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The Roseto Effect – A lesson on the true cause of heart disease

What if I told you that science has figured out a way to eliminate your risk of heart disease if you are under the age of 55, and halve your risk of heart disease if you are over the age of 65, without reducing the amount of fat you eat or alcohol you drink?

Sign me up, right?!

Well, a small town of Italian immigrants in Roseto, Pennsylvania, inadvertently figured out how to do this and the results have been scientifically confirmed and validated.

In 1964 a study published in the Journal of the American Medical Association examined a population of recent Italian immigrants in Roseto, a small town in the state of Pennsylvania. The study was instigated because the town doctor was completely baffled by the Rosetans' near immunity to heart disease. He reported his observation and an extensive statistical population study funded by the American State and Federal governments was conducted.

The study compared health statistics of Rosetans to neighbouring towns and the initial results were astonishing. During the seven year period of study from 1955-1961:

  1. No-one in Roseto under the age of 47 died of a heart attack; there was a complete absence of heart disease in men under the age of 55
  2. The rate of heart attacks in men over 65 was half the national average
  3. The death rates from all causes was 35% lower than anywhere else

The study confirmed the town doctor’s findings and went on to examine the factors that gave the Rosetans such improved health. It became known as the ‘The Roseto Effect’.

So what gave the Rosetans a near imperviousness to heart disease?

Well, the researchers asked the same question and first looked at the most obvious factor – diet. Being Italian immigrants, the researchers thought that the Rosetans must be eating a healthy ‘Mediterranean’ diet of fish, olive oil and fresh vegetables. Not so – in fact the researchers discovered that the Rosetans did not have enough money for fish and ate high fat meatballs and sausages, with an average fat intake of up to 40% of their entire diet! And the fats weren’t your ‘healthy’ types of fat, for the Rosetans liked to fry all of their food in good old lard.

The researchers then thought that surely if diet was not the contributing factor than it must be lifestyle, so they looked at how the Rosetans spent their leisure and work time. It turns out that the Rosetans were very hard workers but mostly worked in slate quarries or mines, which were renowned for having extremely harsh working conditions with high rates of on-site accidents. As for leisure time, the Rosetans loved their wine and cigars and consumed both with reckless abandon.

So let’s get this straight – the Rosetans had extremely low to no heart disease, yet they ate red meat deep-fried in lard, smoked and drank heavily, and worked in toxic slate mines? Yes, indeed.

This also had the researchers totally stumped as well and they studied all other possible factors such as ethnicity, water supply, environment, you name it. In the end, the researchers concluded that the unusually low incidence of heart disease in the town could not be attributed to any of these factors.

While living in the town to conduct the study however, the researchers observed several major differences as to how the Rosetans related to others in their community. They noticed a remarkably close-knit social pattern that was cohesive and mutually supportive with strong family and community ties, where the elderly in particular were not marginalised, but revered. Put simply, the Rosetans lived in brotherhood with one another.

So the researchers instead suggested that “the quality of family relationships and the social milieu may be pertinent to the occurrence of or protection against death from myocardial infarction.”

In other words, they suggested that your relationship with others affects your risk of heart disease.

Wow!!! This bomb was dropped straight into ground zero of the medical community via the rigorously peer-reviewed Journal of the American Medical Association, much to the dismay and critique of many medical professionals at the time. One has to appreciate that this article was published in the early 1960s when only one third of doctors believed that a case against cigarettes had been established as to their contribution to lung cancer[i], and it was only 10 years before this study that we started paying attention to how our diet contributes to our health. So for this study to put even a suggestion that your relationships affect your risk of heart disease was extremely radical, to say the least.

In the subsequent years, the researchers defended their study from the attacks of the cynics and detractors and went a step further in confirming their findings. They obtained funding and returned to Roseto 30 years later.

This time they made the observation that Roseto had become increasingly ‘Americanised’ and the population had become increasingly insular, separated and less supportive of one another. They predicted that mortality rates and heart conditions would rise to similar levels as surrounding towns following this period of erosion of their traditionally cohesive family and community relationships.

And as predicted they confirmed the existence of “consistent mortality differences between Roseto and neighbouring towns during a time when there were many indicators of greater social solidarity and homogeneity in Roseto” and indeed these differences eroded with changes in their relationships with each other. This study was again peer-reviewed and published in 1992 in the American Journal of Public Health[ii].

The findings of these studies are a true landmark in medical research. They present irrefutable peer-reviewed statistical evidence of how our relationships in our community are one of the most significant, if not the main contributor to our health and wellbeing, especially in the case of heart disease.

This information is astounding, however what is more astounding is if this is a scientifically proven fact, then why have we done nothing to promote this in the way we live in our communities? Our lifestyles and relationships are becoming increasingly shallow, fractured, and distracted, despite the fact that medical science has proven this to be detrimental to our health. So the question is, how far will we let our health suffer as a result of our increasingly ill-relationships and communities?

The Roseto study gives us an incredibly valuable, albeit ignored, insight into the real cause of heart disease.

Although medical research has shown that food is a contributing factor to heart disease, this research suggests that food has a much smaller role to play in heart disease than what is currently emphasised.

Relearning how to make moment by moment choices to connect with the people around us at work, with family, even with the random people you pass on the street, has the potential to be the drops of water that will collectively create an ocean of change in the way we relate to each other, and ultimately to our collective health and wellbeing.

  • [i]

    Tobacco Control. Tob Control 2012;21:87-91 doi:10.1136/tobaccocontrol-2011-050338. Retrieved from http://tobaccocontrol.bmj.com/content/21/2/87.full

  • [ii]

    Egolf, B; Lasker, J; Wolf, S; Potvin, L (1992). "The Roseto Effect: A 50-Year Comparison of Mortality Rates" (pdf). American Journal of Public Health 82 (8): 1089–1092. Retrieved from
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1695733/pdf/amjph00545-0027.pdf

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LifestyleHealth conditionsHeart diseaseRelationships

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