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Thursday, April 18, 2013

Ancestral Rabbit Starvation Medical Vacations! The next craze?

I came across this study a bit ago and it caught my eye as I was transfering some stuff between computers:  Marked Improvement in Carbohydrate and Lipid Metabolism in Diabetic Australian Aborigines After Temporary Reversion to Traditional Lifestyle
The rationale for the present study was that temporarily reversing the urbanization process in diabetic Aborigines should improve all aspects of their carbohydrate and lipid metabolism that are linked to insulin resistance. Ten full-blood, diabetic Aborigines from the Mowanjum Community (Derby, Western Australia) agreed to be tested before and after living for 7 wk as hunter-gatherers in their traditional country in northwestern Australia. They were middle aged (53.9 ±1.8 yr) and overweight (81.9 ± 3.4 kg), and all lost weight steadily over the 7-wk period (average, 8 kg). A detailed analysis of food intake over 2 wk revealed a low energy intake (1200 kcal/person/day). Despite the high contribution of animal food to the total energy intake (64%), the diet was low in total fat (13%) due to the very low fat content of wild animals.

... In conclusion, the major metabolic abnormalities of type II diabetes were either greatly improved or completely normalized in this group of Aborigines by relatively short reversal of the urbanization process. At least three factors known to improve insulin sensitivity (weight loss, low-fat diet, and increased physical activity) were operating in this study and would have contributed to the metabolic changes observed.
They worked with a bunch of middle aged, overweight, urbanized Australians of Aboriginal descent ... eating the "SAD" (A=Australian)  circa  early 1980's.  That failed low fat diet?  Not quite:

Urban diet:  The main dietary components were flour, sugar, rice, carbonated drinks, alcoholic beverages (beer and port), powdered milk, cheap fatty meat, potatoes, onions, and variable contributions of other fresh fruit and vegetables.  At the time of the study the composition of the diet was estimated to be: carbohydrate 50%, fat 40%, and protein 10%. There was considerable variation within the group depending on the contribution of alcohol to the diet. The nondrinkers were more concerned about their diet in the urban environment and tended to eat more fresh fruit and vegetables and wholemeal bread.
Below is the summary of the study and general diets:

After initial evaluation, they traveled to remote areas where the participants were cut-off from modern sources of food (e.g. supermarkets).

During the 10-day trip from Derby to the coastal location, the diet was mixed and included locally killed beef, since supplies of bush food were inadequate: meat (beef, kangaroo), fresh-water fish and turtle, vegetables, and honey. It was estimated that beef comprised 75% of the energy intake during this 10-day period  ... No further beef was consumed once the group arrived at the coastal location.  During the 2-wk period spent on the coast, the diet was derived predominantly from seafood with supplements of birds and kangaroo. The lack of vegetable food in this area eventually precipitated the move inland to the now-abandoned site of the old homestead.  ... At the inland location, which was on a river, the diet was much more varied: kangaroo, fresh-water fish and shellfish, turtle, crocodile, birds, yams, figs, and bush honey. 
Ahh!  So they ate a majority animal-based diet that was LCHF.  .... Not so fast.  It was indeed extremely low carb at the coastal area -- which fact caused them to move inland for plants!  But it turns out that wild animals are not particularly fatty ... go figure!  The coastal diet was only estimated to be 20% fat ... look at that protein -- 80%!!!  Oh the rabbit starvation!  But they couldn't assuage that with more fat, they had to find some carbs, at which point fat intake was measured to dip below the 15% mark -- THIRTEEN PERCENT FAT!  In this phase protein made up for 50% of calories.  How can that be?  Well, not hunting and gathering at Whole Foods may have had something to do with the fact that they averaged only 1200 calories per day.  Not a typo.  For the coastal diet, protein intake would have averaged around 240g/day while the more moderate inland diet was roughly 150g/day.   But not only were these diets low fat by percent, they were super low fat by absolute content, only 17 to 27g! Even the 10 traveling days of "high fat" at 40% only amounted to 54g/day.

So I highlighted it twice -- these low carb diets were not high fat.

Here's what happened, in addition to an average of 8kg weight loss:

The major finding in this study was the marked improvement in glucose tolerance in 10 diabetic Aborigines after a 7-wk reversion to traditional hunter-gatherer lifestyle.  There were two components to this improvement: a striking fall in the basal (fasting) glucose concentration and a less marked, but nevertheless significant, improvement in glucose removal after oral glucose.  Associated with the improvement in basal glucose metabolism was a significant fall in the fasting insulin concentration in the diabetic subjects. Although peak postprandial insulin concentrations were no different before and after the temporary lifestyle change, the fall in fasting insulin concentrations indicated that the actual insulin response to oral glucose had increased in these diabetic subjects.  This increased response occurred despite the markedly reduced glycemic stimulus. 
These are summarized in the figures below.

The right side figures are incremental insulin (top) and glucose (bottom) that demonstrate that the acute insulin response is notably improved in these diabetics.  still not a normal response, but bottom left is a marked improvement in both fasting glucose and glucose levels with a 75g OGTT.  

What is responsible for this?  I think it's a combination of increased activity and caloric restriction (due to lesser food availability).  As demonstrated in the LoBAG diet studies (blogged on here), I think the high protein content has a beneficial effect via IGF-1.   Although the LoBAG diets are higher in fat, perhaps the low fat content of the hypocaloric diets helped to reduce pancreatic fat content as in "crash diet" studies (such as blogged on here and here).  The combination seems to have been beneficial.  Yes, carb intake was lowered as well, but the results here are such that they are clearly able to "tolerate" a glucose load better after the intervention.  This reminds me of the Inuit study (help me out I can't find it :( ) where they consume roughly 45% protein in their traditional diet and exhibit excellent glucose tolerance despite consuming essentially zero carb (in that culture/study).  

But to my title, forget PrimalCon ... the next big thing will be medical vacations mimicking this study!



49 comments:

Erik Arnesen said...

And as Loren Cordain and several others point out, the hunter-gatherers' meat was mostly low in SFA as well: («... a year-round dietary intake of high amounts of SFAs would have not been
possible for preagricultural hominins preying on wild mammals»).

carbsane said...

I agree. I wonder what happened with Cordain, and, frankly his protege Wolf. Anyone finding paleo through various forums and blogs these days would be hard pressed to find even an admonition to limit animal fats let alone not "up them". It is rather odd to me.

carbsane said...

I would add that there's also a mistaken notion that the whole carcass is much higher in fat. Yes, there is fat in marrow, brains and some in the intestines, but other organs are generally leaner than muscle meat unless they are from animals that have been raised to have fatty livers (foie gras anyone?)

desmondindalkey said...

The average weight of the participators was 82 kg and they lost 8 kg ending at 74 kg (ave).

Thus at the high protein stage the protein peaked at just over 3 gm/kg.

As far as I can recall "rabbit starvation" sets in when protein consumption is 400 gms, because the liver cannot cope. This would be at 5 gm/kg for a person weighing 80 kg.

Charles Grashow said...

Might the Aborigines be genetically adapted to a higher protein diet?

Charles Grashow said...

http://www.bmj.com/content/346/bmj.f1050



The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes


The interesting part is at the bottom


Competing interests: I have read and understood the BMJ Group policy on declaration of interests and declare: I am employed by the Nutrition Science Initiative, a 501(3)c. NuSI does not accept support from the food industry. I received support (a book advance) from Random House Inc to do the research that is reported in this essay, and I have received honorariums and travel expenses from food industry and academic sources.



Question - What food industry sources??

Mirta Schultz said...

I think they'd have lost weight and improved markers even if they'd been given 1200 calories of burgers and fries, if they had increased mobility with that lower intake of food. I suspect the big cut in calories and big increase in movement (and who knows what other factors from a changed environment) contributed to getting healthier.

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Kade Storm A.K.A. Hedonist said...

Correct me if I am wrong, but doesn't rabbit starvation actually require an almost trace level of other macronutrients? I'd think that with such a large amount of protein in the case of a diet that is still 50% protein, the protein would just be excess and potentially toxic, but not lead to rabbit starvation.

desmondindalkey said...

The description "rabbit starvation" is more correctly "fat & CHO starvation" as far as the human hunter is concerned. In early N Canadian Spring the rabbit has no fat and hardly any glycogen - as Brer has been starving.

It applies to consumption of very lean meat as the only source of food. I imagine one might get it from from consumption of white fish only, or even chicken breast.

From http://en.wikipedia.org/wiki/Rabbit_starvation

"The groups that depend on the blubber animals are the most fortunate in
the hunting way of life, for they never suffer from fat-hunger. This
trouble is worst, so far as North America is concerned, among those
forest Indians who depend at times on rabbits, the leanest animal in the
North, and who develop the extreme fat-hunger known as
rabbit-starvation. Rabbit eaters, if they have no fat from another
source—beaver, moose, fish—will develop diarrhea in about a week, with
headache, lassitude and vague discomfort. If there are enough rabbits,
the people eat till their stomachs are distended; but no matter how much
they eat they feel unsatisfied."

Du Bois subjected V Steffansson to 3 days of lean meat only at start of Bellevue Study. V S develoiped nausea & diarrhea which was resolved after 2 more days when fat was added. See - http://www.jbc.org/content/87/3/651.full.pdf -

desmondindalkey said...

It is the rabbits who have been starving: the humans are fat - hungry.
My guess it would also happen with white fish & chicken breast.


Google: wiki "rabbit starvation" .

Kade Storm A.K.A. Hedonist said...

Thanks for that, I know why it's called rabbit starvation and there's probably about the same potential for problems with chicken breast or white fish. I just wonder whether it applies to diets where people are consuming other nutrients.

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Screennamerequired said...

Many of our animals in Australia are extremely lean, especially kangaroo. I'm not sure if this was true but I remember reading Aboriginals do have an ability to tolerate a higher limit of protein, much like the inuit.. As is the case in most of these types of studies, it's a suboptimal diet (High protein/low in fats/carbs) doing better than a truly dreadful diet (SAD).

Screennamerequired said...

NuSi is once and for all going to prove that the solution for the obesity epidemic is bacon and eggs for breakfast, lunch and dinner. I'm confident that the third and final Atkins resurgence is going to be the one that finally wipes obesity off the map and prove what we knew already knew, that ATKINS WAS RIGHT ALL ALONG

carbsane said...

I should have put the rabbit starvation in quotes because clearly nobody here was starving. It is a real phenom for a healthy active person as I also note they only ate 1200 cal/day. Need carbs or fat for energy at some point!

carbsane said...

I think probably so.

carbsane said...

This guy is so clueless. He makes a point about gastric bypass then says we don't know about the eating less part. Apparently he's ignorant of the sizeable percentage of GBP who regain the weight once they learn to "eat around" their surgery.

carbsane said...

I agree!

carbsane said...

What is interesting is that fat is not available for calories. It would be interesting to see what happens to a full blooded Aboriginal on a LCHF diet.

carbsane said...

I want to see a study ... is there even one planned yet?

Jane Karlsson said...

I think the paper you wanted is 'Studies on the Metabolism of Eskimos' by Peter Heinbecker
http://www.jbc.org/content/80/2/461.full.pdf

Nigel Kinbrum said...

TL; DR. "Never use one word, when a hundred will do" - Gary Taubes. ;-)

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carbsane said...

THANKS!! That's it :D

Sanjeev Sharma said...

> What food industry sources??

makers of high fat, low carbohydrate, high reward food?

Sanjeev Sharma said...

story telling instead of data analysis ... playing to various human cognitive biases.

Typical Taubes.

Lulling the gullible to sleep, eventually putting critical faculties on hold ... good way to sneak your message in ... typical Taubes. FrankG will lap it up like a hungry, thirsty cat.

Nigel Kinbrum said...

I tried to read GCBC. IWSLIFA (it was so long, I fell asleep).

Unfortunately, Toban Wiebe's cliff notes version at http://higher-thought.net/wp-content/uploads/Notes-to-Good-Calories-Bad-Calories.pdf is no more.

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Charles Grashow said...

Then - if the eskimos and the aborigines are genetically adapted to this type of diet then of what use are these studies to the rest of the world??

Also - what damage (long term) is being done by people following a VLCHF diet who are NOT genetically adapted?

carbsane said...

I think they are of limited use to the rest of the world. But ...


(1) While the protein intake was high by %, it's not overly high by absolute amount for humans.


(2) It is useful in that it coincides with other clinical data on mixed populations showing improvements in glucose handling with higher protein diets.

Kade Storm A.K.A. Hedonist said...

So what's the question about again? High protein or VLCHF? Because they're two very different ideas.

carbsane said...

I hope to answer this question very soon Kade.

Kade Storm A.K.A. Hedonist said...

Great. Although my response was a rhetorical question directed at Charles since a hypocaloric, proper low-fat, high protein diet of the individuals that has been discussed in this post--and any further speculation on their genetic adaptations to high protein--has very little to do with the long term implications of VLCHF for the greater population.

Sanjeev Sharma said...

GAWWWWWD !!!


he's STILL going on about the tautology thing.


It's like saying the speed skater spins faster not because of conservation laws[0] (which are tautological) but because of the hormones that make the ATP that pulls the arms in.



What's REALLY funny is, some clueless physicists need to agree with him for some personal reason or other and will support him.


No Taubes, It's the CONSERVATION LAW that's the important thing. The molecular mechanisms are one way to APPLY the law, but it's the law that tells you what strategies will work in the end, and it's the law that lets you figure out what went wrong in the end.



holy frickin hell, wadda maroon.


[0] conservation of angular momentum in the speed skater's case, or in the case of a contracting black hole spinning faster, or galaxies spinning faster as they coalesce from a gas cloud. the law is the important thing, the ATP/gravity/electronics or whatever brings about the reduced radius is an application.

carbsane said...

It's interesting how he references this article:

"By 1939, Newburgh’s biography at the University of Michigan was crediting him with the discovery that “the whole problem of weight lies in regulation of the inflow and outflow of calories” and for having “undermined conclusively the generally held theory that obesity is the result of some fundamental fault.”6

As sceptics [sic] pointed out at the time, though, the energy balance notion has an obvious flaw: it is tautological. If we get fatter (more massive), we have to take in more calories than we expend—that’s what the laws of thermodynamics dictate—and so we must be overeating during this fattening process. But this tells us nothing about cause. "



Where are these skeptics? Any letters to editors in journals or manifestos? Didn't think so!

Jane Karlsson said...

That quote of Feynman's illustrates Taubes's problem. Physicists think biology is the same as physics. It isn't, and Taubes will find that out when NuSI gets going. Biology has far more variables than physics. Taubes thinks biologists don't have the ability to experiment, or honesty in reporting results, and of course they do. And it's helpful if they say what they would like the results to have been, because it tells you what people with a detailed knowledge of that field would have expected. As for 'the intelligence to interpret the results', really this is laughable. What is intelligence if not knowledge of the field? It's Taubes who lacks intelligence in that sense, not biologists.

carbsane said...

Let's make it simple for him, shall we? Taubes says a hypothesis must explain the epidemic. Well, every source -- even those used by LC'ers -- shows we are eating more. HOW can his carb hypothesis explain that when we've consumed carbs all along and the shift is a couple three percent either way but more in absolute amounts of everything!

carbsane said...

Gotcha :D

Andrew Dunbar said...

The Aborigines were using their BODY FAT as a major energy source.


Rabbit Starvation only affects persons who are already very LEAN from extended starvation.

Andrew Dunbar said...

Carbsane is totally incorrect to claim that the Aborigines were on a "low fat" diet.

In fact the subjects were obtaining at least 150g of fat per day from their own body fat stores.



Even at the end of the study most of the Aborigines would have have still been at 10-20kg above their ideal body weights. (Desert Aborigines like the study subjects are typically short with very small frames).


"Rabbit Starvation" only affects people who have minimal stores of body fat.

Nigel Kinbrum said...

The word "diet" refers to that which is consumed, not that which someone's body happens to be burning at any given moment. The Aborigines were on a "low fat" diet.

Nigel Kinbrum said...

The word "diet" refers to that which is consumed, not that which someone's body happens to be burning at any given moment. The Aborigines were on a "low fat" diet.

Jane Karlsson said...

Well when you put it like that, it sounds absolutely silly. I suppose Taubes thinks obesity researchers are even sillier.

carbsane said...

Exactly! I've always thought the "we're all eating high fat" by counting what is being burned as "calories in" very ridiculous.

carbsane said...

My title is somewhat tongue in cheek as it would be "starvation" at some point for some/most of them. However the "eating their own fat" is nonsense, sorry.

Nigel Kinbrum said...

Calories in = (Calories consumed - Calories lost in vomit, faeces, urine, breath, sweat etc)
Calories out = Calories burned (i.e. BMR/RMR + NEAT/SPA + TEA + TEF)

Bris vegas said...

I suggest you visit a university biochemistry or food science department and ask the academics their honest opinion of nutrition research. The overwhelming response will be "crap".

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