As a practicing interventional and preventive cardiologist for over 30 years, I am required to have a grasp of the literature on the connection between diet and heart disease. This interest must lead to the decades of research by Dr. Ancel Keys, Ph.D. The pinnacle of Dr. Keys’ research was the Seven Countries Study that was performed prospectively with 17 international co-authors of great renown and respect. Unfortunately, Dr. Keys has become a target of authors and bloggers after his death in 2004 at age 100. The rise in obesity, diabetes and other chronic conditions in the last generation have been placed fully on his shoulders, with all kinds of unsubstantiated and usually erroneous claims. I have written on these spiteful claims lodged against Dr. Keyes and his co-authors, many still active and accomplished researchers, in a prior article. Most of these inaccurate diatribes were by authors without medical degrees or research careets but they are often repeated in blogs by physicians.
The attacks against Keys and co-authors took an ugly turn earlier this year when world renowned cardiovascular researcher Dr. Salim Yusuf joined the attacks in a speech at the Zurich Heart House to a group of cardiologists. His attack on Dr. Keys and his 17 co-authors was recorded on video and published on the website of the Zurich Heart House. I wrote an article within a few days of the lecture pointing out the gross errors and slander perpetuated by Dr. Yusuf and the video was removed from viewing within 24 hours. Those events did not keep authors and journalists from celebrating the comments by Dr. Yusuf for a while but their celebration quickly fizzled, as I have written about in another piece.
Sadly, it appears that Dr. Yusuf, despite his worldwide prominence in the research world, has not seriously considered his attacks. He also demonstrated that he has a penchant for using sharp and harmful words caught on video that are distributed publically. At a cardiology rounds at Hamilton General Hospital delivered on May 16, 2017 by Dr. S Ganguli of the Division of Gastroenterology with the title “Food as Medicine: Cardiovascular and other chronic disease”, Dr. Yusuf was in the audience. The lecture and Q and A session was recorded and published online. I welcome all academic scientists to listen to the segment from minutes 50 to 55. Dr. Yusuf is not photographed in the video but his attack is recorded on the audio portion.
During those 5 minutes, Dr. Yusuf indicates to the speaker that the origins of the diet-heart hypothesis are “very shaky” and that it started off with Dr. Ancel Keys and his “very cherry picked, and some may call it fraudulent” inclusion of 6 countries. The errors in this attack have been reviewed in my prior articles. Dr. Keys diet-heart retrospective and hypothesis-generating analysis was published in 1953 although Dr. Yusuf seems to think it was 1955 as he argues that an article in in 1957, “2 years” after Keys’ hypothesis, identified the flaws in Keys’ work. This is sloppy research by Dr. Yusuf at best. Futhermore, who are the “some” that may call Dr. Keys’ scientific papers fraudulent? Is that a style that is appropriate for the number 2 most cited cardiovascular researcher a few years back or is it more in keeping with a rag sheet reporter?
Yusuf goes on to claim that the choice of the 7 countries included in the Seven Countries Studies were cherry picked after the 1957 paper by critics of Keys. In reality, the origins of the Seven Countries Study were well under way in 1956 and 1957 as can be easily researched on the website for the study and the fact that the fact that researchers in France, for example, were unwilling to join and fund research in that country is well known.
Perhaps the most bizarre statement that was both inaccurate and inflammatory was when Dr. Yusuf indicated that he could not find any definitions for diet and coronary heart disease mortality for the Seven Countries Study. He said that he wrote to Henry Blackburn, MD, a senior academic physician and researcher at the University of Minnesota who was involved with the Seven Countries Study for decades, and learned that the diet methodology and definitions were available for only 1 country, the Netherlands. He goes on to advise that one has to be “very careful” and he would “strongly urge you” to question the veracity of the work by Dr. Keys and his 17 co-authors. Apparently Dr. Yusuf did not take the care to research and read an academic paper that indeed contained those materials he claims are absent.
It is sad to see a respected researcher like Dr. Yusuf with decades of contributions to the field of cardiovascular epidemiology join a fight in the gutters of journalists that repeat over and over errors about the sequence and foundation of the first major study to investigate diet and lifestyle along with other risk factors for cardiovascular disease across contrasting countries and cultures over an extended period of time. The lack of objectivity and careful research is inexcusable. I do not know whether Dr. Yusuf is aware that his comments were again recorded and distributed worldwide via the Internet but the harm to the reputation of living and deceased pioneers in cardiac research, and their families, will remain long after his 5-minute tirade.