John Walker’s Testimonial

Posted on December 11, 2011 | Comments Off on John Walker’s Testimonial

John Walker a few days ago wrote about his one-year experience with the paleo diet: he’s happy with it.  A snippet:

….I decided to give it a try, and now it’s time to review the results. I consider them remarkable. First of all, shortly after eliminating the non-paleo foods from my diet, my blood pressure dropped from the low yellow right into the middle of the green range and has remained there ever since. I have seen a downward bias in my weight which didn’t exist before and, in fact, without any deliberate intention, my weight today is 6 kg less than it was a year ago. (I experienced what I call the “paleo plunge”, which others have reported: after some turbulence when initially adopting the diet your weight will stay about the same and then, after six or nine months begin to drop smoothly. Some argue that this delay is due to the body’s need to repair ongoing damage and inflammation from non-paleo nutrients and once it’s caught up, weight loss will begin. I don’t know if this is really the explanation for the paleo plunge, but I certainly have experienced it. Should it continue and I begin to bump the bottom of my target weight range, I will add calories to my diet as described in The Hacker’s Diet to stay within the target; it’s a nice problem to have.) I feel great: after a couple of months almost all of the perceptible symptoms of chronic inflammation are gone, along with just about every other complaint of growing old. The persistent skin irritation from low humidity during the winter, which I’ve experienced since the 1990s, is gone. Nine months after the change-over to paleo, I had the first blood work done since before. The doctor went so far as to shake my hand and say, “I’ve never seen a blood panel like this for somebody your age. You have the blood of a 35 year old man.” Works for me.

I hadn’t heard of the “paleo plunge” before.  Mr. Walker’s website  and blog look interesting; I’ll have to return for a look when time allows.

Steve Parker, M.D.

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How Can You Track Omega-6 and Omega-3 Fatty Acid Consumption?

Posted on December 8, 2011 | 8 comments

It’s estimated that the Old Stone Age diet provided much more omega-3 fatty acids and much less omega-6s, compared to modern Western diets.  This may have important implications for development of certain chronic diseases like cancer and heart disease.

This'll improve your omega-6/omega-3 ratio!

I haven’t studied this issue in great detail but hope to do so at some point.  Evelyn Tribole has strong opinions on it; I may get one of her books.

I saw an online video of William E.M.Lands, Ph.D., discussing the omega-6/omega-3 ratio.  He mentioned free software available from the National Insitutes of Health that would help you monitor and adjust your ratio.

You can see the video here.  Dr. Lands’ talk starts around minute 12 and lasts about 45 minutes.  He says it’s just as important (if not more so) to reduce your omega-6 consumption as to increase your omega-3.  And don’t overeat.

Steve Parker, M.D.

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Alex Hutchinson on the Paleo Lifestyle

Posted on December 5, 2011 | 5 comments

Fleas from rats spread Yersinia pestis to humans

Alex Hutchinson has a recent article in Canada’s The Globe and Mail on the potential health benefits of the paleo lifestyle.  His conclusion:

So will going paleo really pay off with better health? As a big-picture guide to how to organize your life, definitely. But don’t get carried away with trying to recreate the exact details of a long-lost diet. Humans have changed and diversified even over the past few thousand years, so the only way to know what works best for your genes is to experiment. Go wild.

The article mentions the “increasing pace of human evolution,” an idea I’m still not convinced is valid.  Sure, a large population of critters should produce more genetic variation and mutation.  But it could take longer for a successful variation to spread through that population, compared to a smaller population.  It depends on selection pressure, to some extent.  The Black Plague in 14th century Europe changed that population quicker than any single genetic mutation I know of.  It wiped out 40% of the population.  Were those who survived genetically different from those who died?

I have much respect for Alex’s thoughts on exercise.  He usually puts more research and thought into his writing.  Check out his Sweat Science blog.

Steve Parker, M.D.

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Chronic Systemic Disease and Dental Problems: A Carbohydrate Connection?

Posted on December 3, 2011 | Comments Off on Chronic Systemic Disease and Dental Problems: A Carbohydrate Connection?

Dentists are considering a return to an old theory that dietary carbohydrates first cause dental diseases, then certain systemic chronic diseases, according to a review in the June 1, 2009, Journal of Dental Research. 

Neither Moore nor Sorrentino, but a nice set of choppers

Jimmy Moore has a recent podcast interview with Dr. John Sorrentino, a dentist who advocates a carbohydrate-restricted paleo diet for prevention and treatment of certain common dental problems.  By coincidence, Sorrentino is an old dental school classmate of Dr. Jack Kruse.  Dr. Sorrentino has a brand new dental blog.

We’ve known for years that some dental and systemic diseases are associated with each other, both for individuals and populations.  For example, gingivitis and periodontal disease are associated with type 2 diabetes and coronary heart disease.  The exact nature of that association is not clear.  In the 1990s it seemed that infections—chlamydia, for example—might be the unifying link, but this hasn’t been supported by subsequent research.     

The aforementioned article is written by Dr. Philippe P. Hujoel, who has been active in dental research for decades and is affiliated with the University of Washington (Seattle).  He’s no bomb-throwing, crazed, radical. 

That's more like it

The “old theory” to which I referred is the Cleave-Yudkin idea from the 1960s and ’70s that excessive intake of fermentable carbohydrates, in the absence of good dental care, leads both to certain dental diseases—caries (cavities), periodontal disease, certain oral cancers, and leukoplakia—and to some common systemic chronic non-communicable diseases such as coronary heart disease, type 2 diabetes, some cancers, and dementia.  In other words, dietary carbohydrates cause both dental and systemic diseases—not all cases of those diseases, of course, but some.   

Dr. Hujoel doesn’t define “fermentable” carbohydrates in the article.  My American Heritage Dictionary defines fermentation as:

  1. the anaerobic conversion of sugar to carbon dioxide and alcohol by yeast
  2. any of a group of chemical reactions induced by living or nonliving ferments that split complex organic compunds into relatively simple substances

As reported in David Mendosa’s blog at MyDiabetesCentral.com, Dr. Hujoel said, “Non-fermentable carbohydrates are fibers.”  Dr. Hujoel also shared some personal tidbits there. 

In the context of excessive carbohydrate intake, the article frequently mentions sugar, refined carbs, and high-glycemic-index carbs.  Dental effects of excessive carb intake can appear within weeks or months, whereas the systemic effects may take decades. 

Hujoel compares and contrasts Ancel Keys’ Diet-Heart/Lipid Hypothesis with the Cleave-Yudkin Carbohydrate Theory.  In Dr. Hujoel’s view, the latest research data favor the Carbohydrate Theory as an explanation of many cases of the aforementioned dental and systemic chronic diseases.  If correct, the theory has important implications for prevention of dental and systemic diseases: namely, dietary carbohydrate restriction.

Juvenile male Homo sapiens on Neolithic diet

Adherents of low-carb diets will love this article; it supports their choices.  The standard American diet provides 55% of energy in the form of carbohydrates.  Stone Age diets on average provided 35 to 40% of energy as carbs, but rarely as the simple sugars and refined starches that characterize modern Western diets.

I agree with Dr. Hujoel that we need a long-term prospective trial of serious low-carb eating versus the standard American high-carb diet.  Take 20,000 people, randomize them to one of the two diets, follow their dental and systemic health over 15-30 years, then compare the two groups.  Problem is, I’m not sure it can be done.  It’s hard enough for most people to follow a low-carb or paleo diet for four months.  And I’m asking for 30 years?!   

Dr. Hujoel writes:

Possibly, when it comes to fermentable carbohydrates, teeth would then become to the medical and dental professionals what they have always been for paleoanthropologists: “extremely informative about age, sex, diet, health.”

Dr. Hujoel mentioned a review of six studies that showed a 30% reduction in gingivitis score by following a diet moderately reduced in carbs.  He mentions the aphorism: “no carbohydrates, no caries.”  Anyone prone to dental caries or ongoing periodontal disease should do further research to see if switching to low-carb eating might improve the situation. 

Don’t be surprised if your dentist isn’t very familiar with the concept.  Has he ever mentioned it to you?

Steve Parker, M.D.

Reference:  Hujoel, P.  Dietary carbohydrates and dental-systemic diseases.  Journal of Dental Research, 88 (2009): 490-502.

Mendosa, David.  Our dental alarm bell.  MyDiabetesCentral.com, July 12, 2009.

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Avoid Drug Toxicity By Eschewing Drugs

Posted on November 28, 2011 | 2 comments

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

Steve Parker, M.D.

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Natural Selection

Posted on November 19, 2011 | 2 comments

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 offspring.  Nature 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.]

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Self-Experimentation: Paleo Diet and Type 1 Diabetes

Posted on November 10, 2011 | 2 comments

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.

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Caveman Mark Trying Paleo Lifestyle for Type 1 Diabetes

Posted on November 7, 2011 | 1 comment

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.

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UCSF Investigating Paleolithic Diet for Diabetics

Posted on November 6, 2011 | 3 comments

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.

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Paleo Diabetic Theory

Posted on November 3, 2011 | 8 comments

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.

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