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Cutting the Fat in Olmsted County
by Brent Wolfe
December 21, 1999
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We're entering the home stretch of the rich holiday eating season where egg nog and Christmas cookies are available at every social gathering. Research shows more Americans are overweight and nutritionists say it's easy to see why when the culture emphasizes high-fat foods and ways to avoid physical activity.

Health experts at the Mayo Clinic have embarked on an effort to reverse the trend in Olmsted County. They want to prove they can change the lifestyle of an entire community and decrease the rate of heart disease in the county.

Visit the Cardiovision 2020 Web site for lifestyle tips and details of events in Olmsted County.
MAYO CARDIOLOGIST Tom Kottke may sound a little like a grinch this time of year, but he looks at holiday food spreads and increased rates of smoking and has a warning: heart disease is on the verge of a rise. Heart disease and heart attacks were unknown at the turn of the last century. The rate then rose dramatically until the early 1960s when doctors started advising people to stop smoking, exercise, and eat less fat. Rates have dropped at about three percent a year since then but Kottke says the risk factors for heart disease are increasing once again.
Kottke: Half of the college freshmen at the University of Minnesota now smoke. Between 40 and 45 percent of high school seniors in Olmsted County smoke at least monthly. The decline in serum cholesterol that we saw in through the '70s and '80s has stopped. People are getting more obese. Diabetes is increasing. And hypertension control has either declined or is not improving.
Kottke says fast food chains have made it convenient and inexpensive to eat foods that are high in fat. And he blames a decrease in exercise on the microchip and misplaced priorities.
Kottke: Nobody runs for the phone anymore because you either have a cellphone or a portable phone or a phone in every room. Because we feel that we're short of money, we've carved physical activity out of the curriculum in schools. We say we can't afford it.
So Kottke and his colleagues have hatched a community education campaign to change the lifestyle of Olmsted County. They call it Cardiovision 2020 and their goal is to make Olmsted County the most "heart-healthy" county in the nation in 20 years.

One place they're starting is the supermarket. Workers at this employee-owned Hyvee in Rochester were recently disturbed to learn their health costs are higher than those at other nearby stores. Assistant store director John Richardson says managers are encouraging employees to take the Cardiovision pledge to quit smoking, exercise 30 minutes a day, eat five servings of fruits and vegetables a day, and avoid high-fat dairy and meat products.
Richardson: We also have a demonstration table set up at the front of the store with the pamphlets and the information on how we can eat healthier and practice healthier lifestyles. We have demonstrations that go on like today we're sampling soy milk products and soybean products.
Mayo got $2 million from McNeil Consumer Products to pay for education and advertising for the project for two years. McNeil is a Johnson & Johnson company that makes Benecol, a new margarine product. Mayo researchers gave benecol to parents in a small Olmsted County school system and found it cut their cholesterol levels by 15 percent. Benecol samples are available at the demonstration table but project leaders say the McNeil grant is unconditional and the company isn't influencing the direction of Cardiovision.

Project coordinators are also approaching restaurants, asking them to list the fat content of items on their menu and to prohibit smoking. They say about 100 Rochester restaurants are now smoke free. Once it's demonstrated that restaurants can give up smoking sections and not lose business, organizers say they'll ask the county board to ban smoking in restaurants.

The success of the project will depend on whether Olmsted County residents become healthier than people in the rest of the country. Similar projects several years ago in Minneapolis, Palo Alto, California, and Pawtucket, Rhode Island failed to reduce the incidence of heart disease more than the national average.

Cardiovision had its beginnings in northeastern Finland. Health educators in North Karelia began working to convince people to give up cigarettes and saturated fat in 1972. Project director Pekka Puska says the rate of heart disease deaths among middle aged men dropped 75 percent over 20 years.
Puska: North Karelia used to be a very traditional, dairy farming, relatively poor area. So changing these kind of lifestyles has not been easy. You know, smoking used to be, as people said, one of the few pleasures so why to give up that? And people were always used to eat a lot of butter and they produced the butter so how could they change their fat to vegetable oils?
The Finnish project sponsored competitions, offering prizes for villages that lowered their smoking or cholesterol rates more than a neighboring town. Dairy farmers were encouraged to develop low fat products or switch to growing berries for juices and jams.

The Finnish government adopted the principals of the project as national policy. Mayo officials may be hoping for the same in this country but a stop at any smoke-filled Rochester bar serving juicy burgers and hot, greasy french fries shows they've got their work cut out for them.