I originally wrote this on 3 February 2011:

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My previous post discussed the passing of Jack Lalanne and Jim Fixx. Here are two more high-profile health advocates: Robert Atkins and Nathan Pritikin.

To recap:

• Jack Lalanne (1914-2011), who advocated exercise, along with a low-fat, minimally-processed, plant-based diet and positive thinking, died at 96 of respiratory failure from pneumonia.
• Jim Fixx (1932-1984), who advocated long-distance running, died at 52 of a heart attack while running.
• Robert Atkins (1930-2003), who advocated a low-carb diet along with moderate exercise died at 72 from head injuries subsequent to a fall.
• Nathan Pritikin (1915-1985), who advocated a low-fat, minimally-processed, plant-based diet, along with moderate exercise died at 69 of suicide related to complications from chemotherapy.

Atkins

As with LaLanne and Fixx, Atkins was in less-than-peak shape in his early years:

“In 1963 [33 years old], when Atkins weighed 100 kg (224 pounds) due to a diet of junk food, he read a study of a low-starch diet in JAMA based on the work of Alfred W. Pennington and successfully lost weight by following it.”

According to a statement released by Atkins’ wife after his death, Atkins developed atherosclerosis as he aged:

“While Robert did have some progression of his coronary artery disease in the last three years of his life including some new blockage of a secondary artery that was remedied during this admission, he did not have a heart attack.”

From Wikipedia:

“Coronary Artery Disease (CAD or atherosclerotic heart disease) is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries.”

This medical examiner’s report of Atkins’ death states the deceased was a 72-year-old white male with a history of MI (myocardial infarction or heart attack), CHF (congestive heart failure), and HTN (hypertension or high blood pressure).

So, Dr. Atkins did have plaque build-up in the arteries supplying his heart, it did get worse as he aged, and he did suffer a heart attack at some point; whether that was the “cardiac arrest” Atkins suffered in 2002 is unclear. Mrs. Atkins maintains that her husband’s heart condition and health problems were the result of a viral infection that affected his heart (cardiomyopathy), not diet.

Pritikin

As with LaLanne, Fixx, and Atkins, Pritikin was in less-than-peak shape in his early years:

“Diagnosed with heart disease in the 1950s [placing him around 40 years old], he engaged in a low-fat diet that was high in unrefined carbohydrates along with a moderate aerobic exercise regime.”

Pritikin’s site describes the evolution of the reversal of his heart disease:

“Pritikin’s own cholesterol [in 1958, at the age of 41] was 280. He created an eating plan rich in fruits, vegetables, whole grains, and beans and with moderate amounts of lean meat, seafood, and nonfat dairy foods. He also began exercising. His cholesterol plummeted to 120. Two years later, a new electrocardiogram showed that his coronary insufficiency had disappeared. His test results: normal.

In 1985, Pritikin died from complications related to a 35-year struggle with leukemia. The results of his autopsy were published in the New England Journal of Medicine, and showed that Nathan Pritikin’s arteries were free of any signs of heart disease, and were as “soft and pliable” as a teenager’s. “In a man 69 years old,” wrote pathologist Jeffrey Hubbard, “the near absence of atherosclerosis and the complete absence of its effects are remarkable.” “

About Pritikin’s death, I found this comment by Joe D. Goldstrich MD in Dr. Michael Eades’ Protein Power blog:

“Concerning Pritikin: I worked with him in the 70s and 80s as the cardiologist and later medical director at the California Pritikin Longevity Center. He developed leukemia long before he began a low-fat diet. Interestingly, the leukemia was totally asymptomatic and in remission for over 20 years when he reluctantly saw a hematologist at UCLA. The hematologist was certain that Pritikin had hairy cell leukemia and that chemotherapy was indicated. Pritikin was convinced to take chemotherapy although it contradicted everything he believed and stood for. He had an extremely adverse reaction to the chemotherapeutic agent that included liver and kidney damage. He was quite thin to begin with and following the chemotherapy he lost about 30 pounds and appeared cadaveric. Pritikin traveled from California to a hospital in New York state under an assumed name for a second opinion. He was told that there was no hope and that he would most likely die quite soon. He said goodbye to his family and sent them out to eat dinner. He then severed both his brachial arteries with a scalpel and bled to death in his hospital bed. His autopsy was subsequently reported in the New England Journal (1985 Jul 4;313(1):52).

His coronary arteries were perfectly clean despite his having had significant (and convincing to me, a pretty good clinical cardiologist) angina in the days before routine coronary angiography. Pritikin developed his diet initially to treat himself. His angina went away early on as he became a low-fat vegetarian. For all apparent purposes his diet served him well.”

So, which diet was better at reducing plaque? Atkins’ meat-based high-fat plan or Pritikin’s plant-based low-fat plan? Atkins’ family did not permit an autopsy, however, the progression of Atkins’ atherosclerosis in the years leading up to his death is worrisome. From this elementary comparison, I would say Pritikin’s diet was better. It looks like I’m not alone. The Centers for Medicare and Medicaid decided to pay for Nathan Pritikin’s and Dean Ornish’s cardiac rehab programs. Both programs promote a low-fat, plant-based diet.