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“If It Isn’t Fun.” – Background of the Seven Countries Study

The Seven Countries Study was the first to examine systematically the relation among lifestyle, diet, and the rates of heart attack and stroke in contrasting populations. It has been one of the finer scientific adventures of our time. The idea of the study arose in various forms in the minds of imaginative individuals capable of integrating clinical, laboratory, and population evidence. Ancel Keys, the leader of the study, gave the concept its scope as well as its substance and direction.

In the late 1950s, when this project was conceived and mounted, there was no “big science,” and nothing like a Program Project. So there was neither precedent nor support for a properly organized, rigorous, centrally directed, adequately funded, multi-center undertaking. Never mind. The Seven Countries Study was bold and forward-looking for its day. Its results, elucidating the lifestyles and mass phenomena that determine population rates of heart attacks, have affected all our lives and have powerfully influenced the public health.

These field experiences are presented with little balance among geographic settings, survey periods, or contributions made. In fact, no coordinator was present at all surveys in all areas, though Alessandro Menotti and I, between us, came close. They represent only a fragment of the adventure.

Admittedly, such a presentation contributes little to the fascinating history of science. Many, however, would find it interesting, I suspect, to read such personal accounts of the peregrinations, emotions, breakdowns, and triumphs of those engaged in some of the grander research projects, say, the Manhattan Project, or the Polio Vaccine Trials. Mainly for this reason, I persist.

The scientific literature today bears the fruits of Seven Countries Study researches. My purpose is to provide the flavor — an account of the joys and tribulations of our field surveys in rural areas around the world. There and then, traditions of subsistence living went on much as they had for centuries. I try to depict the character of these lands and these peoples that we the investigators studied for more than 30 years.

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