Our current ideas of "health" or "optimal health" are modern concepts. Although evolving over millenia, in current form they are specific to our culture and are part of our "language game" - to borrow Ludwig Wittgenstein's term. One definition of a language game is an internally coherent system of values and concepts that are particular to a culture and determine the meaning of words in that cuture. As such, certain elements of a language game (words, concepts) are likely to be literally untranslatable – incomprehensible to anyone outside that culture.
Even if a paleolithic man could speak, within his own culture, within his language game, his concept of health might be radically different and I would argue would have to be radically different. Ideas are unavoidably culturally conditioned, and the errors of Rousseauism (then and now) are to interpret our own lives and health using imagined values we ascribe to paleolithic humans, or to use a naturalist fallacy to try to divine which current behaviors in general are good by examining what we think we know about prehistory.
I often use the examples of honey consumption and infanticide as examples of Paleolithic behavior we might not want to emulate, but it is easy to come up with more.
Here's another example. I think it is likely that early menarche (onset of menses) in our culture is an effect of earlier sexual maturity under the influence of insulin. The same hyperinsulinism that we suspect may contribute to myopia, atherosclerosis, early degenerative joint disease, inflammation and cancer makes us more fecund – more able to get pregnant early and propagate the species.
From the standpoint of our genes, you can see how this might be selected for. Insulin is a phylogenetically old hormone that, in one of its roles as a metabolic messenger, we might think of as in service of our genes more than our bodies. One message conveyed by abundant food might be “mature, propagate the species and get out of the way”. In this way, fertility is "desired" by nature at the expense of longevity or overall health. If true, one implication is that it may indeed be harder for some women to get pregnant on a diet that is otherwise best for their own health and longevity. In this sense, the idea of optimal health has to be an individual one, even within our own language game. Try consoling a woman undergoing the hell of in vitro fertilization that she can’t have a child but the upside is she might live a bit longer. On an actuarial basis, even with good paleolithic nutrition and large pelvic inlets, there is no way childbirth increased the life expectancy of the one doing the birthing, essential as it may have been for the one being birthed.
We can also come up with examples we might want to emulate that from the perspective of the Paleolithic person might not have been fun or healthy.
Let's say involuntary periods of hunger were something that we are so adapted to that we metabolically depend on them to avoid some dieseases. Maybe we are less likely to get cancer if these periods happen to us with some regularity not found in a modern food-abundant environment. Because intermittent fasting might enhance our modern health, do we then say this was a "good" part of paleolithic life, even though the experience might have been uncomfortable and terrifying for paleo man or may have killed weaker members of his kin when it happened?
The meaning of "health" to the subjects experiencing it is totally dependent on the cultural context.
A certain amount of paleo re-enactment is fun and educational and can put food on the table (hunting for deer or morels). Just try not to make fantasies of a Paleolithic eden a religion just like you wouldn’t make modern medical science a religion (or religion a religion ; ) ).
Maybe hang on to the same skepticism that led you to paleonutrition in the first place.
Perhaps avoid thinking "Grok is a better, happier, man than I". I would even be careful of "living your true potential programmed by your genes" - Your genes don't give a damn about the personal "I" that lives inside your head! They did not care 40,000 years ago and they don't care now.
I think "manipulating the genes I am stuck with after a billion years of evolution" is both more appropriately subversive and more accurate .
Go try to kill your own food with late paleolithic tools like a stickbow with arrows. Imagine it without modern clothing and without knowledge that you can return to central heat and access to a refrigerator, and pretend that you and any little humans that survived infancy will go hungry if you don't kill something. Pretend you are a paleolithic human and then ask yourself:
Would I, 28 year old Grok, trade a future risk of cancer and diabetes at age 60 for unlimited abundance of food and central heat right now?
Contemplate that, and then you can understand why PaNu is defined narrowly as "duplicating the evolutionary metabolic milieu".
Because we have to, we start with a definition of "optimal health" that originates in our late industrial language game. This is hard enough and anyone reading medical science critically knows this. The definition can even be different depending on what your values are, like choosing to have many children versus having a perfect AUC for insulin. But generally for me it means less cancer, and less debilitating degenerative diseases that, looking at our knowledge of non-neolithic cultures, might be optional instead of part of the aging process.
Cancer, diabetes, hypertension, coronary disease, stroke, Alzheimer dementia, arthritis, autoimmune disorders – we call these diseases of civilization (DOC). Add your own to the list but there seems to be some consensus within the language game of our paleonutrition community that these are the core DOCs. If it suits you, expand your definition to non-actuarial life extension. Some of my readers do, and bully for them. I think that is like SETI, but I hope they’ll clue me in if they find something! Conversely, if winning an Olympic gold medal is worth injury or even losing a few years of your life, modify “health” to mean quantifiable physical performance. You know that I think some physical parameters may make you live longer, and some may not, but who cares? As long as you are awake to what you value and not fooling yourself that physical activity makes you immortal or even live longer, make your own choices.
Finally, we look for current behaviors that are foreign to what we believe is the evolutionary milieu prior to agriculture, and we see if there are clues to how to change current behavior to improve our current concept of health. This last step is harder and fraught with ambiguity, but by starting in the present and only then looking at the millions of differences between the paleolithic and the present, we can avoid the “Everything ancient is better than now” fallacy that I call paleo re-enactment.
When I apply this method, I come up with the neolithic agents of excess fructose, linoleic acid and gluten grains, and the rest is just tinkering around the edges*.
*The fact that other bloggers, writers , doctors and scientists independently arrive at the same list, some without any appeal to evolutionary reasoning, only makes me more confident that these are the important ones. Any real scientific principle should be independently discoverable. I won’t name any names, but I am skeptical of systems that are either totally unique or too precise.