Does a high animal protein/fat diet forestall obesity?

Don Matesz had an interesting blog post the other day that I tweeted:  Grass-Fed Animal Products Prevent Obesity and Cardiovascular Disease?  He writes:

Not for Mongolians.

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

I have an interest in Mongolians because there's definitely some influence of these people in my husband's ancestral line.   I went looking for any peer review literature that might address the Mongolians and found an interesting article.  But before that, I also found some other info.  Don points out in a note to WAPF (presumably aimed at their promotion of raw milk) that the Mongols boiled their milk and made cheese from it.  But one of the accountings of the diets comes from the WAPF site:  Diet of Mongolia.  

Like many other developing countries, Mongolia is falling prey to Western influences, however, so it is difficult to determine how much influence these foods are having.  Still, in the WP article one has a picture painted of a gluttonous, slothy and very dirty culture that was historically healthy.  I dunno about the lazy factor -- they describe the men as basically trotting around from place to place to supervise herding -- but they do also describe harsh winters and arduous treks for long distances.  I don't know how many of you have ever ridden an animal, but sitting on one and riding is not quite the same as lounging in a recliner!  But anyway, they eat and ate a lot of meat, apparently mostly mutton, and relish the fat.  They eat the entire animal (which prompted my cheeky tweet about Enjoying Entrails, because there's much talk about consuming the entrails in various accounts, and while paleos and others are high on liver and other organs, and they eat a lot of bacon, but I don't hear a lot of chit chat about chitterlings -- pig intestines, pretty readily available -- on the paleo menu!) including the blood.  Now the current diet, particularly in the more urban areas, contains flour, but there is more than one mention of millet consumption in the traditional accounts.

One more general source on the Mongolian diet:  Mongolian Food: Meat, milk and Mongolia: Misunderstood and often maligned, the Mongolian diet does make sense.  Since Paleo Buzz is carrying an Alkaline Paleo blog these days, this sentence caught my eye:

The traditions of using, producing and preparing these foods are stronger outside the main cities, where the population is more reliant on the vast herds for food. B. Baljmaa (Mongolians generally use their first names), a dietitian and nutritionist at the National Nutrition Research Centre, says there is a genetic compatability for the food.

"Before 1992 there wasn't much research in this area. But now we know from our research that Mongolians are better able to absorb foods with more acid. So, traditional food should be kept in the country."

Meat & fat heavy diet is more acidic?  I'm not so high on that whole acid/alkaline thing, but just thought I'd pass this info along in case there's anything to it.  

Here's one peer review article I came across:  Individual-based primary prevention of cardiovascular disease in Cambodia and Mongolia: early identification and management of hypertension and diabetes mellitus.  This is a 2012 publication based on data collected in 2009 (Mongolia) and 2010 (Cambodia).  I thought to myself, how odd to juxtapose these two countries but it is interesting nonetheless.  For reference, at right is a map {click to enlarge} showing the relative locations of these two countries.  

The study surveyed almost 10,000 participants aged 25-64 years old (5433 Mongolians, 4539 Cambodians).  From the abstract:

Mongolia has higher prevalence of CVD risk factors than Cambodia –hypertension (36.5% versus 12.3%), diabetes (6.3% versus 3.1%), hypercholesterolemia (8.5% versus 3.2%), and overweight (52.5% versus 15.5%). The difference in tobacco smoking was less notable (32.1% versus 29.4%).

Those are some pretty substantial differences!  Interestingly, in the full-text we find that the Mongolians have a lower percentage (6.5%) of physically inactive people than the Cambodians (9%).  Someone get on the horn to Gary Taubes.  So what do the Cambodians eat?  According to the WFP {emphasis mine}:

The two key staple foods in Cambodia are rice and fish: rice supplies about 75 per cent of total caloric intake, while fish (from inland water courses and paddy fields, as well as some marine supplies) provides the main source of protein.These are supplemented by maize, root crops (cassava and sweet potatoes), mung beans and groundnuts. A wide variety of fruits and vegetables are produced in Cambodia, though the consumption of vegetables by the rural population appears limited since surplus supplies are often sold rather than consumed. Sugar-palms and sugar-cane are also grown, as are coconuts, pepper, cashew nuts, coffee and oil palms.

Cattle and buffalo are mainly raised for their draught power or as capital savings, although some beef is consumed. Pigs, particularly, are raised for meat, and are an increasingly important source of protein. Chickens and ducks are raised to supply eggs as well as meat. In some parts of the country (particularly forested areas), hunting and trapping of animals are additional sources of food, despite attempted restrictions on hunting.

There are pockets of Cambodian refugees here in the US, having fled the Khmer Rouge.  Here are two articles from WA (general) and MA (peer rev).  It appears many of these US-Cambodians retain much of their traditional diet.  Some quotes from the first article:

Cambodians in Seattle often carry on the nutritional traditions of their homeland - much of the Cambodian diet is based on foods readily available at home. An extensive assortment of greens and tropical fruits were grown in gardens or gathered from wild plants. Poultry was raised on rural homesteads. Fish - cheaper than coveted beef and pork - was popular for main dishes, sauces and soups. These food items remain popular with Cambodians in Seattle.

The shelves of local Cambodian markets in White Center and the Rainier Valley are crammed with bottled sauces and canned fruits, 50-pound bags of rice, noodles, cookies, candies and teas. Freezers  are filled with catfish, mudfish, shrimp and eel. Marinated quail wings soak on ice and barbecued chickens hang by their feet. Impulse items - fried bananas, sticky rice wrapped and tied in banana leaves, plastic cups of sweet rice and green rice flour noodles - await hungry shoppers near cash registers.

... The Cambodian diet is naturally nutritious, full of fish and other seafood, vegetables and fruit. Unlike the average American diet, Cambodian meals are generally low-fat and low- calorie. Local Cambodians say there's not much in the diet to watch out for. Still, locals say some older people splurged on more fattening foods after immigrating to Washington - they weren't accustomed to watching their diets in Cambodia and were deprived during the war. One local grocer said many Cambodians become more health conscious after immigrating to America and learning about fatty foods and cholesterol. Still, he said, "Some cannot resist the pork even though they know it will give them problems later."

Fish and meat with rice and vegetables is considered nutritious. The concept of "junk food" is not the same in Cambodian culture, though coconut is cited as very fattening. ...  Jackfruit, durain, longans, lychees, coconut, mango, papaya and bananas are also commonly eaten fresh for dessert. Coconut milk with banana, sugar and tapioca is another favorite, as is sticky rice filled with pork, jackfruit or banana.

Interesting that now they avoid, but splurge, on fatty foods due to American influences, but didn't need to watch their diets in Cambodia because of lack of food in a war torn country.  Still ... lots of rice!  And some of it sticky -- guess how it gets that way??  One last cite, this one abstract only on a study on teens of SE Asian descent in the US:

Food preferences, beliefs, and practices were assessed among 207 Southeast Asian refugee high school students, all of whom had been in the U.S. five years or less. Questionnaires typed both in English as well as their native language of either Cambodian, Vietnamese, or Hmong, were administered to all students in a classroom setting. Results indicated Southeast Asian refugee youth have maintained strong ties to their native foods and traditional meal patterns. In the U.S., as in Southeast Asia, rice remains the staple food in their diet. High status foods in Southeast Asia such as fruits, meats, and soft drinks remain highly preferred in the U.S. While milk is well-liked, cheese remains a strongly disliked food item. Fruits and vegetables are frequently consumed. Nutritionally weak American foods such as candy bars, cake, and potato chips are not consumed frequently. However, soft drinks are consumed daily by almost one-third of the students. Breakfast was missed by almost 60% of females and 37% of males. Forty-five percent of the youth reported they had primary responsibility for evening meal preparation.

Interesting ...

OK, back to Asia.  I think it is fair to say that the Cambodian culture may well have been contaminated by Western influences moreso than Mongolian culture in that CVD comparison study.  But these cultures were clearly adapted to vastly different diets -- I find it somewhat amusing that the Mongolians dislike fish, while the Cambodians dislike cheese.  But which "base" is better resistant to obesity, either with changing lifestyle (urban life) or cultural dietary contamination?  It would appear the low fat high carb fares far better than the meat and fat eaters.  Same for diabetes and CVD.  Three-fold greater incidence of hypertension and obesity, and two-fold higher incidence in diabetes in fat-based Mongolians as compared to carb-based Cambodians.  Such things are truly difficult to dismiss.

Might be some lessons to the 80/20's out there (that would include me!).  On a personal note, I am not a huge meat and animal fat eater, but significant amounts would be a good description.  I have to admit that I think about trying a pescetarian experiment from time to time (I could not be a vegetarian, even an ovo-lacto) but I find myself getting anxious at the thought of eliminating all butter and land animal meats for even a single month.  Does that sound familiar to what LC'ers chide folks about when they are faced with giving up carbs?   Is meat addictive then?  I dunno about that ... but if a sign of addiction is an unwillingness or angst about giving something up for even a time, perhaps!!

EDIT/ADDED COMMENTARY 10/1

Hey all.  There are a few things about the initial post I wanted to clarify based on some of the comments.

1.  The closing salvo on addiction was a bit tongue in cheek.  It was meant to show the silliness of accusing starch eaters of being carb addicts ... especially when so many of the accusers go on about how much they enjoy their bacon!

2.  I wasn't using the Mongolian v. Cambodian study as anything definitive.  Hopefully the post came across as intended -- just more of a share with a few thoughts off the top of my head.  Perhaps a different title may have been more appropriate.  It's only two countries, but the Cambodians appear to have adapted to their diet with a physiology that is more resistant to Western influences than the Mongolians physiology adapted to theirs.