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Loren Cordain – Origins and Evolution of the Western Diet: Health Implications for the 21st Century.

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Wow what a warm welcome thank you so much Pensacola so I want to thank dr. Ford for the cordial invitation down here also want to thank Roger and/or –then their courtesy for providing me with the house so very much appreciated so let's just go ahead and get into it this this talk is based on a scientific paper our research group published in American Journal of Clinical Nutrition in 2005 and to see the least I've got an incredible mileage out of this paper it's taking me all over the world so as a matter of fact I'm going to be in where am I going to be I'm going to be in Rome in two weeks given a similar talk so a lot of mileage on this all right so any time we're talking about the origins and evolution of the human diet what we're really talking about is the origins and evolution of humanity itself and so let me walk you through this slide because this is going to set the stage for the rest of the lecture and if you look carefully up here there's a couple of key items that we need to consider the first thing is the word hominin in what hominin means is a bipedal ape and so what all of these little boxes here these rectangular boxes represent our hominins so these are different species of our ancestral humans and the length of the box indicates the time in the geologic record in which we find these fossils and so these ones that are labeled in green right here we're not sure if these are Apes or if these are hominids so these are kind of the last common ancestors and you notice then that the period at which we became hominins and bipedal happened roughly five to seven million years ago and as we move in this direction you can see these pink boxes represent our own genus Homo and so as we move further on up you can see that here's homo sapiens and Homo sapiens our own genus and species has only been around for about 200,000 years and there are no other hominids that are left we are the remaining ones there's two key periods that we need to consider for this lecture and one is the Pliocene the Pliocene goes back to five million years ago and then we need to look at the Pleistocene the Pleistocene happened about 1.7 million years ago on up to the present and this is when really all the action happened when we became human and so we believe that diet was one of the environmental factors perhaps the most important environmental factor that allowed us to become human and we're going to get into this issue with the lecture so there may be as many as 20 hominid species that existed they simply did not have one diet we talked about the Paleo diet or the Paleolithic diet the old Stone Age diet there really wasn't one diet and that diet varied by geographical locale season and other factors so let's talk about that period the plyo Pleistocene and what do we know about that period for sure so we know that our ancestors ate an omnivorous diet they both plant and animal food the difference between their plant and animal foods compared to ours is that they were wild and unprocessed they simply did not have the technology to process their foods and so these are some really cool photographs taken by Richard Lee at Harvard and these photographs were taken of the Kuhn people in the 1960s and 1919 60s and so if you look carefully up here I know the people up front can probably see this but this fellow actually has a stone tool in his hand and this was an experiment to see if you could butcher African animal with these stone tools and it turned out they were very effective tools at butchering and dis articulating the carcass if you look up here now these guys are sitting around doing nothing and of course the women have gone out and gotten all the food so yeah we've changed so much happen so so you can see right here if you take a look careful I know in the back it's going to be a little bit more difficult if you could dim the lights but I guess we can't but you'll be able to see that look at the size of her fist right here and then look at the size of this thing that looks like a watermelon it's a tiny little watermelon and indeed that's where watermelons came from they're indigenous to Africa so she had gone out and collected these melons these are called tama melons and if you notice over here here's some berries and here's some roots right here and see this stick that's how she dug up these roots is with her little digging stick and right here in the middle I guess you can see it I've given it away but that's a tortoise so when women go out and gather they get both plant and animal foods so what can we say about the the playa Pleistocene diet and how do we know that it was am nervous what is the evidence to support that notion if we look at our closest living ancestors that last common ancestor about five to seven million years ago probably didn't look a lot like a chimpanzee and it didn't look like us it looks like something in between because chimps have evolved as well but chimps are primarily frugivorous they eat a lot of fruit in their their native environment but they also eat a lot of meat during the dry season and if you look carefully right here this is a male chimp and they go out in the forest in packs probably four to seven males or even more and they chase around these little colobus monkeys and they also chase around small antelope and they catch them with their hands but they don't have large carnivorous carnassial type teeth to be able to tear apart the flesh and so how they kill them is they body slam them they grab them and then boom they pound them to the ground and then it takes them forever in a day to disarticulate the carcass with their small teeth and they literally eat everything they eat the brains that break open the bones and eat the marrow and eat the meat and so forth so they eat close to a quarter pound of meat a day during the dry season so that is indicative that perhaps all hominids were meat eaters this is even more powerful data this is a stable isotope data and if you look carefully up at this fossil this is one of the more famous fossil this is called the town baby and you see that if you look at the teeth right here the enamel is still intact on the teeth and because of that it allows us to go into this tooth and measure an isotope called Delta 13 carbon and by analyzing this isotope we can determine what this particular creature has been consuming and so if there's more of these c3 type foods this is a browser this is an animal that consumes the leaves shrubs and herbs and if there's more of the c4 isotope it's consuming more grass because grass has a different photosynthetic pathway than do herbs and so the signature that ends up in the carbon of the tooth is different and so if we look at these blue squares right here these represent these are members of Homo our own genus and these are hominids that came before Homo and notice that their signature false' halfway between browsers and grazers and it's quite similar to obligate carnivores like hyenas and lions and these animals that are now extinct so animals that eat these other animals if you're a lion or a hyena you're going to eat both a browser and a grazer and that's why they have a mixed signature and so the interpretation here is that these guys we're also eating both plant and animal foods so this is the uncertain part of the diet is how much plant and how much animal food were being consumed and let's go back to that original diagram and what we can say is starting in about two and a half million years ago and it's somewhat coincident with the evolution of our own genus Homo where there's evidence to show us that we're starting to eat more and more meat and I'll show you that's probably one of the key environmental factors that allowed for a large metabolically active brain to evolve so what is that evidence if we look in the fossil record so don't leave us okay they're basically here almost forever and these are stone tools that were unearthed in Ethiopia and this is the guy that actually found them and if you look carefully up here you'll see there's two types of stone tools there are these sharp flakes and the sharp flakes is what these guys are really after when they are making the stone tools they can be used to disarticulate a carcass and modern-day experiments show that they're very effective at cutting open skin and and getting muscle and bone away from the carcass the second part is this core which is results it was a result in part from this chipping process and this is effective at smashing open skulls and getting at brain tissue it's also effective if you put it on a anvil stone and getting it marrow so we think that marrow and brains are some of the key dietary factors that allowed us to become human all right this is one of the most cool fossils ever found and this is the jawbone of either a hartebeest or a wildebeest and if you look up here there's a little scratch mark and if we magnify it with scanning electron microscopy there's a very characteristic mark that is not an on mark from another carnivore nor is it a stone mark that happened to randomly scratch this while it was being fossilized so we know that this is indeed a cut mark and it's on the medial side of the jawbone meaning the insides what do you think they were after yeah they were after the tongue and so work from our laboratory shows that the tongue actually is a high source of monounsaturated fats which are healthy fats and the same thing is true with marrow is when they cracked open the marrow they were also extracting a food that was also very high in monounsaturated fats so these are very healthy fats in terms of what they do for cardiovascular disease okay here's another very intriguing bit of evidence this was a the so-called expensive tissue hypothesis and this was invented by my colleague Leslie Aiello at the University College in London and this paper came out in 1995 and if we look at our brain size and we contrast it to our guts is we have incredibly large brain now we have a very small gut if we were to look at all other primates monkeys and apes and so forth and we were to predict what a 65-pound our sixty five kilo primate ought to look like we should have a very large gut and we should have a small brain but we don't and so the implications of this there was an evolutionary trade-off to evolve a large brain at the expense of having a reduction in our gut size and so this is how we interpret this is if you look at this slide and you envision a brain a brain is the hottest organ we have quote unquote metabolically it uses more ATP than any other organ in the body about nine times as you're at rest right now nine times the amount of energy is devoted to running that brain so think about it if we had a brain that was filled our entire body my god our metabolism would be out the roof wouldn't it and so this is the key to understanding this expensive tissue hypothesis is that we actually measured our overall metabolic rate and guess what it turned out to be the same as all other primates so inferred on that was the notion that another organs metabolic rate had to decline and indeed that's what happened so we started to have this we had selection for a smaller gut which allowed for the selection of a larger brain well how did that happen remember what the diet of the chimpanzee was primarily fruit and so and plant-based food so as we started eating more and more meat in our diet which is more calorically dense then that was the Selective pressure that allowed us to evolve a larger brain so here's some really interesting data if we look at where all hominids actually originated they originated in this East African area here all the way down to South Africa on up to Kenya and the the origin of Homo our own genus occurred about two million years ago so this is a very cool fossil that was found one point six five million years ago but notice that the first fossil hominid found a but in Europe was found in this place site called the dam an AC site in Georgia present-day Georgia and it's dated to 1.8 million years ago so what that tells us is that our own genius somehow had to have gone further north and so the idea is is that we either walk down the Nile and we crossed right up here and then we went up through this Black Sea area the Black Sea actually didn't exist then and this is how we got to 40 degrees north latitude now I don't know about you folks here in Pensacola but I live in Colorado and we're at 40 degrees north latitude right now and the ground is still frozen there's no food so so if you're if you're at foraging you've got to have animal food as a major source of your diet so the behavioral adaptation to either to hunt or to scrounge animal food had to have happened at lower latitudes before we could have got here so even during the interglacial periods you had to have animal foods to live at these very far north latitudes okay this is some interesting data and this is stuff from our laboratory if we look at cats cats are obligate carnivores meaning that they have to get all of the nutrients that they need for their bodies from there total animal food based diet and so I don't want to get into too much of the biochemistry but if we look over here at vitamin A and beta-carotene just the basic metabolic change that we can do on our liver if we eat carrots which have a good source of beta-carotene we can turn them into vitamin A but we don't do that process very well at all okay and vitamin A is absolutely essential for every cell in the body cats can't do it at all so if you were Linda McCartney and you're trying to make your cat a vegan vegetarian you'll kill it right so where where do you suppose these guys before we were feeding them cat food if they can't convert beta-carotene where do they get vitamin A in an animal food the organs yes so liver is a good source of vitamin A marrow also has vitamin A in it and believe it or not tongue has vitamin A in it and so these other biochemical pathways if we have any biochemists in the audience this is the same type of a situation so let's go back to the uncertain how much plant food and how much animal food were being consumed in their diet we know that they were eating more and more animal food but what is the percentage because this is the evolutionary template that we need to address when we talk about a healthful diet in this modern age should we be eating a vegan vegetarian diet should we be eating high meat diet what is the evolutionary template because it provides us insight into how we should be operating now so this is a paper we published all the way back in the American Journal of Clinical Nutrition in the year 2000 and what I did here is I compiled data from a document called the ethnographic Atlas and the ethnographic atlas went out and it looked at all the world's hunter-gatherers and so in the early days there were frontier physicians there were anthropologists there were explorers that went out when there were still hunter-gatherers on the planet and they made notes about what these people were eating and plant and animal food and so forth and admittedly this is pretty soft data but it's some of the only data that still exists so we went through and compiled it and we published our results and let me show you what we found with this soft data and then I'll show you some better data so let me walk you through this little frequency histogram right here and we examined the amount of gathered plant foods in 229 hunter-gatherer societies and so we broke it into one of ten we didn't this was data that was already pre-existing in the ethnographic atlas it was broken into one of ten categories 0 to 5 percent plant foods all the way up to 86 to 100 percent and notice the value here in the middle this represents the mode which is the most frequently occurring value 45 societies consumed 26 to 35 percent of their calories is plant foods it's also the median the value that falls halfway between one and the other value the other point I want to make out is look there is not a single vegan vegetarian society in this whole mess and the reason why there isn't is because this diet is lethal unless you supplement with vitamin b12 and they didn't have supplements back then so and notice here also that only thirteen and a half percent of the societies have more than half of their foods from plant foods so at least this evidence is somewhat supportive of the notion that whenever and wherever possible we would try to consume animal foods and so this is this graph represents the total fished and hunted animal foods in the diet and you'll notice then that the mode and the median right here fall at about 56 to 65 so a little over half to two-thirds of their calories came from animal foods if and when it was possible alright take a look at those six-pack abs on those guys so I've seen many photographs of hunter-gatherers and this is a fairly typical photograph is this is how they looked and the problem with the ethnographic data is it's a very subjective what if it was a man who went out in the field and he was looking at the food that was being brought back in maybe that man ignored what the contribution of the female and the children and the grandparents was from the collected foods and he paid more attention to that so there's it's very loose data and what we ended up doing in another paper is we went in and we found the 13 studies that were quantitative and these are studies in which they were actually able to measure the foods that were consumed the total weight the calories and so forth and there were 13 of them and we ended up eliminating two of them we eliminated the Eskimos right here and they are living in Greenland at 69 degrees north latitude and they were 80 96 percent animal 4% plant well that's skewed our results because they didn't have a choice except for a year a month or two out of the year they couldn't do it and the same thing here with the noonim you people once again ninety nine and one so if we take those two values out what we see is a similar value about two-thirds of the energy come from animal foods and about a third from plant so this corroborates the data that we had from a previous study this is my colleague Mike Richards at Oxford and this is one of the most cool fossils found of all time because this fossil we've actually sequenced the Neanderthal genome from so there's actually a series of fossils but this is one of them this is a mandible dated to 29,000 years from a cave in Yugoslavia called Vindhya and we're looking at another isotope here and the isotope we're analyzing is Delta 15 nitrogen and what this isotope does is it tells us how much animal food those Neanderthals were eating and so what we have to do is we contrast that isotope to other animals to other fossils found alongside that Neanderthal bone and you can see there's a wolf an arctic fox and bison and deer and so forth and carefully look at the signature here this is the Neanderthal it has a signature that is virtually identical or higher than a wolf or an arctic fox so Mike's point was is that the Neanderthals were clearly behaving as top-level carnivores now Neanderthals aren't us that's another different the same genus but on other species so let's take a look at Mike's data from some more modern people these are fossils that were found in England in a place called Gus cave and there were five Homo sapiens dated to about 12,000 years ago and what you can see is once again 12,000 years ago they had this signature that was almost identical to this arctic fox which is a not an obligate carnivore but gets most of his calories from animal food so this data also supports the notion the humans whenever and wherever possible reading a lot of meat okay so you don't have to be a scientist here on this one this is pretty intuitive so we know they're eating minimally processed wild plant animal foods and that should be the template that we use for our modern diet and so obviously they simply did not have the technology to produce these types of foods okay so what's wrong with eating this food versus eating this food you may not think about it but once again sometimes pointing out the obvious is one of the most difficult things to do you know the king is not wearing clothes so this is what we did in a paper published in American Journal of Clinical Nutrition in 2001 and we went in and looked at the disposal data in the United States and it turns out that 70% of our calories come from basically four or five different foods breads dairy refined vegetable oils and sugar okay if you take cereal and combine it with vegetable oil and sugar you can call it a cookie you can call a doughnut you can call it a cracker you can call it whatever you want but it's same combination of all these same ingredients so these things comprise 70% of the calories in the typical Western diet we eat the same things day in and day out and another way of looking at it is with this pie chart and I've deliberately put this pie chart together to show you the foods in white then our these are the recent foods these foods have all been put into our diet since since the industrial era and the Neolithic period and we'll talk about what that is here just shortly and so these foods are calorically less dense they have less vitamins less minerals less phytochemicals and they have weird fatty acid profiles and so by default if you look up here on that pie if you put those in what do they do to the rest of the the foods the real foods the meats the fish the fruits and vegetables they compress it and so our diet becomes nutritionally less dense the vitamins and minerals are less when you include these in your diet so they displace those foods and it has important health implications this is the period called the Neolithic and this is a period when we changed as a species from living as hunter-gatherers to becoming farmers in a period that occurred from about 10,000 years ago when the Agricultural Revolution first began – about 5,500 years ago and so we first domesticated animals 10,000 years ago 10,000 years ago my god that seems so long ago it's so historically remote but on an evolutionary timescale generation is considered to be 30 years that's all we've been 333 human generations so we still have the genetic makeup of stone Age's we are literally Stone Agers living in the space age and we have genes and bodies and digestive systems that are very well adapted to the foods that we have always consumed and so these recent introductions here's the the first time cereal grains were introduced believe it or not we talk about grains as the staples and the staff of life they have only been domesticated in the same time frame the first dairy and evidence we see from about 9,000 years ago but probably people were consuming dairy products once they domesticated these animals so this is just represents a lag in the fossil record okay wine and beer nobody had any fun until six thousand seven thousand years ago okay the first salt mines in Europe appear about a little bit after that and sucrose which is table sugar was first produced in India about 2,500 years ago but the thing is it was made from cane sugar and it wasn't exported around the world so only a few people had it and the rest of the world simply didn't have it until much later okay the Industrial Revolution this is when things really started to change let's take a look at this okay so this is when table sugar or sucrose became available to the masses was starting at about 1798 the turn of the century whenever 200 years ago okay feedlot produce meats fatty meats that never ever happened we didn't have the technology to bring cows and grain to market and produce these fatty meats that are ubiquitous in our diet now refined grains okay white bread white rice all of these things are technological innovations we never did these until fairly recent times and I'll show you the technology that allowed for that refined vegetable oils in all processed foods we put refined vegetable oils in them but once again you can see a very recent addition to of the Western diet and when you look at it from generational perspective obviously our genes have not changed in three or four generations we have the same genes our grandparents or great-grandparents we have basically the same genes that people had ten thousand years ago so this is an onslaught to our physiology and our health to throw 70% of our calories into our diet in the mirror time frame of you know four or five human generations hydrogenated vegetable oils with a little bit later still and HFCS what's that I've wrote those corn syrup now when I was as young as some of the people here in this audience this stuff didn't exist all right okay this is kind of a fun slide we'll just rip through it but this is one process and junk food came about there's Hershey chocolate bar 1900 but we can hear applause if we hit one of your favorites Pepsi 1902 Kellogg's cornflakes 1906 Crisco 11 Oreos have been around since 1913 I guarantee you they'll never ever go away Wonder Bread 1921 Rice Krispies you know those rice krispies treats could have eaten those before 1928 corn chips 1932 M&Ms now that's one that definitely will not go away sugar frosted flakes and Pringles chips 1969 okay so when we look at these Neolithic and industrial era food introductions they cause a lot of problems in our physiology and our health and our well-being we identified seven key characteristics and let me just walk you through these because you may not have a nutritional background but the glycemic load is very important the way a food impacts our blood sugar we can measure it and foods that really raise our blood sugar or blood glucose have high glycemic loads so the white bread right here these potatoes and this drink all absolutely do a number on our blood glucose the unfortunate part of this is they also elevate our insulin insulin is a master hormone and it causes lots and lots of problems fatty acid balance the types of fats that are in this hotdogs are way different than what we find in the tissue of wild animals the macronutrient balance in the Western diet we had ate primarily carbohydrates they're our major source of energy whereas in stone-age diets the predominant energy source was either protein and fat and carbohydrate was always low and so that's a characteristic pattern high protein low carbohydrate that we're not finding out now from randomized controlled trials is helpful for humans trace nutrient density there's no vitamins and minerals in here and when you consume that you are displacing real food fruits and vegetables acid-base balance we'll talk about that in a little bit but if you eat a lot of fruits and veggies you have a net base yielding urine and sodium potassium we salt everything so we have way more salt than we do potassium and there's no fibre left in these things because they're entirely fiber depleted these seven nutritional characteristic wreak havoc with our body and we can trace them to many many diseases the symphony orchestra plays not with a single instrument but together and so all of these factors synergistically impair our health and our well-being okay let's look at these one by one and show you why they were not part of the hunter-gatherer diets let's take a look at cereal grains if we look at grains about a quarter of our calories come from cereal grains unfortunately this is the type of cereal grains we eat in America we eat these refined grains with high glycemic load and that acts virtually affects our health and well-being how we know that hunter gathers didn't eat cereal grains well first off cereal grains are the seeds of grasses and in their wild state they're very small they're difficult to harvest and you got to do a lot of things to them to make them edible you got to grind them up and you got to cook them otherwise the starch and the protein in ISM is not available to you so it represents a lot of work and there's a theory called optimal foraging theory and anthropology and if you go out and you're a forager you've got to get more energy from the food than you expend okay if you go out and you hunt and gather all day long you come back with 50 calories it's a bust so you got to come back you got to you got to get more energy than what you expend and these foods are rotten at getting energy back because it takes so much energy to collect them and process them and cook them and build a fire and all this hunter-gatherers basically ignored these in beautimous starvation foods so when do we first see these grains being included in our diet it's when in the fossil record we see these crude grinding stones and so this occurred in a culture in the Mideast called the Natufian roughly ten to fifteen thousand years ago up until about 1880 the way we ground our cereal grains up to make our bread and our flour was with these stone grinding tools this is how it was first done and then later on we built these waterwheels that turned these gears that ground the stones together and when we made our flour everything was mixed together there's three parts of a wheat berry there's the germ the bran and the endosperm and so when we do it like this everything gets mixed up together and we call that flour 100 percent extraction flour so that's perhaps not as unhealthy as white flour and that's pretty much how it was done up until about 1880 and then in 1880 what happened we invented these things called steel roller mills and if you look up here you can see that we fundamentally have changed the way in which we're breaking up the wheat berry instead of pulverizing it and grinding it with these stones we're putting it through and squeezing it and when we squeeze it a couple of things happens is the German the brand come off is a nice little flake and we can see them out very easily and then once we see them out we don't stop there we continue putting the flour through multiple breaks until we get these tiny little particles and that's what we make our white bread out of now it was done at the time because people like this nice white flour without any brand or German it but had they known the adverse health effects of doing this it probably would have never happened so here's what happens to the glycemic index we talked about the glycemic index the ability of food to raise our blood sugar and what you see right here is we start off with a whole wheat kernel 100% extraction where we keep the brand in the German everything intact it has a low glycemic index and by the time we're down here to making these fancy flowers that we use for you know all kinds of fancy pastries and whatever the glycemic index has risen to 70 or 80 and if you look over here this is a list of foods these are common cereal refined grains and you notice almost every single refined grain up here has a high glycemic index which is defined as greater than 70 so you think about healthy foods like Cheerios there's they're advertising them is heart healthy well I don't think so not based on the glycemic index by any means and so what's some other ones here people like bagels you can see bagels are typically high glycemic load foods all right well what's wrong with a high of glycemic load carbohydrate is that if you eat these things over the course of your lifetime they tend to promote a condition called the metabolic syndrome which is when our body becomes resistant to insulin and when the body becomes resistant to insulin what happens is the pancreas secretes more of it so the muscles say hey I'm full I don't need anymore foods I'm done don't give me any more insulin so what the body does is it sacrifices the insulin for the blood glucose to keep blood glucose low it secretes more and more and more insulin so we have this chronic state of high insulin and that's associated with all of these diseases that you see here type-2 diabetes hypertension are disease you go down to your cardiologist your physician you get your blood chemistry measured I'm sure most of you have had that done and this is what they're measuring these are the values that they measure and what we see with the metabolic syndrome is a very characteristic reduction of HDL which is the good cholesterol we have blood triglycerides elevated and we have LDL which is increased okay something that even if you're involved in nutrition you may have never heard of is the concept of acid-base balance and if we look at all foods they report ultimately to the kidney as either acid or base and so you can see all grains are net acid yielding all the ones in red are acid yielding foods and notice that cheese's paradoxically are almost an order of magnitude higher in their acid yielding than any other food so I will show you that the problem is net acid yielding foods tend to promote osteoporosis the only base yielding foods are fruits and veggies and we don't need very much of these in our diet and so consequently the Western diet is net acid yielding and this is how it works out you can see that grains provide a quarter of the energy their acid yielding meats or acid yielding cheeses except for milk which is about neutral or acid yielding and salt of all things our yeild acid ions to our kidney and we have eat very little fruits and vegetables less than 10% of our calories in the u.s.

Diet come from fruits and veggies it's almost guaranteed that if you do this over a lifetime both men and women will become osteoporotic so what are the diseases associated with a diet that is nettan acid yielding osteoporosis high blood pressure kidney stones and stroke so this is this is how we eat we consume these foods and if you look up here you have trouble seeing any fruits and vegetables there's some parsley and I don't know what maybe it sliced the tomato over there okay what happens to refined grains what happens to the vitamin content after we refined grains well you can see this right here whole wheat you could see has much greater concentrations of almost all of these vitamins and you can see what happens here to all these other vitamins we started to enrich our flour after World War two with these three beet vitamins and iron and I'll show you that here in a minute and then since 1998 we've put folic acid not folate back into our diet and it's turning out that's my probably not a very good idea it's increasing our risk for prostate cancer it reduces the risk of neural tube defects in infants but it's a it's a kind of a Pyrrhic victory it's a trade-off it doesn't seem to work very well okay well let me go back one other point so when you take out all the vitamin b6 and you take out all the folate this increase is a chemical in our Bloods called homocysteine which irritates the lining of our arteries and promotes cardiovascular disease this is what happens to the mineral concentration of flour and you can see all the minerals get knocked out completely and there's a whole bunch of diseases associated with it the calcium that's available in whole grains it's bound to a compound called FIDIC acid or phytate so we actually don't get any of this calcium anyway and these are the some of the diseases associated with poor calcium intake now if you decide to do the Paleo diet and you go to your physician or your nutritionist and you say look I'm going to cut grains whole grains out of my diet they're going to go oh my god where you're going to get your fiber here and have no fiber and be constipated for the rest of your life that's not true if we look at whole grains and we contrast the fiber content to a 1000 kilo calorie sample notice that we have almost twice as much fiber in fruits and non starchy and non starchy vegetables is completely off the roof here so this is a myth and fiber has important effects on our health particularly types of fiber that are in fruits and non starchy vegetables there's soluble fiber verses the insoluble fiber in whole grains except for oats which has a little bit of soluble fiber and so there's the laundry list of diseases for the gastroenterologist in the crowd and some of these aren't completely bought into so some of these have changed a little bit how do we know our ancestral diet we didn't have dairy products okay so take a look up here look at this you know anybody ever try to walk up to a wild animal how about doing this to it you know it's just not going to happen see you have to domesticate an animal before you can milk it and so people simply couldn't have had dairy products in their diet until we domesticated animals this is how the numbers come in for dairy products you can see we eat about 10 percent of our calories as dairy and this is how it mixes up and so you've already seen this slide this is when we first find evidence of daring about 9,000 years ago what's the problem with dairies it dairy products they have a really weird fatty acid balance all foods fat fatty foods or animal foods our mixture of polyunsaturated saturates and saturated but you can see here if we look at wild animal tissue we have a pretty good mix between monounsaturated polyunsaturated amount of saturated here but we have a very very good mix whereas with dairy products you can see we have low levels of polyunsaturated very very high level and so if you include a lot of fatty dairy foods it tends to imbalance fatty acid and tends to promote some diseases now I kind of reversed my position a little bit on the saturated fat thing and I think most of the world has started to see a little bit different perspective so in terms of increasing the risk for heart disease it does but it depends on what you replace saturated fats with if you replace saturated fats with carbohydrate you're in worse shape than starting off with saturated fats that's what the most recent information shows so what we ought to be doing is replacing saturated fats with what we had in our diet originally monounsaturated polyunsaturated dairy products and we talked about the glycemic index and how that promotes many diseases you'll notice that refined grains have really high glycemic indices but come down here look at milk and yogurt my god look at how low they are 27 and 24 at least in theory they ought to be healthy foods but work from our laboratory right here this is one of my graduate students gear at Hoyt turned out differently and what we found is that they knock our insulin levels sky-high it's just like eating cookies okay so let's take a look at that data and you can see here that all dairy products have very very low glycemic index that means they don't jack our blood sugar levels up but paradoxically look compared to white bread yogurt has an insulin index that's even higher so all of these dairy products have these enormous lehigh insulin index and there is at least one experiment in children showing that this it produces insulin resistance a high dairy product or a high dairy diet for only a one week cause insulin resistance and children that experiment hasn't been repeated yet in adults and that's what we want to do in our laboratory okay so another thing is they really didn't eat fatty meats alright they ate everything Nate the entire carcass but wild animals don't have a whole lot of fat on them and let's take a look at that data so here's here's here's the staples in the American diet this isn't me this is fat disguised as me okay and when you look at the percentage of fat and protein what we really need to look at it is not a percent by weight but percent by energy because at the end of the day we eat calories we don't eat weight and so when we look at these values by energy you can really see that these types look at hotdogs oh my god 82 percent fat 14 percent protein so these are very very unnatural compared and I'll show you some really good photos if you look at body fat and wild animals it waxes in wane seasonally and so once we invented agriculture what we could do is we could feed fodder to our animals and we could prevent this seasonal loss and body fat and we weren't stupid enough to slaughter them when they were all leaned out we slaughtered our animals when they were the fattest so that changed things considerably whereas when we were hunter-gatherers we're at the mercy of the seasons we got whatever fat the animals had on them and so this is slide just shows you how the body fat this is body fat percentage on the the y axis here you can see how it changes month by month and in North America the fat in North American animals Peaks just after summer and then it falls again as we move into winter and if we look at that date and we combine it all I point this out to you is that the average body fat in these wild animals over seven months is about three percent from January until July it's about three percent and then it goes up but over the course of the entire year the average body fats only about seven percent I bring this data up because I want to show you what we have in animals that have been raised in feedlots you don't need to look at us you know a graph look at the difference here I mean and these guys have already been trimmed that they've trimmed probably four or five inches of subcutaneous fat after they hang them so most of the fats been trimmed off but look at them compared to a wild animal there's absolutely no comparison and look at the meat there's no marbling here on wild animal meat versus what we see over here so we slaughter cows at 30 percent 25 to 30 percent fat look at that that's ten times more than what wild animals have so other issues with the fat comparisons between wild and domesticated animals are the omega-3 fats and notice then this is work from our laboratory showing that wild animals elk deer and antelope have much higher concentrations of these healthful omega-3s now the crucial take-home point here is if you can get it yes past your fed or grass-fed beef is considerably healthier you can get wild meat better still okay how about salt salt is an additive that we all put in our diet we don't even know it we eat about 10 grams of salt on a daily basis and most of it comes from processed foods if you eat bread you're getting salt a slice of bread has about one and a half grams of salt in it so you don't think about bread as being a salty food but indeed it is so most of it comes from the processed foods that we consume when did we start including salt in our diet that's tough to pinpoint because we live near the oceans of coastal areas and there's no doubt that people probably dip their food in salt but inland Europe and up other places the evidence tells us that people really weren't interested in salt this is an entire mountain of salt in Spain by the way and I I spoke in Spain two years ago I threw this slide up there people out in the eyes oh yeah I know where that is okay so I just downloaded this but this is an entire mountain of salt and the tools that were used to dig the salt out were dated to this time period so people pretty much weren't interested in it okay how about refined sugars we eat almost 20% of our calories depending on whose data you're looking at 15 to 20 percent of our calories as refined sugars and let's see what's wrong with that hunter gathers absolutely no doubt would have consumed honey whenever and wherever they could possibly get it I've got a colleague Kim Hill at the University of New Mexico now at the University of Arizona he spent his entire career studying the ashay people in Paraguay and he tells me that he is seen a male paraguay Sheni up a tree arash a sunni up a tree grabbed honey out of the wild bee hive and throw it down to his colleagues on the ground and the honey comes with the comb the larvae everything and he says he saw a guy eat like 5 pounds of this comb larva and honey and his stomach went like this so they do it occasionally but they certainly don't do it on a daily basis because honey certainly is not available day to day this is a per-capita disposal date of refined sugars from the Netherlands and notice that the average citizen until the Industrial Revolution didn't need very much sugar at all and then from about 1800 until 1940 we got up to over a hundred pounds per capita we see similar figures in England through that same period and notice the two dips during the world wars when sugar was rationed this is so we get up there's an interesting phenomena get to it right here in a minute we get to about 120 pounds per capita and this is sucrose or table sugar so that's about the only sugar we're eating up until 1970s this is data in the u.s.

For all sugars we peaked in the year 2000 we went for a 64% increase from 1909 up to 2000 and then we for the first time in the last decade we went down just a little bit so we're doing a little bit better and this is all sugars but I'll show you the problem in the next slide is starting in about 1970 or we were able to take cornstarch and turn it into fructose for the very first time economically through a process called chromatographic enrichment and we could do this economically so we don't have to put a lot of energy into it it's kind of like a filter and it allowed us for the very first time to make high fructose corn syrup fructose is about 50% sweeter than sucrose so if you're a soda pop manufacturer that means you don't have to put as much into your soda pop so you can sell your soda pop cheaper so it was entirely financial why we change from super sucrose to fructose and this is data from our our group and tracking the infusion of high fructose corn syrup into the u.s.

Diet now when I was in my prime we didn't get any of this stuff in our diet because it didn't exist and then by the next decade by 1980 you can see we slipped a little bit more in and by 2000 we almost had as much high fructose corn syrup in our diet as we did sucrose and now we've done a little bit better in the next decade because I think there's political fallout from high fructose corn syrup now at least not so much with the manufacturers but with the people and the consumers so what are the diseases associated with refined sugars named a disease that isn't but particularly and I haven't listed the the type the epithelial cell cancers breast colon and prostate are all associated with high dietary sugars okay the last item and we're going to finish up here shortly and then we'll open it up for Question and Answer just a few more slides vegetable oils refined vegetables and oils in the diet about 20% of calories and here's where they come from shortening margarine salad oils and cookie Doyle's prior to the Industrial Revolution and actually the last hundred years there was really only one way of making vegetable oils it was with rendering and pressing so like with olives they shredded the flesh from the olive and then they put it in the primitive wooden presses and they pressed the oil out and that was one of the few vegetable oils that humans consumed until the last hundred years or so the other way of making vegetable oils out of plant foods is with Steel Express expellers in that process only happened in the last 120 years and solvents is even more recent still so let's take a look here this is one of these portable steel expellers and using this machine we can get oil out of everything you know when you think about sweet corn on the cob you don't think about as an oily vegetable dunia absolutely not so you can take that and you can squish it with enough pressure and you can get vegetable oil out of it we figured out this hydrogenation process in 1897 we could turn vegetable oils into solid margarine and shortening and that yielded these novel trans fatty acids which we know now are very detrimental to human health we ate those for 70 or 80 years before we figured that one out and this is the data showing how we've increased the vegetable oil consumption since 1909 we had a 500% increase since this time frame now I my grandfather came out to the west coast he came out to Hollywood back in the 1920s and he established a restaurant in Hollywood and he his restaurant served probably between a hundred and two hundred people at any given time and so after he died he all of his stuff went to my mom and after she died I got all of that and I remember about 10 years ago thumbing through one of the books that I had inherited and it was a cookbook from my grandfather's restaurant showing how to make recipes for large groups of people and I as they thumb through it and the book was printed in 1913 I believe as a thumb through it there wasn't a single recipe that used vegetable oil there's a little I think olive oil and one or two but other than that they simply didn't use vegetable oils so in the mirror frame of three or four human generations or less we now have seen this kind of incredible data now what's wrong with it is that vegetable oils are loaded up with a fat called linoleic acid and they have very low alpha linolenic acid meaning that they're high in omega sixes and low and omega threes and we know omega-6 fatty acids tend to be pro-inflammatory and are associated with any disease that has an itis on it such as hypertension autoimmune a gal obesity cardiovascular disease and whatever so these are good things to get out of our diet and go back to more traditional oils like vegetable oil so this is a had a little bit of fun playing around with the USDA food pyramid and chopping it up it's now called my pyramid and and so we've eliminated this we've eliminated this and actually if you look carefully down here I think there's some peanuts which are legumes they're not part of the deal either so eggs and meat and fish and poultry are great and fruits and veggies so this is what I recommend for a modern-day healthy Paleo diet is your eighty-five percent of the way there if you do your shopping and the outside aisles of the supermarket you can get everything you need from fruits veggies meats seafood healthy oils nuts and seeds as a matter of fact the diet is much more nutritionally dense when you follow these types of advice so thank you very much okay so we're going to open it up for question all right okay over here thank you for a wonderful lecture before the lecture we spoke for a few minutes about information being a key in America speak more about inflammation and nutrition if you will please yeah I think that if we look at all the chronic disease in the Western world what we're really looking at is chronic low level inflammation you can't have heart disease you can't have cancer and you can't have autoimmune disease you have to have inflammation to drive the process so the process can be initiated without through other means but to keep it going you have to have inflammation and what we believe is that the gut the intestinal interface is one of the major areas where chronic low level inflammation occurs so the we have an area in our intestines there's roughly two football fields in Square area and we're exposed on a daily basis to more antigen to more viruses and microorganisms in this area than any place we get a cut you know we get a little bit in our mouth but not even close to the surface area in our gut and so there are two types of bacteria in their gut there's Grand positive and gram-negative bacteria and gram-negative bacteria in their cell wall contain a substance called LPS or lipopolysaccharide and lipopolysaccharide is a very potent pro-inflammatory compound and normally that compound in a healthy gut stays in the gut and doesn't leak into our immune system and our circulatory system I've got a colleague patrice Connie in Belgium and this is what his group is doing is that they have developed a procedure to measure LPS in plasma and showing that it is pro-inflammatory and so the series of papers that have come out in the last five years are showing that there's a relationship between LPS and cardiovascular mortality as well as cancer mortality and type 2 diabetes so inflammation is part of the Western diet if you eat wheat you're probably going to many people in this room what most people do eat unless you've got celiac disease you're going to probably have a slight low level inflammation and we can measure with or what are called pro-inflammatory cytokines and so there are ways of doing it but yes inflammation is huge and elements in the Western diet cereal grains legumes tend to be pro-inflammatory as do high glycemic load carbohydrates over here dr.

Horth I think thank you for coming here one of the things I did not notice here and what I've seen in my 30 years of practice is that we used to have conferences because we saw fatty liver and I would give a Grand Rounds or a talk about it today I'll see four to six people in a day with cirrhosis and liver disease now in this country the leading source is probably from obesity for cirrhosis not alcohol that this entire lecture is all linked to that and I wonder if you go ahead and expand on that yeah you know the notion we talked about high fructose corn syrup and many nutritionists as well as biochemists realized that fructose is handled completely differently in our liver than other refined sugars and so what happens with fructose there's a step in metabolism called the phosphofructokinase step and what that step does is it regulates the flux of sugars through the liver and fructose is a very weird sugar is that it bypasses this it's kind of a gatekeeper think about you know it's a waterwheel and it's got this little guy on it that's preventing unlimited flow through that system and so fructose enters beyond that gatekeeper step and fructose then in the liver serves as a substrate to build fat and so the liver actually builds fat there's something called acetyl coenzyme a and another factor you don't need to know the biochemistry and that promotes the synthesis of fat in the liver and so it's not surprising because that pathway this that we find this now on an evolutionary scale why should we have that pathway it makes a lot of sense if you're a chimpanzee and you're living out here in East Africa and fruit is only available seasonally what you want to do is you want to turn it into fat immediately you want to store so when the fruit is ripe you want to be able to metabolically store those calories you don't want it just to come through your body so on a evolutionary perspective it makes sense to have that but when we have unlimited high fructose corn syrup no exercise on top of a high glycemic load it's just pouring gasoline onto the fire back there I didn't say anything mentioned about the effects of all these diets on your teeth and how that might influence cavities and plaque formation and stuff like that yeah you know that's a that's a very good question is that teeth are remarkably preserved in the fossil record and what we find is we can go backwards in time and look at dental caries and prior to the Agricultural Revolution in the course of a lifetime if you pull somebody's teeth out of their mouth the incidence of caries are like you got 32 teeth you know maybe one tooth to max might have caries in it as usually because of not the type of way caries are formed today but because there's been physical damage to the enamel but there is very very low incidence of caries in Hunter and living hunter-gatherers they don't have toothbrushes and they didn't have Dennis okay they didn't floss either they didn't do a little bit of flossing they got things out of their teeth but there was no hygiene like what we do now so the big caries source happened and you can go back in the historical literature is right at the Industrial Revolution is that there was no such thing really as Dennis that wasn't a profession and tooth brushes you know we're not you know pervasive in society so we don't see it until literally the Industrial Revolution with the the advent of sucrose and what sucrose does is it it encourages the growth of a specific type of back our teeth and the acid from their metabolism erodes the enamel and that's what causes caries for the most part yes right over here and then get up to this yes is honey any better than sugar and also is olive oil any better than any other oil is honey any better than sugar no honey is a mixture of glucose and fructose high fructose corn syrup guess what it's a mixture of glucose and fructose so honey metabolically does the same thing to our bodies is high fructose corn syrup it's a it's not sucrose on the other hand is a compound all right it's a disaccharide and we have enzymes in our gut that have to break that compound down so it's released more slowly so honey is is not a good thing and what was the question about olive oil yeah I think olive oil is a very healthy oil it's just it's a monounsaturated meaning that it's stable during cooking so it doesn't break down it tastes great and it's got the approval of five or six thousand years worth of testing on it so I think olive oil is a great oil the only downside olive oil is that it is fairly low in omega-3s and fairly high in omega 6's but if you include fatty fish in your diet or you supplement it's not a problem so olive oils I would encourage you to and extra virgin olive oil is actually better because it contains more polyphenolic compounds that are anti-cancer and so yes over here I'm confused I am the daughter of someone who took her degree many many years ago in nutrition I always thought that if you had were careful in a cheese cottage cheese milk those things it would help prevent osteoporosis and I think what I heard today was it's just the opposite so I'm confused well I would say that cheese's are probably not a good thing to do to prevent osteoporosis and you saw my slide up here where we looked at the acid-base balance they have almost an order of magnitude greater acid load than milk now milk it is neutral but let's once again look at the evolutionary evidence we've been on this planet for 2 and 1/2 million years we've been only drinking milk for less than 10,000 less than 300 human generations how in the world do all the other animals on the planet including all the other primates build bones without milk there's no single animal on the planet that drinks the milk of another species so the answer to that comes in – it's like a bank account alright when we look at bone metabolism we focus upon what the dairy industry the milk moustache people want us to focus upon is that it's all about calcium coming into your body but what you do is when you send your kid off to college to get their degree in nutrition and you give them their checking account for the first time do you say it's all about how much money comes in no it's all about balance isn't it so it's the difference between the calcium coming in and the calcium going out any good account you have to look at the difference between what comes in and what goes out and so that's the important issue is calcium balance and we talked about acid-base balance is the primary mechanism by which we lose calcium is this acid-base balance so if you don't eat fruits and vegetables which we don't we only get less than 10% of our calories and fruits and vegetables we're all have a slight metabolic acidosis so the solution it had to have been that evolution worked out was that yes we can build strong bones how do you think elephants in the jungles build these gigantic bones they don't drink milk is is that we have these physiologic mechanisms in play and the bones are like any other organism is that they operate well under the environment in which they were selected and so we have we've completely disrupted that that environment we ate 10 grams of salt a day salt has been shown to promote osteoporosis if all you do is take salt out of the diet of women and you put them on a DEXA scan what we've now found is after 2 year trial their bone mineral density improves just by getting salt out of their diet so if you if you are a cheese addict you eat a lot of water you drink wine and eat a lot of fruit with it and a balance is that out there you go perfect all right I'd go for that okay how about way in the back here because I haven't gotten back there you yes I do you know I think that that people eat for many many reasons you know and I think that we need sustainable issues as well but I was I had lunch with some very interesting people today and we were talking about that very same idea and there is evidence to suggest that a soybean field that is 5000 acres does more damage to the environment what we're doing is we're trading oil for soy and would you rather trade grass for high-level protein and so we've invented this wonderful machine we call a cow and the cow takes grass that we can't eat and turns it into something we can so when we make a feel of soy beans we're taking oil from the Middle East and fertilizing it to make a food that is potentially damaging so I think that you know some of these issues clearly aren't clear-cut I respect anybody who has religious beliefs or ethical beliefs for not eating animals that's fine but I can guarantee you you're misguided if you're eating a vegetarian diet for health reasons and so we have two more questions here okay ma'am right here you you know I'm writing my fifth book right now and writing a book is painful probably as it is for women to give birth I hate it but I'm happy to get what I see you know and I got a chapter I've got a chapter in there on artificial sweeteners and the FDA the Food and Drug Administration has sanctioned five different sugars and to my way of thinking they're controversial it's not as if all the animal studies show they're safe the animal studies can go either way the epidemiologic studies the population-wise studies generally show them to be safe but to my way of thinking is once again the evolutionary template tells us that if you want something sweet you get a piece of fruit or something or vegetables or whatever but I don't know I don't I don't claim to know everything about nutrition and the xylitol issue I've heard a little bit there's pros and cons to it but my feeling is is that particularly a spar team is that's a nasty substance and aspartame you ought to get out of your diet because I think that there's significant information a paper just came out this year in the American Journal of Clinical Nutrition and it showed that the risk of preterm birth in women who are taking a lot of a spark' goes about threefold higher so that kind of information is not tested early on and we find out after the fact that we shouldn't be doing these things so it's kind of like introducing high fructose corn syrup what a bad idea what we can't it's very difficult to go backwards in time it's like cigarette smoking you know you're never going to get rid of it you need to educate people so I think that that's that's the issue is education rather than legislation okay this guy over here he's had his hand up the whole time thank you there very good presentation for the last 10 or 15 years I've been trying to do what I call that caveman diet without this much information – I like it a lot and I'm convinced that beer is on the cavemen but my question is why don't Eskimos get scurvy that's a that's a good question and it's because the word Eskimo actually means raw fish ear okay so in the Inuit language that's what it means and if you think about it when you eat a vegetable you have vitamin C in all of your tissues right now and so when you eat meat raw it has just enough vitamin C or fish in it to prevent scurvy so they're getting probably less than 30 milligrams a day that's enough to prevent scurvy so that's that's how it works and you know what one other thing along the same lines I know ken wants to call this thing but have you ever thought about you anybody here that is into exercise or fitness you realize that when you go into a running race you want too many people carbohydrate load don't they during yes so we're getting all this this glucose into our muscles and glycogen glycogen is a form of glucose that we store in our muscles and so we have sugar in our muscles well when you go down to the supermarket you buy a piece of meat what happens to the glucose of the glycogen that was in your muscles in the cow because the cow is the same thing anybody have any idea so what well the physicians here in the crew ought to know what happens to somebody when they when they die what happens to their muscles rigor mortis sets in doesn't it and what drives rigor mortis wood allows the muscles to contract after death is the residual glycogen and then when the glycogen is spent muscles relax and so that's why if you eat a cow or an animal immediately after you slaughter it you have a little bit of glycogen in it but once rigor mortis is done there's no carbohydrate or glycogen to me so thank you very much I've enjoyed it Pensacola

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