The Paleo Diet

Welcome to The Paleo Diet Blog!

2010-09-06T11:50:00.000-06:00

The Paleo Diet--the world’s healthiest diet--is based on the simple understanding that the best human diet is the one to which we are best genetically adapted. It is supported by documented scientific evidence and by real-life improvements, even triumphs, of people winning their personal health battles.

The Paleo Diet is based upon the life work of Dr. Loren Cordain. Dr. Cordain is widely acknowledged as a leading expert on the diet of our Paleolithic ancestors. In numerous publications in the world's best scientific journals, he has documented the dramatic health benefits of eating a diet consistent with human genetic evolution and our ancestral, Paleolithic diet. Learn how a diet based on lean meats, seafood, fresh fruits, and fresh vegetables can lead to ideal body weight, optimum health, and peak athletic performance.

This concept represents the "unified field theory" of nutrition that has until now been lacking. The discipline of human nutrition previously had no orienting paradigm to guide research and inquiry, and as such was an immature science. In contrast, cosmology has the big bang theory, which orients all thought regarding the origins of the universe, and geology has continental drift and plate tectonics, which universally guide research into the origins of earth's land mass. In biology, the fundamental, guiding principle is Darwin's theory of evolution through natural selection, which provides a template for the creation of life on earth.

It has only been in the last two decades that a few enlightened scientists have realized that this principle also represents the basic biological principle which determines the nutritional requirements of any organism - including humans. Our genes were shaped by our ancestors' environment, including our nutrtional requirements. Because what we eat today is so far removed from the diet of our hunter-gatherer ancestors, a discordance exists between our genes and our diet, and this factor represents the underlying reason why we are so sick and overweight as a society.

Dr. Cordain has authored three pioneering books that provide specific applications of The Paleo Diet for general health and nutrition, specifically for athletes, and for curing acne.

The Paleo Diet provides the background and basis for the optimally healthful diet. It has been highly praised by researchers, scientists, and readers from all over the world.

The Paleo Diet for Athletes, written by Dr. Loren Cordain and world-class fitness trainer Joe Friel, provides detailed information on how endurance athletes can improve performance, recovery, and health by eating a slightly modified version of the Paleo Diet.

The Dietary Cure for Acne represents the first real cure--not a treatment--a real solution to this pervasive skin disease. It is a natural acne diet program, based on recent research.

We also offer numerous programs designed to help people address particular nutritional and health needs. These programs can enable you to achieve your health goals whether you seek to:

permanently free yourself from acne
improve your athletic performance
enjoy a longer, healthier, more active life
lose weight without dieting and exercise,
reduce or eliminate your risk of diseases, including cancer, heart disease, diabetes, and the vast majority of all chronic degenerative diseases that affect humanity

For more information about our team and our products please visit our Paleo Diet web site as well as our Dietary Cure for Acne web site.

You may post comments and questions at the end of most blog posts. Scroll down to the end of a post, type your comments in the text area under the title Post a Comment, and click the Post Comment button.

Announcing: The Paleo Diet Cookbook

2010-09-06T11:45:00.004-06:00

Editor's note: Dr. Cordain's latest publishing projects include The Paleo Diet Cookbook, available for purchase on December 13, 2010. This article includes a brief interview with Dr. Cordain.

Patrick Baker (PB): What did you hope to achieve by publishing your own cookbook?

Dr. Loren Cordain (LC): The Paleo Diet Cookbook will be published by John Wiley & Sons, the publisher of my first book, The Paleo Diet. Because of the enormous success of The Paleo Diet, my publisher wanted us (me, my wife Lorrie Cordain, and Nell Stephenson) to write a follow-up cookbook that would provide my readers with a "how to, hands on" easy approach to preparing and making delicious Paleo meals and snacks. The book contains more than 150 recipes arranged into the following chapters and topics:

Introduction
CHAPTER 1: The Paleo Diet Basics
CHAPTER 2: Paleo Kitchen Basics
CHAPTER 3: Paleo Breakfasts Dishes
CHAPTER 4: Paleo Snacks and Appetizers
CHAPTER 5: Paleo Poultry
CHAPTER 6: Paleo Beef, Pork, and Lamb
CHAPTER 7: Grass- Fed Meat, Game Meat and Jerky
CHAPTER 8: Paleo Fish and Seafood
CHAPTER 9: Paleo Salads
CHAPTER 10: Paleo Vegetable Dishes
CHAPTER 11: Condiments, Salad Dressings, Sauces and Fruit Purees
CHAPTER 12: Paleo Beverages and Desserts
CHAPTER 13: The Paleo Diet Two Week Meal Plan
CHAPTER 14: Treats and Meals for Crossfitters and Athletes

PB: Given the proliferation of other paleo cookbooks, what makes yours stand out?

LC: I am aware of two other cookbooks that have taken the Paleo approach, however it turns out that many of the recipes are not pure Paleo, and use salt, honey and other non-Paleo ingredients. This book comes straight from the originator of The Paleo Diet, and I can assure my readers that all of the recipes in the book are not only pure Paleo, but also appetizing and nutritious. Nell and Lorrie have done a wonderful job creating some brand new incredibly delicious recipes and snacks.

PB: In general, how does the cookbook reflect the principles outlined in your book The Paleo Diet?

LC: In the first chapter of the book, I outline the basics of Paleo dieting - all the do's and dont's that experienced Paleo Dieters may be aware of, but also great background material for newbies to Paleo Dieting. Actually, as most of our veteran readers realize, The Paleo Diet is not a diet at all, but rather a lifetime plan of eating to optimize health and well being. I've also devoted a large section of Chapter I to autoimmune diseases, and how Paleo Diets can ameliorate symptoms of these illnesses. This is brand new information which has never been published.

PB: Do you cross-reference any of your other published work in the cookbook?

LC: The Paleo Diet Cookbook is consistent with most of the work from my prior three books. However, I have completely updated it based upon the most recent scientific evidence. A couple of key points are different from my first book, The Paleo Diet, which was published in 2002. First, I no longer advocate the use of canola oil, for reasons explained in the book, and I have also taken a softer stand on saturated fats based upon my own article on the topic, published in 2006, and available as a free PDF download from my website. Further, I now advocate coconut and coconut oil consumption.

PB: When will your cookbook be available for purchase?

LC: The Paleo Diet Cookbook can be pre-ordered right now at Amazon, but it will not ship until December 13, 2010.

PB: Where can your readers purchase a copy of your cookbook when it becomes available?

LC: The Paleo Diet Cookbook, as well as my upcoming 2010 Revision to The Paleo Diet, can be purchased at my website, at Amazon, or almost any local bookstore.

The Paleo Diet in the News

2010-07-21T15:25:00.000-06:00

Dear Readers,

The Paleo Diet and Dr. Cordain's work have been cited in recent articles in the following media:

Mail Tribune, Medford, Oregon
Daily News, Redbluff, California
The Ledger, Lakeland, Florida
The Press of Atlantic City
A Sweet Life: An interview with a Type 1 Diabetic
Netstrife News - Rapid Weight Loss on the Paleolithic Diet (click on the article to make the pop-up go away).
Medscape - Does Diet Really Affect Acne?
Total Health Breakthroughs - Beating Obesity, The Old-Fashioned Way
Robb Wolf discusses The Paleo Diet in his podcast The Paleolithic Solution. Robb is a former student of Dr. Cordain's, and an advocate of Cordain's work in paleolithic nutrition.
Psychology Today - features an article on The Paleo Diet in their June edition (print), and their own paleolithic nutrition Q &A referencing Dr. Cordain's work on their blog. PT first wrote about Dr. Cordain's work in paleolithic nutrition in 1997!
WBUR.org (Boston NPR affiliate)
Westword
San Jose Mercury News
ArgusLeader.com
AnnArbor.com
ESPN - main article, expanded article
The Colbert Report - interview with John Durant
The Denver Post
National Post
Voice of America
Macleans
Politics Daily
Sun-Sentinel
AFP
Spiegel Online
Independent Online
The Times Online
The New York Times
The Washington Post
AOL's thatsfit.com
Book publishing news site Galleycat
The Examiner
Medscape
Huffington Post

Consumption of Nightshade Plants paper now available

2010-07-18T11:05:00.000-06:00

Dear Readers,

Dr. Cordain's newest paper "Consumption of Nightshade Plants" is now available from our web store.

Thank you for your continued readership.

Protein Intake for Pregnant Women

2010-07-11T11:30:00.000-06:00

by Loren Cordain, Ph.D., Professor

Q: Hello Dr. Cordain

I would like to know if you could direct me to any research that indicates what amounts of protein are necessary for pregnant women who live the Paleo Diet way. I am in my third trimester with my first child and have been living Paleo since I first heard you lecture on it back at Boulderfest before your book came out. I have been the picture of health and my pregnancy has been very easy. I am finding that my protein and fat requirements are significantly higher.

Is there any research you could direct me to regarding protein requirements for pregnancy based on trimester?

Thank you very much and I look forward to hearing from you.

Best Regards,
Lynda

A: Hi Lynda,

This question has come up before and the bottom line is that your probably should increase your fat and carbohydrate consumption, and limit protein to about 20-25% of energy, as higher protein intakes than this may prove to be deleterious to mother and fetus for a variety of physiological reasons. In my next book, I have devoted a chapter to maternal nutrition before, during and after pregnancy and why protein must be limited during pregnancy.

My colleague John Speth (an anthropologist) at the University of Michigan wrote a paper on protein aversion in hunter-gatherer women during pregnancy. Listed below is the abstract: (note the 25% protein energy ceiling!!!)

"During seasonal or inter-annual periods of food shortage and restricted total calorie intake, ethnographically and ethnohistorically documented human foragers, when possible, under-utilize foods that are high in protein, such as lean meat, in favour of foods with higher lipid or carbohydrate content. Nutritional studies suggest that one reason for this behaviour stems from the fact that pregnant women, particularly at times when their total calorie intake is marginal, may be constrained in the amount of energy they can safely derive from protein sources to levels below about 25% of total calories. Protein intakes above this threshold may affect pregnancy outcome through decreased mass at birth and increased perinatal morbidity and mortality. This paper briefly outlines the evidence for the existence of an upper safe limit to total protein intake in pregnancy, and then discusses several facets of the issue that remain poorly understood. The paper ends by raising two basic questions directed especially toward specialists in primate and human nutrition: is this protein threshold real and demographically significant in modern human foraging populations? If so, does an analogous threshold affect pregnant female chimpanzees? If the answer to both of these questions is yes, we can then begin to explore systematically the consequences such a threshold might have for the diet and behaviour of early hominids."²

The physiological basis for this aversion stems from a reduced rate of urea synthesis during pregnancy that is evident in early gestation¹ as well as increases in the stress hormone cortisol³. Hence, pregnant women should include more carbohydrate and fat (i.e. fattier meats) in their diets and limit dietary protein to no more than 20-25% of their total caloric intake.

Hope this helps!
Loren Cordain, Ph.D., Professor

References:

Kalhan, S. Protein metabolism in pregnancy. Am J Clin Nutr 2000;71 (suppl): 1249S-55S.
Speth JD. Protein selection and avoidance strategies of contemporary and ancestral foragers: unresolved issues. Philos Trans R Soc Lond B Biol Sci. 1991 Nov 29;334(1270):265-9; discussion 269-70.
Herrick, K., Phillips, D. I. W., Haselden, S., Shiell, A. W., Campbell-Brown, M., Godfrey, K. M., 2003. Maternal consumption of a high-meat, low-carbohydrate diet in late pregnancy: relation to adult cortisol concentrations in the offspring. J. Clin. Endocrinol. Metab. 88(8):3554-3560.

Type 2 Diabetes and Endotoxemia

2010-07-04T11:30:00.001-06:00

by Maelán Fontes

Currently there’s an epidemic of type 2 diabetes (T2D) worldwide, especially in Westernized countries. T2D is characterized by persistent elevated glucose levels due to disrupted insulin action or an alteration in pancreatic insulin production¹.

It was estimated that 171 million people were suffering from T2D in 2001, with a total overall population prevalence of 6%. More alarming is the fact that in Caucasian adolescents 4% suffer from T2D and 25% are glucose intolerant¹. However, T2D prevalence in hunter-gatherer societies is low^2-6, and even nonexistent in the island of Kitava in Trobiand Islands in Papua New Guinea³.

Genetics does not seem to explain the difference, because when these populations are Westernized they suffer even more from diseases of civilization such as T2D, obesity, myocardial infarction and stroke among others^7-10 than original Western populations. Furthermore, there’s evidence showing that hunter-gatherer populations can reverse T2D when they are resettled in their ancient habitat⁸, a fact that has been demonstrated in two recent clinical trials conducted on Western populations^{11, 12}.

Insulin resistance seems to be one of the factors involved in T2D which is caused, by low-grade chronic inflammation^13-15 among other factors. Interestingly, low-grade chronic inflammation is a hallmark^16-19 in T2D patients.

Considering these factors, it seems plausible that the nutrition introduced with the agricultural revolution 10,000 years ago played an important role in the current diabetes epidemic in Westernized populations. Western foods are overload with antinutrients, namely lectins, saponins and gliadin, which may explain the great disparity between paleolithic and modern Western food when it comes to metabolic syndrome (a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes). There is evidence showing that antinutrients act as endocrine disrupting substances, promoting metabolic syndrome²⁰. On the other hand, antinutrients may elicit their negative health effects through increased intestinal permeability²¹. However, scant evidence exists regarding the role of antinutrients in the aetiology of Western diseases.

Gliadin and increased intestinal permeability

One of the most studied foods in the recent years is wheat, which contains a protein called gliadin, and is part of the gluten protein family²². Gliadin increases gut permeability by means of Zonulin production (a protein that regulates in tight junctions between cells in the wall of the digestive tract) in the gut enterocytes (epithelial cells found in the small intestines and colon). Zonulin binds the CXCR3 chemokine receptor leading to intracellular signalling cascades, mediated by protein kinase C (PKC), which ultimately causes disruption of the tight junction proteins which maintain the gut barrier function, and lead to increased gut permeability^{23, 24}.

In addition, when intestinal permeability is increased, gliadin - which is resistant to heat and digestive enzymes - is able to interact with gut associated lymphoid tissue (GALT) stimulating the innate immune system, leading to low-grade chronic inflammation^{22, 24}. Several studies have demonstrated that gliadin induces the production of pro-inflammatory cytokines (a small protein released by cells that has a specific effect on the interactions between cells, communications between cells or the behavior of cells), independent of one’s genetic predisposition to celiac disease – which is virtually everyone^{23, 25, 26}.

Lectins and increased gut permeability

Lectins are a family of glycoproteins (a complex protein containing a carbohydrate combined with a simple protein) found in the plant kingdom, including grains, legumes and solanacous plants (tomatoes, potatoes, eggplants and peppers)^{21, 27}. Lectins also have the ability to bind sugar containing molecules. They were first studied for their ability to agglutinate (cause to adhere) red blood cells by binding to their cell membranes. Many lectins present in other foods are harmless, but some lectins found in grains, legumes and solanaceous plants have been shown to be harmful to human physiology²⁸. Lectins are resistant to heat (unless cooked by pressure cooking)²⁹ and digestive enzymes³⁸, and therefore arrive intact when they reach the intestinal epithelium, passing through the intestinal barrier into peripheral circulation. Lectins are able to bind peripheral tissues, producing many deleterious health effects²¹. Furthermore, lectins disrupt intestinal barrier and immunological function when they bind surface glycans (a carbohydrate polymer containing simple sugars) on gut epithelial cells, causing cellular disruption and increasing gut permeability. Lectins also facilitate the growth of certain bacteria strains, stimulate T-cell proliferation, increase intercellular adhesion molecules (ICAM), stimulate production of pro-inflammatory cytokines (IL-1, TNF-alpha, etc.), and amplify HLA class II molecules expression, among other effects²¹.

Saponins and increased gut permeability

Saponins are glycoalkaloids (a family of poisons commonly found in the plant species Solanum dulcamara - nightshades) produced by plants, technically known as steroid glycosides or triterpenoids, are formed by a sugar compound (glucuronic acid, glucose or galactose, among others) and aglycone (non-sugar molecule) portion^30-32. The aglycone portion binds the cholesterol molecule on gut cell membranes. When certain amounts of saponins bind cell membrane cholesterol molecules of the intestinal epithelial cells at a 1:1 ratio, the sugar portion of the saponins bind together, resulting in a complex molecule consisting of cholesterol and saponins. This new molecule disrupts the gut barrier and increases intestinal permeability. This has been shown in humans who consume a diet rich in alpha-solanine and alpha-chaconine - two of the saponins found in potatoes³¹.

On the other hand, saponins have adjuvant-like activity, which means that they are able to affect the immune system leading to pro-inflammatory cytokine production^{33, 34}, ultimately inducing insulin resistance.

Intestinal permeability and endotoxemia

Intestinal epithelia act as a physical barrier between the outside and the inside of the body, meaning that the intestinal lumen is technically outside the organism. When the intestinal barrier is disrupted, it allows increased passage of gut luminal antigens derived from food, bacteria and viruses into the organism²¹. In case of bacteria derived antigens, lipopolysaccharide (LPS) is the most commonly studied and utilized antigen to induce acute immune stimulation, this is known as endotoxemia (the presence of endotoxins - a toxin that forms an integral part of the cell wall of certain bacteria - in the blood which may cause hemorrhages, necrosis of the kidneys, and shock)³⁵. In addition, endotoxemia is associated with low-grade chronic inflammation, insulin resistance and T2D^{13, 18, 36}. In a recent human study it was demonstrated that LPS induced low-grade chronic inflammation in adipose tissue in T2D³⁶ humans.

LPS-TLR4 interaction and low-grade chronic inflammation

The innate immune system is localised in the GALT. When luminal antigens pass through the intestinal barrier, they are phagocited (consumed) by dendritic cells or macrophagues, key components of the innate immune system. Dendritic cells or macrophagues recognize antigens through a family of receptors known as Toll-like receptors (TLR). The best studied and known antigens from gram negative bacteria are LPS which interact with toll-like receptors-4 (TLR4), inducing the production of pro-inflammatory cytokines and ultimately insulin resistance and T2D³⁵. Interestingly, a recently published study demonstrated increased TLR4 expression in T2D humans, contributing to an increased inflammatory state³⁷.

In summary, antinutrients introduced with the agricultural revolution 10,000 years ago may be one of the causal factors in the epidemic of obesity, (as well as T2D) in Western countries. Lectins, saponins and gliadin increase intestinal permeability and allow increased passage of gut bacteria from intestinal lumen to peripheral circulation. LPS - an antigen found in gram-negative bacteria cell membranes - interacts with TLR-4, leading to inflammatory cytokine production and low-grade chronic inflammation, which is at the root of insulin resistance. Insulin resistance is recognised to induce the metabolic syndrome, including T2D. Endotoxemia-induced insulin resistance in T2D patients may be exacerbated, in part, by antinutrients.

References:

Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005;365(9467):1333-46.
Joffe BI, Jackson WP, Thomas ME, Toyer MG, Keller P, Pimstone BL. Metabolic responses to oral glucose in the Kalahari Bushmen. British medical journal 1971;4(5781):206-8.
Lindeberg S, Eliasson M, Lindahl B, Ahren B. Low serum insulin in traditional Pacific Islanders--the Kitava Study. Metabolism: clinical and experimental 1999;48(10):1216-9.
Merimee TJ, Rimoin DL, Cavalli-Sforza LL. Metabolic studies in the African pygmy. The Journal of clinical investigation 1972;51(2):395-401.
Spielman RS, Fajans SS, Neel JV, Pek S, Floyd JC, Oliver WJ. Glucose tolerance in two unacculturated Indian tribes of Brazil. Diabetologia 1982;23(2):90-3.
Zimmet P. Epidemiology of diabetes and its macrovascular manifestations in Pacific populations: the medical effects of social progress. Diabetes care 1979;2(2):144-53.
Cruickshank JK, Mbanya JC, Wilks R, Balkau B, McFarlane-Anderson N, Forrester T. Sick genes, sick individuals or sick populations with chronic disease? The emergence of diabetes and high blood pressure in African-origin populations. International journal of epidemiology 2001;30(1):111-7.
O'Dea K. Marked improvement in carbohydrate and lipid metabolism in diabetic Australian aborigines after temporary reversion to traditional lifestyle. Diabetes 1984;33(6):596-603.
O'Dea K, Spargo RM, Akerman K. The effect of transition from traditional to urban life-style on the insulin secretory response in Australian Aborigines. Diabetes care 1980;3(1):31-7.
O'Dea K, Spargo RM, Nestel PJ. Impact of Westernization on carbohydrate and lipid metabolism in Australian Aborigines. Diabetologia 1982;22(3):148-53.
Jonsson T, Granfeldt Y, Ahren B, et al. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovascular diabetology 2009;8:35.
Lindeberg S, Jonsson T, Granfeldt Y, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007;50(9):1795-807.
Fernandez-Real JM, Pickup JC. Innate immunity, insulin resistance and type 2 diabetes. Trends in endocrinology and metabolism: TEM 2008;19(1):10-6.
Reyna SM, Ghosh S, Tantiwong P, et al. Elevated toll-like receptor 4 expression and signaling in muscle from insulin-resistant subjects. Diabetes 2008;57(10):2595-602.
Song MJ, Kim KH, Yoon JM, Kim JB. Activation of Toll-like receptor 4 is associated with insulin resistance in adipocytes. Biochemical and biophysical research communications 2006;346(3):739-45.
Duncan BB, Schmidt MI. The epidemiology of low-grade chronic systemic inflammation and type 2 diabetes. Diabetes technology & therapeutics 2006;8(1):7-17.
Kimberly MM, Cooper GR, Myers GL. An overview of inflammatory markers in type 2 diabetes from the perspective of the clinical chemist. Diabetes technology & therapeutics 2006;8(1):37-44.
Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes care 2004;27(3):813-23.
Spranger J, Kroke A, Mohlig M, et al. Inflammatory cytokines and the risk to develop type 2 diabetes: results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes 2003;52(3):812-7.
Jonsson T, Olsson S, Ahren B, Bog-Hansen TC, Dole A, Lindeberg S. Agrarian diet and diseases of affluence--do evolutionary novel dietary lectins cause leptin resistance? BMC endocrine disorders 2005;5:10.
Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. The British journal of nutrition 2000;83(3):207-17.
Fasano A. Surprises from celiac disease. Scientific American 2009;301(2):54-61.
Drago S, El Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian journal of gastroenterology 2006;41(4):408-19.
Visser J, Rozing J, Sapone A, Lammers K, Fasano A. Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Annals of the New York Academy of Sciences 2009;1165:195-205.
Bernardo D, Garrote JA, Fernandez-Salazar L, Riestra S, Arranz E. Is gliadin really safe for non-coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides. Gut 2007;56(6):889-90.
Rakhimova M, Esslinger B, Schulze-Krebs A, Hahn EG, Schuppan D, Dieterich W. In vitro differentiation of human monocytes into dendritic cells by peptic-tryptic digest of gliadin is independent of genetic predisposition and the presence of celiac disease. Journal of clinical immunology 2009;29(1):29-37.
Kilpatrick DC, Pusztai A, Grant G, Graham C, Ewen SW. Tomato lectin resists digestion in the mammalian alimentary canal and binds to intestinal villi without deleterious effects. FEBS letters 1985;185(2):299-305.
Cordain L. Cereal grains: humanity's double-edged sword. World review of nutrition and dietetics 1999;84:19-73.
Grant G, More LJ, McKenzie NH, Pusztai A. The effect of heating on the haemagglutinating activity and nutritional properties of bean (Phaseolus vulgaris) seeds. Journal of the science of food and agriculture 1982;33(12):1324-6.
Francis G, Kerem Z, Makkar HP, Becker K. The biological action of saponins in animal systems: a review. The British journal of nutrition 2002;88(6):587-605.
Patel B, Schutte R, Sporns P, Doyle J, Jewel L, Fedorak RN. Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease. Inflammatory bowel diseases 2002;8(5):340-6.
Keukens EA, de Vrije T, van den Boom C, et al. Molecular basis of glycoalkaloid induced membrane disruption. Biochimica et biophysica acta 1995;1240(2):216-28.
Oda K, Matsuda H, Murakami T, Katayama S, Ohgitani T, Yoshikawa M. Adjuvant and haemolytic activities of 47 saponins derived from medicinal and food plants. Biological chemistry 2000;381(1):67-74.
Pickering RJ, Smith SD, Strugnell RA, Wesselingh SL, Webster DE. Crude saponins improve the immune response to an oral plant-made measles vaccine. Vaccine 2006;24(2):144-50.
Cani PD, Bibiloni R, Knauf C, et al. Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes 2008;57(6):1470-81.
Creely SJ, McTernan PG, Kusminski CM, et al. Lipopolysaccharide activates an innate immune system response in human adipose tissue in obesity and type 2 diabetes. American journal of physiology 2007;292(3):E740-7.
Dasu MR, Devaraj S, Park S, Jialal I. Increased toll-like receptor (TLR) activation and TLR ligands in recently diagnosed type 2 diabetic subjects. Diabetes care;33(4):861-8.
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Fundraiser for Documentary Series: In Search of the Perfect Human Diet™

2010-07-01T08:38:00.000-06:00

Fund raising continues for The Ancestral Health Society & Foundation's post-production work on the international documentary series In Search of the Perfect Human Diet™. The four-part series features the world’s leading scientists and advocates in human evolutionary nutrition. For the first time a major television & DVD release will document proof of the Paleo Diet principles.

Donations of $100 or more will get a Special Edition DVD set and Film Credit for their support.

Distribution of this series will create important ongoing financial support for the Ancestral Health Society's non-profit foundation and educational mission via direct financial contributions from all DVD sales.

The four-part series features the world’s leading scientists and advocates in human evolutionary nutrition, including:

Dr. Loren Cordain (author of The Paleo Diet, Colorado State University)
Dr. Michael Richards (Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany -Department of Human Evolution)
Dr. Jay Wortman (Inuit Diet research, Canada)
Dr. Steve Phinney (Professor Emeritus of Medicine, UC Davis)
Gary Taubes (New York Times science writer and author of Good Calories, Bad Calories)
Dr. Michael R. Eades (author of Protein Power)
Barry Sears Ph.D. (author of The Zone)
Dr. Leslie C. Aiello (President, Wenner-Gren Foundation for Anthropological Research, New York)
Robb Wolf (Research bio-chemist, author of The Paleolithic Solution)
Professor Richard D. Feinman, PhD (Downstate Medical Center (SUNY) in New York)
Professor Craig Stanford (Chair, Department of Anthropology, USC)
Dr. Lane Sebring (Sebring Clinic, Wimberley, TX)
Eric Schlosser (author of Fast Food Nation)
And many more…

This fundraiser will enable Hunt Thompson Media, LLC to finish the international documentary series post-production work by Thanksgiving 2010, and release it for the 2010 Christmas and the 2011 New Year's resolution season. For more information on the documentary series visit www.perfecthumandiet.com.

To make a donation click the Chip In button below.

Report Issued on the 2010 Dietary Guidelines for Americans

2010-06-25T11:19:00.002-06:00

by Patrick Baker, Editor

On June 15, 2010 the US Federal Government announced the release of the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, a solicitation for written comments on the report, and an invitation for testimony at a public meeting to be held on July 15, 2010 in Washington D.C. Links to this announcement, the report, and instructions for submitting written comments or attending the public meeting are available at the Dietary Guidelines for Americans web site (www.DietaryGuidelines.gov).

Federal legislation requires that the most recent edition of the guidelines (last published in 2005) be reviewed, updated if necessary, and published every five years. The current report contains the recommendations of the 2010 Dietary Guidelines Advisory Committee (DGAC) to the Secretaries of Agriculture and of Health and Human Services for use in updating the Guidelines.

The Current USDA Food Pyramid. Source: www.health.gov.

In the introduction, the 2010 DGAC report states that two-thirds of the American public is overweight or obese. It goes on to say that "Americans are making dietary choices in a highly obesogenic environment and at a time of burgeoning diet-related chronic diseases affecting people of all ages, ethnic backgrounds, and socioeconomic levels. The DGAC considers the obesity epidemic to be the single greatest threat to public health in this century."

The introduction goes on to discuss the role of diet and physical activity in attenuating the risk of chronic diseases, as well as identifying population groups of particular concern. These include: children, pregnant and lactating women, and older adults.

Dr. Cordain was asked to comment on the report, and stated "I really don't see how these ‘new’ recommendations vary substantially from prior USDA Food Guidelines." Cordain states that the recommendations to consume whole grains and skim milk "obviously vary from the human ancestral diet, and upon closer scrutiny, these two foods are not necessarily healthful."

Dr. Cordain’s cites evidence from his book The Paleo Diet, as well as his and other published research, that whole grain products frequently may contribute to an elevated glycemic load because of the quantity of total grains the USDA recommends (8 ounces per day, equivalent to 8 slices of bread). Wheat in particular is problematic because it contains the storage protein gliadin, shown to increase intestinal permeability in celiac patients as well as in healthy persons.

Cordain notes that increased intestinal permeability promotes passage of a gut borne bacterial substance called lipopolysachharide into the bloodstream, producing a low-level chronic state of inflammation called endotoxemia (see Maelán Fontes’ article on Type 2 Diabetes and Endotoxemia). Endotoxemia likely underlies many chronic disease states, particularly cardiovascular disease and a number of autoimmune diseases, according to Cordain.

Dr. Cordain goes on to say that, "In the U.S. alone, it is estimated that 1 in 100 people or about 3 million US citizens have celiac disease. It is irresponsible to make across-the-board dietary recommendations to the entire population given the high incidence of celiac disease."

Cordain notes that while skim milk is promoted by the USDA because it contains much lower concentrations of saturated fat, it has been shown to be highly insulinotropic – "meaning that it raises blood insulin concentrations, similar to eating candy or a chocolate chip cookie." Dr. Cordain states that, "Work from our laboratory substantiated this effect for both skim and whole milk. In a recent study of young boys, they became insulin resistant after seven days on a high milk diet, compared to seven days on a high meat diet. This study has not been replicated in adults, but there is no reason to believe that the response would vary." Consumption of milk elevates a hormone called IGF-1 - which increases growth in children, resulting in an increased adult stature. However, says Cordain, "it also increases the risk for breast, colon and most particularly prostate cancer."

The Dietary Guidelines Advisory Committee is accepting written comments on the report until July 15, 2010. The public meeting to solicit oral comments on the report will be held on July 8, 2010, starting at 9:00 am EDT. Details are available at the Dietary Guidelines for Americans web site (www.DietaryGuidelines.gov).

Consumption of Nightshade Plants (Parts 1 -3) Newsletter Articles

2010-06-22T08:35:00.003-06:00

Dear Readers,

The three most recent editions of our weekly newsletter The Paleo Diet Update (Vol. 6 Issues 15-17) featured Dr. Cordain's newest paper "Consumption of Nightshade Plants". The final installment (three of three) was published last week. All three parts of the newsletter will available for purchase as back issues from our web store until July 5, after which the entire paper will be available from our web store.

Thank you for your continued readership.

Blood Type and Diet Newsletter Article

2010-06-08T14:30:00.002-06:00

Dear Readers,

Dr. Cordain's article "A Critical Examination Of Blood Type Diets" was published in a recent issue of our weekly newsletter The Paleo Diet Update (Vol. 6 Issue 14). If you're not already a subscriber you may purchase this informative article from our web store. Past issues of our newsletters are available for purchase individually, or as part of the entire archive.

Thank you for your continued readership.

Ishi: America's Last Known Hunter-Gatherer

2010-05-24T14:30:00.000-06:00

by Patrick Baker

Imagine being the last of your kind and entering a world that is nothing like the world your grandparents knew. What if you could no longer live in the homeland that had sustained your ancestors for centuries? This is exactly what happened nearly a century ago for a Native American man known to the modern world as "Ishi."

Ishi ("man" in his native Yana language) was believed to be the last of the Yahi people, and is believed to be the last Native American to have lived the majority of his life outside of American culture as it existed in 1911. Ishi was the name given to the last known hunter-gatherer in America by Alfred Kroeber, an anthropologist at the University of California at Berkeley in 1911.

Ishi shown with anthropologist A.L. Kroeber in 1911¹

Dr. Cordain has been researching Ishi intensely for the past six months, having been first introduced to Ishi by his father at about 11 years of age. Dr. Cordain stated that "I now believe I have an answer to Ishi's final two to three years of existence" in his ancestral home on Deer Creek, located east of present day Los Molinos, California - before his appearance in October, 1911 at a slaughter house in Oroville, California.

Kroeber stumbled into Ishi's life following his "death walk" from his hunter-gatherer home on Deer Creek to the slaughter house near Oroville. Kroeber wrote of and exploited this Native American's life and culture before Ishi’s death in 1916 from tuberculosis.

Cordain states that "sleuthing via Google Earth and the early records of Dr. Kroeber in the academic literature has given me insight into the exact location of his final 'village' of residence, and how he spent the last two to three years of his life with his paralyzed mother at another location on Deer Creek." Historically, this site was known only to the long-dead Kroeber and his colleagues. Cordain states that "modern anthropologic and forensic examination of this site would help to clarify and demystify the legend of Ishi."

Dr. Cordain believes that eventual carbon dating of this site - once verified and reexamined - will reveal the missing two to three years of Ishi’s life before he became known to the world of 20th century America. Cordain has compiled his information and will contact the appropriate members of the California Anthropological community before deciding how to proceed.

Cordain’s research and writings indicate that a contemporary diet that precisely mimics hunter-gatherer diets is "obviously impossible, as most of us don’t have unlimited access to wild game and plant foods." However, Cordain’s studies indicate that "our health, well being and mental state improve, and we can emulate Ishi's personality, psychological state and health" by consuming fresh fruits, vegetables, lean meats and seafood, as documented in his book The Paleo Diet. Dr. Cordain’s dietary recommendations in The Paleo Diet include avoiding processed foods, grains, refined sugars, refined vegetable oils, and salted foods.

Dr. Cordain goes on to say that "Ishi's story is heart-wrenching, sad, warm, but human above all else. His spirit, optimism and love of life - despite the awful events which sealed his fate - represent a truly remarkable and final tale" of the hunter-gatherer lifestyle as it was once practiced by Native Americans and other indigenous peoples. Unfortunately, much of Ishi's life will remain undocumented and unknown, and, according to Dr. Cordain, "the available historical, archaeological and forensic evidence about his final days on Deer Creek as America’s last known hunter-gatherer are vaguely understood and highly speculative."

For many of our readers, the story of Ishi may be unknown, and lost in the fog of a long forgotten history our great-grandparents knew - particularly those among us who lived with Native American inhabitants of this continent, after the American population of European descent had settled in the American West.

References:

Heizer, Robert F. (Editor), Kroeber, Theodora (Editor). Ishi the Last Yahi: A Documentary History. University of California Press, 1981.
Kroeber, Theodora. Ishi in Two Worlds: A Biography of the Last Wild Indian in North America. Deluxe Edition. University of California Press, 2004.
Starn, Orin. Ishi's Brain: In Search of America's Last "Wild" Indian. W.W. Norton & Co., 2005.
DVD Documentary. The Last Yahi (2002). Linda Hunt (Vocals), Jed Riffe (Director), Pamela Roberts (Director)

Audio Interviews with Dr. Cordain

2010-05-14T17:15:00.001-06:00

Dear Readers,

A collection of audio interviews with Dr. Cordain (MP3 format), including his March 30, 2010 guest appearance on Seattle's The Soul's Edge radio program, have been published on our web site. Visit our web site to download the recordings.

Paleo Diet Q & A - Whey Protein

2010-05-11T10:30:00.002-06:00

Q: Could you please provide some details on the benefits/detriments of whey protein supplementation? I am a weight trainer/powerlifter and supplement with whey protein, which is currently touted as the best/most health-conscious choice there is. I have read in your newsletter about the inflammatory aspects of dairy products - is whey protein included in this? Is it better or worse than other dairy products?

Many people interested in the Paleo Diet who are also into strength training and fitness would be interested in your thoughts on this. Any pointers re: inflammation and supplementation of protein would be very well received. Thank you, in advance.

Best regards,
Karl

A: Dear Karl,

Unfortunately, at this point, most of the research has focused on the beneficial effects of whey. It basically revolves around whey's high BCAA content, its use as a post-workout recovery drink ingredient, and its capacity – due to cysteine – to increase Glutathione, a powerful endogenous antioxidant enzyme.

Nevertheless, we believe that whey protein can have some potential adverse effects, because it greatly elevates insulinemia - although it can be therapeutic for diabetics in the short term. We suspect that whey protein could be detrimental long term, as hyperinsulinemia can down-regulate the insulin receptor and lead to insulin resistance. Insulin resistance underlies the Metabolic Syndrome, and is implicated in various other diseases, such as Acne, Alzheimer, various cancers, Coronary Heart Disease, Myopia, PCOS, etc.).

But to be completely sure, we would need intervention studies with whey protein with a relatively long duration in people genetically prone to insulin resistance, or who are in fact insulin resistant.

Also, there is the matter of hormones in milk: estrogens, DHT precursors, Insulin, IGF-1 and the hormone Betacellulin (BTC), which Dr. Cordain has discussed in a previous edition of this newsletter. These are some of the possible mechanisms for which there is repeated epidemiological evidence associating milk consumption with some cancers - especially Prostate Cancer.

We know that these hormones are present in milk and - in the case of BTC - it is present in whey too. Nevertheless, the real content of all these hormones in commercial milk-derived products is an open question that deserves proper and urgent study. So while we don’t know for sure, and since and we have alternatives, I would follow the old saying: do no harm!

Finally, if you have an auto-immune disease or allergy to Beta Lacto Globulin (protein that exists in bovine milk, but nonexistent in human milk) I would stay away from whey. Whey contains not only Beta Lacto Globulin, but also Bovine Serum Albumin. Some peptides from this protein have structural homology with peptides from our own tissues, and BSA has been implicated in Multiple Sclerosis, Rheumatoid Arthritis and Type 1 Diabetes.

In conclusion, I would follow the evolutionary template until all these issues are resolved. which states that recently introduced foods may have potential adverse effects to humans, especially long term. Non-human milk was only introduced in the human diet ~10,000 years ago. Therefore, given the potential health hazards of milk that science is revealing, I would use another protein source. Lean meat and seafood are very good sources of BCAA. If you want a protein drink immediately after strength training to speed recovery and increase muscle mass, I would suggest ~9 grams of essential amino acids, along with a banana.

I hope this helps.

Cordially,
Pedro Bastos

Editor's note: the following blog posts also discuss whey protein:

Q: I started the program and I was wondering if Whey Protein or protein powder in general is against the diet?

Q: I like drinking protein shakes in the morning, but I noticed some of the protein sources in my protein shake are made from milk or dairy products. Is there an alternative that is available in the market place?

Q: I am just trying to figure out your feelings and thoughts on protein powders.

Additional reading: Hyperinsulinemic diseases: more than just Syndrome X.

Paleo Links

2010-05-06T14:45:00.002-06:00

Dear Readers,

In addition to our paleo nutrition links on the right-hand side of the blog (scroll down if not visible), here are useful links for fitness, Paleo Diet, and paleo nutrition-related web sites and blogs.

Nell Stephenson Fitness and Nutrition
Robb Wolf - Intermittent Fasting, Fitness, & Paleolithic Nutrition
Hunter-Gatherer - Health and human nature from an evolutionary perspective

Paleo Diet Q & A - Sprouted Legumes

2010-05-03T15:05:00.000-06:00

Q: Hi, the Paleo Diet makes a lot of sense to me and I very much appreciate the research that's gone into it. However, am I right in thinking that any diet we are adapted to may nevertheless not be an ideal diet? We adapted to a diet that enabled us to be healthy enough to live long enough to reproduce healthy enough offspring.

If I understand correctly, couldn't certain foods could make that basic diet even healthier? For example, I have The Paleo Diet for Atheletes out from the library right now and I see that you believe that the life of an athlete requires departure from a strict paleolithic diet. Couldn't properly treated grains and legumes be beneficial additions to the diet? (i.e. soaked/sprouted to reduce/eliminate anti-nutrients?)

I am waiting to receive The Paleo Diet from the library (I'm on a long waiting list, which is good news I guess!) so maybe you address this issue in the book, in which case, I apologize. But if not, I would appreciate knowing your views on soaking/sprouting grains and legumes, and the reasons behind those views.

Thanks so much,
Zena

A: Dear Zena, first of all - thanks for supporting our work.

Lectins, one of the known antinutrients in cereal grains and legumes¹, have been demonstrated to exert several deleterious effects upon human physiology¹, (especially for those with autoimmune diseases) by increasing intestinal permeability². Their function is to protect the plant against attacks by plant-eating animals by using several toxic substances, such as lectins³. There is a growing body of evidence showing that both the root and the sprout of wheat kernels have significant amounts of wheat germ agglutinin (WGA), one of the most studied lectins. Indeed, WGA originates in the wheat kernel, especially during germination and growth⁴, and the highest concentrations are found in young plant roots, seeds, and sprouts.

Lectins are resistant to digestive enzymes, and are found intact in peripheral circulation, as shown by Wang et al (1998)⁵. Furthermore, they are deposited in the internal organs⁶.

As stated by Pusztai et al⁷, lectins are heat stable, and normal cooking does not completely eliminate these toxic compounds unless they are pressure cooked^8-11. The best way to reduce lectins' adverse health effects is to limit their intake.

In addition, saponins - another type of toxic/antinutritive compound - exist in legume sprouts. Saponins have been shown to affect the gut barrier and by extension immune system function¹². They may also increase the risk of autoimmune diseases in genetically susceptible individuals¹³. Soaking, sprouting or cooking legumes, does not reduce their saponin content^{14, 15}.

In addition, a peptide fraction from gluten proteins called gliadin is found in wheat. Gliadin is resistant to digestive enzyme degradation¹⁶, arrives intact when it comes into contact with intestinal epithelial cells¹⁷, and increases intestinal permeability. Increased intestinal permeability may be at the root of autoimmune diseases such as Celiac Disease and Type 1 Diabetes¹³.

Phytate, the main form of phosphorus storage in many plants (especially bran and seeds) is classified as an antinutrient because is a chelator of iron, magnesium, calcium and zinc¹. Phytate ingestion inhibits the intestinal absorption of those minerals. Phosphorus from phytate is unavailable to humans, as we do not produce the phytase enzyme necessary to break down phytate - unlike ruminants, who do produce phytase, and are able to digest phytate¹⁸. Yeast fermentation in bread reduces phytate content¹⁹. Furthermore, addition of ascorbic acid counteracts the inhibitory effects of phytate upon iron absorption²⁰. Soaking and fermentation reduces the phytate content of grains and legumes as indicated in several studies^{21, 22, 23, 24}.

Having said that, Dr. Cordain in his first book talks about the 85:15 rule, where he explains that 85% of caloric intake from modern paleolithic-like foods is still more healthy than the typical western diet, where more than 70% of caloric intake comes from foods introduced in the human food chain after the agricultural revolution²⁵.

The bottom line is that our metabolism is perfectly adapted to the nutrition that shaped our genome during million of years of evolution. Therefore, any nutrient introduced after the agricultural revolution may not be compatible with our ancient genome. We believe that anyone engaged in athletic activities could do very well on a diet based on 85% paleolithic nutrients, which are preferable to the nutrients found in the typical western diet.

I hope this is helpful.
Maelán Fontes

References:

Cordain L. Cereal Grains: Humanity’s Double-Edged Sword. World Rev Nutr Diet. Basel, Karger,
1999, vol 84, pp 19–73.
Cordain L. et al. Modulation of immune function by dietary lectins in rheumatoid arthritis. British
Journal of Nutrition (2000), 83, 207–217.
Chrispeels, M.J. & Raikel, N.V. (1991) Lectins, lectin genes, and their role in plant defense. Plant Cell 3, 1-9.
Miller, R., & Bowles, D. (1982). A comparative study of the localization of wheat-germ agglutinin
and its potential receptors in wheat grains. Biochem. J., 206, 571-576.
Wang Q, Yu LG, Campbell BJ, Milton JD, Rhodes, JM. Identification of intact peanut lectin in peripheral
venous blood. Lancet 1998;352:1831-32.
Caron, M. & Steve, A.P. (2000) Lectins and Pathology, Taylor & Francis, London.
Pusztai A and Grant G. Assessment of lectin inactivation by heat and digestion. From Methods
in Molecular Medicine. Vol 9 Lectin methods and protocols. Edited by J M Rhodes and J D Milton Humana
Press Inc. Totowa, NJ.
Grant G, More LJ, McKenzie NH, Pusztai A. The effect of heating on the haemagglutinating activity
and nutritional properties of bean (Phaseolus vulgaris) seeds. J Sci Food Agric 1982;33: 1324-1326.
Boufassa C, Lafont J, Rouanet J M, Besancon P 1986 Thermal inactivation of lectins (PHA)isolated
from Phaseolus vulgaris. Food Chem 20 295-304.
Buera M P, Pilosof A M R, Bartholomai G B 1984 Kinetics of trypsin inhibitory activity loss in
heated flour from bean Phaseolus vulgaris. J Food Sci 49 124-126.
Collins J L, Beaty B F 1980 Heat inactivation of trypsin inhibitor in fresh green soybeans and
physiological responses of rats fed the beans. J Food Sci 45 542-546.
Patel B, Rober S, Sporns P, et al. potato glycoalkaloid adversely affect intestinal permeability
and aggravate inflammatory bowel disease.
Visser J, Rozing J, Sapone A et al. Tight junctions, Intestinal permeability and Autoimmunity.
Ann. N. Y. Acad. Sci. 1165: 195-205 (2009).
Ruiz RG, Price K, Rose M, Rhodes M, Fenwick R. A preliminary study on the effect of germination
on saponin content and composition of lentils and chickpeas. Z Lebensm Unters Forsch 1996;203:366-369.
Ruiz RG, Price KR, Arthur AE, Rose ME, Rhodes MJ, Fenwick RG. Effect of soaking and cooking on
the saponin content and composition of chickpeas (Cicer arietinum) and lentils (Lens culinaris).
J Agric Food Chem 1996;44:1526-1530.
Shan L, Qiao SW, Arentz-Hansen H, et al. Identification and Analysis of Multivalent Proteolytically
Resistant Peptides from Gluten: Implications for Celiac Sprue. J Proteome Res. 2005 ; 4(5): 1732–1741.
Drago S, Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac
intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology,
2006; 41:408/419.
Klopfenstein, TJ et al. "Animal Diet Modification to Decrease the Potential for Nitrogen and
Phosphorus Pollution". Council for Agricultural Science and Technology 21.
Reinhold JG. Phytate destruction by yeast fermentation in whole wheat meals. J Am Diet Assoc 1975;66:38-41.
Hallberg L, Brune M, Rossander L. Iron absorption in man: ascorbic acid and dose-dependent inhibition
by phytate. Am J Clin Nutr 1989;49:140-4.
Chen LH, Pan SH. Decrease of phytates during germination of pea seeds (Pisium Sativa). Nutr Rept Int.
1977;16: 125-131.
Walker KA. Changes in phytic acid and phytase during early development of phaseoleus vulgaris beans.
Planta 1974;116:91-98
Bain, J. M., Murcer, F. V.: Changes in phytic acid and acid-soluble phosphorus in maturing pinto beans.
J. Sci. Fd. Agric. 20, 82–84 (1966).
Jennings, A. C., Morton, R. K.: Changes in nucleic acids and other phosphorus-containing compounds of
developing wheat grain. Aust. J. Biol Sci. 16, 332–341 (1963b).
Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the western diet: health implications
for the 21st century. Am J Clin Nutr 2005;81:341–54.

Paleo Diet Q & A: Blood Type and Diet

2010-04-23T11:05:00.006-06:00

Q: Professor, I pulled my information from thepaleodiet.com and attributed the statement, "Paleo is truly is the world’s healthiest diet," to you, which I doubt is a stretch.

Have you gotten into any of the information about the blood-type-related nutrition info? I've only heard snippets, but I'm curious what an expert thinks of it.

Seth

A: Hi Seth,

Thanks for your support. I am currently completing a paper on nightshades, and when it is done the very next topic in the queue is my critique of the Blood Type Diet, which I have been researching and reading about for the past couple of weeks. Although I don’t want to give away the story line, I can say that the concept of four specific types of diet for the four ABO blood groups (A, B, O & AB) is not supported by the available data. However, having said that, susceptibility to disease, and the robustness of the immune response to pathogens throughout the entire GI tract, is very much related to ABO blood groups. Our group has published at least one paper on the dietary lectin/disease concept and we believe that common dietary lectins may promote certain diseases (allergies, autoimmune disease) while simultaneously promoting chronic low level inflammation. However, little evidence in either humans, animals or tissues point in the direction that dietary lectins elicit disease symptoms exclusively via interaction with ABO antigens. Additionally, of the hundreds of plant lectins that have been identified, only a very select few have been demonstrated to bind gut tissue. Hence, most dietary lectins are benign, simply because they cannot penetrate the gut barrier.

Cordially,
Loren Cordain, Ph.D., Professor

Sample Menus for Endurance Athletes

2010-04-20T09:45:00.002-06:00

Dear Readers,

Nell Stephenson, Fitness & Nutritional Professional, Ironman Triathlete, and contributor to our newsletter was recently contacted by Details magazine to write up sample menus for endurance athletes: one for a workout day, the other for an off-day from training.

You will find other paleo-friendly menu ideas on Nell's blog.

Endurance Athlete Sample Menu for Two-a-Day Workout

5:30 AM
Pre-workout Breakfast Smoothie- 8oz brewed, chilled, natural decaf green tea with a banana, egg white protein powder, almond butter whizzed in the blender with some baked yam on the side.

6:30 AM
3-hour bike ride on the trainer-carbohydrate gel taken every 25 minutes.

9:30 AM
Immediate Post-workout recovery drink- HOME BREW (recipe in The Paleo Diet for Athletes) – cantaloupe, egg white protein powder and glucose. Drink plenty of water- keep hydrating.

10:00 AM
Raisins (to restore body alkalinity, continue to help the body recover post workout, and prepare for the session later in the day).

11:30 or 12:00 PM
Grilled Chicken breast, flash-sautéed asparagus, drizzled with flax seed oil and an apple

3:00 PM
Natural unsweetened applesauce with chopped egg whites (to prepare for 2nd workout of the day-shift from the usual Paleolithic macronutrient ratio to the pre-workout focus on carbohydrates).

4:30 PM
Sixty-minute track workout-hard, fast intervals; carbohydrate gel taken immediately post as recovery.

5:45 PM
Banana (high glycemic fruit choice to, again, aid in recovery)

6:30 PM
Poached wild salmon on a bed of steamed kale, mixed green salad, avocado & sliced strawberries, a squeeze of fresh lime juice and a splash of cold-pressed extra virgin oil; sliced oranges on top.

Endurance Athlete Sample Menu for Off-Day from Training

6:00 AM Breakfast
Poached Cod (or Barramundi) on bed of sautéed spinach (with garlic & olive oil), fresh blueberries and strawberries.

9:00 AM
Steamed broccoli, drizzled with cold pressed flax seed oil, sliced orange and chopped egg whites.

Lunch
Mixed green organic salad, with olive oil and lime wedge, served with grilled chicken, avocado and grapes.

Afternoon Meal
Sliced lean turkey breast used as a wrap, with Mache lettuce, raw almond butter and sliced pear inside.

Dinner
Kangaroo Kebabs-lean meat, skewered with red onion & yellow bell peppers, marinated over night in olive oil, lemon juice & your favorite herbs, then grilled or broiled. Serve with grilled green onion and a fresh spinach salad with tomato, walnut oil & a lime wedge.

Snack
Cinnamon dusted sliced apples-slice an apple, toss in lemon juice to prevent browning/oxidation, then sprinkle cinnamon on top. Enjoy with a cup of herbal or green decaf tea!

Chia Seeds Follow-up

2010-04-20T09:30:00.007-06:00

Dear Readers,

This Q & A is in response to Dr. Cordain's special report on Chia Seeds, which appeared in a recent issue of our newsletter, The Paleo Diet Update. The full report is available in The Paleo Diet Update, Volume 6 Issue 7.

Q: Loren,

Hope all is well with you and your work!

After reading your article on chia seeds, I forwarded the article to Dr. Vlad Vuksan in Canada, one of the leading researchers/promoters of Salba Seeds. After he got your article, he seemed to object that your conclusions apply uniquely to chia seeds generically, but not to Salba Seeds (single variety).

Is such a distinction valid? Wouldn't your conclusions regarding chia seeds apply as well to Salba, a variety of chia?

Thanks for your insights,
Frank

A: Hi Frank,

I stand by my conclusions in the newsletter. Until further human trials are completed employing a sample size with sufficient statistical power to resolve these immune system issues, then the potential adverse effects of long term, chronic chia seed consumption may outweigh the potential benefits. I respect Dr. Vukan’s long time collaborative work with David Jenkins at the University of Toronto, particularly in regard to their pioneering work on the glycemic index. I have read both of Dr. Vukan’s recent chia seed papers^{1, 2}, and in neither one do the authors make any distinction between generic Salvia hispanica L. and the trade name (Salba) version of the seed they employed in their two studies. Hence, unless Dr. Vukan and colleagues can show otherwise, the literature results I have uncovered remain unchanged and apply to both Salba and Salvia hispanica L. It should be noted that at least two of the subjects in Dr. Vukan’s first study² refused to continue because of gastrointestinal side effects.

In regard to Dr. Vukan’s first chia study, Table 1 shows a non-significant decrease (7.0 %) in the treatment group’s CRP and a 32.9 % increase in the control group value. The authors interpret this bi-directional group change in the abstract and elsewhere as a significant reduction (40 + 1.6% p less than 0.04) in CRP. This kind of data reporting is misleading when the treatment group mean change was actually non-significant. Despite ANCOVA adjustment for age, gender and sequence in their repeated measures model, their interpretation of the CRP data is at best misleading but likely incorrect. An additional shortcoming in this study involves the reporting of ALA and EPA data (results p. 2806). Why weren’t the actual plasma concentrations (mean + SD) of both of these fatty acids reported in both the experimental and control group? Given that 2% or less of ALA is chain elongated and desaturated into DHA, the EPA data need further scrutiny. Did the reported % differences for ALA and EPA represent within group differences or factorial differences? These shortcomings potentially invalidate the conclusions of the paper that CRP was reduced. In contrast, Nieman and colleagues³ were unable to replicate Dr. Vukan and colleague’s results in a similar study with a much larger sample size and hence greater statistical power.

Cordially,
Loren Cordain, Ph.D., Professor

References:

Vuksan V, Jenkins AL, Dias AG, Lee AS, Jovanovski E, Rogovik AL, Hanna A. Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.). Eur J Clin Nutr. 2010 Apr;64(4):436-8.

Vuksan V, Whitham D, Sievenpiper JL, Jenkins AL, Rogovik AL, Bazinet RP, Vidgen E, Hanna A. Supplementation of conventional therapy with the novel grain Salba (Salvia hispanica L.) improves major and emerging cardiovascular risk factors in type 2 diabetes: results of a randomized controlled trial. Diabetes Care. 2007 Nov;30(11):2804-10

Nieman, D., C., E. J. Cayea, M. D. Austin, D. A. Henson, S. R. McAnulty, F. Jin. 2009. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutrition Research, 29(2009):414-418.

Paleo Diet Special Report: Chia Seeds

2010-04-12T10:15:00.002-06:00

Dear Readers,

The following is an excerpt from a special report authored by Dr. Cordain on Chia seeds. The full report is available in our newsletter, The Paleo Diet Update, Volume 6 Issue 7.

Q: Are there any negative effects associated with chia seeds which would make them inappropriate in The Paleo Diet?

Thank you.

A: Good question. I would imagine that many of our readers have never even heard of chia seeds much less eaten them. Chia seeds (Salvia hispanica L.) are a member of the Labiatae plant family and are native to southern Mexico and northern Guatemala. The seeds are small, oval shaped; either black or white colored and resemble sesame seeds. These seeds were cultivated as a food crop for thousands of years in this region by the Aztecs and other native cultures. Chia seeds can be consumed in a variety of ways including roasting and grinding the seeds into a flour known as Chianpinolli which can then become incorporated into tortillas, tamales, and various beverages. The roasted ground seeds were traditionally consumed as a semi-fluid mucilaginous gruel (Pinole) when water is added to the flour. In post-Columbian times the most popular use of chia flour was to make a refreshing beverage in which the ratio of seeds to water is decreased, thereby resulting in a less gelatinous consistency to which lemon, sugar or fruit juice are added. The sticky consistency of chia seed Pinole or chia beverages comes from a clear mucilaginous, polysaccharide gel that remains tightly bound to the seeds. This sticky gel forms a physical barrier which may impair digestion and absorption of fat from the seed⁴ while also causing a low protein digestibility.

In the past 20 years a revival of interest in chia seeds has occurred primarily because of their high fat content of about 25-39% by weight, of which 50-57% is the therapeutic omega 3 fatty acid and alpha linolenic acid (ALA). In the past 10 years chia seeds have been used as a foodstuff for animals to enrich their eggs and meat with omega 3 fatty acids. So I wholeheartedly approve of feeding chia seeds to animals and then eating the omega 3 fatty acid enriched meat or eggs of these animals.

How about feeding chia seeds to humans – should we consume chia seeds because of their high omega 3 fatty acid (ALA) content? The Table below shows the entire nutrient profile of chia seeds. At least on paper, it would appear that chia seeds are a nutritious food that is not only high in ALA, but also is a good source of protein, fiber, certain B vitamins, calcium, iron and manganese.

Unfortunately, the devil is always in the details...

Radio Interview with Dr. Cordain

2010-04-05T14:55:00.004-06:00

Dear Readers,

Dr. Cordain was a guest on the The Soul's Edge radio program on KKNW Alternative Talk Radio, 1150 AM, in Seattle on March 30. You may listen to an MP3 recording of the interview from our web site. The segment with Dr. Cordain begins at time index 15:23 in the MP3 recording.

Paleo Diet Q & A - Lichen Sclerosis, Stevia

2010-04-02T14:20:00.008-06:00

Lichen Sclerosis

Q: Hi there - I have been following a Paleo Diet for a few weeks now and there is no doubt that I feel much better for it. I did not need to lose weight and I always regarded myself as pretty fit and healthy. However, a little while back I developed a troublesome skin condition called Lichen Sclerosis. Have you ever been asked about this condition and suggested dietary changes? I think part of the problem is that the etiology is not fully understood but many doctors seem to think it has an autoimmune component though I have read recent research that suggests oxidative damage plays a part and that antioxidant therapy may be useful in treatment. This condition is supposedly incurable (though manageable with potent steroids) but I'm sure it would give a great many people some comfort if simple dietary changes could help. Would be really great to hear your thoughts.

Simon

A: Dear Simon,

The available evidence indicates that an autoimmune component likely occurs with Lichen Sclerosis (LS). With all autoimmune diseases, an autoantigen (self protein) exists and represents the target protein being attacked by the immune system. About 75 % of LS patients maintain an IgG autoantibody to Extra Cellular Matrix Protein 1 (ECM1)¹. Acceleration of ECM1 deposition in dermal (skin) blood vessels may underlie the disease symptoms ^{2, 3}. So the question now arises, what causes an accelerated deposition of ECMI in dermal blood vessels in LS patients? The available evidence indicates that increased concentrations of a ubiquitous enzyme in the body called tissue transglutaminase (TG2) is primarily responsible for excessive ECM1 accumulation³. In medical terms, an increase in a concentration of a substance in the bloodstream by another substance is called "upregulation".

So, in LS patients, an upregulation of TG2 causes an upregulation and increased deposition of ECMI in the skin blood vessels in the affected area of the body. The next question to be posed is, what event or events trigger an upregulation of TG2? When we answer this question, then dietary recommendations advocated by the Paleo Diet will make sense. A storage protein called gliadin which is fournd in wheat, rye, barley and oats is known to upregulate TG2 ^4-7. Hence grain free diets may prove to be therapeutic for LS patients, although no current randomized controlled trials of this intervention strategy have yet been conducted.

Cordially,
Loren Cordain, Ph.D., Professor

References:

Chan I, Oyama N, Neill SM, Wojnarowska F, Black MM, McGrath JA. Characterization of IgG autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Clin Exp Dermatol. 2004 Sep;29(5):499-504.
Kowalewski C, Kozłowska A, Chan I, Górska M, Woźniak K, Jabłońska S, McGrath JA.Three-dimensional imaging reveals major changes in skin microvasculature in lipoid proteinosis and lichen sclerosus. J Dermatol Sci. 2005 Jun;38(3):215-24. Epub 2005 Mar 3.
Fisher M, Jones RA, Huang L, Haylor JL, El Nahas M, Griffin M, Johnson TS. Modulation of tissue transglutaminase in tubular epithelial cells alters extracellular matrix levels: a potential mechanism of tissue scarring. Matrix Biol. 2009 Jan;28(1):20-31. Epub 2008 Nov 5.
Michaelsson, G., Ahs, S., Hammarstrom, I., Lundin, I. P., & Hagforsen, E. Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer ki67+ cells in the dermis. Acta Dermato-Venereologica, 2003; 83(6):425-429.
Biagi F, Campanella J, Laforenza U, Gastaldi G, Tritto S, Grazioli M, Villanacci V, Corazza GR. Transglutaminase 2 in the enterocytes is celiac specific and gluten dependent. Dig Liver Dis. 2006 Sep;38(9):652-8.
Gorgun J, Portyanko A, Marakhouski Y, Cherstvoy E. Tissue transglutaminase expression in celiac mucosa: an immunohistochemical study. Virchows Arch. 2009 Oct;455(4):363-73.
Villanacci V, Not T, Sblattero D, Gaiotto T, Chirdo F, Galletti A, Bassotti G. Mucosal tissue transglutaminase expression in celiac disease. J Cell Mol Med. 2009 Feb;13(2):334-40.

Stevia

Q: Is Stevia Paleo? I have attempted to find an answer for this and the information I've found is conflicting at best. Please advise!!
Jeff

A: Dear Jeff,

There's some scientific evidence to support the notion that Stevia is safe, even in type 2 diabetes patients^{1, 2}. Furthermore, it has been demonstrated to have antihypertensive properties, as shown by Chan et al.³ and a long-term study⁴. Having said this, I am not aware of any study examining the potential antinutrient (lectins or saponins) content of the plant, hence we do not know the possible adverse effect of consuming this plant on a daily basis. Hunterh-gatherers used to consume a wide range of plants, thereby minimizing the amount of a single bioactive compound ingested and its toxicity. It is known that rotating the kind of plants is a good strategy in order to decrease food allergy and intolerance.

From an evolutionary standpoint we should look at nutrition as "whole food" rather than nutrients per se. The bottom line is that Stevia seems to be safe, but we need more research to rule out possible side effects.

I hope this is helpful,
Maelán

References

Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism. 2004 Jan;53(1):73-6.
Barriocanal LA, Palacios M, Benitez G, Benitez S, Jimenez JT, Jimenez N, Rojas V. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul Toxicol Pharmacol. 2008 Jun;51(1):37-41. Epub 2008 Mar 5.
Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20.
Hsieh MH, Chan P, Sue YM, Liu JC, Liang TH, Huang TY, Tomlinson B, Chow MS, Kao PF, Chen YJ. Clin Ther. 2003 Nov;25(11):2797-808. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study.

The Paleo Diet and Crohn's Disease

2010-03-30T14:10:00.000-06:00

Q: Can you comment on any reported results in curbing the symptoms of Crohn's Disease with the Paleo Diet. As I am a sufferer, I would love to know.

Thank you,
Shannon

A: Dear Shannon,

Indeed, inflammatory bowel disease (Ulcerative Colitis & Crohn's Disease) patients usually do very well with The Paleo Diet, as nutrients are one of the main environmental triggers of this condition. Crohn's disease is an autoimmune disease where the immune system mounts an attack against its own tissues - in this case the cells lining the intestine.

For an autoimmune disease to occur we need a genetic predisposition and an environmental trigger. The genetic predisposition depends on genes coding for the Human Leukocyte Antigen (HLA) system. One of the environmental triggers may be nutrition, besides infections, geography (vitamin D deficiency), physical trauma or vaccination.

One of the key points in this process is increased intestinal permeability. This means that the gut barrier allows increased passage of bacterial or food proteins (antigens) into peripheral circulation, skipping a process known as oral tolerance. Once antigens come in contact with the immune system located in the gut associated lymphoid tissue, they may elicit a T-cell mediated immune response against those antigens.

If the molecular structure of the dietary or bacterial antigens is similar to that of the HLA system (part of the immune system representing cellular mechanisms), chances are that a cross reaction between foreign antigens and self antigens (produced by T-cells) occur. This is termed molecular mimicry, and leads to self injury by the adaptive immune system.

Hence, decreasing intestinal permeability is one of the treatment targets. There are several nutrients known to increase intestinal permeability that you may want to avoid, at least until symptoms subside. Here is a list, with the noxious substances in parentheses:

Cereal grains (lectins and gliadin)
Legumes, including soya and peanuts (lectins and saponins)
Tomato (tomato lectin and alpha-tomatin)
Potato (lectins and saponins)
Chili (capsaicin)
Quillaja (foaming substance)
Quinoa (saponins)
Egg white (lysozyme)
Alfalfa sprouts (saponins)
Amaranth (saponins)
Alcohol

Moreover, some nutrients exert an adjuvant-like activity (they stimulate the immune system), which is something you don't want to if you are suffering from an autoimmune disease. Nutrients containing adjuvants:

Quillaja extract, found in root beer
Tomato alpha-tomatine

Dairy products and vegetable oils also have deleterious effects upon your immune system.

I hope this helps.
Maelán

Lysozyme from Egg Whites Article

2010-03-22T16:50:00.002-06:00

Dear Readers,

This past week our newsletter (The Paleo Diet Update, volume 6, issue 4) featured an article by Dr. Cordain on Lysozyme and Egg Whites, and autoimmune disease. Readers who are not yet newsletter subscribers may obtain a free subscription on our web site to The Paleo Diet Update.

Readers who would like to obtain a copy of volume 6, issue 4 of The Paleo Diet update may purchase a copy of this and other back issues from our web store.

Paleo Diet Q & A - Epigenetics, Flaxseed Oil

2010-03-12T16:40:00.002-07:00

Epigenetics

Q: What do you think about epigenetics? Many scientists (in Germany) believe that the concept of the Paleo Diet is no longer tenable.

Thanks a lot, Michael

A: Dear Michael,

Epigenetics is defined as the science studying changes in phenotype or gene expression by mechanisms other than changes in DNA nucleotide sequence¹. The phenotype is someone's appearance which it's determined by the genotype (stable and heritable) and the environment (nutrition and other lifestyle factors) which give place to the epigenotype (heritable, labile and rapid)¹. Epigenetic changes are controlled, among other mechanisms, by methylation and histone modification. Altered methylation pattern and histone modification may lead to increased susceptibility to disease. E.G. cancer is associated to generalized hypomethylation and localized promoters hypermethylation¹. Histone manipulation may also increase or decrease disease susceptibility².

Both, methylation and histone manipulation are under the control of dietary substances. For example, methylation depends on SAMe availability, which in turn is influenced by vitamin B6, vitamin B12 and folate intake³, and long chain polyunsaturated fatty acids such as DHA⁴. On the other hand, certain substances such as garlic, horseradish, fiber, blueberries, apple, onion, nuts, berries, red grapes, broccoli, etc. are known nutrients involved in histone modification².

The Paleo Diet is rich is all of these nutrients⁵, hence it may exert positive effects upon epigenetics machinery leading to decreased disease susceptibility. Decreased availability of micronutrients is associated to disease severity, probably, through complex epigenetic mechanisms, and supplementation could improve those symptoms³. Improved epigenetic is influenced by metabolic programming during foetal and early life. These two periods are crucial for the developing newborn and future adult's health. Hence, The Paleo Diet may confer protection against several diseases improving the epigenetic programming.

We hope this is helpful.

Maelán Fontes Villalba
Pedro Carrera Bastos

References:

van Vliet J, Oates NA, Whitelaw E. Epigenetic mechanisms in the context of complex diseases. Cell Mol Life Sci. 2007 Jun;64(12):1531-8.
Delage B, Dashwood RH. Dietary manipulation of histone structure and function. Annu Rev Nutr. 2008;28:347-66.
Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.
Muskiet FA, Kemperman RF. Folate and long-chain polyunsaturated fatty acids in psychiatric disease. J Nutr Biochem. 2006 Nov;17(11):717-27.
Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.
Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.

Flaxseed Oil

Q: I recently visited family and my brother is a new advocate of the paleo diet. For breakfast he made us "fakecakes" which had about 1-2 tablespoons of flaxseed in them that he ground in a coffee grinder. I had few a questions regarding the use of flaxseed in the Paleo Diet.

First, why are flaxseeds ok in the Paleo Diet but other grains (seeds) are not? My understanding for eliminating grains from the diet is the toxins that they contain, but flaxseed contains large amounts of cyanogenic glycosides, producing up to 139 mg/kg of hydrogen cyanide in raw human-grade flaxseed. I am sure flaxseeds are processed somehow before selling them but I don't know what process that is or what effect it has on the HCN concentration.

So, secondly...do you know of any studies on the amount of HCN in meals containing ground flasxseed and the chronic oral exposure of those amounts on humans? My understanding here is the HCN that isn't hydrolysed to formic acid in the stomach and doesn't bind to hemoglobin is converted to thiocyanate which hinders thyroid function.

Thank you for your time and any information you can supply.

Sincerely,
Tim

A: Hi Tim,

We think your thoughts are on the right track.

When Dr. Cordain wrote The Paleo Diet book, the advice to consume flaxseed oil was an attempt to balance the increased omega-6/omega-3 fatty acid ratio due to the exaggerated intake of omega-6 vegetable oils, especially linoleic acid, in the typical western diet.

Nevertheless, animal foods (fish, muscle meat and organs from wild animals) are good sources of w3 fatty acids. Therefore, when people eat these foods regularly along with vegetables and nuts, and avoid vegetable oils (especially oils rich in Linoleic Acid – Omega 6), they get a balanced intake of omega 3, omega 6, monounsaturated and saturated fatty acids. In this situation, there is no need for flax seeds to provide Omega 3 fatty acids and balance the Omega 3/Omega 6 ratio.

Here are some facts that support the notion that animal foods, vegetables and nuts provide the necessary Omega 6 and Omega 3 fatty acids in the right proportion:

Hunter-gatherers do not eat ALA from seeds or vegetable oils.
Nuts, green leafy vegetables and animal foods contain ALA.
The conversion of ALA to EPA+DHA is limited, due to low delta-6 and delta-5 activity, although ALA is highly oxidized (twice that of LA) (see paper by Freemantle et al). This means that at some point in history we included preformed sources of EPA and DHA and still need to do so. Animal foods (especially brain from wild ruminants and fish) are very good sources of these fatty acids.
The essentiality of LA & ALA in human metabolism has been questioned (see paper by Le et al.), as we relied almost on LCPUFA (Arachidonic Acid, EPA and DHA) during the Palaeolithic era (see Dr. Cordain’s papers on that here and here). Moreover, there is already some evidence showing that human metabolism could re-convert AA and DHA into LA and ALA respectively, hence AA and DHA would be the true essential fatty acids.
The possible toxicity from seeds and vegetable oils (HCN, saponins, lectins).
They are not used by current HG societies, and these populations show no signs of western disease, so this means that flax seeds are not necessary.
The well known positive health effects of fish oil supplementation (among other factors to improve omega-6/omega-3 ratio) in contrast with some possible adverse effects of flaxseed oil (like the epidemiological evidence that points towards increased risk of prostate cancer with flax oil consumption – see paper by Brouwer et al).

The bottom line from an evolutionary perspective is that flax seeds and/or flaxseed oil would not have been consumed by pre-agricultural humans. However, having said that, hunter gatherers always would have preferentially sought high oil plant foods as per optimal foraging theory. But, most high fat plant foods contain high MUFA (with the exception of coconut and palm oils).

Hope this helps,
Maelán Fontes Villalba

Additional reading: Effectiveness of different processing methods in reducing hydrogen cyanide content of flaxseed, Feng, et al.

Paleo Diet Q & A - Saturated Fat

2010-03-08T14:40:00.003-07:00

Dear Readers,

This question has come up several times in recent weeks. Maelán's response warrants breaking this out from among the other questions answered in the original post. Included in this post is a link to Dr. Cordain's paper on the subject.

Q: I wanted to ask you why it is that you discourage saturated fats in the paleo diet? From what I have read their are healthy saturated fats from coconuts that are used for around 17% of the Kitavan diet. Also, what about tubers such as sweet potato and yam, do you think that consuming these in moderate portions (small enough to keep a low glycemic load) could be detrimental?

A: Regarding saturated fats:

Saturated fatty acids intake and the risk of developing cardiovascular disease (CVD) is a topic with a lot of controversy. In recent years a wide body of research has suggested that increased consumption of certain saturated fatty acids (Lauric acid, myristic acid and palmitic acid)
down-regulate LDL receptor and thereby increase LDL plasma levels, and this has been associated to increased risk of CVD. On the other hand, stearic acid (a 18 carbon saturated fatty acid) has been shown to decrease LDL plasma levels. However, this view is too simplistic as they are several other factors contributing to CVD, such as smoking, exercise, trans-fatty acids, increased omega-6/omega-3 ratio, free-radicals, nutrient deficiency, homocysteine, alcohol intake and low-grade chronic inflammation among others.

Moreover, some studies have suggested that there’s not enough scientific data to support the view that increased total or LDL cholesterol is an independent risk factor for CVD, but rather oxidized LDL. Plaque production is mediated by oxidized LDL but not LDL. Oxidized LDL can produce shedding of the inner layer of the artery namely glycocalix. Then oxidized LDL infiltrates in the intima of the artery. Oxidized LDL is eaten by macrophagues, a process known as phagocytosis, and therefore macrophagues are transformed into foam cells which produce the fibrous cap.

Once the fibrous cap has been produced we need to break it down in order to produce an ischemic event. Lectins and low-grade chronic inflammation are involved in the activation of matrix metalloproteinases which break down the fibrous cap.

In summary, high total cholesterol or LDL levels do not increase CVD risk but rather oxidized LDL. To produce oxidized LDL we need the factors mentioned above. Hence, consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned before.

Dr. Cordain wrote a book chapter where he shows that saturated fat consumption in ancient hunter-gatherer populations were usually above recommended 10% (American Heart Association) of energy from saturated fats yet non atherogenic.

The bottom line is that we do not recommend cutting down saturated fatty acid intake but rather decrease high-glycemic load foods, vegetable oils, refined sugars, grains, legumes and dairy.

I hope this helps.
Maelán

Link to supporting paper.

Paleo Diet Q & A - Snails

2010-03-08T09:10:00.000-07:00

Q: Do you know if they ate snails in the paleo times? Thank you, Geha

A: Hi Geha,

The Paleolithic era stands for the "Old Stone Age" (Paleo means old; lithic means stone) and extended from 2.6 million years ago with the appearance of the first crude stone tools until the beginning of agriculture 10,000 years ago. During this period, it is estimated that at least 20 species of hominins (upright walking apes) existed¹. Because all hominins were omnivorous opportunists², land snails were almost certainly consumed on an occasional basis throughout hominin evolutionary history.

However, having said this, the first direct evidence for land snail consumption does not appear in the fossil record until 31,000 years ago at the Mumba-Hohle site on the shores of Lake Eyasi in East Africa^{3, 4}. The earliest archaeological evidence for land snail consumption in the Middle East has been dated to 22,000 to 23,000 years ago at the Kvar ‘Aqil site near Beirut, Lebanon³. The hominin that would have eaten these snails was our own species, Homo sapiens. Archaeologists interpret that snails were eaten because their shells were found in huge heaps called middens, and frequently were charred from being cooked⁵. Snail middens dating from 20,000 to 10,000 years ago and from 10,000 to 6,000 years ago are common in lands close to and surrounding the Mediterranean Sea^{3, 5}. The five most commonly consumed species of snails (Helix aspera, Helix melanostoma, Leucochroa candissima, Helicella setifensis, and Otala species) still occur in the Mediterranean region today.

If you don’t know, snail meat is considered a delicacy worldwide and is most commonly known from its French term, "escargot," an appetizer typically cooked in a sauce of butter, garlic and parsley⁶. Although three species of snails (Helix aspera, Helix pomatia) and the African snail (Achatina fulica) are most commonly consumed⁶, a large variety of snail species are eaten worldwide, depending upon location and availability. The cost of 1 kg of prepared snail meat is expensive and fluctuates between $5 - $13⁷. Snail meat, like fish, is high in protein and low in fat, and contains significant amounts of iron (see Table below). Give escargot a try, it’s a great Paleo appetizer.

Table 1. Nutritional value of snails. USDA National Nutrient Standard Reference, release 19 (2006).

Nutrients	Units of measurement for nutrients	Nutrient content per 100 grams of snail
Water	g	79.20
Energy	kilocalorie	90.00
Protein	g	16.10
Total lipid (fat)	g	1.40
Ash	g	1.30
Carbohydrate, by difference	g	2.00
Fiber, total dietary	g	0.00
Sugars, total	g	0.00
Minerals
Calcium, Ca	mg	10.00
Iron, Fe	mg	3.50
Magnesium, Mg	mg	250.00
Phosphorus, P	mg	272.00
Potassium, K	mg	382.00
Sodium, Na	mg	70.00
Zinc, Zn	mg	1.00
Copper, Cu	mg	0.40
Selenium, Se	mcg	27.4
Vitamins
Vitamin C	mg	0.00
Thiamin	mg	0.01
Riboflavin	mg	0.12
Niacin	mg	1.40
Vitamin B-6	mg	0.13
Folate, total	mcg	6.00
Folic acid	mcg	0.00
Folate, food	mcg	6.00
Folate, DFE	mcg_DFE	6.00
Vitamin B-12	mcg	0.50
Vitamin B-12, added	mcg	0.00
Vitamin A, IU	IU	100.00
Vitamin A, RAE	mcg_RAE	30.00
Retinol	mcg	30.00
Vitamin E (alpha-tocopherol)	mg	5.00
Vitamin E, added	mg	0.00
Vitamin K (phylloquinone)	mcg	0.10
Lipids
Fatty acids,total saturated	g	0.361
4:0	g	0.000
6:0	g	0.000
8:0	g	0.000
10:0	g	0.000
12:0	g	0.000
14:0	g	0.056
16:0	g	0.249
18:0	g	0.051
Fatty acids, total monounsaturated	g	0.259
16:1 undifferentiated	g	0.048
18:1 undifferentiated	g	0.211
20:1	g	0.000
22:1 undifferentiated	g	0.000
Fatty acids, total polyunsaturated	g	0.252
18:2 undifferentiated	g	0.017
18:3 undifferentiated	g	0.000
18:4	g	0.015
20:4 undifferentiated	g	0.000
20:5 n-3	g	0.119
22:5 n-3	g	0.099
22:6 n-3	g	0.000
Cholesterol	mg	50.000

References:

Wood B. Hominid revelations from Chad.Nature. 2002 Jul 11;418(6894):133-5.
Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes. In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126.
Lubell, D. Prehistoric edible land snails in the circum-Mediterranean: the archaeological evidence. In, J-J. Brugal & J. Desse (eds.), Petits Animaux et Sociétés Humaines. Du Complément Alimentaire Aux Ressources Utilitaires. XXIVe rencontres internationales d'archéologie et d'histoire d'Antibes, pp. 77-98. Antibes: Éditions APDCA, 2004.
Mehlman MJ. Mumba-Hohle revisited: the relevance of a forgotten excavation to some current issues in East African prehistory. World Archaelogy 1979;11:80-94.
Lubell, D. Are land snails a signature for the Mesolithic-Neolithic transition? In, M. Budja (ed.), Neolithic Studies 11. Documenta Praehistorica XXXI: 1-24.
Ozogogul, Y, Ozogul F, Olgunoglu AI. Fatty acid profile and mineral content of the wild snail (Helix pomatia) from the region of the south of the Turkey. Eur Food Res Technol 2006;221:547-549.
Zymantiene J et al. Selected features of vineyard snails shell, their movement and physic-chemical composition of foot meat. Biotechnol & Biotechnol Eq 2006;20:82-87.

Paleo Diet Q & A - Calcium from where?

2010-03-02T11:25:00.002-07:00

Q: While this style of eating and living makes sense to me, I am still left with the question of how to meet the Recommended Daily Allowance (RDA) for calcium. From all I've read on the subject, it's not possible to reach the RDA with vegetable sources (unless you include fortified soy or rice milk). Since dairy isn't part of your scheme, how does a person meet the RDA? Or do you disagree with the RDA?

A: Indeed, we relieve the RDA is higher than what you would need in a Palaeolithic type diet, because:

The absorption rate from brassica vegetables (e.g. Kale) is slightly higher than from milk (see attached paper) and as so (and also because they have numerous health benefits), we advise the daily intake of these foods.

A diet with lots of vegetables and fruit is net base yielding and in contrast a diet high in grains, cheese and salt and low in fruits and vegetables (which is a characteristic of the American way of eating) is net acid yielding and this increases calcium excretion.

The Paleo Diet is a High protein diet and this increases intestinal calcium absorption^{1, 2} and has an anabolic effect on bone³, particularly in the context of a net base yielding diet³.

By avoiding grains, you decrease anti-nutrient intake, such as phytates, which decrease magnesium⁴, calcium⁵ and zinc⁵ absorption.

The Paleo Diet is a Low Glycemic Load diet and as so, it does not promote Hyperinsulinemia as a high grain diet. It has been known since the year I was born (1975) that high blood insulin levels cause urinary calcium loss⁶.

Milk has a high Insulinotropic effect, and as so it may lead to an increase in urinary calcium excretion, for the reason outlined in point 5.

Links to Relevant Papers:

RDA of calcium

Dietary Acid-Base Balance

Adverse Effects of Sodium Chloride on Bone

Calcium absorption from kale

Diet Evolution and Aging

References:

Kerstetter JE, Gaffney ED, O’ Brien O, et al. Dietary Protein increases intestinal calcium absorption and improves bone balance: An hypothesis.
In Burckhardt P, Heaney R, Dawson-Hughes B. Proceedings of the International Symposium on Nutritional Aspects of Osteoporosis, 4-6 May 2006, Lausanne,
Switzerland. Elsevier, 2007, pp 204-216.

Dawson-Hughes B. Protein intake and calcium absorption – Potential role of the calcium sensor receptor. In Burckhardt P, Heaney R, Dawson-Hughes
B. Proceedings of the International Symposium on Nutritional Aspects of Osteoporosis, 4-6 May 2006, Lausanne, Switzerland. Elsevier, 2007, pp 217-227.

Sebastian A. Dietary protein content and the diet's net acid load: opposing effects on bone health. Am J Clin Nutr. 2005 Nov;82(5):921-2.

Bohn T, Davidsson L, Walczyk T, Hurrell RF. Phytic acid added to white-wheat bread inhibits fractional apparent magnesium absorption in humans.
Am J Clin Nutr. 2004 Mar;79(3):418-23.

Cordain L. Cereal grains: humanity’s double edged sword. World Rev Nutr Diet 1999; 84:19-73.

DeFronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ. The effect of insulin on renal handling of sodium, potassium, calcium, and
phosphate in man. J Clin Invest 1975;55:845–55.

Paleo Diet Q & A - Homocysteine

2010-02-26T12:35:00.005-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A regarding Homocysteine.

Dr. Cordain and his associate Pedro Bastos, were recently contacted by Ben Balzer, M.D. a well known Australian GP, friend and colleague regarding homocysteine issues. According to the American Heart Association, homocysteine is "an amino acid in the blood. Epidemiological studies have shown that too much homocysteine in the blood (plasma) is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease."

Included below are Dr. Balzer's original correspondence, as well as the replies from Dr. Cordain and Mr. Bastos.

Dear Loren and Pedro,

I was writing to a cardiologist today about homocysteine (alternate spelling: homocystine), among other issues. I don’t think I’ve raised it with you before, but it occurs that it may be of interest or relevance, so I’ve repeated it here below. Clinical medicine takes me up a few nutritional pathways that aren’t necessarily paleo, but as I always say paleo is the unifying field theory of nutrition, so it has always made it easier.

I’m a firm believer in homocysteine related issues, but the way modern medicine works it will never be driven hard as there is no commercial imperative--as all the treatments are vitamins and cannot be patented. Though there have been attempts to make a "drug" that will lower homocysteine, which would then magically spark interest.

I am also aware that choline has been given vitamin status and also participates in the 1-carbon cycle. Perhaps you could let me know how the choline intake of the SAD compares to our modern day urban hunter gatherer. Maybe we can shorten that to urban hunter gatherer, but I don’t think UHG will catch on, though it does have a caveman like ring to it.

What is amazing about homocysteine and triple B therapy is how little most Australian cardiologists knew about it. Yet when Lange published a highly flawed negative paper, they all knew about it overnight- highly suggestive of a commercial push.

Regards,
Ben

Hi Ben,

Good to touch bases with you and hopefully we can get together when I am in Sydney in June. Although we havent done the computerized dietary analysis yet -- specific to homocysteine, it is almost certain that sub-artic hominids would have had high plasma concentrations of folic acid, B6 and B12 (see my paper: Cordain L. "The nutritional characteristics of a contemporary diet based upon Paleolithic food groups." J Am Nutraceut Assoc 2002; 5:15-24.) Hence hyperhomocysteinemia likely was not an environmental seletive pressure that routinely affected Homo until very recent times (evolutionarily speaking -- ergo the past 10,000 years). I suspect that modern western diets are significantly lower in choline-rich foods than diets based upon fruits, veggies, meats, seafood, nuts, fish, and organ meats. Once again, we have not done the computerized dietary analyses.

Best wishes,
Loren

Hi Ben.

Good to hear from you. I definitely agree with Loren.

Regarding choline, I would just like to add that from computer analysing several types of diets, I have come to the conclusion that without eating liver or a high amount of egg yolks, it is virtually impossible to achieve 500 mg of choline a day. So, I believe our H/G ancestors got their choline from organ meats. Since today, most of us do not eat organ meats, I would like to know how we can ingest the choline we need.

Here’s a table from the Linus Pauling Institute with some dietary sources of choline. In addition, I would refer you to two papers: one by Bruce Ames on choline and another on food sources of choline and betaine.

Food	Serving	Total Choline (mg)
Beef liver, pan fried	3 ounces*	355
Wheat germ, toasted	1 cup	172
Egg	1 large	126
Atlantic cod, cooked	3 ounces	71
Beef, trim cut, cooked	3 ounces	66
Brussel sprouts, cooked	1 cup	63
Broccoli, cooked	1 cup, chopped	62
Salmon	3 ounces	56
Shrimp, canned	3 ounces	49
Peanut butter, smooth	2 tablespoons	20
Milk chocolate	1.5-ounce bar	20

By the way, here’s the adequate intake:

Adequate Intake (AI) for Choline
Life stage	Age	Males (mg/day)	Females (mg/day)
Infants	0-6 months	125	125
Infants	7-12 months	150	150
Children	1-3 years	200	200
Children	4-8 years	250	250
Children	9-13 years	375	375
Adolescents	14-18 years	550	400
Adults	19 years and older	550	425
Pregnancy	All ages	-	450
Breastfeeding	All ages	-	550

It would be very interesting to estimate the various micronutrient intake of various H/G diets based on Loren’s model.

Best wishes,
Pedro

Submitting Your Questions

2010-02-26T12:30:00.000-07:00

If you have specific questions about the Paleo Diet please send us an email at: questions@thepaleodiet.com

Please note that we receive a great amount of feedback, and are not always able to respond personally. We read all emails, and we are very interested in hearing your thoughts, learning about your experiences, and understanding what questions you have.

Questions and comments are forwarded to our team, who make every effort to provide answers for our readers. We often receive similar questions on a variety of topics, such as saturated fat, diabetes, weight loss, consumption of milk, and a host of other dietary and health-related subjects concerning the Paleo Diet and paleo nutrition.

The entire Paleo Diet web site is searchable, including our FAQ page. We encourage you to search or browse the FAQ page on our web site to see if the information you're seeking has already been documented:

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We have a tremendous amount of information that we've provided in response to reader questions, and update our FAQs frequently - so please check back if you don't see the information you requested.

We also post questions and answers on our blog:

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You may also search our blog for subjects of interest. Go to our blog using the address above and use the search box on the right side.

Regards,
The Paleo Diet Team

Ancestral Health Symposium

2010-02-17T17:15:00.002-07:00

Dear Readers,

Dr. Cordain, Pedro Bastos, and Nell Stephenson have all been invited to participate in the first ever Ancestral Health Symposium to be held at the University of California at Los Angeles during the summer of 2011.

Mission: The Ancestral Health Symposium fosters interdisciplinary collaboration and translational efforts between research scientists, physicians, health experts/professionals, and patients who study and communicate about the human ecological niche and modern health from an evolutionary perspective to develop innovative solutions to our current health challenges.

For more information please visit: ancestryfoundation.org.

Paleo Diet Q & A - 13 February 2010 - No legumes for real?

2010-02-13T15:25:00.002-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A focuses on legumes and protein.

Q: I was just forwarded your peanut manifesto & found it interesting. I love the concept of the whole foods Paleo diet, but no legumes? That goes against everything I have been taught about nutrition. I'm not veg, but eat a primarily whole foods/low animal protein diet. Exactly how would you get enough protein without meat & without legumes? Nuts alone cannot provide the protein & consumed in high quantities would add too much fat to one's diet. Between the protein, fiber & other nutrients, beans are so good for you. I understand the points about peanuts & don't disagree with that...too many peanut allergies out there not to mention the aflotoxin issue.

-Amy

A: Dear Amy,

From an evolutionary perspective, legumes are not part of the human's diet. Prior to the agricultural revolution regular consumption of legumes was not common.

As cereal grains, legumes are great sources of antinutrients, such as lectins, saponins or protease inhibitors which wreak havoc the hormonal and immune systems.

Increased intestinal permeability has been associated to many chronic low-grade inflammatory and autoimmune diseases, such as celiac disease, rheumatoid arthritis, type 1 diabetes or multiple sclerosis. Lectins and saponins are able to increase intestinal permeability hence increasing the risk of inflammatory diseases, see Dr. Cordain's scientific paper:

http://www.thepaleodiet.com/articles/Arthritis%20PDF.pdf.

Regarding the protein content, the paleo diet (based on high protein foods such as lean meats, fish or even eggs) has been shown to be superior in protein than a grain-legume rich diet, as you could see in Dr. Cordain's paper (http://www.thepaleodiet.com/articles/Origins%20Paper%20Final.pdf).

Regarding fiber, vegetables have the higher fiber content among all nutrients.

I hope this helps.
Maelán

Q: The research in The China Study would disagree with Dr. Cordain's findings re: animal protein being superior to plant protein. Although lean meats, like natural grass-fed beef, are certainly superior to corn fed factory farmed beef. Also to consider, Paleolithic people were not living into their 70s, 80s, 90s, 100s like people are today. I imagine that the average life span back then was about 30-35? Eating to make it to 30 is different than eating to live until you are 80+. Are you aware of the "blue spots" in the world, i.e. areas of the world with high numbers of centenarians? Those people eat a diet relatively low or devoid of animal products (the latter being in Loma Linda, California where there is a huge population of vegan Seventh Day Adventists) and probably consume a fair amount of legumes. The other areas are located in Central America, Japan & Sardinia.

I do find it disturbing that there appears to be an increasing number of cases of Celiac's disease and gluten-sensitivity in the world. I have developed an allergy to casein & am senstive to gluten (like many other people) so I understand the merit in limiting or eliminating the sources of these proteins. Has Dr Cordain done any research on sprouting legumes & grains & the positive effects it has on digestion? There is interesting research in that area.

I have immense respect for the evolutionary process, the scientists who study it and how it relates to our health today. Eating a diet of unprocessed, local food is undoubtedly a superior way to nourish oneself. There are many merits to the Paleo diet, but there appears to be some flaws as well. Has Dr Cordain's findings been replicated by any other scientists?

Thank you for your response.
-Amy

A: Dear Amy,

Thanks for your comments, I’ll try to clarify your doubts.

a) Regarding animal/plant protein: please see the discussion between the china study author, Colin Campbell, and Dr. Cordain. Since I believe you are a sophisticated reader you can draw your own conclusions from that report.

b) The popular belief that paleolithic populations did not lived into their 70s, 80s, 90s or 100s is a misconception, as you can read in Dr. Cordain’s scientific papers:

http://www.thepaleodiet.com/articles/Health%20Promotion%20Paper.pdf

http://www.thepaleodiet.com/articles/Counter%20Arguments%20Paper.pdf

Maybe you are not aware of the Kitava Study conducted by our colleague Staffan Lindeberg. This is a pre-agricultural population in Kitava-Papua New Guinea. It turns out that 6% of the population is between 60-95 years old, yet they are virtually free of western disease, such as type 2 diabetes, obesity, cardiac infarction or stroke. This number is not bigger due to the high childhood mortality due to infections and birth problems, among others. I will quote a piece from one of the above studies: “Actually, adoption of farming and settled living appears to have adversely affected longevity, precipitating a substantial decline to about 20 years. Life expectancy in London in 1667 was 18, and it seems likely that from the Neolithic Revolution until the late 18th century, expectation of life in “civilized” nations seldom or never exceeded 25 years. Thereafter, technological breakthroughs in food production, manufacturing, transportation, trade communications, and energy generation gave rise to what economists call modern economic growth”. (Eaton et al. Preventive Medicine, 2002).

The bottom line is that life expectancy does not rely much on nutrition.

c) Regarding your comments on “the blue spots” in the world I’ll copy a previous reply to a similar question by our colleague Pedro Bastos:

Concerning longevity, it is well known that caloric restriction is the only proven method to extend live in various animals including primates (1-6) .

One of the reasons why people from Okinawa live more is because they eat less calories than people from mainland Japan (7). Well, 2 of the 3 intervention studies with a Pre-agriculture Diet show that one people are advised to eat the food groups available in Paleolithic era they eat less calories, although they haven't been advised to do that (8, 9).

Some of the mechanisms by which caloric restriction is beneficial for longevity are:

1 - Decrease in visceral fat - a Paleo type Diet has been shown to do that (8)

2 - Decrease IGF-1/IGFBP-3 - by eating a low glycemic load diet and avoiding high fructose foods you will normalize insulin metabolism and your IGF-1/IGBP-3 may decrease (see this paper to understand what I'm saying: http://www.thepaleodiet.com/articles/Hyperinsulinemic%20Diseases%20Final.pdf )

3 - Decreased glycation - by eating a low glycemic load diet, ingesting plenty of carnosine (10), reducing fructose (11), avoiding galactose (12) and avoiding cooking at high temperatures, you will be decreasing glycation.

4 - Decreased glycolysis (14) - a low Glycemic load diet will achieve this.

5 - Elevated insulin sensitivity - the studies with the Paleo Diet have shown that it increases insulin sensitivity (8, 15)

Moreover, if you read some of Dr. Cordain's papers available here, you will see how the modern diet is responsible for most of the so called diseases of civilization, who normally aflict people in the post reproductive years.

Finally, it should be mentioned that many of the so called healthy diets that are being promoted for longevity and optimal health actually contain one or more characteristics of a pre-agriculture diet (The Paleo Diet), so presumably we would expect them to lead to better health outcomes. For instance, the diet of Crete (which was then used to formulate the Mediterrean diet) has a low w6/w3 ratio, contains plenty of fruits and vegetables and most of the fat is monounsaturated (16), just like pre-agricultures diets.

And the traditional diet of Okinawas is composed by fruit, vegetables, sweet potatoes (not potatoes, which contain harmful glykoalcaloids), rice (it doesn't include gluten grains, which are worse than rice), fish, fermented soy (it is better than normal soy, although it still has harmful saponins and lectins and as so, we don't advise it) and some pork, so it has a lower w6/w3 ratio and no trans fatty acids, which are very important characteristics of pre-agricultures diets.

Furthermore, it's not just diet: we also have to look at their lifestyle which is closer to the one followed by our H/G ancestors: sun exposure, exercise, good sleep patterns and acute stress (exercise) as opposed to chronic stress (the one we experience).

d) Regarding sprouting legumes: Yes, sprouted grains and beans are a much healthier option. When we 'sprout grains' we are allowing the seed to germinate and a shoot will emerge from the seed. This is the part that is cut off and eaten. Therefore, the seed itself is not actually consumed (as is the case with whole grains and wheat flours here the seed proteins and starches are milled and eaten). Since lectins are packaged long with the seed to protect against predation, once the seed sprouts, the lectin concentration diminishes within a couple days. At least by the end of a week, the sprouts should have no residual lectins. Gliadin and glutenin are the dominate proteins located in the endosperm of the seed. The starchy endosperm is located alongside the embryo (germ) within the seed and provides nutrients the embryo needs as it is sprouting and growing.

Therefore, there should be no gliadin or glutenin proteins in the sprout, but rather primarily non-digestible cellulous (dietary fiber). One can consume sprouted grains and beans without fear of anti- nutrients, however keep in mind that these are still nutritionally poor in terms of micronutrients. Leafy greens and other vegetables contribute high fiber AND a higher concentration of nutrients-grains are still 'nutritional lightweights'. I would like to add an amendment to my earlier statement: We can consume GRAIN sprouts without fear of anti-nutrients however, legume sprouts still appear to contain considerable concentrations of saponins--the secondary compounds responsible for increasing gut permeability. Alfalfa sprouts (which are actually in the pea family) have an especially high concentration.

e) Regarding your question: has Dr. Cordain’s findings been replicated by any other scientist? The answer is yes, as you can check in these scientific papers. In one of them (Lindeberg et al. Diabetologia, 2007) it was shown that a paleolithic diet was superior to a Mediterranean diet where they consume legumes and grains.

Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study.
Jönsson T, Granfeldt Y, Ahrén B, Branell UC, Pålsson G, Hansson A, Söderström M, Lindeberg S. Cardiovasc Diabetol. 2009 Jul 16;8:35.

Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet.
Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC Jr, Sebastian A.
Eur J Clin Nutr. 2009 Aug;63(8):947-55. Epub 2009 Feb 11.

Effects of a short-term intervention with a paleolithic diet in healthy volunteers.
Osterdahl M, Kocturk T, Koochek A, Wändell PE.
Eur J Clin Nutr. 2008 May;62(5):682-5. Epub 2007 May 16.15.

A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs.
Jönsson T, Ahrén B, Pacini G, Sundler F, Wierup N, Steen S, Sjöberg T, Ugander M, Frostegård J, Göransson L, Lindeberg S.
Nutr Metab (Lond). 2006 Nov 2;3:39.

A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.
Lindeberg S, Jönsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjöström K, Ahrén B.
Diabetologia. 2007 Sep;50(9):1795-807. Epub 2007 Jun 22.

Cordially,
Maelán

Paleo Diet Q & A - 9 February 2010

2010-02-09T07:45:00.002-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A focuses on fasting.

Q: Hello,

You may have covered this issue already, I have not read that much of your work.

I thought I would point out though that Paleo humans likely went through periods of enforced fasting due to a lack of game or a temporary lack of success in hunting. In fact, there were likely alternating cycles of gorging and fasting. This alternating cycle would change the data on the Paleo diet as modern humans are not likely to be undergoing the fasting phase.

It seems like doing a study using the climate record might help as Paleo man may not have migrated as much as the animals that they hunted.

Have you already covered this?

Just another nutrition student,
Bob

A: Dear Bob,

We agree in that hunter-gatherers would probably have been forced to observe periods of intermittent fasting.

In our archive you can find a published issue of our newsletter (Vol. 1; Issue 3) where Dr. Cordain reports that hunter-gatherers usually ate a single meal in the evening and probably breakfast using leftovers from the night before. This makes sense as they spent the day engaged in foraging and hunting activities and returned to their camps in the sunset. Some of the beneficial effects of intermittent fasting are likely due to caloric restriction, a well as known interventions that increase health in animals and humans, and lifespan in animals such as hamsters, mice, rats, fish, insects and worms.

A feast-famine, exercise-rest cycle has been postulated as a healthful lifestyle similar to that of human beings in the paleolithic. Famine and exercise (simultaneously) decrease muscle glycogen and triglycerides stores increasing AMPK and GLUT4 expression. These two proteins are involved in glucose and triglycerides homeostasis, leading to an efficient storage of energy and increased physical performance. If hunting is successful, a replenishment of glycogen and triglycerides is produced. This is followed by a relative period of rest. This efficient storage of energy increases the probabilities of surviving during another famine/exercise period¹.

This should be a healthy way to improve health and physical performance from an evolutionary perspective.

1. Chakravarthy, M. V., Booth, F. W. Eating, exercise, and "thrifty" genotypes: connecting the dots toward an evolutionary understanding of modern chronic diseases. J Appl Physiol, 96 (1); 3-10.

I hope this helps.

Cordially,
Maelán

Success Story - The Paleo Diet and Type 1 Diabetes

2010-02-04T11:55:00.000-07:00

Dear Readers,

The following post is a testimonial from a mother who's child was diagnosed with Type 1 Diabetes last year, and who has seen a significant improvement in her condition after adopting the Paleo Diet.

We encourage all our readers to share their success stories using the Paleo Diet with us.

I have a most remarkable story! On September 10, 2009, I took my six year old daughter to the pediatrician for what I thought was a urinary tract infection. She had been very thirsty and going to the bathroom excessively. Little did I know that these were symptoms of hyperglycemia! Her BG was tested a 542 in the doctor's office, and she spent 2 days in the hospital. During that time she was diagnosed with Type 1 Diabetes. Her A1c was 10.8. Her IA-2 Ab was strongly positive, with borderline positive insulin Ab, but she had negative GAD-65 and ICA. This is consistent with Type 1 Diabetes. They sent us home to begin a regimen of insulin injections; one basal in the evening, and one before each meal. We did what any parent would do which is: what the doctors told us.

However, after a week or so, we realized we were counting carbohydrates in things like pop tarts. It seems absurd. We decided that all of us needed to clean up our diets. Since we worked out in a Crossfit gym, the diet that came to mind was the Paleo Diet.

What happened next is amazing! My daughter's insulin needs PLUMMETED. Over the next week we made numerous calls to the Endocrinologist to adjust her dosages downward. After about two weeks, she was completely off of insulin! That was roughly October 1st, 2009. She has continued with BG testing, endocrinologist visits, and the Paleo Diet, and as of this day (January 31, 2010) she has close to normal BG and requires no insulin. At her last Doctor visit (late December) her A1c was 6.6. We believe this will be in the 5's at her next visit in March. My challenge is to make a believer out of the Endocrinologist. He believes she is in "remission" and that it will surely wear off. But as more time goes by, I can see his curiosity beginning to awaken. He said that there are some cases of remission lasting this long, but if she makes it to a year, he will have to write a paper.

I’m going to hold him to it.

Sincerely,
JoAnne

Paleo Diet Q & A - 3 February 2010 - Milk During Pregnancy

2010-02-03T15:40:00.000-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A focuses on consumption of milk during pregnancy.

Q: Hi Dr. Cordain,

My sister is a few weeks pregnant and has been following the Paleo Diet for a couple months now. Her doctor just told her to consume lots of milk during her pregnancy. My assumption is that they want to make sure she's getting plenty of vitamin D and calcium. I have her on a 2000 IU/day vitamin D supplement as well as a calcium/vitamin D supplement. What are your thoughts/suggestions?

Drew

A: Dear Drew,

There is good evidence that up until 9,000 years ago in the Middle East¹ and 7,000 years ago in Northern Europe², no human being on the planet consumed non-human milk or dairy products.

So, on an evolutionary time scale non-human milk is a relative newcomer to the human diet.

By using the evolutionary template, and knowing that milk is species-specific, we would expect this new habit to have unintended consequences, which go much beyond lactose intolerance, which is, actually very common, since only a minor percentage of the world’s population continues to produce lactase into adulthood³.

Indeed there are several lines of evidence raising concerns with milk and dairy intake, such as:

1) Milk and fermented milk (yoghurt, for instance), despite having a low Glycemic Index and Load, elicit a very high insulin response and this has been shown repeatedly in intervention studies^4-9.

As you may be aware, constantly increasing insulinemia may down-regulate the insulin receptor and hence lead to insulin resistance^10-12. Thisin turn is the primary metabolic defect underlying The Metabolic Syndrome¹³, and may be a driving force in Obesity^{14, 15}. It should also be mentioned that a chronic state of Hyperinsulinemia may initiate a hormonal cascade that ultimately results in Cancer, Acne and Juvenile Myopia, among other diseases¹³ (as thoroughly documented in Dr.Cordain’s scientific paper Hyperinsulinemic diseases of civilization: more than just syndrome X which you can download here.

Indeed, a high bovine milk diet has been shown to cause insulin resistance in boys⁹. Moreover, dairy intake is strongly associated with a higher incidence of Acne^16-18 and moderately associated with Prostate Cancer^19-23.

2) Cow’s milk appears to be involved in certain Autoimmune diseases (AD):

Various epidemiological studies have associated it with Type 1 Diabetes^24-31, especially when the initial exposure begins in the first months of life.
Epidemiological studies have repeatedly shown a strong correlation between Multiple Sclerosis and cow’s milk consumption^32-36.
There is molecular mimicry between Bovine Serum Albumin and Human Collagen Type 1, which has implications for Rheumatoid Arthritis³⁷. Indeed, case studies have shown that elimination of milk and dairy products from the diets of patients with RA improved symptoms, and the disease was markedly exacerbated on re-challenge³⁷.
Bovine Milk is also implicated (or appears to have adverse effects) in other auto-immune diseases, such as Crohn's disease³⁸, Sjögren's syndrome³⁹, IgA nephropathy^40-42, Behçet's disease⁴³, and even Celiac Disease⁴⁰.

3) Hormones in Milk:

In addition to proteins, fats, lactose, vitamins and minerals, Milk contains various growth-stimulating steroid and peptide hormone and also catalysts, transporters and stabilizers that ensure their maximum bioactivity⁴⁵.

Here’s a short list of some hormones present in cow’s milk that could be problematic for humans:

Insulin
IGF-1
Betacellulin (BTC)
Estrogens (particularly Estrone Sulfate)
Precursors of Dihydrotestosterone (DHT)

Insulin

Cow’s milk, as well as human milk (and presumably milk from all mammals) contains insulin^46-49, and we know that bovine insulin - BI (which differs from human insulin by three amino acids⁵⁰) survives pasteurization, because immunity to this hormone is common in children who consume cow’s milk or who have been exposed to infant formulas containing cow’s milk^51-54.

This not only confirms that BI is present in commercial pasteurized milk, but also in infant formulas and perhaps other dairy products (although direct evidence is lacking). Moreover, these studies provide evidence that BI survives the human digestive processes and crosses the gut barrier intact, although this could be related to the fact that infants have higher intestinal permeability than older children and adults⁵⁰. Nevertheless, various factors may cause the so called "leaky gut" in virtually everyone, so we shouldn’t dismiss bovine insulin altogether.

IGF-1

Cow’s milk contains active IGF-1⁵⁵, but this has been largely dismissed as irrelevant, since pasteurization (time and temperature are crucial factors) and fermentation appears to reduce its content^{56, 57}. Yet cow’s milk consumption, compared to various foods, is associated with higher plasma IGF-1 concentrations in humans (both children^58-61 and adults^62-66, which could be due to calcium in milk (which has been shown to increase IGF-1 in boys and girls⁶⁷), the effect of milk upon insulinemia (the high elevation of plasma insulin caused by milk drinking^4-9 could lead to a higher plasma IGF-1¹³) or indeed residual IGF-1 in casein⁶⁸ (the major protein in milk).

Betacellulin

Betacellulin (BTC) belongs to the Epidermal Growth Factor family of hormones⁶⁹, and it is found not only in cow’s milk⁷⁰ and whey⁷⁰, but also in cheese⁷⁰, so it survives pasteurization and processing. Although no direct evidence exists yet, bovine milk contains peptidase inhibitors which prevent human gut enzymes from degrading EGF⁵ (and most likely BTC) and a low ph, such as may be found in the gut, does not impair or prevent BTC from binding its receptor⁷¹. Finally, there is a luminally expressed EGF receptor in the gut, through which BTC may enter circulation⁶⁹.

Steroid Hormones

The major sources of animal-derived estrogens in the human diet are believed to be milk and dairy products, which presumably account for 70–80% of the total estrogens consumed^72-73. Furthermore, it has been pointed out that most milk for human consumption is obtained from cows in the latter half of pregnancy, when estrogen metabolite levels are greatly elevated^72-74. Confirming this, US researchers have measured estrogen metabolites in various milks and found that buttermilk contains the highest total amount of estrogen metabolites, followed by skim milk, 2% milk and whole milk⁷². So, estrogen metabolites appear to survive pasteurization, and Estrone sulphate, which comprises 45% of the conjugated estrogens in Premarin and Prempro, the most frequently prescribed hormone replacement therapy for menopausal women⁷³ has high oral bioactivity⁷³ and is the most prevalent form of estrogen in cow’s milk^{72, 73}.

There are also other steroid hormones in commercial pasteurized cow’s milk, such as progesterone, 5α-androstanedione and 5α-pregnanedione that are dihydrotestosterone (DHT) precursors⁷⁵.

As expected from the evidence presented, dairy intake is strongly associated with a higher incidence of Acne^16-18, moderately associated with Prostate Cancer^19-23, and mildly associated with ovarian cancer^{76, 77}.

Dairy consumption was also associated with an increased incidence of testicular^78-79, kidney⁸⁰ and head and neck cancer⁸¹, but very few studies looking at this have been conducted to draw more significant conclusions.

Although epidemiological evidence can’t show cause and effect and clearly many more studies need to be conducted, the current evidence strongly suggests that cow’s milk may be implicated in a variety of autoimmune diseases, certain cancers, as well as Acne.

4) Milk has a very high calcium/magnesium ratio and may contribute to some micronutrient imbalances.

Finally, there is evidence of higher fracture incidence rates in countries with higher milk and calcium intake82, some long term prospective studies have failed to show a benefit from drinking milk or taking calcium supplements83-85, and a recent meta-analysis, which analyzed 7 prospective cohort studies (170 991 women), 5 prospective cohort studies (⁶⁸ 606 men), 5 clinical trials, (5666 women, and 1074 men), and 4 clinical trials with separate results for hip fracture (6504 subjects), concluded that calcium intake doesn’t decrease the risk for fractures⁸⁶. And calcium intake is only part of the story – we need to consider the GI absorption and the renal excretion, and in these regards, vegetables from the brassica family have a clear advantage over milk.

I know this may sound overly alarming and exaggerated, but given what I know about milk, I have a hard time recommending it, even though it has some positive effects, such as being a cheap source of high quality protein and various micronutrients.

For those who are fortunate and have access to good (real) food and supplements (such as Vitamin D, which, by the way, may be needed in much higher doses than the ones provided by 3 or 4 servings of dairy a day) and adopt a diet more in line with the Paleo Diet, I believe milk is not necessary.

I hope this helps.
Pedro

References:

Evershed RP, Payne S, Sherratt AG, Copley MS, Coolidge J, Urem-Kotsu D, Kotsakis K, Ozdoğan M, Ozdoğan AE, Nieuwenhuyse O, Akkermans PM, Bailey D, Andeescu RR, Campbell S, Farid S, Hodder I, Yalman N, Ozbaşaran M, Biçakci E, Garfinkel Y, Levy T, Burton MM. Earliest date for milk use in the Near East and southeastern Europe linked to cattle herding. Nature. 2008 Sep 25;455(7212):528-31.
Copley MS, Berstan R, Dudd SN, Docherty G, Mukherjee AJ, Straker V, Payne S, Evershed RP: Direct chemical evidence for widespread dairying in prehistoric Britain. Proceedings of the National Academy of Sciences of the United States of America 2003, 100(4):1524-1529.
Swallow DM. Genetics of lactase persistence and lactose intolerance. Ann Rev Genet 2003;37:197-219
Gannon MC, Nuttall FQ, Krezowski PA, Billington CJ, Parker S. The serum insulin and plasma glucose responses to milk and fruit products in type 2 (non-insulin-dependent) diabetic patients. Diabetologia. 1986 Nov;29(11):784-91.
Holt SH et al. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr. 1997 Nov;66(5):1264-76
Ostman EM, et al. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products. Am J Clin Nutr 2001;74:96 –100.
Liljeberg Elmstahl H & Bjorck I. Milk as a supplement to mixed meals may elevate postprandial insulinaemia. Eur J Clin Nutr 2001; 55:994–999.
Hoyt G et al. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr. 2005 Feb;93(2):175-7
Hoppe C et al. High intakes of milk, but not meat increase s-insulin and insulin resistance in 8-year-old boys. Eur J Clin Nutr. 2005 Mar;59(3):393-8
Rizza RA, Mandarino LJ, Genest J, Baker BA, Gerich JE. Production of insulin resistance by hyperinsulinaemia in man. Diabetologia. 1985 Feb;28(2):70-5.
Treadway JL, Whittaker J, Pessin JE. Regulation of the insulin receptor kinase by hyperinsulinism. J Biol Chem 1989;264:15136–15143
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Paleo Diet Q & A - 2 February 2010 - The Paleo Diet and Children

2010-02-02T15:50:00.001-07:00

Dear Readers,

Today's Paleo Diet Q & A focuses on use of the diet for children.

Q: Thanks for all of the hard work your team puts into this. I've been receiving the e-mail blog for quite some time, have read both Paleo Diet and Paleo Diet for Athletes books, and subscribe to a Yahoo Paleo blog as well. I thoroughly enjoy reading the information sent to me every few days including the archives.

One concern I do have is that the bulk of the information seems to be targeted toward adults. More specifically adults with health problems that have already occurred and are in many cases not being addressed or cured by "traditional" medical practices. As the kids grow I feel it is important to develop proper dietary habits now, not when they are older and dealing with the after effects of poor health.

In my personal case I have a young son who has had issues with asthma. We have sought medical help but my mind keeps coming back to the Paleo Diet. Is there more detailed information available to address the issues of babies, young children and some of the issues they deal with as they mature?

Again, thanks for the great job.
Murray

A: Hi Murray,

The subject of pregnancy, young children, and The Paleo Diet was discussed in Volume 5 Issue 24 of our newsletter, The Paleo Diet Update. Here is the full text of that article:

Pregnancy, Young Children, and the Paleo Diet
by Loren Cordain, Ph.D.

With the growing popularity of the Paleo Diet, we've received questions about adapting this diet for pregnancy, particularly with regard to the low fat aspect of the diet. Others are also asking for more information about adapting the Paleo Diet to the growth and nutritional needs of infants and young children. With a little modification, the Paleo Diet can meet these needs, help children escape the growing childhood obesity problem, build life-long eating habits to lower the risk of disease, and generate healthful, vital longevity. Here are some recommendations for using the Paleo Diet to optimize nutrition during pregnancy, infancy and childhood.

What about pregnancy?

Due to the metabolic changes that occur in the liver during pregnancy, women cannot tolerate protein levels as high as they normally could. This has been documented in both the anthropological and clinical literature. To accommodate this, higher fat meats, higher fat vegetables, and more carbs can be included in the Paleo Diet during pregnancy than most people eating the typical Paleo Diet will need.

Numerous studies have shown that fetal and infant cognitive development requires sufficient omega-3 fatty acids during pregnancy and nursing. Our ancestors got most of their dietary fat from leaner meat, which was a richer source of monounsaturated and omega-3 polyunsaturated fatty acids, than the meat from feedlot animals today. The Paleo Diet is high in mono-unsaturated fats, such as olive oil, and omega-3 polyunsaturated fats from fish. It also avoids feedlot meat to increase the omega-3 in our diet, and enhance the omega-6/omega-3 ratio to more closely resemble the healthful diet of our ancestors.

What about infancy (the first two years of a child's life)?

Hunter-gatherer children were typically introduced to solid food later than what is considered normal in the Western world. Studies of five hunter-gatherer societies (Kung, Ache, Inuit, Australian Aborigines, and Hadza) have revealed the average age of weaning to be 2.9 years. Hence, the early nutrition of hunter-gatherer infants is highly dependent upon mother's milk. Because hunter-gatherers typically consumed a diet higher in omega-3 fatty acids, mother's milk likely would also have been higher in omega-3 fatty acids than milk from the typical nursing Western mother. This difference is important in light of the studies indicating the importance of sufficient omega-3 fatty acids during pregnancy and nursing for cognitive development. For the Western mother, weaning at age 3 is impractical, but weaning should be delayed as long as possible (preferrably at least 1-1.5 years). After weaning, I recommend that infants be given a formula th at is enriched with both docosahexaenoic acid (DHA) and arachidonic acid (AA). Infants should not be given eicosapentaenoic acid (EPA) in the form of fish oil because it competes with AA metabolism and can result in impaired motor development and growth.

Human milk contains very little iron, but infants are born with iron stores sufficient to last 9-12 months. Pediatricians typically recommend that infants' first solid foods be iron-fortified cereals. Commercial baby foods, such as beef, pork, or chicken, are a better alternative to this. Hunter-gatherer mothers introduced their infants to solid foods by thoroughly chewing meat, marrow, nuts, seeds, fruits, etc. If you do give cereal to your infant, I recommend rice and not either wheat or oats.

Virtually all pediatricians recommend that cow's milk and other dairy products, such as yogurt, cheese, etc., be excluded from infant diets during their first year. Early exposure to dairy products has been implicated in increased risk of a number of autoimmune diseases, particularly type 1 diabetes.

What about when solid foods are introduced?

When switching to solid foods, I recommend focusing upon the same basic food types that I recommend for adults, such as fresh fruits and vegetables, fresh meats and seafood. There is evidence that the children's livers are less able to deal with high levels of protein (~30-40 % total energy). Hence, higher fat meats and fish should not necessarily be restricted to the same extent as with adults because this will help balance the protein levels. Higher fat plant foods, such as nuts and avocados, and healthful oils are also useful, but monitor for nut allergies. Omega-3 enriched eggs should be the egg of choice, and they are a source of DHA.

I don't advocate completely restricting processed food from children because eating involves behavioral issues. The best way to get a child to eat junk food is to completely forbid it. In our house, we serve typical Paleo foods in every meal. We stock very little processed food, so if our children are hungry, their choices are primarily healthy foods. We don't allow unlimited access to TV, computers or electronic games, but we do encourage outdoor play. For active children, I don't think that certain high glycemic load foods may be harmful. We do not restrict dried fruit, such as raisins and dates, and we encourage them to eat bananas, yams and sweet potatoes.

Finally, while societies often view being tall positively, it has a downside. It increases the adult risk for a number of cancers, particularly breast cancer in women. The nature of this relationship remains obscure, but our research group thinks that the relationship between stature and cancer risk involves the consumption of high glycemic load carbohydrates during childhood, along with an otherwise healthy diet that is high in protein. I fully explain how high glycemic load carbohydrates can increase height and risk of numerous chronic diseases in my published research article # 24. Cordain L, Eades MR, Eades MD. Hyperinsulinemic diseases of civilization: more than just syndrome X.

Please visit our web site to obtain a copy of Volume 5 Issue 24 of The Paleo Diet Update for a complete list of the references cited in this article.

Dr. Cordain has also written the following comments:

The American Pediatric Society recommends that cow’s milk not be given in the first year ,and a number of studies indicate that it increases the risk for type I diabetes and other autoimmune diseases later in life. I have 3 boys (17, 15, 11) and none of them have ever consumed milk on a regular basis – In fact they rarely or never drink it. They eat cheese and ice cream occasionally, but certainly not daily or even once a week. The 17 yr old is a lean, high level high school swimmer and is 5’10”, 138 lbs. The 15 year old is 6’1” and 145 lbs and plays competitive ice hockey; the 11 year old is 5’4” about 95 lbs and plays all sports. None of them wears glasses, or have ever had acne & among them all there have only been 2 dental caries. We are not strict with the Paleo diet for them, but we never have stocked our house with bread, crackers, milk, candy, soda or processed foods. At every meal we provide a variety of fresh fruits, vegetables, meats, seafood and omega 3 enriched eggs. They eat potatoes, sweet potatoes, and some rice & some processed foods like sushi, beef jerky, fruit popsicles, tacos and other minimally processed foods. All parents want to give their children the best start possible. Our anecdotal successes may not be right for everyone, but they have worked for us.

Loren Cordain, Ph.D.

In addition, Pedro has the following commentary:

During the first year of life, you should give a child human milk or a completely hydrolyzed infant formula (one study used a casein-based commercially available formula in children with high risk for Type 1 Diabetes).

Milk and dairy not only increase the risk for Type 1 Diabetes when consumed early in life, but they are also associated with various auto-immune diseases. Moreover, milk elevates insulin as much as white bread (having been shown to induce insulin resistance in boys) and it increases IGF-1 and decreases IGFBP-3, which is a hormonal pattern implicated in various cancers (prostate, breast, kidney, liver, etc.), myopia and acne.

Finally, milk proteins (especially alpha casein s1 and beta-lactoglobulin, which do not exist in human milk) are common food allergens, and milk is a source of various hormones (commercial milk from pregnant cows and cows who have mastitis and/or are intensively fed to gain weight rapidly have an even higher concentration of some of these hormones). This is another possible mechanism linking milk with hormonal dependent cancers. There various other reasons why I think non-human milk is not ideal for humans, but I tried to present the most important ones.

I know this may sound overly alarming and exaggerated, but given what I know about milk, I have a hard time recommending it, even though it has some positive effects.

In my opinion, the main benefit of milk is that it is a cheap source of high quality protein and various micronutrients. So, for those who are fortunate and have access to good food, milk is not necessary.

Instead of milk, I would continue using a completely hydrolysed formula (like the one used in the Type 1 Diabetes study – make sure it contains DHA and arachidonic acid [AA], or supplement your child's diet with DHA and give them egg yolks to get AA).

If you don’t have a choice and feel like you have to give them milk, I would opt for non-homogenized fermented goat milk (or goat yoghurt), which has much less alpha casein s1 than cow’s milk, and it may contain smaller concentrations of various steroid and peptide hormones. This is because it is fermented, the animal is smaller, and they aren’t typically treated like a cow.

Nevertheless, it most certainly will elevate insulin as much as cow’s milk does, and it will have an impact on the IGF-1 system. Moreover, apart from alpha casein s1, the protein profile of goat milk is similar to cow milk, so the possibility exists that it may also elicit an autoimmune response in some people. Also, there are reports in the medical literature of selective allergy to goat milk. Finally, both milks have a high calcium/magnesium ratio, and may contribute to some micronutrient imbalances.

Pedro

Paleo Diet Q & A - 29 January 2010 - Update on Eggs

2010-01-29T08:55:00.006-07:00

Dear Readers,

Today's Paleo Diet Q & A is in response to a reader comment regarding eggs.

Here's the original reader question and Maelán's answer:

Q: Hello,

I heard Dr. Cordain speak twice in optometry meetings. He understood everything about his diet, but both times, I left with the same question in my head: what about eggs?

SO if you could please pass it on to him, I would appreciate it. Because eggs are a source of lutein which is very bioavailable and because lutein is extremely important in ocular health, I would like to know what his opinion is on that.

Barbara

A: Dear Barbara,

Eggs are part of The Paleo Diet, as humans have consumed eggs during the paleolithic era, although not in a year round basis (because bird eggs appear only seasonally), hence Dr. Cordain has advocated eggs, specially those rich in omega-3 fatty acids, in his three books. One of the egg white functions is to protect the yolk against microbal attack using proteolytic enzymes, besides being storage of nutrients for the growing embryo and transport of nutrients into the growing embryo. Except for ovoalbumen, most of the proteins in egg white have antimicrobial, antibacterial or antiviral activity, some of these proteins are called ovomucoid, ovomucin and lysozyme, among others. These proteins may disrupt the integrity of the gut lining leading to increased intestinal permeability and lysozyme is the most harmful of these proteins in terms of membranolytic activity (breakdown of cell membranes). We recommend that patients suffering from autoimmune diseases to avoid egg white at the beginning as Lysozyme may increase intestinal permeability which is one of the contributing factors in autoimmune diseases. Another issue is egg allergy which is quite common.

On the other hand, eggs are rich in selenium, vitamin A, vitamin D and the B vitamins, and some minerals.

If the person does not suffer from autoimmune disease or egg allergy it shouldn't be a problem to eat eggs.

I hope this helps.
Maelán

Here is our reader's comment:

January 27, 2010

Eric L said...

Please rewrite the the lysozyme section. Lysozyme is an enzyme that breaks down peptidoglycan. Humans obviously do not have peptidoglycan. It makes up the bacterial cell wall. I think some one got lost on this one.

Lysozyme has no eukaryotic membranolytic activity (btw membranolytic is not even a word.)

Please fix Loren.

Thanks,
Eric

Here is Dr. Cordain's response:

Dear Eric,

Many thanks for your response to Maelan’s answer to Barbara’s question about eggs in the Paleo Diet. Let me first address my feelings about egg consumption for the general population and then I will respond to your point, which is technically valid.

In all three of my books, I have advocated egg consumption, particularly eggs that are produced with high omega 3 fatty acid contents. Chicken eggs are generally a nutritious food and are a good source of selenium, vitamin A, vitamin D and the B vitamins, some minerals and lutein as Barbara indicated. Additionally, numerous recent experimental and epidemiological studies (reviewed in references 1, 2) indicate that regular egg consumption (7 per week) does not increase the risk for coronary heart disease (CHD). As I have previously noted, although eggs are one of the most concentrated sources of dietary cholesterol (212 mg per egg), dietary cholesterol has a minimal effect upon blood cholesterol concentrations in most people^{1, 3}. Further, high cholesterol egg diets cause an increase in blood HDL particles (the good particles that remove cholesterol from the body)¹ and reduce the highly atherogenic small dense LDL particles while simultaneously increasing the less atherogenic large, “fluffy” LDL particles^{4, 5}.

So, should everybody include eggs in their diet on a daily basis? Not necessarily, particularly if we examine the evolutionary template. Without question our pre-agricultural ancestors would have collected and consumed eggs from birds’ nests whenever possible. However, in the wild, bird eggs only appear seasonally. Hence, pre-agricultural humans could have never consumed two eggs for breakfast every morning of the year similar to some westernized people, but rather only occasionally for a few brief weeks or months.

If we follow up on the clue from the evolutionary template and examine eggs more closely, they maintain certain nutritional shortcomings that may be problematic, particularly for people suffering from autoimmune diseases and allergies. Although eggs are classified as animal food sources and are lumped together with meats in the USDA My Pyramid, eggs are uniquely different from meats in that they represent the reproductive endpoints of adult birds which exist outside their mother’s body in a semi permeable, warm compartment. As such, all eggs are particularly vulnerable to invasion, attack and destruction by microorganisms such as fungi, bacteria and viruses present in their nesting environment.

The innermost yolk of a chicken egg represents the growing embryo which is anchored to the albumen or egg white by structures called chalazae. Outward from the egg white are the inner and outer membranes and then the shell, all of which provide physical barriers to infection from pathogens and microorganisms. The egg white makes up about 58% of the total egg volume and contains about 50% of the total egg protein and is composed of 88.5% water, 10.5% protein and 0.5% carbohydrate.⁶. The function of the egg white is threefold: 1) storage of nutrients for the growing embryo (yolk), 2) protection of the egg from microbial attack, and 3) transport of nutrients into the growing embryo.

As I have previously mentioned, a chicken egg is the reproductive endpoint for adult birds and survives by living outside its mother’s body in a semi permeable compartment that is essentially immovable. Accordingly, it has no means of protecting itself from microorganisms or predation by physical escape or avoidance. For this reason, the evolutionary strategy eggs have taken to protect themselves from microbial invaders is to select for toxic substances in the egg white; mainly in the form of antimicrobial proteins. Table 1 lists the major proteins in egg whites and their likely functions. Note that except for ovalbumen which comprises 54% of the total protein in egg white, virtually all the other major proteins (~33% of the total) maintain one form or another of antimicrobial activity.

Table 1. Major proteins and their properties found in egg whites (adapted from references 6-10).

Protein	% total proteins	Function(s)
Ovalbumen	54	Storage protein
Ovotransferrin	12	Iron binding with antimicrobial activity
Ovomucoid	11	Protease inhibitor/antimicrobial activity?
Ovomucin	3.5	Potent antiviral activity
Lysozyme	3.4	Antibacterial activity
G2 globulin	4.0?	Antibacterial activity
G3 globulin	4.0?	Antibacterial activity
Ovoinhibitor	1.5	Protease inhibitor/antimicrobial activity?
Ovoglycoprotein	1	?
Thiamin binding protein	1	Thiamin transport
Ovoflavoprotein/Riboflavin binding protein	0.8	Riboflavin transport
Ovomacroglobulin (Ovostatin)	0.5	Protease inhibitor/antimicrobial activity?
Cystatin	0.05	Protease inhibitor/antimicrobial activity?
Avidin	0.05	Antibacterial activity
Total	88.8

Egg white allergy in the general population varies between 1.6 – 3.2 % and is the second most common cause of food allergy in children next to milk⁸. For both adults and children one or more of the following symptoms may occur: hives, atopic dermatitis (red, flaky itchy skin), asthma, runny nose, diarrhea, abdominal pain, rapid swelling of the skin and mucosa, and anaphylactic shock which may be life threatening. The major allergens in egg white are ovomucoid, ovalbumen, ovotransferrin and lysozyme⁸ (Table 1). So for the vast majority of children and adults (98.4 – 96.8% of the population), egg white allergy is not a problem, and except for anaphylactic shock is not a debilitating or life threatening condition.

The same conclusion may not be true for people suffering from an autoimmune disease (e.g. multiple sclerosis, rheumatoid arthritis, ankylosing spondylitis, lupus erythematosus and others), since egg white consumption may contribute to the origin and progression of these diseases via a process of molecular mimicry that I have previously outlined for dietary lectins found in wheat, peanuts and other grains and legumes ¹¹.

You can see from Table 1 that egg white protein is no simple protein, but rather a conglomeration of multiple proteins which have been designed by natural selection to cause toxic and lethal effects in bacteria and microorganisms reminiscent of food lectins found in grains and legumes¹¹. In order for any food proteins to potentially cause or promote an autoimmune disease, it must:

Survive the human digestive processes intact
Cross the gut barrier intact either alone or with other attached proteins
Interact with the immune system in a manner suspected of causing an autoimmune disease.

A number of egg white proteins fulfill these necessary steps. Most problematic is the egg white protein, lysozyme which is actually an enzyme known as N-acetylhexosaminodase that is also found in many human tissues, including tears ¹². The function of lysozyme in both egg whites and in human tears is to act as a potent bacterialcidal agent by binding and dissolving bacterial cell walls¹².

Now let me answer Eric’s specific point. Bacterial cell walls are called the murein or peptidoglycan layer which is a gigantic polymer of (N-acetylglucosamine and N-acetylmuyramic acid) polysaccharide strands cross linked through short peptide bridges at the lactyl groups of the muramic acid residues. Lysozyme degrades bacterial cell walls by catalyzing hydrolysis of the beta (-1,4-) linkage between N-acetylglucosamine and N-acetylmuramic acid. As Eric correctly pointed out human cells do not maintain a murein (peptidoglycan) exterior lining. Consequently, dietary lysozyme from egg whites do no increase intestinal permeability by breakdown of intestinal cell membranes as suggested by Maelan, but rather lysozyme increases intestinal permeability by other means that I will explain. It is this increase in intestinal permeability or "leaky gut" that makes egg white consumption problematic for people with egg allergies or autoimmune disease.

Lysozyme is unusual among the major egg white proteins in that it has an alkaline isoelectric point, which means that it can form strong complexes with other egg white proteins including ovomucin, ovalbumen and ovotransferrin^{6, 12}. Hence, even though lysozyme is a benign enzyme produced in our own bodies, when we eat egg white lysozyme, it comes as a compound attached to other egg white proteins or to gut borne bacterial proteins foreign to our bodies.

In the human digestive tract, enzymes called proteases normally break down proteins into their constituent amino acids so that the amino acids can be absorbed across the intestines. Because egg white protein contains high concentrations of protease inhibitors (ovomucoid, ovoinhibitor, ovostatin, cystatin) (Table 1), the human gut proteases (trypsin and chymotrypsin primarily) are less effective in degrading egg white proteins, and lysozyme/egg white protein complexes. Additionally lysozyme is stable in the acidic gut environment¹² and therefore arrives intact in the lower gastrointestinal tract.

So what’s wrong if lysozyme/egg white protein/bacterial complexes aren’t dissolved by normal digestive processes? Normally, large multifaceted proteins such as these complexes don’t have a prayer of getting across the intestinal barrier and into the bloodstream where they can interact with the immune system. Once again, lysozyme is an unusual protein because it rapidly breeches the gut barrier and enters human circulation¹⁴, due to its unusual chemical properties (a positively charged isoelectric point)¹⁵. Because lysozyme maintains a positive charge, it results in an electrostatic attraction to the negatively charged proteoglycans (the glycocalyx) of intestinal epithelial cells which in turn allows lysozyme to be absorbed rapidly into circulation¹⁵.

Absorption of pure egg white lysozyme by itself into circulation is likely not problematic because lysozyme is an enzyme that the body naturally produces. Rather it is the complexes that lysozyme forms with other egg white proteins, gut borne bacterial peptides and food peptides that may adversely stimulate the immune system. When these chimeric (monster) molecules breech the gut barrier via their net positive charge and enter circulation, they have the capacity to promote allergy and autoimmune disease.

Just how autoimmune diseases are triggered by gut borne antigens from egg white lysozyme and other common foods (cereal grains, legumes, dairy and certain saponin containing foods) is another good story that our research group has been working on for the past decade. We hope to publish this seminal paper in 2010.

Cordially,
Loren

Loren Cordain, Ph.D.
Professor

References

Fernandez ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Curr Opin Clin Nutr Metab Care. 2006 Jan;9(1):8-12.
Kritchevsky SB. A review of scientific research and recommendations regarding eggs. J Am Coll Nutr. 2004 Dec;23(6 Suppl):596S-600S.
Howell WH, McNamara DJ, Tosca MA, Smith BT, Gaines JA. Plasma lipid and lipoprotein responses to dietary fat and cholesterol: a meta-analysis. Am J Clin Nutr. 1997 Jun;65(6):1747-64.
Herron KL, Lofgren IE, Sharman M, Volek JS, Fernandez ML.High intake of cholesterol results in less atherogenic low-density lipoprotein particles in men and women independent of response classification. Metabolism. 2004 Jun;53(6):823-30.
Maki KC, Van Elswyk ME, McCarthy D, Seeley MA, Veith PE, Hess SP, Ingram KA, Halvorson JJ, Calaguas EM, Davidson MH.Lipid responses in mildly hypertriglyceridemic men and women to consumption of docosahexaenoic acid-enriched eggs. Int J Vitam Nutr Res. 2003 Oct;73(5):357-68.
Stevens L. Egg white proteins. Comp Biochem Physiol B 1991;100:1-9.
Szxena I, Tayyab S. Protein proteinases inhibitors from avian egg whites. Cell Mol Life Sci 1997;53:13-23.
Mine Y, Yang M. Recent advances in the understanding of egg allergens: basic, industrial and clinical perspectives. J Agric Food Chem 2008;56:4874-4900.
Wellman-Labadie O, Picman J, Hincke MT. Comparative antibacterial activity of avian egg white protein extracts. Br Poult Sci. 2008 Mar;49(2):125-32.
Takahashi K.G., Nakamura A., Mori K. Inhibitory effects of ovoglobulins on bacillary necrosis in larvae of the pacific oyster, Crassostrea gigas. J Invert Pathol 2000;75:212-217.
Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Br J Nutr. 2000 Mar;83(3):207-17.
Proctor VA, Cunningham FE. The chemistry of lysozyme and its use as a food preservative and a pharmaceutical. Crit Rev Food Sci Nutr 1988;26:359-395.
Holtje JV. Lysozyme substrates. EXS 1996;75:105-10.
Hashida S, Ishikawa E, Nakamichi N, Sekino H. Concentration of egg white lysozyme in the serum of healthy subjects after oral administration. Clin Exp Pharmacol Physiol. 2002 Jan-Feb;29(1-2):79-83.
Nishikawa M, Hasegawa S, Yamashita F, Takakura Y, Hashida M. Electrical charge on protein regulates its absorption from the rat small intestine. Am J Physiol Gastrointest Liver Physiol. 2002 Apr;282(4):G711-9.

Paleo Diet Q & A - 25 January 2010

2010-01-25T11:55:00.001-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A on rheumatoid arthritis.

Q: The article, "Modulation of immune function by dietary lectins in rheumatoid arthritis" is of interest to me, but is 10 years old. Can you suggest any more recent scientifically valid articles on the same topic?

Many thanks,
Allena

A: Hi Allena,

To my knowledge, there are no reviews or studies addressing the role of a paleolithic diet and it's implications in rheumatoid arthritis, except from that of Dr. Cordain. In his MS (Multiple Sclerosis) DVD Dr. Cordain thoroughly explains the dietary mechanisms of autoimmunity in MS, which are almost the same for all autoimmune diseases--including RA. Those are: increased intestinal permeability, increased passage of luminal antigens into peripheral circulation, molecular mimicry and genetic susceptibility (genes encoding for the HLA system), among other factors.

In recent years, new substances have been discovered which might be responsible for increased intestinal permeability, namely saponins (found in legumes), potatoes, soya, quinoa, amaranth, alfalfa sprouts or tomatoes. If you've seen Dr. Cordain's scientific paper entitled "Modulation of immune function by dietary lectins in rheumatoid arthritis", I am sure you are aware of the role lectins play in autoimmunity.

Adjuvants are used by immunologists in order to boost the immune system and induce immunization. It turns out that certain foods have bioactive compounds that have adjuvant-like activity, this is the case for tomatoes or quillaja (a foaming agent used in beers and soft drinks).

Gliadin is a prolamine found in wheat which has been shown to increase intestinal permeability and hence the risk of suffering an autoimmune disease.

On the other hand, several clinical trials have been conducted with promising results. However, they have used a gluten-free diet or vegan diet instead of a whole paleolithic diet, which we think is the superior diet.

In vegan diets, authors often claim that the effects might be due to the lack of meat, but we think the positive effect relies on the lack of diary proteins and gluten. Meat has historically been seen as the "bad guy" in inflammation, but the data to support that notion is not sufficient to support this view.

Below are some references that could be useful.

Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Elkan AC, Sjöberg B, Kolsrud B, Ringertz B, Hafström I, Frostegård J. Arthritis Res Ther. 2008;10(2):R34. Epub 2008 Mar 18.

A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, Brannemark S, Nylander I, Rönnelid J, Laasonen L, Klareskog L. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.

I hope this helps.
Maelán

Paleo Diet Q & A - 22 January 2010

2010-01-22T09:40:00.002-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A discussing flax seed and flax seed oil consumption.

Q: Dear Dr. Cordain,

I recently visited family over the holidays and my brother is a new advocate of the Paleo Diet. For breakfast he made us "fakecakes" which had about 1-2 tablespoons of flax seed in them that he ground in a coffee grinder. I had few a questions regarding the use of flax seed in the Paleo Diet.

Firstly why are flax seeds ok in the Paleo Diet but other grains (seeds) are not? My understanding for eliminating grains from the diet is the toxins that they contain but flax seed contains large amounts of cyanogenic glycosides producing up to 139 mg/kg of hydrogen cyanide in raw human-grade flax seed. I am sure flax seeds are processed somehow before selling them but I don't know what process that is or what effect it has on the HCN concentration.

So, secondly...do you know of any studies on the amount of HCN in meals containing ground flax seed and the chronic oral exposure of those amounts on humans? My understanding here is the HCN that isn't hydrolysed to formic acid in the stomach and doesn't bind to hemoglobin is converted to thiocyanate which hinders thyroid function.

Thank you for your time and any information you can supply.

Sincerely,
Tim

A: Hi Tim,

We think your thoughts are on the right track.

When Dr. Cordain wrote The Paleo Diet, the advice to consume flax seed oil was an attempt to balance the increased omega-6/omega-3 fatty acid ratio due to the exaggerated intake of omega-6 vegetable oils, especially linoleic acid, in the typical western diet.

Nevertheless, animal foods (fish, muscle meat and organs from wild animals) are good sources of w3 fatty acids. As so, when people eat these foods regularly along with vegetables and nuts, and avoid vegetable oils (especially oils rich in Linoleic Acid – Omega 6), they get a balanced intake of omega 3, omega 6, monounsaturated and saturated fatty acids. In this context, there is no need for flax seeds to provide Omega 3 fatty acids and balance the Omega 3/Omega 6 ratio.

Here are some facts that support the notion that animal foods, vegetables and nuts provide the necessary Omega 6 and Omega 3 fatty acids in the right proportion:

Hunter-gatherers do not eat ALA from seeds or vegetable oils.
Nuts, green leafy vegetables and animal foods contain ALA.
The conversion of ALA to EPA+DHA is limited, due to low delta-6 and delta-5 activity, although ALA is highly oxidized (twice as much as LA) (Freemantle et al.). Therefore, this means that at some pointing history we included preformed sources of EPA and DHA and still need to do so. Animal foods (especially brain from wild ruminants and fish) are very good sources of these fatty acids.
The essentiality of LA & ALA in human metabolism has been questioned (Le et al.), as we relied almost on LCPUFA (Arachidonic Acid, EPA and DHA) during the Paleolithic era (see Dr. Cordain’s papers on that here and here). Moreover, there is already some evidence showing that human metabolism could re-convert AA and DHA into LA and ALA respectively, hence AA and DHA would be the true essential fatty acids.
The possible toxicity from seeds and vegetable oils (HCN, saponins, lectins).
They are not used by current HG societies, and these populations show no signs of western disease, so this means that flax seeds are not necessary.
The well known positive health effects of fish oil supplementation (among other factors to improve omega-6/omega-3 ratio) in contrasts with some possible adverse effects of flax seed oil (like the epidemiological evidence that points towards increased risk of prostate cancer with flax oil consumption – see paper by Brouwer et al).

The bottom line from an evolutionary perspective is that flax seeds and/or flax seed oil would not have been consumed by pre-agricultural humans. However, having said that, hunter gatherers always would have preferentially sought high oil plant foods as per optimal foraging theory. But, most high fat plant foods contain high MUFA (with the exception of coconut and palm).

In addition, we will continue to explore the broader impact to health of modern vegetable oils, including flax.

Hope this helps.
Maelán

Paleo Diet Q & A - 20 January 2010

2010-01-20T16:20:00.000-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A on salt.

Q: Hi there! I bought my book and started my diet a couple of days ago. My husband told me that sea salt as opposed to table salt is okay to use. - Is this correct? Can I use sea salt while on the Paleo Diet? Please let me know. Thanks! Sincerely, Lani

A: Hi Lani,

Salt was not part of the hunter-gatherers' diet, hence, our metabolism can not handle salt very well, specially in a context of high fructose intake and high blood pressure sufferers. Nevertheless, a small amount of salt probably won't be an issue for you. But use it in moderation.

On the other hand, conditions such as insomnia or exercise induced asthma may improve on a low-salt diet.

Cordially,
Maelán

Dr. Cordain's Latest Paper

2010-01-20T13:55:00.001-07:00

Dear Readers,

Dr. Cordain, et al, have published a new paper entitled "Diet-dependent acid load, Paleolithic nutrition, and evolutionary health promotion,"available for download on our web site.

Paleo Diet Q & A - 19 January 2010

2010-01-19T09:55:00.000-07:00

Dear Readers,

Today's Paleo Diet Q & A on MS.

Q: As a MS patient for 5 years, I have been following the Swank diet (or the Judy Graham's approach to the Swank diet) since the beginning. Meaning that I am in a low fat diet with a high intake of Omega 6 (2-3 gr. of Primrose Oil daily) and Omega 3 (1 gr. of Fish Oil daily). As a Spanish person, I also take lots of Extra Virgin Olive Oil (as salad dressing or cooking oil). I did not take milk or dairy in all these years. I swim half hour every week. The result is that my lesions are inactive, I have had just one MS episode in the last three years but, on the other side, I suffer of great fatigue and I get very tired after walking short distances. And I hardly can stand stressing situations.

Your conference in Youtube made me buy your book and I have started following the Paleo diet. My question is if I am doing the right thing taking that amount of vegetable oils. I understood (in the video part 3) that lots of Omega 6 and few Omega 3 could be inflammatory and is not recommended for autoinmune diseases. But in my case I think that is helping to feel better (I have felt worse when I have stopped taking it for several weeks).

Do you have any recommendation for me?

Cordially,
Andrés

A: Hi Andrés,

Yes, you are right. We think that a high intake of vegetable oils (specially omega-6 linoleic acid), probably, is not the best approach for inflammatory conditions. However, Primrose Oil is a good source of GLA, a precursor of anti-inflammatory substances namely PGE1.

Perhaps 2-3 grams of Primrose Oil is too much and 1 gram of Fish Oil is not enough. For an inflammatory disease we recommend to take 2 grams EPA+DHA/day.

Regarding your fatigue symptoms, you don't necessarily have to stick to a low-fat diet when treating MS, and muscles should be well adapted to burn fat. One of the causes of chronic fatigue is fatty acid deficiency, so we encourage you to eat good fat sources such as oily fish, olive oil, coconut oil (a good source of Medium Chain Triglycerides for your muscles and keeps harmful bacteria under control) and nuts (macadamia and walnuts).

A paleolithic-type diet will provide you the adequate amount and balance between the different fatty acids.

On the other side, you may be aware of the importance of gut permeability on MS patients, so the paleo diet will help you treating this part of the story.

I hope this is helpful,

Best wishes,
Maelán

The Dietary Cure for Acne Eating Guide

2010-01-14T14:55:00.006-07:00

Dear Readers,

The Dietary Cure for Acne Eating Guide is now available for purchase as a stand-alone product (PDF) for $29.95. The Dietary Cure for Acne Eating Guide contains 63 easy to follow recipes, meal ideas, shopping, food prep, and dining tips, recommended foods, and much more. Please visit our web store for more information.

Autographed Copies of The Paleo Diet for Athletes Now Available

2010-01-13T14:55:00.001-07:00

Dear Readers,

Dr. Cordain's hard cover edition of The Paleo Diet for Athletes (available exclusively from our web store) may now be purchased as an autographed edition signed by Dr. Cordain! Please visit our web store to obtain your copy.

Paleo Diet Q & A - 12 January 2010

2010-01-12T10:25:00.001-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: Have you had any results in curbing the symptoms of Crohn's Disease with the Paleo Diet. As I am a sufferer, I would love to know.

Thank you,
Shannon

A: Dear Shannon,

Indeed, inflammatory bowel disease (Ulcerative Colitis & Crohn's Disease) patients usually do very well with The Paleo Diet, as nutrients are one of the main environmental triggers of this condition.

Crohn's disease is an autoimmune disease where the immune system mounts an attack against its own tissues, in this case the cells lining the intestine.

For an autoimmune disease to occur we need a genetic predisposition and an environmental trigger. The genetic predisposition depends on genes coding for the HLA system. On the other side, one of the environmental triggers may be nutrition, besides infections, geography (vitamin D deficiency), physical trauma or vaccination.

One of the key points in this process is increased intestinal permeability. This means that the gut barrier allows increased passage of bacterial or food proteins (antigens) into peripheral circulation, skipping a process known as oral tolerance. Once antigens get in contact with the immune system located in the gut associated lymphoid tissue, they may elicit a T-cell mediated immune response against those antigens.

If the molecular structure of the dietary or bacterial antigens is similar to that of the HLA system (part of the immune system presenting cells machinery), chances are that a cross reaction between foreign antigens and self antigens (produced by T-cells) occur. This is termed molecular mimicry and leads to self injury by the adaptive immune system.

Hence, decreasing intestinal permeability is one of the treatment targets. There are several nutrients known to increase intestinal permeability that you may want to avoid, at least until symptoms subside. Here you have a list of them and the noxious substance in parentheses:

Cereal grains (lectins and gliadin)
Legumes, including soya and peanuts (lectins and saponins)
Tomato (tomato lectin and alpha-tomatin)
Potato (lectins and saponins)
Chili (capsaicin)
Quillaja (foaming substance)
Quinoa (saponins)
Egg white (lisozyme)
Alfalfa sprouts (saponins)
Amaranth (saponins)
Alcohol

Quillaja extract, found in root beer
Tomato alpha-tomatine

Dairy products and vegetable oils also have deleterious effects upon your immune system.

I hope this helps.
Maelán

Q: Good Morning,

I've recently started on the Paleo Diet. I've read through your site and others to make sure I'm going about it the right way. What a revelation! It's fantastic in its simplicity.

My concern is that when I was about 18 I developed an allergy to fish. I have no idea how this happened. I ate two or three nights a week growing up at home. Curiously, this allergy seems to only apply to scaled fish, as I can still eat shellfish. I am 23 years old.

When I eat fish I get terrible heartburn/indigestion, and the last time I tried it, about two years ago, my face started swelling and itching. I saw an allergist who told me to avoid fish because of the potential of a very serious reaction.

What do you recommend I do? It seems like eating seafood is a big part of the Paleo Diet. I'm happy to eat shellfish, but aside from shrimp it's often prohibitively expensive. Obviously I'm not going to eat fish unless I can "outgrow" the allergy. I was once allergic to eggs, but I've gotten over that now.

Thanks!
Harrison

A: Dear Harrison,

From an evolutionary standpoint fish allergy is nonsense, as it has been part of the human nutrition since, probably, 2-2.5 million years ago.

Allergy is an exaggerated reaction of the body's immune system against foreign proteins, where the body's common mucosal immune system (located in the gut, nose, eyes, lungs, etc) increases the production of cell (eosinophils) and/or antibody (IgE) mediated immune response. This leads to histamine release throughout the CMIS and signs and symptoms related to allergy, such as inflammation, redness, itching, sneezing, or anaphylactic shock if acute vasodilatation occurs.

But how or why do fish proteins trigger an allergy reaction?

An early exposure to food proteins, lets say before 3-6 months of life, when the gut associated lymphoid tissue is immature increases the risk of allergy later in life.
An increased intestinal permeability allows food proteins to pass through the gut barrier and skip M-cells mediated oral tolerance, inducing hyper-sensitivity to those proteins.
In the last years a wide body of scientific papers has shed light to what is known as the "hygiene hypothesis". A correlative association has been shown between increased use of antibiotics and vaccines and inflammatory conditions such as multiple sclerosis, type 1 diabetes and allergy, during the last 50 years. Human beings are less exposed to microorganisms, such as intestinal bacteria, than they used to. This leads to lack of immune regulation mediated, in part, by gut and environmental microorganisms.

How can the Paleo Diet help you?

Of course we can not address point 1 but we can do something regarding points 2 and 3.

The Paleo Diet is free of some food known to increase intestinal permeability such as cereal grains, legumes (soya and peanuts), alcohol, tomato, potato, quinoa, amaranth, egg white, alfalfa sprouts and root beer (quillaja extract). By eliminating those foods and eating a diet based on lean meats, shellfish, vegetables, fruits and nuts your intestinal permeability will decrease and your immune system will be less challenged by those food proteins (fish) and perhaps we can restore immune tolerance to a normal food as fish. For more information about intestinal permeability and nutrition we recommend you to check out our published newsletters section.

Regarding point 3 we suggest you to take a probiotic supplement (6-9 billion/day) for several months.

Other supplements that can help you improve intestinal permeability:

Pre-biotic 2-4grs/day
L-glutamine 0.2grs/kg body weight one month, then 0.1gr/kg
Zinc 25mg/day
Vitamin D 2000 IU
Omega-3 fatty acids EPA+DHA=2.6grs/day

I hope this is useful.
Maelán

Paleo Diet Q & A - 7 January 2010

2010-01-07T14:45:00.001-07:00

Dear Readers,

Here is today's edition of Paleo Diet Q & A.

Q: Hello,

I heard Dr. Cordain speak twice in optometry meetings. He understood everything about his diet, but both times, I left with the same question in my head: what about eggs?

SO if you could please pass it on to him, I would appreciate it. Because eggs are a source of lutein which is very bioavailable and because lutein is extremely important in ocular health, I would like to know what his opinion is on that.

Barbara

A: Dear Barbara,

Eggs are part of The Paleo Diet, as humans have consumed eggs during the paleolithic era, although not in a year round basis (because bird eggs appear only seasonally), hence Dr. Cordain has advocated eggs, specially those rich in omega-3 fatty acids, in his three books. One of the egg white functions is to protect the yolk against microbal attack using proteolytic enzymes, besides being storage of nutrients for the growing embryo and transport of nutrients into the growing embryo. Except for ovoalbumen, most of the proteins in egg white have antimicrobial, antibacterial or antiviral activity, some of these proteins are called ovomucoid, ovomucin and lysozyme, among others. These proteins may disrupt the integrity of the gut lining leading to increased intestinal permeability and lysozyme is the most harmful of these proteins in terms of membranolytic activity (breakdown of cell membranes). We recommend that patients suffering from autoimmune diseases to avoid egg white at the beginning as Lysozyme may increase intestinal permeability which is one of the contributing factors in autoimmune diseases. Another issue is egg allergy which is quite common.

On the other hand, eggs are rich in selenium, vitamin A, vitamin D and the B vitamins, and some minerals.

If the person does not suffer from autoimmune disease or egg allergy it shouldn't be a problem to eat eggs.

I hope this helps.
Maelán

Q: Is The Paleo Diet an option for someone with Type 1 Diabetes being treated with Coumadin?

A: Yes, The Paleo Diet will work good for you. Indeed, in our previous newsletter (v_5#36 2009) we reported how The Paleo Diet influences the different pathways involved in the disorder.

There are several known factors of the western diet contributing to triggering Type 1 Diabetes:

Proteins found in cow's milk: Beta-Lactoglobulin, Bovine Insulin, Bovine Serum Albumin and Beta Casomorphin-7.
Proteins found in cereal grains: Gluten is a well known trigger of an autoimmune disease associated with T1D called Celiac Disease. A gluten-free diet led to improvement in insulin response during a glucose tolerance test.
Another factor at the root of almost all autoimmune diseases is increased intestinal permeability. Certain substances found in the typical western diet (lectins, saponins, gliadin, alcohol and capsaicin) may increase intestinal permeability.
Other factors such as diet's fatty acid composition or vitamin D deficiency contribute to the pathogenesis of T1D.

The Paleo Diet is free of all those harmful substances, being based on lean meats, seafood, fruits, vegetables and nuts.

Finally, a low glycemic load diet will help you to better control your blood glucose levels in the long run.

On the other hand, if you are taking Coumadin it shouldn't be a problem with The Paleo Diet unless you are consuming high amount of omega-3 or vitamin E supplements.

I hope this helps.
Maelán

Paleo Diet Q & A - 6 January 2010

2010-01-06T17:00:00.001-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A. Thank you again for your questions, comments, and your interest in the Paleo Diet.

Q: Recent tests have revealed that I have Polycystic Ovary Syndrome, which is something I have long suspected. I am 34, and have suffered with acne since the age of 11, and I barely ovulate. We would love to have children, and I am thoroughly sick of waiting to 'grow out' of acne. I have recently seen a fantastic doctor about my fertility issues, who has recommended the Paleo Diet. I am really keen to keep to the diet, see the benefits, and have bought the book, but have a few questions about particular foods.

Can smoked salmon (or any other smoked fish/meat) be included in this diet?

Also, you mention that pickled/preserved foods are a bad idea, and I really enjoy sun dried tomatoes, roast peppers in oil, and olives. Could I include any of these in the diet, if they are they are well rinsed of all excess oil etc?

How about decaf coffee?

I struggle a bit to find foods to eat for breakfast and lunch (evening meal no problem), and am REALLY missing cereals such as porridge (I don't know if you have any suggestions for substitutes)?

A: Polycystic Ovary Syndrome (PCOS) and Acne are both conditions associated to insulin resistance. Anovulation and infertility, are also added problems to PCOS and insulin resistance as insulin affects overall hormonal balance and particularly sex hormones through Sex Hormone Binding Globulin (SHBG) down-regulation. Insulin decreases SHBG production in the liver and at the same time increases male sex hormones availability (androgens), leading to an increased ratio of androgens/estrogens.

As thoroughly described by Dr. Cordain in his book The Dietary Cure for Acne and several scientific papers available in the published research section of our web site, diet is linked to the above mentioned hormonal imbalance.

Regarding your questions:

Smoked salmon could be part of your diet but don't use it as a staple food as it contains certain toxic substances.
Pickled tomatoes and/or peppers should be cut down as they may increase intestinal permeability. Intestinal hyperpermeability allows increased passage of intestinal food or bacterial antigens into peripheral circulation. Specially, certain bacterial cell wall antigens namely Lipopolysaccharide (LPS), are potent immune stimulators leading to chronic low grade inflammation which is at the root of many diseases and particularly insulin resistance (IR). IR is something you may want to correct in order to regulate your hormones.
Olives are part of The Paleo Diet.
Coffee shouldn't be a problem for you.
In the nutritional tools section of our web site you can find tons of recipes for your meals.
Cereal grains are all sources of harmful substances called lectins. You should avoid lectin containing foods as they contribute to low-grade chronic inflammation. Almond flour could be an option to substitute cereal grains.

I hope this helps.
Maelán

Q: Are baked sweet potatoes allowed? I thought not!

A: Yes, sweet potatoes are allowed, specially in the post-workout period if you are an athlete. Sweet potatoes are different from potatoes in that they do not contain several harmful substances such as saponins and lectins, which may increase your intestinal permeability (if consumed regularly) and rev-up your immune system. But on the other hand, sweet potatoes are high glycemic index foods and should be restricted if you are struggling with overweight, at least until your body weight normalizes.

I hope this helps.
Maelán

Q: I wanted to ask you why it is that you discourage saturated fats in the paleo diet? From what I have read their are healthy saturated fats from coconuts that are used for around 17% of the Kitavan diet. Also, what about tubers such as sweet potato and yam, do you think that consuming these in moderate portions (small enough to keep a low glycemic load) could be detrimental?

A: Here you have replies to similar questions posted before:

Regarding saturated fats:

Saturated fatty acids intake and the risk of developing cardiovascular disease (CVD) is a topic with a lot of controversy. In recent years a wide body of research has suggested that increased consumption of certain saturated fatty acids (Lauric acid, myristic acid and palmitic acid)
down-regulate LDL receptor and thereby increase LDL plasma levels, and this has been associated to increased risk of CVD. On the other hand, stearic acid (a 18 carbon saturated fatty acid) has been shown to decrease LDL plasma levels. However, this view is too simplistic as they are several other factors contributing to CVD, such as smoking, exercise, trans-fatty acids, increased omega-6/omega-3 ratio, free-radicals, nutrient deficiency, homocysteine, alcohol intake and low-grade chronic inflammation among others.

Moreover, some studies have suggested that there’s not enough scientific data to support the view that increased total or LDL cholesterol is an independent risk factor for CVD, but rather oxidized LDL. Plaque production is mediated by oxidized LDL but not LDL. Oxidized LDL can produce shedding of the inner layer of the artery namely glycocalix. Then oxidized LDL infiltrates in the intima of the artery. Oxidized LDL is eaten by macrophagues, a process known as phagocytosis, and therefore macrophagues are transformed into foam cells which produce the fibrous cap.

Once the fibrous cap has been produced we need to break it down in order to produce an ischemic event. Lectins and low-grade chronic inflammation are involved in the activation of matrix metalloproteinases which break down the fibrous cap.

In summary, high total cholesterol or LDL levels do not increase CVD risk but rather oxidized LDL. To produce oxidized LDL we need the factors mentioned above. Hence, consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned before.

Dr. Cordain wrote a book chapter where he shows that saturated fat consumption in ancient hunter-gatherer populations were usually above recommended 10% (American Heart Association) of energy from saturated fats yet non atherogenic.

The bottom line is that we do not recommend cutting down saturated fatty acid intake but rather decrease high-glycemic load foods, vegetable oils, refined sugars, grains, legumes and dairy.

Regarding sweet potatoes and The Paleo Diet:

Yes, early hominids probably ate large amounts of sweet potatoes as some hunter-gatherers do in Kitava-Papua New Guinea. Our ancestors didn't have an universal diet because it depended on climate, season, latitude, culture, etc. This means that the amount of carbohydrates they ate varied substantially. So, for instance in Kitava they eat a lot of carbohydrates and still have no obesity, so it seems as if some bioactive substances of neolithic foods are responsible for hormonal disruption.

However, there's a big different between potatoes and sweet potatoes. Potatoes are a good source of some known harmful substances namely saponins and lectins. They have the ability to increase intestinal permeability and hence increase the risk of autoimmune diseases (in genetically predisposed individuals), and induce low-grade chronic inflammation which is at the root of many chronic degenerative diseases. On the other hand, there's some preliminary data suggesting that some bioactive substances, such as lectins and saponins, contained in potatoes, grains, legumes, etc. can bind hormonal receptors impairing their function. This could be the case of leptin receptor leading to leptin resistance and some metabolic disorders.

I hope this helps.
Maelán

More on Coconut Oil

2010-01-05T13:35:00.001-07:00

Dear Readers,

The question of using coconut oil has been raised in previous blog questions and emails. Presented in this post are comments from Dr. Cordain and Paleo Diet team member Pedro Bastos on the use of coconut oil as part of the Paleo Diet.

Q: Is there a good reason to avoid using coconut oil?

A: This is not a clear cut issue as it once was. Coconut oil contains high concentrations of a saturated fatty acid called lauric acid (12:0) as well as other medium chain fatty acids (8:0, 10:0) which may have therapeutic effects. Coconut oil also contains other saturated fatty acids which elevate blood cholesterol. However, elevations in blood cholesterol without chronic low level inflammation may not necessarily increase the risk for CHD. My feeling is that coconut oil in the backdrop of a modern day Paleo Diet probably has few negative health implications.

Loren Cordain, Ph.D., Professor

A: I agree with Loren. Lauric acid has a more favorable effect on total HDL cholesterol than any other fatty acid, either saturated or unsaturated.

And, coconut oil appears to decrease Lipoprotein(a). Moreover, in primitive populations living close to water and where coconuts are available, these were probably consumed. I can think of at least 2 populations that eat a high amount of coconuts and exhibit a low incidence of CHD disease (Kitava and Tokelau), although we can't exclude the possibility that they could be even healthier if they didn't eat coconuts.

Hence, I believe coconut oil in the context of a 90% Paleo Diet (+ sun exposure + adequate sleep + regular exercise) may be neutral or even positive.

I hope this helps.
Pedro

Paleo Diet Article in The Washington Post

2010-01-03T09:00:00.001-07:00

Dear Readers,

The Paleo Diet, Dr. Cordain, and Chris LaLanne are cited in a January 2, 2010 article in The Washington Post entitled "Paleolithic diet is so easy, cavemen actually did it."

Paleo Diet Q & A - 31 December 2009

2009-12-31T12:55:00.002-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A. On behalf of the Paleo Diet Team we wish you a happy, healthy, prosperous new year.

Q: Dear Dr. Cordain,

I've been researching diet and its role in male pattern baldness for about a year and a half now. There is a website www.hairloss-research.org that lists studies showing positive hair loss benefits from various phytochemicals in different foods. Essentially, a Mediterranean diet with some aspects drawn from other diets seems to be the most optimal bet. I put to you that it's no coincidence the Japanese population traditionally has no male pattern baldness. Anyhow, one such study involves the legume soy. There is an isoflavone, a specific term for the more general term phytoestrogen in soy that is known to metabolize in the gut to a compound called equol which is a potent male pattern baldness fighter. Studies show only 30-50% of humans produce equol, and other components of the diet play the part in determining who is a strong equol producer. Seaweed or sea vegetables, for example, has a strong correlation with equol producers, and consumption of dairy has a strong negative correlation to being a strong equol producer.

The reason I came across your website is simple: I've been on a diet for the last year and a half that is aimed at fighting male pattern baldness. When I switched from dairy milk to soy milk, 99% of the acne on my back went away. However, I still get some acne, and I've had a dandruff problem for a few months now. Now some Google searches have indicated that dandruff is potentially caused by not shampooing enough -- especially with relatively long hair like myself, not getting enough sunlight or Vitamin D, or showering with too hot water. However, I feel like my problem may be inflammation, since dandruff's real name is seborrheic dermatitis. A video by a guy who in my opinion is very knowledgeable about health on YouTube named lorax2013 brought the Paleo Diet to my attention. He gives studies where subjects were put on the Paleo Diet and their respective ailment--whether multiple sclerosis, lupus, or acne--were remedied almost all the time, if not all the time. However, I don't see any mention of the Paleo Diet's role in male pattern baldness. Were any hunter gatherers of the past or present bald? I've read that chronic inflammation plays a negative role in male pattern baldness, and studies from that site indicate that inflammation is the reason that the hair follicle eventually shrinks and dies.

My question: I don't want to start the Paleo Diet and give up soy only to realize a year or three later that my hair is starting to thin. What are your thoughts on this?

Thanks so much for your time!
Tony

A: Hi Tony,

Thanks for your question. A scientific paper our group has written (Hyperinsulinemic Diseases of Civilization: More than Syndrome X) in part addresses male pattern baldness and how a number of studies indicate that high glycemic load diets may set off a hormonal cascade that is characteristic of men with male pattern baldness. To date, no randomized controlled interventions of low glycemic load diets (basically Paleo Diets) have yet been conducted, so we have no human on whether or not a Paleo Diet may be effective in combating male pattern baldness. However, having said this, numerous historical photographs of hunter gatherers rarely if ever depict young or middle age men with male pattern baldness. I have read anecdotal accounts of hunter gatherers who were described in 19th century writings suggesting that premature graying also rarely occurred. I had not heard about the equol story -- thanks for bringing it to my attention.

Best wishes,
Loren Cordain, Ph.D., Professor

Q: Dr. Cordain,

I am an undergraduate student that's dabbled with both the Paleo Diet and vegetarianism for several months now. I hope you can answer a question that's troubled me greatly.

I'm having trouble coming to terms with what I see as contradictory data on diet. I read the Paleo Diet almost a year ago as it came recommended to me from a fitness website I was browsing. The site raved about how healthy the Paleo Diet was, and how it could work well for an athletic lifestyle. That winter I began to eat much more in the way you described. I came into conflict last summer, working at an environmental nonprofit. My employer has been vegan for a while now and recommended I read another diet/health book called The China Study. Touted as the largest epidemiological study ever performed by man, the study reported that across the board vegan diets proved to be the healthiest among living human populations. My initial reaction that my protein intake would be too low if I pursued such a diet was alleviated by the research provided by the book.

I'm having trouble reconciling these views. Both you and the author of The China Study (Dr. Colin Campbell) provide compelling research to back up your points, and I can't see where to draw the line. The logic behind the Paleo Diet makes more sense to me than the logic of a vegan diet, but I can't argue with the enormous amount of data Dr. Campbell has on current living populations and the health they enjoy. Can you shed some light on this for me?

Thank you for your time,
Ryan

A: Hi Ryan,

We have a PDF that's available for download on our web site that includes two papers: Dr. Cordain's The Evolutionary Basis for the Therapeutic Effects of High Protein Diets and Dr. T. Colin Campbell's paper entitled How Much Protein Is Needed? Dr. Cordain's online "debate" with Dr. Campbell was originally commissioned by Robb Wolf, a strength & conditioning coach, formerly a research biochemist, who hosts a blog discussing intermittent fasting, fitness, and paleolithic nutrition (robbwolf.com).

We hope you find this information useful.
Patrick

Paleo Diet Q & A - 30 December 2009

2009-12-30T16:30:00.000-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: I happen to be Hyperthyroidic patient with plenty of Methimazole to take. My T4 is 15.5 and TSH .006 currently. I do kind of enjoy dairy foods like pot cheese/farmer's cheese, Raisin Bran with organic milk and some shredded wheat cereal. I can give that up. It tastes like horse food hay. My mom loves the Shoprite supermarket baguette Italian bread with plenty of artificial substances in it. I am trying to eat less and less of that. I have given up chocolate and I don't eat green tomatoes generally but the milk has vitamin D and I don't want to overindulge in supplements. My weight has been stable at around 188. I am 6 ft 3in. I weighed 147 early in 2009. I am 38 tomorrow. Now I can't substitute milk/vitamin D or can I? I do enjoy Soy. What else should I take or eat?

Lon

A: Dear Lon,

Hyperthyroidism could be the initial step in Hashimoto's Thyroiditis Disease. This happens to be an autoimmune disease where immune cells, namely T-Lymphocytes) attack cells of the thyroid gland, although a more comprehensive analysis is needed in order to do a diagnosis in your case. Another autoimmune disease called Celiac Disease carries an increased risk for other autoimmune diseases including HT. Celiac Disease is an autoimmune disease where the immune system mounts an attack against the epithelial cells lining the gut, triggered by gluten containing grains such as wheat, barley and rye. Hence, we believe that gluten containing grains may increase the risk for thyroiditis (remember that sometimes starts with hyperthyroidism and them moves to hypothyroidism). All grains and legumes (including soya and peanuts) contain harmful substances namely Lectins which increase intestinal permeability and this is associated to an increased susceptibility to autoimmune diseases.

Regarding dairy, they have several immunogenic (activate the immune system) proteins that may pass through the intestinal barrier if intestinal permeability is increased. Therefore, dairy are not the best choice to eat calcium, but rather green vegetables, such as kale, cauliflower, broccoli, etc.

Vitamin D is a crucial substance in terms of immune regulation. We suggest to measure blood levels of vitamin D and ensure they are in the 50-70ng/ml range.

The bottom line is to eat a diet based on lean meats, seafood, fresh vegetables, fresh fruits, nuts and olive oil. This will also provide you with big amounts of nutrients and antioxidants which may help to your overall health.

We hope this helps.
Maelán

Q: From the reading your studies in The Paleo Diet Update, Volume 2 Issue 2, it appears that the investigators failed as do many others to consider that when the consumption of fruits and vegetables increased, that something else had to have been omitted--or else calorie intake would have increased. Hence, just as well have the omission rather than the inclusion that effected the outcome. Please pass along to Loren for his consideration.

Thanks, Van

A: Thank you for your comment. Indeed, when we add something to a diet in order to maintain a stable caloric intake something has to be removed. As you said, we can't be 100% sure that the positive effect was due to increasing fruits and vegetables. In one of the studies Dr. Cordain mentioned, they didn’t just reduce or increase fruit and vegetables, they also manipulated the variable cereal grains. This would not only have a net acid load and displaced net base yielding fruits & vegetables, but may also adversely affect bone health and calcium balance through other mechanisms.

In science, isolating variables is a frequent practice and this is one of the reasons why the evolutionary template can shed light into difficult nutrition questions. Instead of focusing on only one specific variable, we defend that optimal health can only be achieved if we mimic most of the ancient lifestyle (sun exposure, exercise, sleep, avoiding chronic stress and pollutants) and a pre-agricultural diet (not just a net base yielding diet), which is what we propose with The Paleo Diet.

Nevertheless, it should be mentioned that more and more evidence suggests that the diet’s acid load is important in terms of optimal health.

Cordially,
Pedro

Suggested Resources for Buying Paleo-Friendly Food

2009-12-30T14:30:00.001-07:00

Dear Readers,

The mainstay of the Paleo Diet is lean animal food. For your information, and to assist you in obtaining Paleo Diet-friendly food, we have provided the following list of suppliers reproduced and updated from The Paleo Diet. This includes suppliers of free-range and natural meats, game meats, and omega-3 enriched eggs.

Dr. Cordain Comments on New Evidence of Early Human Grain Consumption

2009-12-26T13:55:00.000-07:00

Dear Readers,

Dr. Cordain was recently asked by a reporter from the journal Nature to comment on an article entitled "Mozambican Grass Seed Consumption During the Middle Stone Age" by Julio Mercader in the journal Science, citing evidence that humans consumed grain much earlier than was previously thought. In addition, one of our readers asked Dr. Cordain to comment on an article in Scientific American entitled "Humans feasting on grains for at least 100,000 years," by Katherine Harmon.

Dear Dr. Cordain,

I am a huge fan of your books and have been eating a paleo diet for years. I've had your graph of the land/water meat/fish, and fruit, nut, seed % breakdown taped to my fridge for years, although I'm so familiar with it that i no longer need to look at it for reference.

The Paleo Diet is predicated upon the fact that humans did not have grain cultivation and consumption until 5,000-8,000 years ago, which coincides with the advent of 'modern' civilization diseases. Up until now, this hypothesis have not been challenged as the archival evidence of grain agriculture matches it.

However, the current issue of Scientific American has an article stating archaeological evidence that humans were eating lots of grains 100,000 years ago.

http://www.scientificamerican.com/blog/post.cfm?id=humans-feasting-on-grains-for-at-le-2009-12-17

I am most curious about your opinion about this and how it effects the paleo dietary theory.

Thanks!

Dr. Cordain's response:

This is an interesting paper ( Mercader J. Mozambican grass seed consumption during the middle stone age. Science 2009;326:1680-83) as it may push probable (but clearly not definite) cereal grain consumption by hominins back to at least 105,000 years ago. Prior to this evidence, the earliest exploitation of wild cereal grains was reported by Piperno and colleagues at Ohalo II in Israel and dating to ~23,500 years ago (Nature 2004;430:670-73). As opposed to the Ohalo II data in which a large saddle stone was discovered with obvious repetitive grinding marks and embedded starch granules attributed to a variety of grains and seeds that were concurrently present with the artifact , the data from Ngalue is less convincing for the use of cereal grains as seasonal food. No associated intact grass seeds have been discovered in the cave at Ngalue, nor were anvil stones with repetitive grinding marks found. Hence, at best, the data suggests sporadic use (and not necessarily consumption) of grains at this early date. Clearly, large scale processing of sorghum for consumption for extended periods seems unlikely.

Further, It should be pointed out that consumption of wild grass seeds of any kind requires extensive technology and processing to yield a digestible and edible food that likely did not exist 105,000 years ago. Harvesting of wild grass seeds without some kind of technology (e.g. sickles and scythes [not present at this time]) is tedious and difficult at best. Additionally, containers of some sort (baskets [not present at this time], pottery [not present] or animal skin containers are needed to collect the tiny grains. Many grain species require flailing to separate the seed from the chaff and then further winnowing ([baskets not present]), or animal skins] to separate the seeds from the chaff. Intact grains are not digestible by humans unless they are first ground into a flour (which breaks down the cell walls), and then cooked (typically in water – e.g. boiling [technology not present]) or parched in a fire which gelatinizes the starch granules, and thereby makes them available for digestion and absorption. Because each and every one of these processing steps requires additional energy on the part of the gatherer, most contemporary hunter gatherers did not exploit grains except as starvation foods because they yielded such little energy relative to the energy obtained (optimal foraging theory).

If indeed the grinder/core axes with telltale starch granules were used to make flour from sorghum seeds, then the flour still had to be cooked to gelatinize the starch granules to make it digestible. In Neolithic peoples, grass seed flour most typically is mixed with water to make a paste (dough) that is then cooked into flat breads. It is highly unlikely that the technology or the behavioral sophistication existed 105,000 years ago to make flat breads. Whole grains can be parched intact in fires, but this process is less effective than making flour into a paste and cooking it to gelatinize the starch granules. Hence, it is difficult to reconcile the chain of events proposed by the authors (appearance of sorghum starch granules on cobbles or grinders = pounding or grinding of sorghum grains = consumption of sorghum). I wouldn’t hang my hat on this evidence indicating grains were necessarily consumed by hominins at this early date. To my mind, the Ohalo II data still represents the best earliest evidence for grain consumption by hominins.

Cordially,
Loren Cordain, Ph.D., Professor

New Products in Web Store!

2009-12-26T13:50:00.000-07:00

Dear Readers,

We're pleased to announce that Dr. Cordain's DVDs Acne Vulgaris: A Disease of Western Civilization and How to Treat Multiple Sclerosis with Diet are now available for purchase as stand-alone products for $19.95. Please visit our web store for more information.

In addition, we are now selling copies of Dr. Cordain's previously unpublished papers on Paleo Diet-related topics. The first paper to be offered is Nutritional Differences between Grass and Grain Fed Beef: Health Implication. The paper is available for $19.95. Please visit our web store for more information.

Christmas Dinner

2009-12-24T10:10:00.000-07:00

Hello,

I am fairly new to the Paleo diet. I want to stick with it through Christmas. Any suggestions?

Thank you,
Randi

Dear Randi,

If you've read The Paleo Diet book there are more than 100 recipes in the book and on our web site (http://www.thepaleodiet.com/nutritional_tools/recipes.shtml). However, you can skip several meals if you wish, maybe the ones where you’ll find more problems to change due to social issues. We believe that doing The Paleo Diet 85% is still a healthy diet.

I hope this helps.
Maelán

Grass-Fed vs. Grain-Fed Beef

2009-12-24T10:00:00.001-07:00

Dr. Cordain,

I attended a lecture you gave at CrossfitRoots in Boulder and have also read your book The Paleo Diet.

My wife and I have been trying to purchase a quarter cow and have been researching farms in the area. I know '100% Grass Fed' is better, but they are not as easy to find so I have a few questions:

1. Do you have any recommended resources for 100% Grass Fed beef in Colorado?

2. Have you done any studies on the fat profile difference between 100% grass fed beef and Grass Fed Beef that is Corn Finished? I'm curious on whether its 20% worse, 50% worse, etc.. It must be better than most grocery store beef, but if its not that much better, then I'll continue trying to find a 100% grass fed cow.

3. I know you are updating your books, but it would be great if the sources of natural 'paleo' food you have listed were on your web-site and more up to date. I think it could drive a lot of business to vetted paleo approved providers. It would certainly make it easier for us to find them.

Thanks for your time,
Scott

Hi Scott,

My friend Jo Robinson operates this website: http://www.eatwild.com/ which lists grass fed beef producers, not only in Colorado, but also all over the U.S. I have written an extensive paper contrasting grass vs. grain produced beef and their potential effects upon human health and well being. This previously unpublished paper has recently been made available for $19.95 as a PDF file at our website. The paper is 39 pages long contains over 7,700 words, 92 references, 7 tables and 10 figures. My manuscript represents the single most comprehensive review to date comparing the potential health effects of grass and grain produced beef. We plan to update all of our recommended sources for Paleo "friendly" food and include them in a new page at our website.

Cordially,
Loren Cordain, Ph.D., Professor

Paleo Diet Q & A - 23 December 2009

2009-12-23T16:25:00.000-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: I like drinking protein shakes in the morning, but I noticed some of the protein sources in my protein is made from milk or dairy products. Is there an alternative that is available in the market place?

Thanks,
John-Michael

A: Dear John-Michael,

Yes, egg white protein powder is a better option than whey protein. Whey is a good source of casein and IGF-1, two insulinogenic (they increase pancreas insulin release) peptides that may lead to hyperinsulinemia which is at the root of many chronic degenerative diseases as shown in Dr. Cordain's scientific paper: "Hyperinsulinemic diseases: more than just syndrome X"
http://www.thepaleodiet.com/articles/Hyperinsulinemic%20Diseases%20Final.pdf.
However, if you suffer from an autoimmune disease you may want to reduce egg whites until your symptoms improve. Lean meats and fish are good sources of proteins and particularly of branched chain amino acids which increase muscle growth.

I hope this helps.
Maelán

Q: I'm a male senior citizen (aged 60+) who is on the Paleo Diet and experiencing unwanted weight loss. What can you suggest to curb my unwanted weight loss?

A: Start a weight Training Program (3 times a week is enough) and pay attention to the post workout period:

After high intensity exercise there is a window of opportunity (that peaks in the first 30 minutes) where it appears that increasing blood levels of insulin, along with amino acids, is beneficial. This facilitates recovery and increases protein synthesis without (theoretically) inducing insulin resistance.

I would use a post-workout shake, composed of water, and liquid essential amino acids, along with net base yielding high glycemic carbohydrates (such as Bananas or grape juice). This has been shown to increase protein synthesis.

The ingestion of an amino acids/high glycemic carbohydrate drink may trigger a very high insulin release that could be followed by Hypoglycemia, which would lead to loss of muscle mass. Moreover, depending on training intensity and duration, it appears that the presence of amino acids (especially leucine) and carbohydrates stimulates protein synthesis for up to 3 hours after a workout (although its peak is reached in the first 30 minutes after training), so it could be useful to eat a solid meal 30 to 60 minutes after the post workout shake, composed of lean meat or fish or egg whites (good source of leucine), and a net base yielding carbohydrate, such as cassava and sweet potatoes. And if this isn’t enough, a second meal (identical to the first one, but with a lower glycemic load) within a 3 hour time frame could be a good idea (lean meat or fish or egg whites and a net base yielding carbohydrate with a lower glycemic load, such as yams).

I hope this helps.

Cordially,
Pedro

Testimonial: Cholesterol, Weight Management

2009-12-21T09:30:00.000-07:00

After 6 months on the Paleo Diet, I'm teary eyed (and that doesn't happen often for an old Marine), I'm so thankful.

My cholesterol was at 250. Being a life-long fitness nut, everyone assumed my high cholesterol had to be genetic. After going on medication, it went down to 213, but I experienced joint pain as a side effect, so I stopped taking it. I went on the Paleo Diet and, with no medication, my cholesterol was at 184 after 3 months. Amazing!

Second, I've cut my inflammation medication regimen from daily doses to once every 3 days, and hope to eliminate that medication also.

Third, I lost the tire around my mid-section that I never had until my mid-40's, and I have more energy in the gym.

Finally, my wife lost 18 lbs and is actually a couple pounds below her college weight. She looks great!

We just rave to everyone about this diet. It will be a life-long change for us.

I can't thank you enough! God bless!

Mark
Wake Forest, NC

Paleo Diet Q & A - 17 December 2009

2009-12-17T11:35:00.001-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A.

Q: I can’t seem to find a scientific answer with research to support why you do not recommend saturated fat and dairy in the diet. Can you please explain the mechanism by which saturated fat clogs arteries? And can you explain why you do not recommend dairy with biochemical explanations?

A: Saturated fatty acid intake and the risk of developing cardiovascular disease (CVD) is a topic with a lot of controversy. In recent years a wide body of research has suggested that increased consumption of certain saturated fatty acids (Lauric acid, myristic acid and palmitic acid) down-regulate LDL receptor and thereby increase LDL plasma levels, which has been associated to increased risk of CVD. On the other hand, stearic acid (a 18 carbon saturated fatty acid) has been shown to decrease LDL plasma levels. However, this view is too simplistic as there are several other factors contributing to CVD, such as smoking, exercise, trans-fatty acids, increased omega-6/omega-3 ratio, free-radicals, nutrient deficiency, homocysteine, alcohol intake and low-grade chronic inflammation among others.

Moreover, some studies have suggested that there’s not enough scientific data to support the view that increased total or LDL cholesterol is an independent risk factor for CVD, but rather oxidized LDL. Plaque production is mediated by oxidized LDL, not LDL. Oxidized LDL can produce shedding of the inner layer of the artery namely glycocalix. Oxidized LDL then infiltrates the intima of the artery. Oxidized LDL is eaten by macrophages, a process known as phagocytosis, causing macrophages to be transformed into foam cells which produce the fibrous cap.

Once the fibrous cap has been produced we need to break it down in order to produce an ischemic event. Lectins and low-grade chronic inflammation are involved in the activation of matrix metalloproteinases which break down the fibrous cap.

In summary, high total cholesterol or LDL levels do not increase CVD risk--rather oxidized LDL increases risk of CVD. To produce oxidized LDL requires the factors mentioned above. Hence, consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned.

Dr. Cordain wrote a book chapter and published a paper (with our team member Pedro Bastos) where he shows that saturated fat consumption in ancient hunter-gatherer populations were usually 10-15% above the recommended 10% of energy from saturated fats, yet they were non-atherogenic.

The bottom line is that we do not recommend cutting down saturated fatty acid intake, but decreasing high-glycemic load foods, vegetable oils, refined sugars, grains, legumes and dairy.

Regarding why we do not recommend dairy products: please refer to the following papers (12 MB zip file) supporting this recommendation.

Other recommended reading is Dr. Cordain and Pedro Bastos' last paper entitled "Dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global and modern perspectives."

Q: I have read your book and gotten on your blog just today. What I would love help with is any information on rheumatoid arthritis which I could email on to a 70 year old female friend who is suffering terribly. I couldn't find a specific article I could forward on to her.

Thanks for any help you can give,
Deanna

A: Deanna,

Please refer to Dr. Cordain's article on rheumatoid arthritis entitled "Modulation of immune function by dietary lectins in rheumatoid arthritis."

Testimonial: Breast Cancer Survivor

2009-12-17T11:30:00.000-07:00

Dear Readers,

Here's a testimonial from a member of the Paleo Diet community regarding her use of the Paleo Diet to beat breast cancer. Her story was originally published in the November 1, 2005 edition of our newsletter. We recently began reissuing archived editions of the newsletter, and Debbie contacted us and graciously provided an update.

Debbie's Story

Dear Dr. Cordain,

I am a breast cancer survivor. I was first diagnosed with breast cancer on May 25, 2001: T1, Node Negative, Her2 positive and nuclear grade 3. I had a lumpectomy, aggressive chemotherapy and radiation. On March 26, 2004 my breast cancer returned to my L-1 disk in my spine. I had 6 months of weekly chemotherapy and radiation. By December 15, 2004 I was declared in remission.

Herceptin was part of the chemo protocol that I had received in 2004 and have been receiving it every three weeks since the beginning of January 2005. Tumor marker tests are also conducted every other month. Unfortunately, my tumor markers started rising and by the end of May tests the upward trend was disturbing.

I share this news with my pharmacist who is also a certified nutritionist on May 28th. He recommended that I immediately eliminate sugar and grains from my diet. I found your book, The Paleo Diet, and started to eliminate sugar, grains and dairy from my diet that day.

The results have been astonishing to say the least. On May 24, 2005 my CA 27 29 marker was 43 and as of October 24, 2005 is 24. My CA 15 3 marker was 28.6 on May 24, 2005 and is now 22.9. I am 100% convinced that it is a result of being a very compliant follower of the Paleo Diet. Cancer likes sugar. Sugar is not my friend and is an enemy to my health.

I am very thankful to a very astute and pharmacist/certified nutritionist who is on top of the current diets and the effects on one's health. We are what we eat. I do not miss any of the sweets that I craved so and love the fact that I have finally lost the 25 chemo/radiation weight that I could not lose no matter how much exercise or dieting I did since 2002. Fresh fruits, fresh vegetables and lean meats and fish are the mainstay of my current good health.

I continue to emphasize to my incredible team of physicians at Duke that the wonderful lower tumor marker results are a result of my new diet. Thank you for your book and I will continue to spread the message to my support group and other women I meet who have breast cancer. Mind, body and soul-keeping each healthy is essential to survive this terrible disease. The diet recommended to me on May 28, 2005 empowered me to continue doing everything possible to win this battle.

Sincerely,
Debbie

Update on Debbie

Dear Dr. Cordain,

My pharmacist emailed me your latest newsletter update and there was my story. Now to add to the story: I will be celebrating my fifth year of being in remission on December 15th—for the second time. I have continued The Paleo Diet and weigh my 2001 pre-cancer weight of 155. I am 5’10” and feel this is my ideal weight. My husband is also on the diet, since he eats what I eat.

I also started working for this pharmacist, Bob Barbrey, in April 2009. His pharmacy, Medicap Pharmacy is just a pharmacy that encourages good diet, nutrition, exercise and sleep as part of the complete picture of being proactive about one’s health. Prescribed drugs are a part of the process, but many of our customers are stepping up to owning their health and want to make changes to ensure they are in control of it. The Paleo Diet guidelines are shared as encouragement to pursue that ideal state of health and weight.

I continue to have excellent tumor markers and I have continue to share my story with my doctors and friends and anyone who cares to listen. I was at a party last Saturday with my husband and saw friends we have not seen in years. Everyone could not believe how healthy I looked and how fabulous I looked! They all were so happy I was still in remission. As a cancer survivor, we can be healthy and look fabulous! It was with great joy I donated my size 16 and 18 clothing to Goodwill as I now wear size 10’s and 12’s. I have lost a total of 45 pounds since May 28, 2005. I have reached my ideal weight naturally through this diet and that is 155.

I am very thankful to Bob Barbrey and his excellent advice on May 28, 2005!

Sincerely,
Debbie

Paleo Diet Q & A - 16 December 2009

2009-12-16T16:15:00.000-07:00

Dear Readers,

Today's edition of Paleo Diet Q & A:

Q: Is almond milk an acceptable drink for the paleo diet?

A: Yes, almond milk is a Paleo friendly food. You can also use hazelnut and coconut milk.

Q: Dear Loren Cordain/Paleo Diet Team,

I can't thank you enough for your research. I have been living the Paleo Diet for nearly a year now, and it has completely transformed my life. I had been suffering from Sjogrens syndrome for years, but after starting this diet my symptoms disappeared almost instantly! I will never eat any other way again.

I also have a question. A friend of mine is suffering from ichthyosis. It is a rare disease where skin dries out. It has a genetic cause. Can the Paleo Diet bring relief to people with these type of diseases as well?

A: Ichthyosis Vulgaris has a genetic background. However, our colleague Pedro provided us some information regarding this rare disease. There's some scant evidence that a gluten-free diet might alleviate symptoms of Ichthyosis, and there appears to be an association with coeliac disease (a gluten-triggered disease).

Folic acid and vitamin D supplementation seems to improve this condition.

There's a case report of a patient suffering from ichthyosis whose symptoms improved within 6 months of treatment.

Please keep us posted.

Q: In your book, you said not to consume fermented foods. However, in the new Paleo Diet blog (which is great, by the way), I've seen probiotics recommended a couple times.

So I'm wondering ... did Paleolithic man consume fermented foods?

A: Yogurt, leavened bread, alcohol, pickled foods and other fermented foods clearly require technology to produce and consume. However, pre-agricultural humans ate plenty of fruits and vegetables (good sources of soluble fiber), which encourage growth of gram positive gut bacteria. For most people, after years on a low-fiber high-glycemic load diet, probiotics have been demonstrated to have many therapeutic effects, perhaps because they restore the gut flora that likely would have been present had they been consuming large quantities of fresh fruits and vegetables throughout their life.

Paleo Diet Q & A - 15 December 2009

2009-12-15T09:15:00.000-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: I was reading around on a few different websites and I found some things that you can have in "moderation". What exactly does this mean? For example it says you can have one 8 oz. glass of wine or one 12 oz. beer, but use in moderation. Does this mean once a day?

A: Fermented foods are not part of The Paleo Diet. However, a little amount of red wine shouldn't be an issue, lets say a glass of wine at lunch. Red wine has a lot of antioxidants that could overcome the negative effects of alcohol. Red wine may also improve insulin sensitivity. On the other hand, beer is not so good as demonstrated in a study conducted in the Czech Republic where the author showed considerable amounts of gluten in beer.

Q: Losing weight the Paleo way while on the pill - is it still possible?

I've combed through The Paleo Diet book several times on how it could be possible I'm not losing weight or at least I'm losing and gaining the same several pounds over and over again for several months now. The only thing I can think of that is stopping me is the pill - have you heard of any other cases similar to this?

I know the diet works, because my boyfriend--who started this lifestyle change 5months ago due to his sleep apnea--has lost 25lbs! He not only looks better, and feels better, but most importantly he no longer has sleep apnea. He no longer uses his very expensive CPAP machine. And he did it all on Paleo--no exercise. I on the other hand, have been exercising like a mad women, and I have lost 0 lbs. I cannot figure out what I am doing wrong. If you have any ideas or suggestions, I would love to hear about it.

A: The pill induces insulin resistance, which makes your pancreas produce high amounts of insulin, namely hyperinsulinemia. Hyperinsulinemia stops fat beta-oxidation, which means you're not burning fats. Maybe if you stop the pill you'll start to loose weight.

On the other hand, you should pay attention to fruits with high amounts of fructose and totals sugars. We suggest reducing consumption of those kinds of fruits until you normalize your body weight. More info: http://www.thepaleodiet.com/nutritional_tools/fruits_table.html

Also, you have to be careful with the amount of calories you eat. Nuts, avocado, olive oil are calorie-dense foods that you should use in moderation.

Another way to optimize your exercise is to avoid eating one and a half hours after exercise. This will make your body crave storage energy. Your muscles and liver must replenish their "tanks" from storage fats.

Dr. Cordain Quoted in December Issue of Science

2009-12-14T14:10:00.002-07:00

Dr. Cordain attended and addressed the conference Evolution and Diseases of Modern Environments, at Charité University Medicine Berlin, Humboldt University, 12–14 October 2009. He's quoted in the latest issue of the magazine Science, 11 December 2009, www.sciencemag.org, in the article "What’s for Dinner? Researchers Seek Our Ancestors’ Answers."

Experimental Autoimmune Encephalomyelitis (EAE)

2009-12-14T14:00:00.001-07:00

Dear Readers,

This post is a discussion on Experimental Autoimmune Encephalomyelitis (EAE) between Dr. Betty Wedman, a Licensed Nutritionist & Environmental Health Specialist. In his response, Dr. Cordain refers to the paper "A model of experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mice for the characterisation of intervention therapies," which is available for download from our web site.

Dr. Cordain,

As a nutrition instructor at 2 Tampa Bay universities, I include the Paleo Diet in my lesson plans frequently and even considering a Nutrition & Anthropology class option. I would like to have more information about the EAE disease study you mentioned at the American Nutraceutical Association Conference 2009.

Thank you.
Betty Wedman

Hi Betty,

Many thanks for your support of my work. I'm sorry that we didn't get to speak to one another directly at the conference. I'm not completely clear on which study I may have mentioned, but I believe it is a study in which EAE (the animal model of MS) was elicited via vaccination with MOG (myelin oligodendrocyte glycoprotein; a known autoantigen in MS) and Quil A as the adjuvant. Quil A is derived from Quillaja, a saponin derived from the bark of a S. American tree and which is a commonly used additive in root beer and soft drinks to make them foam. My point was that the concentration of Quil A used in the mouse study can be achieved via consumption of root beer and that resident E. Coli contain an epitope similar in structure to MOG. Hence it may be possible to elicit autoimmune diseases via unintentionally mucosal vaccination via certain dietary adjuvants (saponins) in naturally occurring foods along with mimicking epitopes derived from resident gut flora. Attached is the EAE paper.

Cordially,
Loren Cordain, Ph.D., Professor

Paleo Diet Q & A - 8 December 2009

2009-12-08T08:15:00.001-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A. Thank you for your contributions!

Q: I just listened to an interview of Cordain. He mentions that Huntington Chorea seems to be an autoimmune disease. I have Huntington Chorea in my family. So obviosly I'd like to know more about your or his findings. Could you please explain if there is any study showing this and what foods one should eliminate from the diet? I'd be so grateful.

Thanks,
Tim

A: Hi Tim,

Huntington's Chorea or Huntington's Disease (HD) results from lesions (alpha synuclein crosslinks) occurring in the brain which cause the characteristic symptoms (tremors and paralysis) of HD. It is well documented that a genetic basis underlies the development of HD. HD patients inherit a specific gene which causes increased expression of a protein called mutant huntingtin protein (mHTT). Whereas people without HD have inherited a gene which expresses the normal version of this protein, simply called, huntingtin protein (HTT). The over expression of mHTT at the expense of HTT is thought to cause the brain lesions of HD.

So, can diet have anything to do with whether or not a person with the mHTT genetic makeup goes on to develop the disease? Yes, and let me explain the underlying rationale. The imbalance in the mHTT to HTT ratio that occurs in HD patients requires the inheritance of the mHTT gene, however the gene cannot make its product without the presence of an enzyme called transglutaminase (TG). Transglutaminase is a post-translational enzyme (meaning that it is required to produce the gene product after the gene has been translated within a cell's nucleus). TG is a ubiquitous post translational enzyme that is found throughout the body's tissues, particularly in the gut, nervous tissue and brain. Without the presence of adequate concentrations of TG in the brain, mHTT cannot be produced in sufficient quantity to imbalance the mHtt to HHT ratio that results in HD.

So the $64,000 question in HD: what is the environmental trigger that causes over expression of TG in the brain? Plain and simple, it is wheat. More specifically, a storage protein in wheat called Gliadin. Unlike other dietary proteins, Gliadin is an unusual protein because it is resistant to the enzymes in the human gut (proteases) which normally degrade proteins into their constituent amino acids. Consequently, Gliadin arrives in the small intestine intact where it has recently been shown to bind a gut receptor (the CRX2 chemokine receptor). When Gliadin from wheat binds CRX2 it causes the intestinal cells to release a recently discovered enzyme known as zonulin. Zonulin release by gut cells causes the gut to become "leaky" and allow passage of intact proteins across the gut barrier -- including Gliadin itself.

Once Gliadin bypasses the gut barrier, it is immediately catalyzed by transglutaminase (TG) which is expressed by local intestinal cells. When you eat wheat on a daily basis, there is so much dietary Gliadin bypassing the gut barrier that it overwhelms the ability of the intestinal cells to produce the enzyme (TG) to catalyze the substrate (Gliadin). Intestinal cells as well as all other cells in the body react to this overload of circulating Gliadin by up-regulating (increasing) TG production.

The proof of the pudding lies in the experimental evidence. Unfortunately no randomized controlled trials of Gliadin free diets in HD patients have been examined to date. Having said this, I am aware of a single HD patient in S. California who was a member of a local CrossFit Gym, and who had been diagnosed with HD by a group of University neurologists employing MRI technology to detect the characteristic brain lesions. After approximately 8 months following adoption of a Paleo Diet (Gliadin free), this patient experienced a dramatic reduction in disease symptoms and subsequent MRI evaluation indicated a reduction in lesion volume. In addition to HD, numerous ataxia patients respond favorably to Gliadin free diets.

Cordially,

Loren Cordain, Ph.D., Professor

Q: In response to the idea that high glycemic foods can cause insulin resistance, what would be your response to people like Dr. John McDougall that claim there are plenty or cultures in Asia who live on diets consisting of high glycemic foods such as potatoes and rice but have little to no rates of diabetes or other chronic illnesses?

Here's a link to his article http://www.drmcdougall.com/misc/2006nl/july/glycemic.htm.

Thanks,

James

A: Hi James.

I believe (and we have evidence backing that up - see links below) that not all people will develop insulin resistance on a high glycemic load diet and not all people will see the same improve their body composition and/or insulin sensitivity on a low glycemic load diet. It appears to be dependant on your genotype (links to a few papers below). We have some examples of that: for instance, the aborigines don’t tolerate a high carb diet very well and the Kitava do better. But don’t forget that low glycemic load doesn’t automatically mean very low carb and high carb or normal carb doesn’t necessarily mean high glycemic load, as the glycemic load depends on the amount of carbs on a given serving of a certain food and the Glycemic Index of that food, so saying that the Asians eat a high glycemic load diet may not necessarily be true.

Another possibility that some people will develop insulin resistance on a high glycemic load diet (and some will not) is that a deprived fetal environment (which normally, but not always, leads to an underweight baby) may lead to a specific metabolic programming that has been called the trify phenotype, which means that these babies will develop various diseases of civilization when exposed to the postnatal environment (western diet and sedentary lifestyle) that is characteristic for affluent societies and of rapidly developing countries.

What I mean here is that depending on your genotype and/or epigenotype you may or may be not react adversely to a high carb diet. Moreover, there are also various variables that need to be considered when we want to know why certain populations suffer more from the diseases of insulin resistance, such as (among many other variables):

Exercise (it has a huge impact on insulin sensitivity and sarcopenia, a typical consequence of inactivity), leads to insulin resistance and an increased risk of the metabolic syndrome).
Vitamin D and/or ultraviolet exposure (for instance, in Kitava they don’t suffer from Vitamin D deficiency, whereas in the western world many of us do and there is evidence linking Vit D deficiency to an increased risk of Type 2 Diabetes and the Metabolic Syndrome, among various other diseases).
Magnesium deficiency is strongly associated to an increased risk of the Metabolic Syndrome and Cardiovascular diseases. Presumably this wasn’t a problem for our ancestrors and to many non-westernized populations, but it is a huge problem in the US.
Fructose intake – although our ancestors and many non-westernized populations around the world eat fruit, which is a source of fructose, fruit also has Vitamin C (which counteracts some of the adverse effects of fructose) and they don’t eat as much fructose as the Americans do, because HFCS has been added to many foods and because of the American eating habits (I’m Portuguese and I always get amazed when I go to the US and see what the people eat and the amount of sodas they drink and the amount of obese people I se there). In Dr. Cordain’s papers and in his lectures (I attended several) he mentions fructose as a cause of elevated uric acid and insulin resistance. And we have a spreadsheet with the fructose content of various foods for those who need to cut back on fructose intake (those who are already insulin resistant or have elevated blood uric acid levels and/or have been eating a very high fructose diet, which upregulates certain enzymes that need to be downregulated in order to reverse the effects of this high fructose intake and the only way to do it is by eating a very low fructose diet for a few weeks, before resuming a normal fructose diet (whose main sources are mainly fruit).
Bioactive peptides and antinutrients in Neolithic foods (see Dr. Cordain’s scientific paper on cereal grains here and Dr. Staffan Lindeberg’s research team paper on lectins and leptin resistance (link below).
Visceral fat – cytokines derived from visceral adipose tissue will cause insulin resistance.
Sleep deprivation – it may set off a hormonal cascade that may ultimately result in insulin resistance and Obesity.
Etc, etc…

We have to realize that many Americans have already the signs and symptoms of the Metabolic Syndrome and/or Type 2 Diabetes insulin resistance and many more have some degree of insulin resistance and for these people a low glycemic load diet may be very beneficial. But, as you may infer from our newsletters and from Dr. Cordain books and scientific papers, eating a low GL diet it is not enough and it is only a characteristic of the many general universal characteristics of pre-agricultural diets that Dr. Cordain and his research team have been deciphering over the past 15 to 20 years. AS so, if one wants to achieved optimal health, he shouldn’t focus only on one dietary characteristic, but on all of them plus the lifestyle that presumably shaped our genome during the Pliocene and Pleistocene (exercise, sun exposure or vitamin D supplementation + sleep + stress management + avoidance of environmental toxins).

All this sheds light on why some Asian populations live on a high carb diet, but do not develop the Metabolic Syndrome. Perhaps because they don’t overeat (remember that caloric restriction is the only proven way to increased longevity in many animal models and presumably one of the main reasons why you have so many centenarians in Okinawa), they don’t eat much fructose, they exercise, they don’t suffer from Vitamin D deficiency (and perhaps also magnesium deficiency), have “normal” sleeping patterns, etc, etc, etc.

Nevertheless, I would like to mention that apparently healthy people from India (living in India and eating their traditional vegetarian diet) have more visceral fat than healthy Caucasians and are more prone to Type 2 Diabetes and other diseases associated with the Metabolic Syndrome.

Finally, even in healthy people with no signs or genetic predisposition for insulin resistance, a high glycemic load diet may not be ideally, as it will increase glycolysis and it will decrease beta-oxidation (aging is associated with an increased glycolysis and decreased beta-oxidation and one of the mechanisms why caloric restriction increases longevity is believed to be a decrease in glycolysis and in increase in beta-oxidation). Moreover, it may increase inflammation (see link to paper) and, it may also cause several hormonal disturbances (elevated IGF-1 and androgens and decreased Sex Hormone Binding Globulin and IGFBP-3), which then increase our risk for various diseases, as you can see here, here and here.

I hope it helps

Pedro

Links to additional papers:

Paleo Diet Recipes from the Paleo Diet Community

2009-12-05T11:05:00.002-07:00

Dear Readers,

This recipe was emailed to us from a reader. If you have your own Paleo recipes you'd like to share with the Paleo Diet community please add a comment to this post.

Banana Pancake
Mash one whole banana. Add an egg, lightly beat together. For extra flavor, add coconut chips, vanilla extract (just a dash) and cinnamon.

Pour this mixture into a frying pan and cook as you would a regular pancake. This is one of my favorite things to eat! You can also do this with a grated apple. Enjoy! I now look forward to breakfast the Paleo way!

Cara

Paleo Diet Q & A - 5 December 2009

2009-12-05T11:00:00.000-07:00

Dear Readers,

Thank you for continuing to post your comments and questions. Here's today's edition of Paleo Diet Q & A.

Q: Dear Dr. Cordain,

I am a PhD student, and I am starting to study how our instinct should lead us to enjoy the foods best suited for us, as it seems it does for any known animal.

Some of the first things I have found are your works. The point I am trying to get at is that we should have in us this instinct. So just one question. Do you know about, or have you read works of any authors that have made research on this point?

Best regards and many thanks.
Alfis.

A: Hi Alfis,

Off the top of my head, I can't remember any specific papers on the topic. However, there are thousands of papers on taste & humans have a proclivity towards sweet, salty and fatty. Under stone age conditions in which these tastes were associated with foods that limited and difficult to procure these tastes led us to foods that conferred survival value. In the modern world in which we have completely dissociated energy expenditure from energy intake we can eat anything that our taste guides us to in virtually unlimited quantity. Hence our hard wired tastes which once conferred survival value in a Stone Age environment now represent a liability in our western world of food abundance.

Best wishes,
Loren Cordain, Ph.D., Professor

Q: I understand the Paleo Diet to be primarily a removal from the diet of all grains, dairy products, and man-processed sugars. But what about potatoes, corn, and legumes (all of which cannot be digested raw and are high in starch), and natural sugars like maple syrup and honey? Do they fit into the Paleo Diet?

I bought and read the book years ago, but cannot remember the exact teachings on these particular foods, and cannot find clear teachings about them on the website. Perhaps I am looking in the wrong place?

A: Potatoes are not part of The Paleo Diet because they contain some harmful substances, namely saponins (solanine and chaconine) which can't be degraded by digestion or cooking. They can contribute to an increase in intestinal permeability which is associated to many chronic diseases.

Regarding legumes, they are also sources of saponins as well as lectins. Lectins are also toxic substances for the intestinal barrier, and they can adversely stimulate the immune system.

Corn is a cereal grain which is also a source of lectins (see Dr. Cordain paper entitled "Cereal grains: Humanity's double edged sword" in our published research section).

Sugars were part of our Hunter-gatherers ancestors' diet but not year round. So, use them in moderation.

Radio Interview with Dr. Cordain - download the podcast!

2009-12-04T15:35:00.000-07:00

Dear Readers,

The podcast for the radio interview with Dr. Cordain conducted by Dr. Ron Hoffman at WOR Radio in New York on December 3, 2009 is now available on the WOR Radio web site - www.WOR710.com - their Podcasts on Demand Section. You may also download the podcast from our web site.

Paleo Diet Q & A - 2 December 2009

2009-12-02T16:30:00.002-07:00

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: I'm a beginner with the Paleo Diet. I want to try it out but I'm a vegetarian (I eat tofu, seitan, tempeh, fish, eggs, and cheese as replacements for meat). I understand I have to leave out the beans, but is it ok to use the rest of the replacements ? Thank you for an answer.

A: The Paleo Diet is based on foods similar to what our hunter-gatherer ancestors ate during the paleolithic era 2.6 million year to 10,000 years ago. That translates into 99.6 % of our evolution history. Our genome is perfectly adapted to eat foods similar to what we found during that period of time. This means eating lean meats, seafood, vegetables, fruits, and nuts. The agricultural revolution (10,000 years ago) lead to a dramatic change in human nutrition. Cereal grains, legumes, dairy, vegetable oils, salt, alcohol, and refined sugars comprise 72% of the nutrition in the modern western society. These foods contain harmful substances associated to many "diseases of civilization", such as diabetes, celiac disease and other autoimmune diseases, obesity, hypertension, certain cancers, acne, polycistic ovary syndrome, myopia, dyslipidemia, cardiovascular disease, etc.

Tofu and tempeh are sources of soy bean agglutinin (SBA). SBA has harmful properties because they break cell membranes. This can induce increased intestinal permeability, which is associated to certain autoimmune diseases and low-grade inflammation. SBA has also been shown to stimulate the immune system, something we don't want in an inflammatory disease.

Seitan contains the worst part of wheat namely gluten. Gluten is a prolamine peptide associated to many diseases typical of western civilization, such as celiac disease, type 1 diabetes, multiple sclerosis, ataxia, rheumatoid arthritis, etc.

So, if you want to eat a paleolithic diet without eating meat you should ensure a good protein intake using egg powder protein shakes along with some supplements:

Vitamin B12 1 mg per day
Taurine 1 gram per day
Carnosine 800 mg per day
Carnitine 400 mg per day

Q: Hi I'm about to have a child, and I don't want to bring it up on a diet of sugar and wheat. Do you have any research for children and the Paleo Diet?

A: No, there aren't any clinical trials for children and The Paleo Diet. However, the current advice for infant nutrition comes from nutritional boards who base their views on:

Western human diet observations.
Randomized controlled trials with single nutrients in a western setting.
Extrapolation of observation in western adults to infants.

This means these recommendations are not based on the evolutionary template, which dictates our metabolic and physiological needs.

For example, recommendations for formula milk composition are the opposite of what research on hunter-gatherer mothers' milk has found. Current recommendations for formula milk state that Linoleic acid content should be high, and saturated fats such as Lauric and Myristic acid should be low. This is the contrary to what we find in mothers on the island of Chole in Tanzania who eat fish, vegetables, fruits and nuts, and turns out that these people are free of "diseases of civilization".

Paleo Diet Q & A - 1 December 2009

2009-12-01T16:40:00.001-07:00

Dear Readers,

Thank you again for your comments and new questions in response to our Q & A. Here's today's edition.

Q: I recognize that I feel much better on small amounts of lean meats with lots of veggies and some fruit, but I become very constipated. How can I correct this and stay on the Paleo Diet?

A: It is unusual to suffer from constipation when eating a lot of veggies, as they are the biggest fiber source. However, you can help your gut health with some supplements until the constipation improves:

Probiotics: between 6-9 billion bacteria/day during one month, then cut down to 4-5 billion.
Prebiotics: 4-6 grams a day during one month (if you do not improve with 4 grams increase up to 6 grams). Then cut down to 2 grams a day.
Coconut oil (a good source of Medium Chain Fatty Acids): a tablespoon per day.

Also, we suggest drinking 1.5 liters of water per day.

Q: I have just had the pleasure of stumbling onto your site and find it very interesting. I would be curious to know of your response to the "thumbs down" your book received by the Weston Price organization. I have found their endorsement of raw milk to also be very logical, but they were none too kind in their review. I look forward to your response, or a link to where you might have already addressed this. Thank You.

A: Here's a reply by Dr. Cordain to this question posted in the FAQ section in our website: http://www.thepaleodiet.com/faqs/#Misc

Q: I'm new to the concept of paleolithic diet, although that is what I have been eating due to some digestive issues. My favorite is just some type of meat and veggie soup. However, I'm not sure what to eat in the morning. I read that brown rice cereal is okay (which I have with hemp milk), and an apple. Is brown rice okay even though it is a grain (or so I thought anyway)? Thank you.

A: No, brown rice is not a Paleo-friendly food, as it is a grain. All grains contain substances such as lectins, alkylresorcinols, protease inhibitors and alpha-amylase inhibitors, which are lend themselves to some health problems. However, brown rice is devoid of gluten which is associated with many diseases.