Greenland Eskimos, Diet and Heart Disease

With so much being written lately about the relationship between dietary fats and  heart disease there’s no wonder we may feel a bit disoriented.

Of course we could take the easy way out, and follow main stream recommendations, limit the total amount of fats consumed, and avoid saturated fats and cholesterol.

Greenland Eskimos, Diet and Heart Disease

Eating less animal and dairy fat, fewer eggs, and more polyunsaturated fats (PUFA’s) and monounsaturated fats (MUFA’S) could be the way to go in order to reach good heart health according to the specialists. However, I believe there’s limited scientific evidence that this will help us avoid heart disease. So what should we do?

If we could, it would certainly be helpful to study populations with a very low risk of  heart disease and see what they’re eating. However, the problem is that today such populations are hard to find.

But, what about going back in history and dig up such cultures, because certainly they have existed. While having these thoughts today I recalled reading a wonderful scientific paper published by Danish experts in The American Journal of Clinical Nutrition in September 1975.

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What the Past Can Teach Us About Diet and Heart Disease

In 1975 it was already known that there was “an intimate relationship”  between the occurrence of coronary atherosclerosis and blood levels of cholesterol and triglycerides. The Greenland Eskimos were no exception from this rule.  Coronary atherosclerosis and heart disease were almost unknown among them when living in their original cultural environment. Their blood levels of cholesterol and triglycerides were very low. However, Greenland Eskimos living in Denmark at that time had much higher cholesterol and triglyceride levels.

The difference in dietary habits between Eskimos living in Greenland and those living in Denmark was substantial. Those living in Denmark had adapted to a Western diet typical of that time.

Meat was the main source of calories among Eskimos living in Greenland, giving rise to a high intake of proteins, and relatively low intake of carbohydrates. The meat mostly originated from animals living in the sea, therefore the composition of the dietary fats was characterized by their maritime origin. In the daily Eskimo food in Greenland the relative amount of protein calories was approximately two and a half times that of the daily Danish food, whereas the relative amount of carbohydrates was only two-thirds. The relative amount of total fat consumption was similar.

The Danish investigators studied the pattern of fatty acids in the blood of 130 West Greenland Eskimos (WGE) and compared them to 30 Eskimos living in Denmark and 31 Caucasian Danes. Very marked differences were observed between the WGE  and the two other groups. The WGE had generally much higher proportions of palmitic acid (saturated fat), stearic acid (saturated fat), palmitoleic acid (omega-7/MUFA), and eicosapentaenoic acid (omega-3/PUFA) and a markedly lower proportion of linoleic acid (omega-6/PUFA).

It is well known that the fatty acid composition of food is a major determinant of fatty acids measured in the blood. So, the Danish scientists had a problem. The generally accepted concept at that time was that a high consumption of PUFA and the avoidance of saturated fats was the best way to avoid heart disease. But here was a population with almost no heart disease and high blood levels of saturated fats, and very low blood levels of PUFA’s (omega-6).

The authors write:

“Coming to this point it is very difficult to combine the generally accepted concept of the advantage of high intake of polyunsaturated fatty acids in prevention of ischemic heart disease with the present results.  The discrepancy is that a generally higher proportion of polyunsaturated fatty acids was not found in the plasma lipids of Greenland Eskimos. In fact, when combining the fatty acids into only three groups: saturated, monoenes, and polyunsaturated, the saturated group was found to be higher and the polyunsaturated lower in the Greenlandic Eskimos. “

This 38 year old paper is probably not less interesting today than it was when it was first published. It strongly suggests that somewhere along our journey to improve health, we may have chosen the wrong path. Furthermore the paper is highly interesting because it was one of the first to highlight a possible relationship between omega-3 consumption and heart disease.

Two years after the publication of this paper, the first dietary guidelines for Americans were released. I assume the Greenland Eskimos would have recommended a different version of that. They would have emphasized that a diet rich in proteins, saturated fats, and omega-3 appears to cut the risk of heart disease. I wonder whether the guideline writers were aware of the Greenland Eskimo experience, or whether they just thought it wouldn’t apply to Americans.

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Hemming
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I actually didn’t know of this study but I’m glad they made the distinction between WGE and Eskimos living in Denmark. The health status of Eskimos living in Denmark is horrible and my best guess is that more than half of them are alcoholics. Another important point is that the Eskimos lived of completely fresh, (more or less) non-polluted food and in a non-polluted environment. I know much of that has changed now but back then they were almost completely isolated. Even though this is an old study it just highlights what Stefansson found 50 years earlier. First by living… Read more »

Robert
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Robert

I think Hemming may have hit the nail on the head. Excellent observations that few people notice when he mentioned a non polluted environment. I too studied the traditional Greenland Eskimos and observed Greenland’s remarkable absence of industry.

Richard Mjödstånka
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Richard Mjödstånka

There’s tons evidence pointing that the idea of Eskimo’ having low rates of CHD is a complete myth. Ancel Keys wrote about the Masai & Eskimo already back in 1975 refuting the whole nonsense (Coronary Heart Disease – The Global Picture; Keys, Atherosclerosis 22, 1975). At the time when diet-heart studies were launched there were only few hundreds Inuits who lived the traditional lifestyle and very few of them knew their own age. Based on the observations by Danish pathologist prior the Diet-Heart era, CHD was rampant among the Greenland Eskimo’s considering the very low life expectancy of these people.… Read more »

Axel F Sigurdsson
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Axel F Sigurdsson

Richard. Several publications have shown that Inuits from Alaska, Canada an Greenland have substantially lower mortality from ischemic heart disease (IHD) than the non-native populations of Alaska, Southern Canada and Denmark.

Here is an overview of cardiovascular risk factors in Inuits of Greenland, published 1997. The main conclusion was: In spite of an increase westernization of the Greenlander´s lifestyle and high prevalence of several cardivascular risk factors, mortality from IHD is still low.

Richard Mjödstånka
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Richard Mjödstånka

Doc, yes, there’s is conflicting information around the Inuits (Bjerregaard et al 2003). However, to answer your original question, yes: the people who drafted the dietary guidelines knew the Inuits. This is what Keys wrote (1975): ”The fact is that nothing is really known about the incidence of atherosclerosis and coronary heart disease among Eskimos. According to Ehrström, arteriosclerosis is common among them, reaching an incidence of 29% in North Greenland, but the evidence is dubious, particularly in regard to atherosclerotic heart disease. In any case we could not expect a high incidence of coronary heart disease among primitive Eskimos… Read more »

Mie
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Mie

Axel, as you can see from Richard’s post, the data is both scarce and conflicting. Furthermore, I’d like to strongly point out that making statements like these ones that you made above: “It strongly suggests that somewhere along our journey to improve health, we may have chosen the wrong path.” and “They would have emphasized that a diet rich in proteins, saturated fats, and omega-3 appears to cut the risk of heart disease.” on the basis of selected ecological data is, simply put, totally unfounded. Axel, c’mon: you should know better. What about e.g. the natives throughout the world who… Read more »

Axel F Sigurdsson
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Axel F Sigurdsson

You´re right Mie. Dietary guidelines should be based on real scientific data. Do you believe they currently are? You are right about my statements. They´re speculative and I guess intended to provoke thoughts and discussions. Of course I don´t have an access to the truth, no more than you do.

Mie
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Mie

“Dietary guidelines should be based on real scientific data. Do you believe they currently are?” More or less, yes. Depending, of course, which guidelines you’re referring to, but I’d say that e.g. Harward Public Health School’s guidelines are indeed based on real (TM) scientific data. If you disagree, I’d like to hear why. Or if you meant some specific guidelines, perhaps you could be more explicit and explain why. P.S. If you’re referring to this “safa case”, it was dealt with SOOOO very extensively earlier in different threads, see e.g. the much-too-long debate between Healthy Longevity and me. To cut… Read more »

Richard Mjödstånka
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Richard Mjödstånka

Mie,

the neo-SFA confusion has its origins among a handful of American epidemiologist who show complete disregard to multiple lines of research and who lack a global scope.

The fact is that the “reductionist” avoidance against SFA has worked tremendously well in Northern Europe, New Zealand, etc (Pedersen et al 2011). People were not asked to adhere to Mediterranean diet, they were asked to cut down the intake of SFA. It’s a simple, cost-effective, non-confusing advice that has served way above the expectations.

Kevin O'Connell
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Kevin O'Connell

Health benefits of safa – how about:
“A diet enriched in saturated fatty acids effectively reverses alcohol-induced necrosis, inflammation, and fibrosis despite continued alcohol consumption. The therapeutic effects of saturated fatty acids may be explained, at least in part, by reduced endotoxemia and lipid peroxidation….” (Nanji, et al., 1995, 2001)

David Brown
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I subscribe to several feed and food industry publications. On occasion, something interesting surfaces that pertains to differences in physiological response to vegetable oils and so-called animal fats. Excerpt from Improving fat digestibility with emulsifiers: “Bile salts are natural emulsifiers. The monoglycerides that are formed after hydrolysis of the fat also act as emulsifiers. Nevertheless, the capacity of these natural emulsifiers can be a constraint for fat digestion. Young animals have a limited production of bile salts and therefore fat digestibility is premature in the early stage of life. On the other hand, the characteristics of dietary fat can restrict… Read more »

Mie
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Mie

Kevin, you’re referencing rat studies.

Return when you’ve got proper clinical evidence on humans and/or prospective cohort studies on people.

Mie
Guest
Mie

“Of course I don´t have an access to the truth, no more than you do.” Of course not. Nobody has. But it’s just that your speculative statements on the basis of ecological data are … Well, they smell of ecological fallacy. And in any way, I fail to see their relevance to adding knowledge in these matters (what constitutes a healthy diet and what doesn’t). We’ve known about the different types of native populations with less CHD (the Inuit or the Pima or etc. etc.) for DECADES! Nutritional research, lipidology, epidemiology etc. etc. have moved countless of miles away from… Read more »

Axel F Sigurdsson
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Axel F Sigurdsson

Point taken 🙂

drphods
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drphods

It’s a bit like the Maasai people in the Rift Valley in Africa. I once read that they live on a diet of animal fats and blood and they are very thin and I believe the article I read also said they had much lower cholesterol than a typical American also.

Per Wikholm
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Interesting article! Have read about that study before but did not know that the Eskimos on Greenland had higher levels of satured fats in their blood despite eating animal food from the North Atlantic Ocean that is low in saturated fats (due to the fact that i e a seal or a whale would not be very mobile in about zero degrees Celsius). And if they didn’t eat a lot of carbs… were did all that saturated fat in their blood come from?

By the way I wrote a blog post about the Sami people in Sweden: https://www.lchf.com/?p=200

Axel F Sigurdsson
Admin
Axel F Sigurdsson

I agree with you Per. Generally it is believed that the Greenland Inuits didn´t consume much saturated fat, below 10% according to this paper. Also the ratio between n-3 PUFA´s and saturated fats was much higher than the traditional western diet.

Will have a look at your article on the Sami people. Thanks

Mie
Guest
Mie

Ecological studies, please. They’re mostly just … well, somewhat interesting. In the sense that the data is scarce and conflicting and that they cannot tell anything about cause & effect.

Richard Mjödstånka
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Richard Mjödstånka

Mie, these are not really ecologic studies, but just mortality statistics. There’s really no systematic data on the diet of the Inuits to would accompany the statistics. The most famous large scale ecologic study was a prospective cohort study which followed the same individuals for decades. Dietary intakes were carefully measured at the baseline. This is the 7CS. Then we have large scale ecologic studies that look at disease outcomes in a given region or a sub-region, these are compared dietary and chemical analysis (blood pressure and cholesterol, etc), but these studies do not necessarily follow the same individual, but… Read more »

Mie
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Mie

“these are not really ecologic studies, but just mortality statistics. There’s really no systematic data on the diet of the Inuits to would accompany the statistics.”

No, these are ecological studies: no prospective approach, limited on the basis of a certain area/ethnic group, data on certain surrogate markers.

Based on the totality of the evidence, both Campbell’s popular books and Taubesian dogma suck. They’re based on cherry-picked ideological stance, with blatant disregard for EVERYTHING that doesn’t fit the pre-conceived ideas.

Mie
Guest
Mie

And to add about safa & the Inuit: the relative amount of safa in their diet was still significantly lower than among Danes in that period (34% of total fat vs. 53% of total fat). P/S ratios, however, weren’t really that different (0.29 among the Inuit and 0.25 among Danes).

davebrown9
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davebrown9

My current thinking on these matters is that a high intake of omega-3 oils accelerates ageing and promotes cancers. https://raypeat.com/articles/articles/fats-degeneration3.shtml So any approach that keeps Intakes of both omega-3s and omega-6s to a safe level will be protective. Low fat diets emphasizing root vegetables and beans automatically do this and are healthy for those who can tolerate them. High fat diets can do this also as long as they do not contain large amounts of separated fats in conjunction with refined carbohydrates. https://rdfeinman.wordpress.com/2012/02/22/saturated-fat-on-your-plate-or-in-your-blood/

KV
Guest
KV

If anybody out there hasn’t seen the photos taken by Peary ~1900 of “the most northerly human beings on the globe” in west Greenland, here they are: https://www.archive.org/stream/northwardovergre01pear#page/478/mode/2up The men are very, very lean; but the women aren’t so lean. I don’t see that gender difference in the Kitavans. https://www.staffanlindeberg.com/KitavaPhotos.html Maybe the Eskimo women spend much more time indoors. I think these kinds of studies are interesting, though they might deserve a standard disclaimer at the top containing the reservations about not necessarily being able to draw conclusions. Speaking of which, some writers point to the high rates of osteoporosis… Read more »

Hemming
Guest

Stefansson mentioned that about the women too. I don’t remember him having any specific rationale for it. He did say that they didn’t look fat or chubby but that it looked like a racial trait. I’m not sure if you can make the argument that it was simply necessary for the women to carry some fat for pregnancies in the cold environment.

Lino Pugliari
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Lino Pugliari

This article is bad. Its full of myths. Eskimos have very high rate of CHD and very low life span.

Axel F Sigurdsson
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Axel F Sigurdsson

It would be great to see some data to support your claims.
Remember that these studies are from 1975. I don’t doubt CHD has become more common since then.
Check this one here
https://link.springer.com/chapter/10.1007/978-1-4757-4448-4_1

haplezz
Guest
haplezz

The notion that the incidence of ischemic heart disease (IHD) is low among the Inuit subsisting on a traditional marine diet has attained axiomatic status. The scientific evidence for this is weak and rests on early clinical evidence and uncertain mortality statistics.

source:
https://www.ncbi.nlm.nih.gov/pubmed/12535749

They had a higher incidence of stroke compared to whites on a Western diet.

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