The Epidemic of the 20th Century: Coronary Heart Disease by Dalen, Alpert, Goldberg & Weinstein, Amer J Medicine, Vol 127, Issue 9, p 807-812, Sep 2014. Available in PDF format. This paper summarizes landmark studies from 1950s as follows:
Researchers were surprised that so many soldiers had atherosclerosis! These soldiers were in their 20s and among the fittest people on the planet! They exercised a lot. Remember the last column in the wikipedia pic on atherosclerosis: "Clinically absent or clinically overt"? These soldiers had no overt signs — they were fit enough to go into battlefields. None had any symptoms of coronary artery disease prior to their deaths in war. For more details, see Heart disease begins in Childhood.
What do we learn about the relationship between exercise, food and protection from coronary artery disease from such studies? That even the fittest of people are not protected.
Dr Greger has some insightful videos explaining that diet is more effective than exercise.
(6 mins) Transcript. The opening minutes of this video explains a study from 1953.
Why were these studies surprising? The subjects were active soldiers killed in battles with average age 22. Soldiers are among the fittest of people! They exercise a lot, yet they were found to have atherosclerosis.
(3 mins) Transcript. Dr Greger explains a study conducted to study the carotid arteries of individuals (because CT scans of arteries in our heart increases lifetime cancer risk). They measured the 'thickness of the inner walls of carotid arteries'. Turns out that these measurements were significantly better among vegans as compared to those consuming Standard American Diet (SAD). In fact, these measurements were better than even those who consumed SAD and had run an average of 48 miles per week for 21 years.
The context of this video by Dr Bimal Chhajer is Shane Warne's recent death attributed to a heart attack. Warne was a legendary cricket player from Australia. His death leaves many of us puzzled: "How could a physically fit person get a heart attack?"
Dr Chhajer helps us understand that the crucial contributory factor to heart disease is dietary; physical fitness alone does not protect us. We must diligently eat the right foods — strict WFPB food plates by Dr Esselstyn are best; plus moderate amounts of exercise.
Actually, way back in 1953, a landmark study showed that American soldiers who had died in the Korean War had early signs of atherosclerosis! Who could possibly be fitter than soldiers killed in action? From such studies, we have learnt that physical fitness alone does not protect us from heart disease.
Over the last 40 years, studies by Dr Ornish and Dr Esselstyn have demonstrated that the crucial protective factor is dietary, not physical fitness. In fact, Dr Esselstyn calls heart disease "a food borne illness"!
What kind of food plates should we assemble to protect ourselves from heart attacks? Those in harmony with strict WFPB guidelines by Dr Esselstyn are best! Along with moderate exercise.
Dr Bimal Chhajer was an Assistant Professor at AIIMS, New Delhi in early 1990s. When he saw Dr Ornish's studies, he decided to shift to Lifestyle Medicine (several years before this term was coined) to help Indian masses adopt WFPB guidelines.