Consumption of Nightshade Plants (Parts 1 -3) Newsletter Articles

Dear Readers,

The three most recent editions of our weekly newsletter The Paleo Diet Update (Vol. 6 Issues 15-17) featured Dr. Cordain's newest paper "Consumption of Nightshade Plants". The final installment (three of three) was published last week. All three parts of the newsletter will available for purchase as back issues from our web store until July 5, after which the entire paper will be available from our web store.

Thank you for your continued readership.

Blood Type and Diet Newsletter Article

Dear Readers,

Dr. Cordain's article "A Critical Examination Of Blood Type Diets" was published in a recent issue of our weekly newsletter The Paleo Diet Update (Vol. 6 Issue 14). If you're not already a subscriber you may purchase this informative article from our web store. Past issues of our newsletters are available for purchase individually, or as part of the entire archive.

Thank you for your continued readership.

Ishi: America's Last Known Hunter-Gatherer

by Patrick Baker

Imagine being the last of your kind and entering a world that is nothing like the world your grandparents knew. What if you could no longer live in the homeland that had sustained your ancestors for centuries? This is exactly what happened nearly a century ago for a Native American man known to the modern world as "Ishi."

Ishi ("man" in his native Yana language) was believed to be the last of the Yahi people, and is believed to be the last Native American to have lived the majority of his life outside of American culture as it existed in 1911. Ishi was the name given to the last known hunter-gatherer in America by Alfred Kroeber, an anthropologist at the University of California at Berkeley in 1911.

Ishi shown with anthropologist A.L. Kroeber in 1911¹

Dr. Cordain has been researching Ishi intensely for the past six months, having been first introduced to Ishi by his father at about 11 years of age. Dr. Cordain stated that "I now believe I have an answer to Ishi's final two to three years of existence" in his ancestral home on Deer Creek, located east of present day Los Molinos, California - before his appearance in October, 1911 at a slaughter house in Oroville, California.

Kroeber stumbled into Ishi's life following his "death walk" from his hunter-gatherer home on Deer Creek to the slaughter house near Oroville. Kroeber wrote of and exploited this Native American's life and culture before Ishi’s death in 1916 from tuberculosis.

Cordain states that "sleuthing via Google Earth and the early records of Dr. Kroeber in the academic literature has given me insight into the exact location of his final 'village' of residence, and how he spent the last two to three years of his life with his paralyzed mother at another location on Deer Creek." Historically, this site was known only to the long-dead Kroeber and his colleagues. Cordain states that "modern anthropologic and forensic examination of this site would help to clarify and demystify the legend of Ishi."

Dr. Cordain believes that eventual carbon dating of this site - once verified and reexamined - will reveal the missing two to three years of Ishi’s life before he became known to the world of 20th century America. Cordain has compiled his information and will contact the appropriate members of the California Anthropological community before deciding how to proceed.

Cordain’s research and writings indicate that a contemporary diet that precisely mimics hunter-gatherer diets is "obviously impossible, as most of us don’t have unlimited access to wild game and plant foods." However, Cordain’s studies indicate that "our health, well being and mental state improve, and we can emulate Ishi's personality, psychological state and health" by consuming fresh fruits, vegetables, lean meats and seafood, as documented in his book The Paleo Diet. Dr. Cordain’s dietary recommendations in The Paleo Diet include avoiding processed foods, grains, refined sugars, refined vegetable oils, and salted foods.

Dr. Cordain goes on to say that "Ishi's story is heart-wrenching, sad, warm, but human above all else. His spirit, optimism and love of life - despite the awful events which sealed his fate - represent a truly remarkable and final tale" of the hunter-gatherer lifestyle as it was once practiced by Native Americans and other indigenous peoples. Unfortunately, much of Ishi's life will remain undocumented and unknown, and, according to Dr. Cordain, "the available historical, archaeological and forensic evidence about his final days on Deer Creek as America’s last known hunter-gatherer are vaguely understood and highly speculative."

For many of our readers, the story of Ishi may be unknown, and lost in the fog of a long forgotten history our great-grandparents knew - particularly those among us who lived with Native American inhabitants of this continent, after the American population of European descent had settled in the American West.

References:

1. Heizer, Robert F. (Editor), Kroeber, Theodora (Editor). Ishi the Last Yahi: A Documentary History. University of California Press, 1981.
2. Kroeber, Theodora. Ishi in Two Worlds: A Biography of the Last Wild Indian in North America. Deluxe Edition. University of California Press, 2004.
3. Starn, Orin. Ishi's Brain: In Search of America's Last "Wild" Indian. W.W. Norton & Co., 2005.
4. DVD Documentary. The Last Yahi (2002). Linda Hunt (Vocals), Jed Riffe (Director), Pamela Roberts (Director)

Audio Interviews with Dr. Cordain

Dear Readers,

A collection of audio interviews with Dr. Cordain (MP3 format), including his March 30, 2010 guest appearance on Seattle's The Soul's Edge radio program, have been published on our web site. Visit our web site to download the recordings.

Paleo Diet Q & A - Whey Protein

Q: Could you please provide some details on the benefits/detriments of whey protein supplementation? I am a weight trainer/powerlifter and supplement with whey protein, which is currently touted as the best/most health-conscious choice there is. I have read in your newsletter about the inflammatory aspects of dairy products - is whey protein included in this? Is it better or worse than other dairy products?

Many people interested in the Paleo Diet who are also into strength training and fitness would be interested in your thoughts on this. Any pointers re: inflammation and supplementation of protein would be very well received. Thank you, in advance.

Best regards,
Karl

A: Dear Karl,

Unfortunately, at this point, most of the research has focused on the beneficial effects of whey. It basically revolves around whey's high BCAA content, its use as a post-workout recovery drink ingredient, and its capacity – due to cysteine – to increase Glutathione, a powerful endogenous antioxidant enzyme.

Nevertheless, we believe that whey protein can have some potential adverse effects, because it greatly elevates insulinemia - although it can be therapeutic for diabetics in the short term. We suspect that whey protein could be detrimental long term, as hyperinsulinemia can down-regulate the insulin receptor and lead to insulin resistance. Insulin resistance underlies the Metabolic Syndrome, and is implicated in various other diseases, such as Acne, Alzheimer, various cancers, Coronary Heart Disease, Myopia, PCOS, etc.).

But to be completely sure, we would need intervention studies with whey protein with a relatively long duration in people genetically prone to insulin resistance, or who are in fact insulin resistant.

Also, there is the matter of hormones in milk: estrogens, DHT precursors, Insulin, IGF-1 and the hormone Betacellulin (BTC), which Dr. Cordain has discussed in a previous edition of this newsletter. These are some of the possible mechanisms for which there is repeated epidemiological evidence associating milk consumption with some cancers - especially Prostate Cancer.

We know that these hormones are present in milk and - in the case of BTC - it is present in whey too. Nevertheless, the real content of all these hormones in commercial milk-derived products is an open question that deserves proper and urgent study. So while we don’t know for sure, and since and we have alternatives, I would follow the old saying: do no harm!

Finally, if you have an auto-immune disease or allergy to Beta Lacto Globulin (protein that exists in bovine milk, but nonexistent in human milk) I would stay away from whey. Whey contains not only Beta Lacto Globulin, but also Bovine Serum Albumin. Some peptides from this protein have structural homology with peptides from our own tissues, and BSA has been implicated in Multiple Sclerosis, Rheumatoid Arthritis and Type 1 Diabetes.

In conclusion, I would follow the evolutionary template until all these issues are resolved. which states that recently introduced foods may have potential adverse effects to humans, especially long term. Non-human milk was only introduced in the human diet ~10,000 years ago. Therefore, given the potential health hazards of milk that science is revealing, I would use another protein source. Lean meat and seafood are very good sources of BCAA. If you want a protein drink immediately after strength training to speed recovery and increase muscle mass, I would suggest ~9 grams of essential amino acids, along with a banana.

I hope this helps.

Cordially,
Pedro Bastos

Editor's note: the following blog posts also discuss whey protein:

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


• Q: I like drinking protein shakes in the morning, but I noticed some of the protein sources in my protein shake are made from milk or dairy products. Is there an alternative that is available in the market place?


• Q: I am just trying to figure out your feelings and thoughts on protein powders.

Additional reading: Hyperinsulinemic diseases: more than just Syndrome X.

Paleo Links

Dear Readers,

In addition to our paleo nutrition links on the right-hand side of the blog (scroll down if not visible), here are useful links for fitness, Paleo Diet, and paleo nutrition-related web sites and blogs.

• Nell Stephenson Fitness and Nutrition
• Robb Wolf - Intermittent Fasting, Fitness, & Paleolithic Nutrition
  
• Hunter-Gatherer - Health and human nature from an evolutionary perspective
  

Paleo Diet Q & A - Sprouted Legumes

Q: Hi, the Paleo Diet makes a lot of sense to me and I very much appreciate the research that's gone into it. However, am I right in thinking that any diet we are adapted to may nevertheless not be an ideal diet? We adapted to a diet that enabled us to be healthy enough to live long enough to reproduce healthy enough offspring.

If I understand correctly, couldn't certain foods could make that basic diet even healthier? For example, I have The Paleo Diet for Atheletes out from the library right now and I see that you believe that the life of an athlete requires departure from a strict paleolithic diet. Couldn't properly treated grains and legumes be beneficial additions to the diet? (i.e. soaked/sprouted to reduce/eliminate anti-nutrients?)

I am waiting to receive The Paleo Diet from the library (I'm on a long waiting list, which is good news I guess!) so maybe you address this issue in the book, in which case, I apologize. But if not, I would appreciate knowing your views on soaking/sprouting grains and legumes, and the reasons behind those views.

Thanks so much,
Zena

A: Dear Zena, first of all - thanks for supporting our work.

Lectins, one of the known antinutrients in cereal grains and legumes¹, have been demonstrated to exert several deleterious effects upon human physiology¹, (especially for those with autoimmune diseases) by increasing intestinal permeability². Their function is to protect the plant against attacks by plant-eating animals by using several toxic substances, such as lectins³. There is a growing body of evidence showing that both the root and the sprout of wheat kernels have significant amounts of wheat germ agglutinin (WGA), one of the most studied lectins. Indeed, WGA originates in the wheat kernel, especially during germination and growth⁴, and the highest concentrations are found in young plant roots, seeds, and sprouts.

Lectins are resistant to digestive enzymes, and are found intact in peripheral circulation, as shown by Wang et al (1998)⁵. Furthermore, they are deposited in the internal organs⁶.

As stated by Pusztai et al⁷, lectins are heat stable, and normal cooking does not completely eliminate these toxic compounds unless they are pressure cooked^8-11. The best way to reduce lectins' adverse health effects is to limit their intake.

In addition, saponins - another type of toxic/antinutritive compound - exist in legume sprouts. Saponins have been shown to affect the gut barrier and by extension immune system function¹². They may also increase the risk of autoimmune diseases in genetically susceptible individuals¹³. Soaking, sprouting or cooking legumes, does not reduce their saponin content^{14, 15}.

In addition, a peptide fraction from gluten proteins called gliadin is found in wheat. Gliadin is resistant to digestive enzyme degradation¹⁶, arrives intact when it comes into contact with intestinal epithelial cells¹⁷, and increases intestinal permeability. Increased intestinal permeability may be at the root of autoimmune diseases such as Celiac Disease and Type 1 Diabetes¹³.

Phytate, the main form of phosphorus storage in many plants (especially bran and seeds) is classified as an antinutrient because is a chelator of iron, magnesium, calcium and zinc¹. Phytate ingestion inhibits the intestinal absorption of those minerals. Phosphorus from phytate is unavailable to humans, as we do not produce the phytase enzyme necessary to break down phytate - unlike ruminants, who do produce phytase, and are able to digest phytate¹⁸. Yeast fermentation in bread reduces phytate content¹⁹. Furthermore, addition of ascorbic acid counteracts the inhibitory effects of phytate upon iron absorption²⁰. Soaking and fermentation reduces the phytate content of grains and legumes as indicated in several studies^{21, 22, 23, 24}.

Having said that, Dr. Cordain in his first book talks about the 85:15 rule, where he explains that 85% of caloric intake from modern paleolithic-like foods is still more healthy than the typical western diet, where more than 70% of caloric intake comes from foods introduced in the human food chain after the agricultural revolution²⁵.

The bottom line is that our metabolism is perfectly adapted to the nutrition that shaped our genome during million of years of evolution. Therefore, any nutrient introduced after the agricultural revolution may not be compatible with our ancient genome. We believe that anyone engaged in athletic activities could do very well on a diet based on 85% paleolithic nutrients, which are preferable to the nutrients found in the typical western diet.

I hope this is helpful.
Maelán Fontes

References:

1. Cordain L. Cereal Grains: Humanity’s Double-Edged Sword. World Rev Nutr Diet. Basel, Karger,
   1999, vol 84, pp 19–73.
2. Cordain L. et al. Modulation of immune function by dietary lectins in rheumatoid arthritis. British
   Journal of Nutrition (2000), 83, 207–217.
3. Chrispeels, M.J. & Raikel, N.V. (1991) Lectins, lectin genes, and their role in plant defense. Plant Cell 3, 1-9.
4. Miller, R., & Bowles, D. (1982). A comparative study of the localization of wheat-germ agglutinin
   and its potential receptors in wheat grains. Biochem. J., 206, 571-576.
5. Wang Q, Yu LG, Campbell BJ, Milton JD, Rhodes, JM. Identification of intact peanut lectin in peripheral
   venous blood. Lancet 1998;352:1831-32.
6. Caron, M. & Steve, A.P. (2000) Lectins and Pathology, Taylor & Francis, London.
7. Pusztai A and Grant G. Assessment of lectin inactivation by heat and digestion. From Methods
   in Molecular Medicine. Vol 9 Lectin methods and protocols. Edited by J M Rhodes and J D Milton Humana
   Press Inc. Totowa, NJ.
8. Grant G, More LJ, McKenzie NH, Pusztai A. The effect of heating on the haemagglutinating activity
   and nutritional properties of bean (Phaseolus vulgaris) seeds. J Sci Food Agric 1982;33: 1324-1326.
9. Boufassa C, Lafont J, Rouanet J M, Besancon P 1986 Thermal inactivation of lectins (PHA)isolated
   from Phaseolus vulgaris. Food Chem 20 295-304.
10. Buera M P, Pilosof A M R, Bartholomai G B 1984 Kinetics of trypsin inhibitory activity loss in
    heated flour from bean Phaseolus vulgaris. J Food Sci 49 124-126.
11. Collins J L, Beaty B F 1980 Heat inactivation of trypsin inhibitor in fresh green soybeans and
    physiological responses of rats fed the beans. J Food Sci 45 542-546.
12. Patel B, Rober S, Sporns P, et al. potato glycoalkaloid adversely affect intestinal permeability
    and aggravate inflammatory bowel disease.
13. Visser J, Rozing J, Sapone A et al. Tight junctions, Intestinal permeability and Autoimmunity.
    Ann. N. Y. Acad. Sci. 1165: 195-205 (2009).
14. Ruiz RG, Price K, Rose M, Rhodes M, Fenwick R. A preliminary study on the effect of germination
    on saponin content and composition of lentils and chickpeas. Z Lebensm Unters Forsch 1996;203:366-369.
15. Ruiz RG, Price KR, Arthur AE, Rose ME, Rhodes MJ, Fenwick RG. Effect of soaking and cooking on
    the saponin content and composition of chickpeas (Cicer arietinum) and lentils (Lens culinaris).
    J Agric Food Chem 1996;44:1526-1530.
16. Shan L, Qiao SW, Arentz-Hansen H, et al. Identification and Analysis of Multivalent Proteolytically
    Resistant Peptides from Gluten: Implications for Celiac Sprue. J Proteome Res. 2005 ; 4(5): 1732–1741.
17. Drago S, Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac
    intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology,
    2006; 41:408/419.
18. Klopfenstein, TJ et al. "Animal Diet Modification to Decrease the Potential for Nitrogen and
    Phosphorus Pollution". Council for Agricultural Science and Technology 21.
19. Reinhold JG. Phytate destruction by yeast fermentation in whole wheat meals. J Am Diet Assoc 1975;66:38-41.
20. Hallberg L, Brune M, Rossander L. Iron absorption in man: ascorbic acid and dose-dependent inhibition
    by phytate. Am J Clin Nutr 1989;49:140-4.
21. Chen LH, Pan SH. Decrease of phytates during germination of pea seeds (Pisium Sativa). Nutr Rept Int.
    1977;16: 125-131.
22. Walker KA. Changes in phytic acid and phytase during early development of phaseoleus vulgaris beans.
    Planta 1974;116:91-98
23. Bain, J. M., Murcer, F. V.: Changes in phytic acid and acid-soluble phosphorus in maturing pinto beans.
    J. Sci. Fd. Agric. 20, 82–84 (1966).
24. Jennings, A. C., Morton, R. K.: Changes in nucleic acids and other phosphorus-containing compounds of
    developing wheat grain. Aust. J. Biol Sci. 16, 332–341 (1963b).
25. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the western diet: health implications
    for the 21st century. Am J Clin Nutr 2005;81:341–54.

Paleo Diet Q & A: Blood Type and Diet

Q: Professor, I pulled my information from thepaleodiet.com and attributed the statement, "Paleo is truly is the world’s healthiest diet," to you, which I doubt is a stretch.

Have you gotten into any of the information about the blood-type-related nutrition info? I've only heard snippets, but I'm curious what an expert thinks of it.

Seth

A: Hi Seth,

Thanks for your support. I am currently completing a paper on nightshades, and when it is done the very next topic in the queue is my critique of the Blood Type Diet, which I have been researching and reading about for the past couple of weeks. Although I don’t want to give away the story line, I can say that the concept of four specific types of diet for the four ABO blood groups (A, B, O & AB) is not supported by the available data. However, having said that, susceptibility to disease, and the robustness of the immune response to pathogens throughout the entire GI tract, is very much related to ABO blood groups. Our group has published at least one paper on the dietary lectin/disease concept and we believe that common dietary lectins may promote certain diseases (allergies, autoimmune disease) while simultaneously promoting chronic low level inflammation. However, little evidence in either humans, animals or tissues point in the direction that dietary lectins elicit disease symptoms exclusively via interaction with ABO antigens. Additionally, of the hundreds of plant lectins that have been identified, only a very select few have been demonstrated to bind gut tissue. Hence, most dietary lectins are benign, simply because they cannot penetrate the gut barrier.

Cordially,
Loren Cordain, Ph.D., Professor

Sample Menus for Endurance Athletes

Dear Readers,

Nell Stephenson, Fitness & Nutritional Professional, Ironman Triathlete, and contributor to our newsletter was recently contacted by Details magazine to write up sample menus for endurance athletes: one for a workout day, the other for an off-day from training.

You will find other paleo-friendly menu ideas on Nell's blog.

---

Endurance Athlete Sample Menu for Two-a-Day Workout

5:30 AM
Pre-workout Breakfast Smoothie- 8oz brewed, chilled, natural decaf green tea with a banana, egg white protein powder, almond butter whizzed in the blender with some baked yam on the side.

6:30 AM
3-hour bike ride on the trainer-carbohydrate gel taken every 25 minutes.

9:30 AM
Immediate Post-workout recovery drink- HOME BREW (recipe in The Paleo Diet for Athletes) – cantaloupe, egg white protein powder and glucose. Drink plenty of water- keep hydrating.

10:00 AM
Raisins (to restore body alkalinity, continue to help the body recover post workout, and prepare for the session later in the day).

11:30 or 12:00 PM
Grilled Chicken breast, flash-sautéed asparagus, drizzled with flax seed oil and an apple

3:00 PM
Natural unsweetened applesauce with chopped egg whites (to prepare for 2nd workout of the day-shift from the usual Paleolithic macronutrient ratio to the pre-workout focus on carbohydrates).

4:30 PM
Sixty-minute track workout-hard, fast intervals; carbohydrate gel taken immediately post as recovery.

5:45 PM
Banana (high glycemic fruit choice to, again, aid in recovery)

6:30 PM
Poached wild salmon on a bed of steamed kale, mixed green salad, avocado & sliced strawberries, a squeeze of fresh lime juice and a splash of cold-pressed extra virgin oil; sliced oranges on top.

---

Endurance Athlete Sample Menu for Off-Day from Training

6:00 AM Breakfast
Poached Cod (or Barramundi) on bed of sautéed spinach (with garlic & olive oil), fresh blueberries and strawberries.

9:00 AM
Steamed broccoli, drizzled with cold pressed flax seed oil, sliced orange and chopped egg whites.

Lunch
Mixed green organic salad, with olive oil and lime wedge, served with grilled chicken, avocado and grapes.

Afternoon Meal
Sliced lean turkey breast used as a wrap, with Mache lettuce, raw almond butter and sliced pear inside.

Dinner
Kangaroo Kebabs-lean meat, skewered with red onion & yellow bell peppers, marinated over night in olive oil, lemon juice & your favorite herbs, then grilled or broiled. Serve with grilled green onion and a fresh spinach salad with tomato, walnut oil & a lime wedge.

Snack
Cinnamon dusted sliced apples-slice an apple, toss in lemon juice to prevent browning/oxidation, then sprinkle cinnamon on top. Enjoy with a cup of herbal or green decaf tea!

Chia Seeds Follow-up

Dear Readers,

This Q & A is in response to Dr. Cordain's special report on Chia Seeds, which appeared in a recent issue of our newsletter, The Paleo Diet Update. The full report is available in The Paleo Diet Update, Volume 6 Issue 7.

Q: Loren,

Hope all is well with you and your work!

After reading your article on chia seeds, I forwarded the article to Dr. Vlad Vuksan in Canada, one of the leading researchers/promoters of Salba Seeds. After he got your article, he seemed to object that your conclusions apply uniquely to chia seeds generically, but not to Salba Seeds (single variety).

Is such a distinction valid? Wouldn't your conclusions regarding chia seeds apply as well to Salba, a variety of chia?

Thanks for your insights,
Frank

A: Hi Frank,

I stand by my conclusions in the newsletter. Until further human trials are completed employing a sample size with sufficient statistical power to resolve these immune system issues, then the potential adverse effects of long term, chronic chia seed consumption may outweigh the potential benefits. I respect Dr. Vukan’s long time collaborative work with David Jenkins at the University of Toronto, particularly in regard to their pioneering work on the glycemic index. I have read both of Dr. Vukan’s recent chia seed papers^{1, 2}, and in neither one do the authors make any distinction between generic Salvia hispanica L. and the trade name (Salba) version of the seed they employed in their two studies. Hence, unless Dr. Vukan and colleagues can show otherwise, the literature results I have uncovered remain unchanged and apply to both Salba and Salvia hispanica L. It should be noted that at least two of the subjects in Dr. Vukan’s first study² refused to continue because of gastrointestinal side effects.

In regard to Dr. Vukan’s first chia study, Table 1 shows a non-significant decrease (7.0 %) in the treatment group’s CRP and a 32.9 % increase in the control group value. The authors interpret this bi-directional group change in the abstract and elsewhere as a significant reduction (40 + 1.6% p less than 0.04) in CRP. This kind of data reporting is misleading when the treatment group mean change was actually non-significant. Despite ANCOVA adjustment for age, gender and sequence in their repeated measures model, their interpretation of the CRP data is at best misleading but likely incorrect. An additional shortcoming in this study involves the reporting of ALA and EPA data (results p. 2806). Why weren’t the actual plasma concentrations (mean + SD) of both of these fatty acids reported in both the experimental and control group? Given that 2% or less of ALA is chain elongated and desaturated into DHA, the EPA data need further scrutiny. Did the reported % differences for ALA and EPA represent within group differences or factorial differences? These shortcomings potentially invalidate the conclusions of the paper that CRP was reduced. In contrast, Nieman and colleagues³ were unable to replicate Dr. Vukan and colleague’s results in a similar study with a much larger sample size and hence greater statistical power.

Cordially,
Loren Cordain, Ph.D., Professor

References:

1. Vuksan V, Jenkins AL, Dias AG, Lee AS, Jovanovski E, Rogovik AL, Hanna A. Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.). Eur J Clin Nutr. 2010 Apr;64(4):436-8.


2. Vuksan V, Whitham D, Sievenpiper JL, Jenkins AL, Rogovik AL, Bazinet RP, Vidgen E, Hanna A. Supplementation of conventional therapy with the novel grain Salba (Salvia hispanica L.) improves major and emerging cardiovascular risk factors in type 2 diabetes: results of a randomized controlled trial. Diabetes Care. 2007 Nov;30(11):2804-10


3. Nieman, D., C., E. J. Cayea, M. D. Austin, D. A. Henson, S. R. McAnulty, F. Jin. 2009. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutrition Research, 29(2009):414-418.

Paleo Diet Special Report: Chia Seeds

Dear Readers,

The following is an excerpt from a special report authored by Dr. Cordain on Chia seeds. The full report is available in our newsletter, The Paleo Diet Update, Volume 6 Issue 7.

Q: Are there any negative effects associated with chia seeds which would make them inappropriate in The Paleo Diet?

Thank you.

A: Good question. I would imagine that many of our readers have never even heard of chia seeds much less eaten them. Chia seeds (Salvia hispanica L.) are a member of the Labiatae plant family and are native to southern Mexico and northern Guatemala. The seeds are small, oval shaped; either black or white colored and resemble sesame seeds. These seeds were cultivated as a food crop for thousands of years in this region by the Aztecs and other native cultures. Chia seeds can be consumed in a variety of ways including roasting and grinding the seeds into a flour known as Chianpinolli which can then become incorporated into tortillas, tamales, and various beverages. The roasted ground seeds were traditionally consumed as a semi-fluid mucilaginous gruel (Pinole) when water is added to the flour. In post-Columbian times the most popular use of chia flour was to make a refreshing beverage in which the ratio of seeds to water is decreased, thereby resulting in a less gelatinous consistency to which lemon, sugar or fruit juice are added. The sticky consistency of chia seed Pinole or chia beverages comes from a clear mucilaginous, polysaccharide gel that remains tightly bound to the seeds. This sticky gel forms a physical barrier which may impair digestion and absorption of fat from the seed⁴ while also causing a low protein digestibility.

In the past 20 years a revival of interest in chia seeds has occurred primarily because of their high fat content of about 25-39% by weight, of which 50-57% is the therapeutic omega 3 fatty acid and alpha linolenic acid (ALA). In the past 10 years chia seeds have been used as a foodstuff for animals to enrich their eggs and meat with omega 3 fatty acids. So I wholeheartedly approve of feeding chia seeds to animals and then eating the omega 3 fatty acid enriched meat or eggs of these animals.

How about feeding chia seeds to humans – should we consume chia seeds because of their high omega 3 fatty acid (ALA) content? The Table below shows the entire nutrient profile of chia seeds. At least on paper, it would appear that chia seeds are a nutritious food that is not only high in ALA, but also is a good source of protein, fiber, certain B vitamins, calcium, iron and manganese.

Unfortunately, the devil is always in the details...

Radio Interview with Dr. Cordain

Dear Readers,

Dr. Cordain was a guest on the The Soul's Edge radio program on KKNW Alternative Talk Radio, 1150 AM, in Seattle on March 30. You may listen to an MP3 recording of the interview from our web site. The segment with Dr. Cordain begins at time index 15:23 in the MP3 recording.

Paleo Diet Q & A - Lichen Sclerosis, Stevia

Lichen Sclerosis

Q: Hi there - I have been following a Paleo Diet for a few weeks now and there is no doubt that I feel much better for it. I did not need to lose weight and I always regarded myself as pretty fit and healthy. However, a little while back I developed a troublesome skin condition called Lichen Sclerosis. Have you ever been asked about this condition and suggested dietary changes? I think part of the problem is that the etiology is not fully understood but many doctors seem to think it has an autoimmune component though I have read recent research that suggests oxidative damage plays a part and that antioxidant therapy may be useful in treatment. This condition is supposedly incurable (though manageable with potent steroids) but I'm sure it would give a great many people some comfort if simple dietary changes could help. Would be really great to hear your thoughts.

Simon

A: Dear Simon,

The available evidence indicates that an autoimmune component likely occurs with Lichen Sclerosis (LS). With all autoimmune diseases, an autoantigen (self protein) exists and represents the target protein being attacked by the immune system. About 75 % of LS patients maintain an IgG autoantibody to Extra Cellular Matrix Protein 1 (ECM1)¹. Acceleration of ECM1 deposition in dermal (skin) blood vessels may underlie the disease symptoms ^{2, 3}. So the question now arises, what causes an accelerated deposition of ECMI in dermal blood vessels in LS patients? The available evidence indicates that increased concentrations of a ubiquitous enzyme in the body called tissue transglutaminase (TG2) is primarily responsible for excessive ECM1 accumulation³. In medical terms, an increase in a concentration of a substance in the bloodstream by another substance is called "upregulation".

So, in LS patients, an upregulation of TG2 causes an upregulation and increased deposition of ECMI in the skin blood vessels in the affected area of the body. The next question to be posed is, what event or events trigger an upregulation of TG2? When we answer this question, then dietary recommendations advocated by the Paleo Diet will make sense. A storage protein called gliadin which is fournd in wheat, rye, barley and oats is known to upregulate TG2 ^4-7. Hence grain free diets may prove to be therapeutic for LS patients, although no current randomized controlled trials of this intervention strategy have yet been conducted.

Cordially,
Loren Cordain, Ph.D., Professor

References:

1. Chan I, Oyama N, Neill SM, Wojnarowska F, Black MM, McGrath JA. Characterization of IgG autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Clin Exp Dermatol. 2004 Sep;29(5):499-504.
2. Kowalewski C, Kozłowska A, Chan I, Górska M, Woźniak K, Jabłońska S, McGrath JA.Three-dimensional imaging reveals major changes in skin microvasculature in lipoid proteinosis and lichen sclerosus. J Dermatol Sci. 2005 Jun;38(3):215-24. Epub 2005 Mar 3.
3. Fisher M, Jones RA, Huang L, Haylor JL, El Nahas M, Griffin M, Johnson TS. Modulation of tissue transglutaminase in tubular epithelial cells alters extracellular matrix levels: a potential mechanism of tissue scarring. Matrix Biol. 2009 Jan;28(1):20-31. Epub 2008 Nov 5.
4. Michaelsson, G., Ahs, S., Hammarstrom, I., Lundin, I. P., & Hagforsen, E. Gluten-free diet in psoriasis patients with antibodies to gliadin results in decreased expression of tissue transglutaminase and fewer ki67+ cells in the dermis. Acta Dermato-Venereologica, 2003; 83(6):425-429.
5. Biagi F, Campanella J, Laforenza U, Gastaldi G, Tritto S, Grazioli M, Villanacci V, Corazza GR. Transglutaminase 2 in the enterocytes is celiac specific and gluten dependent. Dig Liver Dis. 2006 Sep;38(9):652-8.
6. Gorgun J, Portyanko A, Marakhouski Y, Cherstvoy E. Tissue transglutaminase expression in celiac mucosa: an immunohistochemical study. Virchows Arch. 2009 Oct;455(4):363-73.
7. Villanacci V, Not T, Sblattero D, Gaiotto T, Chirdo F, Galletti A, Bassotti G. Mucosal tissue transglutaminase expression in celiac disease. J Cell Mol Med. 2009 Feb;13(2):334-40.

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Stevia

Q: Is Stevia Paleo? I have attempted to find an answer for this and the information I've found is conflicting at best. Please advise!!
Jeff

A: Dear Jeff,

There's some scientific evidence to support the notion that Stevia is safe, even in type 2 diabetes patients^{1, 2}. Furthermore, it has been demonstrated to have antihypertensive properties, as shown by Chan et al.³ and a long-term study⁴. Having said this, I am not aware of any study examining the potential antinutrient (lectins or saponins) content of the plant, hence we do not know the possible adverse effect of consuming this plant on a daily basis. Hunterh-gatherers used to consume a wide range of plants, thereby minimizing the amount of a single bioactive compound ingested and its toxicity. It is known that rotating the kind of plants is a good strategy in order to decrease food allergy and intolerance.

From an evolutionary standpoint we should look at nutrition as "whole food" rather than nutrients per se. The bottom line is that Stevia seems to be safe, but we need more research to rule out possible side effects.

I hope this is helpful,
Maelán

References

1. Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism. 2004 Jan;53(1):73-6.
2. Barriocanal LA, Palacios M, Benitez G, Benitez S, Jimenez JT, Jimenez N, Rojas V. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabetics. Regul Toxicol Pharmacol. 2008 Jun;51(1):37-41. Epub 2008 Mar 5.
3. Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol. 2000 Sep;50(3):215-20.
4. Hsieh MH, Chan P, Sue YM, Liu JC, Liang TH, Huang TY, Tomlinson B, Chow MS, Kao PF, Chen YJ. Clin Ther. 2003 Nov;25(11):2797-808. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study.

The Paleo Diet and Crohn's Disease

Q: Can you comment on any reported results in curbing the symptoms of Crohn's Disease with the Paleo Diet. As I am a sufferer, I would love to know.

Thank you,
Shannon

A: Dear Shannon,

Indeed, inflammatory bowel disease (Ulcerative Colitis & Crohn's Disease) patients usually do very well with The Paleo Diet, as nutrients are one of the main environmental triggers of this condition. Crohn's disease is an autoimmune disease where the immune system mounts an attack against its own tissues - in this case the cells lining the intestine.

For an autoimmune disease to occur we need a genetic predisposition and an environmental trigger. The genetic predisposition depends on genes coding for the Human Leukocyte Antigen (HLA) system. One of the environmental triggers may be nutrition, besides infections, geography (vitamin D deficiency), physical trauma or vaccination.

One of the key points in this process is increased intestinal permeability. This means that the gut barrier allows increased passage of bacterial or food proteins (antigens) into peripheral circulation, skipping a process known as oral tolerance. Once antigens come in contact with the immune system located in the gut associated lymphoid tissue, they may elicit a T-cell mediated immune response against those antigens.

If the molecular structure of the dietary or bacterial antigens is similar to that of the HLA system (part of the immune system representing cellular mechanisms), chances are that a cross reaction between foreign antigens and self antigens (produced by T-cells) occur. This is termed molecular mimicry, and leads to self injury by the adaptive immune system.

Hence, decreasing intestinal permeability is one of the treatment targets. There are several nutrients known to increase intestinal permeability that you may want to avoid, at least until symptoms subside. Here is a list, with the noxious substances in parentheses:

• Cereal grains (lectins and gliadin)
• Legumes, including soya and peanuts (lectins and saponins)
• Tomato (tomato lectin and alpha-tomatin)
• Potato (lectins and saponins)
• Chili (capsaicin)
• Quillaja (foaming substance)
• Quinoa (saponins)
• Egg white (lysozyme)
• Alfalfa sprouts (saponins)
• Amaranth (saponins)
• Alcohol

Moreover, some nutrients exert an adjuvant-like activity (they stimulate the immune system), which is something you don't want to if you are suffering from an autoimmune disease. Nutrients containing adjuvants:

• Quillaja extract, found in root beer
• Tomato alpha-tomatine

Dairy products and vegetable oils also have deleterious effects upon your immune system.

I hope this helps.
Maelán

Lysozyme from Egg Whites Article

Dear Readers,

This past week our newsletter (The Paleo Diet Update, volume 6, issue 4) featured an article by Dr. Cordain on Lysozyme and Egg Whites, and autoimmune disease. Readers who are not yet newsletter subscribers may obtain a free subscription on our web site to The Paleo Diet Update.

Readers who would like to obtain a copy of volume 6, issue 4 of The Paleo Diet update may purchase a copy of this and other back issues from our web store.

Paleo Diet Q & A - Epigenetics, Flaxseed Oil

Epigenetics

Q: What do you think about epigenetics? Many scientists (in Germany) believe that the concept of the Paleo Diet is no longer tenable.

Thanks a lot, Michael

A: Dear Michael,

Epigenetics is defined as the science studying changes in phenotype or gene expression by mechanisms other than changes in DNA nucleotide sequence¹. The phenotype is someone's appearance which it's determined by the genotype (stable and heritable) and the environment (nutrition and other lifestyle factors) which give place to the epigenotype (heritable, labile and rapid)¹. Epigenetic changes are controlled, among other mechanisms, by methylation and histone modification. Altered methylation pattern and histone modification may lead to increased susceptibility to disease. E.G. cancer is associated to generalized hypomethylation and localized promoters hypermethylation¹. Histone manipulation may also increase or decrease disease susceptibility².

Both, methylation and histone manipulation are under the control of dietary substances. For example, methylation depends on SAMe availability, which in turn is influenced by vitamin B6, vitamin B12 and folate intake³, and long chain polyunsaturated fatty acids such as DHA⁴. On the other hand, certain substances such as garlic, horseradish, fiber, blueberries, apple, onion, nuts, berries, red grapes, broccoli, etc. are known nutrients involved in histone modification².

The Paleo Diet is rich is all of these nutrients⁵, hence it may exert positive effects upon epigenetics machinery leading to decreased disease susceptibility. Decreased availability of micronutrients is associated to disease severity, probably, through complex epigenetic mechanisms, and supplementation could improve those symptoms³. Improved epigenetic is influenced by metabolic programming during foetal and early life. These two periods are crucial for the developing newborn and future adult's health. Hence, The Paleo Diet may confer protection against several diseases improving the epigenetic programming.

We hope this is helpful.

Maelán Fontes Villalba
Pedro Carrera Bastos

References:

1. van Vliet J, Oates NA, Whitelaw E. Epigenetic mechanisms in the context of complex diseases. Cell Mol Life Sci. 2007 Jun;64(12):1531-8.
2. Delage B, Dashwood RH. Dietary manipulation of histone structure and function. Annu Rev Nutr. 2008;28:347-66.
3. Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.
4. Muskiet FA, Kemperman RF. Folate and long-chain polyunsaturated fatty acids in psychiatric disease. J Nutr Biochem. 2006 Nov;17(11):717-27.
5. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.
6. Kemperman RF, Veurink M, van der Wal T, Knegtering H, Bruggeman R, Fokkema MR, Kema IP, Korf J, Muskiet FA. Low essential fatty acid and B-vitamin status in a subgroup of patients with schizophrenia and its response to dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 2006 Feb;74(2):75-85.

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Flaxseed Oil

Q: I recently visited family and my brother is a new advocate of the paleo diet. For breakfast he made us "fakecakes" which had about 1-2 tablespoons of flaxseed in them that he ground in a coffee grinder. I had few a questions regarding the use of flaxseed in the Paleo Diet.

First, why are flaxseeds ok in the Paleo Diet but other grains (seeds) are not? My understanding for eliminating grains from the diet is the toxins that they contain, but flaxseed contains large amounts of cyanogenic glycosides, producing up to 139 mg/kg of hydrogen cyanide in raw human-grade flaxseed. I am sure flaxseeds are processed somehow before selling them but I don't know what process that is or what effect it has on the HCN concentration.

So, secondly...do you know of any studies on the amount of HCN in meals containing ground flasxseed and the chronic oral exposure of those amounts on humans? My understanding here is the HCN that isn't hydrolysed to formic acid in the stomach and doesn't bind to hemoglobin is converted to thiocyanate which hinders thyroid function.

Thank you for your time and any information you can supply.

Sincerely,
Tim

A: Hi Tim,

We think your thoughts are on the right track.

When Dr. Cordain wrote The Paleo Diet book, the advice to consume flaxseed oil was an attempt to balance the increased omega-6/omega-3 fatty acid ratio due to the exaggerated intake of omega-6 vegetable oils, especially linoleic acid, in the typical western diet.

Nevertheless, animal foods (fish, muscle meat and organs from wild animals) are good sources of w3 fatty acids. Therefore, when people eat these foods regularly along with vegetables and nuts, and avoid vegetable oils (especially oils rich in Linoleic Acid – Omega 6), they get a balanced intake of omega 3, omega 6, monounsaturated and saturated fatty acids. In this situation, there is no need for flax seeds to provide Omega 3 fatty acids and balance the Omega 3/Omega 6 ratio.

Here are some facts that support the notion that animal foods, vegetables and nuts provide the necessary Omega 6 and Omega 3 fatty acids in the right proportion:

1. Hunter-gatherers do not eat ALA from seeds or vegetable oils.
2. Nuts, green leafy vegetables and animal foods contain ALA.
3. The conversion of ALA to EPA+DHA is limited, due to low delta-6 and delta-5 activity, although ALA is highly oxidized (twice that of LA) (see paper by Freemantle et al). This means that at some point in history we included preformed sources of EPA and DHA and still need to do so. Animal foods (especially brain from wild ruminants and fish) are very good sources of these fatty acids.
4. The essentiality of LA & ALA in human metabolism has been questioned (see paper by Le et al.), as we relied almost on LCPUFA (Arachidonic Acid, EPA and DHA) during the Palaeolithic era (see Dr. Cordain’s papers on that here and here). Moreover, there is already some evidence showing that human metabolism could re-convert AA and DHA into LA and ALA respectively, hence AA and DHA would be the true essential fatty acids.
5. The possible toxicity from seeds and vegetable oils (HCN, saponins, lectins).
6. They are not used by current HG societies, and these populations show no signs of western disease, so this means that flax seeds are not necessary.
7. The well known positive health effects of fish oil supplementation (among other factors to improve omega-6/omega-3 ratio) in contrast with some possible adverse effects of flaxseed oil (like the epidemiological evidence that points towards increased risk of prostate cancer with flax oil consumption – see paper by Brouwer et al).

The bottom line from an evolutionary perspective is that flax seeds and/or flaxseed oil would not have been consumed by pre-agricultural humans. However, having said that, hunter gatherers always would have preferentially sought high oil plant foods as per optimal foraging theory. But, most high fat plant foods contain high MUFA (with the exception of coconut and palm oils).

Hope this helps,
Maelán Fontes Villalba

Additional reading: Effectiveness of different processing methods in reducing hydrogen cyanide content of flaxseed, Feng, et al.

Paleo Diet Q & A - Saturated Fat

Dear Readers,

This question has come up several times in recent weeks. Maelán's response warrants breaking this out from among the other questions answered in the original post. Included in this post is a link to Dr. Cordain's paper on the subject.

Q: I wanted to ask you why it is that you discourage saturated fats in the paleo diet? From what I have read their are healthy saturated fats from coconuts that are used for around 17% of the Kitavan diet. Also, what about tubers such as sweet potato and yam, do you think that consuming these in moderate portions (small enough to keep a low glycemic load) could be detrimental?

A: Regarding saturated fats:

Saturated fatty acids intake and the risk of developing cardiovascular disease (CVD) is a topic with a lot of controversy. In recent years a wide body of research has suggested that increased consumption of certain saturated fatty acids (Lauric acid, myristic acid and palmitic acid)
down-regulate LDL receptor and thereby increase LDL plasma levels, and this has been associated to increased risk of CVD. On the other hand, stearic acid (a 18 carbon saturated fatty acid) has been shown to decrease LDL plasma levels. However, this view is too simplistic as they are several other factors contributing to CVD, such as smoking, exercise, trans-fatty acids, increased omega-6/omega-3 ratio, free-radicals, nutrient deficiency, homocysteine, alcohol intake and low-grade chronic inflammation among others.

Moreover, some studies have suggested that there’s not enough scientific data to support the view that increased total or LDL cholesterol is an independent risk factor for CVD, but rather oxidized LDL. Plaque production is mediated by oxidized LDL but not LDL. Oxidized LDL can produce shedding of the inner layer of the artery namely glycocalix. Then oxidized LDL infiltrates in the intima of the artery. Oxidized LDL is eaten by macrophagues, a process known as phagocytosis, and therefore macrophagues are transformed into foam cells which produce the fibrous cap.

Once the fibrous cap has been produced we need to break it down in order to produce an ischemic event. Lectins and low-grade chronic inflammation are involved in the activation of matrix metalloproteinases which break down the fibrous cap.

In summary, high total cholesterol or LDL levels do not increase CVD risk but rather oxidized LDL. To produce oxidized LDL we need the factors mentioned above. Hence, consumption of saturated fatty acids is not an issue if we control several other factors such as those mentioned before.

Dr. Cordain wrote a book chapter where he shows that saturated fat consumption in ancient hunter-gatherer populations were usually above recommended 10% (American Heart Association) of energy from saturated fats yet non atherogenic.

The bottom line is that we do not recommend cutting down saturated fatty acid intake but rather decrease high-glycemic load foods, vegetable oils, refined sugars, grains, legumes and dairy.

I hope this helps.
Maelán

Link to supporting paper.

Paleo Diet Q & A - Snails

Q: Do you know if they ate snails in the paleo times? Thank you, Geha

A: Hi Geha,

The Paleolithic era stands for the "Old Stone Age" (Paleo means old; lithic means stone) and extended from 2.6 million years ago with the appearance of the first crude stone tools until the beginning of agriculture 10,000 years ago. During this period, it is estimated that at least 20 species of hominins (upright walking apes) existed¹. Because all hominins were omnivorous opportunists², land snails were almost certainly consumed on an occasional basis throughout hominin evolutionary history.

However, having said this, the first direct evidence for land snail consumption does not appear in the fossil record until 31,000 years ago at the Mumba-Hohle site on the shores of Lake Eyasi in East Africa^{3, 4}. The earliest archaeological evidence for land snail consumption in the Middle East has been dated to 22,000 to 23,000 years ago at the Kvar ‘Aqil site near Beirut, Lebanon³. The hominin that would have eaten these snails was our own species, Homo sapiens. Archaeologists interpret that snails were eaten because their shells were found in huge heaps called middens, and frequently were charred from being cooked⁵. Snail middens dating from 20,000 to 10,000 years ago and from 10,000 to 6,000 years ago are common in lands close to and surrounding the Mediterranean Sea^{3, 5}. The five most commonly consumed species of snails (Helix aspera, Helix melanostoma, Leucochroa candissima, Helicella setifensis, and Otala species) still occur in the Mediterranean region today.

If you don’t know, snail meat is considered a delicacy worldwide and is most commonly known from its French term, "escargot," an appetizer typically cooked in a sauce of butter, garlic and parsley⁶. Although three species of snails (Helix aspera, Helix pomatia) and the African snail (Achatina fulica) are most commonly consumed⁶, a large variety of snail species are eaten worldwide, depending upon location and availability. The cost of 1 kg of prepared snail meat is expensive and fluctuates between $5 - $13⁷. Snail meat, like fish, is high in protein and low in fat, and contains significant amounts of iron (see Table below). Give escargot a try, it’s a great Paleo appetizer.

Table 1. Nutritional value of snails. USDA National Nutrient Standard Reference, release 19 (2006).

Nutrients	Units of measurement for nutrients	Nutrient content per 100 grams of snail
Water	g	79.20
Energy	kilocalorie	90.00
Protein	g	16.10
Total lipid (fat)	g	1.40
Ash	g	1.30
Carbohydrate, by difference	g	2.00
Fiber, total dietary	g	0.00
Sugars, total	g	0.00
Minerals
Calcium, Ca	mg	10.00
Iron, Fe	mg	3.50
Magnesium, Mg	mg	250.00
Phosphorus, P	mg	272.00
Potassium, K	mg	382.00
Sodium, Na	mg	70.00
Zinc, Zn	mg	1.00
Copper, Cu	mg	0.40
Selenium, Se	mcg	27.4
Vitamins
Vitamin C	mg	0.00
Thiamin	mg	0.01
Riboflavin	mg	0.12
Niacin	mg	1.40
Vitamin B-6	mg	0.13
Folate, total	mcg	6.00
Folic acid	mcg	0.00
Folate, food	mcg	6.00
Folate, DFE	mcg_DFE	6.00
Vitamin B-12	mcg	0.50
Vitamin B-12, added	mcg	0.00
Vitamin A, IU	IU	100.00
Vitamin A, RAE	mcg_RAE	30.00
Retinol	mcg	30.00
Vitamin E (alpha-tocopherol)	mg	5.00
Vitamin E, added	mg	0.00
Vitamin K (phylloquinone)	mcg	0.10
Lipids
Fatty acids,total saturated	g	0.361
4:0	g	0.000
6:0	g	0.000
8:0	g	0.000
10:0	g	0.000
12:0	g	0.000
14:0	g	0.056
16:0	g	0.249
18:0	g	0.051
Fatty acids, total monounsaturated	g	0.259
16:1 undifferentiated	g	0.048
18:1 undifferentiated	g	0.211
20:1	g	0.000
22:1 undifferentiated	g	0.000
Fatty acids, total polyunsaturated	g	0.252
18:2 undifferentiated	g	0.017
18:3 undifferentiated	g	0.000
18:4	g	0.015
20:4 undifferentiated	g	0.000
20:5 n-3	g	0.119
22:5 n-3	g	0.099
22:6 n-3	g	0.000
Cholesterol	mg	50.000

References:

1. Wood B. Hominid revelations from Chad.Nature. 2002 Jul 11;418(6894):133-5.
2. Cordain L. Saturated fat consumption in ancestral human diets: implications for contemporary intakes. In: Phytochemicals, Nutrient-Gene Interactions, Meskin MS, Bidlack WR, Randolph RK (Eds.), CRC Press (Taylor & Francis Group), 2006, pp. 115-126.
3. Lubell, D. Prehistoric edible land snails in the circum-Mediterranean: the archaeological evidence. In, J-J. Brugal & J. Desse (eds.), Petits Animaux et Sociétés Humaines. Du Complément Alimentaire Aux Ressources Utilitaires. XXIVe rencontres internationales d'archéologie et d'histoire d'Antibes, pp. 77-98. Antibes: Éditions APDCA, 2004.
4. Mehlman MJ. Mumba-Hohle revisited: the relevance of a forgotten excavation to some current issues in East African prehistory. World Archaelogy 1979;11:80-94.
5. Lubell, D. Are land snails a signature for the Mesolithic-Neolithic transition? In, M. Budja (ed.), Neolithic Studies 11. Documenta Praehistorica XXXI: 1-24.
6. Ozogogul, Y, Ozogul F, Olgunoglu AI. Fatty acid profile and mineral content of the wild snail (Helix pomatia) from the region of the south of the Turkey. Eur Food Res Technol 2006;221:547-549.
7. Zymantiene J et al. Selected features of vineyard snails shell, their movement and physic-chemical composition of foot meat. Biotechnol & Biotechnol Eq 2006;20:82-87.

Paleo Diet Q & A - Calcium from where?

Q: While this style of eating and living makes sense to me, I am still left with the question of how to meet the Recommended Daily Allowance (RDA) for calcium. From all I've read on the subject, it's not possible to reach the RDA with vegetable sources (unless you include fortified soy or rice milk). Since dairy isn't part of your scheme, how does a person meet the RDA? Or do you disagree with the RDA?

A: Indeed, we relieve the RDA is higher than what you would need in a Palaeolithic type diet, because:

1. The absorption rate from brassica vegetables (e.g. Kale) is slightly higher than from milk (see attached paper) and as so (and also because they have numerous health benefits), we advise the daily intake of these foods.


2. A diet with lots of vegetables and fruit is net base yielding and in contrast a diet high in grains, cheese and salt and low in fruits and vegetables (which is a characteristic of the American way of eating) is net acid yielding and this increases calcium excretion.


3. The Paleo Diet is a High protein diet and this increases intestinal calcium absorption^{1, 2} and has an anabolic effect on bone³, particularly in the context of a net base yielding diet³.


4. By avoiding grains, you decrease anti-nutrient intake, such as phytates, which decrease magnesium⁴, calcium⁵ and zinc⁵ absorption.


5. The Paleo Diet is a Low Glycemic Load diet and as so, it does not promote Hyperinsulinemia as a high grain diet. It has been known since the year I was born (1975) that high blood insulin levels cause urinary calcium loss⁶.


6. Milk has a high Insulinotropic effect, and as so it may lead to an increase in urinary calcium excretion, for the reason outlined in point 5.

Links to Relevant Papers:

• RDA of calcium


• Dietary Acid-Base Balance


• Adverse Effects of Sodium Chloride on Bone


• Calcium absorption from kale


• Diet Evolution and Aging

References:

1. Kerstetter JE, Gaffney ED, O’ Brien O, et al. Dietary Protein increases intestinal calcium absorption and improves bone balance: An hypothesis.
   In Burckhardt P, Heaney R, Dawson-Hughes B. Proceedings of the International Symposium on Nutritional Aspects of Osteoporosis, 4-6 May 2006, Lausanne,
   Switzerland. Elsevier, 2007, pp 204-216.


2. Dawson-Hughes B. Protein intake and calcium absorption – Potential role of the calcium sensor receptor. In Burckhardt P, Heaney R, Dawson-Hughes
   B. Proceedings of the International Symposium on Nutritional Aspects of Osteoporosis, 4-6 May 2006, Lausanne, Switzerland. Elsevier, 2007, pp 217-227.


3. Sebastian A. Dietary protein content and the diet's net acid load: opposing effects on bone health. Am J Clin Nutr. 2005 Nov;82(5):921-2.


4. Bohn T, Davidsson L, Walczyk T, Hurrell RF. Phytic acid added to white-wheat bread inhibits fractional apparent magnesium absorption in humans.
   Am J Clin Nutr. 2004 Mar;79(3):418-23.


5. Cordain L. Cereal grains: humanity’s double edged sword. World Rev Nutr Diet 1999; 84:19-73.


6. DeFronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ. The effect of insulin on renal handling of sodium, potassium, calcium, and
   phosphate in man. J Clin Invest 1975;55:845–55.
   

Paleo Diet Q & A - Homocysteine

Dear Readers,

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

Dr. Cordain and his associate Pedro Bastos, were recently contacted by Ben Balzer, M.D. a well known Australian GP, friend and colleague regarding homocysteine issues. According to the American Heart Association, homocysteine is "an amino acid in the blood. Epidemiological studies have shown that too much homocysteine in the blood (plasma) is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease."

Included below are Dr. Balzer's original correspondence, as well as the replies from Dr. Cordain and Mr. Bastos.

---

Dear Loren and Pedro,

I was writing to a cardiologist today about homocysteine (alternate spelling: homocystine), among other issues. I don’t think I’ve raised it with you before, but it occurs that it may be of interest or relevance, so I’ve repeated it here below. Clinical medicine takes me up a few nutritional pathways that aren’t necessarily paleo, but as I always say paleo is the unifying field theory of nutrition, so it has always made it easier.

I’m a firm believer in homocysteine related issues, but the way modern medicine works it will never be driven hard as there is no commercial imperative--as all the treatments are vitamins and cannot be patented. Though there have been attempts to make a "drug" that will lower homocysteine, which would then magically spark interest.

I am also aware that choline has been given vitamin status and also participates in the 1-carbon cycle. Perhaps you could let me know how the choline intake of the SAD compares to our modern day urban hunter gatherer. Maybe we can shorten that to urban hunter gatherer, but I don’t think UHG will catch on, though it does have a caveman like ring to it.

What is amazing about homocysteine and triple B therapy is how little most Australian cardiologists knew about it. Yet when Lange published a highly flawed negative paper, they all knew about it overnight- highly suggestive of a commercial push.

Regards,
Ben

---

Hi Ben,

Good to touch bases with you and hopefully we can get together when I am in Sydney in June. Although we havent done the computerized dietary analysis yet -- specific to homocysteine, it is almost certain that sub-artic hominids would have had high plasma concentrations of folic acid, B6 and B12 (see my paper: Cordain L. "The nutritional characteristics of a contemporary diet based upon Paleolithic food groups." J Am Nutraceut Assoc 2002; 5:15-24.) Hence hyperhomocysteinemia likely was not an environmental seletive pressure that routinely affected Homo until very recent times (evolutionarily speaking -- ergo the past 10,000 years). I suspect that modern western diets are significantly lower in choline-rich foods than diets based upon fruits, veggies, meats, seafood, nuts, fish, and organ meats. Once again, we have not done the computerized dietary analyses.

Best wishes,
Loren

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Hi Ben.

Good to hear from you. I definitely agree with Loren.

Regarding choline, I would just like to add that from computer analysing several types of diets, I have come to the conclusion that without eating liver or a high amount of egg yolks, it is virtually impossible to achieve 500 mg of choline a day. So, I believe our H/G ancestors got their choline from organ meats. Since today, most of us do not eat organ meats, I would like to know how we can ingest the choline we need.

Here’s a table from the Linus Pauling Institute with some dietary sources of choline. In addition, I would refer you to two papers: one by Bruce Ames on choline and another on food sources of choline and betaine.

Food	Serving	Total Choline (mg)
Beef liver, pan fried	3 ounces*	355
Wheat germ, toasted	1 cup	172
Egg	1 large	126
Atlantic cod, cooked	3 ounces	71
Beef, trim cut, cooked	3 ounces	66
Brussel sprouts, cooked	1 cup	63
Broccoli, cooked	1 cup, chopped	62
Salmon	3 ounces	56
Shrimp, canned	3 ounces	49
Peanut butter, smooth	2 tablespoons	20
Milk chocolate	1.5-ounce bar	20

By the way, here’s the adequate intake:

Adequate Intake (AI) for Choline
Life stage	Age	Males (mg/day)	Females (mg/day)
Infants	0-6 months	125	125
Infants	7-12 months	150	150
Children	1-3 years	200	200
Children	4-8 years	250	250
Children	9-13 years	375	375
Adolescents	14-18 years	550	400
Adults	19 years and older	550	425
Pregnancy	All ages	-	450
Breastfeeding	All ages	-	550

It would be very interesting to estimate the various micronutrient intake of various H/G diets based on Loren’s model.

Best wishes,
Pedro