Saponin Sacrum

direct image link

Greetings! So with time for a little breather, I'm getting caught up on my reading. I've got three books I plan to review and it's a conundrum which to do first, they are all so bad. Seriously, it's not the style or the writing. It's the content that passes for science these days that is just so mind-numbingly abysmal.

The three books are David Perlmutter's Grain Brain, Jonathan Bailor's The Calorie Myth and Chris Kresser's Your Personal Paleo Code.  I'll save Bailor's for another day, but his poor man's version of GCBC somewhat factors into today's post.  I'll also save the reviews of the others for a later date.  For now, let me share my little round about the internet that inspired the post title here ;-)   

When I first saw the cover of Grain Brain, I really thought the book was a spoof.  Speaking of spoofs, my buddy Mike Howard (author of the upcoming Talking Back to Gurus: An Un-revolutionary and Un-Sexy Guide to Fat Loss) has been busy for a while now churning out some fun honest book titles.  Here are three you might enjoy :-)  (links:  GB , GCBC , WB)

      

But getting back to being serious, sadly, Grain Brain is indeed intended to be a serious work.  I have already highlighted how his risk quiz throws fruit in the mix, and you better be drinking your wine though because grapes bad, wine good.  But far more outrageous is Perlmutter's claim that the paleo diet was 75% fat.  

This nonsense was called out recently by James Hamblin in his piece in the Atlantic entitled This is Your Brain on Gluten.   I'm not sure if that article was read very carefully (or fully) by some initially -- as it was quite roundly shared by a number of pro-GB folks on social media, including Perlmutter himself -- but it's actually kind of a hit piece.  Coincidentally Chris Kresser is quoted.  See, there's a reason I call this the Incestral Health Community ... cause it just is.  So here's the rough flowchart of my internet adventures:

Get Kresser's book

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look for general message

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colorful guru formatting mine

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High fat paleo!  I have cracked the code!

I go looking for where he got this from and

I read on about diets of hunter-gatherers

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paleo papyrus formatting mine

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Yeah, repeating a culture for balance on each side of

the micronutrient spectrum is fine

I guess he consulted pullitfromyourpaleonethers.com for facts

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So I get curious about Masai

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Come across something about saponins in a bark tea they prepare

SAPONINS??? TOXINS!!!

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Which led me to Cordain's site

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Which happened me upon this:Spinning Facts to Fit Biases

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The part of the article Gary took issue with:

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The bottom line of Cordain's response:

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Which indirectly brings me back full circle to Kresser

who is quoted in the article:

“It’s important to realize,” Kresser says, “that just because a low-carb diet can help treat neurological disorders, doesn’t mean the carbs caused the disorder in the first place.”   and

Kresser also tells concerned patients about cultures that do just fine on carbohydrate-based diets. “The Hadza of north-central Tanzania and the Kuna of Panama obtain a high percentage of their total calories from foods that are high in natural sugars, such as fruit, starchy tubers and honey, yet they are remarkably lean, fit and free of modern disease.” He also mentions the Kitava in the Pacific Islands, whose diet heavy in yams, banana, and papaya is 69 percent carbohydrate; the Tukisenta in the Papua New Guinea highlands, whose diet is over 90 percent carbs; and the Okinawans, whose diet is “mostly from sweet potato.”

It's a regular who's who in carbophobic paleo hacks and hucksters brought together unwittingly by Hamblin. Kresser Cordain Taubes Perlmutter Kresser ... fry me up some Bacon?

OK ... Let's organize a bit here.

Composition of the Paleo Diet

Chris Kresser has finally come out and put his stamp on the paleo diet. Nevermind that he used to explicitly distance himself from the label, and then only semi-associate himself with it: Beyond Paleo. As the winds of opportunity shifted, so too has Chris. Which is what it is. He seems nice enough, we've had friendly interactions, he even consulted me for help when he was slated to balance the Safe Starches panel out at AHS12. But for all the hedging, he and fellow macrontrient confusion expert Robb Wolf, got together and launched Paleologix. That supplement line is specific to very low carb diets. So instead of eating more carb and less fat, as is supposedly the intent of the template approach, this duo encourages you to suck it up and take their supplements to reach that land of fat burning nirvana.

Speaking of fat burning, Kresser leaves no room for doubt here either. "Fat is the preferred fuel source for the body" and therefore fat should constitute at least 40% of calories in the diet -- 40% to 70%. Gee, that's quite a range there, so 40% or 75 percent more fat to get to 70%, or pretty darned close to doubling the fat content. If it is the preferred source, then why shouldn't everyone eat closer to the pifypn.com figure of 70%?

Fat as Preferred Fuel - A Challenge

I am sick and tired of hearing this nonsense. Back that up with a reference or shut up already. Seriously. All of these folks making that claim are full of shit. No dainty way to dance around that or make it more diplomatic with flowery language. They all just are up to their necks in shit. They made it up. You will not find that in a biochemistry or physiology text. If we're going to pick winners and losers in cellular macronutrient bigotry, glucose wins hands down. There are cells that can't even burn fat while every cell in your body can burn carb, so there's that. Then there's the hierarchy of macro utilization that clearly takes care of carbs and proteins before fats. The only time fat seems to be preferred is in the fasted or starved state when you are burning energy stores. It's as if the worst thing you could do to yourself is eat, which is pretty ridiculous when you think about it.

I've seen some attempt to back up the assertion relating to mitochondrial function and dysfunction and Complex I vs. II and NADH and such. All of which ignores half or more of what's going on and none of which seems to be relevant to the non-diseased or non-genetically mutant state of humans on very high or very low carb diets. In self-published version of Perfect Health Diet, Paul Jaminet claimed that:

"One reason most cells prefer fats to glucose as an energy source is that fats burn cleanly, while glucose, when it is metabolized for energy, produces reactive oxygen species (ROS). These dangerous molecules can damage or destroy cells." {2011 Kindle version, location 630}

But this does not appear to have been repeated in the most recent publication. Kudos for leaving out the glaring errors, but this also leaves out any justification for fat being somehow metabolically preferred. I'll give Paul credit for trying to justify the macros of his diet, but sadly he falls short on all points (I discussed one of these rationales here). I will point out that whatever the paleo diet was or that of traditional cultures are, these have no bearing on the notion that fat is the preferred fuel for cells. Again, I'll give him credit for re-inventing the late Barry Groves' vision that all animals eat HFLC diets, but there is a serious error in that logic (see When is a fat not a fat) .

As to the rest of them, I'm not even seeing the attempt. The WAPF folks talk about the tooth rotting of carbs and glories of saturated fat, others follow their lead and claim we'd die without fat and cholesterol as some sort of proof (I'd point out to them that we'd die just as quickly if not moreso without glucose). They postulate about saturated fat deficiencies while ignoring all manner of populations that had very low saturated fat intake and seemed to manage, not to mention the paleo insistence that our fat intake was much higher in PUFA, and O3 at that, than it is today. Mark Sisson claims the less glucose you burn in a lifetime the longer you will live. Good thing for all of us, Ron Rosedale (the source of this belief) is wrong and we're not transparent, cold blooded, arrested-development-capable, E.coli eating worms. He also claims we're born fat burners and manage to screw it up from there. Again, nothing to substantiate this -- if a baby's metabolism is different in the early days of life, it is generally because it is trying to build its brain and lay down fat. Some who start life behind the ball will even have RQ's greater than 1.00 as a result. But I digress ... Which all this talk about babies and milk steers me back to the point at hand ... or one of them anyway. But before I do, back up your claim Chris, and all the rest of you.

I've had some fun here with what I consider to be one of the best descriptions of the paleo diet ever:

Chucking the many different hunter–gather diets into a blender to come up with some kind of quintessential smoothie is a little ridiculous. (source)

This is essentially what Eaton and Konner (and adopted by Cordain) did with their various versions of the paleo diet, all of which came out in low fat territory.  There is only the one odd-paper out that, oddly enough, rigorous to a fault science journalist Gary Taubes holds out as the one epitomizing fat consumption in the paleolithic in GC,BC.  Still, even that paper put the ceiling at 58% fat leaving one to wonder evermore where, in a book with paleo in the title, Kresser is getting his recommendation for optimum dietary fat content well exceeding that in some cases.   As to the Inuit, perhaps he's confusing the diets of Stefansson and friend, intended to mimic those of the Eskimos ... er ... Inuit ... er ... terms used to refer to the same people!  These two men didn't fare well on the 45% protein diet, suffering from diarrhea and nausea,  and after a just few days upped their fat to around 80% of calories (the rest being mostly protein).  Their diet of boiled or fried beef and lamb differed substantially from Inuit fare of "high" (rotted) raw seal meat.  But far be it for me to expect just a little accuracy in representation!!  

We'll always have the Masai.  

Or will we?  The Masai are not even hunter-gatherers.  They are described in just about every reference I've seen as somewhat of an "outlier" tribe that are pastoralists -- e.g. cattle (and to a lesser extent sheep and goat) farmers.   While followers of Grok's Primal Whey make concessions to dairy, it is indisputable that dairy is a Neolithic food.  The anthropological record is pretty clear and non-controversial on this point -- well except for Dr. Cate and her cave drawings, but I'll go with the real experts on this if you don't mind.

As much as I dislike linking to Wikipedia as a source -- given problems with some articles, etc. -- I make an exception in this case, because their article on the Masai is extensive and fairly well referenced.  I wonder, how many people citing this group have even bothered to read something like a Wikipedia entry before mentioning them in their books, or in debates on the internet.    Chris would appear to have done some research because he references them twice in reference to pre-conception diets which is a bit more than the offhand mention.   Of course the reason folks know about any of these cultures is generally one of three men -- Staffan Lindeberg, Vilhjalmur Stefansson or Weston A. Price.  Not to give short shrift to anyone else, there are more, but these are virtual "household names" in the IHC.    Such would be the case for the Masai:

"Traditionally, the Maasai diet consisted of raw meat, raw milk, and raw blood from cattle. In the summer of 1935 Dr. Weston A. Price visited the Maasai and reported that according to Dr. Anderson from the local government hospital in Kenya most tribes were disease-free. Many had not a single tooth attacked by dental caries nor a single malformed dental arch. In particular the Maasai had a very low 0.4% of tooth caries. He attributed that to their diet consisting of (in order of volume) raw milk, raw blood, raw meat and some vegetables and fruits, although in many villages they do not eat any fruit or vegetables at all. He noted that when available every growing child and every pregnant or lactating woman would receive a daily ration of raw blood."

We learn a few more details on the dietary composition here. That link is not to the full text, but the preview page contains some more detail on the milk in their diet compared to the US -- higher in fat and lower in sugar. But we're talking the ANTI-paleo diet here! A culture that consumes huge quantities of cow's milk and not much more on a regular basis. This amounts to ~3000 cal/day estimated to be 66% fat (so around 220 g fat).  It is difficult to get information on blood, but this source for lamb blood shows it to be a relatively low fat and low carb source of protein.

So while 66% fat is high by general standards, it is not "extremely high", and nowhere near the 90% cited for the Inuit for shock value.  When the high carb cultures cited were in the 20% and even 10% fat range, and the high fat cultures were really nowhere near 90% fat on a routine basis, I'm calling Chris out here for misleading his readers and formulating his general recommendations for fat intake based on dogmatic paleo-lore instead of the science he so often likes to refer.  No, 40-70% when so many hunter-gatherers consume one-quarter to half of the low range, and on the high end you have the Inuit (closer to 55%) and Masai (almost 70%, but not even HG's) , is unacceptable.    Further to the smoothie making, we've kinda run out of the high fat cultures to throw in that blender while there are many more remaining representing the other extreme in fat consumption -- an extreme that, apparently, Kresser doesn't recommend in his "paleo template" to his (accupuncture) patients clients.

The Masai, Saponins, Cholesterol and Heart Disease

Now here's what really caught my eye on Wikipedia -- since we're talking paleo, and when talking paleo, one is always on the lookout for evil anti-nutrients!

Soups are probably the most important use of plants for food by Maasai.  Acacia nilotica is the most frequently used soup plant. The root or stem bark is boiled in water and the decoction drunk alone or added to soup. The Maasai are fond of taking this as a drug, and is known to make them energetic, aggressive and fearless. Maasai eat soup laced with bitter bark and roots containing cholesterol-lowering saponins; those urban Maasai who don't have access to the bitter plants tend to develop heart disease.[National Geographic, Oct. 1995, p. 161] Although consumed as snacks, fruits constitute a major part of the food ingested by children and women looking after cattle as well as morans in the wilderness. [direct link to citation]

Say what?  Let's ignore the fruit consumption by children and women ... what's with these saponins?    I've got a confession to make, but I'm willing to bet others here can relate.  I never heard of anti-nutrients let alone saponins before maybe 2009-2010-ish.  Since then, I think of them as the things that make potatoes toxic!  (Though I've never given it much of a second thought as potato skins are yummy and if anything I remember being taught that the skins were where the nutrition was).   It's funny really, how well accepted potatoes have become ... at least in some corners of paleo given Loren Cordain's position on them.  I'll get to that in a minute, but was this just an offhand comment on Wikipedia?  Well it did come from a 1995 National Geographic so maybe it's folklore.  But further, almost every time the Masai come up we hear rarely hear about their cholesterol levels (they are assumed to be high in most cases) and conflicting information is given about atherosclerosis (more on that in the coming paragraphs) but the big "sell" is that they don't suffer from heart attacks. 

But I feel like a little Reaganesque with "here we go again" regarding the Masai, and cholesterol, and CVD and saponins.  This has been studied.  This is in the literature. A lot.  Where are the paleo-intellectual types when you need them?

Despite their customary diet composed of 66 per cent calories as fat, they have persistent low serum cholesterol and beta-lipoprotein levels. Post-mortem examinations provided direct proof of a paucity of atherosclerosis. Metabolic studies revealed that the Masai absorbed large amounts of dietary cholesterol, but also possessed a highly efficient negative feedback control of endogenous cholesterol biosynthesis to compensate for the influx of dietary cholesterol. Two unusual serum-protein patterns were observed: the presence of a double alpha2 band; and a high level of serum IgA that is apparent at an early age (four years). The high ratios of phospholipid to cholesterol and bile acid to cholesterol in their gallbladder bile explain the extreme rarity of cholesterol gallstones. All these characteristics may reflect a long-term biologic adaptation of the tribe.   (Some Unique Biologic Characteristics of the Masai of East Africa)

A field survey of 400 Masai men and additional women and children in Tanganyika indicates little or no clinical or chemical evidence for atherosclerosis. Despite a long continued diet of exclusively meat and milk the men have low levels of serum cholesterol and no evidence for arteriosclerotic heart disease. The reasons for this disagreement with the popular hypothesis relating animal fat intake to coronary disease are examined. The authors concede that some overriding protective mechanism such as freedom from emotional stress or abundance of physical exercise may be present. They favor the conclusion that diet fat is not responsible for coronary disease.   (Cardiovascular disease in the Masai (Mann)

The lead author on that second abstract is of note because Mann is the researcher oft cited as having conducted autopsies on Masai (Atherosclerosis in the Masai):

Measurements of the aorta showed extensive atherosclerosis with lipid infiltration and fibrous changes but very few complicated lesions. The coronary arteries showed intimal thickening by atherosclerosis which equaled that of old U.S. men. The Masai vessels enlarge with age to more than compensate for this disease. It is speculated that the Masai are protected from their atherosclerosis by physical fitness which causes their coronary vessels to be capacious.

So Mann's Masai consume a ton of animal fat and have low serum cholesterol.  But I guess they didn't do the CIMT for the first study where they cited an absence of atherosclerosis (repeated by HFLC folks) but they had atherosclerotic plaques after all (repeated by the LFHC camp).    

So see?  Moral of the story is low circulating cholesterol levels have nothing to do with heart disease after all, because they got plaques but they didn't rupture but, but, but.  Some might find this exchange interesting ...

What of these saponins?  

Reports of plants added to milk and meat-based soups by the Maasai and Batemi in East Africa support a role for phenolic antioxidants and hypocholesterolemic agents in the diet, and provide explanation of the low incidence of cardiovascular disease of populations that traditionally consume high levels of dietary fat and cholesterol. ... A total of 81% of the Batemi additives and 82% of those known to be used by the Maasai contain potentially hypocholesterolemic saponins and/or phenolics. (Saponins and phenolic content in plant dietary additives of a traditional subsistence community, the Batemi of Ngorongoro District, Tanzania).  

This isn't a peer-reviewed source, but Saponins: Suprising benefits of desert plants (Peter Cheeke PhD, I'd note his field is more in animal nutrition, which isn't exactly human nutrition and anthropology, but a smidge closer than exercise science).

The blood cholesterol-lowering properties of dietary saponins are of particular interest in human nutrition. One of the most prominent research programs on this subject was that of Dr. Rene Malinow at the Oregon Regional Primate Center, whose research (published in the American Journal of Clinical Nutrition in 1997) demonstrated unequivocally the cholesterol-lowering properties of saponins. This desirable effect is achieved by the binding of bile acids and cholesterol by saponins. Bile acids form mixed micelles (molecular aggregates) with cholesterol, facilitating its absorption. Cholesterol is continually secreted into the intestine via the bile, with much of it subsequently reabsorbed. Saponins cause a depletion of body cholesterol by preventing its reabsorption, thus increasing its excretion, in much the same way as other cholesterol-lowering drugs, such as cholestyramine.

Although there are reports of the development of synthetic saponins as drugs for treating high blood cholesterol, yucca and quillaja extracts are natural phytochemicals currently used in foods and beverages and as herbal products. Interestingly, recent research by scientists in Canada and Africa has suggested that the very low serum cholesterol levels of Masai tribes people in East Africa, who consume a diet very high in animal products, cholesterol, and saturated fat, are likely due to the consumption of saponin-rich herbs. [end quotes from Cheeke]

Thus, saponin‐like compounds are a detectable component of the Maasai diet and extracts likely containing saponins do interact with cholesterol and analogues involved in lipid metabolism that have also been proposed to be involved in in vivo mechanisms of saponin induced hypocholesterolemia.  (Saponin‐like in vitro characteristics of extracts from selected non‐nutrient wild plant food additives used by Maasai in meat and milk based soups)

Maybe they're just too obscure a culture after all, and saponins aren't really known for bioactive properties. Nope.  From: Natural products with hypo-glycemic, hypotensive, hypocholesterolemic, anti-atherosclerotic and anti-thrombotic activities

Price et al (91) have authored a review of saponins which are common in the plant kingdom.  Among the diverse biological activities of saponins is their hypocholesterolemic action. Story et al (92) commented that saponin - cholesterol interaction was an important part of the hypocholesterolemic action of alfafa but interactions of bile acids with other components of alfafa might be equally important. Alfafa plant and sprout saponin bound significant amounts of cholesterol. (Links to cited studies:  Price, Story.)

Going down the "related stories" rabbit hole, I came across this:  Natural medicines used in the traditional Chinese medical system for therapy of diabetes mellitus ... gee, if only we knew someone who studied traditional Chinese medicines who had an interest in health and wellness and ....   Oh wait.  There is one, but I guess promoting bullshit remedies like overpriced betaine HCl for mythical low stomach acid and other supplements for dealing with a so-called paleo high fat diet is more profitable.  (Gosh Facebook has given me such a potty mouth ;-) )

OK ... I could go on and list all that came up in a 10 min search on Google scholar and realms it lead, but I think you get the point.  (Incidentally, I don't have time to upload to docs to share, but I have most of the full texts, you know the drill) .  Clearly there is something unique going on with the Masai other than their mostly raw whole Zebu cow milk diet.  Be it genetic adaptation or plant "medicinals" or their physical fitness, any responsible person counseling someone on nutrition should not be drawing from this culture.  Or, allow me to add the caveat that, if they insist on doing so, then they should also do their homework and present something better than a didn't-even-read-Wikipedia-digest version of what is really going on there.  Further, if you're going to insist on attaching paleo to your schtick, then you don't get to use dairy consuming cultures to promote your diet.  Period.  

Moving on ... but staying with the saponins, Cordain makes a huge deal about these and their supposed toxic effects on gut endothelia resulting in the original paleo fake disease:  leaky gut.  (It took a couple of years for the low carb flu to morph into chronic adrenal fatigue diagnoses left and right, or surely that would be the top paleo ailment, keeps the paleo functional medicine "doctors" in business though).   

In The western diet and lifestyle and diseases of civilization, Cordain teamed up with some names that might be familiar to folks reading this (Pedro Carrera-Bastos, Maelan Fontes-Villalba, James H O’Keefe, and Staffan Lindeberg) .  Yeah unfortunately we don't know much, but I (Cordain) will repeatedly make similar claims, as if this were established fact, saponin swigging Masai be damned.

Even Chris Kresser and Mat Lalonde seemed a bit off put by the anti-saponinicity of Cordain! I think Lalonde distilled it down best, where the supposed gut permeability issues are concerned these are claims extrapolated from some in vitro studies on rat cells ... the applicability to the intact human intestinal tract seems dubious at best. Surely that the Masai regularly consume saponin fortified foods -- one might even say that they supplement with saponins -- should at least have caught the eye of Cordain or any of the other paleo so-called scientists and experts at some point along the line.  

Fat Free Brains & Other Paleo Pontifications

But there I was, finding myself following the saponin spoor to Cordain's site, and lo and behold what do I find on his blog?  A letter from Gary Taubes!  Complaining about some other science journalist "spinning facts to fit his biases".  OH THE IRONY!!!   

So in the Hamblin article in The Atlantic, Loren Cordain is mentioned.  I guess this is why Taubes wrote him, as he feels Cordain is misrepresented by Katz?  I don't know ... let's quibble over Katz incredulity at the erroneous claims made by Perlmutter rather than, say, the erroneous claims made by Perlmutter?  Dr. David Katz, I feel your pain.   Did Loren Cordain take issue with Perlmutter's estimation that "the Stone Age diet was 75 percent fat", no, apparently Taubes and Cordain ignored the fact that this is not even in accordance with any scholarly claims (even those made by a PhD in Exercise Science turned paleo anthropology expert).  They took issue with Katz and his response that this is "wildly preposterous" and his query as to where all this fat would come from.  Perhaps Katz implied incorrectly regarding Cordain's beliefs about veggie vs. animal sources of fat, but he's spot on asking.

Wild animals do not contain a lot of fat.  And by fat I mean fatty acids, and also adipose tissue.  Their skeletal muscle is not marbled, and in the regions we humans are thought to have originated from (e.g. not the arctic), body fat for insulation from the cold just wasn't something those animals had a reason to accumulate.  So when Katz exclaimed: 

Virtually nothing in the natural world is that concentrated of a fat source, except maybe for the brain. Maybe if they just ate the brains of animals?

He's not that far off.  We're told that paleolithic humans and hunter-gatherers ate nose-to-tail, and thanks to Mark Sisson's minion to keep track of CarbSane  we know that bone fat rendering was an isolated practice arising in the late paleolithic (after we had figured out how to eat grains and legumes).  So yeah, where did they get the animal fat to get to 75% fat?  Try to track your macros and get to even 60% fat without considerable veggie contributions (avocados, nuts, seeds) or dairy (butter, cream, even milk).  It is virtually impossible unless you favor ground meats that have been fat fortified.  Organ meats?   Of the visceral organs, only the digestive tract is fattier than domestic skeletal muscle (e.g. stomach ~40%, intestines ~80% ← shall we see this served at the Whole9 table at the #mostlypaleowhitepeoplefest??  LOL), which leaves you with the brains and the bone marrow.  Livers and hearts of wild animals are not fatty. Cordain is playing semantics games by claiming brains contain no fat!  Really?  They contain no adipose tissue, yes.  Neither do your bones.  But they contain fatty acids and phospholipids are included in the "fat" content of foods.  Even if you do that, lamb brain is about 63% calories from fat, 9% by weight.  The sat, mono and poly unsat fats comprise 54% by weight of the total fat, cholesterol ~16% leaving the remaining 30% from phospholipids (or other molecules I can't think of that would be classed as fats).    So yeah, Katz was wrong, they should be eating the guts to feed their brains not having the guts to eat the brains -- but either way if they're eating much else they'll be falling way behind meeting their 75% fat quota.   Nevermind the inconsistency of Cordain and his "student" both advocating lean meat consumption in their books. 

I gotta say, Taubes didn't fail to disappoint in his arrogance, but Cordain sure disappointed me by focusing on minutia and seeming to react to the ego bruise from not being interviewed for the piece(?).  Where would paleolithic humans be sourcing their 75% calories as fat as Perlmutter claims?   I suppose he's preoccupied trying to reconcile his cognitive dissonance over myriad and increasing reports supporting much higher starch consumption than any of his studies ever turned up.

Thus ended my trip around the paleonutritionism sphere yesterday.  Off to make some saponin soup.