Factors that promote heart health include getting lots of exercise, as cross-sectional cohort study involving Tsimane in Bolivian Amazon underlines

A previous post is entitled:

Assuming you know what you’re doing, no harm in skipping breakfast; skipping breakfast can in fact be of tremendous benefit

At that post, I refer to a Lancet study, published in 2017, that indicates that the Tsimane in Bolivian Amazon have the healthiest hearts in the world, as determined by worldwide cardiovascular research conducted up until that time.

The purpose of the current post is to bring attention to the study; at the previous post I have noted that:

An March 17, 2017 Lancet article is entitled: “Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study.”

An excerpt reads:

Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined.

With reference to the above-noted research, a March 17, 2019 CBC article is entitled: “Amazon men in their 80s have the arteries of Americans in their 50s: Lancet study shows diet low on processed carbs, sugar, cholesterol, while active living boosts heart health.”

An excerpt reads:

Kaplan said undertaking the study involved fostering a special relationship with the Tsimane over decades.

“They trust us that we really do care about their best interests. Our arrangement with the tribal council is that we provide medical assistance regardless of whether you’re involved in our study.”

Nearly nine in 10 Tsimane had no risk of heart disease (596 of 705 people, or 85 per cent), 13 per cent had low risk and three per cent had moderate or high risk, according to the Lancet study.

Among those 75 or older, nearly two-thirds (31 of 48, or 65 per cent) had almost no risk and eight per cent had moderate or high risk — the lowest recorded levels of coronary artery disease of any population, the researchers said.

A June 27, 2019 CNN article is entitled: “Life lessons from the native tribe with the healthiest hearts in the world.”

An excerpt reads:

As you might also imagine, the food there is not processed or refined, lacking any added sugars or salts. All-natural carbs are the mainstay of the healthy-hearted Tsimane, along with around 15% fat and 15% protein. Additionally, the diet provides twice as much fiber as the standard American diet, according to an article in the Lancet medical journal. Their diet has lots of micronutrients, such as selenium, potassium and magnesium, coming from their farmed food. Spending time with the Tsimane, I also learned from talking to them and from my own observations that intermittent fasting was part of the culture, not because it is fashionable but because of food scarcity.

Subsequent research report in Lancet questions above-noted research

A related Nov. 4, 2017 Lancet article is entitled: “Diet, atherosclerosis, and helmintic infection in Tsimane.”

An excerpt reads:

We examined the Tsimane population at the same time as Hillard Kaplan and colleagues.1, 2 We disagree with the authors’ description of the Tsimane diet as consisting mostly of non-processed carbohydrates, high amounts of fibre, and very low amounts of simple sugars, as stated in their Article.1

About 29% of the 349 adolescents we questioned reported consuming sugary drinks daily (88% weekly); they listed pasta, jam, sugary sweets, and other highly processed foods as part of their regular diet. These findings align with recent research on the Tsimane population, which shows that sweets are the most common food purchased (by 51% of households) and lead to obesity.3 This sugary diet explains the severely poor dental conditions of Tsimane adults we documented (appendix), and also explains the low HDL cholesterol—a predictor of cardiovascular disease risk—reported by Kaplan and colleagues.1

Additional observations we made of Tsimane adolescents reflect a sugary diet, including dental decay (95%), dental pain (22%), difficulty sleeping because of toothaches (47%), overweight or obesity (16%), prediabetes (11%), and prehypertension (10%).2 The low prevalence of coronary artery calcification1 in Tsimane adults among these obvious signs of deteriorating Tsimane health is indeed remarkable. The low prevalence might be because adults were conceived in a pre-industrial environment,4 because they have not yet consumed a sugary diet for a sufficient number of decades, or because the association between coronary artery calcification and cardiovascular disease is unclear (low high-density lipoprotein, a cardiovascular disease predictor, is associated with an absence of coronary artery calcification in Tsimane people).1, 5 Regardless, we question the highly unlikely ecological conclusions drawn by Kaplan and colleagues regarding current Tsimane diet and health.

Tsimane Fieldsite in Bolivia

Click here for additional details about Tsimane in Bolivia >

Of related interest is an Aug. 11, 2009 Plos One article entitled: “Inflammation and Infection Do Not Promote Arterial Aging and Cardiovascular Disease Risk Factors among Lean Horticulturalists.”

Personality types

Also of interest: A Jan. 3, 2013 CBC article is entitled: “Bolivian villagers defy ‘universal’ personality types: Isolated community doesn’t adhere to ‘Big Five’ dimensions of personality.”

An excerpt reads:

Some personality types thought to cut across cultures may not be as universal as previously thought, according to researchers who spent two years studying an isolated indigenous community in the Bolivian Amazon.

Members of the Tsimane, a society of farmer-foragers that lives in a constellation of villages, did not fit neatly into the “Big Five” dimensions of personality that have been widely recognized by personality researchers.

These five dimensions — through which people reveal their levels of openness, conscientiousness, extraversion, agreeableness and neuroticism — were not expressed in the same ways that researchers have observed in several other cultures.

Instead, the Tsimane recombine personality traits that are typically linked under the Big Five — known in academic circles as the Five-Factor Model — into two other pronounced dimensions: levels of industriousness and levels of socially beneficial behavior, or “prosociality.”

“Despite its popularity, there is no good theory that explains why the Big Five takes the form it does, or why it is so commonly observed,” said lead author Michael Gurven of the University of California, Santa Barbara.

An additional excerpt reads:

The Tsimane

Just over 1,000 members of the Tsimane community live in the Bolivian Amazon.

They are farmer-foragers who live in roughly 90 villages with populations that range from 30 to 500 people.

Most have received no formal education, but roughly 40 per cent speak Spanish in addition to their native tongue.

They live with extended family members, have high fertility rates and they are said to have limited contact with outsiders.

November 2018 Medical News Today article refers to additional research

A Nov. 6, 2018 Medical News Today article is entitled: “Can this Amazonian diet offer a solution to heart disease?”

An excerpt reads:

The researchers thought that one key factor in the Tsimane’s seeming imperviousness to heart disease might be their diets. The Tsimane, the investigators note, have so far been minimally influenced by globalization trends.

Their food tends to come from natural sources, and they purchase very little produce from markets. In this respect, the Tsimane differ from their neighbors, the Moseten, with whom they share the same language but not the same diets and lifestyles.

Unlike the Tsimane, who are more sheltered, the Moseten acknowledge outside influences, which have impacted their dietary habits as well as their lifestyles. As a result, the Moseten may also be more at risk of cardiovascular and metabolic diseases when compared with their more isolated “cousins.”

“Our prior work,” says senior study co-author Prof. Michael Gurven, “showed that the Tsimane have the healthiest hearts ever studied, so naturally there’s a lot of interest in understanding why and how.”

So, to understand what sets the Tsimane apart and allows them to enjoy such perfect heart health well into old age, the researchers interviewed them about their daily dietary and lifestyle choices.

The above-noted article refers to a Dec. 6, 2018 study in the The American Journal of Clinical Nutrition entitled: “Nutrition transition in 2 lowland Bolivian subsistence populations.”

An excerpt from the study, by a team of anthropologists from the University of California-Santa Barbara, reads:

A high-energy diet rich in complex carbohydrates is associated with low cardiovascular disease risk when coupled with a physically active lifestyle. A transition away from a high-fiber and low-fat, low-salt, and low-processed-sugar diet is a salient health risk for transitioning populations. Evidence of a nutrition transition in Bolivia parallels trends of increasing body fat and body mass index, which suggests that a low prevalence of cardiovascular disease may not persist.

A second excerpt reads:

Detailed analysis of the Tsimane diet shows the following: 1) high overall energy intake; 2) high-carbohydrate, high-protein, low-fat consumption; 3) low dietary diversity but high intake of micronutrients of potential relevance to cardiovascular health; and 4) minimal caloric or macronutrient shortfalls. Dietary intake was partially explained by time, geographic location, and their interaction. Furthermore, we observed increasing trends in the consumption of lard, sugar, salt, and oil over time. Although the more-acculturated Moseten consumed many of the same agricultural foods, key differences in diet macronutrient composition and intake of food additives, in addition to spatiotemporal trends in the Tsimane diet itself, belie imminent changes in Tsimane nutrition. Collectively, these features describe a potentially atherosclerotic diet (high-carbohydrate, low-diversity) that is representative of many Amerindian groups (29), but which appears to promote positive health outcomes, at least when coupled with other aspects of the Tsimane lifestyle and environment.

A third excerpt reads:

The diets of horticultural Bolivians do not exhibit boom-bust dynamics, as is sometimes assumed for hunter-gatherers and agriculturalists (53–55), and positive health characteristics in these populations cannot be ascribed to periodic caloric restriction.

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