Kei te orate manawa, kei to orate iwi

Tu Tangata, Issue 28, 1 February 1986, Page 23

Kei te orate manawa, kei to orate iwi

By Michael Romanos

The state of Maori health may be depressing to some or just more pakeha statistics to others. But a Maori view of total health covering te hinengaro, te wairua as well as te tinana is vital to an alive and throbbing heart in the people of the land, the tangata whenua. | ‘Rapuora’ the comprehensive health survey carried out by Nga Wahine Toko I Te Ora confirmed that attention needs to be paid to changing our living, eating, working and recreation : Tabitsryil]][l::fifiiy^l:l:lfii ;/ ,Tlf^fhl:;

This would bring us into line with the teachings of our tupuna, whose survival depended on living in harmony with a world that could at times be just as hostile then as it is for us today.

The following article points out that we need to balance our meat eating and rich foods with activity a little more strenuous than performing the occasional haka or twirling the poi.

The Maori people are disproportionately represented on the high side in most statistics concerning health in New Zealand and it is a little encouraging that in death by disease of the circulatory system, the Maori is well below equating to the pakeha.

Heart disease has been the leading cause of death in New Zealand for many years. For instance, in 1983, 7145 New Zealanders died of heart disease which was around 30 per cent of all registered deaths for that year. Another 5503 people died from other diseases of the circulatory system in 1983 which could be attributable to high cholesterol/cigarette smoking. Of the total 12,648 heartcirculatory deaths, 491 were Maori.

Lowering cholesterol in the blood will reduce the risk of having a heart attack. There are no doubts that cholesterol causes coronary heart disease and is a contributor of other circulatory system disorders. This is New Zealand's major health problem.

Cholesterol was named by a French chemist, Michel Chevreul in 1816 from the Greek: chole (bile) and steros (solid). It is excreted from the body even when food is not eaten for long periods.

Cholesterol is not all bad. In fact it is essential. It holds our cells together and is a building block of cortisone and the sex hormones. Bile acids, which are essential for the digestion of fats, are also made by the liver from cholesterol.

Cholesterol is transported through the bloodstream but unlike salt or sugar, cholesterol and similar fatty substances are not able to dissolve in the blood. Therefore they are packaged together

with protein and form a molecule called lipoprotein.

In certain vulnerable people the lipoprotein causes the artery wall to become rough and diseased (atherosclerosis), finally the blood flow is abruptly halted, often clotted.

Lipoproteins are divided into LDL (low-density) which carry cholesterol in the blood and HDL (high-density) which carry the rest of the cholesterol. Lowering LDL levels or increasing HDL will reduce the risk of heart disease and death.

Since the 1950’s there has been a growing trend for New Zealanders to “enjoy life” by way of relaxed leisure time, less manual and physically strenuous work, consuming fast-foods and concentrated fatty foods and acceptance of heavy smoking and drinking alcohol habits.

And over the same span of time coronary heart disease and strokes have been disturbingly on the increase. This is a condition in which the inner lining of the coronary arteries (supplying blood to the working heart) become infiltrated with cholesterol. The arteries can be thickened so much that complete blockage occurs, resulting in death of part of the heart muscle to produce a heart attack.

Thus soft living, inactivity, a rich, high-fat diet, high blood pressure and smoking are contributors to the heart disease epidemic.

New Zealand has the dubious distinction in being a world heart disease leader. Also New Zealand ranks fourth highest in the world as the most overweight people. The people of Finland who have a very high fat, high cholesterol diet have the world’s highest coronary rate.

The desirability of lowering cholesterol levels are part of a current campaign the New Zealand Health Department is waging.

A study in Oslo several years ago followed 1230 healthy men, most of whom smoked, with high cholesterol levels. The subjects were assigned randomly to a treatment group or a control group. The treatment group dieted and were discouraged from smoking. After five years the number of heart attacks and sudden deaths was 47 per cent lower in the treatment group than in the control group.

The lessons this means for us here in New Zealand is to modify our diet.

This calls for reducing total fat intake, reducing (animal) fat intake, reducing monounsaturated and polyunsaturated fats. It calls for decreasing intake of cholesterol products such as egg yolks, dairy products and meats. It calls for increasing carbohydrate intake and starches.

All these changes can be made with relatively modest alterations of diet even for meat and dairy product-hungry people.

Increase starches such as vegetables, fruits, grains, pasta and breads. Decrease egg yolks, fatty meats, milk fat, butter and cheese. This kind of change represents a small move in the direction of vegetarianism.

Our meat, dairy, egg, tobacco and brewery industries would not be overjoyed with the emphatic findings of the experts and the pronouncements of the New Zealand Heart Foundation on ways of reducing cholesterol and heart disease. But it must be remembered that less than a century ago our European and Asian ancestors suffered little from coronary disease and the Maori and Polynesian people knew even less of it, yet they certainly all did not eat very low-fat diets.

Lifestyle came into play then just as it does nowadays. For example, a combination of regular running, cycling or swimming, kicking the smoking habit and a better diet should produce a very coronary disease-resistent group of men and women.

Consider this: the fat intake of an active runner, cyclist or swimmer consuming 3000 calories per day with a desirable 30 per cent of calories as fat is identical to that of an inactive person consuming 2150 calories with 42 per cent calories as fat.

So running, cycling, swimming, brisk walking and other endurance sports and activities clearly result in increased levels of HDL cholesterol and often produce decreased levels of LDL cholesterol.

Every day around 20 New Zealanders die of coronary disease but these terrible statistics can be halted by a renewed enthusiasm for proper respect of food, alcohol and cigarettes and a programme of endurance exercises.