By Ruth Kava, Ph.D., R.D., Aubrey Noelle Stimola, Rivka Weiser, Lynnea Mills
Posted: Monday, December 13, 2004

REPORT
Publication Date: December 13, 2004

Introduction
Pediatric Vaccines and Autism    
PCBs in Salmon and Cancer   
Cell Phones Cause Brain Tumors    
Nightlights and Leukemia     
Chemicals in Cosmetics     
Mercury in Seafood Causes Neurological Problems in Humans  
Cheeseburgers and Cardiovascular Disease (CVD)  
Antibiotics Cause Breast Cancer    
Teflon Causes Health Problems in Humans   
Soda Causes Esophageal Cancer    
Dishonorable Mention     
Deodorants, Antiperspirants Cause Breast Cancer 
Plastics Cause Cancer

The Scare:
When former President Bill Clinton announced just before Labor Day that he had been diagnosed with severely blocked coronary arteries and was about to undergo surgery to bypass them, a chorus of voices immediately began to blame his diet as a major underlying cause of his disease. As President, Mr. Clinton was well known for his penchant for fast food burgers and French fries, and this indulgence was immediately pounced upon by finger-waggers as being the reason for his cardiac problems. Since CVD is the leading cause of death in America, accounting for about 40% of all mortality, interest in its causes, treatment and sequelae is understandably high. We know that elevated levels of blood cholesterol and high blood pressure (both of which were among Mr. Clinton’s risk factors) are major contributors to CVD. Both of these factors have been definitively linked to family history (genetics), and a family history of heart disease is also part of Mr. Clinton’s medical record. Yet when reading news reports about Mr. Clinton’s illness, as often as not, diet—particularly cheeseburgers—was the major culprit identified.

The Media Coverage:
Coverage of Mr. Clinton’s cardiac problems by the national media ran the gamut from responsible to awful. One article suggested that his condition might be a “wake-up call for aging Americans with a checkered nutritional past.”(92)  Many included a quote from the former president that “I may have done some damage in those years when I was too careless about what I ate.”(93,94)  A report in the Washington Post said, “High cholesterol, genetics, and a love of fast food are likely culprits.”(95) Another report noted that “it’s very hard to undo a lifetime of cheeseburgers and fries,”(96) after stating that a family history of heart disease is a highly reliable indicator of potential problems. These reports didn’t seem to make the connection that a family history predisposes one to heart disease and that this factor probably overrides the importance of even regular consumption of cheeseburgers. One of the more responsible articles appeared in the New York Times; the author, Denise Grady, questioned the idea that Mr. Clinton had brought on his heart disease by indulging in cheeseburgers and cigars.(97) Another journalist also went deeper than the obvious finger-pointing. Delthia Ricks, writing in Newsday, explained that the “notion that former President Bill Clinton ate his way to coronary artery disease on an unending repast of fast foods is far too simplistic.”(98) 

The Bottom Line:
While it is true that lifestyle factors such as smoking, inactivity, and overweight/obesity can raise the risk of a heart attack, it is also true that this is much more of an issue for people whose family history predisposes them towards high blood LDL (“bad”) cholesterol, low HDL (“good”) cholesterol and high blood pressure, as Mr. Clinton’s did. In fact, the former president had been taking medication to lower his blood cholesterol, but at some point stopped taking it—it is not clear whether or not this decision was made on the advice of his physician. The major risk factors for coronary heart disease include several over which an individual has no control—increasing age, male gender, and heredity. A person with the latter two risk factors must be especially vigilant about the rest. The modifiable risk factors include cigarette smoking, high blood pressure, high cholesterol, type 2 diabetes, and physical inactivity.(99)  Diet is not on the list. The danger is that too much focus on supposed dangers, such as one particular type of food, takes people’s attention away from the more serious controllable factors such as smoking and elevated cholesterol. The take-home message should be that people with unmodifiable risk factors should pay particular attention to getting appropriate medical tests and treatment (this by no means implies that people without such risk factors should feel they can ignore appropriate lifestyle changes with impunity). And, when medication is prescribed to control blood pressure and cholesterol levels, it must be emphasized that these medications are more important for prevention of heart disease than is avoidance of a cheeseburger or any other specific food.(100)

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