Friday, March 18, 2011

New Ancestral Diet Review Paper

Pedro Carrera-Bastos and his colleagues Maelan Fontes-Villalba, James H. O'Keefe, Staffan Lindeberg and Loren Cordain have published an excellent new review article titled "The Western Diet and Lifestyle and Diseases of Civilization" (1). The paper reviews the health consequences of transitioning from a traditional to a modern Western diet and lifestyle. Pedro is a knowledgeable and tireless advocate of ancestral, primarily paleolithic-style nutrition, and it has been my privilege to correspond with him regularly. His new paper is the best review of the underlying causes of the "diseases of civilization" that I've encountered. Here's the abstract:
It is increasingly recognized that certain fundamental changes in diet and lifestyle that occurred after the Neolithic Revolution, and especially after the Industrial Revolution and the Modern Age, are too recent, on an evolutionary time scale, for the human genome to have completely adapted. This mismatch between our ancient physiology and the western diet and lifestyle underlies many so-called diseases of civilization, including coronary heart disease, obesity, hypertension, type 2 diabetes, epithelial cell cancers, autoimmune disease, and osteoporosis, which are rare or virtually absent in hunter–gatherers and other non-westernized populations. It is therefore proposed that the adoption of diet and lifestyle that mimic the beneficial characteristics of the preagricultural environment is an effective strategy to reduce the risk of chronic degenerative diseases.
At 343 references, the paper is an excellent resource for anyone with an academic interest in ancestral health, and in that sense it reminds me of Staffan Lindeberg's book Food and Western Disease. One of the things I like most about the paper is that it acknowledges the significant genetic adaptation to agriculture and pastoralism that has occurred in populations that have been practicing it for thousands of years. It hypothesizes that the main detrimental change was not the adoption of agriculture, but the more recent industrialization of the food system. I agree.

I gave Pedro my comments on the manuscript as he was editing it, and he was kind enough to include me in the acknowledgments.

35 comments:

Carolyn Blackburn said...

Hi Stephen,
As a Bowen therapist I am always interested in good health and nutrition so find your blog great reading.
However, I am disappointed that you have no label for water as I feel that inadequate water contributes to many of the ills we suffer these days.
As part of our modern diets, we drink tea, coffee, juice, alcohol, etc. but few of us drink enough pure, fresh water - like our ancestors would have. I have written a lot on this topic at my blog at http://bowentherapytips.blogspot.com
I would encourage your readers to have a look at it and consider the benefits of water as part of a healthy, natural diet.
Regards, and keep up the good work,
Carolyn Blackburn.

Might-o'chondri-AL said...
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Brock said...

Why changes after the Neolithic? The diabetes rate in America in 1900 was 0.0028%. Obesity was negligible. Coronary thrombosis wouldn't even be described in the medical literature until 1912.

We don't have a "Neolithic" health problem. We have strictly a "modern" health problem, most likely caused by PUFA oils, refined carbs (that lack fiber and nutrients), and high-fructose corn syrup.

"It hypothesizes that the main detrimental change was not the adoption of agriculture, but the more recent industrialization of the food system."

Precisely! So why call this a "paleo" diet? It's not. It's just a pre-1850 diet.

Greg said...

I don't see the link to the paper.

Bob said...

That's great, Stephan. I've been meaning to read this paper. I would bet that your acknowledgment is well-deserved.

O Primitivo said...

This is a brilliant paper from Pedro Bastos and Maelán Fontes, and I think we will have many more excellent research papers from this new generation of young researchers.

LeonRover said...

"It hypothesizes that the main detrimental change was not the adoption of agriculture, but the more recent industrialization of the food system."

I agree.

I also like Brock's notion that consideration of pre-1850 food sources & methods of preparation gives a sensible methodology for achieving more healthy nutrition.

As an aside, whenever I read Victorian novelists, I notice just how often brisk walking is described as the mode of getting around such cities as London.

Gabriella Kadar said...

I'm not sure about this agriculture business being fine. Diabetes was alive and well based on the mummified remains of Egyptians.

Modern diagnostic technology has revealed a great many things we did not know about even a couple of decades ago. For example routine ultrasounds during early pregnancy have shown the incidence of natural twin conceptions to be very high.

Absence of evidence is not evidence of absence.

brec said...

The link to the paper is the footnote "1" at the end of the title of the paper.

Helen said...

Air pollution (both outdoor and indoor - as in the indoor fires and stoves used in many parts of the world) also shouldn't be ignored as contributing to inflammatory diseases, lung disease, and cardiovascular disease. I think the focus on dietary changes is valid, but if we don't take into account other changes in our biological experience we will miss part of the picture.

stephen said...

the paper is on scribd

http://www.scribd.com/doc/50659345/RRCC-16919-the-western-diet-and-lifestyle-and-diseases-of-civilization-030811

Might-o'chondri-AL said...
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Dinosaur said...

I've just discovered your brilliant blog and am going to read my way right the way through it.

A note not strictly relevant to this particular post: when my Pakistani landlady soaks legumes, she puts in a pinch of sodium bicarbonate to 'soften' them. It occurred to me when reading some of your posts on phytates to wonder whether this has some impact on the anti-nutrients. So I fished around a bit and came across this tantalising excerpt from a journal:

http://www.springerlink.com/content/h69154m618312084/

-- which suggests that it has at least some effect, but that sodium carbonate is better. Unfortunately, it won't let me in for the lowdown without coughing up 30 quid, so I don't know what the exact denouement is. But I wondered if you'd come across suggestions along these lines before?

Best wishes,
Kate

Dozie Onunkwo, Ph.D. said...

This is a great blog. As someone who is also interested in promoting health and wellness, it's really challenged me to continuously seek new information and re-assess my stance on what is "healthy".

I'd found some older review papers, but I'm looking forward to digging into this one.

Might-o'chondri-AL said...
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mary said...

I believe you incorrectly gave Charles O'Keefe as one of the authors. It should be James O'Keefe.

Stephan said...

Hi Dinosaur,

I know that some people like to use baking soda when they soak beans. Phytase, the enzyme that degrades phytic acid, is most active at lower (more acidic) pH, so it would surprise me if baking soda helps with mineral absorption, although it does seem to soften beans.

Hi Mary,

Thanks for the correction; I've edited the post.

allison said...

Excellent paper on balance. I've only glanced at it, but I do see some of Loren Cordain's unfortunate biases at work. I wonder whether he realizes that fruit today is far different than the native fruits available to ancient humans? Hybridization has produced fruit with fructose levels that would have been far sweeter than anything experienced by hunter-gatherers. I'd like to see a few well-designed studies to explore the alleged harmful effects of dairy. Wouldn't fermentation mitigate some of the alleged deleterious effects of milk sugars? Also, Weston Price documented many isolated cultures with high dairy consumption that exhibited no sign of degenerative disease. And Cordain is an avid disciple of the lipid hypothesis, which seems to bias any discussion of SFA.

Melissa Officinalis said...

A very good review article, and the thorough list of references was fantastic. There were some areas where the technical science slows down the pace a bit, but hey, the science is there. Now the hard part is getting the average person to actually change their habits.

CelticPhoenix said...

Hey Stephan. I'm a LONG time lurker.

I don't know that I agree with the idea that modern dietary and lifestyle changes are more important and/or detrimental than those that define the Neolithic.

Take, for example, the ancient Egyptians, who, themselves, recorded high incidences of obesity and diabetes, due to a diet of wheat, milk, and fruit. Infertility and low life-expectancy were the norm. And how about hearing loss and arthritis in the Norse sagas, among a people who, despite eating much better than many of their continental medieval counterparts, still suffered from these "Western" diseases?

My point is that, while the most modern changes in our diet and lifestyle (such as trans-fats, processed everything, sedentary lifestyle, chronic, low-grade stress, etc) are certainly bad news, I feel it unhelpful to even suggest that the post-1850 changes are bigger culprits to our sad state of affairs than the Neolithic transformations. And, ultimately, I think that is why the “Paleolithic” research will have a tough time catching on to all the “science-minded” medical professionals. Our societal memory is that these very unnatural degenerative diseases have always existed, and that they are just part of aging. Of course, this is just not true. But to try to sell this fact to the cookie-cutter closed-minded physician or public health official is going to take years. Good work is being done, certainly by you and others. I’m just afraid that claiming we could do better by going back to the “Dark Ages” (medieval times) would untrue, and, ultimately, unhelpful in convincing most mainstream researchers and politicians.

Might-o'chondri-AL said...
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Poisonguy said...

Allison, if you take a more meticulous look at the paper you'll notice that "their" stance on saturated fats is much more favorable than it used to be (at least given that Cordain's name appears on the paper). Maybe dairy is next!

Rafael B. said...

GReat articlke and great paper you gave us (thanks god is free!)
http://livinprimal.blogspot.com

Donna said...

Celtic Phoenix,

I think we need to keep mind that transitioning from Paleolithic to neolithic times meant much more than change in diet.

My hypothesis is that there are several other causes that directly/indirectly affected the health of post paleolithic people:

-establishment of societies class hierarchy: For the first time in human history, there was a division of the have and have nots, the invention of a new class of humans that didn't need to hunt/gather their own food, and other classes of humans who probably slaved away and still didn't eat enough nutritious foods.

-The rise of civilization also meant more stress that didn't exist in paleolithic time. (For example, the invention of monetary system would mean that some people started having to worry about money, which never happened before in paleolithic times.)

-Some neolithic people might have less direct contact with nature. In my reading about transdermal magnesium therapy, I realize that people who regularly walk barefoot in mineral-rich soil and swim in mineral-rich waters probably absorb some of the needed minerals via skin, instead of only through diet.

-Invention of shoes/ chairs could also contribute to postural changes and increase in incidence of back pain etc.

People can have a perfect diet and if they were stressed out, they can still become unhealthy.

How does all these changes affect health of neolithic people? I don't think it's been studied extensively. I would love to read about it if anyone can point me to some studies.


"I don't know that I agree with the idea that modern dietary and lifestyle changes are more important and/or detrimental than those that define the Neolithic.

Take, for example, the ancient Egyptians, who, themselves, recorded high incidences of obesity and diabetes, due to a diet of wheat, milk, and fruit. Infertility and low life-expectancy were the norm. And how about hearing loss and arthritis in the Norse sagas, among a people who, despite eating much better than many of their continental medieval counterparts, still suffered from these "Western" diseases?

Might-o'chondri-AL said...
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Jeff said...

The turn of discussion toward historical diet trends evokes a topic I have not seen mentioned--nor considered myself--in these discussions which is evolutionary selection. For example, when CelticPhoenix writes of "ancient Egyptians, who, themselves, recorded high incidences of obesity and diabetes, due to a diet of wheat, milk, and fruit. Infertility and low life-expectancy were the norm," there is clear potential for the population to select fot those who were better able to maintain their fertility in this situation.

This gives perspective to Mi..Al's question concerning "Papua: is the human diet reference the beach low land or the bush high land foods?" Depending on the length of inhabitance and isolation of the population, it's both...or neither.

Has much thought been given to the influence of evolutionary selction on the effects of a Paleo diet on individual human beings? For example, a lot has been written about the Inuit abiity to thrive on a high-fat, high-protein diet, but is it possible that it is dangerous to apply this to populations that have historically eaten a much more varied diet, because the Inuit popualtion has selected for those who would have the ability to thrive eating this way?

Jeff said...

Just to clarify how this differentiates from the study, I'm talking about genetic selection among populations that occured when they were still eating a "Paleo" or at least "pre-industrial" diet.

Might-o'chondri-AL said...
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Stephan said...

Hi Jeff,

Yes, there has been genetic selection both in hunter-gatherers and agricultural populations that have been eating a constant diet for thousands of years. It has been demonstrated for Inuit, Papuans, Europeans and other groups that genetic adaptation to diet has occurred since they left their hunter-gatherer ways. Furthermore, genetic change (including positive selection for certain alleles) has greatly accelerated since the adoption of agriculture/horticulture/pastoralism in cultures that adopted it. It makes sense since there were a whole new suite of selective pressures.

That does complicate the theoretical basis for the "paleo" diet, but it does not invalidate it in my opinion.

CelticPhoenix said...

The evolution of different cultures away from a “Paleo existence” and at different rates is something I have always found interesting.

For example, celiac disease rates are highest among Europeans with Irish ancestry (http://www.ncbi.nlm.nih.gov/pubmed/11482004).

The same is true for diabetes, but I can’t find the article right now.

These observations are to no surprise for racial anthropologists, who agree that the people of Ireland and the British Isles are, along with the Basques of NW Spain, the “oldest in Europe.” By that they mean that these peoples were to first to migrate into Europe (several thousand year later came the “Battle-Axe” people of Scandinavia, the Finno-Slavs, and the peoples that make up the Western mainland). In fact, Gaelic peoples have been dated in Ireland since 10,000 BC or earlier. If grains and herding began in the Middle-East only after his date, and slowly spread outward, then the Irish have simply had less time to adapt to these new pressure than the Mesopotamians or even Mediterraneans. Hence the incidences of celiac disease and diabetes.

Weston Price, in fact, described some western Irish has living on a diet of almost exclusively fish and oats as late as the early 1900s. Granted, oats are a grain; but the Irish have not had wheat as a staple until the early 1900s. And the two are very different in their effect. See: (http://www.ncbi.nlm.nih.gov/pubmed/12145006)

Simply put, eating “Paleo” is more important for Western Europeans (and for some African groups, and Kitavans, and Pimas, and anyone else with shorter histories of “Neolithic” lifestyles) than Asians, Mesopotamians, or Mediterraneans.

One last point. We must be careful when we compare lifestyle and disease across cultures. For example, the consumption patterns of wheat, vegetable oils, and even milk, meat, and fish are VERY similar between USA and Isreal. And Israelis, despite the area’s local violence, live longer than USA and have slightly lower incidences of CVD, stroke, and diabetes. Now, if America’s pride in its “great healthcare system” is not misplaced (and it probably is), then something is going on here.

I think there are two things: first, Israel, generally speaking, has people more adapted to junk. Second, due to Dietary Laws, if I’m not mistaken, Jews eat only unleavened bread. Check out this article:
(http://www.ncbi.nlm.nih.gov/pubmed/11815315)

Notice how pasta (unleavened wheat) has less than half the postprandial insulin as “good ole-fashioned whole-grain” wheat bread. What I am about to say would apply to Mediterraneans, as well (due to their preference for pasta over “bread,” though that is changing). If Gary Taubes and others are even mostly right about the supremacy of insulin signaling, than replacing our bread with pasta or pitas or tortillas or other flat, unleavened breads would add 10+ years to our lives. Now, I believe that wheat is disastrous to our health for reasons beyond postprandial insulin, but it’s worth thinking about.

But the point here is that there are many variables to consider when comparing separate cultures or nations.

Might-o'chondri-AL said...
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Katherine said...

@might-o, wrt ancestral diets, they didn't have to "adapt", they only had to live long enough to reproduce and to insure those offspring lived to reproductive age.
they were already 'adapted' to whatever diets had been present in an EEA and even if (even though) the diet varied as we moved out of africa, this wasn't a huge issue as long as there was a sufficiency of food..and as long as one didn't die of an accident, complications from an accident or infectious disease. An absence of (most) neolithic agents of disease is a given so that's a non-issue.

Clearly you have a lot to say though. Why not start a blog?

Might-o'chondri-AL said...
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Natalia said...

Regarding "adaptations" to diet, hasn't it been observed that when a very healthy culture suddenly adopts a western diet, they begin to get the western diseases at at abnormally high rate (more so than the westerners)? Does that mean they were somehow biologically adapted to their old one, or just went overboard with all the yummy sweets and chips that suddenly became available to them?

Richard said...

http://www.youtube.com/watch?v=jpfs6iT2nDw&feature=related
Can't imagine you not finding this interesting Stephen, I hope you enjoy. It's a video entitled "An Organic Chemist's Perspective on Paleo" by Mathieu Lalonde, PhD