PaNu - The paleolithic nutrition argument clinic

[jk]

Re: PaNu - The paleolithic nutrition argument clinic

JK - your comment makes no mention of the patronising responses obtained to date. Also, I not you do not press your skeptical questions beyond Roger's first dismissals, nor seem to have much conviction in the doubts you express. These are the differences between us.

if you find the comments patronizing, i suggest you ignore the tone and focus on the content. you reinforce whatever it is you respond to. respond to a [perceived] negative tone and you cultivate discord. ignore it to reinforce discourse.

i have no need to press my questions. i asked them, i got rm's answers. i plan to do a bunch of reading [this has been a periodic interest of mine] and draw my own conclusions. to date the most persuasive thing i've read is joel fuhrman's "eat to live," which also eliminates refined carbs, but in a very different, low-fat way. but i remain open to learning more.

i am most convinced by the notion that we do not have definitive answers. also, i don't know if you noted an earlier post of mine, which i'll repost here:

another thought: something i often say to patients is that the most striking thing i've learned in my years of practice is how much individual variability there is: in symptoms and presentation, in response to various treatments, and in ability to tolerate various treatments. put that together with the many testimonials out there for any diet you care to name: mediterranian, chinese, low carb, vegan, paleo, and so on. why should we assume that we all would do best on any one particular regime? why should we assume that any one of us will do best on only one particular regime? it seems to me more likely that there will be a variety of healthy diets, each more or less suitable for any individual. what we do know for sure, however, is that some diets are bad for all comers.

[ThePythonicCow]

Re: PaNu - The paleolithic nutrition argument clinic

JK - your comment makes no mention of the patronising responses obtained to date.

I will agree, Lukester, that Roger might not be the paragon of virtue when it comes to the tone of his replies. But the strongest of your objections seem to be over whether his comments are too American-centric, not over the tone of his replies.

[Guest]

Re: PaNu - The paleolithic nutrition argument clinic

Americans, gastronomically speaking, are barbarians. We have no culinary history worth a damn, and what we have is not particularly healthy.

It seems to this reader, that this swarm of American MD's writing one learned and exotic theory of nutrition after another, while they blithely ignore the excellent nutrition traditions of dozens of other countries around the world, and indeed, arrogate the wisdom to sally forth and denigrate those nutrition traditions when they countervene these US doctors pet theories - this whole tribe of American doctors are making the US look slightly ridiculous in the eyes of other cultures, who are far older and wiser about food than we are.

A US MD setting out to write a book on good nutrition would impress me a lot more if they humbly went out and collected healthful recipes from around the world. Brash, intellectually arrogant - indoctrinating Americans who are by and large, abjectly submissive to the notion of the "scientific method" being the sole font of reliable insights - all of this is quintessentially American, and speaking as someone who is half Italian by cultural upbringing, I can only say that I am decidedly not under it's spell. There is something a bit pathetic about seeing Americans flock to the next scientist who wishes to inform them about their nutrition.

I like Raja's advice better - my instinct tells me it is more down to earth and less enamored of grand unifying theories.

[rogermexico]

Re: PaNu - The paleolithic nutrition argument clinic

another thought: something i often say to patients is that the most striking thing i've learned in my years of practice is how much individual variability there is: in symptoms and presentation, in response to various treatments, and in ability to tolerate various treatments. put that together with the many testimonials out there for any diet you care to name: mediterranian, chinese, low carb, vegan, paleo, and so on. why should we assume that we all would do best on any one particular regime? why should we assume that any one of us will do best on only one particular regime? it seems to me more likely that there will be a variety of healthy diets, each more or less suitable for any individual. what we do know for sure, however, is that some diets are bad for all comers.

All good speculation. The analogy I might use is drug treatment. Individual response to psychotropic medication, I am guessing, is a big part of your practice. That in no way stops us from formulating and testing hypotheses about medical treatments that might be applied to large populations, and on average might be useful to them or even curative more often than not.

The human body, and even most mammals have an endocrine system that is pretty similar and insulin has pretty invariant role in all animal life, even if there are genetic variations in receptor sensitivity (which there clearly are)

That is why in starting to identify what might be "bad for all comers" I start with cellular and tissue metabolism and not with archaeology.

The rules are just an arbitrary construct to help the average joe deal with the world of superabundant garbage we call food - you can see that there can be huge variation in the actual diet as long as one is avoiding high carb intake and grains.

Results using indirect markers of health like % body fat and indicia of inflammation like CRP and cardiovascular markers is for now the best we have clinically, and for me they all go in the same positive direction.

[Guest]

Re: PaNu - The paleolithic nutrition argument clinic

The tone and the substance of his comments is indeed exceedingly America-centric, and limited by that, IMO. Americans are far too abjectly in awe of doctors and scientists telling them what is healthful for them to eat. It is an approach which is *culturally impoverished*.

[rogermexico]

Re: PaNu - The paleolithic nutrition argument clinic

Hello Bart

I've seen that one before - its a good review

Thank you for posting it.

[ThePythonicCow]

Re: PaNu - The paleolithic nutrition argument clinic

I find US doctors (he's a radiologist BTW, not a general practitioner) who assume this paternalistic, dismissive tone grate upon my cultural upbringing from childhood in another country.

Yeah - the paternalistic attitude of American medicine can irk me too . It can be downright unhealthy. Whether Roger manifests such or not I don't know. It could be, but it doesn't matter much to me.

[Guest]

Re: PaNu - The paleolithic nutrition argument clinic

All good speculation. - you can see that there can be huge variation in the actual diet as long as one is avoiding high carb intake and grains.

Rubbish. If you assert rubbish authoritatively enough eventually the entire flock will believe you. At least there is one "foreign national" here to call your summary assertion about "high carbs" BS. Italians lived on high carbs for forty years without demonstrating one jot of the ailments you assert. Pack it in, or address those discrepancies convincingly. And while you are at it, address the issue of 60% fat intake and the elderly.

[cindykimlisa]

Re: PaNu - The paleolithic nutrition argument clinic

Luke

I do not find your comments the only challenging remarks on the board.

But what I see often is they are laced with a superabundence of overt and overreaching anger.

With particular regard to what the Doc says I have some interest because of his credentials.

However, you have no credibility. Your message is all about your anger and all about you which is often the case.

Get it?

[Sharky]

Re: PaNu - The paleolithic nutrition argument clinic

Rubbish. If you assert rubbish authoritatively enough eventually the entire flock will believe you. At least there is one "foreign national" here to call your summary assertion about "high carbs" BS. Italians lived on high carbs for forty years without demonstrating one jot of the ailments you assert. Pack it in, or address those discrepancies convincingly. And while you are at it, address the issue of 60% fat intake and the elderly.

Assuming that Wikipedia's description of the Mediterranean Diet is reasonably accurate, it doesn't sound like it's high carb.

http://en.wikipedia.org/wiki/Mediterranean_diet

food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s", this diet, in addition to "regular physical activity," emphasizes "abundant plant foods, fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts.

In fact, it's noted for it's relatively high fat content (up to 35% of total calories).

The so-called "French Paradox" is based on the fact that some countries (including in the Mediterranean) with relatively high fat diets have lower incidence of heart disease. It is readily explained by the fact that carbohydrates are absorbed much more slowly by the body when they are eaten together with fat. The overall glycemic index of the meal is lowered; insulin levels rise more slowly and don't peak as high.

However, if you decrease the fat or increase the carbs, then it stops working.

[rogermexico]

Re: PaNu - The paleolithic nutrition argument clinic

Assuming that Wikipedia's description of the Mediterranean Diet is reasonably accurate, it doesn't sound like it's high carb.

http://en.wikipedia.org/wiki/Mediterranean_diet

In fact, it's noted for it's relatively high fat content (up to 35% of total calories).

The so-called "French Paradox" is based on the fact that some countries (including in the Mediterranean) with relatively high fat diets have lower incidence of heart disease. It is readily explained by the fact that carbohydrates are absorbed much more slowly by the body when they are eaten together with fat. The overall glycemic index of the meal is lowered; insulin levels rise more slowly and don't peak as high.

However, if you decrease the fat or increase the carbs, then it stops working.

Covered thoroughly by Taubes.

The original mediterranean diet that was actually studied was specific to Crete, not Italy.

High fat diets do not cause heart disease. High carb diets do. The french diet is paradoxical only if you believe Keye's hypothesis, which increasingly appears to be just wrong, if not fraudulent.

It is probably not that you need to have high fat intake for the fat's sake, just that you have to eat something, and the most effective way to do that with low insulin levels, (unless you are starving or an elite athlete burning thosands of calories a day - which in its own way is also not healthy) is to increase your fat consumption, which has no insulinogenic effect and is highly satiating.

Again, intermittent fasting, starvation and running a huge caloric deficit like Dean Karnazes are all alternate ways to lower your insulin levels, but are understandably less practical than eating more fat.

[Guest]

Re: PaNu - The paleolithic nutrition argument clinic

Sharky - there was always plenty of bread on the table, in the 1950's and 1960's with lots of dishes providing plentiful vegetable fat, thus allowing the consumption of meat to be *sparing*. If I gave the impression these people were gorging on carbohydrates alone I gave an incorrect description.

A great part of this diet is built around bread, olive oil, bean dishes, many different kinds of heavenly all-vegetable dishes, some flavored sparingly with meat, and so forth. The point being, there was not the hint of any banishment of grains products from the diet, in order to achieve exemplary good health. Now watch Rogermexico drop innuendoes such as "fraudulent studies and conclusions" into his replies.

The Meditteranean diet is being pulled six ways to sunday by the MD's recasting themselves as nutrition gurus, to prove points they wish and sweep other contradictory points under the rug. Wheat products never slowed down the exemplary Italian health stats one bit. They were merely wholesome grain products, consumed in the right proportion to all the other food components.

They ate with poise and balance in the components of nutrition (lots of vegetables and vegetable fats) - and in those days, with very few processed components.

They were more physically active than we are today - that was back around 1960, when as a concomitant American culinary milestone, the AUTO-MAT and the food diner became ubiquitous across this land. Forty plus years later we are pondering which food components affect insulin levels and applying these culturally parched insights mechanically to our dietary traditions.

Being more sedentary today, we can reduce the bread and grains intake if we wish. We can even concentrate more on the vegetable proteins, lifting the overal fats proportion of what we eat.

But that was not the point - the salient point was that the bread was an integral part of this diet without having anything remotely to do with creating overweight diabetics - and that Italian demographic experiment (doubtless there are plenty of others worldwide) provided very consistent results for an entire population for 30-40 years (ditto health results in this same population in pre-WWII, and even pre-WWI !!)

The excessive preoccupation with diabetes, pancreas / insulin problems as an integral thorny question tangled up with what we eat over here, is at least one of, the epidemiological expressions of a gastronomic cultural void, and it is more characteristic to the US than it has been to many other nations (particularly if we subtract the processed food culture America has exportee worldwide).

It is a cultural void, a flailing around, due to the loss of sensible food traditions - and it is to a great extent, explicit to THIS country and it's industrialised food cultural ethic. And an army of wild squirrels, wild pheasants, wild fish, hand-culled ten pronged wild deer brought down with a long-bow, or plain bear-steaks (presumably wrestled to the ground in a forest) cannot alleviate it.

Assuming that Wikipedia's description of the Mediterranean Diet is reasonably accurate, it doesn't sound like it's high carb.

http://en.wikipedia.org/wiki/Mediterranean_diet

In fact, it's noted for it's relatively high fat content (up to 35% of total calories).

The so-called "French Paradox" is based on the fact that some countries (including in the Mediterranean) with relatively high fat diets have lower incidence of heart disease. It is readily explained by the fact that carbohydrates are absorbed much more slowly by the body when they are eaten together with fat. The overall glycemic index of the meal is lowered; insulin levels rise more slowly and don't peak as high.

However, if you decrease the fat or increase the carbs, then it stops working.

[Rajiv]

Re: PaNu - The paleolithic nutrition argument clinic

No! The amount of sugar and flour eaten were very close to identical -- that is no statistical difference! -- and the typical flour used by South Asians even in the US and UK is whole wheat flour -- only a very small increase in the use of bleached flour, mostly from the slight increase in restaurant eating. Home cooking was almost identical. What is different in food in the US and UK is the reduction in the amount of lentils eaten, and substituting cottage cheese, dairy and meat for the lentils, typically without adding more calories. That, along with a more sedentary life style.



The difference over the years IS diet, but not necessarily what you hypothesize -- though carbohydrates ARE prima facie the culprit, the truth is slightly different, and the changes in dietary pattern between rural India to Urban India is sufficient to make the same carbs act slightly differently -- in rural India, the carbs have sufficient amylase and sucrase inhibitors to decrease the glycemic index of the foods significantly. In Urban India, the food processing changes sufficiently to increase the glycemic index of the foods by decreasing the amylase and sucrase inhibitors associated with the same foods.

[jk]

Re: PaNu - The paleolithic nutrition argument clinic

Sixty-five hundred Chinese have each contributed 367 facts

Observational study based on self-reporting which is very unreliable, especially for diet

not just self-report. sorry my original omission.
"And nowhere else could researchers afford to hire hundreds of trained workers to collect blood and urine samples and spend three days in each household gathering exact information on what and how much people eat, then analyzing the food samples for nutrient content."

[rogermexico]

Re: PaNu - The paleolithic nutrition argument clinic

No! The amount of sugar and flour eaten were very close to identical -- that is no statistical difference! -- and the typical flour used by South Asians even in the US and UK is whole wheat flour -- only a very small increase in the use of bleached flour, mostly from the slight increase in restaurant eating. Home cooking was almost identical. What is different in food in the US and UK is the reduction in the amount of lentils eaten, and substituting cottage cheese, dairy and meat for the lentils, typically without adding more calories. That, along with a more sedentary life style.



The difference over the years IS diet, but not necessarily what you hypothesize -- though carbohydrates ARE prima facie the culprit, the truth is slightly different, and the changes in dietary pattern between rural India to Urban India is sufficient to make the same carbs act slightly differently -- in rural India, the carbs have sufficient amylase and sucrase inhibitors to decrease the glycemic index of the foods significantly. In Urban India, the food processing changes sufficiently to increase the glycemic index of the foods by decreasing the amylase and sucrase inhibitors associated with the same foods.

Thank you. That is another conceivable mechanism whereby carbs are effectively lower in utilization and not inconsitent with other literature I have seen.

The other obvious one is less cooking of starchy foods. Basically, less carbohydrate bioavailability functions the same as less carb intake.

Can you give me your source? Total calories in particular could be quite relevant. How about the sugar and flour consumption of rural compared to city (not US or UK)?

The japanese prior to world war II and shortly after also had high carb consumption (rice), but were also suffering from some serious nutritional deficiencies. They were thin, though. Because they had low caloric intake.

Certainly if your hypothesis is that grains are problematic, and few current populations go without them, its hard to say much about the couterfactual of how healthy any population would be without them, as we have been eating them for 10,000 years.

The archaeological record very clearly shows indigenous north american peoples that went from wild game and vegetables to an agricultural diet (maize and squash) had more disease, worse life expectancy and shorter height.

That eating a diet that somehow mitigates the carb utilization is better than , in your case, the non-lentil diet, does not prove that zero grains would not have been better for either group.