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After smoking, a high-fat diet is the second most lethal habit. According to a report published in the Journal of the American Medical Association, smoking causes 400,000 deaths a year. High-fat diets cause 300,000. Several more highly publicized social evils are comparatively small problems: alcohol (100,000 deaths), guns (35,000), auto accidents (25,000) and drug abuse (20,000). These statistics in no way minimize the tragedies of alcoholism, murder or drug addiction. But they provide a perspective on what is really like killing us. If this sounds a bit extreme, consider the dangers of dietary fat and judge for yourself.

High blood pressure. High blood pressure is a major risk factor for heart disease and stroke. A high-fat diet contributes to this condition because it adds extra pounds. As weight increases, the heart must work harder to pump blood through all the extra tissue. As the heart's effort increases, so does blood pressure.

Diabetes. Diabetes contributes to an estimated 250,000 deaths a year. It involves an inability to metabolize blood sugar because of problems with the pancreatic hormone, insulin. In Type I (insulin-dependent) diabetes, the pancreas stops producing insulin. In more common Type II (non-insulin-dependent) diabetes, typically associated with obesity, insulin production may be normal, but food intake overwhelms the body's ability to process it.

Arthritis. Dietary fat contributes to the most common form of arthritis, osteoarthritis, because excess weight subjects the major joints to extra weight and tear. A high-fat diet also appears to increase the risk of rheumatoid arthritis (RA), the most serious and potentially crippling form of joint disease. Several studies suggest that a low-fat diet relieves RA symptoms.

Stroke. Stroke is the nation's third leading cause of death, claming 144,000 lives a year. There are two major types of stroke, one caused by bleeding in the brain (hemorrhagic), the other by blockage of an artery there (ischemic). About 75 percent of strokes are ischemic, and the vast majority of ischemic strokes are caused by cerebral thrombosis ' blockage of a brain artery by a process similar to heart attack, involving atherosclerosis and plaque rupture.

Obesity.Many people use obese as a synonym for fat, but it has a more precise medical definition ' a weight 20 percent heavier than what is recommended for one's height and build. Anyone who is 35 percent overweight faces a risk of premature death 50 percent greater than average. Obesity is a risk factor for heart disease, several cancers, high blood pressure, diabetes and arthritis. It is a problem only in countries with a high-fat diet. In addition to being hazardous to health, obesity is also an economic handicap, since obese people earn less money than those who are slimmer.

Hear disease. The nation's leading cause of death, heart disease kills 720,000 Americans a year, most as a result of heart attacks. About one American in four has some form of heart disease. Heart disease results from a process called atherosclerosis, which is directly linked to dietary fat. Fatty foods are high in cholesterol and free radicals, which are oxygen molecules that have lost an electron and become highly reactive. As they circulate in the blood, they snatch electrons away from other molecules, sometimes grabbing them from the cells that line artery walls. The microscopic injuries that free radicals inflict begin a decades-long process that eventually narrows the arteries with cholesterol-rich deposits called plaques. Sometimes plaque rupture, spilling their contents into the blood. If a plaque ruptures in one of the coronary arteries that nourish the heart, its debris can cause complete blockage. Without food and oxygen to nourish its hard-working cells, part of the heart dies. That's a heart attack.