Paleo Science and the Paleo Diet

There seems to be a wave of insecurity and fear sweeping through the paleo community.  This is, no doubt, due to the fact that "Paleo" has received a bit of mainstream attention of late -- and it hasn't been positive. 

First there's Marlene Zuk's Paleofantasy: What Evolution Really Tells Us about Sex, Diet, and How We Live.  From Amazon:

An exposé of pseudoscientific myths about our evolutionary past and how we should live today.

We evolved to eat berries rather than bagels, to live in mud huts rather than condos, to sprint barefoot rather than play football—or did we? Are our bodies and brains truly at odds with modern life? Although it may seem as though we have barely had time to shed our hunter-gatherer legacy, biologist Marlene Zuk reveals that the story is not so simple. Popular theories about how our ancestors lived—and why we should emulate them—are often based on speculation, not scientific evidence.

...From debunking the caveman diet to unraveling gender stereotypes, Zuk delivers an engrossing analysis of widespread paleofantasies and the scientific evidence that undermines them, all the while broadening our understanding of our origins and what they can really tell us about our present and our future.

From ScienceBlogs (in partnership with National Geographic) we have:  Paleo and woo: Bad company until the day they die.  (or on Science Based Medicine blog here)

There are many fallacies that undergird alternative medicine, which evolved into “complementary and alternative medicine” (CAM), and for which the preferred term among its advocates is now “integrative medicine,” meant to imply the “best of both worlds.” If I had to pick one fallacy that rules above all among proponents of CAM/IM, it would have to be either the naturalistic fallacy (i.e., that if it’s natural—whatever that means—it must be better) or the fallacy of antiquity (i.e., that if it’s really old, it must be better). Of course, the two fallacies are not unrelated. In the minds of CAM proponents, old is more likely to have been based on nature, and the naturalistic fallacy often correlates with the fallacy of antiquity. Basically, it’s a rejection of modernity, and from it flow the interest in herbalism, various religious practices rebranded as treatments (thousands of years ago, medicine was religion and religion was medicine—the two were more or less one and physicians were often priests as well), and the all-consuming fear of “toxins,” in which it is thought that the products of modernity are poisoning us.

Yes, there is a definite belief underlying much of CAM that technology and pharmaceuticals are automatically bad and that “natural” must be better. Flowing from that belief is the belief that people were happier and much healthier in the preindustrial, preagricultural past, that cardiovascular disease was rare or nonexistent, and that cancer was seldom heard of. .....

This TEDx talk by Christina Warriner on YouTube is making the rounds:  Debunking the Paleo Diet 

This all gets a bit circular, but Zuk's book spawned other articles that are referenced by others, etc.  It seems a bit of circle-jerking, to be fair, and yet circle-jerking is a primal paleo activity.  Why even Dr. Oz is getting in on the act -- I presume the community is going to remain true to their derision of Oz and recognize that his featuring paleo as a fad diet is not a positive development.  (Nah ... several linked to the call for testimonials on FB and on their blogs).  And so, there was a piece in Salon:  “Paleofantasy”: Stone Age delusions

Four years ago, biology professor Marlene Zuk was attending a conference on evolution and diseases of modern environments. She sat in on a presentation by Loren Cordain, author of “The Paleo Diet” and a leading guru of the current craze for emulating the lifestyles of our Stone-Age ancestors. Cordain pronounced several foods (bread, rice, potatoes) to be the cause of a fatal condition in people carrying certain genes. Intrigued, Zuk stood up and asked Cordain why this genetic inability to digest so many common foods had persisted. “Surely it would have been selected out of the population,” she suggested.

Cordain, who has a Ph.D in exercise physiology, assured Zuk that human beings had not had time to adapt to foods that only became staples with the advent of agriculture. “It’s only been ten thousand years,” he explained. Zuk’s response: “Plenty of time.” He looked at her blankly, and she repeated: “Plenty of time.” Zuk goes on to write, “we never resolved our disagreement.” ...

And a piece in Slate:  Paleo Diet Is Nonsense Science.  This one is short but hits the jugular with its closing words:

the paleo concept is a marketing gimmick 

that doesn't have much basis

Yep!  This is what people outside the diet cult can see clear as day, and this is what bothers those in the business of selling paleo books and products.  There have been myriad reactions to this seeming onslaught of largely bad publicity.  Many of the commenters are cheering paleo on!  Hey!  They're talking about us, we've "arrived"!!  Paul Jaminet put an optimistic twist on things:

The Ancestral Health Society is forming a new scholarly journal, The Journal of Evolution and Health, to complement its annual Symposium.

It is coming at a good time: when scholars have begun to appreciate the significance of the Paleo/Primal/PHD/Ancestral movement, yet remain unfamiliar with its recent scientific and intellectual developments.

Yes, the scientific hypotheses on which “Paleo” began were flawed (though insightful and scientifically productive); but a newer and better scientific foundation has been developed.

The Ancestral health movement has become popular because it works: it truly does heal and prevent disease, and millions have experienced its benefits. So it is no fad diet, and will not fade away.

I hope that scholars like Zuk and Warinner will continue their engagement with the ancestral health movement, and help us refine the science still more.

I don't think Zuk and Warinner were engaging the paleo marketing klatch, and the problem I see (do please tell me if I'm wrong) is that the science upon which paleo was built was sketchy to begin with.  The various diet books put slightly different spins on the same themes but the fact remains that the "original" paleo diet of no grains, legumes or dairy is too restrictive for mass appeal so, as I'm repeatedly reminded by others, we have templates and frameworks.  This is not an evolution or refinement of the scientific knowledge underpinning the diet.  The paleo diet community does not take into account new information from the scientific community regarding the diet, life and health of our paleolithic ancestors.  They just don't.

Now Robb Wolf took a different tact with his first salvo which seems largely in response to the Zuk and Slate pieces.   Wolf switches the discussion over to that of the scientific testing of "The Paleo Diet" (TM?) and how implementing the diet stacks up against modern commonly accepted dietary interventions for obesity, cardiovascular disease, diabetes, etc.  It's clever, really, to shift the focus away from the scientific points being made by, well, real scientists who study ancient humans not named Grok.  Anyone checking out the social media visuals coming from PaleoFX 13 last week would think that paleo man ate ribs and sausage and chocolate covered bacon and oh my the cooking demos!!   As I've discussed here several times, the small number of clinical trials involving a "paleo" diet have not used anything remotely resembling the high fat low carb version marketed by the big guns.  The best known intervention, Lindeberg, was low cal, low fat and nothing like the various menus and meals I see about the internet.  To be fair, this is the diet Robb outlines (lean meats, fruits, veggies, nuts -- no grains, legumes, dairy) but he doesn't seem too keen on advertising it in the larger almost anything goes paleo community.   Indeed it was like pulling teeth to get Robb to answer the most basic question regarding the diet the Reno FR are following.  Mind you, I didn't harass or pester him.  I asked him once on Twitter and he responded curtly: go ask Specialty Health.  When Charles Grashow asked him, Robb had a little hissy fit about how a second person had asked what nobody before had bothered to!

Evelyn is the only person who have ever asked a similar question, and is the only one to have “stalked” her way through all the material to ask originally “what was the EXACT “paleo diet” used.

Gee.  I actually read the article he links to regarding his great altruistic works with Reno911 and thought to ask what the diet was?  Why not just answer?  Firstly, now we use "stalking" to equal reading links.  Great Robb!  (especially since in his latest he admonishes his readers for not expending enough skull-sweat before offering up an opinion on something ...) .  Secondly, I did not ask for the EXACT diet.  The response was that I wouldn't like it because it's LC ... which has relevance how?  But then I got that the guidelines were general and he's trying to get it more towards Lindeberg-style.  But speaking of helping people, how about maybe there's a guy out there following the paleo diet and not getting miraculous results who might just benefit from knowing that the diet these police and fire fighters are following is not the bacon, ribeye and butter diet they are led to believe it is.  This is about helping people, right?  But I digress ... (sorry, I can't get over his defensiveness on providing simple details on the diet).

If we are talking the "science" of the here and now, then let's discuss that.  The new science of the paleo diet is not going to be found with Paul's wandering further and further into woo woo land with the Paleocene diet notions he apparently discussed at FX and rolled out in his post I linked to earlier.  But more importantly, nobody appears to be testing the high-to-uber-high fat versions of paleo that seem more the norm.  The PHD promotes 60% or higher fat diet, Mark Sisson's fat burning beast is at least that these days, though his recommendations are such a tangled mess of contradictions it is difficult to know what he actually believes anymore.  In the world of Nora Gedgaudas, there's seemingly no reason whatsoever to allow a disaccharide or starch molecule to ever pass your lips, while Paul includes white rice -- clearly a non-paleolithic food, a grain and not a whole one at that -- on his list of safe starches.  Is it any wonder that real scientists are basically ignoring paleo?  The "big tent" philosophy has led to a bizarre cohesion in the paleo community, but Mark Sisson need not be so surprised that Marlene Zuk might get some misguided notions about the diet?  Ummm, Grok on!

To her credit, Zuk doesn’t throw out the idea of evolutionary mismatch altogether (although you could have fooled me). She just rails against “denouncing modern living as unsuitable to our Stone Age genes,” calling for research into “just what parts of that life send us too far out of our evolutionary zone of tolerance,” as if she’s stumbled upon some revolutionary concept. Really, though, we areexploring and identifying the specific aspects of modern life that trigger a mismatch. We are gathering data. Academics and scientists and bloggers and lay individuals are figuring out, in fits and starts and lurches and self-experiments and clinical trials and study analyses, just what works about modern life and what does not work. We’re not resting on our laurels, on our assumptions.

Sorry, gotta chuckle that he's using "mismatches" ... maybe he always has, I don't really recall, but whenever I hear that term I think of Jack Kruse eating a banana on the North Pole in his grassfed coconut shell hut.  with black shades over the windows.   Umm ... and railing against the notion of dishonoring our Stone Age genes?  Puh leeze Mark!  Here is the Primal Blueprint description on Amazon:

The Primal Blueprint is a simple, flexible plan to help you look and feel your best without struggling or suffering, by adapting the simple lifestyle practices of our hunter-gatherer ancestors into modern life. Sisson presents the compelling premise that you can reprogram your genes in the direction of weight loss, health, and longevity by following 10 immutable Primal Blueprint lifestyle laws validated by two million years of human evolution. Weight loss is largely about insulin; moderate your production by eliminating sugar and grains, and you will lose the excess body fat you desire even while eating delicious, satisfying foods. Plus you will improve your energy level, reduce inflammation, and eliminate disease risk. Eating meat, eggs, and a generally high-fat diet not only is healthy but is the key to effortless weight loss, a healthy immune system, and boundless energy.Slowing down your typical cardiovascular workouts, and incorporating brief, intense strength sessions and occasional all-out sprints can produce fitness benefits far superior to workouts that are longer and more grueling-and can eliminate the risk of burnout.

Then go read Mark's article and see if Zuk is really misunderstanding the downtrodden guru.  The gurus are not interested in the science.  Sorry, but they are not.  When I have called them on scientific inaccuracies in their books, they attack me personally rather than debate the science (e.g. stick up for what they have written and show me wrong) or set the record straight for their followers based on new information.  They can't do that because pretty much the science isn't there to justify the gimmickry.  

I've been meaning to share my reasons for submitting a talk proposal for AHS13, and the reasons for my topic selection.  I'll share more of the former at some point, let's see how things go for a while here.  But as to the topic, it is because of the Pima.  The Pima are the unwitting bearers of the torch of all that is wrong with the IHC. That designation, BTW, is not a poke at any organization or individual per se.  It is a fitting description of the circle-jerking, cultish community that uncritically promotes anyone who comes along to use #paleo, #primal and ... have you noticed? ... #ancestral is being embraced more and more in their schtick.   The thing is, if the Pima went paleo, they would likely not thrive.  As I've discussed here many times, probably summarized best here (you can skip the corn - grin), the traditional Pima diet was very close to 80-10-10, and though they were clearly not vegan, that 80 was for carbs, not some low carb NuttyK fantasy.  From this 1991 -- pre-Taubes hackery , mainstream NYT Jane Brody -- piece:  

GOING back to one's roots could soon take on a more literal meaning for the Indians of the American Southwest, as well as for peoples elsewhere in the world who are poorly adapted to rich, refined foods.

For the sake of their health, as well as their cultural heritage, the Pima and Tohono O'odham tribes of Arizona are being urged to rediscover the desert foods their people traditionally consumed until as recently as the 1940's.

Studies strongly indicate that people who evolved in these arid lands are metabolically best suited to the feast-and-famine cycles of their forebears who survived on the desert's unpredictable bounty, both wild and cultivated. ...

... On the Arizona desert, the desirable food ingredients are found in edible parts of such indigenous plants as the mesquite (mes-KEET) tree, cholla (CHOY-a) and prickly pear cactus, as well as in tepary (TEP-a-ree) beans, chia (CHEE-a) seeds and acorns from live oaks. Tribal elders speak fondly of these one-time favorites, which in recent decades have been all but forgotten as hamburgers, fries, soft drinks and other fatty, sugary, overly refined fast and packaged foods gained favor.

Even those Indians who still rely heavily on beans and corn are today consuming varieties that have little or none of the nutritive advantages found in the staples of their historic diet. ...

Posole:  tepary beans and wheat berries

The bolding in the excerpts is mine.  Because long before the great thinkers of the IHC got in the game, real scientists and nutritionists and botanists were looking at the modern problems of the Pima and looking to their ancestral roots for the answers.  While Warinner's critics laugh at her discussion of modern broccoli (and Zuk's references to brussel sprouts) and comment about her looks and wonder over the state of her abs, real botanists have been taking this sort of thing seriously in the case of the Pima.  We don't need to speculate over what paleolithic humans ate to look back less than a century for far more certain solutions.  And yet, the "no legume, starch-is-bad" brigade would outreach to the Pima -- arguably one of the sickest populations on the planet, ravaged by obesity and diabetes -- with their supposedly evolutionary based medicine and dietary prescriptions and proscriptions.   What utter malarkey!   Wheat is murder and legumes are toxic, and yet there's Pima Posole.   There are, especially desert dwelling, traditional cultures around the world for whom legumes are a large part, not just some minor isolated HG tribe that ate "some beans…and a whole bunch of other stuff".   (Wolf's response to the Warinner video).  

Oh but we don't have Pima Success Story Saturdays on any paleo blog, but it's not because they don't exist:

When Earl Ray, a Pima Indian who lives near Phoenix, switched to a more traditional native diet of mesquite meal, tepary beans, cholla buds and chaparral tea, he dropped from 239 pounds to less than 150 and brought his severe diabetes under control without medication. In a federally financed study of 11 Indian volunteers predisposed to diabetes, a diet of native foods rich in fiber and complex carbohydrates kept blood sugar levels on an even keel and increased the effectiveness of insulin. When switched back to a low-fiber "convenience-market diet" containing the same number of calories, the volunteers' blood sugar skyrocketed and their sensitivity to insulin declined.

And Ray's diabetes was actually "cured" because his body is processing carbs well, rather than becoming increasingly intolerant towards them.  I wonder what the "metabolic derangement" Master Mind panel would think of that and it's just too bad he's not in law enforcement in Reno, right?  Because we all know:

The Paleo diet is the healthiest way you can eat because it is the ONLY nutritional approach that works with your genetics to help you stay lean, strong and energetic!    ~Robb Wolf

Just don't ask him exactly what that diet is when put into practice (along with neolithic statins and metformin) because such a question is pestering and stalking.  It is clear that "Paleo" is not a science-based approach, at least not more than a quarter inch beneath the surface.  It is neither rooted in the findings of academic anthropology/archeology, nor does it "evolve" when new information comes forth from that scientific community.  And it is not rooted in sound nutritional science/biochemistry/physiology nor does it "evolve" when "new" information comes forth in that realm either.  I put new in quotes in that last statement because much of the changing paradigm in the IHC, such as it is, is not the result of new scientific discoveries and understandings.  Most of the changes, if any, have come about because folks like myself have debunked the "novel theories" of Taubes and others with quality peer review literature predating most of the books in which these theories are contained.    

So, I'll leave you with this.  Severely diabetic -- aka metabolically deranged -- Pima Earl Ray adopts the ancestral diet of his culture and defeats his diabetes.   Meanwhile at PaleoFX the MasterMind panel on "Metabolic Derangement", pictured at right, was convened.  Left to right:

1.  Jimmy Moore:  A man who has been eating a decidedly non-paleo diet to lose 75 lbs on an 80-85%  fat diet for some 10 months now.  A man who went from only mild metabolic derangement at 410 lbs to near normalcy in 2005 to a "nightmarish"  LDL-P of  almost 3500 (paging Robb?).  Victory Belt will publish a book by him despite becoming metabolically demolished being his only qualification. 

2.  Dr. Cate Shanahan:  At least she's got a medical background, but peddles woo woo and thinks sugar is sticky to the touch because it is glycating proteins in your skin.  Books and website unfortunately littered with woo woo about birth order using celebrity sisters and whatnot.

3.  Paul Jaminet:  An astrophysicist who has now crossed the line into full fledged weight loss and health guru.  He promotes a reasonable diet (especially for someone like myself, not so much for anyone consuming over 2000 calories IMO) in terms of the foods.  However he is venturing further and further into woo woo land and the basic tenets of PHD are speculations that largely do not stand up to scientific scrutiny.  PHD with it's low fruit and relatively high starch (and white rice) content differs most widely from the paleo diet used in the few studies out there .

4.  Dr. Lauren Noel:  If you want to hone your paranoia over toxins, read this webpage.  Don't know much else about her so I'll leave it at that.

5.  Dr. Lane Sebring:  Don't know anything about him but this quote was tweeted out:  "Metabolic derangement is living in contempt of our genes instead of living in harmony with them."  I so hate my genes ;-)

I wonder if any of the above, or any of the myriad other diet gurus, nutritionists, really believe as they purport, in evolutionary or science-based health/medicine/etc.  When it comes to "paleo", an inability to even come to a somewhat cohesive definition of what that even is just makes it seem not.   From a roundup of #PFX13 tweets:  

Wolf:   We (paleo) are being held to standard that current medicine itself is not being held to. #PFX13 @PaleoPhysicians

No, you are not holding yourselves to anywhere near the standard that current medicine holds itself to.  Not even close. 

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Blogstress Note 1:  I am unsure of if or how my underlying frustration, and at times downright disgust, with this community is coming across here anymore.  If folks read my email exchanges with Robb and still feel the crap flung at me as a result of a single WTF tweet is warranted, I can't change those minds and won't waste time trying.  However, I see it as more important now than ever to keep doing what I do here.  There is a  mostly-hidden epidemic seemingly sweeping through the community, one that has popped a brave head out of hiding from time to time, that is only paid passing lip service if addressed at all.  Paleo doesn't help everyone.  Paleo can worsen the health of many in the long run.  Yes, many get healthier on paleo, they also get healthier on other diets.  For many that improvement is temporary.  Others don't even get better before they start getting worse.  There are too many eating disordered (mostly) women both in this community, even leading it that are neither giving nor getting proper care or advice.  There are books to sell, a movement to protect.  I'm pondering how to approach this on the blog, because no matter how I do, it will be met with disfavor and no doubt vitriol from some corners.  But I think it needs to be addressed.  

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Blogstress Note 2:  I am trying out Discus comments on the Blogger blog.  I started this early yesterday, and unfortunately all existing blog comments have temporarily disappeared.  Discus is apparently experiencing some technical difficulties/backlog so it may not be until tomorrow or even Monday that the old comments are imported properly.  Meanwhile, however, I have successfully synced new Discus comments with Blogger so those who have been following my comment feed can continue to do so, though apparently the links will only go to the blog post and not the comment in question.  There is a Discus feed for comments.   If this experiment doesn't work out, I can revert to Blogger comments and all goes back to the way it was, including any new Discus comments so no information should be lost.   If you posted something in the past few days that isn't showing, feel free to repost (or something similar) rather than waiting for the import to be complete.  I think we can handle a few duplicates when all is said and done so no worries .... or I may well migrate to WP.  I'm a creature of habit and even with the shortcomings, Blogger is more comfortable for me at the moment.  We'll see when my schedule frees up.    My hope is that I can have a mostly unmoderated blog with a system that allows for selective moderation that Blogger itself does not.  There are also sharing and voting options that I think may be helpful/fun/different, and the nesting is pretty cool.  Anyway, let's give it a chance and hope for the best!