'Healthiest hearts in the world' found

https://www.bbc.co.uk/news/health-39292389

by known • 7 years ago

129 99 7 years ago

bbc.co.uk

tpush• 7 years ago

"It means:

72% of calories come from carbohydrates compared with 52% in the US

14% from fat compared with 34% in the US, Tsimane also consume much less saturated fat

Both Americans and Tsimane have 14% of calories from protein, but Tsimane have more lean meat"

That really does seem counter to the low-carb diets that seem to be all the rage among internet communities (also HN).

But, maybe it's just the constant exercise the Tsimane people are getting: "They are also far more physically active with the men averaging 17,000 steps a day and the women 16,000."

dfischer• 7 years ago

I’d say 8 miles a day has a lot to do with it.

4ntonius8lock4• 7 years ago

I love the title in the article:

"Is it only diet and exercise?"

Lol. So... they are telling the 'news' that people who eat well, are very physically active, live in close communities with little individual isolation... and they are healthy?

Hold the presses! Seems like BBC had a day where they needed to put in some filler news articles.

will_brown4• 7 years ago

That really does seem counter to the low-carb diets that seem to be all the rage among internet communities (also HN).

Generally people discussing “low carb diets” really mean managing blood glucose/insulin spikes. So high glycemic carbs, refined sugars, refined carbs.

Not all carbs are created equal when we talk about impacts on blood glucose and/or the liver.

52-6F-622• 7 years ago

This is true.

It's likely that beside the rice and maize, most of their carbs come from vegetables. It's one of the reasons why high-performance diets are usually heavy on the broccoli!

copperx5• 7 years ago

Tangentially, there are two professors that swear by the idea of taking glucose readings soon after eating to know the impact of different foods in your diet. Theoretically, if you eat things that don't raise your glucose too much you can lose weight.

It sounds logical, but I don't know if it's really useful if you're not diabetic.

Edit: the book is called "The Personalized Diet."

phil248• 7 years ago

Carbs are great if you're actually going to use the energy! The best even! The problem with Western habits is we tend to carb load until we have a tremendous excess of energy which we then use to... sit down for several hours while our body gets busy turning all that unused energy in to fat.

rcombine3• 7 years ago

Exactly. Humans are meant to move, and not moving makes us fat. Now that we're extremely sedentary, we literally have no use for the amounts of rice and pasta we consume. We're victims of our own success.

cageface4• 7 years ago

Converting carbs into fat is fairly inefficient. It comes at about a 40% calorie loss. So you can put on fat eating carbs alone but it’s not easy. More often than not we eat carbs together with fat so your body will very happily just directly store the fat and burn the carbs for energy.

This is why things like french fries or pizza are so fattening.

kup0• 7 years ago

Seems like exercise is probably a big factor here. Exercise can help curb insulin spikes caused by high carb intake, among its other benefits

AimForTheBushes2• 7 years ago

"The Tsimane get 72% of their energy from carbohydrates.

The fact that they have the best indicators of cardiovascular health ever reported is the exact opposite to many recent suggestions that carbohydrates are unhealthy."

Refined carbs ARE unhealthy and it's a bit disheartening that they didn't make that distinction in the article.

bpicolo• 7 years ago

Non-processed carbohydrates are grown in the form of rice, plantain, manioc, and corn via slash-and-burn horticulture, and the Tsimane also gather wild nuts and fruits.

Big difference between this and HFCS and table sugar.

pkaye3• 7 years ago

What is the difference?

will_brown4• 7 years ago

To add to your point Okinawans once had the greatest life expectancy on Earth and the majority of their diet was carbs too.

Since the introduction of “western diet” post WW2 the majority of their diet is still carbs and yet they now show significant increase of Chronic disease (obesity, heart disease, type 2 diabetes, fatty liver disease and kidney disease) and lowered life expectancy.

copperx5• 7 years ago

What is that disease attributed to? Do you know?

mikekchar3• 7 years ago

It turns out, though, that Okinawan long life expectancy was actually due to rampant pension fraud rather than long life. I can't remember the exact date, but it would have been around 2008, a reporter went to visit the oldest people in Japan (most of whom were living in Okinawa). They started at the oldest and found that the person wasn't home ("visiting relatives"). So they went to the next oldest. Similar story. They went through the top 20 and couldn't find any of them.

The government clued in and investigated and it turns out that Okinawan doctors were making a tidy profit by agreeing not to file death certificates. This enabled families to continue to claim pension benefits on behalf of their supposedly aged relatives.

After the the smoke died down the went back and looked at Okinawan life expectancy taking pension fraud into consideration and discovered that it was pretty much exactly the same as the rest of Japan. The original life expectancy/diet studies had relied on government information rather than actually interviewing people. I'm sorry I don't have a citation for you as I saw this in a documentary in Japan on TV.

munk-a2• 7 years ago

I am highly skeptical of this article given the lack of any comparison of both natural and artificial sugar consumption as a proportion of those carbohydrates, the foods listed tend to be quite low in sugars and it seems like an obvious factor to investigate and is given... absolutely no consideration. Ditto with their sodium consumption and the fish they're eating are probably isolated enough to not be a dangerous source of heavy metals like the fish we have access to.

I definitely don't think that fat is the best thing ever for you, but butter/lard (and other dairy fat) heavy diets have been around for a long time.

I am really concerned about what we as residents in democratic countries are permitting regulators to hand-wave into our food, there is something really bad that we're all eating or drinking and we're going to need to figure out what it is pretty quickly.

pastor_elm• 7 years ago

Most of the rest comes from family farms growing rice, maize, manioc root (like sweet potato) and plantains (similar to banana)

these aren't refined, but they arguably aren't the healthiest for you

drdrey2• 7 years ago

Why not?

strainer• 7 years ago

In common UK parlance carbohydrates don't include sugars although chemically speaking they should. I think metabolically speaking there is a useful distinction to be made, in fact people are making it here. In dietary context schools have categorised potatoes, rice, pasta, even bread as sources of "carbohydrates" and sweets as sugar sources.

throwaway55554• 7 years ago

Tsimane diet fad coming soon.

rcombine3• 7 years ago

Tsimane _exercise_ regimen, really.

52-6F-622• 7 years ago

Don't forget the intestinal worms

Scaevolus• 7 years ago

At the age of 45, almost no Tsimane had CAC in their arteries while 25% of Americans do.
By the time they reach age 75, two-thirds of Tsimane are CAC-free compared with the overwhelming majority of Americans (80%) having signs of CAC.

The article doesn't mention obesity at all. 40% of Americans over 40 are obese[1]. Tsimane obesity rates of adults (>20 years) are 5.6% for women and 1.6% for men[2].

Journalists love writing about dietary composition as if increasing your fish (or whatever) consumption is a magic bullet, but merely changing composition without losing weight is only a moderate improvement (maybe 30% fewer heart attacks, based on that retracted NEJM dietary study[3]).

[1] https://www.cdc.gov/obesity/data/adult.html [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392307/ [3]: https://www.nejm.org/doi/full/10.1056/NEJMoa1200303

4ntonius8lock4• 7 years ago

It's almost as if human experiences don't fit into the carefully curated categories we have in modern society where individual aspects are considered in isolation and not handled in a holistic way.

It's as if: the need for meaning, relationships, sleep, body, teeth, eating, professional development, daily routine, sitting, walking, how we walk, our individual body constructs, personality archetypes, mental health, etc... were more than the sum of their parts and being overly dissecting such things leads to a lessening, not increase in understanding of the whole.

A great book on psychology like thinking fast and slow will do a great job at dissecting reality from that narrow point of view, just as other books will do the same in other fields. But I don't really know of any field that is respected that combines many elements to study how to maximize human potential/study the human experience as a whole.

I offer no solutions, just an observation in terms of how we deal with the human experience in modernity.

Swizec• 7 years ago

This is because I can change a thing but I can't change my whole life. Well, I can, but that's hard and single things are easy.

ssivark• 7 years ago

It's almost as if human experiences don't fit into the carefully curated categories we have in modern society where individual aspects are considered in isolation and not handled in a holistic way.

Well put. The challenge for any individual author is that it is much easier to write defensively in a narrow niche (cue: increasing specialization in research). It is very easy to start flinging accusations and ad-hominem attacks on an author who's ambitiously trying to synthesize connections between apparently disparate topics, which discourages any ounce of originality/creativity.

A more obvious problem is how our systems bias for an explosion of "content" and evisceration of nuance. For some thoughts on the topic, see https://www.brainpickings.org/2018/09/24/norbert-wiener-comm...

To start with, I wonder whether we can construct a better reading list for an audience with a more holistic bent, not just in relation to health, but for other domains too. Once a curated audience is established, authors might find more inducement to write such stuff. That said, once these floodgates are opened, filtering out the bullshit-mongers will take significant effort and judicious exercise of editorial discretion.

In case anyone is interested, some ad-hoc examples, based on what I've been reading lately:

- Christopher Alexander (full series of ten books, ostensibly relating to architecture, but actually reflecting on so much more)

- Writings by some cybernetics pioneers (eg: Norbert Weiner and Ross Ashby)

- Design as participation, by Kevin Slavin -- https://jods.mitpress.mit.edu/pub/design-as-participation

PS: Some of my current readings skirt "unfashionable" topics related to AI/ML, many of which are papers from the 80s :-)

Edmond• 7 years ago

30% improvement in anything is likely to be considered significant, not "moderate".

ericmcer• 7 years ago

Yeah very strange they do a breakdown of what percentages each diet has, but not the overall caloric intake. If you consume 5000 calories a day, it really does not matter how healthy your macros are. I wonder what the results would show if they did a similar study but compared people of similar body compositions. Who has the healthiest population of people with a BMI of ~20.

txcwpalpha2• 7 years ago

After a quick Google I found several older articles that do mention the caloric intake of the Tsimané [1]. It is curious that the BBC article left that out.

1: https://www.inverse.com/article/50572-tsimane-amazon-healthy...

NikolaeVarius• 7 years ago

Upper level athletes eat 5000 calories a day just fine, though they tend to have better macros

m12k• 7 years ago

Yeah, comparing with Americans seems designed to overstate the effect. If you instead compared with e.g. some European country where the obesity rate is much lower, it would yield a better idea how the two diets compare if the caloric intake was about the same in both cases.

graeme• 7 years ago

About 25% of France is obese. Europe is less obese than America but they're markedly more obese than they were a generation ago. Worlds off from hunter gatherer levels.

oh_sigh2• 7 years ago

Yes, I would be interested in how I, an in-shape individual who exercises regularly compares to the Tsimane.

copperx5• 7 years ago

I was also surprised that the OP scoffed at the 30%. If you sold a drug that did that you would be an instant billionaire.

TulliusCicero5• 7 years ago

The fact that they walk a huge amount (16,000/17,000 steps per day) seems to be a very obvious factor.

Unfortunately, getting this kind of behavior, at least in the US, would be enormously challenging, because our land use policies and regulations are generally designed to make walking useless and/or painful.

I've lived in several parts of the US, currently live in Munich, only NYC felt close to Munich in walkability, and I honestly think I'd still give Munich the edge (even though it's not as dense and business convenience is worse). The other areas I lived in -- Silicon Valley, Seattle suburb, Utah, various parts of Alabama -- were all complete and utter garbage for walking. They're very obviously not even trying.

nickjj3• 7 years ago

Are you unable to walk around your neighborhood in SV, Seattle and other places?

I live on Long Island (not NYC) but it's not hard to find places to walk around in safety. I put in 3-5 miles (roughly 6,000 - 10,000 steps going by Google) a day just aimlessly walking side streets for general exercise and clearing my mind.

When I visited SV it didn't seem too bad downtown. Can't speak for the other places though.

But if you want to put in the steps, you just need ground to walk on and preferably not be constantly dealing with highways (that would really suck).

oh_sigh2• 7 years ago

The US is very walkable, but you might need to drive to walk.

chrischen3• 7 years ago

Well this article seems to be pushing for more carbohydrate consumption and putting that increased level of calories from carbs at the same significance as the massively increased level of physical activity they have.

YUMad• 7 years ago

Dietary composition _is_ the key. No hunter-gatherer group has ever exceeded 50% of total caloric intake coming from plants, especially not from simple sugars.

sharph2• 7 years ago

How much vegetable oil did they consume?

BoneVays2• 7 years ago

Judging from other "natives" I met, probably as much as they can(with Walmart being 1000 miles away, that would be little). I don't know if you were thinking in terms of "incriminating" veg oil in favor of butter etc, which is the trend in Atkins etc, but the takeaway message of such studies is exercise and the stress-free life, you become what you do and what you think! Eating is a part of thinking and doing, but only up to a point.

sharph2• 7 years ago

I was indeed thinking in terms of "incriminating" veg oil, but more in favor of omega 3 fatty acids (as is also the trend in Atkins etc,) not necessarily saturated fats in butter. (edit: Also silently implying here that n-3 to n-6 ratio matters. Omega-6 fats are essential, but in nature n-3:n-6 is found in more desirable ratios.)

I get what you're saying re: exercise and stress, but I have to believe that for some percent of the population, diet rules over the ability to have enthusiasm for exercise and the ability to deal with stress. Everybody's got stress. Some people feel it more than others.

ubertakter• 7 years ago

So, what's their average total caloric intake? Hmm... 2400-2700/day[1] which is not in the Lancet article[2], but I did find that in an American Journal of Clinical Nutrition reference[3]. It appears they get lots of exercise, which isn't surprising.

[1]https://coach.nine.com.au/2018/11/05/14/03/tsimane-diet-card...

[2]https://www.researchgate.net/publication/315262221_Coronary_...

[3]https://www.ncbi.nlm.nih.gov/pubmed/30383188

rcombine3• 7 years ago

That is even more illuminating. They eat primarily unrefined carbs like rice, corn, and plantains, 2400~2700 calories worth of it a day (more than I eat!), and yet they are very healthy and fit. Considering the numbers, it really looks like the difference is the amount of physical activity.

I think that sedentary humans are just not supposed to eat as much as we think or want to do.

rich-tea• 7 years ago

This one was quick. It took decades before anyone questioned the war on fat. Looks like the war on carbs is already at that stage.

Give it a few years and we'll start to see the bad affects of too much protein. Mark my words.

People who live a long time don't care about diets. Show me one who did.

DoingIsLearning• 7 years ago

People who live a long time don't care about diets. Show me one who did.

Jack LaLanne?

He was one of the first modern evangelists of fitness and diet and lived to be 96, according to wikipedia.

Purely anecdotal but you did ask for a single example.

devm0de• 7 years ago

What about what protective or healthy heart genetic markers their population might have?

negamax• 7 years ago

Small anecdote: I did travels through Europe a while back and did lots of walking. That's fairly normal in many European towns and cities. Really felt great and decided to do 20k steps a day after return. Which tapered off slowly and unconsciously. Need to get back to that level. Your body respond quickly in positive direction, I can recall that much.

emptybits2• 7 years ago

Another fact about Bolivians ... they are, on average, the shortest people in the world.

https://www.worldatlas.com/articles/countries-with-the-short...

JoeAltmaier• 7 years ago

Oh! Short stature, mountainous country near the equator - means the least gravity affecting their circulation! Natural heart-healthy situation!

snazz• 7 years ago

Do astronauts have better hearts? Was this studied in the twins experiement we saw a while ago?

emptybits2• 7 years ago

Short heart-to-brain distance may also predict an ability to handle high G-forces as a fighter pilot. https://fightersweep.com/1411/agsm/

copperx5• 7 years ago

You might be joking, but higher altitude also means less oxygen, which translates to reduced oxidation and less risk of cancer.

I'm on my cellphone so I don't have the paper on hand, but there was a big study where they compared lung cancer rates in different geographic areas and found that the highest cancer incidence was at sea level, whereas the lowest was at higher elevations. They tried controlling for other obvious variables but elevation was unquestionably the best explanation.

Oxidation may explain plaque in arteries.

PerfectElement• 7 years ago

72% of calories come from carbohydrates

Not much different from the Blue Zones: https://en.wikipedia.org/wiki/Blue_Zone

caublestone• 7 years ago

Does anyone know if the Tsimane drink alcohol?

lordnacho• 7 years ago

One thing I didn't get a clear answer from the doctor about last time I saw one was this.

Can you unclog your arteries by changing your lifestyle, ie diet and exercise, or is the clogging permanent?

cogman10• 7 years ago

https://www.webmd.com/cholesterol-management/cholesterol-and...

Once a cholesterol plaque is there, it's generally there to stay. With effective treatment, though, plaque buildup may slow down or stop.
Some evidence shows that, with aggressive treatment, cholesterol plaques can even shrink slightly. In one major study, cholesterol plaques shrank 10% in size after a 50% reduction in blood cholesterol levels.
The best way to treat cholesterol plaques is to prevent them from forming or progressing. That can be done with lifestyle changes and, if needed, medication.

hackits• 7 years ago

https://youtu.be/c5ELzL7DGpw?t=2426

Vitamin K - Mk7, Vitamin V, and Magnesium seem to help with the removal of calcifications of the artillery. Though I couldn't really find referees other than reports on `Vitamin K intake and calcifications in breast arteries Angela`

cageface4• 7 years ago

Diet can unclog arteries, at least in some cases.

https://dresselstyn.com/JFP_06307_Article1.pdf

discreteevent• 7 years ago

It would be interesting to know if they observed how much sleep they take.

jonplackett• 7 years ago

Doesn't even mention sugar. Seems like that would be a very large and important difference.

Just says "72% of calories come from carbohydrates compared with 52% in the US", which might encourage a westerner to eat more carbs, but if they're eating whole rice and we're eating sugar that seems kinda important.

Comparison of gut bacteria would be interesting too, bet that's as important as the diet itself.

chrischen3• 7 years ago

They're also exercising more than 100% of what Americans do.

apo• 7 years ago

One idea is that intestinal worms - which dampen immune reactions - could be more common and this may help protect the heart.

That worm infects most of the population:

And about 70% of the population has a parasitic worm infection [Ascaris lumbricoides, a type of roundworm]. ... Up to a third of the world's population also lives with such infections.

https://www.bbc.com/news/health-34857022

Before latching onto exercise or diet as the primary factors, it's worth considering the effect of this worm infection. It could influence the heart indirectly through nutrient flow, immune suppression as suggested for the original article or the one on pregnancy, or directly via for example larvae/segments, etc.

BTW, the lifecycle of this thing is the stuff of nightmares:

Ascaris lumbricoides, a roundworm, infects humans via the fecal-oral route. Eggs released by adult females are shed in feces. Unfertilized eggs are often observed in fecal samples but never become infective. Fertilized eggs embryonate and become infective after 18 days to several weeks in soil, depending on the environmental conditions (optimum: moist, warm, shaded soil).[5]. When an embryonated egg is ingested, a Rhabditiform larva hatches then penetrates the wall of the duodenum and enters the blood stream. From there, it is carried to the liver and heart, and enters pulmonary circulation to break free in the alveoli, where it grows and molts. In three weeks, the larva passes from the respiratory system to be coughed up, swallowed, and thus returned to the small intestine, where it matures to an adult male or female worm. Fertilization can now occur and the female produces as many as 200,000 eggs per day for 12–18 months. These fertilized eggs become infectious after two weeks in soil; they can persist in soil for 10 years or more.[6]

https://en.wikipedia.org/wiki/Ascaris_lumbricoides

Clearly, the juvenile state spends some time in the circulatory system, where it should have some opportunities to influence coronary artery calcium.

I looked for studies that examined the incidence of heart disease/CAC buildup among other infected populations but didn't immediately find anything.

jvanderbot• 7 years ago

You know what else? They dont have air pollution like pm2.5, which is known to cause heart and lung disease.

https://laqm.defra.gov.uk/public-health/pm25.html

deevolution• 7 years ago

"One idea is that intestinal worms - which dampen immune reactions - could be more common and this may help protect the heart"

Let me get some of those worms!

scythe• 7 years ago

But is their health abnormal after accounting for the usual RRs associated with their BMI, exercise, fiber and trans fat intake? They don't drink or smoke, I presume?

The difficulty with "non-mathematical" sciences is that they tend to treat math as a tool for validation rather than expression. This is partially a failure of communication on the part of mathematicians.

netwanderer3• 7 years ago

This is a perfect example of how everything in life is always a trade off. Do you want a healthier heart to live a few extra years or do you want to sit on your couch and browse HN while enjoying your BigMac? Pick one because only a fool would believe they could have both.

'Healthiest hearts in the world' found

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