Twelve Black Code Monkeys

Mr. Tutt from Health Hack, posted a link to this lengthy piece on the paleo diet compiled by Sam Hoxie of Creighton University Medical School. I’ve been adhering to a philosophy of eating suggested in Protein Power which generously takes from the theory of the Paleo Diet, which basically asserts that we should be emulating how our prehistoric ancestors ate. The theory goes that our bodies evolved to thrive on the kinds of foods that we were able to eat over hundreds of thousands of years before the advent of agrigulture – mainly hunted animals and with some wild fruits and vegetables thrown in as occasional supplements. In the 10,000 or so years since agriguculture took hold in a large portion of the population, humans have not had the time for their genetic makeup to change enough to handle a very different diet based primarily on grains with meat as an occasional supplement (although today for developed countries meat is now affordable enough to have regularly).

What interested me, of course were the “counterpoints” that are discussed in the piece. In other words the reasons for NOT eating a paleo-like diet. Many of these arguments seem logical on the face of it, but if you think about it, most don’t hold much water, or are just irrelevant. Here are some counterpoints to the counterpoins:

1. Sustainability: this is definitely an interesting dilemma. I often wonder whether organic methods would provide more sustainability, but I don’t know the answer to that. Still, I’m not sure if it is relevant exactly. The question of something being healthy for the individual and sustainable for the planet if everyone ate a particular way are two seperate issues. I wrote recently about new efforts to produce meat in the lab without actually raising cattle, but that’s in very early stages…
2. Plenty of people develop cardiovascular disease and diabetes who are also in the normal weight category. Their premise is that obesity causes these diseases, but the alternate view (of which the Paleo and other similar diets adhere to) is that obesity is simply another symptop of insulin resistance, which is the real culprit that leads to diabetes, heart disease, high blood pressure, and host of silimilar problems. While eating less and exercising does lower insulin levels and thus improves these problems, it doesn’t always solve the underlying issue. But also, they never really talk about why one would opt for the caloric control model other than that’s what is recommended by most nutritionists. Why would doing this be “better” than living in a way that, supposedly, our bodies were designed to eat?
3. Study: while they call this study “recent,” I’m curious why in the 5 years since I’ve been low-carbing and reading all the battles in the press about low-carb pro and anti, that I’ve only now heard of this study? I’m curious to actually read what it has to say, but so far this is the only study that I’ve ever heard of that has something bad to say about low-carb. Yet, Atkins has been around for 30+ years, so you would think there would be some more evidence that such diets were bad for you over the long haul. I’m all for having scientific studies on these issues, but as we all know, just pointing to a study doesn’t necessarily mean it holds water. It has to be peer reviewed, and even then often from what I’ve seen the conclusions sometimes ignore the obvious because they preconceptions of the authors refuse to consider a possibility that they don’t want and so dismiss results that don’t fit those preconceptions.
4. McDougall: I’ve heard of McDougall, but I can’t place where exactly. Anyway, a couple of points. First, the Zone isn’t a low-carb diet, as far as I can tell, it is way too high in carbs. It may be higher protein than what is recommended by nutritionists, but the amount of carbs that are consumed on such a diet can be harmful for those who are insulin resistant. Secondly, the whole Japanese issue was tackled I think, in Protein Power. The problem with his argument is that it ignores the fact that when Japanese come here and adopt our diet, they are also adopting a new lifestyle, which may increase stress. They also may be eating a diet that has just as many carbs here, less fish, more junk food, etc. Epidemiological studies that purport to prove what healthy eating is by looking at different populations are notoriously unreliable because they just can’t account for all the variables from one population to another. Much more reliable, but still shakey is looking at the same population and making conclusions based on a range of diet and lifestyle variables. McDougall’s quote “If high-protein diets, which means meat, egg, and dairy products, were so good for us then people who subsist on these foods (most Americans) would be the thin and healthy, and vegetarians would be fat and sick. In general, the opposite is the case.” belies some real problems with logic. He doesn’t seem to understand that people who eat based on the concepts of a “high protein” diet, are also not eating all the refined carbs and sweets that “most Americans” eat. As for vegetarians, I’ve seen many an obese vegetarian. Now, when it comes to vegans (perhaps this is the group he really means to talk about because he includes dairy as part of his collection of “high protein” foods), I would agree that most are skinny. In my mind, though, this is not because their diet is somehow better. Skinny does not always equal healthy and in fact until the latter half of last century it was equated with the opposite!
5. Excess: are you sure excess protein is excreted? My sense is it still needs to be digested and depending on what the body needs, it will be converted up to 50% as glucose, which then, if not needed, will be stored as fat. This is one reason why it’s still debated even in some low-carb circles whether eating too much protein may eventually slow weight loss. But the actual digestive process whereby protein is broken down, is very inefficient. It needs more energy than what protein provides in caloric needs (conversion to glucose), so probably eating just too much protein is not going to do much. Besides, protein has been showd to be a much more “self-limiting” macronutrient than either carbs or fat, so you are much more likely to stop at a “reasonable” level. But the other question we should ask is this - why do we need to limit ourselves to only what our body “needs.” Needs in what sense? To survive or to thrive? And this is going to vary a great deal depending on the individual, their activity level, their size, etc. The nutritionists suggest we only need a very small amount of protein, and we shouldn’t go over that amount but I think it’s much less an issue if we get more than enough because protein helps our body maintain it’s vital functions and parts. There has been no ill effects shown from those eating excess protein, except for the limited cases where a person has preexisting pathologies of the kidneys.
6. Water: yet again, this old saw is brought up. Yes, initial weight loss on most diets is mostly water. But someone who loses 50 lbs over a year (or more) is not losing 50 lbs of water! So why even bring this up when this is true of most diets?
7. Calories in vs. Calories out: again, this is the main battle cry of nutritionists - “The only way to lose weight is to use more calories than you consume. For most people this means a sensible, low calorie diet with regular aerobic exercise.” Says who? The problem with this thinking is that it does not work for “most people.” Or rather, it does not work long-term. Anyone can lower there caloric intake and exercise a lot and lose a bunch of weight. I’ve done this numerous times, but like many, the weight always came back. What this approach does not consider is that what we eat and our digestive process itself has an effect on this caloric balance. In other words, metabolism! Not only do different people burn calories at different rates, but you as an individual will burn at a different rate depending on how much muscle you put on (or take off). The added muscle needs more calories and uses them to maintain the muscle mass. In addition to this, there’s something called the “dynamic action of foods” which I alluded to above. This says that different foods (or really different macronutrients – carbs, fat, and protein), have different energy requirements in digestion. Protein is “inefficient” because it takes more energy to digest it that in provides the body. Carbs and fat are much more easily digested and so most of the calories they contain are used by the body either for energy or stored as fat. So a simple calories in vs calories out is really incorrect and incredibly oversimplified.
8. Toxins: toxins are a problem in our food supply in general, but I’m surprised that it’s brought up in relation to free-range meats. Cattle or other animals that are fed an unnatural diet of grain (and probably genetically modified grain), do not have some of the beneficial qualities of free-range/grass fed cattle. I agree that this is something to be concerned about, but where are the studies or the information about such toxins being in meat? Fat is supposed to be the carrier, but a lot of free-range meat is actually lower in fat than its farm-fed counterparts, and again, where are the studies backing this theory up?
9. Disease: the last point of the counterpoint section shows again a point that is made which really effects a very small number of people:
   

   “One of the strongest counterpoints to the Paleodiet is when the dietary recommendations it contains would directly worsen a pre-existing medical condition. Individuals with conditions like liver disease, renal insufficiency or kidney failure or certain metabolic disorders like phenylketouria (PKU) could be caused significant harm by the high protein content in the Paleodiet. As always, discuss any planned dietary changes with your medical doctor before beginning new eating habits.”

   PKU is exceedingly rare, and liver and kidney disease is not very common either. It goes with out saying that if you have a serious illness or condition like one listed above, you should learn as much as possible about what foods you need to be careful about ingesting. But this is like saying that “one of the strongest counterpoints to eating shrimp is that some people suffer allergies to shelfish.” If you go by that logic, than we would have an extremely limited diet, because for almost every food you could probably find someone who is allergic or at least claims to be.