Monthly Archives: November 2011

Avoid Drug Toxicity By Eschewing Drugs

David Mendosa over at Diabetes Developments writes about avoiding diabetes drug toxicity with low-carb eating.  Amen, brother.

Steve Parker, M.D.

Natural Selection

Paleo diets (aka Stone Age, Paleolithic, or caveman diets) have been increasingly popular over the last few years.  The idea is that, for optimal health, we should be eating the things that we are evolutionarily adapted to eat.  Those foods pre-date the onset of large-scale agriculture 10-12,000 years ago.  So grains, dairy products, and industial seed oils play little or no role in someone who has “gone paleo.”

My recollection from college courses years ago is that average lifespan in paleolithic times was perhaps 25-30 years, or less.  If you’re going to die at 25, it may not matter if you eat a lot of  wooly mammath, berries, insects, cholesterol, saturated fats, Doritos, Ding Dongs, or Cheetos.  The diseases of civilization we worry about today—coronary heart disease, high blood pressure, cancer, dementia, type 2 diabetes, etc.—don’t usually appear until after age 30.  Paleolithic Man worried more about starvation, infection, and predation.

More recently, I’ve read that average lifespans of Paleolithic man were so low due to high infant and childhood mortality.  If you survived early childhood, you had a much better chance to hit 50 or better.

But now we live to be 80, long enough for diet-related diseases to appear. We have cancer, heart attacks, and strokes that paleo man rarely saw because he died of trauma or infection or starvation. We even see the expression of genes that were not subjected to survival or selection pressure: Alzheimers disease, Huntingtons chorea, and some breast cancers, for example.  People with genes for these diseases reproduce before the genes do their damage.

In other words, we carry genes that don’t matter if you die at age 30. If you live longer, they express themselves, and I believe we can modify their expression through diet and lifestyle. 

Jenny Ruhl, at her Diabetes Update blog, takes a critical look at the paleo diet concept.  I’m not saying I agree or disagree with her.  Newbies should look at all sides.  

Steve Parker, M.D. 

Extra credit

For purposes of discussion, let’s assume that human evolution actually occurred over millions, or at least hundreds of thousands, of years.  In other words, assume that God didn’t make Adam and Eve in human form in one day.

The theory of evolution proposes that genes that allow an animal to live and reproduce more vigorously in a particular environment will be passed on to the animal’s offspringNature will select those genes to spread through the animal population over time, assuming the environment doesn’t change.  The offspring with those genes will be able to compete with other animals more successfully for food, shelter, and mates.  Factors that promote the persistence and inheritance of specific genes are called “selection pressure.”

Here’s an example of selection pressure.  Remember when you were in grade school on the playground, some people could naturally run faster than others?  Were you one of the fast ones?  If you’ve never seen it for yourself, take my word for it: Some people are naturally gifted with athletic genes.

Let’s say you and I are outside collecting berries and nuts in paleolithic times.  A saber-toothed tiger spots us and charges, hungry for a meal.  You don’t have to outrun the tiger: you just have to outrun me.  I’m slower than you, and get eaten.  I can no longer pass on my slow-running genes to the next generation.  You live another day and pass on your fast-running genes to your children. 

Viola!  Natural selection, via selection pressure, has promoted your genes over mine.

The tiger also passes on her genes since she was fast and smart enough to catch me, preventing starvation of her and her offspring.

[I’m 99% sure I wrote the preceeding few paragraphs originally a couple years ago.  My notes, however, hint that they may have been written by Dr. J., a regular contributor at CalorieLab.  Dr. J., let me know if I’ve plagiarized you and I’ll give you full credit and delete my writing.]

Self-Experimentation: Paleo Diet and Type 1 Diabetes

Feed the whole tribe with this baby!

 

 

Dave Wendel shares his experience treating type 1 diabetes with a paleo approach at Robb Wolf’s blog:

http://robbwolf.com/2011/10/17/type-1-diabetes-the-numbers-dont-lie/

Steve Parker, M.D.

Caveman Mark Trying Paleo Lifestyle for Type 1 Diabetes

Paleobetic is a new blog by a 30-year-old man, Mark, with type 1 diabetes.  At the start of November, 2011, he started the paleo lifestyle and diet, probably in the fashion of Robb Wolf.  He’s starting CrossFit, too.  It’s an open-ended N=1 experiment.

Since I’m in the U.S., I think of blood sugar in mg/dl rather than mmol/l.  Thankfully, Mark often includes his blood sugars in both values.  He’s on an insulin pump and does basal/bolus dosing of insulin.

You may want to follow Mark’s progress.

Steve Parker, M.D.

UCSF Investigating Paleolithic Diet for Diabetics

A May, 2010, press release from University of California San Francisco outlines the university’s research into use of the Paleolithic diet (aka Stone Age or caveman diet) for people with type 2 diabetes.  From the press release:

The initial research findings are striking. Without losing weight, participants in a preliminary study improved blood sugar control, blood pressure control and blood vessel elasticity. They lowered levels of blood fats such as cholesterol. And most amazingly, participants achieved these results in less than three weeks — simply by switching to a Paleolithic diet.

The lead researchers are nephrologist Lynda Frassetto and endocrinologist Umesh Masharani.  Frassetto and team had previously looked at metabolic improvements linked to the paleo diet.

We await publication of their current findings in a peer-reviewed scientific journal.

Steve Parker, M.D.

Paleo Diabetic Theory

In other words, is the paleo diet good for diabetics?

A few others have weighed in on this question in an organized fashion.  Steve Cooksey at Diabetes-Warrior.net immediately comes to mind.  Gary Rea, too (see Links at right).  Many others (hundreds or thousands?) with diabetes have been conducting paleo lifestyle experiments on themselves.

N=1 experiments (self-experimentation) are particularly helpful in the absence of randomized controlled clinical trials, the usual gold-standard study in medical science.  But N=1 experiments aren’t necessarily safe, especially for  a diabetic taking drugs that can cause hypoglycemia.

I’ve already figured out there’s not  much published scientific research on the application of paleo lifestyle choices as therapy for diabetes.  I plan to review the published literature over the coming year.  Coming up with some preliminary answers will also require some inductive reasoning and empiricism.

In thinking about the paleo lifestyle and diabetes, here are some of the issues and questions I need to address over the coming year:

Non-Diet Items 

  • exercise
  • rest
  • play
  • sun exposure
  • sleep
  • social interaction
  • diabetes prevention
  • effect on diabetic complications such as kidney disease, eye disease, nerve impairment, atherosclerosis (hardening of the arteries), heart disease, and stroke
  • spirituality (?)
  • individual genetic variation
  • safety
  • type 1 versus type 2 diabetes
  • drugs for diabetes

Diet-Related

  • what is the paleo diet
  • glycemic index
  • effect on blood sugar
  • diabetes prevention
  • effect of individual paleo diet components on diabetes
  • effect on diabetic complications such as kidney disease, eye disease, nerve impairment, atherosclerosis (hardening of the arteries), heart disease, stroke
  • type 1 versus type 2 diabetes

Imagine a diabetic asking his physician or dietitian, “What about the paleo diet? Can I try it?”  The typical professional is going to answer, “I don’t know.”  How many will have the time or interest to look into it?  Not many. 

Am I missing anything?  Do you know anybody else doing this in a public forum?

Steve Parker, M.D.

PS: A few diabetics don’t like to be called “diabetic.”  I mean no offense by the term.  It’s just typical medical short-hand for “people with diabetes” or “person with diabetes.”  Some blogs even use the acronym PWD.  Similarly, an asthmatic is a person with asthma, and an alcoholic is a person with alcholism.

Quote of the Day

The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases.

Edward Jenner (1749-1823), of smallpox vaccination fame

Masai men in Tanzania. Modern hunter-gatherers?