Tag Archives: paleo diet

Can Diabetes Be Prevented?

Posted on February 12, 2012 | Comments Off on Can Diabetes Be Prevented?
Not Paula Deen

Paula Deen’s recent announcement of her type 2 diabetes got me to thinking about diabetes prevention again.  If you’re at high risk of developing diabetes you can reduce your risk of full-blown type 2 diabetes by 58% with intensive lifestyle modification.  Here’s how it was done in a 2002 study:

The goals for the participants assigned to the intensive lifestyle intervention were to achieve and maintain a weight reduction of at least 7 percent of initial body weight through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking, for at least 150 minutes per week. A 16-lesson curriculum covering diet, exercise, and behavior modification was designed to help the participants achieve these goals. The curriculum, taught by case managers on a one-to-one basis during the first 24 weeks after enrollment, was flexible, culturally sensitive, and individualized. Subsequent individual sessions (usually monthly) and group sessions with the case managers were designed to reinforce the behavioral changes.

Although the Diabetes Prevention Program encouraged a low-fat diet, another study from 2008 showed that a low-fat diet did nothing to prevent diabetes in postmenopausal women. 

I don’t know Paula Deen.  I’ve never watched one of her cooking shows.  She looks overweight and I’d be surprised if she’s had a good exercise routine over the last decade.  I’m sorry she’s part of the diabetes epidemic we have in the U.S.  I wish her well.  Amy Tenderich posted the transcript of her brief interview with Paula, who calculates her sweet tea habit gave her one-and-a-half cups of sugar daily.  Not quite a paleo diet.

  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

I think excessive consumption of concentrated sugars and refined carbohydrates contribute to the diabetes epidemic.  To the extent that paleo diets (aka Old Stone Age or caveman diets) restrict concentrated sugars and refined carbohydrates, they are likely to prevent type 2 diabetes. 

Avoiding overweight, obesity, and physical inactivity may be even more important. 

The Mediterranean diet has also been linked to lower rates of diabetes (and here).  Preliminary studies suggest the Paleo diet may also be preventative (and here).

Greatly reduce your risk of type 2 diabetes by eating right, keeping your weight reasonable, and exercising.

Steve Parker, M.D.

Reference:  Diabetes Prevention Program Research Group.  Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.  New England Journal of Medicine, 346 (2002): 393-403.

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Washington Internist Sees Good Results in Diabetics Eating Paleo-Style

Posted on February 5, 2012 | 1 comment

Dr. Stephan Guyenet recently interviewed Dr. C. Vicky Beer about her experience with the paleo diet in her patients, diabetic or not.  Dr. Beer commented about people with diabetes specifically:

Every patient I have ever had with diabetes who has adhered to the paleo diet for most of the time has experienced dramatic results.  Every one of them has been able to reduce their blood sugars and reduce their medications significantly, and in some instances, stop their medicine altogether.  This is not unlike other more known popular diets such as South Beach or Zone, which are actually quite similar to the Paleo diet in composition.

Just thought you might like to know.

Steve Parker, M.D.

PS: When I write “paleo diet,” you could substitute Old Stone Age, Stone Age, or caveman diet.

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Who’s Ray Audette?

Posted on January 7, 2012 | 11 comments

Ray Audette hunted with hawks

I ran across a 1995 well-researched online article about Ray Audette, author of NeanderThin and one of the modern paleo movement pioneers.  It’s in Dallas Observer News: http://www.dallasobserver.com/1995-07-06/news/neander-guy/

Audette apparently self-published his book in 1995.  (Publishing by a “vanity press” is probably more accurate for the mid-90s.)  The 2000 edition of the book from St. Martin’s Paperbacks has a foreword by Dr. Michael Eades, who is also quoted liberally in the aforementioned article.

Mr. Audette credited his diet for curing both his diabetes and rheumatoid arthritis.  I wonder how he’s doing these days.

1995 was only17 years ago.  It seems like ancient history to me.

Steve Parker, M.D.

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Evidence for Human Grain Consumption 100,000 Years Ago

Posted on December 26, 2011 | 8 comments

ScienceDaily December 17 reported findings of a Canadian archeological team who found evidence of systematic grain consumption by ancient humans in Africa:

The consumption of wild cereals among prehistoric hunters and gatherers appears to be far more ancient than previously thought, according to a University of Calgary archaeologist who has found the oldest example of extensive reliance on cereal and root staples in the diet of early Homo sapiens more than 100,000 years ago.

 

Neolithic technology

In case you’re new to the paleo diet, grains are considered verboten by most adherents.  (Paleo diet is also known as the Stone Age diet, caveman diet, and Paleolithic diet.)  The cereal grain mentioned in the ScienceDaily article is wild sorghum.

Many in the paleosphere believe that such ancient humans didn’t have the technical skills to transform wild grains into something edible on a regular basis.  I haven’t read the source material, nor do I have an opinion on whether the archeologists are correct.  I’m just sayin’…

Steve Parker, M.D.

Reference: Mercader, Julio,  et al.  Mozambican grass seed consumption during the Middle Stone Age. Science, December 18, 2009.

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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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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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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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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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