Abstract
Abstract Heart infarctions were seldom observed during the years 1945–1948 in the area of West Germany which was the occupational zone of the United States, Great Britain, and France. The autopsy records of seven Institutes of Pathology showed neither death from heart infarction nor peripheral atherosclerotic arterial occlusion. Advanced forms of atherosclerosis in all arteries were rare between 1945 and 1948 as compared with 1939 and 1955 based on autopsy analyses in Marburg/Lahn and Basel, Switzerland. Gangrene of the feet or toes was seen in this time period only in occupied southern Germany, an area which was largely agricultural and therefore had no severe food shortage. The lipid values (cholesterol and total lipids in serum) were significantly higher in this region as compared with those in other regions experiencing scarcity. Total cholesterol of the adults was on the average 230 ± 14 mg/dl (SE) compared with 140 ± 11 mg/dl, total lipids 540 ± 32 mg/dl in contrast to 190 ± 24 mg/dl. The average value of total cholesterol in the starving peoples of Western and Northern Europe were extremely low, with an average of 130–150 mg/dl. Pathologic observations of starving prisoners of war showed mainly smooth arteries with low atherosclerotic lesions. This contrasts with the findings in American soldiers who died in Korea, in whom advanced lesions, arteriostenosis, and occlusions were seen. Thromboembolism was also seldom seen in conjunction with undernutrition. The probable causes for these findings are the low total energy consumption (an average of 1000–1200 calories per day), the unavailability of fat, limiting intake to under 10 g of oil or fat per day, the low consumption of animal protein (15–20 g), and the abundance of high-fiber vegetables. These dietary factors can also explain the lack of moderate and advanced diabetic complications. With normalization of the diet in Germany in 1948, a concurrent jump in the incidence of fatal and nonfatal heart infarction and lung embolism was observed. The extremely low cholesterol values and total lipid values climbed rapidly and reached average values comparable with those seen today. Other possible explanations for these increases could be changes in smoking habits, the frequency of high blood pressure, increased body weight, and decreased activity levels, as well as the so-called stress of modern civilization. These explanations were less likely, since from 1948 until 1950 when the dramatic increase in coronary infarction was noted, these risk factors had changed only slightly. The epidemiologic data on coronary heart disease in the years of scarcity in Western Europe are somewhat comparable to those in the People's Republic of China and in rural areas of Japan.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call