Similar to heart disease and diabetes which are "diseases of civilization" or "Western diseases" (Trowell and Burkitt, 1981) that have attained high prevalence in urban society because of environmental factors rather than "genetic deterioration," an epidemiological transition (Omran, 1971) in occlusal health accompanies urbanization.In other words, the reason observational studies in affluent nations haven't been able to get to the bottom of dental/orthodontic problems and chronic disease is that everyone in their study population is doing the same thing! There isn't enough variability in the diets and lifestyles of modern populations to be able to determine what's causing the problem. So we study the genetics of problems that are not genetic in origin, and overestimate genetic contributions because we're studying populations whose diet and lifestyle are homogeneous. It's a wild goose chase.
Western society has completely crossed this transition and now exists in a state of industrially buffered environmental homogeneity. The relatively constant environment both raises genetic variance estimates (since environmental variance is lessened) and renders epidemiological surveys largely meaningless because etiological factors are largely uniform. Nevertheless most occlusal epidemiology and heritability surveys are conducted in this population rather than in developing countries currently traversing the epidemiological transition.
That's why you have to study modernizing populations that are transitioning from good to poor health, which is exactly what Dr. Weston Price and many others have done. Only then can you see the true, non-genetic, nature of the problem.
34 comments:
This is such an important idea, isn't it? Ben Balzar, an Australian doctor who advocates eating a paleo diet, makes a related point in this article, "Why Dietary Diseases Look Like Genetic Diseases":
http://paleolithicdiet.wordpress.com/2008/08/03/why-dietary-diseases-look-like-genetic-diseases-1/
"Why then is so much research focused on finding genetic causes of disease? The reason is a simple logical fallacy- as nearly everybody eats a Neolithic diet, most lines of research won’t show up the dietary cause as the researchers are looking at groups who are all on the same harmful diet. Therefore it looks like diseases are genetic, when in fact they are dietary."
He credits the salt expert, Dr Trevor Beard of www.saltmatters.org, for directing him to the source of the insight, British epidemiologist Geoffrey Rose, and this article in particular:
Rose G. Sick individuals and sick populations. International Journal of Epidemiology. 1985;14:32–8.
He provides the following two quotes, from p. 32:
"If everyone smoked 20 cigarettes a day, then clinical, case-control and cohort studies alike would lead us to conclude that lung cancer was a genetic disease; and in one sense that would be true, since if everyone is exposed to the necessary agent, then the distribution of cases is wholly determined by individual susceptibility."
And this from p. 33:
"The hardest cause to identify is the one that is universally present, for then it has no influence on the distribution of disease."
I can't wait to see the new series you've got in the works.
Can I ask a very off topic question, too. I notice that Peter of Hyperlipid uses small amounts of dextrose (in his daily cocoa I think) as a way of avoiding excess fructose. Any thoughts?
Hello Stephan,
Can you update with the link to the paper? Currently it links to http://en.wikipedia.org/wiki/Occlusion_dentistry
Thanks, Brent.
I've been trying to get that very point across to some family members (esp the kids) who show what I think are clears signs of gluten issues (their doctor just says the various resulting health conditions "run in families" and nothing more about environmental contributions like gluten-induced damage). But knowing that I have two copies of genes that predispose to gluten sensitivity (one from each parent - so that also "runs in families") falls on deaf ears.
Nick,
I used Enterolab (www.enterolab.com) for the various tests. I ordered the entire panel, including the gene tests, as well as the soy, egg, casein, and yeast panel (though I added the last tests later when we had the positive results for genes and IgA antibodies and IgA antitissue transglutaminase, plus our son also had an abnormal
fat result on the fat malapsorption test). I did not go through my doctor,for a variety of reasons.
Great find Stephan! What amazes me is not that the general public or medical community embraces the "search-for-the-gene" approach as being Real Science (with a capitol 'S'), but that even the scientific community seems to have gone on board with this approach, too. That's a shame because the scientists (especially biologists) should know better. It's like they forgot Biology 101 or evolutionary theory 101 and are only paying attention to the latest fad in genomics or quantitative-trait-loci approach or whatever as Real Scientists (i.e., all of their colleagues) should. What would Fischer or Haldane say to this state of affairs?
This reminds me of the n-6 as 4% of calories situation for alot of the heart trials.
I wonder what kind of role genetics plays when one is eating a traditional diet. I have read where people claim that one must eat according to their own ancestry's traditional foods, but i have a feeling that any traditional diet is head and shoulders enough above modern diets that individual genetics falls into the trivial category
Anna,
Thank you. I started going through all of Stephan's posts and comments on gluten and arrived at the info, including your comments on Enterolab, so realized I
shouldn't have asked. I will likely follow what you did (expensive!), as other tests I have taken mirror the health issues you write about on various blogs. My siblings all seem to have worse symptoms than I. I'd really hate to see my genome.
One commenter mentioned 'glutendoctors.com' in Sunnyvale, CA. For what it's worth, they talk about Enterolab, but seem to suggest that one should start with serum tests. One thing I can't seem to discern is if Dr Fine's claims of reliability are verified. Now, if he just had two partners named Dr. Howard...
An expanding area of study recently is epigenetic markers that affect susceptibility to disease. There was a fascinating Nova documentary on this a while back that discussed how identical twins with the same genomes can have wildly different susceptibility to disease based on nutrition and lifestyle, and then pass this susceptibility onto their offspring via epigenetic markers.
http://www.pbs.org/wgbh/nova/genes/
This research is in its infancy to be sure, but could have profound implications on nutrition studies.
Nick, yeah the enterolab reliability isn't certain yet as Fine hasn't submitted his data for peer review yet. I look forward to his doing so. Until then this is definitely not the standard approach. But in our circumstance this approach seemed reasonable and less of a hassle , particularly with our son. And we were already so close to wheat-free anyway. I seriously doubt how seriously it would have been taken had I gone through our pediatrician first. The main downside was the cost. But sometimes the cost of not knowing is potentially higher and not just in $.
Now we've been off wheat therehave been a few instances dining out when we either weren't Strict about GF or circumstances made GF difficult and some GI symptoms came on. In my son's case he wouldn't have known he'd been exposed to gluten so his symptoms were notf due to suggestion. I've experienced it a couple times while eating at sushi places and having the same order as others who had no GI issues later. My husband had reservations but has arrived at the conclusion that thetest is liky to be Accurate despite the lack of universal acceptance still.
Sorry about the typos. I'm struggling with this iPhone email thumbpad but it's my best option at the moment.
Anna:
Wasabi powder has flour in it (tubes are usually ok), and then there's soy sauce...
Lisa,
Thanks for the links. It's a powerful idea.
Brentcu,
Fixed it.
Aaron,
Having gone to genetics conferences, I have to agree. Although I will say that some diseases really do have a strong genetic basis, like the one I study. Those types of diseases are rare though. Also, studying genetics can give insight into the environmental factors that predispose to disease. For example, at the American Society for Human Genetics meeting two years ago, I saw two posters where they found SNPs in vitamin D and vitamin A related genes that associated with Alzheimer's disease.
Matthew,
Exactly. The n-6 issue is an excellent example of this sort of thing. I'm not convinced by the idea that we should eat how our recent ancestors ate. I think the human body is remarkably adaptable within a certain palate of foods.
James,
That is really interesting, I agree. Epigenetics as a field is really young but I think it will turn out to be very important.
Wasabi powder has flour in it?! That's bad news for me.
I didn't know about the wasabi having flour. Drat!
Also, I know now I should specify gluten-free when ordering sushi and sashimi, because even if I am using wheat-free soy sauce at the table/bar, the chef might use a regular soy sauce or Ponzu sauce which is not GF.
And I'm not so familiar with sushi/sashimi menu items to anticipate where the non-obvious wheat content might show up. I'm learning one can't simply avoid the obviously wheaty stuff; the relatively small indcidental exposures can create an uncomfortable experience, too, now that we're GF.
Also, both times I asked if GF soy sauce was available, there was some confusion about whether they had any or not (must be stored in the fridge, unlike conventional SS). I might consider carrying my own SS when I go out for sushi That isn't a high frequency thing; it was unusual for 3 sushi opportunities in one month, but also a interesting opportunity to test with some gluten exposure since beginning an active avoidance of it in January.
I experienced some discomfort after sashimi and made the connection that the problem was soy. I had no idea it could have been caused by the wheat in both the wasabi and the soy sauce.
Anna
You said
'I'm learning one can't simply avoid the obviously wheaty stuff; the relatively small indcidental exposures can create an uncomfortable experience, too, now that we're GF.'
This is what I am experiencing to some degree almost every time I eat food I have not prepared. I have been grain free since March (will add back some grains as I test BS reaction), and I seem more prone to discomfort than I did before I stopped eating wheat. It seems logical that it is the wheat, but I have also suspected added sugar and processed oils as causes of discomfort.
I'm wondering if our GI perhaps loses enzymes that might have helped us adapt to eating the wheat, oils and sugar while it continued to play havoc at the cellular level?
Stephan,
I am curious if you avoid flour on principle, or if you have a gluten intolerance?
Nick,
I don't want to discuss it in public at this point but if you send me a personal e-mail I'll tell you.
Stephan,
Of course I agree that genetics research has a lot to offer. What I was arguing, however, was that the pendulum has swung too far in the direction of an overemphasis on genetics without sufficient emphasis on environment, or on the dynamic and incredibly complex coaction between the two.
Cure by gene?
Are we looking at genetic variance or genetic expression (if genes are active or not in a cell and to what extent.)
Food alters gene expression in a big way.
It looks like cells subtly alter their function to adapt to new "Chords" of gene expression.
This is called epigenetics and involves structural change that is fixed and transmitted during cell reproduction until circumstances again change, and is inheritable but does not involve genetic change to the DNA.
So an infant can inherit the influence of diet through two generations eg the creation of the egg bank of the mother whilst the mother is being gestated in the grandmother
http://en.wikipedia.org/wiki/Epigenetics
Imagine a piano that subtly redesigned itself if you played bass cords with a predominance of certain notes so those cords produced a better quality of sound.
IF piano reproduced that subtle difference would carry forward to the next generation. But if a new player came along that used a different note preference the piano would re adapt.
Birds and insects have been show to exhibit minor genetic adaptations to food in quite short time frames.
Author Omega Six The Devils Fat
www.Omegasixthedevilsfat.com.
New revised hopefully more readable version on the way.
Wasabi is cut with wheat???!
Why not rice flour at the least...
*urrg*
I've considered bringing my own wheat-free Tamari ( soy sauce by San-J) but bringing my own WASABI? *haa*
@ Robert Andrew Brown
thanks for that
I was struggling to understand the implications of this
Is Fructose Dangerous?Fructose-Induced Changes of Gene Expression and Carbohydrate and Lipid Metabolism
and your explanation of the process made it more comprehesible.
Robert,
That is so well explained succinctly, as usual for you. I love all your omega tidbits.
Have you come across studies that show F1 F2 changes are reversible?
Run RNA interference?
Thanks,
G
Dr BG
Thank you for your kind comment. It was much appreciated. I do struggle to explain things sometimes.
I am very much a beginner on epigenetics. I found these links that may be useful.
RNA and epigenetics.
http://www.nature.com/nature/journal/v451/n7175/full/nature06468.html
http://www.caister.com/molecular-biology-blog/2008/12/epigenetics-and-rna.html
Are effects reversible (excluding other damage to cells that has occurred during the transitions) - my GUESS is yes but using the piano analogy to get back to precisely the place you started you would have to exactly reverse the process. Approximate reversal would bring you back more or less where you started.
The abstract below suggests that reversal mechanisms may exist in plants.
http://books.google.com/books?id=hv6QK7HLwHEC&pg=PA188&lpg=PA188&dq=rna+epigenetics&source=bl&ots=uUJkD9QDtn&sig=d9hHAePcxuv14K-7iX9pIvrSFJE&hl=en&ei=XwQ-StqwCpLz-QaL_PC4DA&sa=X&oi=book_result&ct=result&resnum=6
Page 194 RHS bottom
Marsh who writes on epigenetics observed that escaped domestic pigs in Australia reverted to close to their wild ancestors.
We see reversal of tumours in some patients.
It would make sense at an evolutionary level for effects to be to some degree reversible, to allow for changing environmental and dietary circumstances.
Makes sense. Funny I was just thinking on this myself the night before you posted. I took my family to a local park to have a picnic dinner and there were other families with the same idea. The other kids had a pretty wide variety of body shapes. While many were very fat, much fatter than when I was a kid, there were some that were very thin and lean. I was thinking they all eat the same diet and concluded the difference must be genetics. In my kids, who are both very lean, the genetic factors matter far less as they eat the Lacto-Paleo foods my wife and I do. Very timely and good post. I look forward to reading more on this as I sense this is everywhere.
One other thought on this is from Macolm Gladwell. In "Outliers" he discusses the importance of intelligence. In a room full of average people the genius stands out and succeeds but being a bit more clever in a room full of clever people buys little or nothing as other factors come into play. So, depending on the situation, smarts is either really important or not that important just like genetics in the post's example.
Where does the calcium in a modified paleo-diet as recommended here come from, and what would the optimum intake for calcium be?
Also, I was researching cheese and found this interesting post:
From BruceK about casein in the comments section on hyperlipid:
https://www.blogger.com/comment.g?blogID=36840063&postID=266103646027890426
“Milk and cheese also have addictive properties, much like wheat, due to similar opioid peptides. It is much harder to eat cream cheese (with 2g protein / oz) than ice cream, milk, or hard cheese. Any diet that takes out casein, lactose, and gluten can almost be guaranteed to lower one's weight and many other risk factors.
Dr. Eades has a new post about many low-carbers being sabotaged by lots of cheese and nuts. Both have their own addictive qualities, whereas it is much less common for somebody to be addicted to meat or egg yolks or butter. He doesn't seem to realize the role opioids in cheese can play in causing some people to over-eat.
I look for cheeses with low protein and 50% more fat than protein. Good cream cheese is very hard to binge, unless you eat it on a wheat bagel, of course. Less protein equals less opioids. Whey protein has little or no opioids, AFAIK. I feel the safer dairy foods are high-fat, low-carb, and low-protein. Ghee, then butter, then cream cheese, then sour cream. Hard cheese, yogurt, and milk cause increasingly more problems.”
END SNIP
I’m quite sure the French would beg to differ, but what do some of you say?
Also, wiki had this tidbit:
SNIP:
“Casein has a molecular structure that is quite similar to that of gluten.”
http://en.wikipedia.org/wiki/Casein
END SNIP
Well I don’t think many here hold gluten in high regard.
So to sum up:
What’s the stance here on cheese and casein?
Optimum calcium intake range and from what source?
While I’m at it, what’s the optimum intake range for Vitamin A/Retinol?
The reason I ask is, I get very little sun, partly as a result of my doc telling me to avoid it b/c I’m on Lisinopril. So I’m going to start supplementing with 4000 – 5000 or more of vitamin D3 (Good brand?.) I’d like to balance that with retinol and make sure I’m getting enough calcium.
Hi Glenn,
I would recommend the high vitamin butter oil/fermented cod liver oil blend from greenpasture.org. High in vitamins A, D and K2.
For calcium, good sources are bone broths (add a little vinegar when making broth to leach the minerals out of the bones), dolomite powder, leafy greens, salmon with bones, and gnawing on bones paleo-style (if you’ve ever had Korean kal bi, you know what I’m talking about!). Just as important to bone health are vitamin D and magnesium. I take a chelated magnesium supplement. Also remember that on a grain-free diet, you are able to absorb minerals more readily and retain them better without the phytates that bind to them (phosphorous in soft drinks as well).
Glenn,
Calcium is not something you have to worry about on a whole foods diet, even with no dairy involved. Unless it's high in whole grains, soy and beans, in which case the phytic acid may interfere with calcium absorption. I agree with what Cynthia said in the comment above.
Dairy does contain exorphins, but unlike gluten they're typically digested in the stomach before they hit the small intestine.
As far as the vitamin A, just eat eggs, butter and liver and you'll have nothing to worry about. There's no need to supplement. Although you can take cod liver oil if you want.
Robert,
Thank you for the link and Jorg Tost's book! The DNA methylation theory makes some sense. I don't comprehend any of the RNA plant studies, and d*mn used to work on barley calmodulin RNA for a Plant Phys editor... *arrgh* If maternal hypovitaminosis D is severe enough, is that like the plant calmodulin-like protein that behaves like RNAi? Obviously there must be multiple factors but vitamin D in plant, reptilian, bird, and mammalian systems is a BIG controller.
Various nutritional deficiencies (and excess maternal folic acid?) appear to be really affecting our genetic expression over several generations it seems to me.
There is much hope you are right... we are reversing atherosclerotic plaque among many things. Looking to your new book and all your wonderful thoughts in one place... Your tidbits are so easy to miss!
-G
It's an important insight, but not unique. Colin Campbell makes precise the same point in his book "The China Study" and concludes that most studies in Western populations don't find that animal products are bad for us because everyone consumes a more than optimal amount of animal products.
See that's taking a good idea and using it for evil instead of good. We do have studies on vegetarians in Western countries, and overall they don't support the idea that avoiding meat has health benefits.
Campbell refers to all animal protein, so vegeterians don't count - only vegans. However, vegans in western societies are relatively rare in epidemiological studies and have all sorts of other differences from other people in society so are not the best comparison group.
Hmm, so the cure for the "diseases of civilization" is to eat in a way that did not exist before modern times?
No surprise that wheat gluten and refined sugars rot teeth, although the observation that refined wheat is worse for teeth than refined sugars is a surprise.
Imagine you are a contemporary dog or cat, whose ancestoral (evolved) diet is raw meats and meaty bones? You'd think that your human master would be smart enough to figure out you're a carnivore, not a grain-eating omnivore. You might think your owner would know that kibbles and cooked, canned mush are emphatically not what a carnivore needs for healthy teeth and gums and a long lifetime without chronic illnesses. Why do humans, who extoll the virtues of fresh fruits, vegetables and meats for their own omnivore diet, think that feeding carnivorous family members a monotonous diet of cooked starches is okay? We pets heed raw meats and meaty bones we evolved to eat, dummy.
To learn more about how dogs and cats teeth are remineralized by a raw-meaty-bones diet visit rawmeatybones.com and rmb4heathypets.blogspot.com.
Thank you, Your Dogs and Cats
As a possessor of funky genes I'd say: don't throw the baby out with the bathwater! IMO the important thing is the interraction.
For example the same environmental insult which drives most people to obesity and many to diabetes and cardiovascular disease in one side of my family causes "skinny fat" or metabolic obesity where we measure like fat people without the overweight.
It's entirely plausible to me that the selfsame environmental insults may be routed competely differently by different gene sets. For example maybe those families which have a high incidence of cancer but little CVD are routing the inflammation caused by the same diet into different pathways.
In all cases the game is to stop expressing the genes, whichever they are.
Post a Comment