at all. So what’s changed? It certainly wasn’t the genes, and if anything the genes are less likely to do that.
So what changed? Well, they ate taro, which is 1% fat, which is mostly an unrefined complex carbohydrate food. It’s got lots of fiber and its calorie density is very low. And by the way Hawaiians never wasted anything. They would eat the tops too. So they actually eat lots of vegetables too. I don’t want anybody to forget that part of it because that’s actually as important. But grains were the world’s cheap foods throughout history. A starchy high-fiber low-fat staple, and of course in Europe there was some rye and wheat. In Asia, it was rice; in the Americas, it was maize or corn. This is mayan which is Central America.
In Egypt, what do you suppose this is? Looks like another grain, right? Well we know at least one of the grains that they ate in Egypt, which is of course Africa, was barley. How do we know? This was actually found in King Tut’s tomb. So it was actually considered very important food, if they read translations they called it the gift of Sirius, it was a gift of life. So in the old days a staple used to be taro, what’s the staple for Hawaii today? Spam maybe. Well here’s the big difference and this is part of the clue. By the way you can see this wasn’t my idea. This is Hawaiian staple food. Somebody drew this cartoon ,somebody else had the idea about this. But the idea is that nowadays we eat too much spam. I mean we have spam festivals, heaven forbid and is the quintessential junk food and it’s a quintessential example of what is happening and why we have so much heart disease now, because – what is spam? It’s protein, right? It comes from meat. How many see it as a meat product? Right, I mean who doesn’t see it as a meat product? So it should be in protein, right? But how many of you knew it’s only 17% protein? You know what the 83% is right; it’s fat. And that has a lot to do with why people are fat and getting heart disease these days, because of course this is animal product. So lot of the fat comes from saturated fat and of course saturated fat, you will see in later part of my lecture, it’s actually the worst kind of fat you can eat.