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Welcome all seeking refuge from low carb dogma!

Monday, January 14, 2013

The Problem with Science in the Incestral Health Community

I've been discussing lately the entangled web of relationships and referencing in this community, and I have decided that henceforth I'm going to call it on this blog what I've called it in my head for a very long time:  The Incestral Health Community.   This is because everyone has ties to everyone else (or enough) and apparently nobody feels even the slightest bit interested in vetting one another, let alone any professional obligation to do so before slapping the affiliate logo on their website or inviting fellow IHC members to speak at their events.  

I've also been highlighting credentials of late, and will continue to do so when I feel that it is pertinent.  I want to make sure that everyone reading here understands that I am not passing judgment on anyone's academic record, highest degree held, etc.  Fer crying out loud, two of the smartest women I've had the privilege of knowing both dropped out of high school in the 9th grade.  And sadly, the number of functional illiterates matriculating at prestigious institutions these days is mind-blowingly astounding. This is not about academic elitism or snobbery.  It IS about discussing just what makes for an authority, an expert, etc.

Let's say I notice a small blackish-reddish mole growing on my hip in a place that would be covered by even the teensiest bikini, and it is a teensy tiny mole at that.  What do I do?  If you are part of this community, you might go get a can of the new-fangled freeze-off wart removers and be done with it.  And if it got infected, eh, rub on some Neosporin, and if that didn't work, go on the internet and buy antibiotics from Whogivesadamistan or buy rub some coconut oil from Tropical Traditions on it because we know CO cures all.   I probably have the therapeutic order in reverse there.  Coconut oil first, then the "hard stuff".   When the mole returns with a vengence, you go on a ketogenic diet just in case it's cancer, but you remain unphased.  When it still doesn't go away, you go to your local tatoo parlor to have them "erase" the mole like a bad tat.   Anything ... and I do mean  A.N.Y.T.H.I.N.G  but go to a dermatologist, because we all know their training is the low point of intellectualism in their lives and they are just trained to run tests and prescribe pills and collect your insurance money.    Oh ... and make sure to blog on how smart you are for doing that and thumbing your nose at idiot doctors and the remedies developed by Big Pharma.  If the mole metastasizes and causes serious issues down the line?  Well, that must have been from your month experimenting with veganism in your 20's followed by the year on the Little Debbie and Coke diet that blew out your pancreas.  Nevermind you never had blood sugar issues.  We can manufacture those if need be .....

Look, if I were to advocate for anything, and perhaps someday I will, it will be for patient advocates, or advocacy for patient education.  ADVOCACY TO COMPLIMENT AND FACILITATE CARE FROM A FORMALLY TRAINED COMPETENT PHYSICIAN.  Even back in the days of house calls and hour long appointments, doctors only know as much as you told them, and can only make their best appraisals based on what you present to them during short periods of time.  (Though the insights they used to get from house calls are quite interesting).  Look, if I found a mole, my GP referred me to a derma, and the derma recommended good old fashioned "cutting out" of the mole, here's what I'd do.  I would first ASK about less invasive treatments and why the doctor suggested a seemingly more crude/extensive intervention.  And look, if my doc said, "If I cut it out and take an extra millimeter of tissue around it in all directions, then the odds of you ever having any problems arising from your mole are next to nil, and furthermore this is far cheaper than the next alternative", I'm probably going for it.  I'll have a little divet on my hip that only my husband will ever see.  Done.  If the mole is on my face or chest?  Well, perhaps I ask about the risks and costs of other options.  Isn't that how it is supposed to go?  If the issue is more complicated than a little mole, perhaps the problem is not the doctor, or the manufacturer/developer of potential cures, but patient education and advocacy so they can arrive at an informed decision WITH their doctor.  

The IHC seems to thrive on promoting anything but such a path.  Of course you get all of the disclaimers, and the "discuss anything with your doctor", but that all rings hollow against the certitude with which various gurus and such mock, malign and otherwise foment mistrust in conventional medical care (unless, of course, it is an IHC approved doctor espousing alternative superior ways.)    Buy the book, ignore the LDL, hack your condition!  It is all rather disgusting, really.  But this community fosters such a distrust of anything and everything "mainstream" that such disclaimers are nothing more than legalesed butt savers.

Sorry for the set-up rant here, but it needed to be said to discuss a recent post on Balanced Bites:  A Biochem Snapshot: 5 Facts That Keep Me Paleo.  Of course in light of recent posts, that word "biochem" popped out at me over at paleobuzz.com.  Who is this written by?  Why a graduate student at UNC Chapel Hill pursuing a masters degree in Public Health Nutrition, Courtney Locklear.  
Being in grad school sometimes has its perks.
Beyond the chronically stressed, sleep-deprived state we regularly experience, there are moments of fulfillment and satisfaction. This past semester I participated in an advanced biochemistry class, which focused on macronutrient metabolism. Although at times it felt like this class could be the end of my sanity, the science I learned has really solidified my belief in ‘eating like our ancestors’. I’ve included the corresponding slides to show that I didn’t pull this stuff out of thin air (and maybe improve my street cred!).
OK.  I'm going to just focus on Point1.   She may not have pulled any of this out of thin air, but she sure did pull it WAAAY out of context and into the IHC web to boot.  Hang on gang, this is a little nerdy!

1. Consuming carbohydrate, especially in excess, can potentially increase the production of fat.

When we consume carbohydrate, whether they are simple or complex, our insulin levels increase significantly. When insulin rises, enzymes are activated that help build fat molecules for storage in our adipose (fat) tissue. From an evolutionary perspective, it’s a protective mechanism to help us store energy after a “feast” which was often followed be “famine”. After a prolonged diet high in carbohydrate, these enzymes that help synthesize fat (in the form of triglycerides) will actually increase in quantity and therefore function. Without insulin, fat cannot be as easily produced in our fat cells for storage. This contradicts the idea of low-fat diets for fat loss.
Yeah, and?  I'm willing to bet this isn't what you learned in your classes, it is taken out of context.  Let's do the straight biochem first, shall we?   The enzymes don't synthesize triglycerides, they synthesize fatty acids.  A minor distinction, but if we're going to get all science nerdy, let's get it right, shall we?    Secondly, fat does not need to be produced to be stored in fat cells.

I will never understand the ridiculous obsession over the de novo lipogenesis metabolic pathway with low carbers.  Your body stores fat as fat.  If you eat fat the odds are it spends some time residing as fat in your adipose tissue for some period of time.  Fact.  It may not, but the odds are in favor of that happening.  If dietary fat is so great, and saturated dietary fat is at the very least not harmful, what, pray tell, is the problem with converting carbs to fat?  

While Susan Powter was whacked about not being able to get fat on carbs, she had a point -- it is energy intensive to convert carbs to fat.  This, by the way is an argument (rightly) made by Jonathan "Not-so Smarter" Bailor regarding protein.  Well, it holds for carbs as well.  The production of fat from carbs is "inefficient", which, when it comes to getting away without storing excesses, is what you want.

Courtney's contentions are based on two studies she links to:  

The first one is absurdly irrelevant.  In that study they overfed subjects 75% of normal intake in pure carbohydrate and guess what happened?  DNL was upregulated and the subjects made some more fat from the carbs and stored it.  Duh?!  This is relevant to weight maintaining and/or weight loss diets, how?  Or even overeating in general of mixed macros?  It's not.  


The second one is a little more relevant (and relevant to the hypothesis) as it discusses a eu(iso)caloric context.  Still, on 75% liquid glucose polymer carb, it is not surprising that DNL is upregulated.  I have actually been meaning to email Marc Hellerstein about this study as it seems to be somewhat in conflict with a substantial amount of other (later than 1996) research he's published on the topic.  Research utilizing radiolabeled substrates that demonstrated DNL is not a major source of the fatty acids of VLDL trigs in humans.  I'm looking right now at my copy of Nutrition by Insel, Turner & Ross.  There are many editions of this text, mine looks like the one at right (sans the 2002 update banner, mine is copyrighted 2001 but has the wheat cover which is the updated one.  In any case, on p. 241, there is an FYI insert "Do Carbohydrates Turn into Fat?" by none other than Marc Hellerstein, MD, PhD.  In that half page section he writes: "Other conditions yield similar findings.  Very-low-fat diets (10% energy as fat; 70% as carbohydrate) stimulate lipogenesis, but, again, not a large amount."  So I take this as Hellerstein's *authoritative* word on the matter.


And ... here's the IHC angle ... Mark Sisson's "work" is referenced??!!  Yes, that academic work that is the utterly laughable carbohydrate continuum that states that over 150g/day will lead to insidious weight gain.  Really, Mark, you gotta take that down if you want to be taken seriously for your science.  And really, Courtney, Mark Sisson?  You are going to graduate school why?  Have you no more reputable sources to cite from your graduate education?  

This is depressing really.   But this is the crap that passes for "nerdy" biochemistry in the Incestral Health Community these days.  Don't forget to buy your books!    

Speaking of books, however, may I HIGHLY recommend that Nutrition book pictured above?  It is written at a very accessible level and you can get a copy for a song (I think I paid $4 for mine) albeit perhaps an older edition.  Yes, you will find some "mainstream dogma" there, but, like the insert from Hellerstein, it contains those unusual gems from the scientists themselves interpreting their results!  It presents biochemistry in straightfoward, dogma free fashion.  No.  I have no affiliate links to the authors.

142 comments:

Lena said...

The utter contempt that the paleosphere exhibits for real professionals is bizarre. Like the more education you have, the less trustworthy you are.

I remember a couple of years ago, one of the blogs described a case where an infant was removed from his parents because of a fractured bone, and the spin was that the child had some kind of medical issue that resulted in the fracture that doctors and those evil CPS workers were too stupid to know about. Dr. Harris, a radiologist, showed up in the comments and explained how fractures are analyzed and that certain types are obviously not the result of a medical condition but of abuse. One person (maybe more, I stopped reading in disgust) replied that since Dr. Harris is part of the system he can't be trusted, and was there anyone who didn't work for the establishment who can verify his comments?

Diana said...

I would be interested in your demolition of points 2-5. Maybe I'll give it a go....

I notice that front and center on Courtney's page, is this: "Quick reminder for those of you reading this post on or before January 14, 2013 – The Toadally Primal Wellness Bundles of 33 eBooks for just $39 (a $479 value) ends at 11:59pm on 1/14/13 – don’t miss out! Get the details here."

Talk about incestral values.

Laura Semmens said...

ALL the IHC members are pushing that package right now; really disgusting. I'm dying to know how they got that inflated "value"...just picked a number out of the air?

Stephanie said...

I don't have anything intelligent to contribute, I just wanted to let you know that I appreciate your posts. What you are saying needs to be said and I am thankful to you for taking the time to say it. So thank you, and keep up the good work!

Simon Carter said...

Oh, come on Evelyn, don’t be such a cranky old meanie! Courtney appears to be a fine young lady who wrote a magazine style article for this Balanced Bites website, “Real Food For Real People”. Hopefully she got paid a few bucks for it. I think you are being really picky here. Look, it is all about spreading the word about how wonderful and TOADALLY cool this Paleo stuff is. Need to get that buy-in after all. The Balanced Bites crew puts on Nutritional Workshops for Cross Fit gyms all over the country. How come you haven’t tried to tap into any of that easy money?

Simon Carter said...

Wow, that Balanced Bites website is something! I had never seen it before. Those ladies have got it going on!! Podcasts, Seminars, Blogs, Recipes, Detox programs, Books, Guides, e-books. They even have $20 Paleo Socks and $31 t-shirts, Bacon is Rad, Gluten is Bad!
Evelyn, it is obvious that you are completely wasting your time with The Carb-Sane Asylum.
You need to sign up for their $125 per hour Nutritional Career and BUSINESS Coaching. They sure as hell have the business part figured out!

Unknown said...

On Paleo sites I try to avoid mentioning that I am highly educated, it just turns the crowd against you.

James Krieger said...

The Paleo sites associated higher education with the "establishment", so it goes along with their anti-establishment-at-all-cost attitude. I remember Nikoley's readers claiming that I was part of the "establishment." Of course, when I ask people what exactly is the stance of the "establishment", they can never specifically answer the question. Many in the "establishment" don't agree on many things. The "establishment" is an invented bogeyman.

Harry's Acolyte said...

BACON IS RAD, GLUTEN IS BAD!!

What better way to mark yourself as an asshole?

Sanjeev said...

> utter contempt that the paleosphere exhibits for real professionals is bizarre

I disagree - they pick and choose; embrace supportive pros, slag critics.

Much like the alt-med crowd has a love/hate relationship with science. All the "science" (usually the worst controlled, small, exploratory studies, and all the illogical arguments (starting with the naturalistic fallacy)) that's "supportive" gets cited and critical studies dismissed.

The pattern's common - another example's the creationists trying to appear scientific via "intelligent design" but working tirelessly to discredit all science (astronomy, geology, selection, molecular biology, virology) that discredits their stance.

river rance said...

Paleo is a fantasy of the way someone thinks "Grok" or "Crock" lived some 40,000 years ago or pick your millennium as it suits your delusion. Even as recent as the past 100 years, forget 40,000…a lot of people ate anything that was available( soup kitchens ring a bell in the '30's European refugees in the 40's eating garbage to survive), bugs,worms,leaves,rats,mice,tubers,grass, cooked or raw it didn't matter…they ate to survive and didn't eat much at all, probably didn't have any Paleo brownies for dessert either. The most glamorized war with the most American deaths ever was the Civil War with 625,000 + another 400,000 casualties. Another tragic event in the past 200 yrs was the Nazi Holocaust extermination of 10-million + humans. Both events glamorized, by people with a twisted belief that somehow it didn't happen(holocaust) or glamorous (US civil war). David Duke and his ilk come to mind… government….well they are out to get us. That's why the so called Ancestral Community didn't speak loudly and vocally about Jimmy Moore's flippant responses to the Duke interview. After all it's the government, scientists,Doctors,and corporations that are out to get us…it's a conspiracy….just listen to Duke and Moore yuck it up when it comes to wheat and the government. They agree period. They lie and are out to make us sick.
And Robb Wolf 's credibility erodes every day he doesn't abandon the Jimmy Moore Low Carb Ship of Fools. Wolf's recent posts about carbs and Moore's cuddling with David Duke boggles the mind as to why Wolf would jeopardize his reputation for a boat ride on a 2nd class cruise line with Jimmy Moore. Yeah, it is The Incestral Health Community. Genius Evelyn to point out what most have felt but couldn't put in 3-words. HT

George Henderson said...

Actually, a high-carb feed will induce DGAT1, which will synthesize triglycerides, from dietary fats mostly rather than DNL. The fructose portion will tend to supply the glycogen.
She's not that far wrong, just forgetting the Feinman Doctrine; "dietary carbohydrate determines the fate of dietary fats".

http://144.206.159.178/FT/2814/77047/1304075.pdf

lian johnston said...

When you're new to this stuff you read so many of the same view points you generally consider them fact without even checking. They seem to just feed off each other and quote from fringe studies taken out of context or misrepresented entirely. A few years ago Gary taubes was basically a messiah in the paleo community. If only the "establishment" and stupid scientists were to pay attention and learn about cholesterol and fat regulation from marksdailyapple blog posts.

George Henderson said...

I can't think of one; you've done a great job.

lian johnston said...

They also seem to be always on the defense having to discredit or "debunk" every new study that suggests gorging on meat and fat can have potential ramifications.

George Henderson said...

My God! Discrediting and debunking! the Knaves! Wait till Evelyn hears about this, that's her job!

George Henderson said...

Even assuming that "gorging on meat and fat" had ramificatons, why should such ramifications become statistically evident, given everything else that goes on in human lives, everything else that is eaten or not eaten?
Because they don't turn up in any very meaningful way, people who believe in them a priori are adept at cooking the books, whereas people who bring the requisite skepticism seem to see no patterns.
It is frustrating to see no pattern and arrive at a negative conclusion. It takes a very good scientist to do this over and over again, year after year, and not be swayed by the prejudices of ones peers, if such is the nature of the data.
Nil. Zip. Nada.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943062/

Evelyn aka CarbSane said...

Your point?

Josh said...

Yeah one of the problems with paleo science is that it often starts out with the presumption that meat and saturated fat are innocent until proven guilty and grains and legumes are guilty until proven innocent. Any epidemiological study that finds no association with sat fats and heart disease will be happily used as proof that saturated fat doesn't contribute to heart disease whereas an epidemiological study finding that red meat consumption is associated with cancer will be met with the 'correlation doesn't equal causation' mantra.

George Henderson said...

Also, Evelyn, there is a reason smart people have this attitude to doctors.
E.G.
Whooping cough epidemic in N.Z. It's on the news. Supposed to be a big deal. Children's friends start coughing.
Family catches it, including adults. (vaccines and immunity wear off with this one, also strain is changing)
Every doctor seen denies it can be pertussis, every different doctor (we're on holiday and have to see a series of them, no-one sees the same doctor or even the same doctor twice) prescribes a different antibiotic, even to the same person on a second visit. Not many of them are for erythromycin (standard of care for pertussis).
Eventually a test is done and comes back positive for pertussis.
Pertussis is a notifiable disease. So one of maybe 10 cases we knew about was notified to authorities and captured in statistics, and then only at our repeated insistence. And pertussis testing is worthless soon after infection, so even this case could have been missed.
How much of this current epidemic could have been stopped by prophylactic antibiotics or quarantine had GPs been prepared to recognize that adults and older children are going to be infected in an outbreak, that pertussis is not just a disease of mothers and babies, and that vaccination, which is preventive generally, is not that reliably protective on an individual basis (the child with most recent vaccines had by far the mildest symptoms, but there was little pattern otherwise).
Oh, and this chaotic and unsatisfying venture cost a vast amount of money and relieved no-one's symptoms.
One can believe in modern western medicine and yet despair of it.

Evelyn aka CarbSane said...

I certainly hope you aren't insinuating that I'm somehow unquestioningly supportive of every aspect of modern medicine. However I don't operate on the premise that it is wrong and doctors are pill pushing idiots.

Evelyn aka CarbSane said...

This summer I'll be kicking off my 21 Hour Retox programs. ;-) For $500 you can watch Go Kaleo strut the stage in her Buffalo Bill bikini and Num Num Kaleo thigh highs eating ice cream. For the ladies we'll have the former Castle Grok riding a unicycle in his Wheat Power g-string sipping mango and ice cream smoothies. We'll have vendors selling real chocolate, potato latkes, cantaloupe jerky and Winnie the Pooh sized tubs of honey.

Yep, they've got it all going on (the socks are hideous!) which is actually fine by me, to each their own.

What I find sad is that their resident nerd got that post out of an advanced biochemistry class in her nutrition masters program but still cites Mark Sisson's "work" and website on the topic. Ahh well.

Evelyn aka CarbSane said...

Lots of credibility crumbling within the IHC. Paleo FX "sponsored" Jimmy's latest podcast to gin up attendance. It is rather surreal considering they are not "ancestral" but specifically "paleo" ... There is not a paleo guru on the planet even who would consider how he has been eating for the last 8 months or so "paleo" or even "paleo inspired". So what theory to practice will he be representin'??

That there has been no swift and unequivocal blacklash against the lying Jimmy Moore on the David Duke issue is beyond mind blowing. These are not people lacking marketing and public perception skills, so their reticence is quite telling.

I can only conclude that the IHC is only interested in growing and keeping it's cult and has no real aspirations towards mainstreaming their message. Oh they'll tell you till the grass fed cows come home that they are doing this for the children and to save us from our obese and diabetes riddled selves, but actions speak louder than words.

What is getting lost in all of this is that Jimmy Moore LINKED TO THE OFFICIAL WEBSITE OF KNOWN RACIST WHITE SUPREMACIST DAVID DUKE. He did so with the express purpose of providing his readership with nutritional information having been sent links to Duke's nutrition page by a reader and checked them out himself. He defended that linking as "nutrition stuff was spot on" and later "nutrition stuff is in line with my healthy high fat, moderate protein, low carb diet" {paraphrase}, then thought the better of those defenses and deleted them.

The information is out there for every member of the community to see. And if they don't want to read it here, they can go to http://justduckyisback.blogspot.com/2012/12/just-ducky.html

There can be no more excuses that the "big boys" are too busy or above it all, or whatever other excuse has been meted out in the past to absolve the individual from accountability as they signal approval with their silence and business relationships.


Unknown said...

What I find disturbing is when children are involved, say a parent with a 7 year old and a 9 year old seeking health advice for the kids from strangers on the internet, I think it is a given that the children have a pediatrician, why not ask her for advice? She has been rigorously trained in issues pertaining to the health of children, she has a lot to lose if she gives you advice that harms your children, but instead you are looking for advice at Paleo Hacks.

Sue Staltari said...

She wouldn't be able to site Sisson for her masters program.

Diana said...

What if you eat high carb, low fat? Many trad. diets are such.

Susanne said...

As I've pointed out here before, the so-called ancestral health community's "Problem with Science" also exists into the area of using peer-reviewed research conducted by academic archaeologists and paleontologists. The folks who, you know, PRODUCE the data which every ancestral health guru claims supports his or her particular plan. Paleo diet people, in fact, seem to prefer NOT to hear from scientific archaeologists, rather they cite other gurus in a circular fashion, or occasionally just their own ancestral fantasies: "Well, I imagine if I were Grok, this is what I would do."

The one or two times I have seen a degreed working archaeologist actually appear in a public forum discussing ancestral diet, they have been viciously attacked by Paleo followers in comments and blogs, not citing data, but more guru hearsay or emotional reactions -- here's an example from NPR: http://www.npr.org/blogs/13.7/2011/10/27/141666659/the-paleo-diet-not-the-way-to-a-healthy-future

There's a real disconnect between the ancestral community and archaeology scholarship, they're not even speaking the same language. Paleo gurus seem to speak of the human body being "designed for" or becoming "tuned" to a particular past diet, but that's not how evolution works; to an archaeologist that sounds more like a religious creation story. In the Paleo diet world it's taken as accepted fact that Paleolithic people were universally healthier, bigger, longer-lived or whatever than agricultural people. I never learned any such truism in my archaeological training or research, and I've never been able to locate the original source for it in the Paleo diet world: all the gurus, if they cite any source at all, just link back to some other guru. (The earliest I have ever seen it in print is in a 1987 popular article by Jared Diamond, and he doesn't cite any sources either.)

The real picture of ancestral diet, to an archaeologist, is much more interesting and complicated than you can put into a few pages in the introduction of your diet book: it depends on the time period you're looking at, the particular cultures (yes, there are cultures in the Paleolithic as well as the Neolithic), the local area and conditions, people in the past being active agents, not just passive objects in their environment, etc. It's kind of disappointing to me as an archaeologist to hear people claiming to espouse "science", but really preferring a homogenized, simplified, fictional/ideological view of the past, while turning their heads away from learning the WAY COOL STUFF that emerges when you look into the actual primary research.

Mind you, as a scholar, I respect your wierdo culture too, Paleo Dietoids, just as I embrace all equally, and enjoy studying your wacky ideas. :)

Rob Pierre said...

Just curious, since you are an expert, how about a current picture so we can see how fit and healthy you are?

Kade Storm said...

Oh, Diana. . . You have to have special genetics for that and these optimal sugar burners are a piddly minority. ; )

Hornet0123 said...

As someone who briefly got sucked into the whole paleo craze, let me tell you how I was able to be. I was around 50 lbs. overweight from 2003-2007 or so. I ate too much and most of it was crap. During that stretch I developed bad acid reflex. I brought this to my doctor, he wrote be a prescription and said don't drink a lot of alcohol. Now in those days I did not question my doctor he was the professional. I had Trouble breathing one winter- you have Asthma here's more drugs. Plantar fasciitis- take Ibuprofen and rest it. IBS type troubles, well lets discuss some drug treatments. About this time I was tired of being fat and went on the "traditional" low fat diet, lost 50 lbs, and all of the above problems disappeared. I sprained something years later and went to see my doctor. He asked about the asthma, I told him diet and exercise cured it. He scoffed and said I'd be back ( 6 years later I still haven't been). Anyway I overdid the low fat/ calorie counting and that eventually brought on other problems. Enter paleo and its your doctor is dumb message. Well at that point I got pissed and agreed. He never once mentioned diet or exercise as a possible cure. So I definately see how people can go along. Luckily I didn't last too long before I wised up and realized my problem is I overdo every thing and just introduce moderation. I also no longer think doctors are stupid (although some individual ones maybe), but I also no longer blindly take their word either- no matter how many letters after their name

eulerandothers said...

There does seem to be a current pattern: substitute polyunsaturated fat for saturated fat, at least a portion, if not all.

Swede said...

I don't trust mainstream scientists or the "establishment" at all. They all eat wheat, and it is well known that wheat has so many opioids that it is like shooting up heroin. These scientists and researchers are so stoned all of the time that anything they produce is suspect. Of course, this is all because the government is in on a big conspiracy to get everyone to eat wheat, that way they can control the population since we will all be so stoned and care about nothing more than getting our next wheat fix.

See Colbert's take on this (pretty funny - he mentions Dr. Davis!)

http://www.hulu.com/watch/443676

eulerandothers said...

Whoa. Way harsh, dude. (If pictures are proof that someone is an 'expert,' then I would have gone with Suzanne Somers' diet, back in the day!)

Diana said...

IMO the world's greatest expert on weight loss is Christian Bale.

http://m.popstar.com/News/Celebs/Christian%20Bale/Bale_The%20Machinist.png

Shouldn't Jimmy be taking lessons in weight loss from him? What am I saying, shouldn't we all?

George Henderson said...
This comment has been removed by the author.
George Henderson said...

Well I don't think a patient advocate would have solved any of those problems, unless that advocate happened to be a better trained and more experienced (and higher ranking) doctor than the ones we visited.
Unless an advocate has extensive medical training and experience, how can they protect the patient against anything other than emotional abuse?

George Henderson said...

But blurred by the lack of distinction between omega 6 and omega 3 in most studies, and ditto with preformed AA, DHA, EPA compared to parent fats. We get benefits if we add fish oil omegas, but does this have anything to do with these displacing SFA/MUFA? If we instead replaced 1% calories from carbohydrate with 1% of calories from EPA+DHA wouldn't we get the same benefits?

George Henderson said...

Also, to what extent are we talking about a deficiency of EFAs that needs to be corrected? Imagine that in some % of cases the degree of saturation is a marker for outright deficiency of EFAs.
This was surely the case, for example, in the 1950s-60s when many families ate fat from over-cooked boiled meat (and treated any fish the same way) and hydrogenated spreads, with overcooked greens deprived of alpha-linolenic acid.
Rather than the saturated fat in this diet being harmful, it was the virtual absence of omegas - but the two are easily confused when considering degree of saturation.

George Henderson said...

My point? That Courtney is right about carbs and insulin stimulating enzymes that make triglycerides, the paper I cited makes this quite clear. You seem to have jumped to the conclusion that she's confusing DNL and triglyceride synthesis, but this is not a necessary deduction from her words.
And what about the other 4 points?
And why not Sisson? Why shouldn't a discussion of biochemistry lead to one about lifestyle? Do all biochemistry discussions need to be kept pure and separate from philosophies of life?

George Henderson said...

I know a vegan who thinks the holocaust is a hoax and Gadaffi was some sort of Jesus-like martyr. I've met a standard-eater with no dietary philosophy who spouts the same BS. I don't think you can link this disease to any group or expect immunity because of a diet.

Stupid people need food too.

Galina L. said...

Sure not all doctors are pill-pushing idiots, but I think it is better to operate on the premise that a doctor could be making a short-cut in his care plan or even making a mistake. Our smart and intelligent GP who even approves my diet keeps trying to put my husband (who is fit, normal weight, normal bp, normal everything, and with perfectly high HDL, low trigs and fasting blood sugar) on a Lipitor for his total cholesterol of 260.
While no sane person will self-treat strangely-looking moles, ignore caries, or let a lethal infection or a snake bite to ride its natural course, it is better not to let your doctor to be the person in charge who makes all decisions on your behalf. It doesn't mean ignoring his opinion, disrespecting or considering him a fool. He is a part and an employee of a bureaucratic system , and often functions as a part of such system , not as an independent intelligent medically educated person. I absolutely trust my dentist because she earned my trust, and my ob/gyn is really good one. However,the ob/gyn also did in a past some inappropriate pill-pushing when I had returning yeast infections. Well, it is just life, it is unreasonable to expect the total perfection. I am not perfect myself, but I know myself better, or at lest observe myself longer time.

George Henderson said...

I did it again, posted glycogen for glycerol.
If I ever have to start posting anonymously, that's how you'll know me.

Correction; "The fructose portion will tend to supply the glycerol".

eulerandothers said...

I think the PUFA designation is simple enough, although it never hurts to spend time quantifying the types of PUFA used to replace SFA. Since most such studies are based on food records, I'm guessing that fine-tuning the PUFA contributions is, at best, going to be an approximation. Without digging through the NCBI database, I'm guessing research was done in this area. This is a lot of guessing! But, if this is all hypothetical 'what if...', then guessing is going to be fine.

If a study's PUFA was not broken down by category, it's probably because the numbers worked anyway you slice them.

It's not every family or individual who pops fish oil pills in such studies (unless asked to) and if the study was an American one, fish would not be a large part of the diet (unless required for the study). Unless part of a study, I'm guessing omega-3s are not part of saturated fat's problem - or solution. Guessing works here because fish oil pills are not yet part of the Western diet.

I'm not too concerned by the lack of distinction between omega 6s and omega 3s - there is plenty of 6/3 ratio work done already. Would it make a difference if you replaced SFA with only omega 6s? What type of saturated fat - surely, you'd narrow that down, also! Don't stop there!

Suggesting that a deficiency of EFAs is more important than the effects of SFAs is intriguing, but it's a reach ('some percentage of cases' doesn't really say much) to suggest cooking methods of meat account for the bad rap given saturated fats. You may as well say that fried foods (McD's fries) account for saturated fat's bad rap. Oh, wait... I think that's already done.

Evelyn aka CarbSane said...

SO WHAT! That was my point. The studies she cited were (1) WAY overfeeding carbs and high liquid glucose polymer ... DUH! So that carb is turned to fat (at caloric expense). Meanwhile, if you ate that in fat it would go straight to storage.

Sisson's great "work" was his absurd carb curve. QED

Diana said...

@Evelyn, I looked at the paper and was hopelessly lost, this is way above my head. However I noticed that the chow was 70% sucrose; the mice were carb-starved (that is how my amateur brain interprets "carbohydrate starved adipocytes" or "glucose starved adipocytes") before feeding. Does this mean anything?

Carb-based diets aren't 70% sucrose; I am human; I don't wait until I am carb-starved to eat.

I understand that these studies are important to study metabolic pathways in isolation. I do not understand whether they are directly relevant to how human beings eat, and how they get fat. If that makes me sound dumb, so be it.

klaatu33 said...

"In the Paleo diet world it's taken as accepted fact that Paleolithic people were universally healthier, bigger, longer-lived or whatever than agricultural people. I never learned any such truism in my archaeological training or research, and I've never been able to locate the original source for it in the Paleo diet world."

If you are an archaeologist as you claim, it is surprising you don't have at least a passing familiarity with paleodemography where the view that health declined after the transition to agriculture is pretty much mainstream, if not universally accepted:

"The general (consensus) model suggests that among hunter- gatherers, mortality was moderate and fertility relatively low (due perhaps to lactational amenorrhea); fertility and mortality increased with the adoption of agriculture, while “health” declined.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909026/pdf/nihms-198591.pdf

While some in the paleo blogosphere may be guilty of oversimplification or even distortion, this view is not made up as you seem to be suggesting.


Galina L. said...

May be the one of possible sources is the book of Drs.Eades "The Protein Power". As I remember from my reading, in the book it was told how both Drs. came to the idea of treating modern medical issues with a diet low in sugars and grains. One of sources was the medical library three generations of doctors Eades collected during their lifetime, another - the hobby of wife of Dr. Eades, Dr. Mary Dan Eades, who was interested in paleo-anthropology and enjoyed attending conferences of paleontologists.

Charles Grashow said...

http://weightmaven.org/2013/01/15/the-down-side-of-being-a-pear/

"Fat in the abdomen has long been considered the most detrimental to health, and gluteal fat was thought to protect against diabetes, heart disease, and metabolic syndrome. … But our research helps to dispel the myth that gluteal fat is ‘innocent.’ It also suggests that abnormal protein levels may be an early indicator to identify those at risk for developing metabolic syndrome. …

The team found that in individuals with early metabolic syndrome, gluteal fat secreted elevated levels of chemerin and low levels of omentin-1—proteins that correlate with other factors known to increase the risk for heart disease and diabetes. …

High chemerin levels correlated with four of the five characteristics of metabolic syndrome and may be a promising biomarker for metabolic syndrome."

http://www.futurity.org/top-stories/protein-hints-at-downside-of-pear-shape-body/

http://jcem.endojournals.org/content/early/2013/01/09/jc.2012-3673.abstract

coconutz said...

Who needs Science. Jimkkkins will explain it all!

Forward by Dr Duke.

"Knowing your total cholesterol tells you nothing about the state of your LDL, HDL and VLDL cholesterol. I'll be explaining this fully in my book about reading cholesterol test results coming out later this year."

http://www.livinlowcarbdiscussion.com/showthread.php?tid=9810&pid=166830#pid166830

George Henderson said...

If carbohydrate and insulin are needed to activate the DGAT enzyme that makes triglyceride, it might be just a little harder for fat to be stored on a low carb diet, you might need to find something else to do with it.
But then, as Jeff Goldblum said in Jurassic Park, "Life finds a way".

"carb is turned to fat (at caloric expense)" - that's the carbohydrate metabolic advantage, isn't it?

Gabriella Kadar said...

George, if you check the information, the problem with pertussis is the vaccine was changed in the 90s. Not sure which year. It would appear that the original was more effective than the one currently in use. They were trying to provide coverage without causing the really high fevers the original DPT-polio vaccine caused. Shall we hang the bastards or what?

These days doctors have no clinical experience of having kids or adults coming in with whooping cough. Maybe all doctors should spend a couple of years in places like Pakistan, Afghanistan, or Nigeria. Let them personally experience a few courses of malaria, hepatitis of varying types, and whatever else is on the menu. If they survive, then they qualify. What do you think?





George Henderson said...

Well the oils McDs are fried in are vegetable oils and fairly low in SAFA as %.

"some percentage of cases" - I am implying that enough people died from the EFA deficiency to impact the stats and hide the benefits of SFA till recently. If prolonged EFA deficiency is very dangerous, it wouldn't take many cases.

The only positive vegetable oil PUFA trial (the Finnish) for heart disease used canola oil, the only oil high in ALA.
They could have kept their butter and eaten fish and leafy greens.

Fish not a large part of the American diet? That's a correlation right there.

George Henderson said...

Reading social history, including autobiographies and memoirs, is a good way to understand differences in eating habits between different groups and different times. There are few histories that don't mention at least one representative meal, and many memoir writers seem to be obsessed with Mother's cooking skills or lack thereof.
I love reading about food in books about other times or places. Even fiction writers describe real meals and diets (a P.G. Wodehouse character on a low-carb diet in 1954's "French Leave", for example)

George Henderson said...

The dominant pertussis strain has also shifted away from the vaccinated one.
Reasons for not picking up -
1) G.P.s here are not really team players and don't like being told what to do by the Ministry of Health. In a major disease outbreak this lack of co-ordination will be a real problem. The notification system is ignored and neglected.
2) the assumption that vaccines have taken care of pertussis.
3) the modern unwillingness to diagnose an infection without a lab test, and the impossibility of testing for pertussis in many cases. You have to test the most recently infected person, extrapolate to every sick person they've been in contact with, eliminate other causes if necessary, and take a risk.
Amazing that doctors would fear over-diagnosing pertussis (when they were prescribing antibiotics in any case) yet the same doctor diagnose "high cholesterol" from a blood test in a healthy person and try to treat that.
4) the assumption that a disease will present with exactly the symptoms you remember from the textbook or that you saw in hospital cases. With pertussis, hospital cases are hospitalized for a reason. Other cases may differ.

Gabriella Kadar said...

Swede, it is really awesome that you've polled all the mainstream scientists. I had no idea that they all eat wheat. Thanks for the information. It was quite a task you undertook. Too bad all this research is only 'published' in the comments section of Evelyn's blog. You really must put this information out to the general public even if you self publish. The effort will be worth the trouble. No doubt about it.

George Henderson said...

Yes, I was going to say that Eades gives verse and chapter for this stuff on his blog. New research tools and digs can always come along to challenge it somewhat (recently, the discovery that neanderthals ate grains), of course.

eulerandothers said...

'I am implying that enough people died from the EFA deficiency to impact the stats and hide the benefits of SFA till recently.'

A diagnosis? ...

The ONLY positive vegetable oil PUFA trial was Finnish? What does 'positive' mean in that sentence? Just some clarification needed here.

Melissa Mcewen said...

"If you are an archaeologist as you claim, it is surprising you don't have at least a passing familiarity with paleodemography where the view that health declined after the transition to agriculture is pretty much mainstream, if not universally accepted"

No, it's not. This didn't occur in every agricultural transition and even when it did, it was often not permanent, IE, the population's health recovered after some time.

Melissa Mcewen said...

Wait, did I miss Evelyn's Weight Loss Program Book (TM)?

George Henderson said...

I gotta post this here, it is totally on-topic.

http://www.youtube.com/watch?v=_JmaU95qz4k

blogblog said...

I once shared a house with a PhD qualified archeologist who is now a very senior academic. She claimed that cats could detect the auras of sick people and that flint tools were vastly better than steel tools. 'nuff said.

Diana said...

"Yes, I was going to say that Eades gives verse and chapter for this stuff on his blog."

I remember this claim from Protein Power. The fact that Eades made so much of it is reason enough to look at it skeptically. I imagine he took information from here and there and cobbled into his usual propaganda.

George, I used to believe this big strong healthy he-man back in cave days, compared to skinny, rickety peasants. Give it up. It's another thing that the Paleo cult just can't prove.

Gabriella Kadar said...

When I was a kid, my doctor had experience in primitive war situations. He removed my tonsils despite the fact there was no electricity and someone held the flashlight. (My father was really pissed off. But it didn't prevent the two of them from operating on my father's thigh together after office hours removing sequestrae (dead bone bits)from my father's osteomyelytic femur. Bizarre for sure but back in those days there was no health insurance and both of them had surgical experience.)

I doubt he'd ever heard the term 'risk management'. In those dinosaur days no one had yet invented the term. I have to admit, he did a great job. He was always well informed and famously abrasive. He died almost 28 years ago but my own patients who were his patients still tell stories about him. He was 'one of a kind'. He had no trouble with diagnosing all these measles, mumps, rubella, roseola, pertussis, chicken pox, 6th disease and whatever because he had loads of experience seeing these diseases and much, much more. There were way more children around in those days and there wasn't much in the way of vaccination except for small pox and polio.

But as you rightly state, doctors today are risk averse. There's all this stuff about 'standard of care' even if in reality it is 'substandard' given the body of knowledge and experience available. There are more hungry lawyers than there are doctors. There's a general state of 'cover your ass-ism' going on. Don't blame the doctors though. They'd probably be overjoyed at being able to practice their profession in peace. Just think of any working situation: people who aren't working with someone constantly looking over their shoulder tend to do better. Doctors today have to practice in such as way that they've basically got to imagine that there's someone would from college watching every move they make. It's very restricting.

Basically there is a lack of relationship, lack of communication and generalized fear on the parts of everyone, doctor and patient. Discussion seems to have gone the way of the Dodo bird. (Although, I'd say this is a generalized problem in society these days as well.) Patients don't feel that they have ready access to their physicians, physicians cannot allocate the time they know that patients require, etc. The system is broken because it is a system. It shouldn't be a system in the first place. (For example, why do hospitals require presidents and vice presidents? What is that all about? In truth?)

That's why I'm glad I'm not a physician. My friends who are physicians working in hospitals are pressured to spend less time with patients because it's all about the bottom line. Less time means not being able to collect the information necessary to understand the complexity of a patient's problems. Meantime, ironically, it is these physicians who are the ones being chastised by their colleagues and department heads who are being refered the most difficult, complicated patients. Go figure. Or maybe they just recognize that the patients have complex problems because they take the time to find out.

George Henderson said...

So is this.

http://www.informationisbeautiful.net/visualizations/rhetological-fallacies/

If we all took this to heart, man would discussion here dry up.

Susanne said...

Hello klaatu33: Yes, I am aware of these meta-analyses, as well as ones produced by archaeologists that are arguably more suitable for citation on diet specifics, rather than economics and sociology specialists (most of which are produced for different goals than advice on diet). What I tried to take pains to point out was -- as the article you cited in fact says, if you read the whole thing -- is that the picture is vastly more complicated and interesting than what most ancestral diet gurus tell their audiences.

For one thing, there are lots of changes that go on during the transition to agriculture, so it's hard to say that any changes in bones are due just to changes in diet. We don't even know WHY people adopt agriculture, and obviously there could be different factors involved in different areas. In the Middle East, for instance, there are some very interesting temporal correlations between transition to agriculture and climate change, and if that pans out -- data for regional historical climate issues are a whole 'nother can of worms -- it that would be a complicating stress even without a major change in subsistence. Also, what Melissa said -- often in populations that initially show an apparently negative impact in skeletal health close to the transition period, there is a rebound later. Cultural factors are also intriguing components which are very hard to trace. Lowered fertility due to lactational amenorrhea? Possibly one factor. What about infanticide? Could be another one, and documented in hunter-gatherer societies, but not part of the "Noble Savage" picture promoted by ancestral health best-sellers.

From a rigorous statistical point of view, partly because transition to agriculture is associated with lots of other changes in lifestyle and population shifts, we don't have good "controls" for changes in skeletal samples: we don't have populations that we can track across the transition. And there are very very few samples of Paleolithic skeletal data to begin with, largely because they didn't often use cemeteries until quite late in the Paleolithic (does Final Paleolithic count for Paleo Dieters ? Will the gurus ever be specific enough for us to know?).

Suffice to say because I'm getting long, there are examples of malnourished Paleolithic people and Neolithic people, and there examples of big tall robust Neolithic people as well as big tall robust Paleolithic people, and here in the Middle East there were hunting-gathering populations with truly terrible teeth, because their staple for a significant portion of the year was wild dates. Real science is fun and interesting! If you are a paleo diet person and say you are interested in science, read the primary studies and revel in how complex it all is.

Susanne said...


blogblog, I don't know about the cat thing -- degreed people can be loons like anyone else and I personally have a good number of cat ladies and gentlemen in my Facebook roll, archaeologists and non. But the flint tool thing sounds like a reference to the work of Don Crabtree, a pioneer in flaked stone tool studies and experimental archaeology, and rather a character himself apparently. Obsidian blades (not flint that I have heard of) actually can have measurably finer blades than steel tools. Crabtree famously produced a set of obsidian scalpel blades for his doctors to use in a surgical procedure he needed. That's not the same as being "better" (obsidian is not necessarily more practical than steel) but as I noted above it is another WAY COOL THING that archaeology can tell us, and I'm pretty sure it's floating around on paleohacks somewhere too.

Don did not have an academic degree, if I remember correctly, and let me emphasize that I don't want to sound as if I privilege PhD holders as something special. You can have a great interest in and commitment to the scientific method, which involves self-critique and self-examination, and being willing to immerse yourself honestly in the evidence. Which is one reason why lots of our conferences are open to everybody, even it if it means every archaeologist has at least one story of being buttonholed by a "space aliens built the pyramids" aficionado.


Oh, which reminds me. At an academic conference over the winter break, I met my first real in person paleo dieter! First contact! A doctor of optometry. (Many archaeology conferences encourage non-specialists to attend.) So I got to hear all about opiates in wheat, and the Pima Indians and what not. Afterwards, having peeled myself loose after several attempts (all they all this persistent? Need more data) I explained to my puzzled waiting archaeology colleagues about Neolithic Agents of Disease, and we all went out for some excellent tamales, rice and beans.

klaatu33 said...

Melissa: "No it's not."

Sorry but yes and your opinion doesn't change anything. As observed:

"In 1984, Armelagos and M. N. Cohen wrote the book, "Paleopathology at the Origins of Agriculture," which drew from more than 20 studies to describe an increase in declining health and nutritional diseases as societies shifted from foraging to agriculture. The book was controversial at the time, but the link between the agricultural transition and declining health soon became widely accepted in what was then the emerging field of bioarcheology."

http://www.sciencedaily.com/releases/2011/06/110615094514.htm

You may disagree as others do but that doesn't change the fact that the there is a long pedigree for the idea. As I said, disagreement doesn't not mean the notion was invented by paleo bloggers as asserted. It wasn't.

Susanne" "if you read the whole thing -- is that the picture is vastly more complicated and interesting than what most ancestral diet gurus tell their audiences"

Did you read the whole thing? If you did, you would realize the authors are taking issue with what they call the "consensus model' which they wouldn't have felt the need to do if the idea didn't exist in the first place. You and Melissa may disagree with that model, as did those authors to some extent, but your original point was:

"In the Paleo diet world it's taken as accepted fact that Paleolithic people were universally healthier, bigger, longer-lived or whatever than agricultural people. I never learned any such truism in my archaeological training or research."

Your inference was that this concept was invented and clearly it was not. The picture may be more nuanced then sometimes presented but that is hardly shocking in the blogging world is it?




klaatu33 said...

Just another statement of the issue in 2009 by one of the leading figures in the field:

"The general picture of human health that has emerged from bioarcheological studies of the agricultural transition is one of health decline, although the nature and severity of the biological impacts have varied in accordance worldwide diversity in the timing, duration, and specific characteristics of this economic shift."

For the author's pedigree, go here:

http://scholar.google.com/citations?user=9VmIf-oAAAAJ&hl=en

http://www.jstor.org/discover/10.1086/605354?uid=3737864&uid=2&uid=4&sid=21101537576293 (note paywall)

In other words, citing exceptions does not negate the fact that this view is mainstream which was my original point.

blogblog said...

I don't take any notice of archeology because it is so damned unreliable.

Conventional archeology tells us that Australia has had a continuous Aboriginal culture dating back for at least 40,000 years (with claims for over 70,000 years). However the latest published DNA testing tells us that modern aborigines are the descendents of Dravidian people from southern India who arrived a mere 4000 years ago.

Interestingly enough it was quite widely accepted by scientists 150 years ago that Australian Aborigines were of Dravidian origin based on remarkable physical and linguistic similarities.

blogblog said...

I notice that Evelyn almost invariably quotes research from at least a decade ago. A cynic would suggest she does this because the latest scientific literature (particularly post-2010) is frequently highly supportive of basic paleo principles such as intermittent fasting, low carbohydrate intake and and ketogenic diets.

BigWhiskey said...

And, then, there is Joe, the Juicer, Cross, from Australia who lost 90 lbs in a 60 day juice fast, produced a film, "Fat,Sick & Nearly Dead", and subsequently....founded a company named Reboot YOUR Life. Check out the TEAM.

http://fatsickandnearlydead.com/

Kade Storm said...

I am curious to know something. I've seen your posts here and elsewhere, in the past, where you speak favourably of cultures that consume high carbohydrate diets. Has there been a shift in opinion, or were you always of such thinking?

Dave said...

Did the "establishment" ie. people in research positions with advanced degrees use randomized controlled trials to prove the health benefits of whole grains before promoting them to the entire population? If not, then why should we trust this establishment that has already proven it can't be trusted?

Jane said...

Swede
I can confirm your hypothesis from personal observation. Every Tuesday I go to the Oxford Pharmacology research seminar. The scientists simply cannot wait to get out so they can eat their lunch of SANDWICHES. The prof talks to me eating a SANDWICH. Occasionally he looks at it and says 'I shouldn't be eating this, should I'. I grin and say no, and next week he's eating one again.

Evelyn aka CarbSane said...

@klutu -- I see Susanne has responded cordially, as she always does, and you're welcome to post and discuss here, but try to do so in more polite fashion. Insinuating that she is not what she says she is was out of line.

Carry on gang!

Evelyn aka CarbSane said...

Well Rob, this would be question number three. As the other responders have let on, I am no longer answering that question here. This blog is NOT about me. Get it? But I'll tell you what ... So you don't have to keep reading and perhaps learn some basic true biochemistry rather than gimmickified misrepresentations (you don't need to be an expert, BTW, to understand the basics), shoot me an email: carbsane at gmail dot com. I'll put you on my alert list so that when and if the answer to your question becomes relevant, you'll be the first to know!

Evelyn aka CarbSane said...

I quote current research all the time blogblog. If you would like to assist me in finding new research that changes anything from the older literature, I'm happy to save myself the time!

Sanjeev said...

without having to submit problem sets and having them marked, IMHO that's useless.

trying to learn thinking skills without exercises (and repeating the exercises on a staggered schedule to ensure they're well memorized) will improve thinking like READING math textbooks (SKIPPING the exercises) will make one a mathematician.

Evelyn aka CarbSane said...

I'm interested in how he eats today.

Unknown said...

Science is a tool of the devil.

Evelyn aka CarbSane said...

So ... Don't trust establishment but trust anti-establishment? Nope. I have stated repeatedly that I don't think the government's idea of "whole grains" is a good basis for a healthy diet. But this is because what we are encouraged to eat as "whole grains" bears no resemblance to actual food, and unfortunately starchy veggies are counted as veggies and not starches. The My Plate is actually pretty good if you replace grains with starch. There's nothing there that says refined processed crap must be the basis of one's diet.

Diana said...

@Klaatu, I have a confession to make. I've a bit of a crush on Keanu Reeves....

One man's "consensus model" is another man's "CW." The Paleo cult is famous for dismissing the consensus model as conventional wisdom. (Sometimes with justification.) My point here is live by the sword, die by the sword. You can't appeal to the CW/consensus when its expedient. You've got to prove your case.

I don't think we have enough evidence to prove either side. My attitude towards the argument is "so what?" We have lots of evidence of plant/carb-based peoples whose health was terrific. One of them would be the pre-European contact Pima. "Sprightly" and "healthy" according to the explorers quoted by Taubes. A mess, after starvation and subsistence on a crap diet.

Good carbs, bad carbs.

@Susanne,

I didn't post this because I've already done somewhere else and didn't want to be repetitious. Maybe you have already come across it but here is a fascinating study by Kislev et al about how damn easy it is in some places to gather cereal grains. Read the whole thing but I can't resist quoting this part:

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.

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). However, as noted above, in the
southern Levant, collecting in this way is limited to a few days in
most years, and therefore it is not a reliable long-term collecting
technique.


Emphasis added. At some point these guys said to themselves, "gathering is all very well and good, but it doesn't work all year, so let's learn to control production."

But they wouldn't have bothered to do that with a foodstuff that they didn't like - and were adapted to (I suppose the Paleoists would say they were addicted to...). It doesn't make sense to me that you give up a way of life that is great, for a way of life that sucks. Again, too complicated for a blog comment, but I imagine that some folks settled down to become farmers or pastoralists. Some were unsuccessful and died. Some were successful and lived...etc. The latter offered "jobs" to the remaining HGs. And so on.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC373256/

(continued)

Diana said...

@Melissa,

Further to above, perhaps the impetus to shift to a cereal-based diet was absence of meat. I don't know. Assuming that, and it's just an assumption, the first agriculturalists would have been missing a key component of their "traditional" diet, resulting in lowered stature. Maybe. But how long does it take a population to adapt? I am no population geneticist, but my very primitive understanding is that it doesn't take long for a favorable adaptation to sweep through a small population.

And - this is always left out by the Paleoists - agriculturalists were also breeding livestock. They WERE eating meat & animal products (including a new one - dairy), just not as much, except in those where dairy became predominant.

That brings up my main "beef" with the Paleoists - their staunch denial that we've continued to evolve.

@Klaatu - back to you. Back in the 1980s, when this all started, the evolution story was simple: out of Africa sailed a few thousand intrepid AMHs. They took over the world with their high foreheads and efficient brains. The rest is pre-history.

You know that that story has been replaced by something much more complicated. The more we know it seems the less we know. Most important, the takeaway here is: we didn't stop evolving. This makes people uncomfortable because (I think) it sounds racist. I am uncomfortable about it too but it's a fact. You can't say we are Paleolithic creatures and leave out our continued evolution. Some guy says that blue eyes are only 6,000 years old. I have blue eyes. Should my eyes be brown?

Lastly, and I realize I've gone on way long enough, height isn't everything. The Neandertals were short. It's a complex trait governed by many genes and nutrition is only one part of it. When you find that agriculturalists in one area were short, while the HGs who preceded them were tall - might it not have been a different group of people entirely? Modern Europeans aren't descended from the AMHs who colonized Europe 50K years ago - they are descended from Neolithic farmers who came much later. Or so I read.

Diana said...

@Klaatu - I wrote the above comments before I read the Gage/Dewitt paper. It was excellent. Thank you for posting it. However my intepretation of it is directly in opposition to yours. I would suggest a more careful and open-minded reading. You'll accuse me of cherrypicking if I quote. But I will, after I point out that the entire paper is a criticism of the "skeleton lesions" theory of declining health, which data has been gathered from a few samples.

Cherrypicked quote: "Current models of the agricultural demographic
transition are largely based on assumption. We do not reject the description of the agricultural demographic transition as generally outlined. Nor do we wish to declare a farewell to paleodemography. We do want to point out that this scenario is based on a series
of assumptions that are all questionable (at best)."

Questionable at best is how I would put it too. I would rather look for models of health at modern populations who have managed to avoid the OE and who live generally long lives: the Japanese.

Evelyn aka CarbSane said...

Speaking of stature, Rosedale dismissed the Kitavans during the Safe Starches Debacle at AHS12 by pointing to their short stature. I am drawing a blank on the very long lived population that is an isolated one with dwarfism.

Evelyn aka CarbSane said...

Each lab workup reveals more disturbing information for this guy. Cloudy urine with protein and calcium oxalate crystals? Me thinks rather than all of these a la carte tests, this man would do better to work with a single doctor for a period of time.

Evelyn aka CarbSane said...

If you think so little of the discussions here George, perhaps this isn't the place for you? Just sayin ...

Lighthouse keeper said...

The UK eat well plate has potatoes, bread, rice, pasta where the US plate has grains, just heard Zoe Harcombe on LLVLC describe the UK eat well plate thus " It's just full of corn flakes and coke "

Evelyn aka CarbSane said...

That woman is a menace. I just had a Twitter exchange trying to confirm her latest claims to be pursuing a PhD in Nutrition. Given as she dropped the claim when Ben Goldacre outed her (and I highlighted it here on this blog) I believe she should be required to show proof of matriculation in a qualified PhD program. She's studying macros and the 7 Countries Study?

I just asked her where he Diplomas in Nutrition and Weight Management are from. Since she only lists Cambridge on FB ... We'll see if she responds.

I'm afraid I got a little evil and called her stupid on thermodynamics ... but she is. Another one utterly unqualified to discuss biochemistry and metabolism but calls herself first and foremost an "obesity researcher". Oh, and her candida nonsense is ... well ... nonsense!

Zoe self describes her Obesity Epidemic door stopper as an "academic work". Ha! Who would have thunk there are so many comedians in this bunch. First GCBC is 3 PhD theses and now this? LOL

Diana said...

@Swede, That's the reason for the AR. Stone age savages gathered cereal grains, got stoned on them, and boom, soon they were raising their heroin crops. From Stone Age to Stoned Age.

It's a sad story.

Diana said...

Amber "Go Kaleo" did an n=1 with the My Plate and got great results. No Twinkies, just regular food, portion controlled.

Why don't her n=1s get the same attention as Jimmy Moore's? She has a nicer ass than he does.

Sanjeev said...

> pursuing a PhD in Nutrition

If I were a PhD I'd run, seeing what was pursuing me ...

remember "to live and die in LA"? That was the first time I heard those lines

suspect: why you chasin' me?
cop: why you runnin'?

Such an awesome movie, first time I ever saw my favourite actor, Willem Dafoe.

klaatu33 said...

Evelyn: "Insinuating that she is not what she says she is was out of line. "

I am sorry but I thought I had seen a great deal of credential questioning here. In any event, I just found it surprising that somebody who says they have an academic background in this area appears never to have heard of the seminal works of Mark Nathan Cohen, George Armelagos, and Patricia Lambert. It just isn't credible unless she never did any coursework in bio archeology, anthropological nutrition, etc. She was one the one who was arguing from authority after all.

Diana: " I wrote the above comments before I read the Gage/Dewitt paper. It was excellent. Thank you for posting it. However my intepretation of it is directly in opposition to yours. I would suggest a more careful and open-minded reading. You'll accuse me of cherrypicking if I quote. But I will, after I point out that the entire paper is a criticism of the "skeleton lesions" theory of declining health, which data has been gathered from a few samples.

You are also missing the point and I don't need to read it again. As I said above, yes it is a critique of the prevailing wisdom but it clearly identifies the "agricultural transition" and declining health as the mainstream model. (I think you will not find any area of science without dissenters and that does NOT negate the paradigm) The whole point was that Suzanne was suggesting that paleo bloggers had somehow invented the idea which they did not.

Diana; "we didn't stop evolving"

I don't know why you raise this issue as I never brought it up nor did I intend to. My one and only point was that Suzanne was incorrect in suggesting that paleo bloggers invented the idea that the agricultural transition was followed by declining health. I don't know why you all are now ascribing to me all of the beliefs of the paleo community.

Suzann: "height isn't everything"

Its somewhat amusing to me that you are now doing what many here have accused the Paleo community of doing-- quibbling with mainstream science in order to further a point of view. I suggest you contact Patricia Lambert:


http://scholar.google.com/citations?user=9VmIf-oAAAAJ&hl=en

http://www.jstor.org/discover/10.1086/605354?uid=3737864&uid=2&uid=4&sid=21101537576293

And ask her whether her conclusion as cited above was based solely on height. I can assure you, it was not.

Susanne said...

Hello klaatu, I think we are talking at cross-purposes here. I don't believe I said that the ancestral diet community made up the agricultural transition-health link.* My complaint is that they invariably present a decline in health in the Neolithic period as established, universal fact, rarely provide any source for this "fact," and if if they do, always seem to cite someone else in the community rather than a primary source. (For those of you who suggested the Eades' book, thank you, I will follow up, although I don't have access to it at present.) In scientific language, "theory," "model", "hypothesis", are significant terms with specific connotations about (among other things) certainty of evidence, and they are also all different from "fact". You may argue that this is too nuanced for the internet, because the internet is about posting crap, and maybe it is. Free speech and all.

But my feeling is that if an author or blogger spends a lot of time loudly emphasizing that their diet program is based on SCIENCE!, while at the same time refusing to adhere to the basic principles and methods shared by the scientific community, such as transparent citation, honesty about the state of the evidence, and yes, proper use of scientific language, then they should expect to get called out on it. Which is part of the point Evelyn is making above, if I understand her correctly.

If the ancestral health gurus want to tell everyone they are playing in the Science league (and co-opting that name for credibility purposes), then they should be polite enough to play by the Science rules, or they are hypocrites. Pretending to be "scientific" to persuade people to believe you, when you're not, really, is especially egregious in authors who are promoting ideas that can significantly impact people's lives and health, as diets can.

*Aha, on looking back, I see I did use the word "fictional" earlier in my post, which could be seen as referring to this, I suppose, so I am sorry for being misleading there. The "fiction" phrase is my general reaction to the Garden of Eden/Noble Savage type narratives, and anything which involves imagining the daily activities/motivations/preferences of hypothetical Groks, which continue to pop up to spite those Paleo folks who insist that this program is not about "reconstruction."

I didn't say anything about height, as far as I can tell. That whole issue of Current Anthropology (50:5, Oct 2009) provides a nice assessment of the current state of knowledge in the transition to agriculture, and is a good read for anyone who does want to get deeper into the sources.

Melissa Mcewen said...

""In the Paleo diet world it's taken as accepted fact that Paleolithic people were universally healthier, bigger, longer-lived or whatever than agricultural people. I never learned any such truism in my archaeological training or research."

Note the word TRUISM. That would mean it is universally accepted. And it is not, which is what Susanne and I were both saying. We were not saying this is some off the wall view.


Also read those papers a little more carefully- it's not all about diet. The transition to agriculture involved so much more than that, including population densities that lead to the spread of infectious diseases. Also the papers are about a general trend in the adoption of agriculture, they do not say that the agricultural diet is "bad." That is exactly like people who use correlational studies to say fat is bad.

If that were always true there would not be outliers like agricultural societies that have better markers of health than some foraging societies. Also those papers tend to exclude certain lifestyles that are neither foraging nor agriculture per-se like herding and horticulture, the lifestyles of almost all the people that paleo dieters seem to be fixated on like the Masaii and the Kitavans.

Susanne said...

Diana, that is a great experimental study, thanks for pointing it out. If I remember correctly it was part of a back-and-forth series of articles about how practical it was to gather legumes and grains if they were going to be part of a staple diet. The Israeli study looked at an area that was occupied by the Nabatean culture in the Paleo-Neo transition so it's really closely studied by folks interested in the transition to agriculture problem. There was another article by the same authors about how really hard it was to distinguish and collect their targeted legume, I think something in the chickpea family, with photographs of the hilly rocky terrain they had to navigate, ending up with only a handful after a day's hard work, and not all of it the correct seed. Those are the sort of articles I remember when I toy with the idea of doing an experimental project in my archaeology classes -- not sure I am ready yet for the student drama and potential liability that would involve. Maybe making shell beads instead ... that wouldn't be too bad, right?

Transition to agriculture could potentially involve a number of different paths, as suggested by ethnographic studies. There are groups who are not technically farmers, for instance, but who "curate" particular plants in forests, gathering wild specimens but making sure to replant bits to regrow, and even nomadic groups who scatter seed of things they eat, and then leave on their annual tour, coming back around harvest time to see what has survived. Most evidence suggests that early agriculturalists not adopting novel foods, but rather shifting to more deliberate control of plants they already know and have as part of their diet.

Susanne said...

Also, sorry about being anonymous here, gang, but I teach at a non-U.S. university whose ideas about their faculty freely expressing themselves in social media are ... not quite like the situation in the US. But I can tell you I have a US PhD in classical archaeology, speciality Old World Bronze Age, with an interest in food (professional as well as personal).

Diana said...

@Susanne,

Thanks for the background on Kislev. It's very interesting. "Most evidence suggests that early agriculturalists not adopting novel foods, but rather shifting to more deliberate control of plants they already know and have as part of their diet." Yes, that's what I was fumbling at. I think that it's quite rare that human beings adopt novel foods unless of course they have to.

@Klaatu, I was the one who mentioned height, not Susanne. I wasn't quibbling with mainstream science, just pointing out that one of the Paleoist claims (the pop guys, not the academicians) is that AMH's were taller than agriculturalists. That's all.

"I don't know why you raise this issue as I never brought it up nor did I intend to."

My apologies for bringing up something that you didn't!

I don't speak for Susanne but I think her point is that the mainstream CW in academia isn't as rock solid as you say - and if Dewitt/Gage is a defense of it ("questionable assumptions") then you should look further. DeWitt/Gage strikes me as a polite, "Goodbye to all that, let's rethink our premises." In the popular Paleo world, they've adopted the Eades view wholesale.

klaatu33 said...

Susanne: "I don't speak for Susanne but I think her point is that the mainstream CW in academia isn't as rock solid as you say ."

Interesting that mainstream wisdowm is rejected when it is convenient but when the Paleo crowd does it (ala cholesterol), they are ridiculed. Anyway, you are now changing Suzanne's point which was that as an archeologist, she never was taught that the agricultural transition resulted in overall poorer health.

"Dewitt/Gage is a defense of it ("questionable assumptions") then you should look further."

Sigh.....I will say this one last time. The Dewitt/Gage paper was my attempt to show you that even those that have issues with the paradigm (and they are in the minority at this point), acknowledge that is is the current dominant model which is calls into question of How Suzanne could not be aware of that given what she says about her background.

"In the popular Paleo world, they've adopted the Eades view wholesale."
I have no idea what the "Eades view" of this subject is but instead of constantly telling me to read more carefully (ironic really given that I am the only one here citing academic on the issue), perhpas it would be better for you to actually take a look at the work of the already cited scholars.

Diana said...


"Interesting that mainstream wisdowm is rejected when it is convenient but when the Paleo crowd does it (ala cholesterol), they are ridiculed"

This is a complete distortion of what I wrote. I didn't say that Susanne "rejected mainstream CW" --I said she said it wasn't as monolithic as your caricature.

"They are ridiculed" -- Yes, because the Paleo crowd IS ridiculous on this subject. They don't reject CW - they reject the dumbed down pop version of the lipid hypothesis. It's really more nuanced than "high cholesterol will kill you." I used to be a denialist.

Thanks for the Dewitt/Gage cite. It's a beauty, and I will cite it every time a Paleo cultist claims that "science says" the AR brought about a health decline. I read every word.

"Sigh.....I will say this one last time..." No you won't. You'll come back for the last word.

eulerandothers said...

'suspect: why you chasin' me?
cop: why you runnin'? '

Great stuff!

George Henderson said...

Sorry, I was assuming you'd read the reviews on this topic, I don't have time to write a primer but suggest "The Queen of Fats" as a quick easy read.

What you have to realise is the historical context.
Omega 3s did not even exist as a nutritional concept in 1973 when the PUFA recommendation was floated. Ancel Keyes, for example, could have not have known that there was any difference between fish and sunflower oil.

We are talking about recommendations proposed and assumptions formed and studies done in a state of incomplete knowledge that has, over just a few decades, been superseded to an overwhelming extent.

Read any popular book on nutrients written before the 1990s- you are unlikely to see anything more than linoleic acid listed as an EFA.

J Nutr. 1998 Feb;128(2 Suppl):427S-433S.
The slow discovery of the importance of omega 3 essential fatty acids in human health.
Holman RT.

Although linoleic and linolenic acids have been known to be necessary for normal growth and dermal function since 1930, the omega 3 essential fatty acids (EFA) have not received much attention until recently. The two families of acids are metabolized by the same enzymes, making them competitive. Gross deficiencies of omega 6 plus omega 3 EFA have been observed in humans, induced by attempts at total parenteral nutrition (TPN) with preparations devoid of lipids. Deficiency of omega 3 acids has been induced by TPN containing high omega 6 and low omega 3 fatty acids. In natural human populations, a wide range of omega 3 and omega 6 proportions have been found, ranging from high omega 3 and low omega 6 content to low omega 3 and high omega 6 content, showing inverse correlation between sigma omega 6 and sigma omega 3. In humans with neuropathy or impairment of the immune system, significant deficits of omega 3 EFA have been measured.
http://www.ncbi.nlm.nih.gov/pubmed/9478042

The health benefits of the long-chain omega-3 fatty acids — primarily EPA and DHA are the best known. These benefits were discovered in the 1970s by researchers studying the Greenland Inuit Tribe. The Greenland Inuit people consumed large amounts of fat from fish, but displayed virtually no cardiovascular disease. The high level of omega-3 fatty acids consumed by the Inuit reduced triglycerides, heart rate, blood pressure, and atherosclerosis.[68]
On September 8, 2004, the U.S. Food and Drug Administration gave "qualified health claim" status to EPA and DHA n−3 fatty acids, stating, "supportive but not conclusive research shows that consumption of EPA and DHA [n−3] fatty acids may reduce the risk of coronary heart disease."[69] This updated and modified their health risk advice letter of 2001 (see below).

http://en.wikipedia.org/wiki/Omega-3_fatty_acid#History

George Henderson said...

Diane, I said that Eades provides references. He does. I'm not saying I believe the differential always existed; agriculture that supplied meat and non-grain crops would be Paleo in the modern sense of course, and there are obvious disadvantages to an insecure food supply.
Grain agriculture (storage and accumulation) allowed the evolution of political-cultural-economic inequalities that impacted health and cannot be easily separated from health effects of grains.

The "dumbed down pop version" of the lipid hypothesis is actually still the dominant one if you deal with a drug company, a government health service, a food manufacturer, or a non-government health charity.
It is still the one that needs to be challenged.

George Henderson said...

You will notice that I said "we", not "you".

I actually believe that civilized and productive - and enjoyable - discussion is impossible without the use and recognition of these rhetorical tools.

klaatu33 said...

Susanne: "I don't believe I said that the ancestral diet community made up the agricultural transition-health link.* My complaint is that they invariably present a decline in health in the Neolithic period as established, universal fact, rarely provide any source for this "fact,...."

Ok, but I don't see presenting this view as so problematic given that it it is also the mainstream view at this point. I would rather quarrel with the myriad of assumptions that follow from this which are much less well-founded.

Diana: "This is a complete distortion of what I wrote. I didn't say that Susanne "rejected mainstream CW" --I said she said it wasn't as monolithic as your caricature. "They are ridiculed..." --

I was only trying to make a point that it isn't only the Paleo people who cherry pick. See below:

"Thanks for the Dewitt/Gage cite. It's a beauty, and I will cite it every time a Paleo cultist claims that "science says" the AR brought about a health decline. I read every word."

Great...now read every word of all the other studies that support the mainstream view on the agricultural transition or else you are doing exactly what you say the Paleo people do....picking your favorite study and using it as the bible. I think it is perfectly fair at this point to say that there is good scientific basis for the claim that on balance, the agricultural transition brought about a decline in health with all the caveats, qualifiers, etc already discussed. It may be that this view is revised in the future but we are not there yet and certainly not on the basis of one review paper.

George Henderson said...

Blogblog is like a child who questions everything others find comfortable. That is what I like about blogblog. You can learn a lot by looking for answers to those questions.

I don't think good research always has to date. The 1935 "choline and fatty liver" paper is still excellent.

Evelyn aka CarbSane said...

@klaatu, You seem to be reading different comments than I'm reading here. I do not recall you commenting here before, and I have no idea if you are a regular reader, but at some point folks come to get to know one another, backgrounds, etc. So you're coming in here and putting words in others' mouths and making unwarranted presummptions such as which literature they may or may not be familiar with and/or what their opinions are on same. It's frustrating and, frankly, behavior of the trolling variety. Nobody is saying to cherry pick. Go back and re-read Susanne's response (all of the responses from all commenters really, but I'm talking about the one where she speaks of what my point is here, that is spot on) and understand this isn't about cherry picking. If you feel anyone is incorrect in what they say (not what you think they should have said or you think they are leaving out), then challenge that. Nobody should have to waste their time defending themselves against things they didn't say or they didn't mean in the way you seem to twist it. Better to ask first if you are understanding what they are saying before diving in, but I think they are being pretty clear.

Ahh well, I was hoping to catch up on some of the other comments, but could not let this go without further input here.

klaatu33 said...

"So you're coming in here and putting words in others' mouths and making unwarranted presummptions such as which literature they may or may not be familiar with and/or what their opinions are on same. It's frustrating and, frankly, behavior of the trolling variety"

Wow...so I am the one putting words in people's mouths? How about Melissa talking about diet or Diana telling me "we never stopped evolving", neither of which had anything to do with the issue that I was raising which was only that it seemed that a rather mainstream view of the nutritional transition was being maligned.

You may think that you can resolve the issues here by fiat but that suggests to me that this forum is rather less tolerant than professed. No biggie....its not as if any of this has any long term importance. Its just a blog after all.

Cheers.

Evelyn aka CarbSane said...

I didn't say you couldn't keep posting, just don't be surprised when others stop responding. I don't see your examples as in any way similar. Now for example, rather than saying to Susanne "you are obviously not familiar with XYZ" wouldn't you think a better discussion could be had by asking her opinion on XYZ or posting about XYZ that counters what she claims and asking how it jives with her claims? That way we don't waste time going round and round and round, see?

Evelyn aka CarbSane said...

BTW -- I find the best way to "out" a poser is to engage them more deeply in a conversation about the topic. Inevitably the poser says something that exposes their lackings.

Readers who have been around for a while may recall a dermatologist who came here sometime early summer I want to say. He introduced himself off the bat as an MD who was like the only person in forever to place out of organic chem or biochem or somesuch at his medical school. Then he went on about stoichiometry of different fats. I came -><- this close to doing something really mean and having him do a guest post to educate my readers on the topic. You see, he meant stereochemistry, not stoichiometry, and he repeated it enough times that it wasn't a simple mistake, he was baffling with bullshit. In the end, I couldn't embarrass a young doctor even if his bragging was off-putting. Yes, he was a doctor (doing his dermatology residence), but apparently didn't know shit about what he was trying to "school" us on here.

Unknown said...

"She has a nicer ass than he does"

Nicer ass, legs, upper torso, back, arms, exercise will do that.

A famous bodybuilder once said "Everybody wants to look like a bodybuilder but nobody wants to lift any heavy-ass weights."

Diana said...

@George -

"Grain agriculture (storage and accumulation) allowed the evolution of political-cultural-economic inequalities that impacted health and cannot be easily separated from health effects of grains."

I'm with you up to the "cannot easily be separated from health effects of grains." It's certainly the case that the AR led to inequality, and eventually savage inequalities. But why implicate grain agriculture. Please read up about the pre-European Polynesians. Very interesting people - they had slavery, a laboring class, an aristocracy, and royalty. I don't think they had what we call a middle class administrative class, never mind, they were class stratified. What does that have to do with grains? Nothing.

So, I think what we should be doing here is exactly what you suggest: separate the health effects of the grains from the social conditions under which these foodstuffs were consumed. It's a good point.

"The "dumbed down pop version" of the lipid hypothesis is actually still the dominant one if you deal with a drug company, a government health service, a food manufacturer, or a non-government health charity."

Or a doctor who doesn't keep up with the evolving, more nuanced lipid hypothesis. Many times I've told the story here of an aunt who died age 104, no health problems, normal weight, mind clear as a bell until her last illness....TCL over 300. She is what made me a denialist. The whole person has to be looked at.

"It is still the one that needs to be challenged."

No arguments here. I'm in total agreement.

Or a doctor who doesn't keep up with the nuances

Diana said...
This comment has been removed by the author.
Diana said...

Jimmy does claim to exercise and he has put an AMAZING amount of muscle on his body - Dexascans prove that.

[Cue: AMAZING should be said as if you are narrating an infomercial.]

But for a guy his height he doesn't have a huge amount of LBM. If memory serves at 6'3" his LBM is 160. At 5'5" mine is 107 lbs.

Diana said...

@George,

One more thing.

I joined Paleohacks just out of curiosity. There are people on Paleohacks with serious medical conditions, soliciting advice from unqualified total strangers.

I told a woman who is on Nutty K, who has ankylosing spondylitis, to stop asking us for advice, and to go to a qualified doctor. I realized it was fruitless to tell her to stop Nutty K, but I did tell her to go to a doctor.

Can we both agree that this is insanity? Paleohacks is full of that. IMO they should cull these questions out of an ethical responsibility to their users.

Harry's Acolyte said...

Help! My doc is an idiot! Please, anonymous people, reinforce my belief that all is well!!

http://paleohacks.com/questions/173750/hack-my-blood-work-doc-is-freaking#axzz2IB9LnKmB

Evelyn aka CarbSane said...

This is all too common and so epitomizes what is wrong. There is a place for alternative medicine, but the internet is the worst place to get it. It's one thing to chit chat strategies and supplements that help but I've been really disturbed by the "you just need to try this one more thing to make it work and stop feeling like shit" trend. Very often we are talking about really ill people who need to at the very least be working with ONE real life human being to sort things all out. Got a bad doc? Fire him/her find a new one.

eulerandothers said...

No, George, I was looking for the 'people who have died from the EFA deficiency' numbers. I'm guessing, from what you say, that it was the diagnosis and 'cause of death.'

But the other part of my comment was about 'The only positive vegetable oil PUFA trial (the Finnish) for heart disease...'

If that study truly stands alone, what was it (just the link)?

George Henderson said...

Doctors cost money. You have to be pretty rich to go through them like toilet paper. Anyway, wouldn't that be "cherry picking"?

Hey, don't people sometimes use cherry pickers to get a clearer view of something?

George Henderson said...

Ankylosing spondilitis seems to be a starch-sensitive condition

http://www.kickas.org/medical/15.shtml

so maybe her doctor never told her that and after years of avoidable pain she is a bit annoyed at them/afraid of them. I can understand that. Obviously she needs to find a doctor whose patients have used carb restriction for AS, or failing that a low-carb doctor with experience of nutty K.

You've got to recognize what a doctor can do for you and what their blind spots are. My doctor has often been wrong but, like anyone else, she knows best what she sees every day, and I have learned when to trust her and value her advice, and she has learned to trust me, that I am not going to be running to her with a sickness I caused myself, so my crazy opinions are now tolerated.

George Henderson said...

If having adequate DHA/EPA prevents heart attacks, not having enough must contribute to them in some way. Or is this too logical?

Finland? Mental hospital patients, I believe. We have a couple of early studies (Rose corn oil, prudent diet) in which omega 6 PUFAs increase cardiac death rate. Then Finnish study in which canola oil produces benefits, which is taken as contradicting earlier studies, but is consistent once omega 3/6 differential is recognised. I'm not making this up but believe it or not have a busy life and ain't reading that book right now.

Look at it another way - substituting a fair bit of omega 6 for SFA lowers LDL because more LDL receptors are expressed (cells need more cholesterol to stiffen runny membrane fats). More cholesterol is produced, total body cholesterol rises.
Substituting a little DHA for anything lowers LDL because less VLDL is expressed (PPAR-alpha is activated, more fats are burned).

So there are two ways of lowering LDL with EFAs which produce two different states.
We could also factor in the anti-inflammatory effect of EPA and the whole blood-clotting differential.
We could go to Kitava and look at a heart-healthy population who eat coconut and fish.
"Due to the high level of coconut consumption, saturated fat made up an equally large portion of the overall caloric intake as is the case in Sweden."
http://www.staffanlindeberg.com/TheKitavaStudy.html

Evelyn aka CarbSane said...

Holistic cures are not cheap either.

I am not talking about cherry picking, I'm talking about active patient involvement. It doesn't cost a fortune to go to a different doctor and have records transferred. Beats just throwing your hands up and asking some anonymous person on the internet.

eulerandothers said...

'If having adequate DHA/EPA prevents heart attacks, not having enough must contribute to them in some way. Or is this too logical?'

I don't believe it's accurate to state that 'enough people died from the EFA deficiency' unless they were diagnosed as having an EFA deficiency and died from that cause. There are a multitude of factors contributing to deaths, so, no, _ I_ wouldn't say someone 'died from EFA deficiency'. unless a coroner or medical authority reported it at the time of death. Or perhaps the person was diagnosed with that deficiency and it was shown to be the cause of death.

I'm sure you get my drift. Employing hyperbole does not make your point.
To say, 'not having enough must contribute to them in some way. Or is this too logical?' has nothing to do with logic. Because: you did not say that an EFA deficiency 'contributed in some way' to the deaths of a certain population (not clearly identified); you said that they died from a certain cause - as if that certain cause killed them.

eulerandothers said...

'I'm not making this up but believe it or not have a busy life and ain't reading that book right now.'
I don't expect you to be reading any book right now. And we all have busy lives. So, I'll just tab on over search the database for the abstract....

I found:


https://www.ncbi.nlm.nih.gov/pubmed/6840954
is the Finnish Mental Hospital Study
' The incidence of CHD, as measured by the appearance of certain electrocardiographic patterns and by the occurrence of coronary deaths, was in both hospitals during the SCL-diet periods lower than during the normal-diet periods. The differences, however, failed to reach statistical significance. An examination of a number of potential confounding variables indicated that the changes in them were small and failed to account for the reduction in the incidence of CHD. Although the results of this trial do not permit firm conclusions, they support the idea that also among female populations the SCL diet exerts a preventive effect on CHD.'
SCl=Serum-cholesterol-lowering (diet, low saturated fat, high PUFA)

The Finnish study was 'A controlled intervention trial, with the purpose of testing the hypothesis that the incidence of coronary heart disease (CHD) could be decreased by the use of serum-cholesterol-lowering (SCL)'

A more recent report about RCTs:
'Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease.' (https://www.ncbi.nlm.nih.gov/pubmed/12566134)
'The reductions in cardiovascular disease (CVD) caused by these dietary therapies compare favorably with drug treatments for hyperlipidemia and hypertension. Improvement in blood lipid risk factors is an important mechanism to explain the results of trials of unsaturated fats. When saturated or trans unsaturated fats are replaced with monounsaturated or n-6 polyunsaturated fats from vegetable oils, primarily low-density lipoprotein (LDL) cholesterol decreases. The LDL to high-density lipoprotein (HDL) cholesterol ratio decreases. When carbohydrates are used to replace saturated fats, in a low-fat diet, LDL and HDL decrease similarly, and the ratio is not improved; triglycerides increase as well when carbohydrate increases, except when low glycemic index foods are used. The n-3 polyunsaturated fats in fish oils suppress cardiac arrhythmias and reduce triglycerides, but they have little effect on LDL or HDL cholesterol levels. The theme should be that diet has benefits that come directly from foods, as well as from the reduction in saturated fats, cholesterol, meats, and fatty dairy foods.'

These RCTs would then broaden the range to show that it's not true that there was just one - 'The only positive vegetable oil PUFA trial (the Finnish) for heart disease' .

A Danish panel in 2010 produced:
http://www.ncbi.nlm.nih.gov/pubmed/21270379
'This expert panel reviewed the evidence and reached the following conclusions: the evidence from epidemiologic, clinical, and mechanistic studies is consistent in finding that the risk of CHD is reduced when SFAs are replaced with polyunsaturated fatty acids (PUFAs). In populations who consume a Western diet, the replacement of 1% of energy from SFAs with PUFAs lowers LDL cholesterol and is likely to produce a reduction in CHD incidence of ≥2-3%. No clear benefit of substituting carbohydrates for SFAs has been shown, although there might be a benefit if the carbohydrate is unrefined and has a low glycemic index. Insufficient evidence exists to judge the effect on CHD risk of replacing SFAs with MUFAs. No clear association between SFA intake relative to refined carbohydrates and the risk of insulin resistance and diabetes has been shown. The effect of diet on a single biomarker is insufficient evidence to assess CHD risk.'

Again, this makes me question 'The only positive vegetable oil PUFA trial (the Finnish) for heart disease' .!

(Kitava? Coconut consumption? Inflammation? This is not helping you...)

Jane said...

You know according to Cleave in The Saccharine Disease, people have been making white flour forever. I suppose as soon as they could make cloth, they could sieve it. Apparently only rich people could afford it because it was a lot of work. The idea is that the degenerative diseases found in ancient Egyptian mummies came from eating white flour. Now why would they want to eat white flour when wholemeal flour is so much better? I imagine, because it's addictive. I think the scientists in Oxford Pharmacology might be addicted. I've been trying for years with no success to get the prof to throw out the white bread, and recently I had a word with the dinner lady. She said she'd try, but 'they do love their white bread'.

Diana said...

George, you are such a smartie, I am so impressed. Guess what, you are right.

I looked on Pubmed and I cited her a study about just that. But I also told her to take the study to a doctor, and to discuss with her doctor the implications of this.

Avoiding starches is NOT the same thing as Nutty K, which is a crazy, dangerous diet with unknown long-term health implications. Certainly no one with AS should be on it, although I didn't say that to her because there was no point in frightening her further.

What is your point? That because I looked up a study on Pubmed, I'm somehow capable of discussing the implications of it for her condition? That YOU are? What do you know other than what you've looked up on the Internet?

Diana said...

@George,

"Grain agriculture (storage and accumulation) allowed the evolution of political-cultural-economic inequalities that impacted health and cannot be easily separated from health effects of grains."

I'm waiting for you to respond to my response about the above.

Separating the health effects of inequality from the health effects of grains strikes me as a pretty easy thing to do.

Study the health of wealthy people who live on grains. Study the health of impoverished people who live on grains. Compare. Contrast.

See what you get.

There have been inequalities in every society that progressed beyond Stone Age savagery. And so?

For someone who lectures us about our ability to argue, you are quite the coward.

Jane said...

Jesus Christ. This guy is really sick. His kidneys need an urgent repair job. The sieve that filters out proteins is thought to be the basement membrane, made of collagen and glycoproteins/proteoglycans. Repair depends on manganese for glycosylation, and copper for the cross-linking enzyme lysyl oxidase. Calcium oxalate crystals may mean magnesium deficiency. This is interesting because it does suggest a low-carb diet is deficient in these three metals, as one might expect.

Evelyn aka CarbSane said...

He says he's seen specialists and they say he's OK. Somehow I doubt he is discussing his diet truthfully with them.

From his last NuttyK update:

Here are some of the areas of concern and what I’m doing to address them:

Low magnesium levels – taking 300mg of magnesium glycinate twice daily
Low protein and globulin (“leaky gut”) – increasing probiotic intake from food and supplements
Elevated MCV, MCH and homocysteine levels – taking high-potency B-complex twice daily
Elevated cholesterol and LDL – a known issue I’ve discussed previously
Low T4, T3 and FT3 – no action needed since there are no negative effects from it
Protein in the urine – existing problem prior to beginning my NK experiment

So there you have it. Yet another pre-existing condition Mr. Open Book never mentioned to his readers before. Look, he is an n=1. His results don't mean NK is bad for everyone or LC is or whatever. But his proclamations of stellar health over the past several years of blogging -- certainly since 2008 -- are of dubious truthfulness at best. He actively encourages people to follow his lead ... medical disclaimers notwithstanding. Why?

river rance said...

"He actively encourages people to follow his lead ... medical disclaimers notwithstanding. Why?"

Good question Evelyn. Why is Robb Wolf following him on a sea cruise? An effort to sell more books, perhaps? Jimmy is a huckster and liar and the evidence is easily available to anyone that really wants the truth. But Robb? He has come across to me mostly as sincere, so as I sit here scratching my head, why would Robb Wolf associate with Moore. man-o-man. It boggles a simple mind.

Evelyn aka CarbSane said...

Robb confounds me. He's not like the B-list gang. He has his own popular podcast (I believe it repeatedly challenges Jillian Michaels' and always bests Jimmy always), real-life business, wonderful initiatives with tangible results -- e.g. work with law enforcement, looks the look, walks the walk, etc. I think he dramatically underestimates the amount of goodwill and respect he garners in this community, even among those (like myself) who criticize him at times.

I do not know when the Sisson interview that aired yesterday was taped, but shame on him for going on Jimmy's podcast. He didn't sponsor it, however, or the podcast on which the Caltons ABCDEFGHIJKLMNOP (king and queen of credentialation inflation) appeared even though he is publishing their upcoming book.

These two certainly owe Jimmy nothing. But anything for "the movement"? SIGH.

Harry's Acolyte said...

http://paleohacks.com/questions/173867/vap-test-results#axzz2IFqvZ188

And now we have certain LDL being called "FRIENDLY" in addition to the usual large/buoyant/fluffy/etc/whatever.

Evelyn aka CarbSane said...

For a very long time, Jimmy adopted the term used for HDL of "protective" for his "large fluffy" LDL.

Sanjeev said...

> Elevated MCV, MCH and homocysteine levels – taking high-potency B-complex

has something changed in this area recently?

last I researched this, using micronutreints (especially B6/C/folate/Mg) to try to clobber high homocysteine was well on the way out.

The micro-mechanistic reasoning that led to the idea was (surprise !!!!!) BULL; fine at the molecular level, ineffective in real people (anyone who's surprised ... why would you be? this has happened many times).

Sue Staltari said...

Interesting to know has this changed.

Sanjeev said...

just did a quick search to refresh my memory

http://www.quackwatch.org/03HealthPromotion/homocysteine.html

http://www.ncbi.nlm.nih.gov/pubmed/22652362


this does look interesting, BUT this is quite a huge step away from the original observational/micromechanistic rationale for the vitamins (which was for CVD)

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012244

lian johnston said...

I've even heard it being called "non-athrogenic".

Susanne said...

Hi y'all, I'm pretty sure this thread is dead, but I wanted to pop back in again and thank all of you who suggested sources for where the "Neolithic Agents of Disease" etc. meme first entered into ancestral health discussion. The reason it's on my mind at the moment is that I'm preparing a "module" for one of our gen ed classes, Critical Thinking, on the subject of nutrition/personal diet on the internet. Modules are stand-alone units that instructors can insert into courses, which in this case emphasize student self-investigation, and critical understanding of sources, including how to interpret academic/journal reports vs. popular media. My other idea was Learning Logic Through Classic British Mystery Novels, but I decided to focus on this one because during my weight loss I became pretty well acquainted with a lot of different online diet "tribes," and because a recent project by a visiting Fulbright fellow showed that a lot of our students are on diets, including many fad diets, but don't know how to determine what sources of information are reliable. I'm especially interested in internet sources, because according to the study results, the internet, and the advice of friends/family, are more common places for our students to turn to than books.

Chris said...

I think it was through Dr Kurt Harris that I firtst heard the Neolithic Agents of Disease phrase (was this already mentioned?). Harris has withdrawn from the whole thing pretty much nowadays after a lot of disillusionment with the level of discourse.

Jane said...

Jimmy has high homocysteine, high cholesterol/LDL, and low thyroid? All of those can be symptoms of copper deficiency. Like the fatty liver he probably has. Leaky gut possibly too, since its basement membrane needs constant repair like the one in the kidney.

Evelyn aka CarbSane said...

Yeah, I associate NADs with Kurt (an unfortunate acronym if there ever was one!). In addition to his disillusionment, his views of certain foods over time seemed to change as well.

This past month or so has me considering pulling a Kurt myself at times. It's not likely to happen because of the outlet this blogging provides for me, but it gets very disheartening at times.

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