The North Karelia Project

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The other day I was coming home from donating blood (yay me!), and listening to The World on our local NPR station. They were discussing an experiment in North Karelia, Finland. In the 1970s, Finland had the world’s highest death rate from heart disease, and the death rate in North Karelia was even higher…40% higher. It was not unusual in the least for men to die from a heart attack in their 30s or 40s.

Finland’s National Public Health Institute decided to launch a program focused on changing the eating habits in North Karelia, where the diet consisted predominantly of high salt-low grade pork, and dairy. It was not unusual to see families eating nothing but meat and whole milk at most meals.

What was interesting to me about the program that was launched was that it did not stop at public education, like most (mostly unsuccessful) attempts to improve eating habits. What the Fins realized was that it was one thing to preach to people about eating healthy foods, and quite another thing entirely to bring the healthy food to the people. So they looked at the economic structure in the area, and found that the dairy and meat farmers were receiving subsidies from the government to produce their products, while no one was receiving any incentive to produce fruits and vegetables. So they started subsidizing the growth of berries, thus making them more affordable for poor communities to afford to eat more fruits. Instead of subsidizing dairy farms based on the amount of fat in their product (more money for whole milk, less for skim or 2%), they started subsidizing dairy more equally, making healthier options more affordable to the people. And guess what? People started eating fruit. People started drinking lowfat milk. And the death rate from heart attacks fell markedly. From the transcript:

The North Karelian experiment proved a success. From 1970 to 1995, cholesterol and blood pressure levels dropped. More importantly, deaths from heart disease also dropped…by 73 percent for the group most at risk – middle-aged men. The government replicated the North Karelian model across Finland, with similar results. This record of success was particularly striking because large-scale attempts to reduce heart disease in other countries — including the US — have achieved far less impressive results. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale, says that’s because most programs aimed at changing eating habits rely almost exclusively on public education.

Brownell: “Education alone is notoriously ineffective. So you have to do what the Finns did which is to change the environment that’s causing the problem, in concert with some education.”

In other words, he says, you can’t just tell people to eat healthy foods. You have to make it easy for them to choose those foods.

On a personal note, I was reminded of this study by a comment made on my mom’s blog the other day. The commenter wanted to know how to get their granddaughter to eat healthier snacks, without turning into the food police. One thing I’ve noticed is that while some parents say that their kids won’t eat fruits or veggies, only bread and cheese. My experience had been that usually, if these same kids come over, and I put a sliced up apple down in front of them, or some strawberries, they’ll eat them. Not always, there are exceptions certainly (Maya’s BFF, for one), but I would say the huge majority of kids will eat healthy food if it is available. That does not mean they will stop eating unhealthy foods, but it does mean that if you give them healthy options, they will sometimes choose those healthy options. Or choose a combination of healthy and unhealthy options. Some chips AND an apple, perhaps.

And, I think, the same can be said for adults.

This was an interesting segment…if you’re interested in hearing it, or if you would like to read the transcript, you can find either here. It was interesting to me that the segment is part of a series on obesity, but within the study, they never discussed weight. Just diet and cardiovascular disease. Perhaps because the radio segment is focused on obesity, it does not mention the fact that along with changing eating habits, the project also focused on reducing smoking within the population. I suspect that reducing smoking was also a large factor in improving the cardiovascular health in Finland (though certainly not the only factor, as smoking has gone down among men, and increased among women, yet women have also lowered their blood pressure and cholesterol levels), and it brings home the point that sometimes it is important to go to the source of a study and investigate it, rather than only accept what is presented (as in the radio segment) as the final word.

~DoSoEvAyMo
It’s Friday, so today I’m thinking maybe dinner with my family would be nice. I mean, we have dinner every night, but a nice Friday type dinner. 🙂