Ka Wai Ola - Office of Hawaiian Affairs, Volume 7, Number 2, 1 February 1990 — ʻAi Pono, E Ola [ARTICLE+ILLUSTRATION]

ʻAi Pono, E Ola

» By Terry Shintani, M.D., M.P.H.

Saving our kupuna

February is the month for valentines and it's also Nahonal Heart Month as declared by Congress, Gov. Waihee and Mayor Fasi. Why is this important to native Hawaiians? It is important be-

cause heart dtsease is the number one killer of native Hawaiians and one of the main reasons native Hawaiians have the shortest life-span of all ethnic groups in Hawai'i. Although heart disease is the number one killer of native Hawaiians, it is one of the most prevent-

able diseases known. In fact there is one simple thing we ean all do to reduce our risk of dying of this disease to almost zero. This simple step is to lower our cholesterol levels. In fact, there is so close a correlation between heart disease and cholesterol levels that for every one percent decrease in cholesterol Ievel, there is a two percent decrease in heartattack. Today, the National Heart Lung and Blood Institute recommends that everyone reduce their cholesterol level to below 200. In fact, in the largest study of heart disease and cholesterol at Harvard University, no one with a cholesterol level lower than 150 died of a heart attack. The Wai'anae Diet Program and the Moloka'i Diet Study demonstrated that lowering cholesterol ean be done with the traditional Hawaiian diet. lt ean take as little as 2 1 days to make a significant start toward this goal. The Wai'anae Diet Program demonstrated that among 20 individuals who stayed on the diet for 21 days, the average decrease in cholesterol was over 12.5 percent whieh translates to a decrease in risk of heart attack of over 25 percent. Part of the urgency for promoting this program is that there is evidence that indicates that lowering fat consumption and our cholesterol levels ean help even individuals over 40, 60, even over 80-years-old. This means that a good diet ean help our kupuna to live longer right now. One study that supports this idea was a natural experiment that occurred in Europe. During the war years 1940-1945, dietary fat intake decreased drastically because there was rationing and a laek of animal products. Figure 1 indicates howdrama-

tically the death rate from heart disease (circulatory disease) decreased as dietary fat consumption decreased. The effect was seen within a matter of months. Figu>*e 2 shows the distribution of this effect from ages 40 to over 80-years-old. Notice how the death rate from heart disease decreased for every age group including those over 80-years-old. Just imagine if we could do this (and we ean) for all our kupuna. How ean we do this for ourselves? Eating a low cholesterol, low fat, high fiber diet is the cornerstone of a cholesterol lowering plan. The traditional Hawaiian way of eating as demonstrated by the Wai'anae Diet and the Moloka'i Diet is a good example of such a diet. In fact there are many foods from practically every culture that are eho-lesterol-lowering foods. One thing to remember in determining what is a low cholesterol food is to recognize that anything that has a face (or comes from something that has a face) has cholesterol in it including red meat, fowl, dairy food, and egg yolks. Even seafood has cholesterol although fish have certain oils that have some protective effect against cholesterol. In addition, by limiting these kinds of foods, and fried foods (frying was never a Hawaiian way of cooking) we ean eliminate the main sources of fat in our diet. In this way we ean make a start in National Heart Month to help eliminate heart disease in ourselves and our kupuna. Dr. Shintani, physician and nutritionist is the director of preventive medicine at the Wai'anae Coast Comprehensive Health Center. A majorify of the Center's 1 7,000 clients are native Hawaiian.

Figure 1. In Norway during World War II, dietary fat consumption decreased and death from heart disease decreased dramatically in the months following.

Figure 2. The decrease in death from heart disease was in all age groups from 40 to 60 to even over 80 years old.