Thursday, January 5, 2012

Wheat Belly: Fat or Flat

Does a diet high in refined wheat bread make people hungry, fat, diabetic, and prone to cardiovascular disease, as claimed by some authors?

In 1979, Mickelsen et al (full text here ) wanted to see if people can eat a diet high in regular refined wheat bread and lose body fat.  Their rationale follows:


This paragraph seems to fit our times though written more than 30 years ago:

"Incorrect assumptions have taught that bread should be eliminated from weight control plans; this idea has been fostered by the recommendations and instructions of many weight-reducing plans (2).  The instructions of many fad-type diets state that 'starchy' foods such as bread and potatoes should be avoided...Measurement of food intake and caloric deposition in the carcasses of rats fed a high-fat or a natural grain diet indicated that for each 1000 cal intake the high-fat fed rats retained twice as many calories as the grain-fed animals (3)."

To find out if a diet high in wheat grain would have the same effect on humans as on rats (reduced caloric retention), Mickelsen et al recruited 16 overweight college males, all of whom wanted to lose between 4.5 and 12 kg (10 to 26 pounds).

The subjects all agreed to eat all meals in a cafeteria, avoid alcoholic beverages, and consume 12 slices of wheat bread every day (four slices at each of three meals) for eight weeks.  Mickelsen et al randomized the subjects into two groups, one of which received high fiber bread and the other received white bread (i.e. made from refined wheat).  All subjects “were instructed that to lose weight, they would have to restrict caloric intake” but they were allowed to eat as much as desired at meals and were also allowed to snack between meals as desired. 



 
The two types of bread differed in several respects.  The high fiber bread supplied 50 calories and two grams of fiber per slice, while the regular bread supplied 70 calories and only one-tenth of a gram of fiber (the high fiber bread had 20 times the fiber of the regular bread).  The high fiber bread had about half as much fat and twenty-five percent less digestible carbohydrate than the regular bread. The high fiber bread had about 50 percent more iron, present in the added fiber, and was enriched with calcium because the researchers anticipated that the high fiber bread would reduce calcium absorption, although it turned out that the higher fiber intake did not reduce calcium absorption.

Thus, each day of the study period, those eating the high fiber bread ingested 600 calories and 108 g carbohydrate from wheat bread, and those eating the regular bread ingested 840 calories and 156 g carbohydrate from wheat bread. 



For comparison, Ezekiel Bread, a favorite of Ripped author Clarence Bass, supplies 11 g of digestible carbohydrate, 3 g of fiber,  4 g of protein, and 65 calories per slice (the label lists 80 calories per slice but that was derived by including the potential caloric value of the indigestible fiber, which is unavailable to us).  A loaf of Ezekiel Bread has 20 slices, so the subjects of this study ate more than half a loaf of bread every day.  Twelve slices of Ezekiel Bread supplies only about 780 calories, about half of the 1500 calorie intake that would produce weight loss in many women.

So did eating all this wheat make their bellies fatter, or flatter?

Over the eight week period, the subjects eating the regular bread lost an average of 6.25 kg (about 14 pounds; range 4.2 to 7.3 kg), while the subjects eating the high fiber bread lost an average of 8.77 kg (about 19 pounds; range 6.2 to 11.4 kg).  Thus, those eating 12 slices of white bread daily lost an average of one and three-quarters pounds of body weight each week; and those eating 12 slices of high fiber daily lost an average of two and two-fifths pounds of body weight each week.  They did not make any changes in activity level.



Of interest, the subjects succeeded in reducing their caloric intake by 25 to 38 percent while simultaneously experiencing a decrease in hunger.   At the end of the study, the subjects consuming the high fiber bread reported that they did not feel hungry at any time.  Two of the subjects eating the regular bread did feel hungry at the end of the study, one of those only before meals.



The group eating the regular bread had a decrease in serum cholesterol from 231 to 155 mg/dL,  and the group eating the high fiber bread decreased serum cholesterol from 224 to 172 mg/dL.

Follow-ups on 9 of the participants at 3 months, 6 months, and 9 months found that those four who stopped eating the bread regained the weight they had lost, while those five who continued to eat the bread (regular, higher calorie) either maintained most of their weight loss or lost even more weight.

Summary

In summary, this study found that all participants reduced their hunger, cholesterol levels, and body weight by deliberately consuming a dozen slices of bread each day, four slices at each of three meals, more than half a loaf of bread daily, regardless of whether the bread was high in fiber or made from refined white flour.   Those who abandoned this regimen gained the weight back and those who continued to eat a diet revolving around refined white bread maintained their weight loss or lost even more weight. 

Eating 12 slices of wheat bread did not
  • increase their hunger (it decreased their hunger)
  • increase body weight (it resulted in weight loss by reducing other food intake)
  • increase their blood sugar levels (they had no change in blood sugar levels)
  • raise the risk of heart disease (it decreased the levels of a major heart disease risk factor, total serum cholesterol)
All this without inducing the headaches, nausea, malaise, fatigue, and constipation that commonly affect people, particularly women, when consuming high-fat, low-carbohydrate diets.

This study using Caucasian subjects resonates with the experience of millions of Asians who eat an average of one pound of dry rice daily and maintain low body fat levels throughout their lifespan. 

Source:  Abdullah et al (full text pdf)





57 comments:

Will said...

Hi Don,

The experiment didn't use a wheat-free control group, so we can only tell how refined bread stacks up against whole wheat bread (white bread being the loser). I tend to agree that Dr. Davis overstates the case against wheat, but this study does not allow us to extrapolate and claim that wheat is innocent compared to other starchy carbohydrates like rice and potatoes.

Given how the authors stressed the importance of caloric restriction for weight loss (to participants already motivated to lose weight), this is a very likely confounder. They were also instructed to keep a food journal, further increasing their awareness of consumption levels. Would this have impacted subjects similarly had there been a rice-based control group? Who knows.

I know what you're thinking: what about the 3/6/9-month follow-ups? :) It's entirely feasible that the continuation of white-bread consumption was simply a marker of desire to maintain weight loss, and thus a refusal to return to high-calorie, industrially flavored foods. Do you have a reason to believe this was probably not the case?

Mirrorball said...

What Will said. Without a control group, the intervention itself could have acted as a placebo to reduce the subjects' hunger.

rezzrovv said...

Does this not correspond more with the observation of Seth Roberts and the Shangrila Diet than the efficacy of bread to cause weight loss? It has been shown that focusing the diet on single food item causing these outcomes short-term but not long term. The anomaly seems more in the process than in the focused food. This is similar to the guy last year that lost 20 lbs eating nothing but twinkies for 30 days. I believe it happened but surely no one believes eating twinkies is a responsible or healthy diet.

Don! said...

"All this without inducing the headaches, nausea, malaise, fatigue, and constipation that commonly affect people, particularly women, when consuming high-fat, low-carbohydrate diets."

So these are the only two options you can think of? Eating 12 slices of bread a day or going low-carb?

Also, lol at you using the phrase "particularly women" in your indictment of low-carb diets, which means you're clearly aware that men and women may be affected differently by the same type of diet, and at the same time glossing over the fact that all of the subjects in this ridiculous junior high school level experiment are males. And young males at that.

Jimmy Gee said...

Another useless study. Not enough info provided to really analyze the results.

nothing91 said...

"So these are the only two options you can think of? Eating 12 slices of bread a day or going low-carb?"

Don's middle name is 'extremism'. :-)

BTW, those effects of high-fat diets in women are so "common" that it took Don 14 years to realize it.

Rob said...

@rezzrovv

The twinkie guy didn't only eat twinkies, that's just how the media reported it. He also restricted calories.

"Two-thirds of his total intake came from junk food. He also took a multivitamin pill and drank a protein shake daily. And he ate vegetables, typically a can of green beans or three to four celery stalks."

http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html

Don said...

Will,

The simple explanation: When you eat four slices of bread at a meal, it provides a level of satisfaction that enables a person to easily reduce other food intake.

Mirrorball,

A control group would simply be a group not eating 12 slices of bread daily.

Rezzrovv,

Millions of Asians eat rice in caloric quantities similar to or exceeding 12 slices of bread daily

This study does not show that 'bread causes weight loss" and neither I nor the authors claimed so. It shows that people can eat lots of bread and lose weight, and that eating bread probably facilitates weight loss by satisfying some basic biological drives for carbohydrate.

Don!,

Where did I say those were the only two options?

Why is this study ridiculous?

Since we have millions of examples of women who eat high starch diets and remain lean throughout life (Asia, South Pacific, Africa), I would predict similar or better results with women as the subjects, but I have no idea why they chose to use only men.

Also, if you had read the Mickelsen et al study, it was they who referred to this 1932 study that established the differences between men and women in response to ketosis:

DEUEL, H., AND M. GULIK. Studies on ketosis: I.The sexual variations in starvation ketosis. J. Biol.
Chem. 96: 25, 1932.

I am not aware of any evidence that age would change a person's response to 700 calories worth of bread. Clarence Bass doesn't eat less bread now that he is over 70 years of age, yet he remains lean.

nothing91,

What is extreme about 12 slices of bread daily? It only provides ~700 calories, not even half of an adult male's daily caloric requirements. As I pointed out, people in Asia eat at least this amount of rice by caloric value.

If you do a little research ,you will find that Europeans typically ate that amount of bread daily before the industrial revolution. You will also find that in the 1950s the people of Crete ate about a pound of bread daily.

I recognized those effects long before 14 years elapsed. In my last book I advised against low carb diets. But, even if it did take me 14 years, so what?

People are claiming that wheat makes people fat. This study showed that people lost weight when they increased the amount of wheat in their diets. It clearly provides evidence against the claim that wheat is somehow uniquely fattening and 'unsafe' compared to rice or potatoes.

Why don't you people show me some evidence that wheat is uniquely fattening or unsafe?

Don! said...

"I am not aware of any evidence that age would change a person's response to 700 calories worth of bread."

This is risible. Are you just completely unaware that age is a risk factor for Type 2 diabetes? You think age has zero effect on insulin sensitivity? And you don't think that decades of exposure to gluten could have any effect on gluten sensitivity?

A single anecdotal example of an elite athlete who eats bread and stays lean doesn't prove anything. If you want n=1 anecdata, mine is that when I was younger I found bread and other starches very filling, but that changed as I got older. In fact when I was in college I could easily stuff myself with low caloric-density starchy foods and lose weight without hunger, just like the kids in the study, but I can't do that anymore.

The study is ridiculous because there's no non-wheat control group, and nothing else was controlled or accounted for. You don't think that your average chubby college dude would lose weight simply from cutting out alcohol?

All this study shows is that some pudgy college dudes can eat significant amounts of bread and still lose weight. So what? It doesn't show that the bread caused the weight loss. It doesn't show that it works better than a diet without bread. And it certainly doesn't show that the same diet would cause weight loss in women or older people.

I don't believe that a diet high in wheat makes everyone fat and/or sick, nor do I believe that wheat is a necessary part of a healthy diet.

Will said...

Hi Don,

Thanks for clarifying your position that wheat does not cause weight loss.

You say that wheat bread is particularly satiating, and I say that industrial foods are appetite-stimulating. Relative to each other, we're both right. I'm skeptical that wheat is consistently more satiating (if at all) than rice, beans, oats, meat, potatoes, or vegetables. I hope you agree.

"A control group would simply be a group not eating 12 slices of bread daily."

That is one possible control group, though not a very good one if your goal is to study the effect of *wheat* specifically, as opposed to carbohydrate. How about a control group that gets 12 servings of rice instead? (Yes, I am obsessed with rice.) Even better if the control group had to eat 12 slices of gluten-free bread.

"It shows that people can eat lots of bread and lose weight, and that eating bread probably facilitates weight loss by satisfying some basic biological drives for carbohydrate."

Does the paper specifically suggest some biological drive for carbohydrate? I didn't read it deeply but I didn't see this mentioned.

"People are claiming that wheat makes people fat."

My impression is that most (all?) proponents of the idea that wheat is super fattening on its own are also advocates of low carb diets. Is this not your impression?

The rest are primarily cautious of wheat as it pertains to inflammation. My understanding is that there is no smoking gun regarding the safety of wheat, but there's plenty of circumstantial evidence. You take your chances.

Don said...

Don!

That age is a risk factor for type 2 diabetes doesn't show that age affects metabolism of wheat. Further, age is only a risk factor for type 2 diabetes in cultures that have type 2 diabetes; age doesn't increase the risk of type 2 diabetes in, for example, Kitava, despite large amounts of carbohydrates in the Kitavan diet. Similarly, the risk of NIDDM is LOWER in cultures with high carbohydrate diets e.g. Japan.

Insulin sensitivity is not automatically good in youth nor automatically reduced in elders. It is determined by body fat levels, amount of fat in the diet (hence amount of fat the cells have to process), and activity levels, to name the few that come to mind immediately. Anyone with high body fat, high dietary fat, and low activity can develop NIDDM, as well shown by the exploding incidence of NIDDM in young people in America. Yes, in affluent nations, people get fat, eat more fat, and move much less as they age, so age correlates with increased incidence of diabetes in those nations, but this doesn't show that age causes diabetes.

The study is not ridiculous because the only intent was to show how a diet high in bread affects weight loss efforts. They increased the amount of bread, and the subjects were able to lose weight. It shows that people can lose weight eating 12 slices of bread each day.

The subjects were young but they had a disorder associated with aging, namely overweight. Plenty of young people are trying to lose weight so even if this study does not apply to older individuals, it provides valuable info to those younger.

I happen to be 50 years of age, and I eat at least 700 kcal worth of starches daily, and I am quite lean, leaner than I was eating a lower carbohydrate diet, and I am not an elite athlete.

Again, no one said that the bread/wheat caused the weight loss, so I don't understand why you keep bringing that up. By eating the bread, the men were able to eat less calories without being hungry.

This study was not done to try to find out if potatoes or rice would work better than wheat. Again, it was only to find out whether bread can be used as a staple in a weight loss diet. It showed that yes, bread can be used as a staple in a weight loss diet.

I have already posted about other studies showing the same effects in women and older people.

Here's a new one, using women averaging 48 years of age, comparing reduced calorie diets with or without bread:

http://www.ncbi.nlm.nih.gov/pubmed/22209501

Another publication from this same study of women found that "The inclusion of bread in a low-calorie meal may result in a greater sensation of satiety after eating. These results contradict the recommendation to exclude bread from a food plan aimed at weight loss."

http://www.ncbi.nlm.nih.gov/pubmed/22072367

"The bread inclusion in a low-calorie diet designed for weight loss favoured a better evolution of dietetic parameters and greater compliance with the diet with fewer dropouts."

Seems the results are the same for women in the range of 50 years old as for these college-age men in this Mickelsen study.

No one said bread was necessary. But people are being told to avoid bread to lose weight, because bread, supposedly, makes people fat. I want the people who claim that bread makes people fat provide evidence for their claim.

Don said...

Will,

Mickelsen et al started their paper discussing the adverse effects of ketogenic diets, i.e. those that eliminate or provide inadequate carbohydrate. The adverse effects represent a disruption of homeostasis and are prevented by intake of adequate carbohydrate. To the body, ketosis is a signal of starvation (because it occurs with starvation) so the body sends strong signals of distress when put into ketosis, signals that would normally (i.e. without the influence of low carb dogma) drive the person to search for appropriate foods to restore equilibrium.

They don't state directly but this implies a biological drive for carbohydrate to maintain physiological homeostasis, i.e. to prevent ketosis signals of starvation.

I think it reasonable to state and I maintain that the organism will experience greater satisfaction when it is in homeostasis (i.e. equilibrium) and dissatisfaction when not in homeostasis (physiological equilibrium), and that drives arise as means to restore equilibrium/homeostasis.

Thus, the hunger drive arises when we are in disequilibrium, and abates when we are in equilibrium. Hunger drives us to seek out the substance(s) that will restore equilibrium. Since the subjects of this study had less hunger when eating the bread than when not, I derive the implied conclusion that eating the bread satisfied a drive for the carbohydrate that will prevent ketosis (starvation signals) and maintain adequate glycogen levels. I say it is the carbohydrate in the bread and not fat because bread is low in fat, and not protein because bread is not particularly rich in protein nor does it efficiently prevent ketosis.

In summary, the entire study implies that foods rich in carbohydrate help people maintain lower caloric intakes because they satisfy the drive to prevent ketosis, which to the body signals starvation (because it happens when we are starving).

Tonya said...

The study was done in 1974. In 1974 I'll bet a million dollars that they didn't put high fructose corn syrup and partially hydrogenated soybean oil in their bread. And was the genetically modified wheat that is so prevalent now as prevalent then? Also, celiacs generally lose a lot of weight when they eat wheat... I don't think it's the good kind of weight loss though...

But that's neither here nor there. Young males generally have no problem losing weight no matter what diet they follow because weight gain is controlled by hormones and is different for every individual. What works for you might not work for anyone else. We are not calorimeters, petri dishes or rats, thank you very much. And I am not a young male in college.

I know it's anecdotal, and what isn't when it comes to humans, but of the two women in this household, myself included who eat low carb, and sometimes very low carb, we've never had any of those side effects mentioned :)

nothing91 said...

Don,

"Again, no one said that the bread/wheat caused the weight loss, so I don't understand why you keep bringing that up."

Sometime sit seems like there are two Dons: the Don who posts blog entries and the (more reasonable) Don who responds in the comments section. :-) In this very blog entry, you said the following as an introduction to the study's results:

"So did eating all this wheat make their bellies fatter, or flatter?"

So clearly your interpretation of the results was that the wheat made their bellies flatter (i.e., caused weight loss).

Then you say that the wheat "resulted in weight loss by reducing other food intake".

So why play with words now? If you didn't mean to say the wheat caused the weight loss, just say so. Pretending like you didn't say it is bizarre.

Don! said...

Don, you're complaining that others are attacking arguments that you never made (even though you clearly did) while simultaneously attacking arguments that others haven't made. For example, I never wrote that insulin sensitivity is "automatically good in youth nor automatically reduced in elders."

I honestly don't know if you're doing this intentionally in an attempt to redirect the discussion, or if you truly don't understand the not so subtle difference between "age can affect insulin sensitivity" and "age and insulin sensitivity are always inversely linearly correlated." Either way, whether it's intellectual dishonesty or simple intellectual failing, I don't see the point in any further attempts to have a rational discussion with you.

But just so you know, what you're saying about how the satiation attributed to the bread is due solely to the carb content does not jibe at all with the results of one of the studies you linked last night. I'll leave it as an exercise for the reader to figure out why. Maybe that'll keep you busy for a while.

Thomas said...

The major point: bread doesn't make you fat. And there is a good chance it doesn't make many people more hungry either.

This is such an insult to the paradigm that is low carb and paleo, people will tend to lose their heads trying to discredit it.

Saying that the study's worth is less because it doesn't use a control group is interesting, considering that it's a common thought in the paleo movement that eating bread will in-fact lead to weight gain (and diabetes, and cancer and some terrible auto-immune diseases). How eating bread stacks up to rice or potato (weren't these food items thought to be no better than bread a few years ago?) is not the point at all. People lost weight eating bread, they didn't gain! And they weren't hungry either. Hmmm...

In the end, individual results may vary, but I think this study is a cog in the "exploding the low carb and paleo dogma" wheel. It doesn't say anything, by the way, about the worth of low carb and paleo eating, or people's individual results to such diets (good and bad), so people need to relax a bit.

Jeff Consiglio said...

Don said..."Why don't you people show me some evidence that wheat is uniquely fattening or unsafe?"


Amen brother! I had to stop reading certain blogs because I got soooo tired of articles about THEORETICAL reasons as to why wheat is supposedly evil, yet REAL-WORLD evidence fails to support such seemingly "logical" arguments.

Kind of like the seemingly "logical" argument that carbs = insulin = fat gain = your head will eventually explode.

Will said...

"Why don't you people show me some evidence that wheat is uniquely fattening or unsafe?"

I've already stated my agreement that wheat is unlikely to be especially fattening on its own.

But since you also asked about the "unsafe" part, I do have some links with gathered evidence against wheat (really gluten in particular):

http://evolvify.com/the-case-against-gluten-medical-journal-references/

http://camoo.freeshell.org/whyfood.html

Again, the way I see it is that you take your chances. I am not 100% gluten-free, but it's not exactly my staple starch, either.

Bill said...

Since when is weight loss the reason to ditch wheat? I was super lean on very high wheat diet... especially ezekial bread. It was a very tasty and satisfying diet.

Although I was very lean... I suffered depression, acne, dandruff, bloating , ADHD, poor sleep, etc etc

Cutting out wheat made all those problems go away or lessen considerably. I do great with white rice, potatoes, yams, fruit and even good quality raw or goat dairy.... but wheat messes me up badly in other ways.

Sure, the majority of people go "Paleo" for weight loss... but I don't think the majority go "gluten free" for weight loss.

blackflag said...

But what about the gluten? You can convince me about potatoes or rice, but it is the gluten in bead that I am worried about.

Bruce said...

I read Davis' book and decided to give it a try. My partner and I have been wheat free for about 3 months now, and the results have been amazing. I'm down about twenty pounds or so with no other change than eating rice and potatoes instead of sandwhiches and pasta. Of course I'm not counting grams, and it is likely I'm eating less starch overall. Anecdotally this seems to work very well.

Davis makes the point that modern "wheat" is very different from the wheat that europeans ate before industrial revolution. Not only are the kernels fundamentally different, but also the commercial processing.

I have been impressed with how little modern "scientific studies" have contributed to our knowledge of health in the last five generations or so. I think almost all of it amounts to reductionist tunnel vision - http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/ - I think if we poured through all the minutia of the study we would find they are all deeply flawed in a plethora of ways.

The more I understand the many ways in which studies are manipulated (often unconciously through confirmation bias) the less I can believe the "nutritional science".

All I know is, getting rid of wheat has been amazing for everyone in our household, and easy to maintain! I feel like Davis revealed a secret, a profound one. even if reductionist "study" fails to elucidate.

Brave Friend said...

Experimenting on my troubled self, I have found bread and any high-carb food is detrimental IF my diet is high in fat.

When fat is lowered, high-starch, high-carb whole foods, hell even bread, are okay and my body begins to heal. Just sayin, carb-haters and paleo folks. Fair enough, I also had minor improvements on the paleo, low-carb eating style but not as much satiety, satisfaction and stamina as now.

As for the post, very interesting experiement. Thanks, Don!

Don said...

Nothing91,

"So did eating all this wheat make their bellies fatter, or flatter?"

Perhaps not obvious, and perhaps unfortunately, I wrote that for a rhetorical effect.

In this study, the weight loss was caused by the reduction of energy intake below energy expenditure.

I thought that I clearly stated that the subjects were enabled to eat less of other foods by eating 12 slices of bread.

The wheat did not cause the weight loss, and it didn't prevent weight loss.

So: A diet containing a substantial amount of bread enabled these people to create an energy deficit that caused the weight loss.

It seems to me that in the original post I sufficiently emphasized that the weight loss was caused by reduced total food energy intake, and that the bread posed no obstacle to this caloric reduction, but rather supported it by reducing hunger.

lightcan said...

Don,

There shouldn't be any hunger while in ketosis. In ketosis, your body is supposed to access your fat reserves and then use fatty acids as source of energy, which together with tissue insulin resistance and GNG works just fine. It is harder and more work but it is a natural response. It achieves a different homeostasis, based on a different macro ratio. There isn't supposed to be any hunger after a couple of days.
You're saying the body feels is starving and needs carbs. Maybe so, temporarily, but it depends then on fat stores, adequate intake of proteins, adaptation period, etc, you know all this.
Satiety as a gauge for the long-term adherence to a weight-loss diet is used by low carb proponents too, while advising higher protein consumption, higher fat consumption, you know this too.

People are a bit tired of conflicting advice.

Caym said...

Its always puzzled me how grains that are used to fatten livestock magically become slimming when eaten by humans

Brave Friend said...

Caym, let me help your being puzzled. The natural diet for livestock is grass and herbs. You can check out the difference between their digestive system and ours.

And lightcan, if you have ever been on a true paleo diet and a starch-based, plant-based diet you will be able to compare satiety and hunger factors. Ketosis seems like a defense system, not a natural state.

I am yet to find a single paleo eater that does not "cheat" with coffee, potato, rice or some other energy-boosting food. I used coffee extensively while on paleo. Hunger and satiety is a major issue on an animal or diary-based diet. That's why moderation goes out the window in the Western diet.

Don said...

Caym,

No 'magic' involved. To fatten them, cattle are confined (no activity) and overfed a food (grain) more concentrated than that to which they are adapted, resulting in caloric excess.

Humans are not cattle, so I don't know why it should be surprising that grains affect humans differently.

I am always surprised that people can believe that grains make people fat, when it is common knowledge that the people living primarily on grains in the developing nations and Asia are lean.

Lightcan,

If you fast for a few days, you will go into ketosis and not feel hunger the way you do on the first day or so. That doesn't mean you aren't starving.

I agree with Brave Friend. Ketosis is 'natural' as a response to incorrect nutrition, but it is not a state the body prefers, any more than it prefers starvation.

Will said...

Caym,

Corn is the major livestock feed. If corn were intrinsically fattening, you would have to explain how the Aztecs and Mayas could live on corn for 7,000 years without widespread obesity. Ditto for other Native American cultures like the pre-contact Pima and the reclusive Tarahumara.

Brave Friend,

Why are potatoes "cheating" on a paleo diet? Anyone following the modern paleosphere knows that carbohydrates have been vindicated by a large and growing faction of the paleo community already. Don't believe me? Then explain all the complaining over inviting Eades, Naughton, Taubes, et al to AHS 2011.

I can forgive an outsider like Plant Positive for not realizing this in his "debunking" of paleo. Paleo books have not yet caught up to the state-of-the-art.

But I don't understand why Don conflates "low-carb" and "paleo" diets as if they are still one and the same (like in his "Farewell to Paleo" post). He should know that they are not. Reference Cordain's "official" version all you want, but a HUGE contingent of the ancestral health community has moved on already. Staffan Lindeberg, Robb Wolf, Stephan Guyenet, Chris Masterjohn, Chris Kresser, Kurt Harris, Castle Grok, Melissa McEwens, Richard Nikoley, and Denise Minger are not carbophobic in the least. Either Don is playing dumb or he didn't truly understand the status of paleo by the time he left it. I want to give him the benefit of the doubt here, but I still haven't seen a satisfying response after people called him out on it.

Will said...

Brave Friend,

Moreover, I would argue that to call the standard American diet "animal-based" is debatable, if not actually wrong.

Roughly 50% of the calories in the SAD are carbohydrates. These come from plants, not animals. (The only exception is honey, but frankly Americans are getting an overwhelming amount of their sugar fix from plant sources like agave nector, cane sugar, and HFCS.) 30% of the SAD is fat, and a good portion of this is coming from plant-based vegetable oils. So I'd estimate that a majority of the calories in the SAD are derived from plants, not animals. The SAD is already a plant-based diet.

Don said...

Will,

Have you read my book?

Did you peruse any of my 'paleo' or paleo potato posts? Or my posts on Kitavans?

I was one, perhaps one of the earliest advocates of using sweet and white potatoes in a so-called 'paleo' diet, against opposition.

The main feature of so-called paleo paradigm has been that an 'ancestral' diet should be built primarily of meat and possibly fat.

And that we should limit most carbohydrates, and avoid specific carbohydrates, namely grains and legumes, because, supposedly, we are not adapted to them, and they are, supposedly, toxic.

It used to mean avoiding dairy as well.

You list "Staffan Lindeberg, Robb Wolf, Stephan Guyenet, Chris Masterjohn, Chris Kresser, Kurt Harris, Castle Grok, Melissa McEwens, Richard Nikoley, and Denise Minger" as not carbophobic.

I will certainly grant this of Lindeberg, Guyenet, Grok. I am not sure about the others. It all depends on how you define "carbophobic." But I am also not sure how many of those people would call what they do "paleo."

But I guess paleo can be all things to all people. And all things can be "paleo" through some rationale.

So white rice and dairy become paleo to those who want them in their diet, and still want to use the label paleo.

But so far as I know, those who claim to be paleo adhere to the belief that humans are well adapted to a meat-rich diet, that grains and legumes are toxic, and that modern diseases are primarily due to dietary carbohydrates.

"Either Don is playing dumb or he didn't truly understand the status of paleo by the time he left it. I want to give him the benefit of the doubt here, but I still haven't seen a satisfying response after people called him out on it."

Called me out on WHAT?

Are you seriously suggesting that despite my numerous posts on potatoes, my numerous photos of my potato-containing meals, etc, I didn't know that some people had adopted potatoes into their paleo i.e. meat-based diets?

Will said...

Hello Don,

I haven't read your book, though I am aware of your posts. I've read some, but not all, of the potato-related ones in the past. But really, that all seems irrelevant based on how you responded:

"The main feature of so-called paleo paradigm has been that an 'ancestral' diet should be built primarily of meat and possibly fat."

This statement is exactly what I'm disputing (as well as the corollary about limited carbohydrates). The above sentence used to be true in the past, but it's no longer the case. Replace the phrase "has been" by the word "is" in the above quote, and post it to paleohacks. I think you'll find that many (most?) in the paleosphere would disagree with you. Right now, the unifying feature of paleo lies in what it eschews (gluten grains, refined sugar, vegetable oils) rather than what it allows. Meat is relevant to paleo in the sense that you should include some amount of meat > 0% (i.e. not vegan). Beyond that, there is no longer any requirement that you must eat lots of meat.

"Are you seriously suggesting that despite my numerous posts on potatoes, my numerous photos of my potato-containing meals, etc, I didn't know that some people had adopted potatoes into their paleo i.e. meat-based diets?"

Nope! I'm suggesting that you still claim paleo == low-carb (and therefore high meat), even though the two diets have begun diverging for many months now (evidenced by the increased infighting that has happened this past year). Just because you did some posts on potatoes does not make your own paleo diet high-carb. Have you ever tried high-carb paleo? Do you consider a "high-carb paleo diet" to be an oxymoron? If so, I take issue with that. I don't practice a paleo diet myself. But if I went paleo today, I would consume a lot of tubers & vegetables, along with a small-to-moderate amount of meat and fruit. It's 100% paleo and quite healthy.

Will said...

Hello again, Don:

"I will certainly grant this of Lindeberg, Guyenet, Grok. I am not sure about the others. It all depends on how you define 'carbophobic.' But I am also not sure how many of those people would call what they do 'paleo.'"

My definition: you are carbophobic if you believe that a high-carb diet is intrinsically fattening or unhealthy for normal people. Fair?

You have a point that not everyone I listed may call their diet 'paleo', but I think they all consider themselves part of the evolutionary/ancestral health movement. And just because someone eats a low-carb diet, it does not mean their views are carbophobic. CarbSane is an obvious example. But if someone does eat a high-carb diet, then it's pretty likely that person isn't a carbophobe :)

Let me show you why I think these prominent bloggers are not carbophobic and do not oppose a high-carb diet:

Chris Masterjohn.
"Saying that insulin causes insulin resistance is like saying that childhood mortality is caused by children."
http://blog.cholesterol-and-health.com/2010/11/is-insulin-resistance-really-making-us.html
"But the idea that the adipose tissue accumulates fat because there is so much insulin around is, in my opinion, just plain backwards. Adipose tissue stops responding to insulin because it can't handle any more fat storage."
http://paleohacks.com/questions/49970/how-do-we-reconcile-stephan-guyenets-latest-comment-with-the-insulin-story-in/50111#50111

Chris Kresser.
"Some feel better with a low-carb approach, while others feel better eating more carbohydrate. Some seem to require a higher protein intake (up to 20-25% of calories), but others do well when they eat a smaller amount (10-15%)."
http://chriskresser.com/beyond-paleo-moving-from-a-paleo-diet-to-a-paleo-template

Robb Wolf. He's admitted that low-carb is not the ultimate diet he once thought it was.
"In years gone by I’d have staunchly recommended a low carb paleo diet as THE best intervention but I can’t in good faith recommend that anymore."
http://robbwolf.com/2011/09/29/what-is-the-paleo-diet/

Kurt Harris.
"One can probably eat well over 50% of calories from starchy plant organs as long as the animal foods you eat are of high quality and micronutrient content."
http://www.archevore.com/panu-weblog/2011/9/29/jimmy-moore-inquires-about-safe-starches.html

Melissa McEwen.
"The idea that carbohydrates per se cause obesity is only being debated by a few silly reductionists. For those of us who have read extensively about other healthy cultures, that doesn't even begin to make sense. What healthy peoples have in common is the nutrient dense foods they eat, not their macronutrient ratios."
http://huntgatherlove.com/content/good-books-bad-taubes

Richard Nikoley.
"No, I don’t think carbs in an of themselves are pro inflammatory. I have often said that Paleo is anything from zero to high carb, just depends on what works for you, Kitavan, Inuit, or somewhere in between."
http://freetheanimal.com/2010/04/metabolism-digestion-a-key-to-weight-loss-health-part-ii.html#comment-17775

Denise Minger. (Denise actually eats a high-fruit diet herself, by the way. Introducing a small amount of animal foods improved her health.)
"I fully support folks who want to eat the majority of their diet as plants, and believe this can be done quite healthfully."
http://paleovegan.blogspot.com/2011/12/quote-of-unit-time.html

Jordan said...

Perhaps we shouldn't worry about what's "Paleo" or not and just eat whole foods! Simply cutting out the processed crap will go a long way. And each individual can make his or her own determination about wheat, potatoes, dairy, etc.

Don said...

Will,

In The Garden of Eating you will find an outline of a typical day of my meals. I consumed at least 240 g of carbohydrate daily most of the time I called my diet 'practically paleolithic.' For a period last year it was even higher. I was among those who argued FOR inclusion of potatoes and sweet potatoes, based on evidence that paleolithic people ate starchy tubers.

Nevertheless, Cordain, Wolf, DeVany all wrote books describing paleodiet as low carb AND high in animal protein.

"Right now, the unifying feature of paleo lies in what it eschews (gluten grains, refined sugar, vegetable oils) rather than what it allows. Meat is relevant to paleo in the sense that you should include some amount of meat > 0% (i.e. not vegan). Beyond that, there is no longer any requirement that you must eat lots of meat."

The 'reality' you are describing occurred AFTER I ceased to consider my diet 'paleo.' The 'unifying feature' amounts to nothing but the common denominators of all the re-interpretations of 'paleo.'

I notice you didn't include dairy among the things avoided by these 'paleohacks'. The point of the paleo approach was to disclude types of foods not consumed by people of the paleolithic era. It is almost certain that diets of the paleolithic era did not include (non-human) dairy.

If a diet includes grains (non-gluten), dairy, meat, dairy, vegetables, fruits, and nuts, why call it 'paleo'? How does this list of foods relate to paleolithic diets?

Logically, we can't define anything by saying only what it is not.

Try it: Paleolithic diet =df any diet that eschews gluten grains, vegetable oils, and refined sugar, and includes some meat.

So by this definition, a rural Chinese diet composed of 70% rice and millet, 25% vegetables, and 5% fish is a paleo diet.

It could also be called a macrobiotic diet.

Or, for those wanting to call themselves vegans without being vegans, we can call it a pesco-vegan diet.


Cordain is publishing The Paleo Answer this year. Guess what? He isn't into the paleohacks. I got notice of its impending release, which includes this:

"Revelations from the author’s research over the last decade, including why vegan and vegetarian diets are not healthy and why dairy, soy products, potatoes, and grains are not just unhealthy, they may be TOXIC!"

As you can see, the Paleo Answer does not include potatoes, non-gluten grains, legumes, dairy products, or any of the other accessories that paleohacks might incorporate to satisfy their own longings.

Paleohacks, Masterjohn, McEwen, Harris, et al may all disagree with Cordain, but Cordain is the one defining and representing the Paleo Diet (TM).

For this reason, from here on out, when I or anyone else critiques 'the Paleo Diet' they are not going to be addressing the paleohacks or any of the bloggers you mention. They will be addressing Cordain's Paleo Diet (TM).

Therefore, at this time, anyone can correctly 'conflate' low carb and 'Paleo Diet (TM)' because the person who trademarked the term defined Paleo Diet (TM) as a low carb diet.

And anyone who says we are creating a 'straw man' when we say that the Paleo Diet (TM) is 'low carb' is simply wrong, until Cordain himself says that the Paleo Diet (TM) is not low carb.

Brave Friend said...

If this trend keeps up, very soon even Dr. McDougall will be considered 'paleo' :)

The Humane Hominid said...

"If this trend keeps up, very soon even Dr. McDougall will be considered 'paleo' :)"

LOL. No, Brave Friend, that would be the "miocene" diet. ;)

Will,
Your last batch of quotes just reinforces Don's observation that "paleo can be all things to all people"; in which case, it's not a terribly useful idea.

Though Don is over-stating the case a bit, IMO; I think most "paleos" agree people shouldn't go vegan.

Will said...

Hi Don,

Now that I got you on the same page, you bring up a number of more noteworthy points.

240g of daily carbohydrate sounds better than this quote from your final "Primal Potatoes" post: "Presently, I only eat one on each of the days that I spend glycogen in resistance training. Even on those days I don't go above a total of 150 grams of carbohydrate." This is where I got the impression that you were practicing low carb despite eating occasional potatoes. I was unaware that you boosted your carbohydrate intake since then.

"Nevertheless, Cordain, Wolf, DeVany all wrote books describing paleodiet as low carb AND high in animal protein."

Agreed, with the asterisk about Robb Wolf that I mentioned. The fact that nearly all the books continue to emphasize low-carb is a big problem, and it's one that I already hinted at in a previous comment.

"The 'reality' you are describing occurred AFTER I ceased to consider my diet 'paleo."

It certainly picked up steam after your post, but I went back into the RSS feeds anyway to recheck my memory. Except for Wolf and Kresser, everyone else I listed had indicated _before_ your post that they were ok with carbohydrates. Kresser actually commented on your 'Farewell to Paleo' post, making the same point I'm making now. Also see comments from Lord Grimmak, julianne, Evgeny, Melissa, paleo, and others.

"If a diet includes grains (non-gluten), dairy, meat, dairy, vegetables, fruits, and nuts, why call it 'paleo'?"

This is a valid point, and it's my own complaint as well. In fact, the community has been wrestling with this very problem internally -- paleo has become a misnomer for what the community is really doing. It also associates them with the "faileo diets" e.g. of Cordain. Should they rebrand their movement and lose the momentum acquired under the 'paleo' banner? It's a dilemma.

Masterjohn writes about 'paleo' vs 'ancestral' here:
http://blog.cholesterol-and-health.com/2011/08/reflections-on-ancestral-health.html

"Logically, we can't define anything by saying only what it is not."

Why not? Is a vegan diet not defined as the elimination of animal products?

"So by this definition, a rural Chinese diet composed of 70% rice and millet, 25% vegetables, and 5% fish is a paleo diet. It could also be called a macrobiotic diet."

70% rice/millet brings up the same naming issues I described above. You are right that such a diet would not be considered paleo, though it is surely an ancestral diet.

As far as it being a macrobiotic diet, I fail to see why that matters. Diets don't have to be mutually excusive. Fruitarians are also vegans, for example.

"Paleohacks, Masterjohn, McEwen, Harris, et al may all disagree with Cordain, but Cordain is the one defining and representing the Paleo Diet (TM)."

Cordain's new book reflects his continued carbophobia. I have never claimed that Cordain accepts high-carb diets. Despite his "official" status and trademark, his influence in the practicing paleosphere is marginal at best. And I suspect more laypeople are introduced to paleo first through Robb Wolf's and Mark Sisson's books, anyway. I know that these books are low-carb too, but the point is that Cordain is not the best single choice to represent paleo diets as a practical matter.

"For this reason, from here on out, when I or anyone else critiques 'the Paleo Diet' they are not going to be addressing the paleohacks or any of the bloggers you mention. They will be addressing Cordain's Paleo Diet (TM)."

Thanks, Don - I think this is the crux of the matter. I am satisfied with this statement. If you had put this disclaimer at the top of your 'Farewell to Paleo' post verbatim from the get-go, I suspect you may have received less vitriol from the paleo community.

Will said...

Hi Brave Friend,

I would like that very much, as I am a fan of McDougall's work :) In fact, McDougall is on record as saying that veganism is not even necessary to be healthy...

Hi Humane Hominid,

"Your last batch of quotes just reinforces Don's observation that 'paleo can be all things to all people'; in which case, it's not a terribly useful idea."

Yes, and I agree. But I don't think it's accurate to paint the entire paleo community as low-carb -- unless you start talking about some specific prescription of the paleo diet (as Don has clarified).

Don said...

Will,

http://www.lowcarbcruiseinfo.com/speakers/

The Low-Carb Cruise people describe Chris Masterjohn thus:

"One of the most brilliant minds in the low-carb/Paleo community, we are honored to have him join us on The Low-Carb Cruise in 2012."

Denise Minger is among the speakers on the Low Carb Cruise.

The Low Carb Cruise people clearly conflate low carb and paleo because they write "low carb/paleo" multiple times, implying that low carb and paleo are virtually the same thing.

If Masterjohn and Minger are not advocates of low carb diets, I wonder why they participate in a low carb cruise?

I wonder which of these categories each of the people you refer to falls into:

1) Believes that a meat-based low carb diet is best, but also that people can tolerate some amount of carbohydrates from some sources.

Someone who believes this would write somethings like these:

"Eat as much animal food as possible, and as much plant food as necessary."

"If I had unlimited funds, I would eat nothing but meat and fat; but my budget requires me to eat some plants."

2) Believes that a high carb diet is best and that meat of some or all types should be limited or even avoided.

You said that the "unifying feature' of paleo is what is avoided, not what is eaten. I don't think that was the consensus at the time that I wrote Farewell to Paleo. Nevertheless, in Farewell to Paleo I made it very clear that I was rejecting theh idea that meat-based diets promote health.

So, do the paleohacks, Harris, Masterjohn, McEwen, etc agree that meat-based diets are not health-promoting?

So far as I can tell, at least a few of the people you have cited have at some time firmly accepted the idea that meat-based diets promote health and some might even endorse the idea that meat-based diets produce the best of health for humans.

At one time I endorsed those positions which are part of the 'paleo' belief system. But with Farewell to Paleo, I rejected that belief, and I believe that that is why, to use your words, I received vitriol from the paleo community. Its not that I said 'carbs are okay' but that I said 'meaty diets are NOT optimal and plant-based diets are optimal.'

The point about the rural Chinese diet being 'paleo' by that too-broad definition AND being macrobiotic is that if paleo is defined so broadly the definition applies to non-paleo diets.

The rules of definition

http://www.philosophypages.com/lg/e05.htm

state that whenever possible a definition must be affirmative, not negative.

"It is always possible in principle to explain the application of a term by identifying literally everything to which it does not apply. In a few instances, this may be the only way to go: a proper definition of the mathematical term "infinite" might well be negative, for example. But in ordinary circumstances, a good definition uses positive designations whenever it is possible to do so. Defining "honest person" as "someone who rarely lies" is a poor definition."

A vegan diet is properly defined (affirmatively) as a diet consisting entirely of plant and microbial products.

If you define it as 'a diet containing no animal products' then this would include formula diets consisting of artificially produced nutrients, i.e. it is too broad.

Thus, a proper (i.e. sound) definition of "Paleo Diet" must specify what it is, not what it is not. It must specify the genus (e.g. diet) and differentia (the specific features that make it different from other diets), and it must apply to all and only those diets that qualify as 'paleo diet.'

Don said...

Cordain has published more than two dozen peer-reviewed articles or letters in scientific journals, all relating to defining paleo diet for the scientific community, plus three popular books on the topic.

To my knowledge, neither Sisson nor Wolf nor any of the others you have listed have had any peer-reviewed scientific articles on paleo diet published.

So, Cordain is defining paleo diet for both the scientific and the lay communities.

When members of the media want to know about paleo diet, who do you think they will call first: Cordain, Sisson, Wolf, McEwen, Masterjohn, Harris, or someone else on the paleohacks list?

When someone in the scientific community wants to study paleo diet, who do you think he will call on as a guide to paleo diet: Cordain, or one of the others?

You claim that his "influence in the practicing paleosphere is marginal at best." I wonder how you come to this conclusion?

Online forums are probably only a slice of people who have adopted paleo diets. Even if you could satisfactorily establish that these are dominated by people who disagree with Cordain's low-carb version of Paleo Diet (TM) you would not have established that Cordain's influence is less than that of Sisson or Wolf.

Perhaps a better measure would be book sales.

Amazon claims Cordain's book has sold more than 100,000 copies.

I can't even find numbers for the Paleo Solution. When I search with "The Paleo Solution number of copies sold" the first link returned is the Amazon page for Cordain's book. The second is for the Paleo Solution and it has no sales figures. I would hazard a guess that this means that Wolf's book has sold far fewer copies than Cordain's.

This link

http://www.marksdailyapple.com/primal-blueprint-2010-action-plan/#axzz1jeGQ6SX3

claims 16,500 copies of Primal Blueprint sold and another 20,000 ordered in 2010. If all 36,500 have been sold at this point, this would still put sales of Cordain's book at somewhere around 2-3 times that of Sisson's, if not more.

Don said...

Humane Hominid,

Thanks for pointing to my mistake. I think you are correct, the 'paleohacks' seem well-united in the belief that paleo can not include vegan diets.

Will,

There is no incongruity in the overlap between fruitarian and vegan, because fruitarian is a species of vegan.

But there is incongruity in any definition of paleo that produces overlap between the application of the label "paleo diet" and "macrobiotic diet" because the macrobiotic philosophy allows for some consumption of animal foods, but doesn't consider animal foods essential. In other words, paleo diet is not a species of macrobiotic diet, and macrobiotic diet is not a species of paleo diet. The two approaches to diet differ on basic prinicples. Therefore, any definition of paleo that includes any diet that can correctly be called macrobiotic is not adequately distinguishing between paleo diet and other diets.

Brave Friend said...

Don, well said.

Again, hats off to you for being able to think for yourself.

I have always admired how you had the courage ro re-examine everything you used to know. That is a sign of sanity.

Don said...

Will,

I published The Garden of Eating in 2004, about 7 years after starting my experience with "paleoesque' meat-based diets. During the time I was calling my diet "practically paleo" the carbohydrate content from fruits and vegetables varied from as high as 300 g per day to virtually zero and back up again at various times. Most of the time it was in the higher levels. That is why I used the word 'presently' in the quote you produced:

"Presently, I only eat one on each of the days that I spend glycogen in resistance training. Even on those days I don't go above a total of 150 grams of carbohydrate."

I did my best to prevent people from generalizing from one point in time to my entire 'practically paleo history.'

Anyway, I got involved in 'paleo' well before Cordain published his first book. You are talking at me as if I know nothing about the evolution of thinking in the paleo community, but it seems to me that I was one of the people contributing to that evolution.

Don said...

Will,

When McDougall says he doesn't think you have to be vegan to be healthy, he means that you can eat some animal food every now and then and not suffer illness. By the strictest definition, if you eat turkey every Thanksgiving but otherwise avoid animal food, you aren't vegan. But from a practical standpoint, he recommends consuming a vegan diet on a day-to-day basis.

I only say this because I don't want anyone reading this to get the idea that McDougall thinks people can eat animal foods every day and remain healthy. His book The McDougall Plan has the following Chapter Headings:

"Red Meat, Poultry, and Fish are avoided on a Health-Supporting Diet"

"Dairy Products and Eggs are Avoided on a Health-Supporting Diet."

"A Health-Supporting Diet Contains No Cholesterol"

Don said...

My question is, if you don't want to eat the diet that Cordain calls 'paleo diet' then why are you calling what you do paleo diet?

To me this is like calling yourself Catholic when you don't subscribe to, endorse, or practice Catholicism.

Will points at one possible reason: paleohacks want to ride the wave of Cordain's success to promote their own version of 'paleo.'

Some might call this 'bait and switch.'

So I ask:

Do these paleohacks have any evidence to support the idea that all diets that eschew gluten grains, vegetable oils, and sugar have equivalent health effects?

Do they have evidence that a diet consisting of 70% rice and millet, 20% vegetables, and 5% fish has the same health effects as one consisting of 70% milk products, 20% red meat, and 5% fruits and vegetables?

Do they have evidence that a diet that is 50% animal products produces or can produce the same health outcomes as one that is less than 5% animal products?

Do they have evidence that diets rich in total and saturated fats (e.g. Masai) and diets very low in total and saturated fat (e.g. rural Chinese) have exactly similar health outcomes?

Have any of them produced peer-reviewed scientific data supporting any of these beliefs?

Does the 'paleo' or 'ancestral health' community described by Will consist of people who want to believe and promote the idea that any diet followed by any preindustrial group, or any diet consisting of any combination of any food groups eaten by preindustrial people, promotes health as well as any other?

If so, then perhaps "ancestral" has become a way of rationalizing any dietary behavior in spite of evidence. The thinking goes: Our ancestors did it, therefore it must be health promoting.

That's an interesting hypothesis, and fatal to critical thinking, but I don't believe the evidence supports it.

It seems to me that this is one of the fallacies revealed by the Primitive Nutrition videos; I might call it the "ancestral health" fallacy. It is a variation of the fallacy of appeal to tradition.

George Henderson said...

"Fad type diet".
Is that a scientific term now? Surely wherever you read it, you know automatically that objectivity is not on the agenda.
Maybe they lost weight because their guts were so poisoned by gluten and lectins that they absorbed fewer nutrients. I was underweight (with heaps of other problems) when I gave up grains and was able to gain 4Kg fairly quickly.

George Henderson said...

Don, millions of women may stay lean on high-starch diets, but their rate of breast cancer increases sharply as starch % of diet increases. Check it out on Pubmed.
http://cebp.aacrjournals.org/content/13/8/1283.full
"In this population, a high percentage of calories from carbohydrate, but not from fat, was associated with increased breast cancer risk. This relation deserves to be investigated further, particularly in populations highly susceptible to insulin resistance."

I'd rather be fat.

Brave Friend said...

George, what do you expect in Mexico City? have you seen the food they eat? How much cooking oil they use, etc.

Successful starch-based diets in history have been extremely low fat and plant based. You are trying to crucify starch when it is not the starch, it is the fat and the meat.

squidey said...

Mcdougall actually addressed that study back in 2004

http://www.drmcdougall.com/res_breast_cancer2.html

Will said...

Hi Don,

The low-carb cruise speaker list is the same argument Plant Positive tried to use in his videos. I don't find it very convincing. I agree with CarbSane's reading of the situation: "I think Jimmy's been trying to co-opt paleo to keep LC going ... all the while in the past year paleo has become less and less equated with low carb. Jimmy's got a problem ... Livin la vida paleo doesn't have quite the same ring."

I also see it as a remnant of historical ties. Many LC and paleo celebrities are on good terms with each other thanks to their shared past, so it would be impolite and potentially awkward to turn down Jimmy's invite. This is especially likely with the easygoing and friendly personalities that I've seen in Chris Masterjohn and Denise Minger. Moreover, though they may not agree on carbohydrates, they do share some common ground on the benefits of animal food and the potential harm of the NAD.

"I wonder which of these categories each of the people you refer to falls into"

This is a false dichotomy. I thought I made this clear in my previous posts, but perhaps not. Right now, the paleo template does not dictate a particular macronutrient ratio or plant/animal ratio as "ideal" for _everyone_, but rather that you have to find a personalized ratio that works for yourself. As I've stated, I think this philosophy is pretty uninformative as a guiding principle -- but it is what it is.

I do think that some believe animal foods are somewhat preferable to starches, but their reason for this is a micronutrient availability argument rather than anything specifically toxic about carbohydrates.

"You said that the "unifying feature' of paleo is what is avoided, not what is eaten. I don't think that was the consensus at the time that I wrote Farewell to Paleo."

We'll just have to agree to disagree on this, then.

"So, do the paleohacks, Harris, Masterjohn, McEwen, etc agree that meat-based diets are not health-promoting?"

No, I don't think so. Not as a blanket statement, anyway. See my above explanation about individualized diets and self-experimentation. If you ask me, it's entirely possible that there are people out there who function better on a meat-based diet than a plant-based one. I can't rule out the possibility. To say that not a single person on this planet can EVER benefit from a meat-based diet, would be an extremely strong statement. It's not one that I'm confident enough to make.

(As an aside, I don't think it's correct to say "the paleohacks" to refer to the people. A "hack" is a quick fix or way to get something done. It's a term borrowed from computer science. I've been ignoring this until now because it's irrelevant to the conversation. But it's starting to bother me because you're using it repeatedly. Say "paleohacker" or something else instead.)

Will said...

(..continued..)

"If you define it as 'a diet containing no animal products' then this would include formula diets consisting of artificially produced nutrients, i.e. it is too broad."

Actually, it was my understanding that such artificially fortified foods and supplements would be considered vegan even by the strictest definition, as long as they involved no animal testing and whatnot. Are they not actually vegan?

"When members of the media want to know about paleo diet, who do you think they will call first: Cordain, Sisson, Wolf, McEwen, Masterjohn, Harris, or someone else on the paleohacks list?"

Judging by the ABC segment on the paleo diet that started off Plant Positive's video series, it seems like they will call Art De Vany and Robb Wolf, not Cordain:
http://abcnews.go.com/Nightline/video/rethinking-meat-veggies-13034429

Not to say that Cordain would never be called up, of course. But he's clearly not the only representative in popular media. No argument regarding scientific journals, but I was referring to broad exposure to the masses, not the technical literature.

"You claim that his "influence in the practicing paleosphere is marginal at best." I wonder how you come to this conclusion?"

By "paleosphere" I literally meant the paleo dieters represented online - in forums and on blogs. (This is what I presumed it meant, given that the word is derived from "blogosphere".) I do realize that the the web is not necessarily representative of the set of all people on the paleo diet.

But I will readily acknowledge that my claim about the books was based on wild speculation :) Hence why I wrote "I suspect" and not "I know for a fact." And your data shows that Sisson didn't sell nearly as many books as I thought. Even in the Amazon bestsellers rank, The Primal Blueprint is #2,248 while The Paleo Diet is ranked #448. Damn, a total blowout.

But wait! Check out The Paleo Solution and you'll find it ranked an impressive #146 on the bestseller list. Moreover, if you search for "paleo" or "paleo diet" and sort by *popularity*, The Paleo Solution actually comes out _ahead_ of The Paleo Diet. In fact, "The Paleo Diet" doesn't even show up on the first page with the "paleo diet" query! So I consider it reasonable to believe that the order of influence, from most to least, is Wolf, then Cordain, then Sisson.

Will said...

(..continued..)

"In other words, paleo diet is not a species of macrobiotic diet, and macrobiotic diet is not a species of paleo diet."

Two words: Venn diagram. Your argument is flawed from a set theory perspective.

"You are talking at me as if I know nothing about the evolution of thinking in the paleo community,"

Sorry if I gave you that impression, but that was not the intent. I started off by assuming you DID know what was going on in the paleo community, hence my initial speculation that you were "playing dumb." I see now that you were not, but that you truly think the paleo community never vindicated high-carb diets. I still stand by my position that low-carb and paleo have diverged. But I'm growing tired of arguing, so this is probably going to be my final comment on the matter.

"When McDougall says he doesn't think you have to be vegan to be healthy, he means that you can eat some animal food every now and then and not suffer illness."

Yep. I made that comment in a humorous context, but your clarifications are accurate. Though for the record, I do disagree with McDougall on the safe upper limit on animal food.

"My question is, if you don't want to eat the diet that Cordain calls 'paleo diet' then why are you calling what you do paleo diet?"

This is one of the things I can agree with you on. Paleo dieters keep moving the goal posts when 'paleo' is about to be discredited. I'm glad that they are willing to admit to dietary mistakes, but I think the term 'paleo' simply needs to die. Or at least relegate it to people who practice the original incarnation of the paleo diet.

"It seems to me that this is one of the fallacies revealed by the Primitive Nutrition videos; I might call it the 'ancestral health' fallacy. It is a variation of the fallacy of appeal to tradition."

I can tell you right now that some of the bloggers we've mentioned already do NOT actually commit this fallacy as you describe it. This is a subtle point (Plant Positive never addresses this one in his videos, by the way):

http://www.archevore.com/panu-weblog/2010/3/28/the-only-reasonable-paleo-principle.html

Kurt Harris has a label for this kind of reasoning. Paleo 2.0.

Will said...

One more thing:

"Do they have evidence that diets rich in total and saturated fats (e.g. Masai) and diets very low in total and saturated fat (e.g. rural Chinese) have exactly similar health outcomes?"

If saturated fat per se is half as problematic as vegans claim, and refined carbohydrate is bad but not AS bad, then I would like to know your explanation for e.g. the Tokelau migrants,

http://wholehealthsource.blogspot.com/2009/01/tokelau-island-migrant-study-background.html

where the saturated fat intake was cut in half (replaced mostly by flour and sugar) and health deteriorated.

Will said...

Here are links to the full series:

http://wholehealthsource.blogspot.com/2009/01/tokelau-island-migrant-study-final-word.html

Eva said...

In addition to lack of control group, I didn't see any statistical analysis either. You should have both. This study was not very scientific and it's certainly not the kind of study one should be basing one's opinions on. This is the kind of study you do to test the waters and then you should go on to do a much better study afterwards.

In addition, as many have pointed out, bread was very different back then, with no high fructose corn syrup, different types of wheat, different fat sources. The yeast was even different. Obesity was much less in the 70s as well.

I'd have to see a decent study using modern food sources before I decided on what modern food sources were and were not good to eat.

I would be the first to agree that no one has all the answers yet and as new information comes in, the wise man does not get too attached to any one theory. Personally, I feel that the fact that paleo has shifted over time and made alteration to recommended foods is a sign that the are not dogmatically blind but instead are doing their best to be more open minded about the science and what works.

Don said...

George,

Read the study:

"Among premenopausal women, risks of breast cancer increased with consumption of total carbohydrate (OR 2.31 95% CI 1.36-3.91) and sucrose (OR 2.51, 95% CI 1.47-4.26), with significant trends for both. Similarly, among postmenopausal women, the risk of breast cancer was 2.2 times higher among women in the highest quartile of total carbohydrate intake when compared with women in the lowest quartile (OR 2.22, 95% CI 1.49-3.30), with a highly significant trend. Sucrose intake was significantly related to the risk of breast cancer (OR 1.84, 95% CI 1.26-2.71). Slightly increased risks were also observed for glucose and fructose intake, but these trends did not reach significance (Table 3). "

The significant association is with sugar, not starch.

Razwell said...

Don


Have you heard about The HDL Milano Mutation? The most cutting edge research in coronary artery disease is looking into HDL capacity- NOT level.

It's the efflux capacity, the reverse cholesterol transport.


The traditional cholesterol tests ( total cholesterol) are next to worthless for predicting heart disease. And even mean serum HDL levels and LDL levels.

If they could measure efflux capacity THAT would be useful. But it would probably be expensive and is not available yet.

I did an article on "Apo A 1 Milano" , a naturally ocurring HDL MUTANT version that these 40 villagers in Limone sul Garda have. They have HDL levels as low as 7 to 25 YET no CAD.

This low HDL level but no CAD has been observed in some other cultures too.

We are ON TO SOMTHING HUGE.

Dr Daniel Rader and DR. Steven Nissen are leading the way. Anthony Colpo is not at al a reputable source of information. He is scamming people.

Best Wishes,

Raz