Gluten-free diet MAY be unhealthy and MAY increase risk of heart attack (or not)

OK, so I made up the quote above, but it captures a certain zeitgeist that’s in the air right now. The media is all too keen to uncritically give gluten-free and clean diets a kicking at the moment, wagging fingers at all those ‘silly people’ who fell for the anti-gluten message even though they don’t have coeliac disease – what fools!

Except, as we have explained in multiple articles on this site, gluten has a far greater reach than that 1% who have classic coeliac disease. Non coeliac gluten sensitivity (NCGS) is a recognised and studied condition, with an estimated prevalence of up to 6% of the population.

And even a cursory look behind these dismissive headlines shows that the studies they are based on add almost nothing to our understanding of gluten pathology, and indeed contradict themselves. Continue reading

Paleo veggies (video and infographic)

MODERN WILD FOOD GATHERING. When you know what to look for there are plenty of edible wild plants out there. How do they fit into a paleo diet?

There have recently been a number of articles making pronouncements on the original paleo diet, as eaten by our paleolithic ancestors. At the end of last year, December 2016, we had…

  • Ancient leftovers show the real Paleo diet was a veggie feast (New Scientist)
  • Secrets of the paleo diet: Discovery reveals plant-based menu of prehistoric man (Eureka Alert)

Then in March this year…

The more recent articles appeared following a paper by Laura Weyrich et al. published in Nature, March 2017, titled Neanderthal behaviour, diet, and disease inferred from ancient DNA in dental calculus. Afifah has written a post about the herbal medicines these Neanderthals were using, and we are going to publish a guest post addressing the vegetarian claim shortly.

The December articles on paleo veggies were prompted by an Israeli study (Melamed et al. PNAS) which identified the remains of a wide variety of plant food remains in a cave in the Levant (modern Israel). The 780,000 years old remains are unusual as plant materials are rarely preserved at such sites, so this paper provides some insight into the plants resources used by our ancient ancestor homo erectus.

The remnants include no fewer than 55  different species including roots, seeds, nuts, fruit and leaves. Many of these resources were seasonal and some required simple processing and cooking. Here is the New Scientist Video that accompanied their article, which, I think you will agree, has a touch of the Blue Peter about it:

You would think from the headlines that evidence that our ancestors ate a wide variety of plant foods is new or somehow overturns Paleo Diet thinking. The media portrays the Paleo Diet as consisting largely of red meat, but that is wrong. Since its inception, proponents of the modern Paleo Diet such as Professor Lauren Cordain have argued that we should be eating more like hunter-gatherers. That has always meant both the gathering part (eating plant foods) as well as the hunting bit (eating animal products).

What is strange about the recent media pronouncements is that the research that stimulated them is perfectly in accordance with Paleo Diet principles. It seems as if the media are spinning these stories for the sake of headlines, which makes them, in the lingo of the day, fake news does it not?

Paleo Veggies

A careful reflection on the details of the foods identified in the Melamed study suggest a number of subtle paleo principles we might all like to take on board:

1. Increase the range of plant foods eaten

Few of us eat as wide a variety of plant foods as these ancient hominids. Modern hunter gatherers also tend to eat a far wider range of plant foods than typical modern humans. Not only does eating a range of plant foods increase the range of phytonutrients ingested, but it also reduces the exposure to the anti-nutrients found in any one plant source.

2. Eat seasonal food

This is really part of eating a wider range of plant foods and means we give our body a rest from any anti-nutrients when that food is out of season. Another plus is that seasonal foods can be higher in nutrients than those that are grown out of season under artificial light: that’s why winter tomatoes and early season strawberries often taste so insipid (taste being evidence of nutrients. Read ‘The Dorito Effect’ for more info on this amazing area of science).

3. Grow your own

Our ancient ancestors couldn’t preserve foods by canning and freezing. The freshest foods you can eat are those that you have just picked from your own garden, minutes before eating them. Here at Rosemary Cottage we grow a lot of our own fruit, berries, and veg (in fact we have a blog just about this here). They are packed with flavour and much higher in nutrients than supermarket varieties which are often picked under-ripe and have sat around for a couple of days on the shelves or have been flown half way round the world in a low oxygen ‘protective atmosphere’. If you haven’t got a garden or allotment you can buy living salads, mustard and cress, or growing herbs which provide the same fresh-food benefits.

4. Eat wonky, small, damaged  and organic veggies

Studies have shown that fruit and veg that have been exposed to harsh environmental conditions often have higher levels of nutrients as these compounds are primarily plant defence compounds. The perfect, class 1 fruit and veg we are offered in the supermarket have been overly pampered, sacrificing nutrients for looks. Many of the phytonutrients in veggies are concentrated in the colourful skins. Cherry tomatoes therefore pack more nutrients per kilo than their larger cousins as they have a larger surface are to volume ratio. Another benefit is that buying wonky veg increases farm profits and reduces food waste.

Organic fruit and veg tends to be less perfect, more blemished, usually class 2. Possibly for this reason they often have higher levels of nutrients (European Journal of Clinical Nutrition)

5. Include close-to-wild foods

It is a fact that many modern fruit and veg have been bred to increase water, sugars and starches and to be less bitter or sour – all of which has diluted the phytonutrients. Consequently, some of the most nutrient dense plant foods are those that have had the least selective breeding such as the following.

  • Leaves: Water cress, rocket, parsley, purslane, coriander leaf, miners lettuce, samphire, seaweed, tea
  • Fruit: Blueberries, red and white currents, blackberries, raspberries, alpine strawberries, olives, capers, sour cherries
  • Seeds: All nuts and seeds, coffee
  • Roots: Salsify, scorzonera, oca, pink-fir apple potatoes, water chestnuts, tiger nuts
  • Shoots: Sprouted seeds, mustard and cress, bamboo shoots, asparagus, sprouting broccoli
  • Flowers: Artichokes, borage, nasturtium, calendula

Many of the above need only be eaten in relatively small quantities as it is often the toxins in these plants that stimulate our immune system, so you don’t want to over do them. (See our post: The chemical warfare on your plate). For example, health benefits of tea and coffee seem to peak at 4 to 5 cups per day and the benefits of tree nuts levels off at 30g per day. In some cases over doing it can actually lead to harm: for example spinach, which if consumed every day can lead to kidney stones due to its high oxalic acid content. Daily juicing of spinach is therefore unwise, despite ‘green smoothie’ proponents waxing lyrical about it. (Read here about some of the problems with oxalates)

I’ve made a nice info-graphic of some wild-like foods you might want to try. Although they are not always easy to come by I have seen all of these in supermarkets or farmers markets over the last year or so. I have several of them in my current garden, and have eaten all of them at one time or another. How many have you tried?

Final thoughts

A little thought about the paleo veg principles above makes it clear why paleo veganism must have been a rare or intermittent occurrence. Few paleo veggies contain sufficient calories to sustain life, and due to their anti nutrients eating them in large quantities or for prolonged periods could easily lead to problems. Furthermore, the wild foods that are sufficiently high in calories (nuts, seeds and some tubers) would need to be available in quantity, year round, or starvation would be a very real risk. Changing availability and seasonality mean it is unlikely our ancestors were vegans for extended periods, although there would no doubt have been times when animal food sources were limited and they would have been forced to get by on plants alone. In short – humans are and have always been highly adaptable omnivores.

Jordan Peterson on Diet and Health

Jordan Peterson (born 1962) is a Canadian clinical psychologist and tenured professor of psychology at the University of Toronto. His research interests include self-deception, mythology, religion, narrative, neuroscience, personality, deception, creativity, intelligence, and motivation. He is a highly cited and respected researcher in his field.

Recently, and much to his own surprise, Peterson has become an internet sensation, appearing all over the alternative media where he is challenging the contemporary narrative on ‘social justice’, free speech and atheism.

He does this with such clarity and insight that his YouTube videos have quickly racked up millions of hits and he has been sought-after for interviews with alternative news shows such as Stefan Molyneux’s FreeDomain Radio, The Rubin Report and The Saad Truth, all of which are intelligent, thought provoking sites, which I also recommend.

To this new-found audience Peterson has brought a much needed paradigm shift in many areas of previously intransigent and polarised debate. In other words, he’s just my kind of man! If you have not heard him speak then I would recommend starting here (over 2 hrs long) or for here for a juicy 20 minute excerpt. His students really rate him, and I am sure you will see why if you listen to the longer interviews above.

The main purpose of this post, however, is to share some specific points that Peterson has recently made on diet and health as they are surprisingly concordant with the approach we advocate on this blog. I’ve selected the relevant clips from his recent live stream Q&A session below.

Peterson recommending regular sleep to improve circadian rhythms, as well as a protein and fat rich breakfast (2 min clip)…

Peterson explaining how a paleo diet helped his daughter and him improve their health (3 min clip)…

Peterson returns to the subject of diet and how his views on it changed (3 min clip)…

There! Isn’t he a good ‘un?

Please do watch the other videos of this man, his new found Rock Star status is justified on the basis of intellectual depth, breadth and honesty. What’s not to like?

2017 January News Round-Up

I’ve been a bit tardy with getting this post out on time, but that lets me sneak in an article from February, which sums up so much of what natural medicine is all about… so lets go!

Plastic chopping boards much LESS hygienic than wooden ones

“Study found that bacteria thrived on plastic boards overnight but died on wood” (Mail Online, Feb 3rd)

Do you remember a few years back the authorities in the UK attempted to ban wooden chopping boards in restaurants, insisting plastic ones were more hygenic? After all, those grooves in the wood must surely harbour many more bugs than a smooth, inert surface of a plastic board, no? Well no. It turns out that there are natural antiseptics in wood that actually make them excellent for food preparation, whereas plastics have no such built in protection.

A similar over-reaction by the authorities in the USA nearly prevented cheese manufacturers from ripening their wares on traditional wooden shelving (Guardian, Jun 2014) Thank goodness that ordinary people put the authorities in their place!

FSA gives cooked carbs a kicking… (try saying that with a mouthful of roast tatties)

“Eating crisps, well-browned roast potatoes and toast that is more than lightly grilled can increase the risk of cancer”  according to a public health campaign by the Food Standards Agency.

When starches are overcooked a potentially cancer-causing acrylamide is produced. I looked into this five years ago, but didn’t write about it, as the science seemed to say that there was no evidence it actually raised cancer risks in humans at the quantities people consumed them. It would have been easy to use it for a bit of carb bashing, but I resisted the urge. Can’t quite believe the FSA has suddenly taken up the cudgel! (The Guardian, Jan 23rd)

acrylamide-intake

Eggs don’t scramble brains

‘Having eggs for breakfast does not increase risk of dementia’ – OK. glad to hear it.

‘…egg intake was associated with better performance on neuro-psychological tests of the frontal lobe and executive functioning.’ Even more gladder to hear it! (Mail Online, Jan 11th)

american-egg-brainSkipping breakfast linked with heart disease and obesity.
Hold it Fido, hold it! They said ‘linked’ not ’caused’…

The Telegraph (Jan 31st) discusses research that found that people that skipped breakfast were more likely to have raised cholesterol and blood pressure. We have written about the topic of meal timing before (see here), and think that breakfast is, generally, a good thing (no!… put down the cereal packet!). However, the science is not unanimous as reverse-causality confounds the picture (i.e. overweight people probably avoid breakfast more often).

Indeed the researchers found that people who skip breakfast tend to eat more snacks, underlining that it is as much about what you eat as when you eat it. The most significant part of the article IMHO is the idea that eating late in the evening or night disrupts body clocks. Screw with your circadian rhythm(s) at your peril.

The article finishes with eight breakfast egg recipes. (Just watch out – they are not all gluten free). Alternatively, here is our ever popular post Ten Low Carb Breakfast Ideas

Paleo diet improves symptoms in Multiple Sclerosis study finds

A small study of patients with relapsing-remitting multiple sclerosis—RRMS— randomly assigned eight to follow the paleo diet, while the remaining nine ate as usual and acted as the control group.

Those on the diet experienced “reduced fatigue, increasing mental and physical quality of life, increasing exercise capacity, and improving hand and leg function.” (Bel Marra Health, Jan 20th)

Microplastics getting to us via seafoods

As the world wakes up to the environmental disaster of half a century of dumping plastic left right and centre, it looks like those microscopic fragments that affect the bottom of the marine food chain are passing up and into us.

“Now we’ve established that they do enter our body and can stay there for quite a while, we do need to know the fate of the plastics,” (Telegraph, Jan 24th)

Old drug being considered for fighting brain cancer by starving it to death.

Knowridge (Jan 11th) covers the possible use of flavopiridol to fight glioblastomas. Why are we interested in this pharmaceutical drug? Because it’s putative mode of operation is by starving cancer cells of glucose – a route which may well be open to a dietary approach . (We are closely following the trialing of the ketogenic diet in cancer treatment, see our post here)

Bring back the Auroch!

You probably wouldn’t want to bump into this fellow when walking in the woods, but that’s just what they are planning in Central Europe!

The Mirror (Jan 10th) has a nice article about a breeding programme attempting to bring back the original wild European bovines from which domestic cattle were reared. This is a real paleo-project as the aurochs, which only became extinct a few hundred years ago, have featured in European mythology since prehistory appearing in early cave paintings as well as Greek and Roman pottery. They are considered a linchpin of ecosystem health.

For a more modest English approach to rewinding, see our article Rewilding our Food about the Knepp Rewilding Project here in Sussex.

Take statins even if you are healthy, say experts (Telegraph Jan 18th)

Really? I mean really?

When Michael Gove said during the Brexit Campaign that people have had enough of experts many laughed. But Brexit then Trump proved that the public no longer accept ‘facts’ sold to us on the basis of appeals to faceless authority. Those days have gone. Citizen journalism is the new kid on the block, speaking truth to power. So here goes…

  • The clinic trial data for statins has never been released. You can’t look at it. Only one ‘expert’ can and his name is Professor Rory Collins FRS. You have to trust him.
  • In trials comparing the efficacy of one brand of statin to another, surprise, surprise, the statin belonging to the company running the trial usually comes out best.
  • Patients, their families and often their doctors witness adverse reactions to statins which disappear when they stop taking them. Experts, however, say there are very few side effects, but for those of you whiners they have a second drug that counteracts the side effects of the first. Eat up your pills like good little health consumers.
  • Experts say that the benefits of statins are “unequivocal”. The British Medical Association, however, begs to differ. The deputy chairman, Dr Chand, himself a victim of statin side effects, warned that giving the drugs to low-risk patients was “a commercialisation device” and not in their interests. Clearly he is no expert ignore him.
  • Last August, a Mediterranean diet was shown to be more effective than statin therapy. But you can’t patent and monetize the Mediterranean diet, so ignore that too.
med-diet-v-statins

An Italian study finds cardiovascular disease patients who consumed this diet were 37 percent less likely to die than patients who didn’t. This effect trounces into the dust the 18 percent supposed reduced risk of death attributed to statins by a 2013 review. read more

“Statins might alter what is written on your death certificate but they are extremely unlikely to change the date.” (Express, Mar 2014)

Vitamin D supplements reduces respiratory infections

In people over the age of 65, acute respiratory infections – such as the common cold, influenza, or pneumonia – can lead to potentially life-threatening complications. In a recent study, participants in long-term care facilities placed on monthly high dose vitamin D supplement had 40% fewer repiratory infections requiring hospital attention than those given placebo. (News Medical, Jan 5th)

Vitamin D supplementation improves metabolic syndrome in mice

Metabolic syndrome can be induced in rodents fed a high fat or high carb diet. However, a new study has shown that the risk is significantly modified by vitamin D supplementation. In a new study (NewsMedical, Dec 22nd) mice given vitamin D at levels equivalent to human dietary recommendations had a reduction in metabolic syndrome.

The beneficial action appears to be via gut bacteria which utilise vitamin D for production of defensins – anti-microbial molecules that help the good bacteria maintain dominance.

“Remarkably, an insufficient supply of vitamin D aggravates the imbalance in gut flora, contributing to full-scale fatty liver and metabolic syndrome.”

That’s all this month folks. Spring is in the air and snowdrops are peeping over the cold ground. UVB 311nm (the light wavelength needed for skin to produce vitamin D) is still a few months off though, so hang tight for a bit.

August News Round-Up

Breast feeding may protect babies from meningitis, blood poisoning and pneumonia.

The Mail (26th August) reports on a study by Imperial College London, which found that a sugar present in the breast milk of roughly half of women (it depends on blood type!) reduces rotavirus and group B streptococcus, as well as boosting a child’s ‘friendly’ gut bacteria, effectively protecting them from these infections. (Also covered in Medical News Today)

Childhood antibiotics increase risk of T1Diabetes

Whilst on the subject of infant gut health… MedPageToday (24th August) reports on a mouse study mimicking typical early childhood antibiotic exposure, which induced altered gut microbiota, T-cell populations, and gene expression which doubled the incidence of type 1 diabetes compared with mice on a low level of antibiotics.

Mediterranean diet more effective than statins

Many newspapers, including The Telegraph (28th August), reported on a study that looked at the impact of the Med diet on survival of heart patients. It found that it cut the chances of early death by 37 per cent (relative risk). Previous research has found just taking statins cuts mortality by 18 per cent, making the Med diet twice as effective… and at least four times as tasty. OK, I made that last bit up.

...and protects against Alzheimer’s and Dementia

Medical Daily (10th Aug) reports on a study published in the journal Frontiers in Nutrition which found that elderly people who eat a Med diet pattern benefit from better brain health.

Paleo diet in healthy people may improve cardiovascular health

A small preliminary trial found that after just 8 weeks there was an increase in the molecule IL10 (interlukin-10) indicating reduced arterial inflammation. For the exagerated headlines head over to the Mail (29th August), or for a more sober reflection try Medical News Today.

Fish oils in brief:

man-on-wheel

The lab rats get their own back!

Ketones improve cognitive function and endurance

Medical Daily (18th Aug) report on a study which found that lab rats made ‘ketogenic’ through calorie restriction and supplementing with ketones had improved cognitive function and exercise endurance. It’s an odd approach, but seems to lend credence to the performance athletes that are using high fat diets for endurance sports. What is remarkable in this study is that the rats were not only ran for longer, but faster too!

This Month’s Guest Publication: NEW SCIENTIST

New Scientist Aug 2016

In our household New Scientist is the only magazine we have a subscription for, and have received the print edition every week for over a decade. We are often struck by how often it covers topics we have just posted about or covered in a talk (i.e. We got there first – high fives!) This month’s editions have had several articles that I think might be of interest to my readers. If you don’t want to buy the print edition their website has some content that is free, although some requires a sign up or subscription, likewise with some of the links below.

1. Sleep disruption and infections  (FREE ACCESS)

I am seeing more and more evidence on the importance of sleep (see our post on Sleep and Health). Here is another bit: a study in which mice were shown to be more susceptible to viral (herpes) infections towards the end of the day, suggesting that late nights, sleep disruption and shift work may make us more vulnerable to infections.

2. Migraines and Salt  (FREE ACCESS)

What is so great about science is that it is always throwing up unexpected results. Here is one of those. It had previously been observed that sodium levels in the cerebrospinal fluid rise during a migraine. High sodium levels make neurons more excitable. So it seemed reasonable to assume that high levels of salt in the diet might be associated with increased, or worse migraines amongst sufferers.

So researchers were surprised, as was I, when they checked the surveys of 8819 adults and discovered the exact opposite – those with the highest levels of sodium in their diet reported the fewest severe headaches and migraines

3. More doubt on vitamin pills  (FREE SIGN UP

Many vitamin pills – taken as an ‘insurance policy’ when there is no evidence of deficiency – may do more harm than good. The latest bit of research is that calcium supplements appear to increase the risk of dementia. One study found a seven fold increase in risk!

4. Archaeology – food for thought

Otzi and Teotihuacan

LEFT: Analysis of Otzi  the 5300 year old, copper age iceman discovered in the Alps twenty years ago, has shown that he was clothed in the skins of many animals: His quiver was made from roe deer, his hat from brown bear. His coat from goat and sheep, leggings from goat leather, and his loin cloth from sheep leather. (FREE ACCESS)

RIGHT: Studies of the ancient Mexican city of Teotihuacan (1st to 4th century) has revealed that they farmed rabbits in large quantities for food. (FREE ACCESS)

5. BAD MEDICINE: Why so much health advice turns out to be wrong (SUBSCRIPTION REQUIRED)

A great article documenting ten major areas of medicine where the conventional thinking turned out to be wrong. I’ll just give you three of my favourites:

  • HEART STENTS
    Rationale: they work in cases of heart attack, so have been assumed to benefit those with stable heart disease, so became common practice from 2004.
    Reversal: Shown not to reduce future heart attacks or death, and may cause harm
  • CANCER SCREENING
    Rationale: Early detection will help intercept the disease before it progresses too far. So Mammograms and PSA testing have been routine since 1980’s
    Reversal: Many false positives lead to unnecessary procedures. PSA testing no longer recommended in the US.
  • KEYHOLE SURGERY for OSTEOARTHRITIS OF THE KNEE
    Rationale: Removing damaged cartilage will (obviously) reduce pain and increase mobility. By 2002 their were over half a million procedures being carried out each year in the US.
    Reversal: Several trials have found no benefit over physical therapy alone.

I hope you have enjoyed these items. If so, leave a comment to let me know. (Or hit the like button if you’re in a hurry!)

January News Round-Up

Which is worse for the heart, sugar or saturated fat?

It’s amazing isn’t it? For anyone who checks literature the answer to this question has been clear for years, but for much of the public and medical community they can’t quite believe it. Medical Daily (January 14th) explains that a review of a half century of data shows that “sugar consumption, particularly in the form of refined added sugars, are (sic) a greater contributor to (coronary heart disease) than saturated fats.” Uh ha. A good one to email to any doubting Thomas you know. The funniest bit of this ‘no sh*t sherlock’ review is that it is came from the Albert Einstein College of Medicine! Who’d ‘ve thunk it?

High Carb v High Fat diet for endurance athletes

As it happens, I’m meeting a young endurance athlete this weekend who is excited about the possibilities of a high fat diet to improve his performance. The work of Jeff Volek (The Art and Science of Low Carb Performance) has demonstrated that high fat diets can offer considerable performance advantages compared to the high-carb approach recommended by traditional sports scientists.

The debate amongst performance athletes has been heated. The Guardian (January 19th) has a nice blog piece on this topic should you want to learn more.

Low fat v high fat weight loss diets

On the general theme of high fat v low fat, BBC Health (January 5th) had a good article considering both. They referred to recent researchers from Harvard School of Public Health in the United States who reviewed 53 weight loss trials involving 68,128 people.

The results, published in the Lancet medical journal, showed that both low-carb and low-fat approaches led to decent weight-loss. But those eating relatively more fat actually lost marginally more weight. Dr Deirdre Tobias, who led that study, said “Fat has been villainised because there’s a mentality that ‘fat makes you fat’. I think our evidence pretty much puts a nail in that coffin.”

Baby develops scurvy from ‘vegan milk’

A highly cited article in The Telegraph (January 21st) reported on a Spanish baby that developed scurvy (vitamin C deficiency), after being raised on almond milk instead of breast milk or formula milk. Breast milk contains vitamin C, and it is added to formula milk but not to almond milk. Glad we know that now.

Modern diets may be destroying our gut microbes ‘over generations’

mouse_neurons_gut_bacteria_595

National Geographic: An introduction to the microbiome provides a good primer on this revolutionary field

The discovery of a new human organ – the microbiome –  is profoundly changing our view of medicine. As one medic recently said: “Who would want to go to mars when we have the microbiome to explore?”

Science Daily (Januray 13th) reports on a recent paper that found a low plant fibre diet in mice led to depletion in gut bacterial diversity similar to the differences seen between industrialised peoples and hunter-gatherers. Interestingly, the low-fibre mice microbiomes did not recover fully when returned to a normal diet, and their offspring had less diversity too. All this suggests that simply eating a better diet may not be enough to restore a fully functioning microbiome.

“The extremely low-fibre intake in industrialized countries has occurred relatively recently,” noted Justin Sonnenburg. “Is it possible that over the next few generations we’ll lose even more species in our gut? And what will the ramifications be for our health?” Simple tweaks in our cultural practices — for example, not washing our hands after gardening or petting our dogs — could be a step in the right direction, and steering away from overuse of antibiotics certainly is, he said.

Human trials of one solution, faecal transplants, are soon to start with the aim of reversing obesity, according to MD Magazine (January 20th) . In another article Infants’ Long-Term Health Affected by Delivery Method and Diet they report on a study that found C-section delivery changed the infant microbiome even more than diet!

Gluten introduction raises babies risk of Coeliac disease

The physicians news journal MD Magazine (January 28th) reports on a Swedish study that looked at the quantity of gluten in the diets of 400 babies, followed for two years. They found that the greater the exposure to gluten the greater the risk of coeliac disease.

Results from other studies have been mixed, but a position paper, published this month by The European Society For Paediatric Gastroenterology, Hepatology & Nutrition recommend gradual introduction:

…consumption of large quantities of gluten should be avoided during the first weeks after gluten introduction and during infancy.

Optimum diet for weight loss and muscle gain?

Recently, I have been researching the importance of dietary protein for muscle health and intend to write a post about it soon. So a piece in The Independent (January 28th) caught my attention. The study they report on claims to have found  the perfect way for men to gain muscle and lose fat quickly: 40% reduction in calories, six day workout routine and increased protein, for a month. In the trial, split between normal and high protein intake, both groups lost fat mass, but only the high protein group increased muscle mass.

The authors point out that the diet is probably too extreme to be maintained in a non-supervised setting. Like most crash diets it is also not suitable for long term weight loss with many studies finding that almost all weight lost is regained in the long run, with no overall benefit. However, raised protein diets are now seen as important from middle age onwards, and have been shown to prevent age related muscle loss. Keep a look out for the article that we are working on re protein and muscle retention.

Paleo or Mediterranean diets to reverse diabetes?

Would you Adam and Eve it? You wait all year for a diabetes diet book to come along, then two arrive at once!

biabetes_diet_books

The Mirror (January 20th) tells the story of Eddy Marshall, director of BBC’s Holby City and Channel 4’s Hollyoaks, who’s diabetes was reversed using a version of the paleo diet, advocated by David Hack, author of a new book ‘The Back to Basics Diet’. I haven’t read it as it is only out this month, but from the Mirror article, it seems to be advocating a proper paleo diet: “organic meat, poultry, eggs, fish, and “plentiful volumes” of vegetables, salads and nuts” to reverse diabetes. Sounds about right to me.

Meanwhile in the DailyMail (January 18th) TV presenter Michael Mosley promotes his new diabetes-busting book. His diet is based around a version of the Mediterranean diet. So what do these two books have in common? Both avoid processed foods, sugar and sweeteners. Both are lowish-carbs. Both encourage real foods such as meat, fish, eggs and vegetables.

BTW: I’m not recommending either of these books – I haven’t read them.

More on diabetes, potatoes and mum’s to be

This month several papers carried the story that mothers that ate more potatoes in the lead up to pregnancy had a higher risk of gestational diabetes. NHS choices (January 13th) critiques the articles. Potatoes or course, are high glycaemic foods, ramping up blood sugar rapidly after consumption. The more portions of potatoes the women ate per week the higher their risk of diabetes. This shouldn’t surprise anyone, as it is basic physiology.

Should you avoid nightshade foods?

Some of my patients need to be on a Solanaceous (nightshade-family) – free diet. This means no tomatoes, peppers, aubergines, chillies, potatoes or paprika. It’s rare to see any articles about this subject, but Health Magazine’s website (January 28th) has a pretty good one on the subject this month. Take a look.

Nitrates and eye health

The Daily Mail (January 15th) reported on a study indicating that dietary nitrates reduce the risk of glaucoma, cutting the ‘risk of a leading cause of blindness by 30%’. Whilst this is interesting in its own right, I thought it was telling that the article only referred to ‘nitrates from green leafy veg’. Nitrates are also found in bacon and cured ham. Why didn’t they mention that? (see our post on pork for more about nitrates in bacon)

Guardian recipes Jan 2016

Recipes

To finish off, here are a few interesting grain-free vegetable dishes to inspire you, courtesy of the Guardian:

“Scientists claim Paleo diet is nonsense” is nonsense

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Did you see these recent headlines? If not take a moment to scan them now.

Whilst The Telegraph managed a restrained “Paleo diet should include carbohydrates to be authentic, say scientists“, many journalists took the opportunity to really put the boot in with “What Paleo diet experts think – and why they’re wrong” (The Guardian), and “Scientists confirm that the Paleo diet is nonsense” (Quartz). Whilst Delish reached fever pitch with “A New Study Proves That “Paleo Diet” Is Total Bullsh*t (Hooray, carbs!)“.

The scientific paper that stimulated this latest round of paleo-bashing hysteria was “The Importance of Dietary Carbohydrate in Human Evolution.” by Karen Hardy et al, published in The Quarterly Review of Biology (the full text is free, so you can read it if you want). In this paper Hardy et al argue that consumption of cooked starchy tubers played a key role in the expansion of the human brain over the last 800,000 years of human evolution. I’ve made a little graphic so you can orientate yourself on the human brain expansion timeline. Hmm. Seems it did a lot of growing prior to that date, but I’ll address the points raised in this paper in future posts, as it provides many good points for discussion, but for now I’d want to examine the may the media dealt with the issue.

About 2 million year’s ago the human brain began an exponential growth in size, unparalleled in the animal kingdom. In their recent paper, Hardy et al propose that from 0.8 million years ago cooked starch-rich tubers may have played a key role in driving this phenomenum. [Diagram adapted by Keir Watson from Le Journal du Net, 2010]

Anyone reading headlines stating that “Scientists confirm…” or “A new study proves…” would be forgiven for thinking that some new experiment or trial had taken place. Unfortunately, Hardy’s paper does not contain any new data at all – so it’s not actually a ‘study’ in any sense. Rather, it presents a new (ish) hypothesis that argues for a particular interpretation of existing data. This isn’t to diminish it in any way – it is a totally valid academic piece which contributes to a large body of thought on this fascinating subject, but as one of the co-authors, Mark Thomas, Professor of Evolutionary Genetics at University College London, says “Our understanding of what paleolithic people ate is hypothesis-rich and data-poor”. As such, Hardy’s paper will be the subject of sober academic reflection and debate for some time to come and will no doubt provide a stimulus for future studies that aim to test the hypothesis through trials or data gathering.

What Hardy’s paper does not do, and cannot do, however, is “prove that the paleo diet is nonsense”. A hypothesis does not prove anything, and as we will see below the idea that humans ate starchy roots is not even a new idea in paleolithic nutrition, despite what the newspapers’ headlines would like you to believe.

What the papers say a paleo diet includes

  • “High in meat, fish and vegetables it largely excludes dairy and cereal or anything else that emerged in the agricultural evolution [sic]…” (The Telegraph)
  • “The theory behind the very trendy high-protein/low-carb Paleo diet is that we should mimic the diets of our Paleolithic ancestors, eating mainly meat, fish, and a restricted list of pre-agricultural vegetables and fruit.” (Quartz)

This is basically correct. Yet that didn’t stop them illustrating these articles with the good old potato – a vegetable that did not exist pre-agriculture!

Humans must have evolved on diets based on wild foods that could be hunted and gathered so Paleolithic foods clearly included wild roots, bulbs and tubers. So how can Harvy’s suggestion that wild tubers may have played an important part in human evolution in any way prove that the “Paleo diet should include carbohydrates to be authentic”? The paleolithic diet has always included carbs as and when they were available. Such newspaper headlines are a non-story.

When Afifah and I gave our first public talk “Ancestral Nutrition” to a packed auditorium in 2012, before the term ‘paleo diet’ was commonly seen in the media, we used the following slide to illustrate what a paleolithic diet looked like:

Hunter_gatherer_diet_foods

The point of this slide is that these foods are available virtually everywhere on the planet to hunter-gatherer populations. These are the foods humans eat. Being omnivores, humans will always exploit the available plant and animal resources in their environment, and this has always included ‘roots’ i.e. tubers, i.e. carbs, where they were available. Hardy’s paper is not controversial for arguing that a paleo diet included tubers. Yet the news papers seem to think it is. Of course the foods missing from the slide above are the real culprits – foods that do not belong in the paleolithic diet – and they are cereal grains, vegetable oils, refined sugar, dairy products, pulses and the huge range of chemical additives now found routinely in processed foods. These industrialised foods have only been in the diet for a vanishingly small fraction of human evolution – about the same short time that the so called diseases of civilisation – obesity, diabetes, cancer, heart disease, acne and dementia – have become leading causes of death and disability. Eschewing these industrial foods, not tubers per-se, is the basis of the paleo diet.

Conflating low-carb Atkins and Paleo:

  • “The paleo diet revolves around the concept that we should eat like our more primitive ancestors did, meaning lots of animal protein and very little carbs.” (Delish)
  • “It’s been a rough year for adherents of the Paleo diet, the meat-forward lifestyle that took Robert Atkins’s ideas back 10,000 years to declare war on carbs.” (The Guardian)
  • “The Paleo diet is in some form like the Atkins Diet in that it encourages greater protein intake and less carbohydrate intake although perhaps it’s better in that more fibre is included,” (The Telegraph)

The idea that a paleolithic diet must be low carb is an inaccurate representation of the background science. It is well recognised that evidence for early man’s reliance on meat is well represented in the fossil record – because bones preserve well – whilst evidence for the use of plant foods (and marine resources) is harder to come by. One way that researchers get round this limitation is by studying contemporary hunter gatherers who act as surrogates for possible dietary strategies from earlier periods of history.

Hunter_gatherer_diet_ratios

This graph was compiled from data on the utilisation of plant and animal resources by a number of contemporary hunter gatherer tribes. The green bars show the percentage of calories obtained from plants. These plant calories would largely be derived from carbohydrates and small amounts of protein, although in some cases they may include substantial amounts of plant fats. For example the !Kung eat large amounts of Mongongo nuts which are high in fat. The animal sources, by comparison, contain practically zero carbohydrates. The average carbohydrate intake was, therefore, somewhat less than 35% of calories, and more than half the tribes thrived on less than 20% carbs. Compare that to the percentage of carbohydrates in the modern Americans diet, which from 1970 and 2005 rose from 44% to nearly 50% [Austin et al, American Journal of Clinical Nutrition, 2011] This increase in carbohydrates went from very-high to extremely-high, coincided, unsurprisingly, with an explosion in obesity and related diseases.

Dr Loren Cordain, who The Guardian acknowledges as “the founder of the Paleo movement”, stated in his 2000 paper in the American Journal of Clinical Nutrition, that compared to typical western dietary patterns, hunter gatherers have “universally characteristic macronutrient consumption ratios in which protein is elevated at the expense of carbohydrates.” He’s not saying zero carbs. Not even low-carbohydrate like Atkins. Just lower carbs and higher animal protein than a typical western diet.

Perhaps more important than quantity is the source of dietary carbs. Paleolithic carbohydrates came from nuts, tubers, fruit and vegetables, rather than from grains that now dominate western diets. Furthermore, Cordain’s rather modest conclusion, that we might be better off eating this way, has been successfully tested in multiple dietary intervention studies, including randomised controlled trials which I will list below.

Studies finding benefits of the paleolithic diet

  • Improvements in diabetes [ref1ref2, ref3]
  • Reduced energy intake in individuals with ischemic heart disease [ref]
  • Successful treatment of epilepsy [ref]
  • Favourable effects on markers of metabolic syndrome [ref]
  • Weight loss [ref]
  • Acne reduction [ref]

Quotations from these studies

Even short-term consumption of a Paleolithic-type diet improved glucose control and lipid profiles in people with type 2 diabetes compared with a conventional diet [ref]

 

Even short-term consumption of a paleolithic type diet improves BP and glucose tolerance, decreases insulin secretion, increases insulin sensitivity and improves lipid profiles without weight loss in healthy sedentary humans. [ref]

Yet despite these findings The Guardian chooses to slate Dr Cordain under the headline “What Paleo diet experts think – and why they’re wrong”. How journalists are happy to state that “scientists prove ‘Paleo Diet’ Is Total Bullsh*t” (Delish) when every trial so far conducted has demonstrated positive effects beggars belief!

Recent research on hunter-gatherer carbohydrate consumption

In their 2011 paper, Diets of modern hunter-gatherers vary substantially in their carbohydrate content depending on ecoenvironments: results from an ethnographic analysis, Ströhle and Hahn found that hunter-gatherers living within 40 degrees latitude of the equator, primarily in desert and tropical grassland, consistently have carbohydrate intakes of 30%-35% of calories, confirming estimates from the Cordain paper mentioned above. However, beyond 40 degrees latitude, the percentage of carbohydrates consumed falls dramatically, reaching less than 15% for hunter gatherers living in tundra and northern coniferous forests. For 50,000 years homo sapiens has survived in regions where routine carbohydrate intake was close to 15% of calories. That’s much closer to Atkins. And many people of European, Native American and Asian descent have inherited a good percentage of DNA from those hunter gatherers.

Typical Western diets, then, are way above the upper range of normal human consumption. Interestingly, the realisation is growing among policy makers that the last 30 years advice to restrict fat consumption may have been counter productive as it led ‘inadvertently’ to increased carbohydrate consumption, which “may have fueled the obesity epidemic” [Do the dietary guidelines have it wrong?, BMJ, 2014]

The newspapers, of course, always look for an attention grabbing headline and have spun the story so they can knock down their own straw man. They can’t help it. It’s in their blood. Unfortunately the public are left with a distorted impression of the science, which does them a disservice.

So were our ancestors “potato heads”?

New_York_Times_tubers

New York Times: “For Evolving Brains, a ‘Paleo’ Diet of Carbs” (Aug. 13, 2015)

 

Finally, almost all of the newspapers illustrated this story with images of potatoes, and to some extent Hardy’s paper encouraged this by referring to the fact that cooking potatoes makes the starch up to twenty times more available for digestion. Indeed, potatoes are very rapidly digested, and produce a rapid spike in blood glucose. But rather than being associated with improved brain function, such high glycaemic index (high GI) meals have been shown to dis-regulate regions of the brain linked to obesity. One example, a 2013 study in the American Journal of Clinical Nutrition, found that compared to a low GI meal, a high GI meal increased hunger, and “selectively stimulated brain regions associated with reward and craving in the late postprandial period”. i.e. made participants feel hungrier sooner and eat more as a result.

Hardy’s paper argues that humans “needed a rich source of glucose (from starch) to fuel the growing brain”. If that were true, then how come we didn’t evolve the ability to avoid the hypoglycaemic crash that follows a high GI meal 4 hours later?

So are potatoes representative of the kinds of tubers that our ancestors ate? And was cooking effective at releasing starch for digestion? Were such tubers anything like the high GI potato the newspapers were promoting?

Fortunately, some very recent research sheds light on this. I’ll look at it in the next post.

The bottom line

  • Compared to the typical western diets, hunter gatherers typically ate higher levels of animal protein and lower levels (sometimes very low levels) of carbohydrates
  • Those carbohydrates were predominately from roots, fruits and nuts, almost never from grains
  • Paleolithic diets have always included tubers where these were available but such tubers were probably quite unlike potatoes

 

August News Round-Up

SHOCK REVELATION: NHS hands out Gluten-free Junk Food on prescription

The biggest laugh of the month has to be the widely circulated story that the NHS is providing gluten-free junk food (cakes, donuts, pizza) on prescription. According to the Telegraph (August 17th),  “One GP called the measures “irresponsible”, claiming some patients were providing a “shopping list” to feed their whole familes.”

Inevitably, backlash from irate coeliac sufferers followed almost instantly. “Patient groups defend NHS spending on gluten-free food for sufferers”, The Independent declared (August 17th).

As I’ve always argued, so called gluten-free products are part of the problem, not part of the solution. Although it is essential that coeliacs have access to gluten-free food they would be far better off adopting a truly grain-free diet, based around real foods such as meat, fish, nuts, vegetables and fruit, rather than the highly processed gluten-free simulacra. The NHS deserves ridicule simply for its failure to promote real food.

Call to switch focus from calories to nutrition to cut CVD

On the theme of real food, the Nursing TImes (August 27th) report on a paper by doctors Aseem Malhotra & Simon Capewell who say evidence shows that poor diet is consistently responsible for more disease and death than physical inactivity, smoking and alcohol put together. I like that!

In an editorial piece in BMJ’s Open Heart they argue that a move away from sugary drinks and towards regular consumption of fish, nuts and olive oil produces cardiovascular benefit in months. In fact they receive the accolade of…

Quote of the month

“Shifting the focus away from calories and emphasising a dietary pattern that focuses on food quality rather than quantity will help to rapidly reduce obesity, related diseases, and cardiovascular risk,”
Malhotra & Capewell, BMJ Open Heart

Sugar

Giving the real-food movement a shot of celebrity TV drama, Jamie Oliver is on the war path as he attempts to argue the case for a sugar tax. According to The Independent (August 27th) in his upcoming TV series Jamie will meet surgeons removing children’s sugar-rotted teeth and performing amputations on diabetes sufferers. The surgeons warn that the NHS will “crumble” due to the accumulating cost of treating sugar-related outcomes.

Sugar as a public health concern is a cause who’s time has come. It’s easy to understand, sufficient scientists have rallied against it, the public are largely on board, and it’s got the ear of politicians. Whilst, of course, I applaud the general direction of this debate I am always wary when an issue becomes a mass media movement. The media wants a simple story, without the subtleties inherent in the science.

An example of this is a study reported in Diabetes in Control (August 20th) that found vegetable oils (corn and soya oil), caused greater obesity and diabetic symptoms in mice than fructose (sugar), whilst highly saturated fats (coconut oil) caused the fewest symptoms. This didn’t make the main news outlets as it’s off-message. You can see the problem can’t you? Who’s going to break the news to Jamie?

Saturated Fat

The Telegraph (August 11th), in a highly cited article, headlines:

Butter unlikely to harm health, but margarine could be deadly

Although traditionally dieticians have advised people to cut down on animal fats, the biggest ever study has shown that it does not increase the risk of stroke, heart disease or diabetes.

Yes, we know that. But good to see the message is gradually getting out. The ‘margarine could be deadly’ bit refers to trans-fats which were indeed in the original margarines of the 1960’s and 70’s. What people casually refer to as margarines now are ‘vegetable spreads’ which don’t contain trans-fats, but instead those vegetable oils we just heard may cause mor obesity than sugar does. But hey ho! – ‘deadly margarine’ makes a good headline!

A more scientific review of this study can be found on Medpage Today and includes some interesting comments from researchers.

Best butter recipes

These recipes also c/o the Telegraph make good use of butter, and are grain-free:

Fish oils and mental health

The Guardian (August 11th) reported on a recent small study which showed that Omega 3 fish oils could prevent schizophrenia among at-risk young people. There was a marked reduction in incidence after 7 years among the group that was supplemented for only 3 months. Larger trials are called for to confirm the results.

The authors speculate that the timing of the intervention may be critical ― during adolescence and before conversion to psychosis, when the neurodevelopment in brain regions relevant to schizophrenia occurs.
MedScape Today (August 20th)

Meanwhile, The Telegraph (August 25th) reports on a large study that found that fish oils failed to slow cognitive decline in the elderly.

These results make some sense considering – as explained in our fish talks – that omega-3 oils are critical during brain development. Schizophrenia tends to emerge during late teen years as the brain matures, so more omega-3s at this critical point makes sense. For the elderly, the supplementation started 70 years too late!

Iodine in pregnancy

Linked to fish, is the issue of iodine. Based on earlier studies that identified the UK population as mildly to moderately iodine deficient, a new study has modelled the benefits of iodine supplementation during preganancy suggesting it could be cost effective simply through the national increase in child IQ. BBC News (August 10th) covered it well, whilst NHS Choices gave an in-depth analysis, and, to their credit, recommend good dietary sources of iodine (fish, milk, seaweed) rather than pill popping. So maybe I should be lenient on the NHS after all, as they certainly have this advice correct.

Vitamin D and Multiple Sclerosis

The relationship between low vitamin D status and incidence of multiple sclerosis (MS) is long standing and has been seen time and again in population studies. Observational associations do not, however, prove causality: it is quite possible that a third factor could be driving both low vitamin D and MS for instance.

A new study, reported in The Science Times (August 28th), however, takes us one step closer to an answer. Researchers looked at genes that limit vitamin D synthesis in people and found they were more common among MS patients. As these genes are inherited randomly and are not influenced by environmental factors, the results suggest that low vitamin D is a causative risk factor. Medpage Today (August 31st) goes into the methodology in a bit more detail.

Paleo News

Click to view The Guardian article

This beautiful image comes from The Guardian (August 18th) showing a wonderful range of paleo diet foods. So where’s the story in this?

A paper published this month has argued that the evolution of the human brain depended on access to tubers (like the sweet potato above) as well as meat. Apparently this is news, with The Guardian running the headline: “What Paleo diet experts think – and why they’re wrong“.

The problem with the media is that they always want a bite-size story. There has never been any doubt that the original paleolithic diet included tubers, along with nuts, fruit, leaves, molluscs, shellfish, elephants*, insects… i.e. real foods that can be hunted or gathered. Indeed studies of modern hunter-gatherers have provided evidence for the paleo-diet. Here is some of what these studies say:

  1. The consumption of carbohydrates varies enormously with geographic location
  2. On average carbohydrate consumption is lower than standard western diets whilst protein consumption is higher
  3. Carbohydrate consumption typically comes from tubers, fruit and nuts – but virtually never from grains
  4. Hunter gatherers almost always prize hunted game above gathered tubers which are very much seen as a second rate, fallback food.

Another thing the news papers have failed to point out clearly is that this paper includes no new data – it is simply presenting a hypothesis making an argument for tubers as a source of glucose for brain fuel. It’s a useful, if not entirely original, contribution to the discussion, but didn’t warrant the excitable headlines that most news outlets employed.

The paper that provoked these headlines (The Importance of Dietary Carbohydrate in Human Evolution) deserves a detailed analysis, but that will have to wait for another time.

Humans had a taste for elephants

In the previous section you may have noticed I cheekily slipped in elephants among the list of paleo foods? Even though we all associate cave men with eating woolly mammoths, we often forget that for much of human evolution African elephant was on the menu.

2A26519400000578-0-Early_human_ate_elephants

The Mail Online (July 2nd) had a great article covering recent research about modern tribes who hunted elephants.The researchers studied the taste preferences and hunting behaviour of several ethnographic hunter gatherer groups. They found:

  • Historically, tribes living in East Kenya, such as the Liangula, hunted elephants for meat and particularly preyed upon juveniles because their meat was said to taste better.
  • The Mbuti Pygmy people of Zaire particularly cherish the bone marrow of elephants.
  • The Nuer people of Southern Sudan hunt elephants illegally as they consider the meat to be a delicacy. They describe the flesh as tasting sweet and fat.
  • Historical texts by Western scientists described the taste of elephant meat as being ‘delicate’, ‘tender’ and ‘sweet’.

Take a look at the rest of the article which covers the archaeological evidence of similar consumption patterns going back 400,000 years!

I bet elephant burgers tasted good with roast yam chips. Wait… there’s a T-shirt for that…

Mammoth_Burger

P.S. Before I get complaints from people that don’t recognise a joke… I’m not actually advocating eating elephants! Or yam chips!