Beyond Cholesterol

Cynicism, hostility, and isolation have been identified as factors of heart disease

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Much has been written about dysfunctional families, but the bonds among family members can also enhance one's health. A most fascinating long-term study was conducted by Stewart Wolf, M.D., in Roseto, Pennsylvania. The researchers sought to explain the very low incidence of heart disease and concluded that the supportive, interactive, and close-knit nature of the town's primarily Italian-American population created their "immunity" to heart disease. A special March 1998 Newsweek issue on health dubbed this phenomenon in Roseto the "Pennsylvania Paradox" because although residents' diets included food generously prepared with lard, they had almost no heart disease. What stood out as a critical variable was the fact that residents held on to the Old World values--drinking wine with meals and maintaining very strong social and familial ties.

Wolf's findings had a counterpart in the French Paradox, a study conducted by Boston University Department of Medicine epidemiologist, Dr. Curtis Ellison, in which the drinking of red wine positive correlated with low heart disease among the French despite a high cholesterol and high fat diet.

Dr. Wolf, who with John G. Bruhn co-authored the 1979 book "The Roseto Story" and the 1993 follow-up book "The Power of Clan," forecasted that when the researchers returned in the mid-1970s they would find increased mortality from heart disease. When Wolf first arrived in Roseto the town's families lived in tidy homes on a tightly packed avenue, their kitchens were often filled with neighbors who they also met with in the streets after leisurely dinners. Slowly and subtly, however, things changed. Traditionally the men worked in salt quarries, the women in the numerous textile mills, but as education became more important, their children became professionals. The younger people were very respectful of the Roseto spirit and attitudes but didn't want it for themselves. Since maintaining links to the past, which included behaviors that seemed to ward off heart disease, became less important than material success, Dr. Wolf accurately predicted that Roseto would lose its relative immunity to coronary heart.

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Researchers then predicted that national cholesterol education programs and other public health measures would decrease the incidence of heart disease during the 80's. But when they returned in 1985, they found that despite decreasing fat intake and smoking rates, the rate of heart disease continued to climb. They concluded that the new way of life was preventing the expected decline in heart disease.

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Elaine Ferguson
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