Answers to Questions Posted by Blog Readers - 11.23.09

Dear Readers,

Thank you for your comments and questions! Our team is working to review your Paleo Diet-related questions and provide you with answers. We read all comments, and we are very interested in hearing your thoughts, learning about your experiences, and understanding what questions you have.

The Paleo Diet Team

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Blog Q: Ok, so I am just starting the diet and have just a few questions. I know processed grain/rice is a no but what about wild rice? I'm from Minnesota and my dad and I harvest our own rice from wild patches that grow in lakes. The rice is just then shaken and boiled and not processed so would this be an acceptable food?

Second question: my friend is the one who started me on this diet and she said that the only cheese that is OK is goat cheese. I know goat cheese is still dairy so I just wanted to confirm that it's a no-go and also if there are any cheese or cheese like substitutes.

A: Virtually all grains contain harmful substances namely lectins, alkylresorcinols, alpha-amylase inhibitors and protease inhibitors, independent of whether or not they are refined or whole grains. However, we believe that rice is probably the less harmful grain and wheat, barley, rye and maize the worst ones.

Regarding your second question, goat cheese is still a dairy product. Cow milk proteins are well studied and have been consistently demonstrated to be harmful to humans, but there's not enough literature to scientifically demonstrate that dairy products derived from goats have the same deleterious health effects. We think that because goat milk contain proteins from a different species it may have immunity stimulating proteins, and may therefore increase the risk of allergies or autoimmune diseases.

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Blog Q: I have been doing the paleo diet for a few months now, prior to this I followed
the Zone diet for 12 years. I have a mild autoimmune condition (lupus) ANA positive 1:64 speckled pattern. I used to get swollen knees, and a sore neck, but not any more using paleo foods combined with zone balance and added Omega 3 and vitamin D.

Other problems that are completely resolved are PMS (breast pain, but no more now), Severe menstrual pain (virtually none now with paleo, exercise and omega 3), Constipation (none now with paleo).

A couple of months ago I had blood tests and found a few problems. Thyroid: TSH slightly high 5.1, T4 okay. Also borderline low B12 and folic acid. Both of which I get plenty of in food and a supplement. I also have Raynauds (not very severe though).

Dr thinks they are all related to the auto immune problems. I would like to resolve the B12 and thyroid problem. I was using a little soy milk, but I've cut that out 6 weeks ago. I've started
taking iodine tabs (Kelp) and had to have a vitamin B12 injection. I would like to know what factors might be causing me not to absorb B12 and folic acid. Also how can I improve thyroid function.

No other health problems, I'm at my ideal weight, do CrossFit for exercise. I'm 50.

Julianne

A: Your thyroid problems might be caused by an autoimmune reaction. Many Celiac Disease patients also suffer from Autoimmune Thyroid Disease and the former disease is triggered by grains containing gluten such as wheat, rye and barley. Hence, avoiding foods containing gluten may decrease the risk of an autoimmune reaction against your thyroid gland.

Legumes, cereal grains, eggs, tomatoes, potatoes, chili peppers, quinoa, amaranth, and root beer are foods containing lectins and saponins. Lectins and saponins, along with gluten, increase intestinal permeability, allowing the increased passage of bacterial, viral or food antigens into peripheral circulation. Some of these antigens may have molecular similarity (molecular mimicry) with certain self antigens, like thyroglobulin, and therefore can trigger an autoimmune reaction of T-Lymphocytes against our own tissues.

Iodine supplementation is a good intervention since it is needed for T3 production. Selenium supplements can also help because it is needed for T3 (the active form of thyroxin) production. Selenium deficiency is common because the soil where vegetables are grown nowadays are empty of selenium.

Regarding B12, a substance known as Intrinsic Factor is needed in order to absorb B12. Intrinsic Factor is produced in a healthy GIT, hence a Paleo Diet devoid of saponins, lectins and gluten can improve the production of Intrinsic Factor and therefore B12 absorption.

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Blog Q: What is Dr. Cordain’s current recommendation regarding supplements? His books indicate supplementing certain vitamins (E, D, C, etc.) along with Selenium but I’m concerned that advice might be outdated. Recent literature (my apologies for not referencing them) along with some mainstream Dr’s--such as Dr. Dean Adel--indicate recent studies suggest supplements may be dangerous and to remove them all from your diet. Any comments or recent recommendations?

Similar Blog Q: In regards to the question on seafood, doesn't the recommendation to take supplements conflict with a recent newsletter that said vitamins aren't necessary? And that the human body wasn't meant to receive vitamins/antioxidants in pure form?

A: Dr. Cordain's current recommendations regarding supplements are based on the fact that our genome evolved in a diet rich in vitamins, mineral and phytochemicals compared to the typical western diet. In his scientific paper titled "The Nutritional Characteristics of a Contemporary Diet Based Upon Paleolithic Food Groups" he demonstrates that by eating a diet similar to what our ancestors did during 2.6 million years ago the amount of vitamins and minerals is much higher when compared to a typical western diet. This means that our "machinery", shaped by our ancient genome, needs high amount of vitamins, minerals and several other substances--not the ones recommended by current nutritional boards based on observations made in western populations. Hence, if you eat a Paleolithic diet you won't need to take supplements except for vitamin D, which is produced by the action of the sun in our skin. So, unless you have adequate exposure to sunlight (depending on season, latitude, skin color, etc.) you'll probably need to take vitamin D supplements.

In summary, if you've been eating a typical western diet, you are probably deficient in almost all vitamins and minerals, and will need to supplement them at least during a few months and cut them if you eat a Paleolithic diet most of the time. The ideal vitamins should be in their pure form.

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Blog Q: In the newsletter v5 #24, you recommend breastfeeding until at least 1-1.5 years.

Is there a chance that auto-antibodies can be passed on to the child through mothers milk so that the child has greater risk in developing autoimmune disease? If that is the case, is it better to stop breastfeeding and start giving solid paleo food earlier?

Do you know if auto-antibodies pass on to the child during pregnancy?

Sincerely, Ohana

A: Dear Ohana,

Mother's milk provides the breast-fed baby with what is called passive immunity, this means that the mothers antibodies pass through to the infant in order to protect it against infections. Hence, the infant is protected against the same bacteria or virus as the mother is. However, our team is not aware of any research demonstrating that this mechanism increases the risk of autoimmune diseases. What has been shown is that food peptides from the mother's gut can pass on to the breast milk and therefore to the breast-fed baby. This might increase the risk of autoimmune or allergy diseases.

The bottom line is to eat as Paleo as possible in order to not increase the risk of these possible mechanisms of disease.

Regarding your last question, yes, auto-antibodies pass on to the child during pregnancy.

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.

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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.

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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.

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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:

1. Increase your caloric intake using fat-dense foods such as olive oil, coconut oil, avocado or nuts. All of them sources of good fats.
2. 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.
3. 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.
4. 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.

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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.

Paleo Diet Q & A - 11.5.09

Dear Readers,

More Q & A from the Paleo Diet community:

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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.

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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.