* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download paleolithic health - Healthcare Professionals
Survey
Document related concepts
Obesity and the environment wikipedia , lookup
Ketogenic diet wikipedia , lookup
Vegetarianism wikipedia , lookup
Body fat percentage wikipedia , lookup
Fat acceptance movement wikipedia , lookup
Low-carbohydrate diet wikipedia , lookup
Abdominal obesity wikipedia , lookup
Raw feeding wikipedia , lookup
Calorie restriction wikipedia , lookup
Adipose tissue wikipedia , lookup
Human nutrition wikipedia , lookup
Saturated fat and cardiovascular disease wikipedia , lookup
Transcript
PALEOLITHIC HEALTH Randall F. Moore, M.D., J.D. Department of Psychiatry Scott and White Texas A & M College of Medicine OUTLINE • • • • • • • • • • Most important themes to remember Definitions Theory Hunter-gatherer diets Hunter-gatherer activities Hunter-gatherer outcomes Modern studies Recommendations Themes revisited Comments and questions MOST IMPORTANT THEMES TO REMEMBER • Organisms thrive best in the milieu and on the diet to which they are evolutionarily adapted • Various lines of evidence describe the way our ancestors lived • Paleolithic diet and exercise patterns improve health DEFINITIONS • Discordance hypothesis – The hypothesis that many of the diseases of modern humans occur in significant part because of discordance between our diet and lifestyle and the diet and lifestyle of our ancestors DEFINITIONS • Hunter-gatherer – A person who makes a living by hunting and gathering and who not does not rely on agriculture • Paleolithic period – Human history from the invention of the first stone tools 2.6 million years ago until the development of agriculture 10,000 years ago • 100,000 generations of human hunter-gatherers • 500 generations of agriculturalists • 10 generations in industrial age THEORY • Organisms thrive best in the milieu and on the diet to which they are evolutionarily adapted (genetically selected) – Human lifestyles have changed rapidly in the last 10,000 years – Human genome has changed 0.01% since advent of agriculture HOW WOULD A POLAR BEAR DO IN THE JUNGLE? HUNTER-GATHERER DIETS WHAT OUR ANCESTORS DID NOT EAT: GRAIN • 24% of modern U.S. diet by Calories • Humans cannot digest raw wheat, brown rice or corn • Cell walls must be mechanically disrupted by milling – First stone milling tools appear in the archeological record 13,000 years ago • Grain starches must be cooked to be made digestible MORE ON GRAIN • Refining grain eliminates most vitamins and minerals – Refined grains are junk food • Whole grains contain phytic acid • Phytic acid binds calcium, iron, magnesium and zinc and significantly limits their absorption from the gut • Grains acidify the body – The body releases calcium salts from bones and nitrogen (in glutamine) from muscles to neutralize the acidity – Grains make your bones and muscles weaker GRAIN AND BODY FAT • Whole and refined grains have high glycemic indices compared to fruits and vegetables • Grains strongly raise serum glucose and thus insulin levels • Insulin causes fat storage WHAT OUT ANCESTORS DID NOT EAT: DAIRY • 11% of modern U.S. diet by Calories • Hunter-gatherers did not keep dairy animals • Predecessors of modern cattle (aurochs) not domesticated until 7,000-10,000 years ago • Cave painting: auroch with horses MORE ON DAIRY • High insulin response • Many dairy products have high levels of saturated fats • Cheeses are strongly acidifying – Glutamine from muscles and calcium salts from bone used to neutralize acids – Dairy may cause net calcium loss from body WHAT OUR ANCESTORS DID NOT EAT: LEGUMES • Beans – Phytic acid • Peanuts – Peanuts very atherogenic in animals, maybe because of peanut oil lectin – Peanuts are fed to lab animals to produce atherogenesis WHAT OUR ANCESTORS DID NOT EAT: HUGE AMOUNTS OF SUGAR • Modern diet – 18.6% of diet by Calories – 152 pounds a year (including high fructose corn syrup) • Sugar strongly raises LDL • Hunter-gatherers consumed honey only seasonally – 2% of diet by Calories WHAT OUR ANCESTORS ATE: PLANTS VERSUS ANIMALS (LINES OF EVIDENCE) • Pre-mammalian and early mammalian ancestors • Studies of modern non-human primates • Archeology • Ethnographic studies • Biochemical analyses Important Principle • Evolution is conservative • Many of our biochemical mechanisms are hundreds of millions of years old PRE-MAMMALIAN, EARLY MAMMALIAN ANCESTORS • Therapsids (mammallike reptiles) – 200 million years ago – Primarily insectivorous • Early mammals – Primarily insectivorous • Insects nutritionally very similar to wild game Therapsid MODERN NON-HUMAN PRIMATES • Chimps – During dry season meat may account for 25% of energy consumed by males GUTS VERSUS BRAINS • Overall chimps eat much more plant food than meat • Much of the plant food is quite fibrous and hard to digest • Therefore, chimp’s gut is much bigger than human’s • Human brain is 3X chimp’s size and needs a lot of energy • That amount of energy requires more animal foods to ensure enough Calories and nutrients GUTS, BRAINS AND TOOLS • Archeological and fossil record – 2.6 million years ago primates first used tools to butcher animals – Shortly thereafter brain size began to increase • Meat, marrow and organs, especially brains, allowed the hominid brain to grow • A vegan expending 3,000 Calories per day would have to eat enormous amounts of food to consume enough energy – 30 pounds of tomatoes or 18 pounds of cantaloupe or 6 pounds of potatoes ARCHEOLOGY: FOSSILS • Calcium verus strontium ratios and nitrogen 15 isotope studies of early hominid bones imply consumption of significant quantities of meat • Isotope studies of Neanderthal bones imply those people were “top level carnivores” • Neanderthal child ANIMAL FOSSILS • Some archeological sites contain the bones of literally thousands of butchered animals • Pre-agricultural human encampments usually near game migration routes • Mammoth bones in modern Czech Republic Prehistoric Art • Prehistoric art often glorified hunting • Lascaux Cave, France: Bison and hunter HUNTING BIG, FAT ANIMALS • Hunters preferred big animals – Much more fat than small animals • Protein must be mixed with fat or carbohydrate • Diet with >40% Calories • San (Bushman) art from from protein leads to southern Africa sickness – “Rabbit starvation” RABBIT STARVATION • Diet with > 40% Calories from protein leads to sickness • Liver cannot metabolize protein fast enough and kidneys cannot excrete urea fast enough • Ammonia and urea become toxic • Symptoms: diarrhea, headache, fatigue, hypotension, bradycardia, hunger relieved only by fat or carbohydrate ETHONOGRAPHIC STUDIES • Ethnographic Atlas – Statistics on world’s cultures • 229 Hunter gatherer societies surveyed – 65% Calories from animals, 35% from plants • Only studies with explicit quantification of food – 11 excluding Innuit (no plant food available) – 2/3 of Calories from animal foods BIOCHEMICAL ANALYSES • Taurine – Essential amino acid – Not found in any plant food – Cows can synthesize, cats can’t – Humans have limited capacity to synthesize – Vegans have low serum levels BIOCHEMICAL ANALYSES • 2O carbon fatty acids – Required to synthesize eicosanoids, which include prostaglandins and leukotrienes • Involved in inflammatory control and central nervous system signaling – Herbivores can synthesize from 18 carbon fatty acids – Carnivores have very limited capacity to synthesize – Humans convert 18 carbon to 20 carbon fatty acids inefficiently WHAT OUR ANCESTORS DRANK • Water • Soda is second most consumed beverage in U.S. • Americans average consuming 44 gallons of soft drinks per year – Lots of sugar, lots of diabetes! – Lots of phosphorous, lots of bone loss! • All the sugar, twice the caffeine and no biologically redeeming value! WHAT OUR ANCESTORS ATE • Wild animals – Meat – Marrow and organs, including brains • • • • • • • Fish Shellfish Fruits Vegetables Nuts Seeds Eggs MACRONUTRIENT PROPORTIONS Hunter-gatherer Modern Carbs 35% Carbs 48% Fat 35% Fat 34% Prot 30% Prot 15% ETOH 3% CARBOHYDRATES • Hunter-gatherer – Low glycemic index fruits and vegetables – Honey: 2% of Calories • Modern – High glycemic index grains • 85% refined – Sugar: 19% FAT • Hunter-gatherer – Poly/Mono/Saturated ratio = 7/8/5 – 25% of fat is saturated – Omega 6/Omega 3 = 2/1 • Modern – Poly/Mono/Saturated ratio = 7/9/16 – 50% of fat is saturated – Omega 6/Omega 3 = 10/1 – 18% of total Calories from refined vegetable oils OMEGAS • Omega 6 fatty acids pro-inflammatory – Common in processed vegetable oils • Omega 3 fatty acids anti-inflammatory – = aspirin • Docosahexaenoic acid (Omega 3) JUNK IN YOUR TRUNK • 71% of modern diet consists of grains, refined sugars, refined vegetable oils and dairy • 0% of hunter-gatherer diet CHOLESTEROL • Modern average intake = 266 mg/day • Hunter-gatherer = 500 mg/day • Serum cholesterol driven more by saturated fat and refined sugars and less by dietary cholesterol intake • Cholesterol PROTEIN • Excluding water, protein comprises 50% of body weight DRIVE IT HOME… …YOU NEED PROTEIN TO BE HEALTHY • Excluding water, protein comprises 50% of of body mass • 86 year-old bodybuilder • Woman with anorexia nervosa PROTEIN • Modern – Ground beef – 15% fat by weight – 63% fat by Calories • High saturated fat • Omega 6/Omega 3 = 25/1 – 35% protein by Calories • Hunter-gatherer – Bison roast – 2.4% fat by weight – 16% fat by Calories • Low saturated fat • Omega 6/Omega 3 = 6/1 – 84% protein by Calories • Red on yellow kills a fellow MICRONUTRIENTS • Hunter-gatherer – Sodium < 1 gram • Yanomamö: 250 mg/day – Potassium 7 grams • Yanomamö men hunting • Modern – Sodium 3.5 grams • 10 grams NaCl – Potassium 2.6 grams FIBER • Hunter-gatherer – 70 grams/day • Modern – 15 grams/day HUNTER-GATHERER ACTIVITIES ARCHEOLOGICAL EVIDENCE • Early human bones similar to those of modern athletes who perform exercises requiring high peak efforts • Tendon insertion sites suggest great strength • Torsional strength of human femur – 25% higher in early Homo species compared to modern humans – Suggests greater repetitive use • Cross sections of tibia near knee – Anterior-posterior diameter greater than lateral diameter in early human males – Consistent with much long-distance running PHYSIOLOGY • Humans sweat (few animals do) • Humans have little body hair • These features suggest adaptation to prolonged activities generating a lot of heat HISTORICAL DESCRIPTIONS • Lewis and Clark – Native -Americans stampeded bison into ravine 8 feet deep – Bull bison > 1 ton each – 5 hunters pulled bison out of ravine and butchered them in one day HISTORICAL DESCRIPTIONS • Nootka natives of Vancouver Island – 16 men in 2 small boats rowed harpooned whales to shore • British colonialists in Tasmania – Recorded Tasmania Aboriginals throwing 15 foot spears 250 feet PLANES, TRAINS, AUTOMOBILES … … POWER TOOLS, TV AND VIDEO GAMES • Modern Americans are the weakest people to have ever walked the earth ETHNOGRAPHIC DATA: MODERN HUNTER-GATHERERS • Cross train to hunt and gather – Light, medium, hard cardio – Sprinting and jumping – Throwing and lifting • Alternate hard and easy days • Exercise is outdoors, in nature – Sunlight => Vitamin D – Nature => Lower stress • Dancing at night for hours is common ETHNOGRAPHIC DATA: BELIEVE IT OR NOT • In addition to the energy expended by a modern office worker, the modern huntergatherer expends enough energy to walk 12 miles a day (≈ 1,000 Calories/day) – Modern hunter-gatherers do live on more marginal lands than most of our ancestors did • More foot travel required to hunt and gather HUNTER GATHERER OUTCOMES ARCHEOLOGY • Our ancestors – Strong bones • Osteoporosis: very rare – Height • 1.6 million years ago: Homo erectus as tall as modern people; built like middle distance runner • Early agriculturalists 4 inches shorter than first Homo sapiens sapiens of 30,000 years ago • Cro-Magnon 25,000 years ago: men = 70 inches, women = 66 inches • Modern U.S. – Osteoporosis: 26% of women Caries • Late Paleolithic – 2% of tooth fossils show caries (usually small) • Modern U.S. – 92% of U.S. adults have had caries in permanent teeth DIVERTICULOSIS • Traditional Africans – Minimal incidence – Probably secondary to high fiber diet • Modern U.S. – 50% of those over 50 CAVE PAINTINGS DEPICTED LEAN PEOPLE Lascaux Cave, France RECENT HISTORICAL DESCRIPTIONS OF HUNTER-GATHERERS • Cabeza de Vaca: Native Americans in Florida in 1527 – “Wonderfully built, spare, very strong and very swift” • Rene de Laudonniere: Native Americans in 1564 – “Women … can swim over great rivers, bearing their children upon one of their arms” RECENT HISTORICAL DESCRIPTIONS • Captain Cook: the Maori in 1772 – “ … nor among the numbers that we have seen naked did we perceive the slightest eruption upon the skin” – “ … great number of old men … none of them were decrepit” • Henry Savage Landor: Borono Amazonians 1913 – “ … powerful chests … beautiful bronze torsi … arms were powerful, exquisitely chiseled … legs marvelously modeled, without an ounce of extra flesh” Body Composition • Hunter-gatherers – Minimal lean body tissue loss into old age, essentially no fat gain • Modern U.S. – Adults: 36% obese, 33% overweight – Children: 17% obese, 15% overweight • 60 year-old Waorani DIABETES AND CHOLESTEROL • Hunter-gatherers – Diabetes 1.1% – Cholesterol • • • • • • Aborigines: 139 Hadza: 110 Innuit: 141 San: 120 Mbuti: 106 Yanomamö: 133 • Modern U.S. – Diabetes 8.3% – Cholesterol: 210 BLOOD PRESSURE • Yanomamö aged 50+ – Women: 106/64 – Men 100/64 • Modern U.S. – Age 55-64: 54% have blood pressure >140/90 ATHEROSCLEROSIS • Kikuyu – Early 1900s – > 1,000 autopsies – No significant atherosclerosis • Modern U.S. – Healthy Korean War KIA – Average age 22 – Coronary atherosclerosis in 75% • Atherosclerotic coronary VO2 MAX • • • • • • • • Innuit: 56 Lapps: 53 Lufas: 67 Masai: 59 San: 47 Tarahumara: 63 Warao: 51 Western men: 41 Tarahumara ACNE • Common in western world – High glycemic load carbohydrates and insulinotropic dairy drive IGF-1 – IGF-1 stimulates sebaceous lipogenesis • Very uncommon in hunter-gatherers MODERN STUDIES 7 WEEK ABORIGINAL TRIAL • Urban-dwelling Australian Aborigines with DM2 • Return to bush in phases • Inland phase: 64% of Calories from animals • Weight lost: 17.6 pounds • Fasting glucose down 43% • Fasting insulin down 48% • VLDL down 90% 2007 DIET TRIAL • 12 weeks Paleolithic versus Mediterranean (self-policed after education) • Men with ischemic heart disease and DM2 or glucose intolerance • Same weight of food consumed—25% less Calories in Paleolithic group • Glycemic load 47% lower in Paleolithic group • Fasting plasma glucose – Paleo down 25% – Med down 13% • Fasting plasma insulin – Paleo down 16% – Med down 18% • OGTT AUC insulin – Paleo down 30% – Med down 13% • Waist circumference – Paleo down 5.3% – Med down 2.7% 2009 DIET TRIAL • 7 days ramp up, then 10 days controlled Paleolithic diet • Healthy, obese adults • Designed to not cause weight loss Fasting glucose down 5% Fasting insulin down 68% TG down 35% Total cholesterol down 16% • LDL down 22% • • • • – Compare: statins lower LDL 25-50% over 3 months EXERCISE AND THE BRAIN • ↑ dopamine, norepinephrine, serotonin • ↑ BDNF → neurogenesis, synaptogenesis • ↑ Fibroblast GF → longterm potentiation, neurogenesis, vascular genesis • ↑IGF1 → ↑ serotonin, BDNF receptors • ↑ Vascular endothelial GF → vascular genesis • Target HR → atrial natriuretic peptide → dampens NE (↓ anxiety) and ↓ CRH → ↓ cortisol → ↓ hippocampal damage • Anaerobic → ↑ ↑ BDNF and GH → neurogenesis and ↑ IGF1 HUNTER-GATHERER SOCIAL LIFE • Prolonged breast feeding (IgA and macrophages enhance immunity) • Respond to infant cries quickly • Patient indulgence of young children • Self-reliance and flexibility encouraged in children more than obedience • Multi-age play groups • Gender egalitarianism • Leaders build consensus more than they impose answers RECOMMENDATIONS DIET • Whole, natural, unprocessed foods as much as possible • Fruits, vegetables, berries, nuts, seeds – Walnuts, macadamia nuts, ground flax seeds for omega 3s • Lean meat – Bison, turkey, elk, deer, fish, shellfish • Northern white fish for omega 3s • • • • Eggs Cook with olive oil Drink water Don’t add salt EXERCISE • Cross train • Do light, moderate and hard cardio – Peak effort once or twice a week – Maximum brain benefit: hard cardio requiring mental and motor coordination • Vigorous strength training • Alternate hard and easy days • For sustained body fat loss expend: – 3,000 Calories per week for men – 2,600 Calories per week for women • Source: National Weight Control Registry • Exercise outside as much as possible – More reinforcing – Better lowers stress READING • The Paleolithic Prescription – S. Boyd Eaton M.D. – Marjorie Shostak – Melvin Konner, M.D., Ph.D. • The Paleo Diet – Loren Cordain, Ph.D. THEMES REVISITED • Organisms thrive best in the milieu and on the diet to which they are evolutionarily adapted • Various lines of evidence describe the way our ancestors lived • Paleolithic diet and exercise patterns improve health COMMENTS AND QUESTIONS and THANK YOU!