Arthur Agatston on the Conflict Between Ancient DNA and Modern Diet
People between the ages of 30 and 45 have more plaque in their coronary arteries than their elders did when they were in that age range, and more young people are having heart attacks. The reason, according to preventive cardiologist and South Beach Diet creator Arthur Agatston: Modern humans’ diet and activity are contrary to the way we evolved.
“My job is actually to scare you,” Agatston told the crowd during his keynote address at the University of Miami Global Business Forum, held Jan. 12–14, 2011.
Agatston, who is also a professor at UM’s Miller School of Medicine, did note that the incidence of heart disease has generally continued to decline in the United States, after peaking in 1967. “And it’s going down even though we’re continually getting fatter and more diabetic,” he reported. “Well, so what’s goin’ on?”
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Arthur Agatston, MD, Preventative Cardiologist and
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Agatston pointed to autopsy-based studies by the Mayo Clinic that corroborate other findings indicating that plaque levels in this demographic’s coronary arteries have plateaued and are starting to go up. “What these data tell us is despite all our advances in preventing heart disease, our lifestyle is actually trumping those advances,” he said. “It may be the first generation that won’t live as long as their parents.”
Consider the “potbelly,” which is evidence of the ways our modern diet and lifestyle are in conflict with how our bodies evolved. A “survival mechanism” in our DNA triggers the storage of fat, especially in the stomach area. That was a beautiful thing more than 20,000 years ago, when virtually everyone on the planet was a hunter-gatherer and suffered through annual feast-and-famine cycles. “Wouldn’t it be great if, during summer and fall months, when food was very plentiful and you were eating, you could store some of those extra calories as fat, maybe in your belly, so you could still run and hunt, and then in the inevitable winter famine live off that fat?” Agatston asked. “Well, that’s actually the way our DNA was designed to [help us] survive in the wild.” Belly fat also played a role in increasing the production of chemicals involved in the inflammation process, which helped the body fight infections.
But our DNA never planned for the belly to keep growing and growing. “Today, where there’s no famine, there’s only feast, and the belly continues to grow, we’re literally bathing our tissues with these inflammatory chemicals,” Agatston explained. Those chemicals, not usually needed for fighting off infection, are contributing to cardiovascular disease and other chronic illnesses including macular degeneration, Alzheimer’s and all kinds of cancers.
In addition, belly fat has another disease-causing by-product: insulin resistance, or pre-diabetes, a condition in which insulin works more slowly after meals to get nutrients into the bloodstream. In the process, blood sugar surges, then dives when the insulin kicks in, resulting in reactive hypoglycemia. That’s good if you are a hunter-gatherer regularly burning off all the fat, bad if you’re a sedentary citizen of the developed world in the 21st century.
Agatston noted with some humor that we’ve gotten fat not because of a conspiracy of the food companies or the government, or a lack of self-control, but because of “the economy, stupid” — albeit “the economy going back to about 10,000 B.C.” That’s when many homo sapiens shifted from full-time hunting and gathering to agriculture, working fewer hours for their food. That freed them up for other activities, such as the creation of armies, guns and steel, he said. But their diets became less diverse. “The average height of the agriculturalist went from about 5-foot-9 to 5-foot-3. They weren’t as healthy because they often depended on one source of nutrients instead of a big variety,” Agatston said. But they weren’t fat, either, and their hearts were healthy. Even during the industrial revolution, when vast numbers of human beings moved off of farms and into cities, “there was no coronary disease or many of our chronic diseases,” he said. Why? Because most people still engaged in hard physical labor.
Twentieth-century comforts such as the automobile, refrigeration and longer shelf lives for food contributed to a rise in heart disease. “We weren’t eating things as fresh,” Agatston said. Instead, Americans began consuming more foods made with artery-clogging tropical oils and, later, trans fats, which kept food tasting good even though it might have been several weeks old.
And Americans have grown increasingly less active, especially compared to our hunter-gatherer ancestors. “A decade or two ago, we were still going out to the sandlot and the fields and playing baseball, football, basketball. Today, most of those sports are being played on video games and computers,” Agatston lamented.
Consequently, a rising tide of overweight, sick people is threatening to engulf the U.S. health care system. “With all due respect to President Obama and his Republican detractors,” Agatston said, “whether we end up with a one-payer system, multi-payer system or market system, it doesn’t matter. The system is going to be overwhelmed by chronic diseases if we don’t make changes, particularly in the younger generation today.” With her efforts to end childhood obesity, he added, “It may be that [First Lady] Michelle Obama has the most important approach, by going into our schools and working on the youngest Americans.”
Agatston, too, hopes to reach children with his message about better eating and exercise, through the Agatston Research Foundation’s Healthier Options for Public Schoolchildren. One of its recent studies involved elementary students in central Florida and Buffalo, N.Y. “We changed what was in the cafeteria and we gave the kids education and participation. And we did have less weight gain, better concentration and even better [test] scores,” Agatston said. “But the most important thing that I learned was these young elementary kids in these schools love healthy food. And when they left the HOPS program and went to middle school, they asked, ‘Where is the HOPS food?’ So kids will accept healthy food.”
And what does healthy food mean — for children and adults? Agatston said medical scientists have reached consensus on the definition of a healthy diet, which he described as “more fruits and vegetables, more high fiber, whole grains, fish, good fat, lean sources of protein.”
