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Following the 1970 survey in Crete, I wrote the following baroque piece that was eventually published in the American Journal of Cardiology and rather widely quoted. It is modified and reproduced here by permission of the journal:

Maybe you have heard this now-classic satire by Gordon Myers of Boston on the "theoretical low-coronary-risk male:"

"An effeminate municipal worker or embalmer, completely lacking in physical and mental alertness and without drive, ambition or competitive spirit, who has never attempted to meet a deadline of any kind. A man with poor appetite, subsisting on fruits and vegetables laced with corn and whale oil; detesting tobacco, spurning ownership of radio, TV or motor car; with full head of hair and scrawny and unathletic in appearance yet constantly straining his puny muscles by exercise; low in income, blood pressure, blood sugar, uric acid, and cholesterol; who has been taking nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration."

In contrast, let me sketch the "real low-coronary-risk male," who we have documented to live on the Isle of Crete:

He is a shepherd or small farmer, a beekeeper or fisherman, or a tender of olives or vines.

He walks to work daily and labors in the soft light of his Greek isle, midst the droning of crickets and the bray of distant donkeys, in the peace of his land.

At the end of his morning's work, he rests and socializes with cohorts at the local cafe under a grape trellis, celebrating the day with a cool glass of lemonade and a single, hand-rolled, hand-cured cigarette of long-leafed Macedonian tobacco.

He continues the siesta with a meal and nap at home, and returns refreshed to complete the day's work.

His midday, main meal is of eggplant, with large livery mushrooms, crisp vegetables and country bread dipped in the nectar that is golden Cretan olive oil.

Once a week there is a bit of lamb, naturally spiced from grazing in thyme-filled pastures.

Once a week there is chicken.

Twice a week there is fish fresh from the sea.

Other meals are hot dishes of legumes seasoned with meats and condiments.

The main dish is followed by a tangy salad, then by dates, Turkish sweets, nuts or succulent fresh fruits. A sharp local wine completes this varied and savory cuisine.

This living pattern, repeated six days a week, is climaxed by a happy Saturday evening. The ritual family dinner is followed by relaxing fellowship with peers. Festivity builds to a passionate midnight dance under the brilliant moon in the field circle where the grain of the region is winnowed.

Our Cretan, in the presence of admiring friends, is a man dignified in bearing, happy in countenance, and graceful in the dance.

On Sunday he strolls to worship with his children and wife. In church he listens to good sense preached by the Orthodox priest, a respected leader involved with his own family as well as his political and religious responsibilities.

Then our truly low-risk male returns home for a quiet Sunday afternoon, chatting with family in the shade, cooled by the salubrious sea breeze that is gently perfumed by smoke from olive-wood charcoal grills and fragrances of herbs and fresh animal dung wafted from nearby fields.

This man of Crete gazes peacefully on a severe but harmonious landscape. He is secure in his niche in a long history from the Minoans and before, a human in the long line of humanity.

He relishes the natural rhythmic cycles and contrasts of his culture: work and rest, solitude and socialization, seriousness and laughter, routine and revelry.

In his elder years, he sits in the slanting bronze light of the Greek sun, enveloped in a rich lavender aura from the Aegean sea and sky.

He is handsome, rugged, kindly - and virile.

His is the lowest heart-attack risk, the lowest death rate, and the greatest life expectancy in the Western world.

Finally, though healthy, he is prepared to die.

This, then, is a portrait of the man truly most free of coronary risk of all men on earth.

A Note from the Author

I took a six-month research rotation in the University of Minnesota Laboratory of Physiological Hygiene in 1954, during my Internal Medicine residency, to pursue a longstanding interest in electrocardiography with physiologist Ernst Simonson. There I met Ancel Keys, director of the laboratory, who had recently returned from Sabbatical leave at Oxford from whence he had traveled extensively for nutritional researches. He was full of fascinating stories about different dietary and cultural characteristics of people in different lands.

His ideas about mass phenomena that might influence disease risk struck a responsive chord with me. I had early been shaken from conventional views of the causes and care of disease during intense experiences as physician to a mission in rural Cuba in pre-Castro days, and later, directing quarantine operations in Displaced Persons Camps in Austria. There, the conditions we encountered seemed to me to derive mainly from poverty and malnutrition, ignorance, and social chaos. They clearly required greater understanding and measures for their alleviation than I, and medicine alone, could offer.

Having completed my medical fellowship in 1956, I accepted a faculty position in Keys' laboratory, along with a mandate from him to develop ways of recording and classifying heart diseases systematically for the broad-ranging population studies then getting under way. It was the very beginning of the powerful new science of cardiovascular disease epidemiology, and Keys and colleagues at Minnesota were at the hub.

I brought to the new field my own peripatetic observations and international training and experience: youth in small-town Florida, college at the fledgling University of Miami, wartime service at Key West Naval Hospital, medical training at Tulane University in exotic New Orleans, internship in Chicago, a medical mission in Batista Cuba, residency at the American Hospital of Paris, military duty in the U.S. Public Health Service in Austria, and specialty training at the University of Minnesota. As a young physician, with interests beyond the clinic, the match-up with the Seven Countries Study of Keys and colleagues was appealing. It became a great and productive adventure in science for many of us.

From journals, conversations, and recollections over thirty-five years of the study, I attempt here to bring some of the rich images, sounds, and savor of this pioneering expedition among peoples of different cultures who had a common theme of traditional, rural lifestyles.