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The low risk coronary male
July 1, 1986
THE AMERlCAN
JOURNAL
OF CARDIOLOGY
Volume 58
181
The low Risk CoronaryMale HENRY BLACKBURN,
M
aybe you have heard this now classic satire by Gordon Myers of Boston on the “theoretical low coronary risk male”: An effeminate municipal worker or embalmer, completely lacking in physical and mental alertness and without drive, ambition or competitive spirit, who has never attempted to meet a deadline of any kind. A man with poor appetite, subsisting on fruits and vegetables laced with corn and whale oil; detesting tobacco, spurning ownership of radio, TV or motor car; with full head of hair and scrawny and unathletic in appearance yet constantly straining his puny muscles by exercise; low in income, blood pressure, blood sugar, uric acid, and cholesterol; who has been taking nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration.
In contrast, let me sketch the “real low coronary risk male,” who is documented to live on the Isle of Crete? He is a shepherd or small farmer, a beekeeper or fisherman, or a tender of olives or vines. He walks to work daily and labors in the soft light of his Greek isle, midst the droning of crickets and the bray of distant donkeys, in the peace of his land. At the end of the morning’s work, he rests and socializes with cohorts at the local cafe under a grape trellis, celebrating the day with a cool glass of lemonade and a single, hand-rolled, hand-cured cigarette of long-leafed Macedonian tobacco. He continues the siesta with a meal and nap at home, and returns refreshed to complete the day’s work. His midday, main meal is of eggplant, with large livery mushrooms, crisp vegetables and country bread dipped in the nectar that is golden Cretan olive oil. Once a week there is a bit of lamb, naturally spiced from sheep grazing in thyme-filled pastures. Once a week there is chicken. Twice a week there is fish fresh from the sea.
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, Manuscript received January 29,1986, accepted February 4.1986. Address for reprints: Henry Blackburn, MD, Division of Epidemiology, University of Minnesota, Stadium Gate 27, 611 Beacon Street SE, Minneapolis, Minnesota 55455.
MD
Other meals are hot dishes of legumes seasoned with meats and condiments. The main dish is followed by a tangy salad, then by dates, Turkish sweets, nuts or succulent fresh fruits. A sharp local wine completes this varied and savory cuisine. This living pattern, repeated six days a week, is climaxed by a happy Saturday evening. The ritual family dinner is followed by relaxing fellowship with peers. Festivity builds to a passionate midnight dance under the brilliant moon in the field circle where the grain of the region is winnowed. Our Cretan, in the presence of admiring friends, is a man dignified in bearing, happy in countenance and graceful in the dance. On Sunday he strolls to worship with his children and wife. In church he listens to good sense preached by the orthodox priest, a respected leader involved in turn, with his own family and his political and religious responsibilities. Then our truly low risk male returns home for a quiet Sunday afternoon, chatting with family in the shade, cooled by the salubrious sea breeze gently perfumed by smoke from olive-wood charcoal grills, and fragrances wafted from the fields of herbs and fresh animal dung. This man of Crete gazes on a severe but harmonious landscape. He is secure in his niche in a long history from the Minoans and before, a human in the long line of humanity. He relishes the natural rhythmic cycles and contrasts of his culture: work and rest, solitude and socialization, seriousness and laughter, routine and revelry. In his elder years, he sits in the slanting bronze light of the Greek sun, enveloped in a rich lavender aura from the Aegean sea and sky. He is handsome, rugged, kindly and virile. His is the lowest heart attack risk, the lowest death rate and the greatest life expectancy in the Western world. Finally, though healthy, he is prepared to die. This, then, is a portrait of the man truly most free of coronary risk of all men on earth.
References 1. Keys A, ed. CoronaryHeart Disease in 1970;41:suppI I.
SevenCountries.Circulation
THE AMERlCAN
JOURNAL
OF CARDIOLOGY
Volume 58
181
The low Risk CoronaryMale HENRY BLACKBURN,
M
aybe you have heard this now classic satire by Gordon Myers of Boston on the “theoretical low coronary risk male”: An effeminate municipal worker or embalmer, completely lacking in physical and mental alertness and without drive, ambition or competitive spirit, who has never attempted to meet a deadline of any kind. A man with poor appetite, subsisting on fruits and vegetables laced with corn and whale oil; detesting tobacco, spurning ownership of radio, TV or motor car; with full head of hair and scrawny and unathletic in appearance yet constantly straining his puny muscles by exercise; low in income, blood pressure, blood sugar, uric acid, and cholesterol; who has been taking nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration.
In contrast, let me sketch the “real low coronary risk male,” who is documented to live on the Isle of Crete? He is a shepherd or small farmer, a beekeeper or fisherman, or a tender of olives or vines. He walks to work daily and labors in the soft light of his Greek isle, midst the droning of crickets and the bray of distant donkeys, in the peace of his land. At the end of the morning’s work, he rests and socializes with cohorts at the local cafe under a grape trellis, celebrating the day with a cool glass of lemonade and a single, hand-rolled, hand-cured cigarette of long-leafed Macedonian tobacco. He continues the siesta with a meal and nap at home, and returns refreshed to complete the day’s work. His midday, main meal is of eggplant, with large livery mushrooms, crisp vegetables and country bread dipped in the nectar that is golden Cretan olive oil. Once a week there is a bit of lamb, naturally spiced from sheep grazing in thyme-filled pastures. Once a week there is chicken. Twice a week there is fish fresh from the sea.
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, Manuscript received January 29,1986, accepted February 4.1986. Address for reprints: Henry Blackburn, MD, Division of Epidemiology, University of Minnesota, Stadium Gate 27, 611 Beacon Street SE, Minneapolis, Minnesota 55455.
MD
Other meals are hot dishes of legumes seasoned with meats and condiments. The main dish is followed by a tangy salad, then by dates, Turkish sweets, nuts or succulent fresh fruits. A sharp local wine completes this varied and savory cuisine. This living pattern, repeated six days a week, is climaxed by a happy Saturday evening. The ritual family dinner is followed by relaxing fellowship with peers. Festivity builds to a passionate midnight dance under the brilliant moon in the field circle where the grain of the region is winnowed. Our Cretan, in the presence of admiring friends, is a man dignified in bearing, happy in countenance and graceful in the dance. On Sunday he strolls to worship with his children and wife. In church he listens to good sense preached by the orthodox priest, a respected leader involved in turn, with his own family and his political and religious responsibilities. Then our truly low risk male returns home for a quiet Sunday afternoon, chatting with family in the shade, cooled by the salubrious sea breeze gently perfumed by smoke from olive-wood charcoal grills, and fragrances wafted from the fields of herbs and fresh animal dung. This man of Crete gazes on a severe but harmonious landscape. He is secure in his niche in a long history from the Minoans and before, a human in the long line of humanity. He relishes the natural rhythmic cycles and contrasts of his culture: work and rest, solitude and socialization, seriousness and laughter, routine and revelry. In his elder years, he sits in the slanting bronze light of the Greek sun, enveloped in a rich lavender aura from the Aegean sea and sky. He is handsome, rugged, kindly and virile. His is the lowest heart attack risk, the lowest death rate and the greatest life expectancy in the Western world. Finally, though healthy, he is prepared to die. This, then, is a portrait of the man truly most free of coronary risk of all men on earth.
References 1. Keys A, ed. CoronaryHeart Disease in 1970;41:suppI I.
SevenCountries.Circulation