Friday, September 28, 2012

Grass-Fed Animal Products Prevent Obesity and Cardiovascular Disease?

Not for Mongolians.

Mongols eat a diet largely composed of milk products, meat, and fat from free-ranging, organic, grass-fed animals.  They consume few plant foods because few edible plants grow in the cold continental climate of Mongolia.  The climate forced them into a natural experiment in low-carb nutrition based on grass-fed animal products.

In this 2010 episode of Bizarre Foods, Andrew Zimmern eats sheep head stew at a Mongolian cafe and goat carcass and intestine-wrapped liver on the steppes, samples "stomach butter" and fermented mare's milk, and has some pretty strong cheeses, among other full-fat bizarre foods as he calls them.   As Zimmern says, "its a faraway land of meat, meat, and more meat."  Of interest to the WAPF crowd, they use boiled milk, not raw milk, to make their cheese and some other processed dairy products.  Watch the markets for processed carbohydrates....

Most of them eat a WAPF low-carb primal paleo grass-fed animal fat dream diet (although the lean journalist admitted that she avoids fats).   According to Wikipedia, as of 2006, the United Nations reported that about sixty percent of Mongolians live in urban circumstances, so about forty percent live in rural areas.  Does their fleshy, fatty, milky diet keep them lean and healthy in either circumstance?

According to this World Health Organization document, in Mongolia in 2005,  fifty-six percent of men and seventy percent of women were overweight.  It is expected that by 2015, seventy-five percent of men and seventy-nine percent of women will be overweight.

Source:  World Health Organization

The WHO document also reports that chronic diseases cause sixty percent of deaths.  In 2002, thirty percent of Mongols died from cardiovascular disease, and twenty-one percent from cancer.

Source:  World Health Organization

No doubt, some will try to blame this on the introduction of plant foods into Mongolian diets.

In 2008, Bolomaa et al of the Nutrition Research Centre, National Public Health Institute of Mongolia reported that on average Mongolians consumed only 3.2 servings of fruit or vegetables daily.  They also found that one in every five people had three and more risk factors or was at high risk for developing non-communicable diseases, and "one in every two males aged 45 years and above was at high risk in developing NCDs. "

In 2008 Komatsu et al of Kagawa Nutrition University in Japan reported:

1.  Mongolians have a relatively short life expectancy.

2.  The residents of Murun, a north Mongolian city, eat large amounts of meat, milk, dairy products, and wheat flour products, but little vegetables, fruits, or fish.

3.  Compared to average values in Japanese, Murun residents have significantly higher levels of serum  serum triglycerides, low-density lipoprotein cholesterol (LDL) and homocysteine, and lower levels of high-density lipoprotein cholesterol (HDL), n-3 PUFA, folic acid and adiponectin.

4.   Mongolians also had significantly higher levels of oxidative stress markers, including oxidized LDL and serum reactive oxygen metabolites (ROM).

5.  The serum ROM in Mongolians correlated positively with their body fat ratio and inversely with their hand-grip strength.

6.  Mongolians aged 30 years or greater had a high incidence of obesity.

7.  Mongolians aged 40 years and older had markedly decreased handgrip strength.

Komatsu et al concluded that "These findings suggest that in the Mongolians the dietary habits associate with their lifestyle-related diseases and early aging, and the improvement of dietary habits is an effective strategy for health promotion of the inhabitants."

In 2009, Dugee et al (full text) reported that

"Mongolians have a distinctive lifestyle and dietary habits that are characterized by a preference for high protein and fatty foods of animal origin. Such a dietary preference is probably in keeping with the country’s extreme continental climate and nomadic lifestyle where meat and meat derivatives are the main sources of energy and nutrients during both winter and spring, while dairy products are commonly consumed during summer and autumn."  [Italics added-DM]
Dugee et al found three dietary patterns among Mongolians aged 25 years or more:

1.  A transitional pattern, high in grass-fed meats (beef, mutton, goat), pork, and sausages, but including some vegetables (cabbage, onion, carrot), potato, and bread.

2.  A traditional pattern consisting of foods Mongolians traditionally ate in summer: whole milk, yogurt, horse meat, wheat products, fats and oils, and confections (such as the milk-based item Zimmern tasted in the Mongolian market in the first video above).

3.  A modernized healthy pattern with greater intake of whole grains (rice, millet, barley, whole wheat), vegetables, and fruits.

As quoted above,  Dugee et al admitted that "meat and meat derivatives are the mains sources of energy and nutrients during winter and spring" in Mongolia.  Further, Dugee et al also say that they call the milk-based pattern "traditional" because "the food items reflect the diet of Mongolians during summer."  This suggests that what they called a "transitional" diet actually represents a pattern similar to the Mongolian winter/spring diet (meat products and hardy vegetables), while what they called a "traditional" diet is only traditional in Mongolia in summer and autumn.

 In other words, it suggests that they were actually comparing the "healthy" pattern to the two seasonal traditional patterns of Mongolian diet, and that labeling the one pattern "transitional" was misleading.  I think it would have been more appropriate to call the first pattern the meat-based traditional pattern, and the second the milk-based traditional pattern.

In studies of this type, researchers primarily compared the people who most closely adhered to one of these three patterns, simply because the less adherent any individual was to any one pattern, the more that individual's diet included elements of two or more patterns, making it very difficult to sort the different effects of the patterns.  For example, say someone in this particular study was trying to improve his health by eating more whole plant foods, but he was still eating meat and milk every day.  His diet would have a mix of all three patterns, and his weight would show the effect of that mix.  Therefore, when doing this type of study, the most clear information will come from comparing the individuals have the most distinct diets.

Dugee et al looked at the relationship between these patterns and obesity among the studied  Mongolians, and found:

1. For both sexes, those with the diet highest in whole plant foods carried the lowest risk of obesity, half the risk of other patterns.

2. For both sexes, those having the most "transitional" (i.e. animal flesh- and fat-based) diet pattern had doubled the risk of obesity relative to low intake of these meats and fats.

3. Greater adherence to a "traditional" (milk-based) diet pattern had the intermediate risk for both sexes.

4. Among women, adherence to a traditional diet pattern carried the highest risk of abdominal obesity, almost 5 times greater risk of abdominal obesity than those Mongolian women having diet pattern least like traditional.

Overall, these studies indicate that the Mongolians habitually eat a diet based on grass-fed animal animal products, those who eat in the most traditional pattern have an increased risk of obesity, cardiovascular disease, and early mortality, and those who eat more whole plant foods and less of traditional animal products have less obesity.

It really isn't news.  As noted by Healthy-Longevity in a comment left on a different post on this blog, the WAPF primal paleo grass-fed animal dream diet didn't keep the early 20th century Kirghiz plainsmen of paleo-Siberian origin lean or healthy either:

"These findings resemble the Kuczynski’s report in 1925, who observed that the nomadic Kirghiz plainsmen who habitually consume a diet with large amounts of organic meat and milk from grass-fed livestock had a high incidence of obesity, premature extensive atherosclerosis, contracted kidney, apoplexy and arcus senilis, which was not exhibited by their urbanized counterparts who consumed a more varied diet."  Source: Coronary Heart Disease Epidemiology, Second Edition, Oxford University Press, 2005, page 22.
You can't blame the obesity and poor health of nomadic Kirghiz plainsmen of 1925 on late-20th century processed foods or urban sedentary lifestyle.  The only dietary factors in common between the Kirghiz and the Mongolians are the grass-fed animal products.

The WAPF, primal paleo grass-fed animal dream diet didn't keep the Kirghiz people lean and healthy 100 years ago, and adhering more closely to it it still doesn't seem to be keeping the Mongolians lean or free of cardiovascular disease or cancer.