Primal Wisdom

Wheat Again

2012-01-31T19:13:00.000-08:00

The USDA has published this chart of U.S. consumption of wheat flour between 1830 and 2008.

Before 1850, U.S. consumption of wheat was lower than between 1850 and 1910. The USDA explains:

"Wheat production was difficult in New England and in much of the South in the colonial era (1600s and 1700s), making wheat flour too expensive for regular use. High transportation costs also made long-distance transport of wheat and flour from regions better suited for wheat growing unprofitable. Therefore, colonists in these regions turned to other crops, especially corn. The wealthy were the principal consumers of wheat bread."

In the U.S., wheat flour (and thus wheat bread) consumption peaked in the late 19th century at about 220 pound per capita per annum. That means that in the late 19th century, U.S. citizens were consuming an average of about 10 ounces of wheat flour daily.

That would provide about 950 kcalories, 37 g protein, and 200 g carbohydrate from whole wheat flour alone. It is equivalent to consuming 12 slices of whole wheat bread daily.

About 1910 the per capita wheat flour consumption dropped below 200 pounds, and now it is about 150 pounds per annum, so we have seen a 32 percent drop in wheat flour consumption since the late 19th century.

So, during the 20th century, what replaced grain consumption? The USDA says :

"Historically, economic development has been accompanied by the substitution of meat for grain in the diet, and this was true in the United States starting in the 1870s."

The substitution of meat for grains as a consequence of economic development represents part of what nutritionists have called the nutrition transition , which Popkin characterizes here :

"Major dietary change includes a large increase in the consumption of fat and added sugar in the diet, often a marked increase in animal food products contrasted with a fall in total cereal intake and fiber."

Put another way, up until the late 19th century, the U.S. was an agrarian nation. Agrarian nations typically derive most of their sustenance from cereal grains and this was true of the U.S. for its first 100 years, during which corn and wheat provided the majority of calories consumed by the majority of people.

So far as I can tell, rates of obesity, diabetes, and cardiovascular disease in the U.S. went up during a time when consumption of wheat and corn was well below that of the late 19th century.

According to an article by B.C. Curtis posted on the Food and Agriculture Organization website, the French consume almost twice as much wheat per capita as people of the United States.

According to World Health Organization data, the U.S. has about 2.5 times as many heart disease deaths as France.

France also has an obesity rate one-third of that of the U.S.A..

It doesn't look like consumption of bread increases the risk of heart disease or obesity in France.

We do have evidence indicating that whole grains including whole wheat protect against heart disease.

Groen (pdf) studied the effect of dietary wheat bread on serum cholesterol. He found first that Trappist monks, Yemenite Jews, and Arab Bedouins consumed an average of 600, 500, and 750 g of bread daily, compared to an average of 150 g bread daily in a Western diet, but the bread eaters had low serum cholesterol levels and very low risk of ischemic heart disease.

The Bedouins consumed the most bread (750 g daily) and the least animal protein (5 g daily) and total fat (38 g) and had the lowest serum cholesterol.

One slice of bread weighs about 30 g, so the Trappists ate about 20 slices daily, the Yemenites about 17 slices, and the Bedoins about 25 slices daily, compared to about 5 slices in the typical Western diet. These levels of bread intake are common among people who eat bread as a staple food.

Groen compared the effects on serum cholesterol of low-fat, low-sugar diets in which most of the protein came from animal sources, or most of the protein came from wheat gluten. The study suggested that a gluten-rich diet may produce a lower cholesterol level than one based on animal protein.

Groen also found that replacing bread with equal caloric amounts of sugar raised serum cholesterol.

Study: Sleep Deprivation Activates Hunger Center of Brain

2012-01-20T16:24:00.000-08:00

A team of Swedish researchers from Uppsala University, led by Christian Benedict and Helgi Schiöth, have published a report in the Journal of Clinical Endocrinology and Metabolism indicating that acute sleep deprivation enhances the brain's response to pleasurable food.

They found that "Compared with sleep, total sleep deprivation was associated with an increased activation in the right anterior cingulate cortex in response to food images, independent of calorie content and prescan hunger ratings."

According to an article about this study by Kathleen Blanchard, RN:

"Christian Benedict and Helgi Schiöth, of the Department of Neuroscience at the University also showed that lack of sleep leads to increased hunger.

"According to Benedict, findings from their newest investigation revealed, “After a night of total sleep loss, these males showed a high level of activation in an area of the brain that is involved in a desire to eat.”

"The study participants were shown images of food during the brain scans, with and without a good night’s sleep.

"Benedict adds, 'Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people’s risk to gain weight in the long run. It may therefore be important to sleep about eight hours every night to maintain a stable and healthy body weight.' ”

Over the twentieth century, average sleep duration for U.S. citizens declined from about 9 hours daily to about 7 hours daily. During that same time, per capita energy intake and obesity rates both increased.

McAllister et al suggest "that a myopic emphasis on" changes in food habits and activity levels as causes of weight gain has "caused the popular media, and perhaps some researchers as well, to neglect the potential contributions of other factors to the balance between energy intake and expenditure."

"Our questioning of the big two stems from two points. First, the evidence supporting various elements of the big two as contributors to individual or population levels of obesity is often quite weak. Second, even though some elements of the big two do very likely play some role in influencing obesity levels, we believe that an unquestioned assumption of their preeminence has led to the possibly ill-advised expenditure of public effort and funds on programs aimed at reducing population levels of obesity and has also reduced the exploration of other potential causes and the alternative obesity reduction programs that might stem from their identification."

McAllister et al point to evidence showing that sleep deprivation and nine other factors––including microorganisms, epigenetics, increasing maternal age, greater fecundity among people with higher adiposity, assortative mating, environmental endocrine disrupters, pharmaceutical medical interventions, reduction in variability of ambient temperatures, and intrauterine and intergenerational effects–– have have all played a role in promoting the obesity epidemic.

Wheat Belly: Fat or Flat

2012-01-05T18:58:00.000-08:00

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)

Vitamin B12 and Human Nutritional Evolution

2011-12-21T17:53:00.000-08:00

I once believed and argued that the fact that humans require vitamin B-12 provided substantial support for the idea that humans have a biological requirement for dietary meat. My reasoning went thus:

Humans require vitamin B-12, and only animal products reliably provide natural bioactive vitamin B-12, therefore we must be adapted to and dependent upon meat-eating.

I have since realized that I made a few mistakes here. Although we definitely require B-12, animal products are not the only reliable sources of natural bioactive B12, and human B-12 metabolism provides evidence that our ancestors adapted to an environment/diet that had a low availability of B-12 compared to currently recommended daily reference intakes.

Human B-12 Metabolism

Humans have enterohepatic circulation of vitamin B-12.[1 ] As noted by Herbert [2 ], this can allow an initially B-12 replete adult go 20-30 years without vitamin B-12 intake:

“The enterohepatic circulation of vitamin B-12 is very important in vitamin B-12 economy and homeostasis (27). Nonvegetarians normally eat 2-6 mcg of vitamin B-12/d and excrete from their liver into the intestine via their bile 5-10 mcg of vitamin B-12/d. If they have no gastric, pancreatic, or small bowel dysfunction interfering with reabsorption, their bodies reabsorb ~3-5 mcg of bile vitamin B-12/d. Because of this, an efficient enterohepatic circulation keeps the adult vegan, who eats very little vitamin B-12, from developing vitamin B-12 deficiency disease for 20-30 y (27) because even as body stores fall and daily bile vitamin B-12 output falls with body stores to as low as 1 mcg, the percentage of bile vitamin B-12 reabsorbed rises to close to 100%, so that the whole microgram is reabsorbed.”

What kind of environment/diet would naturally favor the survival of humans having such efficient recycling of vitamin B-12 but not of other B-complex vitamins?

As a general principle, if an organism subsists on a diet with a low availability of a certain essential nutrient, it needs mechanisms for increasing absorption and retention of that nutrient, to prevent deficiency. On the other hand, if an organism subsists on a diet with a very high availability of a certain essential nutrient, then it needs mechanisms for reducing absorption, detoxifying, and eliminating that nutrient.

Put in natural selection terms, only an ancient environment/diet with a low B-12 availability would have favored the survival and reproduction of humans who could recycle B-12 very efficiently. An ancient environment/diet with a high B-12 availability would have made such a capacity unnecessary; on the contrary, an environment with a high availability of vitamin B-12 would have favored those who were less efficient at using B-12, or those who deliberately excreted excessive B-12 (in order to prevent B-12 accumulation and toxicity).

Thus, modern human B-12 metabolism suggests that modern humans are adapted to a diet that provides B-12 in less than required amounts on a daily basis, while occasionally providing larger doses in excess of requirements.

Currently the National Academy of Sciences recommends that adults consume 2.4 mcg of B12 daily. They calculated that this covers the needs of 98 percent of individuals, but most of us require less than this. The following table shows the B12 contents of commonly consumed animal products:

Three ounces of beef or salmon provides the recommended intake, and three ounces of shellfish substantially exceeds the recommended 2.4 mcg. In contrast, one would have to consume 24 ounces of chicken or turkey daily to ingest 2.4 mcg of B12.

Non-animal B-12 Sources

As I said above, I previously accepted that only animal products reliably provide natural vitamin B-12. Although this is a common belief, and probably a good general rule in modern industrialized nations, I think we have significant evidence that pre-industrial humans had other significant sources of vitamin B-12.

First, although animal products provide the most common vector for delivery of B-12 in modern industrialized nations, only microbes produce vitamin B-12. [3] Many microbes have the ability to produce B-12, among them the following genera: Aerobacter, Agrobacterium, Alcaligenes, Azotobacter, Bacillus, Clostridium, Corynebacterium, Flavobacterium, Micromonospora, Mycobacterium, Norcardia, Propionibacterium, Protaminobacter, Proteus, Pseudomonas, Rhizobium, Salmonella, Serratia, Streptomyces, Streptococcus and Xanthomonas.

Bacillus megaterium is a common soil bacteria, not pathogenic to humans, and a producer of vitamin B-12.[4] According to Patricia Vany of the Department of Biological Sciences at NIU, B. megaterium occurs in human breast milk.[15, third slide]

Lactobacillus reuturi, a member of the gastrointestinal ecosystems of humans, poultry, swine, and other animals, and present in sourdough culture, produces vitamin B-12. [5]

Albert et al reported “the human small intestine also often harbours a considerable microflora and this is even more extensive in apparently healthy southern Indian subjects. We now show that at least two groups of organisms in the small bowel, Pseudomonas and Klebsiella sp., may synthesize significant amounts of the vitamin.”[6]

In 1995 Suzuki reported that the marine algae, nori, prevented all signs of B12 deficiency symptoms in 6 vegan children he studied:

“A nutritional analysis was conducted on the dietary intake of a group of 6 vegan children aged 7 to 14 who had been living on a vegan diet including brown rice for from 4 to 10
years, and on that of an age-matched control group. In addition, their serum vitamin B12 levels and other data (red blood cell count, hematocrit, hemoglobin, etc.) were determined in the laboratory. In vegans' diets, 2-4 g of nori (dried laver), which contained B12, were consumed daily. Not a single case of symptoms due to B12 deficiency was found. There were no statistically significant differences between the two groups with respect to any of the examination data, including B12 levels (p < 0.05). Therefore, consumption of nori may keep vegans from suffering B12 deficiency.” [7]

[In 2005 Croft et al reported that algae acquire vitamin B12 through a symbiotic relationship with bacteria. (14) ]

In 2009 Koyyalamudi et al [8] reported that the common white button mushroom can provide vitamin B12 of value equivalent to that found in beef, beef liver, salmon, egg, and milk (not analogues). Koyyalamudi et al determined that the mushrooms probably absorbed the B12 from bacteria inhabiting their growth medium:

“High concentrations of vitamin B12 were also detected in the flush mushrooms including cups and flats. HPLC and mass spectrometry showed vitamin B12 retention time and mass spectra identical to those of the standard vitamin B12 and those of food products
including beef, beef liver, salmon, egg, and milk but not of the pseudovitamin B12, an inactive corrinoid in humans. The results suggest that the consumer may benefit from the consumption of mushroom to increase intake of this vitamin in the diet.” [8]

In 1994, Mozafar reported that spinach leaves and barley seeds grown on soil fertilized with organic matter or isolated B12 take up vitamin B12 into their tissues from the soil. The spinach leaves and barley kernels were thoroughly washed with distilled water before being tested for B12 content, so this was not a case of finding B12 on soiled plants. Their testing confirmed that these plants contained active B12, not inactive analogues.[9]

In summary, it appears that non-pathogenic soil microbes, human small intestinal bacteria, lactobacilli from fermented foods, some sea algae, common mushrooms, and plants grown on soil fertilized with animal manure can all can provide biologically active B12. Any of these could have served as ongoing sources of B12 for prehistoric human ancestors, but modern circumstances may make these non-animal sources of B12 unreliable for modern humans.

I think it safe to assume that our prehistoric ancestors had more contact with soil than we do, sitting on it, sleeping on it, digging in it, and drawing water from sources in contact with the soil. Humans like other primates are apt to touch their own lips from time to time, providing a vector by which soil microbes could enter the human gut.

Humans living in modern industrialized nations typically ingest multiple courses of oral antibiotics over a lifetime, reducing or eliminating the population of B12-producing bacteria residing in the small intestine. All of our prehistoric ancestors would have been breast fed and probably kissed often, which transmits flora from one generation to another, and this transmission would not have been interrupted by antibiotic treatments.

Fermentation of plant foods, particularly fruits, occurs spontaneously in nature, providing another route by which our ancestors may have ingested B12-producing lactobacilli. Our ancestors almost certainly consumed any edible wild mushrooms and all of the plants they ate grew in soils teaming with bacteria and fertilized by fermented organic wastes, providing another B12 source.

All of this information suggests that modern hygiene, indoor lifestyles, antibiotics, and use of chemical rather than biomass fertilizers in farming have reduced the amount of B12 available to humans in modern urban environments from non-animal sources.

Thus, the low availability of B12 from non-animal sources in modern urban environments is an artifact not reflective of preindustrial environments, and it appears probable that our prehistoric ancestors had more non-animal sources present in their environment, like the southern Indians studied by Albert et al.[6]

My Fallacious Appeal to 'Nature'

When I previously argued that meat-eating is the 'natural' way to get B12, I committed the fallacy of appeal to nature.

The problem here lies in these underlying assumptions: 1) all 'natural' behaviors are 'health-promoting' behaviors for modern urban humans, and 2) all 'unnatural' behaviors are unhealthful.

Consider these questions:

Is it natural for humans to wear clothing? Does wearing clothing promote better health in some circumstances? (Imagine people living in Minnesota rejecting clothing because their African ancestors didn't wear any.)

Is it natural for humans to live in igloos in the arctic circle? Does living in igloos in the arctic circle promote the best of health?

Is it natural for humans to live in natural caves? Do humans have the best possible health when living in natural caves? Is a natural cave the best possible human shelter?

Is it natural for humans to commit homicide, engage in war, or eat human flesh? Do any of these promote health?

If all you mean by 'natural' is 'spontaneously occurring,' then all human behaviors are 'natural.'

But is the 'natural' choice of our ancestors the best possible choice for modern humans of the present day?

Simply put, the fact that our ancestors did something then does not tell us that it is the best thing for us to do now.

The fact that our ancestors obtained B12 by a 'natural' route (eating meat) does not tell me that this is the optimal way for me to get B12 in our modern circumstances.

The Nature of B12 Supplements

Artificial synthesis of B12 requires about 70 synthesis steps, making it impractical as a method for commercial production of B12. “Therefore, today vitamin B12 is exclusively produced by biosynthetic fermentation processes, using selected and genetically optimized micro-organisms.” [10]

In other words, we cultivate, feed and breed living microbes so that they will produce the nutrient we want. This practice seems similar to cultivating cattle to produce protein or B12. If the former is ‘artificial,’ so is the latter.

Tablets of microbially synthesized B12, burgers of ground beef, capsules of vitamin D extracted from sheep’s hair, and tortillas made from corn are all end products of humans processing a raw material into a form that humans can conveniently consume. If you reject B12 tablets as ‘unnatural,’ you should similarly reject ground beef burgers and vitamin D capsules.

The information above indicates that modern antibiotics and hygiene have reduced or eliminated intestinal flora that would otherwise produce B12 for us, and modern agricultural practices have reduced the B12 content of plant foods. Similarly, modern indoor lifestyles have reduced our endogenous production of vitamin D. We can reasonably use supplements to correct for these technology-induced deficiencies.

In short, B12 supplements are the most reliable source of natural B12 in the modern environment.

Microbial B12 Supplements Recommended To People Past 50 Years Of Age

The Linus Pauling Institute at Oregon State University recommends that all people (including omnivores) over the age of 50 take a B12 supplement:

“Also, individuals over the age of 50 should obtain their vitamin B12 in supplements or fortified foods like fortified cereal because of the increased likelihood of food-bound vitamin B12 malabsorption.”[11]

In the publication Dietary Reference Intakes [12 ], the National Academy of Science Food and Nutrition Board concurs:

So these sources do not consider animal foods to be reliable sources of B12 for those of us more than 50 years of age.

Do we reject this advice because it is not 'natural' to take supplements?

Some B12 Options

Modern humans typically use their minds to identify their requirements for health and comfort, then develop and use appropriate technology to provide those requirements in the most efficient, safest possible way.

Thanks to microbe-ranching, each modern urban human now has the opportunity to decide which of at least 3 courses s/he would prefer to take to ensure achievement of a healthy B12 status.

Course 1: Obtain B12 directly from a cultivated microbial source, the production of which requires relatively little land and water and produces no urine or feces. This source is free of saturated fats, cholesterol, heterocyclic amines, lipid peroxides, pathogenic organisms, or antigenic Neu 5Gc sialic acid (a suspect in human cancers and autoimmunity, found only in mammal’s products, 13 ).

Course 2: Obtain B12 from animal products, the production of which requires enormous amounts of land and water and produces tremendous amounts of urine and feces requiring safe disposal. This source also supplies saturated fats and cholesterol, heterocyclic amines (cooked meat), and lipid peroxides (cooked fat), and is frequently contaminated with various potential pathogens (E. coli 0157:H7, MAR bacteria, salmonella, vibrio, etc.). Red meats and mammalian milks also provide antigenic Neu5Gc sialic acid. [13]

As noted above, current science indicates that Course 2 is probably not reliable for people more than 50 years of age.

Course 3: Use both B12 supplements and animal products.

Take your pick, or perhaps you will discover another way.

Thanks to the author/producer of the Primitive Nutrition video series for alerting me to the article on the B12 content mushrooms used in this post.

Primitive Nutrition Critique Parts 4 and 5

2011-12-12T15:47:00.000-08:00

In The Protein Debate, Loren Cordain wrote the following:

He seems to be saying two things:

1) Nutrition as a science suffers from “chaos, disagreement, and confusion.”

And

2) Use of ‘an evolutionary model’ would elimate “chaos, disagreement, and confusion” by providing “coherent way to interpret the data.”

With regard to the first statement, I don’t know where he finds the “chaos, disagreement, and confusion” in nutrition science. I can’t find this in any standard nutrition textbooks, in the National Academy of Sciences Food and Nutrition Board Dietary Reference Intakes publications, or among various expert panels making dietary recommendations to the public. Among these scientific sources, I find very little or no debate as to human requirements for protein, fat, carbohydrate, vitamins, and minerals. Also, the general guidelines for diet vary little from expert panel to expert panel. Do I see a straw man here?

Or is Cordain preoccupied with the confusion among lay people, generated by the profusion of fad diet books?

Or is the disagreement he refers to the disagreement between his recommendation for a low-carbohydrate, high-protein diet, and the science which shows that humans only require a small amount of protein (one-third of what Cordain advocates) and lots of carbohydrates?

With regard to the second statement above, this implies that we should find even greater agreement among those who profess to use “an evolutionary model” to evaluate nutrition than we do among the conventional sources that Cordain derides.

So let’s take a look.

Fruits and Vegetables

Regarding consumption of fruits and vegetables, expert panels of the USDA, American Heart Association, National Cancer Institute, American Institute for Cancer Research, World Cancer Research Fund, and many others generally agree that we benefit from eating fruits and vegetables.

In contrast, among those using an evolutionary model, Cordain believes that we should eat them because they provide important phytochemicals that protect against cancer and inflammation, but evolutionary model advocate and radiologist Kurt Harris, M.D. has once expressed the view that “plants and plant compounds are not essential or magic,” stating:

"Show me a randomized intervention that shows the benefits of fruits and vegetables. Such trials have been done and they have not shown a benefit."

Unfortunately I do not know to which trials he refers as he provided no reference. In that essay, Harris added that the idea that a particular plant compound is essential is inherently implausible and in need of a rigor of proof suitable for establishing the idea that there exists some extraterrestrial intelligence:

"To overcome the inherent implausibility of a particular compound or plant being essential or uniquely beneficial to health, there must be a high standard of proof.

"Similar to the level of proof there that there is extraterrestrial intelligence. It's implausible, so good evidence is needed."

Dr. Harris has amended his view on this topic somewhat since those words, and has written a blog indicating he believes that some plant compounds may provide benefits and "that eating some veggies is a hedge against going without unspecified beneficial compounds."

My question is, if the evolutionary model is so helpful for eliminating chaos and confusion, why didn't it clearly favor one or the other of these views about plants and plant compounds?

Nutrition science recognizes many plant compounds essential to health (although apparently not those that Dr. Harris had in mind in his 'plant compounds are not essential' essay). Those include, minimally, the vitamins thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, folate, ascorbic acid, phylloqunione (vitamin K1), tocopherols (vitamin E); the essential fats linoleic and linolenic acids; and the essential amino acids isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine, and histidine.

All of these compounds are originally synthesized by plants and, except for niacin, appear in animal tissues only because the animal ate plants directly or ate another animal that ate plants. The evidence that we require these plant compounds is thoroughly discussed in the various Dietery Reference Intakes publications of the Food and Nutrition Board of the National Academy of Sciences as well as numerous standard nutrition textbooks.

Amazingly, nutritional scientists discovered the essentiality of these nutrients for modern humans without speculating about the habits of stone age hunter-gatherers, consulting archaeologists, or asking anthropologists what isolated hunter-gatherers eat. Am I to believe that all of this talk of essential nutrients is nonsense because it was discovered without applying an evolutionary model?

In addition, while I would agree that it is implausible that any particular plant (e.g. spinach) is essential to health, plants world-wide have similar constituents (including non-vitamin phytonutrients). For example, polyphenols occur in many species of plants world-wide. To my knowledge, no nutrition scientist is arguing that any particular plant is essential or uniquely beneficial to human health, but many would suggest that humans have adapted to (possibly to become reliant upon) consumption of families of plant compounds (e.g. polyphenols). I find this considerably more plausible than the idea of extraterrestrial intelligence (I don't know if Dr. Harris has changed his opinion here), since we already have established a human need for the plant compounds I have listed above.

So far as I can tell, except for vitamin D, which our own bodies synthesize if exposed to sunlight, not one nutrient mentioned in those FNB documents as an essential dietary component for humans is originally synthesized only by animals; i.e. all are originally synthesized by plants or microbes, or present as inorganic components of the earth's crust. This table lists the essential nutrients and their original sources:

Nutrient	Original Source(s)
Essential amino acids (9)	Plants
Linoleic acid	Plants
Linolenic acid	Plants
Glucose	Plants
ß-carotene (provitamin A)	Plants
Tocopherols (vitamin E)	Plants
Cholecalciferol (vitamin D3)	Endogenous synthesis after sunlight exposure
Phylloquinone (vitamin K)	Plants
Thiamine (B1)	Plants and microbes
Riboflavin (B2)	Plants and microbes
Niacin (B3)	Plants
Pantothenic acid (B5)	Plants and microbes
Pyridoxine (B6)	Plants and microbes
Folate	Plants and microbes
Cobalamin (B12)	Microbes
Ascorbic acid (vitamin C)	Plants
Minerals	Rocks, soil (brought into the food chain by plants)

Cholesterol

Regarding dietary and blood cholesterol, scientific bodies consistently agree that dietary cholesterol is not beneficial or essential, and reducing cholesterol levels is desirable and necessary for avoiding cardiovascular disease (atherosclerosis). For example, the NAS Food and Nutrition Board writes:

"There is much evidence to indicate a positive linear trend between cholesterol intake and low density lipoprotein cholesterol concentration, and therefore increased risk of coronary heart disease (CHD). A Tolerable Upper Intake Level is not set for cholesterol because any incremental increase in cholesterol intake increases CHD risk. Because cholesterol is unavoidable in ordinary diets, eliminating cholesterol in the diet would require significant changes in patterns of dietary intake. Such significant adjustments may introduce undesirable effects (e.g., inadequate intakes of protein and certain micronutrients) and unknown and unquantifiable health risks. Nonetheless, it is possible to have a diet low in cholesterol while consuming a nutritionally adequate diet. Dietary guidance for minimizing cholesterol intake is provided in Chapter 11."

Let me emphasize some lines from this passage:

"There is much evidence to indicate a positive linear trend between cholesterol intake and low density lipoprotein cholesterol concentration, and therefore increased risk of coronary heart disease (CHD)."

"....any incremental increase in cholesterol intake increases CHD risk."

Of interest, this paragraph illustrates my previous point that the dominant nutrition paradigm includes Cordain's belief that elimination of animal foods from the diet "may introduce undesirable effects (e.g., inadequate intakes of protein and certain micronutrients) and unknown and unquantifiable health risks." This passage documents that Cordain's perspective is conservative, not revolutionary, compared to Campbell's, because, unlike Cordain and the Food and Nutrition Board, Campbell does not believe that eliminating cholesterol from the diet would result in protein or micronutrient deficiencies or 'unknown and unquantifiable health risks.'

Nevertheless, the Food and Nutrition Board maintains that dietary cholesterol (i.e. animal food) intake increases coronary heart disease risk. The National Heart, Lung, and Blood Institute concurs and adds that "the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack." Their publication "High Blood Cholesterol: What You Need To Know" includes this:

Again, no confusion or chaos apparent in the nutrition science Cordain has attacked.

In contrast, among those using the supposedly ‘unifying’ evolutionary model, Cordain believes that LDL cholesterol should be less than 70 mg/dL, but Kurt Harris, M.D. has expressed an opposing opinion of no confidence at all in any version of the lipid hypothesis:

"I do not believe in any of the versions of the lipid hypothesis, ranging from Ancel Keys' original idea that cholesterol or dietary fat clogs the arteries, to the currently fashionable one that “small, dense” LDL particles are like microscopic rodents that are designed to burrow under the intima of your blood vessels and kill you."

Why didn't their common use of an evolutionary model eliminate this disagreement?

Saturated Fat

Regarding saturated fat, scientific consensus documents such as the Food and Nutrition Board (FNB) of the NAS clearly state that we have no requirement for dietary saturated fat and any incremental increase in dietary saturated fat increases heart disease risk. Here again I quote the FNB Dietary Reference Intakes for Fats:

"Saturated fatty acids are synthesized by the body to provide an adequate level needed for their physiological and structural functions; they have no known role in preventing chronic diseases. Therefore, neither an AI nor RDA is set for saturated fatty acids. There is a positive linear trend between total saturated fatty acid intake and total and low density lipoprotein (LDL) cholesterol concentration and increased risk of coronary heart disease (CHD). A UL is not set for saturated fatty acids because any incremental increase in saturated fatty acid intake increases CHD risk." [emphasis added]

You will find that all major expert panels around the world maintain this position.

In contrast, among those claim to use the supposedly ‘unifying’ evolutionary model, Cordain believes the evolutionary model prescribes lean meat and low intake of dietary saturated fat, while Michael Eades, M.D. thinks that the evolutionary model prescribes fatty meat and high intake of saturated fat.

Should I really believe that the members of the Institute of Medicine's Food and Nutrition Board, composed of individuals who have invested their whole lives in studying nutrition both as scholars and bench scientists, do not understand the effect of nutrition on CHD risk, because they failed to use an evolutionary model? Do you think the members of the FNB know the difference between correlation and causation? Or did they get to the top of their field without mastering this concept presented in any undergraduate course in statistics or science?

Fitness

Regarding fitness, at least one advocates of looking at things with an evolutionary model, Art DeVany believes that the scientific data proscribes distance running (note: in the comments below Dr. Harris disavows using an exclusively evolutionary model to come to this conclusion), while Daniel E. Lieberman, a Harvard evolutionary biologist, and Dennis M. Bramble, a biologist at the University of Utah, believe that an evolutionary model prescribes distance running. If the evolutionary model is so powerful for eliminating chaos and confusion, why don't advocates of an evolutionary model agree on this point?

Confusion Within the Evolutionary Model

The ‘evolutionary model’ offered by Cordain and low-carbers also seems to introduce some confusion into the ‘evolutionary model’ itself.

According to this model, we should eat the imagined meaty low-carbohydrate diet of stone age mammoth hunters in order to increase our metabolic rates and lose body fat.

Does this make evolutionary sense?

I mean, would a high metabolic rate induced by a high protein/lean meat intake really benefit to a stone age hunter gatherer who already had difficulty getting hold of enough food to meet his metabolic needs?

And would a low body fat level achieved by a meaty low carb diet be an evolutionary advantage to humans dealing with extremely cold winters during the ice ages?

Groking the Source of Confusion

Could it be that Paleo advocates are confused and confusing because they rely on an imaginary Grok for their guidance rather than science?

By that I mean that the paleo diet ‘evolutionary’ model is based on largely imagining what stone age people did. In case you didn’t notice, we don’t have any body composition data, diet or medical records, photos, or videos from the stone age people the paleo crowd wants to emulate.

This means you have to use your imagination to come up with any picture of them and their diets and lifestyles. My imagination is different from yours, so we just might come up with different Groks to emulate.

Cordain and his colleagues used their imaginations when they published "Estimated macronutrient and fatty acid intakes from an East African Paleolithic diet" in the British Journal of Nutrition.

I have realized that few if any of the conclusions in this document are subject to either confirmation or falsification. You can invent any number of 'models' of paleolithic diets and none can be either confirmed or falsified simply because we have no direct access to or records of East African Paleolithic human diets.

Let me put it this way. If I estimate that present-day Italian farmers consume 400 g of wheat bread and 3000 kcal per day in the winter, I can test my estimate by going to Italy, collecting diet records, and doing the math. Others can test my estimate by the same procedure. I could be proven wrong by someone else. But if I estimate that Neanderthal females consumed 1200 kcal, 500 mg of DHA, and 30 mg of vitamin C daily in the summer, neither I nor anyone else can test my estimate against reality because neither Neanderthals nor their habitat exist any longer.

And that is my introduction to these two videos:

Primitive Nutrition Critique of Paleo Diet Conceptual Framework, Part 2

2011-12-10T13:10:00.000-08:00

Paleo diet proponents promote their viewpoint as a scientific revolution akin to the Copernican revolution.

In his contribution to The Protein Debate , Loren Cordain claims that “The study of human nutrition remains an immature science because it lacks a universally acknowledged unifying paradigm." Apparently he thinks other sciences are "mature," i.e. virtually completed, which would be news to physicists, astrophysicists, chemists, and biologists, most of whom know that we have only scratched the surface of the world we study.

He goes on to claim that “nothing in nutrition seems to make sense because most nutritionists have little or no formal training in evolutionary theory, much less human evolution. Nutritionists face the same problem as anyone who is not using an evolutionary model to evaluate biology: fragmented information and no coherent way to interpret the data.”

I don’t know why he thinks nothing in nutrition seems to make sense. Does he really think that if you open a textbook of nutrition, nothing in that book makes sense? Are those chapters telling us about the scientifically established nutrient requirements of humans just gibberish to him?

Perhaps he thinks this because there seems to be a general scientific consensus that we can improve our health prospects by reducing animal food consumption, but he prefers to eat a lot of meat. The American Heart Association, the American Institute for Cancer Research, and numerous other scientific medical organizations recommend eating more plant-based diets rich in fruits, vegetables, whole grains, legumes, nuts, and seeds, while reducing intake of animal products. Naturally, for someone who fervently believes in a low carbohydrate, high meat diet, the recommendations of the American Heart Association and the American Institute for Cancer Research don’t make sense.

Cordain sees his mission as providing a “universally acknowledged unifying paradigm” through his paleo diet hypothesis. According to him, we can ‘make sense’ of all the ‘confusing’ information he sees “By carefully examining the ancient environment under which our genome arose.” Here's a snapshot of his claim in The Protein Debate:

Certainly, nothing can be easier to do than examine the ancient environment under which our genome arose. We'll just get into our handy time machine that will take us back 200 million years to the emergence of the first mammals (a large part of the human genome emerged that long ago; we are a variation on a biological theme, not a totally unique entity) so we can “carefully examine” that environment first hand, rather than examine imaginary reconstructions offered by various creative minds.

Similarly Rob Wolf refers to non-believers in the paleo diet paradigm as similar to members of the “flat-earth society,” implying that paleo believers are akin to Copernicus, while non-believers are akin to those who still believe that the earth is ‘flat.’

Paleo advocates also claim to be bucking ‘conventional wisdom,’ again implying that they have the advance take on diet and everyone else is in the dark ages believing in the nutritional equivalent of a ‘flat earth.’

So let’s see, which of these two statements is more aligned with ‘conventional wisdom’ and which is more ‘revolutionary’ in the context of historical and recent beliefs about human nutrition, biology, and medicine?

Loren Cordain’s Paleo Belief: Humans must eat meat to obtain adequate protein and other nutrients, to build muscle mass and excel athletically, to maintain intelligence, and to maintain health. People can reverse disease by eating more animal products and less plant foods.

T. Colin Campbell’s Vegan Belief: Humans do not need to eat any animal products to obtain adequate protein and other nutrients, to build muscle mass, to excel athletically, to maintain intelligence, or to maintain health. We can reverse diseases by eating more plant foods and avoiding animal foods.

Given that approximately 98 percent of people in the U.S.A. eats meat on a daily basis, and many (including many paleo diet adherents) will immediately ask a vegan advocate “But where do you get your protein?” I submit that the paleo diet belief is far from revolutionary, indeed I might consider it reactionary.

Let me put it this way. At this present time, very few people accept the idea that a vegan diet can adequately provide protein and general nutrition to the average human, which explains why very few people eat vegan diets. Most people ‘believe’ that we need to eat meat, the way that, at the time of Copernicus, most people believed in a flat earth at the center of the sun’s orbit.

This belief in the importance of meat to human nutrition has a long history. I know of no time in Euro-American history when Campbell’s vegan belief was as widely accepted as the belief in a geocentric universe was at the time of Copernicus. On the contrary, the vegetarian perspective has been accepted by only a minority of people, mostly philosophers (e.g. Plato, Pythagorus) and medical doctors (e.g. Christoph Hufeland), throughout the history of Western civilization since the time of the Greeks.

In fact, T. Colin Campbell himself was initially indoctrinated to believe in meat and animal protein as critical to human health. It was only through research that he came to reject this widely accepted belief. That makes him more like Copernicus, challenging the widely held assumptions of his generation, whereas Cordain is simply agreeing with the long widely held belief that we have to eat meat to be healthy, smart, strong, and human.

Further, the idea that a vegan diet can reverse degenerative diseases contradicts the long-held belief of Western medical scientists that diet alone is inadequate for treatment of disease. The orthodoxy believes in eating meat and using drugs and surgery to treat disease. The revolutionary believes in avoiding meat and using a vegan diet as the primary tool in treatment of disease.

It seems to me that Cordain's paleo diet view aligns more with conventional wisdom and has more in common with the 'flat earth society,' and Campbell's vegan view bucks conventional wisdom and has more in common with Copernicus.

That’s my introduction to these two videos from PrimitiveNutrition which explore in greater depth the poor reasoning behind the paleo 'paradigm' starting with the fallacious appeal to nature (i.e. Eating meat is natural, therefore eating meat is optimal) which itself is based on a short-range view of 'natural' behaviors and their consequences (homicide is also natural, but if we all acted homicidal, we would be suicidal).

Primitive Nutrition Critique of Paleo Diet Part 1

2011-12-09T16:46:00.000-08:00

A much needed critical look at the fundamentals of paleo diet logic as offered by its leading proponents. I truly wish I had had the acumen to have done this degree of critical thinking before I got involved in, let alone invested in, paleo dieting.

Discovering Tao

2011-12-02T15:06:00.000-08:00

Tracy and I have started a new blog together: Discovering Tao: Training For Awakening Oneself.

My first posts there:

Staying Flexible features this video:

If You Want To Rebel, Act Kind about Pancho Ramos Stierle, the guy meditating surrounded by police in war-gear.

Meditation Disturbs The Peace?

Study Indicates Prostate Cancer Is Reversible By Diet

2011-11-26T17:22:00.000-08:00

According to the National Cancer Institute, each year in the U.S., 240,890 men get diagnosed with prostate cancer, and 33,720 men die from it.

According to the American Cancer Society,

"About 1 man in 6 will be diagnosed with prostate cancer during his lifetime. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

"Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 36 will die of prostate cancer."

I have a family history of prostate cancer, so I have a personal interest in prevention and remedy for this disease of civilization.

According to some people, whole grains and legumes cause or promote the diseases of civilization, including cancer.

If this disease is caused by eating grains and legumes, then any diet based on grains and legumes should promote cancer. If you give men living with prostate cancer a diet rich in whole grains and legumes, you should see a promotion of the cancer.

My friend, Gordon Saxe, M.P.H., Ph.D., M.D., professor of medicine at U.C.S.D., has actually tested this hypothesis, albeit unintentionally.

Gordon has lead pilot research in which men with diagnosed with prostate cancer were taught to eat a diet consisting of whole grains, legumes, vegetables, fruits, nuts, and seeds, while eliminating animal products, based on evidence [discussed here] that this dietary pattern may reduce the risk or progression of prostate cancer.

If whole grains and legumes promote prostate cancer then these men should have had an accelerated progression of their cancers. However, in the first study, over six months, this intervention produced just the opposite effect: a 100-fold reduction in the rate of rise of their disease, as measured by the rate of change in levels of prostate-specific antigen (PSA). As stated by Saxe et al:

"The rate of PSA increase decreased in 8 of 10 men, while 3 had a decrease in absolute PSA. Results of the signed rank test indicated a significant decrease in the rate of increase in the intervention period (p = 0.01). Estimated median doubling time increased from 6.5 months (95% confidence interval 3.7 to 10.1) before to 17.7 months (95% confidence interval 7.8 to infinity) after the intervention. Nine of 10 participants in the study had reduction in the rate of rise of their PSA, a marker for progression of disease."

When 9 of 10 people respond in the very same way to an intervention, in this case with a reduction in rate of rise of PSA, this tends to suggest that the effect is no accident and most likely indicates a definite therapeutic effect of the intervention.

In the second study, involving 14 men, Saxe et al produced a similar result. In this second study they explored the biological mechanisms involved:

"During the first 3 months of the intervention, as both median WHR and body weight declined significantly, the median rate of PSA rise not only declined but became negative, reflecting a slight reduction in absolute PSA and possibly disease regression in patients with absolute reductions. Conversely, during the second 3 months of the intervention, when median body weight increased (though not significantly), median PSA began to rise again, albeit more slowly than during the period prior to Baseline."

This second study suggested that weight-related metabolic changes may have mediated the reduction in rate of PSA increase. In other words, the intervention resulted in a loss of body fat and concommitant metabolic changes related to reduction of body fatness, including an increase in sex hormone binding globulin, that influence prostate cancer.

"Assuming that the attenuation of PC progression was mediated by weight-related metabolic changes, a question arises as to what aspect of intervention brought about the observed reduction in adiposity. Earlier ⁵³, we described large increases during months 0–3 in intake of whole grains and vegetables, food groups which are fiber and water-rich, very low in fat, and therefore of low energy density. However, intake of these foods declined slightly during months 3–6. Weight loss during the first three months may possibly have resulted from replacing energy-rich foods with energy-poor foods, and the slight increase in body weight during the second three months may have resulted from a small degree of dietary recidivism."

So this intervention, based on increasing intake of whole grains, legumes, etc., resulted in body fat reduction during the period when the subjects ate the most of these foods, and body weight increased during the period when these subjects ate less of these foods. This clearly undermines the idea that diets rich in grains and legumes cause two of the major diseases of civilization, i.e. obesity and cancer.

Saxe et al consider the possibility that any diet that induces weight loss may reduce cancer progression.

"A second question that naturally arises regarding the reduction in adiposity is whether it matters, in terms of effects on prostate cancer progression, how it is achieved. One aspect of this question has to do with the preferred dietary strategy for reducing energy intake. Another facet regards whether it is more desirable to increase energy expenditure or decrease intake to achieve this end. Although our study and its findings did not address these issues, they remain important ones that warrant consideration in the planning and design of future behavioral approaches to the management of progressive PC. What can be said is that while both a plant-based diet and a high-protein, low-carbohydrate diet high in foods of animal origin (such as the popular Atkins diet) may both result in weight loss, the former is far more consistent with the dietary cancer prevention guidelines of various agencies (69).⁵⁴ "

Some people reject those cancer prevention guidelines of various agencies, which emphasize increased consumption of whole plant foods and decreased consumption of animal products, claiming that whole grains and legumes are the true causes of diseases of civilization. These two studies, among others, weaken that claim.

So far, the only studies I can find testing the effect of a low-carbohydrate diet on prostate cancer were done with mice, not men. In this one, researchers from Duke Prostate Center fed mice with prostate cancer either a "Western" diet, "low-fat high-carbohydrate" diet, or a zero-carbohydrate diet. The results:

"Fifty-one days after injection [with xenograft tumors], NCKD mice tumor volumes were 33% smaller than Western mice (rank-sum, P = 0.009). There were no differences in tumor volume between low-fat and NCKD mice. Dietary treatment was significantly associated with survival (log-rank, P = 0.006), with the longest survival among the NCKD mice, followed by the low-fat mice."

I don't have access to the full text, but if done in a typical fashion, all diets would have been pellets made from isolated nutrients (e.g. casein, starch, sugar, etc.) so this can't tell us much about what would happen in humans if we compared a whole foods vegan diet (whole grains, legumes, vegetables, fruits, nuts, seeds) to a zero-carbohydrate diet (meat and fat only). The effects of a casein-based zero-carbohydrate diet on mice might be very different from the effects of a meat-based zero-carbohydrate diet on humans.

In a second study, Masko et al fed mice diets containing 0, 10, or 20 percent carbohydrate and again injected them with prostate cancer cells. As a 'control' they fed a group of mice a 12% fat diet, but they did not inject cancer cells into these mice--which to me means they weren't much of a control group, because they differed from the others not only in dietary composition but also in absence of tumor injection.

The full text of this study tells us the components of all diets: corn oil, lard, milk fat, casein, dl-methionine, dextrine, maltodextrine, corn starch, sucrose, and isolated vitamins and minerals.

In the low-fat arm, 72% of calories came from carbohydrate, and 50% of total calories came from sucrose, which means that about 25% of total calories came from refined fructose. Meanwhile, in the 10% and 20% carbohydrate arms, all of the carbohydrate was provided in the form of corn starch.

This makes me wonder again about diet composition in the other Duke University study cited above. Were those mice on the low fat diet also eating a 50% sucrose/25% fructose diet? If so, did this rig the study, intentionally or not, so that the low fat group would have more body fat and shorter lifespan than the zero-carbohydrate group?

Moving on, all the mice got all of their protein from casein-plus-methionine, none ate any meat. Most people eating low carbohydrate diets eat cooked meats, not isolated casein, as their main protein source. Meat is nutritionally complex, and affected by cooking process, in ways that may result in it having a different effect on prostate cancer than casein-plus-methionine. For example, unlike the casein-methionine mix fed to these mice, meat contains heme iron and if cooked at high heat, heterocyclic amines, all of which have been linked to prostate cancer causation or promotion [e.g. Sinha et al full text]. So it is not clear how a study of mice eating a low carbohydrate diet wherein casein is the main protein will apply to people eating low carbohydrate diets wherein cooked meat, poultry, and fish are the main protein sources.

Masko et al found that the survival rates of the mice in the 0, 10, and 20 percent carbohydrate groups were similar. They liked this finding because, as they say, people find it extremely difficult to follow zero-carbohdyrate diets, so now they are ready to test the 20 percent carbohydrate diet on human prostate cancer patients.

Masko et al also found that the mice in the 20% carbohydrate group had the lowest insulin level, about which they comment:

"It was unexpected that the lowest levels of insulin were observed in mice fed with 20% carbohydrate, but there are possible explanations for this phenomenon. First, there is always the possibility for a type I error in the analysis. Second, it is known that low-carbohydrate diets promote insulin sensitivity in animals (38) and humans (39, 40). Thus, it is possible that a diet containing a small amount of carbohydrates may actually improve insulin sensitivity compared with a diet completely lacking of carbohydrates."

Perhaps unknown to Masko et al, it is also 'possible' that a diet containing an even large amount of carbohydrate may actually improve insulin sensitivity compared to a diet with only 20% carbohydrate. In 1971, Brunzell et al [abstract only] evaluated the effect of increased dietary carbohydrate at the expense of fat in humans, both non-diabetic and mildly diabetic. In the New England Journal of Medicine they reported that after feeding these subjects a diet providing 85 percent of energy as carbohydrate for 10 days,

"Fasting plasma glucose levels fell in all subjects and oral glucose tolerance (0 to 120-minute area) significantly improved ..... Fasting insulin levels also were lower on the high carbohydrate diet; however, insulin responses to oral glucose did not significantly change. These data suggest that the high carbohydrate diet increased the sensitivity of peripheral tissues to insulin."

An diet supplying 85 percent of energy as carbohydrate is by necessity very low in fat, so perhaps Brunzell et al could have emphasized that this very low fat diet increased insulin sensitivity. The mice of Masko et al that got the 20 percent carbohydrate diet had a lower fat intake than the mice on the zero-carbohydrate diet; rather than increasing carbohydrate being responsible for promoting insulin sensitivity, perhaps it is reducing fat (replacing it with starch) that does the trick.

Anyway, the Masko et al study has a few features that make me skeptical that they will have similar results in humans. I feel curious to see if their approach will have results as good as those found by Saxe et al.

Twenty-one Day "Daniel Fast" Reduces Insulin Levels by 23%

2011-11-17T14:23:00.000-08:00

Also improves multiple metabolic markers

The Biblical book of Daniel includes a description of what some assert to be the first dietary clinical trial recorded in "Western" literature. In Daniel 1:8-16 (NIV) we find:

"But Daniel resolved not to defile himself with the royal food and wine, and he asked the chief official for permission not to defile himself this way. Now God had caused the official to show favor and sympathy to Daniel, but the official told Daniel, 'I am afraid of my lord the king, who has assigned your food and drink. Why should he see you looking worse than the other young men your age? The king would then have my head because of you.' Daniel then said to the guard whom the chief official had appointed over Daniel, Hananiah, Mishael and Azariah, 'Please test your servants for ten days: Give us nothing but vegetables to eat and water to drink. Then compare our appearance with that of the young men who eat the royal food, and treat your servants in accordance with what you see.' So he agreed to this and tested them for ten days. At the end of the ten days they looked healthier and better nourished than any of the young men who ate the royal food. So the guard took away their choice food and the wine they were to drink and gave them vegetables instead. "

Daniel 10:2-3 provides a similar passage:

"At that time I, Daniel, mourned for three weeks. I ate no choice food; no meat or wine touched my lips; and I used no lotions at all until the three weeks were over."

I wonder if these passages might provide some cognitive dissonance for Judeao-Christian followers of low-carbohydrate diets, at least those who take the Bible as guidance from God.

Whether your consider these passages history or fiction, it seems likely to me that the author(s) had some experience that informed it. The author(s) evidently believed that 'royal food' including meat and wine pollutes and corrupts humans, and that a 10-21 day diet consisting exclusively of "vegetables" would make a person look "healthier and better nourished" than a royal diet, although at that time the meat would have come from grass-finished animals and the wine from 'organically grown' fruits.

Susan Gregory has written a book about the Daniel Fast, so-called because the follower abstains from animal foods and alcohol, while having ad libitum intake of unrefined plant foods. The book apparently focuses on the 'fast' as a religious, not health care, method. I myself would not call a eating plan that allows you to eat unlimited plant foods a 'fast.' To me, doing so sort of implies that you believe that only animal products, not plants, qualify as food. So I prefer to call this the Daniel Diet.

However, Bloomer et al decided to find out how 21 days on the Daniel Diet affects human health.

They enrolled 43 subjects ranging in age from 20 to 62, six of whom reported adhering to a 'vegetarian' diet before doing the 'fast.' Bloomer et al give more details:

"Forty-four subjects (13 men; 31 women) were initially recruited to participate and were enrolled in this study. The mean age of subjects was 35 ± 1 years, with a range of 20-62 years. One female subject had a diagnosis of well-controlled type II diabetes (and used oral hypoglycemic agents), and one male subject had a history of coronary artery bypass graft surgery (and used both a statin and Plavix®). Three subjects were hypertensive upon enrollment (BP≥140/90 mmHg; 2 men and 1woman) and seven had hypercholesterolemia (total cholesterol > 200 mg·dL-1; 1 man and 6 women). One man used a beta blocker and one man used an anti-depressant. Three women used anti-depressants, six used oral contraceptives, two used estrogen replacement, two used a sleep aid, one used a statin, and one used an angiotensin II receptor antagonist."

Bloomer et al describe the 'fast' here:

"A Daniel Fast involves ad libitum intake of specific foods, but the food choices are restricted to essentially fruits, vegetables, whole grains, nuts, seeds, and oil. This plan resembles a vegan diet, which has been reported to yield health enhancing properties [16,17]. However, a Daniel Fast is more stringent, in that aside from the exclusion of all animal products, there are no processed foods, white flour products, preservatives, additives, sweeteners, flavorings, caffeine, or alcohol allowed in this plan."

Apparently the subjects liked the intervention:

"Subjects noted that they enjoyed the ad libitum nature of the plan, as well as the wide variety of food choices. In fact, most subjects reported that they would continue implementing many components of the plan into their previous diets."

The following table shows the dietary data of the subjects during the final 7 days of the Daniel 'fast.'

Some notes on the nutritional profile of the 'fast':

Total protein intake declined by about one-third, but the average remained at the level recommended for a lean 77 kg/171 pound man.
Total carbohydrate intake declined by only about 20 g per day, but as a percentage of calories, total carbohydrate intake increased from 53% to 62%.
Fiber intake increased by more than 50% (up 14 g per day)
Fat intake declined by 20 g per day, and from 30% of energy to 27% of energy
Saturated fat intake declined from 24 g per day to 9 g per day, a reduction of 63%.
Polyunsaturated fat intake increased by only 1 g.
Omega 3 intake increased by 87 mg (12%) daily.
Vitamin C intake increased by about 50 mg daily, but remained at only about 120 mg daily, indicating a rather low intake of vegetables and fruits by my standards. A produce-dominated diet can easily supply 400+ mg of vitamin C daily, so this diet probably was dominated by grains, legumes, nuts, and seeds low in vitamin C.
Vitamin E intake increased by almost 50%.

The following three tables show some of the changes that occurred over 21 days on the Daniel Fast:

Notable improvements in table 1 include decreases in heart rate, blood pressure, body weight, and body fat. This study did not find a marked average decline in body weight and body fat mass primarily because almost half (21) of the subjects were classified as normal weight at the outset of the study; these lean people didn't lose weight, so they diluted the weight loss average.

Fat free mass declined by an average of 1.7 kg, which could have been water or muscle; we can't determine which from this data in table 1 alone. However, since blood pressure and insulin levels (data below) dropped significantly, I would expect that this lean mass loss consisted primarily of a significant loss of sodium and water in the 10 overweight and 13 obese subjects in the study (because insulin increases sodium retention, hence water retention and blood pressure).

The subjects did report a small decline in mental health. According to Bloomer et al, "Through completion of a post fast questionnaire, subjects reported that the main enervation of their mental health was the omission of caffeine." In other words, they had caffeine withdrawal syndrome.

Notable improvements listed in table 3 include:

Reduced blood sugar
Reduce Blood Urea Nitrogen
Slightly reduced AST and ALT, possibly indicating healthier liver function

Notable improvements:

Total cholesterol declined about 30 points to less than 150 mg/dL, a level thought to confer virtual immunity to heart attack and found by Esselstyn to allow reversal of atherosclerosis.
Triglycerides declined by about 12%.
LDL-C declined to about 76 mg/dL, a level found in wild animals, hunter-gatherers, and newborn infants.

In addition:

"Insulin (pre: 4.42 ± 0.52 vs. post: 3.37 ± 0.35 μU·mL-1; p = 0.10), HOMA-IR (pre: 0.97 ± 0.13 vs. post: 0.72 ± 0.08; p = 0.10), and CRP (pre: 3.15 ± 0.91 vs. post: 1.60 ± 0.42 mg·L-1; p = 0.13) were lowered in a clinically meaningful manner, although this decline failed to reach statistical significance."

This whole foods diet rich in carbohydrates produced a 23% decline in insulin levels, a 26% decline in insulin resistance (measured by HOMA-IR), and a 49% decline in C-reactive protein, indicating a substantial decline in inflammation. Although not statistically significant, these are clinically very significant reductions boding well for these subjects.

Did the Daniel Diet affect obese people differently from lean? Apparently not.

"Although our intention with this study was not to make comparisons between normal weight and overweight/obese subjects, in an attempt to clarify our findings we also analyzed data using a 2 (weight status: normal weight vs. overweight/obese) × 2 (pre/post fast) analysis of variance. No interaction effects were noted for any variable (p > 0.05), indicating that normal weight and overweight/obese subjects respond to the Daniel Fast in a similar manner."

Although not inspired by the Bible, Tracy and I have been eating mostly (well more than 99%) plant foods for a couple of months now, as an ongoing experiment. We differ from the Daniel Fast in that we have emphasized eating more like a wild chimp or gorilla: lots of green leaves, non-green vegetables (including starchy vegetables), fruits, beans, nuts, and seeds, while limiting whole grains, not including them every day or in large amounts.

Compared to my previous experiments with diets containing minimal or no animal products, I have recently focused on eating larger amounts of green and starchy vegetables, nuts, and seeds, with limited amounts of beans, even more limited whole grains. In those past experiments I ate very limited amounts of nuts and seeds but large amounts (2-3 times daily) of whole grains including substantial amounts of home-made whole wheat breads (both sourdough and yeasted) on most days. Now I have many days with no grains at all, and very little wheat in comparison.

We have so far responded very favorably to this produce-dominated, 99%+ plant food approach. We'll see how it progresses.

Pharmaceutical Antibiotics Probably Promote Obesity

2011-11-05T15:06:00.000-07:00

We may add obesity to the long list of iatrogenic (medicine-caused) disorders.

Katie Moisse of ABCnews online reports that antibiotics may promote obesity.

Her article refers to research done by Dr. Martin Blaser of New York University Langone Medical Center. Blaser studies the effects of antibiotics on Helicobacter pylori — a bacterium that lives quietly in most but leads to ulcers in some.

In his animal research, Dr. Blaser found that:

"...antibiotics for H. pylori trick the body into eating more by disrupting hunger hormone levels. Indeed, mice given antibiotics get fatter than their untreated counterparts despite having the same diet."

Blaser published his concerns in an editorial in the August 24, 2011 issue of Nature under the title "Antibiotic overuse: Stop the killing of beneficial bacteria."

I don't have access to that full text article, but in April of this year a team including Blaser published the results of a human intervention study in which they tested their hypothesis that altering intestinal flora with antibiotics influences appetite-regulating hormones and body mass: The effect of H. pylori eradication on meal-associated changes in plasma ghrelin and leptin (full text).

They found that people treated with antibiotics had a 6-fold increase in post-meal ghrelin, a 20 percent increase in leptin levels, and a 5 percent increase in body mass index 18 months after completing the course of antibiotics.

Science Daily reports that ghrelin "not only stimulates the brain giving rise to an increase in appetite, but also favours the accumulation of lipids in visceral fatty tissue." [1] So antibiotics promote central abdominal obesity, the type associated with metabolic syndrome and increasing the risk of diabetes.

Even if this treatment had spectacular success in treating the main complaints of the patients involved, they might not appreciate the side effect of increased obesity. But it gets worse. The text contains this passage:

"At baseline, the 38 H. pylori-negative and 44 H. pylori-positive subjects did not differ significantly in median pain, non-pain, and satisfaction scores (data not shown). Among the 21 patients from whom H. pylori was eradicated, there were no significant differences between baseline and follow-up pain scores [Median (IQR) 9 (2-23) vs. 6 (2-15); p = 0.86], non-pain scores [13 (12-16) vs. 10 (10-18); p = 0.28], or satisfaction scores [13 (10-23) vs. 19 (12-20); p = 0.29]. Thus, the observed increase in BMI following eradication (Figure3) was not correlated with diminished dyspepsia that could increase appetite." [Emphasis added]

According to these authors, pain levels did not differ between people who were H. pylori positive and those who were H. pylori negative. This might suggest to some people (like myself) that H. pylori does not cause of the problem. Further, treatment to eradicate H. pylori did not result in any significant reduction in dyspepsia (stomach discomfort). This again suggests that H. pylori does not cause the problems experienced by the patients.

So, the destruction of H. pylori didn't give the patients significant relief from their main complaint (stomach discomfort), but it did make them fatter. How do you like that for an effective treatment strategy?

I hypothesize that the gut flora reflect the diet, and that imbalanced nutrition causes both H. pylori overgrowth and dyspepsia. If you change the food flowing through the gut, you will change the flora. Overgrowth of H. pylori only serves as a marker for a particular type of diet, and does not the cause the dyspepsia. Killing off H. pylori doesn't give people relief from their gut complaints because their gut complaints arise from dietary and stress factors that remain unchanged by eradication of H. pylori.

How about holiday weight gain? Many people report gaining weight over the winter, which may coincide with increased (misguided) use of antibiotics for upper respiratory infections.

Not Just Obesity?

According to another article on ABC News online by Mikaela Conley, "Blaser hypothesized that the overuse of antibiotics may even be fueling the 'dramatic increase' in many illnesses, including type 1 diabetes, allergies and inflammatory bowel disease by destroying the body's friendly flora, or protective bacteria" in his Nature editorial.

Some cancers appear related to antibiotic use as well.

Tamim et al reported finding a dose-response relationship between antibiotic exposure and breast cancer in Canada, with the highest antibiotic exposure linked to a nearly doubled risk of breast cancer:

"The incidence of breast cancer was higher in subjects who had more antibiotic prescriptions during the 1-15 years prior to the index date (RRs = 1.50, 1.63, 1.71 and 1.79 for the four quartiles, respectively, p-trend = 0.0001). Similar results were found when a number of units were considered. We did not find any effect of the timing of antibiotic exposure on breast cancer risk. Similar patterns of increased risk of breast cancer were detected for the specific antibiotic classes."

Tamim et al also reported a dose-response relationship between antibiotic exposure and prostate cancer in Canada, with the highest exposure linked to an almost tripled risk of prostate cancer:

"Antibiotics exposure (number of prescriptions) during the period of 1-15 years in the past was significantly associated with an increased risk of prostate cancer; RR = 1.69, 2.61, 2.71, and 2.83 for the 4 quartiles, respectively, p-trend = 0.0001. When number of units was taken as the exposure definition, similar results were found. We did not find any effect of the timing or class of antibiotic exposure on prostate cancer risk. We found a dose-dependent association between antibiotics exposure up to 15 years in the past and risk of prostate cancer. However, the lack of temporal trends and the absence of class specific effects suggest a noncausal relationship."

Both of these studies suggested a noncausal relationship between antibiotics and cancer. Since the relationship seems fairly strong on a statistical basis, I would guess that people who use antibiotics often have cancer-promoting lifestyles, whereas those who avoid antibiotic use have cancer-preventive lifestyles. The habits that make people prone to infections also make them prone to cancers.

Prevalence of Antibiotic Abuse

Conventional physicians most commonly prescribe antibiotics for upper respiratory, sinus, or ear infections, despite the fact that most of these events involve viruses or fungi (sinuses), which are not susceptible to antibiotics.

Apparently, according to Blaser, the average American child will receive 10 to 20 courses of antibiotics by the time he is 18 years old, and one-third to one-half of pregnant women will receive them during pregnancy.

This means that the average American probably has disrupted gut flora and increased ghrelin levels before reaching adulthood.

The Herbal Alternative

I haven't used antibiotics for 30 years.

If I, Tracy, or one of my patients needs help with an acute respiratory illness, I use acupuncture and herbal remedies. Often the early application of the appropriate herbal formula can reduce the duration of a 'cold' or 'flu' to 3 days or less, compared to the 7 to 10 days typical for these challenges.

For my patients with chronic stomach discomfort associated with ulcers (or not), I use diet changes and if necessary, herbal medicines, with good results.

Evolutionary biology supports the use of herbal antimicrobials. Plants need to defend themselves against viruses, bacteria, and fungi without pharmaceutical aid. Natural selection favored the survival of plants that could fend off microbes, so those plants that could produce antimicrobial compounds survived evolution and those that could not, did not.

Plenty of scientific research shows various herbs have strong antimicrobial activities. For example, following traditional Chinese medical practice, I use formulas containing forsythia fruit to treat sore throats and acne. Qu et al reported on the antibiotic properties of forsythia components:

"Forsythiaside was found to possess strong antioxidant and antibacterial activity but forsythin was much weaker. Owing to these properties, the study can be further extended to exploit the possible application of forsythiaside as an alternative antioxidant and antibacterial agent of natural origin."

The "possible application"? Physicians trained in Chinese medicine have been using this herb for centuries!

Notice their reductionistic approach based on their limited knowledge. They believe that forsythiaside is 'stronger' than forsythin because the former performed better in their test than the latter.

This reflects the pharmaceutical approach, which so far focuses on taking one agent, isolating it and increasing the dose, hoping to find some dose of that one compound that will take down all of the cells in the microbial colony. This ignores the variability of individual microbes which almost guarantees that no one compound will kill all individual microbial cells in a colony.

Its like thinking that 100 highly amplified violins will produce the same music (have the same effect) as a 100-piece symphony consisting of a dozen different instruments. Using the example above, people who focus only on one plant compound like forsythiaside because it appears 'strongest' in some laboratory test forget that their test is limited by what they think they know. They think forsythin is less important because it performed worse on their test.

But forsythias produce 'weaker' chemicals like forsythin for some purpose, probably unknown to these researchers and to myself. Not knowing the reason, we can't assume that the 'stronger' compound is the better one in a natural context.

I would wildly guess that in nature, some microbes will survive a huge dose of the 'strong' compound but die on contact with a small dose of the 'weak' compound.

The benefit of whole herbs lies in their provision of multiple antimicrobial compounds, each acting slightly differently from the others, resulting in a whole that exerts a greater effect than any single part--just like a symphony exerts a greater effect than 100 amplified violins. The multiple angles of defense against microbes provided by a whole herbal extract increases the chance that it will weaken all microbes it contacts, and reduces the opportunity for the microbial colony to develop resistance to any one of the herbal compounds.

Plants evolved their approach to controlling microbes over millenia. Do we really think we can by dicking around with our limited intelligence improve on an approach that evolved by a process that we don't and will never understand completely?

According to my copy of Chinese Medical Herbology and Pharmacology by John Chen PhD, PharmD, OMD, L.Ac., the essential oil of forsythia fruit (Chinese: Lian Qiao):

" ...has demonstrated a broad specturm of inhibitory effects against Staphylococcus aureus, Diplococcus pneumoniae, Bacillus dysenteria, alpha-hemolytic streptococcus, beta-hemolytic streptococcus, Neisseria catarrhalis, Salmonella typhi, E. coli, Mycobacterium tuberculosis, Bacillus proteus, Boretella pertussis, Corynebacterium diphtheriae, leptospira, and some dermatophytes and influenza viruses." (p. 175)

This provides only one example of literally dozens of antimicrobial herbs in the herbal pharmacopiae.

With this knowledge, I just say no to pharmaceutical antibiotics.

Fatty Foods and Sugar Addictive Like Cocaine

2011-11-03T13:01:00.000-07:00

An article at Bloomberg.com reports:

"Cupcakes may be addictive, just like cocaine.

A growing body of medical research at leading universities and government laboratories suggests that processed foods and sugary drinks made by the likes of PepsiCo Inc. and Kraft Foods Inc. (KFT) aren’t simply unhealthy. They can hijack the brain in ways that resemble addictions to cocaine, nicotine and other drugs.

“The data is so overwhelming the field has to accept it,” said Nora Volkow, director of the National Institute on Drug Abuse. “We are finding tremendous overlap between drugs in the brain and food in the brain.”

"Lab studies have found sugary drinks and fatty foods can produce addictive behavior in animals. Brain scans of obese people and compulsive eaters, meanwhile, reveal disturbances in brain reward circuits similar to those experienced by drug abusers."

To repeat, the director of the National Institute on Drug Abuse believes that "The data is so overwhelming the field has to accept it." Read more here.

It seems science has discovered a few new things about how food affects us since the early 20th century when German scientists believed, incorrectly, that insulin made people fat.

Read Stephan Guyenet's series about food reward starting here.

Can The Oceans Support Recommended Fish and Fish Oil Intakes?

2011-11-02T17:27:00.000-07:00

Like many nutritionists, physicians, and 'public health" organizations, I have previously recommended increased intake of fish and fish oils to raise intake of omega-3 fatty acids, supposed to prevent or remedy cardiovascular and neurological diseases and possibly reduce cancer risk.

Although the American Heart Association and similar organizations endorse this idea, in 2009 Jenkins et al questioned its wisdom on two bases: the weakness of evidence for benefits of fish and fish oil intake, and the strength of evidence that global fisheries are collapsing and unable to support current, let alone increased, use of fish and fish oils.

"The main problem with this advice is that, even at current levels of fish consumption, fisheries globally have reached a state of severe crisis (Figure 1).5-8 Already, the demand from affluent and developing economies, particularly newly affluent China, cannot be met by the world's fisheries.6 Moreover, declining catches are increasingly diverted toward affluent markets rather than local ones, with dire consequences for the food security of poorer nations, islands and coastal communities.9"

Uncertain health benefits of fish and fish oil

Jenkins et al point to a number of problems with the evidence supporting use of fish and fish oils:

1. Healthy subject effect: "....fish eaters generally have healthier lifestyles than the rest of the population. They exercise more, smoke less and have better diets.11^–13" This makes it very hard to determine whether the better health found among people eating more fish is due to their fish consumption, or to these other habits.

2. Inconsistent results: Some interventional studies show benefits from increased intake of fish and fish oils, while others do not, and some, such as DART-2, showed harm, with an increased risk of cardiac death among men who took fish oils.

3. Vegetarians appear to have a lower risk of cardiovascular disease and death therefrom, despite avoiding fish and fish oils, suggesting that non-fish dietary factors play a larger role.

4. We have little evidence supporting the use of fish and fish oils for metabolic syndrome, diabetes, or neurological or autoimmune diseases, or even for neurological development.

Regarding the neurological argument, although Jenkins et al do not mention this, Sanders reviewed the available literature and reported that "There is no evidence of adverse effects on health or cognitive function with lower DHA intake in vegetarians." In addition, Beezhold et al found a lower incidence of depression among vegetarians than among omnivores, despite lower intake of omega-3 fatty acids among the former. They reported that "participants with low intakes of EPA, DHA, and AA and high intakes of ALA and LA had better mood," contradicting the hypothesis that depression results from insufficient intake of pre-formed long-chain omega-3 fatty acids.

Declining Fish Stocks

Jenkins et al report:

"In contrast to the uncertainty over the value of omega-3 fish oils in the scientific literature, there is little doubt about the gravity of the fisheries crisis and the prospect of ongoing collapses of fish stocks. There is scientific consensus about the rapid worldwide decline of fish stocks. Notably, and despite increasing fishing effort, global catches have been in decline since the late 1980s (Figure 1A),5 and the number of collapsed stocks has been increasing exponentially since 1950 (Figure 1B).8^,47^,48 There are also over 100 confirmed cases of extinctions of marine populations in the world's oceans.49"

"When projected forward, these trends imply the collapse of all commercially exploited stocks by midcentury.7^,8 Yet the dire status of fisheries resources is largely unrecognized by the public, who are both encouraged to eat more fish and are misled into believing that we still sail in the sea of plenty.50 Indeed, the species that Westerners are supposed to eat in increasing amounts have stocks that are already under tremendous pressure (e.g., yellowfin tuna, the basis of the much recommended North American “tuna-fish sandwich”51) or that have collapsed, sometimes spectacularly, such as cod off the coast of northeastern Canada.52"

According to an article in the National Geographic, large fish stocks have declined 90 percent since 1950.

On November 2, 2006, Richard Black of the BBC reported on a study published in Science: "There will be virtually nothing left to fish from the seas by the middle of the century if current trends continue." Black reported:

Steve Palumbi, from Stanford University in California, one of the other scientists on the project, added: "Unless we fundamentally change the way we manage all the ocean species together, as working ecosystems, then this century is the last century of wild seafood."

In short, the drive to eat more fish and fish oils will only accelerate the rate of destruction of marine ecosystems.

At the very least, our hunger for fish and fish oils will leave future generations with a world wherein they will be unable to eat cod liver oil or fatty fish even if they needed to, because there just won't be any left in the oceans.

Seafood Poisoning

Perhaps people eating increased amounts of seafood will suffer the same fate as ocean fish. Seafoods commonly contain chemical contaminants that appear to impair fertility, including mercury, PCBs, PEs, and others.

Rozati et al found, among Indian men:

"PCBs were detected in the seminal plasma of infertile patients but absent in fertile controls (Table 1)."

"...a comparison between fish-eaters and non fish-eaters, irrespective of the dwelling revealed higher PCB concentrations and significantly lower total motile sperm counts in fisheaters than in non fisheaters (Tables 2,3)."

"Fish-eating urban dwellers had the highest PCB concentrations, followed in order by fish-eating rural dwellers, non fish-eating urban dwellers with an exclusively vegetarian diet and non fish-eating rural dwellers with an exclusively vegetarian diet. The total motile sperm counts in these men were inversely related to their PCB concentrations, being the least in fish-eating urban dwellers followed by fish-eating rural dwellers, non fish-eating urban dwellers with an exclusively vegetarian diet and non fish-eating rural dwellers with an exclusively vegetarian diet (Tables 2)."

Another study reported:

“The lowest levels of p,p'-DDT+p,p'-DDE and PCBs were found in milk from lacto-vegetarians and the highest levels in milk from mothers who regularly consumed fatty fish from the Baltic.”
Norén K. Levels of organochlorine contaminants in human milk in relation to the dietary habits of the mothers. Acta Paediatr Scand. 1983 Nov;72(6):811-6.

Does that make fish look like good brain food?

Insulin Myths Dispelled

2011-10-27T17:25:00.000-07:00

Jame Krieger dispels myths about insulin in his series on the hormone starting with Insulin....An undeserved bad reputation.

Phytate Facts

2011-10-19T19:25:00.000-07:00

Concerned about phytates in seed foods (nuts, seeds, grains, legumes) blocking mineral absorption and causing ill health?

You can relax. Context matters.

Consuming foods rich in ascorbate (vitamin C) with foods rich in phytate can cancel the negative effects of phytate on mineral absorption.[1, pdf] Just eat some fruits and vegetables with foods that supply phytate.

Some studies have shown substantial degradation of phytate in the human gut (70-86%), indicating that humans adapt to diets high in phytate by increasing small intestinal production of phytase. [2 full text link, 3]

I have never seen any evidence that dietary phytate causes mineral deficiencies except in the context of overall poor quality diet, such as people attempting to live on diets composed entirely of unleavened grains and legume flours without adequate intake of vegetables, fruits, and other mineral sources.

If you live in a modern industrialized nation, when was the last time you had someone tell you that a physician diagnosed her with multiple mineral deficiencies caused by excessive dietary phytate?

I have never seen it.

Anticancer Effects of Phytates

Everything has a front and a back.

According to researchers from Linus Pauling Institute of Science and Medicine, phytates appear to have anticancer effects by binding excess minerals in tissues, depriving tumors of essential minerals.[4 pdf]

Vucenik and Shamsuddin discuss the anticancer properties of phytate in detail; all information and quotes remaining in this post come from their report in the Journal of Nutrition.[5 full text]

Almost all mammalian cells contain phytate in the inositol hexaphosphate (IP6) form and others with smaller numbers of phosphate groups (IP1-5). When we ingest dietary phytate, intracellular levels of IP6 increase, and from this cells increase the levels of the other forms, which appear involved in "cellular signal transduction, regulation of cell function, growth, and differentiation."

Dietary phytate enters the blood stream and reaches tissues, including tumors, far from the gut.

Tumor cells take up phytate, probably by pinocytosis or receptor-mediated endocytosis.

Phytate inhibits malignant growth in human leukemic, colon cancer, breast cancer, cervical cancer, prostate cancer, and liver cancer cells.

"IP₆ inhibited the growth of all tested cell lines in a dose- and time-dependent manner. The growth of cells of hematopoietic lineage was inhibited: human leukemic hematopoietic cell lines, such as K-562 (26,27) and human normal and leukemic hematopoietic cells (27). The antiproliferative activity of IP₆ was further reported in human colon cancer HT-29 cells (28), estrogen receptor–positive and estrogen receptor–negative human breast cancer cells (32), cervical cancer (25), prostate cancer (15,33,34), and HepG2 hepatoma cell lines (31). IP₆ also inhibited the growth of mesenchymal tumors, murine fibrosarcoma (39), and human rhabdomyosarcoma (38)."

Phytate also causes malignant cells to mature and differentiate into normal cells:

"The potential of IP₆ to induce differentiation and maturation of malignant cells, often resulting in reversion to the normal phenotype, was first demonstrated in K-562 hematopoietic cells (26). IP₆ was further shown to increase differentiation of human colon carcinoma HT-29 cells (28,29), prostate cancer cells (33), breast cancer cells (32), and rhabdomyosarcoma cells (38)."

Phytates provide an intracellular antioxidant function by binding with iron, which suppresses formation of the most hazardous hydroxyl radicals:

"The antioxidant role of IP₆ is known and widely accepted; this function of IP₆ occurs by chelation of Fe³⁺ and suppression of ·OH formation (11). Therefore, IP₆ can reduce carcinogenesis mediated by active oxygen species and cell injury via its antioxidative function."

Phytate also stimulates the immune response and protects against carcinogen-induced depression of natural killer cell activity.

"Besides affecting tumor cells, IP₆ can act on a host by restoring its immune system. IP₆ augments natural killer cell activity in vitro and normalizes the carcinogen-induced depression of natural killer cell activity in vivo (59). "

Phytate only adversely affects malignant cells, not normal cells:

" The most important expectation of a good anticancer agent is for it to only affect malignant cells and not affect normal cells and tissues. That property was recently shown for IP₆. When the fresh CD34⁺ cells from bone marrow was treated with different doses of IP₆, a toxic effect (inhibition of the clonogenic growth or as cytotoxicity on liquid cultures) was observed that was specific to leukemic progenitors from chronic myelogenous leukemia patients but no cytotoxic or cytostatic effect was observed on normal bone marrow progenitor cells under the same conditions."

This indicates that normal cells are adapted to phytate. Of course, since phytate is abundant in the plant world and also present in almost every mammalian cell.

Phytate inhibits all of the several pathways supporting malignancy:

" From the behavior and characteristics of malignant cells, several principal pathways of malignancy have been established, such as proliferation, cell cycle progression, metastases and invasion, angiogenesis, and apoptosis; interestingly, IP₆ targets and acts on all of them."

In one pilot clinical trial, six patients with advanced colorectal cancer (Dukes C and D) with multiple liver and lung metastasis received oral phytate plus chemotherapy. One of the patients refused additional chemotherapy after one session and she was treated only with IP₆ plus inositol. What happened?

"...her control ultrasound and abdominal computed tomography scan 14 mo after surgery showed a significantly reduced growth rate. A reduced tumor growth rate was noticed overall and in some cases a regression of lesions was noted."

Say again? A simple, natural dietary ingredient reversed the progress of cancer!

Which reminds me:

"Pioneering experiments showing this novel anticancer feature of IP₆ were performed by Shamsuddin et al. (18–20), who were intrigued by the epidemiologic data indicating that only diets containing a high IP₆ content (cereals and legumes) showed a negative correlation with colon cancer."

Most hunter-gatherer groups would have consumed significant phytate from nuts and seeds of various sorts, including legumes.

Dietary Phytate Safety

Vucenik and Shamsuddin agree that chronic phytate ingestion does not cause mineral deficiencies whether gotten from food or isolated form unless the overall diet lacks essential minerals:

"Some concerns have been expressed regarding the mineral deficiency that results from an intake of foods high in IP₆ that might reduce the bioavailability of dietary minerals. However, recent studies demonstrate that this antinutrient effect of IP₆ can be manifested only when large quantities of IP₆ are consumed in combination with a diet poor in oligoelements (60–63). A long-term intake of IP₆ in food (60,61) or in a pure form (64) did not cause such a deficiency in humans. Studies in experimental animals showed no significant toxic effects on body weight, serum, or bone minerals (Table 5) or any pathological changes in either male F344 or female Sprague-Dawley rats for 40 wk (40,51,52). Grases et al. (65) confirmed our findings and also reported that abnormal calcification was prevented in rats given IP₆."

Phytate has many benefits:

"In humans, IP₆ not only has almost no toxic effects, but it has many other beneficial health effects such as inhibition of kidney stone formation and reduction in risk of developing cardiovascular disease. IP₆ was administered orally either as the pure sodium salt or in a diet to reduce hypercalciuria and to prevent formation of kidney stones, and no evidence of toxicity was reported (64,65,79,80). A potential hypocholesterolemic effect of IP₆ may be very significant in the clinical management of hyperlipidemia and diabetes (75,76,81). IP₆ inhibits agonist-induced platelet aggregation (82) and efficiently protects myocardium from ischemic damage and reperfusion injury (83), both of which are important for the management of cardiovascular diseases. "

Perhaps avoiding and removing phytates from food doesn't serve your best interests?

Perhaps we evolved to consume significant amounts of phytates, and cancer is a disease facilitated by a dietary deficiency of phytates?

Strength Training May REDUCE Protein Requirements

2011-10-08T13:09:00.000-07:00

Conventional wisdom maintains that people engaged in intense strength training have increased protein requirements making it necessary for them to consume more protein than untrained individuals. I have believed this myself.

I just came across an elegant study by Moore et al [1] which produced evidence that a resistance training program may reduce protein requirements.

The Study Methods

Moore et al put 12 healthy untrained young males (20-24 years old) on a 12 week strength training program described thus:

“The 12-wk whole body resistance training program involved 13 guided-motion resistance exercises divided over 3 different training days, as previously described (8). Briefly, training days were divided into legs (leg press, leg curl, leg extensions, and standing calf raises), pushing exercises (seated military press, bench press, vertical bench press, chest fly, and seated machine triceps extensions), and pulling (latissimus pull-down, seated wide-grip row, seated narrow low row, and seated biceps curl) exercises. One repetition maximum (1 RM) was measured for each exercise before training and 2–4 d after the last training session to evaluate strength changes. Participants trained 5 d/wk at an initial intensity of ∼70% of the pretraining 1 RM with a goal of 2 sets of 10–12 repetitions during the first 2 wk. In wk 3–12, exercise intensity was adjusted to ∼80–85% 1 RM so that 3 sets of 6–10 repetitions were performed. All training sessions were supervised by a study investigator to ensure proper technique and exercise intensity adherence. Compliance with the training program in terms of attendance was >95% for all participants.”

Moore et al monitored the results of the training on body composition and protein metabolism using muscle biopsies, nitrogen balance markers (urinary, fecal, sweat and miscellaneous nitrogen losses), and blood assays. They estimated dietary protein intake using diet records, except for 5 days before and during the final week of training, when the subjects received prepackaged meals of measured protein, fat, and carbohydrate content. They maintained protein intake constant at ~1.4 g/kg/d for each subject. Protein intake averaged 109-125 g per day throughout the duration of the study.

Unlike other studies of this type, Moore et al measured protein metabolism in both the fed and the fasting state.

Results

Over the course of the study, the subjects increased strength by 30-90% and gained an average of 2.1 kg bodyweight. Lean body mass increased by ~2.8 kg (6 pounds) while fat mass decreased by ~0.9 kg (2 pounds). lean mass accrued at a rate of 233 g (~0.5 pound) per week, or 33 g (slightly over an ounce) per day, an amount undetectable on a day to day basis. Muscle fiber cross-sectional area increased by about 50%.

Moore et al found that this 12-wk training program reduced whole body protein turnover, meaning, the training reduced whole body protein breakdown and synthesis. Although this might surpise some people, they refer to five studies showing that “resistance exercise is a potent anabolic stimulus that increases the intracellular reutilization of amino acids from protein breakdown in both the fasted and fed states (1,2,28–30). The net result would be that amino acid release from the intramuscular free pool would be reduced with resistance exercise.”

Since protein intake did not change from habitual intakes, they concluded that novice trainees adding significant lean mass do not require additional protein beyond habitual intakes. They also surmised that since advanced trainees gain lean mass at a much slower rate, or not at all, the protein requirement of an advanced trainee is probably even lower than that of a novice.

In their words:

“Although our data do not directly address the level of protein intake at which zero nitrogen balance would occur, the significantly more positive nitrogen balance after training demonstrates a more efficient utilization of dietary protein in the trained state.”

Commentary

Moore et al report a very rapid rate of lean mass accrual. If maintained for 50 weeks in a row, an individual would gain 25 pounds of lean mass. A subject starting at 150 pounds would end the year weighing 175 pounds, a huge transformation.

These results suggest that the actual protein requirement for a novice trainee adding 0.25 kg (0.5 pound) lean mass per week lies somewhere below 1.4 g/kg/d.

How far below?

Castaneda et al investigated the effect of 12 weeks of resistance training on muscle mass accrual in older adults (average age of 65 years) with chronic kidney disease. [2] These people consumed a diet providing only 0.6 g protein/kg bodyweight/d, less than half the amount consumed by the subjects of the Moore et al study.

After 12 weeks of strength training, the subjects showed substantial decreases in markers of inflammation (C-reactive protein and interleukin-6) and substantial increases in strength (about 28%) and muscle hypertrophy (about 23% increase in muscle fiber cross-sectional area). Considering that these subjects were about 3 times the age of the subjects in the Moore et al study (65 vs. 22 years) and suffering from chronic kidney disease, this 23% increase in muscle cross-sectional area compares very well with the 50% increase found in the Moore et al study.

This study indicates that humans can gain muscle mass on protein intakes as low as 0.6 g/kg/d, which interestingly roughly corresponds to the estimated median protein requirement of 0.65 g/kg/d. [3]

Human muscle consists of ~70% water, ~30% protein by weight. The Moore et al subjects added ~33 g of lean mass daily, equating to adding ~10 g of protein to their musculature daily.

The Moore et al subjects averaged 62 kg of lean mass at the start of the study and 65 kg at the end. [4]

Using the estimated protein requirement of 0.83 g/kg/d [3], ninety-eight percent of individuals starting this program at 62 kg (136 lb) of lean mass would require not more than 50 g of protein per day. After gaining 2.8 kg (6 pounds) of lean mass, the individual would have 65 kg (143 lb) of lean mass and a protein requirement of not more than 52 g per day. During the training period, he would require an additional 10 g of protein per day (to accrue 33 g of lean mass daily). Thus, from start to end, I would estimate his protein requirement as no higher than 60-62 g per day.

Using the median protein requirement of 0.65 g/kg/d, possibly fifty percent of individuals in the Moore study would require no more than 50 g of protein per day to achieve the results reported.

Since Moore et al report the habitual and controlled protein intake of these subjects as falling between 109 and 125 g per day, by my calculations, the people in this study may have consumed 40 to 60 g excess protein every day, beyond the requirement for building 6 pounds of lean mass in 12 weeks.

According to Moore et al, their 12 subjects required and consumed about 3000 kcal per day. Sixty-two grams of protein provides 248 kcal, which constitutes eight percent of total energy intake. It would seem possible then that adult physically active humans are adapted to food sources that provide about 8 percent of calories as protein, assuming carbohydrate requirements are met directly rather than through gluconeogenesis.

The following table provides the percent of calories supplied as protein in various foods:

From this it appears that many plant foods, like potatoes, could provide plenty of protein for supporting health and muscle growth if eaten in quantities adequate to cover caloric requirements.

From an evolutionary standpoint, the Moore et al findings make more sense than the idea that strength training increases protein requirements.

As a general rule, organisms adapt to demands by resisting the damage those demands inflict. For example, using your hands for labor will result in callus formation. Calluses are more resistant to damage than soft skin. Tanned skin is more resistant to sun damage than pale skin. Thus, we should expect that the body would respond to heavy physical activity by becoming more resistant to muscle protein degradation and reducing the protein requirements of muscle tissue.

Natural selection would have favored those humans that were most efficient at using available resources. Those who had tremendously increased protein requirements as a result of physical activity would have had to expend more energy on the food quest than those who became more efficient at using protein and deriving protein from less energy expensive resources (i.e. plants vs. animals). Those forced to spend more energy on the food quest would have had less energy left for reproduction; hence they would have left fewer descendants.

Survival of the most efficient.

Dietary Protein, IGF-1, and Hyperinsulinemic Diseases of Civilization

2011-10-05T19:06:00.000-07:00

In their paper, “Hyperinsulinemic diseases of civilization: more than just Syndrome X,” Loren Cordain, Michael Eades, and Mary Dan Eades argue that dietary carbohydrate intake, particularly of refined sugars, promotes hyperinsulinemia, which in turn raises levels of insulin-like growth factor-1 (IGF-1) and androgens, while reducing levels of insulin-like growth factor-binding protein-3 (IGFBP-3) and sex hormone-binding globulin (SHBG).[1]

These endocrine system changes create an environment that promotess cell proliferation and growth, acne, early menarche, epithelial cell cancers (breast, prostate, and colon), increased stature, myopia, cutaneous papillomas (skin tags), acanthosis nigricans, polycystic ovary syndrome (PCOS) and male vertex balding.

Effect of Protein Intake on IGF-1: Experimental Results

In “Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans,” Fontana et al report on their studies of the effect of either caloric restriction or protein restriction on these endocrine markers in humans. [2]

In one study, they compared the effects of three interventions:

1) 20% caloric restriction with no change in energy expenditure (CR)

2) 20% increase in energy expenditure with no change in caloric intake (EX)

3) healthy lifestyle control group with no specific manipulation of energy balance (HL)

All three groups consumed diets supplying about 16% of energy as protein.

After one year, although both the CR and the EX interventions produced substantial and similar changes in body mass (~ 6 kg lost) and body fat percentage (~ 23% decrease), neither intervention reduced levels of IGF-1 or increased IGFBP-3. This contrasts with rodent studies, wherein caloric restriction does reduce IGF-1 and increase IGFBP-3.

In the second study, they compared the IGF-1 and IGFBP-3 levels in members of the Caloric Restriction Society (CR) who had been practicing caloric restriction for an average of 6 years, with those of age-matched controls consuming a typical Western diet (WD). The CR group averaged only 1800 kcal per day with 24% of energy from protein and 28% from fat, while the WD group averaged 2500 kcal per day with 16% from protein and 34% from fat.

Thus, the CR group averaged 108 g of protein daily, and the WD group 100 g of protein daily, both at least twice the required amount for a 150 pound male.

They reported:

“As in our 1-year CR study, we found that there were no differences in serum IGF-1 and IGFBP-3 concentrations, and IGF-1 : IGFBP-3 ratio between the CR and Western diet groups.... These data provide evidence that, in contrast to the decrease in IGF-1 in rodents, a reduction of IGF-1 expression is not a component of the adaptive response to long-term CR in humans.”

In contrast to these findings, Fontana et al note that fasting for 10 days markedly reduces IGF-1 into the range found in growth hormone deficient patients, and this correlates closely with the excretion rate for urea, a marker for nitrogen balance and thus protein intake.

Consequently, Fontana et al did a third study “comparing the serum IGF-1 and IGFBP-3 concentrations, and IGF-1 : IGFBP-3 ratio in 28 vegans who had been consuming a moderately protein-restricted (PR) diet (0.76 g kg−1 per day; ~10% of intake from protein) for ~5 years age-matched with 28 members of the Calorie Restriction Society who consume a high-protein diet (1.73 g kg−1 per day; ~24% of energy intake from protein).”

The vegan/PR group had an average protein intake of 50 g per day, while the CR group averaged twice as much, 106 g per day.

Fontana et al found that “Both serum IGF-1 concentration and IGF-1 : IGFBP-3 ratio were significantly lower in the moderately PR diet group than in the severe CR diet group, whereas fasting insulin and C-reactive protein were similarly low in the moderately low-protein vegan and CR groups.’

In other words, the vegan/PR group had the most favorable IGF-1 and IGFBP-3 levels, while also having low serum insulin and C-reactive protein comparable to the CR group, without enduring caloric restriction.

This table compares the values of the PR group to the CR group:

The low protein group had an IGF-1 level 21% lower than the low calorie group

Of interest, the “serum total and free IGF-1 concentrations were lower in the moderately PR group than in the severe CR high-protein diet group, despite the PR groups’ higher body weight, BMI and body fat content.”

This raised the possibility that the higher protein intake of the CR group prevented desired declines in IGF-1, so Fontana et al performed a fourth study. They had 6 CR volunteers to reduce their protein intake from 1.67 g/kg per day to 0.95 g/kg per day, a 43% reduction, while maintaining caloric intake constant. The 0.95 g/kg/d level of intake still exceeds the reference daily intake of 0.83 g/kg/d, which covers the needs of 98% of the population.

As a result of this reduction of protein intake, the CR volunteers had an average 25% reduction in IGF-1 levels, confirming the hypothesis that high protein intake prevents reduction of IGF-1 levels even in the context of caloric restriction.

This then suggests that high protein intake may raise IGF-1 levels and thus promote all the diseases that Cordain, Eades, and Eade linked to elevated IGF-1 and androgens and reduced IGFBP-3 and SHBG: acne, early menarche, epithelial cell cancers (breast, prostate, and colon), increased stature, myopia, cutaneous papillomas (skin tags), acanthosis nigricans, polycystic ovary syndrome (PCOS) and male vertex balding.

Another question arises from this research: Since the vegans had lower IGF-1 levels than the omnivorous CR group, and plant proteins have different amino acid profiles than animal proteins, I wonder if plant protein has a different effect on IGF-1 than animal protein?

Who eats a high protein diet?

Most people do not understand that the reference daily intake (RDI) is not a minimum requirement. In fact, the RDI for protein, 0.83 g/ kg of body weight per day, is calculated to cover the needs of the people in the 98th percentile of requirements.

Many people require substantially less protein than the RDI. The median requirement for the general population actually only amounts to 0.65 g/kg per day, about 20% less than the RDI. [ 4 ]

For a 150 pound (68 kg) male with 10% body fat, this translates to a requirement of 40 to 50 g of protein daily. NHANES data suggests that half of U.S. males consume 40% more than the RDI level of protein, which means that many consume more than twice as much protein as they actually require.[5]

When I ate a meat-based paleo diet, my protein intake ranged from 130 -190 g per day, two to four times the maximum requirement of someone with my bodyweight; which according to human protein requirements research [6] amounts to an excessive protein intake.

According to this research, I probably had an elevated IGF-1 level and ratio to IGFBP-3.

Iron, Oxidation, Inflammation, and Aging

2011-09-29T18:20:00.000-07:00

In my Ancestral Health Presentation I discussed the idea that nutritional diseases fall into two categories, excess and deficiency.

When we compare recently observed hunter-gatherers with members of modern affluent nations, we see important differences between the two groups in general nutritional status throughout life. Hunter-gatherers have very low body fat levels incomparison to modern people, which reflects the fact that from birth they have a low fat intake relative to fat expenditure

As the rapid sales of nutritional supplements in the U.S. shows, we tend to worry a lot about deficiencies. From an evolutionary psychology standpoint, we might have this predisposition toward thinking that our problems are due to deficiency of something because our ancestors were more likely to develop dietary deficiencies than dietary excesses.

In the ancestral environment, food was more scarce than in modern nations, and it took more energy to get that food, a situation favoring deficiency (low nutrient availability plus high nutrient expenditure). In our modern environment, we have a high availability of nutrients and do not need to expend much to get those nutrients, a situation favoring development of excesses.

Worldwide, iron deficiency is the most common nutrient deficiency, occurring mainly in developing nations (low food/iron availability) and among children and menstruating women (high iron demand).

But in modern nations, a growing body of evidence suggests that excessive iron intake and retention promotes chronic degenerative diseases.

Iron and Oxidation

In human metabolism, iron play a critical role, as part of hemoglobin and myoglobin, in the promotion of mitochondrial oxidation reactions that sustain the process of life. The oxidation process inevitably produces peroxide and superoxide radicals. These radicals themselves are comparatively non-toxic, and cells have evolved means of dealing with them [1]. However, when these oxide radicals react with unbound or poorly bound iron, they generate much more damaging hydroxyl radicals.

According to Chinese medical theory, we classify anything that acts like fire as relatively yang. Fire consumes by oxidation and produces heat and light. Oxidation fuels the normal process of transformation (growth and development, or aging); acceleration of oxidation accelerates transformation (growth, development, aging). For example, a log left to age will gradually oxidize and turn to ashes; subjecting the log to fire just accelerates the transformation from log to ash.

Indeed, Ou et al have proposed that, on a biological level, the concepts of yang and yin correspond, in part, respectively, to oxidation (yang) and antioxidation (yin). They found that traditional Chinese herbal medicines classified as yin tonics (used to nourish yin or promote water-like, cool, moist aspects of the body) have, on average, six times more antioxidant activity and polyphenolic contents than herbals classified traditionally as yang tonics (used to fortify yang or promote fire-like, hot, dry aspects of the body).

Since iron supports oxidation, iron deficiency reduces rates of cellular oxidation, and results in a more yin condition: the iron-deficient person feels cold, fatigued, and weak, and suffers from pallor and cognitive impairment, a weakening of the light of the mind. Its like the inner fire has died down. Returning iron sufficiency restores the heat, energy, strength, color (reddish) and mental function, all signs of a fire burning more brightly.

Chinese medical theory predicts that an excess of a yang factor like iron would result in excessive 'fire' in the body, which Western medicine calls in-flamm-ation, the "flamm" simply meaning 'flame,' i.e. fire. Exposing any tissue of the body to chronic in-flame-ation--low level fire-- results in scarring and hardening.

In "Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases," [2] Douglass Kell reviews an impressive body of evidence indicating

(i) that it is this combination of poorly liganded iron species, coupled to the natural production of ROSs, that is especially damaging, (ii) that the role of iron has received far less attention than has the general concept of ROSs, albeit the large literature that we review, and (iii) that this basic combination underpins a great many (and often similar) physiological changes leading to a variety of disease manifestations, and in particular those where the development of the disease is manifestly progressive and degenerative.

Kell's paper reviews evidence linking excess, unbound, or poorly bound iron to the following disorders:

Preeclamsia
Diabetes type 2, insulin resistance, and metabolic syndrome
Hypertension
Cardiovascular disease (heart failure, stroke, and atherosclerosis)
Alzheimer's, Parkinson's, and other neurodegenerative diseases
Amyotrophic lateral sclerosis (ALS, Lou Gerhig's)
Rheumatoid arthritis
Lupus
Asthma
Inflammatory bowel disease
Psoriasis
Gout
Age-related macular degeneration
Frailty
Aging
Chronic obstructive pulmonary disease
Cancer

I have also found studies linking elevated body iron to PCOS [3] and Multiple Sclerosis [4].

Kell notes that many natural plant food compounds act to bind iron or block iron uptake:

Even though elements of the 'Mediterranean' diet that are considered to be beneficial are usually assumed to be so on the basis of their antioxidant capabilities (but cf. [1820]), many of the polyphenolic compounds (e.g. flavones, isoflavones, stilbenes, flavanones, catechins (flavan-3-ols), chalcones, tannins and anthocyanidins) [1821-1828] so implicated may also act to chelate iron as well [1073,1829-1843]. This is reasonable given that many of these polyphenols and flavonoid compounds [1821,1844-1853] have groups such as the catechol moiety that are part of the known iron-binding elements of microbial siderophores. Examples include flavones such as quercetin [914,1813,1829,1854-1864], rutin [1829,1857,1858,1865,1866], baicalin [1860,1867], curcumin [1813,1868-1872], kolaviron [1873], flavonol [1874], floranol [1875], xanthones such as mangiferin [1876-1879], morin [1876], catechins [1073,1807,1838,1854,1880,1881] and theaflavins [1882], as well as procyanidins [1835,1883] and melatonin [1628,1884-1887].

In addition to the phenols and flavonoids, dietary tannins (tea, coffee, nuts, vegetables) phytates (seeds, nuts, grains, beans), calcium, phosphorus, dairy products, and reduce iron uptake.

On the other hand, dietary factors that increase iron availability include:

Dietary meat, poultry, and fish: All enhance iron absorption via the MFP factor, which promotes absorption of iron from non-animal foods eaten with the animal product. Meat, fish and poultry also provide the most bioavailable heme iron, of which the body consistently absorbs about 23 percent, up to ten times more than from non-animal sources. Red meat generally provides the greatest level of iron as well.

Dietary acids: Vitamin C and other dietary acids (e.g. those found in sodas) increase the availability of dietary iron.

Hunter-Gatherers and Iron

In my Ancestral Health Presentation, I argued that hunter-gatherers and modern people differ in some very important contextual aspects. The following slide from my presentation summarizes my observations:

To summarize the table, in comparison to modern people, hunter-gatherers live in an environment with a low food availability and a high energy expense required to get that food. This combination results in lifelong caloric restriction and low body fat levels in the hunter-gatherer.

Hunter-gatherers also consume many unrefined plant foods and herbs that contain polyphenols, flavonoids, tannins, and fiber, all of which so-called 'antinutrients' reduce iron uptake and bind iron to reduce its availability for reaction with peroxide and superoxide. Finally, they have many other factors causing blood and iron loss, including parasites, insects, and injuries.

This environment is similar to that of our primate ancestors. Hence, I would surmise that human metabolism is adapted to an environment with a high intake of 'antinutrients,' a low dietary iron availability and a condition of borderline iron deficiency.

In such an environment, meat, particularly red meat, with its highly available iron, may serve as a medicine.

In contrast, people in modern affluent nations inhabit an environment with a low intake of 'antinutrients' (due to emphasis on refined plant foods), a high food iron availability and comparatively few drains on body iron stores.

Even many menstruating women have less iron loss in modern nations due to use of birth control methods.

Thus, modern people have a tendency to accumulate excess iron.

Comparing Nations and Diets

In The Iron Factor of Aging, Francesco S. Facchini discusses the relationship between iron and chronic diseases at length. After a thorough review of the evidence linking iron to inflammation, disease, and aging, he notes that when we look at modern nations, people who have diets with a lower iron availability also have lower rates of chronic inflammatory, autoimmune, and degenerative diseases. These include the Mediterranean and Asian nations where tea, wine, cheese, legumes, vegetables, and fruits provide the 'antinutrients' reducing iron availability, and people either consume less red meat and more white meat (fish and poultry, lower in iron) or nearly vegetarian diets.

This perspective raises the possibility that fish consumption sometimes correlates with reduced risks of degenerative diseases not because it provides some essential nutrient (e.g. fish oils) but because people eating fish instead of land animal meat will have a lower intake of iron.

Also, vegetarian diets have a lower iron availability, and also associate with lower risks of chronic degenerative diseases.

The modern diet provides more iron by route of red meat and iron-enriched foods consumed in combination with highly acidic foods or beverages or vitamin C supplements.

Context

Iron nutrition provides a good example of how context can modify the effect of a food. The French eat more red meat than the Japanese, and they have a higher risk of cardiovascular disease, but not as high as in the U.S.

The Japanese eat vegetables, rice, fish, and soy products, and drink tea. They typically eat no red meat. Their vegetables, soy, and tea all reduce iron availability, while nothing in their typical diet is a rich source of bioavailable iron. They live long lives with a low incidence of chronic degenerative diseases.

The French eat meat with vegetables, fruits, dairy, and wine, all of which reduce iron availability. In contrast, Americans eat meat with bread made from iron-enriched flour, hardly any vegetables, and typically drink either acidic soda or low-polyphenol beer.

The typical French meal would not provide as much iron as the typical American meal. The typical French man or woman would have less stored iron and this may explain why he or she has a lower risk of cardiovascular disease.

Men vs. Women

Historically, U.S. men have higher risks of cardiovascular diseases than U.S. women, until women pass menopause. This means women have lower risk when they have monthly losses of iron through menstruation, and their risk rises when they stop losing iron.

In general, in modernized nations, women have a greater life expectancy than men. This means women age more slowly, and this may occur because premenopausal women lose iron every month, resulting in a lower iron status, and a lower level of hydroxyl radical formation, during much of their lives.

However, the iron hypothesis predicts that women who reduce menstrual blood losses by birth control methods without compensating by reducing dietary iron availability will have an increased risk of iron-related diseases.

Men can reduce their iron stores by regularly consuming 'antinutrients' and giving blood.

Potatoes and Protein

2011-09-23T16:50:00.000-07:00

The Food and Nutrition Board of the National Academies of Science publishes the Dietary Reference intakes, which includes Estimated Average Requirements for Indispensible Amino Acids for Adults Aged 19 years or Older.

I decided to find out whether the average person could meet his or her IAA requirements eating a diet composed solely of white potatoes. I used the USDA nutrient database to find the amino acid delivery of potatoes at 1880 kcal and 2350 kcal, approximate caloric requirements of a 120 pound woman or a 160 pound man, respectively. I created the following table for the purpose:

Click for larger version

According to these FNB and USDA data, the average person can meet all indispensable amino acid requirements eating potatoes as his/her sole protein source. No 'limiting amino acids' nor protein complementing required so long as caloric requirements are met.

Kon and Klein reported in 1927 on The Value of Whole Potato in Human Nutrition. Two healthy adults obtained all of their protein and IAAs from potatoes for 167 days. They maintained nitrogen balance. They reported:

"The digestion was excellent throughout the experiment and both subjects felt very well. They did not tire of the uniform potato diet and there was no craving for change."

The potato provides only about 10% of calories as protein. A mixed diet containing other plant foods providing higher proportions of protein, like green vegetables (20-40% of calories as protein), nuts (~25% of calories as protein), or legumes (~25% of calories as protein) will provide higher levels of the IAAs and total protein.

It seems that humans can obtain all of the protein they require from a food like the potato. What does this tell us about ancestral nutrition?

I decided to compare the IAA delivery of potatoes to that of 95% lean ground beef. I compared the IAA delivery of amounts of beef and potatoes that provide comparable total protein, and created the following table to illustrate:

Click for larger version

Both the beef and the potato provide adequate amounts of total protein and IAAs. The much smaller portion of beef (200 g vs 2500 for the potatoes) provides larger doses of the IAAs, presumably constituting greater excesses of IAAs for the average individual.

The body will deaminate and oxidize these excesses of IAAs, increasing the amount of ammonia the liver must detoxify and sulfuric acid and urea the kidneys must excrete.

Since the beef supplies only about 14% of total energy requirements, the individual who fills in the other 86% of calories with whole foods that also provide protein will automatically consume a higher amount of IAAs than one who consumes a mix of plant foods with a far smaller amount of animal protein.

For those who have concerns about overconsuming methionine because some research suggests that reduced methionine consumption might increase longevity, I find it interesting to note that the ground beef provides about 15 times more methionine+cysteine per unit weight than the potatoes (about 9.5 mg per g cooked beef, versus 0.6 mg per g cooked potatoes).

Let's say someone consumes the half-pound of beef (328 kcal) and gets the remainder of his required 2350 calories from potatoes (2022). He would get 1906 + 0.86(1425) = 3132 mg of methionine+cysteine, compared to 1425 mg (less than half as much) if he ate only potatoes.

I wonder if the body has an internal regulatory mechanism for amino acid consumption, which drives appetite to control total amino acid intake, such that if a person eats a diet rich in animal protein, the sytem drives the appetite toward attempting to fill the bulk of caloric requirements with low protein items like fat/oil, sugar, fruits, some very low protein tubers (e.g. cassava), or some refined starches?

Zone Out

2011-09-10T12:34:00.000-07:00

Neil Mann belongs to the team of researchers who work with Loren Cordain and promote high intakes of lean meat on an evolutionary basis.

For example, he authored Dietary lean red meat and human evolution in which he argues that various lines of study "indicate the reliance on meat intake as a major energy source by pre-agricultural humans."

Mann and another team from Royal Melbourne Institute of Technology published a new study of the efficacy of a high (30%) protein diet, in comparison to a high (55%) carbohydrate diet, for type 2 diabetes.

The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial.

In this study, 99 subjects received advice to follow low-fat (30% total energy) diets; 53 of those received instructions to eat a diet supplying 30% of total energy from protein and 40% from carbohydrate (high protein arm), while 46 received instructions to eat a diet supplying 55% of total energy from carbohydrate and 15% from protein.

The high-protein diet had the same proportions of protein, fat, and carbohydrate (30:30:40) recommended by Barry Sears in his "Zone" diet books. Supposedly this proportion produces better blood sugar and insulin control than a high carbohydrate, lower protein diet.

The aim was to find out if eating a diet high in protein would provide superior glycemic control to a diet high in carbohydrate, so the primary endpoint was change in HbA(1c). "Secondary endpoints included changes in weight, lipids, blood pressure, renal function and calcium loss."

The results?

"HbA(1c) decreased in both groups over time, with no significant difference between groups (mean difference of the change at 12 months; 0.04 [95% CI -0.37, 0.46]; p = 0.44). Both groups also demonstrated decreases over time in weight, serum triacylglycerol and total cholesterol, and increases in HDL-cholesterol. No differences in blood pressure, renal function or calcium loss were seen."

Mann et al concluded:

"These results suggest that there is no superior long-term metabolic benefit of a high-protein diet over a high-carbohydrate in the management of type 2 diabetes."

I don't have access to the full text, but since the team that did this study includes Neil Mann, one of the strongest proponents of the idea that humans are adapted to diets high in animal protein, who might have a bias in favor of high-protein diets, this study appears to undermine the high-protein approach to diabetes.

It doesn't appear to do the Zone Diet any favors either.

On the other hand, it supports the already established body of literature showing efficacy of a high-carbohydrate approach to diabetes type 2. The high-carbohydrate diet apparently produced meaningful decreases in weight, HbA(1c), triglycerides, and total cholesterol, and increases in HDL.

The decrease in trigs and elevation of HDL are particularly of interest, since very often I see claims that high carb diets raise trigs and lower HDL.

This study provides evidence against the claim that humans are specially, evolutionarily adapted to high-protein diets and maladapted to high-carbohydrate diets, and undermines the claim that this one disease of civilization, type 2 diabetes, and its chief feature, hyperinsulinemia, arise from high-carbohydrate diets.

Of interest, both diets had relatively low fat contents. Since altering the ratio of protein and carbohydrate appeared to have no effect on results, this study may also suggest that reduction of dietary fat proportion plays a key role in the treatment of type 2 diabetes if the goals are reduction of body mass, HbA(1c), triglycerides, and total cholesterol, along with increases of HDL.

Interesting Links

2011-09-02T17:28:00.000-07:00

Eating six potatoes daily lowers blood pressure withoutpromoting weight gain in overweight subjects

In a small pilot study, 18 overweight people ate six to eight small purple potatoes twice daily for a month and found their systolic and diastolic blood pressures (the top and bottom numbers on a blood pressure reading) dropped by 3.5 and 4.3 percent, respectively.

The potatoes were microwaved, with no toppings added. I prefer mine steamed. I usually eat 3 to 6 potatoes daily.

I believe that potatoes frequently correlate with increased disease risks in epidemiological studies because people usually eat them fried or topped with fat and liberally salted, and they travel with otherwise poor quality food choices. Hence, they tend to serve as a marker for poor diet choices that promote fat gain, metabolic syndrome, and diabetes. The potatoes themselves are not to blame, they just happen to be at the scene of the crime.

This clinical study shows that the potato itself promotes cardiovascular health without weight gain.

Potatoes have a very high potassium to sodium ratio (about 56:1 when microwaved, no salt added) and I suspect this potassium infusion provided the blood pressure correction. However it is possible that potatoes contain some other phytochemical that affects blood pressure as well. Whole foods are greater than the sum of their parts.

People who substitute beans for white rice have a lower risk of metabolic syndrome.

In Costa Rica, "People who ate at least two servings of beans for every serving of white rice tended to be at lower risk for metabolic syndrome. In those who substituted a serving of beans for a serving of white rice the risk of metabolic syndrome was reduced by 35 percent, the researchers report in American Journal of Clinical Nutrition.”

This study suggests that we are metabolically better adapted to cooked dried beans than to white rice. Legumes have a lower glycemic load, a higher proportion of protein, and a fiber profile more like fresh vegetables and fruits (higher in soluble fiber) than cereal grains.

I think we have reason to believe that human ancestral diets included some fresh legumes and this use provided the segue into the use of dried legumes as a part of the agricultural evolution. I think we are better adapted to fresh than dried legumes. Dried legumes have more resistant starch than fresh legumes, and this feeds gut flora, resulting in bloating when you exceed your personal legume limit.

Soaking and sprouting start converting the dried legume back into a fresh vegetable. Among the dried legumes, the smaller varieties (lentils, adukis, mungs) and those in the pea family (peas, chickpeas) have lower proportions of the resistant starch.

High intensity training increases caloric expenditure during 14 hours following session.

People who trained vigorously for 45 minutes at a level of effort that increased body temperature, raised heart rate, and induced sweating burned an average of 190 extra calories in the 14 hours following the training session. They also burned about 590 total calories in the exercise session itself. This contrasts with low intensity exercise, which does not increase caloric expenditure in the hours following exercise sessions.

Nature breaks more effective mental refreshment than other breaks.

As this article points out, if you need mental refreshment, a coffee break will probably backfire, but a growing body of research shows that making contact with live plants and animals, even if vicarious (photos of forests) is more effective than other diversions. A little time enjoying the sights and sounds of nature also has proven successful at relieving depression and anxiety and boosting cognitive performance.

This makes sense from an ancestral perspective. For millenia the human body-mind adapted to life surrounded by plants and animals in wild settings. Our nervous systems are adapted to the stimuli provided by living environments. Now in civilization we spend most of our time in less lively built environments. Our nervous systems apparently go awry in such spaces.

I suspect this contributes not only to mental illness, but also to disorders we tend to consider 'physical' like cardiovascular disease. The great health of isolated tribes might have a lot to do with the fact that the human neuroendocrine system is adapted to their more natural surroundings. I would guess that they have very different levels of various neuroendocrine chemicals (such as adrenaline and cortisol) found out of balance in diseases like metabolic syndrome.

This also means we can help ourselves by naturalizing our built environments. The Chinese developed an art of building and arranging environments to make them more natural and conducive to human vitality. They routinely incorporated natural sights and sounds--like stones, flowing water, fish ponds and tanks, plants and trees-- into built environments with the express intent of maximizing the beneficial impact on human health and awareness.

This part of Feng Shui (literally translated, Wind Water) centers on understanding how various environmental elements affect the nervous system. Its not hocus-pocus. It focuses on how to make built environments compatible with human needs by incorporating the 'five elements' of water, wood, fire, soil, and mineral, and balancing complementary such as bright and dark, wet and dry, hard and soft, heavy and light in ways that calm the nervous system or produce another desired effect, depending on location.

By bringing the elements of wind, water, wood, sunlight or fire, earth, and stone into our home and work spaces, we make them more like our ancestral environment and beneficial to our health. Then, we simply arrange them in the way than makes the space feel most comfortable and fitting for the use.

Catching Fire

2011-09-01T14:50:00.000-07:00

Catching Fire by Richard Wrangham presents a compelling argument that the primary nutritional change driving human evolution from small-brained Homo habilis to large-brained Homo sapiens was cooking––not meat-eating.

Wrangham starts off with some critical observations: No known human tribe lives on a predominantly raw food diet, and those modern people who attempt to live on a largely raw food diet have demonstrated difficulties maintaining body mass, energy levels, and fertility. This points to the hypothesis that modern humans are actually "adapted to eating cooked food in the same essential way as cows are adapted to eating grass, or fleas to sucking blood, or any other animal to its signature diet. We are tied to our adapted diet of cooked food, and the results pervade our lives, from our bodies to our minds. We humans are the cooking apes, the creatures of the flame."

Traditional Chinese medicine has for milennia maintained that humans need to eat cooked food to get adequate food energy (Pinyin: gu qi). In The Tao of Healthy Eating, traditional Chinese physician Bob Flaws writes:

"Traditional Chinese medicine suggests that most people, most of the time, should eat mostly cooked food. Cooking is predigestion on the outside of the body to make food more easily digestible on the inside. By cooking foods in a pot on the outside of the body, one can initiate and facilitate the stomach's rottening and ripening in its pot on the inside of the body. cold and raw foods require that much more energy to transform them into warm soup within the pot of the stomach. Since it takes energy or qi to create this warmth and transformation, the net profit from this transformation is less. Whereas, if one eats cooked foods, less qi is spent in the process of digestion. This means that the net profit of digestion, i.e. qi or energy, is greater."

This perspective contradicts the common belief that raw food is better than cooked because cooking can destroy nutrients. But as Flaws points out, net nutrient delivery matters more than gross amount of nutrient in the raw food. Let's assume that a carrot has 10 units of X nutrient, but only 10% of it is available to humans because it is locked in an largely indigestible cellulose envelope. Let's say that cooking destroys 50% of that nutrient (a gross overestimation for proper cooking), but increases the availability to 50%. The net delivery of X from the raw carrot is 1 unit, but the net from the cooked carrot is 2.5 units.

Wrangham presents multiple lines of evidence that humans and non-humans have a greater net macronutrient absorption from cooked than from raw foods, resulting in cooked foods delivering more energy than raw foods.

Wrangham includes some of the research I discussed in my series on raw vegan diet, which found that a high proportion of people eating diets high in raw foods (70% or more raw) are underweight and have low fertility. Belgian researchers showed that humans can digest only about 65% of the protein in raw eggs, but 91-94% of the protein from cooked eggs. [1] Another team showed that enzymatic digestion of heated beef protein increased by four times over raw beef protein. [2] This occurs because cooking denatures protein more effectively than stomach acid, making it more vulnerable to enzymatic digestion.

Wrangham's hypothesis competes with the Man-The-Hunter hypothesis which maintains that humans evolved big brains and small guts by route of increased meat-eating. However, Wrangham points out that the hunting hypothesis can't account for some of the facts. Increased meat-eating might explain the transition from Australopithecines to Homo habilis (habilines), but not the transition from the habilines to Homo erectus:

"Meat-eating accounts smoothly for the first transition, jump-starting evolution toward humans by shifting chimpanzeelike australopithecines into knife-wielding, bigger-brained habilines, while still leaving them with apelike bodies capable of collecting and digesting [raw] vegetable foods as efficiently as did australopithecines. But if meat eating explains the origin of the habilines, it leaves the second transition unexplained, from habilines to Homo erectus. Did habilines and Homo erectus obtain their meat in such different ways that they evolved different kinds of anatomy? Some people think the habilines might have been primarily scavengers while Homo erectus were more proficient hunters. The idea is plausible, though archaeological data do not directly test it. But it does not solve a key problem concerning the anatomy of Homo erectus, which had small jaws and small teeth that were poorly adapted for eating the tough raw meat of game animals. These weaker mouths cannot be explained by Home erectus's becoming better at hunting. Something else must have been going on."

Increased meat eating can't explain whey we have such small mouths and jaws.

"Given that the mouth is the entry to the gut, humans have an astonishingly tiny opening for such a large species....To find a primate with as relatively small an aperture as that of humans, you have to go to a diminutive species, such as a squirrel monkey weighing less than 1.4 kilograms (3 pounds). In addition to having a small gape, our mouths have a relatively small volume––about the same size as chimpanzee mouths, even though we weigh some 50 percent more than they do. Zoologists often try to capture the essence of our species with such phrases as the naked, bipedal, or big-brained ape. They could equally well call us the small-mouthed ape."

Compare the jaws of any raw food eating animal to human jaws. The largely vegetarian chimp has a gape much larger than that of a human:

Source: Junglewalk

The carnivorous cat has a gape nearly half the size of its head, and the jaws are very powerful for cutting through raw meat.

You can see some other big yawns here. Compare to the modern human gape:

Source: Flikr

Humans have a small mouth for such a large head. The larger gape of other species is not for taking in large bites, it is necessary for leverage to crush tough, chewy raw foods.

By the way, although Wrangham does not mention it, the shrinkage and reorganization of the mouth laid the foundation for speech. Thus, we may owe our linguistic abilities to the mastery of fire and cooking. I seem to recall reading that another anthropologist had proposed this hypothesis more than 20 years ago, but I no longer have the book that had the reference.

If evolution from Homo habilis to Homo erectus had been driven by increased consumption of raw meat, with technology and cooking as an afterthought, we would expect to have seen it maintain the large powerful ape mouth and jaws, retained the large, sturdy teeth, and increased the shearing action for adaptation to meat eating. Instead, from the habilines to the erectines the mouth and teeth shrank.

Here's a habiline skull:

Source: www.anhb.uwa.edu.au/.../ skulls/s10_homo_habilis

And here's an erectine skull:

Source: www.ma.krakow.pl

The erectine jaw and teeth are much smaller relative to body size. Erectines had a smaller gape and must have had a softer diet than the habilines. The skeletal remains provide the best available evidence that some tribe of Homo habilis discovered something that made for a much softer and energy-rich diet, giving rise to Homo erectus.

One might think that the use of knives and hammers alone selected for smaller mouths. Perhaps habilines simply cut the meat into small pieces or pounded it tender. Although initially plausible, on further examination, this loses credibility, because it can't explain how an animal adapted to a diet consisting predominantly of raw vegetation can continue eating that vegetation while adapting to the raw meat portion of the diet.

Wrangham notes that "Peter Lucas has calculated that the size of a tooth needed to make a crack in a cooked potato is 56 percent to 82 percent smaller than needed for a raw potato." Thus, so long as human ancestors continued to eat raw plants, they needed large teeth and jaws. And they definitely needed to eat plants.

"The problem is that tropical hunter-gatherers have to eat at least half of their diet in the form of plants, and the kinds of plant foods our hunter-gatherer ancestors would have relied on are not easily digested raw.

Tropical wild game simply does not provide adequate amounts of fat or carbohydrate to prevent excessive intake of protein resulting in ammonia and urea accumulation, especially in the annual dry seasons, when the whole carcass fat levels of game will drop as low as 1 percent to 2 percent.

By the way, Wrangham notes:

"Starchy foods make up more than half of the diets of tropical hunter-gatherers today and may well have been eaten in similar quantity by our human and pre-human ancestors in the African savannas."

Moreover, if raw meat was a staple of our ancestors, we would expect modern humans to have some significant resistance to toxins produced by bacteria that infect raw meat. But we are still vulnerable to those bacterial toxins.

In addition, there is a major economic problem with the meat-eating hypothesis. Wrangham has studied chimps directly, watching them hunt and eat. The typical chimp has to spend about 6 hours daily chewing its bulky, chewy raw foods. They hunt opportunistically, but will only spend 15 to 20 minutes on a hunt. If not successful in that time frame, they give up and return to eating plants. Why?

Wrangham explains that because digestion of raw food takes more time than digestion of cooked food and costs a lot of energy, a chimp has to devote eight or nine hours daily to feeding in order to get adequate energy. Australopithecines and habilines probably had similar constraints. This would have prevented them from investing much time in hunting:

"Males who did not cook would not have been able to rely on hunting to feed themselves. Like chimps, they could hunt in opportunistic spurts. But if they devoted many hours to hunting, the risk of failure to obtain prey could not be compensated rapidly enough. Eating their daily required calories in the form of their staple plant foods would have taken too long."

As Wrangham explains, a division of labor into hunting and gathering would not solve this problem, so long as the food was consumed raw.

"Suppose that a hunter living on raw food has a mate who is willing to feed him, that his mate could collect enough raw foods for him (while satisfying her own needs) and would bring them back to a central place, to be met by her grateful mate. Then suppose the male has had an unsuccessful day of hunting....The hungry hunter needs to consume, say, two thousand calories, but he cannot eat after dark. To do so would be too dangerous, scrabbling in the predator-filled night to feel for the nuts, leaves, or roots his gatherer friend brought him. If the hunter slept on the ground, he would be exposed to predators and large ungulates as he fumbled for his food. If he were in a tree, he would find it hard to have his raw foods with him because they do not come in tidy packages.

"So to eat his fill he would have to do most of his eating before dusk, which falls between about 6 and 7 P.M. in equatorial regions. If he had eaten nothing while on the hunt, he would need to be back in camp before midday, and there he would find his mate's gathered foods 9assuming she had been able to complete her food gathering so early in the day). He would then have to spend the rest of the day eating, resting, eating, resting, and eating. In short, the long hours of chewing necessitated by a raw diet would have sharply reduced hunting time. It is questionable whether the sexual division of labor would have been possible at all.

"The use of fire solved the problem. It freed hunters from previous time constraints by reducing the time spent chewing. It also allowed eating after dark. The first of our ancestral line to cook their food would have gained several hours of daytime. Instead of being an opportunistic activity, hunting could have become a more dedicated pursuit with a higher potential for success. Nowadays men can hunt until nightfall and still eat a large meal in camp. After cooking began, therefore, hunting could contribute to the full development of the family household, reliant as it is on a predictable economic exchange between women and men."

In short, cooking (and other culinary technologies that make food softer and easier to digest) made it possible for humans to pursue increased meat-eating. It freed men from the need to continuously feed on plant foods, giving them time to devote to hunting meat.

Simply put, cooked food delivers more energy and nutrition in a smaller, more easily digested package than raw food. Wrangham argues that since Homo erectus had a larger brain and a much smaller face, mouth and teeth than Homo habilis, probably some tribe of Homo habilis first controlled fire and used it for cooking. The resulting increase in energy and nutrient availability led to rapid selection for smaller guts and larger brains and bodies. By providing protection from nocturnal predators, control of fire also enabled human ancestors to give up tree-dwelling. It also supported the sexual division of labor (hunting and gathering/cooking) present in human cultures.

Wrangham's Catching Fire will provide plenty of food for thought for anyone interested in ancestral nutrition.

Some Recent Meals

2011-08-25T14:07:00.000-07:00

This is a so-called 'century egg,' a Chinese invention. They take raw duck eggs, pack them in in a mixture of clay, ash, salt, lime, and straw or rice hulls for several weeks to several months, depending on the method of processing.

When you crack it open, you find that the white has turned gelatinous and black.

They have a strong flavor. I cut them into slices like below. Inside you find that the yolk has turned blue-green, and semi-solid. The alkalinity of the curing materials above raises the pH of the egg to 9 or more, causing changes in the egg proteins.

I cut the egg into slices and put a few along with slices of an omelet on top of this miso soup that contained bok choy, bean sprouts, onions, and other vegetables.

On May 30 I had the plate below. Egg omelet, two types of sweet potato, white potato, and a combination of steamed Asian greens.

On August 12, I had the meal below. Two grass-fed beef burgers, one raw and one cooked, about 8 ounces total. On the cooked burger, we had a sauce Tracy created from blended tofu and spices that made it look a lot like cheese. I had a large sweet potato, a large ear of fresh corn, some cooked kale and onions, and a green salad with quick-pickled cucumbers that Tracy made atop. To finish I had one of those quarters of a small watermelon.

On August 22 my first feeding consisted of this bowl of fruit and nuts. It contained a half banana, 9 grapes, an apricot, half a pint of raspberries, a plum, a quarter-cup of cashews, a quarter-cup of almonds, an a couple of tablespoonfuls of coconut flakes.

A couple hours later, I had the plate below with about 4 ounces of leftover cod, a pile of kabocha winter squash, steamed kale with some carrot raisin salad atop, half an avocado, and some cole slaw. The two photos have different dates because it changes date some time in the mid morning (apparently I didn't set it correctly and don't want to take time to fix it).

Later that same day I had two plates of food. The first has a ~4 ounce turkey burger under that pile of wilted onions (seasoned with cumin), more kale, slaw, olives, avocado, and green salad. I ate this while waiting for our potatoes to steam. Then I had the second plate: another turkey burger and onions, and two steamed red potatoes with black pepper. Then I had the bowl of blueberries and banana with coconut milk.

My Ancestral Health Symposium Presentation

2011-08-23T17:41:00.000-07:00

"Ancestral nutrition: An alternative approach" by Don Matesz, MA, MS from Ancestry on Vimeo.

You may need to attach speakers or earphones to your computer to hear the audio.

Due to time constraints, I was not able to go into details explaining how each of the items I pointed to as adaptations to a plant-based diet could prove maladaptive for a diet providing a major proportion of energy from meat or fat. I will expand on one example here and leave the others for others to think through.

Humans as well as other primates have uric acid levels higher than other mammals due to knock-out of the uricase-coding gene at least 15 million years ago. [1] This appears to have occurred as an adaptation to several environmental factors including 1) high dietary vitamin C (which lowers uric acid), 2) low sodium intake, and 3) low dietary fat combined with high fructose intake.

Elevated uric acid appears to have at least two adaptive functions in such a context: 1) It raises blood pressure in the face of very low sodium and very high potassium intake, and 2) it facilitates the conversion of fructose into fat for adipose storage when vitamin C intake declines (in autumn, when fruits contain more fructose and less vitamin C).

This human/primate feature has positive effects in the context of a diet low in sodium and dietary fat, but high in potassium and fructose.

However, it is potentially maladaptive when dietary sodium, fructose, or meat increase, and dietary potassium and vitamin C decrease.

Meat typically has a K:Na ratio of ~5:1 or lower, whereas fruits (the presumed main foods of the common ancestor of humans and chimps) have so little sodium, that the ratio is 100:1 or more. Therefore, simply switching from plant-based to meat-based, without any addition of granular salt, automatically results in a relatively high sodium intake, for an animal adapted to the reverse, a low sodium, high potassium diet.

In addition, meat provides purines, which feed into the production of uric acid. Elevated serum uric acid can produce overt gout, but before it does that, it can promote general inflammation [2], and elevated uric acid has been linked to chronic heart failure and increased cardiovascular risk [3, 4], metabolic syndrome [5], and elevated blood pressure [6, 7]. It also appears that uric acid increases the storage of body fat [1]:

Specifically, uric acid causes mitochondrial dysfunction with specific effects to increase fat accumulation by both increasing fat synthesis and by blocking fat oxidation (Sánchez Lozada LG et al, manuscript in preparation). Indeed, acutely raising serum uric acid with a uricase inhibitor in rats will result in fat accumulation in the liver within 24 hours, and this is not observed if the rise in uric acid is prevented. Other studies have suggested effects of uric acid on blood pressure, insulin resistance, and adipocyte activation (28, 29). Indeed, Cheung et al recently reported that mice that cannot produce uric acid (XOR knockout mice) have a central defect in adipogenesis and fail to get fat (30).

Vitamin C reduces uric acid concentrations [8]. Therefore, low intake of vegetables and fruits rich in vitamin C, combined with high intake of meat and fat, may promote abnormal elevated uric acid levels and all of the disorders above.

Fructose also feeds the production of uric acid, and vitamin C blocks the undesirable effects of fructose (which explains why eating fruits has a different metabolic effect than eating refined sugars) [9]. In the ancient environment, when our ancestors had diets low in fat but high in fruit, the pathway that converts fructose to fat when vitamin C concentrations are low was adaptive. In the fall, when wild fruits had an increase in fructose content and a decrease in vitamin C content, the liver converted a higher proportion of the fructose into fat to be stored as adipose, as a combination of insulation against colder weather and a supply of energy to draw on when food supplies declined through the winter. In the modern environment with a high ratio of fructose to vitamin C, the same system is maladaptive, resulting in increased uric acid levels, body fat accumulation, inflammation, and metabolic syndrome.

So, human uric acid metabolism remains adapted to a diet with a high ratio of potassium to sodium, and a high ratio of vitamin C to fructose. In the context of a high dietary ratio of animal protein and fat reducing vitamin C intake and the K:Na ratio and providing purines, this system will likely prove maladaptive for at least some individuals. The imbalance can manifest in variety of ways: inflammation effects, metabolic changes, hypertension, increased cardiovascular disease risk, increased fat storage, gout, etc..

This then provides one example where the effect of meat consumption depends on the quantity and dietary context, as well as individual variation in uric acid metabolism. The higher our ratio of meat and fat to vegetables and fruits, the lower our vitamin C intake and K:Na ratio, and the more purines we have feeding the production of uric acid. Higher intakes of vegetables and fruits rich in vitamin C and potassium will tend to counter the effects of the purines and sodium, which will delay the appearance of symptoms and reduce their severity.

If someone eats a diet containing a high proportion of animal protein but also includes a fairly large amount of vegetables and fruits, he or she may not see any adverse symptoms related to excess serum uric acid appear for a long period of time. The context (high intake of fruits and vegetables) modifies the effect of the high meat intake. Further, the body's ability to adapt to any stressor (e.g. excess serum uric acid) declines as exposure continues for a longer period of time. The adverse effects creep in slowly, at a rate as noticable as hair growth, or become more noticable after she or he reduces produce intake, or some other factor (e.g. stress) reduces the body's ability to deal with the excessive uric acid, or, simply, the body's ability to deal with the excess uric acid declines due to long exposure to the overload. As things change, the person naturally gravitates toward non-nutritive ingestive behaviors that tend to reduce the symptoms.

For example, she has a premenstrual headache. She doesn't immediately think, "Oh, this is due to the long accumulation of congesting effects of my diet." Instead, she takes a nap, or an aspirin, gets relief, and goes on her way. If another person notices a little extra inflammation in a chronic skin condition that naturally fluctuates anyway, he doesn't immediately think that his food caused this, instead he puts some soothing balm on it, or takes an anti-inflammatory, which reduces the discomfort enough that he loses interest in exploring it further. The use of non-nutritive ingestive behaviors is evolved and hence the natural approach to discomfort: We "take something for it" because our species evolved to use non-nutritive ingestion as an integral part of dietary adaptation. People start looking deeper only when the non-nutritive ingestive behaviors no longer control the discomfort adequately. So small things so gradually turn into large things that we often don't figure things out until they have gotten very persistent and distracting of our attention.

Legumes: Neolithic or Not?

2011-08-12T15:34:00.000-07:00

Some people have suggested that legumes are a relatively ‘new’ food in human diets, introduced only with agriculture, discordant with human biology, and causes of disease. Some have raised concerns about a number of secondary plant compounds in legumes, especially isoflavones considered phytoestrogens.

I have decided to view human evolution in the larger context of primate evolution, because we share so many characteristics with other primates and have a genome 98 percent similar to that of our nearest relative, the chimpanzee. Since modern humans eat legumes, and humans share a common ancestor with chimps, if modern chimps eat legumes, this would suggest that probably the last common ancestor of humans and chimps also ate legumes.

So I decided to find out, do modern wild chimps eat legumes?

It only took a few internet searches to find that, indeed, non-human primates, including chimps, consume legume seeds, leaves, and flowers.

The most remarkable of the literature I have so far come across on this topic is a paper published in the American Journal of Primatology by Shoeninger, Moore, and Sept, entitled “Subsistence Strategies of Two “Savanna” Chimpanzee Populations: The Stable Isotope Evidence.” [1 pdf] In this paper, the authors report on Ugalla chimps, living “in open, grassy woodland habitats similar to those in which the last common ancestor of apes and humans probably lived.” These chimps consumed a diet very rich in fresh legumes, estimated at 50% of total food consumption, certainly a level requiring some level of physiological adaptation.

This puts fresh legumes in a different class from grains. So far as I know, we have no evidence of chimps consuming any significant amounts of immature grass seeds (grains).

Green Peas. Source: Ecosalon

Based on this type of evidence, it seems probable that fresh legumes were part of hominoid diets for millions of years before the advent of agriculture. This would give plenty of time for hominoid physiology to become adapted to regular intake of fresh legumes and their phytochemical constituents, and also provide an evolutionary pathway to the domestication of legumes.

I know many people feel worried about isoflavones with phytoestrogen properties affecting sexual development, function, and fertility. They have the idea that plants produce these compounds to disrupt the fertility of animals consuming them.

It is easy to think of the herbivore as the enemy of the plants it consumes, and vice versa, but grazing herbivores provide water, nitrogen, and minerals to plants via saliva, urine, and feces deposited in the field while grazing. Herbivore hooves also knead and soften the soil. The plants receive many needed services from their ‘enemies,’ not the least of which is a supply of carbon dioxide, without which they can’t live. The herbivores need the nutrients and oxygen the plants produce. Food plants and animals using them form a yin-yang pair, complementary and opposite, but if antagonistic, both sides fail.

If a plant slightly limits the fertility of an animal grazing upon it, this actually serves the animal species. Sure, some individuals may complain because they don't get the litters they want, but by keeping the animal numbers within limits, this reduces the chance that the animal population will overshoot its resource base and crash, while also increasing the amount of food/nutrients available for each individual animal, increasing the quality of life for the grazier. The plant helps the animal maintain a sustainable population size, and by grazing, the animal helps the plant maintain a sustainable population size. In the big picture, this is synergism, not antagonism.

The synergism and mutuality of plant-animal nutrition relationships is especially evident in human interactions with plants. When humans like a plant, usually because the plant helps them thrive and reproduce, the people take on the task of feeding, protecting, and promoting the reproduction of that plant. Humans help plants that help humans thrive, so plants that help humans have become among the dominant plant species on the planet.

When thinking about evolutionary plant-animal interactions, I feel it is important to realize that organisms adapt not only to ‘beneficial’ but also to challenging aspects of their habitats, if given enough time.

Let’s assume that at some point in the past, some herbivores were grazing on plants rich in phytoestrogens. Let’s also assume that, initially, the herd grazing on these plants does have reduced fertility. Nevertheless, within the herbivore herd a range of susceptibility to the phytoestrogens’ effects on fertility. That is, some of the animals may be rendered completely infertile, some will have reduced fertility in varying degrees, some will have no reduction in fertility, and it is possible that in some animals the increase of phytoestrogens will actually increase fertility.

If this process continues for several generations, gradually the animal population will move toward adaptation to the isoflavones. The animals resistant to the anti-fertility effects of the isoflavones will have more offspring than those not resistant. Eventually, the entire herd will have resistance to the effects of the typically encountered levels of isoflavones.

Now, let’s suppose that the mechanism of action of the isoflavones is to reduce hormone levels in the animals. In this situation, the animals resistant to the anti-fertility effects of these phytochemicals will be those who have an endogenous production of hormones high enough to counter the negative effects of the phytoestrogens. Over several generations, the evolutionary result will be a species adapted to a phytochemical drain on its endogenous hormone production by virtue of a higher endogenous output of hormones to compensate for the losses induced by the phytochemical.

Now, if you take this species off of the diet to which it is adapted, removing or greatly reducing the ‘hormone disrupting’ phytochemicals, the animal’s usual hormonal output might be excessive. As a consequence, the animal might develop disorders due to excessive levels of its own hormones. Adding the phytochemicals back to its diet will reduce those hormone levels, producing a more balanced physiology, because the animal is genetically adapted to a diet containing chemicals that ‘disrupt’ its hormones. It may actually need the ‘hormone disrupters’ to maintain hormone balance.

Edamame. Source: Dried-edamame.com

I suggest that this may provide part of an evolutionary explanation for the growing body of research suggesting that consumption of legumes and other plant foods containing phytoestrogens may have positive effects on human health.

I discussed here some research that supports the idea that plant-rich diets and specific whole plant foods can reduce the excessive sex hormone levels present in premature menarche, premenstrual symptoms, menstrual pain, polycystic ovary syndrome, hirsutism, menopausal syndrome, and reproductive system (breast, ovarian, etc.) cancers in women.

Tham et al of the Stanford Center for Research in Disease Prevention and the Department of Medicine discuss the growing evidence for potential health benefits of dietary isoflavones and lignans, two types of phytoestrogens including prevention of cardiovascular disease, promoting bone health, and regulating hormone levels across the life cycle, in both men and women, to prevent sex hormone-linked reproductive system cancers. [2]

World-wide patterns of human population growth seem to lend little support to the idea that phytoestrogens make people infertile. Historically, growth rates have been luxuriant in nations consuming more plant-based diets (India, China, Asia in general) rich in phytoestrogens.

Legume proteins may also have unique benefits. For example, multiple studies have shown that substituting soy protein for animal protein might improve kidney function in type II diabetics with nephropathy [3, 4, 5, 6, 7, 8]. This may not be a property unique to soy, but an effect of legume protein versus animal protein, due to legume proteins having a different ratio of amino acids. It certainly does not indicate lack of adaptation to legume proteins.

I find it hard to fit this data into an picture of human evolution that considers legumes discordant with human biology, but it makes sense in a view that includes legumes among human ancestral foods.

Lignans are another type of phytoestrogen. As shown in this table, lignans occur in fruits and vegetables as well as seeds, nuts, legumes, and grains. Although the seeds typically have the highest concentrations, sweet potatoes, carrots, asparagus, and garlic have levels comparable to pinto beans, peanuts, and several grains.

Legumes like clover naturally occur in grasslands, and farmers grow clover as part of their pastures and fodder for ruminants. Consequently, products from either pasture- or grain/legume-finished animals also can contain phytoestrogens, although in lesser amounts than in plants. Hence, human ancestors probably would have gotten exposed to these compounds through eating wild game meat as well as plants.

Of course, as with every other item we ingest, dose and context affects outcome. Nature never delivered isoflavones in concentrated pills or isolated legume proteins, absent counter-balancing compound present in the whole foods, nor did it give isoflavone-rich soy formula (based on soy protein isolate) to human infants. Obviously, substituting soy infant formula for human breast milk is discordant with human biology.

Now on to one of America's favorite beans.

Coffee Bean. Source: Whos3d3n

Did you know that coffee supplies the same isoflavones found in soybeans, albeit in smaller amounts?

"This paper reports the isoflavone contents of roasted coffee beans and brews, as influenced by coffee species, roast degree, and brewing procedure. Total isoflavone level is 6-fold higher in robusta coffees than in arabica ones, mainly due to formononetin. During roasting, the content of isoflavones decreases, whereas their extractability increases (especially for formononetin). Total isoflavones in espresso coffee (30 mL) varied from 40 μg (100% arabica) to 285 μg (100% robusta), with long espressos (70 mL) attaining more than double isoflavones of short ones (20 mL). Espressos (30 mL) prepared from commercial blends contained average amounts of 6, 17, and 78 μg of genistein, daidzein, and formononetin, respectively. Comparison of different brewing methods revealed that espresso contained more isoflavones (170 μg/30 mL) than a cup of press-pot coffee (130 μg/60 mL), less than a mocha coffee (360 μg/60 mL), and amounts similar to those of a filtered coffee cup (180 μg/120 mL)."

J. Agric. Food Chem., 2010, 58 (5), pp 3002–3007

The Ancestral Health Symposium

2011-08-09T16:30:00.000-07:00

Last Thursday Tracy and I drove to L.A. from Phoenix so that we could participate in the Ancestral Health Symposium at UCLA. I feel grateful that Aaron Blaisdell and Brent Pottenger invited me to speak at the conference nearly a year ago. They put together an awesome event.

We got a bit of a late start Thursday morning. Mapquest says the drive takes a little over 6 hours. We were right on track until we got to Pasadena and hit rush hour traffic at about 6 p.m. It took something like an hour and a half to cover the last 20 miles. At one point, we waited about 20 minutes just to traverse an exit from one road to another. Welcome to L.A.!

We were hoping to arrive at Aaron's home shortly after the Thursday evening presenter gathering started but didn't get there until about 7:30 p.m. The party was still in progress though we unfortunately missed a presentation by Denise Minger.

We were very hungry, having eaten very lightly since our pre-trip breakfast at about 9:30 that morning. There were hardly any vegetables and fruits left, but they had some nice red wine, the first thing Tracy got for us, and they still had salmon and steaks on the grill. After the wine, Tracy and I split a small steak, had a little salmon, and shared a small bowl of strawberries with new friends.

At the party and the symposium, I was pleased to meet people I previously knew only via electronic communication. When I first walked in, I saw a young man I thought looked a little familiar, but couldn't place his face. It was Stephan Guyenet, he put a name to my face before I could identify him.

Next I met Jimmy Moore in the kitchen while Tracy was getting the wine.    Next came Denise Minger (yes she is a real person, contrary to vegan myths), then Richard and Bea Nickoley, and Chris Masterjohn. I really enjoyed talking with Richard and Chris as Tracy and I waited for the food. As the evening progressed, we met Rob Wolf, Mark Sisson, Loren Cordain, Paul and Shou-Ching Jaminet, Staffan Lindeberg, Gary Taubes, Mike and Mary Dan Eades, Seth Roberts, and Dr. BG.

The next morning Tracy and I walked down 14 flights of stairs of the Palomar hotel then 15 minutes to the Ackerman hall on UCLA campus to check in. There I was pleased to meet Doug McGuff. I had in mind to ask him a question about some recent research I saw on retention of training effect from resistance training in older people, but got distracted because there was some problem finding Tracy's admission ticket in the electronic data base. The kind fellow at the door waved at me, saying "Don, you're okay, come on in," but I said "not without Tracy." Fortunately I had brought the hard copy of the ticket.

Once in we went to the table to get our name tags, where we also met Rob Wolf's wife Nicki.

After check in, we walked rapidly back to the hotel to change our clothes. We were right on time to get to other presentations, until we got to the parking kiosk. The attendant tried to show me on a map how to get to the only lot still having empty spots. I thought I had it, but the UCLA roads were under construction and not well marked, so I couldn't really follow the map. I got lost at some turn, and ended up at a lot for student dorms, a ways from the Ackerman hall. We asked some one for re-directions, which again were difficult to follow because of the construction. We found some students who finally gave us directions that took us off campus for a short drive, circumventing the construction, and found the lot. Unfortunately, by that time we had missed Loren Cordain's presentation.

We finally got to the hall shortly before Staffan Lindeberg gave his presentation on his work with the Kitavans. Well worth watching. I wanted to ask him a question, but I had to leave before the end of his presentation in order to get to the other hall where I was scheduled to speak. I got the impression that he said his team has found no Kitavans on their native diet with atheroma, and apparently no one has found atheroma in any wild animal living on its native diet. This contrasts with some human tribes, such as the Masai, who have extensive, although apparently stable atherosclerosis. I found this supportive of my developing ideas on human dietary adaptation.

I did my presentation Friday morning at ~11 a.m.: Ancestral Nutrition: An Alternative Approach. When the video link is available I will let you all know. It seemed well received.

At my presentation, and later, we were glad to see our friends from Phoenix, Marty Wilson (Ecotone Wellness), Cathy Pisano and Karen Marco (Fooditude), and Keven Kula (Ready State Fitness).

After my presentation, there was a lunch break, but most of it I spent talking with people who had questions after my presentation. Then we went back to the main hall for an interview, which didn't happen during the break because we couldn't find the video camera guy. He appeared with the camera just before Stephan started his presentation. I was very sorry to miss it.   The interviewers, Tess and Alyssa, the Planetary Girl, spent the length of Stephan's presentation interviewing me, very interested in my approach to paleo, sustainability, and perspective on adjusting dietary proportions to male vs female metabolism using an evolutionary context.

After the interview we attended Linda Frasseto's talk on her work using paleo diet, one of the few clinical studies on paleo diet published in peer-reviewed literature. Her paleo diet approach was very high in plant foods to supply, if I remember correctly, a ~12g/d intake of potassium and a 12:1 K:Na ratio. It produced some remarkable improvements in metabolism and blood pressure, but was more effective in salt-sensitive individuals than in 'normal' people. Since the diet she used improved insulin function, I asked her if she knew of any research connecting K:Na ratio to insulin function. She did not, but Loren Cordain said he did. I will follow up on that.

By the way, her version of 'paleo' was 45% carbohydrate and much of that from carrot juice (essentially simple sugars), and only 30% fat. She also worked to keep the caloric intake up at maintenance levels, which was difficult according to her report. It was among the facts that got me thinking again, there is no universal application of 'paleo' diet (just as there is no universal vegetarian diet).   In contrast to her study, this one produced a 'paleo' diet that was low in calories (1445 on average), 24% protein, 39% fat, and 32% carbohydrate. This might be fine for people wanting to lose weight, but we can't assume that this diet will have identical or beneficial effects for someone maintaining weight and eating 2500 calories per day, because increasing caloric intake at the same proportions will result in greater absolute intakes of fat, protein, and carbs. Especially in the case of protein, the more you eat, the more toxic waste you produce (acids, ammonia and urea), which puts additional burden on detoxification systems.

One of the challenges I had with meat-based, low-carb paleo revolved around how to get 2500 calories daily without eating above 25% carbohydrate. The nub for me involved the nausea and appetite loss that I would get whenever eating a large amount of fat. Sometimes I would get such bloating and discomfort from high fat meals that I would be unable to eat much but fruit and juice for a couple of days, completely negating the temporary increased caloric intake I got from the extra fat. This is an accepted effect of high fat meals (even Peter at Hyperlipid mentions it fairly often), not unique to me, which some might consider a benefit for people trying to limit energy intake, but it is certainly undesirable when it prevents adequate energy intake. At one point I decided to try drinking milk to fill in the calorie gap, adopting a 'pastoral' diet, despite my previous experience that milk increased my sinus congestion and allergy difficulties, hoping that in the context of a grain-free diet, milk would have a different effect on me. Alas, it did not.

We had to leave the symposium shortly after that because we were hungry and had to drive back to Phoenix, because Saturday I started teaching at Phoenix Institute of Herbal Medicine and Acupuncture.

But before we left, we had another chance to chat with Richard Nickoley and Bea. We also met Erwan LaCorre of MovNat, and a few people who follow my blog.

Before leaving we went down stairs to the student food concession. We got a grilled chicken salad and an order of black beans from a Rubios concession.

I was sorry to have to leave early and miss the presentations given on Saturday. We had a wonderful time and look forward to the next opportunity to participate. Thanks again to Aaron Blaisdell and Brent Pottenger, and the dozens of volunteers who pulled this off.

Follow-up on Farewell to Paleo, and Comments on Confirmation Bias

2011-08-04T06:57:00.000-07:00

Seems that many people did not understand my Farewell to Paleo post.

I wrote that blog after ~14 y of tinkering with paleo principles under the common assumption that we (humans) are fully adapted to a meat-based diet, i.e. that a 'paleodiet' should supply most of its energy and protein from meat and fat.

My experience didn't confirm this belief. Tracy and I, and many of my clients and students, had increasing problems with inflammation, accumulation, congestion and stagnation while eating a meat-based diet supplying ~50-60 percent of calories as fat, despite avoiding the dreaded neolithic foods and also eating a large amount of produce.

It seems paleo has for many people become synonomous with meat-based, high-fat nutrition, and so many 'paleo' and 'primal' people are also endorsing and including processed meats (bacon, sausages, etc.) or dairy products (cream, butter, etc.), that it has become little more than a kind of rehashed Atkins.

I regret having contributed to that.

It is to that 'paleo' that I said good bye.

After looking at research ignored by advocates of meat-based and high-fat nutrition, thinking things through, and experimenting a bit, I now have a different understanding of paleo diet. I leave the details for the follow-up on the Ancestral Health Symposium.

For now, in case you didn't notice, people in the media have already pegged 'paleo' as rehashed Atkins in the 'caveman diet' guise. If anything will destroy paleo, it is this.

Now, I have also noticed that people in the paleosphere have taken to accusing me of confirmation bias. I find that very rich indeed.

Confirmation bias means only seeing evidence that supports your beliefs, and not seeing evidence that contradicts your beliefs.

In the paleo- and low-carbo- spheres, confirmation bias looks like this:

Only focusing attention on or considering as important those physiological features that make humans different from other primates, and ignoring the many nutrition-related physiological features that humans share with other primates.

Only seeing/accepting evidence that meat-eating has benefits, while ignoring, refusing to accept, or denying good evidence that meat-eating can in some quantities and contexts be harmful.

Only seeing/accepting evidence that saturated fats are neutral or beneficial, refusing to accept good evidence that excess dietary SFs have harmful effects in certain quantities and contexts.

Only seeing/accepting evidence that unsaturated fats are harmful, while ignoring contrary evidence.

Only seeing/accepting evidence for the positive effects of cholesterol, while ignoring a mountain of contrary evidence showing adverse effects of excess dietary and serum cholesterol.

Only seeeing/accepting evidence that grains and legumes are harmful, refusing to acknowledge evidence that they can be neutral or beneficial.

Only seeing/accepting evidence that 'vegetables are useless or unnecessary,' while refusing to acknowledge evidence that they have benefits.

Only seeing/accepting evidence of potential harm from eating nuts (e.g. so-called antinutrients), while ignoring or belittling evidence that they provide benefits.

And so on.

I was caught up in that confirmation bias for quite a while.

But as I have increasingly broken away from it, and written blogs discussing evidence contradictory to the popular 'paleodiet' and high-fat/low-carb perspectives, I get attacked for confirmation bias?

It reminds me of the old adage: When you point a finger at someone else, you have several pointing back at yourself.

As I said in the 'Farewell to Paleo' post, I said farewell after tolerating cognitive dissonance for too many years.

I forgot to write that I came to meat-based 'paleo' diet after ~14 years eating a primarily vegetarian, grain-based, macrobiotic diet. That diet, combined with herbal medicine, had provided me with many health benefits, not the least of which being control of my constitutional tendency to respiratory allergies and inflammatory skin conditions (diagnosed as eczema and psoriasis, labels I don't necessarily accept).

As a graduate of the American Academy of Nutrition, and after 14 years as a vegetarian, I could martial plenty of evidence for a vegetarian, low-fat diet. When I encountered the evidence for meat-based 'paleo' I of course found it was totally contrary to my expectations, but after serious consideration it appeared strong enough to me that I could no longer ignore it, so I switched from macrobiotic to meat-based, intellectually convinced that the change might improve my health even further than I had gotten with macrobiotics.

I'm not one to try things lightly then dismiss them. If I think 'paleo' should work, and I find glitches, I will go back to re-evaluate the basics. If I still think the basic plan is correct, I will try some adjustment within the framework, like decreasing protein and increasing fat, or some other. I might be stubborn, but I don't give up on what I think is correct until I seem to have exhausted all possible variations, OR I notice that I am ignoring evidence that the basic plan has some important flaw.

When I see evidence contrary to my expectations repeatedly coming to my attention, I can't keep ignoring it, or explaining it away, to satisfy my preconceptions.

In my life, not only me, but people I love were putting into practice the ideas that increasing intake of meat and saturated fat will improve health, and they were suffering: Gaining body fat, rising blood lipids, congestion, malaise, low energy, etc.

Meanwhile, I could no longer ignore or consider invalid all of the literally thousands of epidemiological, clinical, and animal studies linking modern degenerative diseases to excessive intake of meat and fats, including saturated fats, in modern nations.

Nor could I continue to ignore or belittle all of the hundreds of well-designed studies showing positive health effects of increasing the plant: animal ratio or particular plant components of modern diets.

And that's why I finally said farewell to meat-based, high-fat 'paleo.' I just couldn't keep ignoring evidence hitting me in the face, contradicting my belief that a diet providing a high proportion of energy from meat and fat promotes health.

I could no longer accept a flat earth, when the evidence for a sphere hit me in the face.

Which led me to realize, that if the paleo principle is correct, there must be some evidence for strong human adaptation to plant-based diets that the meat-based paleo crowd has either overlooked or ignored.

And I think I have found that evidence.

Its complicated. The effect of any nutrient or food on human health depends on quality, quantity, and context of consumption.

I can no longer allow myself to fall into simplistic thinking like 'meat good, grains bad,' 'fats good, carbs bad,' and such.

Meat can have benefits in some quantities, qualities, and contexts, and cause harm in other quantities, qualities, and contexts.

Ditto for fats, carbs, grains, everything.

Done with nutritional dualism.

Everything is relative.

Anything can be medicine or poison, depending on quality, quantity, and context.

Ancestral Nutrition: An Alternative Approach

2011-08-01T17:22:00.000-07:00

I gave that title to the talk I will give at the Ancestral Health Symposium this Friday morning at UCLA.

I wrote this description of it:

For about 65 million years our primate ancestors consumed plant-dominated diets. Humans developed the technological ability to consume meat-based diets only within the last 2 million years, so at least 98 percent of the evolution producing our basic primate physiology occurred before humans could obtain meat-based diets.

Condensing the 65 million years of primate evolution into a 24 hour period, our ancestral diet was plant-based for at least 23 hours and 30 minutes, and animal-based diets emerged only within the last 30 minutes.

Ninety-eight percent of the human genome is identical to the nearest primate relative, chimpanzees, who eat a 95 percent plant diet. Recent hunter-gatherers consume up to 20 times more meat than chimpanzees on a percent energy basis, a substantial deviation from the primate baseline.

Similar to other primates, humans retain many physiological and behavioral features displaying adaptation to a plant-based diet, some of which are potentially maladaptive for diets supplying a high proportion of energy from meat, fat, or refined carbohydrates. Recent hunter-gatherers and pastoralists appear protected from maladaptive responses to animal-based diets by their baseline body composition, ecological context, low total energy intake, and evolved non-nutritive ingestive behaviors.

Modern people adopting meat-based ‘paleo-facsimile” diets may differ from recent hunter-gatherers in lifetime caloric balance, body composition, ecological context, and non-nutritive ingestive behaviors. By comparing hunter-gatherers and modern people, I show how the quality, quantity, and context of meat consumption will affect the outcome for any individual.

Plant and animal foods generally have opposite yet complementary nutritional characteristics. I present an integration of Chinese medical yin-yang theory with Western nutrition that can enable us to understand the relation each type of food (plant or animal) to modern diseases of deficiency or excess, and can help guide us to identify an appropriate dietary plant-animal ratio for any individual.

Time permitting, I plan to post a preview sometime later this week, and after the symposium, I will present the lecture in blog form.

Diet and Female Hormone Balance

2011-07-21T19:39:00.000-07:00

High levels of serum estrogens and androgens promote premature menarche, premenstrual symptoms [1], menstrual pain [2], polycystic ovary syndrome, hirsutism, menopausal syndrome, and reproductive system (breast, ovarian, etc.) cancers in women [3].

Asian women and women eating plant-based diets excrete more estrogens via the stool than omnivores, and can have 15-30% lower estrogen levels than women eating omnivorous diets, along with lower risks of all of the conditions above [4 , 5 , 6 ].

The Diet and Androgens (DIANA) trial produced a reduction of insulin resistance, a 4 kg weight loss, a small decrease in estrodiol, and a 20% decrease in serum testosterone in women who adhered to a very low fat, plant-based diet with high intake of whole grains, flaxseed and legumes, and minimal intake of animal products over the course of 4.5 months [7].

Nowak et al reported a dramatic decrease in testosterone levels and hirsutism in a PCOS patient who consumed 30 G daily of flaxseed for 4 months [8 ].

Barnard et al reported a decrease in body weight, duration and intensity of premenstrual symptoms, water retention, and duration and intensity of menstrual pain in 33 women who ate a low fat, vegetarian diet for two menstrual cycles [9 ].

Bagga et al reported a significant decrease in serum estrogens with no adverse effects on menstrual cycling among women who ate an ad libitum diet supplying 10% of energy from fat and 25-35 g of fiber daily [10 ].

Excess stored iron appears to play a role in PCOS and insulin resistance [11], and we have evidence suggesting a role in breast cancer [12]. Meat provides more bioavailable iron (heme iron) than plant foods, and oral contraceptives reduce iron losses; each of these could contribute to excessive stored iron.

I think the literature gives a pretty clear picture. Women eating diets low in fat and animal products, and high in whole plant foods, generally have lower estrogen and testosterone levels and lower incidences of hormone-related diseases, compared to women eating diets high in fat and animal products. Certain plant foods, e.g. flaxseed, legumes, whole grains, appear particularly effective at increasing elimination of excess estrogens and androgens. Clinical trials show that reducing fat and animal products and increasing plant foods rich in fibers will for many women result in reduced hormone levels. A reduction in hormone levels will generally result in reduced premenstrual discomfort and dysphoria, menstrual pain, fibrocystic changes, and risk of hormone-related cancers.

From an evolutionary perspective, women performed most of the gathering, and while gathering, they probably nibbled on what they were gathering, so I would suspect that they consumed considerable amounts of plant foods on a daily basis, including various seeds, nuts, fruits, and even fresh legumes (wild peas and beans) containing phytoestrogens, just like other primates.

So here's my hypothesis: I think it probable that human metabolism is adapted to regular intake of phytoestrogens, meaning that our hormone production pattern proceeds on the genetically built-in premise that phytoestrogens and other plant chemicals will be part of the diet, altering hormone levels. In other words, our hormone production proceeds with the assumption that phytochemicals will be draining out some of our hormones; its production is adapted to a drain that was constant in the millions of years that our ancestors ate plant-based diets. When we adopt diets that lack these compounds, while simultaneously increasing intake of other compounds (animal protein and fat) that feed the cholesterol and steroid production system, our own production of hormones becomes excessive, producing disease.

Legumes in Hunter-Gatherer Diets

2011-07-13T14:19:00.000-07:00

Did hunter-gatherers eat legumes?

According to Sigrid Leger, author of The Hidden Gifts of Nature, Bushmen ate the following legumes:

Wild Coffee Beans (Bauhinia petersiana): "The seeds are edible and can be gathered from February until May. The pod is removed, the seeds are put into hot ash for a minute and are cooked in this way. After that the seeds can be eaten just as they are or they are pounded and then eaten."

Marama bean (Tylosema esculentum): "The whole pod is put into hot ash for a short time and removed again. After having cooled down, the pods are opened, the skin of the seed is removed and the seed itself is eaten."

These examples appear to illustrate that the absence of pots and pans in the archaeological record does not serve as evidence that prehistoric people did not eat cereals or legumes. Anyone who has eaten popcorn or peanuts might realize that people can eat grains and legumes roasted as an alternative to boiled.

According to Brand-Miller and Holt, Australian Aborigines also made use of legumes:

"Although seeds, particularly cereals (seeds of the family Gruminae) are thought to have played only a minor role in palaeolithic diets, they appeared to be important in the diet of at least some groups of Australian Aborigines (AA). Before European occupation, collection of seeds was widespread, particularly in arid areas. It was predominant in the grassland areas of Australia but also in the desert areas where acacia trees (wattle trees) yielded abundant seeds. Grindstones used for seed grinding have been found in many areas."

And:

"It appears that ~ 50 of the 800 species of Acacia (wattle trees) native to Australia were used by AA for food. Despite the wattle being Australia’s national flower, the seeds are generally unknown to non-AA as food sources. But Acacia seeds are outstanding in their nutrient content, being much higher in energy, protein and fat than any cereal crop such as wheat and rice. Their composition more closely resembles that of the legume family to which the Acacias actually belong."

According to some, legumes are among the neolithic foods that cause disease because of their supposed discordance with human genetics, yet both !Kung and AA appeared to have a high immunity to modern diseases of affluence.

The Real Gladiator Diet

2011-07-09T12:28:00.000-07:00

Source: U of Texas Course Intro To Greece

What did the gladiators eat?

According to Andrew Curry, author of "The Gladiator Diet," an article in the journal Archaeology, Karl Grossschmidt, a paleo-pathologist at the Medical University of Vienna, did an analysis of bones of gladiators found in an 1800 year old graveyard near Ephesus, in what is now western Turkey.

"Contemporary accounts of gladiator life sometimes refer to the warriors as hordearii--literally, "barley men." Grossschmidt and collaborator Fabian Kanz subjected bits of the bone to isotopic analysis, a technique that measures trace chemical elements such as calcium, strontium, and zinc, to see if they could find out why. They turned up some surprising results. Compared to the average inhabitant of Ephesus, gladiators ate more plants and very little animal protein."

Interesting. The top athletes, with their lives on the line, ate 'very little' animal protein compared to non-athletes. According to Grossschmidt, gladiators ate this way to get fat:

"The vegetarian diet had nothing to do with poverty or animal rights. Gladiators, it seems, were fat. Consuming a lot of simple carbohydrates, such as barley, and legumes, like beans, was designed for survival in the arena. Packing in the carbs also packed on the pounds. "Gladiators needed subcutaneous fat," Grossschmidt explains. "A fat cushion protects you from cut wounds and shields nerves and blood vessels in a fight." Not only would a lean gladiator have been dead meat, he would have made for a bad show. Surface wounds "look more spectacular," says Grossschmidt. "If I get wounded but just in the fatty layer, I can fight on," he adds. "It doesn't hurt much, and it looks great for the spectators."

What an interesting hypothesis. Grossschmidt apparently believes that barley and beans are "simple carbohydrates" that "pack on the pounds" making people fat, and that a gladiator would prefer to be fat than lean and muscular.

I challenge Grossschmidt to consume a diet of barley and beans, with less than 10% of his diet as animal products, for a year, to find out if he grows fat eating that way. Since cooked barley supplies only about 200 calories per cup, he can look forward to eating 6 cups daily just to get to 1200 kcal. Add one cup of lentils (230 kcal), 4 cups of cooked kale (280 kcal), 4 ounces of sardines (240 kcal), and an ounce of almonds (180 kcal) and you have a nutritionally dense meal plan supplying about 2130 kcal and more than 11 cups of food. See if you can eat it all, then enough additional to 'pack on the pounds.'

I also suggest that he produce some evidence that gladitors were fat. He could spend a little time looking at reliefs and other art depicting gladiators of the time. I found a good selection online from a University of Texas course, Introduction to Greece, here. I put one of them at the head of this article. Those men obviously have little subcutaneous or intra-abdominal fat, with ribs, rectus abdominus, deltoids, and upper back muscles clearly defined; they won't qualify as 'fat' by any standard.

Here are a few more from the same source:

Funny, I don't see any fat gladiators. I didn't cherry-pick, you can look for yourself here. These depictions don't look that much different from a modern vegetarian combat athlete, Chris Campbell, who won a bronze wrestling in the 1992 Olympics at age 37:

Source: Information Processing

You can see how fat and weak Campbell got eating all those "simple sugars."

I can't imagine any reason artists would falsely depict gladiators as lean and muscular, if they really were fat. I wonder where Grossschmidt got his idea?

Grossschmidt apparently believes that "a lean gladiator would have been dead meat" compared to a fat one. I have to doubt that Grossschmidt has any experience in the fighting arts. Fat slows you down, making you an easy target. The goal of a gladiator was to survive, not to put on a good show; only a fool would choose to get fat for battles against armed opponents where you only walk away if you can move faster and hit harder than the other guy.

Grossschmidt also believes that those gladiators had to supplement calcium to their barley and vegetable diet:

"But a diet of barley and vegetables would have left the fighters with a serious calcium deficit. To keep their bones strong, historical accounts say, they downed vile brews of charred wood or bone ash, both of which are rich in calcium. Whatever the exact formula, the stuff worked. Grossschmidt says that the calcium levels in the gladiator bones were "exorbitant" compared to the general population. "Many athletes today have to take calcium supplements," he says. "They knew that then, too."

What? Despite having low animal protein intake, and eating a diet based on 'toxic' neolithic barley supplying much-feared gluten, phytates, and other "anti-nutrients" supposed to interfere with calcium absorption, these gladiators had 'exhorbitant' calcium levels in their bones? Strong bones in agriculturalists? How could that happen?

Well, let's see if they needed calcium supplements. Ephesus lies on the west coast of Turkey, near the mouth of the Menderes River, so I will assume the gladiators ate some fish. I'll build the diet of barley, lentils, kale, olives, acorns, and sardines, all possible foods for those people. Here's a nutritional analysis of a hypothetical barley diet with less than 10% of calories from sardines:

Click to Enlarge

As you can see, to get to 3400 kcal required by a large, physically active martial artist using swords, tridents, and similar arms, the barley men would have to eat 10 cups of cooked barley in a day. Now imagine having to eat several more daily to 'pack on the pounds.' Good luck with that!

With only 4 ounces of sardines (supplying only 236 calories, less than 10% of total) and two cups of lentils, it supplies 116 g of protein, enough for a 220 pound athlete. The diet supplies energy in the following proportions: 70/18/12, carbohydrate/fat/protein. It supplies all required nutrients in adequate amounts (most nutrients at 2-4 times the RDA) except vitamin E, which is 77% of RDA, probably adequate for most people eating a diet this low in fat (71 g/d), but we could boost this by exchanging one cup of barley for one cup of olives (that brings the vitamin E to 97% of RDA and fat to 22% of calories).

I also tested 3000 calories of this diet by removing 2 cups of barley. It became 67/20/13 (carb/fat/pro) and still supplied 110 g protein, enough for a 220 pound athlete. It still supplied at least 100% of the RDA for all listed nutrients except vitamin E, still at 77%.

Now, back to the 'exorbitant' levels of calcium in these athlete's bones. First, ancient athletes were familiar with resistance training, using all types of heavy objects to increase strength. Physical training with heavy weapons and other sources of resistance stresses the bones, increasing mineral deposition, so we should expect athletes like gladiators to have high bone mineral density.

Second, humans appear to absorb more calcium from some plants, especially cabbage-family green leafy vegetables, than from milk. In one study humans absorbed a greater proportion of calcium from kale (and probably similar brassica vegetables) (41%) than from milk (32%) [1]. As an aside, Heaney et al found that humans absorbed calcium from leavened whole wheat bread at at higher rate than from milk [2].

Third, we have evidence from other paleo diet research suggesting that a diet with a high ratio of plant to animal protein may promote greater bone mineral density. Richman et al compared bones of three aboriginal American populations: Pueblos, Arikaras, and Inuit [3 ]. These groups had similar genetic backgrounds, all descended from the few humans who first populated the Americas.

Richman et al looked for type II osteons, characteristic of increased bone mineral resorption involved in maintaining physiological homeostasis, such as buffering to maintain the pH of urine in the range safe for kidney tubules. They found that the Pueblos had the least evidence of this type of remodeling, and Eskimos had four times as many type II osteons as the Pueblos. The diet of the Pueblos consisted largely (80%) of maize and 90% of plant foods, while the Eskimo diet consisted 90% of meat. The Arikaras consumed more meat than Pueblo and less than Eskimos, and had twice as many type II osteons the Pueblos.

When I first reviewed this study, I missed the fact that it contradicted the theory that people are less adapted to grains than to meat. If the antinutrients in grains impair calcium and vitamin D metabolism, the Pueblos should have had the worst bone health because they had the highest cereal grain intake, supposedly blocking vitamin D action and calcium absorption; but in fact they had the lowest markers of resorption.

We have plenty of evidence that isolated Inuit had severe and early onset osteoporosis [4, 5]. Similar to the Pueblos, largely vegetarian Bantu women eating grain-based diets have extremely low rates of osteoporosis despite very low (200-450 mg/d) intakes of calcium and a high number of pregnancies (~10 per woman) with prolonged breastfeeding [6 ].

We have some evidence that a diet with a high ratio of animal protein to vegetable protein increases urinary calcium losses and that this may result in demineralization of the bones [7 , 8 , 9 , 10, among others]. While some consider this research inconclusive so far [11], it seems to me that the bulk of research points in the direction of diets with high ratios of animal protein increasing the risk of bone mineral loss, although the mechanism may be unclear and other factors may modify this risk (resistance training, vitamin D, vitamin K, dietary acid-base ratio, sodium intake, to name a few). Anyway, it appears possible that the gladiators' high ratio of vegetable to animal protein contributed to their maintaining a high bone mineral density.

I conclude that a diet of barley, lentils, olives, acorns, green vegetables, and small amount of small fish can provide plenty of calcium, which when combined with hard physical training will produce very dense, strong bones. Maybe those gladiators did add wood ash or bone meal, but they may have been overdosing on unnecessary calcium, the same way the many modern athletes take unnecessary supplements hoping for greater performance.

The Progression of Disease According To Oriental Medicine: Part 2

2011-07-07T15:20:00.000-07:00

In Part 1 of this series, I presented the overview of the progression:

1. Normal discharge and elimination

2. Abnormal discharge and general fatigue

3. Aches and pains signalling sluggish blood circulation

4. Blood quality decline with chronic discharge

5. Accumulation of excess nutrients in circulation

6. Storage of excess nutrients in various compartments

7. Nervous system disorders

8. Delusion

In that post I also presented what happens in stage 1, health, and stage 2, temporary changes in elimination and physical, emotional, and mental activities as the bodymind attempts to metabolize the excess nutrients. In this part, I will look at stages 3 and 4.

3. Aches and pains signaling sluggish blood circulation

In Chinese medicine, we have a principle: "If there is pain, there is impaired flow; if there is good flow, there is no pain." This encapsulates the direct experience that if anything impairs circulation to any part of the body, that part will suffer some type of discomfort. From this experience, Chinese physicians realized that if any part of the body suffers from some discomfort, this signifies an impairment of circulation of vital blood, nutrients, fluids, and nerve impulses to that part or associated parts.

(By the way, this principle applies equally to social-political and environmental disorders as well. Social-political disorders arise from poor circulation of resources, allowing some parts of the body politic to suffer deficiencies while others have excesses, creating tension and inflaming passions. Environmental disorders arise when one organism monopolizes excessive resources while other organisms suffer deficiencies.)

All assimilated nutrients temporarily affect the composition of the blood. After meals, we see increases of blood fats, sugars, amino acids, vitamins, and minerals. The body tries to maintain healthy blood levels of water, fats, glucose, cholesterol, minerals, etc. regardless of diet. If a meal contributes more of any of these factors than the body can readily manage or easily store, it will temporarily affect blood circulation while the body works to remove the incoming nutrients from the blood and store them in appropriate places.

However, if a person continuously eats three or more meals daily providing excess nutrition, more than the body can use quickly or easily store in an appropriate location in a non-toxic form, this can result in a more or less continuous overabundance of nutrients in the blood, and that can result in a more or less continuous alteration in blood circulation.

Most people in industrialized nations have had the experience of eating a large holiday meal (feast) and feeling simply overloaded, sluggish, short of breath, and fatigued afterwards. This provides a direct experience of how excessive nutrition places a burden upon the body, particularly the cardiovascular system, and the effect can last for several hours or more. If a person feasts 3 times daily, the cardiovascular system will have to deal with excessive nutrition almost continuously through the day.


High-fat blood sample. Source: Case Reports in Medicine

As I have discussed here, Western research has also shown that rich, i.e. high-fat, meals increase blood coagulation factors. High-fat meals have been shown to increase platelet aggregation, fibrinogen, factor VII, and other hemostatic factors; meals rich in saturated fats (e.g. butter) having the strongest procoagulant effect, followed by meals rich in monounsaturated fats (e.g. olive oil).(1, pdf )

Thus it seems that Western research may support the Oriental medicine perspective that an excessive intake of rich foods can produce sluggish blood circulation. The thick sluggish blood can’t properly nourish, lubricate, or detoxify the tissues, including the heart and brain. The tissues don't get enough oxygen, and waste products accumulate faster than they are removed. These internal changes reach our awareness as aches and pains and disturbances of normal function.

In line with this, Kuo et al found that fat ingestion can induce myocardial pain (angina pectoris) in patients with coronary artery disease (2). Afaq et al found that patients with excess blood cholesterol had reduced oxygen delivery to the calf muscles and consequent shorter time to claudication, which involves pain in the calves along with decreased ability to walk (3). Mattson et al demonstrated that dietary cholesterol affects serum cholesterol in a dose-response fashion; a cholesterol-free, 40% fat diet produced average serum cholesterol of 164 mg/dl; adding 126 mg cholesterol produced an average serum cholesterol of 174 mg/dl; 212 mg cholesterol daily raised serum cholesterol to an average of 181 mg/dl; and 317 mg cholesterol daily raised the average to 198 mg/dl (4). Hunter-gatherers, non-human primates, and wild animals have serum cholesterol levels below 150 mg/dl (5, pdf), showing that nature prefers a serum cholesterol below 160 mg/dl.

Total Cholesterol In H-Gs and Wild Animals. Source: 5

Other populations with high immunity to cardiovascular diseases also have average serum cholesterols below 150 mg/dl, including rural Chinese (127 mg/dl, 6), Tarahumaras (125 mg/dl, 7), and Caucasian men eating macrobiotic diets (147 mg/dl, 8). Based on this data I have revised my views and now consider anything over ~160 mg/dl excess serum cholesterol.

According to Oriental medicine, the following signs and symptoms all reveal developing, diet-induced blood stagnation:

muscle pain and tension

headaches

menstrual cramps

numbness

moderate aches and pains

intermittent abdominal discomforts

sleep disturbances

breathing problems

heart disturbances

chills and fevers

motion and coordination problems

Due to disturbances of blood circulation to the brain and heart, as this stage develops the individual may also experience more frequent mental and emotional disturbances such as hyperexcitability, worry, insecurity, sadness, depression, frustration, and impatience.

To restore balance at this stage, one must remove the causes, maintain a healthy diet with a negative balance of items taken in excess, take appropriate exercise and rest.

Assuming interruption of this process early in its development, recovery from this stage requires restoring the free flow of blood which will require several days to several weeks of healthy diet and lifestyle.

4. Blood quality decline and chronic discharge

If someone continues to consume an excess of some or all nutrients past stage 3, the blood quality gradually declines because the sluggish circulation slows down removal of wastes from the blood by the liver and kidney. Consequently, the whole bodymind system progresses to chronic illness and development of chronic abnormal discharges.

In general, according to Chinese medicine, chronic blockage of blood circulation generates heat (inflammation) in the blood, which gradually affects the entire body if not corrected.

As excess nutrients in circulation gradually but increasingly impair circulation to the lungs, large intestine, liver, kidneys, and skin vessels and pores, the organs can’t properly detoxify the blood and the blood, in turn, can’t properly nourish, moisten, and detoxify the skin.

In a healthy condition, the body controls the growth of abnormal cells. However, when the blood constantly contains excess nutrients that cells need for growth and replication (amino acids, fatty acids, cholesterol, etc.), and the immune system is impaired by poor circulation and accumulation of toxic wastes, abnormal cellular growth can occur unchecked, producing first benign tissue overgrowths like skin tags, moles, bunions, and so on. If left unchecked, this process eventually leads to malignant growths.

Thus, skin abnormalities herald this stage of disease. As the skin becomes overburdened with metabolic wastes, skin diseases can develop, often in a step-wise fashion from minor to major. At first the skin diseases may come and go with more or less inflammation or infection. If left uncorrected, the underlying systemic imbalance will lead next to more constant and serious disorders, generally in a step-wise fashion:

1. pimples, spots, rashes, moles, warts, bunions, dryness, etc.

2. eczema, psoriasis

3. skin cancer

As the blood quality declines, while also containing surplus nutrients, it gradually becomes a favorable environment for microbial or abnormal cellular growth, producing blood disorders progressing gradually in seriousness:

1. chronic infections

2. blood malignancies

Other signs of this stage include chronic nasal discharge or sinus congestion, irregular bowel movements, abnormal sweating, rapid respiration, frequent urination, bad breath, chronic vaginal discharges, and chronic unpleasant body odor, all produced as the body attempts to use every possible channel of elimination to get rid of the excess stuff in the blood, attempting to prevent accumulation of these wastes in the tissues.

By careful observation, Chinese physicians discovered that when the body gets too hot and dry, it produces thicker, darker, more odorous secretions, and when it gets too cold or damp, it produces thinner, lighter secretions. Thus, darker, drier, concentrated, hard to expel, strong smelling, and more concentrated urine, mucus, feces, sweat, and odor all indicate a body afflicted with heat that can arise from chronic excessive intake of heating and drying, or yang (pronounced "yahng") foods (e.g. red meat, spices), and clear, copious, more watery, runny, and less odorous urine, etc. all can indicate a body imbalanced by excessive intake of cooling and moistening, or yin (pronounced "yeen") foods (e.g. fruits, ice cream). A person who overconsumes both types of foods can have a mix of both types of symptoms and signs.

Since the blood serves as the material foundation of the mind, as the blood becomes continuously and progressively sluggish and toxic, more chronic mental and emotional disorders arise, such as nervousness, oversensitivity, depression, hyperactivity, confusion, and disorientation (loss of purpose), along with an increasing sense of alienation from one’s community.

Chinese medicine categorizes foods according to whether they are relatively more yin—or cooling, moistening, and draining—or relatively more yang—heating, drying, and congesting. In terms of mental-emotional effects, excess intake of more yin items (e.g. ice cream, sugar, fruits) produces a more withdrawn, passive affect, and excess of yang items (e.g. red meat, spices, greasy foods) produces a more aggressive affect.

To restore balance at this stage one must eliminate the excess intake, eat an appropriate diet, take exercise and rest, and employ special medicinal foods, drinks, and compresses. Recovery will take from 10 days (for plasma renewal) to 4 months (for red blood cell renewal).

Stoned On Fat?

2011-07-05T12:49:00.000-07:00

Neuroscience researchers at UC Irvine, , led by Daniel Piomelli, have just announced results of a study done on rats, in which they found that ingestion of fatty foods stimulates the release of endocannibinoids, chemicals that activate the same receptors affected by THC. According to the UC Irvine news release:

"The process starts on the tongue, where fats in food generate a signal that travels first to the brain and then through a nerve bundle called the vagus to the intestines. There, the signal stimulates the production of endocannabinoids, which initiates a surge in cell signaling that prompts the wanton intake of fatty foods, Piomelli said, probably by initiating the release of digestive chemicals linked to hunger and satiety that compel us to eat more."

In other words, rats eating fats had the munchies. Feeding rats carbohydrate or protein did not have this effect. Piomelli offers an evolutionary explanation:

"Piomelli said that from an evolutionary standpoint, there’s a compelling need for animals to consume fats, which are scarce in nature but crucial for proper cell functioning. In contemporary human society, however, fats are readily available, and the innate drive to eat fatty foods leads to obesity, diabetes and cancer."

The study results will appear this week in the online edition of Proceedings of the National Academy of Sciences.

This finding dovetails with the reward theory of overeating, suggesting that animals including humans get more immediate endogenous drug-like reward from eating fats than carbohydrates or proteins, partially because fats supply more than twice as much energy per gram as carbohydrate or protein.

Piomelli apparently also serves as Director of the UCI School of Medicine’s Center for Drug Discovery & Development and hopes to find a pharmaceutical solution:

"The findings suggest it might be possible to curb this tendency by obstructing endocannabinoid activity – for example, by using drugs that “clog” cannabinoid receptors. Since these drugs wouldn’t need to enter the brain, they shouldn’t cause the central side effects — anxiety and depression — seen when endocannabinoid signaling is blocked in the brain, Piomelli noted."

So there you go, a pharmaceutical solution to the obesity problem. Just throw a monkey wrench into the intricate and poorly understood symphony of neurochemicals. No need to worry about side-effects, right?

How about teaching people to recreate the ancestral environment instead? What did he say? "Fats are scarce in nature." By "nature" he means in the ancestral environment.

Could this be why humans need only about 20-25 g of essential fats daily, compared to ~50-60 g of protein and at least 150 g of glucose? Does it make sense that human macronutrient requirements would mirror the relative availability of nutrients in the ancestral environment and diet?

And are things really that different in the agricultural food supply? I mean, although fat seems abundant in industrialized nations, does this reflect nature, or human intervention? After all, agriculture is part of nature. Does agriculture produce more fats, proteins, or carbohydrates? If you look at the world at large, at the entire human food supply on the planet, is fat relatively abundant, or relatively scarce, although concentrated in certain locations? How about protein? Carbohydrate?

Why would evolution favor a system that offers an animal a higher immediate reward for eating fats than for eating protein or carbohydrate?

Would this reward system be more advantageous in an environment where fats were easy to obtain, or in an environment where fats were hard to obtain?

In other words, would nature make it more highly rewarding to eat something available frequently, with little effort, or something available only infrequently and with great effort?

From another angle, which would this system help most: an animal that had a continuous supply of fats, or one that had an intermittent supply of fats?

Gathering Wild Grains

2011-06-19T15:59:00.000-07:00

From the book Lost Crops of Africa: Volume 1: Grains published by the National Academies Press:

"Over large areas of Africa people once obtained their basic subsistence from wild grasses. In certain places the practice still continues—especially in drought years (see boxes, pages 258 and 264). One survey records more than 60 grass species known to be sources of food grains.²

Despite their widespread use and notable value for saving lives during times of distress, these wild cereals have been largely overlooked by both food scientists and plant scientists. They have been written off as ''obsolete"—doomed since hunting and gathering started giving way to agriculture thousands of years ago. Certainly there has been little or no thought of developing wild grains as modern foods.

This deserves reconsideration, however. Gathering grains from grasslands is among the most sustainable organized food production systems in the world. It was common in the Stone Age³ and has been important almost ever since, especially in Africa's drylands. For millennia people living in and about the Sahara, for instance, gathered grass seeds on a grand scale. And they continued to do so until quite recently. Early this century they were still harvesting not insignificant amounts of their food from native grasslands.

However, in previous centuries the grains of the deserts and savannas were harvested in enormous quantities. In the Sahel and Sahara, for example, a single household might collect a thousand kilos during the harvest season.⁴ The seeds were piled in warehouses by the ton and shipped out of the region by the caravan-load. It was a major enterprise and a substantial export from an area that now has no equivalent and is often destitute."

If possible in relatively recent centuries, why not during the stone age?

By the way, in prehistoric sites the evidence points to consumption of sorghum, a gluten-free grain, at about 100,000 years before present.

If so, then what about leading up to that? Evolutionary explanations generally involve gradual changes over long periods of time. A species generally does not change its means of subsistence suddenly, or even over a few millennia. Adaptation to a new niche (if truly new) generally takes a very long time.

The hypothesis that grains were hardly ever consumed before about ten thousand years ago suffers from lacking a plausible explanation for why and how a species never adapted or even interested in cereal grains would so suddenly (on an evolutionary time scale) adopt a totally new behavior and means of subsistence.

Supposedly gathering grains would be a poor time investment for a forager. Put to the experimental test, this turns out to be untrue. From Kislev et al, "Impetus for sowing and the beginning of agriculture: Ground collecting of wild cereals" [1 full text]:

"We found that hand gathering of wild barley and emmer spikelets from the ground in Korazim and Mount of Beatitudes (Israel) is simple and efficient. About 0.25–0.5 kg (0.337 kg on the average) of pure grain could be gathered per hour by a single person, which provides on the average between a half and a whole day of the nutritional requirements for an adult individual."

So, in one to two hours a forager could collect enough wild grain to feed himself for a day, just collecting it off the ground by the handful. Eight hours of collecting could supply him with grain for a whole week. A smart forager would quickly come up with ways to make the work easier and more efficient. Kislev et al continue:

"Our results are in accordance with Harlan, who, after experimental hand stripping of pre-full-ripe ears of wild einkorn at Karacadag, southeast Turkey, claimed that in three weeks, a family group could gather more grain than it could possibly consume in an entire year (28)."

Three weeks investment for more food than you can eat in an entire year doesn't count as optimal foraging? More from Kislev et al:

"The significance of recognizing the practicality of spikelet gathering from the ground is that the gathering of large-seeded cereals as a staple food is not restricted to early summer. Rather, it can continue throughout the summer into the autumn, July through October, when the first heavy rains arrive and the dispersed grains begin to sprout. In other words, the collecting of grains from the ground would supply hunter-gatherers with a ready source of vegetal food until October, when acorns, their second most important plant resource, matured (29). The availability of acorns in October enabled them to invest part of the harvested grains for sowing. Moreover, stored grains and acorns would have provided nourishment until the following summer. There would then have been no period of vegetal food shortage due to seasonality of the two major harvests that helped support human groups in Western Asia at least from the beginning of the Upper Palaeolithic."

Has the bubble burst yet?

Put this together with evidence that Paranthropus boisei, a human relative dating to 1.4 to 1.9 million years ago, grazed on grass [2]. Paranthropus and humans both descended from Australopithecus, but the Paranthropus went extinct. To several scientists working with this information, this new data on Paranthropus suggests a reinterpretation of previously collected data on Australopithecine diet, i.e. that Australopithecus may also have eaten grasses.

Perhaps we can start to put together a plausible path for the incorporation of cereal grains--grass seeds--into human diets. Perhaps human ancestors used grasses as food more than 2 million years ago. Human evolution might look something like this: the grass-eaters went extinct, but the grass-seed eaters thrived.

The Progression of Disease According to Oriental Medicine: Part 1

2011-06-19T11:35:00.000-07:00

Warning: This series of blogs presents an alternative Chinese-scientific perspective on the development of disease. I won't and can't provide 'research' to back everything largely because modern scientists have not shown much interest in understanding the directly observable marks of deteriorating health, due to their entrancement by laboratory tests which may distract them from direct observation of the people they attempt to help.

In the Yellow Emperor’s Classic of Internal Medicine (Huang Di Nei Jing), Qi Bo, the emperor’s personal physician, says (paraphrased):

“Those who wait to treat disease until it has already arisen are like those who wait until they are thirsty to dig a well, or wait until they are in battle to forge weapons. Are not these actions too late?”

Due to this preventive perspective, for several thousand years of development Chinese physicians focused on identifying early signs of imbalance so that they could take actions to avert health disasters by adjusting their own, and their patient’s diets and lifestyles. Perhaps as a consequence, famous traditional Chinese physicians had extraordinary healthy lifespans for their times. For example:

Dr. Sun Su Mao (Ssu-Mo) (581-682) – lived 101 years, an impressive feat for the 6th century. He once said “Anyone over 40 years old should try to avoid laxatives, which will weaken his body, and begin to take tonics. Anyone over 50 years old should take tonics all year round; such are the secrets of nourishing life to enjoy longevity.”

Dr. Meng Shen (621-713) – lived 92 years. He once said “A person who really knows how to nourish the body should always keep good foods and herbs handy.”

Dr. Luo Ming Shan (1869-1982) lived 113 years.

In Chinese Foods for Longevity, Henry Lu points out that according to Outstanding Chinese Physicians in the Past and their Medical Theories published by Peking College of Chinese Medicine in 1964, the 37 most outstanding Chinese physicians between 581 CE and 1964 CE had an average lifespan of 80.56 years.

Many of these guys lived well before the 18^th century, yet, on average they lived 10 years longer than the average modern citizen of modern industrialized nations.

Over the millennia of its development, due to their considering dietetics one of the essential branches of medicine, Chinese physicians realized that many supposedly ‘minor’ symptoms arise from dietary imbalances, and that if left unchecked the process producing these 'minor' symptoms would eventually produce a major disease. Gradually this came to formulation as an understanding of how the bodymind (Chinese medicine considers mind and body as one unit) progresses from minor to major diseases based on an imbalance between dietary intake and elimination or expenditure.

The Chinese perspective rests on the realization that to maintain homeodynamics (health) the bodymind must have just the right amount of nutrition, neither too much nor too little. Like Plato, ancient Chinese physicians noticed a clear division of disease incidence between wealthy aristocrats and ordinary peasants.

So long as they had adequate quantity and variety of simple plant foods and a little animal products, the peasants remained lean, healthy and fit and had long lives. If they suffered food shortages, often due to excessive taxation (taxes were paid in bushels of grain) by overlords, they developed deficiency diseases marked by infectious disease susceptibility, weakness, wasting, mental and physical listlessness, and pallor.

In contrast, among wealthy and overfed overlords who used some of the grains procured by taxation to produce grain-fed animal products for their own feasting, physicians saw diseases of excess marked by abnormal accumulations: obesity, diabetes mellitus (identified by Chinese physicians by 700 AD, 900 years before Europeans), tumors, restlessness, tension, and sluggishness.

This led the Chinese philosopher-physicians to both political and medical conclusions. On the political side, they vigorously opposed taxation, as recorded in the Tao Te Ching and many works of Confucius, Mencius, and other so-called Confucians:

"Human hunger is the result of overtaxation; For this reason, there is hunger." Tao Te Ching Chapter 75

They also developed a unique view of the role of the physician, and identified three ranks of physicians:

Lower doctors: Those who treat and heal sicknesses symptomatically but do not treat the whole personality of the patient or guide to a healthy lifestyle.

Middle doctors: Those who treat and heal by guiding the patient to change his or her personal habits and attitudes, including diet, exercise, meditation, and ethics.

Highest doctors: Those who treat and heal the sicknesses of society, nation, and world through philosophy and education to align self with others, and humanity with nature.

The "Confucian" Classic of Great Learning encapsulates some of the central tenets of "higher medicine" as conceived by Chinese philosopher-physicians.

On the medical side, by treating both the wealthy and the poor, Chinese physicians developed a clear understanding of how disease develops.

On the one hand, deficiency of intake relative to requirements (elimination and expenditure) will create deficiency diseases, and on the other hand, excessive intake relative to requirements will create diseases of excess, accumulation, congestion, blockage, and stagnation. Chinese philosopher-physicians saw this process occurred whether talking about diet (excess or deficiency of food) or other matters (excess or deficiency of clothing, shelter, possessions, etc.).

To the Chinese, health, whether personal, mental, social, or political, could arise only through achieving the Golden Mean, a concept held in common with Aristotle.

These days, in modernized industrial nations, a majority of the people live like the royalty of the past, with plenty of rich food to eat. Consequently, people in modern industrialized nations suffer primarily from nutritional excess diseases such as obesity (accumulations of body fat), diabetes (excess fat and sugar in the blood), cardiovascular diseases (accumulations, congestion, and blockage of blood vessels causing stagnation of blood circulation), neurological diseases involving accumulation of plaque (Alzheimer’s, multiple sclerosis), and numerous others. Among affluent populations, deficiencies occur almost always in a context of excesses.

Oriental medical theory maintains that in most cases these late stages of psychophysical degeneration are preceded by a long gradual process of apparently minor alterations in health that herald the oncoming or eventual disaster and offered opportunities for self-correction. Chinese physicians taught their patients to stay aware of this process and to self-correct using food therapy.

However, one must understand that these food therapy methods work well only in the context of the basic healthy diet developed and integrated into Asian cuisine: starch-based, low in fat and animal products, rich in colorful vegetables. You can't overturn the ill effects of a very imbalanced diet by adding a few servings of a medicinal food.

Basically, if you understand how disease progresses from minor to major, you can interrupt the process before it becomes so deeply rooted that you will have trouble correcting it with natural approaches. Updated application of this perspective using traditional Chinese medical theories (yin-yang, Eight Principles, and Five Transformations) can easily incorporate and make sense of otherwise inexplicable medical findings, such as why many people with skin disorders have a history of respiratory allergies or asthma as well.

In outline form, the progression looks like this:

1. Health: Balanced intake and normal discharge

2. Abnormal discharge and general fatigue

3. Impairment of blood circulation and aches and pains

4. Impaired blood quality with chronic discharge

5. Accumulation of excess material in circulation

6. Storage of excess material in various compartments

7. Nervous disorders
8. Diseases of mind and spirit, summed as self-delusion

1. Healthy condition: Balanced Intake and Discharge

We take in nutrients from foods and beverages as well as influences from climate (hot, cold, damp, dry) and social environment (emotions, sounds, colors, etc.). All of these inputs have some effect on our physiology. To maintain health we have to retain what we need and discharge any excess.

We all transform or discharge inputs through respiration, perspiration, urination, defecation, and physical and metal activities. Women have additional avenues of discharge through menstruation, parturition, and lactation.

Every physical or mental activity we express reflects the quality of what we have ingested.

Accordingly, in addition to climate, time and place, diet exerts an influence on culture through its psychophysical effects on the creators/participants. Thus, different climates and diets produced different historical qualities of art, music, architecture, literature, games, sports, etc.. For example, the traditional Chinese diet produced people who resonated with the traditional Chinese music, the Indian diet produced people who resonated with traditional Indian-style music, and the diet of certain youth in the U.S. produced people who resonated with heavy metal rock.

What comes out reflects what went in.

2. Excessive intake and abnormal discharge.

If from a healthy state you ingest or inhale or otherwise absorb an input that supplies something that exceeds the bodymind’s needs and the capacity of normal routes of discharge, the bodymind will manifest alterations of function, most moving the excess input out of the body, such as:

coughing and sneezing
more frequent defecation
more frequent urination
increased and spontaneous sweating and sudden rashes
fidgeting, tapping, muscle spasms and tension, acute hyperactivity
rapid blinking
irritability, anger
anxiety, excitability

The more extreme the imbalance of intake, more extreme the output, such as: shivering, trembling, nausea, vomiting, crying, shouting, screaming.

The input here could include healthy food (subtle reactions), spoiled food or an allergen (strong reactions), or traumatic experience like witnessing some aweful crime, losing a loved one, or enduring a natural disaster, among many other possibilities.

Chinese physicians did not recognize a dichotomy of body and mind, nor did traditional Western physicians or culture. Chinese physicians watched the development of internal organ disorders and saw mental and emotional effects of those disorders, and also the reverse, that sudden emotions resulted in altered operations of internal organs. They correlated fear with the kidneys, anger with the liver, joy with the heart, rumination with the digestive system, and grief with the lungs, by noticing how emotions affected or were affected by the organs.

So for example, in fear people may lose control of urination, in anger they may get indigestion marked by reflux, bloating and pain, rumination can destroy the appetite, overjoy (excitement) can affect heart rate and strength, and grief affects respiration (sobbing).

In English, we still have words reflecting this ancient understanding. For example, an disrespectful person "has the gall," referring originally to an imbalance of the gall bladder, a depressed person has 'melancholy,' an imbalance of the bile (chol-), and an aggressive or angry person is 'bilious' or 'choleric,' again, an imbalance of the bile, or liver/gallbladder system [1]. And how about being "pissed off" and "so scared I shit my pants"? Chinese medicine has a way of physiologically understanding the actual experiences that gave rise to these locutions as well.

I know, where are the 'studies' to support this? I don't know of any, yet. Chinese physicians discovered that eating animal liver would treat night blindness hundreds of years before laboratory science discovered retinol (vitamin A) and showed that night blindness results from retinol deficiency. If they had waited for double-blind, placebo-controlled studies and modern biochemistry to confirm that eating animal liver treats night blindness, thousands of people would have gone blind from deficiency over the years.

Modern laboratory and clinical science creating 'top-down' knowledge only studies a quite small part of reality and moves very slowly compared to empirical discovery growing from 'bottom-up.'

Check your own experience. For my part, I see these relationships in my clinic on a daily basis.

Anyway, these signs, among others, indicate that the specific organ(s) have taken the brunt of the dietary excess:

• A tendency to obsessive thinking, rumination, whining, complaining can indicate an overload of the digestive system.

• A tendency to anger, impatience, or shouting can arise from an overload of the liver and indecision can arise from an imbalance of the gall bladder.

• A tendency to anxiety and fear can arise from an imbalance affecting the kidneys, urinary bladder, or endocrine system.

• A tendency to fall into crying or grief can indicate an imbalance affecting the lung or large intestine.

• A tendency to nervousness, hyperexcitability, or inappropriate laughter can indicate an imbalance affecting the heart.

At this stage of imbalance we may also feel general fatigue resulting from the burden placed on body organs by the overload of input.

At this stage of disease, recovery requires removal of the dietary and other causes, and improvement of diet and exercise. Since the imbalance does not have deep roots, it may take only several hours to several days to recover.

I'll go through the rest of the stages in future posts.