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A Brief History of the Contemporary Paleo Diet Movement | The Paleo Diet

INTRODUCTION

In order to appreciate any concept, including the Paleo Diet, it is important to recognize its history and how it came to be. Most of you are aware that Paleo and particularly Paleo diets have recently become very hot, on trend topics.

These ideas have become household words in the past few years; however it hasn’t always been this way. Below is a graph from for the words “ the Paleo diet” (Figure 1).  It’s fairly clear from Figure 1 that, except for the past four years, the Paleo diet was virtually unknown to all but dedicated fans. Fortunately, I’ve been in the middle of this worldwide movement from nearly its very beginnings. So, I can personally tell you how it all began and my involvement in it.

Google Trends | The Paleo Diet Over Time

Figure 1. Google Trends. 25 June 2015.

Last October, I approached my 64th birthday with just a little trepidation because I was part of the 60’s generation whose mantra was not to trust anyone over 30, and now I’m twice that age.  As I look back over my life, I can pinpoint a few key events which led me to discover and appreciate what is now almost universally known as the Paleo diet.

I came of age as a track and field athlete at the University of Nevada, Reno in the late 60s and early 70s, and as such was always interested in diet, fitness and athletic performance. Later as a lifeguard at Lake Tahoe, my friends and I read all of the now classic vegetarian diet/health books such as Francis Moore Lappe’s Diet for a Small Planet, Paivo Airola’s Are You Confused? and Dick Gregory’s Natural Diet for Folks Who Eat among others. I even attended a Dick Gregory lecture in Seattle and got to shake this famous comedian’s hand.

My lifeguard friends and I experimented with , fasting, and all kinds of vitamins and supplements. Almost everyone seemed to own a juicer. Each summer, instead of shying away from the sun and using sunscreens, we all tried to get the deepest tans possible. We swam in Tahoe’s icy, invigorating, non-chlorinated waters, and decades before Vibram Five Fingers and Nike Frees were the rage, we ran barefoot in the sand along Sand Harbor’s pristine shoreline.

Those 20 memorable summers as a lifeguard at Tahoe heightened my awareness of the outdoor, natural world, sunshine, health, fitness and diet. As my lifeguarding days drew to a close in 1991, Lorrie and I had just begun to eat Paleo. Here’s how it began.

THE START OF IT ALL

I completed my Ph.D. in exercise physiology at the University of Utah in the spring of 1981 and promptly hired as a young assistant professor in the Department of Health and Exercise Science at Colorado State University. For the first 5-10 years of my career, my research focused mainly upon how diet and exercise affected fitness and athletic performance. I still hadn’t discovered Paleo, but read widely and had a considerable interest in anthropology.

In the spring of 1987, I happened upon Boyd Eaton’s (M.D.) now classic scientific paper which was published two years earlier in the prestigious New England Journal of Medicine.7 This article made a lasting impression upon me and was the single factor which caused me to focus my research interests upon ancestral human diets from that point forward.

For me, one of the surprising points that Dr. Eaton made in a subsequent paper was that s were rarely or never consumed by pre-agricultural hunter-gatherers.6  In the days and months after reading Boyd’s groundbreaking paper,7 I became absolutely engrossed in studying ancestral human diets and voraciously read everything I could about the topic. At first, I simply filed all of these scientific papers and documents into a single file folder I labeled “Paleolithic Nutrition.” Early on I realized that this strategy wouldn’t work because of the enormous volume and diversity of topics that materialized.

As I read more and more, patterns began to emerge. Stone Age people did not drink milk or consume dairy products. So, I created a file folder labeled “Dairy.” They also didn’t eat cereal grains, so I created a single file folder called “Cereal Grains.” However, just like the single folder I had originally created for “Paleolithic Nutrition,” it soon became apparent that the topic of cereal grains and their potential for adversely affecting health was an enormous topic that ultimately would require a huge number of file folders.

Over the course of the next seven or eight years, I collected more than 25,000 scientific papers and filled five large filing cabinets – each with hundreds of categories dealing with all aspects of Paleo diet and Paleo lifestyle. In 1994, I eventually mustered enough courage to telephone (no one used email then) the man who was responsible for my collection of articles on anything and everything related to Paleo. Dr. Eaton is a true gentleman and scholar in every sense of the word.  We spoke for almost an hour on that very first telephone call, and he gave me one of the greatest compliments of my life at the end of the conversation when he said, “It sounds to me like you know more about this than I do.”

Boyd and I eventually met in 1995, and two years later he invited me to speak with him at an international conference on fitness and diet organized by Dr. Artemis Simopoulos in Athens, Greece. Artemis was a wonderful hostess for the conference, and during my two week stay in Greece we had many conversations about diet and health. I mentioned that I had written a partially completed manuscript on the nutritional shortcomings of cereal grains. About a year later she asked me if I could complete the paper and submit it for publication in a scientific journal she edited.  I did, and that paper, , published in 199934 launched my published career in Paleo diets.

The Paleo Diet concept is now taken seriously in the scientific world thanks in part to Boyd Eaton’s pioneering work. There is no doubt in my mind that without Dr. Eaton’s influential 1985 New England Journal of Medicine paper,7 Paleo would continue to be an obscure word known mainly to anthropologists and would not have become the household term now recognized by millions. The Paleo Diet and Paleo lifestyle are clearly much larger than either my writings or Boyd Eaton’s. Hundreds if not thousands of scientists, physicians and people from all walks of life are responsible for creating this incredibly powerful idea that can be used to bring order and wisdom to dietary and lifestyle questions and issues.

Some of the key players who came before Dr. Eaton in the Paleo diet and lifestyle world require no introductions. Charles Darwin’s Origins of the Species was published in 1859 and started it all. It still amazes me that the most powerful idea in all of biology (evolution via natural selection) generally had not been applied to nutritional thought until 126 years later with Dr. Eaton’s classic paper.7  Theodosius Dobzhansky, a well-known Ukranian evolutionary biologist said, “Nothing in biology makes sense, except under the light of evolution.” Indeed, his statement could easily be reworked to “Nothing in nutrition makes sense, except under the light of evolution.5 A similar quote could also be applied to a multitude of lifestyle issues.

One way in which we can look at how and where the Paleo diet and Paleo lifestyle concepts arose would be to examine the contributions of a few of the key players who came both before and after Dr. Eaton’s landmark paper. Obviously, Charles Darwin started it all, but a number of noteworthy people had already recognized the value of ancestral dietary patterns decades before the publication of Boyd’s article.

Perhaps the very first book to achieve notoriety about non-western diets and disease was Weston Price’s Nutrition and Physical Degeneration, A Comparison of Primitive and Modern Diets and Their Effects, first published in 1939.23 Dr. Price, a U.S. dentist, extensively traveled the world in the 1920s and 30s and made detailed observations about diet and health in numerous non-westernized populations including Amazon Indians, Alaskan Eskimos, Australian Aborigines, Canadian Indians, Polynesians and African tribal populations among many others. This book is a real treasure and contains hundreds of photographs of non-westernized people in exquisite health taken in an era when modern processed foods were not universally available. Dr. Price noted that wherever and whenever modern diets were adopted by non-westernized cultures, their health declined. His statement was just as true then as it is today.

An intriguing aspect of early books like Dr. Price’s is that frequently the diet/health observations were correct but the underlying mechanisms about how diet and lifestyle specifically affected health were either unknown or poorly understood.  In the early part of the 20th century before population wide vaccination programs existed, tuberculosis remained a major public health problem responsible for millions of deaths worldwide.  In his book,23 Dr. Price noted that in Europe, heliotherapy (sunbathing) was being effectively used to treat tuberculosis. At the time and even decades later, these kinds of observations were commonly ridiculed by the “best medical minds” because they seemed ludicrous and had no known physiological basis. Let’s fast forward 65 years and put this 1930s observation under new light.

Discoveries made just in the past 5-7 years now show that sunlight exposure might be one of the best strategies to prevent or cure tuberculosis infections.10, 19, 27, 31, 35, 36  When you sunbathe, ultraviolet radiation from the sun causes vitamin D to be produced in your skin. The more sun you get, the more vitamin D is produced. Blood concentrations of vitamin D regulate the synthesis of a recently identified substance called cathelicidin which turns out to be one of the most potent antimicrobial (bacteria killing) peptides that our bodies produce. Cathelicidin shows specific killing activity against bacteria that cause tuberculosis,31, 35, 36 and epidemiological (population) studies confirm vitamin D insufficiency is a risk factor for tuberculosis.10, 19, 37  Most of us have been vaccinated against tuberculosis, so we really don’t need to worry about this disease.

Although Dr. Price’s book23 was advanced for its time, the evolutionary basis for optimal nutrition and healthy lifestyles still lay decades in the future. Other early popular books touching upon ancestral diets and health include:  Arnold DeVries’s Primitive Man and His Food (1952),4 Walter Voegtlin’s The Stone Age Diet (1975),30 Leon Chaitow’s, Stone Age Diet (1987),2 and Boyd Eaton’s The Paleolithic Prescription (1988).8

All of these books are long out of print and except for Boyd’s volume; these books simply fizzled and faded into obscurity because they didn’t have the bigger picture right. Without the evolutionary template correctly in place, these early books were incomplete and inconclusive.  At the time, scientists and the public at large still weren’t quite ready for Paleo diets and Paleo lifestyles.

Prior to the publication of Dr. Eaton’s 1985 paper,7 a few scientists had independently recognized the evolutionary underpinnings for healthful diets and lifestyle, but their work was published in obscure scientific journals that received little or no public notoriety.1, 25, 26, 28, 29, 32, 37 After publication of Boyd Eaton’s influential paper in the New England Journal of Medicine,7 a number of events ultimately set the stage for the worldwide recognition of the Paleo diet as well as the evolutionary basis for modern day Paleo lifestyles.

THE DAWN OF DARWINIAN MEDICINE

The basic foundation and logic for the Paleo diet concept lies in a recently recognized discipline called Darwinian Medicine. Following in the footsteps of Boyd’s landmark paper,7 came another revolutionary scientific publication in the Quarterly Review of Biology (1991) by Drs. George Williams and Randy Neese from the State University of New York at Stony Brook.33  The title of this paper was, “The Dawn of Darwinian Medicine.

As you can imagine from its title, it represented the very first scientific publication addressing how our ancestral evolutionary experience affects the manner in which we view and treat modern diseases. Although this paper is now more than 20 years old, its message is finally being filtered down to many physicians, their patients and the public at large.20

Here’s a quote from this paper that sums up Darwinian Medicine, “Human biology is designed for Stone Age conditions. Modern environments may cause many diseases.” Also, another enlightening quote that is totally relevant to this book: “it provides new insights into the causes of medical disorders.” For instance, cough, fever, vomiting, diarrhea, fatigue, pain, nausea and anxiety are widespread medical problems. Many orthodox physicians focus upon relieving short term distress by prescribing pharmaceuticals to block these responses. Darwinian Medicine would say these responses are not necessarily harmful, but rather signify the body’s effort to remedy a problem. In most situations coughing when you are sick is a natural and healthy response because it helps to purge disease causing microbes from your throat and lungs.

Similarly fever increases your body temperature which helps to destroy pathogens that have infected your body. Medications that suppress coughs and block fever may relieve symptoms but may actually prolong the illness. Obviously, certain extreme situations necessitate a balanced approach between our body’s evolutionary response to disease and modern medicine. For example, blocking fever can prevent febrile seizures and stopping vomiting can prevent severe dehydration.

The message is clear. We need to balance our hunter gatherer genetic legacy with the best technology of our modern world.

THE PROOF IS IN THE PUDDING

Having been a faculty member at a Division I Research University for 32 years, I can tell you that your personal experience with the Paleo diet and a dollar will buy you a single cup of coffee in the scientific community. In other words:  no matter how much weight you have dropped on the Paleo diet; no matter how much your blood chemistry has improved; nor how much better you feel, the medical and scientific community will, by and large, not listen to you. Your real world experiences have little or no traction in the academic community of science and medicine.   What they require is not your personal experience (anecdotal evidence), but rather experimental evidence based upon one of the following four scientific methods:  1) animal studies, 2) tissue or organ studies, 3) epidemiological [population] studies or 4) randomized controlled human trials.

When I first published The Paleo Diet in 2002 thousands of indirect experimental studies had supported its general principles in promoting weight loss, improving overall health and curing disease. For instance, a multitude of well controlled experimental studies had already confirmed beyond a shadow of a doubt that low glycemic load diets improved health and promoted weight loss. The Paleo diet is a low glycemic load diet.  Similarly, high protein diets were shown to be the most effective strategy to improve blood chemistry and help you lose weight. Yet again, the Paleo diet is a high protein diet.

Even in 2002, when The Paleo Diet first came into print, you would have been hard pressed to find a single nutritionist who would disagree with the notion that omega 3 fats improved health and well being in almost every conceivable way. Do I need to repeat myself? The Paleo diet is a diet rich in omega 3 fats.

By 2002 when my first book came into print, the thousands of scientific papers were independently verified that certain individual aspects of the Paleo diet normalized body weight and improved health and wellbeing. Nevertheless, at that time, not a single study had yet examined all of the combined nutritional characteristics of the Paleo diet.

Was a diet high in animal protein, omega 3 fats, monounsaturated fats, vitamins, minerals, phytochemicals, fiber and low in salt, refined sugars, cereal grains, dairy products, vegetable oils and processed foods healthy? Was it more healthful than the officially sanctioned USDA My Plate Diet or even the highly touted Mediterranean diet? The direct scientific answers to these questions had yet to be answered in 2002.

Fortunately, in the past eight years a number of scientists worldwide have dared to test contemporary versions of humanity’s original diet against supposed “healthful diets” as seen in Table 1 below.

One of the key figures behind this ground breaking research is my friend and colleague, Dr. Staffan Lindeberg (M.D., Ph.D.) from Lund University in Sweden. Staffan became interested in Paleo diets almost 25 years ago through his medical studies of the Kitavans,14-17 a non-westernized group of 2,250 people living on remote islands near Papua New Guinea. The Kitavans obtain virtually all of their food from either the land or the sea and have little contact with the modern world. Common western foods such as cereals, dairy, refined sugars, vegetable oils and processed foods are nearly absent from their diets.14-17 Predictably, these people represent the epitome of health compared to the average citizen living in the western world.  None of them are overweight, and heart disease and stroke are extremely rare. and are non-existent,14-17 and acne is not present among their children or teenagers.38 I doubt that you could round up a random group of 2,000 western people anywhere on the planet without encountering high rates of all of these diseases which are rare or not present in the Kitavans.

In the late 1990s I first began corresponding with Dr. Lindeberg on the then youthful internet.  We soon discovered that we had read almost all of the same scientific papers and were interested in almost all of the same diet/health topics. One study that stood out to both of us was an incredible experiment performed by Dr. Kerin O’Dea at the University of Melbourne and published in the Journal, Diabetes in 1984.21 In this study Dr. O’Dea gathered together 10 middle aged Australian Aborigines who had been born in the “Outback.” They had lived their early days primarily as hunter-gatherers until they had no choice but to finally settle into a rural community with access to western goods. Predictably, all 10 subjects eventually became overweight and developed type 2 diabetes as they adopted western sedentary lifestyles in the community of Mowwanjum in the northern Kimberley region of Western Australia.  However, inherent in their upbringing was the knowledge to live and survive in this seemingly desolate land without any of the trappings of the modern world.

Dr. O’Dea requested these 10 middle aged subjects to revert to their former lives as hunter-gatherers for a seven week period. All agreed and traveled back into the isolated land from which they originated. Their daily sustenance came only from native foods that could be foraged, hunted or gathered. Instead of white bread, corn, sugar, powdered milk and canned foods, they began to eat the traditional fresh foods of their ancestral past: kangaroos, birds, crocodiles, turtles, shellfish, yams, figs, yabbies (freshwater crayfish), freshwater bream and bush honey.   At the experiment’s conclusion, the results were spectacular, but not altogether unexpected given what was known about Paleo diets, even then. The average weight loss in the group was 16.5 lbs; blood cholesterol dropped by 12% and triglycerides were reduced by a whopping 72%. Insulin and glucose metabolism became normal, and their diabetes effectively disappeared.

Dr. Lindeberg and I both realized that this type of experiment would probably never be repeated simply because the hunter-gatherer lifestyle is nearly extinct, and very few contemporary people have the knowledge or skills to live entirely off the land. Back in those early days of our friendship, we both had the same vision. This experiment should be conducted in a slightly different manner but not with westernized, former hunter-gatherers. Why not take a group of typically unhealthy westerners and put them on commonly available contemporary foods that mimic the nutritional characteristics of hunter-gatherer diets? Wow, what a great idea! We both knew that this experiment was precisely what Dr. Eaton had in mind with his inspirational paper way back in 1985.7

RECENT EXPERIMENTAL STUDIES OF THE PALEO DIET

It took nearly 22 years for Dr. Eaton’s dream of experimentally testing modern day Paleo diets to come true, but it finally happened with the publication of a paper by Dr. Lindeberg’s research group in 2007.18 Staffan followed this publication with two additional papers in 200911 and 2010.13 Good ideas catch on, and two other independent research groups around the world followed suit with similar results – the first in 2008 by Dr. Osterdahl and co-workers at the Karolinska Institute in Sweden22 and the next in 2009 by my friend and colleague Dr. Lynda Frasseto (M.D.) from the University of California San Francisco School of Medicine.9

Although science may move slowly, it eventually does move forward as old ideas are replaced with new and better thoughts and information. I can assure you that this fundamental diet and lifestyle concept based upon evolutionary biology is not a fad and will not fade away.

In his first study in 200718 Dr. Lindeberg and associates placed 29 patients with type 2 diabetes and heart disease on either a Paleo diet or a Mediterranean diet based upon whole grains, low-fat dairy products, vegetables, fruits, fish, oils, and margarines. Note the Paleo diet excludes grains, dairy products, and margarines while encouraging greater consumption of meat and fish. After 12 weeks on either diet blood glucose tolerance (a risk factor for heart disease) improved in both groups, but was better in the Paleo dieters.

In a 2010 follow-up publication,18 of this same experiment the Paleo diet was shown to be more satiating on a calorie by calorie basis than the Mediterranean diet because it caused greater changes in leptin, a hormone which regulates appetite and bodyweight.

In the second ever study (2008) of Paleo diets, Dr. Osterdahl and co-workers put 14 healthy subjects on a Paleo diet. After only three weeks the subjects lost weight, reduced their waist size and experienced significant reductions in blood pressure, and plasminogen activator inhibitor (a substance in blood which promotes clotting and accelerates artery clogging). Because no control group was employed in this study, some scientists would argue that the beneficial changes might not necessarily be due to the Paleo diet. However, as you shortly will see, a better controlled experiment showed similar results.

In 2009, Dr. Frasetto and co-workers put nine inactive subjects on a Paleo diet for just 10 days.9 In this experiment, the Paleo diet was exactly matched in calories with the subjects’ usual diet.  Almost anytime people eat diets that are calorically reduced, no matter what foods are involved, they exhibit beneficial health effects. So the beauty of this experiment was that any therapeutic changes in the subjects’ health could not be credited to reductions in calories, but rather to changes in the types of food eaten. While on the Paleo diet either eight or all nine participants  experienced improvements in blood pressure, arterial function, insulin, total cholesterol, LDL cholesterol and triglycerides. What is most amazing about this experiment is how rapidly so many markers of health improved, and that they occurred in every single patient.

In an even more convincing recent (2009) experiment, Dr. Lindeberg and colleagues compared the effects of a Paleo diet to a generally recommended for patients with type 2 diabetes.11 The diabetes diet was intended to reduce total fat by increasing whole grain bread and cereals, low fat dairy products, fruits and vegetables while restricting animal foods. In contrast, the Paleo diet was lower in cereals, dairy products, potatoes, beans, and bakery foods, but higher in fruits, vegetables, meat, and eggs compared to the diabetes diet. The strength of this experiment was its cross over design in which all 13 diabetes patients first ate one diet for three months and then crossed over and ate the other diet for three months. Compared to the diabetes diet, the Paleo diet resulted in improved weight loss, waist size, blood pressure, HDL cholesterol, triglycerides, blood glucose and hemoglobin A1c (a marker for long term blood glucose control).    From an experimental design perspective, this trial represents a powerful example of the Paleo diet’s effectiveness in treating people with serious health problems.

From 2007 until 2010 only five experimental studies tested contemporary “Paleo” diets in humans (Table 1).  However since then, interest in experimentally testing these diets has grown concurrently (Table 1) with the general public’s explosive awareness of the Paleo Diet concept (Figure 1). Except for a single study, human trials testing modern day Paleo Diets have shown them to be therapeutic and generally more effective in reducing body weight and ameliorating symptoms of the metabolic syndrome (Table 1) than conventional western diets, type 2 diabetic diets, the Mediterranean diet, and the American Heart Association (AHA) diet (Table 1).   Further, contemporary “Paleo diets” are nutritionally more dense in the 13 vitamins and minerals most lacking in the typical U.S. diet when contrasted to the USDA my Plate recommendations,39, 40 the Mediterranean diet, and vegan/vegetarian diets.

Table 1.  Paleo Diet References: Direct Human/Animal Experimental and Epidemiological Studies in chronological order (oldest to most recent).

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1984

  1. O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.

2006

  1. Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson Lindeberg S: A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond) 2006, 3:39.

2007

  1. Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.

2008   

  1. Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.

2009

  1. Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35
  2. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.

2010

  1. Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85

2013

  1. Carter P, Achana F, Troughton J, Gray LJ, Khunti K, Davies MJ. A Mediterranean diet improves HbA1c but not fasting blood glucose compared to alternative dietary strategies: a network meta-analysis. J Hum Nutr Diet. 2014 Jun;27(3):280-97
  2. Jönsson T, Granfeldt Y, Lindeberg S, Hallberg AC.Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutr J. 2013 Jul 29;12:105. doi: 10.1186/1475-2891-12-105.
  3. Ryberg M, Sandberg S, Mellberg C, Stegle O, Lindahl B, Larsson C, Hauksson J, Olsson T. A Palaeolithic-type diet causes strong tissue-specific effects on ectopic fat deposition in obese postmenopausal women. J Intern Med. 2013 Jul;274(1):67-76
  4. Frassetto LA, Shi L, Schloetter M, Sebastian A, Remer T. Established dietary estimates of net acid production do not predict measured net acid excretion in patients with Type 2 diabetes on Paleolithic-Hunter-Gatherer-type diets. Eur J Clin Nutr. 2013 Sep;67(9):899-903

2014

  1. Fontes-Villalba M, Jönsson T, Granfeldt Y, Frassetto LA, Sundquist J, Sundquist K, Carrera-Bastos P, Fika-Hernándo M, Picazo Ó, Lindeberg S. A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study–Alimentation and Diabetes in Lanzarote–ADILAN.Trials. 2014 Jan 2;15:2. doi: 10.1186/1745-6215-15-2.
  2. Bisht B, Darling WG, Grossmann RE, Shivapour ET, Lutgendorf SK, Snetselaar LG, Hall MJ, Zimmerman MB, Wahls TL. A multimodal intervention for patients with secondary progressive multiple sclerosis: Feasibility and effect on fatigue. J Altern Complement Med. 2014 Jan 29. [Epub ahead of print]
  3. Mellberg C, Sandberg S, Ryberg M, Eriksson M, Brage S, Larsson C, Olsson T, Lindahl B. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial. Eur J Clin Nutr. 2014 Mar;68(3):350-7.
  4. Smith, M, Trexler E, Sommer A, Starkoff B, Devor S.teven (2014) Unrestricted Paleolithic Diet is associated with unfavorable changes to blood lipids in healthy subjects. Int J Exer Sci 2014, 7(2) : 128-139.
  5. Talreja D, Buchanan H, Talreja R, Heiby L, Thomas B, Wetmore J, Pourfarzib R, Winegar D. Impact of a Paleolithic diet on modifiable CV risk factors. Journal of Clinical Lipidology, Volume 8, Issue3, Page 341, May 2014.
  6. Boers I, Muskiet FA, Berkelaar E, Schur E, Penders R, Hoenderdos K, Wichers HJ, Jong MC. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrom. A randomized controlled pilot-study. Lipids Health Dis. 2014 Oct 11;13:160. doi: 10.1186/1476-511X-13-160.
  7. Stomby A, Simonyte K, Mellberg C, Ryberg M, Stimson RH, Larsson C, Lindahl B, Andrew R, Walker BR, Olsson T. Diet-induced weight loss has chronic tissue-specific effects on glucocorticoid metabolism in overweight postmenopausal women. Int J Obes (Lond). 2014 Oct 28. doi: 10.1038/ijo.2014.188. [Epub ahead of print]
  8. Whalen KA, McCullough M, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and mediterranean diet pattern scores and risk of incident, sporadic colorectal adenomas. Am J Epidemiol. 2014 Dec 1;180(11):1088-97. doi: 10.1093/aje/kwu235. Epub 2014 Oct 17.
  9. Toth C, Clemens Z. Type 1 diabetes mellitus successfully managed with the Paleolithic ketogenic diet. Int J Case Pep Images. 2014 5(10):699-703.

2015

  1. Talreja A, Talreja S, Talreja R,Talreja D. The VA Beach Diet Study: An investigation of  the effects  of plant-based, Mediterranean, Paleolithic, and Dash Diets on cardiovascular disease risk. J Am Coll Cardiol Intv. 2015;8(2_S):S41-S41.  doi:10.1016/j.jcin.2014.12.161
  2. Bligh HF, Godsland IF, Frost G, Hunter KJ, Murray P, MacAulay K, Hyliands D, Talbot DC, Casey J, Mulder TP, Berry MJ.Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study.Br J Nutr. 2015 Feb 28;113(4):574-84.
  3. London DS, Beezhold B. A phytochemical-rich diet may explain the absence of age-related decline in visual acuity of Amazonian hunter-gatherers in Ecuador. Nutr Res. 2015 Feb;35(2):107-17.
  4. Masharani U, Sherchan P, Schloetter M, Stratford S, Xiao A, Sebastian A, Nolte Kennedy M, Frassetto L. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Eur J Clin Nutr. 2015 Apr 1. doi: 10.1038/ejcn.2015.39. [Epub ahead of print]
  5. Tóth, C, and Zsófia, C. “Gilbert’s Syndrome successfully treated with the Paleolithic ketogenic diet.” Am J Med Case Reports. 2015 3(4).
  6. Pastore RL, Brooks JT, Carbone JW. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations. Nutr Res. 2015; 35:474-479.

 

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REFERERNCES

[1]Abrams, HL. The relevance of Paleolithic diet in determining contemporary nutritional needs. J Applied Nutr 1979;31: 43-59.

[2]Chaitow, L. Stone Age Diet. London, Macdonal & Co. (Publishers) Ltd., 1987.

[3]Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002 Dec;138(12):1584-90.

[4]DeVries, A. Primitive Man and His Food. Chicago, Chandler Book Company, 1952.

[5]Dobzhansky T. Am Biol Teacher. 1973 March; 35:125-129.

[6]Eaton SB, et al. Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective. Am J Med 1988;84:739-49.

[7]Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med 1985;312:283-9.

[8]Eaton SB, Shostak M, Konner M. The Paleolithic Prescription. New York, Harper & Row, 1988.

[9]Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, Jr., Sebastian A: Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. Eur J Clin Nutr 2009.

[10]Ho-Pham LT, Nguyen ND, Nguyen TT, Nguyen DH, Bui PK, Nguyen VN, Nguyen TV. Association between vitamin D insufficiency and tuberculosis in a Vietnamese population. BMC Infect Dis. 2010 Oct 25;10:306.

[11]Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol. 2009;8:35

[12]Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M, Frostegard J, Goransson Lindeberg S: A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. Nutr Metab (Lond) 2006, 3:39.

[13]Jonsson T, Granfeldt Y, Erlanson-Albertsson C, Ahren B, Lindeberg S. A Paleolithic diet is more satiating per calorie than a Mediterranean-like diet in individuals with ischemic heart disease. Nutr Metab (Lond). 2010 Nov 30;7(1):85

[14]Lindeberg S, Lundh B: Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: a clinical study in Kitava. J Intern Med 1993, 233(3):269-275.

[15]Lindeberg S, Nilsson-Ehle P, Terént A, Vessby B, Scherstén B. Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease: the Kitava study. J Intern Med. 1994 Sep;236(3):331-40.

[16]Lindeberg S, Berntorp E, Carlsson R, Eliasson M, Marckmann P. Haemostatic variables in Pacific Islanders apparently free from stroke and ischaemic heart disease–the Kitava Study. Thromb Haemost. 1997 Jan;77(1):94-8.

[17]Lindeberg S, Eliasson M, Lindahl B, Ahrén B: Low serum insulin in traditional Pacific Islanders–the Kitava Study. Metabolism 1999, 48(10):1216-1219.

[18]Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B: A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007, 50(9):1795-1807.

[19]Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol. 2008 Feb;37(1):113-9.

[20]Nesse RM, Stearns SC, Omenn GS. Medicine needs evolution. Science 2006;311:1071.

[21]O’Dea K: Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984, 33(6):596-603.

[22]Osterdahl M, Kocturk T, Koochek A, Wandell PE: Effects of a short-term intervention with a paleolithic diet in healthy volunteers. Eur J Clin Nutr 2008, 62(5):682-685.

[23]Price WA. Nutrition and physical degeneration; a comparison of primitive and modern diets and their effects. P.B. Hoeber, Inc., New York, 1939.

[24]Pritchard JK. How we are evolving. Sci Am. 2010 Oct;303(4):40-47.

[24]Shatin R. Man and his cultigens. Scientific Australian 1964;1:34-39

[26]Shatin R. The transition from food-gathering to food-production in evolution and disease. Vitalstoffe Zivilisationskrankheitein 1967;12:104-107.

[27]Talat N, Perry S, Parsonnet J, Dawood G, Hussain R. Vitamin d deficiency and tuberculosis progression. Emerg Infect Dis. 2010 May;16(5):853-5.

[28]Truswell AS. Diet and nutrition of hunter-gatherers. In: Health and disease in tribal societies. New York: Elsevier; 1977:213-21.

[29]Truswell AS. Human Nutritional Problems at Four Stages of Technical Development. Reprint. Queen Elizabeth College (University of London), Inaugural Lecture, May, 1972.

[30]Voegtlin, WL. The Stone Age Diet. New York, Vantage Press, 1975.

[31]Yamshchikov AV, Kurbatova EV, Kumari M, Blumberg HM, Ziegler TR, Ray SM, Tangpricha V. Vitamin D status and antimicrobial peptide cathelicidin (LL-37) concentrations in patients with active pulmonary tuberculosis. Am J Clin Nutr. 2010 Sep;92(3):603-11.

[32]Yudkin, J. Archaeology and the nutritionist. In: The Domestication and Exploitation of Plants and Animals, PJ Ucko, GW Dimbleby (Eds.), Chicago, Aldine Publishing Co, 1969, pp. 547-552.

[33]Williams GC, Nesse RM. The dawn of Darwinian medicine. Q Rev Biol. 1991 Mar;66(1):1-22.

[34]Cordain L. Cereal grains: humanity’s double edged sword. World Review of Nutrition and Dietetics. 1999;84:19-73.

[35]Afsal K, Harishankar M, Banurekha VV, Meenakshi N, Parthasarathy RT, Selvaraj P.Effect of 1,25-dihydroxy vitamin D3 on cathelicidin expression in patients with and without cavitary tuberculosis. Tuberculosis (Edinb). 2014 Dec;94(6):599-605.

[36]Selvaraj P. Vitamin D, vitamin D receptor, and cathelicidin in the treatment of tuberculosis. Vitam Horm. 2011;86:307-25.

[37]Abrams HL. A dischronic perview of wheat in hominid nutrition. J Appl Nutr 1978;30:41-43.

[38]Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: A disease of civilization. Arch Dermatol. 2002;138: 1584-90.

[39]Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Neutraceut Assoc 2002; 5:15-24.

[40]Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54.

Are Sugary Drinks Killing Your Liver? | The Paleo Diet

Everyone knows that increased sugar intake increases your risk for type 2 diabetes and obesity. The consumer market competes daily on how to cater to the average individual’s sweet tooth. In a society that loves the indulgence of super-sized drinks, it becomes easy to fall prey. Given the metabolism and breakdown of sugar takes place in the liver, it is no surprise excess sugar intake can lead to major liver problems.

According to a recent study conducted at Tufts University, and published in the Journal of Hepatology, drinking sugary drinks daily puts you at risk for non-alcoholic fatty liver disease.1 This condition can eventually lead to liver cirrhosis, just like with alcohol, in some cases liver cancer, and have the individual needing a liver transplant.2

In the study, 2,634 self-reported dietary questionnaires from mostly Caucasian middle-aged men and women enrolled in the National Heart Lunch and Blood Institute (NHLBI) Framingham Heart Study’s Offspring and Third Generation cohorts were analyzed. The sugary beverages listed on the questionnaires comprised of caffeinated and caffeine-free colas, other carbonated beverages with sugar, fruit punches, lemonade or other non-carbonated fruit drinks. Afterwards, a computed tomography (CT) scan was carried out on the participants to determine the quantity of fat in the liver and the authors of the current study used a previously defined cut-point to identify NAFLD.

Among the participants who drank sugar sweetened beverages, those who drank one or more sugar-sweetened beverage per day experienced a higher prevalence rate and had a 60% greater risk of NAFLD compared to people who said they drank no sugar-sweetened beverages. This association was still evident even after controlling for possible confounders, which could affect the results, such as age, sex, body mass index, calories and other risk factors. Basically, the more sugary beverage the people drank, the greater the risk. An estimated two thirds of the participants drank at least some fruit, cola or other sugary beverage, and over 10% drank the sugary beverage daily.

Between mislabeling, misleading advertisements, and chronic sugar addiction, it’s easy to understand why Dr. Cordain advocates eating your fruit whole rather than drinking commercial juices, which may be loaded with sugar.

About 20-30% of people living in the US has nonalcoholic fatty liver disease (NAFLD)3. The primary cause behind this condition remains relatively unknown. With NAFLD, in about 25% of the cases, there are no symptoms, with the fat accumulation in the liver only found from imaging results, when the liver has pretty much lost the sugar battle. Researchers have shown obesity increases a person’s risk for NAFLD, as well as a correlation between NAFLD and heart disease and type 2 diabetes.4 In other words, keep drinking that sugary beverage daily, and not only may you need a heart transplant, but you could have also traded in your heart and received a free serving of type 2 diabetes as well. Clearly not a fair or even worthy exchange.

The problem may lie in a part of sugar used in the beverages, known as fructose, and how it is processed within the body. When taken alone, fructose is poorly absorbed from the gastrointestinal tract, and it is almost completely cleared by the liver. While regular glucose blood concentration is with 5.5 mmol/L , that of fructose is about 0.01 mmol/L in peripheral blood.5

Both fructose and glucose follow different paths for absorption in the body. While glucose results in the release of insulin from the pancreas, fructose is unable to do so. Many cells lack the type of sugar transporter that takes fructose into the cell, unlike glucose. The breakdown of fructose mainly takes place in the liver, through a process known as phosphorylation, which avoids the rate-limiting phosphofructokinase step.6 While your body uses up glucose, for example the brain for energy, hepatic metabolism of fructose leads to the free fatty acids (FFAs), VLDL (the damaging form of cholesterol), and triglycerides, which get stored as fat. So, think of drinking that sugary beverage like you are drinking fat, because essentially that is what it ends up as.

Here in the Paleo world, it is safe to understand why we stay far away from commercial products such as sugar sweetened beverages. Not only do they provide empty calories, but there is the possibility of leaving your body in worse shape than imagined. Care for a liver transplant? I’ll pass, that refreshing glass of cold water sounds even better.

 

REFERENCES

[1] Ma, J; Fox, CS; Jacques, PF; Speliotes, EK; Hoffmann, U; Smith, CE; Saltzman, E; and McKeown, NM. (2015, June 5). Sugar-Sweetened Beverage, Diet Soda, and Fatty Liver Disease in the Framingham Study Cohorts. Journal of Hepatology.

[2] Ibid.

[3] Ma, J; Fox, CS; Jacques, PF; Speliotes, EK; Hoffmann, U; Smith, CE; Saltzman, E; and McKeown, NM. (2014, April). Sugar-sweetened beverage intake is associated with fatty liver in the Framingham Offspring Study (267.3).  The FASEB Journal. 28(1).

[4] Cassidy, S., Hallsworth, K., Thoma, C., MacGowan, G., Hollingsworth, K., Day, C., . . . Trenell, M. (2015, Feb 13). Cardiac structure and function are altered in type 2 diabetes and non-alcoholic fatty liver disease and associate with glycemic control. Cardiovasc Diabetol, 14(23). doi:doi: 10.1186/s12933-015-0187-2.

[5] Bray, G. (2007). How bad is fructose?1,2. Am J Clin Nutr, 86(4), 895-896.

[6] Ibid.

The End of the Low-Fat Era? | The Paleo Diet

The year was 1977. The US Senate Select Committee on Nutrition and Human Needs, led by Senator George McGovern, issued the first Dietary Goals for Americans, thereby marking the beginning of the low-fat era of dietary nutrition, arguably the most misguided period of government-led nutrition ever. After 38 years, however, the low-fat era might officially end later this year.

The Dietary Goals evolved into the Department of Health and Human Services’ (HHS) and Department of Agriculture’s (USDA) Dietary Guidelines for Americans, later represented as the Food Pyramid and, currently, as MyPlate. The Guidelines’ dominant theme has been that calories consumed should equal calories expended. And since fat has 9 calories per gram, compared to only 4 for both carbohydrates and protein, fat became typecast as the “bad guy” nutrient.

Furthermore, since saturated fat and dietary cholesterol have been thought to promote cardiovascular disease, the Guidelines have recommended restricting fat to less than 30% (revised to 35% in 2005) of total calories. Consequently, carbohydrates, particularly refined carbohydrates and added sugars, came to replace healthy fats in Americans’ diets.

USDA and HHS update the Guidelines once every five years and the next revision is forthcoming later this year. Historically, the Guidelines echo the Dietary Guidelines Advisory Committee (DGAC) report, written by appointed scientists who systematically review the scientific literature on nutrition. The current DGAC report, published earlier this year, features two monumental deviations from the current Guidelines.

First, as we previously reported, the DGAC no longer considers dietary cholesterol to be a “nutrient of concern.”1 Previously, they recommended limiting cholesterol to 300 mg/day, but now acknowledge, “available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.”

Second, the DGAC recommends removing upper limits on total fat consumption with respect to total calories. “In low fat diets,” they write, “fats are often replaced with refined carbohydrates and this is of particular concern because such diets are generally associated with dyslipidemia.”2 Reducing total fat (replacing total fat with overall carbohydrates), they conclude, “does not lower cardiovascular disease risk.”

So what does all this mean? If USDA and HHS follow the DGAC’s recommendations, the low-fat era will finally end and, going forward, Americans will have more scientifically accurate information about fat and will likely embrace healthful, fatty foods more readily.

CALLING ALL NUTRITION ADVOCATES

The DGAC recommendations are clear, but in making their final decision, the USDA and HHS also consider comments from the public, academics, advocacy groups, and industry. As such, two prominent scientists, Dr. David Ludwig and Dr. Dariush Mozaffarian, recently penned an article for the Journal of the American Medical Association in which they strongly endorsed lifting the total fat limits.3

Their article follows-up on a similar article they co-authored in 2010 about the previous Dietary Guidelines update. In their 2010 article, they recommended moving away from a nutrient-metrics approach, whereby specific nutrient targets are defined, and toward an approach emphasizing specific, healthy foods. They noted that the proportion of total energy from fat “appears largely unrelated to risk of , cancer, diabetes, or obesity” and that saturated fat “has little relation to heart disease within most prevailing dietary patterns.”4

We recently caught up with Dr. Mozaffarian to ask him about this extremely important story.

Q: What are your impressions about the progress made since your 2010 article with Dr. Ludwig? Are we moving in the right direction?

A: The 2015 DGAC report has made great strides in the right direction, with its major new focus on healthful, food-based, diet patterns. Now we must wait to see what the USDA and HHS do with this information in the final Guidelines—boldly move toward this modern evidence, or sit back and return to old conventions.

Assuming the USDA drops its limits on total fat consumption, how impactful do you think this could be?

This could have tremendous positive impact, especially if mirrored in other national policies e.g. food labeling, school lunch, feeding programs, and so on. Consumers and companies would be unshackled to allow focus on increasing healthy foods, including those higher in fat, and on reducing refined grains and sugars.

Would you care to comment on the Paleo diet from a nutritional perspective?

The main benefits of Paleo are recognizing the harms of refined grains, starches, and sugars, which dominate the food supply; and the (potential) focus on fruits, vegetables, nuts, and fish. But, if ‘Paleo’ leads one to high-meat diets, few benefits will be gained.

Dr. Mozaffarian makes a valid point. One of the largest misconceptions surrounding Paleo diets and lifestyles is that it promotes high-meat consumption without balance from other food groups. Dr. Cordain among the many other thought leaders in the scientific and lay communities continue to debunk this misconception. A real Paleo diet is a high-vegetable diet with moderate amounts of animal protein, including lean meat and fish high in omega-3, plus animal and vegetable sources of fat.

In our interview with Dr. Mozaffarian, he also noted that some vegetable oils “are extremely healthy, but are shunned by many Paleo aficionados.” While we respectfully disagree about the health impact of high-omega-6 vegetable oils, we strongly agree that proportional upper limits on total fat must be removed from the US Dietary Guidelines.

For nearly four decades, the US government has promoted high-carbohydrate, low-fat diets. Incidentally, a recent systematic review of the randomized controlled trials available to McGovern’s Committee back in 1977 determined there was no scientific basis for their restrictions on fat.[5] In other words, the low-fat era never should have happened. And with the 2015 Dietary Guidelines update, it should finally end.

 

REFERENCES

[1]

[2] Ibid, Dietary Guidelines Advisory Committee.

[3]

[4]

[5]

Grapefruits: The Best Boost for Your Arteries | The Paleo Diet

INTRODUCTION: HERE IS A GRAPEFRUIT

If you are a devout follower of Paleo, then you know that we encourage eating fruits such as grapefruit. In addition to being low in calories, it is also a great source of vitamin C, as well as vitamin A, vitamin B5, and vitamin B9.1 Furthermore grapefruit is packed with fiber, and phytonutrients like lycopene, limonoids and flavanones.2

Over the years, many scientific studies have shown the great health benefits, including decreasing cancerous growth3, and possibly being as effective in treating diabetes type II as metformin.4 An exceptional study just published in the American Journal of Clinical Nutrition provides great evidence regarding the benefits of grapefruit consumption on vascular function in postmenopausal women and decreasing the risk of arterial stiffness.5 In simpler terms, how drinking grapefruits can boost the arteries, and decrease the risk of developing such as a myocardial infarction/heart attack, or a stroke.

OVERVIEW OF STUDY

Researchers recruited 48 healthy postmenopausal women who were between three to 10 years post menopause. These women were randomly assigned to drink 340 mL of grapefruit juice a day containing 210 mg naringenin glycosides (flavanones), or a matched control drink without flavanones for 6 months each. Then there was a two month washout period between beverages, before the participants were crossed over into the other group.

The most important end-point was the measurement of endothelial function in the brachial artery by means of flow-mediated dilation. Additionally, blood pressure, arterial stiffness, and endothelial function in the peripheral arterial bed were assessed as signs of vascular function. These measurements and blood collection for clinical biochemical markers were carried out in overnight-fasted subjects, pre and post the six month treatment periods.

The results showed a significant decrease in the carotid-femoral pulse wave velocity (PWV) after the consumption of grapefruit juice, at 7.36 m/s. On the other hand, it was 7.70 m/s after consumption of the matched control drink without flavanones. This PWV is seen as the gold standard for evaluating central arterial stiffness, and has a strong correlation with the development of the risk of cardiovascular disease6. The scientists estimate that the PWV reduction of -0.524 m/s is similar to about an absolute 5% risk reduction in cardiovascular disease.

WHAT ARE FLAVANONES?

Many people may be unaware of flavanones. These are compounds that are a subclass of flavonoids, and seen mainly in citrus fruits such as oranges and grapefruits.7 While an orange has the highest amounts of flavanones at 48 mg/100 g aglycones,8 a grapefruit has a total flavanone content (summed means) of 27 mg/100 g9. Lemons contain an overall flavanone content of 26 mg aglycones/100 g edible fruit or juice, while limes have 17 mg aglycones/100 g edible fruit or juice.10 Epidemiological studies showed and demonstrated the many benefits of flavanones including its anti-inflammatory and lipid-lowering properties.11 A previous study demonstrated the possibility of flavanones decreasing the risk of ischemic stroke in women by 17%.12

Well you may be wondering since oranges have a greater content of flavanones, would it not be easier to just drink up some orange juice instead? Well as we have always advocated, commercial juices frequently contain excess sugar, and while you may benefit from the decreased risk of cardiovascular disease, it would be unwise to do so at the expense of diabetes.

ARTERIAL STIFFNESS

As one ages, the aorta stiffens, a process that may be hastened by arterial hypertension.13 It results in a condition known as arteriosclerosis.14 So, if you have high blood pressure, you really should be eating your grapefruits and oranges. Arterial stiffness describes the decreased ability of the artery to swell up and contract as a result of any pressure changes.15 In addition, multiple studies have also shown the predictive significance of arterial stiffness (AS) in a range of populations as an independent predictor of cardiovascular morbidity and all-cause mortality.16

CONCLUSION

In closing, this recent study suggests that the consumption of grapefruit juice by middle aged post-menopausal women is beneficial for arterial stiffness. Given the earlier statement about the possibility of increased sugar in juices, my suggestion instead would be to eat grapefruit whole instead, as we recommend with other fruit and vegetables when following a Paleo diet. Moreover, careful chewing has been shown to stimulate the release of 2 intestinal peptides which decrease appetite and food intake.17 This indicates more benefits for you to actually eat a grapefruit, instead of drinking the juice.

 

REFERENCES

[1] Consumption of Clarified Grapefruit Juice Ameliorates High-Fat Diet Induced Insulin Resistance and Weight Gain in Mice. PLoS ONE 9(10): e108408. doi:10.1371/journal.pone.0108408

[2] Consumption of Clarified Grapefruit Juice Ameliorates High-Fat Diet Induced Insulin Resistance and Weight Gain in Mice. PLoS ONE 9(10): e108408. doi:10.1371/journal.pone.0108408

[3] Consumption of Clarified Grapefruit Juice Ameliorates High-Fat Diet Induced Insulin Resistance and Weight Gain in Mice. PLoS ONE 9(10): e108408. doi:10.1371/journal.pone.0108408

[4] Chudnovskiy R, Thompson A, Tharp K, Hellerstein M, Napoli JL, Stahl A (2014) Consumption of Clarified Grapefruit Juice Ameliorates High-Fat Diet Induced Insulin Resistance and Weight Gain in Mice. PLoS ONE 9(10): e108408. doi:10.1371/journal.pone.0108408

[5] Habauzit V, Verny MA, Milenkovic D, Barber-Chamoux N, Mazur A, Dubray C, Morand C.Flavanones protect from arterial stiffness in postmenopausal women consuming grapefruit juice for 6 mo: a randomized, controlled, crossover trial. Am J Clin Nutr. 2015 Jul;102(1):66-74. doi: 10.3945/ajcn.114.104646

[6] Cavalcante JL, Lima JC, Redheuil A, Al-Mallah MH. Aortic Stiffness: Current Understanding and Future Directions. J Am Coll Cardiol. 2011;57(14):1511-1522. doi:10.1016/j.jacc.2010.12.017.

[7] Peterson, J., Beecher, G., Bhagwat, S., Dwyer, J., Gebhardt, S., Haytowitz, D., & Holden, J. (2006). Flavanones in grapefruit, lemons, and limes: A compilation and review of the data from the analytical literature. Journal of Food Composition and Analysis, 19, S74–S80.

[8] Peterson, J., Beecher, G., Bhagwat, S., Dwyer, J., Gebhardt, S., Haytowitz, D., & Holden, J. (2006). Flavanones in grapefruit, lemons, and limes: A compilation and review of the data from the analytical literature. Journal of Food Composition and Analysis, 19, S74–S80.

[9] Peterson, J., Beecher, G., Bhagwat, S., Dwyer, J., Gebhardt, S., Haytowitz, D., & Holden, J. (2006). Flavanones in grapefruit, lemons, and limes: A compilation and review of the data from the analytical literature. Journal of Food Composition and Analysis, 19, S74–S80.

[10] Peterson, J., Beecher, G., Bhagwat, S., Dwyer, J., Gebhardt, S., Haytowitz, D., & Holden, J. (2006). Flavanones in grapefruit, lemons, and limes: A compilation and review of the data from the analytical literature. Journal of Food Composition and Analysis, 19, S74–S80.

[11] Peterson, J., Beecher, G., Bhagwat, S., Dwyer, J., Gebhardt, S., Haytowitz, D., & Holden, J. (2006). Flavanones in grapefruit, lemons, and limes: A compilation and review of the data from the analytical literature. Journal of Food Composition and Analysis, 19, S74–S80.

[12] Cassidy, A., Rimm, E., O’Reilly, E., Logroscino, G., Kay, C., Chiuve, S., & Rexrode, K. (2012). Dietary Flavonoids and Risk of Stroke in Women. Stroke, 43, 946-951. doi:10.1161/STROKEAHA.111.637835

[13] Cavalcante JL, Lima JC, Redheuil A, Al-Mallah MH. Aortic Stiffness: Current Understanding and Future Directions. J Am Coll Cardiol. 2011;57(14):1511-1522. doi:10.1016/j.jacc.2010.12.017.

[14] Cavalcante JL, Lima JC, Redheuil A, Al-Mallah MH. Aortic Stiffness: Current Understanding and Future Directions. J Am Coll Cardiol. 2011;57(14):1511-1522. doi:10.1016/j.jacc.2010.12.017.

[15] Cavalcante JL, Lima JC, Redheuil A, Al-Mallah MH. Aortic Stiffness: Current Understanding and Future Directions. J Am Coll Cardiol. 2011;57(14):1511-1522. doi:10.1016/j.jacc.2010.12.017.

[16] Cavalcante JL, Lima JC, Redheuil A, Al-Mallah MH. Aortic Stiffness: Current Understanding and Future Directions. J Am Coll Cardiol. 2011;57(14):1511-1522. doi:10.1016/j.jacc.2010.12.017.

[17] Keller, D. (2011, September 13). Thorough Chewing Raises Hormones Regulating Food Intake. Retrieved July 9, 2015, from Medscape: //www.medscape.com/viewarticle/749504

Not So (Artifically) Sweet | The Paleo Diet

I have had countless clients try to replace their sugar-laden diets with ones rich with artificial sweeteners. While this may work in the short term, it definitely does not work in the long term.1 2 And, the reasons for this are countless.3,

New research shows sugars specifically activate six neurosecretory cells in the brain, which produce Dh44, a homolog of the mammalian corticotropin-releasing hormone.4, 5 Artificial sweeteners do not activate these same cells – possibly leaving the brain in a half-finished reward state – potentially leading to more calories being taken in.6, 7

Not So (Artificially) Sweet | The Paleo Diet

Yang, Qing. “Gain Weight by ‘going Diet?’ Artificial Sweeteners and the Neurobiology of Sugar Cravings: Neuroscience 2010.” The Yale Journal of Biology and Medicine 83.2 (2010): 101–108. Print.

Another issue with artificial sweeteners is they are typically much, much sweeter than sugar. Just how much sweeter are these manmade creations? Most artificial sweeteners are 200-400 times sweeter than regular table sugar!8 Many researchers argue this leaves the brain expecting a plethora of calories, and also disrupts the brain’s natural reward mechanisms.9

While followers of the Paleo diet will certainly know that artificial sweeteners have no place in a healthy lifestyle, many who are trying to change their eating habits rely on artificial sweeteners for brief time periods. Not a great idea. As the scientific literature suggests, artificial sweeteners (because they are sweet) encourage sugar craving and sugar dependence.10

Even stevia, which many will argue is a healthier alternative to most artificial sweeteners, is 100-300 times sweeter than table sugar!11 It is certainly not a good idea to be consuming something that sweet on a regular basis – whether it contains sugar or not. Furthermore, artificial sweeteners are typically packaged in foods or drinks that have a laundry list of other negative substances and artificial ingredients.12

Salient scientific studies clearly show how in repeatedly exposing ourselves to sugar, we help to train our flavor preference. In short – the more sweet we eat, the more we crave and expect it. Many studies have shown lowering fat and/or salt intake, over several weeks, leads to less craving of these elements. This is exactly how you should treat sugar and artificial sweeteners.

Not So (Artificallyy) Sweet | The Paleo Diet

Sclafani, Anthony. “Sweet Taste Signaling in the Gut.” Proceedings of the National Academy of Sciences of the United States of America 104.38 (2007): 14887–14888. PMC. Web. 7 July 2015.

On a granular level, T1R2 and T1R3 sweet taste receptors are found in taste cells in the mouth and enteroendocrine cells in the gut.13 Stimulation of the T1R2 and T1R3 receptors in the mouth by sugars and artificial sweeteners activates intracellular signaling elements, which trigger peripheral taste nerves and brain gustatory pathways. This is one way in which artificial sweeteners actually have a similar effect to sugar – which is not a good thing.

Moreover, research shows substituting sucrose-sweetened drinks for diet drinks does not reduce total energy intake – and may even result in a higher intake during the following day.14 Artificial sweeteners are not the answer.

Even back in 1986, researchers concluded that the data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain.15

Not So (Artifically) Sweet | The Paleo Diet

Fernstrom, John D. et al. “Mechanisms for Sweetness.” The Journal of Nutrition 142.6 (2012): 1134S–1141S. PMC. Web. 7 July 2015.

So why are artificial sweeteners still used? Well, quite simply: money and industry.

Artificial sweeteners are beneficial to the food industry for a variety of reasons. One – they are cheap, and can help make poor quality foods taste ‘better’. Two – it makes it seem like they care. They sell you the sugar-laden stuff, and then – if you are ‘health conscious’ – you can buy their artificially sweetened product instead. Either way – they win.

I may be preaching to the converted here on The Paleo Diet, but often times even the most disciplined of us slowly let little ‘cheats’ into our diet – without realizing the long term impacts these seemingly innocuous choices may be having on our bodies and brains. If we have any hope of getting out of the current obesity pandemic we currently find ourselves in, it starts with removing all the sweetness (artificial or not) from our collective diet.16, 17, 18, 19, 20, 21 Your health (and waistline) will thank you for it!

 

REFERENCES

[1] Feijó Fde M, Ballard CR, Foletto KC, et al. Saccharin and aspartame, compared with sucrose, induce greater weight gain in adult Wistar rats, at similar total caloric intake levels. Appetite. 2013;60(1):203-7.

[2] Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. Eur J Clin Nutr. 2007;61(6):691-700.

[3] Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514(7521):181-6.

[4] Available at: //www.endocrinologyadvisor.com/neuroendocrinology/sugar-artificial-sweeteners-satiety/article/423644/. Accessed July 5, 2015.

[5] Dus M, Lai JS, Gunapala KM, et al. Nutrient Sensor in the Brain Directs the Action of the Brain-Gut Axis in Drosophila. Neuron. 2015;87(1):139-51.

[6] Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16(8):1894-900.

[7] Blundell JE, Hill AJ. Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet. 1986;1(8489):1092-3.

[8] Pandurangan M, Park J, Kim E. Aspartame downregulates 3T3-L1 differentiation. In Vitro Cell Dev Biol Anim. 2014;50(9):851-7.

[9] Fernstrom JD, Munger SD, Sclafani A, De araujo IE, Roberts A, Molinary S. Mechanisms for sweetness. J Nutr. 2012;142(6):1134S-41S.

[10] Yang Q. Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010;83(2):101-8.

[11] Goyal SK, Samsher, Goyal RK. Stevia (Stevia rebaudiana) a bio-sweetener: a review. Int J Food Sci Nutr. 2010;61(1):1-10.

[12] Kellett GL, Brot-laroche E, Mace OJ, Leturque A. Sugar absorption in the intestine: the role of GLUT2. Annu Rev Nutr. 2008;28:35-54.

[13] Sclafani A. Sweet taste signaling in the gut. Proc Natl Acad Sci USA. 2007;104(38):14887-8.

[14] Lavin JH, French SJ, Read NW. The effect of sucrose- and aspartame-sweetened drinks on energy intake, hunger and food choice of female, moderately restrained eaters. Int J Obes Relat Metab Disord. 1997;21(1):37-42.

[15] Stellman SD, Garfinkel L. Artificial sweetener use and one-year weight change among women. Prev Med. 1986;15(2):195-202.

[16] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[17] Soeliman FA, Azadbakht L. Weight loss maintenance: A review on dietary related strategies. J Res Med Sci. 2014;19(3):268-75.

[18] Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307-21.

[19] Isganaitis E, Lustig RH. Fast food, central nervous system insulin resistance, and obesity. Arterioscler Thromb Vasc Biol. 2005;25(12):2451-62.

[20] Lustig RH, Sen S, Soberman JE, Velasquez-mieyer PA. Obesity, leptin resistance, and the effects of insulin reduction. Int J Obes Relat Metab Disord. 2004;28(10):1344-8.

[21] Lustig RH. The neuroendocrinology of obesity. Endocrinol Metab Clin North Am. 2001;30(3):765-85.

Does Fructose Promote Overeating? | The Paleo Diet

In the early 1980s, public health authorities began warning that saturated fat was driving obesity and various degenerative diseases. During this same period, high-fructose corn syrup (HFCS) rose to prominence, sneaking itself into processed foods, especially sodas, cookies, and cakes.

Saturated fat consumption fell. Sugar consumption and overall caloric intake rose. Obesity, metabolic syndrome, , and other diet-related diseases got worse. These disturbing facts have prompted nutrition scientists to begin investigate fructose (a primary type of sugar) as a possible driver of the obesity crisis.

Does fructose uniquely promote overeating? Does fructose affect satiety differently than other sugars, particularly ?

Before looking into these questions, we should note that fructose is almost always accompanied by glucose in natural foods. The following chart, for example, shows the sugar content of common foods.

Does Fructose Promote Overeating? | The Paleo Diet

Almost all foods containing sugars, including vegetables, include both glucose and fructose (as well as sucrose, which is 50% fructose and 50% glucose). The ratio of fructose to glucose for most foods hovers around 50:50 and generally never exceeds 70:30.

It’s been suggested that high-fructose corn syrup is more dangerous than table sugar because it contains proportionally more fructose, a modest 55% compared to 50% for ordinary table sugar. According to the numbers in the chart, if fructose were inherently more dangerous than glucose, we would have to conclude that apples and pears are worse than bananas and blueberries.

So is there any evidence that fructose promotes overeating? Is snacking on apples rather than bananas a bad idea? In 2013, a study published in the Journal of the American Medical Association sparked headlines like, “Fructose changes brain to cause overeating, scientists say,” and “Revealed: fructose ‘may spur overeating.’”1, 2

From the actual study, we read, “Glucose but not fructose ingestion reduced the activation of the hypothalamus, insula, and striatum—brain regions that regulate appetite, motivation, and reward processing; glucose ingestion also increased functional connections between the hypothalamic-striatal network and increased satiety.”3

It seems convincing. But was this study representative of real-world scenarios? Let’s see how the study was organized. The scientists worked with 20 normal-weight subjects (10 men, 10 women) without diabetes and a mean age of 31. The study was a blinded, random-order crossover design (so far so good).

Following an overnight fast, subjects drank 300ml of cherry-flavored water with either 75g of fructose or 75g of glucose. 60 minutes later, blood samples were drawn and the subjects completed a series of surveys rating “feelings of hunger, satiety, and fullness on a scale of 1 to 10.”

First of all, 75g of sugar, whether fructose or glucose, is an inordinately large amount to consume at one time. Roughly equivalent to 2.5 cans of soda, this might not be reflective of real-world consumption patterns. More importantly, however, we never consume foods or beverages sweetened entirely by fructose or by glucose. Invariably, both sugars are present, typically in 50:50 ratios.

This study made headlines because it contradicted previous studies. A 2007 study, for example, tested energy balance and satiety of high-fructose corn syrup (55% fructose, 45% glucose) compared to sucrose (50% fructose, 50% glucose). The scientists found that glucose and fructose contribute to satiety through different biochemical mechanisms, but overall there are no significant differences between sucrose- and HFCS-sweetened drinks with respect to satiety and energy balance.4

Ultimately, the fructose/overeating issue comes down to quantity and form (whole foods versus liquids). Fructose appears to have bidirectional effects. In other words, effects on certain biomarkers (fasting triglycerides, insulin sensitivity, etc.) at moderate doses may be absent or even opposite those observed at very high/excessive doses.5

Very high/excessive doses are almost certainly detrimental, but moderate doses, especially when consumed as whole foods, can be very beneficial. Researchers from the Harvard School of Public Health, for example, determined that consumption of whole fruits, particularly blueberries, grapes, and apples, is associated with decreased type-2 diabetes risk, whereas consumption of fruit juice is associated with increased risk.6

THE BOTTOM LINE

Foods containing fructose, especially fruits and vegetables, are healthy when consumed as part of a balanced Paleo diet. Eating a couple pieces of fruit each day doesn’t promote overeating, but drinking 4 cans of soda or fruit juice might. More research must be done to better understand fructose, but when you read that fructose is dangerous, ask about the quantity, source, and form (liquid/whole food) of fructose. Also keep in mind that glucose almost always accompanies fructose in real foods, so studies on pure fructose consumption may not be relevant to real-world eating.

Christopher James Clark, B.B.A.


Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, .

 

REFERENCES

[1] CBS/Associated Press. (January 2, 2013). Fructose changes brain to cause overeating, scientists say. CBS News. Retrieved from //www.cbsnews.com/news/fructose-changes-brain-to-cause-overeating-scientists-say/

[2] Associated Press. (January 2, 2013). Revealed: fructose ‘may spur overeating.’ The Independent. Retrieved from //www.independent.co.uk/life-style/health-and-families/health-news/revealed-fructose-may-spur-overeating-8434959.html

[3] Page, KA., et al. (January 2, 2013). Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved With Appetite and Reward Pathways. Journal of the American Medical Association, 309(1). Retrieved from //jama.jamanetwork.com/article.aspx?articleid=1555133

[4] Soenen, S., et al. (December 2007). No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preloads. American Journal of Clinical Nutrition, 86(6). Retrieved from //ajcn.nutrition.org/content/86/6/1586.full

[5] Livesey, G. (April 22, 2009). Fructose Ingestion: Dose-Dependent Responses in Health Research. The Journal of Nutrition, 139(6). Retrieved from //jn.nutrition.org/content/139/6/1246S

[6] Muraki, I., et al. (August 29, 2013). Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. British Medical Journal, 347. Retrieved from //www.bmj.com/content/347/bmj.f5001

Nutrition Divided: Low-Fat vs. High-Fat Diet | The Paleo Diet

The amount of debate in the nutrition field has never been greater.1, 2, 3 As Americans (and everyone in the world) gets progressively more obese, we seem to be digging into our respective trenches, saying ‘this diet or that diet will cure all ills’.4, 5 This is a sad waste of resources, and a little bit irresponsible, especially in a field where the endgame should be helping people – not furthering one’s own agenda. Sure, you may say I’m biased as well, writing this piece for The Paleo Diet. But the bottom line is, I care about people’s health more than I care about making money.

If you don’t believe me, go ahead and take a look at my website . See if I have anything for sale, or any agenda to be pushed. You will find that I have a nutrition lecture, with slides and scientific references for sale, for a whopping $2 – and that’s it. And it isn’t a ‘pro-Paleo, bash everything else’ lecture. It highlights the science behind good nutritional choices. The long-winded opening here is simply to make a point: everyone who has a ‘big voice’ in nutrition – also has an agenda.6, 7, 8 And they’re not going to stray from their agenda, because it might mean less book sales, less money and less of a voice.

Possibly the single best example of this is Dean Ornish.9 While at first glance Ornish seems like a great nutrition icon (after all, he pushes low fat diets, lots of vegetables, etc.) if you dig a little below the surface, you will find some rot.10 Okay – lots of rot.11 Did you know that Ornish is paid by McDonald’s?12 Yes – that McDonald’s. ConAgra and Pepsi Co. also have Ornish on the payroll.13, 14 Since we all clearly know that McDonald’s, ConAgra and Pepsi are making us all healthier, we really should applaud Dr. Ornish for his work – right? My tongue is planted firmly in cheek on that one.

Nonetheless, because I firmly believe in unbiased science, if Ornish’s approach had some scientific merit, I would actually applaud him for some of his work (the Big Food work is never going to get my approval, but to each their own). But the simple fact is – Ornish’s approach has little-to-no scientific merit.15, 16 While he is indeed correct in stating that we all likely need to eat more vegetables, he goes far away from good science by virtually ignoring the huge problem of sugar – which is undoubtedly one of our biggest dietary downfall in the last 50 years.17, 18, 19 Is it a mere coincidence that if Ornish bashed sugar, he might lose his McDonald’s, ConAgra and Pepsi deals? I think any astute reader will clearly be able to draw the obvious conclusion here.

If you haven’t caught on to the fact that your favorite dietary “guru” may just be cashing in on things, it may be a good idea to take a look around and do some internet searching – just to see what really goes on behind the scenes. If one wants to see some clear bias in action, go ahead and read Dr. Ornish’s piece for The New York Times.20 But this isn’t to simply bash Ornish – like any headline-grabbing nutrition guru, he does offer some good advice. Because when it comes to nutrition, there are always some broad agreements that can be made.21, 22

No one will ever debate that organic vegetables should be included in every diet.23, 24 That is because they have clearly been found to support many different neuronal and physiologic processes.25 26, 27 Though Ornish himself ignores this next point (another nail in the coffin for his bias) almost everyone else agrees that good amounts of healthy fats are very beneficial (elements such as extra virgin olive oil, avocados, almonds, etc.).28, 29, 30 Another common point that nearly everyone agrees on? Eating organic, lean protein.31, 32, 33 This means wild caught salmon, organic chicken and other muscle-building sources of essential amino acids.

Another point that – again, everyone but seemingly Ornish – can agree on? Keep sugar to a minimum – especially added sugar.34, 35 Even the World Health Organization agrees on this point.36 If Ornish’s bias isn’t crystal clear by now, then I’d be shocked. You can also clearly see that I have yet to mention a Paleo Diet. Again, I am not biased. Does it happen that all of these points fall squarely under the Paleo Diet umbrella? Sure. But all of these elements also fall under the Mediterranean Diet umbrella – which nearly everyone in the nutrition world agrees – is extremely healthy.37 And guess what? The science backs up that diet, too.38

Even Dr. David Perlmutter’s often controversial ketogenic diet approach, is substantiated by sound scientific research.39 While one could argue the science doesn’t quite back up all of Dr. Perlmutter’s conclusions yet, the point is he has salient scientific data to support his claims. And I do think one day he will end up being right about nearly everything he states in his book. Only time – and more scientific research – will tell.

So, when you look to indulge in a healthy diet, they may be confused by all of the noise in the media. At that point, I think it is important readers look to the science. And what does the science say? Avoid lots of sugar, eat lots of vegetables, eat lots of healthy fats, and consume quality sources of protein.40 That is all you really need, to put together a healthy diet.

Another huge issue here, which seemingly is only hinted at, is that people have trouble sticking to any diet.41 That is another discussion for another day, but the human factor must be weighed into the scientific debate, as well. The bottom line is, take care of yourself, worry only about your health, and not the back-and-forth bantering that goes on in the media.

There is very little new in the world of nutrition, and the same foods which have been helping humans thrive for centuries, will also be the ones we should keep consuming, since our physiology will not change enough by the time I’m dead, or you are dead, to warrant brand new food choices. If you are overweight, think of all the food choices that led you to this state. Too much sugar? Too many processed foods? Not enough vegetables? That’s what I thought. You don’t need to read biased, industry-backed propaganda to know what to eat. Intrinsically, you’ve known all along.
 

REFERENCES

[1] Willett WC. Diet and health: what should we eat?. Science. 1994;264(5158):532-7.

[2] Kornhuber J. [What should we eat?]. Fortschr Neurol Psychiatr. 2014;82(6):309-10.

[3] Adams SM, Standridge JB. What should we eat? Evidence from observational studies. South Med J. 2006;99(7):744-8.

[4] Roth J, Qiang X, Marbán SL, Redelt H, Lowell BC. The obesity pandemic: where have we been and where are we going?. Obes Res. 2004;12 Suppl 2:88S-101S.

[5] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[6] Available at: //www.npr.org/templates/story/story.php?storyId=6759000. Accessed May 5, 2015.

[7] Available at: //www.nytimes.com/2007/01/09/health/09research.html. Accessed May 5, 2015.

[8] Available at: //www.latimes.com/entertainment/tv/showtracker/la-et-st-dr-oz-hits-back-with-investigation-of-mysterious-critics-20150423-story.html. Accessed May 5, 2015.

[9] Available at: //www.yourdoctorsorders.com/2011/12/the-ornish-myth/. Accessed May 5, 2015.

[10] Available at: //www.menshealth.com/nutrition/high-protein-diets. Accessed May 5, 2015.

[11] Available at: //articles.chicagotribune.com/1990-11-15/entertainment/9004040864_1_fat-diet-nathan-pritikin-diseased-arteries. Accessed May 5, 2015.

[12] Available at: //www.weightymatters.ca/2007/02/dr-dean-ornish-shills-for-mcdonalds.html. Accessed May 5, 2015.

[13] Available at: //www.foodonline.com/doc/dr-dean-ornish-endorses-conagras-natural-food-0001. Accessed May 5, 2015.

[14] Available at: //www.hsc.wvu.edu/Wellness/Dr-Dean-Ornish-Program/Bio-Dean-Ornish.aspx. Accessed May 5, 2015.

[15] Available at: //www.scientificamerican.com/article/why-almost-everything-dean-ornish-says-about-nutrition-is-wrong/. Accessed May 5, 2015.

[16] Gardner CD, Kiazand A, Alhassan S, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA. 2007;297(9):969-77.

[17] Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;174(4):516-24.

[18] Ahmed SH, Guillem K, Vandaele Y. Sugar addiction: pushing the drug-sugar analogy to the limit. Curr Opin Clin Nutr Metab Care. 2013;16(4):434-9.

[19] Avena NM, Rada P, Hoebel BG. Sugar and fat bingeing have notable differences in addictive-like behavior. J Nutr. 2009;139(3):623-8.

[20] Available at: //www.nytimes.com/2015/03/23/opinion/the-myth-of-high-protein-diets.html. Accessed May 5, 2015.

[21] Liu RH. Health-promoting components of fruits and vegetables in the diet. Adv Nutr. 2013;4(3):384S-92S.

[22] Steinmetz KA, Potter JD. Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc. 1996;96(10):1027-39.

[23] Magkos F, Arvaniti F, Zampelas A. Organic food: buying more safety or just peace of mind? A critical review of the literature. Crit Rev Food Sci Nutr. 2006;46(1):23-56.

[24] Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. Am J Clin Nutr. 2003;78(3 Suppl):517S-520S.

[25] Martin A, Cherubini A, Andres-lacueva C, Paniagua M, Joseph J. Effects of fruits and vegetables on levels of vitamins E and C in the brain and their association with cognitive performance. J Nutr Health Aging. 2002;6(6):392-404.

[26] Polidori MC, Praticó D, Mangialasche F, et al. High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 2009;17(4):921-7.

[27] Pandey KB, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009;2(5):270-8.

[28] Lawrence GD. Dietary fats and health: dietary recommendations in the context of scientific evidence. Adv Nutr. 2013;4(3):294-302.

[29] De roos N, Schouten E, Katan M. Consumption of a solid fat rich in lauric acid results in a more favorable serum lipid profile in healthy men and women than consumption of a solid fat rich in trans-fatty acids. J Nutr. 2001;131(2):242-5.

[30] Willett WC. Dietary fat plays a major role in obesity: no. Obes Rev. 2002;3(2):59-68.

[31] Brehm BJ, D’alessio DA. Benefits of high-protein weight loss diets: enough evidence for practice?. Curr Opin Endocrinol Diabetes Obes. 2008;15(5):416-21.

[32] Paddon-jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008;87(5):1558S-1561S.

[33] Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373-85.

[34] Clabaugh K, Neuberger GB. Research evidence for reducing sugar sweetened beverages in children. Issues Compr Pediatr Nurs. 2011;34(3):119-30.

[35] Basu S, Lewis K. Reducing added sugars in the food supply through a cap-and-trade approach. Am J Public Health. 2014;104(12):2432-8.

[36] Available at: //www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/. Accessed May 5, 2015.

[37] Willett WC. The Mediterranean diet: science and practice. Public Health Nutr. 2006;9(1A):105-10.

[38] Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol. 2006;59(6):912-21.

[39] Available at: //www.drperlmutter.com/learn/studies/. Accessed May 5, 2015.

[40] Babio N, Bulló M, Salas-salvadó J. Mediterranean diet and metabolic syndrome: the evidence. Public Health Nutr. 2009;12(9A):1607-17.

[41] Thomas SL, Hyde J, Karunaratne A, Kausman R, Komesaroff PA. “They all work.when you stick to them”: a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals. Nutr J. 2008;7:34.

Getting Fatter and Fatter: The Psychology of Eating | The Paleo Diet

What we eat is determined by how we feel. But what we feel is partially determined by what we eat.1, 2, 3 This paradoxical catch-22 is doubly important because of the obesity pandemic which we currently find ourselves in.4, 5 Clearly, there is a great psychological disruption from the obvious paradigm of eating healthy foods, which help us to feel good and keep us on a healthy path.6, 7 And the mere fact that that issue is so largely affecting so many of us, means that there must be a lot more to this issue.

Getting Fatter and Fatter: The Psychology of Eating | The Paleo Diet

Asmaro, Deyar, and Mario Liotti. “High-Caloric and Chocolate Stimuli Processing in Healthy Humans: An Integration of Functional Imaging and Electrophysiological Findings.” Nutrients 6.1 (2014): 319–341. PMC. Web. 10 Apr. 2015.

When we eat vegetables, like kale, broccoli or spinach, we don’t attain any reward, biochemically speaking. However, we, as a world, are now largely subsisting on processed, junk and fast foods – all of which affect our psychology much differently.8, 9 Drinking 20 oz. of soda is a quick way to short-circuit your brain’s pleasure center – by giving it too much, too fast.10, 11

Getting Fatter and Fatter: The Psychology of Eating

Gómez-Pinilla, Fernando. “Brain Foods: The Effects of Nutrients on Brain Function.” Nature reviews. Neuroscience 9.7 (2008): 568–578. PMC. Web. 10 Apr. 2015.

But perhaps worse, is that we are now consuming these foods when we are stressed. And we are now stressed all the time.12 Food as a coping mechanism is a very unhealthy relationship, and more and more, that’s the kind of relationship our citizens are in.13 With the short-term reward of a digital, hyper-connected world, we now seek less and less direct human companionship, resulting in a closer relationship with food, or more accurately, “food-like products.”14

Processed, microwaved pizzas, donuts, pastries, sugary breakfast cereals – these have become our fallbacks.15 As we become lonelier and more isolated, we become closer and closer with our genetically modified foodstuffs. And as a result, we become fatter and fatter. We also develop a deeply unsettling relationship with food, as we psychologically use it as a crutch for just about everything.16, 17

We no longer even seem to know the difference between cravings and hunger. And this is the key difference that stops us from making poor, stress-related food choices. Sugar alone is a key issue that is destroying our world’s health.18 Perhaps having the greatest single impact on the psychology around food, sugar is by far the biggest factor that we can control, and which will make the biggest difference on our mental health, in regards to food.19

Getting Fatter and Fatter: The Psychology of Eating | The Paleo Diet

Gómez-Pinilla, Fernando. “Brain Foods: The Effects of Nutrients on Brain Function.” Nature reviews. Neuroscience 9.7 (2008): 568–578. PMC. Web. 10 Apr. 2015.

By avoiding excess amounts of sugar, we are automatically focusing on more nutritious food choices. And this is what we need, more than anything else, in order to regain a healthy mental relationship with food.20, 21, 22 Eating meals when we’re hungry, full of brain healthy foods, will help us focus on what really matters – rather than something that temporarily relieves our stress.

And perhaps the worst element of all, is that the more and more we consume foods empty in calories and high in reward – the more we need of them – just to feel normal. This is due to a down-regulation of D2 (dopamine) receptors.23 This is the same mechanism that underlies addictions to alcohol, cocaine and other addictive substances.24, 25 Surprising, isn’t it?

Since Americans are now eating about four to five times more than the amount of sugar they actually need – this is a serious problem.26, 27 And, once our brain feels that reward – it never forgets it. This is the crux of the underlying psychological hold which food has on us. When stressed, we don’t turn to sweet potatoes, kale and liver – we turn to candy, soda – the “hard” stuff.

Consuming a Paleo Diet will help us avoid excess, processed sugar, and will reward our brain in a different way – with neuron-boosting nutrients. Not only does this improve our psychological relationship with food, it keeps us trim and fit. Win-win. Instead of spending your brain’s energy thinking about donuts and sugar, focus instead on Paleo-friendly foods like wild-caught fish, grass-fed beef and spinach.

Avoid those psychologically unhealthy “foods” made in factories and with added chemicals and preservatives – and you will be well on your way to improving your mental and physical health.  This is a definite step in the right psychological direction – just by changing the food on your plate. Your health is ultimately in your control – make the right choices when it comes to the psychology of eating, and you will be much healthier for it.

 

REFERENCES

[1] Nguyen-rodriguez ST, Unger JB, Spruijt-metz D. Psychological determinants of emotional eating in adolescence. Eat Disord. 2009;17(3):211-24.

[2] Harris JL, Bargh JA, Brownell KD. Priming effects of television food advertising on eating behavior. Health Psychol. 2009;28(4):404-13.

[3] Wilson GT, Grilo CM, Vitousek KM. Psychological treatment of eating disorders. Am Psychol. 2007;62(3):199-216.

[4] Roth J, Qiang X, Marbán SL, Redelt H, Lowell BC. The obesity pandemic: where have we been and where are we going?. Obes Res. 2004;12 Suppl 2:88S-101S.

[5] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[6] Blechert J, Goltsche JE, Herbert BM, Wilhelm FH. Eat your troubles away: electrocortical and experiential correlates of food image processing are related to emotional eating style and emotional state. Biol Psychol. 2014;96:94-101.

[7] Asmaro D, Liotti M. High-caloric and chocolate stimuli processing in healthy humans: an integration of functional imaging and electrophysiological findings. Nutrients. 2014;6(1):319-41.

[8] Smeets PA, De graaf C, Stafleu A, Van osch MJ, Nievelstein RA, Van der grond J. Effect of satiety on brain activation during chocolate tasting in men and women. Am J Clin Nutr. 2006;83(6):1297-305.

[9] Gómez-pinilla F. Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci. 2008;9(7):568-78.

[10] Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20-39.

[11] Green E, Murphy C. Altered processing of sweet taste in the brain of diet soda drinkers. Physiol Behav. 2012;107(4):560-7.

[12] Jackson M. The stress of life: a modern complaint?. Lancet. 2014;383(9914):300-1.

[13] Rorabaugh JM, Stratford JM, Zahniser NR. A relationship between reduced nucleus accumbens shell and enhanced lateral hypothalamic orexin neuronal activation in long-term fructose bingeing behavior. PLoS ONE. 2014;9(4):e95019.

[14] Cohen DA, Babey SH. Contextual influences on eating behaviours: heuristic processing and dietary choices. Obes Rev. 2012;13(9):766-79.

[15] Kant AK. Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr. 2000;72(4):929-36.

[16] Greeno CG, Wing RR. Stress-induced eating. Psychol Bull. 1994;115(3):444-64.

[17] Nguyen-rodriguez ST, Unger JB, Spruijt-metz D. Psychological determinants of emotional eating in adolescence. Eat Disord. 2009;17(3):211-24.

[18] Hoebel BG, Avena NM, Bocarsly ME, Rada P. Natural addiction: a behavioral and circuit model based on sugar addiction in rats. J Addict Med. 2009;3(1):33-41.

[19] Lien L, Lien N, Heyerdahl S, Thoresen M, Bjertness E. Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway. Am J Public Health. 2006;96(10):1815-20.

[20] Lieberman HR. Nutrition, brain function and cognitive performance. Appetite. 2003;40(3):245-54.

[21] Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006;10(5):377-85.

[22] Bradbury J. Docosahexaenoic acid (DHA): an ancient nutrient for the modern human brain. Nutrients. 2011;3(5):529-54.

[23] Halpern CH, Tekriwal A, Santollo J, et al. Amelioration of binge eating by nucleus accumbens shell deep brain stimulation in mice involves D2 receptor modulation. J Neurosci. 2013;33(17):7122-9.

[24] Liu Y, Von deneen KM, Kobeissy FH, Gold MS. Food addiction and obesity: evidence from bench to bedside. J Psychoactive Drugs. 2010;42(2):133-45.

[25] Suto N, Ecke LE, Wise RA. Control of within-binge cocaine-seeking by dopamine and glutamate in the core of nucleus accumbens. Psychopharmacology (Berl). 2009;205(3):431-9.

[26] Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120(11):1011-20.

[27] Terry-mcelrath YM, Johnston LD, O’malley PM. Trends in competitive venue beverage availability: findings from US secondary schools. Arch Pediatr Adolesc Med. 2012;166(8):776-8.

Mid-Victorian Diet, How Far Have We Come? | The Paleo Diet

Review of:

Context: Early Victorian era was plagued with starvation; this was corrected, technically, during the late Victorian era, but at what cost?

Dietary changes in the late 19th century in Britain reduced malnutrition and starvation-induced morbidity and mortality, but were far from optimal.

Refined flour, fresh and tinned meat, canned fruit preserved in heavy syrups, and evaporated milk became readily available to the public. In turn, sugar consumption increased exponentially.

Reduced starvation? The population at large became weaker and frailer, their teeth rotted, albeit they were less starved.

Previously, their diet included healthier foods like onions, cherries and apples, bones, dripping, offal, and meat scraps. The study authors inevitably concluded the malnourishment abated because the food got cheaper (less starvation), not healthier.

Another factor in reduced starvation was the fact that physical activity markedly declined in this period, so people simply needed fewer calories to survive. Combine that with sugar-laden confectionaries and otherwise junk food and you have a recipe for disaster.

In other words, they went from a Paleo-template to a Western diet in just a few years. The nutrient density, fibre, potassium, and omega-3 fatty acids were diluted with and refined flour. And so a sad state of health was born: diets low in fresh fruits and veggies, and rich in high glycemic index foods like potato products, breakfast cereals, confectioneries, and refined baked foods.  And low physical activity.  They call it “Type B Malnutrition.”  The cause?  Sedentary lifestyle and cheap junk food… in other words, “not Paleo.”

History has repeated itself.  Now that we are in a state where healthy food prices are comparable to junk food, we should be striving to get back to our dietary roots.  A diet rich in whole foods, more similar to an early Victorian or otherwise Paleo template.  That is a necessary prerequisite to curb the rising rate of non-communicable diseases.  “It’s too expensive” is no longer a valid excuse.

William Lagakos, Ph.D.

William Lagakos, Ph.D.Dr. William Lagakos received a Ph.D. in Nutritional Biochemistry and Physiology from Rutgers University where his research focused on dietary fat assimilation and integrated energy metabolism. His postdoctoral research at the University of California, San Diego, centered on obesity, inflammation, and insulin resistance. Dr. William Lagakos has authored numerous manuscripts which have been published in peer-reviewed journals, as well as a non-fiction book titled which explores the concept of calories and simultaneously explains how hormones and the neuroendocrine response to foods regulate nutrient partitioning. He is presently a nutritional sciences researcher, consultant, and blogger.

Neurobiology of Sugar Cravings | The Paleo Diet

The scientific basis behind the recommendation to cut out sweets for weight loss and overall health benefit is often overlooked.1, 2, 3, 4, 5 Did you know that the more sugar you consume, the more you come to crave it?6, 7, 8, 9, 10 Or how about that eating sweet foods causes a reward in the brain and mesolimbic dopamine pathway?11, 12, 13, 14

The science behind sweet is surprisingly complex, and also paints these foods in a fairly negative light.15, 16, 17, 18 Gambling, shopping, cocaine, heroin, and alcohol – are all common addictions supported by salient science.19 But food and sugar addiction is still questioned – even though our world’s population has never been fatter than we are right now.20, 21, 22 Oftentimes, we see clients turn to artificial sweeteners. And while these may be good as a “methadone” to getting off of sugar, they actually tend to result in weight gain, not weight loss.23, 24, 25

Neurobiology of Sugar Cravings | The Paleo Diet

Yang, Qing. “Images in This Article.” Yale Journal of Biology and Medicine. U.S. National Library of Medicine, 29 Nov. 0005. Web. 18 Nov. 2014.

Neurobiology of Sugar Cravings | The Paleo Diet

Ahmed, Jessica, […] Robert Preissner. Oxford University Press. U.S. National Library of Medicine, 14 Oct. 2010. Web. 18 Nov. 2014.

There are a multitude of reasons to avoid both sugar and artificial sweeteners.26, 27, 28 The body responds to sweet food with a need for more sweet food, and ignores foods that will contain more nutrients, and have more satiety.29 If we look at something like fructose specifically, some researchers have pointed out fructose is nearly equal to alcohol, in both societal function, hedonic and neuronal response, among others.30, 31

Molecularly, the structure of artificial sweeteners is interesting.32, 33 These creations have only existed for a little over 100 years, so we know very little about how our genome responds to them, at least in the long term.34, 35, 36

Neurobiology of Sugar Cravings | The Paleo Diet

Yang, Qing. “Images in This Article.” Yale Journal of Biology and Medicine. U.S. National Library of Medicine, 29 Nov. 0005. Web. 18 Nov. 2014.

In 2008, only 15% of the population consumed artificial sweeteners, but that number has increased every year since. The number of products containing artificial sweeteners has also increased substantially, from 369 in 1998 to 2,346 in 2010. Interestingly, table sugar and glucose activate human taste pathways differently than artificial sweeteners.37

Neurobiology of Sugar Cravings |The Paleo Diet

“Download PDFs.” Altered Processing of Sweet Taste in the Brain of Diet Soda Drinkers. N.p., n.d. Web. 18 Nov. 2014.

Sucrose elicts a stronger brain response in the following regions: the anterior insula, frontal operculum, striatum and anterior cingulate.38 Sugar also stimulates the dopaminergic midbrain areas in relation to the behavioral pleasantness response.39 Your brain can tell the difference between artificial sweeteners and sugar, but does that mean that artificial sweeteners are better for us?

Neurobiology of Sugar Cravings | The Paleo Diet

“Download PDFs.” Altered Processing of Sweet Taste in the Brain of Diet Soda Drinkers. N.p., n.d. Web. 18 Nov. 2014.

The answer: No.40 41 The link between artificial sweetener consumption and obesity is an interesting one.42 Presumably, non-nutritive sweeteners would be a better alternative. However, there are alterations in reward processing of sweet taste in individuals who regularly consume diet soda.43 The more the reward process is altered, the more diet soda is consumed.44

Addictive drugs cause increases in extracellular dopamine in the brain’s “pleasure center,” the nucleus accumbens.45 When you consume sugar, binging on the substance releases dopamine, similarly to addictive drugs.46 The brain responds to chronic high sugar consumption by altering its own dopamine receptors.47 The sugar-opiate similarities are fascinating, and even work at a genetic level.48 In fact, research shows sugar-dependent rats have alterations in dopamine and opioid mRNA levels, similar to morphine-dependent rats.49

The best way to combat sugar cravings and live a healthier life? Consume a Paleo Diet. You will be loading up on nutrient dense foods, and avoiding large amounts of sugar. You will also be cutting out artificial sweeteners entirely. By resetting your taste for sweet foods, a little fruit here and there, will go a long way, to satisfying your sweet tooth. And if you must indulge, aim for some very dark, organic, chocolate. Enjoy the slimmer, trimmer, version of yourself, as a result.

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