* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download The Optimal Human Diet - Vision Institute of Canada
Survey
Document related concepts
Abdominal obesity wikipedia , lookup
Obesity and the environment wikipedia , lookup
Adipose tissue wikipedia , lookup
Food politics wikipedia , lookup
Fat acceptance movement wikipedia , lookup
Vegetarianism wikipedia , lookup
Vitamin D deficiency wikipedia , lookup
Raw feeding wikipedia , lookup
Low-carbohydrate diet wikipedia , lookup
Food choice wikipedia , lookup
Human nutrition wikipedia , lookup
Diet-induced obesity model wikipedia , lookup
Transcript
Implementing The Paleo Diet: The Synthesis & Nutrient Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups Loren Cordain, Ph.D. Department of Health & Exercise Science Colorado State University Fort Collins, Co USA Diet & Disease: Genetic Discordance How Do Zoo Keepers Determine the Optimal Diet of Wild Animals? v The closer zookeepers can match, an animal’s captive environment v To its natural environment, v The healthier the animal will be and more likely to reproduce v This includes the exact type of foods they would normally eat in their wild state v These are the foods to which the animal species is genetically adapted Giraffes in The San Diego Zoo Wild Animal Park The Optimal Human Diet v Humans are no different than any other wild animal v We are genetically well adapted to the foods normally eaten in our native ecological niche v What is the native human ecological niche? v Hunter Gatherer !Kung Hunter Gatherer in East Africa Circa - 1964 Eaton SB et al. Paleolithic nutrition. A consideration of its nature and Current implications. N Engl J Med 1985 312 283-89. Our Ancient Hunter Gatherer Heritage v Despite our cities, cars, computers and modern technology v All Humans have only very recently left the Stone Age KNM ER 1470 (Homo habilis) vSince the appearance of the human genus (Homo habilis) 2.4 Million years ago v Humans have occupied the Hunter-gatherer niche until: vThe Agricultural Revolution only 10,000 yrs (500 generations) ago Our Ancient Hunter Gatherer Heritage v Human nutritional needs were established in the remote pre-historic past over eons of evolutionary experience v The selective pressures of the hunter-gatherer niche determined our present day genetic makeup including our nutritional requirements Generations (~30 yrs) in the Evolution of Humanity Generations Homo habilis (1st Homo species ) 76,667 Homo erectus (modern body size) 60,000 Modern Homo sapiens (cranial size) 6,666 Agricultural Revolution (cereals) 333 Advent of Dairying (milk, cheese etc) 200 Industrial Revolution (refined sugars, 7 refined cereals, oils, canned food) Food Processing Industry (junk food) 4 % Total 100.0 78.2 8.7 0.4 0.26 0.009 0.005 Conclusion: 99.6% of all Homo generations had no evolutionary experience with commonly consumed modern foods introduced during the Neolithic! Our Ancient Hunter Gatherer Heritage v Mitochondrial DNA + single nucleotide polymorphisms (SNPs) evidence from diverse ethnic groups world wide: v Some, but relatively little change in human genome since the appearance of behaviorally modern humans (Homo sapiens) 40,000 yrs ago Macaulay V et al. The emerging tree of Western Eurasian mtDNAs a synthesis of control-region sequences and RFLPs. Am J Hum Genet 1999 64 232-49. Cordain L. et al. Fatty acid composition and energy density of foods available to African hominids: evolutionary implications for human brain development. World Review of Nutrition and Dietetics, 2001, 90: 144-161. Voigth BF et al. A map of recent postive selection in the Human genome. PLOS Biol 2006 4 0446-0458. Our Ancient Hunter Gatherer Heritage Discordance Hypothesis v The discordance between modern foods and those to which pre-agricultural people were genetically adapted v Contributes to many diet related health problems of modern humans v Modern Anatomy Physiology & v Hence, Nutritional requirements v Remain virtually identical to those of Stone Age Hunter Gatherers Cordain L. Cereal grains. Humanity’s double Edged sword. World Rev Nutr Diet 1999 84 19-73 These foods comprise (>70% energy) in typical Western Diets But were virtually unknown in Ancestral Human Diets Breads, Cereals, Rice and Pasta Dairy Products Refined sugars, grains, vegetable oils and dairy = 70.9% of energy in the U.S. food supply Meats, Fish Added Salt 15.7 18.6 1.4 Eggs Nuts, Seeds 3.1 Legumes 3.3 Fruits Refined Sugars Refined Vegetable Oils Grains Dairy 4.8 Vegetables 17.8 Refined Vegetable Oils Refined Sugars (except honey) 0.8 Miscellaneous Fatty Meats Alcohol 23.9 10.6 v Refined sugars, grains, vegetable oils and dairy represent Neolithic & Industrial era foods that were not present in traditional ancestral human diets v By default, their inclusion displaces minimally processed, wild plant and animal foods. Cordain et al. Am J Clin Nutr 2000 71 682-92 Gerrior S, Bente I. 2002. Nutrient Content of the U.S. Food Supply, 1909-99: A Summary Report. U.S.D.A, Center for Nutrition Policy and Promotion. Home Economics Research Report No. 55 The Synthesis & Nutrient Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups Fish Seafood Lean Meats Food Components of Typical Hunter-Gatherer Diet Typical Macronutrient Breakdown (28-47 %) Fat (19-35 %) Protein (22-40 %) Carbohydrate Fresh Veggies Nuts/Seeds Fresh Fruits Apportionment of daily energy to the five food groups in a contemporary diet based upon Paleolithic food groups 30 27.5 v 1. v v v v v v v v Animal food energy = 55% a. Hunted animal = 27.5% b. Fished animal = 27.5% c. No fatty or processed meats d. No dairy foods 2. Plant food energy = 45% a. No cereal grains b. Minimally processed fresh fruits, vegetables, seeds & nuts 3. No Processed Foods Cordain L et al. Am J Clin Nutr, 2000, 71: 682-692. Modern Foods to Use: Top 20 Most Commonly Consumed Vegetables v 1. Potato 27.5 % Total Energy 25 20 15 15 15 15 10 5 0 Vegetables Fruits Nuts/seeds Sea Food Lean Meats Cordain L et al. Am J Clin Nutr, 2000, 71: 682-692. 1. Sweet Corn is excluded because it is a grain 2. Potatoes are excluded because they maintain characteristics (high glycemic index) not found in Paleolithic diets v v v v v v v v v v v v v v v v v v v 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Iceberg lettuce Tomato Onion Carrot Celery Sweet Corn Broccoli Green cabbage Cucumber Bell pepper Cauliflower Leaf lettuce Sweet potato Mushroom Green onion Green bean Radish Summer squash Asparagus Modern Foods to Use: Top 20 Most Commonly Consumed Fruits 1. Dried fruits (raisins, dates etc. are excluded because they maintain characteristics (high glycemic load) not found in Paleolithic diets v v v v v v v v v v v v v v v v v v v v 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. % Protein 80 60 67 75 68 19 26 89 40 ck en Ch i 5 Tu rk ey 28 0 Po rk 20 Be ef % total energy 100 v v v v v v v v v v v v v v v v v v v Banana Apple Watermelon Orange Cantaloupe Grape Grapefruit Strawberry Peach Pear Nectarine Honeydew melon Plum Avocado Lemon Pineapple Tangerine Sweet cherry Kiwi fruit Lime Modern Foods to Use: Top 4 Most Commonly Consumed Lean Meat % Fat Modern Foods to Use: Top 20 Most Commonly Consumed Fish/Seafood v 1. Shrimp v 1. Beef (Sirloin tip roast trimmed of visible fat) v 2. Chicken (breasts without skin & trimmed of visible fat) v 3. Pork (Loin roast trimmed of visible fat) v 4. Turkey (Breasts without skin) 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Cod Pollock Catfish Scallop Salmon Flounder Sole Oyster Orange Roughy Mackerel Ocean Perch Rockfish Whiting Clam Haddock Blue Crab Rainbow trout Halibut Lobster Modern Foods to Use: Top 10 Most Commonly Consumed Nuts/Seeds v v v v v v v v v v 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Almonds Walnuts Pecans Filberts Brazil nuts Pistachio nuts Macadamia nuts Coconut Sunflower seeds Pumpkin seeds Sample 1-day Menu (25 yr female, 2200 kcal) Breakfast Cantaloupe Atlantic salmon (broiled) Lunch Vegetable salad with walnuts Shredded Romaine lettuce Sliced carrot Sliced cucumber Quartered tomatoes Lemon juice dressing Walnuts Broiled lean pork loin Dinner Vegetable avocado/almond salad Shredded mixed greens Tomato Avocado Slivered almonds Sliced red onion Lemon juice dressing Steamed broccoli Lean beef sirloin tip roast Dessert – Strawberries Snacks Orange Carrot sticks Celery sticks Food Quantity (g) 276 333 Energy (kcal) 97 605 68 61 78 246 31 11 86 10 26 10 52 8 70 205 112 123 85 45 29 31 468 235 130 16 26 150 260 11 8 131 400 39 66 81 90 30 35 14 My Pyramid: Stated Dietary Goals Shaw A et al. Using the Food Guide Pyramid: A Resource for Nutrition Educators. USDA, Food, Nutrition and Consumer Services. v v v v v v v v v v v v v A Diet Adequate in: Protein (RDA) Vitamins (RDA) Minerals (RDA) Fiber (no RDA): 20-35 g (ADA) Without Excessive: Calories Fat (< 30 % energy) Saturated Fat (< 10 % energy) Cholesterol (< 300 mg) Sodium (< 2,400 mg) Added Sugars (<8.7 % energy) Alcohol (<1-2 std drinks) Nutrient Comparison: USDA Recommended vs. Paleo Diet USDA Recommended Shaw A et al. Using the Food Guide Pyramid: A Resource for Nutrition Educators. USDA, Food, Nutrition and Consumer Services. 5 Days Menus at 2,200 Calories Modern Paleolithic Diet Comparison: Dietary Characteristics for all Individuals in U.S. Versus: USDA Food Pyramid Recommendations (Red Values = Do Not Meet Recommendations Energy Carbohydrate (% total energy) Added sugars (% total energy) Fiber Total fat (% total energy) Saturated fat (% total energy) Saturated fat (% total fat energy) Monounsaturated fat (% total fat energy) Polyunsaturated fat (% total fat energy) Omega 3 fat Omega 6 fat Trans fatty acids (% total fat energy) Cholesterol Protein (% total energy) Total alcohol (% total energy) Sodium Potassium Salt (NaCl) Actual Pyramid 2002 kcal 51.8 % 16.1 % 15.1 g 32.8 % 11.3 % 37.4 % 41.4 % 21.2 % 2.3 g 13.0 g 7.9 % 256 mg 15.4 % 1.4 % 3271 mg 2620 mg 9.6 g Recom varies none 8.7 20-35g <30 <10 none none none none none none <300 (>9-11%) (<10%) <2400 none Percentage of All Individuals (2 yrs & older) Not Meeting 100% of 1989 RDAs in US (1994-96) 14 Nutrients Most Lacking in U.S. Diet v v v v v v v v v v v v v Summary: Differences in Actual Vs: My Pyramid Recommended Nutrients v v v v v v v Zinc = 73.3 % Calcium = 65.1 % Magnesium = 61.6 % Vitamin A = 56.2 % Vitamin B6 = 53.6 % Iron = 39.1 % Vitamin C = 37.5 % Folate = 33.2 % Vitamin B1 = 30.2 % Vitamin B2 = 30.0 % Vitamin B3 = 25.9 % Protein = 20.5 % Vitamin B 12 = 17.2 % v v v v v “Paleo Diet” Vs. Food Pyramid: Nutrient Characteristics (25 yr female – 2,200 Kcal) Protein (g) Protein (% energy) Carbohydrate (g) Carbohydrate (% energy) Total sugars (g) Fiber (g) Fat (g) Fat (% total energy) Saturated fat (g) Saturated fat (% total energy) Monounsaturated fat (g) Polyunsaturated fat (g) Omega 3 fat (g) Omega 6 fat (g) Cholesterol (mg) Sodium (mg) Potassium (mg) Paleo Diet 217 38 129 23 76.5 42.5 100.3 39.0 18.0 6.4 44.3 26.7 9.6 14.2 461 726 9062 Food Pyramid 113 20 302 53 96.6 30.0 67.0 27.0 19.6 7.0 22.8 19.0 1.0 14.3 219 2626 3450 Nutrient Values Refined sugars too high Fiber too low Total fat too high? Saturated fat too high Sodium too high Trace Nutrients (majority of population deficient): Vitamin B6 too low Vitamin A too low Magnesium too low Calcium too low Zinc too low “Paleo Diet” Vs. Food Pyramid: Trace Nutrients: 25 yr. Female – 2,200 kcal Vitamin A (RE) Vitamin B1 (mg) Vitamin B2 (mg) Vitamin B3 (mg) Vitamin B6 (mg) Folate (μg) Vitamin B12 (μg) Vitamin C (mg) Vitamin E (IU) Calcium (mg) Phosphorus (mg) Magnesium (mg) Iron (mg) Zinc (mg) PALEODIET % RDA 6386 798 3.4 309 4.2 355 60 428 6.7 515 891 223 17.6 733 748 1247 19.5 244 691 69 2546 364 643 207 24.3 162 27.4 228 FOOD PYRAMID % RDA 1,659 207 2.3 209 2.6 236 30 214 2.6 200 453 113 4.7 196 233 388 10 125 1215 122 1808 258 427 138 19 127 14 116 Food Group: Nutrient Density Ranking (nutrient/ energy) 13 Most Frequently Deficient Nutrients Nutrient Density for Food Groups (100 kcal samples) Superscripts are rank scores (7=highest;1=lowest) for each nutrient Whole Whole Grains Milk Fruits Lean Vitamin B12 (μg) 0.004 0.585 0.004 0.004 7.427 0.636 0.004 Vitamin B3 (mg) 1.124 0.141 0.893 2.735 3.196 4.737 0.352 Phosphorus (mg) 903 1525 331 1576 2197 1514 802 Vitamin B2 (mg) 0.052 0.266 0.093 0.337 0.094 0.145 0.041 Vitamin B1 (mg) 0.125 0.061 0.113 0.267 0.082 0.186 0.124 Folate (μg) 10.34 8.12 25.06 208.37 10.83 3.81 11.05 Vitamin C (mg) 0.01 1.54 74.26 93.67 1.95 0.12 0.43 Iron (mg) 0.904 0.081 0.692 2.597 2.076 1.105 0.863 Vitamin B6 (mg) 0.093 0.071 0.205 0.427 0.194 0.326 0.082 Vitamin A (RE) 22 505 946 6877 324 11 23 Magnesium (mg) 32.64 21.92 24.63 54.57 36.16 18.01 35.85 Calcium (mg) 7.62 194.37 43.04 116.86 43.15 6.11 17.53 Zinc (mg) 0.674 0.623 0.251 1.045 7.67 1.96 0.62 Sum Rank Score 42 43 47 82 66 51 39 Veggies Seafood Meats USDA Recommended Nuts/seeds v v v v v v v 6 Oz Daily Dietary Acid/Base Balance Potential Renal Acid Loads of Foods (100 g portion) + values = acid -values = alkaline Grains Brown rice Rolled oats Whole wheat bread Spaghetti Cornflakes White Rice Dairy Parmesan cheese Processed cheese Hard cheese Cottage Cheese Whole milk Legumes Peanuts lentils Peas 12.5 10.7 8.2 7.3 6.0 4.6 34.2 28.7 19.2 8.7 0.7 8.3 3.5 1.2 Meats, Fish, Eggs Trout 10.8 Turkey 9.9 Chicken 8.7 Eggs 8.2 Beef 7.8 Cod 7.1 Fruits Raisins -21.0 Black currants -6.5 Bananas -5.5 Apricots -4.8 Vegetables Spinach -14.0 Celery -5.2 Carrots -4.9 Lettuce -2.5 Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc 1995;95:791-97 Nutrient Density Rankings per Food Group 3 Cups Daily No. 1: Veggies (82) No. 2: Seafood (66) No. 3: Lean meats (51) No. 4. Fruits (47) No. 5. Whole Milk (43) No. 6. Whole grains (42) No. 7. Nuts/Seeds (39) Conclusion Displacement of vegetables, seafood, lean meats and fruit by whole milk reduces the overall dietary trace nutrient density U.S Diet: Acid/Base Balance v The average western diet produces a slight chronic metabolic acidosis v Net Acid Yielding: v 1. Cereal Grains = 23.9 % energy v 2. Meats, fish = 15.7 % energy v 3. Dairy = 10.6 % energy v 4. Nuts, legumes = 3.1 % energy v 5. Eggs = 1.4 % energy v 6. Salt (NaCl) = 9.6 g/day v Net Alkaline Yielding: v 1. Vegetables = 4.8 % energy v 2. Fruits = 3.3 % energy v Neutral (but displace alkaline foods): v 1. Refined sugars = 18.6 % energy v 2. Refined Oils = 17.9 % energy Kurtz I et al. Effect of diet on plasma acid-base composition in normal humans. Kidney Int 1983 24 670-80 Potential Renal Acid Load (PRAL) in Example Diet (PRAL Food Data from Remer & Manz, 1995) Alkaline Yielding Foods Cantaloupe Lettuce Carrot Cucumber Tomatoes Lemon juice Salad greens Avocado Almonds Onion Broccoli Strawberries Orange Celery Total Acid Yielding Foods Salmon Pork Beef Walnuts Total Weight (g) 276 68 142 78 331 62 112 85 45 29 468 130 66 90 PRAL/100 g -3.5 -2.5 -4.9 -0.8 -3.1 -2.5 -2.5 -3.5 -2.8 -1.5 -1.2 -2.2 -2.7 -5.2 Net PRAL -9.7 -1.7 -7.0 -0.6 -10.3 -1.6 -2.8 -3.0 -1.3 -0.4 -5.6 -2.9 -1.8 -4.7 -53.2 333 86 235 11 7.9 7.9 7.8 6.8 26.3 6.8 18.3 0.7 51.4 Summary: Health Implications Important Differences in Modern Paleo Diet Vs: Food Pyramid Recommended Nutrients v v v v v v v v v v v v v v v Nutrient Protein Refined sugars Glycemic load Fiber Saturated fat MUFA PUFA omega 3 PUFA Cholesterol Sodium Potassium Calcium Acid/Base All other trace nutrients Paleo higher lower lower higher lower higher higher higher higher lower higher lower net alkaline higher Pyramid lower higher higher lower higher lower lower lower lower higher lower higher net acidic lower Acid/Base Balance v The displacement of fruits and vegetables by cereal grains, dairy products and processed foods shifts diet to net acid yielding v Diseases promoted by a net metabolic acidosis: v 1. Osteoporosis v 2. Hypertension v 3. Kidney stones v 4. Stroke Sebastian A et al. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors Am J Clin Nutr 2002 76 1308-16 Potential Nutritional Shortcomings: The Paleo Diet vs. The Food Pyramid v No vitamin D? v Insufficient calcium? v Excessive cholesterol? v Excessive protein? “Paleo Diet” Vs. Food Pyramid: Calcium Intake: 25 yr. Female – 2,200 kcal Calcium Homeostasis & Bone Mineral Status: A Function of Calcium Balance v Balance = (Calcium In - Calcium Out) ACTUAL U.S. DIET PALEODIET % RDA 691 69 1215 122 v Calcium out: v 1. v v v 2. v v Calcium Homeostasis & Bone Mineral Status: A Function of Calcium Balance Total dietary calcium ingested Total dietary calcium absorbed from GI tract Calcium lost in urine a. Dietary calcium b. Body stores of calcium Calcium lost in feces a. Dietary calcium b. Body stores of calcium Calcium Density (mg/kcal) in Food Groups: 0.455 mg/kcal = Minimum density needed to Achieve RDA 2.5 1.28 1.5 1 0.5 0.061 0.075 0.175 Seeds/nuts 0.32 0.43 0.455 Whole Milk 0 Veggies v The RDA for calcium is 1000 mg for a 25 year old woman consuming 2200 kcal v Hence, the average calcium density of any single food needed to achieve the RDA is (1000mg/2200 kcal) = 0.455mg/kcal 1.94 2 Whole Grains v Calcium in (ingested): Lean Meats v Balance = (Calcium In - Calcium Out) Minimum 70 v 1. v 2. % RDA Fruits 701 % RDA Legumes Calcium (mg) v Calcium in: FOOD PYRAMID Conclusion: Of all Paleo Food Groups, only vegetables have a sufficient calcium density to meet the RDA for calcium How Much Vegetable Food Only is Sufficient to Achieve Calcium DRI (1000 mg) 25 yr Old Female, 2,200 kcal v Mean Ca+ density for 20 Commonly consumed vegetables in U.S. = (1.28 mg/kcal) v 1000 mg Ca/1.28 mg = 781 kcal of vegetables v 781 kcal/2200 kcal = 35.5 % energy Calcium Homeostasis & Bone Mineral Status: A Function of Calcium Balance v Balance = (Calcium In - Calcium Out) v Calcium out (urinary calcium): v A primary determinant of urinary calcium loss is acid/base balance v A net acid diet increases urinary calcium losses, a net alkaline diet prevents urinary calcium losses Sebastian A et al. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994 330 1776-81. Questions: How Do Hunter-Gatherers Maintain Calcium Balance & Healthy Bones Without Dairy Foods? v How Did Humanity Maintain Calcium Balance & Healthy Bones Prior to Agriculture? U.S Diet: Acid/Base Balance v The average western diet produces a slight chronic metabolic acidosis v Net Acid Yielding: v 1. Cereal Grains = 23.9 % energy v 2. Meats, fish = 15.7 % energy v 3. Dairy = 10.6 % energy v 4. Nuts, legumes = 3.1 % energy v 5. Eggs = 1.4 % energy v 6. Salt (NaCl) = 9.6 g/day v Net Alkaline Yielding: v 1. Vegetables = 4.8 % energy v 2. Fruits = 3.3 % energy v Neutral (but displace alkaline foods): v 1. Refined sugars = 18.6 % energy v 2. Refined Oils = 17.9 % energy Kurtz I et al. Effect of diet on plasma acid-base composition in normal humans. Kidney Int 1983 24 670-80 Potential Renal Acid Load (PRAL) in Example Diet (PRAL Food Data from Remer & Manz, 1995) Alkaline Yielding Foods Cantaloupe Lettuce Carrot Cucumber Tomatoes Lemon juice Salad greens Avocado Almonds Onion Broccoli Strawberries Orange Celery Total Acid Yielding Foods Salmon Pork Beef Walnuts Total Weight (g) 276 68 142 78 331 62 112 85 45 29 468 130 66 90 PRAL/100 g -3.5 -2.5 -4.9 -0.8 -3.1 -2.5 -2.5 -3.5 -2.8 -1.5 -1.2 -2.2 -2.7 -5.2 Net PRAL -9.7 -1.7 -7.0 -0.6 -10.3 -1.6 -2.8 -3.0 -1.3 -0.4 -5.6 -2.9 -1.8 -4.7 -53.2 333 86 235 11 7.9 7.9 7.8 6.8 26.3 6.8 18.3 0.7 51.4 Relation Between the Absorption Fraction of Calcium and Daily Dietary Calcium Intake % Calcium Absorbed 0.8 0.7 At the mean Ca intake (700 mg for 25 yr old female), ~25% of dietary calcium is absorbed 0.6 0.5 0.4 0.3 0.2 0.1 0 0 0.2 0.4 0.6 0.8 1 1.2 1.4 Calcium Intake (g/day) O’Brien K et al. Am J Clin Nutr 1996 63 579-83 1.6 1.8 2 Calcium Homeostasis & Bone Mineral Status: A Function of Calcium Balance v Balance = (Ca+ In - Ca+ Out) v Calcium in (absorption): v Hunter Gatherers spent most of the day outdoors v Increased sunshine exposure increased vitamin D synthesis in skin, thereby increasing intestinal calcium absorption, effectively reducing the calcium RDA Conclusions: v It is possible to achieve the RDA for calcium on non-dairy foods v Calcium balance is more important that RDA intake in determining calcium homeostasis v When ingestion of alkaline foods > acid foods, calcium homeostasis can likely be achieved at < RDA v To achieve a net dietary alkalosis total fruits + veggies = (~35-40% of energy) Except for Fortified Foods, There are No Natural Foods Containing Substantial Concentrations of Vitamin D v Cod liver oil is the only natural food containing high concentrations of Vitamin D v Starting in the 1950’s- 60’s v Milk and margarine was fortified with Vitamin D Cod liver oil was routinely Fed to children in the1940s1950s to prevent rickets “Paleo Diet” Vs. Food Pyramid: Cholesterol Intake: 25 yr. Female – 2,200 kcal Cholesterol (mg) ACTUAL U.S. DIET PALEO DIET FOOD PYRAMID RECOMMENDED INTAKE 256 491 219 300 Conclusions: Copper Eskimos: Circa 1913 v Hunter gatherers would have acquired virtually all body vitamin D stores via sunlight exposure v Exception: Hunter gatherers living in polar regions eating marine mammal and fish organs v Modern Paleo Diets require either sunlight exposure or vitamin D supplement Influence of Dietary Cholesterol Upon Serum Cholesterol Howell Equation: Allows the prediction of changes in serum cholesterol from changes (Δ) in dietary Polyunsaturated fat (PUFA), Saturated fat (SFA) & Cholesterol (CHOL) Δ serum CHOL (mg/dL) = 1.918 x ΔSFA – 0.900 x ΔPUFA + 0.0222 x ΔCHOL Where: SFA = % saturated fat energy PUFA = % polyunsaturated fat energy CHOL = dietary cholesterol (mg) Howell WH et al. Am J Clin Nutr 1997 65 1747-64 Interaction of Dietary (Polyunsaturated/Saturated) Ratio & Cholesterol Upon Serum Cholesterol 491 500 400 300 256 300 219 200 100 0 Actual U.S. Diet Paleo Diet Food Pyramid Recommended Conclusions: 1. Dietary cholesterol has a minimal effect upon serum cholesterol levels 2. When the dietary P/S > 0.8, additional dietary cholesterol has no effect upon serum cholesterol v The dietary P/S influences the effect of dietary cholesterol upon serum cholesterol v Lower P/S = Higher Serum CHOL v Higher the P/S = Lower Serum CHOL v At P/S of > 0.80, the addition of 750 mg of dietary cholesterol did not elevate serum LDL cholesterol 2 Dietary P/S v Lowering Dietary Cholesterol from 491 mg to 300 mg drops serum cholesterol by 4.5 mg/dl v Lowering Dietary Cholesterol from 491 mg to 219 mg drops serum cholesterol by 6.0 mg/dL v HIGH CHOL > 240 mg/dL v BORDERLINE CHOL = 200-239 mg/dL v DESIRABLE CHOL = < 200 mg/dL v Cutting dietary cholesterol from 491 to 219 would reduce a high cholesterol (240 mg/dL) to 234 or 2.5% Serum cholesterol (mg/dL) Dietary Cholesterol Has a Minimal Influence Upon Serum Cholesterol 1.48 1.5 1 0.9 0.56 0.7 0.5 0 Actual U.S. Diet Paleo Diet Food Pyramid Recommended Schonfeld G et al. J Clin Invest 1982 69 1072-80 Excess Dietary Protein: Can it lead to Kidney Disease? v Brenner Hypothesis: Increased Glomerular Filtration Rates (GFR) induce hyper-filtration causing glomerulosclerosis v Glomerulosclerosis causes elevated levels of albumin (plasma protein) in urine because of altered glomerular permeability v Reduced protein diets improve kidney function (reduce GFR & urinary albumin) in some, but not all patients with pre-existing kidney disease Brenner BM et al. N Engl J Med 1982 307 652-59 Excess Dietary Protein: Can it lead to Kidney Disease? Excess Dietary Protein: Can it lead to Kidney Disease? v Almost all studies of acute (1-4 wks) high protein diets show them to elevate GFR v Observational studies of vegetarians show them to have lower GFR than non-vegetarians v Does this evidence indicate that high protein diets promote kidney disease? v Not necessarily so v Why? Skov AR et al. Int J Obes Metab Disord 1999 23 1170-77. Skov AR et al. Int J Obes Metab Disord 1999 23 1170-77. High Animal Protein Improves Blood Lipids v Wolfe BM et al. Potential role of raising dietary protein for reducing risk of atherosclerosis. Can J Cardiol 1995 11:127G-31G v Exchange of low fat, animal protein for carbohydrate: 1. reduced LDL (9%), 2. reduced total chol/HDL (15%) 3. reduced triglycerides by 23% 4. increased HDL by 12% v The only long term trial of high protein diets (25 % energy) showed no deleterious kidney changes after 6 months v NO changes in urinary albumin (pre/post diet) v GFR increased, but so did kidney volume (measured via MRI) v GFR expressed per kidney volume did not change v Conclusion: kidney adapts to high protein diets in HEALTHY NORMALS Bison Steaks: 84% Protein, 16% fat High Protein Reduces the Risk of Heart Disease v Hu FB et al. Dietary protein and risk of ischemic heart disease in women. Am J Clin Nutr 1999 70 221-7 1. Nurses Health Study: 80,082 women followed since 1976 2. High protein intake (both animal & vegetable) were associated with low risk of coronary heart disease Alaskan King Crab Legs: 85% protein, 15% fat High Protein Increases Metabolism and Promotes Weight Loss PROTEIN has 2.5 - 3.5X the thermic effect (ability to increase metabolism) of either FAT or CHO PROTEIN exerts a higher effect upon both: 1) meal satiation and 2) post meal satiation than HIGH FAT or HIGH CARB food Thermic Effect PROTEIN = 261 kJ CARBOHYDRATE = 97 kJ FAT = 71 kJ Crovetti R et al. The influence of thermic effect of food on satiety. Eur J Clin Nutr 1998 52 482-88. High Protein Increases Satiation and Promotes Weight Loss Skinless Chicken Breast: 63% protein, 37% fat High Protein Diet is More Effective than High Carbohydrate Diet in Causing Weight Loss “Replacement of some dietary Porrini M et al. Weight, protein, fat and timing of preloads affect food intake. Physiol Behav 1997 62 563-70 Steamed Shrimp: 90% protein, 10% fat High Protein is Associated with Reduced the Risk of Hypertension & Stroke Hypertension v Obarzanek E et al. Dietary protein and blood pressure. JAMA 1996;275:1598-1603 carbohydrate by protein in and ad libitum fat-reduced diet, improves weight loss and increases the proportion of subjects achieving a clinically relevant weight loss.” Stroke v Klag MJ et al. The decline in stroke mortality. An epidemiologic perspective. Ann Epidemiol 1993;3:57175 Skov AR et al. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord 1999 23 528-36 Lean flank steak trimmed of visible fat: 62% protein, 38% fat Broiled Salmon Steaks: 62% protein, 38% fat High Protein Increases Survival Time for Patients with Breast Cancer Holmes MD et al. Dietary factors and the survival of women with breast cancer. Cancer 1999;86:826-35. “No survival advantage was found for a low fat diet after a diagnosis of breast carcinoma. However, increased survival was observed among women eating more protein, but not red meat” Steamed Lobster Tail: 89% protein, 5% fat THANK YOU! v MY BOOK: v Published by John Wiley & Sons, Inc. v 80,000 words v 12 Chapters v >350 references v Available at Amazon.com v My Webpage: www.thepaleodiet.com v Describes how to implement healthful, low glycemic, low saturated fat diets