My review of Sally Fallon Morell's review of Robb Wolf's book and the "Original Human Diet"

Around a month or so ago Sally Fallon Morell, President o the Weston A. Price Foundation, reviewed Robb Wolf's book and gave it a "Thumbs Down".  What's up with her?  Wasn't the response to her President's Message from this past June enough to put her in her place?   I had parts of a post together at that time, but since the full letter wasn't publicly available at the time, and who knows what else was going on, I never published it.  I was going to augment that and include with this, but perhaps another time ... it got too long and convoluted.  Some day ... I make no promises though.  In any case, my link here is now to the full letter for anyone interested, but to sum up she wanted to clear up some myths about WAPF:

• It's not high protein, most do best on 10-15% protein and WAPF diet is small amounts of fatty animal protein, including organ meats, with each meal ... emphasis on fat, while high lean protein depletes Vitamin A.
• It's not low carb.  Some of Dr. Price's studied cultures ate quite high carb diets.
• It's not paleo. 

Thud.  Fallon threw down the hammer of discord.  How dare she!  At the time the cries of "we're on the same side" and "can't we all just get along" were loud and many.  There was also the "she's clueless, nobody eats a low fat paleo diet" attack ... but she was right, and those critics are wrong.   At least about what's out there on paper and written on the web.  You see, she addressed The Paleo Diet™ of Loren Cordain, which does, indeed, emphasize lean protein, and does not use animal fats in cooking, butter especially, as dairy is explicitly excluded.  Now many "paleodieters" as Fallon points out, tout a different version of the diet and call themselves "paleo" -- but, it is just a marketing gimmick.  That folks call themselves paleo and practice other dietary patterns is not a defense, no matter how many times Diane Sanfilippo tries to redefine the term to fit her WAPF-influenced version.

So my guess is that the misdirected response is why Sally decided to read and review the "new guy", Robb Wolf's book ... after all this time.    Robb's book came out in 2010 which by my math makes it only half as old and outdated as Gary Taubes' Good Calories, Bad Calories.   Judging from many of the 'why now?' comments in the social media sphere that Fallon's review provoked, you'd think he wrote the book in a year beginning with a 19 or something.  Robb's name became synonymous with paleo with that book, and just because Diane's book is more popular on Amazon.com at the moment, I think it's fair to say that Robb has yet to relinquish his crown from that coronation.  As his mini-bio on his website states:

Imagine someone having yet to read the book ... curious about what the fuss is all about at this late date?  Like, oh ... say ... me around a year ago?   Or perhaps someone who just now wants to try paleo?  I mean seriously, what if they actually thought to buy the book and read it, here in late 2013, before jumping in.  To the best of my knowledge, it's still for sale all over the place, on the Amazon sales widgets of many blogs (including Diane's!) etc.  There's no disclaimer attached that I am aware of.   Why NOT review the book at any time?   After all, on his  What is the Paleo Diet link, you learn a bit about the diet ... and at the end?  Buy the Book!!  I'll come back to this, but for now, let's just say he's not exactly running away from The Paleo Solution.  So ...

Summary of Fallon's Review:
1.  Too high protein (and dry and bland)
2.  Too low fat, low saturated fat in particular
3.  Robb Wolf is inconsistent and all over the map on saturated fat in the book.
4.  Not high enough in carbs to make up for #2.

The review focuses mostly on the diet provided on page 218.  OK ... I missed this one in the first read through, or I would have noted over time that we now have three versions of *the* paleo diet in the book!  That's right.  Robb describes his first two miracle meals on paleo:  

I bought a pack of ribs from Whole Foods, along with salad fixings. I made a rub of garlic and ginger powder for the ribs and set them baking in the oven. I made a salad of field greens, fennel, and sweet red onions. Two hours later, the timer on the oven rang, and I reset it for twenty minutes to let the meat “rest” (which seemed odd considering it was already dead). When the second timer rang, I cut off a section of ribs and piled my plate high with salad. I garnished the whole mess with olive oil and balsamic vinegar. I ate. And ate, and ate. About six ribs and a pound of salad later I was warmly satisfied, clear headed, and I felt better than I had in years. After one meal. I had no gas, no bloat, and no stomach problems. That night I slept better than I had in recent memory. I woke up the next day rested and not in a fog. I made scrambled eggs with chopped basil and rounded things out with half a cantaloupe. I felt great! I had energy, I could think. I actually felt like I wanted to live.    (pgs. 20-21)

There are no ribs to be had on your first 30 days, however.  Those menus are three meals and a snack and work out to one small fruit per day.  He cooks with olive oil, for example 2 tsp for a pound of beef tip steak, or a "little bit of coconut oil" for a baking dish for a pound of salmon.   In the entire week, you get sweet potato hash at one meal, most veggies are steamed, most eggs are poached or hard boiled, white turkey meat, stewed pork tenderloin, etc.

This still differs considerably from the diet on page 218 that Fallon pans.  That diet comes from Loren Cordain from an article entitled:  The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups.

The gram measures may be deceiving to those that aren't used to them vs. American measures.  This sample day adds up to 321g meat, 333g fish, 988g fruit, 987g veg and 56g nuts (if we count tomatoes and avocados as veggies, 534g fruit and 1441g veg.)   This equates to just about 3/4 pound each of meat and fish, over 2 pounds each of fruit and veggie (or over a pound of fruit and 3 pounds of veggies), and 2 oz nuts.  Yeah ... a pound of broccoli for dinner in addition to a salad seems a bit over the top, eh?  Cordain writes of this diet (in 2002, still this century if that matters to you):

There is now substantial evidence to indicate that the absolute amount of dietary fat is less important in lowering blood lipid levels and reducing the risk for CVD than is the relative concentrations of specific dietary fatty acids.  Low (22% energy) and high (39% energy) fat diets which had identical (polyunsaturated/saturated) (n3/n6) and (monounsaturated/total fat) fatty acid ratios produced no significant differences in total or LDL cholesterol following a 50 day trial.  Hypercholesterolemic fatty acids include 12:0, 14:0, 16:0, and trans-9 18:1, whereas monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids are hypocholesterolemic, and 18:0 is neutral. Omega 3 PUFA have wide-ranging cardiovascular protective capacities including lowering of plasma VLDL cholesterol and triacylglycerol (TG) concentrations.   Consequently, it is entirely possible to consume relatively high fat diets that do not necessarily produce a plasma lipid profile that promotes CVD given sufficient MUFA, PUFA, and an appropriate n6/n3 PUFA ratio relative to the hypercholesterolemic fatty acids.

Although more than 50 % of the energy in the contemporary Paleolithic diet is derived from animal foods, the saturated fat content (7.0% energy) not only falls within recommended healthful limits ( < 10 % energy), but also within limits (< 7 %) for individuals with elevated LDL cholesterol concentrations or CVD.   The dominant fats in the example diet are cholesterol lowering MUFA (17.2 % energy) and PUFA (10.4 % energy). MUFA may also confer additional cardiovascular protective effects beyond lowering serum cholesterol by its ability to reduce LDL oxidizability, a key step in the atherosclerotic process.

Now, this comes out to quite a bizarre diet and version of paleo, but this is what Robb Wolf has IN HIS BOOK.  This is even higher in protein than the 30-35% figure cited by Fallon.  We're talking over 200 grams of protein for a young woman!!  I thought I ate pretty high protein, but that is a lot of protein!!   Did Sally Fallon Morell mischaracterize Robb's paleo diet?  No.  She did not.   Did she err in her own concerns?  I believe so.  Fallon wrote:

... the high protein content, along with vitamin D supplements ... can rapidly deplete vitamin A. When vitamin A is depleted, we are vulnerable to all sorts of medical conditions, particularly autoimmune disease. 

I put this diet quickly into FitDay and here's the micronutrient breakdown.



While RDAs tend to be low, I think folks consuming the above diet, even with Vitamin D supplementation, are safe from Vitamin A depletion.  Sally continues ...

The second danger is a deficiency of saturated fat. Our bodies need saturated fat in large amounts―to build cell membranes for one thing (which need to be at least 50 percent saturated to work properly) and to support hormone formation and the immune system. The fats in Wolf's diet are mostly monounsaturated, with saturated fats comprising a measly 18 grams (just over 1 tablespoon) per day. When we do not get enough saturated fat in the diet, the body can make these from carbohydrates―but carbs are not allowed in the diet either. The result is either severe deficiency in saturated fat (for those with will power to stay on the diet) or bingeing and splurging on refined carbs and foods rich in saturated fat, like chocolate and ice cream.

The above is the stuff of pure fantasy.  Sorry.  And I'll invoke the paleotype's favorite fatty hunter-gatherers on this one!  That's right, the Inuit.  Who don't consume near as high fat a diet as is often portrayed, but are likely well under 10% saturated fat intake because their mainstay seal fat contains only about that much.  Or how about the paleotype's favorite sat fatty hunter-gatherers, the Kitavan.  Yeah, well their long chain sat fat intake is also lacking at ~30% of ~17% total sat fat (roughly only 5%!) I'm surprised Fallon hasn't dispatched a rescue party.   At least the Kitavan have enough carbs to make their own I suppose.... (Shhh!  This paleo diet has over 75g sugars for that!)

Perhaps Robb didn't notice the macro breakdown provided in Cordain's article.   Somehow I doubt that.  But this really matters not, because it made it into his book.  Even considering the somewhat more liberal-with-the-olive oil 30 day menus, Robb's version of paleo is simply not what is portrayed and sold under the term "paleo" these days, and graces the pages of the myriad and sundry cook books (or as popular-guru endorsed products), and this seems to be the rebuttal from those folks.   This may be a fair cry from them, but it cannot be a fair rebuttal for Robb, because he owns this diet.  This version.  In this book.

Now here's the good part if you are into evidence based nutritional recommendations.  The diets in Robb's book resemble the diets used in clinical trials in large part.  Those diets tested in the clinical studies of paleo, use lean meat and use minimal-to-no added fats.  There's no dairy allowed, raw, grassfed, coconut clonked or otherwise.  That's a biggie.  No getting around it.  And speaking of coconuts, I don't see them as their own food group there either.

However small the studies, short duration, limited ... they have all produced some manner of beneficial result despite Fallon's worries over saturated fat deficiency or excessive unpalatable lean animal protein.  Robb's and Cordain's versions of paleo are on the higher end of fat content, but at 7% and 17g, quite low in saturated fat -- as are all clinical paleo diets.

Fat aside, what of the other proscriptions in Wolfpaleo?  No grains.  No legumes.  Because Satan's excrement (that didn't make the book) and all that.  Just before Fallon mentions Wolf's concessions for alcohol and coffee, she writes this:

Other inconsistencies abound: Wolf says grains and legumes are bad because they contain phytate acid, lectins and enzyme inhibitors. Nuts also contain phytic acid, lectins and enzyme inhibitors, but they are allowed. He ignores all the evidence for grain consumption in primitive groups, and the widespread consumption of high-carb foods like yams, cassava, tubers and bananas. Dairy foods are dismissed in one short sidebar as a source of gut-irritating proteins (true, when they are pasteurized), antinutrients (none that we know of in dairy, at least not in raw dairy) and protease inhibitors (none in dairy foods), with no discussion of milk consumption among populations of healthy Laplanders, Mongolians, Southeast Asians, Africans and traditional European societies.

Again, the modern paleos -- the primals if you will -- have largely embraced dairy, especially that which WAPF would approve.  Most are on the anti-O6 kick and still bring up the lectin and phytate thing, but then retire to their kitchens to bake with almond flour ... but I'll concede that on these points, at least, Wolf and Cordain remain pretty resolute.  On paper anyway.

So how about the fallout from Fallon's latest "attack"?  The comments on social media were of the "he has changed his mind", "changed his opinions", "stated on the podcast how his views have changed", etc.  variety.  Such as:

@pauljaminet seems like many of the points she's negative about are ones he has addressed since the publishing of the book
— John Hodorowicz (@johnhodorowicz) November 11, 2013

Earth to paleo community ... In the real world when someone goes to learn about a particular program -- be it diet, fitness or method for counting cards in Vegas -- they generally go to the original source.  No, Sally, nor I, nor anyone else for that matter, need not read every blog post or listen to a bunch of podcasts to glean the nuances of how Robb's opinions or dietary views have changed over the years.  That they should be changing or not, I'll get to, but for now, let's stick with where that information belongs if they did.  The proper way to update written materials is ... in written form.  If it's not time for a new book, then perhaps a formal update?  And I'm not talking about his posts on carbs which in the end didn't say anything concrete other than to bash his readers.

Is paleo low carb?  Supposedly not, and yet here's a screenshot of his front page right now ... what's that on the very first tab there?  (Nevermind that most of the need for Paleologix is geared towards issues some encounter with low carb and high fat diets).  He can go on about macronutrient agnosticism, truth is Robb is still mired in the flawed ideas about carbohydrates and insulin.  But let's suppose someone clicks through the home page to learn more about the paleo diet.  What is it?  Robb has a tab.  Here's the screenshot:

Eat:  Fruits, Vegetables, Lean Meats, Seafood, Nuts & Seeds, Healthy Fats

Avoid:  Dairy, Grains, Processed Foods & Sugars, Legumes, Starches, Alcohol

Just don't ask him exactly what *THE* healthiest way is -- that's all individual now you see.  It's the *ONLY* diet though.  Can't have it both ways.  What if I want more information?  Why Robb wrote a book about it!  Here's how the book is described, today, 11/21/13, on his website:

I wrote a book called The Paleo Solution which went on to become a New York Times Bestseller. This book incorporates the latest, cutting edge research from genetics, biochemistry and anthropology to help you look, feel and perform your best. I am a research biochemist who traded in his lab coat and pocket protector for a whistle and a stopwatch to become one of the most sought after strength and conditioning coaches in the world. With my unique perspective as both scientist and coach you will learn how simple nutrition, exercise and lifestyle changes can radically change your appearance and health for the better.

Now, look at that book there.  Notice a problem with this?  This is not Robb Wolf's Paleo Solution, it is *the* Paleo Solution.    But a more difficult sticking point, still, is the subtitle:  The Original Human DIET.  This is definitive ... as it should be for a diet that's been "old news" for what?  Millions of years now?  The original human diet, if there ever was a single one, was what it was, and to the extent that we know what it was, it hasn't changed in three years (or 30 years or 300 years for that matter).  It is indeed true that new anthropological evidence has surfaced in more recent years and decades to shed light on the composition of this diet ... but the paleos are NOT interested in that because it doesn't fit the anti-grain, anti-legume, general anti-starch basis of "paleo".    No new evidence has come to light about what the paleos portray the so-called caveman diet to be.

In publishing this book, and titling it as he did, Robb sealed his fate, for better or worse, and clearly he's not running away from it or his inflated credentials.  What sort of cutting edge, unique takes from an ... ahem ... former research biochemist turned coach?    Well, I wonder if Sally doesn't read my blog as she highlighted the same passage (blue) that I did in this post:

Palmitic acid is 16 carbons long, fully saturated, and commonly found in palm oil and animal products, including beef, eggs, milk, poultry, and seafood. Palmitic acid has long been implicated in CVD, as it tends to raise LDL cholesterol. Among the saturated fats, it would appear palmitic acid does pose the greatest likelihood of increasing LDL cholesterol. However, palmitic acid has also recently been shown to be vital both to forming new memories and accessing long-held memories. As we shall see when we investigate how our diet has changed, a Paleo diet supplies an adequate amount of palmitic acid for optimum cognitive function while limiting the intake to levels that are not harmful to the cardiovascular system. It is also important to note that excessive carbohydrate intake leads to palmitic acid production. If you recall from the insulin chapter, when liver glycogen is full, additional carbohydrate is converted to palmitic acid. This process appears to blunt our sensitivity to leptin, which then inhibits our satiety to a normal meal. This is the beginning of insulin resistance and is at the heart of the mechanism of how we cease to respond to food by feeling "full."

I won't repeat my post, it might be worth a gander if you're new here.  Basically Robb suffered a bit of a fit of science-y verbal diarrhea here, what with the unreferenced mention of memories and throwing everything out there to see what would stick.  If you're going to bring the science, then bring it.  Otherwise leave your lab tech coat where you left it!   Robb's current "work" with the Reno law enforcement program is aimed at lowering LDL particle number -- through diet and medication.  Try as he might ... a mainstream approach to cholesterol, risk assessment, and yes, management.  One that Fallon and her organization is at odds with it would appear.  Hence the thumbs down.  This is not to support or vindicate Fallon, because if the Reno program is using a diet inspired by Robb Wolf's book, then it's nothing out of the mainstream and low saturated fat, if not low fat over all.

Bottom line:  If anything had changed since the publication of the book, the current page about the diet, on his website, would be where Robb should guide potential readers as to the what, wheres and whys.  He does not.  Instead, we get the following -- again, current content 11/21/13 --

Saturated fat has been demonized by our health authorities and media. What is the basis for this position on Saturated fat? Are current recommendations for VERY low saturated fat intake justified? How much saturated fat (and what types), if any should one eat? Without a historical and scientific perspective these questions can be nearly impossible to answer. In this paper Prof. Cordain looks at the amounts and types of saturated fats found in the ancestral diet:  Saturated fat consumption in ancestral human diets: implications for contemporary intakes.

That article is not only in stark contrast to everything else that bears Cordain's name, but if he believes it, should be published as a manifesto along with a demand that Wolf publish a disclaimer on Cordain's diet presented in his book!   But Frassetto!  Lindeberg!  Paleo!!!  So Cordain won't, and Wolf certainly won't, and both will simply ignore when paleo becomes synonymous with bacon and butter, not to mention dark chocolate.  Unless and until Cordain comes out, Wolf certainly won't because Loren Cordain was his mentor.  He "studied" under him -- which is a funny thing because Loren Cordain is in the Health & Exercise Science department and has his PhD in Exercise Physiology.  He doesn't even teach a class in paleolithic nutrition ... which begs the obvious question how Robb became a "world leading expert" in such a topic in the first place.

The "paleo diet" traces back to the Eaton & Konner paper, and this version is the one that Cordain sought to bring to the mainstream and is cited in most books.   As recently as 2010, they updated their version of paleo.  Nothing has changed.    Robb couldn't very well have written a book and expected Cordain's endorsement were he to counsel bacon and eggs, prime rib with butter and NorCals.   And he cannot do so front and center on his website either.  For all the tweeting about tequila and going along with the butter and bacon crowd, Robb remains indebted to the version of paleo that got him to where he is.  Because of that, he stands tall upon a house of cards ... or more like sits on a fence ... which someone should remind him tends to not end well for the genitalia the longer you try to do it.

So everyone else can sit around bashing Fallon for her review and making excuses for Robb.  I won't be one of them.   There's one question still on the table here.  It should be simple for Robb Wolf to answer for himself.  What was the saturated fat content of THE paleolithic original human diet, and what were the sources.   To the best of my knowledge he has never answered that ... even with the disclaimer "My current state of knowledge is that ....".

For better or worse, we do know the position of the Weston A. Price Foundation on the topic.  To the best of my knowledge that position has not changed much, if any, over the years.  This is not to agree with all of those positions, but at least they have the courage of their convictions to state their case, unequivocally, and defend it.  Far more than can be said for paleo "leaders" like Robb.

Oh ... you wanted my review of his book?  It's a horrible read, contradicts itself, and includes a ton of opinion as fact and unreferenced information.  This is not surprising as the author was never a research scientist, doesn't know the difference between an experiment and an observational study, falls for all manner of quackery, changes his mind on a whim, and has no special training or demonstrated knowledge of nutrition basics, paleo or otherwise.  There's nothing groundbreaking in the science or nutrition department.  Lastly, any book that contains the term cock-blocked and calls vegans the devil is just one I'd never recommend no matter the author.   Howzzat?

The Original Human Diet is:  high protein from lean meats and seafood ... high low starch veggie ... fruit (? high or low depends on the version in the book) ... low/no starch ... grain and dairy FREE ... period ... and low saturated fat.  Some would even say VERY low.