	November 14, 2007 \| Issue 142
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Heart Disease Deaths Plunge 75%

What Happened In Finland?

In the 1960s, men in Finland thought it normal to suffer chest pain before age 50. When friends asked, “Do you have heart disease?” a very common reply among 30- and 40-year-olds was “Not yet.”

HEALTH NEWS

Less Meat Helps Keep Pounds Off

In a major study of nearly 22,000 residents of Oxford, England, researchers found that the people least likely to gain weight over a five-year period were meat-eaters who had switched to near-vegetarian or completely vegetarian diets.

What happened?

It started in 1971 in an eastern region of Finland called North Karelia, where heart attacks were so epidemic that one-tenth of working-age men and women were on disability due to diseased arteries. The citizens of North Karelia, desperate to find a way to keep their young people from dying, petitioned the national government for help.

The government gave them Pekka Puska, a 27-year-old doctor fresh out of medical school and fresh with ideas. He’d also completed graduate work in social science. He fervently believed that high rates of heart disease were not inevitable and that the disease’s roots were lifestyle related. The problems to attack were smoking, physical inactivity, and a diet loaded with saturated fat and lacking in fruits and vegetables.

Although much still needs to be learned, he wrote, “very much is known already to serve prevention. Actually so much is known that the main question for cardiovascular disease prevention is not ‘what should be done,’ but ‘how should it be done.’”

Everyone on board

Dr. Puska stressed to government officials that healthy choices should be easy, maybe even fun. And the only way to make them easy, this past president of the national student’s union asserted, was to get all of society on board, including health centers, worksites, the media, supermarkets, women’s groups, schools, private industry, and legislation.

That’s precisely what Dr. Puska and his team orchestrated over the next 25 years, starting with North Karelia, and within five years, all of Finland.

Butter to berries

It was no small accomplishment. The culture was in many ways traditional, resisting change. Dairy farming was a major source of livelihood. Butter was the local product, “much liked,” recalls Dr. Puska. And “the national dairy industry took major efforts and resources to protect their economic interests.”

But Pekka Puska and project coordinators persisted, launching a multi-pronged, community-wide approach. One key to their success was a motivated citizenry. The vast majority wanted help. To them, heart disease was the plague of the 20th century. Quickly and forcefully, Finns wanted it eradicated.

Dr. Puska and colleagues began by visiting farmers and other food producers, lauding the benefits of a low-saturated-fat diet and encouraging them to diversify into crops such as berries, a longtime Finnish forest tradition that had fallen by the wayside. They urged bread companies to lower the salt and replace the butter in their recipes with vegetable oil.

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