“Why Fuss About Paleo Life?”

dearime asks:

Why do people fuss so much about paleo life? The population has grown so much since that it’s easy to believe that we’ve evolved a long way from then.

Jared Diamond wrote a paper about rapid evolution on an isolated island. When modern (factory) food was introduced to the island (in the 1940s?), there was a very high rate of diabetes, presumably due to the new food. Since then, the rate of diabetes on the island has gone way down, although they still eat modern food. Diamond took this to be due to evolution (people with diabetes-resistant genes had more offspring), supporting dearime’s point of view.

After the first Ancestral Health Symposium, Melissa McEwen commented how unhealthy many of the top people looked. On the other hand, Tucker Max commented how healthy the attendees looked in general. I agree with both observations. A paradox.

When I was an assistant professor, and wanted to sleep better, I believed wondering about paleo life was unhelpful because (a) we knew so little about it and (b) it must have differed in thousands of ways from modern life. Should I spend an hour trying to find out about paleo life and/or what paleo gurus recommend for bad sleep? Or should I spend an hour trying to find out how ordinary people have improved their sleep? My answer was the latter. I ignored paleo life.

Looking into how ordinary people improved their sleep did help. I eventually reached a non-trivial conclusion: Eating breakfast made my sleep worse. No paleo guru had said that — I had been right to ignore them. Yet it made evolutionary sense. Cavemen did not eat breakfast, I was pretty sure. (No refrigerators.) After that I paid more attention to what evolutionary thinking would suggest. This led to several discoveries: the effect of faces in the morning on mood, the effect of standing on sleep, and the Shangri-La Diet. It is incredibly hard to discover big new experimental effects (such as the effect of morning faces), especially in fields you know little about (my specialty in psychology was animal learning, not mood, sleep or weight control). I was impressed.

The effect of bedtime honey (more generally sweets in the evening) on sleep emphasizes the paradox or puzzle or whatever you call it. I found out about the honey effect by paying attention to what works. No paleo involved. Stuart King told me it improved his sleep. Here are three reasons to look at ordinary experience and avoid paleo theorists: 1. It turned out to help. 2. It’s a huge effect and very easy. 3. Paleo theorists have said the opposite: avoid carbs, avoid sugar. If you followed their advice, you would do the opposite of what helped Stuart and me. On the other hand, I increased my belief in the effect because it made evolutionary sense: 1. It makes sense of why we like sweets. 2. It makes sense of why our liking for sweets goes down when we are hungry (surely due to an evolved mechanism). 3. It makes sense of why we eat sweets more in the evening (presumably due to an evolved mechanism that makes sweets taste better in the evening).

The short answer to dearime’s question is that, in my experience, it is incredibly hard to learn anything about health. There are so many possibilities and evolutionary thinking helps choose among them — decide which to take the trouble to test.

Bedtime Honey Doubles a Measure of Strength

A reader of this blog named Nile McAdams, who lives in Minnesota, wrote:

When I read your first blog post about honey I was gobsmacked. Not so much by the improved sleep — the idea of a bedtime snack improving sleep has been around a long time — but by the fact that a tablespoon of honey could double the time you were able to stand on one leg. [One bent leg. After being roughly constant for a year, the time doubled in two weeks. — Seth] Impossible!! Not that I thought you were lying — I didn’t — it is just that a lot can go wrong between collecting the data and interpreting the data. So I had to try it for myself. Continue reading “Bedtime Honey Doubles a Measure of Strength”

Unhelpful Answers (Ancestral Health Symposium 2013)

At the Ancestral Health Symposium, I went to a talk about food and the brain, a great interest of mine. The speaker said that flaxseed oil was ineffective because only a small fraction (5%) gets converted into DHA — a common claim.

During the question period, I objected.

Seth I found that after I ate some flaxseed oil capsules, my balance improved. Apparently flaxseed oil improved my brain function. This disagrees with what you said.

Speaker Everyone’s different.

A man in the audience said what I observed might have been a placebo effect. I said that couldn’t be true because the effect was a surprise. He disagreed. (The next day, in the lunch line, he spoke to a friend about getting in a kerfuffle with “an emeritus professor who wasn’t used to being disagreed with.”) I spoke to the speaker again:

Seth Is it possible that flaxseed oil is converted to DHA at a higher rate than you said?

Speaker Anything’s possible.

This reminded me of a public lecture by Danny Kahneman at UC Berkeley. During the question period, a man, who appeared to have some kind of impairment, asked a question that was hard to understand. Kahneman gave a very brief answer, something like “No.” 

Afterwards, a woman came over to me. Maybe flaxseed oil reduced inflammation, she said. Given that the brain is very high in omega-3, and so is flaxseed oil, this struck me as unlikely. I said I didn’t like how my question had been answered. I’ve been there, she said. Other members of her family were doctors, she said. She would object to what they said and they would respond in a dismissive way.

The speaker is/was a doctor. Her talk consisted of repeating what she had read, apparently. The possibility that something she read was wrong . . . well, anything’s possible.




Correlation of Body and Soul (Ancestral Health Symposium 2013)

Geoffrey Miller, speaking at the Ancestral Health Symposium, said that every mental disorder impairs your sense of humor, so sense of humor is a good marker for overall brain function. It’s a fascinating point: what is the evolutionary reason that humor exists? Miller says it helps in mate choice. We select people in many ways (spouse, lover, business partner, friend, student, teacher, etc.). Maybe sense of humor is a general signal of health.

At the first Ancestral Health Symposium, Tucker Max noted that the attendees looked much better — healthier — than usual. It was a good point. Almost no one was fat, for example. And a large fraction of them became interested in paleo because of their own poor health, which paleo helped with. At this year’s symposium, I’ve noticed that the attendees strike me as in unusually good mental health, in the sense that I find everyone easy to talk to. For example, I had an interesting talk with a woman about “unschooling”. (I realized from what she said that non-traditional schooling is close to common sense when it is done with kids who are doing badly in school Why repeat what isn’t working? My experience suggests it also helps kids who have done well in school. Where it is non-intuitive. If something is working, why change it?) Likewise, all of the questions after talks are polite, none are too long, none are grandstanding.


The Feet of People Who Never Wear Shoes

In the 1940s, a podiatrist named Samuel Shulman examined the feet of a few thousand Chinese and Indians who never wore shoes. Their feet were in much better shape than the feet of people who wear shoes regularly.

The resulting complete absence of onychocryptosis [ingrown toenail] should serve to prove that proper nail care plus nonrestrictive footgear are all that is necessary to prevent the condition even in the presence of congenital nail malformations that are considered predisposing factors. . . . One hundred and eighteen of those interviewed were rickshaw coolies. Because these men spend very long hours each day on cobblestone or other hard roads pulling their passengers at a run it was of particular interest to survey them. If anything, their feet were more perfect than the others. All of them, however, gave a history of much pain and swelling of the foot and ankle during the first few days of work as a rickshaw puller. But after a rest of two days or a week’s more work on their feet, the pain and swelling passed away and never returned again.

Chinese parks often have cobblestone-like paths that are extremely painful to walk on barefoot (for me) but that others (usually old Chinese people) walk on barefoot for health. I was surprised how clearly the pain went away day by day of exposure. A 2005 study showed that four months of walking on cobblestone mats reduced blood pressure and improved balance compared to a group that walked the same amount normally:

Participants [average age about 80 years old] were randomized to a cobblestone mat walking condition (n=54) or regular walking comparison condition (n=54) and participated in 60-minute group exercise sessions three times per week for 16 consecutive weeks.

Measurements: Primary endpoint measures were balance (functional reach, static standing), physical performance (chair stands, 50-foot walk, Up and Go), and blood pressure (systolic, diastolic). . . .

Results: At the 16-week posttest, differences between the two exercise groups were found for balance measures (P=.01), chair stands (P<.001), 50-foot walk (P=.01), and blood pressure (P=.01).

Some of the cobblestone walkers walked barefoot, some wore socks. A hypertension expert, apparently not understanding statistics, said he wanted a larger study. I agree with him when he says that the speed of the improvement is what’s most impressive.

Because our ancient ancestors no doubt went barefoot and walked on irregular surfaces, both sets of results — the foot survey and the cobblestone experiment — support conventional paleo theorizing.

I have a cobblestone mat. I tried to walk on it. It was so painful I couldn’t get past the initial difficulty. Maybe I will try again.

Progress in Reducing Acne

A new study has found that persons with Laron Syndrome (a kind of dwarfism) get almost no acne. Persons with this syndrome, because of a mutation, are insensitive to growth hormone. As a result, they produce much less IGF-1 (insulin-like growth factor) than normal. When given synthetic IGF, they may develop acne; when the dose is reduced, the acne goes away. The authors say: “The findings suggest that an interaction between IGF-1 and androgens is necessary for the development of acne.” This is great progress because people with Laron Syndrome are different from everyone else in just one tiny way (albeit a tiny way with many consequences).

The first important step in understanding the cause of acne was finding two (“primitive”) groups of people with no acne. This suggested that acne has an environmental cause. There were thousands of differences between the lifestyle of those people and “modern” people, so this was just a start. It was hard to know which differences mattered. The Laron Syndrome finding is consistent with the earlier result (no acne in two groups of “primitive” people) because a “Western diet with [its] high intake of hyperglycemic carbohydrates and insulinotropic dairy over-stimulates IIS” (insulin-like/insulin signaling).

This view predicts that if you replace hyperglycemic foods with foods lower in glycemic index acne should be reduced. This study did that and, indeed, acne decreased (compared to a control group) after ten weeks. The study ended after ten weeks. The patient who reduced his/her glycemic index the most saw the greatest decrease in acne. A second study found the same thing: a low-glycemic-index diet reduced acne. It lasted twelve weeks. With longer follow-up, there might have been even more improvement.

Thanks to Paul Nash.




Assorted Links

Thanks to Dave Lull.

Assorted Links

  • Five quantified-self stories
  • False Alzheimer’s diagnosis. “Alzheimer’s symptoms such as confusion, memory loss and personality changes also can be side effects from medication—even commonly used drugs. For example, the entire class of anticholinergic drugs, which includes many antihistamines, antianxiety drugs, muscle relaxants and sleeping pills . . . Cholesterol-reducing statins have also been linked to brain fog in some people. In many cases, the cognitive symptoms vanish when medication is stopped. “I have had people referred to me with a clear history of dementia and when I started to peel back the medications, they were much better,” says Gary Kennedy, chief of geriatric psychiatry at Montefiore Medical Center in the Bronx, N.Y.”
  • Ancestral Health Symposium 2012 (Boston) recaps. I thought Robb Wolf’s talk was excellent. Jay Stanton had original ideas about weight control. Most of the other talks, not so much.

Vitamin K2 Deficiency Linked To Parkinson’s Disease

Parkinson’s disease often runs in families and some of the genes responsible have been identified. One is called PINK1. A new fruit fly model uses fruit flies with a similar genetic defect.

Patrik Verstreken and his team used fruitflies with a genetic defect in PINK1 or Parkin that is similar to the one associated with Parkinson’s. They found that the flies with a PINK1 or Parkin mutation lost their ability to fly.

Upon closer examination, they discovered that the mitochondria in these flies were defective, just as in Parkinson’s patients.  Because of this they generated less intracellular energy – energy the insects needed to fly. When the flies were given vitamin K2, the energy production in their mitochondria was restored and the insects’ ability to fly improved. The researchers were also able to determine that the energy production was restored because the vitamin K2 had improved electron transport in the mitochondria.  This in turn led to improved energy production.

The obvious conclusion is that some Parkinson’s patients may benefit from eating more Vitamin K2. Less obvious and less certain is that our diets contained more K2 in the past (so that the various genes that now cause Parkinson’s were rendered harmless).  Warren Buffet famously said about risk exposure: “”It’s only when the tide goes out that you learn who’s been swimming naked”. Likewise, changes in diet (such as reduction in K2 intake) expose disease-causing genes. I have made this point several times. It is counter-intuitive that disease-gene linkages suggest bad environmental changes.

Thanks to Melissa McEwen.

How Common Are Medical Errors? A Horror Story

In this post a contract artist who calls himself Wolverine gives a long list of life-threatening medical errors that happened to him. I hope that he will eventually add dates so that the rate of error becomes clearer [more: all the errors happened within a 14-month period] but even without them the stories suggest that life-threatening errors are common. (As does the effectiveness of surgical checklists.) Medicine is a job where if you make a mistake only the customer suffers not you. Surely this is why the error rate is so high. Wolverine was operated on by a surgeon who, because of a fatal error, had lost his license to practice in California. He changed states, was hired again, and made the same error on Wolverine.

I learned about this from Tucker Goodrich, who has been corresponding with the author and told me something remarkable:

He’s eating a paleo with raw milk diet.  The other transplant patients he knows are all eating the modern American diet and dying of infections; he’s been infection-free for two years.


Assorted Links

Thanks to Tom George and Mark Griffith.

Assorted Links

Thanks to Ryan Holiday, Matt Cassel, Tom George and Dave Lull.

Assorted Links

Thanks to Robin Barooah and Mike Bowerman.

Let Them Get Sick (running)

I wrote recently about how our health care system resembles a protection racket. In a protection racket, you or someone else threatens people so that you can make money protecting them. Modern health care, especially in America, ignores prevention. It says let them get sick. Let the general public get sick so that we (health care providers) can make money treating them.

The profitability of let them get sick is illustrated by some numbers in Run Barefoot Run Healthy, a new book by Ashish Mukharji  (who gave me a copy). Ashish has run several marathons. Before he started running barefoot, running caused all sorts of problems. To deal with them was costly:

  • Two or three pairs of orthotics (a type of insole): $200-$300 each.
  • One MRI, for what turned out to be ITBS (Iliotibial Band Syndrome, a thigh injury): around $1,000.
  • Twenty or more deep-tissue massage treatments for ITBS: around $80 each.
  • Corns removed (twice): $500 per treatment.
  • Twenty or more sessions of physical therapy for ITBS and Achilles tendonitis: $100-$250 per session.
  • Several visits to orthopedists and podiatrists: $150 per visit.
  • Cortisone injection for plantar fasciitis: $200.

Since he started barefoot running (3 years and 2 marathons ago), he has incurred no (zero) running-injury expenses. Interviews with other barefoot runners convince him this is typical. Long ago a runner friend of mine told me everyone who runs eventually hurts themselves. The truth of this was confirmed many times by runners I met after she said this. Now it appears she was right because all the runners she and I knew wore shoes.

I started barefoot running/walking on my treadmill a year ago. I have never had running injuries (probably because I walk — uphill fast — much more than run). Going barefoot saved time. During the first few months, I got four or five cuts (actually, splits) on the sides of my feet. The skin was split by  downward pressure. The cuts made ordinary walking (in shoes) a little unpleasant. I did nothing  about them. They healed and have not recurred.

A better health care system would have discovered the damage caused by running shoes long ago. We are lucky to live when personal scientists such as Ashish can figure out the truth themselves and tell others.

Assorted Links

Thanks to Anne Weiss.

Assorted Links

Thanks to Tucker Max, Melissa McEwen, Peter Couvares, Edward Jay Epstein, and Alexandra Carmichael.

What We Learn From the Better Health of Vegetarians

Lots of people think it’s obvious: vegetarians are healthier than omnivores in Study X. Therefore vegetarianism is healthy. This is such a common line of argument that I draw your attention to already blogged about. The slides make clearer than I did what she said. It’s all excellent but the best part is at the beginning where she points out the many confounds in the studies of Dean Ornish, Neal Barnard, Caldwell Esselstyn, and John McDougall. They change many things but — as Denise put it — What caused the benefits?  It must be the vegetarianism! Paleo humor.

There are lots of other interesting things in Denise’s talk, as you will see, such as the health of religious vegetarians.



Ancestral Health Symposium: Meat versus Fat

Yesterday I was telling a relative about the Ancestral Health Symposium and I mentioned the emphasis on meat eating — for example, two vendors gave out samples of beef jerky. To most people, I think paleo means eating lots of meat. I told my relative I disagreed with this. I find nothing wonderful about meat protein; I would happily get my protein from plants.  I eat meat almost only for the associated fat. Which I can get from butter. A lot of meat I am served, such as in fancy restaurants, strikes me as too low in fat. Yesterday I requested butter at a sushi restaurant. The waitress was unsure if they had some.

Today I see Melissa McEwen said the same thing much better:

It was interesting to observe that [at the Ancestral Health Symposium] among the low-carbers, there seemed to be an epidemic of puffy red skin, particularly in older men. I’m sure the pictures, when they are posted, will make obvious who these people are.  The ones who had healthy complexions like the Eades and Nora are those espousing a high-fat diet. It goes very well with some of the anthropological stuff I’ve been working on showing that almost all cultures that eat meaty diets are doing so because they have access to high-fat game.