Wednesday, August 13, 2008

The Kitavans: Wisdom from the Pacific Islands

There are very few cultures left on this planet that have not been affected by modern food habits. There are even fewer that have been studied thoroughly. The island of Kitava in Papua New Guinea is host to one such culture, and its inhabitants have many profound things to teach us about diet and health.

The Kitava study, a series of papers produced primarily by Dr.
Staffan Lindeberg and his collaborators, offers a glimpse into the nutrition and health of an ancient society, using modern scientific methods. This study is one of the most complete and useful characterizations of the diet and health of a non-industrial society I have come across. It's also the study that created, and ultimately resolved, my cognitive dissonance over the health effects of carbohydrate.

From the photos I've seen, the Kitavans are beautiful people. They have the broad, attractive faces, smooth skin and excellent teeth typical of healthy non-industrial peoples.


Like the
Kuna, Kitavans straddle the line between agricultural and hunter-gatherer lifestyles. They eat a diet primarily composed of tubers (yam, sweet potato, taro and cassava), fruit, vegetables, coconut and fish, in order of calories. This is typical of traditional Pacific island cultures, although the relative amounts differ.

Grains, refined sugar, vegetable oils and other processed foods are virtually nonexistent on Kitava. They get an estimated 69% of their calories from carbohydrate, 21% from fat, 17% from saturated fat and 10% from protein. Most of their fat intake is saturated because it comes from coconuts. They have an omega-6 : omega-3 ratio of approximately 1:2. Average caloric intake is 2,200 calories per day (9,200 kJ). By Western standards, their diet is high in carbohydrate, high in saturated fat, low in total fat, a bit low in protein and high in calories.


Now for a few relevant facts before we really start diving in:

  • Kitavans are moderately active. They have an activity level comparable to a moderately active Swede, the population to which Dr. Lindeberg draws frequent comparisons.
  • They have abundant food, and shortage is uncommon.
  • Their good health is probably not related to genetics, since genetically similar groups in the same region are exquisitely sensitive to the ravages of industrial food. Furthermore, the only Kitavan who moved away from the island to live a modern life is also the only fat Kitavan.
  • Their life expectancy at birth is estimated at 45 years (includes infant mortality), and life expectancy at age 50 is an additional 25 years. This is remarkable for a culture with limited access to modern medicine.
  • Over 75% of Kitavans smoke cigarettes, although in small amounts. Even the most isolated societies have their modern vices.
The first study in the series is provocatively titled "Apparent absence of stroke and ischaemic heart disease in a traditional Melanesian island: a clinical study in Kitava." In it, Dr. Lindeberg presents data from interviews and electrocardiograms (ECG) suggesting that heart disease and stroke are absent or extremely rare on Kitava. The inhabitants are entirely unfamiliar with the (characteristic) symptoms of heart attack and stroke, despite the sizable elderly population. This is confirmed by the ECG findings, which indicate remarkable cardiovascular health. It also agrees with data from other traditional cultures in Papua New Guinea. Lindeberg states:
For the whole of PNG, no case of IHD or atherothrombotic stroke has been reported in clinical investigations and autopsy studies among traditionally living Melanesians for more than seven decades, though an increasing number of myocardial infarctions [heart attacks] and angina pectoris in urbanized populations have been reported since the 1960s.
Dementia was not found except in in two young Kitavans, who were born handicapped. The elderly remained sharp until death, including one man who reached 100 years of age. Kitavans are also unfamiliar with external cancers, with the exception of one possible case of breast cancer in an elderly woman.

Overall, Kitavans possess a resistance to degenerative diseases that is baffling to industrialized societies. Not only is this typical of non-industrial cultures, I believe it represents the natural state of existence for Homo sapiens. Like all other animals, humans are healthy and robust when occupying their preferred ecological niche. Our niche happens to be a particularly broad one, ranging from near-complete carnivory to plant-rich omnivory. But it does not include large amounts of industrial foods.

In the next few posts, I'll discuss more specific data about the health of the Kitavans.

22 comments:

Chainey said...

I'm so glad you stated the life-expectancy at age 50 as well as the overall figure. To people who are interested in matters of diet/lifestyle, it's completely unsatisfactory to state a bald life-expectancy figure (as so many do) and leave people to draw wrong conclusions from it.

If a population is exposed to frequent warfare, wild animals, lack of emergency healthcare, etc., then their base L.E. doesn't help us at all. I wonder what our much-vaunted life-expectancy in the West would look like if you withdrew all modern healthcare - I for one would be dead (burst appendix - age 11. Too many grains, LOL)

reid said...

The data from Dr. Lindeberg's study is pretty compelling evidence indicating carbs and refined foods are responsible for the problems commonly attributed to natural lipids and other factors.
But I wonder how the NYT would spin it?

Stephan said...

Chainey,

Yes I was glad to find those data in his papers. I agree with your interpretation. I'm glad you're still with us, at least most of you (minus one appendix).

Stephan said...

Reid,

Maybe refined foods, but not carbs. They were getting 69% of their calories from carb.

reid said...

My mistake. I was thinking carbs from grains.

Debs said...

This is fascinating. So, do they not experience lung cancer either?

I wonder how the mainstream would dismiss this, since you make the points you do about genetic variation, minimal exercise, and food abundance. They don't have the cold weather of the Inuit.

I bet it would feel weird to be the only fat Kitavan.

Debs
Food Is Love

Stephan said...

Debs,

The cancer thing has not been studied systematically, it's just based on interviews.

Kayaman said...

Glad your CD is resolved...still working on mine: If they're not particularly active and have an abundance of food then how does their fasting insulin stay so low?

Stephan said...

Hi kayaman,

That's the big question. My theory is that gluten grains, sugar and perhaps certain other foods cause insulin resistance over time. It's the same in Japan. They eat lots of rice but don't become insulin resistant, at least not to the extent of Americans. However, if you introduce Western food, as in Okinawa, they get fat just like Americans.

merryweather said...

How do the Kitavans prepare their carbs? Do they use any fermentation methods or use lactic-acid at all?

It would be great to know.

merryweather

Stephan said...

Merryweather,

Good question, I wish I knew the answer! Cassava is often fermented in Africa and native Hawaiians fermented taro into poi, so it wouldn't surprise me if they fermented some or all of their root crops. I didn't come across any references to it in the papers.

mlcondiff said...

Does anyone know what kind of fish they eat? I mean are they the oily kind (salmon) or white kind (cod).

Stephan said...

mlcondiff,

I would guess they are not oily fish. Tropical fish tend to be less fatty than cold water fish. They eat them as a staple but only get about 4g total fish fat per day (about one teaspoon).

anandsr said...

It seems to me that everything is boiling down to just two things.

Vitamin D and Omega 3.

The Kitavans have these two in abundance. The rest I guess does not matter much, as long as calories are coming.

I think its important to get Omega3 as high as possible. It seems Omega6 is not that important, and anyway comes automatically with Omega3 sources.

Vitamin D needs to be supplemented because of the lack of sun in our lifestyles.

In North India people are vegetarian, and do not have access to Omega3 from Fishes. So they used to rely on Mustard oil which has a 1:1 ratio of omega6:omega3 fats.

I think our health problems would have started ever since everybody had clothes to wear ;-), and lack of vitamin D set in. Now with hydrogenated oils and refined oils, Mustard and consequently Omega3 has also been removed from our diet.

I think this is the reason why we have 4 times the heart disease in the world. Before vegetarianism would not have mattered much but now it causes a lot of ill health.

I guess if I just switch back to Mustard oil and supplement vitamin D, a mostly vegetarian diet would not be a problem. Ofcourse eating natural diet is better, but most of us Indians do cook our food from natural sources.

Thanks for a very informative website. It has cleared so many things for me.

regards,
-anand

Stephan said...

Anand,

I do think the two things you mentioned are critical. And I agree that the high-n6 vegetable oil is probably one of the main contributors to CHD in India and around the world.

I think pastured ghee is superior to mustard oil, although a modest amount of uncooked mustard oil is probably good as well.

kitavan said...

Thanks to you Stephan. Am from Kitava Island and am so proud to find that we (Kitavans) are eating our way forward at least on the right part. Unfortunately am living out of the island at the moment but it doesn't mean that am going to grow round like a ball, well am keeping a very strict traditional diet and I'm happy about it. Thanks to you and congrats on your informative website.

Stephan said...

Hi Kitavan! Nice to hear from you. I have many questions about the Kitavan diet and lifestyle that Staffan Lindeberg's papers didn't answer for me. If you are willing to help me understand more, please send me an e-mail at wholehealthsource (at) yahoo.com. Thanks!

Angi said...

If Dr Linus Pauling was alive today, he would cite the high levels of vitamin C in the diet (and bloodstream) of the Kitavan's as the main reason for their healthy profile. The fruit, veg and meat that they eat will no doubt contain much higher levels of vitamin C than the fruit, veg and meat that we eat. Our food and meat is heavily depleted because of modern farming methods.

Do you agree that Dr Paulings ideas should be thrown into the mix?

Unknown said...

Dr Rosedale did a great point on this. http://www.facebook.com/notes/dr-rosedale-and-the-rosedale-health-plan/the-longevity-of-the-okinawans-and-kitavans-dr-rosedales-response/201274489941868

Dan said...

Stephan,

Does it all come down, possibly, to omega 3 in the diet? 2 or 3 to 1 (omega 3 to omega 6) ? And I don't mean eat anything and everything and then supplement with omega 3s to get the balance back. I mean eat foods, similar to the Kitavans, that translate to a 2 to 1 omega 3 outcome.

When we eat like this, the foods that the current population of the USA are eating that is causing so much disease and over weight people, these problems tend to go by the wayside. Maybe it's simpler than sugar or fat or carbs or protein and the percentage of all that. Maybe if it has a 10 to 1 omega 6 makeup, perhaps you simply avoid eating it and it's that simple.

Thoughts?

Thanks for your blog.
Dan

Jim Smith said...

Stephen,

Do these folks have a dietary source of caffeine? Also, does their diet result in an extraordinary amount of nitric oxide/hydrogen sulfide through synthesis or consumption?

Thank you,
Jim

Greggatshack said...

"Even the most isolated societies have their modern vices"
Not so - are you aware of the North Sentinalese?