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Post 60

Thursday, September 2, 2010 - 4:25pmSanction this postReply
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Bill,

So where do you get the other fats that you claim would offset the fatty composition of modern meat? Fish, fish oil? How much fish or fish oil, would you then have to take on the Paleo diet to offset the fat composition of modern meat and approximate the fat composition of the hunter-gatherer diets?
First of all, I was quoting from thepaleodiet.com. In answer to your question, you get the other fats from veggies, walnuts, macadamia nuts, fruits, and fish. An example might be something close to the following, with 69 grams of fat -- 25 grams of fat from meat, poultry, & eggs; and 44 grams of fat from plants & fish:

**********************************
1-lb spinach
=======
104 kcal
13 pro
2 fat
17 carb

1/4-lb yam
=======
135 kcal
2 pro
0 fat
32 carb

1/4-lb blueberries
=======
65 kcal
1 pro
0 fat
17 carb

1-lb pears
=======
263 kcal
2 pro
1 fat
70 carb

1 oz walnuts (14 halves)
=======
185 kcal
4 pro
18 fat
4 carb

1 oz macadamias (10-12 kernels)
=======
204 kcal
2 pro
21 fat
4 carb

1/2-lb beefalo
=======
324 kcal
52 pro
10 fat
0 carb

1/2-lb turkey breast
=======
236 kcal
39 pro
4 fat
10 carb

1/2-lb light tuna
=======
264 kcal
58 pro
2 fat
0 carb

1/4-lb eggs
=======
163 kcal
14 pro
11 fat
1 carb
**********************************

Ed


Post 61

Thursday, September 2, 2010 - 4:35pmSanction this postReply
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Bill,

Since modern meat is not the same as wild game, wouldn't it be difficult to know if the composition of the diet available today met Stone Age standards?
Some approximation is inevitable. It, however, doesn't detract from the merit of approximating as best as we can.

Perhaps, but I'll bet you won't find anyone on the Paleo diet who got it as low as 120 mg/dL or who got their LDL low enough to promote reversal of atherosclerosis.
First of all, you are assuming that a total cholesterol of 120mg/dL is healthy. At any rate, I'll comb the scientific archives searching for evidence of atherosclerotic reversal/regression ...

Ed


Post 62

Thursday, September 2, 2010 - 7:53pmSanction this postReply
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Bill,

According to recent research, a total cholesterol of 120 mg/dL is not healthy**! 

1) If your LDL is low, and you take statin drugs, you get more cancer:

***********************
RESULTS: In the statin arms, meta-regression analysis demonstrated an inverse association between on-treatment LDL-C and incident cancer, with an excess of 2.2 (95% confidence interval: 0.7 to 3.6) cancers per 1,000 person-years for every 10 mg/dl decrement in on-treatment LDL-C (p=0.006). ...

CONCLUSIONS: There is an inverse association between on-treatment LDL-C and incident cancer.
***********************
http://www.ncbi.nlm.nih.gov/pubmed/18804740

Note:
Statin drugs don't seem to be the problem, LDL level seems to be the problem. The risk of cancer was dependent on LDL level, regardless of the amount of, or even the effect of, statin medication.


2) If your HDL is low, and you take cholesterol medications, you get more cancer:

***********************
The inverse association persisted after adjusting for baseline low-density lipoprotein cholesterol, age, body mass index (BMI), diabetes, sex, and smoking status, such that for every 10-mg/dl increment in HDL-C, there was a 36% (95% confidence interval: 24% to 47%) relatively lower rate of the development of cancer (p < 0.001).
***********************
http://www.ncbi.nlm.nih.gov/pubmed/20579542


3) Low HDL is more dangerous than high LDL:

***********************
Total/high-density lipoprotein (HDL) cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.
***********************
http://www.ncbi.nlm.nih.gov/pubmed/19774217


On a (mg/dL)-per-(mg/dL) basis, decreases in HDL cholesterol are more than 5 times more dangerous than are increases in LDL cholesterol. A 15 mg/dL increase in HDL will cut CHD risk by two-thirds. In order to get the same risk reduction, you would have to cut LDL levels by 80 mg/dL.

For a stunning visualization of this effect, a person with these cholesterol levels:

HDL: 30 mg/dL
LDL: 60 mg/dL
-------------
Total: 120 mg/dL

... is at more CHD risk than a person with these cholesterol levels:

HDL: 60 mg/dL
LDL: 150 mg/dL
-------------
Total: 240 mg/dL


Source:
http://jama.ama-assn.org/cgi/content/full/302/18/1993


Ed

**Cancer risk aside, a total cholesterol of 120 mg/dL might not be a great CHD risk if your HDL levels were a third of the total (40 mg/dL or higher).
(Edited by Ed Thompson on 9/02, 10:13pm)


Post 63

Thursday, September 2, 2010 - 8:47pmSanction this postReply
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In light of the evidence that -- when HDL is less than a third of the total -- a total cholesterol of 120 mg/dL is not healthy for humans -- I will present results of paleo-friendly interventions on raw CHD risk-reduction, instead.

In light of the evidence, the goalpost should be moved. Instead of me trying to find someone who cut cholesterol in half, it'd be more fruitful to find the risk-reduction (based on the 4 best surrogate markers of risk) and to challenge you, Bill, to do the same. Here are some results. We'll start off with just low- vs. high carbohydrate diets:
... high-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-carbohydrate diets (after 6 months, ... weighted mean difference, 4.6 mg/dL [0.12 mmol/L]; 95% CI, 1.5-8.1 mg/dL [0.04-0.21 mmol/L]), ...

... but ... low-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-fat diets (weighted mean difference in low-density lipoprotein cholesterol after 6 months, 5.4 mg/dL [0.14 mmol/L]; 95% CI, 1.2-10.1 mg/dL [0.03-0.26 mmol/L]).


http://www.ncbi.nlm.nih.gov/pubmed/16476868

Summary percent risk reduction (holding every other, non-mentioned variable constant): since a 4.6 mg/dL increase in HDL reduces risk more than a reduction of 5 times as much LDL, in order to offset the risk-reduction of a 4.6 mg/dL increase in HDL one would need to reduce LDL by more than 23 mg/dL. Since the observed reduction in LDL was only 5.4 mg/dL, it's indicated that those in the low-carbohydrate diets reduced CHD risk moreso than those in the low-fat diet did.

HDL change: +4.6 mg/dL = 21% reduction in risk
LDL (or non-HDL) change:
systolic BP change:
C-reactive protein change:

And now we'll move on to 3 trials of paleo-friendly diets:
RESULTS: Mean weight decreased by 2.3 kg (P<0.001), body mass index by 0.8 (P<0.001), waist circumference by 0.5 cm (P=0.001), systolic blood pressure by 3 mm Hg (P=0.03) and plasminogen activator inhibitor-1 by 72% (P=0.020).
http://www.ncbi.nlm.nih.gov/pubmed/17522610
 
Summary percent risk reduction (holding every other, non-mentioned variable constant): pending

HDL change:
LDL (or non-HDL) change:
systolic BP change: -3 mm Hg = 5% less risk (of fatal stroke)
C-reactive protein change:

Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p = 0.01), triacylglycerol (-0.4 mmol/L, p = 0.003), diastolic blood pressure (-4 mmHg, p = 0.03), weight (-3 kg, p = 0.01), BMI (-1 kg/m2, p = 0.04) and waist circumference (-4 cm, p = 0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p = 0.03).
http://www.ncbi.nlm.nih.gov/pubmed/19604407

Summary percent risk reduction (holding every other, non-mentioned variable constant): pending

HDL change: +0.08 mmol/L = + 3 mg/dL = 14% risk reduction
LDL (or non-HDL) change:
systolic BP change:
C-reactive protein change:

RESULTS: Compared with the baseline (usual) diet, we observed (a) significant reductions in BP associated with improved arterial distensibility (-3.1+/-2.9, P=0.01 and +0.19+/-0.23, P=0.05);(b) significant reduction in plasma insulin vs time AUC, during the OGTT (P=0.006); and (c) large significant reductions in total cholesterol, low-density lipoproteins (LDL) and triglycerides (-0.8+/-0.6 (P=0.007), -0.7+/-0.5 (P=0.003) and -0.3+/-0.3 (P=0.01) mmol/l respectively).
http://www.ncbi.nlm.nih.gov/pubmed/19209185
 
Summary percent risk reduction (holding every other, non-mentioned variable constant): 28%

HDL change:
LDL (or non-HDL) change: -0.7 mmol/L = -27 mg/dL = 23% less risk
systolic BP change: -3.1 mm Hg = 5% reduced risk (of fatal stroke)
C-reactive protein change:


Ed

Source for risk of systolic BP increases:
http://www.bmj.com/content/323/7304/75/T3.expansion.html
from:
http://www.bmj.com/content/323/7304/75.long

(Edited by Ed Thompson on 9/03, 3:13pm)


Post 64

Thursday, September 2, 2010 - 8:54pmSanction this postReply
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Ed wrote,
First of all, you are assuming that a total cholesterol of 120mg/dL is healthy.
Yes I am. Are you now going to argue that it isn't? Ah, yes, I see that in subsequent posts, you do argue this. But your argument is based on correlation, not causation.

Yes, low LDL levels are associated with cancer, but it's the cancer that causes the low LDL, not the other way around. For example, alcoholics with liver cancer have low LDL, because the liver is the organ that produces cholesterol, and a damaged liver produces very little. Also, cancer is a wasting disease and in that respect can lower your LDL.

But there is no evidence that in a healthy person, a low LDL causes cancer. In fact, Pritikin had cancer and his ultra-low-fat diet was accompanied not only by a reversal of his heart disease but also by a remission of his cancer.


(Edited by William Dwyer on 9/02, 9:08pm)


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Post 65

Thursday, September 2, 2010 - 10:36pmSanction this postReply
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Bill,

**************
Yes, low LDL levels are associated with cancer, but it's the cancer that causes the low LDL, not the other way around. For example, alcoholics with liver cancer have low LDL, because the liver is the organ that produces cholesterol, and a damaged liver produces very little. Also, cancer is a wasting disease and in that respect can lower your LDL.
**************

Good point, though I'd like to view at least animal research quantifying the extent of this. The prospective studies I mentioned above followed folks through time -- and found that those who started with low LDL (or low HDL even) "ended up" with cancer.

One way for you to be right is if all of those folks (over 8000 folks) who "ended up" with cancer had already started with (undetected) cancer. Then, the temporality at work could have a chance to work in favor of the hypothesis that cancer caused those reduced lipoprotein levels in the first place.

Another possibility is that a third factor causes both low lipoproteins and high cancer incidence.

Ed
(Edited by Ed Thompson on 9/02, 10:38pm)


Post 66

Friday, September 3, 2010 - 3:24pmSanction this postReply
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Bill,

In the last study in my post 63, I calculated risk for 2 independent risk factors and added them (see edited post). The total risk reduction for the 2 factors came to 28%. It's possible that hdl cholesterol and C-reactive protein also improved. If they did, then this study might be one where CVD risk was cut in half ... as promised.

Can you even find a study where a Pritikin-friendly diet modified the Big 4 risk factors (hdl, ldl, BP, C-reactive protein) with a result of at least a 28% risk reduction? I understand that atherosclerotic regression has been noted (which supercedes all talk of risk factors as surrogate markers of disease). But do you have the data anyway?

The reason I ask is that it should be possible to compare the risk reduction and extrapolate to expected atherosclerotic regression. In other words, if paleo diets cause as much risk reduction as Pritikin diets, then it can be expected that they may cause as much atherosclerotic regression, too.

Ed


Post 67

Saturday, September 4, 2010 - 11:29amSanction this postReply
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Bill,

I found the evidence I asked you for. In 2007, Gardner et al. investigated reduction in CVD risk factors for folks who spent a year on the Ornish diet:

HDL change (from baseline): 0.0 = no risk
LDL change (from baseline): -3.8 mg/dL = 3% drop in risk
systolic BP change (from baseline): -1.9 mmHg = 3% drop in risk
CRP change (from baseline): not measured
=============
Total risk change: 6% drop in CVD risk

Source:
http://jama.ama-assn.org/cgi/content/full/297/9/969


Also, in 2009, Miller et al. investigated reduction in CVD risk factors for folks who spent 4 weeks on the Ornish diet:

HDL change (from baseline): -8.7 mg/dL = 39% rise in risk
LDL change (from baseline): -16.6 mg/dL = 14% drop in risk
systolic BP change (from baseline): not measured
CRP change (from baseline): non-significant 0.17 mg/L = no appreciable change in risk
=============
Total risk change: 25% increase in CVD risk

Source:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693202


Conclusion
So far, paleo-friendly diets (28% drop in CVD risk) outperform Pritikin-friendly diets (6% drop in CVD risk). If atherosclerotic regression has been noted in Pritikin-friendly diets, it is likely (though not certain) that up to 4 times as much atherosclerotic regression will be found in folks following paleo-friendly diets.

Ed

p.s. Interestingly, there was a great difference noted in HDL change in these 2 studies of the Ornish diet -- when comparing 4 weeks on it against a year on it. In the year-long study, researchers noted a large drop in HDL in the first 2 months (similar to what was observed in the 4-week trial). However, this drop reversed as time went on toward the 12-month time point -- where previously-lost HDL had been restored. Even still, the noted reduction in CVD risk on the Ornish diet pales in comparison to noted reductions on paleo-friendly diets.

(Edited by Ed Thompson on 9/04, 11:38am)


Post 68

Saturday, September 4, 2010 - 3:40pmSanction this postReply
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I misread a study. When reading it the first time, I thought it said that a 15 mg/dL rise in HDL lowers risk by two-thirds, OR an 80 mg/dL drop in LDL lowers risk by two-thirds.

In reality, it was the combination of the two that did it. This changes all my calculations.

Oops.

Ed

Post 69

Sunday, September 5, 2010 - 10:29amSanction this postReply
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I never expected my posted quote to stir such a heated debate!

Post 70

Sunday, September 5, 2010 - 12:11pmSanction this postReply
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The nutrition wars.... Who knew?

Post 71

Sunday, September 5, 2010 - 12:15pmSanction this postReply
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Luke,

I'm wondering if your quote wasn't, itself, prophetic.

:-)

Anyway, I grabbed the data I needed to adjust things. It's from:
http://circ.ahajournals.org/cgi/content/full/104/10/1108

Here are the risks of changing your blood lipids:

An increase of 1 mmol/L LDL (39 mg/dL) in males gives rise to a 40% increase in risk. The same increase in females gives rise to a 23% increase in risk.

An increase of 0.40 mmol/L HDL (15 mg/dL) in males gives rise to a 36% reduction in risk. The same increase in females gives rise to a 31% reduction in risk.

For males, it's about 1% increased risk for every 1 mg/dL LDL and about 2.5% increased risk for every 1 mg/dL drop in HDL -- HDL changes being 2.5 times more important (when compared on a mg-to-mg basis).

If you run my numbers above, I'm sure you'll still find paleo-friendly diets beating out Pritikin-friendly diets in terms of protection from CVD.

Ed
(Edited by Ed Thompson on 9/05, 12:17pm)


Post 72

Monday, September 6, 2010 - 8:23amSanction this postReply
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Paleo still better than Pritikin

Exhibit A
In 2009, Frassetto et al. published findings showing that a paleo-styled diet led to these changes:

-- a 27 mg/dL drop in LDL (which carries with it a risk drop of 27%)
-- a 3.1 mmHg drop in systolic BP (which carries with it a risk drop of 5%)

For a summary risk drop of 32%.

Exhibit B
In 2007, Garner et al. published findings showing that the Ornish diet (a Pritikin-styled diet) led to these changes:

-- a 3.8 mg/dL drop in LDL (which carries with it a risk drop of 4%)
-- a 1.9 drop in systolic BP (which carries with it a risk drop of 3%)

For a summary risk drop of 7%.

Observation
So, revised data indicate that paleo-styled diets may be up to 4 times more anti-atherogenic than Pritikin-styled diets.

Ed

(Edited by Ed Thompson on 9/06, 8:27am)


Post 73

Wednesday, September 8, 2010 - 9:49amSanction this postReply
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Ed,

Thanks for all your research. Two things I'd like to see:

1) A head-to-head comparison of the Paleo diet with the Ornish diet under carefully controlled conditions using isocaloric diets on similar subjects.

2) A comparison of the two diets for their ability to induce atherosclerotic regression. It's one thing to hypothesize how effective the Paleo diet will be in producing regression vis-a-vis the Pritikin/Ornish diet. It's another thing to demonstrate this in reality, as the Pritikin/Ornish diet has done.

I think more studies are needed with the Paleo diet -- specifically with respect to the amount of fat, protein and carbohydrate -- because the dietary recommendations seem a bit too general. How much meat is permitted -- how much required -- how much fruit and vegetables are permitted -- how much required -- how much nuts are included -- how much required, and what kind?

Early man probably didn't eat a lot of nuts, if only because they were difficult to find and to shell. Nowadays, we can buy nuts already shelled and consume large quantities of them with ease, which can easily lead to overconsumption. And I wonder too just how much meat he ate, because it probably was not easy to find and hunt down an animal. I would think he was probably more of a gatherer than a hunter.

Also, do you follow the Paleo diet consistently, and if so, what changes have you noticed in your weight, blood pressure, cholesterol, glucose, etc., since you first adopted it?


(Edited by William Dwyer on 9/08, 9:57am)


Post 74

Wednesday, September 8, 2010 - 5:28pmSanction this postReply
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Bill,
Two things I'd like to see:

1) A head-to-head comparison of the Paleo diet with the Ornish diet under carefully controlled conditions using isocaloric diets on similar subjects.

2) A comparison of the two diets for their ability to induce atherosclerotic regression.


Me, too.

I think more studies are needed with the Paleo diet -- specifically with respect to the amount of fat, protein and carbohydrate -- because the dietary recommendations seem a bit too general.
The recommendations seem too general to you because you are used to a paradigm-free, single-number solution.

With Pritikin, the single-number solution is the total dietary fat -- with the admonition to, above all else, control this one factor, this one overriding thing.

With the original Atkins diet, the single-number solution is the total dietary carbohydrate -- with the admonition to, above all else, control this one factor, this one overriding thing.

What each of these 2 diets miss, is a paradigm. Before we start talking about which micro- or macro-nutrient we should focus most or all of our attention on, we should ask many, many other questions.

What do we know about humans? How do humans work? What have they been eating for literally hundreds of thousands of years? What do contemporary primitive people eat? What is the noted disease incidence and prevalence in such populations? Are there important genetic differences between them and us? How does all of this information integrate with the larger body of the science of biology? Etc., etc., etc.


How much meat is permitted -- how much required -- how much fruit and vegetables are permitted -- how much required -- how much nuts are included -- how much required, and what kind?
This string of questions is answered -- albeit indirectly -- on p. 22 of Loren Cordain's book, The Paleo Diet:
1. Eat a relatively high amount of animal protein ...

2. Eat fewer carbohydrates than most modern diets recommend, but eat lots of good carbohydrates--from fruits and vegetables ...

3. Eat a large amount of fiber ...

4. Eat a moderate amount of fat, with more ... monounsaturated and polyunsaturated fats than ... saturated fats, and nearly equal amounts of omega 3 and omega 6 fats.

5. Eat foods with high potassium content and low sodium content.

6. Eat a diet with a net alkaline load.

7. Eat foods rich in plant phytochemicals, vitamins, minerals, and antioxidants.


And here are the AMDRs (acceptable macronutrient distribution ranges) for the Paleo diet (from p 11):

Protein: 19-35%
Carbohydrate: 22-40%
Fat: 28-47%

If you work real hard to understand these limitations (from just p. 11 and p. 22 of one key book), then you will discover direct answers to your string of questions.

Early man probably didn't eat a lot of nuts, if only because they were difficult to find and to shell. Nowadays, we can buy nuts already shelled and consume large quantities of them with ease, which can easily lead to overconsumption.
Good point. Cordain says to eat nuts in moderation, focusing on Walnuts and Macamia nuts -- and not going nuts on other nuts but, instead, using them in prepared dishes or to garnish a salad, for instance.

And I wonder too just how much meat he ate, because it probably was not easy to find and hunt down an animal. I would think he was probably more of a gatherer than a hunter.
If the remaining 225 hunter-gatherer societies investigated in 2000 offer an indication of what was eaten, then one-third (by weight) of a man's diet was meat -- while our genes were adapting to our environment. This translates to just over half of all calories from meat.

Also, do you follow the Paleo diet consistently, and if so, what changes have you noticed in your weight, blood pressure, cholesterol, glucose, etc., since you first adopted it?
I've only followed the Paleo diet consistently when I didn't even know about it (I used to eat that way for bodybuilding competitions). Now that I know about it -- and it's superiority over every other kind of eating -- I haven't followed it (consistently).

Back when I (unknowingly) followed it, my body fat percentage got down to 4.6% (based on 7-site skinfold-thickness measurements). The skin on my abdomen was almost as thin as the skin on the back of my hand.

Lately, I've only made half-hearted changes to my diet. Each meal I eat contains at least a serving of fruit, if not both a serving of fruit and 2 or 3 servings of veggies. Dairy, grains, and legumes (all not on the Paleo diet) are in my diet, but in only heavily-moderated amounts. I haven't had my vitals, or a blood test, in over a year.

Ed

(Edited by Ed Thompson on 9/08, 6:50pm)


Post 75

Sunday, September 12, 2010 - 11:55pmSanction this postReply
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Hi Ed,

I wrote, "I think more studies are needed with the Paleo diet -- specifically with respect to the amount of fat, protein and carbohydrate -- because the dietary recommendations seem a bit too general." You replied,
The recommendations seem too general to you because you are used to a paradigm-free, single-number solution.

With Pritikin, the single-number solution is the total dietary fat -- with the admonition to, above all else, control this one factor, this one overriding thing.
Actually, not. Pritikin also eliminates sugars -- no white or brown sugar, no honey, no molasses, no syrup, and if you eat raisins or dried fruit, you must eat them in small quantities only. He also cautions against too much fruit in general and too much salt. He also wants you to limit total protein from all sources. He recommends something like 65 grams per day for the average person. And he limits cholesterol to no more than 100 mg/day, and he recommends a high amount of fiber.

Here are his basic dietary principles:

Eat two kinds of whole-grains daily, such as wheat, oats, barley, brown rice, or buckwheat.

Eat some raw vegetable salad and some raw or cooked green or yellow vegetables every day.

Eat a piece of citrus fruit and up to three additional pieces of fresh fruit daily.

Add beans or peas three times a week if you like them. Once a week will do if you don't like them.

Eat sweet potatoes or hard yellow squash once or twice a week if you like them.

Eat six ounces of low-fat, low cholesterol animal protein per week -- but not more than one-and-one-half pounds. He recommends no more than three to four ounces a day.

Eat three full meals daily.

Maintain your ideal weight.

So, his diet isn't quite so simple as limiting fat to 10% of total calories. It's not a single-number solution; that's a caricature.
With the original Atkins diet, the single-number solution is the total dietary carbohydrate -- with the admonition to, above all else, control this one factor, this one overriding thing.

What each of these 2 diets miss, is a paradigm. Before we start talking about which micro- or macro-nutrient we should focus most or all of our attention on, we should ask many, many other questions.

What do we know about humans? How do humans work? What have they been eating for literally hundreds of thousands of years? What do contemporary primitive people eat? What is the noted disease incidence and prevalence in such populations? Are there important genetic differences between them and us? How does all of this information integrate with the larger body of the science of biology? Etc., etc., etc.
Well, before deciding on his diet, Pritikin did a lot of epidemiological research on populations throughout the world, observing that those who ate his kind of diet rarely if ever got heart disease. In other words, he arrived at his diet inductively by observing its results in practice.

I asked, "How much meat is permitted -- how much required -- how much fruit and vegetables are permitted -- how much required -- how much nuts are included -- how much required, and what kind?"
This string of questions is answered -- albeit indirectly -- on p. 22 of Loren Cordain's book, The Paleo Diet:
1. Eat a relatively high amount of animal protein ...

2. Eat fewer carbohydrates than most modern diets recommend, but eat lots of good carbohydrates--from fruits and vegetables ...

3. Eat a large amount of fiber ...

4. Eat a moderate amount of fat, with more ... monounsaturated and polyunsaturated fats than ... saturated fats, and nearly equal amounts of omega 3 and omega 6 fats.

5. Eat foods with high potassium content and low sodium content.

6. Eat a diet with a net alkaline load.

7. Eat foods rich in plant phytochemicals, vitamins, minerals, and antioxidants.
Some good recommendations here, but I'm uncomfortable with 1. and 3., especially 3. Just how do you get more monounsaturated and polyunsaturated fats than saturated fats, given the high meat content of this diet? Wouldn't you have to add a lot of vegetable oil to your food, especially if, as you say, Cordain recommends limiting nut consumption? Polyunsaturated vegetable oils can cause cancer, if eaten in large amounts. And fats of this kind cause blood platelets to become sticky and aggregate into clumps, inhibiting blood circulation. Fats (other than omega 3's) can also make the body less sensitive to insulin. One of the reasons my glucose is so low (both fasting and non-fasting glucoses are in the 70's) is that my diet is so low in fat. A reading of 70's is exceptional for someone my age. Ask any doctor or healthcare professional. I'd be surprised if you could get this low a reading on the Paleo diet.
And here are the AMDRs (acceptable macronutrient distribution ranges) for the Paleo diet (from p 11):

Protein: 19-35%
Carbohydrate: 22-40%
Fat: 28-47%

If you work real hard to understand these limitations (from just p. 11 and p. 22 of one key book), then you will discover direct answers to your string of questions.
This is a pretty broad range, don't you think? -- 19-35%, 22-40% and 28-47%?

I wrote, "Early man probably didn't eat a lot of nuts, if only because they were difficult to find and to shell. Nowadays, we can buy nuts already shelled and consume large quantities of them with ease, which can easily lead to overconsumption."
Good point. Cordain says to eat nuts in moderation, focusing on Walnuts and Macamia nuts -- and not going nuts on other nuts but, instead, using them in prepared dishes or to garnish a salad, for instance.
The only caveat I'd have with walnuts is that they contain a lot of arachidonic acid, which has been associated with cancer. But if the amount consumed is small, I suppose it's not an issue.

I wrote, "And I wonder too just how much meat he [early man] ate, because it probably was not easy to find and hunt down an animal. I would think he was probably more of a gatherer than a hunter."
If the remaining 225 hunter-gatherer societies investigated in 2000 offer an indication of what was eaten, then one-third (by weight) of a man's diet was meat -- while our genes were adapting to our environment. This translates to just over half of all calories from meat.
Well, that's modern hunter-gatherers. How do we know that paleolithic hunter-gatherers consumed that much?

I asked, "Also, do you follow the Paleo diet consistently, and if so, what changes have you noticed in your weight, blood pressure, cholesterol, glucose, etc., since you first adopted it?"
I've only followed the Paleo diet consistently when I didn't even know about it (I used to eat that way for bodybuilding competitions). Now that I know about it -- and it's superiority over every other kind of eating -- I haven't followed it (consistently).
Wow, you were in body-building competition? How did you do?
Back when I (unknowingly) followed it, my body fat percentage got down to 4.6% (based on 7-site skinfold-thickness measurements). The skin on my abdomen was almost as thin as the skin on the back of my hand.
Amazing. How did you feel otherwise? Did you have plenty of energy? Did you feel good?
Lately, I've only made half-hearted changes to my diet. Each meal I eat contains at least a serving of fruit, if not both a serving of fruit and 2 or 3 servings of veggies. Dairy, grains, and legumes (all not on the Paleo diet) are in my diet, but in only heavily-moderated amounts. I haven't had my vitals, or a blood test, in over a year.
Interesting.





Post 76

Wednesday, September 15, 2010 - 11:15amSanction this postReply
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Bill,

Pritikin also eliminates sugars -- no white or brown sugar, no honey, no molasses, no syrup, and if you eat raisins or dried fruit, you must eat them in small quantities only. He also cautions against too much fruit in general and too much salt.
So does Atkins. All these points are isolated and jumbled together (rather than held together by an integrating paradigm of nutrition), that's why you can find them all simultaneously on "opposite" diets such as Pritikin and Atkins.

He also wants you to limit total protein from all sources. He recommends something like 65 grams per day for the average person.
What a terrible recommendation (from a genetic-paradigm standpoint of nutrition).

Eat two kinds of whole-grains daily, such as wheat, oats, barley, brown rice, or buckwheat.

Eat some raw vegetable salad and some raw or cooked green or yellow vegetables every day.

Eat a piece of citrus fruit and up to three additional pieces of fresh fruit daily.

Add beans or peas three times a week if you like them. Once a week will do if you don't like them.

Eat sweet potatoes or hard yellow squash once or twice a week if you like them.

Eat six ounces of low-fat, low cholesterol animal protein per week ...
I like the fruit, veggie, root veggie recommendations. But to condemn a tenth of us -- immunologic studies show about 1 in 10 folks have trouble with grains and/or legumes(1) -- to condemn a tenth of us to eat such immuno-offensive things even "if you don't like them." is just terrible advice.

Well, before deciding on his diet, Pritikin did a lot of epidemiological research on populations throughout the world, observing that those who ate his kind of diet rarely if ever got heart disease. In other words, he arrived at his diet inductively by observing its results in practice.
Yeah? So did Atkins. Again, if "opposite" diets can use many similar methods and obtain many similar conclusions, then I question the paradigm.

Just how do you get more monounsaturated and polyunsaturated fats than saturated fats, given the high meat content of this diet?
Breakfast
Cantaloupe, 276 g
Atlantic salmon (broiled), 333 g

Lunch
Vegetable salad with walnuts
-shredded romaine lettuce, 68 g
-sliced carrot, 61 g
-sliced cucumber, 78 g
-quartered tomatoes, 246 g
-lemon-juice dressing, 31 g
-walnuts, 11 g
Broiled lean pork loin, 86 g

Dinner
Vegetable avocado/almond salad
-shredded mixed greens, 112 g
-tomato, 123 g
-avocado, 85 g
-slivered almonds, 45 g
-sliced red onion, 29 g
-lemon-juice dressing, 31 g
Steamed broccoli, 468 g
Lean beef sirloin tip roast, 235 g

Dessert
Strawberries, 130 g

Snacks
Orange, 66 g
Carrot sticks, 81 g
Celery sticks, 90 g

This is a pretty broad range, don't you think? -- 19-35%, 22-40% and 28-47%?
Yeah, but that's what science can prove that man ate. To narrow it down farther would require some kind of omniscience about what man ate -- and science is about the progressively narrowing down of error (not about arriving at instaneously maximized precision and accuracy like a mystic would want).

The only caveat I'd have with walnuts is that they contain a lot of arachidonic acid, which has been associated with cancer. But if the amount consumed is small, I suppose it's not an issue.
The important thing about arachidonic acid is not how much you get -- you, here, are stuck in a "single-number" solution again (single-number thinking) -- the important thing is how much you get in relation to long-chain polyunsaturated omega-3 fatty acids. Just like carbs and fats and protein and anti-oxidants, the balance of nutrients is more important than an unintegrated laundry list of individualized amounts viewed in a vacuum (in isolation).

Well, that's modern hunter-gatherers. How do we know that paleolithic hunter-gatherers consumed that much?
By indirect evidence and direct reasoning. I'll take the second point first.

Direct reasoning states that we get sick because of big changes in diet, precisely the kind of big changes that occur with industrialization. Folks who don't have the industrialization, don't have (or didn't make) the big dietary changes.

Indirect evidence can be found by comparing the length of intestines and the encephalization of lions (obligate carnivores), gorillas (vegetarian apes), and man. Nutritionally, man is closer to lion than gorilla.

Wow, you were in body-building competition? How did you do?
5th Place, Mr. Minnesota Classic, 1995

Amazing. How did you feel otherwise? Did you have plenty of energy? Did you feel good?
I sleep well, but work very long hours. I feel good on Sundays (after a full day of rest).

Ed

Reference
(1) "RESULTS: The point prevalence of sensitization (>1.0 kU/L) to milk and egg allergens progressively decreased from about 4% at 2 years to <1% at 10 years. By contrast, the prevalence of IgE to wheat and soy progressively increased with age, from 2% to 7% (soy) and from 2% to 9% (wheat)."
http://www.ncbi.nlm.nih.gov/pubmed/18269671

(Edited by Ed Thompson on 9/15, 6:00pm)


Post 77

Thursday, September 16, 2010 - 4:12pmSanction this postReply
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I wrote, "Pritikin also eliminates sugars -- no white or brown sugar, no honey, no molasses, no syrup, and if you eat raisins or dried fruit, you must eat them in small quantities only. He also cautions against too much fruit in general and too much salt." You replied,
So does Atkins. All these points are isolated and jumbled together (rather than held together by an integrating paradigm of nutrition), that's why you can find them all simultaneously on "opposite" diets such as Pritikin and Atkins.
I wouldn't say that they're "isolated and jumbled together." They're part of an integrated paradigm in the Pritikin/Ornish program as well.

I wrote, "[Pritikin] also wants you to limit total protein from all sources. He recommends something like 65 grams per day for the average person." You replied,
What a terrible recommendation (from a genetic-paradigm standpoint of nutrition).
If it's such a "terrible recommendation," then why has it worked so well for me and countless others? When I mentioned that Pritikin recommends two kinds of whole-grains daily, such as wheat, oats, barley, brown rice, or buckwheat," you replied,
to condemn a tenth of us -- immunologic studies show about 1 in 10 folks have trouble with grains and/or legumes(1) -- to condemn a tenth of us to eat such immuno-offensive things even "if you don't like them." is just terrible advice.
I doubt that Pritikin would insist on this recommendation for that 10% of the population. He also recommends using egg white as an ingredient in certain foods, but I wouldn't conclude from that that he recommends it for people like myself who are allergic to egg white. A little common sense is always helpful in evaluating dietary advice.

I wrote, "Well, before deciding on his diet, Pritikin did a lot of epidemiological research on populations throughout the world, observing that those who ate his kind of diet rarely if ever got heart disease. In other words, he arrived at his diet inductively by observing its results in practice."
Yeah? So did Atkins. Again, if "opposite" diets can use many similar methods and obtain many similar conclusions, then I question the paradigm.
But Atkins didn't do the same epidemiological research on heart disease and cancer that Pritikin did; otherwise, he would have had to arrive at the same conclusions.

Btw, I'm glad to see that at least you're diet doesn't include any polyunsaturated vegetable oils.

I wrote, "This is a pretty broad range, don't you think? -- 19-35%, 22-40% and 28-47%?"
Yeah, but that's what science can prove that man ate. To narrow it down farther would require some kind of omniscience about what man ate -- and science is about the progressively narrowing down of error (not about arriving at instaneously maximized precision and accuracy like a mystic would want).
The point is that when you do studies on the paleo diet, the results may be affected by the particular version your using. The lower-fat portion of the range yields may yield results that differ from the higher-fat portion, etc. When evaluating a diet empirically, a reasonable degree of precision is necessary.

I wrote, "The only caveat I'd have with walnuts is that they contain a lot of arachidonic acid, which has been associated with cancer. But if the amount consumed is small, I suppose it's not an issue."
The important thing about arachidonic acid is not how much you get -- you, here, are stuck in a "single-number" solution again (single-number thinking) -- the important thing is how much you get in relation to long-chain polyunsaturated omega-3 fatty acids. Just like carbs and fats and protein and anti-oxidants, the balance of nutrients is more important than an unintegrated laundry list of individualized amounts viewed in a vacuum (in isolation).
I agree that omega-3 fats can help to counteract the arachidonic acid, and I didn't mean to suggest that the arachidonic acid from the walnuts was anything major, but you're also getting it from meat. I notice that you included as much salmon as meat, which should provide a significant amount of omega-3's, otherwise I think you're courting too big a risk with all the meat that you eat, which is a far cry in its fatty-acid composition from the wild game that comprised the diet of paleolithic man.

I wrote, "Well, that's modern hunter-gatherers. How do we know that paleolithic hunter-gatherers consumed that much?"
By indirect evidence and direct reasoning. I'll take the second point first.

Direct reasoning states that we get sick because of big changes in diet, precisely the kind of big changes that occur with industrialization. Folks who don't have the industrialization, don't have (or didn't make) the big dietary changes.
Of course, industrialization enabled us to prevent and cure a great many diseases. It also enabled us to grow an abundance of food and prevent recurrent starvation, which ravaged preindustrial populations. Moreover, atherosclerosis, which has been dubbed a disease of civilization, also afflicts relative primitive populations like the Maasai of Kenya, who traditionally lived on meat, milk and blood from their cattle. Although they have very low serum cholesterol, they exhibit extensive atherosclerosis, which has been discovered on autopsies of Maasai who have died in accidents. It has been conjectured that some aspect of their diet, perhaps the milk, drives the cholesterol into their arteries and lowers its circulation in the blood, which accounts for their surprisingly low serum cholesterol. They don't die of heart disease, because their arteries are exceptionally wide, due to all the exercise they get, enabling them to avoid the heart attacks that afflict Americans.

I wrote, "Wow, you were in body-building competition? How did you do?"
5th Place, Mr. Minnesota Classic, 1995
Pretty impressive, unless there were only 5 contestants. ;-)

I wrote, "Amazing. How did you feel otherwise? Did you have plenty of energy? Did you feel good?"
I sleep well, but work very long hours. I feel good on Sundays (after a full day of rest).
No, I mean then. Paste tense: "How DID you feel otherwise?" I was referring to your body-building period, not to how you're feeling today.



Post 78

Thursday, September 16, 2010 - 6:40pmSanction this postReply
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Bill,

If it's such a "terrible recommendation," then why has it worked so well for me and countless others?
When you say it worked well, that's subjective. When objectively compared (by science), higher protein diets are consistently better.

But Atkins didn't do the same epidemiological research on heart disease and cancer that Pritikin did; otherwise, he would have had to arrive at the same conclusions.
No. Atkins did a ton of epidemiological research. It's mere speculation for you to say that he'd have to come to Pritikin's conclusions. You are assuming that Pritikin -- when looking at research -- was critical and rational and objective. This argument applies to Atkins, too. You can't assume that Diet Gurus of any stripe are critical, rational, and objective. Instead, you have to view the studies yourself.

Btw, I'm glad to see that at least you're diet doesn't include any polyunsaturated vegetable oils.
Olive oil is on it, and canola and flaxseed oil aren't left out.

The point is that when you do studies on the paleo diet, the results may be affected by the particular version your using. The lower-fat portion of the range yields may yield results that differ from the higher-fat portion ...
You still don't understand diet as a natural balance -- still looking at one number (such as fat amount) and claiming that that's a big, overriding deal.

I notice that you included as much salmon as meat, which should provide a significant amount of omega-3's, otherwise I think you're courting too big a risk with all the meat that you eat ...
That's a sample day diet from Cordain's book (Paleo Diet for Athletes). And it's unsubstantiated for you to claim I court danger with meat. Show me the research.

It has been conjectured that some aspect of their diet, perhaps the milk, drives the cholesterol into their arteries and lowers its circulation in the blood, which accounts for their surprisingly low serum cholesterol. They don't die of heart disease, because their arteries are exceptionally wide, due to all the exercise they get, enabling them to avoid the heart attacks that afflict Americans.
They don't die because they don't clot. Atherosclerosis never kills you (it is physiologically impossible to have 100% atherosclerotic occlusion). Instead, what kills you is often a blood clot that gets caught in a partially-occluded blood vessel. It is natural and normal for the body to deposit cholesterol on damaged blood vessel walls. Cholesterol is a natural cement which patches up damage in vessels.

Keeping vessels from getting damaged in the first place (with ample dietary flavanoids and vitamin C) is, of course, the best course of action. My diet has tons of flavanoids and vitamin C -- hundreds and hundreds of milligrams of each.

Pretty impressive, unless there were only 5 contestants. ;-)
There were only 7 contestants.

No, I mean then. Paste tense: "How DID you feel otherwise?" I was referring to your body-building period, not to how you're feeling today.
It was a peak of energy and vitality.

Ed


Post 79

Friday, September 17, 2010 - 12:08pmSanction this postReply
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I wrote, "If it's such a "terrible recommendation," then why has it worked so well for me and countless others?" Ed replied,
When you say it worked well, that's subjective.
It's not subjective! Laboratory tests back it up.
When objectively compared (by science), higher protein diets are consistently better.
Science proves no such thing! The diet I'm on is no way inferior to a higher protein diet. I used to follow a much higher protein diet, and I was far less healthy than I am today. My blood pressure was higher; my glucose was higher, and my cholesterol was much, much higher than it is today. And please don't tell me that I'm being "subjective."

I wrote, "But Atkins didn't do the same epidemiological research on heart disease and cancer that Pritikin did; otherwise, he would have had to arrive at the same conclusions."
No. Atkins did a ton of epidemiological research. It's mere speculation for you to say that he'd have to come to Pritikin's conclusions.
Are you seriously telling me that Atkins showed that populations on high-fat and high-saturated fat diets had lower rates of heart disease than populations on very low-fat diets? Ed, that is simply fantastic. Of course, he neither showed nor discovered any such thing. Pritikin, on the contrary did show that populations on very low-fat diets had dramatically reduced rates of heart disease.

I wrote, "Btw, I'm glad to see that at least you're diet doesn't include any polyunsaturated vegetable oils."
Olive oil is on it, and canola and flaxseed oil aren't left out.
I meant omega-6 oils like safflower, sunflower and corn oil. Olive and canola are predominantly monosaturated oils, and flaxseed is predominantly an omega-3 oil.

I wrote, "The point is that when you do studies on the paleo diet, the results may be affected by the particular version your using. The lower-fat portion of the range yields may yield results that differ from the higher-fat portion ..."
You still don't understand diet as a natural balance -- still looking at one number (such as fat amount) and claiming that that's a big, overriding deal.
No, I'm not! I'm saying that when you do the studies, you have to be reasonably precise in order to know what factors are responsible for the results.

I wrote, "I notice that you included as much salmon as meat, which should provide a significant amount of omega-3's, otherwise I think you're courting too big a risk with all the meat that you eat ...
That's a sample day diet from Cordain's book (Paleo Diet for Athletes). And it's unsubstantiated for you to claim I court danger with meat. Show me the research.
I was simply saying that if you eat the kind of meat that's available today in the supermarket, you're going to be getting too much saturated fat and omega-6 fatty acids relative to the omega-3's unless you consume extra omega 3's.

I wrote, "It has been conjectured that some aspect of [the Maasai) diet, perhaps the milk, drives the cholesterol into their arteries and lowers its circulation in the blood, which accounts for their surprisingly low serum cholesterol. They don't die of heart disease, because their arteries are exceptionally wide, due to all the exercise they get, enabling them to avoid the heart attacks that afflict Americans."
They don't die because they don't clot. Atherosclerosis never kills you (it is physiologically impossible to have 100% atherosclerotic occlusion). Instead, what kills you is often a blood clot that gets caught in a partially-occluded blood vessel. It is natural and normal for the body to deposit cholesterol on damaged blood vessel walls. Cholesterol is a natural cement which patches up damage in vessels.
The point is that the wider your arteries the less chance there is for a blood clot that breaks free to form a blockage.
Keeping vessels from getting damaged in the first place (with ample dietary flavanoids and vitamin C) is, of course, the best course of action. My diet has tons of flavanoids and vitamin C -- hundreds and hundreds of milligrams of each.
Are you saying that the only way that cholesterol gets deposited on the artery walls is if there is damage to the artery, so that a person could have very high serum cholesterol and not have any atherosclerosis whatsoever? Are you sure that's correct? Is there evidence of people with very high serum cholesterol who have no atherosclerosis?


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