The Paleo Solution Part 2

We finish our margaritas (waste not, want not) and embark on our adventure. As luck would have it, most of the Anthropology Department is eating lunch together this day. When we walk in, someone asks, "Can we help you?"

"We need Anthropologists," I respond. "Now!"

We do not look too dangerous, so these folks invite us to have a seat and to explain what we need. I want to do this in a way that is not leading, as you are only half convinced of this Paleo-craziness, and I ponder my first question carefully. Finally I ask, "What is the single most important event in all of human history? What changed things, for good or ill, more than any other event or occurrence?"

A low murmur builds amid the faculty as they begin weighing potential answers. This goes on for a minute or so before the room quiets and the department chair, a stately woman in her early fifties, announces, "The agricultural revolution." All heads around the table nod agreement. Your head nods because of the margaritas, but you are drawn in by the consensus. You are not completely out of it, however, and ask an important follow-up question.

"Why? Why is the agricultural revolution so important?"

The faculty murmurs briefly and, again, the department chair replies. "Let's look at this question in a way that paints human history in a relative scale. If we stood on an American football field (100 yards from end-zone to end-zone) we could represent a timeline of human history in the following way: If we started walking from one end-zone toward the other, we could walk 99.5 yards, and this would represent all of human history except the last 5,000 years or so. . . 99.5 of the 100 yards.

"This is when our genetics were selected for survival in a hunting-gathering lifeway and we were d.a.m.n good at it. We evolved and adapted to this way of living and the interaction of our genetics and our environment made us who we were, and who we are. Our genetics are virtually identical to those of our early human ancestors from more than 120,000 years ago. The last 10,000 years, the time in which we transitioned from the hunting and gathering lifeway to agriculture, is the last half yard of our timeline. The last few inches represent television, the Internet, refined vegetable oils, and most of what we take to be "normal" modern living."

The room falls silent and it's obvious the department head and the rest of the group are waiting for a response. You are taking all this in and ask another important question. "What happened with this change healthwise? What were we like as hunter-gatherers, and what happened when we changed to agriculture?"

A new surge of discussion, and then the department chair starts in again. "Oh, that's a great question! Our HG ancestors were remarkably healthy. They were as tall or taller than modern Americans and Europeans, which is a sign they ate a very nutritious diet. They were virtually free of cavities and bone malformations that are common with malnutrition. Despite a lack of medical care, they had remarkably low infant mortality rates, yet had better than 10 percent of their population live into their sixties.

"Historical accounts of contemporary HGs who were studied by explorers and anthropologists show these people to be virtually free of degenerative disease such as cancer, diabetes, and cardiovascular disease. They also showed virtually no near-sightedness or acne. Our HG ancestors were powerfully built, with strength and endurance on a par with modern athletes. This fitness was built by living the foraging lifestyle, which was active yet afforded much downtime and relaxation. Most people contributed about ten to fifteen hours per week toward food, clothing, and shelter, with the remaining time spent talking, visiting family members in nearby groups, or simply resting."

You take this in. It's interesting, almost convincing, but you have watched your share of Discovery Channel and you seem to recall HGs lived short brutish lives. You articulate as much to the group and you add that it's seems like a remarkable a.s.sortment of "just-so" stories, all this talk of "tall cave men with good teeth." You ask a pointed question: "Isn't this all a bunch of conjecture? Why don't I hear about this more if it's true?"

The department chair looks at her colleagues, shrugs, and then motions toward the floor to ceiling books and journals lining the walls. "These are all accounts of early peoples. Hunter-gatherers, pastoralists, and agriculturalists have been extensively studied since the mid-1800s. We know quite a lot about how these people lived, what they ate, and the relative differences in their health and wellness. The whole field of forensic science is an outgrowth of medical anthropology. Are you aware that a trained forensic scientist or medical anthropologist can tell you within minutes whether an ancient skeleton was that of a hunter-gatherer or agriculturalist? This based on the remarkably increased rates of dental caries (cavities), bone malformations, and general poor health of the early farmers as compared to their hunter-gatherer cousins."

You are becoming more convinced by the second, but you want something more tangible. "Do you have any specific examples of this difference you could show me?"

The department chair thinks a moment, then excuses herself and heads to her office. In a few minutes she returns with an old, well-worn book t.i.tled, Nutritional Anthropology: Contemporary Approaches to Diet and Culture. She turns to a chapter called "Nutrition and Health in Agriculturalists and Huntergatherers: A Case Study of Two Pre-historic Populations."

She walks you through an a.n.a.lysis of two peoples who lived near the Ohio River valley. The farmers, referred to as the "Hardin Village" group in the book, lived in the area about 500 years ago. The hunter-gatherers, who are given the name "Indian Knoll" for the area in which their remains are found, lived in the area 3,000-5,000 years ago. The sites are significant in that each one produces a large number of skeletal remains. For statistical purposes, this makes information derived from the sites more compelling. The agriculture-based Hardin Villagers subsisted mainly on corn, beans, and squash, as is typical of many groups of Native Americans, including the Pima of Mexico and Arizona. The HGs of Indian Knolls subsisted on a mixed foraging diet of meat, wild fruits, fish, and sh.e.l.lfish. The differences in the health of the two people is remarkable: The HGs show almost no cavities, whereas the farmers showed almost 7 cavities on average per person.

The HGs show significantly less bone malformations consistent with malnutrition. That is-the HG's were much better fed.

The HGs showed a remarkably lower rate of infant mortality relative to the farmers. The most significant difference was between the ages of two and four when malnutrition is particularly damaging to children.

The HGs were, on average, healthier, as evidenced by decreased rates of bone malformations typical of infectious disease.

The HGs on average lived longer than the farmers.

The HGs showed little to no sign of iron, calcium, and protein deficiencies, whereas this was common in the farmers.

The department chair whisks away to make a copy of the chapter for you to take home. (If you'd like to read this chapter in its entirety, visit my website, www.Robbwolf.com, for the links.) You contemplate your next question, while considering the information you were just presented. When she returns, you ask her the only things that come to mind: "Is the situation you showed me typical? Isn't this an exception? Haven't we adapted to eating grains?"

She looks at you sympathetically and contemplates her response for a moment. "Our genetics are nearly identical to those of our early H. Sapien ancestors from 100,000200,000 thousand years ago. We are genetically wired for a lifeway that is all but gone now, and our health reflects this. The change from HG to agriculturalist that I described to you is typical of every transition we have studied. We moved from a nutrient-dense, protein-rich diet that was varied and changed with location and seasons to a diet dependent upon a few starchy crops. These starchy crops provide a fraction the vitamins and minerals found in fruits, vegetables, and lean meats. These "new foods" create a host of other health problems ranging from cancer to autoimmunity to infertility. I have no idea why this is not widely understood by the medical community, but I know for a fact few nutritional science departments offer course work in ancestral diets or the role evolution plays in our health and wellness."

You are now completely sober and not really that happy. This is all feeling very heavy. The department chair seems to detect your disquiet and offers to take you on a tour of the department. She shows you the forensics lab where students are trained in the discovery, identification, collection, and preservation of human remains. You had no idea all the stuff you've see on CSI actually had its beginning as an outgrowth of anthropology and the study of ancient humans. We thank the department chair for her time and expertise and wander outside into the warm, Northern California day. We look at each other, and you ask, "Should we go over to the Nutritional Sciences Department?"

"Sure, but you will wish we went and had a few more NorCal margaritas first!"

We make the short walk across campus and enter the hallowed halls of the Department of Nutritional Sciences. Keep in mind, this department exists under the umbrella of the School of Biological Sciences. Just keep that in mind.

We walk into the department and, as luck would have it, several of the faculty are sitting together eating an early afternoon snack of bagels and orange juice. You really need to stay ahead of lowblood sugar crashes that happen midday!

We introduce ourselves and mention we have some questions about nutrition and health. The nutrition scientists tell us we have come to the right place, so we launch in with the same question posited to the anthropology professors: What is the most important event in human history?

The nutrition scientists look at each other as if suspecting one of them set this situation up as a joke, but alas this is not a joke. One of them asks us, "What does history have to do with nutrition and health?"

I look knowingly at you and encourage you to take the point on this skirmish. You ask the group, "What about the development of agriculture? Wasn't that important for the health and wellness of our species?"

The nutrition scientists nod slowly, but you can tell they are not comfortable with this situation. Not at all. A gaunt fellow wearing a T-s.h.i.+rt proclaiming, "Tofu: It's What's for Dinner," chimes in.

"Of course this was important. Prior to agriculture people lived short, brutish lives".

Another posits, "Yes, it's hard to catch animals and the "stable" food supply of agriculture allowed the population to expand. Humans developed art and science and medicine."

We both concede the truth of cultural development, but you mention the change in health and wellness the anthropology professors related to us just an hour earlier. You mention the remarkable health of our Paleolithic ancestors as described by the anthropology professors. You mention the difference between the skeletons of agriculturalists versus hunter-gatherers.

The group of nutrition scientists are really not happy now. One quips, "How are we to know what our ancestors ate? This is all conjecture." Another faculty member, who has a body ma.s.s index of 32, adds, "Just because our ancestors ate that way does not mean it's healthy. All those people died young, undoubtedly from the meat they ate. Everyone knows meat gives you cancer."

You reply that the anthropology professors related the fact hunter-gatherers appeared to suffer virtually no cancer until they adopted grains, legumes, and dairy. We are met with eye rolling and muttering. This exchange of ideas is quickly coming to a close.

I ask a few more questions: "The Nutritional Sciences Department, it's under the auspices of the School of Biological Sciences, yes?" Everyone nods agreement. "So, really, the nutritional sciences should be looked at as a branch of biology, yes?" More nods of agreement. "What is the foundational, guiding tenet of biology? What idea is used to make sense of the ever-increasing amounts of information in the various branches of biology? What is the idea that ties together all of biology?" I'm met with blank looks. "Do you use the concept of evolution via natural selection to guide you as scientists?"

To this, one of the nutrition scientists responds, "Evolution has obvious application to the biological sciences, but it is of limited utility in understanding human beings."

"So, humans are exempt from the laws of biology?" I ask this person.

This creates a little mumbling that winds down to stony silence. These nice people would like to see our backsides. I ask one more question: "What do you use to make dietary recommendations?" To this the cheerful nutrition scientist wearing the tofu T-s.h.i.+rt responds, "Oh! We use this!" And he slides me a copy of the USDA "My Pyramid" food guide.

The Rest of the Story.

The story above is just that, a story. I've taken significant liberty here, but it has a remarkable thread of truth. I have had this conversation with faculty in the Nutritional Sciences Department (at CSU Chico and elsewhere) that was essentially the same as related in my fable above. The people who push and promote the nutritional guidelines for most of the Westernized world do not believe our hunter-gatherer origins have any bearing on our health. These people think they are scientists, yet when their feet are held to the fire, they have no science to stand upon. Physicists have theories such as quantum mechanics and relativity, which they use to answer questions about our world. These theories provide the continuity to evaluate the new information we gather.

Occasionally, our information forces us to reevaluate our models, but we know we are onto something good when we can use our model to make predictions. Physicists would not dream of operating without the models they have, yet the vast majority of people in medicine and the nutritional sciences have no idea where to look for a unified theory of health and wellness. This is due in part to laziness and, literally, a lack of thinking things through. People are spoon-fed ideas that make no sense (fat makes you fat, yet the people who eat more fat, like the French, Spanish and Greeks, are not as fat as we are. We will just call this finding "paradoxical" and move along without thinking). This laziness might be excusable if it was not costing billions of dollars and cutting short hundreds of thousands of lives. I won't even get into the people who are profiteering from your early demise with pharmaceuticals and processed foods.

The point I'd like to make is this: You are on your own. You can walk into your doctor's office with horrible blood work, all while eating a low-fat, high-carb diet of "whole grains." You can then s.h.i.+ft to an ancestral way of eating that involves lean meats, seafood, seasonal vegetables, and fruit. Walk back into your doctors' office with perfect blood work, yet he will not believe that eating more protein and fat is what fixed your broken blood work. We are working to develop a physician network of doctors educated in evolutionary medicine and the Paleo diet-I just hope we can keep you alive long enough to see one.

Now that we understand a little more about our hunter-gatherer ancestry and the blinders most of medicine and nutritional sciences are wearing, it's time to learn a little science so you can make sense of your Paleo Solution. It won't hurt, and it will likely save or dramatically improve your life.

THREE.

Knowledge Is Power, But It Will Not Run A Hair Dryer.

I'm not going to spend a huge amount of time trying to scare you into action, but you might need a little more convincing. You have questions. You want to know why cardiovascular disease, cancer, diabetes, autoimmunity, and infertility are on the rise? Why is it that these conditions are largely preventable (they are), yet our government does not tell us how to prevent them? I must admit, these are some pretty good questions, and we have not even gotten to things like, "Does cholesterol cause heart disease?" or "does protein cause kidney damage?"

To answer these questions I need to do a little explaining. I'm not going to spend a chapter on each of these topics, detailing the pathophysiology of each disease, but I need to look at some of the basics. If you want to skip to the "how to" chapters, go for it. As I mentioned before, you do not need to understand any of this to do it. But if you skip your homework, if you take this shortcut, you need to do exactly what I tell you, and you don't get to ask any questions!

You still with me? Good. However, I have to warn you. The answers to these questions require some of that nerdy "sciency" stuff. While it might be a bit technical, trust me when I tell you that you'll do better once you earn your nutri-geek-decoder ring. If you don't have your sights set on this precious bauble, you can still learn the essence of the science. For the pocket-protector crowd, I have separated some of the tougher material and placed it in the geek-speak boxes throughout the text.

All Roads Lead To . . .

Keep in mind, we can prevent or reverse cancer, diabetes, neurodegeneration, and infertility (depending upon how far down the path to destruction you may have wandered). You might have noticed many of these diseases occur together. Heart disease and depression. Infertility and autoimmunity. This is because these seemingly separate diseases share an underlying mechanism: Inflammation. Inflammation is a natural process that we will die without, but we will also die with too much. This is a case of Goldilocks wanting things to be "just right."

I'm going to walk you through the mechanisms behind your Inflammation Apocalypse and hopefully convince you to change your "evil" ways. Then we will get down to fixing y'all's little red wagons!

To understand how food influences inflammation, which is the underlying cause of diabetes, cardiovascular disease, Parkinson's, and Alzheimer's, we need to understand just a little bit about digestion and the hormonal consequences of our food.

I'm going to define a few terms before we get started. We need to understand the players in digestion, starting with what our food is made of (protein, carbohydrate, and fat) and the hormonal signals that are released in response to food (or the lack thereof). Armed with this information, we can begin to understand how food choices today can manifest as either health or disease tomorrow. In addition, we will learn a dizzying array of polysyllabic terms that only a biochemist could love. Please keep hands inside the ride at all times, do not feed the microflora.

Digestion: From Your Pie Hole to Your Hoo-Ha in 453 Easy Steps.

Proteins.

Proteins are what make up our skin, muscle, hair, and nails, to say nothing of neurotransmitters, enzymes, and hormones. Good sources of protein include fish, fowl, meat, eggs, and sh.e.l.lfish. Some well-intentioned but misguided souls will tell you that you can get protein from beans and rice, nuts and seeds. That's true, but these are what I call "third world proteins." They will keep you alive, but they will not make you thrive. This should be clear from the previous chapter that compared hunter-gatherer and agrarian societies.

Proteins are made of molecules called amino acids. Our physiology makes use of twenty-one amino acids, eight of which are "essential." We must get them from our food. Think about amino acids and proteins like different building blocks that allow you to construct cool stuff, like giraffes, whales, hormones, and steaks!

Carbohydrates.

Technically, carbohydrates include everything from wood to gra.s.s to apples to bread. Depending on how you link carbohydrates together, you can have anything from a plate of pasta to a sequoia, but it all starts simply, with what are called "monosaccharides." Mono, of course, means "single." Sacchar means "sugar." So, monosaccharide literally means "one sugar." The two monosaccharides, or sugars, we will follow most closely are glucose (the main sugar used for energy in our bodies) and fructose (a relative of glucose). Think about fructose like a drunk aunt at a family reunion: She seems nice enough, but wreaks havoc wherever she goes.

Next we have "disaccharides," which means "two sugars." You are all familiar with sucrose (table sugar)-this is a disaccharide of glucose and fructose.

Finally, we have "polysaccharides," which literally means "many sugars." For our jaunt through your digestive tract, we will consider two types of polysaccharides-indigestible carbohydrates, which we commonly refer to as fiber (both soluble and insoluble), and digestible polysaccharides we know as starch. Rice, potatoes, corn, and flour are all examples of polysaccharides/starch. The next time you have a chubby physician or dietician tell you that complex carbs are healthy, ask yourself, Does it make sense that "many sugars" might be good for me? Hmmm.

Fats.

There are quite a number of fats, and we will consider specific fats in a later chapter, but for now we just need to know that what we commonly refer to as "fat" is called a triglyceride-an alcohol-like molecule called glycerol that is attached to three fatty acids. Think about triglycerides like a molecular party: glycerol brings the "booze," the fatty acids bring the energy and good times!

Hormones: for Digestion and Fun or Can You Hear Me Now?

Now that we know the players (protein, carbohydrate, and fat), let's see how they fit into digestion, hormonal release, and eventually health and disease.

How does your body know it's "hungry"? What does "hunger" really mean? You likely have a much better social life and get out more than I do, so you have never pondered these riveting topics, but since we are here, we might as well ask the important questions-and they are important.

Understanding how our body normally regulates hunger will give us insight into the development of obesity, cancer, diabetes, and a number of other nasty problems we would all do well to avoid. Similar to the fuel gauge of an automobile, our sense of hunger tells us when our body is running out of stored energy. But when we eat, we need to know when we have had enough. Hunger lets us know when we are "running on empty" and the sense of satiety tells us when the fuel tanks are full.

All of this information is communicated throughout the body by chemical messengers called hormones. Before you are finished with this book, you will "meet" quite a number of hormones and you will understand a good bit of what they do in critters such as yourself. In simple terms, hormones are messengers that communicate information throughout the body. How we age, burn fat, think, and reproduce are largely controlled by hormones.

Each hormone has a very specific way of interacting with the cells in our bodies. They interact through a molecule called a receptor site. A common a.n.a.logy for hormones and receptors is the picture of a lock and key. The key would be the hormone, which fits snuggly into the specific "lock" (receptor). This a.n.a.logy is helpful in that it describes accurately the physical interaction of a hormone and receptor based on shape, but it is a bit odd to imagine keys floating about your body.

I like the additional a.n.a.logy of hormones acting like radio signals and receptors acting like receivers tuned to specific hormones. The combination describes both the physical interaction of the hormone and receptor, but also the fact that information can be transmitted across vast distances by the hormone, which is then received by the receptor site. Hormonal communication in the body controls our levels of body fat, our thinking, our hunger, and just about anything you can think of.

Now let's look at the main hormone players, beginning with insulin.

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Insulin is critical in regulating blood sugar, body fat, and aging. To live long, look good, and keep our marbles, we would do well to keep our insulin on the low side by controlling carbs and certain lifestyle factors.

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Geek-Speak Insulin acts as a nutrient-storage hormone that maintains blood glucose levels. In simple terms, insulin puts nutrients into our cells. What we will find, however, is that insulin plays a key role in a staggering number of critical processes completely unrelated to blood sugar management.

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Why Is Blood Glucose Important?

So, I mention blood glucose (sugar) levels quite a few times in this book. Why is it important? Well, the red blood cells and certain parts of the brain can run on no other fuel besides glucose. In certain situations like insulin resistance, blood sugar levels can fall and the result can range from dizziness and hunger to unconsciousness and death. So, we should eat lots of carbs then, right? Uh, no. As you will see we are better served if we can encourage most of the body to run on fat and just provide enough carbohydrate to meet the needs of these truly glucose-dependent tissues. By reducing the body's total need for carbohydrate, we actually protect ourselves from blood sugar crashes.

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Insulin is relevant not only in glucose storage, but also in fat and protein (amino acid) storage. Insulin is released from the beta cells of the pancreas primarily in response to increasing blood levels of glucose and amino acids and plays a significant role in micronutrient storage and conversions. Insulin's primary role as a nutrient sensor (when you ingest food, insulin tells those nutrients where to be stored) greatly influences genetic expression surrounding aging by up or down regulating maintenance and repair at the cellular level. If you are interested in aging, your level of body fat, when or if you will lose your marbles, and whether or not your "reproductive machinery" works, you will want to keep an eye on insulin.

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Glucagon helps normalize blood sugar and energy levels between meals by releasing energy from the liver and allowing us to better access our body fat for energy.

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Geek-Speak Glucagon is the counter-hormone to insulin and prompts the release of glucose from the liver, as well as free fatty acids from fat stores, by a process called lipolysis. Glucagon secretion is stimulated by decreased blood glucose levels (hunger), increased blood amino acid levels, and the hormone cholecystokinin (CCK). High levels of insulin, free fatty acids, ketone bodies, or urea in the bloodstream will inhibit glucagon release. Insulin and glucagon play complementary roles of helping us to manage energy levels by storing and releasing nutrients at the right time. Insulin facilitates the pa.s.sage of nutrients into cells, while glucagon tends to release stored nutrients to be used for energy.

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Leptin tells our body how much fuel we have in storage, and when we are "full." If we lose the ability to sense leptin, appet.i.te control is lost.

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Geek-Speak Leptin regulates both appet.i.te and metabolism. Leptin enters the central nervous system where it acts on receptors in the brain that control energy intake and expenditure. Leptin is produced by white adipose tissue (fat cells), as well as the cells lining the wall of the stomach. The leptin produced by the cells in the stomach is responsible for controlling appet.i.te. When Leptin is working correctly, it's very effective at telling us we are "full" after eating a meal. As we will see, when leptin signaling (how a hormone "talks to a receptor") breaks, it is the beginning of problems ranging from cancer to accelerated aging to neurological degeneration.

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Ghrelin tells us we are hungry or low on energy. We would like this to be an accurate message, but it is important to note that stress and lack of sleep can alter ghrelin levels and unfavorably increase our sense of hunger.

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Geek-Speak Ghrelin is a hormone that stimulates hunger, increases food intake, and increases fat ma.s.s. It is produced by cells in the lining of the stomach, as well as epsilon cells of the pancreas. Ghrelin is also produced in the hypothalamic arcuate nucleus, where it stimulates the secretion of growth hormone. Inadequate sleep is a.s.sociated with high levels of ghrelin. A little down the road, you will discover just how important sleep is to maintaining a lean, healthy body. Since sleep deprivation increases ghrelin, and since ghrelin increases appet.i.te, this is one of the reasons why sleep disturbance leads to increased food intake.

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Adiponectin is another of several satiety hormones. Not only does it tell us when we've had enough food, but it also protects our arteries from oxidative damage.

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Geek-Speak Adiponectin is a protein hormone that is secreted by adipose tissue and has the following effects: decreases gluconeogenesis (the conversion of protein into glucose), increases glucose uptake, and protects from endothelial dysfunction (a common feature of atherosclerosis). Although released by adipose tissue, levels of adiponectin in the bloodstream of adults is inversely correlated with percentage of body fat (folks with low body fat have high adiponectin). Adiponectin is an independent risk factor for metabolic syndrome and plays a role in the suppression of the metabolic derangements that may result in type 2 diabetes, obesity, atherosclerosis, and nonalcoholic fatty liver disease.