Since it began, the Bogalusa Heart Study has generated thousands of research studies, and helped train hundreds of students in medicine and public health. Although the study focused on heart disease in childhood, including the effects of diet, eating unhealthy foods is not just associated with heart problems. Many studies have shown that people who eat high-fat diets, particularly diets high in animal fats, are more likely to develop cancer. Diet is one of the biggest risk factors for many diseases—including cancer—that we have some control over. (Chapter 9 will provide more information about cancer’s links to diet.) Indeed, more than 30% of cancers in adults could be delayed or even prevented by healthy diet, regular exercise, and maintaining a healthy weight. Not surprisingly, a heart-healthy diet is also one that protects against cancer: Specifically, a diet rich in plant-based foods (such as fruits and vegetables), whole grains, and fish appears to be protective, while few fruits and vegetables, extra portions of processed meat, sodium, alcohol, refined carbohydrates, and high amounts of total fat have the opposite effect. Naturally, watching your calorie intake and having a healthy body weight also help.

High-fat diets may also increase the risk of obesity, although that idea remains somewhat controversial. Fat is calorie dense, and any extra is more likely to be stored as body fat than excess protein or carbohydrate. Obesity is a particular problem in Louisiana, which is one of a series of states (those located between Texas and Florida) that epidemiologists refer to as the “diabetes belt,” “stroke belt,” or “obesity belt.” For some reason—no one knows exactly why—CVD seems to cluster in this region.

This is a phenomenon that’s now become all too familiar to Gerald Berenson, Principal Investigator of the Bogalusa Heart Study. The many house calls he’s made to study participants in Louisiana over the decades have helped him retain an air of the old-fashioned family doctor. “If there was any kind of medical problems I went and examined them myself and took care of them,” Berenson recalled in an interview with Tulane’s Global Health News in 2012. Initially, he had to examine more than 4,000 patients.

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Because he grew up there, Berenson knew Bogalusa like the back of his hand. And that firsthand knowledge of this town less than two hours north of New Orleans proved crucial in solidifying support for the study. In fact, nearly everyone in the town has participated in the study in some way: Teachers and nurses at local schools serve as study liaisons; the pathologists who conducted the autopsies had Berenson as an instructor in medical school. Even Berenson and the coroner were old friends, and it was because of that relationship that Berenson was able to work out the arrangement that enabled the heart autopsies to be performed. “Eighty percent of the known deaths in the area we were able to autopsy,” says Berenson proudly. “Nobody gets that kind of rate.”

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But to truly help the children in his neighborhood, he knows he needs to address more than just their cardiovascular risk factors. In one very depressing statistic, Berenson found that many kids in Bogalusa start smoking as early as the third grade. That’s why Berenson is on a new mission: to get heart disease prevention taught in elementary schools, alongside standard subjects like reading and math. He and his colleagues have developed a curriculum called Health Ahead/Heart Smart that builds on the lessons of the Bogalusa Heart Study and attempts to apply them in practical ways to help prevent heart disease.

It’s this personalized approach to medicine, combined with Berenson’s brand of southern tenacity, that has ensured success of the study over the years. “I’m often asked ‘Why Bogalusa?’” The answer is simple, he says: “It’s where I’m from.”

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