Perfect Health Diet Evolving??
Note: Some of the graphics I'm going to use in this post aren't great, but I don't think I need make much comment as to the changing picture of the so-called Perfect Health Diet.
Paul Jaminet has called his diet the most scientifically sound version of the paleo diet (small caps). In his tribute to Seth Roberts, Paul wrote:
Paul Jaminet has called his diet the most scientifically sound version of the paleo diet (small caps). In his tribute to Seth Roberts, Paul wrote:
The weaknesses of Seth’s approach to science show up best, I think, in how he ate. Although he considered ours the “sanest” diet book, he didn’t eat our diet. He prized his own experimental results above all else. If an experiment persuaded him that eating something would improve his health, he ate it.
To my mind, this led him on a somewhat fanciful peregrination through dietary parameter space. His approach risked two pitfalls:
- ...
- ... most modern health problems take 60 years to develop. So there was no way for Seth to directly appraise whether his diet would generate good health or poor health; ...
There can be no doubt that Paul believes his diet is backed by these principles, but if it indeed were, why has the diet changed in the span of around four years?
[For some of the reasons I do not believe Paul's diet to be backed by the scientific evidence see: No, Paul Jaminet, the LoBAG Diet Isn't "Close" to the Perfect Health Diet Either (this post contains links to other critiques and/or mentions of the diet). Also this: Perfect Health Diet Macronutrient Ratios ~ Part I: Breast Milk .]
from Fat Head Q&A May 2014 |
There has been a definitive dialing back of the fat content and upping of the carb content -- a 10% swing. Carbs are now 30% vs. 20% while fat has been decreased from 65% down to 55% . This may not seem that consequential, but Paul goes to great lengths to specify optimal ranges for humans based on various rationales. Further, an increase from 20% to 30% of total energy from carbs constitutes an increase in the absolute carbohydrate intake of 50%. The decrease in fat content is less pronounced on an absolute level, but significant nonetheless.
The Evolution
2010 e-book
Kindle Version (2011) of the Original Late 2010 Paperback
New Late 2012 Scribner Edition
2014 Version from Perfect Health Diet Retreat
Now, to be fair, these recommendations are similar to the 2012 book ... but in contrast to the infographic presented several times on the pages of that book. Indeed the ranges of macros in the book go even higher on the carbs and lower on the fat. (Beginning at Kindle location 203)
The Perfect Health Diet in Brief The Perfect Health Diet is, by calories, a low-to-moderate-carbohydrate (20 to 35 percent), high-fat (50 to 65 percent), moderate-protein (15 percent) diet. However, by weight, the diet is about 65 percent plant foods, 35 percent meats and oils.Again, it would be nitpicky in general were someone to point out inconsistencies in, say, the diet of a general population. These are "edicts" for "perfect health" however, based on years of research of human evolution and physiology. As such, they should not be evolving.
DO eat:
• About one pound per day— roughly, four fist-sized servings —of “safe starches ”: white rice, potatoes, sweet potatoes, taro, winter squashes, and a few others. Add up to another pound of sugary plants— fruits, berries, beets, carrots, and such— and as many low-calorie vegetables as you like. Be sure to include a bit of seaweed, for minerals. In total, you might eat 2 to 3 pounds of plant foods.
• At least a half pound, probably not more than one pound, of fatty meats, seafood , and eggs. Once a week, eat salmon or other cold-water fish for omega-3 fatty acids.
• Eat 2 to 4 tablespoons of healthful cooking oils and fats per day— enough to make your food delicious but not oily. Butter, sour cream, beef tallow, duck fat, coconut oil, olive oil, and tree nut butters are the best fats. Use spices, including salt. Liberally use acids such as vinegar, lemon juice, and lime juice.
• Adjust the amount of food to fit your appetite, but keep these relative proportions of plant and animal foods. Adjust the proportions of fat, starch, and protein to make your food as delicious as possible.
The new graphic is now 3 pounds plants, 1 pound meat on the top end, while meat minimums have been raised to 0.2 lbs from 0.5 lbs (an increase of 40% of the previous minimum).
Some Strange Things:
- Honey, which is 50% fructose (calculated from sugar breakdown and assigning half of sucrose to fructose from here) is up there on the leaf with "non-fructose sweeteners". Honey is a very recent addition to the PHD for sure! PHD has always included verbiage on the toxicity of fructose, a la the man himself, Robert Lustig. Combined with the specific 1 pound recommendation for sweet plants, it seems an odd turn.
- Butter is the first fat -- pay no attention to its dairy derivation I suppose. Of all the so-called neolithic foods, dairy remains the one that we can be pretty sure humans rarely if ever consumed post weaning.
- Including fats in flavorings makes sense for a "balanced diet" (e.g. one where you use a pat of butter as a condiment). But the high end of 4T refined fats to round out the caloric needs of a diet limited in carb and protein? That's one-quarter cup of added fats. Not paleo, and not backed by evolution.
- I just think it is hilarious that a line is drawn between a peanut and a walnut or almond. One is a "never eat" legume, the others are "pleasure foods" alongside chocolate and dairy and sweets. The nutritional profiles of these three foods are quite similar (from here, here and here) and all the so-called evils of legumes are present in nuts and other PHD approved foods.
So meanwhile ....
Paul has made PHD into a full blown business what with luxury health retreats and the like. Ultimately, there is little science or basic human cultural evidence, to back up much of what is put forth in the books. There is some solid stuff in there, but the part that makes it PHD? That is just not there. The diet is really just another collection of rules cobbled together from cherry picked studies and personal preferences. Of all the paleos, he has least claim to the label given the foods advised. That would be fine, but for the fact that he weaves "paleolithic" lore into the rationale for the diet, after all, most of paleo isn't authentic (as much as it even could be) anyway.
It is more than unfortunate that a promising "moderate" approach could go so far off the rails in the name of science.
Jimmy Moore and his wife are currently on one of the retreats, and reporting blood glucose readings that are disturbing to them. There was a time when PHD seemed a great stepping stone out of the carbophobic rabbit hole: paleo or otherwise. But the more you look, the more you learn, and the books really paint a much more focused view than his website ever did. It is silly to even think that the metabolic damage (and it is damage, though maybe not permanent) that has been brought on by Jimmy's diet since 2008 or so, exacerbated by the uber extreme hypercaloric high fat diet can be addressed in even a month of a less high fat diet like PHD. Like others, PHD is only likely helpful coming from full on SAD-junk diet.
I'll leave you with this graphic from the 2012 book.
I suppose the Inuit are missing here, but it is clear that nobody reporting data are consuming under 40% carbohydrate. Contrary to Paul's claims, many traditional cultures from where he claims to glean food cues (e.g. Pacific Islanders), traditionally consumed more carbohydrate rather than the high fat diet he espouses. When it comes to self experimentation, it IS these high fat diets that are the self-experiment with no long term track record in free living humans to back up the claims of health ... let alone perfect health.
Comments
There were some excellent folks on that website, but that I consider an incidental feature. As to the crowd it was attracting, it had become a half-way house for certain political and general nutters in paleo transit, engaged in all manner of crazy stuff including the various flavours of body shaming and cheap fringe rhetoric. So, to answer your question: some were just trolling for fun, but some were bat**** for real.
They steer people who don't think much about nutrition, if at all, in a reasonable direction.
Maybe here's some more paleo/primal certified expert advice we should dispense to the public.
To students that have to eat in a cafeteria -
" Try to choose a lean protein with a salad. It may not be grass fed beef but you have to deal with the cards your dealt. Either prepare your own salad dressing the night before with paleo approved ingredients, otherwise you're most likely be served a non certified olive oil dressing that's made up with 40% sunflower oil, these oils can be toxic and are a major contributor to metabolic syndrome and heart disease.
Avoid the croutons at all cost because they are not only made from modern dwarf wheat which can cause leaky gut but they are also coated in toxic industrial seed oils.
The bean option is reasonable but only if they have been through the WAPF process of a 48 hour soak."
Sleep problems are one of the most common ailments in our society but on the internet you have to consult a guru to tell you how to sleep properly.*
In real life if you told your physician "Doc, I'm only getting 7 hours of sleep a night" he would reply "And?"
*Gurus have also devoted their attention to how to poop properly it involves purchasing a special pooping stool.
It is just crying out to be spread onto a healthy slice of slow-fermented bread. Perhaps toasted.
When you've paid mega-bucks for single farm sourced, lightly roasted coffee beans, why would you wreck it by putting butter in it?
My experience suggests that if you do grain, it is better to soak/sour it before use.
That seems to indicate that not all bacteria get destroyed by stomach acid.
Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort
Abstract
Background:
Epidemiologic evidence, reinforced by clinical and laboratory studies, shows that the rich Western diet is the major underlying cause of death and disability (e.g, from cardiovascular disease and type 2 diabetes) in Western industrialized societies. The objective of this study is to document the effects that eating a low-fat (≤10% of calories),
high-carbohydrate (~80% of calories), moderate-sodium, purely plant-based diet ad libitum for 7 days can have on the biomarkers of cardiovascular disease and type 2 diabetes.
Methods:
Retrospective analysis of measurements of weight, blood pressure, blood sugar, and blood lipids and estimation of cardiovascular disease risk at baseline and day 7 from 1615 participants in a 10-day residential dietary intervention program from 2002 to 2011. Wilcoxon’s signed-rank test was used for testing the significance of changes from baseline.
Results:
The median (interquartile range, IQR) weight loss was 1.4 (1.8) kg (p < .001). The median (IQR) decrease in total cholesterol was 22 (29) mg/dL (p < .001). Even though most antihypertensive and antihyperglycemic medications were reduced or discontinued at baseline, systolic blood pressure decreased by a median (IQR) of 8 (18) mm Hg (p < .001), diastolic blood pressure by a median (IQR) of 4 (10) mm Hg (p <.001), and blood glucose by a median (IQR) of 3 (11) mg/dL (p < .001). For patients whose risk of a cardiovascular event within 10 years was >7.5% at baseline, the risk dropped to 5.5% (>27%) at day 7 (p < .001).
Conclusions:
A low-fat, starch-based, vegan diet eaten ad libitum for 7 days results in significant favorable changes in commonly tested biomarkers that are used to predict future risks for cardiovascular disease and metabolic diseases.
Why Are So Many People Saying You Can Eat Like A Pig And Still Lose Weight?
"“Butter is a processed food,” Aragon told me. “If you get most of your calories from processed food you’re already violating hippie rule #1 about avoiding man-made foods.”
On that note, the award for stupidest comment ever about how butter is totally paleo, or something, goes to LOW CARB blogger Jimmy Moore, who tweeted his recommendations for what qualified as “#realfood.” But when he was challenged that eating massive quantities of butter didn’t meet his hunter-gatherer criteria he replied with, “Butter is gathered.”
Butter is gathered? BAHAHAHAHAHAHA!!!! What’s next? Elmer Fudd with his scattergun saying, “Be vewy, vewy quiet. I’m huntin’ butter.”
http://www.thejournal.ie/kerrygold-bulletproof-coffee-1525522-Jun2014/
People in America are putting Kerrygold in their coffee
Why? Erm…to lose weight?"
No mention of whole grains. I imagine the rice was brown, and the wheat flour products were made from wholemeal flour, but why doesn't he say so? Perhaps he's trying to avoid criticism from the scientific community. Even respectable scientists have been fooled by the paleo hype over wheat and phytic acid and lectins and the like.
This is where the AND gets it's corporate funding. No conflict of interest here. /sarc
Abbott Nutrition
National Dairy Council
The Coca-Cola Company Beverage Institute for Health & Wellness
General Mills
Kellogg Company
McCormick
PepsiCo
Unilever
A veritable Who's Who of the junk food industry.
http://www.eatright.org/corporatesponsors/
The Australian Dietetics Association was recommending sugar laden cereals, sweetened yoghurt sugary and confectionery as healthy diets for children a few years ago. It just happened to exactly match the products made by their sponsors.
EVERY major dietitic and nutritition body in the world is heavily influenced by the food processing industry.
Jimmy isn't directly responsible for the training and accreditation of the 72,000 dietitians in the USA. He doesn't obtain millions of dollars of annually from Pepsico, Coca Cola and General Mills to add an air of legitimacy to their unhealthy crap.
You are probably not aware (because you are only interested in exposing "low carb hucksters") that many dietitians and nutrition researchers are gravely concerned with the influence of the food industry on public health policy. T Colin Campbell devoted an entire chapter to this subject in The China Study.
What concerns me is the idiotic notion amongst readers of this blog that the health authorities are giving independent science based advice. They are actually promoting the processed food industry agenda. Whole grains aren't healthy they are merely less unhealthy than refined grains.
Basically now I eat like a chimpanzee (our nearest relative).
I adopted the following changes over about a year:
- Very small quantities (<100g) of skinless chicken or fish.
- No dairy.
- A huge amount of low fodmaps fruit (2-3Kg/day) such as oranges. NO juice only whole fruit.
- Very little grains or legumes (except fresh peas and beans)
- No fatty foods.
- Leafy greens and vegetables. I
One probiotic capsule daily.
A multivitamin.
I have 1-2 bowel motions daily. It literally takes a few seconds to defecate. My stools are very soft and odourless (which means no putrefactive bacteria.)
Note. This isn't a cure just a permanent remission. A few days of ordinary foods will bring back the IBS with a vengeance. It takes a week or so to recover from bad' eating.
I think you can adapt to any fruit if you are patient enough.
Another option is a DIY poo transplant. Unless you live in Australia you can't get it legally performed by a doctor.
The ONLY way to improve your gut microbiota is a permanent change to a low fat high soluble fibre diet (or a poo transplant). ..
DOODR - U GOTS LEEKY GUTZ! EAT SUM POO! UR DOG EATZ POOPS SO U SHUD KNO IT'Z GUD!!!
I imagine that's horribly misrepresenting the facts, but still- I imagine that's what most people hear if they can even get past the fact someone is suggesting doing anything with shit besides flushing it.
This comparison unfairly insults pigs
All of the issues I've had the past few years could be totally unrelated to diet - certainly no doctor has been unhappy with my lipids, and hardly anyone thinks that red meat causes anaemia. My urologist targeted the greens I eat as well as the carrots and beets as probable causes of the kidney stone I had, which was the oxalate variety, not uric variety. My pain issues no one has ben able to explain, or want to explain them with structuralism, so I'm skeptical, but may not have a thing to do with diet. Truthfully, it's most reasonable that sitting on my ass 10 - 12 hours a day is what's the matter. But I don't want to be the next example of how "paleo kills" or whatever, so I'm trying new things. I've never really been happy with eating as much meat as I am, and frankly, I also need to reduce my grocery bill.
I'm glad that what you're doing works for you, though. Fruit has been hard for me to eat, well, forever, though, so fruitarianism, for me, seems like a very difficult goal to reach. Truth be told, watching the WFF vids, I'm sort of envious and sort of repulsed.
Here's a real honest question - in all these discussions about health, and how My Plate has failed us, and how Ancell Keys was a megalomaniac liar who doomed us all to certain death, etc, why does everyone miss the fact that a nation gorging itself on McDonalds and "snack cakes" and XXXtra Bold Sour Cream and Bacon Lays is hardly meeting its demise at the hands of the sinister My Plate?
How many people get horribly sick and die from eating moderate amounts of protein, starches, veggies, fruit, and a little dairy? I'd imagine far less then either the Paleo or vegan camps would have us believe.
The list of more unhealthy and more commonly consumed foods than whole grains is very, very long. Perhaps you should start your campaign higher up on that list if you want to sound not crazy.
days with a Waffle Taco and Mountain Dew Kickstart? I think you might
be missing the bigger picture, BV."
Quoted for great justice.
What to do if a Low-Carb Diet Raises Your Cholesterol
"Remove Bulletproof Coffee From Your Diet
“Bulletproof” coffee is very trendy in the low-carb and PALEO communities.
It involves adding 1-2 tablespoons of MCT oil (orcoconut oil) and 2 tablespoons of butter into your morning cup of coffee.
I haven’t tried it myself, but many people claim that it tastes delicious, gives them energy and kills their appetite.
Well… I’ve written a lot about coffee, saturated fat, butter and coconut oil. I love all of them and think they are very healthy.
However, even though “normal” amounts of something are good for you, it doesn’t mean that massive amounts are better.
All the studies showing that saturated fat is harmless used normal amounts… that is, amounts that the average person consumes.
There is no way to know what happens if you start adding massive amounts of saturated fat to your diet, especially if you’re eating it instead of other more nutritious foods. This certainly isn’t something that humans evolved doing.
I’ve also heard reports from low-carb friendly docs (Drs Spencer Nadolsky and Karl Nadolsky. They had low-carb patients with massively increased CHOLESTEROLwhose levels normalized when they stopped drinking bulletproof coffee.
If you drink bulletproof coffee and have CHOLESTEROL problems, then the firstthing you should do is try removing this from your diet.
Bottom Line: Try removing bulletproof coffee from your diet. This alone may be sufficient to solve your problem."
It's post-prandial TG that captures the atherogenic effect anyway. Why do you think people like Dr. Shanahan is disregarding these blood marker and focusing instead on TG/HDL? Because it's one of the few only blood marker that serve low-carbing well.
http://www.foodnavigator-usa.com/Markets/Dietary-Guidelines-put-industry-interests-before-public-health-Harvard-professors
The current research supports a diet of fruit and vegetables with NO animal products, limited whole grains and no refined carbohydrates.
Dairy also has a very high Zn-Cu ratio. Many years ago it was found that a high fat diet causing heart disease in mice didn't do so if they were given extra copper. So it looks like the problems with dairy can all be traced to refined carbs.
There is no know case of any disease being transmitted by a medically supervised faecal transplant. [Over 20,000 performed in the past 50 years]
They are performed routinely in Australia by Professor Thomas Borody.
Veges are much cheaper than meat.
'The result was very remarkable. Disease was abolished. This astonishing
consequence, however, must be given in McCarrison's own words in the first of
two lectures given at the College of Surgeons in 1931.
"During the
past two and a quarter years there has been no case of illness in this
'universe' of albino rats, no death from natural causes in the adult stock, and,
but for a few accidental deaths, no infantile mortality. Both clinically and at
post-mortem examination this stock has been shown to be remarkably free from
disease. It may be that some of them have cryptic disease of one kind or
another, but, if so, I have failed to find either clinical or macroscopical
evidence of it."'
http://www.soilandhealth.org/02/0203cat/020301wrench/02030100frame.html
"Milk REDUCES bone density. Your best source of calcium is leafy greens."
Think so?
Since this claim is so frequently made, it's worth addressing this vegan error.
Dr. Herta Spencer, of the VA Hospital in Hines, Illinois, explains that the animal and human studies that correlated calcium loss with high protein diets used isolated, fractionated amino acids from milk or eggs:
http://jn.nutrition.org/content/116/2/316.full.pdf
Her studies show that when protein is given as meat, subjects do not show any increase in calcium excreted, or any significant change in serum calcium, even over a long period:
http://ajcn.nutrition.org/content/37/6/924.full.pdf
Other investigators found that a high-protein intake increased calcium absorption when dietary calcium was adequate or high, but not when calcium intake was a low 500mg per day:
http://onlinelibrary.wiley.com/doi/10.1111/j.2164-0947.1974.tb01584.x/abstract
So meat alone will not help build strong bones. But meat plus dairy is
an excellent combination. The following list illustrates the difficulty of obtaining adequate calcium from Bris Vegas' green leafy vegetables or legumes, and contradicts the oft-repeated vegan claim that leafy greens and legumes supply more calcium on a per-calorie basis. The opposite is the case:
Food..................Kcal/100g......Ca in mg/100g.....Ca/Calorie Ratio
Cheddar cheese....402................718.......................1.8
Whole milk...............66................117.......................1.7
Spinach....................91.................93........................1.02
Lentils.....................106.................25........................0.23
∴ The amount needed for RDA (1,200mg):
Cheddar cheese............170g (about 6 ounces) = 680kcal
Whole milk.....................1,000g (about 4 cups) = 660kcal
Spinach..........................1,300g (about 13 cups) = 1,200kcal
Lentils.............................4,800g (about 32 cups) = 5,100kcal
We can see that the RDA for calcium can be met for under 700kcal using cheese or milk, but requires 1,200kcal for spinach and 5,100kcal for lentils. I think we can safely say that not even the most dedicated vegans could choke down 13 cups of spinach or 32 cups of lentils per day. AND—leafy greens present additional problems because they contain—straight from Mother Nature—calcium-binding oxalic acid.
Further: calcium assimilation requires not only adequate protein but also fat-soluble vitamins A, D, & K₂, found only in animal fats. The lacto-ovo vegetarian consuming butter and full-fat milk—as in the case of Ms Karlsson—will take in the types of nutrients needed to maintain healthy bone mass, but not the vegan.
Only what was available in Africa? Which parts of Africa?
http://www.bradshawfoundation.com/journey/
By current research, you mean what? Science and research show that there are many possible diets that are healthy and nearly all of them utilize animal foods albeit sometimes in small amounts. The "bad" diets seem to be those that try to eliminate an entire food group, whether that be animal or plant, fat or starch, or whatever (hint,hint). And then, to make matters worse, further compound ill-advised choice by adding a missionary zeal and righteous rigidity to what should be a joyously open and happy event, namely eating.
Chapter XIV
The Food of the Hunzas
http://www.soilandhealth.org/02/0203cat/020302rodale/02030215.html
Chapter XV
The Health of the Hunzas
The Secrets Of Sugar (Full Documentary)
http://www.ncbi.nlm.nih.gov/pubmed/8618945
b. Yes, the balance between Ca and Mg is very important. A high intracellular Ca-Mg ratio seems to be a feature of metabolic disease. Mg makes ATP which pumps out the Ca.
But then, oxidative stress is also a feature of metabolic disease, and Mn and Cu activate important antioxidant enzymes. You aren't concerned about that, I suspect, because you are scared stiff of Wooo. Don't worry, everybody else is too.
other characteristic of the dairy foods may have contributed to the elevated risk. ... Some of the classical experiments on copper deficiency were done by feeding the
animals milk diets. ... the higher fracture rate in nurses who consume more dairy calcium may have been
from a concomitantly lower copper intake.'
http://www.ars.usda.gov/Research/docs.htm?docid=10866
b. Is it "a stretch" to think that milk is any good for anyone
other than babies"? Let's compare milk's role as a food for infants vs non-infants:
"Human Milk. The lower limit of dietary carbohydrate compatible with life or for optimal health in infants is unknown. Human milk is recognized as the optimal milk source for infants throughout at least the first year of life and is recommended as the sole nutritional milk source for infants during the first 4 to 6 months of life...
Over the first 6 months of life, the volume [of breast milk] consumed is about 0.78 liter/d; therefore approximately 60g of carbohydrate represents about 37 percent of total food energy. This amount of carbohydrate and the ratio of carbohydrate to fat in human milk can be assumed to be optimal for infant growth and development over the first 6 months of life." [USDA. Dietary Reference Intakes; Chapter 6: Dietary Sugars and Starches. (p.281)]:
http://www.nal.usda.gov/fnic/DRI/DRI_Energy/265-338.pdf
So does this mean that once past the first 6 months milk intake should be stopped? Certainly not!— from now on milk's role shifts from being the sole optimal food source, to being the ideal supplementary food—for children, for youth, and for everyone else (and those who can't handle lactose will of course still benefit from the various products of milk):
"The most marked deficiency of milk is its content of iron, which is very low. The newborn mammal is provided with a store of this element in its tissues, sufficient to tide it over the period while it is on an exclusive milk diet, but if a child were confined too long to milk as its sole food it would suffer from anemia for lack of iron...Milk is too bulky to be satisfactory as the sole food for the adult, because of the difficulty of taking a sufficient amount to cover the energy requirements. It is therefore to be valued essentially as a food for supplementing other foods and for specifically correcting their deficiencies. The striking fact brought out by modern nutrition investigations is that most animal and vegetable foods are singly or collectively faulty in sufficient degree to interfere seriously with the physical development of the young —and to lead to early deterioration of the adult...For this purpose—[compensating for the deficiencies of most animal and vegetable foods]—milk is truly the ideal food."
[E.V. McCollum. The Newer Knowledge of Nutrition. Macmillan.
p.149-150]
Thus I am persuaded that those who believe that "fortified" so-called almond-milk, or so-called soy-milk [i.e., soybean juice] are not merely equal to but even superior to real milk are, to put it kindly, verging on an error.
An Interview with Dr. Lester Breslow
"Throughout much of his work, an emphasis on individual initiative in health behavior change is evident. Breslow believes that an overemphasis on individual responsibility instead of societal responsibility leads to “victim blaming.” “In the report on Health Needs of the Nation for Truman in 1952,” he said, “we delineated the issue quite clearly. People make choices. You and I can decide each day on positive health behavior or negative [health behavior], though most [behaviors] become ingrained in us as habits. Such decisions are not made nor habits developed in a vacuum, but in a social context in which we live. If people live with smokers, smoking is more likely; if people live with exercisers, they tend to exercise. Social factors, advertising, availability, are all determinants of each individual’s choices. As public health workers, we should make it clear that people do have choices, but they exercise them mainly under social influences.”
At the end of his book Health and Ways of Living,3 Breslow specifies that social action is necessary to influence health-related behavior decisions—social interventions will be more practical and efficient than individual ones. “An example of that,” he said in the interview, “is the successful tobacco smoking control PROGRAM in California. A great effort of volunteers, public health, and medical people was instrumental in passing legislation as an initiative. A tax of 25 cents per pack is for specific hospital, medical, and other services, with 20% for interventions encouraging people not to smoke. The program involved a very broad network: school, work, health department, state, community organizations, [and] media. Projects spreading the word in neighborhoods, as well as use of mass media, were quite effective. The whole milieu about smoking was being changed, reversing the general tolerance of it. In government offices, smoking was prohibited, in workplaces and in restaurants and bars smoking was also prohibited. So there is progress to making smoking unacceptable.”
"In conducting social interventions, there is the potential for conflict between personal autonomy and the common good. Is it right to make laws on personal health choices when such decisions can improve the health of the whole society? Some have referred to this as “health fascism,” an observation that drew laughter from Breslow. “Such laws can appropriately be passed when individual behavior is a hazard to someone else,” he said. “For example, secondhand smoke kills people and causes disease. Laws may be passed to protect people who may be exposed in the workplace, such as flight attendants. Yes, it is appropriate when one’s individual behavior imposes a risk on other people.”
Breslow is a person who practices what he preaches. He has learned from his own research. This is exemplified by his personal interests and hobbies. “You should know I am in my 86th year. I walk 2 and a half miles for 45 minutes 5 days a week,” he said. (Three years later, aged 89, he reports still walking 5 times a week.)
“Two years ago I had a heart attack. People ask, how come? I answer, for the first 50 years of my life we didn’t know the reasons for them. I garden, raising vegetables and fruit. You should have seen the figs this morning. Also in season we have oranges, lemons, plums, peppers, tomatoes, beets, etc. I am married, have children, grandchildren, and two great-grandchildren ages 6 and 3.”
http://heb.sagepub.com/content/26/1/121.full.pdf+html
Personal Responsibility for Health?
A Review of the Arguments and the Evidence at Century’s End
http://www.nytimes.com/2012/04/15/health/lester-breslow-who-tied-good-habits-to-longevity-dies-at-97.html?_r=1&
Lester Breslow, Who Linked Healthy Habits and Long Life, Dies at 97
a. Your link's abstract does not say that the fat fed to the rats was lard. Indeed, the fats actually used, said Wapnir in his later paper [below], were fractionated:
"...free palmitate (16:0) and stearate (18:0) reduced considerably the rate of copper removal from the jejunal lumen, whereas free caprylate (8:0) and caproate (6:0) had no effect."
[Note: "free" palmitate or stearate or caprylate or caproate ≠ dairy fat]
b. Furthermore: while your copper expert may have found some problems re reduced absorption of copper with "free" palmitate & stearate, he declared in his later paper [below] that with respect to copper, milk was altogether something special:
Raul A Wapnir. Copper Absorption and Bioavailability.
http://ajcn.nutrition.org/content/67/5/1054S.full.pdf
Milk as a special copper source:
"The bioavailability of trace elements in milk is extremely high
for the young of any given species, regardless of the elements’ absolute concentrations. Human breast milk has the highest concentration of copper among mammalian milks consumed by
humans, which generally range from 0.25 to 0.60 mg/L (3.9 to 9.5 µmol/L)... The overall bioavailability of copper in human breast milk has been estimated to be 24%; that of cow milk is 18%. Nevertheless, cow milk can exert a positive effect on the absorption and retention of trace elements—[e.g., copper!]—later in life, above and beyond that achieved by vegetable protein supplementation."
[McCollum's meticulous dietary research way back when led him to the recommendation: "There is no substitute for milk."]
a. With respect to your link: Walter Willett has squeezed out a career's worth of media-ready sound bite associations from the Nurses' Health Study and the male Health Professionals Study. His dietary pronouncements aren't all as dubious as the ones re dairy: "Calcium might be the culprit in prostate cancer??? "Galactose linked to ovarian cancer???
So then: Dairy: good or not good?
Let's compare Willett's dairy/cancer scare-claims to another examination of the evidence which found instead an inverse association of calcium in dairy—but not in supplements—with cancers:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796799/
Q: Which "associations" strike you as being plausible causal factors?
As we might expect of someone at the green pastures of Harvard University, Willett remains conventionally spooked by saturated fat, but he's also subject to what Señor Bris Vegas correctly identified as the "Shangri-La" syndrome—only in Willett's case [along with Ancel Keys] it's applied not to the Himalayas but to the sunny Mediterranean. His visits to the region gave him—as to so many others—an enamored view of all things "Mediterranean". That "Mediterranean Diet Pyramid" of his advises (and he follows) a somewhat lower total carb intake [whole grains, of course] & a heftier fat intake—but only so long as that fat stuck in his walrus mustache comes from plant oils and not dairy fat.
[However, to Willett's credit, he did eventually come out strongly against trans-fats.]
b. Dairy: good or not good? Consider the Calcium-Shift Phenomenon:
Takuo Fujita. Aging and calcium as an environmental factor.
http://www.ncbi.nlm.nih.gov/pubmed/2943880
"Calcium deficiency is a constant menace to land-abiding animals, including mammals. Humans enjoying exceptional longevity on earth are especially susceptible to calcium deficiency in old age. Low calcium and vitamin D intake, short solar exposure, decreased intestinal absorption, and falling renal function with insufficient 1,25(OH)2 vitamin D biosynthesis all contribute to calcium deficiency, secondary hyperparathyroidism, bone loss and possibly calcium shift from the bone to soft tissue, and from the extracellular to the intracellular compartment, blunting the sharp concentration gap between these compartments. The consequences of calcium deficiency might thus include not only osteoporosis, but also arteriosclerosis and hypertension due to the increase of calcium in the vascular wall, amyotrophic lateral sclerosis and senile dementia due to calcium deposition in the central nervous system, and a decrease in cellular function, because of blunting of the difference in extracellular-intracellular calcium, leading to diabetes mellitus, immune deficiency and others."
http://www.ncbi.nlm.nih.gov/pubmed/2943880
'ABSTRACT Approximately 20 years ago a diet high in lard and sucrose was described that produced extensive cardiovascular damage in adult mice. Atrial thrombosis, myocardial necrosis and sudden death were frequent. These experiments were repeated as closely as possible; the adverse effects were prevented by a drinking solution containing 10 micrograms copper/ml. ...'
http://www.ncbi.nlm.nih.gov/pubmed/3157387
This result needs an explanation. We know now that the saturated fat in lard can inhibit copper absorption. There might be other explanations, for instance that the fat increased absorption of iron, which saturated fat is known to do, and this caused copper deficiency.
http://www.ncbi.nlm.nih.gov/pubmed/3373335
b. As you point out, human milk has a lot more copper than cow's milk. Wapnir says about 5 times as much. There really is no getting away from the fact that dairy is very low in copper - butter has none, remember? - and might inhibit Cu absorption too. To me, the solution is to eat dairy with whole grains or legumes, because phytic acid can lower the Zn-Cu ratio.
'...Phytic acid is postulated to enhance Cu utilization by its ability to bind other dietary components, such as Zn, that compete with Cu at the site of intestinal absorption.'
http://www.ncbi.nlm.nih.gov/pubmed/3373335
Phytic acid inhibits iron absorption, of course. It seems not to inhibit manganese absorption much. This means it could in theory correct both the high Zn-Cu ratio of dairy (and meat), and the high Fe-Mn ratio of meat. Perhaps this is how it prevents cancer.
I have heard this kind of thing time and time again. 'Vegetarians have Zn deficiency'. 'Women have Fe deficiency'. 'Old people have Ca deficiency'. No, they don't. They have deficiencies of other things, if they eat food which has had them removed. White flour has added Ca but no added Mg.
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