Laura Dolson over at About.com has a helpful list of low-carb veggies. Helpful if you experience excessive
blood sugar spikes from high-carb items, or if you’re restricting carbs for weight management.
-Steve
Laura Dolson over at About.com has a helpful list of low-carb veggies. Helpful if you experience excessive
blood sugar spikes from high-carb items, or if you’re restricting carbs for weight management.
-Steve
How long has man had fire? Biological anthropologist Richard Wrangham estimates hominins tamed fire and started cooking with it 1.8 million years ago. So I’m cooking my paleo foods if I wish.
As with my beloved Mediterranean diet, definitions of the paleo diet vary. The following guidelines are influenced by my review of blogs or websites by Loren Cordain, Julianne Taylor, Robb Wolf, and Kurt Harris. The first three are closely affiliated with each other, so expect lots of overlap. It’s simplest to define paleo by what’s not allowed.
What’s NOT Paleo?
Industrial vegetable oils (e.g., soybean, corn,safflower), legumes, dairy, refined sugars, grains, alcohol, and high salt consumption.
The focus is on minimally processed, in-season, locally available foods. Many favor pastured, grass-fed beef, free-range chickens, “organic,” and the like. I guess that’s fine if you can afford it; I choose to spend my money elsewhere.
Proteins
Meat, fish/seafood, eggs, poultry, and wild game. Most paleo proponents favor lean meats over fatty ones; it’s debatable. Undoubtedly, our domesticated feedlot animals are fattier than wild game, generally. Processed meats such as bacon would not be pure paleo, but many paleo advocates allow it.
Nuts and Seeds
Favor those with the best omega-6/omega-3 ratio (2 or 3:1), such as walnuts, almonds, macadamia, and cashews. Modern humans eat way more omega-6 fatty acids compared to ancient hunter-gatherers.
Fruits and Vegetables
It’s probably best to favor those with lower glycemic index. Examples are berries, melons, cauliflower, tomatoes, onions, and broccoli. Most modern fruits and veggies have been bred for large size and good looks. Ancient fruits and veggies were smaller and had much more fiber per serving.
Tubers, Roots, Bulbs
These are OK per Cordain, and I agree. Examples include potatoes, cassava, taro root, onions. Some paleo proponents exclude potatoes.
Oils
Cordain favors oils such as canola, flax, olive. Others mention avocado oil. Aim for a good omega-6/omega-3 ratio. Lard is probably OK although obviously processed.
Herbs and Spices
Many of our favorites should be OK. Wolf says balsamic vinegar is allowed, although processed, like all vinegars. Vinegar is “natural,” as you might have noticed if you ever walked through an apple orchard with rotting fruit on the ground; you can smell the vinegar.
Condiments
Undecided. Note that you can make mayonnaise from olive oil and egg yolk.
Miscellaneous
Olives? They’re processed, but I’m inclined to keep them in the mix. Coffee? Not paleo, but I ain’t givin’ it up. Consider limiting nuts to one ounce daily since most of them are high in omega-6 fatty acids. Fresh foods are more purely paleo than canned or frozen, but I’ll not exclude canned and frozen. Limit fruit? Probably: in most environments, they’re available only seasonally. Diet sodas? Clearly not paleo, but I enjoy one now and then and don’t see any drawbacks to low consumption.
Update October 8, 2012
I learned today that my version of paleo, by coincidence, is similar to the Hartwigs’s Whole30 plan. But they allow clarified butter or ghee, green beans, and snow peas. I include potatoes, but Whole30 doesn’t.
Much of the world has seen a significant decline in populaton-wide physical activity over the last few decades, according to Nike-sponsored research reported in Obesity Reviews.
Countries involved with the study are the U.S., U.K., Brazil, China, and India. How did they measure activity levels?
Using detailed historical data on time allocation, occupational distributions, energy expenditures data by activity, and time-varying measures of metabolic equivalents of task (MET) for activities when available, we measure historical and current MET by four major PA domains (occupation, home production, travel and active leisure) and sedentary time among adults (>18 years).
The authors note the work of Church, et al, who found decreased work-related activity in the U.S. over the last half of the 20th century.
Inexplicably, they don’t mention the work of Westerterp and colleagues who found no decrease in energy expenditure in North American and European populations since the 1980s.
My gut feeling is that advanced populations around the globe probably are burning fewer calories by physical activity over the last 50 years, if not longer, thanks to technologic advances. We in the U.S. are also eating more calories lately. Since the 1970s, average daily consumption by women is up by 150 calories, and up 300 by men. I’m surprised we’re not fatter than we are.
Comments Off on Are We Fat Because We’re Less Active?
Posted in Overweight
Tagged calorie consumption over time, causes of overweight and obesity, physical activity over time
“Frederick Douglass taught that literacy is the path from slavery to freedom. There are many kinds of slavery and many kinds of freedom, but reading is still the path.”
Comments Off on Quote of the Day
Posted in Quote of the Day, Uncategorized
Tagged Carl Sagan, Frederick Douglass, freedom, literacy, reading, slavery
Aggressive efforts to control blood sugar either prevent or delay clinical neuropathy in patients with type 1 diabetes, according to the Cochrane Collaboraton as reported in MedPage Today. Type 2 diabetics showed a strong trend in the same direction, but did not quite reach statistical significance (p=0.06, which is darn close to significant). Be aware, however, that tight control of diabetes is often at the cost of more frequent episodes of hypoglycemia.
Intensive blood sugar control is also a treatment for established neuropathy.
One in ten diabetics has neuropathy at the time of diagnosis. After 10 years, four or five of every 10 have it. The pain of neuropathy is worse than the numbness.
The medical community is still debating how aggressively blood sugars should be managed.
PS: I don’t know what the Cochrane reviewers consider “tight control” because the article is behind a paywall, and the MedPage Today article didn’t address that either.
Regain of lost body fat is the most problematic area in the field of weight management. Whoever solves this problem for good will win a Nobel Prize in Medicine. Why do most diets ultimately fail over the long run? Because people go back to their old habits. Here are the two secrets to prevention of weight regain:
“Successful losers” apply self-restraint on an almost daily basis, avoiding food they know will lead to weight regain. They limit how much they eat. They consciously choose not to return to their old eating habits, despite urges to the contrary.
The other glaring difference is that, compared to regainers, the successful losers are physically active. Oftentimes, they exercised while losing weight, and almost always continue to exercise in the maintenance phase of their program. This is true in at least eight out of 10 cases. It’s clear that regular exercise isn’t always needed, but it dramatically increases your chances of long-term success.
Here are more tips for prevention of weight regain.
Steve Parker, M.D.
Posted in Exercise, Weight Loss
Tagged prevent weight regain, weight loss maintenance, weight regain
It’s common on any weight-loss program to be cruising along losing weight as expected, then suddenly the weight loss stops although you’re still far from goal weight. This is the infamous and mysterious stall.
Once you know the reason for the stall the way to break it becomes obvious. The most common reasons are:
If you still can’t figure out what’s causing your stall, do a nutritional analysis of one weeks’ worth of eating, with a focus on total calories. You can do this analysis online at places like FitDay (http://fitday.com/) or Calorie Count (http://caloriecount.about.com/). You may be surprised to find out you’re eating a lot more calories than you thought. Assuming you indeed have excess fat to lose, you can break your stall by cutting your total daily calorie intake by 400–500. Try it for a week or two.
Posted in Weight Loss
Tagged Calorie Count, calories, FitDay, stopped losing weight, weight loss, weight loss stall
TV’s “The Biggest Loser” weight-loss program works great for overweight diabetics and prediabetics, according to an article May 30, 2012, in MedPage Today.
This isn’t directly related to the paleo diet or lifestyle, but I thought you might be interested.
Some quotes:
For example, one man with a hemoglobin A1c (HbA1c) of 9.1, a body mass index (BMI) of 51, and who needed six insulin injections a day as well as other multiple prescriptions was off all medication by week 3, said Robert Huizenga, MD, the medical advisor for the TV show.
In addition, the mean percentage of weight loss of the 35 contestants in the study was 3.7% at week 1, 14.3% at week 5, and 31.9% at week 24…
The exercise regimen for those appearing on “The Biggest Loser” comprised about 4 hours of daily exercise: 1 hour of intense resistance training, 1 hour of intense aerobics, and 2 hours of moderate aerobics.
Caloric intake was at least 70% of the estimated resting daily energy expenditure, Huizenga said.
At the end of the program, participants are told to exercise for 90 minutes a day for the rest of their lives. Huizenga said he is often told by those listening to him that a daily 90-minute exercise regimen is impossible because everyone has such busy lives.
“I have a job and I work out from 90 to 100 minutes per day,” he said. “It’s about setting priorities. Time is not the issue; priorities are the issue.”
Of the 35 participants in this study, 12 had prediabetes and six had diabetes. This is a small pilot study, then. I bet the results would be reproducible on a larger scale IF all conditions of the TV program are in place. Of course, that’s not very realistic. A chance to win $250,000 (USD) is strong motivation for lifestyle change.
PS: Although not mentioned in the article, these must have been type 2 diabetics, not type 1.
Posted in Diabetic Diet, Weight Loss
Tagged diabetes, prediabetes, Robert Huizenga, The Biggest Loser, type 2 diabetes, weight loss
I scored of copy of “A multidisciplinary reconstruction of Palaeolithic nutrition that holds promise for the prevention and treatment of diseases of civilisation” by RS Kuipers, JCA Joordens, and FAJ Muskiet. I’m not going to review it here. I’m just assembling some interesting “facts” for my files, so this could be boring. You won’t offend me much if you stop reading now.
This paper is from the University Medical Center Groningen and Human Origins Group (Faculty of Archaeology, Leiden University), both in The Netherlands. It’s 23 pages long, not counting the 450 references.
I’ll following the spelling conventions of the paper’s publisher.
“…our genome has remained basically unchanged since the beginning of the Palaeolithic era.”
“Since the onset of the Agricultural Revolution, some 10 thousand years ago, and notably in the last 200 years following the start of the Industrial Revolution, humans have markedly changed their dietary habits. Consequently, it has been advocated that the current pandemic of diseases of civilization results in part from the mismatch between the current diet and our Palaeolithic genome.”
These are some of the diseases that may result from the mismatch of our Palaeolithic genome and modern lifestyle (including diet): type 2 diabetes, high blood pressure, osteoporosis, fertility problems (polycystic ovary syndrome), pregnancy complications (pre-eclampsia, gestational diabetes), some cancers (colon, breast, prostate), heart disease (such as coronary artery disease), major and postpartum depression, autism, schizophrenia, some neurodegenerative diseases (Parkinsons disease, Alzheimer’s disease). [Sorry, Dr. Cordain – no mention of acne. And I wonder about dental and eye problems.]
“Many, if not all, diseases can become explained [sic] by both proximate and ultimate explanations. The science searching for the late explanations has become known as ‘evolutionary medicine.’ Unfortunately, modern medicine deals mostly with proximate explanations, while ultimate explanations seem more prudent targets for long-time disease prevention.”
The term “evolutionary medicine” was coined by Randolph M. Nesse and George C. Williams in the early 1990s. It’s also called Darwinian medicine.
“…about 20% of modern hunter-gatherers reach at least the age of 60 years.”
After the transition to the Agricultural Revolution about 10,000 years ago, life expectancy fell from about 40 years to about 20 years. This is astounding news to me, assuming it’s accurate. (Remember that for most of human existence, infant and child mortality has been very high. If an infant dies at 6 months old and an adult dies at 40 years, average life expectancy for the two would be about 20 years.)
Average life expectancy among modern hunter-gatherers is about 40 years—same as it was for students of the Harvard College class born in 1880.
Life expectancy in the Neolithic era was stable until the late 18th century, rarely exceeding 25 years in civilized nations. At that point, life expectancy started to improve dramatically thanks to sanitation, water and food hygiene, immunizations, and quarantine practices. (Thomas Jefferson was the third president of the U.S. His wife Martha had six children but only two survived to adulthood.)
The earliest species in the genus Homo appeared about two million years ago. Homo sapiens appeared about 200,000 years ago in south or east Africa. Several different hominin lines co-existed with modern humans.
The current world population of humans may be derived for only 1000 or so individuals that survived a decimating event.
The ability to store fat is one of the things that differentiate us from other primates.
The composition of the early human diet is still hotly debated.
In modern hunter-gatherers, only about 30% of diet energy is derived from hunting, with the rest coming from gathering plant food and aquatic animals.
In contrast to the arid, hot, iconic savanna, “…the combined evidence strongly suggests that early hominins frequented the land-water ecosystem and thus lived there.” If rainfall and other conditions allowed, there would be wooded grasslands.
“…the proportion of the human gut dominated by the small intestine (>56%) suggests adaptation to a diet that is highly digestible, indicating a closer structural analogy with carnivores than to [animals that eat leaves and fruit].”
“The data of combined studies of early hominins and the more recent hominins suggest a gradual increase in dietary animal protein, a part of which may derive from aquatic resources. In the more recent human ancestors, a substantial part of the dietary protein was irrefutably derived from marine resources, and this habit was only abandoned in some cases after the introduction of agriculture at the onset of the Neolithic.”
Sea levels have risen over the past 17,000 years, up to 150 meters.
“In conclusion, there is ample archeological evidence for a shift from the consumption of plant towards animal foods.”
“For a long time period in hominin evolution, hominins derived large amounts of energy from (terrestrial and aquatic) animal fat and protein. This habit became reversed only by the onset of the Neolithic Revolution in the Middle East starting about 10,000 years ago.”
“The Homo genus has been on earth for at least 2.4 million years and for over 99% of this period has lived as hunter-gatherers.”
“We conclude that gathering plays, and most likely always played, the major role in food procurement of humans. Although hunting doubtlessly leaves the most prominent signature in the archaeological record, gathering of vegetables and the collection of animal, notably aquatic, resources (regardless of whether their collection is considered as either hunting or gathering), seems much easier compared with hunting on the hot and arid savanna. We suggest that it seems fair to consider these types of foods as an important part of the human diet, unless proven otherwise. Conversely, while hunting might have played a much more important role at higher latitudes, dietary resources in these ecosystems are rich in n-3-fatty acids (for example, fatty fish and large aquatic mammals), while the hominin invasion of these biomes occurred only after the development of more developed hunting skills.”
Even though traditional Maasai showed extensive atherosclerosis with fibrous changes and lipid infiltration, they had very few complicated arterial lesions and rarely had clinical cardiovascular disease events.
“Contrary to earlier belief, the advent of agriculture coincided with an overall decline in nutrition and general health, but at the same time provided an evolutionary advantage since it increased birth rates and thereby promoted net population growth.” [Both supporting references are from CS Larsen.]
With the advent of the Industrial Revolution, nutritional quality and general health declined even more rapidly.“Among the many dietary and lifestyle changes are: a grossly decreased n-3:n-6 fatty acid ratio, the combined high intakes of saturated fatty acids and carbohydrates, the introduction of industrially produced trans-fatty acids, reduced intakes of n-3 and n-6 long-chain polyunsaturated fatty acids, reduced exposure to sunlight, low intakes of vitamins D and K, disbalanced anti-oxidant status and high intakes of carbohydrates with high glycaemic indices and loads, such as sucrose and industrially produced high-fructose maize syrup.” [Aren’t we eating more n-6 fatty acids, not less?]
The authors conclude with a review of the few medical scientific studies of Palaeolithic diets in modern humans. These are the ones by Frassetto, Osterdahl, Jönsson, and Lindeberg. I’ve already reviewed those here. They missed O’Dea and Kerin’s study.
This article seems very well researched. It lays out a logical framework for the discipline of evolutionary medicine and should spur further clinical research. It’s well worth a read if you have more than a passing interest in paleo lifestyle theory.
Bear in mind I’m not a paleontologist, anthropologist, paleo-anthropologist, or archeologist. So caveat lector.
Steve Parker, M.D. (B.S. degree in zoology)
Reference: Kuipers,RS; Joordens, JCA; and Muskiet, FAJ. A multidisciplinary reconstitution of Palaeolithic nutrition that holds promise for the prevention and treatment of diseases of civilization. Nutrition Research Reviews, 25 (2012): 96-129. doi: 10.1017/S0954422412000017
PS: The Paleolithic diet is also called paleo, ancestral, hunter-gatherer, Stone Age, Old Stone Age, and caveman diet.
I’m considering whether I should advise my patients with diabetes to pay careful attention to the protein content of their diet. It’s an important issue to Dr. Richard K. Bernstein, who definitely says it has to be taken into account.
Here are some of Dr. Bernstein’s ideas pulled from the current edition of Diabetes Solution:
Dr. Bernstein wrote:
In many respects—and going against the grain of a number of the medical establishment’s accepted notions about diabetics and protein—protein will become the most important part of our diet if you are going to control blood sugars just as it was for our hunter-gatherer ancestors.
I haven’t changed my thinking on this issue yet, but will let you know if and when I do. I don’t talk much about protein in Conquer Diabetes and Prediabetes in part because I wanted to keep the program simpler than Dr. Bernstein’s.
As with most aspects of diabetes, your mileage may vary. The effect of dietary protein on blood sugars will depend on type 1 versus type 2 diabetes, and will vary from one person to another. So it may be impossible to set rigid guidelines.
If interested, you can determine how much protein is in various foods at NutritionData.