72 Joel Fuhrman, M.D.
saturated fat. Certainly it is more significant than dietary cholesterol.
We do know that animal protein has a quick and major impact on
enzymes involved in the metabolism of cholesterol. Whether it is the
immune system, various enzyme systems, the uptake of carcinogens
into the cells, or hormonal activities, animal protein generally only
causes mischief.
14
It may be impossible to extricate which component of animal
food causes the most mischief. However, it is clear that while Amer-
icans struggle in vain to even marginally reduce the amount of fat in
their diet, they still consume high levels of animal products and very
little unrefined produce.
Cholesterol levels can be decreased by reducing both saturated fat and
animal protein while eating more plant protein.
Remember, those countries and areas of China with extremely
low rates of Western diseases did not achieve them merely because
their diets were low in fat. It was because their diets were rich in un-
refined plant products — they were not eating fat-free cheesecake
and potato chips.
Never forget that coronary artery disease and its end result —
heart attacks, the number one killer of all American men and
women — is almost 100 percent avoidable. Poring through nation-
by-nation mortality data collected by the World Health Organization,
I found that most of the poorer countries, which invariably consume
little animal products, have less than 5 percent of the adult popula-
tion dying of heart attacks.
15
The China Project confirmed that there
were virtually no heart attacks in populations that consume a life-
long vegetarian diet and almost no heart attacks in populations con-
suming a diet that is rich in natural plant foods and receives less than
10 percent of its calories from animal foods.
My observation of the worldwide data is supported by studies
of American vegetarians and nonvegetarians.^16 These studies show
that the major risk factors associated with heart disease — smoking,
physical inactivity, and animal-product consumption — are avoid-
able. Every heart attack death is even more of a tragedy because it
likely could have been prevented.