When we think about enormously complex problems, like the social and economic burdens of chronic degenerative diseases, we sometimes presume that the solutions must also be complex. Complex problems, however, often have simple, straightforward solutions.
Imagine you’re an astronaut living on a space station powered by enormous solar-powered generators. Your worst-case scenario would be for those generators to break down and for you to be missing the tools required to fix them. In 2012, astronauts aboard the International Space Station found themselves in precisely this situation. One of the station’s power distributors went down, but when the astronauts ventured outside to assess the situation, they discovered that metal shaving had accumulated around several critical bolts.
NASA had equipped them with highly technical tools, but none of their tools could remove the shavings, and if the shavings remained in place, the generator could not be repaired. After a thwarted 8-hour repair attempt, the astronauts went back inside to brainstorm solutions. Finally, they improvised a makeshift tool consisting of an allen wrench and a toothbrush. It worked – a $3 toothbrush saved a $100 billion space station.1
Could the same graceful simplicity be applied to the cardiovascular disease and diabetes crises? The American Heart Association estimates that in 2011 the annual cost of cardiovascular disease and stroke in the US was $320 billion.2 Similarly, the cost of diabetes increased over 40% from 2007 to 2012 and now costs at least $245 billion annually in the US.3
In a new editorial published in Open Heart, Doctors Aseem Malhotra, James DiNicolantonio, and Simon Capewell argue that complex, expensive, and ultimately ineffective “solutions” are exacerbating the heart disease and diabetes crises while simple, relatively inexpensive, effective solutions are being overlooked.
Specifically, they argue, “An exaggerated belief in the (modest) benefits of pharmacotherapy, aggressively reinforced by commercial vested interests, can often mislead patients and doctors, and promotes overtreatment in chronic disease management, and may even distract from and undermine the benefits of simple lifestyle interventions.”4
In short, our approach to chronic diseases is one of treating symptoms rather than addressing underlying disease causes. Likewise, our approach to food is one focusing on calorie-counting and energy balance rather than sound nutrition. The diet industry generates $58 billion annually the US but long-term follow-up studies show the vast majority of dieters regain the weight they lost during diet regimens.5
So what is the solution? In their Open Heart editorial, the doctors point to numerous randomized controlled trials in which simple dietary interventions resulted in dramatic disease risk reductions. In the DART trial, for example, the consumption of fatty fish among survivors of myocardial infarction resulted in a significant 29% reduction in all-cause mortality compared to control patients. Moreover, in an Italian study, the consumption of 1 daily gram of omega-3 fatty acids led to clinically important and statistically significant reductions in all-cause and cardiovascular disease mortality.
Higher-fat diets inclusive of nuts, olive oil, oily fish, as well as plenty of vegetables, consistently outperform the antiquated low-fat, high-carbohydrate diet recommended by the American Heart Association with respect to attenuating inflammation, atherosclerosis, and thrombosis. In their editorial, the doctors specifically endorse “a high-fat Mediterranean-type diet and lifestyle.” A high-fat Mediterranean-type diet has remarkable overlaps with the Paleo diet, as both emphasize sound nutritional principles and a widely varied, yet balanced diet. Our modern health problems are complex, but the solutions can be as simple as respecting and embracing the dietary traditions and nutritional wisdom of our ancestors.
 Mozaffarian, D., et al. (December 17, 2014). “Heart Disease and Stroke Statistics – 2015 Update,” Circulation 2015, 131.
 Malhortra, A., et al. (August 26, 2015). “It is time to stop counting calories, and time instead to promote dietary changes that substantially and rapidly reduce cardiovascular morbidity and mortality,” Open Heart, 2(1).