It turns out that if we feed our bodies with the diet we evolved to accommodate, we are healthier and live longer.

I’m not a big believer in much of the touch-feely, do-it-yourself health care theories, and certainly not the herbal remedies that Americans spend a fortune on each year. I don’t see any real virtue to exercise beyond moderate walking and light lifting, and certainly there is no evidence that exercise either improves health or extends life; people with heart disease tend to not exercise while those with good cardiac function are able, and that explains all the differences seen in exercise-related studies. As well, the extreme caloric reduction diets like the Ornish regimen are in my view overrated, and strict vegetarianism does not reflect the reality of our hereditary physiological needs.

On the other hand, the average modern diet is disastrous for us both from the standpoint of becoming overweight and hypertensive. Smoking aside, those are the two things that will kill you early. High fat, simple carbohydrates, excessive salt and low fiber combine in ways we don’t fully understand to harden arteries and increase fat stores. Both of those things increase the risk of stroke and heart attack, and both of them are rampant in modern society. Many millions of dollars are spent annually on expensive drugs to counteract our dietary indiscretion, and many lives are lost or compromised in spite of all the medication.

A major new study, just reported in the Annals of Medicine, shows without question that a simple dietary strategy with an emphasis on vegetables, fruits, and complex carbohydrates can dramatically reduce the risk of both stroke and heart attack. Drawing on the data collected from 88,517 women over 24 years in the Nurses’ Health Study, researchers stratified the women’s diets according to how closely they came to the guidelines provided by the Dietary Approaches to Stop Hypertension (DASH) diet. None of the women were required to change their diet, just to record their daily intake, so it was not randomized prospective or blinded, but there is no reason to believe that pre-existing disease influenced their dietary choices.

Following the DASH diet has been shown to reduce blood pressure in both hypertensive and normotensive individuals, especially when salt intake is also moderated, and also to lower LDL cholesterol concentrations. What wasn’t known for certain was the effect of these reductions on substantive health issues.

What this new study found is that the DASH diet reduces the incidence of strokes and heart attack. The difference between the quintile that most closely followed the DASH guidelines and the quintile that was closest to the typical American diet was both large and highly significant. Risk of heart attack was reduced by 24% (p < 0.001), and risk of stroke was lowered by 18% (p = 0.002). As well, there were large reductions in C-Reactive Protein and Interleukin-6, blood chemicals associated with generalized inflammation and a higher risk for many diseases.

Full text of the new study is here. These results were considered so important to public health that the editors of the journal Archives of Internal Medicine suspended normal practice and have made the entire report available free of charge. The other dietary studies cited above have also been made available for free in their entirety; these decisions by the Archives, the New England Journal of Medicine and the American Journal of Clinical Nutrition are to be commended.

The DASH guidelines are here; the only caveat I would offer to these recommendations is with the use of margarine, of which I am not a fan. My view, the polyunsaturated fat in margarine has a health risk that is at least equivalent to that of butter, and the increased flavor of butter lets me be satisfied in my cooking with less. I also allow myself beef a couple of times a month, lean cuts like tri-tip and top sirloin, because otherwise I’d pine for it and what’s the point of that? Life should be lived, not endured.

Man ist, was man isst.