Kurt Harris MD

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« Why Paleo 2.0? | Main | Tylenol and The War on Drugs Updated »
Wednesday
Mar302011

Paleo 2.0 - A Diet Manifesto

 

In 1985, a radiologist named Boyd Eaton wrote an article for the New England Journal of Medicine called Paleolithic Nutrition. As far as I can tell, we can trace the use of the term Paleolithic Diet or Paleo diet to this article. Eaton later inspired and collaborated with Loren Cordain, a professor of exercise science at Colorado State, and author of what seems to be the most popular book with the base sequence of “paleo” in the title.

A gastroenterologist named Walter L. Voegtlin had written a book called The Stone Age Diet much earlier in 1975. Starting an unfortunate trend that continues to this day, the book had a cave man on the cover, complete with loincloth and spear. Interestingly, both Voigtlin and Eaton seemed to consider the macronutrient ratio to be the key parameter of the Paleolithic diet we should try to emulate. I consider this the least important element.

I had first heard the term paleolithic diet through Eaton’s article. When I started on this path in September 2007 I came across it and remembered that I had first read it in medical school (1985) as I had a subscription to NEJM at the time. But although when I re-encountered the article it was familiar, I can’t say it had previously made much impression, as until I read Good Calories, Bad Calories (GCBC) by Gary Taubes I still thought that food was just fuel and obesity was always due to bad genes, or overeating, or lack of exercise - the usual suspects.

Reading GCBC in 2007 left me with several impressions:

1) The vilification of saturated fat, and its most common source, animal foods, was a 50-year error of criminal dimensions.

My own diet, due to hubris and the belief that I had “good genes”, had thankfully never been deficient in eggs, red meat, butter or bacon. They had tried to teach us that “cholesterol” was something to fret about when I was in medical school, but even my undergraduate and medical school biochemistry at the time made that seem only vaguely plausible. Hadn’t humans been eating meat for millions of years?

It may have helped that I had a cholesterol screening in medical school. As I recall, my total cholesterol was around 140 and HDL around 50 - on a high animal fat and egg diet. And I could not with any decent disposition go more than a day without some serious meat anyway, so if it was to ultimately kill me, then so be it.

So in the fall of 2007, this book seemed above all a vindication of the stubborn and instinctive nucleus of my by-then 45-year lifetime diet - animal products and their fats.

An anecdote from 1995: A former partner of mine, on seeing the breakfast I had just bought at the hospital cafeteria, remarked “Now there’s a heart-healthy breakfast!”. I looked down at my tray, which had about 3 scrambled eggs, as many sausage links and pieces of bacon, and a carton of whole milk. None of the mockery was intended for the single slice of wheat toast used to mop up the egg yolk, but the two pats of butter on the toast were surely part of the condemned. I was quite taken aback by his response as I had eaten this way since I was a child. I was to discover later that my lack of dietary consciousness had actually saved me from much of the harm that has been perpetrated by nutritional “experts” since Ancel Keys first fudged the data to make it look like saturated fat causes heart disease in the 1950s. And my partner’s wife was bit of a lefty; a Unitarian, and an artist. I suspect my partner was only “serving” me with what he would have received had he eaten such fare at home.

2) Some diseases that are very common today, which we call Diseases of Civilization or DOCs, do not occur with any frequency in native or hunter-gatherer populations until western foods are introduced.

I had never before heard evidence that some of the diseases I’d been seeing my whole career might be optional. Diseases like diabetes, heart disease, common epithelial cancers, diverticulitis, and appendicitis. Most medical schools don’t really treat this issue of DOCs. The background assumption was that cancer, heart disease and obesity are only issues because we live long enough to get them now, and aren’t we lucky for modern medicine? The diet/heart hypothesis - the idea that cholesterol or saturated fat or red meat was responsible for vascular disease and heart attacks - had been around for decades, but did not seem to be as woven into the fabric of culture as it is now. There was really no print equivalent to today’s 24/7 propaganda of pop nutrition via MSN and Yahoo, with perky titles about the latest worthless observational study associating a colorful plant with some tertiary biomarker of health status.

So we were taught that cholesterol and fat in the diet might contribute to heart attacks, but cancer, diabetes and autoimmune disorders were mostly considered just part of the human condition.

But in GCBC and in writings by Cleave and Price and others, the descriptions of populations that ate native whole-foods diets, and what happened to them when they started to eat the white man’s food, was totally eye opening and had never been hinted at in my medical school curriculum.

GCBC described the common elements as carbohydrates - easily digestible carbohydrates - and this formed the basis of his carbohydrate hypothesis of diseases of civilization. Not only were dietary fats not responsible for heart attacks - and this case seems convincing to me still -but a whole suite of diseases of civilization might instead be caused by the very macronutrient that for 40 or so years has been pushed on us by governments and their confederacy of do-gooders as the antidote to the evils of artery-clogging animal fats (saturated fats) - carbohydrate. Avoid red meat. Eat more pasta and “low-fat” fare.

The nutritional transition seemed to be related to the introduction of "easily digestible" carbohydrate in the form of wheat flour and sugar  - the staple foods of both genocidal state armies and the nanny state government rations that inevitably followed them.

Time and again it could be seen that in less than a generation, a native population that had once been free of cancer, diabetes, heart attacks, dementia, diverticulitis, appendicitis, etc., would begin to suffer from these diseases the same way that the colonizing white man had, or worse.

I read the further source works, by John Yudkin, T.L. Cleave, Weston Price, and others, and began immersing myself in the primary literature of nutrition, metabolism, endocrinology, gastroenterology, and anthropology and paleo-anthropology. I started reading many scientifically oriented blogs and thinking about what they had to say; reading papers they referenced, and following leads on pubmed, the national library of medicine’s index of peer reviewed articles.

I came to believe very strongly in the concept of the nutritional transition.

In the early days of my blog, I thought the brightest dividing line between the healthy ancestral diets and modern ones was likely to be around the time that homo sapiens had adopted the practice of sedentism - living in one spot- and therefore the time of adoption of agriculture. (It is now thought that sedentism may have preceded domestication of grains by several thousand years). This occurred around 10,000 years ago, give or take.

So “paleolithic nutrition” seemed like good shorthand for what we should be eating to avoid the diseases that came with civilization - the DOCs.

The problem came when I started to read what others before me were characterizing as key features of the “paleolithic diet”.

Some of these ideas -like avoiding eating wheat and other gluten grains - struck me as reasonable, but some were weakly supported, some were just silly, and some of them directly contradicted what I felt to be the most scientifically sound arguments. 

Hominin ancestors ate only lean meats and little saturated fat

A paleolithic diet is characterized by plenty of cultivated nuts

A paleolithic diet has plenty of sweet fruit year-round - fruits that did not even exist until they were artificially bred a few hundred years ago

 A Hunter-gatherer diet always had a precise balance between “acidic” and “basic” foods and failure to maintain this precision would lead to calcium being “leached” from your bones, resulting in osteoporosis.

A paleolithic diet has plenty of grilled salmon and skinless chicken breasts.

Eating fish is essential to brain growth and general health.

Milk and cheese are causes of cancer.

Eggs can be eaten, but you should throw away the yolks to avoid too much cholesterol.

These ideas all seemed questionable to me at best, and so far have not withstood the scrutiny of either sustained pubmed searches or informed reasoning.

In the penumbra of the paleo internet and blogosphere, there seemed to be even nuttier ideas. Admittedly, most of the “paleo” movement does not embrace these, but their existence proves there is hardly a licensing system to prevent bizarre speculation about the natural human diet, without any reference to what is actually known about ancestral diets.

Hence we get:

We did not evolve to eat cooked food, and to do so is to invite disease.

We did not evolve to eat any plant food at all.

We did not evolve to eat any animal food at all.

(You all know this one - The vegan menace. Killing infants and robbing adults of their vitality is the ultimate denial of biology. Endorsed by countless brainless celebrities)

And then the inevitable combinatorial madness of:

The natural human diet is all raw plant food.

The natural human diet is nothing but ground beef and water.

The natural human diet is nothing but raw meat and water.

The natural human diet is nothing but raw fruit.

You get the picture 

It seemed that the only commonly agreed-upon element among those claiming to invoke what we are “evolved” to eat, might be that cereal grains should not be a predominant part of the diet.

But then I spent some time reading at the Weston Price Foundation. WAPF is inspired by, naturally enough, Weston Price, a polymath dentist who made extensive studies of traditional foodways and modern hunter- gatherers, and attempted to identify the common elements that made them all healthy. I found that although WAPF advocated consumption of grains treated using traditional preparation methods (something I do not advocate) that on the health status of virtually every other available food I agreed more with them than with most of the paleo movement luminaries at the time - the ones claiming to be basing their recommendations on what we were “designed” to eat.

Whither Paleo Diets and Paleonutrition?

So where does that leave us? What of the concept of returning to our ancestral diet, the diet we were designed by evolution to eat?

How can we eat a Paleolithic diet if no one can agree on what it is?

The concept of "a Paleolithic diet" is flawed for a number of reasons. Most of the foods that we evolved eating are not actually available to us now, either in type or quantity.

And there never was any one diet eaten by the succession of species of hominins throughout our millions of years of evolution.

The idea that there has been evolution of our food sources, but little or no adaptive evolution at all by the organisms that consume them (us), is also not completely accurate.

That we are eating some things we are clearly inadequately adapted to seems certain, but the idea that the dietary bright line is narrow and exists at the 10,000 year mark is a cartoon view not supported by the science. I believe most of the dietary damage is due to industrial processing amplifying the effect of things that have always been around and were never good for us in the first place, even as I do believe wheat and other grains to the exclusion of animal products has been an issue for 10,000 years.

The idea that anything before 10,000 years ago is good for us, and anything that with a shorter history is bad for us is incoherent.

The “Paleolithic diet “ is a chimera, a myth.

No more real than a Griffin.

A beautiful thing that doesn’t really exist.

I coined the term “evolutionary metabolic milieu” or EM2, to signify that we cannot hope to duplicate the exact diet that was eaten, for all of these reasons. Instead, we can strive to use science and our reasoning to emulate the important elements of the evolutionary metabolic environment - the internal environment of our bodies.

Here was the way to connect the ideas of Taubes, Yudkin, Cleave and Price, who never really invoke evolutionary reasoning, to a sound way of thinking about diet in an evolutionary context.

A way where “Paleo” no longer refers to any particular diet eaten at any particular time, but only to paleo in the sense of “old”. Traditional Neolithic, Paleolithic and modern foods that we know are healthy or are similar nutritionally or metabolically to what archaic diets might have been like - there is room for all of these concepts.

I wrote a blog post about how my concept of evolutionary reasoning was different from trying to re-create a chimerical past. 


I said:

….if foods contribute to disease, it is unlikely (but not impossible) that the bad foods are what we have been eating a long time, and much more likely that they are something relatively new 

…. a food being evolutionarily novel was a likely condition for it being an agent of disease, but that novelty was neither necessary nor sufficient for agent of disease status.

It seems obvious that the universe of foods that were newer or Neolithic would provide candidates for the dietary agents of disease, and that a disease-causing agent would be very likely to be a Neolithic one

but…. being a Neolithic food alone is not sufficient to make it an agent of disease.

When we have medical and metabolic evidence that a Neolithic food is healthy and we find its constituents to be totally compatible with foods we consider Paleolithic, we can conclude that food is not in the agent of disease part of the Venn diagram.

So we are defining a healthy diet more by what is missing from it than by trying to duplicate a chimera.

If Neolithic Agents of Disease, by definition, are something that causes the nutritional transition that ushers in the DOCS, then our efforts should be focused on defining what they are.

I call such an approach, when using all available science, and not just evolutionary speculation, Paleo 2.0

Paleo 2.0  is paleonutrition where the paleo- prefix means archaic, not paleolithic

We appeal to archaic foodways to learn what is wrong with our modern Neolithic/industrial diet. These archaic foodways could be hundreds of years old, or many thousands.

We focus on the nutritional transition, then we bring all of our scientific resources to bear on finding putative Neolithic agents of disease.

In biology, “putative” means an agent that we think is the responsible or active agent, but we are always trying to falsify our hypothesis. We are always looking for evidence that we might be wrong about our agent.

In my own intellectual evolution, I have expanded and modified the "carbohydrate hypothesis" of the nutritional transition to one that does not indict a whole class of macronutrients.

I don’t believe the problem with wheat or sugar is either that they contain or are carbohydrates.

My Neolithic Agents of Disease include the following, in chronological order of introduction into our diets.

Wheat

Wheat contains starch, which is fine, but along with starch wheat contains gluten, which is a complex of proteins that has been linked to a variety of diseases, and wheat germ agglutinin, that is a lectin antinutrient. Celiac disease, obesity, diabetes and mental illness are all linked to wheat consumption.

The problem in wheat is likely the proteins, not carbohydrate. White flour is dense and highly concentrated in these problematic proteins and antinutrients. Wheat causes problems even in populations who’ve been eating it for thousands of years.

Eat potatoes, sweet potatoes or root veggies for your starch, and stop eating all bread, cookies cakes and other baked goods.

Excess Fructose

Fructose is a carbohydrate, but metabolically it is quite different from the glucose that comes from starch. In small amounts or in moderate amounts in real food, fructose may not be a problem, but the ubiquity of fructose in the modern diet may create obesity, insulin resistance, fatty liver disease, and abnormal bacterial growth in the gut with consequent inflammation.

Fructose is easily minimized by simply refusing to eat processed food that comes in a box (especially “low fat” foods), and by refusing to drink caloric drinks like soda pop and fruit juices and sports drinks.

Wheat flour and fructose are the two NADs in most of the historically documented nutritional transitions.

Excess Linoleic acid

Linoleic acid is an omega 6 fatty acid, a polyunsaturated fat or PUFA. Along with n-3, the other type of PUFA, it is technically an essential fatty acid, but the actual requirement is so small it might be better considered a micronutrient. A hunter-gatherer or Paleolithic human might have had a total PUFA intake of 3% of calories. Modern north americans have a PUFA intake of around 15%, most of it due to n-6. The problem with this is twofold.

1)   As n-3 and n-6 precursors compete for the same enzyme in the eicosanoid pathway, the excess of n-6 in the diet means that n-3 is outcompeted at the enzyme level. The result is a preponderance of inflammatory molecules. Increased cancer and inflammation are both likely related to this

2)   Many are aware that 6:3 ratio is important, so they try to compensate by taking fish oil to balance the 6:3 ratio. This doesn’t really work too well – you can’t realistically eat that much fish, and if you take fish oil supplements, you now exacerbate the second and more important problem with excess n-6, which is your total PUFA intake. High total PUFA, especially including the highly unstable n-3, leads to oxidative damage to your cells. Your arteries, liver and  other organs don't appreciate extra oxidative damage.

The way to correct the modern excess of n-6 or linoleic acid is to avoid the modern sources of it. Stop eating all temperate vegetable oils – cooking and frying oils like corn, soy, canola, flax, all of it. And go easy on the nuts and factory chicken. These are big sources of n-6, especially the nuts and nut oils.

I started reading and thinking about nutrition over 3 ½ years ago and began blogging almost 2 years ago. What I have seen in the past few years is that there are a number of other writers who also emphasize these same Neolithic Agents.

Critically, these other writers also:

1) Reject the alternative hypothesis of saturated fat or cholesterol as a Neolithic agent – the so-called diet/heart hypothesis

2) Believe that obtaining a substantial fraction of nutrition from animal sources is necessary for health

3) Discount the absolute importance of macronutrient ratios in the nutritional transition.

4) Believe that a whole foods diet that includes adequate micronutrients is the best way to eat healthy.

5) Believe that tubers, root vegetables and other sources of starch can be healthy for normal people, but that gluten grains are a suboptimal source of nutrition in other than small amounts.

I’ve written this post both for my regular readers, and also for new readers who may never have heard of “paleo” diets or paleonutrition.

I invite all new readers to start with the blog posts I’ve linked to get a better idea of what Archevore is all about as a diet. It is really more of a philosophy and an approach than a set of rules to follow.

I also invite other bloggers, writers and thinkers to voluntarily affiliate with the appellation Paleo 2.0.

Many figures whom I think of as Paleo 2.0 compliant don’t and probably won't identity themselves as “paleo” at all. Given some of the nonsense I’ve seen under the rubric of paleo, I can understand that, and I’ve considered the extirpation of the label from my own blog for some time now.

But no one owns the greek word palaios. The English paleo- is just a modifier. And language evolves. We can use Paleo 2.0 until it means what we want it to. A diet that is archaic, in the sense of appealing to the past with both science and history, but not intending to re-enact a battle that has only happened in our imaginations.

If you identify with the concept of the NAD and the 5 corollary points, and want to claim the “paleo-” prefix as separate from the chimera of a paleo- “lithic” diet, then please say so.

Some will criticize my proposal as threatening to collapse a big tent.

I prefer to think of it as leaving the tent to erect a proper building.

 

There is no such thing as a macronutrient

No such thing as a macronutrient part II

The argument against cereal grains part I

The argument against cereal grains part II

Get Started

 

 

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Reader Comments (95)

I've been trying to make a "paleo" soundbite for months now, in order to have something on hand to correct the various nonsense that swirls around the paleo concept out on the internets. The best I could do was:

"Paleo is a heuristic which helps you figure out what not to eat."

Now I can add a link to this article and be done with it. Thanks for keeping paleo sane and rational. Sometimes this blog is the only candle in the dark, and I hope you keep it that way.

KGH: Thanks for your support, PFW.

March 31, 2011 | Unregistered Commenterpfw

Thanks for this post Dr. Harris, I will definitely be circulating this post since it is well written and I find myself in total agreement with all of your tenets of Neolithic Agents of Disease and corollary points. I find these are some of the most important factors of the toxicity and deficiencies that we see so commonly amongst North Americans that are the cause of most chronic diseases. I don't suspect either that there is a diet that is perfect for everyone, but there is certainly specific dietary purities and sufficiencies that every human needs in order to express optimal health. I like to remind my patients that we are a mammal species, and just like every other mammal there is an ideal diet they innately eat that allows them to express true health. Hence our estimated ancestral diet style being such a successful way of eating in terms of optimal health. Part of the problem is that we have dissociated ourselves from the animal kingdom so much so that even at a university there are totally different departments and buildings to study animal physiology vs human physiology. Which is why everyone knows that you shouldn't feed your dog pepsi and doritos, but they don't think twice about letting their kids eat it.

March 31, 2011 | Unregistered CommenterDr. Ryan Hewitt

Great post! I stumbled upon this site recently after ~2 years of experiencing fatigue and anxiety issues, without anything resembling a conclusive diagnosis*, but tons of diet advice, much of it containing no remotely scientific reasoning. The thing that steered me towards paleo was going on a candida cleanse and needing some recipes, I have a brother in law who is into paleo, and I realized they were pretty similar.

On to my question: One problem I had with my paleo/candida diet was constant hunger. I can eat 6 slices of bacon, 5 eggs and some cottage cheese and be hungry a few hours later. However, if I have just 3 slices of bacon, 2 eggs, some cottage cheese and 2 slices of french toast, I'll be fine until late afternoon. Other starchy foods do not seem to have the same satiating effect as bread for me. Is this a mental effect? I've read that grains can be physically addictive. I'm not looking for an excuse to eat flour, I just want to not be so hungry, and not lose any weight while eating this way.

*(vitamin D depletion was diagnosed, but not determined the main cause. partially conclusive: adrenal fatigue, candida. negative on all allergies)

March 31, 2011 | Unregistered CommenterPeter C

Kurt,

This post was perhaps the clearest summary of the clearest thinking on "Paleo" that I've read anywhere. You've hit many if not all of my pet peeves regarding the often poorly-thought-out (if thought out at all) leaps that so many people, inside the paleo community and outside, seem to make. Your rigorous thought and reasoning are a breath of fresh air. Bravo! Please keep up the good work.

Eric

March 31, 2011 | Unregistered CommenterEricW

Dr. Harris,
I'm a big fan of your work and agree with every word of this post. Thank you for this awesome post... just in time when too many people were prescribing too many paleo diets as THE paleo diet! It all comes down to this...

"The “Paleolithic diet “ is a chimera, a myth.

No more real than a Griffin.

A beautiful thing that doesn’t really exist."

March 31, 2011 | Unregistered CommenterRaj Ganpath

With no access to unprocessed sources of LCSFA nor to meat from pastured grass-fed cows or pigs, nor to eggs from grass-fed chickens, would pasteurized cream, butter made of the same, low-quality eggs and meat still constitute the best parts of a healthy diet? I'm wondering whether pasteurization and excess n-6 leave anything to be gained from moving from, say, potatoes to cream and grain-fed beef. Where I am from lack of availability is a huge problem. Only what is popoular is available, basically. So I am also wondering what I should eat, given that I have to choose from a far less than ideal list of foods. :(

March 31, 2011 | Unregistered CommenterPlutok

Kurt, it's just so good to have you back, and in top form, I must say. I hope you are still planning on writing a book, when the time is right; I have no doubt that when you do, it will be one of the most substantial and least "fluffy" books about "Paleo" yet to be published.

March 31, 2011 | Unregistered CommenterNathaniel

a total 're-enactment' may be either impossible (lack of information, absence of foods themselves) or inadvisable (even if something has been consumed that does not mean it is inherently 'healthy'), but it surely has a clear aesthetic component, which for some is not that much less important than a pure and dry rationalization: thus for less scientifically inclined / driven abstaining from nightshades or working out with stones may have a greater allure than some meta-model of paleolithic milieu emulation

KGH:

Some people spend time re-enacting the battle of Antietam.

Some people go through training to become a Navy SEAL.

As long as you are conscious of the difference, I have no problem with either one.

March 31, 2011 | Unregistered Commentergn

I loved this post! Thanks, Kurt!
I got into Paleo-esque eating via the Nora Gedgaudas type Primal approach (OMG! GLYCATION!!!) and then I mellowed out a bit on the carb phobia. I still feel better eating less of them rather than more, but it's good to have room to evolve (all puns intended;). I want my readers to know that I don't have all the answers and am very much a work in progress.

I'm more than happy to be associated with Paleo 2.0. Sign me up!

However, I'd like to up the ante a little more: I have to admit that "Paleo" more often than not tends to get a bit bogged down in "science" (I say that tongue-in-cheek) and I feel like there's a bit of tunnel vision going on regarding the bigger picture. Realistically, all indigenous cultures have some system of ethnobotanical medicine. It's not only about the food and movement. "Paleo" tends to be missing out on a lot of cool stuff in the way of using plants as medicine and exploring systems of traditional medicine and healing. Don Matesz (Primal Wisdom) almost seems a little subversive writing about things like shamanism in the context of evolution. I'd love to see more smart people coloring outside the lines a little;)

KGH:

I like to color outside the lines, but maybe confine the coloring more to the realm of art than science.

"all indigenous cultures have some system of ethnobotanical medicine"

No doubt. And many of them engage in colorful practices like scarification and genital mutilation and cannabalism and infanticide and ....

March 31, 2011 | Unregistered CommenterErin

Funny -- just a few days ago, in my tiny corner of the nutrition-blogging world, I used Paleo 2.0 in a somewhat different sense. What I meant by it was the trend of paleo practitioners having gotten so far in our health/weight optimization efforts that we're bumping up against certain limits, so that we are driven to increase our understanding of the mechanisms that much more. In a way, you seem to be poking at the same phenomenon, but coming from a place of pessimism rather than optimism. I hope all the encouraging comments here give you a little bit more faith in humanity. :-) Thanks for listening, and thanks for all the good work you do.

March 31, 2011 | Unregistered CommenterEve M.

Thanks for this and all of your other posts. I found this way of eating after reading Gary Taubes last September. Since then I've put it into practice and lost about 50 lbs (mostly) eating along the lines you lay out. Moreover, changing my diet modified my blood chemistry such that I've gotten my doctor off of my back about my cholesterol and triglycerides (and statins, which I refused to take because of how they made me feel).

Anyway - I've read widely in this area trying to see what there is out there. Your blog is one of very few (the others mostly appear in your blog roll) that I check on regularly and in which have gone back to read older posts. I appreciate your efforts and reasoned arguments.

March 31, 2011 | Unregistered CommenterRob S

Hi Dr. Harris,
I really liked your post. I have spent the past few weeks reading your entire blog, and some of it I will probably never comprehend because it goes beyond what organic chemistry I took in college before switching majors :) I do have one question though. I really want to understand what you're saying about the different types of fats more, but honestly what you've posted on several occasions is beyond me. I can get the point of not eating certain types of oils and nuts, but I'm having a hard time explaining why to others. Your comment about fish oil today also threw me for a loop, making me feel even more confused. Can you break down everything about fats to a very, very basic level in a future post? It would be extremely helpful.

Thanks!

KGH:

If you're not satisfied with what is here, Stephan and Peter and Chris Kresser and Chris Masterjohn all have pretty good discussions of n-6 and n-3.

March 31, 2011 | Unregistered CommenterRachel

This. Post. Rocks.

This is a great summary / primer for common-sense and evidence-based paleo advice (post-paleo?)

March 31, 2011 | Unregistered CommenterCorey McMahon

KGH:

"No doubt. And many of them engage in colorful practices like scarification and genital mutilation and cannabalism and infanticide and ...."

LOL! Always the smartass;) True, although we Americans still practice genital mutilation on a regular basis despite lack of science behind it, and we might not be cannibals, but I sure know a lot of people with tattoos and piercings, so it's not just the "savages" doing those things, but I digress...

I suppose my point is that even hunter-gatherers eating 'ideal" diets who don't suffer from degenerative diseases still seem to have arsenals of remedies for other ailments, and we could learn a lot from them (maybe not in the infanticide dept!) but we keep looking to them for dietary clues , so clearly, they offer something to glean from, as far as both food and medicines go.

KGH:

I certainly wasn't excusing savagery among the "civilized".

And the alternative takeaway to the universality of efforts to combat illness, even in the presence of an ancestral diet, is that diet is not everything, and there is no such thing as perfect health.

I prefer this interpretation. In other words, just because modern medicine is often wasteful and ineffective does not for a moment mean native potions or any form of "alternative" quackery is any more effective.

Just cheaper.

Many people think my medical nihilism means I am a proponent of alternative or complementary medicine. Nope.

March 31, 2011 | Unregistered CommenterErin

I am physician and a very well controlled diabetic on a very low carb life style, i.e paleo 2.0. I know that there are many genetic precursors of diabetics but they all seem to act in some way on the metabolic pathway of glucose particularly when there is an excess of glucose in the diet. There is very little wheat glucose in the paleo 2.0 diet and therefore I it would seem to be an excellent way to treat our population's obesity/diabetic explosion and much cheeper and safer than drugs. However is is hard to get people to listen! Your post hopefully will help.

March 31, 2011 | Unregistered CommenterHarold Dobbs, M.D.

Corey Mc Mahon suggested "Post-Paleo".

I like that.

I think it makes sense on many different levels. Really, what Dr. Kurt is summarizing here is a transcendence through and beyond a cultural movement (as culture encompasses cuisine, politics, art, education, science, production of ideas...) that was ignited when Taubes' NYTimes Magazine article, "What if it's all been a big fat lie?", hit the news stands.

KGH: I considered "post-paleo" but it has echoes of postmodern which I don't like. I think plain old Paleo as in paleoconservative is fine, but I like Paleo 2.0 for several reasons. The ideas are of varying ages but the proponents are newer on the scene. The 2.0 implies an improved version, as with software, that WORKS better than the previous one. It is a statement of pragmatist philosophy. We are open to there being a 3.0 and I like that implication as well.

Think of Mac Os X vs System 9. Os X is newer as a marketed system and works better, but has a Unix core - free BSD, which is based on UNIX, which is actually much older than Mac OS 9. So I was thinking of this software transition as a natural metaphor for our WOE/dietary method.

I agree about the whole cultural effects. One reason I don't like "ancestral" is that that term has so many non-dietary elements associated with it that may be fun and exciting, but are either unproven or so silly that they contribute to the carnival atmosphere.

Towing a $70,000 land rover with a rope in a suburban driveway is claimed to be "ancestral"...

We're face with saying either:

"no it's not that type of ANCESTRAL - we don't insist you must never run at a steady pace or use barbells (you must sprint and use kettlebells or rocks...)"

or

"no, it's not that kind of PALEO, we don't think butter causes cancer or heart attacks.."

We can instead say "it's PALEO 2.0 - A version that for now, just works better - it gets us where we want to go. Here, read this...)

Maybe sometime in the future Paleo 2.0 will be ascendant and no one will remember the other versions which evoke cavemen, and one will be able to say Paleo and it will mean what we want it to. Half the readers of this post probably don't even know there ever was a Mac OS 9, or that Macs used to run on PowerPC chips by Motorola. Mac OS and Mac OS X are the same thing to them.

Astute readers will note the influence here of William James, Ludwig Wittgenstein and Richard Rorty

April 1, 2011 | Unregistered CommenterPatricia C Psy.D.

I join with many of the above readers in thanking you for writing such a fantastic portrayal of what "paleo-dieting" should be. You've taken the fantasy and emotion out of what most paleo bloggers put out there these days. It brings the diet back down to earth rather than pedestaling it as the cure-all rule list, gloom and doom message it's sortof become. It's like you took the religion out of paleo-dieting. thanks, I've passed this on to several friends.

April 1, 2011 | Unregistered CommenterKrista

Maybe you can answer a question of mine about nutrition and native diets: Since this is America, the only natives here are the Indians. Everyone else descends from somewhere else. So if we as Americans descending from somewhere else want to follow an ancestral diet, do we look back into our own individual heritages and eat what they ate, or do we follow correct Paleo eating principles by skipping individual ancestry and going all the way back to the trunk of humanity, and eating THAT diet?

I've recently been reading a lot about how native diets help Hispanics, Filipinos, and other cultures return to a picture of health after the so-called "Western diet" (another misnomer--it should be the Drive-thru Diet) wrecked their health and made them obese. If WE were to do so, what diet would we follow--our own heritage's diets, or the correct Paleo one?

If we were to follow our own heritage's diets, we'd need to go back at least 4 generations, because epigenomics indicates diets affect three generations in one diet and one body.

As far as I'm concerned, there is no Western diet, unless you count native Americans and ONLY native Americans. The rest of us are from somewhere else! When Pilgrims and others arrived here, they ate what the Indians gave them, or could forage/hunt/grow themselves, so in essence, the native American "native diet" should be called the Western diet, and not this fast-food crap contained in the Drive-thru Diet.

FWIW, I eat Paleo (correctly) because I have to --food allergies drove me this way some time ago. Now I know there's a name for the way I have to eat. WAPF prep methods didn't help at all, so avoidance is the key (and cheaper, too!).

KGH: If you read my blog and think about what you just wrote, the answer is that there is no particular ancestral diet to refer to in terms of what to eat, but there might be in terms of what not to eat.

April 1, 2011 | Unregistered CommenterWenchypoo

Thank you very much for this article!

April 1, 2011 | Unregistered CommenterFrançois

I share this same approach but to be honest I dislike the Paleo 2.0 name.

I will suggest a name like Based on Human Evolution Diet
The BHE Diet or the BE Diet

But in the end is your approach and your blog so you can call it as you want :)
Keep the good work!

KGH:

When you write your book you can call it BHE or anything you like. As I tend to think of it as based more on modern knowledge of metabolism than on sketchy speculation about human evolution, of which there is already plenty, I would not use something like that.

April 1, 2011 | Unregistered CommenterJorge from Venezuela

Dr. Kurt,

Yep, "2.0" makes sense to me now. And I understand how the "post" prefix might suggest nuances you may not want or intend.

When people ask me questions about why I choose to eat this and not that (e.g., "Wow, you're actually going to say no to croissants and bagels?" at a brunch or meeting), I simply like to say, "There are a few things that are known to cause disease in humans, and without which we can all probably afford to live. Isn't it nice that we have options?"

If they ask to know more, I can now just tell them to go google Paleo 2.0, and hopefully their curiosity will be rewarded.

KGH: I want it to be voluntary and open- source. It will work best if I'm not the only one using it.

April 1, 2011 | Unregistered CommenterPatricia C Psy.D.

Having read all the comments but I was wondering what are highly unstable n-3s?

KGH: All n-3 polyunsatured fats, including the "good" ones like EPA and DHA, have even more double bonds than n-6 PUFAs. So all n-3s are hihgly unstable - they react chemically - oxidize or spoil - very easily.

April 1, 2011 | Unregistered CommenterJohn Tatore

Re n-3s, did you see this news? "Booming sales of omega-3 fortified cooking oil in China may show how countries with nutritional deficiencies can boost the nutritional intakes of a population, said a leading omega-3 figure." http://bit.ly/fgRgj3

Yeah, that'll boost their nutritional intake!

KGH:

The wall steet journal had an article about the gallons of soybean oil that typical chinese families consume per month - I read that and thought about all the cancer and heart attacks in the pipleline...

Of course in a decade or so, we can still say the sickening chinese have "western" diseases as the soy is grown right here in the USA.

April 1, 2011 | Unregistered CommenterBeth@WeightMaven

An excellent post (except for the gratuitous attack on religion) and a well stated Best Approach To Diet.

Now let's start working on the other, largely ignored, major cause of illness & premature death, STRESS!

KGH; All of my attacks on religion have been and will remain free of charge, but I have not idea what you are talking about.

April 1, 2011 | Unregistered CommenterT.O.

My mistake.

April 1, 2011 | Unregistered CommenterT.O.

Dr Harris: You mentioned that the issue with wheat and sugar is not that they are carbohydrates. However my understanding of Taubes's approach is that the carbohydrates by their nature may lead to a metabolic disorder of fat acumulation and subsequently to other Diseases of Civilization. I assume that you are implying that gluten and fructose are the problem and that therefore something like tubers and dairy would be ok.

KGH: Read No such thing as a macronutrient. The nutritional transition is not due to starch, IMO.

April 2, 2011 | Unregistered CommenterJose Marti

Thank you I will. On the issue of the gallons of soybean oil in China , I can testify that in my home country, the Dominican Republic, we switched from cooking with "manteca"(pork fat) 20 years ago to soybean oil and as a result there is now a epidemy of diabetes, heart disease and those dreadful colon and breast cancers. These diseases were, if anything, extremely rare in the period of my grandfathers , early XX century.

KGH: Very interesting. I'll have to look into that more - do you have a source of any statistics?

April 2, 2011 | Unregistered CommenterJose Marti

The statistics are in the Ministry of Health and I will be going to DR next week so I will look for them. The oils used are the soybean and another one that is soybean and sunflower combined. Pork fat can only be found in the countryside as well as the coconut oil. Can you believe that?. In a country covered in coconut trees. I plan to give a public lecture in Santo Domingo on the diseases and the modern diet. That is if I am not executed by a doctor ,or worse, a nutricionist before that. I have always enjoyed your clear writing. You have study your Wittgenstein well.

KGH: Thank you - I would appreciate any more info you could provide on this - Info on nutritional transitions with PUFA are somewhat lacking.

April 2, 2011 | Unregistered CommenterJose Marti

I'm fine with "Paleo 2.0". It seems that it is an attempt to distance the concept of Paleo eating from Dr. Cordain.

One modern Paleo food pioneer that you did not mention is Ray Audette, whose book "Neanderthin" was published in 1995, with the obligatory caveman on the cover. His "Ten Commandments" of diet are: No Grains, No Beans, No Potatoes, No Dairy, No Sugar. Yes Meats and meat fats; Yes Fruits eaten fresh, Yes Veggies that can (but need not be) eaten raw, Yes Nuts, Yes Berries. His rule of thumb is to eat only those foods that would be available to you if you were naked with a sharp stick.

Another little sound bite from the book: First Law: Do not eat the Fruit of Technology that makes Edible the Inedible. It is a little treasure of a book if you can still find it.

Thanks for an excellent article.

KGH: Thanks. Yes, I've heard of Audette and his book, There may be hundreds of people who came up with the "eat only what they ate" thing.

April 2, 2011 | Unregistered CommenterLynnet

Very interesting read, very informative and a nice introduction to a subject I'm very new to.

I do have one very niggling criticism however, for all of the claims of the article, and the discussion of the countless scientific papers which have been read to compile this, there isn't a single reference to primary scientific literature.

Like I say, I am very new to the topic so the post makes a lot of bold claims for me, these are claims which it would be nice to see the science you purport there to be. I think for any post challenging set ideas like this, transparency and references are essential.

KGH:

If you insist on references for every essay, you are definitely reading the wrong blog.

There are references in other articles when I discuss specific papers, but I am not going to reference hundreds of papers and books for a broad summary that is basically an editorial.

You might actually have to do some work on your own with the search button or google....

April 3, 2011 | Unregistered CommenterDan M

Fine post Kurt. Following VLC for 3 years made a large improvement in my metabolic syndrome and going by the labs I was 'cured'...it wasn't perfect though.

Your list of Neolithic agents are spot on. To this day I still get nasty atopic symptoms from even a small amount of wheat. I have recently tried to introduce healthy starches back into my diet I seem tolerate them well apart from the fact they seem to make my skin very oily. I'm not sure what this indicates but I imagine that's not a good sign.

April 4, 2011 | Unregistered CommenterStephen F

As a fellow neuroradiologist, I find your medical nihilism and dietary skepticism refreshing. keep up the good work.

April 4, 2011 | Unregistered Commenterbdm

Dr Harris: As a follow up to a previous post I recommend you to check the site "mercasid.com.do" where you can see the full list of cooking oils offered by the company. You will see the praise for the health benefits of PUFA. MERCASID is by far the largest producer in DR of cooking oils (90% plus of the market) and furthermore they are the local representatives of all the products of Unilever, basically processed foods. They are also the main producers of cold cuts that acording to the consumers joke have everything except real meat.

April 4, 2011 | Unregistered CommenterJose Marti

Something I've noticed in everything I've read about the "Paleolithic Diet" and defining what it is we are supposed to eat is the lack of any mention of seasonality in hunter gatherers diet. Seasons are everywhere, we all live on a spinning rock which is orbiting a giant flaming gas ball and that influences everything on the said rock. To me this implies that the ancient diet was a bit more varied than a lot of sources seem to present. While you would have opportunities for meat just about year round, plants would seem to present as more seasonal opportunities.

Just a thought.

KGH: Yes, diets vary seasonally and even more from one biome to the next.

April 4, 2011 | Unregistered CommenterAGP

As an avid reader of your blog, Paleo.02 is fine with me, and keep up the good work! I sent your Paleo 2.0 blog to a friend who is a DVM. I have wondered for some time now that if grains are not good for us, why are they the principal ingredient in pet food? Am I setting up my Persian Cat for the same problems I might suffer for heavy consumption of grains since they are mammals too? Just curious!
Don

KGH: Umm... Yes, you are ruining your cat. I don't like cats too much, but if you like yours you should feed it meat.

April 4, 2011 | Unregistered CommenterDon Blankman

Thank you for this post.

April 5, 2011 | Unregistered Commenterrmv

I meant to include this in my original post.

"So we are defining a healthy diet more by what is missing from it than by trying to duplicate a chimera."

Excellent statement! Interestingly when I was recovering from metabolic syndrome I fell victim to a few fads as one is liable to do when starting out. I bought into the alkalizing craze but still consumed plenty of animal products. My diet consisted of...

- Nuts
- Raw dairy
- Free-range chicken
- Huge amount of low carb vegetable juices to make sure I was buffering those evil 'acidic' foods.

While far from paleo my health improved rapidly. Made me realize how diet fads catch on (south beach diet, macrobiotics etc) The reason I think is the SAD diet is so destructive any deviation from it is guaranteed to produce improvements...hence the lay person trying vegan-ism for example and feeling better (at least initially). I realize while my diet wasn't perfect it still was free from the neolithic agents of disease.

KGH: Well, the nuts may have put you a little high on the PUFA scale. But certainly one NAD is better than 3.

April 5, 2011 | Unregistered CommenterStephen F

Some thoughts on Paleo 2.0 on my blog http://thorfalk.wordpress.com/2011/04/05/paleo-20/

KGH: Yes, I know, you don't like the name

April 5, 2011 | Unregistered CommenterThor Falk

@KGH - Well, I have got used to the name, not ideal IMHO but it will probably work with the Paleo folk. As for everyone else - paleo has in my view just too many connotations of grunting and dirt etc to ever become mainstream. Paleo is primitive in the true sense of the word, but umfortunately primitive is not a good word nowadays. I have to say though, Mark has done a great job with Grok because he has really managed to make him a positive and adorable persona.

But whilst branding is important - especially if the FMCG giants are on the other side - I personally still want to focus on the content, not the marketing (...not the creative type...), so my post was actually more content driven. I took your Venn diagram by the way, I hope that was OK.

KGH:

No problem. I may stop using paleo altogether as it is hard to tear it away from the cartoon idiocy.

April 5, 2011 | Unregistered CommenterThor Falk

After reading this with my husband (who can translate "academic" into "housewife" for me), and discussing your manifesto at length, we both agree it's time to come out of the cave, as it were. I am going one step further, and stating that "Paleo" is marketing, and marketing to "greens" and "eco-weenies" in an attempt to sell a simplistic lifestyle by calling it something else, and inventing a surrounding mystique.

This marketing mystique has sold many a book, and continues to sell books.

Hubby and I also find, that while we're not archaeologists or anthropologists, it seems the term PALEO has been confused with NEO when it comes to -lithic lifestyle re-enactment. Also, are we talking Paleolithic Era, or Paleo-Indians? Both were eons apart, and quite different from each other.

KGH: I still like paleo in the general sense of old, and will encourage descriptions using Paleo 2.0, but I agree it will remain wedded to -lithic in the realm of diet.

I think a better term for what these people practice would be a LONGEVITY AND DISEASE PREVENTION lifestyle, but alas...there's no marketing to be done, because there's no money in it (unless you add to the steaming pile of books already written).

I am still in agreement with Weston A. Price's lessons, because he actually examined bones, examined burial sites, found out what they ate, and talked with the current communities and learned the history of what was eaten, how it was prepared, etc.--he was a dentist-anthropologist...SCIENTIFIC FACT WITH EVIDENCE. Unfortunately for me, even the WAPF method of preparing beans and grains didn't help with my allergies to them, so i just started avoiding them. I was just glad to find others who willingly ate like I was forced to eat.

Ancient diets were situational at best. Trying to figure out who ate what largely depends on where they were at the time, and what weather was encountered at what locale--today's frozen-over areas may have been a humid shangri-la in the past, and vice-versa. And God knows who carried what with them to new areas, and maybe planted stuff? We need more evidence.

Ok--I'm going back to my cave now and remodeling. Thank you for making this "diagnosis." :)

April 6, 2011 | Unregistered CommenterWenchypoo

Archevore is an interesting name - is it meant to replace Paleo 2.0, or is it meant to be your special branch of Paleo 2.0, with another being for example Mark's Primal Bluerprint?

KGH:

Yes, it's my trademark - my "special branch".

I never intended Paleo 2.0 to anything other than a descriptive term so folks can explain why they are not lipophobes but they avoid grains. I still offer it for anyone who wants to use it or they can ignore it. I don't retract that essay. The blog rebranding is a related, but separate step.

I never intended to name the blog Paleo 2.0 for that reason. I have thought of changing the blog name for a long time, and after discussing it with some blogger friends, I decided it made sense to do so.

No one ever pronounced PaNu correctly, it doesn't mean anything when you hear it, and yes, I am trying to disassociate from the "paleo" label.

Ancestral foodways are a source of the Arche, but not the only source. I've long wanted the whole blog to be more general and less pigeon-holed.

April 6, 2011 | Unregistered CommenterThor Falk

Thanks for doing the research and sharing the information. Really appreciate this article. Well written. I agree with your thoughts and am guided to share that we must find what nutrition works for all of us individually.

April 6, 2011 | Unregistered CommenterTina

I told my wife months ago that "Dr. Harris will sooner or later move away from any association with the word Paleo".
Good move! What you do has nothing in common with the mythical caveman world or those who sell their version of it. I love this blog. Thank you for your work.
Bill E

KGH: thank you!

April 6, 2011 | Unregistered CommenterBill E

Nothing to contribute here, just saying "thank you." I deal with a lot of people who think my decision to eat Paleo 2.0 is some kind of fad, which is not helped by all the commercial sites/blogs (although some do have great info, they are all still sales pitches). This post on your blog is one I feel comfortable sharing with friends and family who are worried about my "extreme diet plan" because it is well balanced and realistic. No, we can't actually recreate the diet of our ancestors (and being a writer and grad student, I can't even afford to try) but as you point out, we can utilize the basic principles of Paleo 2.0 to enrich our health.

This post is a great introduction to the concept, the ideals, and the limitations of the paleolithic diet paradigm. I like the phrase Paleo 2.0 a lot, and intend to incorporate it into my own discussions about my diet changes.

And for the record? I've been eating this way for eight months, and I've never felt healthier. I sleep better, I eat less, I've lost weight, and my eczema cleared up. I'm rarely hungry too, which wow is something I thought I would NEVER say while still actually, you know, alive. :)

April 7, 2011 | Unregistered CommenterKimBooSan

Great article. Will probably stir some debate and strong arguing. I am making my transition into a "primal" (should we called Archivory now??) lifestyle. You can all see it at http://livingprimal.blogspot.com

April 8, 2011 | Unregistered Commenterrafael
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