Friday, November 23, 2012

Food Reward Friday

This week's winner: poutine!

While not as appetizing looking as the Monster Thickburger, poutine is probably more popular.  For those who aren't familiar, poutine is a large plate of French fries, topped with gravy and cheese curds.  It originated in Quebec, but has become popular throughout Canada and in the Northern US.

Poutine shows that hyper-rewarding, hyperpalatable junk food doesn't have to be corporate.  It also comes from restaurants and even our own homes.

Poutine is often consumed late at night while inebriated.  Alcohol facilitates poor food choices by increasing impulsiveness and perhaps also hunger.  When drunk, people don't go for celery sticks and hummus-- they go for the most energy-dense, highly palatable food available.  It's interesting that one would actually be more inclined to eat after consuming hundreds of excess calories from alcohol, but it is a fact.  In Seattle, a large number of late night hot dog vendors make a living off this phenomenon by setting up outside bars.


George Goodall said...

Whoa! Criticizing poutine may set off a constitutional crisis in Canada. It's a fundamental part of national identity... and, as you noted, a great après-drunk food. It's also exceptionally popular following skiing and other cold weather activity indicating that you don't need to chemically induce serotonin and dopamine imbalances to eat it!

Ed said...

I'm interested in the foodstuffs that go against conventional wisdom. Highly palatable, high energy density, highly engineered foods that most people think are at least innocuous, or even good for you.

For example, Goldfish crackers, a staple of children across the US.

Or, anything by Clif. Clif seems egregious to me. Thoroughly delicious, highly engineered, high energy density junk food masquerading as health food.

Foods that are "obviously" high reward are a bit of a yawn for me. I think if you asked the average person you met on the street, "is poutine fattening?" you'll get a lot of people who think so, yes. But ask them if goldfish crackers are fattening, and they'd say "no." I'm interested in getting those discrepancies publicized.

LeonRover said...

So Stefan,

I guess your recommendation would not be:

"Qu'ils mangent de la poutine" ?


Moldy Salami said...

Poutine is great. Lots of saturated fat and potatoes Stephan, can't knock it! :)

I agree with Ed though, this series should include more mundane foods that people tend to overlook in the semi-junk category such as:

-granolas and other "whole grain" breakfast cereals
-fruit juices & smoothies
-flavored rice cakes
-coffee add-ons like sugary fat-free half n half (wtf?)

Sanjeev said...

> mundane foods that people tend to overlook

mundane (regular, habitual) foods that highly stimulate reward systems must be the worst.

As the behaviourists (like Dr Wansink) demonstrate conscious thought and consideration is bypassed by the automaticity of easy/habitual/ritual/social consumption, and reward systems get fired up probably leading to higher downstream calorie consumption.

spughy said...

GASP!!!! Not poutine!!!! It's sacred to Canadians! Well, it was until McPoutine happened.

Poutine in my house is what happens when you make too much gravy and the roast beef runs out before the gravy. You get some cheese curds, and make oven fries. It's a cheap and easy way to use up the lovely gravy you made with your homemade bone broth. ;-)

Puddleg said...

Are then any calorie comparison metabolic ward experiments using high-alcohol diets?
Might be a good test of the "calorie is a calorie" concept.

Peter said...

Very nice Friday pick, Stephen. Stayin' away from LDL cholesterol elevating saturated fats is a no brainer even for the Inuits.

Consumption of omega-3 fatty acids is not associated with a reduction in carotid atherosclerosis: The Genetics of Coronary Artery Disease in Alaska Natives study

"Dietary intake of omega-3 FAs in a moderate-to-high range does not appear to be associated with reduced plaque, but is negatively associated with IMT. The presence and extent of carotid atherosclerosis among Eskimos is higher with increasing consumption of saturated FAs".

Your colleagues at the AACE would approve a ban for the Poutine as well, I think.

"Low-density lipoprotein cholesterol (LDL-C) is identified in the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) report as the most abundant and clearly causal atherogenic lipoprotein on the basis of many observational and experimental studies over several decades.1 Guidelines from the American Association of Clinical Endocrinologists (AACE) are in agreement with NCEP ATP III that LDL-C is central in the diagnosis of dyslipidemia. Any LDL-C level above 100 mg/dL appears to promote atherogenesis".

Forks Over Knives and Healthy Longevity: A Missed Opportunity for the Cholesterol Skeptics

Anonymous said...

That picture also makes me ill...

Stephan Guyenet said...

Hi Ed,

Good idea.

Hi Peter,

I suspect most of them are fried in "heart-healthy" refined soybean oil.

Miss Zephyr Haversack said...

Stephan, how could you!? Cave art clearly depicts our ancestors eating poutine, with elk gravy and bison curds. Your science is lacking! It's also the healthiest thing a person can eat, clearly, as it's made with potatoes, or 'ambrosia' as they were known to those on Olympus. Tut tut tut!

Cassandra said...

Along the lines of Ed said, I would say one that speaks specifically to Paleo folks - sweet potato fries. I became obsessed with them for a while after I realized I actually really don't like flavorless white potatoes and allowed myself to gorge on sweet potato fries for about a week. Then I remember oh right, they're still starch dumped in fat with scorching heat. But oh man, with a good salt, they are so easy to just eat and eat.

Peter said...

"I suspect most of them are fried in "heart-healthy" refined soybean oil"

Thanks to the works of Rudell, Blankenhorn and Vogel, I am not too big of a fan of vegetable oils either. All of these oils, besides canola oil, contains lot of SFA. What many people tend to oversee is that these "healthy oils" comes in a package. The observed beneficial effects these oils are reported to have may very likely to vanish immeadiately when they are measured against complex carbohydrates instead of butter and candies as it is usually done in Western studies.

As a general rule, cultures where chronic disease is absent, the intake of oils are kept low. F.ex in rural China the intake of fat varies between 6-20% but very rarely exceeds that (Campbell & Junshi, 1994). Snapper made some detailed observations in Northern China in the 1940's. This was the part of China were fat intake was somewhat higher, as opposed to rural regions in the South where dietary patterns were more similar to Okinawa (except that rice was the staple starch).

In 1940, I confirmed De Langen’s results... by the observation that in North China, coronary disease, cholesterol [gall]stones and thrombosis were practically nonexistent among the poorer classes. They lived on a cereal-vegetable diet consisting of bread baked from yellow corn, millet, soybean flour and vegetables sautéed in peanut and sesame oil. Since cholesterol is present only in animal food, their serum cholesterol content was often in the range of 100 mg. per cent. These findings paralleled the observation of De Langen that coronary artery disease was frequent among Chinese who had emigrated to the Dutch East Indies and followed the high fat diet of the European colonists .

BTW, I noticed you had an interesting paper from Central-Africa and Cassava-diet that you tweeted about, I have couple of pearls from the < 10% fat - cultures for you as well:

1) Epidemiological studies in a total highland population, Tukisenta, New Guinea. Cardiovascular disease and relevant clinical, electrocardiographic, radiological and biochemical findings

2)Serum Lipid Levels Among Rural Guatemalan Indians

Diet, Blood Cholesterol, Blood Pressure and Risk of Stroke: Part I

Keep up the good work.


Chris said...

Interesting. In the north of England chip shops sell chips and gravy. In Scotland they sell chips topped with grated cheese. What a combo. Of course in Scotland chip shops routinely sell deep fried pizza which is surprisingly popular.

Stephen said...

Gravy would just turn the french fries to mush. I prefer my fries twice cooked and dressed with a pinch of salt and liberal dose of black pepper.

Anonymous said...

This story is a key reason why giving children access to health care – no matter what their pre-existing conditions may be – is a huge win for all of us. September 23rd will mark the day for children nationwide to start receiving health care no matter what their prior health issues have been. It’s the first step in a road of recovery for many.
Best Of Tricks

Paul N said...

of course, home made poutine can be quite healthy, and even "paleo"

-skinless potatoes (or sweet potatoes), organic or home grown
-fried at moderate temperature in beef tallow rendered from the suet of grass fed cows (I do this myself)
-gravy made from (grass fed) beef bone broth, with sea salt, vinegar, Worcestershire sauce or Vegemite, and thickened with arrowroot/tapioca/cassava etc
-cheese curds from grass fed milk

What's not to like, or unhealthy, about that?

I agree with George Goodall, poutine after cold weather exercise like skiing is fantastic. A Quebec friend of mine tells me that, traditionally, it was only eaten in winter, which makes sense to me.

Paul Simon said...

Peter, correct me if I'm wrong but you appear to think that SFA are positively linked with heart disease?

Gabriella Kadar said...

Mmmm. Poutine made with thick chunky fries (so they don't get too soggy), a couple Coronas and a football game. It's about serving size and frequency of consumption. Don't see anything majorly wrong with it so long as it's not a regular menu item or supersized.

I can think of way worse like instant ramen noodle soups. At least fries and cheese curds are real food.

Dr. Curmudgeon Gee said...

I second Ed's idea.

so far, these high reward food are quite "in your face".
(they're quite repulsive to me.)

energy bars, granola bars, crackers, juice drinks, flavored/sweeteneddrinks of soy/dairy/coconut/rice, veg chips/sticks, popcorn lightly coated w/ caramel, ...
now these are something else.

i belete they're more insidious.



Dr. Curmudgeon Gee said...

oh, yes, i forgot about instant noodle soup. i used to crave soup those in winter night. i know if it's the wheat or MSG.

most instant soup also pretty bad too.

(now i make my own bone broth)

i meant most "flavored/sweetened drinks" also belong to this addictive category (esp. summer).

since they masquerade as healthy hence more insidious.

Dan said...

Hi Stephan, I don't think a single Canadian believes poutine to be healthy. I agree with the comments that suggest focusing on foods that we don't expect to be unhealthy.

Julie Anderson said...

Wow!Yummy food!But i think it is high rich in fat!But fat food is not good for health!

iamcrystal said...

Just saw this dish today, and I think I'd love it. Wow! Really looks delicious! Is this kinda rich in vitamin, too? Like vitamin C or K2?

Peter said...

@Paul Kayley,

I though I was very clear with this one. Avoiding SFA is no brainer. The dairy industry uses an old gimmick by comparing a nutrient or food x to the overall calory intake in an attempt to hide the detrimental effects of their product (SFAs). Don't be fooled.

For example, it may not be useful, as is usually done, to compare a specific food to all other sources of energy, which are usually mainly refined starches, sugars, red meat, and fat-rich dairy products in typical Western diets.

--Walter Willett (Harvard School of Public Health)

The cholesterol denialist usually refer to cross-sectional studies and observational studies on saturated fat and serum lipids, the nonsense often mentioned by the denialists were already refuted several decades ago.

It was estimated over four decades ago that in order to estimate within 20% of the actual dietary intake, there is a requirement of at least 22 days of 24-hour dietary recalls for saturated fat. Inaccurately measuring intraindividual variation has been shown to lead to a miss-classification of subjects into ranges of usual dietary intakes, and biasing correlation coefficients towards null. The majority of the observational studies cited by the skeptics used single 24-hour dietary recalls and therefore a null association between saturated fat and serum cholesterol is to be expected. Furthermore, the denialists often fail to cite numerous observational studies that used higher quality dietary measurement methods with a larger participant size that found a positive association between saturated fat and serum cholesterol.

Another issue with the observational studies that skeptics have cited is that many only used single measurements of serum cholesterol. Several measurements of serum cholesterol are required to measure mean cholesterol due to the substantial intraindividual variation in concentrations, and therefore would have likely biased the association between saturated fat and serum cholesterol towards null.

One more major issue with observational studies, as was noted in the Chicago Western Electric Company study is that the cross-sectional association between saturated fat and serum cholesterol can be biased towards the opposite direction due to participants lowering intake of saturated fat in response to elevated serum cholesterol, which is similar to the “sick quitter effect", this would have likely biased the association between saturated fat and coronary heart disease towards null in meta-analyses of prospective studies.

Forks Over Knives and Healthy Longevity: Perhaps the Science is Legit After All

Peter said...

Saturated fat and heart disease

"A major weakness of the meta-analysis is the imprecision of dietary assessment methods used in the underlying studies. About half of the studies used 1-d dietary assessments or some other unvalidated method. Food intake varies from day to day, and there is a substantial literature showing that a single 24-h recall provides a poor estimation of the usual dietary intake of an individual (5). Such methods cannot reliably rank individuals by their long-term intake, especially within populations with a uniformly high saturated fat intake. Such imprecision in the assessment of disease determinants systematically reduces the strength of association of determinants with the disease. This is referred to as attenuation (6) or regression dilution bias (7). Observational studies that used such dietary assessment methods failed to show an association between diet and serum cholesterol concentrations (6). This shows the shortcomings of such dietary methods, because the effect of diet on serum cholesterol concentrations has been well established in randomized controlled trials (2, 8). Thus, the lack of a significant association between saturated fat intake and CHD may well reflect the consequences of regression dilution bias"

"We believe that the conclusions of Siri-Tarino et al are invalid and are likely to mislead the general population"

Dietary lipids and serum cholesterol level: change in diet confounds the cross-sectional association.
Shekelle RB, Stamler J, Paul O, Shryock AM, Liu S, Lepper M.

"In the Chicago Western Electric Company study, diet was assessed at the initial examination, in 1957-1958, of 1900 middle-aged men and again at their second examination about one year later. At the first examination, lipid composition of the diet, as summarized by a score based on the formula of Keys, Anderson and Grande, was positively associated with level of serum cholesterol. Between the first and second examinations, however, hypercholesterolemic men were more likely than others to have reduced intake of dietary saturated fatty acids and cholesterol...........The bias introduced by change in diet among hypercholesterolemic men differs importantly from bias due to unreliability of measurement and to interindividual differences in intrinsic level of serum cholesterol, because it can produce statistically significant but spurious correlations".

This paper examines how the failure to account for regression dilution bias (systematic error) dilutes the strenght of the associations of TC cholesterol and CHD and Ischemic stroke in several large-scale, high-risk Western cohorts (Framingham, Whitehall).

While regression dilution bias is adjusted for, a different picture emerges, even within populations with very low serum cholesterol concentrations as the base-line.

"Numerous other observational studies, particularly in men, have demonstrated a strong, continuous, graded, and independent association between cholesterol and the risk of CHD.1–,6 The current data clearly extend these findings to Asian populations with substantially lower average levels of cholesterol, and confirm that effects are similar in men and women"

VVilly said...


Is Peters material new to you? Will you be able to comment on it sometime soon? eg. If Denise was wrong and 'forks over knives' was largely right then I've been eating the wrong diet. This is stuff I need to know.

Thanks to both of you for your work.

Peter said...


Campbell & Junshi's (1994) paper was excellent. The scholars reported that the chief correlate to all diseases of affluence was serum TC cholesterol (p=0.01) in a population with signficantly lower cholesterol than observed in Western societies. The energy intake in rural China was 30% above to what is observed in US.

Diet and Chronic degenerative disease: perspective from China

"There appears to be no treshold of plant-food enrichment or minimization of fat intake beyond which further disease prevention does not occur"

"These findings suggest that even small intakes of foods of animal origin are associated with significant increases in plasma cholesterol concentrations, which are associated, in turn, with significant increases in chronic degenerative disease mortality rates".

Similar observations in rural Asia had been previously made by Dutch colonial doctors (de Langen & Snapper) who even conducted clinical experiments by feeding the natives similar high-cholesterol diets than the Dutch colonialists ate at the time.

These observations may sound radical for a Westernes who indulges him/herself with dietary cholesterol and saturated fat in every meal 4-5 times a day, but basically Campbell and Junshi observed that TC cholesterol levels above what is observed in free-ranging mammalians that do not develope atherosclerosis are unhealthy. Elevated cholesterol is associated with increased risk for CHD even in free-ranging primates eating only foods found in nature (this may due to atherogenic food selection or LDL receptor inactivity, nevertheless the harm caused by elevated LDL accrue most likely independent of the mechanism used).

In western socities LDL cholesterol that is 200% above to what is physiologic is the norm. By physiologic is meant the cholesterol levels observed in free ranging mammalians, healthy neonates and members in socities where chronic disease is near-absent (Central Africa, rural Asia, Guatemala, trophical gatherers etc).

If your diet does not provide you physiologic cholesterol levels (TC cholesterol <150 (3,88mmol/l), LDL <70, (1.8mmol/) or very close to it, it probably is not the best diet to sustain long-term health. Think TC cholesterol as it was blood pressure or BMI. These things must be low for optimal, long-term health.

I thank Stephen for showing red light against against SFA laden foods. This is a great serie.

Forks Over Knives and Healthy Longevity: A Missed Opportunity for the Cholesterol Skeptics

Chris Wilson said...

Peter has made appearances on this site before. There was extensive discussion of his (and others) "plant positive" hypothesis in the comments section to previous posts. Given that the content and manner (replete with liberal block quotes from favorite studies) is basically the same, these current posts seem a bit like trolling to me, especially as Stephan is talking about *Food Reward* not the diet-heart hypothesis...


CHIEFROK said...

Hey Stephan, I got an email about this this morning and so I must officially challenge you in the name of poutine.

I loved your debate with Taubes and I fully respect you but you have crossed a line blaming poor old poutine that so many of my skinny friends demolish.

I disagree with your palatability theory and I challenge you to get better results with low reward food than I can with high reward food.

Give me anyone on this planet looking to lose weight and I will have them losing it eating copious amounts of poutine and other yummy stuff to their hearts content. I know this works because as a trainer I have repeatedly done so with my trainees, in fact I will include this in an upcoming video project documenting it.

Poutine, I got your back homie.

Gabriella Kadar said...

Ya, this Peter dude is a China Study troll.

Let him eat grass.

Peter said...


what exactly did you think the food reward -researchers are going to put you eat? It's all about low-fat & high fiber cuisine. Very few people wake up in the middle of the night and go oh my god, I need to have my whole-wheat-berries and jerusalem artichokes. High-fiber foods are not really the kind of foods that cause people to get overly stimulated and see dreams about, and perhaps that may just be the solution for many.

Jane said...

@Peter & Willy Rempel & Paul Kayley
Stephan has written about this. Here's some of what he says. 1963, Dr. C. R. Ball and colleagues published a paper describing blood clots in the heart and coronary arteries, heart muscle degeneration, ventricular calcification and early death in mice fed a lard-rich diet...

Dr. Klevay suspected that Ball's mice had suffered from copper deficiency, and decided to test the hypothesis. He replicated Ball's experiment to the letter, using the same strain of mice and the same diet. Like Ball, he observed abnormal clotting in the heart, degeneration and enlargement of the heart muscle, and early death.

...But then the coup de grace: he prevented these symptoms by supplementing the drinking water of a second group of mice with copper (4). In the words of Dr. Klevay: "copper was an antidote to fat intoxication" (5). I believe this was his tongue-in-cheek way of saying that the symptoms had been misdiagnosed by Ball as due to dietary fat, when in fact they were due to a lack of copper.

Since this time, a number of papers have been published on the relationship between copper intake and cardiovascular disease in animals, including several showing that copper supplementation prevents atherosclerosis in one of the most commonly used animal models of cardiovascular disease...

For more than three decades, Dr. Klevay has been a champion of the copper deficiency theory of cardiovascular disease. According to him, copper deficiency is the only single intervention that has caused the full spectrum of human cardiovascular disease in animals, including:

Heart attacks (myocardial infarction)
Blood clots in the coronary arteries and heart
Fibrous atherosclerosis including smooth muscle proliferation
Unstable blood vessel plaque
Foam cell accumulation and fatty streaks
Calcification of heart tissues
Aneurysms (ruptured vessels)
Abnormal electrocardiograms
High cholesterol
High blood pressure

If this theory is so important, why have most people never heard of it? I believe there are at least three reasons. The first is that the emergence of the copper deficiency theory coincided with the rise of the diet-heart hypothesis, whereby saturated fat causes heart attacks by raising blood cholesterol. Bolstered by some encouraging findings and zealous personalities, this theory took the Western medical world by storm, for decades dominating all other theories in the medical literature and public health efforts. My opinions on the diet-heart hypothesis aside, the two theories are not mutually exclusive. ..

Peter said...


you should sent your findings to the American heart association, they've missed an important part of the literature :)

Anyways, good point. We need to keep our copper status in check, do doubt about it.

What do you think about the +100 hundred experiments demonstrating that dietary cholesterol induces experimental atherosclerosis in virtually any animal model that it elevates serum cholesterol in, even when the elevation is considered to be small, this includes omnivorous non-human primates. Experiments on non-human primates have demonstrated that intake of even small amounts of dietary cholesterol as low as 43µg/kcal, the equivalent found in only half of a small egg in a human diet of 2,000 kcal induces atherosclerotic lesions. Furthermore, there was no evidence of a threshold for dietary cholesterol with respect to an adverse effect on arteries. This persisted even when the researhers made sure all micronutrient requirements were being met.

Do you think Darwin's homology has any predictive value for humans? Unfortunately, due to (too) stringent ethical considerations, we cannot perform these feeding experiments with dietary cholesterol to cholesterol skeptics who would happily volunteer.

Kuczynski (1925) reported on nomadic Kirghiz plainsmen who habitually consumed very large amounts of organic, grass-fed meat and organic milk. He noted high incidence of obesity, premature extensive atherosclerosis, contracted kidney, apoplexy, and arcus senilis. Their urbanized kinsmen, subsisting on more varied fare, did not exhibit such severe vascular disease.

In regards to these Kirghiz pastorals, Kuczynski asserted that:

"They get arteriosclerosis in an intense degree and often at an early age as shown by cardiac symptoms, nervous disordes, typical changes of the peripheral vessels, nephrosclerosis and, finally, apoplectic attacks. Even in men thirty-two years old I frequently observed arcus senilis

Perhaps copper defiency explains these findings among Kirghiz?

It has also been documented that numerous preserved pre-contact Inuit who were mummified dating all the way back to 1,500 years ago had a severe degree of atherosclerosis, osteoporosis, and osteoarthritis, consistent with studies of Inuit living in the 20th century. Perhaps the Western diet helped Inuits boost their copper status, since the Inuits appear to be the only population in the world who have experienced decreased stroke mortality after the adherance to more Western style dietary pattern.

For references, refer to:

Forks Over Knives and Healthy Longevity: Perhaps the Science is Legit After All


Naturalistic fallacy

Chris Wilson said...

Oh brother, here we go again (except I'll be sitting out this time!). On a related side note, I like how the "plant positive" crew is now trying to use the ancestral/global-comparative kinds of arguments that were pioneered by the paleo-diet advocates against animal foods-- now with their own favorite case study, the Kirghiz tribesfolk.I guess "if you can't beat 'em, join 'em" is the working principle here. Since these kinds of arguments are really very compelling (see here for a decent primer:, especially absent definitive head-to-head dietary trials, it is certainly a shrewd tactical pivot for that cadre to take, so that newcomers will get to hear the ancestral/global POV from their side first, and thus be less likely to form a balanced judgement about where the weight of evidence lies.

It's been fascinating to watch this scene unfold. I first learned about anthropological approaches to nutrition (and from there WAPF, paleo, etc.) back in the Dark Ages of 2003, and have been following the scene ever since. I was trying to eat "paleo" in 2004 and absolutely NO ONE had ever even heard the premise before. At that time, Evfit and Beyondveg were the main internet sites for any of this stuff- but I also had my anthropology textbook to go from too, plus having read Linus Pauling's critique of the diet-heart hypothesis. In all this time, I count Stephan as one of the most level-headed sources of information around- and reading his critique of CIH and exposition of Food Reward theory was the biggest revelation I've had since getting the ancestral premise back in 2003.

Anyways, too much rambling!

Peace and health!


Peter said...


I believe evolution has not much to provide in terms of long-term health (although I like Richard Wranghams idea's and their potential implications to dietary recommendations). However, evolution does not care about long-term health, it cares about re-production. I think we can go far with nutrition science alone. We don't need evolution to tell us coca-cola or poutine are unhealthy. This was what PlantPositive with his primitivenutrition serie aimed to convey. I used the examples about native cultures partly because I wanted to resonate with my audience.

Incase, you did not notice, I actually tried to hint about the appeal-to-nature fallacy by referring to wikipedia article.


Peter said...


BTW in regards to the link you proposed, the authors (Cordain, de Lorgerill, etc) are all well known denialists whose idea's about the alleged lack of consensus among biomedical community are just borderline comedy. These are the true merchants of doubt.

The consensus of biomedical community in regards to SFA is that proposed by the second co-author of Siri-Tarino meta-analysis, professor Frank Hu (february 2012):

Why is red meat harmful? “Saturated fat, which can lead to cardiovascular disease, is really just the beginning of the story,” explains Hu”

Is there something in the article by Ramsden et al (2009) you'd like partcularly point out?

I have an evolution for you: eat a diet and live a lifestyle that give you the serum cholesterol levels equivalent to those observed in a) free-ranging mammalians, especially those that do not develope atherosclerosis, b) healthy neonates and c) people livin' in societies where chronic disease is near-absent.

In the industrial era, the Japanese were the embodiment of this evolution. The seven Countries study baseline data (1960s) on Japan showed a dietary total fat of ≈10% of kcal (≈3% SFA, 3% MUFA, 3% PUFA); high, mostly complex, total carbohydrate; favorable serum lipid concentrations; and very low CHD rates for an industrialized society.

Anyways, props for Cordain & Co for atleast giving a lip service for the importance of having very low cholesterol levels, the levels people have had throughout the human evolution.

Optimal low-density lipoprotein is 50 to 70 mg/dl: Lower is better and physiologically normal

The average total cholesterol level in American adults today is 208 mg/dl (corresponding to an LDL of approximately 130 mg/dl) (13). In this case, average is not normal because atherosclerosis is present in up to 40% to 50% of women and men by age 50 (14). Atherosclerosis is endemic in our population in part because the average person's LDL level is approximately twice the normal physiologic level (Figure 1).

Brown & Goldstein:

Several lines of evidence suggest that plasma levels of LDL-cholesterol in the range of 25-60 mg/dl (total plasma cholesterol of 110 to 150 mg/dl) might indeed be physiologic for human beings. First, in other mammalian species that do not develop atherosclerosis, the plasma LDL-cholesterol level is generally less than 80 mg/dl. In these animals the affinity of the LDL receptor for their own LDL is roughly the same as the affinity of the human LDL receptor for human LDL, implying that these species are designed by evolution to have similar plasma LDL levels. Second, the LDL level in newborn humans is approximately 30 mg/dl, well within the range that seems to be appropriate for receptor binding. Third, when humans are raised on a low fat diet, the plasma LDL-cholesterol tends to stay in the range of 50 to 80 mg/dl. It only reaches levels above 100 mg/dl in individuals who consume a diet rich in saturated animal fats and cholesterol that is customarily ingested in Western societies".

Jane said...

Hi Peter
Yes I agree the AHA should know. Many years ago I wrote to various authorities trying to alert them to these things, with no success.

About dietary cholesterol inducing atherosclerosis. If you feed purified cholesterol to animals some of it will be oxidised, and we know oxidised cholesterol is very toxic.

'..Rabbits were fed a diet containing 0.33% nonoxidized cholesterol (control diet) or the same diet containing 0.33% cholesterol of which 5% was oxidized (oxidized diet). ... feeding a diet enriched in oxidized cholesterol resulted in a 100% increase in fatty streak lesions in the aorta. ..'

Only 5% of the cholesterol was oxidised, and lesions increased by 100%! The authors continue:
'Western diets contain high concentrations of oxidized cholesterol products, and our results suggest that these foods may be a risk factor for atherosclerosis.' Yes indeed.

In addition, Klevay tells us cholesterol feeding induces copper deficiency.
'..That cholesterol feeding can induce copper deficiency has been confirmed several times (22–24, 28, 29, 31) since the phenomenon was reported two decades ago (16). ..'

This means that even when 'the researchers made sure all micronutrient requirements were being met' as you say, the animals would probably still have had copper deficiency.

I'm not sure about the Kirghiz. They were presumably eating organ meats which are high in copper. On the other hand, dairy products are extremely low in copper, at least they are today. For the pre-contact Inuit, my own feeling is that their degenerative diseases were likely a result of manganese deficiency. Meat is very low in manganese, and very high in iron which not only competes with manganese for absorption, but causes damage to mitochondria which only manganese can prevent. And to add insult to injury, saturated fat increases absorption of iron and inhibits absorption of manganese, at least in rats.

Saturated fat also inhibits absorption of copper (in rats)
...which means the Kirghiz might indeed have had copper deficiency.

FlowT said...

Alcohol increases your metabolism, so after a long night drinking and dancing i guess those calories are burned and there u got the alcomunchies!

FlowT said...

Alcohol increases your metabolism, so after a long night drinking and dancing i guess those calories are burned and there u got the alcomunchies!

Chris Wilson said...
This comment has been removed by the author.
Anonymous said...

Here in Jersey we call this monstrosity "disco fries".

Takoja said...

Hi Richard,

Breastfed babies have total cholesterol levels of about 190mg/dl at six months. Doesn't it make sense that this is what can be called "physiologic level". There are good reasons why neonates have lower levels.
Read more at Paul Jaminet's blog.

Chris Wilson said...

prepare for some mad block quotes in the service of demonstrating that Paul Jaminet is a misinformed "denialist".


Peter said...

@Takoja & Chris,

I actually quoted Brown & Goldstein:

Brown & Goldstein:

"Several lines of evidence suggest that plasma levels of LDL-cholesterol in the range of 25-60 mg/dl (total plasma cholesterol of 110 to 150 mg/dl) might indeed be physiologic for human beings. First, in other mammalian species that do not develop atherosclerosis, the plasma LDL-cholesterol level is generally less than 80 mg/dl. In these animals the affinity of the LDL receptor for their own LDL is roughly the same as the affinity of the human LDL receptor for human LDL, implying that these species are designed by evolution to have similar plasma LDL levels. Second, the LDL level in newborn humans is approximately 30 mg/dl, well within the range that seems to be appropriate for receptor binding. Third, when humans are raised on a low fat diet, the plasma LDL-cholesterol tends to stay in the range of 50 to 80 mg/dl. It only reaches levels above 100 mg/dl in individuals who consume a diet rich in saturated animal fats and cholesterol that is customarily ingested in Western societies".

The mean TC cholesterol of North- American (US) adolescents aged 6-19 years is 160mg/dl.

For optimal long-term health, aim for below 3,8mmol/l, 150mg/dl

Peter said...

"Prepare for some mad block quotes in the service of demonstrating that Paul Jaminet is a misinformed "denialist".

:) Can you come with a single case he has ever made about cholesterol research and cardiovascular epidemiology that wasn't nonsense from the waist down? Do you have something specific in your mind?

For cellular function, LDL cholesterol levels of 15mg is needed, there's not really upside for having anything above. Whether the requirements for serum cholesterol levels for breast-fed babies going through the most rapid growth period of the life-span are different, is something I cannot answer. Never thought about it. This may well be. I suggest people consult the AHA instead of Jaminet's blog.

Jaminet claims to not have seen evidence for benefits of low cholesterol levels. About the benefits of very low, physiologic serum cholesterol levels, please refer to my previous posts on the same thread as well as these:

Every 1mmol/l (38mg/dl) drop in LDL cholesterol since birth translates to 55% reduction cardiovascular disease end point. This study and others found that individuals who inherit a variant of the statin drug targeted HMGCR gene that is associated with life-long reduced LDL, have an equal degree lower risk of coronary heart disease as individuals who inherited any of the other 8 studied gene variants. Each studied mutation in 9 different SNP:s lower LDL cholesterol with a mechanism of its own, nevertheless the end result is identical, suggesting that the benefit of LDL lowering accrue independent of the mechanism used.

1) A Mendelian Randomized Controlled Trial of Long Term Reduction in Low-Density Lipoprotein Cholesterol Beginning Early in Life

Number of participants in meta-analysis = 1,003,207

Prolonged exposure to lower LDL-C beginning early in life associated with 3-fold greater clinical benefit for each unit lower LDL than treatment with a statin started later in life (Mean age at randomization in statin trials: 63 years; p = 0.00000000000000000843)

Absence of Heterogeneity: Suggests the effect of each of included SNPs on risk of CHD is mediated largely or entirely through effect on circulating levels of LDL-C, rather than through some other pleiotropic effect.

The increased clinical benefit associated with lowering LDL-C beginning early in life appears to be independent of the mechanism by which LDL-C is lowered. Diet and exercise are probably as effective as other therapies at reducing the risk of CHD (per unit reduction in LDL-C)

2) Individuals born with extremely efficient cholesterol metabolism that cause life-long LDL levels of <15 mg/dl display increased longevity and end-up living 9-12 years longer than their peers.

Katy said...

I just had to comment because I'm a fitness junkie but I. Love. Poutine. And I'm Canadian.

I love it when I'm writing/tweeting about fitness, health and then… BAM! Giant picture of a disgustingly delicious poutine. Then some of my readers will call me a hypocrite and unfollow me. I often preach fitness, health, eating clean but I also preach about balance, living life and being happy. Poutine is my #1 guilty pleasure and I don’t consume it every day (although I don’t think I’d mind if I can do it without the consequences) but a couple times a month is not going to kill me! Poutine makes me happy. :) My boyfriend actually makes a homemade poutine from time to time to indulge me too. A girl can’t ask for more!

Chris Wilson said...

"Can you come with a single case he has ever made about cholesterol research and cardiovascular epidemiology that wasn't nonsense from the waist down? Do you have something specific in your mind?"

Yes, Peter, I did have something specific in my mind. The block quotes I was referring to were yours. Thank you for demonstrating my point!

I wonder if some of this uptick in the use of ancestral type reasoning amongst the "plant positive" camp is due to Don Matesz. Having been firmly ancestral/paleo for a long time, he kind of backed himself into a corner with the "Farewell to Paleo" and its aftermath.

He seems like a nice guy, though, based on his AHS11 talk...