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Tuesday, December 8, 2009

Paleo Diet Q & A - 8 December 2009

Dear Readers,

Here's today's edition of Paleo Diet Q & A. Thank you for your contributions!

Q: I just listened to an interview of Cordain. He mentions that Huntington Chorea seems to be an autoimmune disease. I have Huntington Chorea in my family. So obviosly I'd like to know more about your or his findings. Could you please explain if there is any study showing this and what foods one should eliminate from the diet? I'd be so grateful.

Thanks,
Tim

A: Hi Tim,

Huntington's Chorea or Huntington's Disease (HD) results from lesions (alpha synuclein crosslinks) occurring in the brain which cause the characteristic symptoms (tremors and paralysis) of HD. It is well documented that a genetic basis underlies the development of HD. HD patients inherit a specific gene which causes increased expression of a protein called mutant huntingtin protein (mHTT). Whereas people without HD have inherited a gene which expresses the normal version of this protein, simply called, huntingtin protein (HTT). The over expression of mHTT at the expense of HTT is thought to cause the brain lesions of HD.

So, can diet have anything to do with whether or not a person with the mHTT genetic makeup goes on to develop the disease? Yes, and let me explain the underlying rationale. The imbalance in the mHTT to HTT ratio that occurs in HD patients requires the inheritance of the mHTT gene, however the gene cannot make its product without the presence of an enzyme called transglutaminase (TG). Transglutaminase is a post-translational enzyme (meaning that it is required to produce the gene product after the gene has been translated within a cell's nucleus). TG is a ubiquitous post translational enzyme that is found throughout the body's tissues, particularly in the gut, nervous tissue and brain. Without the presence of adequate concentrations of TG in the brain, mHTT cannot be produced in sufficient quantity to imbalance the mHtt to HHT ratio that results in HD.

So the $64,000 question in HD: what is the environmental trigger that causes over expression of TG in the brain? Plain and simple, it is wheat. More specifically, a storage protein in wheat called Gliadin. Unlike other dietary proteins, Gliadin is an unusual protein because it is resistant to the enzymes in the human gut (proteases) which normally degrade proteins into their constituent amino acids. Consequently, Gliadin arrives in the small intestine intact where it has recently been shown to bind a gut receptor (the CRX2 chemokine receptor). When Gliadin from wheat binds CRX2 it causes the intestinal cells to release a recently discovered enzyme known as zonulin. Zonulin release by gut cells causes the gut to become "leaky" and allow passage of intact proteins across the gut barrier -- including Gliadin itself.

Once Gliadin bypasses the gut barrier, it is immediately catalyzed by transglutaminase (TG) which is expressed by local intestinal cells. When you eat wheat on a daily basis, there is so much dietary Gliadin bypassing the gut barrier that it overwhelms the ability of the intestinal cells to produce the enzyme (TG) to catalyze the substrate (Gliadin). Intestinal cells as well as all other cells in the body react to this overload of circulating Gliadin by up-regulating (increasing) TG production.

The proof of the pudding lies in the experimental evidence. Unfortunately no randomized controlled trials of Gliadin free diets in HD patients have been examined to date. Having said this, I am aware of a single HD patient in S. California who was a member of a local CrossFit Gym, and who had been diagnosed with HD by a group of University neurologists employing MRI technology to detect the characteristic brain lesions. After approximately 8 months following adoption of a Paleo Diet (Gliadin free), this patient experienced a dramatic reduction in disease symptoms and subsequent MRI evaluation indicated a reduction in lesion volume. In addition to HD, numerous ataxia patients respond favorably to Gliadin free diets.

Cordially,

Loren Cordain, Ph.D., Professor

Q: In response to the idea that high glycemic foods can cause insulin resistance, what would be your response to people like Dr. John McDougall that claim there are plenty or cultures in Asia who live on diets consisting of high glycemic foods such as potatoes and rice but have little to no rates of diabetes or other chronic illnesses?

Here's a link to his article http://www.drmcdougall.com/misc/2006nl/july/glycemic.htm.

Thanks,

James

A: Hi James.

I believe (and we have evidence backing that up - see links below) that not all people will develop insulin resistance on a high glycemic load diet and not all people will see the same improve their body composition and/or insulin sensitivity on a low glycemic load diet. It appears to be dependant on your genotype (links to a few papers below). We have some examples of that: for instance, the aborigines don’t tolerate a high carb diet very well and the Kitava do better. But don’t forget that low glycemic load doesn’t automatically mean very low carb and high carb or normal carb doesn’t necessarily mean high glycemic load, as the glycemic load depends on the amount of carbs on a given serving of a certain food and the Glycemic Index of that food, so saying that the Asians eat a high glycemic load diet may not necessarily be true.

Another possibility that some people will develop insulin resistance on a high glycemic load diet (and some will not) is that a deprived fetal environment (which normally, but not always, leads to an underweight baby) may lead to a specific metabolic programming that has been called the trify phenotype, which means that these babies will develop various diseases of civilization when exposed to the postnatal environment (western diet and sedentary lifestyle) that is characteristic for affluent societies and of rapidly developing countries.

What I mean here is that depending on your genotype and/or epigenotype you may or may be not react adversely to a high carb diet. Moreover, there are also various variables that need to be considered when we want to know why certain populations suffer more from the diseases of insulin resistance, such as (among many other variables):

Exercise (it has a huge impact on insulin sensitivity and sarcopenia, a typical consequence of inactivity), leads to insulin resistance and an increased risk of the metabolic syndrome).
Vitamin D and/or ultraviolet exposure (for instance, in Kitava they don’t suffer from Vitamin D deficiency, whereas in the western world many of us do and there is evidence linking Vit D deficiency to an increased risk of Type 2 Diabetes and the Metabolic Syndrome, among various other diseases).
Magnesium deficiency is strongly associated to an increased risk of the Metabolic Syndrome and Cardiovascular diseases. Presumably this wasn’t a problem for our ancestrors and to many non-westernized populations, but it is a huge problem in the US.
Fructose intake – although our ancestors and many non-westernized populations around the world eat fruit, which is a source of fructose, fruit also has Vitamin C (which counteracts some of the adverse effects of fructose) and they don’t eat as much fructose as the Americans do, because HFCS has been added to many foods and because of the American eating habits (I’m Portuguese and I always get amazed when I go to the US and see what the people eat and the amount of sodas they drink and the amount of obese people I se there). In Dr. Cordain’s papers and in his lectures (I attended several) he mentions fructose as a cause of elevated uric acid and insulin resistance. And we have a spreadsheet with the fructose content of various foods for those who need to cut back on fructose intake (those who are already insulin resistant or have elevated blood uric acid levels and/or have been eating a very high fructose diet, which upregulates certain enzymes that need to be downregulated in order to reverse the effects of this high fructose intake and the only way to do it is by eating a very low fructose diet for a few weeks, before resuming a normal fructose diet (whose main sources are mainly fruit).
Bioactive peptides and antinutrients in Neolithic foods (see Dr. Cordain’s scientific paper on cereal grains here and Dr. Staffan Lindeberg’s research team paper on lectins and leptin resistance (link below).
Visceral fat – cytokines derived from visceral adipose tissue will cause insulin resistance.
Sleep deprivation – it may set off a hormonal cascade that may ultimately result in insulin resistance and Obesity.
Etc, etc…

We have to realize that many Americans have already the signs and symptoms of the Metabolic Syndrome and/or Type 2 Diabetes insulin resistance and many more have some degree of insulin resistance and for these people a low glycemic load diet may be very beneficial. But, as you may infer from our newsletters and from Dr. Cordain books and scientific papers, eating a low GL diet it is not enough and it is only a characteristic of the many general universal characteristics of pre-agricultural diets that Dr. Cordain and his research team have been deciphering over the past 15 to 20 years. AS so, if one wants to achieved optimal health, he shouldn’t focus only on one dietary characteristic, but on all of them plus the lifestyle that presumably shaped our genome during the Pliocene and Pleistocene (exercise, sun exposure or vitamin D supplementation + sleep + stress management + avoidance of environmental toxins).

All this sheds light on why some Asian populations live on a high carb diet, but do not develop the Metabolic Syndrome. Perhaps because they don’t overeat (remember that caloric restriction is the only proven way to increased longevity in many animal models and presumably one of the main reasons why you have so many centenarians in Okinawa), they don’t eat much fructose, they exercise, they don’t suffer from Vitamin D deficiency (and perhaps also magnesium deficiency), have “normal” sleeping patterns, etc, etc, etc.

Nevertheless, I would like to mention that apparently healthy people from India (living in India and eating their traditional vegetarian diet) have more visceral fat than healthy Caucasians and are more prone to Type 2 Diabetes and other diseases associated with the Metabolic Syndrome.

Finally, even in healthy people with no signs or genetic predisposition for insulin resistance, a high glycemic load diet may not be ideally, as it will increase glycolysis and it will decrease beta-oxidation (aging is associated with an increased glycolysis and decreased beta-oxidation and one of the mechanisms why caloric restriction increases longevity is believed to be a decrease in glycolysis and in increase in beta-oxidation). Moreover, it may increase inflammation (see link to paper) and, it may also cause several hormonal disturbances (elevated IGF-1 and androgens and decreased Sex Hormone Binding Globulin and IGFBP-3), which then increase our risk for various diseases, as you can see here, here and here.

I hope it helps

Pedro

Links to additional papers:

Saturday, December 5, 2009

Paleo Diet Recipes from the Paleo Diet Community

Dear Readers,

This recipe was emailed to us from a reader. If you have your own Paleo recipes you'd like to share with the Paleo Diet community please add a comment to this post.

Banana Pancake
Mash one whole banana. Add an egg, lightly beat together. For extra flavor, add coconut chips, vanilla extract (just a dash) and cinnamon.

Pour this mixture into a frying pan and cook as you would a regular pancake. This is one of my favorite things to eat! You can also do this with a grated apple. Enjoy! I now look forward to breakfast the Paleo way!

Cara

Paleo Diet Q & A - 5 December 2009

Dear Readers,

Thank you for continuing to post your comments and questions. Here's today's edition of Paleo Diet Q & A.

Q: Dear Dr. Cordain,

I am a PhD student, and I am starting to study how our instinct should lead us to enjoy the foods best suited for us, as it seems it does for any known animal.

Some of the first things I have found are your works. The point I am trying to get at is that we should have in us this instinct. So just one question. Do you know about, or have you read works of any authors that have made research on this point?

Best regards and many thanks.
Alfis.

A: Hi Alfis,

Off the top of my head, I can't remember any specific papers on the topic. However, there are thousands of papers on taste & humans have a proclivity towards sweet, salty and fatty. Under stone age conditions in which these tastes were associated with foods that limited and difficult to procure these tastes led us to foods that conferred survival value. In the modern world in which we have completely dissociated energy expenditure from energy intake we can eat anything that our taste guides us to in virtually unlimited quantity. Hence our hard wired tastes which once conferred survival value in a Stone Age environment now represent a liability in our western world of food abundance.

Best wishes,
Loren Cordain, Ph.D., Professor

Q: I understand the Paleo Diet to be primarily a removal from the diet of all grains, dairy products, and man-processed sugars. But what about potatoes, corn, and legumes (all of which cannot be digested raw and are high in starch), and natural sugars like maple syrup and honey? Do they fit into the Paleo Diet?

I bought and read the book years ago, but cannot remember the exact teachings on these particular foods, and cannot find clear teachings about them on the website. Perhaps I am looking in the wrong place?

A: Potatoes are not part of The Paleo Diet because they contain some harmful substances, namely saponins (solanine and chaconine) which can't be degraded by digestion or cooking. They can contribute to an increase in intestinal permeability which is associated to many chronic diseases.

Regarding legumes, they are also sources of saponins as well as lectins. Lectins are also toxic substances for the intestinal barrier, and they can adversely stimulate the immune system.

Corn is a cereal grain which is also a source of lectins (see Dr. Cordain paper entitled "Cereal grains: Humanity's double edged sword" in our published research section).

Sugars were part of our Hunter-gatherers ancestors' diet but not year round. So, use them in moderation.

Wednesday, December 2, 2009

Paleo Diet Q & A - 2 December 2009

Dear Readers,

Here's today's edition of Paleo Diet Q & A.

Q: I'm a beginner with the Paleo Diet. I want to try it out but I'm a vegetarian (I eat tofu, seitan, tempeh, fish, eggs, and cheese as replacements for meat). I understand I have to leave out the beans, but is it ok to use the rest of the replacements ? Thank you for an answer.

A: The Paleo Diet is based on foods similar to what our hunter-gatherer ancestors ate during the paleolithic era 2.6 million year to 10,000 years ago. That translates into 99.6 % of our evolution history. Our genome is perfectly adapted to eat foods similar to what we found during that period of time. This means eating lean meats, seafood, vegetables, fruits, and nuts. The agricultural revolution (10,000 years ago) lead to a dramatic change in human nutrition. Cereal grains, legumes, dairy, vegetable oils, salt, alcohol, and refined sugars comprise 72% of the nutrition in the modern western society. These foods contain harmful substances associated to many "diseases of civilization", such as diabetes, celiac disease and other autoimmune diseases, obesity, hypertension, certain cancers, acne, polycistic ovary syndrome, myopia, dyslipidemia, cardiovascular disease, etc.

Tofu and tempeh are sources of soy bean agglutinin (SBA). SBA has harmful properties because they break cell membranes. This can induce increased intestinal permeability, which is associated to certain autoimmune diseases and low-grade inflammation. SBA has also been shown to stimulate the immune system, something we don't want in an inflammatory disease.

Seitan contains the worst part of wheat namely gluten. Gluten is a prolamine peptide associated to many diseases typical of western civilization, such as celiac disease, type 1 diabetes, multiple sclerosis, ataxia, rheumatoid arthritis, etc.

So, if you want to eat a paleolithic diet without eating meat you should ensure a good protein intake using egg powder protein shakes along with some supplements:

Vitamin B12 1 mg per day
Taurine 1 gram per day
Carnosine 800 mg per day
Carnitine 400 mg per day

Q: Hi I'm about to have a child, and I don't want to bring it up on a diet of sugar and wheat. Do you have any research for children and the Paleo Diet?

A: No, there aren't any clinical trials for children and The Paleo Diet. However, the current advice for infant nutrition comes from nutritional boards who base their views on:

Western human diet observations.
Randomized controlled trials with single nutrients in a western setting.
Extrapolation of observation in western adults to infants.

This means these recommendations are not based on the evolutionary template, which dictates our metabolic and physiological needs.

For example, recommendations for formula milk composition are the opposite of what research on hunter-gatherer mothers' milk has found. Current recommendations for formula milk state that Linoleic acid content should be high, and saturated fats such as Lauric and Myristic acid should be low. This is the contrary to what we find in mothers on the island of Chole in Tanzania who eat fish, vegetables, fruits and nuts, and turns out that these people are free of "diseases of civilization".

Tuesday, December 1, 2009

Paleo Diet Q & A - 1 December 2009

Dear Readers,

Thank you again for your comments and new questions in response to our Q & A. Here's today's edition.

Q: I recognize that I feel much better on small amounts of lean meats with lots of veggies and some fruit, but I become very constipated. How can I correct this and stay on the Paleo Diet?

A: It is unusual to suffer from constipation when eating a lot of veggies, as they are the biggest fiber source. However, you can help your gut health with some supplements until the constipation improves:

Probiotics: between 6-9 billion bacteria/day during one month, then cut down to 4-5 billion.
Prebiotics: 4-6 grams a day during one month (if you do not improve with 4 grams increase up to 6 grams). Then cut down to 2 grams a day.
Coconut oil (a good source of Medium Chain Fatty Acids): a tablespoon per day.

Also, we suggest drinking 1.5 liters of water per day.

Q: I have just had the pleasure of stumbling onto your site and find it very interesting. I would be curious to know of your response to the "thumbs down" your book received by the Weston Price organization. I have found their endorsement of raw milk to also be very logical, but they were none too kind in their review. I look forward to your response, or a link to where you might have already addressed this. Thank You.

A: Here's a reply by Dr. Cordain to this question posted in the FAQ section in our website: http://www.thepaleodiet.com/faqs/#Misc

Q: I'm new to the concept of paleolithic diet, although that is what I have been eating due to some digestive issues. My favorite is just some type of meat and veggie soup. However, I'm not sure what to eat in the morning. I read that brown rice cereal is okay (which I have with hemp milk), and an apple. Is brown rice okay even though it is a grain (or so I thought anyway)? Thank you.

A: No, brown rice is not a Paleo-friendly food, as it is a grain. All grains contain substances such as lectins, alkylresorcinols, protease inhibitors and alpha-amylase inhibitors, which are lend themselves to some health problems. However, brown rice is devoid of gluten which is associated with many diseases.

Friday, November 27, 2009

Paleo Diet Q & A - 11.27.09

Dear Readers,

We hope you're gaining insight into The Paleo Diet and nutrition from the Q &A provided by the TPD community. Here's today's edition of Q & A.

Q: I've got a 10-year old boy who is 1.48m tall and weighs 36kg. He is very fit, with resting heart beat of 60 (he's been checked and has first degree AV heart block which is nothing to worry about). He's a high-performance tennis player and footbal player, training/playing 4 times per week. He also has a magnificent appetite and a real love for meat, chicken, salads and dairy products.

I want to gradually introduce the diet to him, which means a significant shift from his Readybrek (a sort of refined porridge for children) with chopped fruits, 3 pots of fromage frais, 250 ml of fruit smoothie and a slice of wholemeal toast. This is because after I introduced solids to his diet at the age of 10 months he developed this skin condition that has been misdiagnosed as eczema until now, when one of the many dermatologists he has seen, has suggested he might have keratosis pilaris rubra fascia, with the differential diagnosis being comedonal acne vulgaris. On examination he showed follicular white papules across both cheeks with background erythema which appears telangiectatic in areas. He also has one or two similar lesions on his upper arms and thighs.

However, I believe that there must be something in his diet that is causing this (although the doctors here seem to disagree) since he had never suffered from this skin condition until I stopped breastfeeding him at the age of 9 months, so I want to give this new way of eating a try. He's not in to junk food or sweet things (bless him!!), and he really wants for his skin condition to improve as he was recently bullied at school.

My questions are:

Is his calcium intake going to be affected and how to prevent it from happening?
Can I still give him soya milk/youghrt or even greek youghart instead of cow's products?
Where can I find appetising paleo recipes for children, including healthy breakfasts that will satisfy him?
I have purchased 2 of your books for the whole family as a starting point, as although we are all slim and eat pretty well, my husband and I have begun to put on a bit of weight around our waistlines and tend to feel quite drained with 2 children to take care of, so again, I want to give this diet a try.

I would really really appreciate if you could point me in the right direction as I am a great believer that you are what you eat and I am desperate to help my boy before he becomes a teenager with low self-esteem because of his facial appearance: he's already a bit shy.

A: Keratosis Pilaris is linked to elevated androgens and insulin serum levels leading to keratinocytes hyperproliferation (increased keratinocytes division). Both hormones are involved in another skin condition, namely acne. We receive many testimonials and I see many acne patients in my practice who have achieved outstanding results with The Paleo Diet. So, maybe The Paleo Diet can improve Keratosis Pilaris in your child, as it has a very positive response with androgens and insulin metabolism. The Paleo Diet relies on low-glycemic foods, and is free of dairy products, both of which are one of the causes of hyperinsulinemia and subsequent keratinocyte hyperproliferation.

You can find more details regarding acne treatment in our book The Dietary Cure for Acne available at our web site.

Regarding your questions:

No, calcium metabolism is not going to be negatively impacted, but rather improved with The Paleo Diet. Calcium metabolism is not only the amount you eat but also the amount your body eliminates. Calcium is one of the minerals able to reduce metabolic acidosis, produced by meat, fish, eggs, dairy and grains. Conversely, metabolic alkalinity is produced by vegetables and fruits. The Paleo Diet is rich in vegetables and fruits, meat and fish, and low in dairy and grains. This results in a net alkalinity state, meaning your body excretes less calcium. Broccoli, kale, brussel sprouts and cauliflower are good calcium sources.
Soy is not part of the Paleo Diet as soy is a bean/legume. Soy is a source of harmful substances, namely lectins, which could induce so-called leaky gut and low-grade inflammation.
Please visit our web site for a list of recommended recipes: http://www.thepaleodiet.com/nutritional_tools/recipes.shtml
The Paleo Diet is free of some of the known foods that cause insulin resistance and therefore central fat, such as grains and legumes, dairy, refined sugars and vegetable oils.

Q: I have read all of your website about curing acne naturally through diet and purchased the book. I had a baby a month ago and my face broke out very badly afterward, so I decided to try this. I've been doing it solidly for a week and a half and my face has gone from bad to ABSOLUTELY WORSE! There are nodules that are so inflamed on my upper lip that my lip itself is swollen. I have two on my forehead that are making the area between my eyes swollen. Not to mention--they hurt so bad!!

My questions is if going Paleo makes the acne worse before it gets better? If that's not it, I need to see a dermatologist and get on meds. I can't handle this much longer if it doesn't mean it is a sign of improvement. I really don't want to go on meds since I'm nursing my little one, but I need something because of how swollen and inflamed my face is.

A: The majority of acne patients see improvement in their symptoms within weeks. They typically don't get worse in the beginning. I am aware of some patients who see their symptoms dramatically worsen in the beginning--typically they are Rheumatoid Arthritis patients. This is due to the fact that in order to resolve inflammation an acute response is compulsory. Maybe this could be your case. Moreover, these RA patients noticed great improvement in 6 weeks. We don't know if your case will take the same amount of time.

However, this is a extremely strange phenomenon. We strongly recommend you use some helpful supplements:

Vitamin D start with 5000 IU per day and measure your blood levels
Omega-3 take between 3-4 grams of DHA+EPA per day
Zinc 50 mg per day
Probiotic 6-9 billion per day

Please keep us posted.

Follow-up response: Thank you for your response. You gave me enough to know that this probably wasn't normal. I went to a naturopathic doctor today who said I have impetigo. After doing my own research online, I see that this is probably the correct diagnosis for me.

Once the impetigo clears up, I think I'll stick with the Paleo Diet to clear up my regular acne. I will keep you posted!

Wednesday, November 25, 2009

Paleo Diet Q & A - 11.25.09

Dear Readers,

We hope you find the daily Q & A from the Paleo Diet community useful and insightful in your efforts to meet your health and nutritional requirements.

Q: I've read your books The Paleo Diet and The Paleo Diet for Athletes, and I find them very interesting. I am a 22 year old full time athlete from Norway, and my goal is to compete in the World Championship in Cross country skiing in 2011. Last year I got to represent Norway in the U23 WC in France, and now I put all of my energy in taking new steps towards my goals every day!

But.. I have a problem, that doesn't seem to go away. And it frustrates me!

After a lot of stomach trouble as a junior (18-19 years old), I've been focusing a lot on what to eat, and after reading your books, I think I've found the answer.

The doctors told me back then that I had an inflammation in my rectum (about 4 years ago). They gave me some medication and told me that it would go away, and it did. For a while... When it came back it got gradually worse, and I was pretty depressed at the moment. (My athletic performance wasn't very good either.) I became aware of what different foods do to your body, and a long story short, I cut out dairy products, wheat and rye. (I also started taking NDS probiotic.) Now I am mutch better, but not completely well. Sometimes I'm good, and sometimes I have symptoms again. And it wears me out!

Therefore I want to follow the guidelines of the Paleo Diet, given that I probably have a chronic inflammatory condition, and see if I can take out the rat once and for all! I hope you can be so kind to give me answers to a few questions that I have:

You say in your book that lectins from grains, dairy and legumes may be a "villain" in my situation. When I train a lot, I need to get some protein in step 3 (food system in The Paleo Diet for Athletes). Now I have soy protein powder and pea protein powder. Is there lectins in these products? And do you know of any other products to replace them?
When I train alot, I need a satisfying amount of carbohydrates. Is it ok to use potatoes and white rice (and starch/syrup)?
Is corn ok? And corn products (starch and syrup)? I read something about avoiding corn in the book.
I've cut out normal table salt, and replaced it with Himalaya salt (I'm told it contains more minerals). Should I also cut that out?
I have been making bread from amaranth, quinoa and other naturally gluten-free flours. Do these products also contain lectins, or other bad sources?
And at last: Would it be necessary to completely avoid grains, dairy and legumes if I want to get rid of this plague? Or can I sometimes, for example with friends, enjoy a pizza or a beer?

PS: Are there anything else I should be aware of?

A: Thanks for your interest in the Paleo Diet and I wish you well in your quest to compete in the World Cross Country Skiing championship.

Diet can have an impact upon athletic performance, and in my book, The Paleo Diet for Athletes, we show how a 1-2% performance difference can make or break whether or not an athlete places in a race. Gastrointestinal problems certainly can adversely affect performance,and as you have outlined in your case, a number of foods and food groups may promote GI upset. We do not recommend that dairy, grains or legumes be consumed by normals as well as athletes because of the numerous potential adverse health effects that these foods may elicit -- including GI inflammation and distress.

Whole grains and legumes contain not only lectins, but also saponins which adversely affect human gastrointestinal physiology as well as that in animal models. In my book, The Paleo Diet for Athletes, we recommend that in order for you to get sufficient carbohydrates in your diet you replace grains with high glycemic fruits including bananas, raisins, dates, dried fruit, and fresh fruits. Yams and sweet potatoes are also a good source of vegetable high glycemic load carbs. White potatoes can be problematic as they contain high concentrations of saponins which may exacerbate GI tract problems. Of all grains, rice seems to be the least problematic in terms of interacting with the immune system and GI function. Do I recommend it? Try it & see how you feel -- same advice for all dietary suggestions -- listen to your body -- it is the final judge. Corn and corn products also have been shown to adversely affect human GI tract function & you may want to experiment with eliminating these products. Endurance athletes in training may need additional sources of dietary salt to prevent hyponatremia (low blood salt) -- see my book for recommendations. Amaranth and Quinoa may contain high concentrations of saponins which as I pointed out with potatoes have the potential to adversely affect GI tract function by increasing intestinal permeability. These grains are also net acid yielding -- root foods like sweet potatoes or yams are better choices as are bananas and other fresh fruits and fruit juices. Food supplements containing soy or legumes should be avoided as they contain high concentrations of both saponins and lectins, which have been demonstrated in human and animal models to increase intestinal permeability, which concomitantly increases low level gut inflammation.

Yes, go out with your friends and enjoy a pizza and beer occasionally. It will do your spirit well. Life is also about fun and enjoyment. But know that when these foods become staples, your health may suffer. I suggest red wine and smoked salmon rather than beer and pizza. SALUD!!

Dr. Cordain

Q: I recognize that I feel much better on small amounts of lean meats with lots of veggies and some fruit.......but I become very constipated on this........how can I correct this and stay on the Paleo Diet?

A: It is quite strange to suffer from constipation eating a lot of veggies as they are the biggest fiber source. However, you can help your gut health with some supplements until constipation improves:

Probiotics: between 6-9 billion bacteria/day during one month, then cut down to 4-5 billion.
Prebiotics: 4-6 grams a day during one month (if you do not improve with 4 grams increase up to 6 grams). Then cut down to 2 grams a day.
Coconut oil (a good source of Medium Chain Fatty Acids): a tablespoon per day.
Drink 1.5 liter of water a day.

Tuesday, November 24, 2009

Paleo Diet Q & A - 11.24.09

Dear Readers,

Here is today's edition of the Paleo Diet Q & A. Thank you to everyone who has posted comments and questions.

Q: I enjoy your newsletters and eat an occasional Paleo Diet (I get lazy and eat like the norm and then get back to the Paleo way). Anyway it is my husband I am concerned with. Approx. 2 months ago he suffered from the H1N1 flu which moved into his lungs to bronchitis, then stress from work created heart palpation, shortness of breathe, dizziness, weight loss...the list goes on. I know the Paleo diet helps with a lot of aliments...what about stress

A: We believe that The Paleo Diet can prevent, or even reverse, many chronic degenerative diseases, included psychiatric diseases. We recently published a newsletter covering this topic, which you can purchase in our website (The Paleo Diet Update v5, #39 - Leaky Gut, Irritable Bowel Syndrome (IBS), and Psychiatric Disease).

Currently there aren't clinical trials showing the effects of The Paleo Diet on mood disorders, however a recent wide body of research shows that some pathways may link The Paleo Diet to mood improvement. A Belgian scientist has demonstrated the effects of a "leaky gut diet" (free of dairy and gluten) on mood and chronic fatigue syndrome. But this is not strictly a Paleo Diet, so we believe The Paleo Diet could even improve more, as briefly explained below.

Recent research has demonstrated that the mechanisms underlying depression and anxiety are:

a) Impaired neurotransmitter metabolism
b) Impaired neuroendocrine function
c) Impaired neural plasticity

Chronic low-grade inflammation is a the root of all of these pathophysiologic pathways. The Paleo Diet fights against inflammation because emphasizes a proper omega6/omega3 ratio and avoids immunostimulants substances such as lectins and saponins (found in cereal grains and legumes).

Hyperinsulinemia is also related to disrupted brain glucose metabolism and The Paleo Diet helps with hyperinsulinemia.

Furthermore, a critical point in low-grade inflammation is leaky gut syndrome or increased intestinal permeability. Increased gut permeability may allow increased passage of bacterial and/or dietary antigens into circulation inducing an immune activation and inflammation. The Paleo Diet is free of the foods that induce leaky gut syndrome and therefore low grade inflammation may decrease.

The case of your husband could be explained because a viral infection activates the immune system and high amounts of cytokines (immune cells messengers) are produced. Cytokines are at the root of the above mentioned pathways leading to depression and anxiety. A well known model of cytokine induced anxiety/depression is treatment with Interferon Alpha in Hepatitis C patients which often leads to depression or anxiety.

Q: I recently began my new life as a paleo eater – but I don’t seem to find information on coconut. Is it okay to eat the fresh and ground nut meat – and what about coconut oil?

A: Yes, I understand your confusion. The state of nutrition is very confusing, primarily because there is not an overriding paradigm that helps people put nutritional questions into context. We believe of course that the evolutionary paradigm can guide you to the correct answers, though ultimately the science speaks for itself.

On this page from our web site, you can see the fatty acid profile of various nuts: http://www.thepaleodiet.com/nutritional_tools/nuts_table.html

The most important factor to consider when eating fat is the composition. Our ancestors evolved eating a range of macronutrients that certainly varied by region and diet, but the fatty acid profile of the foods they ate were much different than that which the average Westerner eats today. Here is a good guideline for the composition of the fat you eat:

Monounsaturated fats –50% of total fat energy
Polyunsaturated fats – 25% of total fat energy
Omega 3 fatty acids – 7% of total fat energy (preferably long-chain omega-3s such as EPA and DHA)
Omega 6 fatty acids – 18% of total fat energy
Saturated fat – 25% of total fat energy
Stearic acid – 12.5% of total fat energy
Lauric, myristic, and palmitic acid – 12.5% of total fat energy

If you are eating healthful fats according to the above ratios, then you can eat a diet that is relatively high in total fat without running into problems.

So for instance, the American Heart Association (AHA) recommends that one not exceed 10% of total energy (not total fat energy). Thus, in 2,000 calorie diet, 200 calories are permitted by the AHA from saturated fat. In the Paleo Diet, only 12.5 % of all fats are pro-atherogenic, so even if 50% of total energy (1000 kcal) comes from fat, only 12.5% (125 kcal) is atherogenic -- well below AHA recommendations.

Certain saturated fatty acids downregulate the LDL receptor, leading to higher circulating levels of LDL (“bad”) cholesterol. These are primarily lauric acid (12:0), myristic acid (14:0), and palmitic acid (16:0), which should generally be limited to no more than 10% of total calories. Stearic acid, though it is a saturated fat, does not raise plasma cholesterol levels.

Grass-fed meat or wild game tends to have a healthful fatty acid profile, whereas most factory-farmed meat is raised on corn, and has a very different fatty acid profile which can lead to elevated cholesterol concentrations.

Coconut oil is about 90% saturated fat. Of that, 44.6% is lauric acid, 16.8% is myristic, and 8.2% is palmitic. So excess amounts will likely promote atherosclerosis, though this does not necessarily mean a heart attack will result. There has been research Jamaica and other areas where coconuts are a large part of the diet, where there is severe atheroma caused presumably by the coconut oil, yet the atheroma does not seem to cause coronary thrombosis.

Coconut oil also has medium chain triglycerides (MCTs), which can help promote gut integrity, and in general we would recommend anyone with digestive issues or autoimmune disease consider adding MCTs to their diet. Coconut oil would also be more stable for use in cooking, and would last longer before going rancid.

So, I hope that helps. The fat intake of our hunter-gatherer ancesters would have included marrow from long bones, and also long-chain omega-3 fats from brains. While we may not be able to (or want to) eat that way today, the closer we can emulate the dietary composition of our Paleolithic ancestors, the more we will be eating according to how our genome has evolved.

Friday, November 20, 2009

Paleo Diet Q & A - 11.20.09

Dear Readers,

We hope you're continuing to experience the health benefits of eating Paleo. Here is today's edition of Paleo Diet Q & A. If you find that reading our Q & A raises new questions for you about the Paleo Diet please post a comment and our team will respond.

Q: I have just started the diet. For years I have been using pan sprays without alcohol for cooking. With soy and soy oil being detrimental, how bad is soy lecithin? It's not only in pan sprays, but 9 out of 10 fish oil supplements.

I am the chef/owner of a Mediterranean restaurant. Eating a Mediterranean diet (and exercise) has made me healthier, but my triglycerides are way high--but then it appears to be genetic. Hoping the Paleo Diet will reverse this.

A: Yes, this diet should definitely lower your triglycerides. I do not know if soy lecithin contains lectins and saponins or not (two of the main problematic components of soy) – it is something we will have to look into, and perhaps cover in a future newsletter.

Q: I first want to thank you and your research group immensely for doing the work you do. I have read The Paleo Diet and The Dietary Cure for Acne, which have made a great impact in my life (and some of my friends' as well!). I have suffered intense acne for years and have tried basically every acne medication out there without success; except for Accutane because of the possible side effects. After two months of being on the diet, I can see incredible progress in my complexion and continuously see improvements. I cannot express the astounding changes with words; my family and friends are amazed. Again, for this I thank you deeply. I have also cherished the changes the Paleo Diet has brought to different aspects of my life, one of these has been better racquetball performance (I'm a racquetball aficionado).

I do have a quick question. In The Dietary Cure for Acne you explain how teens are most susceptible to acne because the body normally increase the amount of insulin in the blood in order to facilitate the adolescent growth spurt. Since the Paleo Diet decrease this insulin, does it also put the body in a less favorable state to grow (height-wise) than the normal American diet? (Assuming that all other variables as nutrients, vitamins, etc are the same.) I have noticed that the hunter-gatherers living today have a lower average height than Americans/Europeans. Is this the reason?

Although I am past my growth spurt, I have not recommended this diet to young teens because I would like to let them know about this information as well, if my conclusions are true. If they are not, please explain to me why not.

A: Thanks for the feedback and congratulations on your success. Yes, because insulin is a pro-growth hormone, it is possible that the increasing height seen in many people today is the result of a high-glycemic diet. It is also possible that the same diet may increase their risk for certain cancers as they age. Epidemiological studies also support this notion.

Q: I have read The Paleo Diet for Athletes and have put it into effect with excellent results. While obviously ground nuts should be a good substitute for flour, you don't mention chestnuts in your book. Are chestnuts and chestnut flour in the same category as almonds, walnuts, etc., or should they be avoided?

A: Yes, chestnut and chestnut flour are allowed in The Paleo Diet. Chesnuts belong to the nut family.

Wednesday, November 18, 2009

Paleo Diet Q & A - 11.18.09

Dear Readers,

Here's today's edition of Q & A from the Paleo Diet community. Thanks to those of you who've left questions and comments in reply to these posts. Our team is currently reviewing all outstanding questions and will have answers to post soon.

Q: My question is regarding the consumption of milk. There are a great number of coaches around the country who advocate at least moderate, if not generous, amounts of milk in their athletes' diets. Does it not provide a good source of protein and carbohydrate balance, not to mention the calcium content? What is the paleo stance on milk and why?

A: There are several reasons why not to consume dairy products:

Hominids evolved during 2.6 million years behaving as hunter-gatherers.

Although there wasn’t a single diet, and diet rather varied by latitude, season, climate, culture, etc., all ancestral diets shared key characteristics. Food sources were limited to unprocessed foraged plants, and unprocessed land and marine animals hunted from the proximate environment. As such, human diets consisted of combinations of wild animal carcasses (including brains, bone marrow, and organs), shellfish, fish, fruits, leafy vegetables, mushrooms, insects, larvae, nuts, seasonal honey, and eggs.

Ten thousand years ago, major changes in the environment happened, including the human diet. New foods, such as cereal grains, legumes, dairy, vegetable oils, refined sugars, fatty domesticated meats and salt, were introduced.

Since that time, there is strong evidence that our genome has remained essentially unchanged over the past 10,000 years. Evolutionary medicine predicts that these environmental changes may have caused adverse effects.

Indeed, it is believed that this mismatch between our ancient genome and the modern environment (including our modern diet) is at the root of the so-called diseases of western civilization, such as type 2 diabetes, obesity, dislipidemia, hypertension, certain types of cancer, acne, autoimmune diseases, myopia, polycystic ovary syndrome and more.

Regarding dairy, we know that this food group was not available for human intake prior to the onset of animal husbandry--roughly 9,000 years ago in the Middle East, and 7,000 years ago in Northern Europe. So dairy is a relatively new food on an evolutionary time scale, which explains why it may produce the following adverse effects, through different mechanisms:

Milk is a source of estrogens and dihydrotestosterone precursors, which can increase the risk of certain cancers and acne.
Milk increases IGF-1, and the IGF-1/IGFBP-3 ratio, and this increases the risk of certain cancers and acne--among other diseases--as explained by Dr. Cordain in his 2003 paper “Hyperinsulinemic diseases of civilization: more than just syndrome X” (http://www.thepaleodiet.com/articles/Hyperinsulinemic%20Diseases%20Final.pdf)
Milk contains insulin, and bovine insulin differs in only 3 amino acids from human insulin. This feature can increase the risk of Type 1 diabetes in genetically susceptible persons.
Betacellulin: is a hormone belonging to the EGF family of hormones. If it is confirmed that Betacellulin is able to enter circulation, then there is a very good possibility that it may increase the susceptibility of certain epithelial cancers.
Milk elevates insulin as much as white bread. Constantly elevating plasma insulin levels may lead to insulin resistance, which is at the root of several metabolic diseases such as obesity, type 2 diabetes or hypertension.
High calcium intake adversely affects zinc absorption, a key mineral in more than 300 enzymatic reactions.
Milk contains several allergenic proteins.
Dairy products, especially hard cheeses, yield a very high net acidic load which might lead to calcium and muscle loss and decrease growth hormone.

In sports nutrition BCAA intake is crucial for muscle recovery. Lean meat is the biggest sources of BCAA (33 grs/1000Kcal). Dairy contains much less BCAA (12 grs/1000Kcal), so if you replace lean meats with dairy you are taking much less BCAA which is crucial in muscle recovery.

Q: I was diagnosed with ulcerative colitis about 3 years ago. It started off as a very mild case but recently progressed to the point where my doctor was discussing having my colon removed if a new medication (Remicade) did not work. Being on Remicade has helped, and I was able to put 20 pounds back on. However, I do not believe in medication alone. I believe that diet is a key component to living a healthy life. I follow the Paleo Diet which has helped tremendously. I know that there are certain foods like night shade vegetables, which are part of the Paleo Diet, that I should avoid. Is there any other foods on the Paleo Diet that I should eliminate?

A: Yes, autoimmune patients should make some changes regarding The Paleo Diet:

Nightshade (potatoes, eggplants, peppers and tomatoes) should be removed from your diet as they contain harmful lectins and saponins.
Egg white is a source of a membranolytic (breaks cell membranes) protein--namely Lisozyme--and therefore should also be removed from your diet.
Remember that soy beans derived products, as well as peanuts, are legumes. They should be removed from your diet.
Another harmful nutrients are quinoa, amaranth and root beer.

You can find more info in our "How to Treat MS with Diet" program, which is available from our website: http://www.thepaleodiet.com/store.shtml.

Monday, November 16, 2009

Paleo Diet Q & A - 11.16.09

Dear Readers,

Here is today's edition of Q & A from the Paleo Diet community.

Q: Hello -- basically:

I'm 18 years weighing in at 11 stone 1/8 something like that.
I play 3 sports: cricket, hockey and rugby.
I'm not overweight.
I'm underweight by about a few pounds so not much.
I've stopped playing sports for the summer and have realized that i may soon be going over that okay perfect weight boundary
I eat anything fatty or not--it has never seemed to bother me until now, and I have stopped the chocolate and the booze for 2 weeks. Now I've tried to cut out the fat altogether.

I'm interested in using the Paleo Diet, and for my workout I'm trying "the 300 workout." I have realized a high amount of protein is required.

I just wanted to know if this diet will work for me. Will it help me gain muscle and become bigger built along with my workout? I have acne, so this diet is ideal already but I'm not overweight so is it ideal to take on this diet underweight or not to help with my workout?

A: In most people The Paleo Diet helps to maintain or achieve optimal body weight and fat/muscle mass distribution. If you are underweight you should increase your caloric intake with good fats such as olive oil, avocado, nuts, and protein from seafood, lean meats and eggs (if you don't suffer from an autoimmune disease). Branched chani amino acid supplementation will also help you to gain muscle mass.

Regarding acne, The Paleo Diet has been shown to dramatically improve this condition in most patients, demonstrated in a controlled clinical trial with 43 patients (Smith et al).

Q: I am completely satisfied with the switch over to eating paleo. I've been eating for three days strictly paleo but find myself hungry after each meal. I must admit I am not serving myself much fruit or vegetables at each sitting. I eat three meals per day but am hungry in between. Before increasing fruit and vegetable servings at each meal, is it appropriate to snack in between or should I just increase meat serving at each meal. I've been eating around 3-4 ounces per meal. Is this enough? Any suggestions

A: Basically, if you are still hungry, you need to eat more. This is a common experience many people have, because when you remove the bread, rice, or pasta you remove a whole lot of calories, so your plate should be overflowing with meat, fruits, and veggies. If you need a snack between meals that is ok too, though the first step I would recommend is eating larger meals.

Q: I am a registered dietitian and clinical nutritionist. I value the Paleo Diet and all the research you have done to support this way of eating. I am just trying to figure out your feelings and thoughts on protein powders. I am assuming because the sources of the protein are either whey, soy, or rice, that all are taboo. What do you think about Hemp since it is plant based? Or are there others to consider? Many of my clients and athletes prefer having a smoothie with fruits and vegetables, seeds, nuts, and protein powder. I would appreciate it if you could comment on this.

A: If the person does not have an autoimmune disease, we would generally recommend egg white protein as your best protein powder. Alternatively, you may want to consider a liquid amino acid supplement. You are correct, we do not generally recommend whey, rice, or soy, and I am not aware of studies looking at lectin content of hemp seeds, so cannot advise you there.

Thursday, November 12, 2009

Paleo Diet Q & A - 11.12.09

Dear Readers,

Here are today's Q & A from the Paleo Diet community.

Q: If I am a longtime Juvenile Diabetic (45 years), in very good shape despite the length of time with this disorder, would this diet work for me?

I am 5'3" tall and weigh 140 lbs. Recent complete blood work shows no problems of any kind.

I am wondering if the Paleo Diet would work for me despite my dependence on Insulin and refined sugars at times to reverse hypoglycemic onset.

A: Yes, The Paleo Diet will work well for you. Indeed, in our newsletter (v_5#36 2009) we reported how The Paleo Diet influences the different pathways involved in the disorder.

There're are several known factors of the western diet that trigger Type 1 Diabetes:

Proteins found in cow's milk: Beta-Lactoglobulin, Bovine Insulin, Bovine Serum Albumin and Beta Casomorphin-7
Proteins found in cereal grains: Gluten is a well known trigger of an autoimmune disease associated with T1D called Celiac Disease. A gluten-free diet led to improvement in insulin response during a glucose tolerance test.
Another factor at the root of almost all autoimmune diseases is increased intestinal permeability. Certain substances found in the typical western diet (lectins, saponins, gliadin, alcohol and capsaicin) may increase intestinal permeability.
Other factors such as diet's fatty acid composition or vitamin D deficiency contribute to the pathogenesis of T1D.

The Paleo Diet is free of all those harmful substances as it is based on lean meats, seafood, fruits, vegetables and nuts.

Finally, a low glycemic load will help you to better control your blood glucose levels in the long run.

Q: What is the calculation when prescribing fish oil? I am not intending to prescribe it to anyone I was just curious.

A: From an evolutionary standpoint, it seems that hunter/gatherers consumed around 1 gram a day of EPA+DHA, as stated by Dr. Cordain in his paper Dietary intake of long-chain polyunsaturated fatty acids during the paleolithic, World Rev Nutr Diet, 1998.

Taking into account that the intake of vegetable omega-6 fatty acids in the paleolithic was considerably lower than the western diet, 1 gram of DHA+EPA was enough for healthy people to achieve a 1:1 ratio of omega-6/omega-3 (which was the estimated ratio for late paleolithic hunter-gatherers). In the western diet the omega-6/omega-3 ratio is between 10-15:1, so we recommend to cut down vegetable omega-6 oils and increase the intake of fish oil (omega-3) to 2 grams of EPA+DHA (not all omega-3 is DHA and EPA and we need 2 grams of EPA+DHA). In case of an inflammatory and/or autoimmune disease increase this amount to 4 gram a day of EPA+DHA.

So, the bottom line is to eat fish 3-4 times per week plus a supplement of 2 grams a day, at least during the first 4-6 months. All of this depends on how much you adhere to The Paleo Diet. In case of autoimmune and/or inflammatory disease increase this amount to 4 grams a day.

Q: What is the effect of the Paleo Diet on seniors with respect to gout? I've heard that protein in one's diet can have an adverse effect.

A: Gout is considered as part of a metabolic syndrome and insulin resistance is at the root of gout. Along these lines, gout was rare among pre-agricultural populations (Hunter-gatherers). Serum uric acid levels depend on the amount entering the blood and the amount leaving the blood.

The amount of uric acid entering the blood depends on the amount of it produced by the liver (1/3 from the diet and 2/3 from the body turn-over of cells) and the amount of uric acid leaving the blood depends on the kidneys' excretion capacity. The metabolic syndrome and insulin resistance induce kidney underexcretion of uric acid. On the other hand, when the kidney is
faced with high protein purine-containing foods, serum uric acid levels decrease because the kidney increases uric acid excretion (this is an evolutionary trade-off).

So, the real problem is increased liver production of uric acid and kidney uric acid underexcretion. High glycemic load foods (as found in the typical western diet and not in The Paleo Diet) and subsequent hyperinsulinemia halt the kidneys' capacity to excrete uric acid. Regarding liver production of uric acid: fructose, and particularly High Fructose Corn Syrup (HFCS), decreases inorganic phosphate in the liver and this increases the production
of uric acid from purines.

The Paleo Diet helps to fight gout as is based on low glycemic load foods, high protein and no HCFS foods.

Wednesday, November 11, 2009

Paleo Diet Q & A - 11.11.09

Dear Readers,

More Q & A from the Paleo Diet community. We hope you're gaining insight into others' experiences with the Paleo Diet and the helpful responses from our team.

Thank you for your continued interest in the Paleo Diet.

Q: I recently purchased the Paleo Diet book and I was wondering about eating bacon. I’m assuming regular bacon is out of the question because it’s high in fat. I was curious about Turkey or Chicken Bacon. Are these allowed?

A: Yes you're right. Bacon is approximately 77% fat and only 21% protein, so it shouldn't be part of a regular diet. Moreover, the kind of fat in bacon is higher in saturated fats (they increase the risk of cardiovascular disease) compared to game meat. Chicken or turkey bacon is also high in fat.

Q: My friend and I are both on the diet. We are arguing about ground turkey. Is ground turkey allowed?

A: Yes, ground turkey is a Paleo-friendly food, especially if you eat the lean cuts, such as turkey breast.

Q: I'm reading The Paleo Diet for Athletes am an athlete, and I'm concerned about losing weight on the diet. How can I avoid losing weight and still eat Paleo?

A: If you are prone to losing weight there are a few things you should do:

Increase your caloric intake using fat-dense foods such as olive oil, coconut oil, avocado or nuts. All of them sources of good fats.
The Paleo Diet is high in Branched-chain Amino Acids (BCAA)-valine, leucine and iso-leucine. BCAA, are crucial for muscle recovery and muscle growth. BCAA are found in lean meats and fish, however you can use them as a supplement, especially in the 30 minute post-exercise period. Cereal grains are poor sources of BCAA compared to lean meats and fish. Egg whites are also a good BCAA source. The recommended dose is 6 grams/day as a supplement.
The Paleo Diet is high in net base carbohydrates. This means that the post-exercise metabolic acidity is halted by vegetables and fruits. This prevents muscle wasting as a result of metabolic acidity.
Use high-glycemic load fruits (bananas and grapes) and vegetables (sweet potatoes and yams) in the 30 minute post-exercise period to restore muscle glycogen levels.

Q: I am not a fan of the taste of shellfish or seafood. Can I still obtain the same benefits of this diet if I only eat the meat and not any of the suggested fish or seafood?

A: There are a lot of crucial substances for optimal health in fish and seafood, such as omega-3 fatty acids, zinc, selenium, vitamin E, etc. So, if you can't eat seafood we suggest you to take some supplements, such as:

Omega-3 fatty acids: EPA+DHA 3-4 grams a day.
Zinc: 25mg per day.
Multivitamin/multimineral supplements

Eat lean meat to ensure an adequate protein balance.

Tuesday, November 10, 2009

Paleo Diet Q & A - 11.10.09

Dear Readers,

Here are more Q & A from the Paleo Diet community. We're very encouraged by your responses to our posts so far, and our team is reviewing your questions left as comments here on the blog.

Thank you for your continued interest in The Paleo Diet.

Q: I am wondering your collective thoughts on grains that have been sprouted? Are these still a big no as well? My understanding has been that sprouted grains differ greatly than non-sprouted?

A: Yes, sprouted grains and beans are a much healthier option. When we 'sprout grains' we are allowing the seed to germinate and a shoot will emerge from the seed. This is the part that is cut off and eaten. Therefore, the seed itself is not actually consumed (as is the case with whole grains and wheat flours where the seed proteins and starches are milled and eaten). Since lectins are packaged along with the seed to protect against predation, once the seed sprouts, the lectin concentration diminishes within a couple days. In a week's time the sprouts should have no residual lectins.

Gliadin and glutenin are the dominate proteins located in the endosperm of the seed. The starchy endosperm is located alongside the embryo (germ) within the seed, and provides nutrients the embryo needs as it is sprouting and growing. Therefore, there should be no gliadin or glutenin proteins in the sprout, but rather primarily non-digestible cellulous (dietary fiber). One can consume sprouted grains and beans without fear of anti-nutrients. However, keep in mind that these are still nutritionally poor in terms of micronutrients. Leafy greens and other vegetables contribute high fiber AND a higher concentration of nutrients-grains are still 'nutritional lightweights'.

I would like to amend my earlier statement: We can consume GRAIN sprouts without fear of anti-nutrients. However, legume sprouts still appear to contain considerable concentrations of saponins--the secondary compounds responsible for increasing gut permeability. Alfalfa sprouts (which are actually in the pea family) have an especially high concentration.

Q: I am just starting on the Paleo Diet and have read the book The Paleo Diet. However, I do not find advice on combining foods. Can fruits, nuts, vegetables and meat be all eaten at the same meal, or should they be eaten at different times so that appropriate and efficient digestive processes can take place?

A: Usually Paleo Recipes would combine carbohydrates and proteins, such as a salad with turkey breast, however, we would recommend not mixing fruits with main meals as they sometimes produce bloating or indigestion because the sugars in fruits are not well digested when combined with either fats or protein. My advice is to listen to your body and see what happens when you eat fruit with protein or fats. If you don't experience bloating or indigestion, go ahead and eat fresh fruits for dessert.

Q: Is there a definitive test for leaky gut?

I am 64 years old and retired. I have lived in the central mountains of Colorado for the past seven years, and generally, in good health. I use a treadmill for walking in the winter with an occasional downhill ski day or snow shoe day. In the summer I hike and spend most of day outside around the house. I was glad to see your latest "Update" talks about people in their later years.

I have been on the Paleo Diet since 2004, each year getting closer to 100%. I stopped dairy except for once a month when a pint of B&J ice cream calls to me from the freezer. The grains were the last to go. A rye bread chicken sandwich for lunch was replaced with steamed fresh broccoli and chicken. Potato chips were finally replaced with pecans and almonds, but the table salt on all meals is still in my diet. I eat fresh fruit throughout the day. Supper was composed of tomatoes, celery, onions, potatoes, mushrooms, carrots, raisins, green peppers, spices and ground bison or chicken. I say was because I read a few weeks ago in The Paleo Diet Update about Leaky Gut, and realized the nightshade family of vegetables may not be good for me if I have a leaky gut.

I took a blood test about 17 years ago named the "ELISA/ACT". This tested the lymphocytes for their reaction to 235 purified foods, preservatives, and chemicals most commonly found in the American diet back in 1992. My results indicated a strong reaction to 11 items and an intermediate reaction to 13 items. I have avoided eating most these items since the test. My blood tests from the 9HealthFair for the last 5 years have been good. I had a colonoscopy 4 years ago which was good.

My questions are:

I know there is a definitive blood test for Celiac disease, but is there a definitive test for a leaky gut? If the blood test I took 17 years ago indicated food molecules in my blood, then will I always have a Leaky Gut to these foods? i.e. If I stop these foods for 2 months or more will my gut stop leaking?
If my blood tests results from the 9HealthFair were all in the normal range, then doesn't that indicate a Leaky Gut may not be present?

A: Yes, there's a test for leaky gut namely Lactulose & Mannitol Test, where test subjects ingest 10ml of Lactulose (a non metabolized sugar) and 10ml of Mannitol (an absorbable sugar). Your physician then collects urine for 6 hours after ingestion and measure sugars. Increased intestinal permeability is when the L:M ratio is between 0.15-0.40. Normal should be 0.04-0.09.

If you remove nutrients known to increase gut permeability, then the L:M test results will probably improve. However, if you've been following The Paleo Diet, then the L:M test should be OK.

Yes, if you eat The Paleo Diet, then the antibodies against those foods you tested for some time ago should decrease.

Q: Hi -- my husband was recently introduced to The Paleo Diet through his gym. He has lost over 40 pounds in just over 2 months and continues to lose weight even though he would have liked to level out a while ago. He is 6'1" and weighs 170 pounds and looks a little skeletal. What can he eat to help him level out and even gain a little weight back? Is there a web site that gives an example meal plan with desired calorie intake, or some tips you can give us to help prepare foods that will give him a little more fat?

I am unsure what to try besides having him eat avocados and lots of nuts, and drizzling olive and canola oils over his vegetables. All the websites we have gone through talk about the added benefit of weight loss achieved by this diet, but none that we have found so far tell you what to do to stop the weight loss once you have reached your desired weight. Thank you for your time!

A: If your husband is active he should emphasize a high glycemic load food post-workout, such as a recovery drink with glucose, bananas, grapes and Branched Chain Amino Acids (BCAA) with a dosage of 6-7 grams. This post-workout period lasts approximately 30 minutes, and is the best time to replenish your muscles with energy. Otherwise, his body will start to burn fat (and lose weight) in order to recover energy levels. He can also add a protein shake an hour and a half later, such as egg protein powder. The goal should be 1.2 grams/kg body weight.

Please keep us posted.

Please submit your comments and questions for the Paleo Diet team.

Paleo Diet Food Pyramid

Dear Readers,

Recently we received a question from a member of the Paleo Diet community asking whether there was a Paleo Diet food pyramid. Dr. Cordain published what he dubbed Humanity's Evolutionary Food Pyramid (aka The Paleo Diet Food Pyramid) in the inaugural edition of The Paleo Diet Update (Volume 1, Issue 1), originally published in February, 2005. The USDA food pyramid is also included in this post for reference.

The key recommendations Dr. Cordain suggested in his article from Volume 1, Issue 1 are:

Avoid the several ounces of grains per day the USDA Dietary Guidelines recommend.
Don’t buy into the diary industry’s well-financed and politically connected campaign to convince you that you need to drink milk.
Increase your intake of omega 3 fatty acids.
Eat more protein and less high glycemic load carbohydrates than are recommended by the USDA Dietary Guidelines.

Monday, November 9, 2009

Paleo Diet Q & A - 11.9.09

Dear Readers,

We hope you're finding our Q&A posts from the Paleo Diet community to be useful and informative. We've received several new questions and comments on previous Q&A posts, and encourage you submit yours.

We receive a great amount of feedback, and we are not able to always answer personally. We do read all questions, and are very interested in hearing your thoughts and learning about your experiences with the Paleo Diet.

Q: Dr. Cordain, I was interested in your Sept. 25th issue because of long standing problems (since the early 1980's) with Chronic Fatigue Syndrome and also various bowel problems. I have been doing quite well for the last seven or so years (thought I am 70 now) thanks to the Paleo Diet, but am not fully recovered. With regard to your list of foods to avoid, I do avoid, completely, all those foods except pepper with capsaisin. Over the course of a week, I consume 2 teaspoons of cayenne pepper. I do this specifically to help with widespread inflammation as capsaisin in known for healing inflammation. I am alarmed now that something I am eating is actually working against my recovery and healing, but I can't understand why a product that reduces the inflammation connected with CFS and bowel disease would be contributing to those diseases. Perhaps you made this obvious in your report, and I simply didn't understand it. But if you could make it more clear to me, in layman's language, I would be very grateful.

Thank you.

A: Yes, capsaicin has anti-inflammatory properties. However, in case of irritable bowel syndrome, capsaicin is able to increase intestinal permeability and this condition can increase the activity of the immune system lining the gut, which means low grade chronic inflammation, despite capsaicin's anti-inflammatory properties. In other words, increased intestinal permeability (and hence inflammation) exceeds the anti-inflammatory capacity of capsaicin. If you didn't have irritable bowel syndrome capsaicin would be an anti-inflammatory nutrient. As you may know, increased intestinal permeability allows increased passage of gut bacteria and nutrient antigens into circulation, and this is associated to CFS (see reference list of the last newsletter).

On the other hand, in the case of intestinal irritability, we recommend the use of several supplements such as Probiotics (6-9 billions/day), Prebiotics (2-4 grams/day, L-glutamine (0,2grs/kg/day), Zinc (25mg/day), vitamin D3 (test your blood levels and be sure to be in the 50-70ng/ml range) and omega-3 fatty acids (4 grams a day at the beginning).

We hope this helps.

Q: I am a personal coach working with some clients on health issues. At a table discussion last week a colleague mentioned that amaranth and quinoa are exceptions in the general GRAIN category and therefore acceptable in the Paleo Diet. I think not, but would like your opinion.

A: You are correct. Quinoa and amaranth are grain-like crops with potential harmful substances namely saponins. Saponins have been demonstrated to increase intestinal permeability which is one of the factors contributing to many autoimmune diseases, as well as irritable bowel syndrome. So, we recommend to avoid quinoa and amaranth, specially if you suffer from an autoimmune disease.

Q: I am not a fan of the taste of shellfish or seafood. Can I still obtain the same benefits of this diet if I only eat the meat and not any of the suggested fish or seafood?

A: There are a lot of crucial substances for optimal health in fish and seafood such as omega-3 fatty acids, zinc, selenium, vitamin E, etc. So, if you can't eat it we suggest you to take some supplements, such as:

Omega-3 fatty acids: EPA+DHA 3-4 grams a day
Zinc 25mg a day
Multivitamin/multimineral supplement

Eat lean meat to ensure an adequate protein balance.

Thursday, November 5, 2009

Paleo Diet Q & A - 11.5.09

Dear Readers,

More Q & A from the Paleo Diet community:

Q: I believe in the Paleo Diet and want to introduce it into my lifestyle but I have a chronic renal condition (IgA nephropathy) which is still mild. Can I still follow this diet but eating moderate protein instead of high? Or do you have any other suggestions to how I can go about it? The doctors never advised me to restrict my protein intake but I have read many articles that says that restricting protein intake benefits renal disease sufferers.

A: Circumstantial data from the Inuit people, before westernization, suggests that they ate high protein diets for a lifetime, and likely had normal kidney function. The available human data suggests that the kidney responds to a higher protein diet by increasing the glomerular filtration rate (GFR). This response is not pathological, but rather a healthful response as the effective GFR remains constant as kidney mass increases. The analogy is like a muscle that responds to lifting more weight - it hypertrophies (gets larger) to adapt to the increased load.

Yes, people with pre-existing kidney disease will worsen on a higher protein diet. My recommendation for these people would be to reduce the glycemic load of their diet (e.g. get rid of most processed food) first and carefully monitor kidney function until it begins to improve. Ironically, it is likely a high glycemic load diet that worsens kidney function in the first place.

Q: I am not yet on the Paleo diet, though I would really like to be. I do not doubt the validity of the science or the biology that leads to the Paleolithic diet being so successful. However, living in the Western world means that just about everything has dairy and grains in it, along with unhealthy refined carbohydrates and trans fatty acids, therefore the most logical and reliable way to get a healthy Paleo diet is to buy the basic organic ingredients and make meals from them oneself.

Unfortunately, I don't know what the correct proportions of the food groups for a well-balanced Paleo diet are; i.e. how much fruit and vegetables compared with lean meat compared with nuts and seeds compared with fish, etc?

I also wanted to ask about the sorts of foods that should be eaten instead of grains and dairy. Although I am aware that calcium uptake is based on many factors besides just calcium intake, what is the source of calcium in the diet? Fish bones and the like? For grains, what should we eat instead for those meals: I know it has been said that vegetables of some kind (or fruit) should be eaten with every meal, but what does that make breakfast and lunch besides a pile of vegetables?

What else do we eat with them?

With this increase in fruit and veg consumption (about how many portions per day do you recommend?), how do we prevent ourselves getting massive diarrhoea? I personally had one point in my life where I was eating over 30 portions of fruit and five portions of veg per day. Is this too much, perhaps even to the point of being unhealthy?

Furthermore, with this increase in meat and seafood consumption, even with the reduction in grain and dairy production, will not an increased percentage of Paleo dieters hasten the trends of soil erosion and landscape damage due to the increase quantity of land required for farming to feed people?

Finally, with increased individual meat consumption, would not the risk of things like gout increase? Would it not at least potentially be risking the same health problems and complications of the Atkin's Diet?

Thank you for your help.

A: Regarding the optimal proportion of fruits, vegetables, lean meats and seafood there's not a consensus. Some studies made by Dr. Cordain et al. have shown plant to animal ratio ranges from 35:65 to 65:35 percent. This depends on latitude, season, climate, culture, etc. However, all ancestral diets shared key characteristics. Food sources were limited to unprocessed plants for ages, and unprocessed land and marine animals hunted from the proximate environment. We believe that the most common pattern was 30-35% protein (40% is the toxic ceiling), 30% fats and 40% carbohidrates. This means that lunch and dinner are based on lean meats or seafood and vegetables. Breakfast could be an opportunity to eat fruits, nuts, eggs or even vegetables and protein (turkey breast), see our newsletter v5_#39. Fruits and nuts are good options for snacks.

Grains and dairy are nutritionally poor when compared to fruits, vegetables, seafood and lean meats. So, grains and dairy have no natural substitute. Milk and grains are usually eaten with breakfast, and I've provided some ideas for breakfast. In our published research section on our website you can download Dr. Cordain's scientific paper regarding grains titled: Cereal grains: humanity's double edged sword.

Broccoli, cauliflower, kale and all green leaves are good calcium sources without the problematic issues that dairy has: they increase metabolic acidity which leads to bone calcium loss.

Yes, too much fruit consumption is not the healthiest choice. High fructose intake is related to many metabolic diseases, especially obesity. Diarrhea is usually associated to fructose intolerance.

So, one doesn't have to precisely count caloric intake from protein, fats and carbohydrates as long as you combine seafood and lean meats with vegetables in meals and use fruits and nuts as breakfast and snack options.

Regarding gout: gout is considered part of a metabolic syndrome and insulin resistance is at the root of gout illness. Along these lines, gout is rare among pre-agricultural populations (Hunter-gatherers). Serum uric acid levels depends on the amount entering the bloodstream and the amount leaving the bloodstream. The amount of uric acid entering the bloodstream depends on the amount of it produced by the liver (1/3 from diet and 2/3 from body turn-over of cells). The amount of uric acid leaving the bloodstream depends on the kidneys' excretion capacity. The metabolic syndrome and insulin resistance induce kidney underexcretion of uric acid. On the other hand, when the kidney is faced with high protein purine-containing foods, serum uric acid levels decrease because the kidney increases uric acid excretion (this is an evolutionary trade-off).

So, the real problem is increased liver production of uric acid and kidney uric acid underexcretion. High glycemic load foods (as found in the typical Western diet and not in The Paleo Diet), and subsequent hyperinsulinemia halts the kidney capacity to excrete uric acid. Regarding liver production of uric acid: fructose--and particularly High Fructose Corn Syrup (HFCS)--decreases inorganic phosphate in the liver, and this increases the production of uric acid from purines.

The Paleo Diet helps to fight gout as it is based on low-glycemic load foods, high protein, and no HCFS foods.

We hope this helps.

Wednesday, November 4, 2009

Paleo Diet Q & A - 11.4.09

Dear Readers,

We are often sent questions from our readers about the Paleo Diet. We will publish these questions and our follow-up answers periodically to share with the Paleo Diet community. If you have specific questions regarding the Paleo Diet please send us a comment!

The Paleo Diet Team

Q: Are eggs (mainly just egg whites) considered to be an OK food for this diet?

A: Yes, egg whites are OK on The Paleo Diet. The only exception is autoimmune diseases. In that case you should avoid egg whites as some proteins in it (Lysozyme) may increase intestinal permeability which is at the root of many autoimmune diseases. Otherwise, you can eat egg whites.

Q: I started the program and I was wondering if Whey Protein or protein powder in general is against the diet.

A: Egg protein powder is a better option in order to avoid certain harmful whey proteins, specially if you suffer from an autoimmune disease. Whey protein also produces hyperinsulinemia (high insulin levels) which on the long run may produce insulin resistance and hence hormonal disruption.

Q: In the article in today's email "The Paleo Diet Promotes Greater Vitality in Later Years" by Pedro Bastos he writes about the Okinawan Diet. He writes that they don't eat potatoes but I understand that they eat lots of Sweet Potatoes.

A: Yes, probably they ate big amounts of sweet potatoes as some hunter-gatherers do in Kitava-Papua New Guinea. Our ancestors didn't have an universal diet because it depended on climate, season, latitude, culture, etc. This means that the amount of carbohydrates they ate varied substantially. So, for instance in Kitava they eat a lot of carbohydrates and still have no obesity, so it seems as if some bioactive substances of neolithic foods are responsible for hormonal disruption rather than merely carbohydrate content.

However, there's a big difference between potatoes and sweet potatoes. Potatoes are a good source of some known harmful substances namely saponins. They have the ability to increase intestinal permeability and hence increase the risk of autoimmune diseases (in genetically predisposed individuals), and induce low-grade chronic inflammation which is at the root of many chronic degenerative diseases. On the other hand, there's some preliminary data suggesting that some bioactive substances, such as lectins and saponins, contained in potatoes, grains, legumes, etc. can bind hormonal receptors impairing their function. This could be the case of leptin receptor leading to leptin resistance and some metabolic disorders.

Potatoes are a very new food for humans, as they came from North America less than 600 years ago. On the other hand, it seems that sweet potatoes are part of the human diet since a long time ago.

Q: Can you please give me some ideas for breakfast, as I am anxious to get started with The Paleo Diet?

A: First of all you have to take out of your mind the idea that a healthy breakfast is composed of milk, cereal grains and cookies. Not even Paleo-friendly foods such as fruits are the only options you have for breakfast, although they are one of them. Breakfast is just another meal of the day and as such you can eat lean protein such as turkey or chicken breasts, steamed vegetables, avocado, nuts, eggs (if you are not following the autoimmune plan), salmon and fresh fruit. Another good option is leftovers from the previous day's meals. I usually cook a large amount for dinner in order to have the next day's breakfast ready!

You can find more ideas in our website: http://www.thepaleodiet.com/nutritional_tools/recipes.shtml.

Tuesday, December 8, 2009

Paleo Diet Q & A - 8 December 2009

Saturday, December 5, 2009

Paleo Diet Recipes from the Paleo Diet Community

Paleo Diet Q & A - 5 December 2009

Wednesday, December 2, 2009

Paleo Diet Q & A - 2 December 2009

Tuesday, December 1, 2009

Paleo Diet Q & A - 1 December 2009

Friday, November 27, 2009

Paleo Diet Q & A - 11.27.09

Wednesday, November 25, 2009

Paleo Diet Q & A - 11.25.09

Tuesday, November 24, 2009

Paleo Diet Q & A - 11.24.09

Friday, November 20, 2009

Paleo Diet Q & A - 11.20.09

Wednesday, November 18, 2009

Paleo Diet Q & A - 11.18.09

Monday, November 16, 2009

Paleo Diet Q & A - 11.16.09

Thursday, November 12, 2009

Paleo Diet Q & A - 11.12.09

Wednesday, November 11, 2009

Paleo Diet Q & A - 11.11.09

Tuesday, November 10, 2009

Paleo Diet Q & A - 11.10.09

Paleo Diet Food Pyramid

Monday, November 9, 2009

Paleo Diet Q & A - 11.9.09

Thursday, November 5, 2009

Paleo Diet Q & A - 11.5.09

Wednesday, November 4, 2009

Paleo Diet Q & A - 11.4.09

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